STANLY MEDICAL SERVICES INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- STANLY MEDICAL SERVICES INC (EIN 56-1892763)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-14
- IRS object ID
- 201302269349303635
- Schema version
- 2011v1.5
- 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) |
|---|---|---|
| Timestamp | 2013-08-14T15:57:47-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 N TRYON STREET SUITE 1000 | AddressLine1 |
| City | CHARLOTTE | City |
| State | NC | State |
| ZIP Code | 28246 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561892763 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STANLY MEDICAL SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STAN | NameControl |
| Phone | 7049820636 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 320 YADKIN STREET | AddressLine1 |
| City | ALBEMARLE | City |
| State | NC | State |
| ZIP Code | 28001 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | NYKOLA SAMILO | Name |
| Title | OFFICER | Title |
| Phone | 7049820636 | Phone |
| Date Signed | 2013-08-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN NORMAN | Name |
| PTIN | P01506766 | PTIN |
| Phone | 7049985200 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ALFRED TAYLOR | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 320 YADKIN STREET | AddressLine1 |
| City | ALBEMARLE | City |
| State | NC | State |
| ZIP Code | 28001 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 15443852 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.STANLYMEDICALSERVICES.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | TO PROMOTE, IMPROVE, AND ENHANCE THE HEALTH AND WELFARE OF COMMUNITIES IN OR OUTSIDE OF THIS STATE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 2 | NbrIndependentVotingMembers |
| Total Nbr Employees | 161 | TotalNbrEmployees |
| Total Nbr Volunteers | 2 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 15239717 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 15438104 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 5748 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 15239717 | TotalRevenuePriorYear |
| Total Revenue Current Year | 15443852 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 13075748 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 14447184 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5046222 | OtherExpensePriorYear |
| Other Expenses Current Year | 4393666 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 18121970 | TotalExpensesPriorYear |
| Total Expenses Current Year | 18840850 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -2882253 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -3396998 | RevenuesLessExpensesCY |
| Total Assets BOY | 3897837 | TotalAssetsBOY |
| Total Assets EOY | 3671353 | TotalAssetsEOY |
| Total Liabilities BOY | 2757259 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3775840 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1140578 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -104487 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | 1) TO PROMOTE, IMPROVE, AND ENHANCE THE HEALTH AND WELFARE OF COMMUNITIES IN OR OUTSIDE OF THIS STATE THROUGH THE SUPPORT OF OR INVOLVEMENT IN THE RECRUITMENT, FORMATION, DEVELOPMENT, MANAGEMENT, EQUIPPING, AND MAINTENANCE OF HEALTHCARE SERVICES PROVIDED IN AFFILIATION WITH THE HEALTH CARE SYSTEM OF WHICH STANLY REGIONAL MEDICAL CENTER, INC., A NORTH CAROLINA NONPROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE CODE, IS AN AFFILIATE AND OTHER HEALTH CARE PROVIDERS LOCATED IN AND AROUND ALBEMARLE, STANLY COUNTY, NORTH CAROLINA (A MEDICALLY UNDERSERVED AREA). 2) TO PROVIDE FUNDS, PROPERTY, OR OTHER BENEFITS FOR THE BENEFIT OF OTHER MEDICALLY UNDERSERVED AREAS IN OR OUTSIDE OF THIS STATE. 3) TO PROMOTE AND CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE CARE OF THE SICK, INJURED, OR RELATED TO THE PROMOTION OF HEALTH. 4) TO PROMOTE OR CARRY OUT SUCH OTHER ACTIVITIES AS MAY BE DEEMED ADVISABLE FOR THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITIES SERVED. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 16213231 | Expense |
| Revenue | 15438104 | Revenue |
| Description | HEALTH SERVICESPROVIDED HEALTHCARE IN A PROVIDER'S OFFICE SETTING. SERVICES INCLUDED GENERAL PATIENT SERVICES, LABORATORY SERVICES, AND X-RAY SERVICES. | Description |
| Total Program Service Expense | 16213231 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 12 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 161 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 2 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENNY PATRICK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7049844643 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 YADKIN STREET | AddressLine1 |
| City | ALBEMARLE | City |
| State | NC | State |
| ZIP Code | 28001 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (11 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| ALFRED TAYLOR | |||||||
| BOARD MEMBER | 1.00 | X | X | 0 | 327705 | 44411 | |
| BRAD MARINO | |||||||
| VP | 40.00 | X | X | 0 | 166251 | 19618 | |
| AMY BOGER | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DR YOLANDA JOHNSON | |||||||
| BOARD MEMBER | 1.00 | X | 220192 | 0 | 19022 | ||
| NYKOLA SAMILO | |||||||
| BOARD MEMBER | 1.00 | X | X | 0 | 204977 | 32981 | |
| KRISTI JACKSON | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| ERIC JOHN MALLICO | |||||||
| PHYSICIAN | 40.00 | 709263 | 0 | 21660 | X | ||
| JOHN DAVID HILL | |||||||
| PHYSICIAN | 40.00 | 518066 | 0 | 22832 | X | ||
| JOSEPH ZUCKER | |||||||
| PHYSICIAN | 40.00 | 436407 | 0 | 24860 | X | ||
| ALEX HORCHAK | |||||||
| PHYSICIAN | 40.00 | 425268 | 0 | 23567 | X | ||
| STEVE M MARTIN | |||||||
| PHYSICIAN | 40.00 | 530057 | 0 | 16206 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2839253 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 698933 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 225157 | TotalOtherCompensation |
| Number Individuals GT100 K | 23 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| WINDSTREAM | |||||
| PO BOX 9001908 | LOUISVILLE | KY | 402901908 | PHONE/FAX/INTERNET SERVICES | 288447 |
| ECLINICAL | |||||
| PO BOX 847950 | BOSTON | MA | 022847950 | COMPUTER MAINTENANCE | 282296 |
| STERICYCLE | |||||
| PO BOX 6582 | CAROL STREAM | IL | 60197 | HAZARDOUS WASTE | 225887 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 753972633 | LOCUMS/DR FILL-INS | 158377 |
| STAFF CARE INC | |||||
| PO BOX 281923 | ATLANTA | GA | 30384 | LOCUMS/DR FILL-INS | 149329 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT REVENUE | Description |
| Business Code | 621300 | BusinessCode |
| Total Revenue Column | 14945655 | TotalRevenueColumn |
| Related Or Exempt Function Income | 14945655 | RelatedOrExemptFunctionIncome |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 492449 | TotalRevenueColumn |
| Related Or Exempt Function Income | 492449 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 15438104 | TotalProgramServiceRevenue |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5748 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5748 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 5748 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15443852 | TotalRevenueColumn |
| Related Or Exempt Function Income | 15443852 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11776469 | Total |
| Program Services | 10928112 | ProgramServices |
| Management And General | 848357 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 267923 | Total |
| Program Services | 41688 | ProgramServices |
| Management And General | 226235 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1804153 | Total |
| Program Services | 674559 | ProgramServices |
| Management And General | 1129594 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 598639 | Total |
| Program Services | 535735 | ProgramServices |
| Management And General | 62904 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44665 | Total |
| Management And General | 44665 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 787947 | Total |
| Program Services | 764302 | ProgramServices |
| Management And General | 23645 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30633 | Total |
| Program Services | 29730 | ProgramServices |
| Management And General | 903 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 518360 | Total |
| Program Services | 429192 | ProgramServices |
| Management And General | 89168 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 160117 | Total |
| Program Services | 158358 | ProgramServices |
| Management And General | 1759 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71308 | Total |
| Program Services | 71308 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23591 | Total |
| Program Services | 8240 | ProgramServices |
| Management And General | 15351 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68390 | Total |
| Program Services | 58210 | ProgramServices |
| Management And General | 10180 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148308 | Total |
| Program Services | 132218 | ProgramServices |
| Management And General | 16090 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 73224 | Total |
| Program Services | 37919 | ProgramServices |
| Management And General | 35305 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BUILDING & LAND RENTAL/ | 1221948 | 1126372 | 95576 |
| SUPPLIES | 1099643 | 1103310 | -3667 |
| REPAIR & MAINTENANCE/RE | 70881 | 53090 | 17791 |
| BOOKS AND SUBSCRIPTIONS | 50133 | 37932 | 12201 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24518 | Total |
| Program Services | 22956 | ProgramServices |
| Management And General | 1562 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18840850 | Total |
| Program Services | 16213231 | ProgramServices |
| Management And General | 2627619 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1184709 | BOY |
| EOY | 909273 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1909210 | BOY |
| EOY | 1900581 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 92160 | BOY |
| EOY | 81694 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 3561209 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2857186 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 666734 | BOY |
| EOY | 704023 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45024 | BOY |
| EOY | 75782 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3897837 | BOY |
| EOY | 3671353 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1821149 | BOY |
| EOY | 2178114 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 936110 | BOY |
| EOY | 1597726 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2757259 | BOY |
| EOY | 3775840 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1140578 | BOY |
| EOY | -104487 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1140578 | BOY |
| EOY | -104487 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3897837 | BOY |
| EOY | 3671353 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -3396998 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 2151933 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 71189 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 19143 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 20382 | CurrentTaxYearMinus2Years |
| Total | 110714 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 11420767 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 13121277 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13609817 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 15239717 | CurrentTaxYearMinus1Year |
| Current Tax Year | 15438104 | CurrentTaxYear |
| Total | 68829682 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 11491956 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 13140420 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13630199 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 15239717 | CurrentTaxYearMinus1Year |
| Current Tax Year | 15438104 | CurrentTaxYear |
| Total | 68940396 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 68940396 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2342 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 364 | CurrentTaxYearMinus3Years |
| Total | 2706 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2342 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 364 | CurrentTaxYearMinus3Years |
| Total | 2706 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 3390 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3144 | CurrentTaxYearMinus2Years |
| Current Tax Year | 5748 | CurrentTaxYear |
| Total | 12282 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 11494298 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 13144174 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13633343 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 15239717 | CurrentTaxYearMinus1Year |
| Current Tax Year | 15443852 | CurrentTaxYear |
| Total | 68955384 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99980 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99980 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00000 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00010 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 125358 | OtherCostOrOtherBasis |
| Depreciation | 13681 | Depreciation |
| Book Value | 111677 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3434752 | OtherCostOrOtherBasis |
| Depreciation | 2843505 | Depreciation |
| Book Value | 591247 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1099 | OtherCostOrOtherBasis |
| Book Value | 1099 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 704023 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| PENSION LIABILITY | $1,596,971 |
| ADVANCES FROM AFFILIATES | $755 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1597726 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | THE FILING ORGANIZATION IS A NON PROFIT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM INCOME TAX ON REVENUE EARNED FROM ITS TAX-EXEMPT STATUS. THE FILING ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE FILING ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUSES NOR IS IT AWARE OF ANY OF ITS ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE TAX RETURNS FOR THE YEARS 2008 TO 2011 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. THE FILING ORGANIZATION HAS ADOPTED THE INCOME TAX STANDARD ISSUED BY FINANCIAL ACCOUNTING STANDARDS BOARD IN LIGHT OF ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL AND STATE INCOME TAXES. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALFRED TAYLOR | |||||||||||||
| 0 | 243624 | 0 | 66000 | 0 | 18081 | 0 | 20692 | 0 | 23719 | 0 | 372116 | 0 | 0 |
| BRAD MARINO | |||||||||||||
| 0 | 145879 | 0 | 20372 | 0 | 0 | 0 | 3429 | 0 | 16189 | 0 | 185869 | 0 | 0 |
| DR YOLANDA JOHNSON | |||||||||||||
| 207937 | 0 | 12255 | 0 | 0 | 0 | 3334 | 0 | 15688 | 0 | 239214 | 0 | 0 | 0 |
| NYKOLA SAMILO | |||||||||||||
| 0 | 163135 | 0 | 39367 | 0 | 2475 | 0 | 15702 | 0 | 17279 | 0 | 237958 | 0 | 0 |
| ERIC JOHN MALLICO | |||||||||||||
| 503401 | 0 | 115066 | 0 | 90796 | 0 | 8250 | 0 | 13410 | 0 | 730923 | 0 | 0 | 0 |
| JOHN DAVID HILL | |||||||||||||
| 494733 | 0 | 0 | 0 | 23333 | 0 | 6615 | 0 | 16217 | 0 | 540898 | 0 | 0 | 0 |
| JOSEPH ZUCKER | |||||||||||||
| 436407 | 0 | 0 | 0 | 0 | 0 | 8810 | 0 | 16050 | 0 | 461267 | 0 | 0 | 0 |
| ALEX HORCHAK | |||||||||||||
| 415268 | 0 | 0 | 0 | 10000 | 0 | 7356 | 0 | 16211 | 0 | 448835 | 0 | 0 | 0 |
| STEVE M MARTIN | |||||||||||||
| 479993 | 0 | 0 | 0 | 50064 | 0 | 6688 | 0 | 9518 | 0 | 546263 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THREE EMPLOYEES (CEO, COO, CFO) ARE EMPLOYED BY THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY D/B/A CAROLINAS HEALTHCARE SYSTEM ("CHS") AND LEASED TO THE ORGANIZATION THROUGH A MANAGEMENT AGREEMENT. AS SUCH, THEIR COMPENSATION INFORMATION IS NOT REQUIRED ON PART VII. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE CFO AND CONTROLLER WILL REVIEW THE DRAFT, COPIES WILL BE EMAILED TO THE BOARD MEMBERS, AND THE DRAFT WILL BE REVIEWED AT THE BOARD MEETING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BYLAWS ADDRESS WHAT CONSTITUTES CONFLICTS OF INTEREST, THE RESPONSIBILITY OF DISCLOSURE OF EACH MEMBER, HOW CONFLICTS (AND POTENTIAL CONFLICTS) ARE ADDRESSED, AND EACH MEMBER OF THE BOARD OF DIRECTORS FILES A CONFLICT OF INTEREST STATEMENT ANNUALLY WHICH IS REVIEWED BY THE BOARD CHAIR AND IS MAINTAINED BY THE CORPORATE SECRETARY. MEMBERS WITH POTENTIAL CONFLICTS ARE ASKED TO EXCUSE THEMSELVES FROM VOTING ON MATTERS THAT ARE OF POTENTIAL CONFLICT. | |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION OF TOP EXECUTIVES AND TOP MANAGEMENT AND OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED THROUGH AN INDEPENDENT CONSULTANT'S REVIEW OF MARKET COMPARISON STUDIES. THIS PROCESS WAS LAST PERFORMED IN 2012. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THESE DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART XI, LINE 5: | UNRECOGNIZED PENSION EXPENSE -388,517. TRANSFERS FROM AFFILIATES 2,540,450. TOTAL TO FORM 990, PART XI, LINE 5: 2,151,933. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C | THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| STANLY REGIONAL MEDICAL CENTER FOUNDATION INC | ||||||||||
| 301 YADKIN STREET | ALBEMARLE | NC | 28001 | 561698181 | CHARITY | NC | 501(C)(3) | 170(B)(1)(A)(VI) | N/A | 0 |
| STANLY REGIONAL MEDICAL CENTER INC | ||||||||||
| 301 YADKIN STREET | ALBEMARLE | NC | 28001 | 560556760 | HOSPITAL | NC | 501(C)(3) | 170(B)(1)(A)(III) | N/A | 0 |
| STANLY MANOR INC | ||||||||||
| 625 BETHANY ROAD | ALBEMARLE | NC | 28001 | 561623092 | LONG-TERM HEALTHCARE | NC | 501(C)(3) | 509(A)(2) | N/A | 0 |
| STANLEX INC | ||||||||||
| 907 NORTH SECOND STREET | ALBEMARLE | NC | 28001 | 561532751 | HEALTHCARE | NC | 501(C)(3) | 509(A)(3) | N/A | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| STANLY REGIONAL MEDICAL CENTER INC | ||
| R | 547000 | CASH VALUE |
| STANLY REGIONAL MEDICAL CENTER INC | ||
| J | 728296 | MARKET VALUE |
| STANLY REGIONAL MEDICAL CENTER INC | ||
| P | 1993450 | EXPENSES |