JUPITER ISLAND MEDICAL CLINIC INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- JUPITER ISLAND MEDICAL CLINIC INC (EIN 20-4659155)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-03-11
- IRS object ID
- 201510709349300966
- Schema version
- 2013v4.0
- 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 | 2015-03-11T18:50:29-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 651063964 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NARDA E BUTNER CPA PA | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3307 NORTHLAKE BLVD STE 105 | AddressLine1 |
| City | PALM BEACH GARDENS | City |
| State | FL | State |
| ZIP Code | 334031703 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204659155 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JUPITER ISLAND MEDICAL CLINIC INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JUPI | BusinessNameControlTxt |
| Phone | 7725463751 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 ESTRADA SQUARE | AddressLine1 |
| City | HOBE SOUND | City |
| State | FL | State |
| ZIP Code | 33475 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TYLER R CAIN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 7725463751 | PhoneNum |
| Signature | 2015-02-21 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | NARDA E BUTNER | PreparerPersonNm |
| PTIN | P00844716 | PTIN |
| Phone | 5616533330 | PhoneNum |
| Preparation | 2015-02-21 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TYLER R CAIN | PrincipalOfficerNm |
| Gross Receipts | $1,642,702 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | NONE | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE MEDICAL SERVICES TO ALL MEMBERS OF THE COMMUNITY WHO NEED THEM REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 4 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $756,538 | PYContributionsGrantsAmt |
| CY Contributions Grants | $900,967 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $121,178 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $113,880 | CYProgramServiceRevenueAmt |
| PY Investment Income | $32,127 | PYInvestmentIncomeAmt |
| CY Investment Income | -$7,951 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $909,843 | PYTotalRevenueAmt |
| CY Total Revenue | $1,006,896 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $166,695 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $189,954 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $4,162 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $484,032 | PYOtherExpensesAmt |
| CY Other Expenses | $561,977 | CYOtherExpensesAmt |
| PY Total Expenses | $650,727 | PYTotalExpensesAmt |
| CY Total Expenses | $751,931 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $259,116 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $254,965 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,692,968 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,104,391 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,809 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $18,617 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,677,159 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,085,774 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE MEDICAL SERVICES TO ALL MEMBERS OF THE COMMUNITY WHO NEED THEM REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH SERVICES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $625,471 | ExpenseAmt |
| Desc | TO PROVIDE MEDICAL SERVICES TO ALL MEMBERS OF THE COMMUNITY WHO NEED THEM REGARDLESS OF THEIR ABILITY TO PAY. | Desc |
| Total Program Service Expenses | $625,471 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 4 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VICKIE HOFMEISTER | PersonNm |
| Phone | 7725463751 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 ESTRADA ROAD | AddressLine1 |
| Address Line2 | 100 ESTRADA ROAD | AddressLine2 |
| City | HOBE SOUND | City |
| State | FL | State |
| ZIP Code | 33455 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (3 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| TYLER R CAIN | ||||||
| PRESIDENT | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LODEWIJK J R DE VINK | ||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JOANIE MADEIRA | ||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CHERYL J ROBERT MD | |||||
| 100 ESTRADA SQUARE | HOBE SOUND | FL | 33455 | MEDICAL DOCTOR | $195,873 |
| DANIEL HARWITZ MD | |||||
| 100 ESTRADA SQUARE | HOBE SOUND | FL | 33455 | MEDICAL DOCTOR | $144,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $900,967 | AllOtherContributionsAmt |
| Total Contributions | $900,967 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| DR. ROBERTS PATIENT FEES | $71,572 | $71,572 |
| DR. HARWITZ FEES | $39,569 | $39,569 |
| MEDICARE - DR. ROBINSON | $2,709 | $2,709 |
| MEDICARE - DR. HARWITZ | $1,390 | $1,390 |
| PATIENTS REFUNDS - DR. HARWIT | -$100 | -$100 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,260 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$1,260 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $113,880 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,813 | TotalRevenueColumnAmt |
| Exclusion | $15,813 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $612,042 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $635,714 | SecuritiesAmt |
| Other | $92 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$23,672 | SecuritiesAmt |
| Other | -$92 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$23,764 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$23,764 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,006,896 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $90,116 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $15,813 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,764 | TotalAmt |
| Program Services | $76,601 | ProgramServicesAmt |
| Management And General | $67,163 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,000 | TotalAmt |
| Program Services | $35,000 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,190 | TotalAmt |
| Program Services | $5,931 | ProgramServicesAmt |
| Management And General | $5,259 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,388 | TotalAmt |
| Management And General | $5,388 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $432,269 | TotalAmt |
| Program Services | $432,269 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,214 | TotalAmt |
| Program Services | $9,220 | ProgramServicesAmt |
| Management And General | $37,994 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,594 | TotalAmt |
| Program Services | $15,594 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES AND SERV | $12,949 | $12,949 |
| COMPUTER SUPPORT | $9,395 | $9,395 |
| OFFICE SUPPLIES AND EXPEN | $8,937 | $8,937 |
| COMPUTER SOFTWARE AND SUP | $8,194 | $8,194 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,037 | TotalAmt |
| Program Services | $11,381 | ProgramServicesAmt |
| Management And General | $6,494 | ManagementAndGeneralAmt |
| Fundraising | $4,162 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $751,931 | TotalAmt |
| Program Services | $625,471 | ProgramServicesAmt |
| Management And General | $122,298 | ManagementAndGeneralAmt |
| Fundraising | $4,162 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,581 | BOYAmt |
| EOY | $13,680 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $273,225 | BOYAmt |
| EOY | $364,409 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,251 | BOYAmt |
| EOY | $6,794 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,711 | BOYAmt |
| EOY | $2,053 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $80,098 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $41,990 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,413 | BOYAmt |
| EOY | $38,108 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,319,787 | BOYAmt |
| EOY | $1,679,347 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,692,968 | BOYAmt |
| EOY | $2,104,391 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,141 | BOYAmt |
| EOY | $17,379 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $668 | BOYAmt |
| EOY | $1,238 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,809 | BOYAmt |
| EOY | $18,617 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $357,372 | BOYAmt |
| EOY | $606,427 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,319,787 | BOYAmt |
| EOY | $1,479,347 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,677,159 | BOYAmt |
| EOY | $2,085,774 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,692,968 | BOYAmt |
| EOY | $2,104,391 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $254,965 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $153,657 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$7 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ACCRUED WAGES & PAYROLL TAXES | Desc |
| Amt | $1,238 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,238 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $1,160,553 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $153,657 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $153,657 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,006,896 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $1,006,896 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $751,936 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $5 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $5 | ExpensesNotReportedAmt |
| Expenses Subtotal | $751,931 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $751,931 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 4, PART XII, LINE 2D | FormAndLineReferenceDesc |
| Explanation | ROUNDING 0 BOOK / TAX DEPRECIATION DIFFERENCE 5 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 1, PART I, LINE 6 | THE VOLUNTEER ARE THE BOARD OF DIRECTORS AND MEMBERS OF THE BOARD |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE BOARD OF DIRECTORS REVIEW AND APPROVES THE ANNUAL AUDITED FINANCIAL STATEMENTS. THE BOARD OF DIRECTORS ALSO REVIEWS AND APPROVES THE ANNUAL FORM 990 RETURN OF THE ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THERE ARE NO RELATED PARTIES EMPLOYED BY THE CLINIC. THE EMPLOYEES AND DOCTORS ARE HIRED BASED ON THEIR SKILLS AND ABILITY TO DO THE JOB. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD OF DIRECTORS APPROVES ALL SALARIES AND DOCTORS COMPENSATIONS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE BOARD OF DIRECTORS GIVE ANNUAL BONUSES AND RAISES BASED ON THE INDIVIDUALS ABILITY AND SKILLS DEMONSTRATED ON THE JOB. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | DR. CHERYL J. ROBERTS 195,873 0 0 DR. DANIEL HARWITZ 144,000 0 0 NURSE CONTRACT 92,396 0 0 |
| FORM 990, PART XI, LINE 9 | ROUNDING 0 BOOK / TAX DEPRECIATION DIFFERENCE -5 |
| FORM 990, PART XI, LINE 9 | ROUNDING -2 DEPRECIATION ROUNDING 0 |
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