CRESCENT OF HERNANDO INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
CRESCENT OF HERNANDO INC (EIN 30-0475982)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-05-06
IRS object ID
201641279349300739
Schema version
2015v2.1
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)
Return2016-05-06T12:06:43-07:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MYERS BUSINESS SERVICES INCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 10189AddressLine1Txt
CityBROOKSVILLECityNm
State AbbreviationFLStateAbbreviationCd
ZIP346030189ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN300475982EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Crescent of Hernando IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCRESBusinessNameControlTxt
Phone3526109916PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15244 Commercial WayAddressLine1Txt
CitySpring HillCityNm
State AbbreviationFLStateAbbreviationCd
ZIP346061933ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonHUSAM ABUZARAD MDPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone3526109916PhoneNum
Signature2016-04-27SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonGK MYERSPreparerPersonNm
Phone3525440024PhoneNum
Preparation2016-05-06PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2016-09-27 15:27:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerHUSAM ABUZARAD MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line15244 Commercial WayAddressLine1Txt
CitySpring HillCityNm
State AbbreviationFLStateAbbreviationCd
ZIP346061933ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$146,647GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.crescentclinic.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2008FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionTo provide free quality healthcare to the uninsured and low income residents.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee2TotalEmployeeCnt
Total Volunteers110TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$231,414PYContributionsGrantsAmt
CY Contributions Grants$135,125CYContributionsGrantsAmt
PY Program Service Revenue$5,587PYProgramServiceRevenueAmt
CY Program Service Revenue$11,522CYProgramServiceRevenueAmt
PY Investment Income$1,336PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$238,337PYTotalRevenueAmt
CY Total Revenue$146,647CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$35,618CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$19,753CYTotalFundraisingExpenseAmt
PY Other Expenses$98,189PYOtherExpensesAmt
CY Other Expenses$106,106CYOtherExpensesAmt
PY Total Expenses$98,189PYTotalExpensesAmt
CY Total Expenses$141,724CYTotalExpensesAmt
PY Revenues Less Expenses$140,148PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$4,923CYRevenuesLessExpensesAmt
Total Assets BOY$396,149TotalAssetsBOYAmt
Total Assets EOY$401,072TotalAssetsEOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$396,149NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$401,072NetAssetsOrFundBalancesEOYAmt
MissionTo provide free quality healthcareMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$14,030ExpenseAmt
Grant$2,264GrantAmt
Revenue$2,083RevenueAmt
DescQUALITY HEALTHCARE TO THE UNINSURED & LOW INCOME.Desc
Total Program Service Expenses$14,030TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee2EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcfalseRegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonHUSAM ABUZARAD MDPersonNm
Phone3526109927PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15244 Commercial WayAddressLine1Txt
CitySpring HillCityNm
State AbbreviationFLStateAbbreviationCd
ZIP346061933ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
HUSAM ABUZARAD MD
President10.00Yes (X)$0$0$0
MOHAMMAD A JOUD MD
Secretary10.00Yes (X)$0$0$0
ABDUSALAM KHALIL
Treasurer5.00Yes (X)$0$0$0
RODNEY S ACKLEY DDS
Director5.00$0$0$0Yes (X)
AZZAM MUFTAH MD
Director5.00$0$0$0Yes (X)
SYED WAQAR HASAN MD
Director5.00$0$0$0Yes (X)
AMY CAPOOCIA MD
Director5.00$0$0$0Yes (X)
ELAINE MOORMAN DHSC ARNP
Director5.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Fundraising$2,901FundraisingAmt
Government Grants$2,264GovernmentGrantsAmt
All Other Contributions$129,960AllOtherContributionsAmt
Total Contributions$135,125TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescHealthcare ServicesDesc
Business621400BusinessCd
Total Revenue Column$11,522TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$11,522TotalProgramServiceRevenueAmt
Contri Rpt Fundraising Event$2,901ContriRptFundraisingEventAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$146,647TotalRevenueColumnAmt
Related Or Exempt Func Income$11,522RelatedOrExemptFuncIncomeAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$35,265TotalAmt
Program Services$0ProgramServicesAmt
Management And General$35,265ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$353TotalAmt
Program Services$0ProgramServicesAmt
Management And General$353ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$901TotalAmt
Program Services$901ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,850TotalAmt
Program Services$0ProgramServicesAmt
Management And General$4,850ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$19,063TotalAmt
Program Services$0ProgramServicesAmt
Management And General$19,063ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,610TotalAmt
Program Services$1,610ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$18,906TotalAmt
Program Services$0ProgramServicesAmt
Management And General$18,906ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$4,126TotalAmt
Program Services$4,126ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Repairs & Maintenance$1,534$0$1,534$0
Supplies$26,834$1,720$25,114$0
Telephone$2,856$0$2,856$0
Utilities$5,673$5,673$0$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$19,753TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$19,753FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$141,724TotalAmt
Program Services$14,030ProgramServicesAmt
Management And General$107,941ManagementAndGeneralAmt
Fundraising$19,753FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$63,533BOYAmt
EOY$57,362EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$151,625BOYAmt
EOY$181,625EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$166,925LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$59,142LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$126,689BOYAmt
EOY$107,783EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$54,302BOYAmt
EOY$54,302EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$396,149BOYAmt
EOY$401,072EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$396,149BOYAmt
EOY$401,072EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$396,149BOYAmt
EOY$401,072EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$396,149BOYAmt
EOY$401,072EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$4,923ReconcilationRevenueExpnssAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind
Public Support Total170$0PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support CY1700PublicSupportCY170Pct

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$103,677CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$79,428CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$164,035CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$215,635CurrentTaxYearMinus1YearAmt
Current Tax Year$149,647CurrentTaxYearAmt
Total$712,422TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$9,194CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,587CurrentTaxYearMinus1YearAmt
Total$14,781TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$103,677CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$79,428CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$173,229CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$221,222CurrentTaxYearMinus1YearAmt
Current Tax Year$149,647CurrentTaxYearAmt
Total$727,203TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$727,203PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$1,336CurrentTaxYearMinus1YearAmt
Total$1,336TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$1,336CurrentTaxYearMinus1YearAmt
Total$1,336TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Total$728,539TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99820PublicSupportCY509Pct
Public Support PY5090.99800PublicSupportPY509Pct
Investment Income CY0.00180InvestmentIncomeCYPct
Investment Income PY0.00200InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$54,302BeginningYearBalanceAmt
End Year Balance$54,302EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$54,302BeginningYearBalanceAmt
End Year Balance$54,302EndYearBalanceAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$120,250InvestmentCostOrOtherBasisAmt
Depreciation$22,214DepreciationAmt
Book Value$98,036BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$46,675InvestmentCostOrOtherBasisAmt
Depreciation$36,928DepreciationAmt
Book Value$9,747BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$107,783TotalBookValueLandBuildingsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Pt VI, Line 7aN/A
Pt VI, Line 11bCopy available for review
Form 990, Part IX, Line 24fFUNDRAISING EXPENSES 19753. 0. 0. 19753.

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