CHS Healthcare Foundation Inc: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- CHS Healthcare Foundation Inc (EIN 26-0229508)
- Tax period
- 2020-04-01 to 2021-03-31
- Filed
- 2022-05-13
- IRS object ID
- 202201339349306850
- Schema version
- 2020v4.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule L
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-13T14:49:54-04:00 | ReturnTs |
| Tax Period End | 2021-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 260254161 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tuscan & Company PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12621 World Plaza Lane Bldg 55 | AddressLine1Txt |
| City | Fort Myers | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33907 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 260229508 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHS Healthcare Foundation Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHSH | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1454 Madison Ave | AddressLine1Txt |
| City | Immokalee | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 34142 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dennis Brown | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 2396583000 | PhoneNum |
| Signature | 2021-07-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Dennis | PersonFirstNm |
| Person Last | Brown | PersonLastNm |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jeffrey M Tuscan CPA | PreparerPersonNm |
| PTIN | P00184439 | PTIN |
| Phone | 2393332090 | PhoneNum |
| Preparation | 2022-05-13 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| OOB Security Verification | 00 | OOBSecurityVerificationCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Final Return | Yes (X) | FinalReturnInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Healthcare Network | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $201,970 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.healthcareswfl.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | To support the programs and services of Healthcare Network (HCN) to enable HCN to meet its mission to provide a quality healthcare home accessible to everyone in its community. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 0 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,140,528 | PYContributionsGrantsAmt |
| CY Contributions Grants | $201,970 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,140,528 | PYTotalRevenueAmt |
| CY Total Revenue | $201,970 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,067,458 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $102,915 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $47,898 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $82,838 | PYOtherExpensesAmt |
| CY Other Expenses | $47,898 | CYOtherExpensesAmt |
| PY Total Expenses | $2,150,296 | PYTotalExpensesAmt |
| CY Total Expenses | $150,813 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$9,768 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $51,157 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $654,019 | TotalAssetsBOYAmt |
| Total Assets EOY | $0 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $40,875 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $613,144 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To support the programs and services of Healthcare Network (HCN) to enable HCN to meet its mission to provide a quality healthcare home accessible to everyone in its community. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | Yes (true) | SignificantChangeInd |
| Expense | $102,915 | ExpenseAmt |
| Grant | $102,915 | GrantAmt |
| Desc | See attached PDF. | Desc |
| Total Program Service Expenses | $102,915 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (true) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | Yes (true) | TerminateOperationsInd |
| Partial Liquidation | Yes (true) | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Employment Tax Returns Filed | false | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 0 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | The Organization | PersonNm |
| Phone | 2396583000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1454 Madison Ave | AddressLine1Txt |
| City | Immokalee | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 34142 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| Lou Traina | |||||||
| VP of Philantropy | 40.00 | 0.00 | Yes (X) | $0 | $105,089 | $5,283 | |
| Steve Wheeler | |||||||
| VP Development | 40.00 | 0.00 | Yes (X) | $0 | $10,938 | $5,287 | |
| Charles Johns | |||||||
| Trustee | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Gail Webster | |||||||
| Trustee | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Edward Morton | |||||||
| Trustee | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Cee Cee Marinelli | |||||||
| Trustee | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Pat Read Botthof | |||||||
| Trustee | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Jeff Fridkin | |||||||
| Trustee | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Richard Craven | |||||||
| Trustee | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Nina Gray | |||||||
| Trustee | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Haris Domond | |||||||
| Trustee | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| J Doug Campbell | |||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Dennis Brown | |||||||
| TrusteeTreasurer | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Fred Pezeshkan | |||||||
| TrusteeChair | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Adria Starkey | |||||||
| TrusteeVice Chair | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $116,027 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $10,570 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| All Other Contributions | $201,970 | AllOtherContributionsAmt |
| Total Contributions | $201,970 | TotalContributionsAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $201,970 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,915 | TotalAmt |
| Program Services | $102,915 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,217 | TotalAmt |
| Fundraising | $12,217 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | FundraisingFundraisingAmt |
|---|---|---|
| Other | $35,562 | $35,562 |
| Interest and bank fees | $44 | $44 |
| Bad debt | $25 | $25 |
| Supplies | $50 | $50 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,813 | TotalAmt |
| Program Services | $102,915 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $47,898 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $304,374 | BOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $234,949 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,696 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $654,019 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,875 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,875 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $613,144 | BOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $613,144 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $654,019 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $51,157 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$664,301 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,401,410 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,052,841 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $917,373 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,140,528 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $201,970 | CurrentTaxYearAmt |
| Total | $5,714,122 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,401,410 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,052,841 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $917,373 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,140,528 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $201,970 | CurrentTaxYearAmt |
| Total | $5,714,122 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $485,562 | SubstantialContributorsTotAmt |
| Public Support Total170 | $5,228,560 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $897 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,870 | CurrentTaxYearMinus3YearsAmt |
| Total | $7,767 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $5,721,889 | TotalSupportAmt |
| Public Support CY170 | 0.91380 | PublicSupportCY170Pct |
| Public Support PY170 | 0.94900 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Accrued liabilities | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $316,883 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $114,913 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $114,913 | RevenueNotReportedAmt |
| Revenue Subtotal | $201,970 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $201,970 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $265,726 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $114,913 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $114,913 | ExpensesNotReportedAmt |
| Expenses Subtotal | $150,813 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $150,813 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Footnote for uncertain tax position under FIN 48 (Part X) | FormAndLineReferenceDesc |
| Explanation | The Financial Accounting Standards Board has issued guidance on accounting for uncertainty in income taxes and the Organization has adopted this guidance. The Organization has evaluated its tax positions and any estimates utilized in its tax returns, and concluded that it has taken no uncertain tax positions that require adjustment to the consolidated financial statements to comply with the provisions of this guidance. Interest and penalties associated with uncertain tax positions will be recognized in income tax expense, if required. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Healthcare Network | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1454 Madison Ave | AddressLine1Txt |
| City | Immokalee | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 34142 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 591741277 | RecipientEIN |
| IRC Section | 501c3 | IRCSectionDesc |
| Cash Grant | $31,177 | CashGrantAmt |
| Purpose Of Grant | Healthcare | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Monitoring procedures (Part I, line 2) | FormAndLineReferenceDesc |
| Explanation | The Foundation maintains records for all grants or assistance provided to organizations and ensures that the organization meets any applicable conditions before distributing funds. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|
| J Douglas Campbell | ||
| Trustee | see below | false |
| Adria Starkey | ||
| TrusteeVice Chair | see below | false |
| Haris Domond | ||
| Trustee | see below | false |
| Dennis Brown | ||
| TrusteeTreasurer | see below | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Supplemental Information for Schedule L | FormAndLineReferenceDesc |
| Explanation | J. Douglas Campbell was a member of the Board of Directors for both CHS Healthcare Foundation and Healthcare Network (HCN) during the fiscal year. HCN received $31,177 in grants from CHS Healthcare Foundation and an equity transfer of $664,301. Dennis Brown was a member of the Board of Directors for both CHS Healthcare Foundation and Healthcare Network (HCN) during the fiscal year. HCN received $31,177 in grants from CHS Healthcare Foundation and an equity transfer of $664,301. Haris Domond was a member of the Board of Directors for both CHS Healthcare Foundation and Healthcare Network (HCN) during the fiscal year. HCN received $31,177 in grants from CHS Healthcare Foundation and an equity transfer of $664,301. Adria Starkey was a member of the Board of Directors for CHS Healthcare Foundation. She is married to Jerry Starkey who was on the Board of Directors for Healthcare Network (HCN) during the fiscal year. HCN received $31,177 in grants from CHS Healthcare Foundation and an equity transfer of $664,301. | ExplanationTxt |
Schedule N IRS990ScheduleN
Liquidation Of Assets Table LiquidationOfAssetsTableGrp
Liquidation Of Assets Detail LiquidationOfAssetsDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | Dissolution | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2020-12-31 | DistributionDt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 governing body review Part VI line 11 | Governing board reviews Form 990. The CFO approves the 990 to be filed. |
| Conflict of interest policy compliance Part VI line 12c | Enforcement of policies include references to conflict of interest policy and procurement by contracting staff monitors transactions closely for compliance. |
| CEO executive director top management comp Part VI line 15a | An independent compensation consultants services are utilized to review salaries. |
| Other officer or key employee compensation Part VI line 15b | An independent compensation consultants services are utilized to review salaries. |
| Governing documents etc available to public Part VI line 19 | Financial statements are available on website. All others are available upon request. |
| Cessation of or significant change to any program service Part III line 3 | The Foundation was officially dissolved on December 22, 2020. |
| Explanation of other changes in net assets or fund balances Part XI line 9 | The Foundation ceased operations on December 22,2020 and as a result transfered all its equity of $664,301 to Collier Health Services, Inc. |
| General explanation attachment | On Form 990, Part VII, Section A there are 13 Directors listed, however, on Part I Line 3/4 and Part VI Section A Line 1a/1b there are none listed as those lines specifically report the total voting and independent members at year end. The Organization ceased operations prior to year end on December 22, 2020. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Healthcare Network | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1454 Madison Avenue | AddressLine1Txt |
| City | Immokalee | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 34142 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 591741277 | EIN |
| Primary Activities | Medical Care | PrimaryActivitiesTxt |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Exempt Code Section | 501c3 | ExemptCodeSectionTxt |
| Public Charity Status | 7 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
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