FLORIDA MEDICAL PRACTICE PLAN INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
FLORIDA MEDICAL PRACTICE PLAN INC (EIN 57-1234883)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-12
IRS object ID
202211329349306041
Schema version
2020v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-05-12T15:17:47-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN593204548PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1JAMES MOORE & CO PLBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12477 TIM GAMBLE PLACE SUITE 200AddressLine1Txt
CityTALLAHASSEECityNm
State AbbreviationFLStateAbbreviationCd
ZIP323084386ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN571234883EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FLORIDA MEDICAL PRACTICE PLAN INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFLORBusinessNameControlTxt
Phone8506452827PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11115 W CALL STAddressLine1Txt
CityTALLAHASSEECityNm
State AbbreviationFLStateAbbreviationCd
ZIP323043556ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN FOGARTY MDPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone8502247144PhoneNum
Signature2022-05-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJOHNPersonFirstNm
Person LastFOGARTY MDPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKEVIN WARRENPreparerPersonNm
PTINP00642409PTIN
Phone8503866184PhoneNum
Preparation2022-05-12PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJOHN FOGARTY MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11115 W CALL STAddressLine1Txt
CityTALLAHASSEECityNm
State AbbreviationFLStateAbbreviationCd
ZIP323043556ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$9,443,720GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MED.FSU.EDU/FMPPWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2006FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionTHE PURPOSES OF FLORIDA MEDICAL PRACTICE PLAN ARE TO: 1) FURTHER THE EDUCATION, SERVICE, AND RESEARCH MISSIONS OF THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE, A COMPONENT OF THE FLORIDA STATE UNIVERSITY BOARD OF TRUSTEES; AND 2) ENABLE FACULTY TO MAINTAIN CLINICAL COMPETENCE, FULFILL CERTIFICATION REQUIREMENTS, SHARE EXPERTISE WITH OTHER HEALTH CARE PROVIDERS, AND SERVE AS CLINICAL TEACHERS FOR STUDENTS AND RESIDENT PHYSICIANS.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$7,486,569PYProgramServiceRevenueAmt
CY Program Service Revenue$8,675,873CYProgramServiceRevenueAmt
PY Investment Income$139,113PYInvestmentIncomeAmt
CY Investment Income$767,847CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$7,625,682PYTotalRevenueAmt
CY Total Revenue$9,443,720CYTotalRevenueAmt
PY Grants And Similar Paid$239,473PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$218,268CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,124,366PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,348,769CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,609,488PYOtherExpensesAmt
CY Other Expenses$1,746,882CYOtherExpensesAmt
PY Total Expenses$7,973,327PYTotalExpensesAmt
CY Total Expenses$9,313,919CYTotalExpensesAmt
PY Revenues Less Expenses-$347,645PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$129,801CYRevenuesLessExpensesAmt
Total Assets BOY$6,439,041TotalAssetsBOYAmt
Total Assets EOY$6,356,277TotalAssetsEOYAmt
Total Liabilities BOY$3,306,300TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,093,735TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,132,741NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,262,542NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE PURPOSES OF FLORIDA MEDICAL PRACTICE PLAN ARE TO: 1) FURTHER THE EDUCATION, SERVICE, AND RESEARCH MISSIONS OF THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE, A COMPONENT OF THE FLORIDA STATE UNIVERSITY BOARD OF TRUSTEES; AND 2) ENABLE FACULTY TO MAINTAIN CLINICAL COMPETENCE, FULFILL CERTIFICATION REQUIREMENTS, SHARE EXPERTISE WITH OTHER HEALTH CARE PROVIDERS, AND SERVE AS CLINICAL TEACHERS FOR STUDENTS AND RESIDENT PHYSICIANS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$9,213,935ExpenseAmt
Grant$218,268GrantAmt
Revenue$8,675,873RevenueAmt
DescPERFORMED PROFESSIONAL SERVICES IN SUPPORT OF: 1) AN AFFILIATION AGREEMENT WITH A HOSPITAL FOR GRADUATE MEDICAL EDUCATION PROGRAMS, AND 2) AGREEMENTS WITH HEALTH DEPARTMENTS, CLINICS, AND OTHER FOR PATIENT CARE.Desc
Total Program Service Expenses$9,213,935TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign ActivitiesYes (1)ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document13IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DAWN SNYDERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8506445024PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11115 WEST CALL STREETAddressLine1Txt
CityTALLAHASSEECityNm
State AbbreviationFLStateAbbreviationCd
ZIP32306ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JOHN FOGARTY MD
PRESIDENT2.0040.00Yes (X)Yes (X)$0$439,819$44,212
DANIEL VAN DURME MD
VICE PRESIDENT1.0040.00Yes (X)Yes (X)$0$327,948$46,307
JONATHAN APPELBAUM MD
TREASURER1.0040.00Yes (X)Yes (X)$0$322,473$43,909
ALMA LITTLES MD
SECRETARY1.0040.00Yes (X)Yes (X)$0$327,964$43,922
PAUL KATZ MD
DIRECTOR1.0040.00Yes (X)$0$318,192$43,901
JOEDRECKA BROWN SPEIGHTS MD
DIRECTOR1.0040.00Yes (X)$0$310,762$35,480
RICHARD NOWAKOWSKI PHD
DIRECTOR1.0040.00Yes (X)$0$272,937$34,084
JAMES ZEDAKER MPAS PA-C DFAAPA
DIRECTOR1.0040.00Yes (X)$0$222,821$36,423
JOAN MEEK MD MS
DIRECTOR1.0040.00Yes (X)$0$262,317$32,470
LESLIE BEITSCH MD JD
DIRECTOR1.0040.00Yes (X)$0$296,566$65,904
KYLE CLARK MBA
DIRECTOR0.5040.00Yes (X)$0$431,318$45,985
SALLIE MCRORIE PHD
DIRECTOR0.5040.00Yes (X)$0$476,750$47,398
HEATHER FLYNN PHD
DIRECTOR1.0040.00Yes (X)$0$237,848$29,221
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,247,715TotReportableCompRltdOrgAmt
Total Other Compensation$549,216TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

FieldValueIRS element (for citing)
PersonMARY TERRY MEEKPersonNm

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line13244 ARBOR HILL WAYAddressLine1Txt
CityTALLAHASSEECityNm
State AbbreviationFLStateAbbreviationCd
ZIP32309ZIPCd
FieldValueIRS element (for citing)
ServicesCFMSDServicesDesc
Compensation$189,370CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CLINICAL REVENUE624100$8,287,099$8,287,099
MEDICAID REVENUE624100$388,774$388,774
FieldValueIRS element (for citing)
Total Program Service Revenue$8,675,873TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$767,847TotalRevenueColumnAmt
Exclusion$767,847ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,443,720TotalRevenueColumnAmt
Related Or Exempt Func Income$8,675,873RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$767,847ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$218,268TotalAmt
Program Services$218,268ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,775,801TotalAmt
Program Services$5,775,801ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$438,536TotalAmt
Program Services$438,536ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$824,674TotalAmt
Program Services$824,674ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$309,758TotalAmt
Program Services$309,758ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$22,200TotalAmt
Management And General$22,200ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$313,639TotalAmt
Program Services$313,639ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,359TotalAmt
Management And General$2,359ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$75,425TotalAmt
Management And General$75,425ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$60,953TotalAmt
Program Services$60,953ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$88,510TotalAmt
Program Services$88,510ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$14,770TotalAmt
Program Services$14,770ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$639,414TotalAmt
Program Services$639,414ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
PROGRAM DEVELOPMENT$300,805$300,805
MEDICAL SUPPLIES$202,514$202,514
BANKING FEES$22,778$22,778
MEDICAL SERVICES$3,515$3,515

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$9,313,919TotalAmt
Program Services$9,213,935ProgramServicesAmt
Management And General$99,984ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$14,578BOYAmt
EOY$20,957EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,454,837BOYAmt
EOY$354,970EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$464,715BOYAmt
EOY$743,674EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$47,510BOYAmt
EOY$40,934EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$129,100LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$33,641LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$110,229BOYAmt
EOY$95,459EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,746,905BOYAmt
EOY$2,246,788EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,600,267BOYAmt
EOY$2,853,495EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,439,041BOYAmt
EOY$6,356,277EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$171,725BOYAmt
EOY$79,894EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$125,864BOYAmt
EOY$115,004EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,008,711BOYAmt
EOY$2,898,837EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,306,300BOYAmt
EOY$3,093,735EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$3,132,741BOYAmt
EOY$3,262,542EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,132,741BOYAmt
EOY$3,262,542EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,439,041BOYAmt
EOY$6,356,277EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$129,801ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1FLORIDA STATE UNIVERSITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN591961248EIN
Organization Type2OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$7,348,769SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$7,348,769SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$129,100OtherCostOrOtherBasisAmt
Depreciation$33,641DepreciationAmt
Book Value$95,459BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$95,459TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
FSU FOUNDATION$1,156,457F
FLORIDA SPECIAL PURPOSE INVESTMENT ACCOUNT (VIA UNIVERSITY)$1,697,038F
FieldValueIRS element (for citing)
Total Book Value Securities$2,853,495TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
FLORIDA STATE UNIVERSITY AUXILIARY$1,243,867
DEPARTMENTAL DISTRIBUTION$1,654,970
FieldValueIRS element (for citing)
Total Liability$2,898,837TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$9,443,720TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$9,443,720RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$9,443,720TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$9,313,919TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$9,313,919ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$9,313,919TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationIT IS THE POLICY OF MANAGEMENT TO EVALUATE ITS TAX POSITIONS ON AN ONGOING BASIS AND TO DISCLOSE ANY SUCH POSITIONS IT BELIEVES WOULD HAVE A MATERIAL IMPACT ON THE FINANCIAL STATEMENTS AND RELATED NOTES. MANAGEMENT ALSO BELIEVES THAT NO SUCH REQUIRED DISCLOSURES CURRENTLY EXIST.ExplanationTxt

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

FieldValueIRS element (for citing)
RegionCENTRAL AMERICA AND THE CARIBBEAN - NICARAGUARegionTxt
Offices0OfficesCnt
Employee0EmployeeCnt
Type Of Activities ConductedPROGRAM SERVICETypeOfActivitiesConductedTxt
Specific Services ProvidedMEDICAL MISSION FACULTY TRIPSSpecificServicesProvidedTxt
Region Total Expenditures$7,503RegionTotalExpendituresAmt
FieldValueIRS element (for citing)
Subtotal Offices0SubtotalOfficesCnt
Subtotal Employees0SubtotalEmployeesCnt
Continuation Total Office0ContinuationTotalOfficeCnt
Continuation Total Employee0ContinuationTotalEmployeeCnt
Total Office0TotalOfficeCnt
Total Employee0TotalEmployeeCnt
Subtotal Spent$7,503SubtotalSpentAmt
Continuation Spent$0ContinuationSpentAmt
Total Spent$7,503TotalSpentAmt
Transfer To Foreign Corp0TransferToForeignCorpInd
Interest In Foreign Trust0InterestInForeignTrustInd
Foreign Corp Ownership0ForeignCorpOwnershipInd
Passive Foreign Investmest Co0PassiveForeignInvestmestCoInd
Foreign Partnership0ForeignPartnershipInd
Boycott Countries0BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART III ACCOUNTING METHOD:FormAndLineReferenceDesc

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINEBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11115 WEST CALL STREETAddressLine1Txt
CityTALLAHASSEECityNm
State AbbreviationFLStateAbbreviationCd
ZIP32306ZIPCd
FieldValueIRS element (for citing)
Recipient EIN591961248RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$218,268CashGrantAmt
Purpose Of GrantDEPARTMENTAL DISTRBUTION SUPPORTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JOHN FOGARTY MD
PRESIDENT$0$438,619$0$1,200$0$0$0$25,585$0$18,627$0$484,031$0$0
DANIEL VAN DURME MD
VICE PRESIDENT$0$316,748$0$1,200$0$10,000$0$27,680$0$18,627$0$374,255$0$0
JONATHAN APPELBAUM MD
TREASURER$0$321,273$0$1,200$0$0$0$25,282$0$18,627$0$366,382$0$0
ALMA LITTLES MD
SECRETARY$0$326,764$0$1,200$0$0$0$25,295$0$18,627$0$371,886$0$0
PAUL KATZ MD
DIRECTOR$0$316,992$0$1,200$0$0$0$25,274$0$18,627$0$362,093$0$0
JOEDRECKA BROWN SPEIGHTS MD
DIRECTOR$0$309,562$0$1,200$0$0$0$25,245$0$10,235$0$346,242$0$0
RICHARD NOWAKOWSKI PHD
DIRECTOR$0$271,737$0$1,200$0$0$0$23,849$0$10,235$0$307,021$0$0
JAMES ZEDAKER MPAS PA-C DFAAPA
DIRECTOR$0$187,828$0$1,200$0$33,793$0$17,796$0$18,627$0$259,244$0$0
JOAN MEEK MD MS
DIRECTOR$0$248,680$0$1,200$0$12,437$0$23,812$0$8,658$0$294,787$0$0
LESLIE BEITSCH MD JD
DIRECTOR$0$295,366$0$1,200$0$0$0$47,277$0$18,627$0$362,470$0$0
KYLE CLARK MBA
DIRECTOR$0$388,868$0$26,250$0$16,200$0$25,407$0$20,578$0$477,303$0$0
SALLIE MCRORIE PHD
DIRECTOR$0$439,550$0$31,200$0$6,000$0$38,070$0$9,328$0$524,148$0$0
HEATHER FLYNN PHD
DIRECTOR$0$236,648$0$1,200$0$0$0$20,563$0$8,658$0$267,069$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationCOMPENSATION FOR THE ORGANIZATION'S OFFICERS/FACULTY ARE DETERMINED BY THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE AND APPROVED BY FSU'S HUMAN RESOURCE DEPARTMENT (A RELATED ORGANIZATION). THE COMPENSATION IS ESTABLISHED BASED ON BENCHMARKS WITHIN THE INDUSTRY. IN ADDITION, FSU UTILIZES A COMPENSATION COMMITTEE, WRITTEN EMPLOYMENT CONTRACTS AND APPROVAL BY THE BOARD/COMPENSATION COMMITTEE TO ESTABLISH COMPENSATION.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2SALLIE MCRORIE, PH.D. AND KYLE CLARK, MBA SERVE TOGETHER ON THE FOLLOWING ORGANIZATION BOARDS: FAMU-FSU COLLEGE OF ENGINEERING JOINT MANAGEMENT COUNCIL AND THE FSU RESEARCH FOUNDATION, INC.
FORM 990, PART VI, SECTION B, LINE 11BA COPY OF THE FINAL FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS THROUGH ELECTRONIC MAIL PRIOR TO SUBMITTAL TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12CANY DIRECTOR, PRINCIPAL, OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, IS COVERED UNDER THE POLICY. ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST MUST BE DISCLOSED TO THE DIRECTORS, AND THE DIRECTORS WILL DECIDE IF A CONFLICT OF INTEREST EXISTS. IF A MEMBER FAILS TO DISCLOSE A CONFLICT OF INTEREST IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION FOR THE ORGANIZATION'S TOP OFFICIAL, OFFICERS, AND KEY EMPLOYEES IS DETERMINED BY FAIR MARKET VALUE, SALARY SURVEYS AND A SALARY RANGE PROVIDED BY FLORIDA STATE UNIVERSITY, THE SUPPORTED ORGANIZATION.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990 PART XII, LINE 2CTHE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1FLORIDA STATE UNIVERSITYBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1A2201 UNIVERSITY CENTERAddressLine1Txt
CityTALLAHASSEECityNm
State AbbreviationFLStateAbbreviationCd
ZIP32306ZIPCd
FieldValueIRS element (for citing)
EIN591961248EIN
Primary ActivitiesUNIVERSITYPrimaryActivitiesTxt
Legal Domicile StateFLLegalDomicileStateCd
Exempt Code Section115(1)ExemptCodeSectionTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1FLORIDA STATE UNIVERSITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeOTransactionTypeTxt
Involved$7,348,769InvolvedAmt
Method Of Amount DeterminationCASHMethodOfAmountDeterminationTxt

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