CHS Healthcare Foundation Inc: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CHS Healthcare Foundation Inc (EIN 26-0229508)
- Tax period
- 2012-04-01 to 2013-03-31
- Filed
- 2013-11-20
- IRS object ID
- 201323249349300632
- Schema version
- 2012v2.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-20T17:02:15-05:00 | Timestamp |
| Tax Period End Date | 2013-03-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 260254161 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tuscan & Company PA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12621 World Plaza Lane - Bldg 55 | AddressLine1 |
| City | Fort Myers | City |
| State | FL | State |
| ZIP Code | 33907 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-04-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 260229508 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHS Healthcare Foundation Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHSH | NameControl |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1454 Madison Ave | AddressLine1 |
| City | Immokalee | City |
| State | FL | State |
| ZIP Code | 34142 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dennis Brown | Name |
| Title | Treasurer | Title |
| Phone | 2396583000 | Phone |
| Date Signed | 2013-10-11 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jeffrey M Tuscan | Name |
| PTIN | P00184439 | PTIN |
| Phone | 2393332090 | Phone |
| Date Prepared | 2013-11-20 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HealthCare Network of SWFL FDN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 601171 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.healthcareswfl.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2007 | YearFormation |
| State Legal Domicile | FL | StateLegalDomicile |
| Activity Or Mission Description | To support the programs and services of Collier Health Services Inc (4CHSI4) to enable CHSI to meet it9s mission to provide a quality healthcare home accessible to everyone in it9s community. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 18 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 18 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 19 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 376851 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 601171 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 376851 | TotalRevenuePriorYear |
| Total Revenue Current Year | 601171 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 366391 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 488894 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 6226 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 37772 | OtherExpensePriorYear |
| Other Expenses Current Year | 86431 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 404163 | TotalExpensesPriorYear |
| Total Expenses Current Year | 575325 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -27312 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 25846 | RevenuesLessExpensesCY |
| Total Assets BOY | 235023 | TotalAssetsBOY |
| Total Assets EOY | 368704 | TotalAssetsEOY |
| Total Liabilities BOY | 154408 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 262243 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 80615 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 106461 | NetAssetsOrFundBalancesEOY |
| Mission Description | To support the programs and services of Collier Health Services Inc (4CHSI4) to enable CHSI to meet it9s mission to provide a quality healthcare home accessible to everyone in it9s community. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 488894 | Expense |
| Description | A private, not-for-profit 9safety net9 health care provider with health care facilities located throughout Collier County, which includes the Ronald McDonald Care Mobile. Healthcare Network of Southwest Florida (formerly CHS Healthcare) is the primary healthcare provider for 35,700 patients with 110,384 visits. We have the experience of serving this area for 36 years. Together with our partners, we offer reliable, affordable and sustainable services. | Description |
| Total Program Service Expense | 488894 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Employment Tax Returns Filed | false | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 18 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 18 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | false | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | The Organization | NamePerson |
| Telephone Number | 2396583000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1454 Madison Ave | AddressLine1 |
| City | Immokalee | City |
| State | FL | State |
| ZIP Code | 34142 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| Carlos Tarra | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Charles Johns | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Dennis Brown | ||||||
| Treasurer | 2.00 | X | 0 | 0 | 0 | X |
| Dottie Gerrity | ||||||
| Secretary | 2.00 | X | 0 | 0 | 0 | X |
| Ed Morton | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Edwin Colodny | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Emily Watt | ||||||
| Chairman | 2.00 | X | 0 | 0 | 0 | X |
| Eugenie Bodick | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Fred Pezeshkan | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| George McLaughlin | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| J Douglas Campbell | ||||||
| Vice Chairman | 2.00 | X | 0 | 0 | 0 | X |
| Jennifer Walker | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Jinny Johnson | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Jody Alexander | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Marsha Murphy | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Richard Akin | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Sue Dalton | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | X |
| Tom Schneider | ||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| All Other Contributions | 601171 | AllOtherContributions |
| Noncash Contributions | 64967 | NoncashContributions |
| Total Contributions | 601171 | TotalContributions |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 601171 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 488894 | Total |
| Program Services | 488894 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30 | Total |
| Fundraising | 30 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3321 | Total |
| Management And General | 3050 | ManagementAndGeneral |
| Fundraising | 271 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8970 | Total |
| Management And General | 7495 | ManagementAndGeneral |
| Fundraising | 1475 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2554 | Total |
| Management And General | 1192 | ManagementAndGeneral |
| Fundraising | 1362 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 209 | Total |
| Management And General | 209 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|
| In Kind | 64967 | 64967 | |
| Special Events | 36 | 36 | |
| Licensing Fees | 200 | 200 | |
| Printing | 2464 | 2464 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3680 | Total |
| Management And General | 3292 | ManagementAndGeneral |
| Fundraising | 388 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 575325 | Total |
| Program Services | 488894 | ProgramServices |
| Management And General | 80205 | ManagementAndGeneral |
| Fundraising | 6226 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 234239 | BOY |
| EOY | 367719 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 410 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1463 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 888 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 784 | BOY |
| EOY | 575 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 235023 | BOY |
| EOY | 368704 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1805 | BOY |
| EOY | 262243 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 152603 | BOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 154408 | BOY |
| EOY | 262243 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 80615 | BOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 106461 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 80615 | BOY |
| EOY | 106461 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 235023 | BOY |
| EOY | 368704 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 25846 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 60960 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 79032 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 123597 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 376851 | CurrentTaxYearMinus1Year |
| Current Tax Year | 536204 | CurrentTaxYear |
| Total | 1176644 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 60960 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 79032 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 123597 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 376851 | CurrentTaxYearMinus1Year |
| Current Tax Year | 536204 | CurrentTaxYear |
| Total | 1176644 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 39267 | AmountsSubstContributorsTotal |
| Public Support Total170 | 1137377 | PublicSupportTotal170 |
| Total Support | 1176644 | TotalSupport |
| Public Support Pertcentage170 | 0.96660 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.73300 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1463 | OtherCostOrOtherBasis |
| Depreciation | 888 | Depreciation |
| Book Value | 575 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 575 | TotalOfBookValueLandBuildings |
| Tot Revenue Etc Audited Fincl Stmt | 601171 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 601171 | RevenueSubtotal |
| Total Revenue Per Form990 | 601171 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 575325 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 575325 | ExpensesSubtotal |
| Total Expenses Per Form990 | 575325 | TotalExpensesPerForm990 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHS Healthcare | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1454 Madison Ave | AddressLine1 |
| City | Immokalee | City |
| State | FL | State |
| ZIP Code | 34142 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 591741277 | EINOfRecipient |
| IRC Section | 501 | IRCSection |
| Amount Of Cash Grant | 488894 | AmountOfCashGrant |
| Purpose Of Grant | Healthcare | PurposeOfGrant |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Sharing Of RevenuesSharingOfRevenues |
|---|---|
| Richard Akin | |
| CHSI-CEO | true |
| J Douglas Campbell | |
| CHSI-Board Member | true |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | In Kind | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 64967 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | Cost | MethodOfDeterminingRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| O01 | Form 990 governing body review Part VI line 11 | A draft of the tax return is reviewed by the board for accuracy and completeness prior to signing and filing the return. |
| O02 | Conflict of interest policy compliance Part VI line 12c | Conflicts of interest are discussed and disclosed at board meetings, primarily on an issue by issue basis. |
| O03 | Governing documents etc available to public Part VI line 19 | The organization makes it9s governing documents, conflicts of interest policy, and financial statements available to the public upon request. |
Comments