Instrumentl eFile Render
Object ID: 202113169349304376 - Rendered 2024-10-22
TIN: 04-3722352
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
20
Open to Public Inspection
Name of the organization
VIRTUA HEALTH FOUNDATION INC
Employer identification number
04-3722352
Part I
Identification of Disregarded Entities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
Part II
Identification of Related Tax-Exempt Organizations.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
VIRTUA HEALTH INC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
22-3524939
SUPPORTING ORGANIZATION
NJ
501 (C) (3)
12A
N/A
No
(2)
VIRTUA - MEMORIAL HOSPITAL BURLINGTON COUNTY INC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
21-0634562
GENERAL ACUTE CARE HOSPITALS
NJ
501 (C) (3)
3
VIRTUA HEALTH INC
No
(3)
VIRTUA - WEST JERSEY HEALTH SYSTEM INC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
21-0634532
GENERAL ACUTE CARE HOSPITALS
NJ
501 (C) (3)
3
VIRTUA HEALTH INC
No
(4)
VIRTUA SURGICAL GROUP PA
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
22-2580215
SURGICAL PHYSICIAN PRACTICE
NJ
501 (C) (3)
10
N/A
No
(5)
VIRTUA HEALTH AND REHABILITATION CENTER AT BERLIN INC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
80853
22-3554707
REHABILITATION CENTER AND NURSING HOME
NJ
501 (C) (3)
10
VIRTUA HEALTH INC
No
(6)
VIRTUA HEALTH AND REHABILITATION CENTER AT MOUNT HOLLY INC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
22-2394675
REHABILITATION CENTER AND NURSING HOME
NJ
501 (C) (3)
10
VIRTUA HEALTH INC
No
(7)
VIRTUA HOME CARE - COMMUNITY NURSING SERVICES INC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
21-0679591
HOME CARE
NJ
501 (C) (3)
10
VIRTUA HEALTH INC
No
(8)
SUMMIT HEALTH - VIRTUA INC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
52-1814579
HEALTH AND WELLNESS SERVICES
NJ
501 (C) (3)
3
VIRTUA HEALTH INC
No
(9)
WEST JERSEY RENEW INC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
22-3580917
LOW INCOME HOUSING
NJ
501 (C) (3)
10
VIRTUA HEALTH INC
No
(10)
MEMORIAL HOSPITAL OF BURLINGTON COUNTY FOUNDATION INC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
22-2337170
FUND RAISING FOUNDATION
NJ
501 (C) (3)
7
VIRTUA HEALTH INC
No
(11)
WEST JERSEY HEALTH & HOSPITAL FOUNDATION INC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
23-7414388
FUND RAISING FOUNDATION
NJ
501 (C) (3)
7
VIRTUA HEALTH INC
No
(12)
VIRTUA MEDICAL GROUP PA
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
27-1348772
PHYSICIAN SERVICES
NJ
501 (C) (3)
10
N/A
No
(13)
WEST JERSEY HEALTH SYSTEM WORKERS COMP TRUST
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
22-3142739
WORKERS COMP TRUST
NJ
501 (C) (3)
12A
VIRTUA HEALTH INC
No
(14)
VIRTUA OUR LADY OF LOURDES HOSPITALINC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
21-0635001
GENERAL ACUTE CARE HOSPITALS
NJ
501 (C) (3)
3
OUR LADY OF LOURDES HEALTH CARE SERVICES
No
(15)
VIRTUA WILLINGBORO HOSPITALINC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
22-3612265
GENERAL ACUTE CARE HOSPITALS
NJ
501 (C) (3)
3
OUR LADY OF LOURDES HEALTH CARE SERVICES
No
(16)
LOURDES CARDIOLOGY SERVICES PC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
27-4357794
HEALTH CARE SERVICES
NJ
501 (C) (3)
3
N/A
No
(17)
OUR LADY OF LOURDES FOUNDATIONINC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
22-2351960
FUND RAISING FOUNDATION
NJ
501 (C) (3)
7
OUR LADY OF LOURDES HEALTH CARE SERVICES
No
(18)
LOURDES ANCILLARY SERVICES
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
22-2568525
HEALTH CARE SYSTEM SUPPORT
NJ
501 (C) (3)
12B
OUR LADY OF LOURDES HEALTH CARE SERVICES
No
(19)
OUR LADY OF LOURDES HEALTH CARE SERVICESINC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
22-2568528
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT
NJ
501 (C) (3)
12B
VIRTUA HEALTH INC
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
(1)
SOUTH JERSEY MUSCULOSKELETAL INSTITUTE LLC
556 EGG HARBOR ROAD
SEWELL
,
NJ
08080
20-4481032
SURGICAL CENTER
NJ
N/A
No
No
(2)
SUMMIT SURGICAL CENTER LLC
200 BOWMAN DRIVE SUITE D160
VOORHEES
,
NJ
08043
73-1730859
SURGICAL CENTER
NJ
N/A
No
No
(3)
AMBULATORY SURGERY CENTER AT VIRTUA WASHINGTON TOWNSHIP LLC
239 HURRFVILLE-CROSS KEYS RD STE 18
SEWELL
,
NJ
08080
20-8643005
SURGICAL CENTER
NJ
N/A
No
No
(4)
SHORE AMBULATORY SURGERY CENTER LLC
405 BETHEL ROAD
SOMERS POINT
,
NJ
08244
22-3778333
SURGICAL CENTER
NJ
N/A
No
No
(5)
ROCKLAND SURGICAL PROJECT LLC RAMAPO VALLEY SURGICAL CENTER
500 NORTH FRANKLIN TURNPIKE
RAMSEY
,
NJ
07446
20-0580403
SURGICAL CENTER
NJ
N/A
No
No
(6)
FREEHOLD ENDOSCOPY ASSOCIATES LLC
222 SCHANCK ROAD SUITE 100
FREEHOLD
,
NJ
07728
84-1634126
SURGICAL CENTER
NJ
N/A
No
No
(7)
CENTER FOR AMBULATORY AND MINIMALLY INVASIVE SURGERY LLC
234 INDUSTRIAL WAY BUILDING B
EATONTOWN
,
NJ
07724
27-0907140
SURGICAL CENTER
NJ
N/A
No
No
(8)
VIRTUA ADULT IMAGING SERVICES AT VOORHEES LLC
303 LIPPINCOTT DRIVE 4TH FLOOR
MARLTON
,
NJ
08053
46-4055781
IMAGING SERVICES
NJ
N/A
No
No
(9)
GASTRO-SURGI CENTER OF NJ LLC
1132 SPRUCE DRIVE
MOUNTAINSIDE
,
NJ
07092
22-3472632
SURGICAL CENTER
NJ
N/A
No
No
(10)
VOORHEES ENDOSCOPY HOLDING CO LLC
1A BURTON HILLS BLVD
NASHVILLE
,
TN
37215
47-4669710
MEDICAL
TN
N/A
No
No
(11)
VIRTUA PENN RADIATION ONCOLOGY PARTNERS LLC
200 BOWMAN DRIVE SUITE D190
VOORHEES
,
NJ
08043
82-1947444
RADIOLOGY SERVICES
NJ
N/A
No
No
(12)
VIRTUA PENN RADIATION ONCOLOGY LEASING LLC
303 LIPPINCOTT DR
MARLTON
,
NJ
08053
83-1438811
LEASING SERVICES
NJ
N/A
No
No
(13)
FRESENIUS MEDICAL CARE MARLTON LLC
920 WINTER STREET
WALTHAM
,
MA
02451
47-2128074
DIALYSIS
NJ
N/A
No
No
(14)
VANTAGE SURGICAL CENTER LLC
180 ROUTE 70
MEDFORD
,
NJ
08055
45-0516750
SURGICAL CENTER
NJ
N/A
No
No
(15)
MEMORIAL AMBULATORY SURGERY CENTER LLC
160 MADISON AVENUE
MT HOLLY
,
NJ
08060
20-4941260
SURGICAL CENTER
NJ
N/A
No
No
(16)
VIRTUA-SCA HOLDINGS LLC
569 BROOKWOOD VILLAGE SUITE 901
BIRMINGHAM
,
AL
35209
47-3247166
MEDICAL
AL
N/A
No
No
(17)
BURLINGTON CTY ENDO CTR LLC CO PHYSICIANS ENDOSCOPY LLC
2500 YORK ROAD SUITE 300
JAMISON
,
PA
18929
20-8205206
HEALTH CARE
NJ
N/A
No
No
(18)
VIRTUA-USP PRINCETON LLC
15305 DALLAS PKWY STE 1600 LB 28
ADDISON
,
TX
75001
81-3270494
MEDICAL
NJ
N/A
No
No
(19)
ACENTUS PRACTICE MANAGEMENT LLC
1040 N KINGS HIGHWAY STE 701
CHERRY HILL
,
NJ
08034
81-4861192
COLLECTIONS SERVICE
NJ
N/A
No
No
(20)
EMMAUS HOLDINGS LLC
569 BROOKWOOD VILLAGE SUITE 901
BIRMINGHAM
,
AL
35209
83-1806511
MEDICAL
AL
N/A
No
No
(21)
MT LAUREL ENDOSCOPY CENTER LP
15000 MIDLANTIC DR SUITE 110
MT LAUREL
,
NJ
08054
56-2350370
OUTPATIENT CARE CENTER
NJ
N/A
No
No
(22)
USRC GLOUCESTER LLC
5851 LEGACY CIRCLE SUITE 900
PLANO
,
TX
75024
38-4117029
MEDICAL
TX
N/A
No
No
(23)
LOURDES SPECIALTY HOSPITAL OF SOUTHERN NJ LLC
10735 DAVID TAYLOR DRIVE SUITE 200
CHARLOTTE
,
NC
28262
86-1139477
HEALTH CARE
NC
N/A
No
No
(24)
CENTENNIAL SURGUNIT LLC
502 CENTENNIAL BLVD SUITE 1
VOORHEES
,
NJ
08043
22-3580847
AMBULATORY HEALTH CARE SERVICES
NJ
N/A
No
No
(25)
SPECIALIZED SURGICAL CENTER OF CENTRAL NEW JERSEY LLC
562 EASTON AVE
SOMERSET
,
NJ
08873
22-3296144
SURGICAL CENTER
NJ
N/A
No
No
(26)
TYLER DIALYSIS LLC
C/O TAX DEPT PO BOX 4388
FEDERAL WAY
,
WA
98063
45-4079716
DIALYSIS
NJ
N/A
No
No
(27)
VIRTUA - SCA HOLDINGS II LLC
569 BROOKWOOD VILLAGE SUITE 901
BIRMINGHAM
,
AL
35209
85-2278858
MEDICAL
AL
N/A
No
No
(28)
RIVER DRIVE HOLDING COMPANY LLC
303 LIPPINCOTT DR FL 4TH
MARLTON
,
NJ
08053
84-3655618
MEDICAL
NJ
N/A
No
No
(29)
ACCESS HOLDING COMPANY LLC
2500 YORK ROAD SUITE 300
JAMISON
,
PA
18929
85-0718604
MEDICAL
PA
N/A
No
No
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
VIRTUA ASSURANCE
76 SAINT PAUL ST SUITE 500
BURLINGTON
,
VT
05401
20-3025606
CAPTIVE INSURANCE COMPANY
VT
N/A
C
No
(2)
VRI INC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
26-0247120
HEALTH AND WELLNESS
NJ
N/A
C
No
(3)
HEALTH MANAGEMENT SERVICES ORGANIZATION INC
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
22-3366580
MEDICAL ADMINISTRATION
NJ
N/A
C
No
(4)
LOURDES MEDICAL ASSOCIATES PA
303 LIPPINCOTT DR 4/FLR
MARLTON
,
NJ
08053
22-3361862
MEDICAL SERVICES
NJ
N/A
C
No
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page
3
Part V
Transactions With Related Organizations.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
No
e
Loans or loan guarantees by related organization(s)
............................
1e
No
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
Yes
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
No
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
Yes
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
No
p
Reimbursement paid to related organization(s) for expenses
............................
1p
Yes
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
No
s
Other transfer of cash or property from related organization(s)
............................
1s
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership.
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference
Explanation
Schedule R (Form 990) 2020
Additional Data
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