VOLUNTEERS IN MEDICINE JACKSONVILLE INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
VOLUNTEERS IN MEDICINE JACKSONVILLE INC (EIN 75-3002172)
Tax period
2016-10-01 to 2017-09-30
Filed
2018-06-21
IRS object ID
201841729349300509
Schema version
2016v3.0
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)
Return2018-06-21T09:02:34-05:00ReturnTs
Tax Period End2017-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN590602635PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SMOAK DAVIS & NIXON LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15011 GATE PARKWAY BLDG 100 STE 300AddressLine1Txt
CityJACKSONVILLECityNm
State AbbreviationFLStateAbbreviationCd
ZIP322560562ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN753002172EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1VOLUNTEERS IN MEDICINE JACKSONVILLE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlVOLUBusinessNameControlTxt
Phone9043992766PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line141 EAST DUVAL STREETAddressLine1Txt
CityJACKSONVILLECityNm
State AbbreviationFLStateAbbreviationCd
ZIP32202ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARY PAT CORRIGANPersonNm
Person TitleCHIEF EXECUTIVE OFFICERPersonTitleTxt
Phone9043992766PhoneNum
Signature2018-06-01SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonROBERT T LOVERICHPreparerPersonNm
PTINP00218080PTIN
Phone9043965831PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address97.65.155.77IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-06-01IPDt
IP Tm09:14:04IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id33CEE054FD698F2386728B357601231EA9C7622AAtSubmissionCreationDeviceId
At Submission Filing Device Id0C06AD6731CA7362BC2C1E7CB11F7F2749C9D066AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2018-06-14 16:35:46ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARY PAT CORRIGANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line141 EAST DUVAL STREETAddressLine1Txt
CityJACKSONVILLECityNm
State AbbreviationFLStateAbbreviationCd
ZIP32202ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$828,100GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.VIM-JAX.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2002FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionTO IMPROVE THE HEALTH OF THE NORTHEAST FLORIDA COMMUNITY BY PROVIDING FREE PRIMARY AND LIMITED SPECIALTY CARE TO THE WORKING POOR, WHO CANNOT AFFORD HEALTH INSURANCE OR HEALTHCARE FOR THEMSELVES AND THEIR FAMILIES. WE ACCOMPLISH THIS THROUGH VOLUNTEER DOCTORS, NURSES AND A LIMITED COMPENSATED STAFF, WHO KEEP OUR PATIENTS HEALTHY, WORKING AND OUT OF THE EMERGENCY ROOM.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee8TotalEmployeeCnt
Total Volunteers290TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$778,132PYContributionsGrantsAmt
CY Contributions Grants$828,087CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$336PYInvestmentIncomeAmt
CY Investment Income$13CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$778,468PYTotalRevenueAmt
CY Total Revenue$828,100CYTotalRevenueAmt
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$457,696PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$504,168CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$214,789CYTotalFundraisingExpenseAmt
PY Other Expenses$259,468PYOtherExpensesAmt
CY Other Expenses$346,198CYOtherExpensesAmt
PY Total Expenses$717,164PYTotalExpensesAmt
CY Total Expenses$850,366CYTotalExpensesAmt
PY Revenues Less Expenses$61,304PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$22,266CYRevenuesLessExpensesAmt
Total Assets BOY$108,515TotalAssetsBOYAmt
Total Assets EOY$152,058TotalAssetsEOYAmt
Total Liabilities BOY$42,450TotalLiabilitiesBOYAmt
Total Liabilities EOY$108,259TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$66,065NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$43,799NetAssetsOrFundBalancesEOYAmt
MissionTO SERVE LOW-INCOME WORKING UNINSURED ADULTS AND THEIR FAMILIES BY PROVIDING ACCESS TO FREE, HIGH QUALITY PRIMARY AND PREVENTATIVE HEALTH CARE SERVICES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$507,205ExpenseAmt
DescIN FY 2017, VOLUNTEERS IN MEDICINE JACKSONVILLE PROVIDED 4,744 MEDICAL APPOINTMENTS AND MAINTAINED 1,495 ACTIVE CLIENTS. THROUGH THE WORK OF VOLUNTEER PHYSICIANS, NURSE PRACTITIONERS, NURSES, DENTISTS AND OTHERS, ALONG WITH COMMUNITY PARTNERSHIPS, WE WERE ABLE TO GIVE OUR CLIENTS ACCESS TO PRIMARY CARE AND SPECIALTY CARE; PRESCRIPTION MEDICATIONS; CHRONIC DISEASE MANAGEMENT; LAB TESTS; CANCER SCREENINGS,SUCH AS MAMMOGRAMS; PRESCRIPTION EYEGLASSES; MENTAL HEALTH COUNSELING AND BASIC DENTAL CARE. IN-KIND DONATIONS OF OVER $1.4M BRING THE ACTUAL EXPENSE OF OPERATING THE CLINIC TO OVER $2.3M.Desc
Total Program Service Expenses$507,205TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
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 With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee8EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
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
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
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 CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Own WebsiteYes (X)OwnWebsiteInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MARY PAT CORRIGANBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9043992766PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line141 EAST DUVAL STAddressLine1Txt
CityJACKSONVILLECityNm
State AbbreviationFLStateAbbreviationCd
ZIP32202ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
LEO ALONSO DO
DIRECTOR2.00Yes (X)$0$0$0
RON MALLET
DIRECTOR, EMERITUS2.00Yes (X)$0$0$0
GUY CUDDIHEE
DIRECTOR2.00Yes (X)$0$0$0
JIM JAMISON MD
DIRECTOR, EMERITUS2.00Yes (X)$0$0$0
WILL KETCHUM
DIRECTOR2.00Yes (X)$0$0$0
LI LORIZ PHD ARNP
DIRECTOR, EMERITUS2.00Yes (X)$0$0$0
CB MCINTOSH MD
DIRECTOR, EMERITUS2.00Yes (X)$0$0$0
CORY MEYERS RN MN
DIRECTOR2.00Yes (X)$0$0$0
HELEN MORSE
CHAIRMAN OF THE BOARD2.00Yes (X)$0$0$0
JACQUELINE RUDLOFF
DIRECTOR2.00Yes (X)$0$0$0
REV RICHARD PETRY
DIRECTOR, EMERITUS2.00Yes (X)$0$0$0
GEORGE RIDGE ESQ
DIRECTOR, EMERITUS2.00Yes (X)$0$0$0
MARK J SHORSTEIN CPA
DIRECTOR2.00Yes (X)$0$0$0
LISA WEATHERBY CIMA CIS
DIRECTOR2.00Yes (X)$0$0$0
JOHN WILLIS
DIRECTOR2.00Yes (X)$0$0$0
JIM BURT MD
DIRECTOR, EMERITUS2.00Yes (X)$0$0$0
DOTTIE DORION RN
DIRECTOR, EMERITUS2.00Yes (X)$0$0$0
REV EUGENE ZIMMERMAN
DIRECTOR, EMERITUS2.00Yes (X)$0$0$0
KRISTI AIELLO
DIRECTOR2.00Yes (X)$0$0$0
MICHAEL BOYLAN
DIRECTOR2.00Yes (X)$0$0$0
ANN CAREY
DIRECTOR2.00Yes (X)$0$0$0
ELIZABETH MCGRAW MD
DIRECTOR2.00Yes (X)$0$0$0
MARY PAT CORRIGAN
CEO40.00$90,000$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$90,000TotalReportableCompFromOrgAmt
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
Fundraising$165,660FundraisingAmt
All Other Contributions$662,427AllOtherContributionsAmt
Total Contributions$828,087TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$13TotalRevenueColumnAmt
Exclusion$13ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$165,660ContriRptFundraisingEventAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$828,100TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$13ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$451,772TotalAmt
Program Services$289,311ProgramServicesAmt
Management And General$38,461ManagementAndGeneralAmt
Fundraising$124,000FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$22,339TotalAmt
Program Services$14,744ProgramServicesAmt
Management And General$1,787ManagementAndGeneralAmt
Fundraising$5,808FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$30,057TotalAmt
Program Services$19,838ProgramServicesAmt
Management And General$2,404ManagementAndGeneralAmt
Fundraising$7,815FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$24,491TotalAmt
Management And General$24,491ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$4,935TotalAmt
Management And General$4,935ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$45,764TotalAmt
Program Services$5,982ProgramServicesAmt
Management And General$39,782ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$46,424TotalAmt
Program Services$41,146ProgramServicesAmt
Management And General$5,278ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,666TotalAmt
Program Services$3,299ProgramServicesAmt
Management And General$367ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$24,772TotalAmt
Program Services$20,265ProgramServicesAmt
Management And General$4,507ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtFundraisingFundraisingAmtProgram ServicesProgramServicesAmt
MISCELLANEOUS$77,166$77,166
PHARMACY$28,025$28,025
X-RAY EXPENSE$23,030$23,030
LAB EXPENSE$15,632$15,632

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$52,293TotalAmt
Program Services$45,933ProgramServicesAmt
Management And General$6,360ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$850,366TotalAmt
Program Services$507,205ProgramServicesAmt
Management And General$128,372ManagementAndGeneralAmt
Fundraising$214,789FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$20,376BOYAmt
EOY$107,786EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$18,300EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$74,725BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$6,941BOYAmt
EOY$1,858EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$288,511LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$264,997LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,873BOYAmt
EOY$23,514EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$600BOYAmt
EOY$600EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$108,515BOYAmt
EOY$152,058EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$42,450BOYAmt
EOY$63,259EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
EOY$45,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$42,450BOYAmt
EOY$108,259EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$65,129BOYAmt
EOY$10,576EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$936BOYAmt
EOY$33,223EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$66,065BOYAmt
EOY$43,799EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$108,515BOYAmt
EOY$152,058EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$22,266ReconcilationRevenueExpnssAmt
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)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$665,859CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$669,403CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$763,346CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$778,132CurrentTaxYearMinus1YearAmt
Current Tax Year$828,087CurrentTaxYearAmt
Total$3,704,827TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$665,859CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$669,403CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$763,346CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$778,132CurrentTaxYearMinus1YearAmt
Current Tax Year$828,087CurrentTaxYearAmt
Total$3,704,827TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$3,704,827PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus2 Years$21CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$336CurrentTaxYearMinus1YearAmt
Current Tax Year$13CurrentTaxYearAmt
Total$374TotalAmt
FieldValueIRS element (for citing)
Total Support$3,705,201TotalSupportAmt
Public Support CY1700.99990PublicSupportCY170Pct
Public Support PY1700.99930PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$206,396OtherCostOrOtherBasisAmt
Depreciation$206,396DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$61,631OtherCostOrOtherBasisAmt
Depreciation$51,581DepreciationAmt
Book Value$10,050BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,484OtherCostOrOtherBasisAmt
Depreciation$7,020DepreciationAmt
Book Value$13,464BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$23,514TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$2,299,141TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts$1,471,041DonatedServicesAndUseFcltsAmt
Revenue Not Reported$1,471,041RevenueNotReportedAmt
Revenue Subtotal$828,100RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$828,100TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$2,321,407TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$1,471,041DonatedServicesUseFcltsAmt
Expenses Not Reported$1,471,041ExpensesNotReportedAmt
Expenses Subtotal$850,366ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$850,366TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION IS A TAX-EXEMPT ORGANIZATION AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. THE ORGANIZATION APPLIES GENERALLY ACCEPTED ACCOUNTING PRINCIPLES RELATED TO INCOME TAX UNCERTAINTIES. THE ORGANIZATION HAS DETERMINED THAT THERE WERE NO UNRECOGNIZED TAX BENEFITS FOR THE YEARS ENDED SEPTEMBER 30, 2017 AND 2016. THE ORGANIZATION FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTIONS. TAX YEARS THAT REMAIN SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTIONS ARE 2014 AND FORWARD.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1ANNUAL FUND KICK-OFFEvent1Nm
Gross Receipts Event1$165,660GrossReceiptsEvent1Amt
Charitable Contri Event1$165,660CharitableContriEvent1Amt
Gross Receipts Total$165,660GrossReceiptsTotalAmt
Charitable Contributions Tot$165,660CharitableContributionsTotAmt

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp (4 entries)

Non Cash CheckboxNonCashCheckboxIndDescDescContributionContributionCntNoncash Contributions Rpt F990NoncashContributionsRptF990AmtMethod Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)MEDICAL SERVICES0$1,031,451STATE OF FL ALLOWED
Yes (X)LABORATORY TESTS0$251,238INVOICES
Yes (X)DONATED PRESCRIPTION MEDICATION0$151,152INVOICES
Yes (X)IN KIND RENT0$37,200MARKET RENT SURVEY
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE COMPLETED DOCUMENT IS SENT TO THE BOARD FINANCE COMMITTEE WHO WILL REVIEW AND RECOMMEND CHANGES. THIS COMMITTEE, ON BEHALF OF THE ENTIRE BOARD, WILL APPROVE THE FORM 990. THE ENTIRE BOARD IS SENT A COPY OF THE FINAL FORM 990.
FORM 990, PART VI, SECTION B, LINE 12CTHE POLICY IS REVIEWED ANNUALLY AT A BOARD OF DIRECTORS MEETING.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF DIRECTORS MAKES ALL DECISIONS REGARDING THE COMPENSATION OF THE CEO. THE CEO MAKES ALL DECISIONS REGARDING THE COMPENSATION OF ALL OTHER EMPLOYEES. THE CEO REVIEWS COMPENSATION CHANGES WITH THE FINANCE COMMITTEE OF THE BOARD.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS AND AUDITED FINANCIAL STATEMENTS ARE AVAIAILBLE UPON REQUEST, AND ARE MADE AVAILABLE VIA A WEBSITE ON THE INTERNET.
FORM 990, PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

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