Civic Intelligence

Randolph Specialty Group Practice

990 • Fiscal year 2010 • EIN 11-3827203

Oct 01, 2009 to Sep 30, 2010 • Filed on Aug 15, 2011

Organization ProfileRANDOLPHHEALTH.ORG
364 White Oak Street27204
Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

97th percentile

1.56x

Higher debt load relative to assets than 97% of similar nonprofits.

2010 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2010

Liabilities / Revenue

Score unavailable

No value available

Liabilities-to-revenue requires both liabilities and revenue on this filing.

Source year 2010

Net Margin

Score unavailable

No value available

Net margin requires both revenue and expenses on this filing.

Source year 2010

Top Officer Pay

Score unavailable

No value available

This filing does not contain officer compensation rows.

Source year 2010

Asset Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2010

Revenue Growth

Score unavailable

No value available

No valid filing value is available for this score.

Balance Sheet
Liabilities / Assets97th percentile

Assets

$1,618,463

No earlier filing loaded for comparison.

Net Assets

-$910,436

No earlier filing loaded for comparison.

Liabilities

$2,528,899

No earlier filing loaded for comparison.

Revenue And Expenses
Liabilities / RevenueScore unavailableNet MarginScore unavailable

Revenue

-

No earlier filing loaded for comparison.

Expenses

$3,800,588

No earlier filing loaded for comparison.

Net Income

-

No earlier filing loaded for comparison.

Historical Trend

Balance Sheet Trend

Asset GrowthScore unavailable

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$40M$20M$0-$20M-$40MAssets 2010: $1,618,463Liabilities 2010: $2,528,899Net Assets 2010: -$910,4362010Assets 2011: $1,485,692Liabilities 2011: $3,342,389Net Assets 2011: -$1,856,6972011Assets 2012: $3,027,074Liabilities 2012: $5,397,240Net Assets 2012: -$2,370,1662012Assets 2013: $3,275,418Liabilities 2013: $6,634,166Net Assets 2013: -$3,358,7482013Assets 2014: $3,864,521Liabilities 2014: $8,233,503Net Assets 2014: -$4,368,9822014Assets 2015: $6,026,671Liabilities 2015: $13,214,496Net Assets 2015: -$7,187,8252015Assets 2016: $5,559,096Liabilities 2016: $15,104,352Net Assets 2016: -$9,545,2562016Assets 2017: $4,807,917Liabilities 2017: $17,459,581Net Assets 2017: -$12,651,6642017Assets 2018: $4,373,403Liabilities 2018: $20,650,048Net Assets 2018: -$16,276,6452018Assets 2019: $3,421,820Liabilities 2019: $22,957,758Net Assets 2019: -$19,535,9382019Assets 2020: $3,673,247Liabilities 2020: $26,240,664Net Assets 2020: -$22,567,4172020Assets 2021: $0Liabilities 2021: $0Net Assets 2021: $02021

Highlighted filing

2010

Assets$1,618,463
Liabilities$2,528,899
Net Assets-$910,436
Open 2010 Filing

Operations Trend

Revenue GrowthScore unavailable

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$30M$20M$10M$0-$10MExpenses 2010: $3,800,5882010Revenue 2011: $4,868,116Expenses 2011: $5,814,377Net Income 2011: -$946,2612011Expenses 2012: $6,574,0372012Revenue 2013: $8,956,160Expenses 2013: $9,978,651Net Income 2013: -$1,022,4912013Revenue 2014: $10,801,932Expenses 2014: $11,812,166Net Income 2014: -$1,010,2342014Revenue 2015: $20,215,150Expenses 2015: $21,652,193Net Income 2015: -$1,437,0432015Revenue 2016: $20,516,381Expenses 2016: $22,873,812Net Income 2016: -$2,357,4312016Revenue 2017: $20,206,239Expenses 2017: $23,312,647Net Income 2017: -$3,106,4082017Revenue 2018: $19,612,554Expenses 2018: $23,237,535Net Income 2018: -$3,624,9812018Revenue 2019: $21,096,252Expenses 2019: $24,355,545Net Income 2019: -$3,259,2932019Revenue 2020: $20,702,907Expenses 2020: $23,734,386Net Income 2020: -$3,031,4792020Revenue 2021: $17,445,662Expenses 2021: $20,247,772Net Income 2021: -$2,802,1102021

Highlighted filing

2010

Revenue-
Expenses$3,800,588
Net Income-
Open 2010 Filing
Jump To
Filing Snapshot
Filing Period
Oct 1, 2009 to Sep 30, 2010
Signed
Aug 15, 2011
Return Version
2009v1.7
Gross Receipts
$3,029,563
Mission and Program Overview

Mission

The mission of randolph specialty group is to provide timely, convenient access to a broad range of quality medical services.

Filing and Contact Details

Filer

EIN
11-3827203
Raw XML AppendixShowing 400 of 519 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

Path#Value
IRS990/AccountantCompileOrReview00
IRS990/AccountsPayableAccruedExpenses/BOY0565085
IRS990/AccountsPayableAccruedExpenses/EOY0966870
IRS990/AccountsReceivable/BOY0215063
IRS990/AccountsReceivable/EOY0491889
IRS990/ActivitiesConductedPartnership00
IRS990/ActivityOrMissionDescription0TO PROMOTE, IMPROVE, AND ENHANCE THE QUALITY OF HEALTH CARE SERVICES IN RANDOPLH COUNTY.
IRS990/AddressPrincipalOfficerUS/AddressLine10364 WHITE OAK STREET
IRS990/AddressPrincipalOfficerUS/City0ASHEBORO
IRS990/AddressPrincipalOfficerUS/State0NC
IRS990/AddressPrincipalOfficerUS/ZIPCode027204
IRS990/Advertising/ProgramServices031447
IRS990/Advertising/Total031447
IRS990/AnnualDisclosureCoveredPersons01
IRS990/AuditCommittee01
IRS990/BalanceSheetAmountsReported01
IRS990/BenefitsPaidToMembersCY00
IRS990/BsnssRltnshpThruFamilyMember00
IRS990/BsnssRltnshpWithOrganization00
IRS990/CashNonInterestBearing/BOY054366
IRS990/CashNonInterestBearing/EOY0100256
IRS990/ChangesToOrganizingDocs00
IRS990/CollectionsOfArt00
IRS990/CompCurrentOfficersDirectors/ManagementAndGeneral06119
IRS990/CompCurrentOfficersDirectors/ProgramServices0299851
IRS990/CompCurrentOfficersDirectors/Total0305970
IRS990/CompensationFromOtherSources00
IRS990/CompensationProcessCEO00
IRS990/CompensationProcessOther00
IRS990/ComplianceWithBackupWitholding01
IRS990/ConflictOfInterestPolicy01
IRS990/ConservationEasements00
IRS990/ConsolidatedAuditFinancialStmt01
IRS990/ContributionsGrantsCurrentYear00
IRS990/CreditCounseling00
IRS990/DecisionsSubjectToApproval00
IRS990/DeductibleContributionsOfArt00
IRS990/DeductibleNonCashContributions00
IRS990/DelegationOfManagementDuties00
IRS990/DepreciationDepletion/ProgramServices079396
IRS990/DepreciationDepletion/Total079396
IRS990/DescribedIn501C301
IRS990/Description0RANDOLPH SPECIALTY GROUP WAS ORGANIZED FOR THE PURPOSE OF PROMOTING COMMUNITY HEALTH THROUGH THE PROVISION OF "SPECIALIZED" HEALTH CARE SERVICES TO THE MEDICALLY UNDER SERVED POPULATIONS OF RANDOLPH COUNTY AND SURROUNDING COUNTIES. RANDOLPH SPECIALTY GROUP PROVIDED SPECIALIZED CARE TO A TOTAL OF 37,011 PATIENTS DURING THE FISCAL YEAR OF 2010.
IRS990/DisregardedEntity00
IRS990/DocumentRetentionPolicy01
IRS990/DonorAdvisedFunds00
IRS990/ElectionOfBoardMembers01
IRS990/EmploymentTaxReturnsFiled01
IRS990/ExcessBenefitTransaction00
IRS990/Expense03760165
IRS990/FamilyOrBusinessRelationship00
IRS990/FederalGrantAuditRequired00
IRS990/FeesForServicesAccounting/ManagementAndGeneral07235
IRS990/FeesForServicesAccounting/Total07235
IRS990/FeesForServicesLegal/ManagementAndGeneral010035
IRS990/FeesForServicesLegal/Total010035
IRS990/FeesForServicesManagement/ProgramServices07475
IRS990/FeesForServicesManagement/Total07475
IRS990/FeesForServicesOther/ProgramServices0709924
IRS990/FeesForServicesOther/Total0709924
IRS990/FinancialStatementConsolidated0X
IRS990/FollowSFAS1170X
IRS990/ForeignActivities00
IRS990/ForeignFinancialAccount00
IRS990/ForeignOffice00
IRS990/Form8282PropertyDisposedOf00
IRS990/Form990PartVIISectionA/AverageHoursPerWeek03.00
IRS990/Form990PartVIISectionA/AverageHoursPerWeek12.00
IRS990/Form990PartVIISectionA/AverageHoursPerWeek23.00
IRS990/Form990PartVIISectionA/AverageHoursPerWeek32.00
IRS990/Form990PartVIISectionA/AverageHoursPerWeek42.00
IRS990/Form990PartVIISectionA/AverageHoursPerWeek52.00
IRS990/Form990PartVIISectionA/AverageHoursPerWeek62.00
IRS990/Form990PartVIISectionA/AverageHoursPerWeek740.00
IRS990/Form990PartVIISectionA/AverageHoursPerWeek840.00
IRS990/Form990PartVIISectionA/HighestCompensatedEmployee0X
IRS990/Form990PartVIISectionA/HighestCompensatedEmployee1X
IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector0X
IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector1X
IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector2X
IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector3X
IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector4X
IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector5X
IRS990/Form990PartVIISectionA/IndividualTrusteeOrDirector6X
IRS990/Form990PartVIISectionA/NamePerson0STEVE EBLIN
IRS990/Form990PartVIISectionA/NamePerson1ROBERT MORRISON
IRS990/Form990PartVIISectionA/NamePerson2GLENN MAC PUGH
IRS990/Form990PartVIISectionA/NamePerson3SAMUEL A RANKIN JR
IRS990/Form990PartVIISectionA/NamePerson4SAM CRANFORD JR
IRS990/Form990PartVIISectionA/NamePerson5CHARLES STOUT MD
IRS990/Form990PartVIISectionA/NamePerson6BETH RUSSELL
IRS990/Form990PartVIISectionA/NamePerson7CHARLES WEST
IRS990/Form990PartVIISectionA/NamePerson8ROBERT WILSON MD
IRS990/Form990PartVIISectionA/Officer0X
IRS990/Form990PartVIISectionA/Officer1X
IRS990/Form990PartVIISectionA/Officer2X
IRS990/Form990PartVIISectionA/Officer3X
IRS990/Form990PartVIISectionA/Officer4X
IRS990/Form990PartVIISectionA/OtherCompensation036178
IRS990/Form990PartVIISectionA/OtherCompensation185476
IRS990/Form990PartVIISectionA/OtherCompensation20
IRS990/Form990PartVIISectionA/OtherCompensation30
IRS990/Form990PartVIISectionA/OtherCompensation40
IRS990/Form990PartVIISectionA/OtherCompensation50
IRS990/Form990PartVIISectionA/OtherCompensation60
IRS990/Form990PartVIISectionA/OtherCompensation73043
IRS990/Form990PartVIISectionA/OtherCompensation80
IRS990/Form990PartVIISectionA/ReportableCompFromOrganization00
IRS990/Form990PartVIISectionA/ReportableCompFromOrganization10
IRS990/Form990PartVIISectionA/ReportableCompFromOrganization20
IRS990/Form990PartVIISectionA/ReportableCompFromOrganization30
IRS990/Form990PartVIISectionA/ReportableCompFromOrganization40
IRS990/Form990PartVIISectionA/ReportableCompFromOrganization50
IRS990/Form990PartVIISectionA/ReportableCompFromOrganization60
IRS990/Form990PartVIISectionA/ReportableCompFromOrganization7302927
IRS990/Form990PartVIISectionA/ReportableCompFromOrganization80
IRS990/Form990PartVIISectionA/ReportableCompFromRelatedOrgs0280531
IRS990/Form990PartVIISectionA/ReportableCompFromRelatedOrgs1313250
IRS990/Form990PartVIISectionA/ReportableCompFromRelatedOrgs20
IRS990/Form990PartVIISectionA/ReportableCompFromRelatedOrgs30
IRS990/Form990PartVIISectionA/ReportableCompFromRelatedOrgs40
IRS990/Form990PartVIISectionA/ReportableCompFromRelatedOrgs50
IRS990/Form990PartVIISectionA/ReportableCompFromRelatedOrgs60
IRS990/Form990PartVIISectionA/ReportableCompFromRelatedOrgs70
IRS990/Form990PartVIISectionA/ReportableCompFromRelatedOrgs80
IRS990/Form990PartVIISectionA/Title0PRESIDENT
IRS990/Form990PartVIISectionA/Title1SECRETARY/TREASURER
IRS990/Form990PartVIISectionA/Title2CHAIRMAN
IRS990/Form990PartVIISectionA/Title3VICE CHAIRMAN
IRS990/Form990PartVIISectionA/Title4BOARD MEMBER
IRS990/Form990PartVIISectionA/Title5BOARD MEMBER
IRS990/Form990PartVIISectionA/Title6BOARD MEMBER
IRS990/Form990PartVIISectionA/Title7EXECUTIVE DIRECTOR
IRS990/Form990PartVIISectionA/Title8DOCTOR
IRS990/Form990ProvidedToGoverningBody01
IRS990/FormersListed00
IRS990/FSAudited01
IRS990/FundraisingActivities00
IRS990/FundsToPayPremiums00
IRS990/Gaming00
IRS990/GrantsAndSimilarAmntsCY00
IRS990/GrantsToIndividuals00
IRS990/GrantsToOrganizations00
IRS990/GrantToRelatedPerson00
IRS990/GrossReceipts03029563
IRS990/GroupReturnForAffiliates00
IRS990/Hospital00
IRS990/IndependentAuditFinancialStmt00
IRS990/InformationTechnology/ProgramServices021247
IRS990/InformationTechnology/Total021247
IRS990/Insurance/ProgramServices062743
IRS990/Insurance/Total062743
IRS990/InventoriesForSaleOrUse/BOY09353
IRS990/InventoriesForSaleOrUse/EOY092824
IRS990/InvestmentIncomeCurrentYear00
IRS990/InvestmentInJointVenture00
IRS990/LandBldgEquipmentAccumDeprec0109251
IRS990/LandBuildingsEquipmentBasis0452868
IRS990/LandBuildingsEquipmentBasisNet/BOY0139404
IRS990/LandBuildingsEquipmentBasisNet/EOY0343617
IRS990/LoanToOfficerOrDQP00
IRS990/LobbyingActivities00
IRS990/LocalChapters00
IRS990/MaterialDiversionOrMisuse00
IRS990/MembersOrStockholders01
IRS990/MethodOfAccountingAccrual0X
IRS990/MinutesOfCommittees01
IRS990/MinutesOfGoverningBody01
IRS990/MissionDescription0RANDOLPH SPECIALTY GROUP PRACTICE WAS FORMED TO PROMOTE, IMPROVE AND ENHANCE THE QUALITY OF HEALTH CARE SERVICES IN RANDOLPH COUNTY, NC AND SURROUNDING COUNTIES BY PROVIDING PHYSICIANS AND OTHER MEDICAL SERVICES TO THE COMMUNITY.
IRS990/MoreThan5000KToIndividuals00
IRS990/MoreThan5000KToOrganizations00
IRS990/NameOfPrincipalOfficerPerson0STEVE EBLIN
IRS990/NbrIndependentVotingMembers05
IRS990/NbrVotingGoverningBodyMembers07
IRS990/NbrVotingMembersGoverningBody07
IRS990/NetAssetsOrFundBalancesBOY0-139411
IRS990/NetAssetsOrFundBalancesEOY0-910436
IRS990/NetUnrelatedBusinessTxblIncome00
IRS990/NonDeductibleContributions00
IRS990/NumberFormsTransmittedWith1096022
IRS990/NumberIndependentVotingMembers05
IRS990/NumberIndividualsGT100K01
IRS990/NumberOfContractorsGT100K00
IRS990/NumberOfEmployees034
IRS990/NumberW2GIncluded00
IRS990/Occupancy/ProgramServices0155981
IRS990/Occupancy/Total0155981
IRS990/OfficeExpenses/ManagementAndGeneral017034
IRS990/OfficeExpenses/ProgramServices0432910
IRS990/OfficeExpenses/Total0449944
IRS990/OfficerEntityWithBsnssRltnshp00
IRS990/OfficerMailingAddress00
IRS990/Organization501c0X
IRS990/OtherAssetsTotal/BOY04343
IRS990/OtherAssetsTotal/EOY0529496
IRS990/OtherEmployeeBenefits/ProgramServices0136392
IRS990/OtherEmployeeBenefits/Total0136392
IRS990/OtherExpensePriorYear0534831
IRS990/OtherExpensesCurrentYear01854671
IRS990/OtherExpenses/Description0BAD DEBT EXPENSE
IRS990/OtherExpenses/Description1MISCELLANEOUS EXPENSES
IRS990/OtherExpenses/ProgramServices0308573
IRS990/OtherExpenses/ProgramServices16150
IRS990/OtherExpenses/Total0308573
IRS990/OtherExpenses/Total16150
IRS990/OtherLiabilities/BOY00
IRS990/OtherLiabilities/EOY01562029
IRS990/OtherRevenueCurrentYear0626
IRS990/OtherRevenueMisc/BusinessCode0900099
IRS990/OtherRevenueMisc/Description0OTHER MISC REVENUE
IRS990/OtherRevenueMisc/ExclusionAmount0626
IRS990/OtherRevenueMisc/TotalRevenueColumn0626
IRS990/OtherSalariesAndWages/ProgramServices01396812
IRS990/OtherSalariesAndWages/Total01396812
IRS990/OtherWebsite0X
IRS990/PartialLiquidation00
IRS990/PayrollTaxes/ProgramServices0106743
IRS990/PayrollTaxes/Total0106743
IRS990/PoliticalActivities00
IRS990/PremiumsPaid00
IRS990/PrepaidExpensesDeferredCharges/BOY03145
IRS990/PrepaidExpensesDeferredCharges/EOY060381
IRS990/PriorExcessBenefitTransaction00
IRS990/ProfessionalFundraising00
IRS990/ProgramServiceRevenue/BusinessCode0621300
IRS990/ProgramServiceRevenueCY03028937
IRS990/ProgramServiceRevenue/Description0NET PATIENT SERVICE RE
IRS990/ProgramServiceRevenuePriorYear01087634
IRS990/ProgramServiceRevenue/RelatedOrExemptFunctionIncome03028937
IRS990/ProgramServiceRevenue/TotalRevenueColumn03028937
IRS990/ProhibitedTaxShelterTrans00
IRS990/QuidProQuoContributions00
IRS990/RegularMonitoringEnforcement01
IRS990/RelatedEntity01
IRS990/RelatedOrgControlledEntity00
IRS990/Revenue03028937
IRS990/RevenuesLessExpensesCY0-771025
IRS990/RevenuesLessExpensesPriorYear0-139411
IRS990/SalariesEtcCurrentYear01945917
IRS990/SalariesEtcPriorYear0692214
IRS990ScheduleA/AmtsFromSubstContributors/Total00
IRS990ScheduleA/AmtsRecdFromDisqualPersons/Total00
IRS990ScheduleA/First5Years5090X
IRS990ScheduleA/GrossReceiptsFromAdmissions/CurrentTaxYear03028937
IRS990ScheduleA/GrossReceiptsFromAdmissions/CurrentTaxYearMinus1Year01087634
IRS990ScheduleA/GrossReceiptsFromAdmissions/Total04116571
IRS990ScheduleA/OtherIncome509/CurrentTaxYear0626
IRS990ScheduleA/OtherIncome509/Total0626
IRS990ScheduleA/PubliclySupportedOrg509a20X
IRS990ScheduleA/PublicSupportTotal50904116571
IRS990ScheduleA/SupportFromDQPsEtc/Total00
IRS990ScheduleA/Total509/CurrentTaxYear03028937
IRS990ScheduleA/Total509/CurrentTaxYearMinus1Year01087634
IRS990ScheduleA/Total509/Total04116571
IRS990ScheduleA/TotalSupportTotal/CurrentTaxYear03029563
IRS990ScheduleA/TotalSupportTotal/CurrentTaxYearMinus1Year01087634
IRS990ScheduleA/TotalSupportTotal/Total04117197
IRS990/ScheduleBRequired00
IRS990ScheduleD/Equipment/BookValue0338536
IRS990ScheduleD/Equipment/Depreciation0108632
IRS990ScheduleD/Equipment/OtherCostOrOtherBasis0447168
IRS990ScheduleD/ExcessOrDeficitForYear0-771025
IRS990ScheduleD/ExcessOrDeficitPerFS0-771025
IRS990ScheduleD/ExpensesNotRptdF99000
IRS990ScheduleD/ExpensesNotRptdOnFinStmt00
IRS990ScheduleD/ExpensesSubtotal03800588
IRS990ScheduleD/LeaseholdImprovements/BookValue05081
IRS990ScheduleD/LeaseholdImprovements/Depreciation0619
IRS990ScheduleD/LeaseholdImprovements/OtherCostOrOtherBasis05700
IRS990ScheduleD/OtherAssets/BookValue0529496
IRS990ScheduleD/OtherAssets/Description0OTHER RECEIVABLES
IRS990ScheduleD/OtherLiabilities/Amount0190207
IRS990ScheduleD/OtherLiabilities/Amount11352
IRS990ScheduleD/OtherLiabilities/Amount21370470
IRS990ScheduleD/OtherLiabilities/Description0DUE TO RHI
IRS990ScheduleD/OtherLiabilities/Description1DUE TO RHI
IRS990ScheduleD/OtherLiabilities/Description2INVESTMENT BY rhi
IRS990ScheduleD/RevenueNotRptdF99000
IRS990ScheduleD/RevenueNotRptdOnFinStmt00
IRS990ScheduleD/RevenueSubtotal03029563
IRS990ScheduleD/TotalAdjustments00
IRS990ScheduleD/TotalBookValueOtherAssets0529496
IRS990ScheduleD/TotalExpenses03800588
IRS990ScheduleD/TotalExpensesPerForm99003800588
IRS990ScheduleD/TotalOfAmounts01562029
IRS990ScheduleD/TotalOfBookValueLandBuildings0343617
IRS990ScheduleD/TotalRevenue03029563
IRS990ScheduleD/TotalRevenuePerForm99003029563
IRS990ScheduleD/TotExpensesEtcAuditedFinclStmt03800588
IRS990ScheduleD/TotRevenueEtcAuditedFinclStmt03029563
IRS990ScheduleJ/AnyNonFixedPayments00
IRS990ScheduleJ/CompBasedNetEarningsFilingOrg00
IRS990ScheduleJ/CompBasedNetEarningsRelateOrgs00
IRS990ScheduleJ/CompBasedOnRevenueOfFilingOrg00
IRS990ScheduleJ/CompBasedOnRevenueRelatedOrgs00
IRS990ScheduleJ/EquityBasedCompArrangement00
IRS990ScheduleJ/Form990ScheduleJPartII/BaseCompensationFilingOrg00
IRS990ScheduleJ/Form990ScheduleJPartII/BaseCompensationFilingOrg10
IRS990ScheduleJ/Form990ScheduleJPartII/BaseCompensationFilingOrg2247928
IRS990ScheduleJ/Form990ScheduleJPartII/BonusFilingOrg00
IRS990ScheduleJ/Form990ScheduleJPartII/BonusFilingOrg10
IRS990ScheduleJ/Form990ScheduleJPartII/BonusFilingOrg254999
IRS990ScheduleJ/Form990ScheduleJPartII/BonusRelatedOrgs020000
IRS990ScheduleJ/Form990ScheduleJPartII/BonusRelatedOrgs148643
IRS990ScheduleJ/Form990ScheduleJPartII/BonusRelatedOrgs20
IRS990ScheduleJ/Form990ScheduleJPartII/CompBasedOnRelatedOrgs0180478
IRS990ScheduleJ/Form990ScheduleJPartII/CompBasedOnRelatedOrgs1264607
IRS990ScheduleJ/Form990ScheduleJPartII/CompBasedOnRelatedOrgs20
IRS990ScheduleJ/Form990ScheduleJPartII/CompReportPrior990FilingOrg00
IRS990ScheduleJ/Form990ScheduleJPartII/CompReportPrior990FilingOrg10
IRS990ScheduleJ/Form990ScheduleJPartII/CompReportPrior990FilingOrg20
IRS990ScheduleJ/Form990ScheduleJPartII/CompReportPrior990RelatedOrgs00
IRS990ScheduleJ/Form990ScheduleJPartII/CompReportPrior990RelatedOrgs10
IRS990ScheduleJ/Form990ScheduleJPartII/CompReportPrior990RelatedOrgs20
IRS990ScheduleJ/Form990ScheduleJPartII/DeferredCompFilingOrg00
IRS990ScheduleJ/Form990ScheduleJPartII/DeferredCompFilingOrg10
IRS990ScheduleJ/Form990ScheduleJPartII/DeferredCompFilingOrg20
IRS990ScheduleJ/Form990ScheduleJPartII/DeferredCompRelatedOrgs024410
IRS990ScheduleJ/Form990ScheduleJPartII/DeferredCompRelatedOrgs151161
IRS990ScheduleJ/Form990ScheduleJPartII/DeferredCompRelatedOrgs20
IRS990ScheduleJ/Form990ScheduleJPartIII/Explanation0SEVERAL OFFICERS OF RANDOLPH SPECIALTY GROUP PRACTICE ARE COMPENSATED BY A RELATED TAX-EXEMPT ENTITY, RANDOLPH HOSPITAL, INC. SAID OFFICERS ARE ALLOWED REIMBURSEMENTS FOR HEALTH AND/OR SOCIAL CLUB DUES. RANDOLPH HOSPITAL, INC. HAS A WRITTEN REIMBURSEMENT POLICY AND DOES REQUIRE SUBSTANTIATION BEFORE ISSUING ANY REIMBURSEMENTS. ADDITIONALLY, OFFICER'S COMPENSATION AMOUNTS ARE DETERMINED USING A VARIETY OF SOURCES INCLUDING; FORM 990 OF SIMILAR ORGANIZATIONS, COMPENSATION SURVEYS AND STATISTICS, AN INDEPENDENT CONSULTANT, AND A COMPENSATION COMMITTEE. ONCE A COMPENSATION PACKAGE IS APPROVED BY THE BOARD OF DIRECTORS, A WRITTEN EMPLOYMENT CONTRACT IS DRAFTED AND SIGNED BY THE APPLICABLE PARTIES. CERTAIN INDIVIDUALS ARE ALLOWED TO PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. A DESCRIPTION OF THIS PLAN IS LISTED BELOW. THE AMOUNTS REPRESENTED AS DEFERRED COMPENSATION ON SCHEDULE J HAVE NOT BEEN PAID TO THE INDIVIDUALS. THE NUMBER REPRESENTS VESTED BENEFITS WHICH MAY BE PAID IN FUTURE YEARS, DEPENDING ON THE INDIVIDUAL'S LIFE SPAN AND OTHER FACTORS WHICH COULD RESULT IN FORFEITURE OF THE BENEFIT. DURING 1998, RANDOLPH HOSPITAL (A RELATED ORGANIZATION) ESTABLISHED SUPPLEMENTAL PLANS TO COVER HIGHLY COMPENSATED EMPLOYEES. THESE PLANS INCLUDED A NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN, A DEFERRED COMPENSATION PLAN, AND A SPLIT-DOLLAR LIFE INSURANCE PLAN. THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN PROVIDES ADDITIONAL BENEFITS TO SUPPLEMENT BENEFITS EARNED UNDER THE DEFINED BENEFIT PENSION PLAN. IN 2005, THE HOSPITAL INSTITUTED A NONQUALIFIED DEFERRED COMPENSATION PLAN. THE PURPOSE OF THIS PLAN IS TO PROVIDE ADDITIONAL RETENTION INCENTIVES AND RETIREMENT SECURITY FOR CERTAIN MEMBERS OF THE HOSPITAL'S SENIOR MANAGEMENT TEAM AND TO ALLOW FOR THE DEFERRAL OF COMPENSATION OF THOSE ELIGIBLE MEMBERS OF ITS SENIOR MANAGEMENT. THIS IS INTENDED TO BE A NONQUALIFIED PLAN. THE SPLIT-DOLLAR LIFE INSURANCE AGREEMENT INVOLVES THE PAYMENT OF PREMIUMS BY THE HOSPITAL FOR A LIFE INSURANCE POLICY, THE BENEFITS OF WHICH ARE SPLIT BETWEEN THE EMPLOYEES' BENEFICIARIES AND THE HOSPITAL UP TO THE AMOUNT OF PREMIUMS PAID. PREMIUMS PAID UNDER THIS PLAN WILL CONTINUE UNTIL THE AGREEMENT IS TERMINATED OR UPON THE DEATH OF THE INSURED EMPLOYEES. DISTRIBUTIONS FOR THE NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN FOR THE YEAR TOTALED $653,901. FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010, THE HOSPITAL CONTRIBUTED APPROXIMATELY $654,000. STEVE EBLIN RECEIVED A PAYOUT ON THE NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN FOR THE YEAR IN THE AMOUNT OF $80,053. THE BENEFIT OBLIGATION IS RECORDED IN OTHER LONG-TERM LIABILITIES. PREMIUMS PAID UNDER THE SPLIT-DOLLAR INSURANCE POLICY WERE $9,822 FOR THE FISCAL YEAR. SCHEDULE J, PART II: WE ARE REQUIRED TO REPORT COMPENSATION OF KEY INDIVIDUALS THAT WORK FOR AND ARE PAID BY A RELATED ORGANIZATION. COMPENSATION REPORTED ON THIS SCHEDULE DOES NOT NECESSARILY MEAN THAT THE COMPENSATION WAS PAID BY THIS ORGANIZATION.
IRS990ScheduleJ/Form990ScheduleJPartIII/Identifier0Supplemental Information
IRS990ScheduleJ/Form990ScheduleJPartIII/ReturnReference0Part III
IRS990ScheduleJ/Form990ScheduleJPartII/NameBusiness/BusinessNameLine10STEVE EBLIN
IRS990ScheduleJ/Form990ScheduleJPartII/NameBusiness/BusinessNameLine11ROBERT MORRISON
IRS990ScheduleJ/Form990ScheduleJPartII/NameBusiness/BusinessNameLine12CHARLES WEST
IRS990ScheduleJ/Form990ScheduleJPartII/NontaxableBenefitsFilingOrg00
IRS990ScheduleJ/Form990ScheduleJPartII/NontaxableBenefitsFilingOrg10
IRS990ScheduleJ/Form990ScheduleJPartII/NontaxableBenefitsFilingOrg23043
IRS990ScheduleJ/Form990ScheduleJPartII/NontaxableBenefitsRelatedOrgs011768
IRS990ScheduleJ/Form990ScheduleJPartII/NontaxableBenefitsRelatedOrgs134315
IRS990ScheduleJ/Form990ScheduleJPartII/NontaxableBenefitsRelatedOrgs20
IRS990ScheduleJ/Form990ScheduleJPartII/OtherCompensationFilingOrg00
IRS990ScheduleJ/Form990ScheduleJPartII/OtherCompensationFilingOrg10
IRS990ScheduleJ/Form990ScheduleJPartII/OtherCompensationFilingOrg20
IRS990ScheduleJ/Form990ScheduleJPartII/OtherCompensationRelatedOrgs080053
IRS990ScheduleJ/Form990ScheduleJPartII/OtherCompensationRelatedOrgs10
IRS990ScheduleJ/Form990ScheduleJPartII/OtherCompensationRelatedOrgs20
IRS990ScheduleJ/Form990ScheduleJPartII/TotalCompensationFilingOrg00
IRS990ScheduleJ/Form990ScheduleJPartII/TotalCompensationFilingOrg10
IRS990ScheduleJ/Form990ScheduleJPartII/TotalCompensationFilingOrg2305970
IRS990ScheduleJ/Form990ScheduleJPartII/TotalCompensationRelatedOrgs0316709
IRS990ScheduleJ/Form990ScheduleJPartII/TotalCompensationRelatedOrgs1398726
IRS990ScheduleJ/Form990ScheduleJPartII/TotalCompensationRelatedOrgs20
IRS990ScheduleJ/InitialContractException00
IRS990/ScheduleJRequired01
IRS990ScheduleJ/SeverancePayment00
IRS990ScheduleJ/SupplementalNonqualRetirePlan01
IRS990ScheduleO/GeneralExplanation/Explanation0THE CORPORATION IS A MEMBERSHIP CORPORATION, WITH RANDOLPH HOSPITAL, INC. AS THE SOLE MEMBER.
IRS990ScheduleO/GeneralExplanation/Explanation1THE BOARD OF DIRECTORS IS ELECTED BY THE AFFIRMATIVE VOTE OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER, RANDOLPH HOSPITAL, INC.
IRS990ScheduleO/GeneralExplanation/Explanation2THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. UPON COMPLETION, THE RETURN WAS REVIEWED BY THE FINANCE, AUDIT, INVESTMENT, AND RETIREMENT COMMITTEE OF THE BOARD. ALL OTHER BOARD MEMBERS ARE INVITED. ANYONE NOT AT THE MEETING WAS GIVEN A COPY OF THE RETURN AND INVITED TO ASK QUESTIONS BEFORE FILING THE RETURN WITH THE IRS.
IRS990ScheduleO/GeneralExplanation/Explanation3THE ORGANIZATION SHARES WITH RANDOLPH HOSPITAL A FULL TIME CORPORATE COMPLIANCE OFFICER CHARGED WITH EDUCATING THE BOARD, OFFICERS, AND OTHER EMPLOYEES ON THE CONFLICT OF INTEREST POLICY. ALL NEW EMPLOYEES ARE GIVEN INFORMATION UPON ORIENTATION, AND ALL CURRENT EMPLOYEES ARE REQUIRED TO TAKE ANNUAL EDUCATION ON COPMLIANCE WITH THE POLICY. THERE IS A MONTHLY CORPORATE COMPLIANCE MEETING TO UPDATE KEY INDIVIDUALS ON NEW ISSUES AND NEW INFORMATION REGARDING CORPORATE COMPLIANCE. THE BOARD OF DIRECTORS IS REQUIRED ANNUALLY TO READ, SIGN, AND REMIT A COPY OF THE POLICY TO THE BOARD CHAIR. ALL BOARD MEMBERS ARE AWARE OF THE POLICY AND IN CASE OF ANY CONFLICT OF INTEREST, THEY WILL RECUSE THEMSELVES.
IRS990ScheduleO/GeneralExplanation/Explanation4THE ORGANIZATION DOES NOT COMPENSATE ANY EXECUTIVE OFFICER OR KEY EMPLOYEE.
IRS990ScheduleO/GeneralExplanation/Explanation5PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG.
IRS990ScheduleO/GeneralExplanation/Explanation6PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE.
IRS990ScheduleO/GeneralExplanation/Identifier0Form 990, Part VI, Section A, line 6
IRS990ScheduleO/GeneralExplanation/Identifier1Form 990, Part VI, Section A, line 7a
IRS990ScheduleO/GeneralExplanation/Identifier2Form 990, Part VI, Section B, line 11
IRS990ScheduleO/GeneralExplanation/Identifier3Form 990, Part VI, Section B, line 12c
IRS990ScheduleO/GeneralExplanation/Identifier4Form 990, Part VI, Section C, line 18
IRS990ScheduleO/GeneralExplanation/Identifier5Form 990, Part VI, Section C, line 19
IRS990/ScheduleORequired01
IRS990ScheduleR/ExchangeOfAssets00
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/AddressLine10PO BOX 1048
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/AddressLine11346 WHITE OAK STREET
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/AddressLine12132 WEST MILLER STREET
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/AddressLine13364 WHITE OAK STREET
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/City0ASHEBORO
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/City1ASHEBORO
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/City2ASHEBORO
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/City3ASHEBORO
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/State0NC
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/State1NC
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/State2NC
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/State3NC
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/ZIPCode027204
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/ZIPCode127204
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/ZIPCode227204
IRS990ScheduleR/Form990ScheduleRPartII/AddressUS/ZIPCode327204
IRS990ScheduleR/Form990ScheduleRPartII/DirectControllingEntityNA0N/A
IRS990ScheduleR/Form990ScheduleRPartII/DirectControllingEntityNA1N/A
IRS990ScheduleR/Form990ScheduleRPartII/DirectControllingEntityNA2N/A
IRS990ScheduleR/Form990ScheduleRPartII/DirectControllingEntityNA3N/A
IRS990ScheduleR/Form990ScheduleRPartII/EIN0560530234
IRS990ScheduleR/Form990ScheduleRPartII/EIN1582240755
IRS990ScheduleR/Form990ScheduleRPartII/EIN2561853201
IRS990ScheduleR/Form990ScheduleRPartII/EIN3562181482
IRS990ScheduleR/Form990ScheduleRPartII/ExemptCodeSection0501(c)(3)
IRS990ScheduleR/Form990ScheduleRPartII/ExemptCodeSection1501(c)(3)
IRS990ScheduleR/Form990ScheduleRPartII/ExemptCodeSection2501(c)(3)
IRS990ScheduleR/Form990ScheduleRPartII/ExemptCodeSection3501(c)(3)
IRS990ScheduleR/Form990ScheduleRPartIII/AddressUS/AddressLine1011221 ROE AVE SUITE 320
IRS990ScheduleR/Form990ScheduleRPartIII/AddressUS/City0LEAWOOD
IRS990ScheduleR/Form990ScheduleRPartIII/AddressUS/State0KS
IRS990ScheduleR/Form990ScheduleRPartIII/AddressUS/ZIPCode066211
IRS990ScheduleR/Form990ScheduleRPartIII/DirectControllingEntityNA0N/A
IRS990ScheduleR/Form990ScheduleRPartIII/EIN0264317497
IRS990ScheduleR/Form990ScheduleRPartIII/LegalDomicileState0KS
IRS990ScheduleR/Form990ScheduleRPartIII/NameOfRelatedOrg/BusinessNameLine10CENTRAL PIEDMONT SURGERY CENTER LLC
IRS990ScheduleR/Form990ScheduleRPartIII/PrimaryActivity0HEALTHCARE

Document Assets

No mirrored PDF or thumbnail assets are attached yet.

Filings

Displayed year

2010 • Form 990Facts available. Structured filing facts are available, but richer extracted sections are limited.

Open filing
Assets
$1,618,463
Liabilities
$2,528,899
Net assets
-$910,436
Revenue
-
Expenses
$3,800,588
Net income
-
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2021Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.00$0.00$0.00$17.4$20.2$2.80
2020Import issue. A filing source exists for this year, but detailed import did not complete cleanly.$3.67$26.2$22.6$20.7$23.7$3.03
2019Facts available. Structured filing facts are available, but richer extracted sections are limited.$3.42$23.0$19.5$21.1$24.4$3.26
2018XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$4.37$20.7$16.3$19.6$23.2$3.62
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$4.81$17.5$12.7$20.2$23.3$3.11
2016XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$5.56$15.1$9.55$20.5$22.9$2.36
2015XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$6.03$13.2$7.19$20.2$21.7$1.44
2014Detailed filing. Detailed filing data is available for this year.$3.86$8.23$4.37$10.8$11.8$1.01
2013Import issue. A filing source exists for this year, but detailed import did not complete cleanly.$3.28$6.63$3.36$8.96$9.98$1.02
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$3.03$5.40$2.37$6.57
2011Summary only. Only limited summary data is available for this year.$1.49$3.34$1.86$4.87$5.81$0.95
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$1.62$2.53$0.91$3.80