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SOMC MEDICAL CARE FOUNDATION INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
SOMC MEDICAL CARE FOUNDATION INC (EIN 31-1374523)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-14
IRS object ID
201231359349304688
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-14T14:39:28-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line165 EAST STATE STREET SUITE 600AddressLine1
CityCOLUMBUSCity
StateOHState
ZIP Code43215ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN311374523EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SOMC MEDICAL CARE FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSOMCNameControl
Phone7403567622Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11248 KINNEYS LANEAddressLine1
CityPORTSMOUTHCity
StateOHState
ZIP Code45662ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDEAN WRAYName
TitleVP FINANCETitle
Phone7403567622Phone
Date Signed2012-05-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBERNIE OSTROWSKIName
Phone6148493000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMR RANDAL ARNETTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11805 27TH STREETAddressLine1
CityPORTSMOUTHCity
StateOHState
ZIP Code45662ZIPCode
FieldValueIRS element (for citing)
Gross Receipts39937647GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SOMC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1993YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionSEE SCHEDULE OActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees72TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI312295TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year17332770ContributionsGrantsPriorYear
Contributions Grants Current Year20193963ContributionsGrantsCurrentYear
Program Service Revenue Prior Year19080052ProgramServiceRevenuePriorYear
Program Service Revenue CY19275348ProgramServiceRevenueCY
Investment Income Prior Year64189InvestmentIncomePriorYear
Investment Income Current Year95613InvestmentIncomeCurrentYear
Other Revenue Prior Year378127OtherRevenuePriorYear
Other Revenue Current Year372295OtherRevenueCurrentYear
Total Revenue Prior Year36855138TotalRevenuePriorYear
Total Revenue Current Year39937219TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year29480017SalariesEtcPriorYear
Salaries Etc Current Year31604510SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year8155679OtherExpensePriorYear
Other Expenses Current Year9957566OtherExpensesCurrentYear
Total Expenses Prior Year37635696TotalExpensesPriorYear
Total Expenses Current Year41562076TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-780558RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1624857RevenuesLessExpensesCY
Total Assets BOY6661152TotalAssetsBOY
Total Assets EOY6956591TotalAssetsEOY
Total Liabilities BOY4175861TotalLiabilitiesBOY
Total Liabilities EOY6067751TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2485291NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY888840NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE OWE WILL MAKE A DIFFERENCE. AT SOMC, OUR MISSION IS TO MAKE A DIFFERENCE. WE STRIVE TO LIVE OUT THAT MISSION BY PROVIDING OUR REGION WITH THE HIGHEST QUALITY OF CARE, DELIVERED BY PROFESSIONALS WHO ARE AMONG THE BEST IN THEIR FIELDS. WE EXTEND THAT CARE AND PASSION TO MAKE A DIFFERENCE IN THE COMMUNITY BY BEING A VERY GOOD NEIGHBOR, EMPLOYER, AND COMMUNITY SUPPORTER.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense8029512Expense
Revenue2548050Revenue
DescriptionSOMC ANESTHESIA ASSOCIATES - MEDICAL DOCTORS TRAINED TO ADMINISTER ANESTHETICS AND MANAGE THE MEDICAL CARE OF PATIENTS BEFORE, DURING, AND AFTER SURGERY.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense6105480Expense
Revenue1797254Revenue
DescriptionSOMC HEART AND VASCULAR SERVICES - MEDICAL DOCTORS WORKING TO PREVENT, DIAGNOSE, AND TREAT DISORDERS OF THE HEART AND BLOOD VESSELS.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense5994757Expense
Revenue3575323Revenue
DescriptionSOMC RADIOLOGY SERVICES - MEDICAL DOCTORS TRAINED TO USE STATE-OF-THE-ART RADIANT ENERGY MEDICAL IMAGING TECHNOLOGY TO HELP PREVENT, DIAGNOSE, AND TREAT DISEASES.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense21289435Expense
Revenue11414721Revenue
DescriptionVARIOUS SPECIALTIESDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp21289435TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev11414721TotalOfOtherProgramServiceRev
Total Program Service Expense41419184TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109620NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees72NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1RICHARD GILCHERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7403567622TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11248 KINNEYS LANEAddressLine1
CityPORTSMOUTHCity
StateOHState
ZIP Code45662ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
RANDAL ARNETT
PRESIDENT & CEO-SOMC1.00XX0681059300785
CLAUDIA BURCHETT
VP OF NURSING & CNO-SOMC1.00X0260525116783
LI-FEN CHANG MD
SMD RADIATION ONCOLOGY1.00X1005922034571
BENJAMIN GILL
VP SUPPORT SVCS & ADM DIR-SOMC1.00X012426726158
VICKI NOEL
VP HUMAN RESOURCES-SOMC1.00X021181374955
ELIE SAAB MD
SMD CRITICAL CARE-SOMC1.00X615111092517
LEEANN SAMMONS
VP SAFETY & CSO-SOMC1.00X018809265533
VINCENT SCARPINATO MD
SMD SURGERY-SOMC1.00X6424100151621
KENDALL L STEWART MD
VP MEDICAL AFFAIRS-SOMC1.00X0153713733645
DEAN WRAY
VP FINANCE & CFO-SOMC1.00XX0345786125933
ELIZABETH SCHMIDT
ADM DRCTR, PHYSICIAN SRVCS1.00X48840018853
DANIEL B JOVANOVICH
PHYSICIAN40.009608350204448X
HENRY E CHILDERS IV
PHYSICIAN40.008228260203084X
ROBERT J SCHRIMPF
PHYSICIAN40.00767000037991X
SCOTT D LOGAN
PHYSICIAN-RADIOLOGY40.007455330161199X
JENNIFER M JONES
PHYSICIAN40.00743167022579X
FieldValueIRS element (for citing)
Total Reportable Comp From Org6351644TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3348679TotalReportableCompFrmRltdOrgs
Total Other Compensation1670655TotalOtherCompensation
Number Individuals GT100 K56NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MEDICAL DOCTOR ASSOCIATES INC
1445 TECHNOLOGY PKWY NWNORCROSSGA30092LOCUMS1235638
ADVANTAGE HEALTHCARE
30 TECHNOLOGY DR SUITE 1NWARRENNJ07059ANESTHESIA BILLING139536
ACCUTYPE MEDICAL SERVICES INC
10300 W 103RD STOVERLAND PARKKS66214DICTATION/TRANSCRIPTION126674
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Related Organizations20193963RelatedOrganizations
Total Contributions20193963TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICESDescription
Business Code621300BusinessCode
Total Revenue Column19275348TotalRevenueColumn
Related Or Exempt Function Income19275348RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue19275348TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column96041TotalRevenueColumn
Exclusion$96,041ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other428Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-428Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-428TotalRevenueColumn
Exclusion-$428ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MANAGEMENT SERVICES561000170001170001
BILLING SERVICE FEES561000142294142294
REHAB CARE CREDIT6211106000060000
FieldValueIRS element (for citing)
Total Other Revenue372295TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column39937219TotalRevenueColumn
Related Or Exempt Function Income19335348RelatedOrExemptFunctionIncome
Unrelated Business Revenue312295UnrelatedBusinessRevenue
Exclusion$95,613ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2525787Total
Program Services2525787ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total25421126Total
Program Services25339259ProgramServices
Management And General81867ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total38649Total
Program Services38401ProgramServices
Management And General248ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3618948Total
Program Services3593927ProgramServices
Management And General25021ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1627095Total
Program Services1624965ProgramServices
Management And General2130ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5387597Total
Program Services5382476ProgramServices
Management And General5121ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total400610Total
Program Services397413ProgramServices
Management And General3197ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total136603Total
Program Services120297ProgramServices
Management And General16306ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total678278Total
Program Services674466ProgramServices
Management And General3812ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total6118Total
Program Services5993ProgramServices
Management And General125ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total9747Total
Program Services9424ProgramServices
Management And General323ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total213676Total
Program Services211625ProgramServices
Management And General2051ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total462908Total
Program Services462908ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PHYSICIAN RECRUITMENT574140574140
EDUCATION30234330233112
EQUIPMENT RENTAL4686446271593
DUES & LICENSES2670626486220
BOOKS & JOURNALS2409523646449

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total60786Total
Program Services59369ProgramServices
Management And General1417ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total41562076Total
Program Services41419184ProgramServices
Management And General142892ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1800BOY
EOY2000EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1972973BOY
EOY1226114EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2393370BOY
EOY2547977EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY4808BOY
EOY4808EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY651467BOY
EOY766068EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
EOY167EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2563170LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1216287LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY759257BOY
EOY1346883EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY877477BOY
EOY1062574EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6661152BOY
EOY6956591EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3006367BOY
EOY4357171EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1169494BOY
EOY1710580EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4175861BOY
EOY6067751EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2485291BOY
EOY888840EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2485291BOY
EOY888840EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6661152BOY
EOY6956591EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1624857ReconcilationRevenueExpenses
Reconcilation Other Changes28406ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Written IRS DeterminationXWrittenIRSDetermination
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1SOUTHERN OHIO MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
EIN310678022EIN
Type Of Organization3TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts
General ExplanationSCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SOMC MEDICAL CARE FOUNDATION PROVIDED NONMONETARY SUPPORT TO SOUTHERN OHIO MEDICAL CENTER AS REPORTED IN FORM 990 SCHEDULE R (LEASE OF FACILITIES, PERFORMANCE OF SERVICES, USE OF SHARED EMPLOYEES, AND REIMBURSEMENT OF EXPENSES).GeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis22873OtherCostOrOtherBasis
Depreciation3754Depreciation
Book Value19119BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2540297OtherCostOrOtherBasis
Depreciation1212533Depreciation
Book Value1327764BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1346883TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionMALPRACTICE SELF INSURANCE FUNDDescription
Book Value1062574BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets1062574TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionACCRUED SELF-INSURED LIABILITYDescription
Amount$1,710,580Amount
FieldValueIRS element (for citing)
Total Of Amounts1710580TotalOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RANDAL ARNETT
048801701657630272790278475022310098184400
CLAUDIA BURCHETT
02108870487170921092798023985037730800
LI-FEN CHANG MD
989284000166380980002477101040493000
BENJAMIN GILL
0110672013477011805711020447015042500
VICKI NOEL
01681560433010356048811026144028676800
ELIE SAAB MD
598521000165900662470262700707628000
LEEANN SAMMONS
01490330387540305041054024479025362500
VINCENT SCARPINATO MD
6181910002421901368850147360794031000
KENDALL L STEWART MD
030421207937101153554014700018945015707820425226
DEAN WRAY
02571140705000181720106175019758047171900
DANIEL B JOVANOVICH
94419700016638018067802377001165283000
HENRY E CHILDERS IV
79683700025989018386701921701025910000
ROBERT J SCHRIMPF
750242000167580183500196410804991000
SCOTT D LOGAN
7289730001656001348290263700906732000
JENNIFER M JONES
67202800071139079130146660765746000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 4BSOUTHERN OHIO MEDICAL CENTER, A RELATED ORGANIZATION, MADE CONTRIBUTIONS TO A SERP FOR THE FOLLOWING INDIVIDUALS: RANDAL ARNETT: $261,325 DEAN WRAY: 91,475 CLAUDIA BURCHETT: 71,795 VICKI NOEL: 35,834 LEEANN SAMMONS: 31,512 THE SERP PLAN IS AVAILABLE ONLY TO INDIVIDUALS WHO HAVE HELD AN EXECUTIVE POSITION FOR ONE YEAR. THE SERP WILL VEST UPON THE EXECUTIVE REACHING A SPECIFIED AGE. IF AN EXECUTIVE SEVERS EMPLOYMENT OR IS TERMINATED, A NONCOMPETE AGREEMENT IS IN PLACE FOR 2 YEARS. THE EXECUTIVE FORFEITS ANY SERP PAYMENTS IF HE/SHE DOES NOT CONFORM TO THE NONCOMPETE AGREEMENT. SOUTHERN OHIO MEDICAL CENTER, A RELATED ORGANIZATION, MADE CONTRIBUTIONS TO A CERP (COMMUNITY EMERGENCY RESPONSE PLAN) FOR THE FOLLOWING INDIVIDUALS: DR. HENRY CHILDERS: 28,800 DR. DANIEL JOVANOVICH: 21,075 DR. ROBERT SCHRIMPF: 8,550 DR. SCOTT LOGAN: 1,450 DR. VINCENT SCARPINATO: 17,900 DR. ELLIE SABB: 4,875 THE CERP PROGRAM IS AN INCENTIVE PROGRAM FOR PHYSICIANS TO BE AVAILABLE ON CALL IN THE EVENT OF AN EMERGENCY. A PHYSICIAN MUST PARTICIPATE IN THE PROGRAM FOR 5 YEARS BEFORE BECOMING VESTED AND THE PHYSICIAN ALSO MUST REACH A SPECIFIED AGE. A NONCOMPETE AGREEMENT IS IN PLACE, AND THE PHYSICIAN FORFEITS ANY CERP PAYMENTS IF HE/SHE DOES NOT CONFORM TO THE NONCOMPETE AGREEMENT. THE AMOUNTS LISTED ABOVE ARE INCLUDED IN COMPENSATION REPORTED IN SCHEDULE J, PART II, COLUMN C.
PART IIIPART I, LINE 3: COMPENSATION PAID TO THE ORGANIZATION'S CEO IS ESTABLISHED BY A RELATED ORGANIZATION AND INCLUDES USE OF AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS, A WRITTEN EMPLOYMENT CONTRACT, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.SUPPLEMENTAL INFORMATION

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonDR HENRY CHILDERSNamePerson
Purpose Of LoanEDUCATIONAL LOANPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$25,000OriginalPrincipalAmount
Balance Due4808BalanceDue
Default0Default
Approved By Board1ApprovedByBoard
Written Agreement1WrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due4808TotalBalanceDue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 6SOMC MEDICAL CARE FOUNDATION HAS A SINGLE SHARE OF STOCK OWNED BY DR. KENDALL STEWART, PRESIDENT & CEO. THE ORGANIZATION WAS REQUIRED TO HAVE A SHAREHOLDER UPON ITS FORMATION, IN ORDER TO QUALIFY AS A PROFESSIONAL ASSOCIATION. DR. STEWART REPRESENTS THE TRUSTEE WHO HOLDS LEGAL TITLE TO THE SHARE BUT THE BENEFICIAL OWNER OF THE SHARE, AND THE SOLE VOTING MEMBER, IS SOUTHERN OHIO MEDICAL CENTER. DR. STEWART HAS SIGNED AN AGREEMENT STATING HE HOLDS THE SHARE ONLY BECAUSE A PHYSICIAN IS REQUIRED TO, AND THAT ALL DUTIES REST WITH SOUTHERN OHIO MEDICAL CENTER.
FORM 990, PART VI, SECTION A, LINE 7ASOMC MEDICAL CARE FOUNDATION'S BOARD OF DIRECTORS ARE ELECTED BY SOUTHERN OHIO MEDICAL CENTER'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BSOMC MEDICAL CARE FOUNDATION'S DECISIONS THAT ARE MADE BY THEIR BOARD OF DIRECTORS CAN BE OVERRULED BY SOUTHERN OHIO MEDICAL CENTER'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11FORM 990 INFORMATION IS COMPILED IN THE ACCOUNTING DEPARTMENT THEN SENT TO THE INDEPENDENT TAX ACCOUNTANTS TO ANALYZE THE INFORMATION AND COMPLETE THE TAX RETURN. THE FORM IS THEN REVIEWED BY FINANCIAL STAFF, TIED OUT TO THE TRIAL BALANCE, AND E-MAILED TO THE BOARD. IN ADDITION, THE CFO PRESENTS FORM 990 TO THE BOARD EXECUTIVE COMPENSATION COMMITTEE BEFORE FILING WITH THE IRS.
CONFLICT OF INTEREST STATEMENTS ARE FILLED OUT ANNUALLY IN JANUARY FOR OFFICERS AND FOR NEW AND RETURNING BOARD MEMBERS. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE AUDIT & COMPLIANCE COMMITTEE. ANY CONFLICTS ARE DOCUMENTED IN THE MINUTES AND ADDRESSED. CONFLICTS OF INTEREST ARE RAISED BY OFFICERS OR BOARD MEMBERS ONCE THEY ARE KNOWN BY THE INDIVIDUAL. BOARD MEMBERS ABSTAIN FROM VOTING IF A CONFLICT IS IDENTIFIED THAT THE BOARD MEMBER IS INVOLVED WITH.FORM 990, PART VI, SECTION B, LINE 12C
COMPENSATION REVIEW IS COMPLETED BY A RELATED ORGANIZATION, SOUTHERN OHIO MEDICAL CENTER. ON AN ANNUAL BASIS, AN INDEPENDENT CONSULTANT PROVIDES THE BOARD COMPENSATION COMMITTEE WITH COMPARABLE DATA AND OTHER FACTS WHICH ARE USED BY THE COMMITTEE TO DETERMINE EXECUTIVE PAY PHILOSOPHY. THE DECISIONS FOR OFFICER COMPENSATION ARE DOCUMENTED IN THE BOARD COMPENSATION COMMITTEE MINUTES, WHICH WAS LAST PERFORMED DURING 2011. THIS COMMITTEE DETERMINES THE CEO'S PAY AND SETS PAY RANGES FOR THE OTHER EXECUTIVES.FORM 990, PART VI, SECTION B, LINE 15
FORM 1023, FORM 990, AND FORM 990-T ARE AVAILABLE UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 18
SOMC MEDICAL CARE FOUNDATION, INC. PROVIDES ITS FINANCIAL STATEMENTS TO THE PUBLIC THROUGH ITS BOND DISCLOSURE. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC ON SOUTHERN OHIO MEDICAL CENTER'S WEBSITE.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 28,406.FORM 990, PART XI, LINE 5:
THE ORGANIZATION HAS A COMMITTEE RESPONSIBLE FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.FORM 990, PART XII, LINE 2C:
SOMC MEDICAL CARE FOUNDATION IS ORGANIZED AND OPERATES EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL AND SCIENTIFIC PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR ANY SUCCESSOR STATUTE BY RENDERING ANY TYPE OF PROFESSIONAL SERVICE IN THE PRACTICE OF MEDICINE OR SURGERY OR ANY OF ITS BRANCHES, AUTHORIZED UNDER CHAPTER 4731 OF THE OHIO REVISED CODE, FOR THE BENEFIT OF SOMC, AN OHIO NON-PROFIT CORPORATION INCLUDING (A) PROVIDING MEDICAL,SURGICAL AND OTHER HEALTH CARE AND TREATMENT OF THE SICK, DISABLED, AND INJURED, REGARDLESS OF RACE, COLOR, RELIGION, NATIONAL ORIGIN, AGE, HANDICAP, SEX, OR THE ABILITY TO PAY FOR SERVICES; (B) CONDUCTING EDUCATIONAL ACTIVITIES RELATED TO HEALTHCARE AND TREATMENT OF THE SICK, DISABLED, INJURED AND TO PROMOTE AND CARRY ON MEDICAL, SCIENTIFIC AND CLINICAL RESEARCH RELATED TO HEALTH CARE AND TREATMENT OF THE SICK, DISABLED, AND INJURED; AND (C) ENGAGING IN ANY LAWFUL ACTIVITIES FOR WHICH CORPORATIONS MAY BE FORMED UNDER CHAPTER 1785 OF THE OHIO REVISED CODE THAT ARE NOT CONSISTENT WITH THE FOREGOING.FORM 990, PAGE 1, PART I, LINE 1:
FORM 990, PART VII: THE FOLLOWING OFFICERS DEVOTED TIME TO SOUTHERN OHIO MEDICAL CENTER: RANDAL ARNETT 40 HOURS DEAN WRAY 40 HOURS KENDALL STEWART 40 HOURS CLAUDIA BURCHETT 40 HOURS VICKI NOEL 40 HOURS LEANN SAMMONS 40 HOURS BENJAMIN GILL 40 HOURS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
SOUTHERN OHIO MEDICAL CENTER
1248 KINNEYS LANEPORTSMOUTHOH45662310678022HEALTH CAREOH501(C)(3)3N/A0
SOMC FOUNDATION INC
1805 27TH STREETPORTSMOUTHOH45662311564440HOLD INVESTMENTS FOR BENEFIT OF SOUTHERN OHIO MEDICAL CENTEROH501(C)(3)LINE 11A, I1SOUTHERN OHIO MEDICAL CENTER
SOUTHERN OHIO MEDICAL CENTER TITLE HOLDING COMPANY
1805 27TH STREETPORTSMOUTHOH45662311417566MANAGE REAL ESTATEOH501(C)(2)N/A1SOUTHERN OHIO MEDICAL CENTER
THE FRIENDS OF SOUTHERN OHIO MEDICAL CENTER
1805 27TH STREETPORTSMOUTHOH45662310677520FUNDRAISINGOH501(C)(3)LINE 11A, I1SOUTHERN OHIO MEDICAL CENTER
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
SOUTHERN OHIO MEDICAL CENTER
C19574646ACCRUAL TRANSACTIONS
SOUTHERN OHIO MEDICAL CENTER
I238639RENTAL CHARGES PER CONTRACT
SOUTHERN OHIO MEDICAL CENTER
K142581COST PER CONTRACT
SOUTHERN OHIO MEDICAL CENTER
L52369COST PER CONTRACT
SOUTHERN OHIO MEDICAL CENTER
N29118611ALLOCATION OF COSTS
SOUTHERN OHIO MEDICAL CENTER
O8293102ALLOCATION OF COSTS
SOUTHERN OHIO MEDICAL CENTER
P16421024ALLOCATION OF COSTS
SOMC TITLE HOLDING COMPANY
J619317RENTAL CHARGES PER CONTRACT
SOMC TITLE HOLDING COMPANY
C619317FORGIVENESS OF RENTAL CHARGES