2020-10-23T11:42:42-05:00 2019-12-31 204193611 Batts Morrison Wales & Lee PA 801 North Orange Avenue Suite 800 Orlando FL 32801 990 2019-01-01 820770125 Honey Lake Clinic Inc HONE 9047371121 PO Box 551213 Jacksonville FL 32255 Lisa Stewart Secretary 9047371121 2020-10-21 1 Michele M Wales P00428093 4077706000 2020-10-21 64.88.174.3 2020-10-21 09:17:06 ED P 935CACE8365413C0D76314017BD70661184C200E 3A6B9484FAD7FF6E8A5586DFFF05C196B2B256A2 2019 2021-01-29 14:40:06Z Dr David Hoskins PO Box 551213 Jacksonville FL 32255 11669025 0 X www.honeylake.clinic X 2017 FL To help individuals renew their minds, achieve their God-given potential and live transformed lives. 7 4 180 5 0 0 21000 23754 8038893 11645271 0 0 0 0 8059893 11669025 2007942 2163620 0 0 2895665 5615409 0 0 0 2874601 3378721 7778208 11157750 281685 511275 7919993 13010568 5824346 10505758 2095647 2504810 X The Organization exists so that God and the name of Jesus would be glorified as individuals psychologically and spiritually renew their minds, achieve their God-given potential, and live transformed lives of joy, peace, forgiveness, freedom, meaning, purpose and fulfillment. 0 0 10223650 2163620 11645271 The Organization operates a biblically-based, holistic mental health and rehabilitation clinic. The Organization provides a place for broken and burned out people struggling with depression and other mental illnesses, as well as for people struggling with substance abuse or addictions. The Organization serves these individuals through outpatient treatment, residential treatment programs, rehabilitation programs with community housing, intensive inpatient, residential detoxification, aftercare, and intervention and case management. All patients are assigned a case manager who assumes the responsibility of engaging patients in the treatment and recovery process, overseeing the coordination of care, serving as advocates for the patients, providing education and continual support, and otherwise working with the patients throughout the residential and outpatient programs. The Organization also has a specialized pastoral track for pastors and ministry leaders. The Organization recognizes the significant need in this area - to provide Christian counseling and rehabilitation for pastors who are leading and living on empty. The Organization utilizes its connections with ministries and churches across the U.S. to identify patients that would be a good fit for this specialized program. 10223650 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 69 0 1 180 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 4 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 X Lisa Stewart 9047371121 1290 NW Honey Lake Road Greenville FL 32331 Dr David Hoskins Co-Chairman/Pres./Director 40.00 X X 39800 0 0 Pastor Stovall Weems Co-Chairman/Director 0.50 X X 0 0 0 Dr Kim Nachtwey Treasurer/Director 40.00 X X 24893 0 0 Lisa Stewart Secretary/Director 10.00 X X 0 0 0 Dr Karl Benzio Director 40.00 X 92800 0 0 Dale Berkey Director 0.50 X 0 0 0 David Branker Director 0.50 X 0 0 0 157493 0 0 0 0 0 0 Lightkeepers International Inc 13639 Allamanda Cir Port Charlotte FL 33981 Contract Labor 288805 Daniel Wright NP LLC 225 Chinaberry Ln Moultrie GA 31788 Medical Services 285698 Lighthouse Psychiatry LLC 1290 NW Honey Lake Rd Greenville FL 32331 Medical Services 173850 Thomas Smith 2940 E Park Ste 1a Tallahassee FL 32301 Clinical Services 119104 4 23754 23754 Patient Fees 623990 11645271 11645271 11645271 11669025 11645271 0 0 589262 589262 1574358 1574358 157493 149618 7875 173850 173850 4972833 4735812 237021 311233 295672 15561 56776 56776 1685 1685 116046 116046 571847 571847 46700 33489 13211 39736 31789 7947 469015 469015 4925 4925 365922 365922 337901 270321 67580 359029 287223 71806 Kitchen 281706 281706 Patient Services 242672 242672 Operations & Guest Svcs 118582 32181 86401 Medical 98309 98309 267870 194454 73416 11157750 10223650 934100 0 186935 421566 6000 6000 13262376 679374 7727058 12583002 7919993 13010568 51161 87241 5660341 10203561 112844 214956 5824346 10505758 X 2095647 2504810 2095647 2504810 7919993 13010568 X 511275 -102112 X 1 X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3858723 3858723 8695363 464059 8231304 650279 200067 450212 58011 15248 42763 12583002 Interest rate swap 214956 214956 1 Celebration Church 10302 Deerwood Park Blvd Ste 104 Jacksonville FL 32256 593548973 501(c)(3) 286431 General support Lightkeepers International Inc 13639 Allamanda Cir Port Charlotte FL 33981 812900787 501(c)(3) 286431 General support Global Teen Challenge 15 W 10th St Columbus GA 31901 593302759 501(c)(3) 10000 General support 3 0 Scholarships to patients 133 1574358 Part I, Line 2: Grants to organizations: The Organization makes grants to organizations whose purposes are consistent with the purposes set forth in the Organization's Articles of Incorporation and Bylaws. The Organization maintains ongoing relationships with the grantee organizations and therefore no additional monitoring of the granted funds is considered necessary. Scholarship grants to individuals: The Organization accepts patients who do not have private health insurance or cannot otherwise pay for the cost of their care. Prior to admittance to the Organization's treatment programs, the Organization evaluates on a case-by-case basis whether patients qualify for financial assistance. Recipients of financial assistance (either in the form of fee discounts or in the form of financial assistance covering the entire cost of their care) are determined by the Organization's Board of Directors. The determination of whether patients qualify for financial assistance includes an evaluation of the patient's household income as compared to the federal poverty level. Lighthouse Psychiatry LLC See part V 173850 See Part V 0 Part IV, Line 1 See Schedule O regarding approval of compensation paid to interested persons. Part IV, Line 1, Column (b): Limited liability company of which a board member of the Organization is the sole member. Part IV, Line 1, Column (d): Amount paid for medical services. Form 990, Part VI, Section A, line 2 Dr. David Hoskins, Dr. Kim Nachtwey, and Dr. Karl Benzio had a business relationship. Lisa Stewart and Pastor Stovall Weems have a business relationship. Form 990, Part VI, Section A, line 6 The Organization has three permanent members: CCJI Ministry, LLC, a single-member LLC of which Celebration Church of Jacksonville, Inc., an unrelated tax-exempt church, is the sole member; Celebration Care Ministries, an unrelated tax-exempt organization; and Lightkeepers International, Inc., an unrelated tax-exempt organization. Form 990, Part VI, Section A, line 7a The Organization's members have the authority to appoint the number of directors specified in the Organization's bylaws. Form 990, Part VI, Section A, line 7b The Organization's members have the authority to approve or reject any amendment to the Organization's articles or bylaws that may materially reduce, eliminate, or affect any such member's rights or privileges thereunder, and to approve or reject dissolution of the Organization. Form 990, Part VI, Section B, line 11b The Organization's top management official and top financial official each review the Form 990 prior to its filing with the IRS. A copy of the final Form 990 is also provided to the voting members of the Organization's governing body prior to its filing with the IRS. Form 990, Part VI, Section B, line 12c The Organization's conflict of interest policy is distributed to each member of the Organization's governing body, its officers and its key employees on an annual basis. Each such individual provides an annual disclosure statement indicating that they have received, read, understood and agreed to comply with the policy, certifying that: (1) they have no relationships or interests that present a conflict of interest, (2) they have one or more conflicts of interest that have been fully disclosed as required by the policy and have been properly administered in conformity with the policy, or (3) they have previously undisclosed conflicts of interest and disclosing the details of such conflicts. Any disclosure statements with previously undisclosed conflicts of interest are forwarded to appropriate Organization officials to take appropriate actions as required by the policy. Form 990, Part VI, Section B, line 15 The Organization's Board of Directors, or an independent committee thereof, annually reviews and approves the compensation levels of the Organization's CEO, officers, key employees, and directors (including compensation paid to entities owned or controlled by such individuals). The deliberations and decisions of the committee are contemporaneously substantiated. The committee utilizes comparability data in its deliberations; updated comparability data is generally obtained every two to three years. Form 990, Part VI, Section C, line 19 The Organization provides, upon request, copies of its Articles of Incorporation, bylaws, conflict of interest policy, and its financial statements. Form 990, Part XI, line 9: Interest Rate Swap -102,112. Greenville Outpatient Services Inc 437 Jack Rabbit Loop Greenville FL 32331 844133737 Outpatient Services FL 501(c)(3) Line 3 N/A 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0