VOLUNTEERS IN MEDICINE JACKSONVILLE INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- VOLUNTEERS IN MEDICINE JACKSONVILLE INC (EIN 75-3002172)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-03-03
- IRS object ID
- 201740629349300829
- Schema version
- 2015v3.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-03-03T13:54:16-06:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 590602635 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SMOAK DAVIS & NIXON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5011 GATE PARKWAY BLDG 100 STE 300 | AddressLine1Txt |
| City | JACKSONVILLE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 322560562 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 753002172 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VOLUNTEERS IN MEDICINE JACKSONVILLE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | VOLU | BusinessNameControlTxt |
| Phone | 9043992766 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 41 EAST DUVAL STREET | AddressLine1Txt |
| City | JACKSONVILLE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32202 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARY PAT CORRIGAN | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 9043992766 | PhoneNum |
| Signature | 2017-02-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ROBERT T LOVERICH | PreparerPersonNm |
| PTIN | P00218080 | PTIN |
| Phone | 9043965831 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARY PAT CORRIGAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 41 EAST DUVAL STREET | AddressLine1Txt |
| City | JACKSONVILLE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $778,468 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.VIM-JAX.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE OTO 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 Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 8 | TotalEmployeeCnt |
| Total Volunteers | 290 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $763,346 | PYContributionsGrantsAmt |
| CY Contributions Grants | $778,132 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $21 | PYInvestmentIncomeAmt |
| CY Investment Income | $336 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $763,367 | PYTotalRevenueAmt |
| CY Total Revenue | $778,468 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $442,093 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $457,696 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $146,298 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $249,281 | PYOtherExpensesAmt |
| CY Other Expenses | $259,468 | CYOtherExpensesAmt |
| PY Total Expenses | $691,374 | PYTotalExpensesAmt |
| CY Total Expenses | $717,164 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $71,993 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $61,304 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $29,817 | TotalAssetsBOYAmt |
| Total Assets EOY | $108,515 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $25,056 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $42,450 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,761 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $66,065 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO 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 Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $466,973 | ExpenseAmt |
| Desc | IN FY 2016. VOLUNTEERS IN MEDICINE JACKSONVILLE PROVIDED 5,158 MEDICAL APPOINTMENTS AND MAINTAINED OVER 1800 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 $1.2M BRING THE ACTUAL EXPENSE OF OPERATING THE CLINIC TO OVER $1.9M. | Desc |
| Total Program Service Expenses | $466,973 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 8 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARY PAT CORRIGAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9043992766 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 41 EAST DUVAL ST | AddressLine1Txt |
| City | JACKSONVILLE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32202 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| LEO ALONSO DO | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| RON MALLET | ||||||
| DIRECTOR, EMERITUS | 2.00 | Yes (X) | $0 | $0 | $0 | |
| GUY CUDDIHEE | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JIM JAMISON MD | ||||||
| DIRECTOR, EMERITUS | 2.00 | Yes (X) | $0 | $0 | $0 | |
| WILL KETCHUM | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| LI LORIZ PHD ARNP | ||||||
| DIRECTOR, EMERITUS | 2.00 | Yes (X) | $0 | $0 | $0 | |
| CB MCINTOSH MD | ||||||
| DIRECTOR, EMERITUS | 2.00 | Yes (X) | $0 | $0 | $0 | |
| CORY MEYERS RN MN | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| HELEN MORSE | ||||||
| CHAIRMAN OF THE BOARD | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JACQUELINE RUDLOFF | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| REV RICHARD PETRY | ||||||
| DIRECTOR, EMERITUS | 2.00 | Yes (X) | $0 | $0 | $0 | |
| GEORGE RIDGE ESQ | ||||||
| DIRECTOR, EMERITUS | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MARK J SHORSTEIN CPA | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| LISA WEATHERBY CIMA CIS | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JOHN WILLIS | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JIM BURT MD | ||||||
| DIRECTOR, EMERITUS | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DOTTIE DORION RN | ||||||
| DIRECTOR, EMERITUS | 2.00 | Yes (X) | $0 | $0 | $0 | |
| REV EUGENE ZIMMERMAN | ||||||
| DIRECTOR, EMERITUS | 2.00 | Yes (X) | $0 | $0 | $0 | |
| KRISTI AIELLO | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MICHAEL BOYLAN | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| ANN CAREY | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| ELIZABETH MCGRAW MD | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MARY PAT CORRIGAN | ||||||
| CEO | 40.00 | $90,000 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $90,000 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $127,988 | FundraisingAmt |
| All Other Contributions | $650,144 | AllOtherContributionsAmt |
| Total Contributions | $778,132 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $336 | TotalRevenueColumnAmt |
| Exclusion | $336 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $127,988 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $778,468 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $336 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $405,884 | TotalAmt |
| Program Services | $265,813 | ProgramServicesAmt |
| Management And General | $33,571 | ManagementAndGeneralAmt |
| Fundraising | $106,500 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,435 | TotalAmt |
| Program Services | $16,787 | ProgramServicesAmt |
| Management And General | $2,035 | ManagementAndGeneralAmt |
| Fundraising | $6,613 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,377 | TotalAmt |
| Program Services | $17,409 | ProgramServicesAmt |
| Management And General | $2,110 | ManagementAndGeneralAmt |
| Fundraising | $6,858 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,006 | TotalAmt |
| Management And General | $20,006 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,566 | TotalAmt |
| Management And General | $5,566 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,304 | TotalAmt |
| Program Services | $9,375 | ProgramServicesAmt |
| Management And General | $25,929 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,930 | TotalAmt |
| Program Services | $43,997 | ProgramServicesAmt |
| Management And General | $5,933 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,858 | TotalAmt |
| Program Services | $2,572 | ProgramServicesAmt |
| Management And General | $286 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,134 | TotalAmt |
| Program Services | $16,912 | ProgramServicesAmt |
| Management And General | $4,222 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | FundraisingFundraisingAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| OTHER DIRECT EXPENSES | $26,002 | $26,002 | |
| PHARMACY | $25,778 | $25,778 | |
| X-RAY EXPENSE | $23,221 | $23,221 | |
| MEDICAL SUPPLIES | $11,781 | $11,781 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,888 | TotalAmt |
| Program Services | $33,328 | ProgramServicesAmt |
| Management And General | $4,235 | ManagementAndGeneralAmt |
| Fundraising | $325 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $717,164 | TotalAmt |
| Program Services | $466,973 | ProgramServicesAmt |
| Management And General | $103,893 | ManagementAndGeneralAmt |
| Fundraising | $146,298 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,055 | BOYAmt |
| EOY | $20,376 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $74,725 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,431 | BOYAmt |
| EOY | $6,941 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $267,204 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $261,331 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,731 | BOYAmt |
| EOY | $5,873 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $600 | BOYAmt |
| EOY | $600 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,817 | BOYAmt |
| EOY | $108,515 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,056 | BOYAmt |
| EOY | $42,450 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,056 | BOYAmt |
| EOY | $42,450 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$13,435 | BOYAmt |
| EOY | $65,129 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,196 | BOYAmt |
| EOY | $936 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,761 | BOYAmt |
| EOY | $66,065 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,817 | BOYAmt |
| EOY | $108,515 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $61,304 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $481,478 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $665,859 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $669,403 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $763,346 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $778,132 | CurrentTaxYearAmt |
| Total | $3,358,218 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $481,478 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $665,859 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $669,403 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $763,346 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $778,132 | CurrentTaxYearAmt |
| Total | $3,358,218 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $3,358,218 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,133 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus1 Year | $21 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $336 | CurrentTaxYearAmt |
| Total | $2,494 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $3,360,712 | TotalSupportAmt |
| Public Support CY170 | 0.99930 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99910 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $206,396 | OtherCostOrOtherBasisAmt |
| Depreciation | $206,396 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $36,431 | OtherCostOrOtherBasisAmt |
| Depreciation | $36,431 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,377 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,504 | DepreciationAmt |
| Book Value | $5,873 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,873 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $2,003,700 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $1,225,232 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $1,225,232 | RevenueNotReportedAmt |
| Revenue Subtotal | $778,468 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $778,468 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,942,396 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $1,225,232 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $1,225,232 | ExpensesNotReportedAmt |
| Expenses Subtotal | $717,164 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $717,164 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agrmt Prof Fundraising Acty | 0 | AgrmtProfFundraisingActyInd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | ANNUAL FUND KICK-OFF | Event1Nm |
| Gross Receipts Event1 | $127,988 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $127,988 | CharitableContriEvent1Amt |
| Gross Receipts Total | $127,988 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $127,988 | CharitableContributionsTotAmt |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp (4 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | MEDICAL SERVICES | 19787 | $997,422 | STATE OF FL ALLOWED |
| Yes (X) | DONATED PRESCRIPTION MEDICATION | 0 | $99,298 | INVOICES |
| Yes (X) | LABORATORY TESTS | 0 | $91,312 | INVOICES |
| Yes (X) | IN KIND RENT | 1 | $37,200 | MARKET RENT SURVEY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE 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 12C | THE POLICY IS REVIEWED ANNUALLY AT A BOARD OF DIRECTORS MEETING. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE 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 19 | GOVERNING 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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