UNIVERSITY SURGICAL ASSOCIATES INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- UNIVERSITY SURGICAL ASSOCIATES INC (EIN 05-0389803)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-02-06
- IRS object ID
- 201500379349300635
- Schema version
- 2013v4.0
- 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 | 2015-02-06T14:45:25-06:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 050353162 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PICCERELLI GILSTEIN & CO LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 144 WESTMINSTER STREET | AddressLine1 |
| City | PROVIDENCE | City |
| State | RI | State |
| ZIP Code | 029032282 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 050389803 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY SURGICAL ASSOCIATES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIV | BusinessNameControlTxt |
| Phone | 4014446290 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 593 EDDY STREET APC 431 | AddressLine1 |
| City | PROVIDENCE | City |
| State | RI | State |
| ZIP Code | 02903 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WILLIAM CIOFFI MD | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 4014446290 | PhoneNum |
| Signature | 2015-01-24 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN M MATHIAS | PreparerPersonNm |
| PTIN | P00008458 | PTIN |
| Phone | 4018310200 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | WILLIAM CIOFFI MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 593 EDDY STREET APC 431 | AddressLine1 |
| City | PROVIDENCE | City |
| State | RI | State |
| ZIP Code | 02903 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $48,546,320 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.USASURG.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1980 | FormationYr |
| Legal Domicile State | RI | LegalDomicileStateCd |
| Activity Or Mission | UNIVERSITY SURGICAL ASSOCIATES, INC. IS A NONPROFIT CORPORATION FOUNDED TO PROVIDE DIAGNOSIS AND TREATMENT OF DISORDERS FOR PATIENTS OF RHODE ISLAND HOSPITAL AND OTHERS REQUIRING SURGERY; TO CONDUCT RESEARCH IN THE FIELD OF SURGERY AND TO TEACH PHYSICIANS, MEDICAL STUDENTS AND OTHER HEALTH CARE PERSONNEL IN THE FIELD OF SURGERY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 210 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$33,099 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,890 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $32,733,486 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $35,249,908 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,120,787 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,055,460 | CYInvestmentIncomeAmt |
| PY Other Revenue | $71,211 | PYOtherRevenueAmt |
| CY Other Revenue | $45,021 | CYOtherRevenueAmt |
| PY Total Revenue | $34,925,484 | PYTotalRevenueAmt |
| CY Total Revenue | $37,358,279 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $276,750 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $198,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $26,437,741 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $29,605,131 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $135,972 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,197,963 | PYOtherExpensesAmt |
| CY Other Expenses | $6,346,426 | CYOtherExpensesAmt |
| PY Total Expenses | $32,912,454 | PYTotalExpensesAmt |
| CY Total Expenses | $36,149,557 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,013,030 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,208,722 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,334,560 | TotalAssetsBOYAmt |
| Total Assets EOY | $28,992,193 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,565,662 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,014,573 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $22,768,898 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,977,620 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | UNIVERSITY SURGICAL ASSOCIATES, INC. IS A NONPROFIT CORPORATION FOUNDED TO PROVIDE DIAGNOSIS AND TREATMENT OF DISORDERS FOR PATIENTS OF RHODE ISLAND HOSPITAL AND OTHERS REQUIRING SURGERY; TO CONDUCT RESEARCH IN THE FIELD OF SURGERY AND TO TEACH PHYSICIANS, MEDICAL STUDENTS AND OTHER HEALTH CARE PERSONNEL IN THE FIELD OF SURGERY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $27,398,459 | ExpenseAmt |
| Grant | $198,000 | GrantAmt |
| Revenue | $35,247,025 | RevenueAmt |
| Desc | PROVIDES DIAGNOSIS AND TREATMENT OF DISORDERS AND SURGERY FOR PATIENTS AS WELL AS RESEARCH IN SURGERY AND RELATED FIELDS AND PROVIDES INSTRUCTION IN SURGERY AND RELATED FIELDS. | Desc |
| Total Program Service Expenses | $27,398,459 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | 0 | 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 | 43 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 210 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | Yes (1) | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HELEN REID | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4014446290 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 75 NEWMAN AVENUE | AddressLine1 |
| City | RUMFORD | City |
| State | RI | State |
| ZIP Code | 02916 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| JEFFREY SLAIBY MD | |||||||
| TRUSTEE | 40.00 | Yes (X) | $384,227 | $0 | $46,476 | ||
| DAVID HARRINGTON MD | |||||||
| TRUSTEE | 40.00 | Yes (X) | $376,737 | $0 | $20,495 | ||
| G DEAN ROYE MD | |||||||
| TRUSTEE | 40.00 | Yes (X) | $380,705 | $0 | $55,328 | ||
| ARLET KURKCHUBASHCE MD | |||||||
| TRUSTEE | 40.00 | Yes (X) | $352,095 | $0 | $54,338 | ||
| WILLIAM CIOFFI MD | |||||||
| PRESIDENT | 40.00 | $457,048 | $0 | $39,408 | Yes (X) | ||
| EDWARD MARCACCIO MD | |||||||
| VICE PRESIDENT | 40.00 | $703,526 | $0 | $62,834 | Yes (X) | ||
| STEPHEN MIGLIORI MD | |||||||
| TREASURER/SECRETARY | 40.00 | $413,492 | $0 | $44,946 | Yes (X) | ||
| THOMAS F TRACY JR MD | |||||||
| PHYSICIAN | 40.00 | $505,574 | $0 | $64,002 | Yes (X) | ||
| OREST ZAKLYNSKY MD | |||||||
| PHYSICIAN | 40.00 | $519,241 | $0 | $62,787 | Yes (X) | ||
| THOMAS NG MD | |||||||
| PHYSICIAN | 40.00 | $464,631 | $0 | $55,508 | Yes (X) | ||
| CHARLES ADAMS | |||||||
| PHYSICIAN | 40.00 | $426,103 | $0 | $57,770 | Yes (X) | ||
| GUY NICASTRI MD | |||||||
| PHYSICIAN | 40.00 | $402,776 | $0 | $61,872 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,386,155 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $625,764 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 63 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NEW ENGLAND MEDICAL BILLING INC | |||||
| 75 NEWMAN AVE SUITE 100 | RUMFORD | RI | 02916 | BILLING SERVICES | $847,283 |
| RHODE ISLAND HOSPITAL | |||||
| 593 EDDY STREET | PROVIDENCE | RI | 02903 | RESEARCH SALARY SUPPORT | $436,350 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $7,890 | AllOtherContributionsAmt |
| Total Contributions | $7,890 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT FEES | 621110 | $17,662,710 | $17,662,710 |
| CONTRACT REVENUE - RI HOSPITAL | 621110 | $6,806,696 | $6,806,696 |
| OTHER INCOME - SURGERY | 621110 | $5,111,280 | $5,111,280 |
| CONTRACTUAL REVENUE - MIRIAM HOSP | 621110 | $2,945,675 | $2,945,675 |
| OTHER CONTRACT REVENUE | 621110 | $988,560 | $988,560 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,734,987 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,734,987 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $35,249,908 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $757,551 | TotalRevenueColumnAmt |
| Exclusion | $757,551 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $92,200 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $47,179 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $45,021 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,021 | TotalRevenueColumnAmt |
| Exclusion | $45,021 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,438,771 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $11,137,979 | SecuritiesAmt |
| Other | $2,883 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,300,792 | SecuritiesAmt |
| Other | -$2,883 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,297,909 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$2,883 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,300,792 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,358,279 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,247,025 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,103,364 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,000 | TotalAmt |
| Program Services | $198,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,436,176 | TotalAmt |
| Program Services | $1,546,279 | ProgramServicesAmt |
| Management And General | $1,855,535 | ManagementAndGeneralAmt |
| Fundraising | $34,362 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,776,720 | TotalAmt |
| Program Services | $15,216,293 | ProgramServicesAmt |
| Management And General | $4,487,141 | ManagementAndGeneralAmt |
| Fundraising | $73,286 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,651,070 | TotalAmt |
| Program Services | $2,044,358 | ProgramServicesAmt |
| Management And General | $596,605 | ManagementAndGeneralAmt |
| Fundraising | $10,107 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,533,404 | TotalAmt |
| Program Services | $1,949,201 | ProgramServicesAmt |
| Management And General | $574,829 | ManagementAndGeneralAmt |
| Fundraising | $9,374 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,207,761 | TotalAmt |
| Program Services | $929,251 | ProgramServicesAmt |
| Management And General | $274,041 | ManagementAndGeneralAmt |
| Fundraising | $4,469 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,970 | TotalAmt |
| Management And General | $64,970 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,205 | TotalAmt |
| Management And General | $51,205 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,748 | TotalAmt |
| Program Services | $121,748 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,644 | TotalAmt |
| Program Services | $78,644 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,577,299 | TotalAmt |
| Program Services | $1,454,520 | ProgramServicesAmt |
| Management And General | $122,779 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,713,362 | TotalAmt |
| Program Services | $1,413,619 | ProgramServicesAmt |
| Management And General | $299,743 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,705 | TotalAmt |
| Program Services | $35,705 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,439 | TotalAmt |
| Program Services | $6,439 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $206,882 | TotalAmt |
| Program Services | $200,957 | ProgramServicesAmt |
| Management And General | $5,925 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $930,378 | TotalAmt |
| Program Services | $744,264 | ProgramServicesAmt |
| Management And General | $181,740 | ManagementAndGeneralAmt |
| Fundraising | $4,374 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OUTSIDE SERVICES | $871,188 | $871,188 | |
| SUPPORT SERVICES | $492,589 | $394,071 | $98,518 |
| DUES AND SUBSCRIPTIONS | $104,735 | $102,640 | $2,095 |
| LICENSES AND PERMITS | $71,803 | $71,803 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,479 | TotalAmt |
| Program Services | $19,479 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,149,557 | TotalAmt |
| Program Services | $27,398,459 | ProgramServicesAmt |
| Management And General | $8,615,126 | ManagementAndGeneralAmt |
| Fundraising | $135,972 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $945,952 | BOYAmt |
| EOY | $1,355,350 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $480,343 | BOYAmt |
| EOY | $999,711 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,628 | BOYAmt |
| EOY | $117,515 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,429,230 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,706,966 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $833,475 | BOYAmt |
| EOY | $722,264 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,070,642 | BOYAmt |
| EOY | $20,412,338 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,273,616 | BOYAmt |
| EOY | $4,844,594 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $639,904 | BOYAmt |
| EOY | $540,421 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,334,560 | BOYAmt |
| EOY | $28,992,193 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,152 | BOYAmt |
| EOY | $35,050 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $211,228 | BOYAmt |
| EOY | $134,929 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,326,282 | BOYAmt |
| EOY | $4,844,594 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,565,662 | BOYAmt |
| EOY | $5,014,573 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,638,704 | BOYAmt |
| EOY | $3,363,897 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,938,082 | BOYAmt |
| EOY | $20,401,744 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $192,112 | BOYAmt |
| EOY | $211,979 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,768,898 | BOYAmt |
| EOY | $23,977,620 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,334,560 | BOYAmt |
| EOY | $28,992,193 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,208,722 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RHODE ISLAND HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 050258954 | EIN |
| Organization Type | 3 | OrganizationTypeDesc |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Supported Org Notified | Yes (1) | SupportedOrgNotifiedInd |
| US Organized | Yes (1) | USOrganizedInd |
| Support | $0 | SupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $192,112 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $22,023 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,918 | OtherExpendituresAmt |
| Administrative Expenses | $238 | AdministrativeExpensesAmt |
| End Year Balance | $211,979 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $175,293 | BeginningYearBalanceAmt |
| Contributions | $249 | ContributionsAmt |
| Investment Earnings Or Losses | $18,320 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,750 | OtherExpendituresAmt |
| End Year Balance | $192,112 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $152,515 | BeginningYearBalanceAmt |
| Contributions | $17,500 | ContributionsAmt |
| Investment Earnings Or Losses | $6,679 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,316 | OtherExpendituresAmt |
| Administrative Expenses | $85 | AdministrativeExpensesAmt |
| End Year Balance | $175,293 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $155,665 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $5,180 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,632 | OtherExpendituresAmt |
| Administrative Expenses | $2,698 | AdministrativeExpensesAmt |
| End Year Balance | $152,515 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $152,711 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $6,142 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,188 | OtherExpendituresAmt |
| End Year Balance | $155,665 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,000 | OtherCostOrOtherBasisAmt |
| Book Value | $12,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $374,829 | OtherCostOrOtherBasisAmt |
| Depreciation | $229,033 | DepreciationAmt |
| Book Value | $145,796 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $314,410 | OtherCostOrOtherBasisAmt |
| Depreciation | $206,788 | DepreciationAmt |
| Book Value | $107,622 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,727,991 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,271,145 | DepreciationAmt |
| Book Value | $456,846 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $722,264 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED COMPENSATION AGREEMENT | Desc |
| Book Value | $4,844,594 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $4,844,594 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED COMPENSATION | Desc |
| Amt | $4,844,594 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,844,594 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $37,361,162 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $37,361,162 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$2,883 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$2,883 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $37,358,279 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $36,152,440 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $2,883 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $2,883 | ExpensesNotReportedAmt |
| Expenses Subtotal | $36,149,557 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $36,149,557 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | W.R. THOMPSON LECTURESHIP ENDOWMENT IS USED TO ACCOUNT FOR FUNDS SET ASIDE TO ESTABLISH THE WR THOMPSON LECTURESHIP IN ESOPHAGASTRIC SURGERY. THE INTEREST EARNED ON THE CORPUS MAY BE USED FOR AN ANNUAL LECTURESHIP. THE PRINCIPAL MAY NOT BE INVADED; AS A RESULT, THIS FUND IS CONSIDERED AN ENDOWMENT FUND. |
| PART X, LINE 2: | THE ORGANIZATION INTERNALLY MONITORS ITS TAX POSITIONS TO DETERMINE WHETHER ANY ARE UNCERTAIN. A TAX POSITION IS TAKEN IF IT IS DETERMINED THAT THE POSITION WILL "MORE-LIKELY-THAN-NOT" BE SUSTAINED UPON EXAMINATION BY A TAXING AUTHORITY. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION, AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2014, THERE WERE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE THE RECOGNITION OF A LIABILITY OR ASSET OR DISCLOSURE IN THE FINANCIAL STATEMENTS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE FISCAL YEARS PRIOR TO 2009. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | LOSS ON DISPOSAL OF ASSET -2,883. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | LOSS ON DISPOSAL OF ASSET 2,883. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (7 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| HASBRO CHILDREN'S HOSPITAL | |||||||
| 593 EDDY STREET | PROVIDENCE | RI | 02903 | 581563444 | 501 (C) 3 | $5,000 | CHILDREN HOSPITALHOSPITAL GALA/ MEDICAL |
| THE MIRIAM HOSPITAL | |||||||
| 164 SUMMIT AVE | PROVIDENCE | RI | 02906 | 050258905 | 501 (C) 3 | $5,000 | MEDICAL |
| THE TOMORROW FUND | |||||||
| 593 EDDY STREET | PROVIDENCE | RI | 02903 | 050450569 | 501 (C) 3 | $5,000 | CANCER RESEARCH |
| NEWPORT HOSPITAL FOUNDATION | |||||||
| 11 FRIENDSHIP STREET | NEWPORT | RI | 02840 | 222535533 | 501 (C) 3 | $5,000 | MEDICAL |
| RHODE ISLAND HOSPITAL FOUNDATION | |||||||
| PO BOX H | PROVIDENCE | RI | 02901 | 050258954 | 501 (C) 3 | $110,000 | MEDICAL |
| BROWN UNIVERSITY | |||||||
| BOX G-ADV | PROVIDENCE | RI | 02912 | 050258809 | 501 (C) 3 | $50,000 | EDUCATION |
| AMERICAN CANCER SOCIETY | |||||||
| 931 JEFFERSON BLVD | WARWICK | RI | 02886 | 131788491 | 501 (C) 3 | $5,000 | CANCER RESEARCH |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 7 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | OUR ORGANIZATION IS FREQUENTLY APPROACHED BY OTHER 501(C)3 ORGANIZATIONS FOR SUPPORT OF VARIOUS PROGRAMS WHICH ARE IN LINE WITH OUR MISSION. WE MAINTAIN A FILE OF SUCH SOLICITATIONS ALONG WITH THE ACKNOWLEDGEMENTS OF THEIR RECEIPT OF OUR CONTRIBUTIONS AS WELL AS THEIR CANCELLED CHECKS | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFFREY SLAIBY MD | ||||||||||||||
| TRUSTEE | $384,227 | $0 | $0 | $0 | $0 | $0 | $23,000 | $0 | $23,476 | $0 | $430,703 | $0 | $0 | $0 |
| DAVID HARRINGTON MD | ||||||||||||||
| TRUSTEE | $376,737 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,495 | $0 | $397,232 | $0 | $0 | $0 |
| G DEAN ROYE MD | ||||||||||||||
| TRUSTEE | $380,705 | $0 | $0 | $0 | $0 | $0 | $35,000 | $0 | $20,328 | $0 | $436,033 | $0 | $0 | $0 |
| ARLET KURKCHUBASHCE MD | ||||||||||||||
| TRUSTEE | $352,095 | $0 | $0 | $0 | $0 | $0 | $40,500 | $0 | $13,838 | $0 | $406,433 | $0 | $0 | $0 |
| WILLIAM CIOFFI MD | ||||||||||||||
| PRESIDENT | $457,048 | $0 | $0 | $0 | $0 | $0 | $17,500 | $0 | $21,908 | $0 | $496,456 | $0 | $0 | $0 |
| EDWARD MARCACCIO MD | ||||||||||||||
| VICE PRESIDENT | $703,526 | $0 | $0 | $0 | $0 | $0 | $40,500 | $0 | $22,334 | $0 | $766,360 | $0 | $0 | $0 |
| STEPHEN MIGLIORI MD | ||||||||||||||
| TREASURER/SECRETARY | $413,492 | $0 | $0 | $0 | $0 | $0 | $40,500 | $0 | $4,446 | $0 | $458,438 | $0 | $0 | $0 |
| THOMAS F TRACY JR MD | ||||||||||||||
| PHYSICIAN | $505,574 | $0 | $0 | $0 | $0 | $0 | $40,500 | $0 | $23,502 | $0 | $569,576 | $0 | $0 | $0 |
| OREST ZAKLYNSKY MD | ||||||||||||||
| PHYSICIAN | $519,241 | $0 | $0 | $0 | $0 | $0 | $40,500 | $0 | $22,287 | $0 | $582,028 | $0 | $0 | $0 |
| THOMAS NG MD | ||||||||||||||
| PHYSICIAN | $464,631 | $0 | $0 | $0 | $0 | $0 | $35,000 | $0 | $20,508 | $0 | $520,139 | $0 | $0 | $0 |
| CHARLES ADAMS | ||||||||||||||
| PHYSICIAN | $426,103 | $0 | $0 | $0 | $0 | $0 | $35,000 | $0 | $22,770 | $0 | $483,873 | $0 | $0 | $0 |
| GUY NICASTRI MD | ||||||||||||||
| PHYSICIAN | $402,776 | $0 | $0 | $0 | $0 | $0 | $40,500 | $0 | $21,372 | $0 | $464,648 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|
| WILLIAM CIOFFI MD | ||
| BOARD PRESIDENT | WILLIAM CIOFFI, MD IS ON THE BOARD OF NEW ENGLAND MEDICAL BILLING, WHICH IS A VENDOR OF UNIVERSITY SURGICAL ASSOCIATES. | 0 |
| THERESA A GRAVES MD | ||
| MARRIED TO WILLIAM CIOFFI, MD, PRESIDENT | THERESA A GRAVES, MD IS EMPLOYED BY UNIVERSITY SURGICAL ASSOCIATES, INC. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | FAMILY RELATIONSHIP: THERESA GRAVES, MD AND WILLIAM CIOFFI, MD |
| FORM 990, PART VI, SECTION A, LINE 4 | THE ORGANIZATION ADDED THE FOLLOWING PROVISION OF BYLAWS RELATED TO RHODE ISLAND MEDICAL GROUP, INC., A RHODE ISLAND NONPROFIT MEMBERSHIP CORPORATION: SECTIONS 2.3.5 THROUGH 2.3.8 OF ARTICLE II: 2.3.5. RIMG DESIGNATED MEMBER. NOTWITHSTANDING ANYTHING IN THIS ARTICLE II TO THE CONTRARY, RHODE ISLAND MEDICAL GROUP, INC., A RHODE ISLAND NONPROFIT MEMBERSHIP CORPORATION ("RIMG"), SHALL DESIGNATE A PHYSICIAN AS A MEMBER OF THE CORPORATION WHO SHALL HAVE A SPECIAL MEMBERSHIP INTEREST IN THE CORPORATION WITH THE VOTING RIGHTS AS SPECIFIED HEREIN (THE "RIMG DESIGNATED MEMBER"). IN ACCORDANCE WITH RIMG'S DESIGNATION, THE PHYSICIAN WHO IS THE PRESIDENT OF THE CORPORATION AS PROVIDED IN SECTION 5.1.1 BELOW SHALL ALSO SERVE AS THE RIMG DESIGNATED MEMBER. 2.3.6. APPROVAL RIGHTS OF RIMG DESIGNATED MEMBER. THE FOLLOWING MATTERS SHALL REQUIRE THE APPROVAL OF THE RIMG DESIGNATED MEMBER, IN HIS/HER CAPACITY AS SUCH, BEFORE BEING UNDERTAKEN BY THE CORPORATION, NOTWITHSTANDING ANYTHING TO THE CONTRARY CONTAINED IN THESE BYLAWS: (A) ANY AMENDMENT OF THE ARTICLES OF INCORPORATION OF THE CORPORATION OR THESE BYLAWS; (B) ELECTION OF ANY ELECTED TRUSTEES; (C) ANY MERGER, CONSOLIDATION, DIVISION OR DISSOLUTION OF THE CORPORATION; AND (D) THE SALE, LEASE, EXCHANGE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S PROPERTY AND ASSETS. 2.3.7. METHOD OF EXERCISE OF RIMG DESIGNATED MEMBER RIGHTS. IN EXERCISING ANY OF HIS/HER RIGHTS UNDER THESE BYLAWS, THE RIMG DESIGNATED MEMBER, IN HIS/HER CAPACITY AS SUCH, SHALL COMPLY IN ALL RESPECTS WITH THE ARTICLES OF INCORPORATION AND THE BYLAWS OF RIMG, AS AMENDED FROM TIME TO TIME. IN ACCORDANCE THEREWITH, THE RIMG DESIGNATED MEMBER, IN HIS/HER CAPACITY AS SUCH, SHALL PRESENT AND OBTAIN PRIOR APPROVAL FROM RIMG BOARD OF DIRECTORS WITH RESPECT TO ANY FOREGOING APPROVAL RIGHTS SPECIFIED IN SECTION 2.3.6, PRIOR TO GIVING HIS/HER APPROVAL OF THE MATTER TO THE CORPORATION. 2.3.8. AUTOMATIC REPEAL. THE PROVISIONS OF THESE BYLAWS RELATED TO RIMG (SECTIONS 2.3.5 THROUGH THIS SECTION 2.3.8 OF ARTICLE II) SHALL BE AUTOMATICALLY REPEALED AND OF NO FURTHER FORCE AND EFFECT IF THE DEFINITIVE AGREEMENT FOR THE FORMATION OF RHODE ISLAND MEDICAL GROUP, INC., DATED FEBRUARY 28, 2014, TERMINATES WITH RESPECT TO THE CORPORATION FOR ANY REASON, AND SUCH REPEAL SHALL BE CONTEMPORANEOUS WITH SUCH TERMINATION. |
| FORM 990, PART VI, SECTION A, LINE 6 | PER THE ARTICLES OF INCORPORATION, THE CORPORATION SHALL BE A MEMBERSHIP CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | PER THE ARTICLES OF INCORPORATION, THE MEMBERSHIP SHALL CONSIST INITIALLY OF THE MEMBERS NAMED IN THE BY-LAWS TO BE ADOPTED BY THE INCORPORATORS AND OF SUCH ADDITIONAL MEMBERS AS MAY THEREAFTER BE ELECTED TO MEMBERSHIP FROM TIME TO TIME UPON SUCH TERMS AND CONDITIONS AS THE BY-LAWS SHALL SET FORTH. |
| FORM 990, PART VI, SECTION A, LINE 7B | PER THE ARTICLES OF INCORPORATION, THE AFFAIRS AND BUSINESS OF THE CORPORATION SHALL BE MANAGED BY A BOARD OF TRUSTEES. THE TRUSTEES AND OFFICERS OF THE CORPORATION, TERMS OF OFFICE, METHOD OF SELECTION, RESPECTIVE DUTIES, AND ALL THINGS PERTAINING THERETO, SHALL BE AS DEFINED AND ESTABLISHED BY THE BY-LAWS. |
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 IS REVIEWED BY THE PRESIDENT OF THE BOARD AND THE ORGANIZATION'S ADMINISTRATIVE DIRECTOR WHO SUBSEQUENTLY COMMUNICATE TO THE ENTIRE BOARD OF TRUSTEES THAT THEY APPROVED THE FORM 990 FOR FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS DISTRIBUTED ANNUALLY AND EXPLAINED TO THE PRESIDENT AND MEMBERS OF THE BOARD OF TRUSTEES AND SENIOR MANAGEMENT. THE DOCUMENTATION INCLUDES A DETAILED EXPLANATION OF THE POLICY AND THE ACTIONS TO BE TAKEN IF A CONFLICT SHOULD ARISE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION MAINTAINS SALARY RANGES FOR ALL EMPLOYEES WHICH IS UPDATED AND APPROVED BY THE BOARD OF TRUSTEES ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND 990 OF THE ORGANIZATION ARE MADE AVAILABLE TO THE PUBLIC ON GUIDESTAR.ORG. THE CONFLICT OF INTEREST POLICY WOULD BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | COMMITTEE'S OVERSIGHT OF AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANT PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | USA PAWTUCKET PROPERTIES LLC (DISREGARDED ENTITY) | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 15 HAZEL STREET | AddressLine1 |
| City | PAWTUCKET | City |
| State | RI | State |
| ZIP Code | 02860 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 261855890 | EIN |
| Primary Activities | RENTAL PROPERTY | PrimaryActivitiesTxt |
| Legal Domicile State | RI | LegalDomicileStateCd |
| Total Income | -$44,474 | TotalIncomeAmt |
| End Of Year Assets | $550,722 | EndOfYearAssetsAmt |