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UNIVERSITY SURGICAL ASSOCIATES INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
UNIVERSITY SURGICAL ASSOCIATES INC (EIN 05-0389803)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-07-12
IRS object ID
201101939349300310
Schema version
2009v1.7
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)
Timestamp2011-07-12T10:10:47-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Piccerelli Gilstein & Co LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1144 Westminster StreetAddressLine1
CityProvidenceCity
StateRIState
ZIP Code029032282ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN050389803EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1UNIVERSITY SURGICAL ASSOCIATES INCBusinessNameLine1
Business Name Line2(FORMERLY RIH SURGERY FOUNDATION INCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlUNIVNameControl
Phone4014446290Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1593 EDDY STREET APC 451AddressLine1
CityPROVIDENCECity
StateRIState
ZIP Code02903ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWILLIAM CIOFFI mdName
TitlepresidentTitle
Phone4014446290Phone
Date Signed2011-06-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJohn M MathiasName
Phone4018310200Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer Personwilliam cioffi MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1593 EDDY STREET APC 451AddressLine1
CityPROVIDENCECity
StateRIState
ZIP Code02903ZIPCode
FieldValueIRS element (for citing)
Gross Receipts38465428GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.USASURG.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1980YearFormation
State Legal DomicileRIStateLegalDomicile
Activity Or Mission DescriptionUNIVERSITY 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 Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees163TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI230688TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year12704ContributionsGrantsPriorYear
Contributions Grants Current Year3262ContributionsGrantsCurrentYear
Program Service Revenue Prior Year29664765ProgramServiceRevenuePriorYear
Program Service Revenue CY29940993ProgramServiceRevenueCY
Investment Income Prior Year-552082InvestmentIncomePriorYear
Investment Income Current Year747421InvestmentIncomeCurrentYear
Other Revenue Prior Year83315OtherRevenuePriorYear
Other Revenue Current Year74924OtherRevenueCurrentYear
Total Revenue Prior Year29208702TotalRevenuePriorYear
Total Revenue Current Year30766600TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year189300GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY87250GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year23937932SalariesEtcPriorYear
Salaries Etc Current Year24563547SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year184081TotalFundrsngExpCurrentYear
Other Expense Prior Year5963863OtherExpensePriorYear
Other Expenses Current Year5826193OtherExpensesCurrentYear
Total Expenses Prior Year30091095TotalExpensesPriorYear
Total Expenses Current Year30476990TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-882393RevenuesLessExpensesPriorYear
Revenues Less Expenses CY289610RevenuesLessExpensesCY
Total Assets BOY22225613TotalAssetsBOY
Total Assets EOY22278080TotalAssetsEOY
Total Liabilities BOY3693335TotalLiabilitiesBOY
Total Liabilities EOY3456191TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY18532278NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY18821889NetAssetsOrFundBalancesEOY
Mission DescriptionUNIVERSITY 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 Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense24055337Expense
Grants87250Grants
Revenue29940993Revenue
DescriptionPROVIDES 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 FIELDSDescription
Total Program Service Expense24055337TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109622NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees163NumberOfEmployees
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
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
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
Other WebsiteXOtherWebsite

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1HELEN REIDBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4014446290TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line175 newman avenueAddressLine1
CityrumfordCity
StateRIState
ZIP Code02916ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
JEFFREY SLAIBY MD
TRUSTEE40.00X386970063147
DAVID HARRINGTON MD
TRUSTEE40.00X376050073663
THOMAS SHAHINIAN MD
TRUSTEE40.00X416033070013
WILLIAM CIOFFI MD
PRESIDENT40.00409655083500X
EDWARD MARCACCIO MD
VICE PRESIDENT40.00691159077861X
THOMAS F TRACY JR MD
TREASURER40.00507860075085X
STEPHEN MIGLIORI MD
SECRETARY40.00410236059714X
VICTOR PRICOLO MD
PHYSICIAN40.00575464060803X
OREST ZAKLYNSKY MD
PHYSICIAN40.00549695073318X
THOMAS NG MD
PHYSICIAN40.00454694074112X
G Dean RoyE MD
PHYSICIAN40.00419121076703X
CHARLES ADAMS
PHYSICIAN40.00404156075450X
FieldValueIRS element (for citing)
Total Reportable Comp From Org5601093TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation863369TotalOtherCompensation
Number Individuals GT100 K47NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
new england medical
75 Newman AveRumfordRI02916billing service856063
NAVIX DIAGNOSTIX INC
100 myles standish blvdtauntonMA02870VASCULAR TESTING SERVICES186075
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
All Other Contributions3262AllOtherContributions
Total Contributions3262TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Patient Fees621110197347061969964735059
Fees from RI Hospital62111058641595864159
Fees from Miriam Hospi621110858530858530
OTHER REVENUE621110819249819249
Fees from Newport Hosp621110682766682766

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column1981583TotalRevenueColumn
Related Or Exempt Function Income1785954RelatedOrExemptFunctionIncome
Unrelated Business Revenue195629UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue29940993TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column579052TotalRevenueColumn
Exclusion$579,052ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real102000Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real27076Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real74924Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column74924TotalRevenueColumn
Exclusion$74,924ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities7840121Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities7665086Securities
Other6666Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities175035Securities
Other-6666Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column168369TotalRevenueColumn
Related Or Exempt Function Income-6666RelatedOrExemptFunctionIncome
Exclusion$175,035ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column30766600TotalRevenueColumn
Related Or Exempt Function Income29703639RelatedOrExemptFunctionIncome
Unrelated Business Revenue230688UnrelatedBusinessRevenue
Exclusion$829,011ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total87250Total
Program Services87250ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3833638Total
Program Services1797976ProgramServices
Management And General1946338ManagementAndGeneral
Fundraising89324Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total16384737Total
Program Services13597263ProgramServices
Management And General2727774ManagementAndGeneral
Fundraising59700Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1816123Total
Program Services1418211ProgramServices
Management And General385926ManagementAndGeneral
Fundraising11986Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1629101Total
Program Services1286341ProgramServices
Management And General334616ManagementAndGeneral
Fundraising8144Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total899948Total
Program Services702769ProgramServices
Management And General191239ManagementAndGeneral
Fundraising5940Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total15862Total
Management And General15862ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total44509Total
Management And General44509ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total124728Total
Program Services124728ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total527455Total
Program Services484672ProgramServices
Management And General42783ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1675935Total
Program Services1592138ProgramServices
Management And General83797ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total43055Total
Program Services43055ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total4626Total
Program Services4626ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total156151Total
Program Services151748ProgramServices
Management And General4403ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1790471Total
Program Services1422163ProgramServices
Management And General359484ManagementAndGeneral
Fundraising8824Fundraising

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Office Expense and Post431361409793215680
Outside Services36033536033500
Support Services352982282386705960
Miscellaneous11693411693400
DUES AND SUBSCRIPTIONS990849710219820

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total82705Total
Program Services75847ProgramServices
Management And General6695ManagementAndGeneral
Fundraising163Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total30476990Total
Program Services24055337ProgramServices
Management And General6237572ManagementAndGeneral
Fundraising184081Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2858023BOY
EOY1153155EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY544468BOY
EOY795352EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY85932BOY
EOY38118EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2060453LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1221249LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY622846BOY
EOY839204EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY13962508BOY
EOY15792422EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2597143BOY
EOY3152179EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1554693BOY
EOY507650EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY22225613BOY
EOY22278080EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY34493BOY
EOY47464EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY78197BOY
EOY204300EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3580645BOY
EOY3204427EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3693335BOY
EOY3456191EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1286196BOY
EOY2238011EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY17093371BOY
EOY16428213EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY152711BOY
EOY155665EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY18532278BOY
EOY18821889EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY22225613BOY
EOY22278080EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1RHODE ISLAND HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
EIN050258954EIN
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

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance152711BeginningOfYearBalance
Investment Earnings Or Losses6142InvestmentEarningsOrLosses
Other Expenditures3188OtherExpenditures
End Of Year Balance155665EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance171221BeginningOfYearBalance
Investment Earnings Or Losses-13362InvestmentEarningsOrLosses
Other Expenditures5148OtherExpenditures
End Of Year Balance152711EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis12000OtherCostOrOtherBasis
Book Value12000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis374829OtherCostOrOtherBasis
Depreciation172572Depreciation
Book Value202257BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis229598OtherCostOrOtherBasis
Depreciation134419Depreciation
Book Value95179BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1444026OtherCostOrOtherBasis
Depreciation914258Depreciation
Book Value529768BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings839204TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionDeferred Compensation AgreementDescription
Book Value3152179BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities3152179TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Deferred Compensation$3,152,179
Due to Other Funds$52,248
FieldValueIRS element (for citing)
Total Of Amounts3204427TotalOfAmounts
Total Revenue30766600TotalRevenue
Total Expenses30476990TotalExpenses
Excess Or Deficit For Year289610ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS289610ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt30773267TotRevenueEtcAuditedFinclStmt
Other Revenues6666OtherRevenues
Revenue Not Rptd F9906666RevenueNotRptdF990
Revenue Subtotal30766601RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99030766601TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt30483656TotExpensesEtcAuditedFinclStmt
Other Expenses Included6666OtherExpensesIncluded
Expenses Not Rptd F9906666ExpensesNotRptdF990
Expenses Subtotal30476990ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99030476990TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part V, Line 4:Description of Intended Use of Endowment Funds:W.R. Thompson Lectureship Endowment is used to account for funds set aside to establish the WR Thompson Lectureship in Esophagastric Surgery. The interest earned on the corpus may be used for an annual lectureship. The principal may not be invaded; as a result, this fund is considered an endowment fund.
Part XII, Line 2d - Other Adjustments:LOSS ON DISPOSAL OF ASSETS: 6666.
Part XIII, Line 2d - Other Adjustments:LOSS ON SALE OF INVESTMENTS: 6666.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
HASBRO CHILDREN'S HOSPITAL
593 EDDY STREETPROVIDENCERI02903581563444501 (c) 310000CHILDREN HOSPITALHOSPITAL GALA/ MEDICAL
AMERICAN CANCER SOCIETY
931 jefferson blvdwarwickRI02886131788491501 (c) 35000CANCER RESEARCH
RIH FOUNDATION
593 EDDY STREETPROVIDENCERI02903050258954501 (c) 35000CAMPAIGN FOR THE NEXT GENERATION AND FOURTH INSTALLMENT FOR PRIOR CAMPAIGN PLEDGE
the miriam hospital
164 summit aveproviDENCERI02906050258905501 (c) 335000MEDICAL
HOPE FUNDS FOR CANCER RESEARCH
226 BELLEVUE AVENUE STE 6NEWPortRI02840205799367501 (c) 37500CANCER RESEARCH
NEWPORT HOSPITAL FOUNDATION
11 FRIENDSHIP STREETNEWPORTRI02840222535533501 (c) 35000MEDICAL
THE TOMORROW FUND
593 EDDY STREETPROVIDENCERI02903050450569501 (c) 310000PROVIDES SUPPORT TO CHILDREN WITH CANCER AND THEIR FAMILIES

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierOther Information:Identifier
Return ReferencePart IV:ReturnReference
ExplanationOUR 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

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
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 (12 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
JEFFREY SLAIBY MD
35893105000023039044654018493045011702812500
DAVID HARRINGTON MD
33697905000034071056011017652044971302733750
THOMAS SHAHINIAN MD
37417805000036855051260018753048604603000000
WILLIAM CIOFFI MD
38672005000017935065829017671049315502570000
EDWARD MARCACCIO MD
59255105000093608059139018722076902004500000
THOMAS F TRACY JR MD
46262305000040237054613020472058294503750000
STEPHEN MIGLIORI MD
3634940500004174205517804536046995002962500
VICTOR PRICOLO MD
54209205000028372041831018972063626704312500
OREST ZAKLYNSKY MD
50369205000041003054630018688062301303975000
THOMAS NG MD
41579605000033898054404019708052880603385000
G Dean RoyE MD
38017405000033947056977019726049582403047500
CHARLES ADAMS
36493005000034226055939019511047960602960000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
WILLIAM CIOFFI MD
BOARD PRESIDENTWILLIAM 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, presidentTheresa A graves, MD is employed by University Surgical Associates, Inc.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 2FAMILY RELATIONSHIP: THERESA GRAVES, MD AND WILLIAM CIOFFI, MD
Form 990, Part VI, Section A, line 4THE BY-LAWS WERE CHANGED DURING THE FISCAL YEAR 9/30/2010. THE AMENDED BY-LAWS ARE ATTACHED FOR YOUR REVIW.
Form 990, Part VI, Section A, line 6PER THE ARTICLES OF INCORPORATION, THE CORPORATION SHALL BE A MEMBERSHIP CORPORATION.
Form 990, Part VI, Section A, line 7aPER 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 7bPER 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 11FORM 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 12cTHE 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 15THE 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 19THE 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 PAGE 12, PART XI, QUESTION 2CTHE AUDIT COMMITTEE MEMBERS CONSIST OF DEAN ROYE, THOMAS F. TRACY, JEFFREY M. SLAIBY AND ARLET KURKCHUBASCHE.AUDIT COMMITTEE
FORM 990 PART VI GOVERNING BODY AND MANAGEMENTTHE BY-LAWS WERE AMENDED AT THE OCTOBER 5, 2009 FOUNDATION MEETING. THE REVISIONS RELATED TO MEMBERSHIP LANGUAGE. THE BY-LAWS NOW STATE THAT THAT EVERYONE WHO JOINS USA WILL COME IN AS A NON-VOTING EMPLOYEE FOR TWO YEARS. DR. CIOFFI HAS THE DISCRETION TO OFFER MEMBERSHIP INTO THE FOUNDATION AND WAIVE THE TWO YEAR PERIOD.CHANGE IN BY-LAWS

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1USA Pawtucket Properties LLC (Disregarded entity)BusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line115 hazel streetAddressLine1
CitypawtucketCity
StateRIState
ZIP Code02860ZIPCode
FieldValueIRS element (for citing)
EIN261855890EIN
Primary ActivitiesRENTAL PROPERTYPrimaryActivities
Legal Domicile StateRILegalDomicileState
Total Income74924TotalIncome
EOY Assets72716EOYAssets