2012-11-13T08:15:48-06:00 2012-03-31 MYERS BRETTHOLTZ & COMPANY PA 12671 WHITEHALL DR FORT MYERS FL 339073626 990 2011-04-01 260229508 CHS HEALTHCARE FOUNDATION INC CHSH 2396583000 1454 MADISON AVE IMMOKALEE FL 34142 DENNIS BROWN 2396583000 2012-11-01 true JOHN M LOPEZ CPA 2399395775 2012-11-13 2011 2016-02-24 21:20:13Z DENNIS BROWN 1454 MADISON AVE IMMOKALEE FL 34142 376851 false X WWW.CHSHEALTHCAREFOUNDATION.ORG X 2007 FL TO SUPPORT THE PROGRAMS AND SERVICES OF COLLIER HEALTH SERVICES, INC. ("CHSI") TO ENABLE CHSI TO MEET ITS MISSION TO PROVIDE A QUALITY HEALTHCARE HOME ACCESSIBLE TO EVERYONE IN ITS COMMUNITY. 21 21 0 25 0 123597 376851 0 0 0 123597 376851 366391 0 0 0 26549 6814 37772 6814 404163 116783 -27312 120424 235023 12499 154408 107925 80615 TO SUPPORT THE PROGRAMS AND SERVICES OF COLLIER HEALTH SERVICES, INC. ("CHSI") TO ENABLE CHSI TO MEET ITS MISSION TO PROVIDE A QUALITY HEALTHCARE HOME ACCESSIBLE TO EVERYONE IN ITS COMMUNITY. false false 366391 366391 THE FOUNDATION RAISES AWARENESS AND FUNDING FOR THE PROGRAMS AND SERVICES OF CHSI. TO RAISE AWARENESS, THE BOARD OF THE FOUNDATION HAS FORMED A SUBCOMMITTEE TO CREATE NEW BRANDING AND MAREKETING MESSAGES FOR CHSI. CHSI IS A PRIVATE, NOT-FOR-PROFIT "SAFETY NET" HEALTH CARE PROVIDER WITH 12 HEALTH CARE FACILITIES LOCATED THROUGHOUT COLLIER COUNTY, WHICH INCLUDES THE RONALD MCDONALD CARE MOBILE. CHSI PROVIDED PRIMARY MEDICAL AND DENTAL HEALTH CARE TO OVER 43,000 PATIENTS (30,000 CHILDREN) FOR A TOTAL OF 154,500 PATIENT VISITS. RAISING PHILANTHROPIC SUPPORT WILL ALLOW CHSI TO CONTINUE TO GROW TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY. 366391 true true false false false false false false false false true false false false true false true false false false false false false false false false false true false false false false false false false false false true false false false false false false false false false false true 0 0 0 false false false false false false X 21 21 false false false false false false false true true false false true true true true false false false false false X X COLLIER HEALTH SERVICES INC 2396583039 1454 MADISON AVE IMMOKALEE FL 34142 X EMILY WATT 2.00 X X 0 0 0 DOUG CAMBELL 1.00 X X 0 0 0 DENNIS BROWN 1.00 X X 0 0 0 DOTTIE GERRITY 1.00 X X 0 0 0 JOHN MCDONOUGH 1.00 X 0 0 0 RICHARD AKIN 1.00 X 0 0 0 JODY ALEXANDER 1.00 X 0 0 0 DOLLY BODICK 1.00 X 0 0 0 EDWIN COLODNY 1.00 X 0 0 0 CHARLES JOHNS 1.00 X 0 0 0 JINNY JOHNSON 1.00 X 0 0 0 GEORGE MCLAUGHLIN 1.00 X 0 0 0 SUSAN MORRISON 1.00 X 0 0 0 EDWARD MORTON 1.00 X 0 0 0 MARSHA MURPHY 1.00 X 0 0 0 FRED PEZESHKAN 1.00 X 0 0 0 TOM SCHNEIDER 1.00 X 0 0 0 CARLOS TARRA 1.00 X 0 0 0 JENNIFER WALKER 1.00 X 0 0 0 KEN MURRAY 1.00 X 0 0 0 CONNSTANCE DILLON 40.00 X 0 0 0 false false false 376851 376851 376851 366391 366391 175 175 23443 3270 20173 153 153 8221 3006 5215 425 425 209 209 CELL PHONE 1957 1957 SMALL EQUIPMENT 1350 1350 DUES AND PUBLICATIONS 991 396 595 OTHER 848 457 391 404163 366391 11223 26549 119131 234239 300 1463 679 993 784 120424 235023 12499 1805 152603 12499 154408 X 107925 80615 107925 80615 120424 235023 -27312 2 X false true true X false X 10000 60960 79032 123597 376851 650440 10000 60960 79032 123597 376851 650440 173646 476794 650440 0.73300 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false 1463 679 784 784 AGENCY TRANSACTIONS 152603 152603 376851 404163 -27312 7530815 7530815 7503503 69899351 69843892 69843892 55459 321392 321392 376851 62395848 62313077 62313077 82771 321392 321392 404163 RECONCILIATION OF CHANGES - OTHER SCHEDULE D, PAGE 4, PART XI, LINE 8 COLLIER HEALTH SERVICES, INC. REVENUE 31,142,595 INTEGRAL HEALTH PLAN, INC. REVENUE 42,168,904 INTERCOMPANY ELIMINATIONS -3,467,607 AGENCY TRANSACTIONS -321,392 COLLIER HEALTH SERVCIES, INC. EXPENSES -25,725,857 INTEGRAL HEALTH PLAN, INC. EXPENSES -40,054,827 INTERCOMPANY ELIMINATIONS 3,467,607 AGENCY TRANSACTIONS 321,392 REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 2D COLLIER HEALTH SERVICES, INC. REVENUE 31,142,595 INTEGRAL HEALTH PLAN, INC. REVENUE 42,168,904 INTERCOMPANY ELIMINATIONS -3,467,607 REVENUE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 4B AGENCY TRANSACTIONS 321,392 EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER SCHEDULE D, PAGE 4, PART XIII, LINE 2D COLLIER HEALTH SERVCIES, INC. EXPENSES 25,725,857 INTEGRAL HEALTH PLAN, INC. EXPENSES 40,054,827 INTERCOMPANY ELIMINATIONS -3,467,607 EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XIII, LINE 4B AGENCY TRANSACTIONS 321,392 SUPPLEMENTAL FINANCIAL INFORMATION SCHEDULE D, PAGE 4, PART XIV THE AUDITED FINANCIAL STATEMENTS OF THE FOUNDATION WERE BASED ON THE CONSOLIDATED FINANCIAL STATEMENTS OF COLLIER HEALTH SERVICES, INC. ("CHSI"), INTEGRAL HEALTH PLAN, INC. ("IHP") AND CHS HEALTHCARE FOUNDATION, INC. ("FOUNDATION"). FORM 990 ONLY INCLUDES THE ACTIVITY OF THE FOUNDATION. true CHS HEALTHCARE 1454 MADISON AVENUE IMMOKALEE FL 34142 591741277 501 45000 HEALTHCARE CHS HEALTHCARE 1454 MADISON AVENUE IMMOKALEE FL 34142 591741277 501 321391 AGENCY TRANSACTIONS 1 CONNIE DILLON CHSI EMPLOYEE false DENNIS BROWN CHSI BRD MEMBER false DOUG CAMPBELL CHSI BRD MEMBER false RICHARD AKIN CHSI - CEO false ADDITIONAL INFORMATION SCHEDULE L PART V THE FOUNDATION GRANTED 45000 TO CHSI AND COLLECTED FUNDS IN THE AMOUNT OF 321391 ON CHSIS BEHALF ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B A DRAFT OF THE TAX RETURN IS REVIEWED BY THE BOARD FOR ACCURACY AND COMPLETENESS PRIOR TO SIGNING AND FILING THE RETURN. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C CONFLICTS OF INTEREST ARE DISCUSSED AND DISCLOSED AT BOARD MEETINGS, PRIMARLIY ON AN ISSUE BY ISSUE BASIS. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.