Chesapeake Medical Group Inc: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- Chesapeake Medical Group Inc (EIN 54-1857174)
- Tax period
- 2014-04-01 to 2015-03-31
- Filed
- 2016-02-15
- IRS object ID
- 201600479349302080
- Schema version
- 2014v6.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-02-15T00:00:00-06:00 | ReturnTs |
| Tax Period End | 2015-03-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 541857174 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Chesapeake Medical Group Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHES | BusinessNameControlTxt |
| Phone | 8044358661 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 Harris Drive | AddressLine1Txt |
| City | Kilmarnock | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22482 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Steve Quiriconi | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 8044358661 | PhoneNum |
| Signature | 2016-02-16 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Steve Quiriconi | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 Harris Drive | AddressLine1Txt |
| City | Kilmarnock | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22482 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,126,822 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | Not-for-Profit primary medical care services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 21 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 17 | VotingMembersIndependentCnt |
| Total Employee | 95 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $4,618,098 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $201,650 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,194,294 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,618,098 | CYProgramServiceRevenueAmt |
| PY Investment Income | $200 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$967 | PYOtherRevenueAmt |
| CY Other Revenue | $2,295,729 | CYOtherRevenueAmt |
| PY Total Revenue | $6,193,527 | PYTotalRevenueAmt |
| CY Total Revenue | $7,115,477 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,145,986 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,170,030 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,356,642 | PYOtherExpensesAmt |
| CY Other Expenses | $2,250,874 | CYOtherExpensesAmt |
| PY Total Expenses | $7,502,628 | PYTotalExpensesAmt |
| CY Total Expenses | $6,420,904 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,309,101 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $694,573 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,690,493 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,968,940 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,884,692 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,440,573 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$7,194,199 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$6,471,633 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission of Chesapeake Medical Group, Inc. (CMG) is to provide quality, compassionate, cost effective primary medical care services to the community as a whole in a defined geographic area of the northern neck and middle peninsula of Virginia. The company will pursue its mission through the development and management of one group medical practice operating at multiple locations which are reasonably equipped and efficiently staffed by competent clinical and administrative individuals. The corporation is committed to providing medical services without regard to the patients' race, color, creed, national origin, religion or disability and will provide primary medical care to any individual with an acute injury or illness without regard to their ability to pay. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,741,490 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $4,618,098 | RevenueAmt |
| Desc | During the fiscal year, Chesapeake Medical Group employed 9 physicians and 3 nurse practitioners who provided either family practice, pediatric or surgical medical care at 7 offices located in three counties. CMG providers treated a total of 42,000 patients during the fiscal year. Chesapeake Medical Group policy is to provide care to any patient regardless of their ability to pay and accepts both current and new patients regardless of available insurance coverage. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $147,384 | ExpenseAmt |
| Desc | During the year, CMG physicians and nurse practitioners provided numerous services for the community which included: a. Providing admission services and coverage to area nursing homes.b. Providing free health care to indigent patients in CMG locations and through participation with the Northern Neck Free Health Clinic.c. Providing free community education through speaking and teaching engagements on numerous topics. d. Participation in discount sports physicals for secondary school students of Lancaster, Middlesex, Northumberland, Richmond, Westmoreland and Essex Counties.e. Participation in free health screening events in service area. The health screenings included free blood glucose testing; cholesterol testing; and blood pressure testing. Additionally, preventative health care information was provided at each screening event.f. Our policy remains to provide care to any patient regardless of their ability to pay. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $5,888,874 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 95 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 21 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 17 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | John Headley | PersonNm |
| Phone | 8044358000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 Harris Road | AddressLine1Txt |
| City | Kilmarnock | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22482 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (38 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Bonnie Abbott | |||||||||
| Secretary (Apr-Dec) | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| David Antonio MD | |||||||||
| Board Member (Apr-Dec) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| James Bryant MD | |||||||||
| Board Member (Apr-Dec) | 1.00 | 39.00 | Yes (X) | $0 | $212,602 | $12,942 | |||
| James Holmes Jr | |||||||||
| President/Treasurer (Apr-Dec)/BD (Jan-Mar) | 6.00 | 34.00 | Yes (X) | Yes (X) | $0 | $233,879 | $29,009 | ||
| Stephen Whiteway | |||||||||
| Board Member (Apr-Dec) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Marian Walker | |||||||||
| Board Member (Apr-Dec) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Jean Bolling | |||||||||
| Board Member (Jan-Mar) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| John Bowman MD | |||||||||
| Board Member (Jan-Mar) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Barry Case | |||||||||
| Board Member (Jan-Mar) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Chandrashekar Challa | |||||||||
| Board Member (Jan-Mar) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| John Daniel III MD | |||||||||
| Board Member (Jan-Mar) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Anup Gokli MD | |||||||||
| Board Member (Jan-Mar) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Mark Gordon | |||||||||
| Board Member (Jan-Mar) | 2.00 | 48.00 | Yes (X) | $0 | $546,935 | $49,326 | |||
| Pamela Hacker | |||||||||
| Board Member (Jan-Mar) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| BH Hubbard | |||||||||
| Board Member (Jan-Mar) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Sr Anne Mack CBS | |||||||||
| President (Jan-Mar) | 3.00 | 48.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Joanne Nattrass | |||||||||
| Board Member (Jan-Mar) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Fr Jack Podsiadlo | |||||||||
| Board Member (Jan-Mar) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Michael Robinson | |||||||||
| Board Member (Jan-Mar) | 2.00 | 48.00 | Yes (X) | $0 | $730,851 | $25,808 | |||
| Sr Victoria Segura CBS | |||||||||
| Board Member (Jan-Mar) | 2.00 | 48.00 | Yes (X) | $0 | $0 | $0 | |||
| William Shewmake | |||||||||
| Board Member (Jan-Mar) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Shannon Sinclair | |||||||||
| Board Member (Jan-Mar) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| William Stallings MD | |||||||||
| Board Member (Jan-Mar) | 2.00 | 38.00 | Yes (X) | Yes (X) | $0 | $224,680 | $16,206 | ||
| Nancy Thomas | |||||||||
| Chair (Jan-Mar) | 3.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Michael Williams | |||||||||
| Board Member (Jan-Mar) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Thomas Winfree | |||||||||
| Board Member (Jan-Mar) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Norman Tingle Jr | |||||||||
| Board Member ( Apr-Jan) | 40.00 | 0.00 | Yes (X) | $229,855 | $0 | $3,400 | |||
| Marvene Ruit | |||||||||
| Vice President Operations (Apr-Dec) | 39.00 | 1.00 | Yes (X) | $0 | $113,005 | $18,030 | |||
| Toni Ardabell | |||||||||
| CEO-SMH / CEO-Richmond (Jan-Mar) | 1.00 | 49.00 | Yes (X) | $0 | $734,625 | $39,627 | |||
| Peter Bernard | |||||||||
| CEO - Virginia (Jan-Mar) | 1.00 | 49.00 | Yes (X) | $0 | $1,489,553 | $197,160 | |||
| Allen Goolsby III | |||||||||
| Secretary (Jan-Mar) | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Stephan Quiriconi | |||||||||
| Treasurer (Jan-Mar) | 2.00 | 48.00 | Yes (X) | $0 | $307,530 | $13,955 | |||
| Jim Godwin | |||||||||
| VP HR | 1.00 | 49.00 | $254,827 | $0 | $28,849 | Yes (X) | |||
| Darlene Stibal | |||||||||
| Physician | 40.00 | 0.00 | $277,437 | $0 | $7,088 | Yes (X) | |||
| Barbara Kahler | |||||||||
| Physician | 40.00 | 0.00 | $191,140 | $0 | $10,388 | Yes (X) | |||
| Bridgitte Wolf-Small | |||||||||
| Physician | 40.00 | 0.00 | $158,189 | $0 | $12,668 | Yes (X) | |||
| Carlos Martinez | |||||||||
| Physician | 40.00 | 0.00 | $146,392 | $0 | $13,860 | Yes (X) | |||
| Steven Oltermann | |||||||||
| Physician | 40.00 | 0.00 | $144,204 | $0 | $8,721 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,402,044 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,593,660 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $487,037 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CompHealth | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 972651 | AddressLine1Txt |
| City | Dallas | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75397 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Surgical locum coverage | ServicesDesc |
| Compensation | $147,978 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $201,650 | GovernmentGrantsAmt |
| Total Contributions | $201,650 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient Service Rev. | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $4,618,098 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $4,618,098 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,618,098 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $11,200 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $11,345 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$145 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$145 | TotalRevenueColumnAmt |
| Exclusion | -$145 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Forgiveness of Debt | 900099 | $2,222,269 | $2,222,269 |
| Billing Ser.to Related | 900099 | $73,605 | $73,605 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,295,874 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,115,477 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $4,618,098 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,295,729 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $233,256 | TotalAmt |
| Program Services | $209,930 | ProgramServicesAmt |
| Management And General | $23,326 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,329,947 | TotalAmt |
| Program Services | $2,996,952 | ProgramServicesAmt |
| Management And General | $332,995 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,182 | TotalAmt |
| Program Services | $43,364 | ProgramServicesAmt |
| Management And General | $4,818 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $321,301 | TotalAmt |
| Program Services | $289,171 | ProgramServicesAmt |
| Management And General | $32,130 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $237,344 | TotalAmt |
| Program Services | $213,610 | ProgramServicesAmt |
| Management And General | $23,734 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $572,019 | TotalAmt |
| Program Services | $572,019 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,904 | TotalAmt |
| Program Services | $3,514 | ProgramServicesAmt |
| Management And General | $390 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,321 | TotalAmt |
| Program Services | $59,689 | ProgramServicesAmt |
| Management And General | $6,632 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $652 | TotalAmt |
| Program Services | $587 | ProgramServicesAmt |
| Management And General | $65 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $296,396 | TotalAmt |
| Program Services | $266,756 | ProgramServicesAmt |
| Management And General | $29,640 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,232 | TotalAmt |
| Program Services | $11,009 | ProgramServicesAmt |
| Management And General | $1,223 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,101 | TotalAmt |
| Program Services | $17,191 | ProgramServicesAmt |
| Management And General | $1,910 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,745 | TotalAmt |
| Program Services | $27,745 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $231,114 | TotalAmt |
| Program Services | $208,003 | ProgramServicesAmt |
| Management And General | $23,111 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,497 | TotalAmt |
| Program Services | $149,847 | ProgramServicesAmt |
| Management And General | $16,650 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $297,568 | $297,568 | |
| Bad Debt Expense | $203,309 | $203,309 | |
| Purchased Services | $189,686 | $170,717 | $18,969 |
| Mgmt Fee Allocation | $136,683 | $123,015 | $13,668 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,647 | TotalAmt |
| Program Services | $24,878 | ProgramServicesAmt |
| Management And General | $2,769 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,420,904 | TotalAmt |
| Program Services | $5,888,874 | ProgramServicesAmt |
| Management And General | $532,030 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,063 | BOYAmt |
| EOY | $339,236 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $295,735 | BOYAmt |
| EOY | $487,135 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,697 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,388 | BOYAmt |
| EOY | $143,258 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,057,160 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $57,849 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,202,591 | BOYAmt |
| EOY | $999,311 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,019 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,690,493 | BOYAmt |
| EOY | $1,968,940 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $570,893 | BOYAmt |
| EOY | $1,423,027 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $524,188 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,789,611 | BOYAmt |
| EOY | $7,017,546 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,884,692 | BOYAmt |
| EOY | $8,440,573 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$7,194,199 | BOYAmt |
| EOY | -$6,471,633 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$7,194,199 | BOYAmt |
| EOY | -$6,471,633 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,690,493 | BOYAmt |
| EOY | $1,968,940 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $694,573 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $27,993 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $201,650 | CurrentTaxYearAmt |
| Total | $201,650 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,244,651 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,903,242 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,672,691 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,194,294 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,618,098 | CurrentTaxYearAmt |
| Total | $30,632,976 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,244,651 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,903,242 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,672,691 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,194,294 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,819,748 | CurrentTaxYearAmt |
| Total | $30,834,626 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $30,834,626 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,182 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,298 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,091 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,760 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,300 | CurrentTaxYearAmt |
| Total | $67,631 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,182 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,298 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,091 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,760 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,300 | CurrentTaxYearAmt |
| Total | $67,631 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $2,468,953 | CurrentTaxYearAmt |
| Total | $2,468,953 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,258,833 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,917,540 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,686,782 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,208,054 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,300,001 | CurrentTaxYearAmt |
| Total | $33,371,210 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.92400 | PublicSupportCY509Pct |
| Investment Income CY | 0.00200 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $34,000 | OtherCostOrOtherBasisAmt |
| Book Value | $34,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $368,167 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,375 | DepreciationAmt |
| Book Value | $358,792 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $79,604 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,923 | DepreciationAmt |
| Book Value | $76,681 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $554,809 | OtherCostOrOtherBasisAmt |
| Depreciation | $45,551 | DepreciationAmt |
| Book Value | $509,258 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,580 | OtherCostOrOtherBasisAmt |
| Book Value | $20,580 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $999,311 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Affiliates | $6,579,430 |
| Due to BSHSI | $435,507 |
| Other Debt General Curr Portion | $1,678 |
| Fin/Issue Costs & Misc | $931 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,017,546 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| James Bryant MD | ||||||||||||||
| Board Member (Apr-Dec) | $0 | $212,602 | $0 | $0 | $0 | $0 | $0 | $5,850 | $0 | $7,092 | $0 | $225,544 | $0 | $0 |
| James Holmes Jr | ||||||||||||||
| President/Treasurer (Apr-Dec)/BD (Ja | $0 | $233,879 | $0 | $0 | $0 | $0 | $0 | $7,939 | $0 | $21,070 | $0 | $262,888 | $0 | $0 |
| Mark Gordon | ||||||||||||||
| Board Member (Jan-Mar) | $0 | $336,416 | $0 | $144,733 | $0 | $65,786 | $0 | $21,206 | $0 | $28,120 | $0 | $596,261 | $0 | $17,280 |
| Michael Robinson | ||||||||||||||
| Board Member (Jan-Mar) | $0 | $464,732 | $0 | $154,883 | $0 | $111,236 | $0 | $15,600 | $0 | $10,208 | $0 | $756,659 | $0 | $0 |
| William Stallings MD | ||||||||||||||
| Board Member (Jan-Mar) | $0 | $224,680 | $0 | $0 | $0 | $0 | $0 | $5,850 | $0 | $10,356 | $0 | $240,886 | $0 | $0 |
| Norman Tingle Jr | ||||||||||||||
| Board Member ( Apr-Jan) | $229,855 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $3,400 | $0 | $233,255 | $0 | $0 | $0 |
| Toni Ardabell | ||||||||||||||
| CEO-SMH / CEO-Richmond (Jan-Mar) | $0 | $493,876 | $0 | $159,372 | $0 | $81,377 | $0 | $37,127 | $0 | $2,500 | $0 | $774,252 | $0 | $25,794 |
| Peter Bernard | ||||||||||||||
| CEO - Virginia (Jan-Mar) | $0 | $789,743 | $0 | $326,469 | $0 | $373,341 | $0 | $166,398 | $0 | $30,762 | $0 | $1,686,713 | $0 | $186,126 |
| Stephan Quiriconi | ||||||||||||||
| Treasurer (Jan-Mar) | $0 | $248,452 | $0 | $57,920 | $0 | $1,158 | $0 | $3,672 | $0 | $10,283 | $0 | $321,485 | $0 | $0 |
| Jim Godwin | ||||||||||||||
| VP HR | $206,334 | $0 | $47,086 | $0 | $1,407 | $0 | $6,792 | $0 | $22,057 | $0 | $283,676 | $0 | $0 | $0 |
| Darlene Stibal | ||||||||||||||
| Physician | $277,437 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $7,088 | $0 | $284,525 | $0 | $0 | $0 |
| Barbara Kahler | ||||||||||||||
| Physician | $191,140 | $0 | $0 | $0 | $0 | $0 | $3,300 | $0 | $7,088 | $0 | $201,528 | $0 | $0 | $0 |
| Bridgitte Wolf-Small | ||||||||||||||
| Physician | $158,189 | $0 | $0 | $0 | $0 | $0 | $4,590 | $0 | $8,078 | $0 | $170,857 | $0 | $0 | $0 |
| Carlos Martinez | ||||||||||||||
| Physician | $146,392 | $0 | $0 | $0 | $0 | $0 | $1,500 | $0 | $12,360 | $0 | $160,252 | $0 | $0 | $0 |
| Steven Oltermann | ||||||||||||||
| Physician | $144,204 | $0 | $0 | $0 | $0 | $0 | $4,235 | $0 | $4,486 | $0 | $152,925 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 4b | FormAndLineReferenceDesc |
| Explanation | The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and is available only to officers and key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution include: Peter Bernard, 241,741; Toni Ardabell, 37,602; Mark Gordon, 25,011. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 4 | On December 31, 2014, the articles and bylaws of both of these entities were amended and restated in their entirety to reflect that as a result of the Rappahannock transaction, Bon Secours-Richmond Health System acquired the sole membership interest in each entity. |
| Form 990, Part VI, Section A, line 6 | Bon Secours Health System, Inc. is the sole member of Bon Secours Richmond LLC. Bon Secours Richmond LLC holds the majority interest in Bon Secours - Richmond Health System, which in turn is the sole member of the filing organization. |
| Form 990, Part VI, Section A, line 7a | The governing body of the filing organization is appointed by it's member Bon Secours - Richmond Health System and subject to approval by Bon Secours Health System, Inc. |
| Form 990, Part VI, Section A, line 7b | Certain authorities of the filing organization are reserved to its member or to Bon Secours Health System, Inc. |
| Form 990, Part VI, Section B, line 11 | The Form 990 for the filing organization will be provided to the Board after filing. Any material changes to the return will be reflected in an amended return, as necessary. |
| Form 990, Part VI, Section B, line 12c | The organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members). |
| Form 990, Part VI, Section B, line 15 | The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of the BSHSI. The compensation committee consists of a group of independent board members and engages an independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Form 990, Part VI, Section b, Line 15b - Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources. |
| Form 990, Part VI, Section C, line 19 | The filing organization makes all documents available to the general public upon request. |
| Form 990, Part VII - Additional Disclosure: | Board Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment and do not receive additional compensation for their board responsibilities. The governing bodies of the hospitals of Bon Secours Richmond Health System, including Bon Secours St. Mary's Hospital, Bon Secours St. Francis Medical Center, Bon Secours Memorial Regional Medical Center and Richmond Community Hospital, Chesapeake Hospital Corporation, as well as the Chesapeake Medical Group, are comprised of the same board members and board officers (Chairman, President, Secretary and Treasurer). These governing bodies are referred to as the Richmond Joint Board. Hours reported for these voluntary board positions represent total hours worked per week, which include responsibilities for all four hospitals. Sr. Anne Marie Mack and Sr. Victoria Segura do not receive payroll distributions as they have taken vows of poverty. |
| Form 990, Part XI, line 9: | Misc adj to net assets 27,993. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Chesapeake Hospital Corporation | |||||||||||
| PO Box 1449 | Kilmarnock | VA | 22482 | 237424835 | Health Care | VA | 501(c)(3) | Line 3 | Bon Secours Richmond Health System | 0 | |
| Chesapeake Health Services Inc | |||||||||||
| PO Box 1449 | Kilmarnock | VA | 22482 | 541513371 | Management Services | VA | 501(c)(3) | Line 11a, I | 0 | N/A | |
| Rappahannock General Hospital Foundation | |||||||||||
| PO Box 1449 | Kilmarnock | VA | 22482 | 541210450 | Fundraising | VA | 501(c)(3) | Line 7 | Bon Secours Richmond Health System | 0 | |
| Bon Secours Health System Inc | |||||||||||
| 1505 Marriottsville Road | Marriottsville | MD | 21104 | 521301088 | Parent Org. Management Services | MD | 501(c)(3) | Line 11c, III-FI | Bon Secours Inc | 0 | |
| Bon Secours Richmond Healthcare Foundation | |||||||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 541201346 | Grant Making Foundation | VA | 501(c)(3) | Line 7 | Bon Secours Richmond LLC | 0 | |
| Bon Secours Richmond Health System | |||||||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 521988421 | Local System Parent Org. | VA | 501(c)(3) | Line 11c, III-FI | Bon Secours Richmond LLC | 0 | |
| Bon Secours Memorial Regional Medical Center | |||||||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 541744931 | Health Care | VA | 501(c)(3) | Line 3 | Bon Secours Richmond Health System | 0 | |
| Bon Secours Richmond Community Hospital | |||||||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 540647482 | Health Care | VA | 501(c)(3) | Line 3 | Bon Secours Richmond Health System | 0 | |
| Bon Secours St Francis Medical Center | |||||||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 311716973 | Health Care | VA | 501(c)(3) | Line 3 | Bon Secours Richmond Health System | 0 | |
| St Mary's Hospital of Richmond Inc | |||||||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 540793767 | Health Care | VA | 501(c)(3) | Line 3 | Bon Secours Richmond Health System | 0 | |
| Laburnum Properties | |||||||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 521260700 | Title Holding Company | VA | 501(c)(2) | Bon Secours Richmond Health System | 0 | ||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| St Mary's MRI LP | |||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 541568022 | Imaging Services | VA | N/A |
| RI LP | |||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 541708835 | Imaging Services | VA | N/A |
| Broad64 Imaging LLC | |||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 205886018 | Imaging Services | VA | N/A |
| Richmond Radiation Oncology Center I LLC | |||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 208444551 | Radiation Oncology Services | VA | N/A |
| Chesterfield Community Healthcare Center MOB I LLC | |||||||
| 435 Southlake Blvd | Richmond | VA | 23236 | 541745670 | Rental - Medical Office Building | VA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Chesterfield Community Healthcare Center Inc | |||||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 541812738 | Ambulatory Healthcare Services | VA | N/A | C | 0 |
| RHS Management Corporation | |||||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 541313425 | Independent Living Facility | VA | N/A | C | 0 |
| Bon Secours - Virginia HealthSource Inc | |||||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 541417686 | Ambulatory Healthcare Services | VA | N/A | C | 0 |
| Richmond MRI Inc | |||||||||
| 8580 Magellan Parkway | Richmond | VA | 23227 | 541568452 | Imaging Services | VA | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |