FLORIDA MEDICAL PRACTICE PLAN INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- FLORIDA MEDICAL PRACTICE PLAN INC (EIN 57-1234883)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-14
- IRS object ID
- 201741349349301119
- 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 | 2017-05-14T16:31:27-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 593204548 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAMES MOORE & CO PL | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2477 TIM GAMBLE PLACE SUITE 200 | AddressLine1Txt |
| City | TALLAHASSEE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 323084386 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 571234883 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA MEDICAL PRACTICE PLAN INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FLOR | BusinessNameControlTxt |
| Phone | 8506452827 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1115 W CALL ST | AddressLine1Txt |
| City | TALLAHASSEE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 323064300 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | OFFICER | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 8502247144 | PhoneNum |
| Signature | 2017-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KEVIN WARREN | PreparerPersonNm |
| PTIN | P00642409 | PTIN |
| Phone | 8503866184 | PhoneNum |
| Preparation | 2017-05-08 | PreparationDt |
| 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 | JOHN FOGARTY MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1115 W CALL ST | AddressLine1Txt |
| City | TALLAHASSEE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 323064300 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,865,545 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MED.FSU.EDU/FMPP | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2006 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | THE 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 Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,416,967 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,844,365 | CYProgramServiceRevenueAmt |
| PY Investment Income | $22,752 | PYInvestmentIncomeAmt |
| CY Investment Income | $21,180 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $12,439,719 | PYTotalRevenueAmt |
| CY Total Revenue | $8,865,545 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $291,739 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $265,872 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,777,482 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,152,791 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,659,618 | PYOtherExpensesAmt |
| CY Other Expenses | $1,688,127 | CYOtherExpensesAmt |
| PY Total Expenses | $11,728,839 | PYTotalExpensesAmt |
| CY Total Expenses | $8,106,790 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $710,880 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $758,755 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,622,522 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,234,474 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,132,832 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,892,473 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,489,690 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,342,001 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE 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 Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,075,411 | ExpenseAmt |
| Grant | $265,872 | GrantAmt |
| Revenue | $8,844,365 | RevenueAmt |
| Desc | PERFORMED 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 | $8,075,411 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | 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 | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | 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 | 8 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAWN SNYDER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8506452827 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1115 WEST CALL STREET | AddressLine1Txt |
| City | TALLAHASSEE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32306 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| DANIEL VAN DURME MD | ||||||||
| VICE PRESIDENT | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $269,192 | $36,309 | |
| ALMA LITTLES MD | ||||||||
| SECRETARY | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $278,231 | $35,657 | |
| JOHN FOGARTY MD | ||||||||
| PRESIDENT | 2.00 | 40.00 | Yes (X) | Yes (X) | $0 | $401,161 | $35,752 | |
| RICHARD NOWAKOWSKI PHD | ||||||||
| TREASURER | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $246,989 | $28,135 | |
| RICARDO GONZALEZ-ROTHI MD | ||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $298,137 | $29,096 | ||
| LESLIE BEITSCH MD JD | ||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $264,261 | $34,814 | ||
| KYLE CLARK MBA | ||||||||
| DIRECTOR | 0.50 | 40.00 | Yes (X) | $0 | $330,133 | $37,941 | ||
| SALLIE MCRORIE PHD | ||||||||
| DIRECTOR | 0.50 | 40.00 | Yes (X) | $0 | $330,348 | $32,859 | ||
| PAUL KATZ | ||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $197,716 | $24,897 | ||
| KENNETH V BRUMMEL-SMITH MD | ||||||||
| FORMER DIRECTOR | 1.00 | 40.00 | $0 | $254,521 | $34,839 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,870,689 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $330,299 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CLINICAL REVENUE | 624100 | $8,772,897 | $8,772,897 |
| MEDICAID REVENUE | 624100 | $71,468 | $71,468 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,844,365 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,180 | TotalRevenueColumnAmt |
| Exclusion | $21,180 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,865,545 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,844,365 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $21,180 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $265,872 | TotalAmt |
| Program Services | $265,872 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,117,781 | TotalAmt |
| Program Services | $5,117,781 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $326,042 | TotalAmt |
| Program Services | $326,042 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $490,852 | TotalAmt |
| Program Services | $490,852 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $218,116 | TotalAmt |
| Program Services | $218,116 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,000 | TotalAmt |
| Management And General | $15,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,260 | TotalAmt |
| Program Services | $170,260 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,049 | TotalAmt |
| Management And General | $3,049 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,330 | TotalAmt |
| Management And General | $13,330 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,376 | TotalAmt |
| Program Services | $46,376 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,330 | TotalAmt |
| Program Services | $34,330 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,074,662 | TotalAmt |
| Program Services | $1,074,662 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| PROGRAM DEVELOPMENT | $178,742 | $178,742 |
| MEDICAL SUPPLIES | $130,262 | $130,262 |
| BANKING FEES | $18,116 | $18,116 |
| MEDICAL SERVICES | $4,000 | $4,000 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,106,790 | TotalAmt |
| Program Services | $8,075,411 | ProgramServicesAmt |
| Management And General | $31,379 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,254,680 | BOYAmt |
| EOY | $1,034,408 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,449,472 | BOYAmt |
| EOY | $407,208 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,846 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $131,644 | BOYAmt |
| EOY | $36,570 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $994,880 | BOYAmt |
| EOY | $1,019,476 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $750,000 | BOYAmt |
| EOY | $1,736,812 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,622,522 | BOYAmt |
| EOY | $4,234,474 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $146,487 | BOYAmt |
| EOY | $36,268 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $4,800 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,986,345 | BOYAmt |
| EOY | $1,851,405 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,132,832 | BOYAmt |
| EOY | $1,892,473 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,489,690 | BOYAmt |
| EOY | $2,342,001 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,489,690 | BOYAmt |
| EOY | $2,342,001 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,622,522 | BOYAmt |
| EOY | $4,234,474 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $758,755 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $93,556 | PriorPeriodAdjustmentsAmt |
| 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| 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) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA STATE UNIVERSITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 591961248 | EIN |
| Organization Type | 2 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $6,152,791 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $6,152,791 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| FSU FOUNDATION | $720,406 | F |
| FLORIDA SPECIAL PURPOSE INVESTMENT ACCOUNT (VIA UNIVERSITY) | $1,016,406 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $1,736,812 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| FLORIDA STATE UNIVERSITY AUXILIARY | $644,314 |
| DEPARTMENTAL DISTRIBUTION | $1,207,091 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,851,405 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $8,865,545 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $8,865,545 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $8,865,545 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $8,106,790 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $8,106,790 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $8,106,790 | TotalExpensesPerForm990Amt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1115 WEST CALL STREET | AddressLine1Txt |
| City | TALLAHASSEE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32306 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 591961248 | RecipientEIN |
| IRC Section | 115(1) | IRCSectionDesc |
| Cash Grant | $265,872 | CashGrantAmt |
| Purpose Of Grant | DEPARTMENTAL DISTRBUTION SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DANIEL VAN DURME MD | ||||||||||||||
| VICE PRESIDENT | $0 | $269,192 | $0 | $0 | $0 | $0 | $0 | $21,087 | $0 | $15,222 | $0 | $305,501 | $0 | $0 |
| ALMA LITTLES MD | ||||||||||||||
| SECRETARY | $0 | $278,231 | $0 | $0 | $0 | $0 | $0 | $20,435 | $0 | $15,222 | $0 | $313,888 | $0 | $0 |
| JOHN FOGARTY MD | ||||||||||||||
| PRESIDENT | $0 | $401,161 | $0 | $0 | $0 | $0 | $0 | $20,530 | $0 | $15,222 | $0 | $436,913 | $0 | $0 |
| RICHARD NOWAKOWSKI PHD | ||||||||||||||
| TREASURER | $0 | $246,989 | $0 | $0 | $0 | $0 | $0 | $19,507 | $0 | $8,628 | $0 | $275,124 | $0 | $0 |
| RICARDO GONZALEZ-ROTHI MD | ||||||||||||||
| DIRECTOR | $0 | $298,137 | $0 | $0 | $0 | $0 | $0 | $21,944 | $0 | $7,152 | $0 | $327,233 | $0 | $0 |
| LESLIE BEITSCH MD JD | ||||||||||||||
| DIRECTOR | $0 | $264,261 | $0 | $0 | $0 | $0 | $0 | $19,592 | $0 | $15,222 | $0 | $299,075 | $0 | $0 |
| KYLE CLARK MBA | ||||||||||||||
| DIRECTOR | $0 | $321,433 | $0 | $0 | $0 | $8,700 | $0 | $20,609 | $0 | $17,332 | $0 | $368,074 | $0 | $0 |
| SALLIE MCRORIE PHD | ||||||||||||||
| DIRECTOR | $0 | $253,428 | $0 | $0 | $0 | $76,920 | $0 | $25,678 | $0 | $7,181 | $0 | $363,207 | $0 | $0 |
| PAUL KATZ | ||||||||||||||
| DIRECTOR | $0 | $197,716 | $0 | $0 | $0 | $0 | $0 | $14,749 | $0 | $10,148 | $0 | $222,613 | $0 | $0 |
| KENNETH V BRUMMEL-SMITH MD | ||||||||||||||
| FORMER DIRECTOR | $0 | $254,521 | $0 | $0 | $0 | $0 | $0 | $19,617 | $0 | $15,222 | $0 | $289,360 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | COMPENSATION 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 ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | ALMA B. LITTLES, M.D. AND JOHN P. FOGARTY, M.D. ARE ON THE AMA COUNCIL TOGETHER. ALMA B. LITTLES, M.D, AND DANIEL J. VAN DURME, M.D. ARE ON THE FAFP BOARD TOGETHER. |
| FORM 990, PART VI, SECTION B, LINE 11 | A 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 12C | ANY 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 15 | COMPENSATION 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 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990 PART XII, LINE 2C | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA STATE UNIVERSITY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | A2201 UNIVERSITY CENTER | AddressLine1Txt |
| City | TALLAHASSEE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32306 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 591961248 | EIN |
| Primary Activities | UNIVERSITY | PrimaryActivitiesTxt |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Exempt Code Section | 115 | ExemptCodeSectionTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA STATE UNIVERSITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | O | TransactionTypeTxt |
| Involved | $6,152,791 | InvolvedAmt |
| Method Of Amount Determination | CASH | MethodOfAmountDeterminationTxt |
Comments