UNIVERSITY SURGICAL ASSOCIATES INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- UNIVERSITY SURGICAL ASSOCIATES INC (EIN 05-0389803)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-05-03
- IRS object ID
- 201341239349300229
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-03T10:53:09-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 050353162 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PICCERELLI GILSTEIN & CO LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| 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 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 050389803 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY SURGICAL ASSOCIATES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | UNIV | NameControl |
| Phone | 4014446290 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 593 EDDY STREET APC 451 | AddressLine1 |
| City | PROVIDENCE | City |
| State | RI | State |
| ZIP Code | 02903 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WILLIAM CIOFFI MD | Name |
| Title | PRESIDENT | Title |
| Phone | 4014446290 | Phone |
| Date Signed | 2013-04-30 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN M MATHIAS | Name |
| PTIN | P00008458 | PTIN |
| Phone | 4018310200 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | WILLIAM CIOFFI MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 593 EDDY STREET APC 451 | AddressLine1 |
| City | PROVIDENCE | City |
| State | RI | State |
| ZIP Code | 02903 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 44425888 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.USASURG.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1980 | YearFormation |
| State Legal Domicile | RI | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 156 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -75316 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1390 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 18850 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 29925867 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 31627497 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 735632 | InvestmentIncomePriorYear |
| Investment Income Current Year | 860990 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 69818 | OtherRevenuePriorYear |
| Other Revenue Current Year | 77199 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 30732707 | TotalRevenuePriorYear |
| Total Revenue Current Year | 32584536 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 297750 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 255700 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 23879215 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 24994891 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 149271 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5960675 | OtherExpensePriorYear |
| Other Expenses Current Year | 5942637 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 30137640 | TotalExpensesPriorYear |
| Total Expenses Current Year | 31193228 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 595067 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1391308 | RevenuesLessExpensesCY |
| Total Assets BOY | 22907029 | TotalAssetsBOY |
| Total Assets EOY | 24703282 | TotalAssetsEOY |
| Total Liabilities BOY | 3542470 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3947414 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 19364559 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 20755868 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 23843436 | Expense |
| Grants | 255700 | Grants |
| Revenue | 31627828 | Revenue |
| Description | PROVIDES DIADNOSIS 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 | Description |
| Total Program Service Expense | 23843436 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | 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 | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 1 | 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 | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 0 | 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 | 33 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 156 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | 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 |
| Other Website | X | OtherWebsite |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HELEN REID | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4014446290 | TelephoneNumber |
Address US AddressUS
| 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 Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JEFFREY SLAIBY MD | |||||||
| TRUSTEE | 40.00 | X | 383727 | 0 | 62245 | ||
| DAVID HARRINGTON MD | |||||||
| TRUSTEE | 40.00 | X | 362054 | 0 | 25268 | ||
| THOMAS SHAHINIAN MD | |||||||
| TRUSTEE | 40.00 | X | 189084 | 0 | 21782 | ||
| G DEAN ROYE MD | |||||||
| TRUSTEE | 40.00 | X | 370878 | 0 | 55108 | ||
| ARLET KURKCHUBASHCE MD | |||||||
| TRUSTEE | 40.00 | X | 300624 | 0 | 49408 | ||
| WILLIAM CIOFFI MD | |||||||
| PRESIDENT | 40.00 | 451743 | 0 | 42105 | X | ||
| EDWARD MARCACCIO MD | |||||||
| VICE PRESIDENT | 40.00 | 689314 | 0 | 55880 | X | ||
| THOMAS F TRACY JR MD | |||||||
| TREASURER | 40.00 | 492938 | 0 | 61491 | X | ||
| STEPHEN MIGLIORI MD | |||||||
| SECRETARY | 40.00 | 393913 | 0 | 42954 | X | ||
| VICTOR PRICOLO MD | |||||||
| PHYSICIAN | 40.00 | 532194 | 0 | 45348 | X | ||
| OREST ZAKLYNSKY MD | |||||||
| PHYSICIAN | 40.00 | 524250 | 0 | 61947 | X | ||
| THOMAS NG MD | |||||||
| PHYSICIAN | 40.00 | 437656 | 0 | 55674 | X | ||
| CHARLES ADAMS | |||||||
| PHYSICIAN | 40.00 | 408601 | 0 | 46694 | X | ||
| ELIZABETH ALTENHEIN MD | |||||||
| PHYSICIAN | 40.00 | 377688 | 0 | 61876 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 5914664 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 687780 | TotalOtherCompensation |
| Number Individuals GT100 K | 26 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| NEW ENGLAND MEDICAL BILLING INC | |||||
| 75 NEWMAN AVE SUITE 100 | RUMFORD | RI | 02916 | BILLING SERVICES | 838554 |
| NAVIX DIAGNOSTIX INC | |||||
| PO BOX 347203 | PITTSBURGH | PA | 15251 | VASCULAR TESTING SERVICES | 285868 |
| COVIDIEN VASCULAR AND MEDICAL SUPPLIES | |||||
| PO BOX 120823 | DALLAS | TX | 75312 | MEDICAL SUPPLIES | 146936 |
| THE STANDARD | |||||
| PO BOX 5676 | PORTLAND | OR | 97228 | LONG-TERM DISABILITY INSURANCE | 132221 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| All Other Contributions | 18850 | AllOtherContributions |
| Total Contributions | 18850 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT FEES | 621110 | 18879031 | 18879031 |
| FEES FROM RI HOSPITAL | 621110 | 8006951 | 8006951 |
| FEES FROM MIRIAM HOSPI | 621110 | 1929091 | 1929091 |
| OTHER INCOME - SURGERY | 621110 | 1020218 | 1020218 |
| FEES FROM WOMEN AND IN | 621110 | 571668 | 571668 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1220538 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1220538 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 31627497 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 665999 | TotalRevenueColumn |
| Exclusion | $665,999 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 110500 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 33301 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 77199 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 77199 | TotalRevenueColumn |
| Exclusion | $77,199 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 12002711 | Securities |
| Other | 331 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 11808051 | Securities |
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 194660 | Securities |
| Other | 331 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 194991 | TotalRevenueColumn |
| Related Or Exempt Function Income | 331 | RelatedOrExemptFunctionIncome |
| Exclusion | $194,660 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 32584536 | TotalRevenueColumn |
| Related Or Exempt Function Income | 31627828 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $937,858 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 255700 | Total |
| Program Services | 255700 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3413807 | Total |
| Program Services | 1536213 | ProgramServices |
| Management And General | 1843456 | ManagementAndGeneral |
| Fundraising | 34138 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16677620 | Total |
| Program Services | 13128823 | ProgramServices |
| Management And General | 3470892 | ManagementAndGeneral |
| Fundraising | 77905 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1993232 | Total |
| Program Services | 1556941 | ProgramServices |
| Management And General | 423214 | ManagementAndGeneral |
| Fundraising | 13077 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1926382 | Total |
| Program Services | 1521071 | ProgramServices |
| Management And General | 395679 | ManagementAndGeneral |
| Fundraising | 9632 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 983850 | Total |
| Program Services | 768289 | ProgramServices |
| Management And General | 209068 | ManagementAndGeneral |
| Fundraising | 6493 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37666 | Total |
| Management And General | 37666 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43350 | Total |
| Management And General | 43350 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 129123 | Total |
| Program Services | 129123 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31425 | Total |
| Program Services | 31425 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1067190 | Total |
| Program Services | 993004 | ProgramServices |
| Management And General | 74186 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1585900 | Total |
| Program Services | 1310174 | ProgramServices |
| Management And General | 275726 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55221 | Total |
| Program Services | 55221 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2439 | Total |
| Program Services | 2439 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 165608 | Total |
| Program Services | 160922 | ProgramServices |
| Management And General | 4686 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1638312 | Total |
| Program Services | 1302729 | ProgramServices |
| Management And General | 327557 | ManagementAndGeneral |
| Fundraising | 8026 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| OUTSIDE SERVICES | 564504 | 564504 | |
| SUPPORT SERVICES | 466469 | 373175 | 93294 |
| DUES AND SUBSCRIPTIONS | 87334 | 85587 | 1747 |
| LICENSES AND PERMITS | 43356 | 43356 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24740 | Total |
| Program Services | 24740 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31193228 | Total |
| Program Services | 23843436 | ProgramServices |
| Management And General | 7200521 | ManagementAndGeneral |
| Fundraising | 149271 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 959632 | BOY |
| EOY | 1244491 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 898339 | BOY |
| EOY | 1413734 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33002 | BOY |
| EOY | 43829 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 2151774 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1456301 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 720902 | BOY |
| EOY | 695473 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16543805 | BOY |
| EOY | 17053802 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3326520 | BOY |
| EOY | 3777743 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 424829 | BOY |
| EOY | 474210 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22907029 | BOY |
| EOY | 24703282 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41591 | BOY |
| EOY | 19824 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 149358 | BOY |
| EOY | 118847 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3351521 | BOY |
| EOY | 3808743 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3542470 | BOY |
| EOY | 3947414 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2257756 | BOY |
| EOY | 3294403 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16954288 | BOY |
| EOY | 17286172 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 152515 | BOY |
| EOY | 175293 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19364559 | BOY |
| EOY | 20755868 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22907029 | BOY |
| EOY | 24703282 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1391308 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 1 | 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 Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type3 Func Int | X | SupportingOrg509a3Type3FuncInt |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RHODE ISLAND HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 050258954 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Supported Organization Notified | 1 | SupportedOrganizationNotified |
| Organized In US | 1 | OrganizedInUS |
| Amount | $0 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 152515 | BeginningOfYearBalance |
| Contributions | 17500 | Contributions |
| Investment Earnings Or Losses | 6679 | InvestmentEarningsOrLosses |
| Other Expenditures | 1316 | OtherExpenditures |
| Administrative Expenses | 85 | AdministrativeExpenses |
| End Of Year Balance | 175293 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 155665 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 5180 | InvestmentEarningsOrLosses |
| Other Expenditures | 5632 | OtherExpenditures |
| Administrative Expenses | 2698 | AdministrativeExpenses |
| End Of Year Balance | 152515 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 152711 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 6142 | InvestmentEarningsOrLosses |
| Other Expenditures | 3188 | OtherExpenditures |
| End Of Year Balance | 155665 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 171221 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -13362 | InvestmentEarningsOrLosses |
| Other Expenditures | 5148 | OtherExpenditures |
| End Of Year Balance | 152711 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12000 | OtherCostOrOtherBasis |
| Book Value | 12000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 374829 | OtherCostOrOtherBasis |
| Depreciation | 200803 | Depreciation |
| Book Value | 174026 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 247465 | OtherCostOrOtherBasis |
| Depreciation | 165921 | Depreciation |
| Book Value | 81544 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1517480 | OtherCostOrOtherBasis |
| Depreciation | 1089577 | Depreciation |
| Book Value | 427903 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 695473 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DEFERRED COMPENSATION AGREEMENT | Description |
| Book Value | 3777743 | BookValue |
| Method Of Valuation | C | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 3777743 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DEFERRED COMPENSATION | $3,777,743 |
| DUE TO OTHER FUNDS | $31,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3808743 | TotalOfAmounts |
| Total Revenue | 32584536 | TotalRevenue |
| Total Expenses | 31193228 | TotalExpenses |
| Excess Or Deficit For Year | 1391308 | ExcessOrDeficitForYear |
| Other | $1 | OtherAmount |
| Total Adjustments | 1 | TotalAdjustments |
| Excess Or Deficit Per FS | 1391309 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 32584205 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -331 | OtherRevenues |
| Revenue Not Rptd F990 | -331 | RevenueNotRptdF990 |
| Revenue Subtotal | 32584536 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 32584536 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 31192897 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | -331 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | -331 | ExpensesNotRptdF990 |
| Expenses Subtotal | 31193228 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 31193228 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | 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. |
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | DR. SHOAIB SHEIKH SURGICAL FUND WAS ESTABLISHED TO AWARD A RESIDENT OF RHODE ISLAND HOSPITAL AND BROWN UNIVERSITY SURGICAL PROGRAM WHO PUBLISHES THE BEST SURGICAL PAPER ACCEPTED TO A NATIONAL SURGICAL SOCIETY. THE ENDOWMENT WILL ALSO FUND EXPENSES FOR AN INTERNATIONAL BURN TRIP WITH THE SURGICAL FACULTY OF UNIVERSITY SURGICAL ASSOCIATES. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | ROUNDING 1. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | GAIN ON DISPOSAL OF ASSETS -331. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | GAIN ON SALE OF INVESTMENTS -331. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| HASBRO CHILDREN'S HOSPITAL | |||||||
| 593 EDDY STREET | PROVIDENCE | RI | 02903 | 581563444 | 501 (C) 3 | 5000 | CHILDREN HOSPITALHOSPITAL GALA/ MEDICAL |
| AMERICAN CANCER SOCIETY | |||||||
| 931 JEFFERSON BLVD | WARWICK | RI | 02886 | 131788491 | 501 (C) 3 | 5000 | CANCER RESEARCH |
| THE MIRIAM HOSPITAL | |||||||
| 164 SUMMIT AVE | PROVIDENCE | RI | 02906 | 050258905 | 501 (C) 3 | 65400 | MEDICAL |
| THE TOMORROW FUND | |||||||
| 593 EDDY STREET | PROVIDENCE | RI | 02903 | 050450569 | 501 (C) 3 | 5000 | CANCER RESEARCH |
| NEWPORT HOSPITAL FOUNDATION | |||||||
| 11 FRIENDSHIP STREET | NEWPORT | RI | 02840 | 222535533 | 501 (C) 3 | 5000 | MEDICAL |
| RIH FOUNDATION | |||||||
| PO BOX H | PROVIDENCE | RI | 02901 | 050258954 | 501 (C) 3 | 110000 | MEDICAL |
| THE CRANSTON ARC | |||||||
| 111 COMSTOCK PKWY PO BOX 20130 | CRANSTON | RI | 02920 | 056015153 | 501 (C) 3 | 5000 | MEDICAL |
| BROWN UNIVERSITY | |||||||
| BOX G-ADV | PROVIDENCE | RI | 02912 | 050258809 | 501 (C) 3 | 50000 | EDUCATION |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 6 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | OUR ORGANIZATION IS FREQUENTLY APPROACHED BY OTHER 501(C)3 ORGANIZATIONS FOR SUPPORT OF VARIOUS PROGRAMS WHICH ARE IN LINE 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. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| 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 (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFFREY SLAIBY MD | |||||||||||||
| 383727 | 0 | 0 | 0 | 0 | 0 | 38500 | 0 | 23745 | 0 | 445972 | 0 | 0 | 0 |
| DAVID HARRINGTON MD | |||||||||||||
| 338054 | 0 | 0 | 0 | 24000 | 0 | 0 | 0 | 25268 | 0 | 387322 | 0 | 0 | 0 |
| THOMAS SHAHINIAN MD | |||||||||||||
| 189084 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 21782 | 0 | 210866 | 0 | 0 | 0 |
| G DEAN ROYE MD | |||||||||||||
| 359216 | 0 | 0 | 0 | 11662 | 0 | 33000 | 0 | 22108 | 0 | 425986 | 0 | 0 | 0 |
| ARLET KURKCHUBASHCE MD | |||||||||||||
| 300624 | 0 | 0 | 0 | 0 | 0 | 38500 | 0 | 10908 | 0 | 350032 | 0 | 0 | 0 |
| WILLIAM CIOFFI MD | |||||||||||||
| 451743 | 0 | 0 | 0 | 0 | 0 | 16500 | 0 | 25605 | 0 | 493848 | 0 | 0 | 0 |
| EDWARD MARCACCIO MD | |||||||||||||
| 689314 | 0 | 0 | 0 | 0 | 0 | 33000 | 0 | 22880 | 0 | 745194 | 0 | 0 | 0 |
| THOMAS F TRACY JR MD | |||||||||||||
| 492938 | 0 | 0 | 0 | 0 | 0 | 38500 | 0 | 22991 | 0 | 554429 | 0 | 0 | 0 |
| STEPHEN MIGLIORI MD | |||||||||||||
| 393913 | 0 | 0 | 0 | 0 | 0 | 38500 | 0 | 4454 | 0 | 436867 | 0 | 0 | 0 |
| VICTOR PRICOLO MD | |||||||||||||
| 532194 | 0 | 0 | 0 | 0 | 0 | 22000 | 0 | 23348 | 0 | 577542 | 0 | 35297 | 0 |
| OREST ZAKLYNSKY MD | |||||||||||||
| 524250 | 0 | 0 | 0 | 0 | 0 | 38500 | 0 | 23447 | 0 | 586197 | 0 | 0 | 0 |
| THOMAS NG MD | |||||||||||||
| 437656 | 0 | 0 | 0 | 0 | 0 | 33000 | 0 | 22674 | 0 | 493330 | 0 | 0 | 0 |
| CHARLES ADAMS | |||||||||||||
| 363851 | 0 | 0 | 0 | 44750 | 0 | 24750 | 0 | 21944 | 0 | 455295 | 0 | 0 | 0 |
| ELIZABETH ALTENHEIN MD | |||||||||||||
| 377688 | 0 | 0 | 0 | 0 | 0 | 38500 | 0 | 23376 | 0 | 439564 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|
| 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
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | FAMILY RELATIONSHIP: THERESA GRAVES, MD AND WILLIAM CIOFFI, MD | |
| 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 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 XI, LINE 5: | ROUNDING 1. TOTAL TO FORM 990, PART XI, LINE 5: 1. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| THE ORGANIZATION HAS AN AUDIT COMMITTEE. THE ORGANIZATION HAS HAD THIS COMMITTEE IN THE PRIOR YEAR AND NO CHANGES HAVE BEEN MADE. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | USA PAWTUCKET PROPERTIES LLC (DISREGARDED ENTITY) | BusinessNameLine1 |
Address US AddressUS
| 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 | PrimaryActivities |
| Legal Domicile State | RI | LegalDomicileState |
| Total Income | 77199 | TotalIncome |
| EOY Assets | 62959 | EOYAssets |