Chesapeake Medical Group Inc: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- Chesapeake Medical Group Inc (EIN 54-1857174)
- Tax period
- 2009-04-01 to 2010-03-31
- Filed
- 2011-02-10
- IRS object ID
- 201120419349300637
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-02-10T11:51:20-06:00 | Timestamp |
| Tax Period End Date | 2010-03-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WITT MARES PLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 TOWN CENTER DRIVE SUITE 900 | AddressLine1 |
| City | NEWPORT NEWS | City |
| State | VA | State |
| ZIP Code | 236064287 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-04-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 541857174 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Chesapeake Medical Group Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHES | NameControl |
| Phone | 8044358582 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1328 | AddressLine1 |
| City | Kilmarnock | City |
| State | VA | State |
| ZIP Code | 22482 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | James M Holmes Jr | Name |
| Title | President | Title |
| Phone | 8044358582 | Phone |
| Date Signed | 2011-02-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | THOMAS R BROOKS | Name |
| Phone | 7578731587 | Phone |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | James M Holmes Jr | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1328 | AddressLine1 |
| City | Kilmarnock | City |
| State | VA | State |
| ZIP Code | 22482 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 5506481 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | n/a | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | VA | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE QUALITY, COMPASSIONATE, COST EFFECTIVE PRIMARY MEDICAL CARE SERVICES TO THE COMMUNITY AS A WHOLE IN A DEFINED GEOGRAPHIC AREA OF THE NORTHERN NECK AND MIDDLE PENINSULA OF VIRGINIA. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 89 | TotalNbrEmployees |
| Total Nbr Volunteers | 5 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 5013778 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 5492407 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1384 | InvestmentIncomePriorYear |
| Investment Income Current Year | 514 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -13 | OtherRevenuePriorYear |
| Other Revenue Current Year | -801 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5015149 | TotalRevenuePriorYear |
| Total Revenue Current Year | 5492120 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 3811677 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4245763 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1545347 | OtherExpensePriorYear |
| Other Expenses Current Year | 1638689 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 5357024 | TotalExpensesPriorYear |
| Total Expenses Current Year | 5884452 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -341875 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -392332 | RevenuesLessExpensesCY |
| Total Assets BOY | 1480556 | TotalAssetsBOY |
| Total Assets EOY | 1366380 | TotalAssetsEOY |
| Total Liabilities BOY | 6331586 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 6609742 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -4851030 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -5243362 | NetAssetsOrFundBalancesEOY |
| Mission Description | The mission of Chesapeake Medical Group, Inc., (CMG) is to provide quality, compassionate, cost effective primary medical care services to the community as a whole in a defined geographic area of the Northern Neckand Middle Peninsula of Virginia. The company will pursue its mission through the development and management of one group medical practice operating at multiple locations which are reasonably equipped and efficiently staffed by competent clinical and administrative individuals. The Corporation is committed to providing medical services without regard to the patients' race, color, creed, national origin, religion or disability and will provide primary medical care to any individual with an acute injury or illness without regard to their ability to pay. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 4999182 | Expense |
| Revenue | 5492407 | Revenue |
| Description | During the fiscal year, CMG employed 13 physicians and 5 nurse practitioners who provided either family practice, pediatric, GYN or Surgical medical care at 7 offices located in four counties. CMG providers saw a total of 76,785 patients during the fiscal year. Of the total services rendered, 60% was billed to Medicare/Medicaid; 20% to Anthem; 13% to other commercial payors; and 7% was billed directly to patients. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 144485 | Expense |
| Description | During the year, CMG physicians and nurse practitioners provided numerous services for the community which included:a. Providing admission services and coverage to five area nursing homes.b. Providing free health care to indigent patients through participation with the Northern Neck Free Health Clinic.c. Providing free community education through speaking and teaching engagements on numerous topics. d. Participation in free sports physicals for secondary school students of Lancaster, Middlesex, Northumberland, Richmond, Westmoreland and Essex Counties.e. Participation in free health screening events in Northumberland counties.The health screenings included free blood glucose testing; cholesterol testing; and blood pressure testing. Additionally, preventative health care information was provided at each screening event.f. Providing free medical services for children in the annual Cub Scout Day Camp held in Lancaster County.g. Our policy remains to provide care to any patient (other than routine care)regardless of their ability to pay. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 5143667 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 6 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 89 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | John Headley | NamePerson |
| Telephone Number | 8044358000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 Harris Road | AddressLine1 |
| City | Kilmarnock | City |
| State | VA | State |
| ZIP Code | 22482 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (12 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| James M Holmes Jr | |||||||
| president | 6.00 | X | X | 0 | 280037 | 15977 | |
| Bonnie B Abbott | |||||||
| vice president of operat | 40.00 | X | X | 81897 | 0 | 5251 | |
| James E Bryant MD | |||||||
| board member | 1.00 | X | 0 | 196429 | 11065 | ||
| David R Antonio MD | |||||||
| board member | 1.00 | X | 0 | 0 | 0 | ||
| Stephen K Whiteway | |||||||
| board member | 1.00 | X | 0 | 0 | 0 | ||
| Marian L Walker | |||||||
| board member | 1.00 | X | 0 | 0 | 0 | ||
| Norman R Tingle Jr MD | |||||||
| physician | 40.00 | X | 359272 | 0 | 11896 | X | |
| Buchanan Dugan MD | |||||||
| physician | 40.00 | 224994 | 0 | 5678 | X | ||
| Matthew Vogel MD | |||||||
| physician | 40.00 | 179982 | 0 | 11344 | X | ||
| John Daniel MD | |||||||
| physician | 40.00 | 163934 | 0 | 10842 | X | ||
| Mathew Jaeger MD | |||||||
| physician | 40.00 | 156888 | 0 | 9097 | X | ||
| Brigitte Wolf-Small MD | |||||||
| Physician | 40.00 | 153107 | 0 | 11528 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1320074 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 476466 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 92678 | TotalOtherCompensation |
| Number Individuals GT100 K | 6 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | chesapeake health services | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 harris road | AddressLine1 |
| City | kilmarnock | City |
| State | VA | State |
| ZIP Code | 22480 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | management fee | DescriptionOfServices |
| Compensation | 113592 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Patient Service Revenu | 621110 | 5270365 | 5270365 |
| Service Contract Reven | 621110 | 222042 | 222042 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5492407 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 514 | TotalRevenueColumn |
| Exclusion | $514 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 13560 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 14361 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -801 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -801 | TotalRevenueColumn |
| Exclusion | -$801 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5492120 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5492407 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$287 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 472652 | Total |
| Program Services | 378122 | ProgramServices |
| Management And General | 94530 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3169488 | Total |
| Program Services | 2812577 | ProgramServices |
| Management And General | 356911 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54091 | Total |
| Program Services | 54091 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 314722 | Total |
| Program Services | 314722 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 234810 | Total |
| Program Services | 234810 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 113592 | Total |
| Management And General | 113592 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140 | Total |
| Management And General | 140 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 340347 | Total |
| Program Services | 228705 | ProgramServices |
| Management And General | 111642 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8031 | Total |
| Program Services | 5834 | ProgramServices |
| Management And General | 2197 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 105914 | Total |
| Program Services | 79141 | ProgramServices |
| Management And General | 26773 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 205870 | Total |
| Program Services | 184270 | ProgramServices |
| Management And General | 21600 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12254 | Total |
| Program Services | 3895 | ProgramServices |
| Management And General | 8359 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47279 | Total |
| Program Services | 47279 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55783 | Total |
| Program Services | 55783 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 206749 | Total |
| Program Services | 206749 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad Debt Expense | 239450 | 239450 | |
| Medical supplies and ph | 216040 | 216040 | |
| Dues and subscriptions | 39533 | 37693 | 1840 |
| Repairs, maintenance an | 39137 | 39137 | |
| Other taxes and license | 4889 | 4889 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3681 | Total |
| Program Services | 480 | ProgramServices |
| Management And General | 3201 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5884452 | Total |
| Program Services | 5143667 | ProgramServices |
| Management And General | 740785 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135680 | BOY |
| EOY | 138148 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 479921 | BOY |
| EOY | 394046 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 70388 | BOY |
| EOY | 74276 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21205 | BOY |
| EOY | 28650 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1433691 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 705723 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 803750 | BOY |
| EOY | 727968 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3612 | BOY |
| EOY | 3292 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1480556 | BOY |
| EOY | 1366380 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 252593 | BOY |
| EOY | 332281 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 646896 | BOY |
| EOY | 627165 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5432097 | BOY |
| EOY | 5650296 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6331586 | BOY |
| EOY | 6609742 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -4851030 | BOY |
| EOY | -5243362 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -4851030 | BOY |
| EOY | -5243362 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1480556 | BOY |
| EOY | 1366380 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type2 | X | SupportingOrg509a3Type2 |
| Certification Checkbox | X | CertificationCheckbox |
| 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 | Chesapeake Hospital Corp | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237424835 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| 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 D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 34000 | OtherCostOrOtherBasis |
| Book Value | 34000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 836191 | OtherCostOrOtherBasis |
| Depreciation | 237649 | Depreciation |
| Book Value | 598542 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 106716 | OtherCostOrOtherBasis |
| Depreciation | 99942 | Depreciation |
| Book Value | 6774 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 456784 | OtherCostOrOtherBasis |
| Depreciation | 368132 | Depreciation |
| Book Value | 88652 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 727968 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Due to Rappahannock Gen Hosp | $4,032,291 |
| Due to Chesapeake Health Svcs | $1,618,005 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 5650296 | TotalOfAmounts |
| Total Revenue | 5492120 | TotalRevenue |
| Total Expenses | 5884452 | TotalExpenses |
| Excess Or Deficit For Year | -392332 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | -392332 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 5506481 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 14361 | OtherRevenues |
| Revenue Not Rptd F990 | 14361 | RevenueNotRptdF990 |
| Revenue Subtotal | 5492120 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 5492120 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 5898814 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 14362 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 14362 | ExpensesNotRptdF990 |
| Expenses Subtotal | 5884452 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 5884452 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part X: | Description of Uncertain Tax Positions Under FIN 48: | Schedule D RHS, the Hospital, CMG and the Foundation are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and are exempt from Federal income taxes on related income pursuant to Section 501(a) of the Code. CPS is a wholly-owned, taxable subsidiary of RHS. RHS is subject to income taxes on profits, if any, from CPS. Effective 2009, FASB Accounting Standards Codification 740 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. RHS's management has evaluated the impact of the standard to its financial statements, but does not anticipate a material effect. RHS is not aware of any material uncertain tax positions and has not accrued the effect of any uncertain tax positions as of March 31, 2010. |
| Part XII, Line 2d - Other Adjustments: | Rental expense: 14361. | |
| Part XIII, Line 2d - Other Adjustments: | Rental expenses: 14361. Rounding: 1. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| James M Holmes Jr | |||||||||||||
| 0 | 279071 | 0 | 0 | 0 | 966 | 0 | 4937 | 0 | 11040 | 0 | 296014 | 0 | 0 |
| James E Bryant MD | |||||||||||||
| 0 | 196429 | 0 | 0 | 0 | 0 | 0 | 5123 | 0 | 5942 | 0 | 207494 | 0 | 0 |
| Norman R Tingle Jr MD | |||||||||||||
| 359272 | 0 | 0 | 0 | 0 | 0 | 3600 | 0 | 8296 | 0 | 371168 | 0 | 0 | 0 |
| Buchanan Dugan MD | |||||||||||||
| 224994 | 0 | 0 | 0 | 0 | 0 | 2856 | 0 | 2822 | 0 | 230672 | 0 | 0 | 0 |
| Matthew Vogel MD | |||||||||||||
| 179982 | 0 | 0 | 0 | 0 | 0 | 5399 | 0 | 5945 | 0 | 191326 | 0 | 0 | 0 |
| John Daniel MD | |||||||||||||
| 163934 | 0 | 0 | 0 | 0 | 0 | 3000 | 0 | 7842 | 0 | 174776 | 0 | 0 | 0 |
| Mathew Jaeger MD | |||||||||||||
| 156888 | 0 | 0 | 0 | 0 | 0 | 2850 | 0 | 6247 | 0 | 165985 | 0 | 0 | 0 |
| Brigitte Wolf-Small MD | |||||||||||||
| 153107 | 0 | 0 | 0 | 0 | 0 | 3000 | 0 | 8528 | 0 | 164635 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Return Reference | Part III | ReturnReference |
| Explanation | Supplemental Compensation information | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Chesapeake Bank | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | James M Holmes Jr is an officer of CMG & a Board member of Chesapeake Bank | Relationship |
| Amount Of Transaction | 47279 | AmountOfTransaction |
| Description Of Transaction | Interest paid on outstanding loans | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part V, line 7g | The organization did not receive any contributions of qualified intellectual property. |
| Form 990, Part VI, Section A, line 3 | DAILY MANAGEMENT DUTIES ARE HANDLED BY CHESAPEAKE HEALTH SERVICES. |
| Form 990, Part VI, Section A, line 6 | THE ORGANIZATION HAS STOCKHOLDERS. |
| Form 990, Part VI, Section B, line 11 | When the completed form 990 comes back from the outside tax preparers, it is reviewed by the chesapeake health services (chs) vice president-finance or chs controller for accuracy. once it is determined to be the final draft, the package is given to the president. The president will schedule a meeting of the chs board's executive committee which consists of the chairman-chesapeake health services board, chairman-chesapeake hospital corporation board, finance committee chairman, and a member of the chs board. The executive committee reviews the return in detail and recommends that the board of directors accept it. at the next scheduled rgh board meeting (or a called meeting if necessary to mail the return on time), the form 990 is discussed with copies being available for any other board member to review. Once this meeting and approval of the form 990 have taken place, the return is signed and e-filed. |
| Form 990, Part VI, Section B, line 12c | All documents are available to the public for review in administration during regular business hours, monday through friday. All board members sign a conflict of interest statement once a year stating they will make the board aware if there is a conflict of interest. |
| Form 990, Part VI, Section B, line 15 | The Chesapeake Health Services (chs) executive salary committee of the board of directors meets at least annually to review the compensation of the CEO, officers & other key employees. These are shared positions with Chesapeake Health Services, Rappahannock General Hospital, Rappahannock General Hospital Foundation and Chesapeake Medical Group. The CHS president will schedule a meeting of the board's executive salary committee which consists of the chairman-Chesapeake Health Services board, chairman-Chesapeake Hospital Corporation board, finance committee chairman, and a member of the CHS board. The CHS executive committee reviews the current salary and benefits of each officer and key employee and recommends adjustments as necessary. Their review consists of comparing the salary and benefits to a periodic survey done by an outside third party or hospital-related circulations. If it has been determined that no increases will be given in the fiscal year, no meeting will take place. |
| Form 990, Part VI, Section C, line 19 | All documents are available upon request by appointment in Administrations, Monday through Friday, during regular business hours. |
| Form 990, Part XI, Line 2c | The organization does have a committee who assumes the responsibility for oversight of the audit and the process remains unchanged during the year. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| Chesapeake Hospital Corporation | |||||||||
| po box 1449 | kilmarnock | VA | 22482 | 237424835 | hospital | VA | 501(c)(3) | 3 | N/A |
| Chesapeake Health Services inc | |||||||||
| po box 1449 | kilmarnock | VA | 22482 | 541513371 | management services | VA | 501(c)(3) | 11 | N/A |
| Rappahannock General Hospital Foundation | |||||||||
| po box 1449 | kilmarnock | VA | 22482 | 541210450 | fundraising | VA | 501(c)(3) | 11 | N/A |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| chesapeake hospital corporation | |
| J | 45600 |
| Chesapeake Hospital Corporation | |
| L | 29336 |
| Chesapeake Hospital Corporation | |
| K | 221999 |
| Chesapeake Health Services | |
| L | 113592 |
| Chesapeake Hospital Corporation | |
| O | 388393 |
| Chesapeake Hospital Corporation | |
| E | 4032291 |
| Chesapeake Health Services | |
| D | 1618005 |
| Chesapeake Health Services | |
| J | 97056 |