PEDIPLACE: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- PEDIPLACE (EIN 75-2512752)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-08-27
- IRS object ID
- 201222409349300307
- Schema version
- 2011v1.2
- 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 | 2012-08-27T09:25:27-00:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Albright Hill and Sumpter PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12160 N Abrams Road Suite 412 | AddressLine1 |
| City | Dallas | City |
| State | TX | State |
| ZIP Code | 75243 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 752512752 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEDIPLACE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PEDI | NameControl |
| Phone | 9724367962 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 S OLD ORCHARD Room No 126 | AddressLine1 |
| City | LEWISVILLE | City |
| State | TX | State |
| ZIP Code | 75067 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LARRY ROBINS | Name |
| Title | PRESIDENT AND CEO | Title |
| Date Signed | 2012-08-27 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jennifer Hill | Name |
| Phone | 9722705452 | Phone |
| Date Prepared | 2012-08-27 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LARRY SMITH | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 512 S OLD ORCHARD SUITE 126 | AddressLine1 |
| City | LEWISVILLE | City |
| State | TX | State |
| ZIP Code | 75067 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 2110495 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.PEDIPLACE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1993 | YearFormation |
| State Legal Domicile | TX | StateLegalDomicile |
| Activity Or Mission Description | Provide medical services to uninsured and under-insured children living in North Texas. Our mission is making healthcare a reality for every kid. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 19 | NbrIndependentVotingMembers |
| Total Nbr Employees | 34 | TotalNbrEmployees |
| Total Nbr Volunteers | 811 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 887558 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 754721 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 1352727 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1328073 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 5338 | InvestmentIncomePriorYear |
| Investment Income Current Year | 5509 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 27871 | OtherRevenuePriorYear |
| Other Revenue Current Year | -15098 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 2273494 | TotalRevenuePriorYear |
| Total Revenue Current Year | 2073205 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 1252272 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 1441161 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 132707 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 706290 | OtherExpensePriorYear |
| Other Expenses Current Year | 600139 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1958562 | TotalExpensesPriorYear |
| Total Expenses Current Year | 2041300 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 314932 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 31905 | RevenuesLessExpensesCY |
| Total Assets BOY | 1108511 | TotalAssetsBOY |
| Total Assets EOY | 1139405 | TotalAssetsEOY |
| Total Liabilities BOY | 69129 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 68118 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1039382 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1071287 | NetAssetsOrFundBalancesEOY |
| Mission Description | Provide medical services to uninsured and under-insured children living in North Texas. Our mission is making healthcare a reality for every kid. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 1691980 | Expense |
| Revenue | 1312975 | Revenue |
| Description | This organization provides medical services to under-insured and uninsured children living throughout North Texas. | Description |
| Total Program Service Expense | 1691980 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| 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 | true | 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 | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | 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 | false | 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 | 11 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 34 | NumberOfEmployees |
| Employment Tax Returns Filed | true | 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 |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 19 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | 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 | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LARRY ROBINS | NamePerson |
| Telephone Number | 9724367962 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 512 S OLD ORCHARD SUITE 126 | AddressLine1 |
| City | LEWISVILLE | City |
| State | TX | State |
| ZIP Code | 75067 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| LARRY SMITH | ||||||||
| CHAIR | 002.00 | X | X | 0 | 0 | 0 | ||
| LYNN BENJAMIN | ||||||||
| CHAIR ELECT | 001.00 | X | X | 0 | 0 | 0 | ||
| JEFF BRANNEN | ||||||||
| VICE CHAIR | 001.00 | X | X | 0 | 0 | 0 | ||
| MELISSA DEWITT | ||||||||
| TREASURER | 002.00 | X | X | 0 | 0 | 0 | ||
| KEVIN ROGERS | ||||||||
| SECRETARY | 001.00 | X | X | 0 | 0 | 0 | ||
| LINDA BURNEY-FUHR | ||||||||
| PAST CHAIR | 001.00 | X | X | 0 | 0 | 0 | ||
| LARRY ROBINS | ||||||||
| EX-OFFICIO/PRESIDENT CEO | 045.00 | X | 148800 | 0 | 0 | X | X | |
| JOHN ALLEN | ||||||||
| DIRECTOR | 001.00 | X | 0 | 0 | 0 | |||
| MIKE FRYE | ||||||||
| DIRECTOR | 001.00 | X | 0 | 0 | 0 | |||
| DOUG KILLOUGH | ||||||||
| DIRECTOR | 001.00 | X | 0 | 0 | 0 | |||
| DARLA KINCAID | ||||||||
| DIRECTOR | 001.00 | X | 0 | 0 | 0 | |||
| CAROL LONGACRE | ||||||||
| DIRECTOR | 001.00 | X | 0 | 0 | 0 | |||
| MATT MCCORMICK | ||||||||
| DIRECTOR | 001.00 | X | 0 | 0 | 0 | |||
| CARL MENCKHOFF | ||||||||
| DIRECTOR | 001.00 | X | 0 | 0 | 0 | |||
| S T NEWTON | ||||||||
| DIRECTOR | 001.00 | X | 0 | 0 | 0 | |||
| JOHN O'NEILL | ||||||||
| DIRECTOR | 001.00 | X | 0 | 0 | 0 | |||
| CAROL POPE-CODY | ||||||||
| DIRECTOR | 001.00 | X | 0 | 0 | 0 | |||
| MIKE SCHNITTKER | ||||||||
| DIRECTOR | 001.00 | X | 0 | 0 | 0 | |||
| HAROLD SHEPARD | ||||||||
| DIRECTOR | 001.00 | X | 0 | 0 | 0 | |||
| MARK VARGUS | ||||||||
| DIRECTOR | 001.00 | X | 0 | 0 | 0 | |||
| SHAWN BLACK | ||||||||
| EX-OFFICIO | 001.00 | X | 0 | 0 | 0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 148800 | TotalReportableCompFromOrg |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | SEE SCHEDULE O | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Federated Campaigns | 275000 | FederatedCampaigns |
| Fundraising Events | 40251 | FundraisingEvents |
| Government Grants | 51965 | GovernmentGrants |
| All Other Contributions | 387505 | AllOtherContributions |
| Noncash Contributions | 96776 | NoncashContributions |
| Total Contributions | 754721 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MEDICAL SERVICES | Description |
| Total Revenue Column | 1328073 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1328073 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1328073 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5509 | TotalRevenueColumn |
| Exclusion | $5,509 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 22192 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 40251 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 37290 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -15098 | TotalRevenueColumn |
| Exclusion | -$15,098 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2073205 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1328073 | RelatedOrExemptFunctionIncome |
| Exclusion | -$9,589 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148800 | Total |
| Program Services | 122373 | ProgramServices |
| Management And General | 14209 | ManagementAndGeneral |
| Fundraising | 12218 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1036075 | Total |
| Program Services | 852068 | ProgramServices |
| Management And General | 98936 | ManagementAndGeneral |
| Fundraising | 85071 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24861 | Total |
| Program Services | 21372 | ProgramServices |
| Management And General | 1822 | ManagementAndGeneral |
| Fundraising | 1667 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 141904 | Total |
| Program Services | 132455 | ProgramServices |
| Management And General | 6972 | ManagementAndGeneral |
| Fundraising | 2477 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89521 | Total |
| Program Services | 75180 | ProgramServices |
| Management And General | 8012 | ManagementAndGeneral |
| Fundraising | 6329 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees For Services Prof Fundraising | FeesForServicesProfFundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 119546 | Total |
| Program Services | 94553 | ProgramServices |
| Management And General | 15543 | ManagementAndGeneral |
| Fundraising | 9450 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6948 | Total |
| Program Services | 427 | ProgramServices |
| Management And General | 4795 | ManagementAndGeneral |
| Fundraising | 1726 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51288 | Total |
| Program Services | 34915 | ProgramServices |
| Management And General | 10715 | ManagementAndGeneral |
| Fundraising | 5658 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39050 | Total |
| Program Services | 29467 | ProgramServices |
| Management And General | 6598 | ManagementAndGeneral |
| Fundraising | 2985 | Fundraising |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 104324 | Total |
| Program Services | 82620 | ProgramServices |
| Management And General | 21704 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5486 | Total |
| Program Services | 1864 | ProgramServices |
| Management And General | 3058 | ManagementAndGeneral |
| Fundraising | 564 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61368 | Total |
| Program Services | 49094 | ProgramServices |
| Management And General | 12274 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23989 | Total |
| Program Services | 21571 | ProgramServices |
| Management And General | 1915 | ManagementAndGeneral |
| Fundraising | 503 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| PHYSICIAN EXPENSES | 128647 | 128647 | ||
| LABORATORY EXPENSE | 21450 | 21450 | ||
| DRUGS/MEDICAL SUPPLIES/MEDICAL WASTE | 13860 | 13755 | 105 | |
| CONTINUING EDUCATION | 5128 | 3712 | 1247 | 169 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19055 | Total |
| Program Services | 6457 | ProgramServices |
| Management And General | 8708 | ManagementAndGeneral |
| Fundraising | 3890 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2041300 | Total |
| Program Services | 1691980 | ProgramServices |
| Management And General | 216613 | ManagementAndGeneral |
| Fundraising | 132707 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 596274 | BOY |
| EOY | 67193 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 162615 | BOY |
| EOY | 621902 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 225333 | BOY |
| EOY | 164040 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 53795 | BOY |
| EOY | 55804 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2200 | BOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15983 | BOY |
| EOY | 4816 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 653658 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 429508 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50811 | BOY |
| EOY | 224150 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1500 | BOY |
| EOY | 1500 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1108511 | BOY |
| EOY | 1139405 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 69129 | BOY |
| EOY | 45418 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 22700 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 69129 | BOY |
| EOY | 68118 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 816136 | BOY |
| EOY | 991100 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 212746 | BOY |
| EOY | 69687 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10500 | BOY |
| EOY | 10500 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1039382 | BOY |
| EOY | 1071287 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1108511 | BOY |
| EOY | 1139405 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 31905 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
| Public Support Total170 | 0 | PublicSupportTotal170 |
| Public Support Pertcentage170 | 0.00000 | PublicSupportPertcentage170 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 442351 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 515001 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 559888 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 887558 | CurrentTaxYearMinus1Year |
| Current Tax Year | 754721 | CurrentTaxYear |
| Total | 3159519 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1089294 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1166146 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1285229 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1352727 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1328073 | CurrentTaxYear |
| Total | 6221469 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1531645 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1681147 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1845117 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2240285 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2082794 | CurrentTaxYear |
| Total | 9380988 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 9380988 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 614 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6526 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7235 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 5338 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5509 | CurrentTaxYear |
| Total | 25222 | Total |
Post1975 UBTI Post1975UBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 614 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6526 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7235 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 5338 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5509 | CurrentTaxYear |
| Total | 25222 | Total |
Net Income From Other UBI NetIncomeFromOtherUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1532259 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1687673 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1852352 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2245623 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2088303 | CurrentTaxYear |
| Total | 9406210 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99730 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99770 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00270 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00230 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Included On FS | false | IncludedOnFS |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 264589 | OtherCostOrOtherBasis |
| Book Value | 264589 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 389069 | OtherCostOrOtherBasis |
| Book Value | 389069 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Depreciation | 429508 | Depreciation |
| Book Value | -429508 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 224150 | TotalOfBookValueLandBuildings |
| Total Revenue | 2073205 | TotalRevenue |
| Total Expenses | 2041300 | TotalExpenses |
| Excess Or Deficit For Year | 31905 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 31905 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 2207239 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 134034 | DonatedSrvcAndUseOfFacilities |
| Revenue Not Rptd F990 | 134034 | RevenueNotRptdF990 |
| Revenue Subtotal | 2073205 | RevenueSubtotal |
| Total Revenue Per Form990 | 2073205 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 2175334 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 134034 | DonatedServicesUseOfFacilities |
| Expenses Not Rptd F990 | 134034 | ExpensesNotRptdF990 |
| Expenses Subtotal | 2041300 | ExpensesSubtotal |
| Total Expenses Per Form990 | 2041300 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| X | 2 | The Organization files an annual income tax return. With few exceptions, the Organization is no longer subject to U.S. federal income tax examinations by tax authorities for years before 2008. The Organization has adopted the provisions of FASB ASC 740, Accounting for Uncertainty in Income Taxes. There were no unrecognized tax benefits as of December 31, 2011 and 2010. |
| X | 2 | The Organization recognizes interest accrued related to unrecognized tax benefits in interest expense and penalties in operating expense. There were no such interest and penalties for 2011 and 2010. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GALA | NameOfEvent1 |
| Gross Receipts Event1 | 49260 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 30986 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 18274 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 28910 | OtherDirectExpensesEvent1 |
| Name Of Event2 | FASHION SHOW | NameOfEvent2 |
| Gross Receipts Event2 | 13183 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 9265 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 3918 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 8380 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 62443 | GrossReceiptsTotal |
| Charitable Contributions Total | 40251 | CharitableContributionsTotal |
| Gross Revenue Total Events | 22192 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 37290 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 37290 | DirectExpenseSummaryEvents |
| Net Income Summary | -15098 | NetIncomeSummary |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | SOFTWARE | Description |
| Noncash Contribs Rptd F990 | 96776 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | BOOK VALUE | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | true | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990 Part VI | 11b | After preparation of the Form 990 and before filing of the form, the preparer provided a copy for the finance committee to review. A copy of the tax return was provided to the organization for its files. |
| Form 990 Part VI | 12c | The tone for a high level of ethics is set at the top. The board of directors imparts its expectations to all levels of management. In connection therewith, all board members, members of committees who are not board members, officers and employees are required to review the conflict of interest policy and to annually sign a conflict of interest statement. The signed forms are reviewed and the accounting department is advised of any disclosed conflicts. Any individual with a possible conflict, or who perceives or recognizes a conflict of others, is encouraged to discuss the matter with their immediate supervisor. All conflicts are ultimately to be discussed with the board of directors. |
| Form 990 Part VI | 15b | The President CEOs compensation is reviewed annually by a committee appointed by the chair of the board of directors. Base salary is compared with similar not-for-profit and for-profit organizations. Staff size, annual budget, market trends and skill level is used to determine comparable salaries. Benchmark information from other employers and summary data compiled from not-for-profit entity surveys presented bi-annually by the Community Council of Greater Dallas is consulted. Annual performance measurements are established to evaluate bonus guidelines. |
| Form 990 Part VI | 19 | Copies of requested governing documents and open pages of Form 990 are made available upon request. No such requests were received during 2011. |
| Form 990 Part VII | 1 | Community Medical Associates, Inc., 385 W Main St., Suite A, Lewisville, Texas 75057, Contract Physician Service, 128,647 |
| Form 990 Part VI Section B Line 11b After preparation of the Form 990 and before filing of the form, the preparer provided a copy for the finance committee to review. A copy of the tax return was provided to the organization for its files. Form 990 Part VI Section B Line 12c The tone for a high level of ethics is set at the top. The board of directors imparts its expectations to all levels of management. In connection therewith, all board members, members of committees who are not board members, officers and employees are required to review the conflict of interest policy and to annually sign a conflict of interest statement. The signed forms are reviewed and the accounting department is advised of any disclosed conflicts. Any individual with a possible conflict, or who perceives or recognizes a conflict of others, is encouraged to discuss the matter with their immediate supervisor. All conflicts are ultimately to be discussed with the board of directors. Form 990 Part VI Section B Line 15b The President CEOs compensation is reviewed annually by a committee appointed by the chair of the board of directors. Base salary is compared with similar not-for-profit and for-profit organizations. Staff size, annual budget, market trends and skill level is used to determine comparable salaries. Benchmark information from other employers and summary data compiled from not-for-profit entity surveys presented bi-annually by the Community Council of Greater Dallas is consulted. Annual performance measurements are established to evaluate bonus guidelines. Form 990 Part VI Section C Line 19 Copies of requested governing documents and open pages of Form 990 are made available upon request. No such requests were received during 2011. Form 990 Part VII Section B Line 1 Community Medical Associates, Inc., 385 W Main St., Suite A, Lewisville, Texas 75057, Contract Physician Service, 128,647 |
Comments