SMHA HEALTHCARE INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
SMHA HEALTHCARE INC (EIN 58-2460001)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-06-30
IRS object ID
202031829349300123
Schema version
2019v5.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2020-06-30T13:30:20-05:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN560747981PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1Txt
CityASHEVILLECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28806ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN582460001EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SMHA HEALTHCARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSMHABusinessNameControlTxt
Phone8475832804PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 W NEW ENGLAND AVE STE 300AddressLine1Txt
CityWINTER PARKCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32789ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMATTHEW RUBINPersonNm
Person TitleCFOPersonTitleTxt
Phone8475832804PhoneNum
Signature2020-06-30SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMY BIBBYPreparerPersonNm
PTINP00445891PTIN
Phone8282542254PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address47.27.82.235IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-06-30IPDt
IP Tm08:50:12IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdBEC9594289F9DCBB4F655B5045764FC48E5A1487AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2020-04-17 16:48:07ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMATTHEW RUBINPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 W NEW ENGLAND AVE STE 300AddressLine1Txt
CityWINTER PARKCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32789ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,479,857GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTO SUPPORT SMHA HEALTHCARE CENTER (FORMERLY MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER, INC.)ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$3,528TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$2,159NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$341,657,811PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$1,137,701PYOtherRevenueAmt
CY Other Revenue$1,479,857CYOtherRevenueAmt
PY Total Revenue$342,795,512PYTotalRevenueAmt
CY Total Revenue$1,479,857CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$14,128,387PYOtherExpensesAmt
CY Other Expenses$6,714,741CYOtherExpensesAmt
PY Total Expenses$14,128,387PYTotalExpensesAmt
CY Total Expenses$6,714,741CYTotalExpensesAmt
PY Revenues Less Expenses$328,667,125PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$5,234,884CYRevenuesLessExpensesAmt
Total Assets BOY$49,405,253TotalAssetsBOYAmt
Total Assets EOY$44,563,351TotalAssetsEOYAmt
Total Liabilities BOY$12,605,235TotalLiabilitiesBOYAmt
Total Liabilities EOY$5,681,552TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$36,800,018NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$38,881,799NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE ADMINISTRATIVE SUPPORT BY ENGAGING IN SUCH OTHER ACTIVITIES THAT BENEFIT, PERFORM THE FUNCTIONS OF, OR CARRY OUT THE PURPOSES OF MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER, INC. AND AFFILIATES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$5,068,817ExpenseAmt
DescTO PROVIDE ADMINISTRATIVE SUPPORT BY ENGAGING IN SUCH OTHER ACTIVITIES THAT BENEFIT, PERFORM THE FUNCTIONS OF, OR CARRY OUT THE PURPOSES OF SMHA HEALTH, INC.JANUARY 31, 2018 THE ORGANIZATION CLOSED ON THE ASSET PURCHASE AGREEMENT WITH HOSPITAL CORPORATION OF AMERICA (HCA). DISCLOSURES AND ACTIVITIES REPORTED REPRESENT THIS TRANSACTION.THE ORGANIZATION SUPPORTS THE EXCLUDED ASSETS AND LIABILITIES ASSOCIATED WITH THE ASSET PURCHASE TRANSACTION AND THE WIND DOWN OF SUCH ACTIVITIES.Desc
Total Program Service Expenses$5,068,817TotalProgramServiceExpensesAmt
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 Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
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 EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
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 Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
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 CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MATTHEW RUBINBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8475832804PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 W NEW ENGLAND AVE SUITE 300AddressLine1Txt
CityWINTER PARKCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32789ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
BRUCE BARRAGAN
CHAIRMAN JAN - NOV1.003.00Yes (X)Yes (X)$0$0$0
REX TEMPLETON
NEW CHAIRMAN1.003.00Yes (X)Yes (X)$0$0$0
ISRAEL SMALL
DIRECTOR1.003.00Yes (X)$0$0$0
CHARLES MCMILLIAN
DIRECTOR1.003.00Yes (X)$0$0$0
CURTIS LEWIS
DIRECTOR1.003.00Yes (X)$0$0$0
SUSAN WILLETTS
DIRECTOR1.003.00Yes (X)$0$0$0
FRANK ROSSITER
DIRECTOR1.003.00Yes (X)$0$0$0
ARTHUR DANA
DIRECTOR1.003.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
RECOVERIES FROM SAVANNAH REHAB900099$1,168,420$1,168,420
OTHER RECOVERIES900099$300,137$300,137
MISCELLANEOUS INCOME900099$11,300$7,772$3,528
FieldValueIRS element (for citing)
Other Revenue Total$1,479,857OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,479,857TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$3,528UnrelatedBusinessRevenueAmt
Exclusion$1,476,329ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$750,000TotalAmt
Program Services$750,000ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,276,990TotalAmt
Program Services$2,276,990ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$607,776TotalAmt
Management And General$607,776ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$800,327TotalAmt
Program Services$263,434ProgramServicesAmt
Management And General$536,893ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$32,327TotalAmt
Management And General$32,327ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$363,783TotalAmt
Management And General$363,783ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,247TotalAmt
Management And General$1,247ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$103,763TotalAmt
Management And General$103,763ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$135TotalAmt
Management And General$135ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICARE COST REPROT$1,646,357$1,646,357
BAD DEBT$106,622$106,622
SETTLEMENT$25,000$25,000
MISCELLANEOUS$414$414

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,714,741TotalAmt
Program Services$5,068,817ProgramServicesAmt
Management And General$1,645,924ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$29,524,234BOYAmt
EOY$22,572,467EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$13,693,943BOYAmt
EOY$15,977,594EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$6,187,076BOYAmt
EOY$6,013,290EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$49,405,253BOYAmt
EOY$44,563,351EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,237,437BOYAmt
EOY$589,572EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$8,367,798BOYAmt
EOY$1,942,644EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$3,149,336EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,605,235BOYAmt
EOY$5,681,552EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$36,800,018BOYAmt
EOY$38,881,799EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$36,800,018BOYAmt
EOY$38,881,799EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$49,405,253BOYAmt
EOY$44,563,351EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$5,234,884ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$7,316,665OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SMHA HEALTHCARE CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN311126469EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$0SupportAmt
Other Support$5,068,817OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$5,068,817OtherSupportSumAmt

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
FieldValueIRS element (for citing)
Majority Dir Trst Supported OrgYes (1)MajorityDirTrstSupportedOrgInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescASSETS FOR DISPOSITIONDesc
Book Value$6,013,290BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$6,013,290TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO HCADesc
Amt$3,149,336Amt
FieldValueIRS element (for citing)
Total Liability$3,149,336TotalLiabilityAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE TAX RETURN IS PREPARED BY AN UNRELATED, INDEPENDENT ACCOUNTING FIRM AND THEN SUBMITTED TO MANAGEMENT FOR REVIEW BEFORE BEING FILED.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS ARE REQUIRED TO UPDATE AND SUBMIT A NEW CONFLICT OF INTEREST STATEMENT ANNUALLY. THE CHAIRMAN OF THE BOARD SHALL BECOME FAMILIAR WITH THE STATEMENTS OF THE BOARD MEMBERS IN ORDER TO GUIDE THEIR CONDUCT SHOULD A CONFLICT ARISE AT SUCH TIMES AS ANY MATTER COMES BEFORE THE BOARD THAT MAY POTENTIALLY RESULT IN A CONFLICT OF INTEREST. THE AFFECTED BOARD MEMBER SHALL MAKE KNOWN THE POTENTIAL CONFLICT, WHETHER OR NOT DISCLOSED IN A WRITTEN STATEMENT. THE AFFECTED BOARD MEMBER MAY MAKE A PRESENTATION TO THE BOARD, BUT AFTER SUCH PRESENTATION, HE OR SHE MUST LEAVE THE MEETING DURING THE DISCUSSION OF AND THE VOTE ON THE TRANSACTION OR ARRANGEMENT CONSIDERED TO BE A CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION C, LINE 18THE FORM 990 IS MADE AVAILABLE UPON REQUESTION. IN ADDITION, THE FORM 990 IS AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS OF THE ORGANIZATION ARE HELD AS PUBLIC RECORDS OF THE STATE OF GEORGIA SECRETARY OF STATE OFFICE. AS SUCH, THESE DOCUMENTS ARE OPEN TO THE PUBLIC. THE CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC AS THIS IS NOT A REQUIREMENT.
FORM 990, PART IX, LINE 11GOTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 263,434. MANAGEMENT AND GENERAL EXPENSES 274,963. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 538,397. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 261,930. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 261,930.
FORM 990, PART XI, LINE 9:NET EQUITY TRANSFERS FROM AFFILIATES 7,316,665.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
SMHA CARDIOVASCULAR LLC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789473916622PROVISION OF MEDICAL SERVICESGAMEMORIAL HEALTH INC
MEMORIAL HEALTH UNIVERSITY PHYSICIANS LLC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789INACTIVEGAMEMORIAL HEALTH INC

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER FOUNDATION
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789581618486SUPPORT OF MHUMCGA501(C)(3)LINE 12A, ISMHA HEALTHCARE INCYes (1)
SMHA HEALTHCARE CENTER INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789311126469HEALTH CARE PROVIDERGA501(C)(3)LINE 3SMHA HEALTHCARE INCYes (1)
SMHA PHYSICIANS GROUPS INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789474332277PROVISION OF MEDICAL SERVICESGA501(C)(3)LINE 10SMHA HEALTHCARE INCYes (1)
SMHA CARDIOLOGY INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789472872276PROVISION OF MEDICAL SERVICESGA501(C)(3)LINE 10SMHA HEALTHCARE INCYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PAULSEN STREET SURGERY CENTER LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 W NEW ENGLAND AVE STE 300AddressLine1Txt
CityWINTER PARKCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32789ZIPCd
FieldValueIRS element (for citing)
EIN454517515EIN
Primary ActivitiesHEALTH CAREPrimaryActivitiesTxt
Legal Domicile StateGALegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
4600 WATERS AVE PROFESSIONAL CONDO ASSOCIATION INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789581990705CONDO ASSOCIATIONGASMHA HEALTH SERVICES GROUP INCC0.52000Yes (1)
SMHA HEALTH PARTNERS INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789581707311MANAGED CAREGASMHA HEALTH SERVICES GROUP INCC1.00000Yes (1)
SMHA ANESTHETISTS INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789431985441MEDICAL SERVICESGASMHA HEALTH SERVICES GROUP INCC1.00000Yes (1)
SMHA VENTURES INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789582162071PHYSICIANS PRACTICEGASMHA HEALTH SERVICES GROUP INCC1.00000Yes (1)
SMHA HEALTH SERVICES GROUP INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789581611969MEDICAL SERVICES/ CONSOLIDATING ENTITYGASMHA HEALTH INCC1.00000Yes (1)
PROVIDENT PROFESSIONAL BUILDING CONDO ASSOCIATION INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789581845972CONDO ASSOCIATIONGASMHA HEALTH SERVICES GROUP INCC0.69560Yes (1)
SMHA PROPERTIES INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789582537941REAL ESTATE HOLDINGGASMHA HEALTH SERVICES GROUP INCC1.00000Yes (1)
SMHACORPORATE SERVICES INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789900963434CORPORATE SERVICESGASMHA HEALTH SERVICES GROUP INCC1.00000Yes (1)
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 OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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