STRATEGY STUDIO / PUBLIC DATA EXPLORER

SWANNANOA VALLEY MEDICAL CENTER INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
SWANNANOA VALLEY MEDICAL CENTER INC (EIN 56-1040100)
Tax period
2015-07-01 to 2016-06-30
Filed
2016-11-15
IRS object ID
201623209349301367
Schema version
2015v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-11-15T08:51:14-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN561678110PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1HELGREEN AND DALTON ACCOUNTANTSBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1103 SCOTLAND STREETAddressLine1Txt
CityBLACK MOUNTAINCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28711ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN561040100EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SWANNANOA VALLEY MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSWANBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 1446AddressLine1Txt
CityBLACK MOUNTAINCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28711ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAMBER KNIGHTONPersonNm
Person TitleCHAIRMANPersonTitleTxt
Phone8285521201PhoneNum
Signature2016-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJAN H ALLISONPreparerPersonNm
PTINP01238740PTIN
Phone8286698784PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCARL ZIEGLERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 HAWTHORNE DRIVEAddressLine1Txt
CitySWANNANOACityNm
State AbbreviationNCStateAbbreviationCd
ZIP28778ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$71,714GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1974FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionMEDICAL FACILITY CHARITABLEActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$22PYContributionsGrantsAmt
CY Contributions Grants$21CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$2,172PYInvestmentIncomeAmt
CY Investment Income$1,260CYInvestmentIncomeAmt
PY Other Revenue$15,435PYOtherRevenueAmt
CY Other Revenue$19,522CYOtherRevenueAmt
PY Total Revenue$17,629PYTotalRevenueAmt
CY Total Revenue$20,803CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$47,685PYOtherExpensesAmt
CY Other Expenses$25,037CYOtherExpensesAmt
PY Total Expenses$47,685PYTotalExpensesAmt
CY Total Expenses$25,037CYTotalExpensesAmt
PY Revenues Less Expenses-$30,056PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$4,234CYRevenuesLessExpensesAmt
Total Assets BOY$445,362TotalAssetsBOYAmt
Total Assets EOY$422,866TotalAssetsEOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$445,362NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$422,866NetAssetsOrFundBalancesEOYAmt
MissionMEDICAL FACILITY CHARITABLEMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$25,037ExpenseAmt
DescPROVIDE MEDICAL FACILITIES FOR THE SWANNANOA VALLEY CHARITABLE RELIGIOUS EDUCATIONAL AND SCIENTIFIC PURPOSES INCLUDINGMAKING CONTRIBUTIONS TO ORGANIZATIONS THAT QUALIFY AS EXEMPT ORGANIZATIONS UNDER SECTION 501 C 3Desc
Total Program Service Expenses$25,037TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document7IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonAMBER KNIGHTONPersonNm
Phone8285521201PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line157 HERSHEL LANEAddressLine1Txt
CitySWANNANOACityNm
State AbbreviationNCStateAbbreviationCd
ZIP28778ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
NORM GOTTLIEB
BOARD MEMBER1.000.00Yes (X)$0$0$0
MARY SOYENOVA
VICE CHAIR1.000.00Yes (X)$0$0$0
CONNIE SMITH
TREASURER1.000.00Yes (X)$0$0$0
STAN BRANK
BOARD MEMBER1.000.00Yes (X)$0$0$0
BETTY HERMELEE
BOARD MEMBER1.000.00Yes (X)$0$0$0
KEVIN WEST
ADMINISTRATOR5.000.00Yes (X)$8,313$0$0
SCOTT COOK
BOARD MEMBER1.000.00Yes (X)$0$0$0
CARL ZIEGLER
CHAIRMAN1.000.00$0$0$0Yes (X)
SHARON ZIEGLER
SECRETARY1.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$8,313TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Membership Dues$21MembershipDuesAmt
Total Contributions$21TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,260TotalRevenueColumnAmt
Related Or Exempt Func Income$1,260RelatedOrExemptFuncIncomeAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$70,433RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$50,911RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$19,522RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,522TotalRevenueColumnAmt
Related Or Exempt Func Income$19,522RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,803TotalRevenueColumnAmt
Related Or Exempt Func Income$20,782RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$5,900TotalAmt
Program Services$5,900ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$1,439TotalAmt
Program Services$1,439ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,650TotalAmt
Program Services$1,650ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$497TotalAmt
Program Services$497ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,458TotalAmt
Program Services$1,458ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$14,093TotalAmt
Program Services$14,093ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$25,037TotalAmt
Program Services$25,037ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$700BOYAmt
EOY$900EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$272,525BOYAmt
EOY$263,922EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$613,347LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$455,303LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$172,137BOYAmt
EOY$158,044EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$445,362BOYAmt
EOY$422,866EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$412,343BOYAmt
EOY$390,704EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$32,957BOYAmt
EOY$32,100EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$62BOYAmt
EOY$62EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$445,362BOYAmt
EOY$422,866EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$445,362BOYAmt
EOY$422,866EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$4,234ReconcilationRevenueExpnssAmt
Prior Period Adjustments-$18,262PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
FS AuditedfalseFSAuditedInd
Audit CommitteefalseAuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Not Described Section501c3falseNotDescribedSection501c3Ind

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$75,750InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$3,250OtherCostOrOtherBasisAmt
Book Value$79,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$534,347InvestmentCostOrOtherBasisAmt
Depreciation$455,303DepreciationAmt
Book Value$79,044BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$158,044TotalBookValueLandBuildingsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Members or stockholder classes and rights Part VI line 6EACH RENTOR PAYS AN ANNUAL MEMBERSHIP TO THE SWANNANOA VALLEY MEDICAL CENTER THE MEMBERSHIP DOES NOT PROVIDE FOR ANY VOTING PRIVILEGES ON THE BOARD OF DIRECTORS
Form 990 governing body review Part VI line 11THE FORM 990 IS REVIEWED AT THE NEXT REGULAR BOARD OF DIRECTORS MEETING AFTER COMPLETION
Governing documents etc available to public Part VI line 19ALL GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST OF THE BOARD OF DIRECTORS
Explanation of other changes in net assets or fund balances Part XI line 9NET INCREASE IN MARKET VALUE OF INVESTMENTS