2012-11-14T10:57:06-06:00 2011-12-31 260004395 HALT BUZAS & POWELL LTD 1199 NORTH FAIRFAX STREET 10TH FLOO ALEXANDRIA VA 22314 990 2011-01-01 341985248 DIVINE MERCY CARE DIVI 7039345552 11096-A LEE HIGHWAY NO 101 FAIRFAX VA 220305039 KAREN CASSIDY 7039345552 2012-11-14 1 CAROL MOUNT P00699613 7038361350 2012-11-14 2011 2016-02-24 21:20:13Z X JOHN T BRUCHALSKI 11096-A LEE HIGHWAY NO 101 FAIRFAX VA 220305039 4499955 0 X WWW.DIVINEMERCYCARE.ORG X 2004 VA OUR MISSION IS TO CONVEY THE HEALING PRESENCE OF CHRIST THROUGH EXCELLENT MEDICAL CARE WHICH RESPECTS THE CONSCIENCES OF PATIENTS AND PROVIDERS; SERVES THE POOR; AND UPHOLDS THE SANCTITY OF LIFE AT ALL STAGES. WE LOVINGLY CARE FOR ALL PATIENTS, RICH OR POOR, INSURED OR UNINSURED, REGARDLESS OF THEIR FAITH, ETHNICITY, OR NATIONAL ORIGIN. 7 6 35 30 0 0 736826 678649 4151028 3762667 818 1916 6167 -6121 4894839 4437111 0 0 0 0 1953677 2061763 0 0 104228 2721906 2445963 4675583 4507726 219256 -70615 701305 607432 447068 425000 254237 182432 X OUR MISSION IS TO CONVEY THE HEALING PRESENCE OF CHRIST THROUGH EXCELLENT MEDICAL CARE WHICH RESPECTS THE CONSCIENCES OF PATIENTS AND PROVIDERS; SERVES THE POOR; AND UPHOLDS THE SANCTITY OF LIFE AT ALL STAGES. WE LOVINGLY CARE FOR ALL PATIENTS, RICH OR POOR, INSURED OR UNINSURED, REGARDLESS OF THEIR FAITH, ETHNICITY, OR NATIONAL ORIGIN. 0 0 4224033 3762667 PROVIDING CULTURE OF LIFE CHARITABLE MEDICAL CARE, THROUGH THE TEPEYAC FAMILY CENTER LLC, TO APPROXIMATELY 15,000 WOMEN, INCLUDING INDIGENT WOMEN AND THOSE IN CRISIS PREGNANCIES. 4224033 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 7 0 35 1 0 0 0 0 0 1 1 0 0 X 7 6 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 0 1 1 1 0 X X THE ORGANIZATION 7039345552 11096-A LEE HIGHWAY NO 101 FAIRFAX VA 220305039 JOHN T BRUCHALSKI MD 40.00 X X 179987 0 13419 ADO MACHIDA 1.00 X X 0 0 0 MARY JULIANNE O'DONNELL 3.00 X X 0 0 0 J PATRICK KEARNS 1.00 X X 0 0 0 JOSEPH G COSBY 1.00 X 0 0 0 ROBERT LAIRD 1.00 X X 49779 0 923 EDWARD J GROGAN 1.00 X 0 0 0 KAREN CASSIDY 60.00 X 65193 0 5472 MARIE ANDERSON 40.00 X 228429 0 14516 DANIEL FISK 40.00 X 221492 0 14516 MIRIAM PEREIRA 40.00 X 238017 0 6308 LORNA CVETKOVICH 40.00 X 194167 0 14033 1177064 0 69187 5 0 1 0 CAPTURE BILLING 43063 PEACOCK MARKET PLAZA SOUTH RIDING VA 20152 BILLING SERVICES 133497 1 198564 480085 678649 PROFESSIONAL FEES 621110 3762667 3762667 3762667 266 266 1650 0 1650 1650 1650 53510 198564 62844 -9334 -9334 OTHER INCOME 900099 3213 3213 3213 4437111 3762667 0 -4205 793726 670559 84995 38172 1031604 1027672 3869 63 20909 20505 404 104914 104914 110610 102466 8144 1639 1639 195514 154376 41138 11626 10556 1070 4124 833 3291 169030 125628 19689 23713 10404 10404 285270 261566 23704 3501 799 1373 1329 29788 3602 26186 8681 8681 24404 21478 2926 270866 270866 PATIENT/INSURANCE/CHARI 1398354 1398354 LAB FEES EXPENSE 16210 16210 PATIENT REFUNDS 14097 14097 TAXES 2455 2430 25 4507726 4224033 179465 104228 197838 162913 50000 93839 213318 121357 40038 51644 133495 77350 65390 56145 10866 9859 119188 107008 4667 4667 701305 607432 238692 223818 23323 23323 185053 177859 447068 425000 X 238697 167392 15540 15040 254237 182432 701305 607432 X -70615 -1190 X 0 0 0 X 627325 571587 797493 741386 480120 3217911 73225 80567 88500 80220 252074 574586 700550 652154 885993 821606 732194 3792497 133764 32000 19000 184764 0 133764 32000 19000 184764 3607733 19080 12489 19655 818 266 52308 19080 12489 19655 818 266 52308 719630 664643 905648 822424 732460 3844805 0.93830 0.87270 0.01360 0.01680 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 133495 77350 56145 56145 ANNUAL GALA 235009 198564 36445 62844 235009 198564 36445 62844 62844 -26399 X X X X 0 0 0 0 0 0 0 0 0 JOHN T BRUCHALSKI MD 179987 0 0 0 0 0 5211 0 8208 0 193406 0 0 0 MARIE ANDERSON 228429 0 0 0 0 0 6308 0 8208 0 242945 0 0 0 DANIEL FISK 221492 0 0 0 0 0 6308 0 8208 0 236008 0 0 0 MIRIAM PEREIRA 238017 0 0 0 0 0 6308 0 0 0 244325 0 0 0 LORNA CVETKOVICH 194167 0 0 0 0 0 5825 0 8208 0 208200 0 0 0 JOHN T BRUCHALSKI DEMAND LOAN FROM JOHN T. BRUCHALSKI, MD, PC X 23323 0 1 1 23323 FORM 990, PART VI, SECTION A, LINE 7A [EXPLANATION FOR MEMBERS THAT CAN ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY] FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED FORM 990 IS PREPARED AND REVIEWED BY THE ORGANIZATION'S INDEPENDENT TAX ACCOUNTANT. THE 990 IS THEN SUBMITTED TO THE AUDIT REVIEW COMMITTEE, WHICH CONSISTS OF BOARD MEMBERS, FOR REVIEW AND REVISIONS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S BOARD OF DIRECTORS MEET QUARTERLY AND DISCUSS ANY CONFLICTS OF INTEREST AT THAT TIME. ADHERENCE TO THE WRITTEN POLICY IS CONFIRMED ANNUALLY BY THE ORGANIZATION'S INDEPENDENT AUDITORS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE ORGANIZATION'S CHAIRMAN, EXECUTIVE DIRECTOR, AND KEY EMPLOYEES IS REVIEWED ON AN ANNUAL BASIS BY THE COMPENSATION COMMITTEE, WHICH INCLUDES INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. COMPENSATION IS EVALUATED IN LIGHT OF COMPARABILITY DATA FOR NORTHERN VIRGINIA. 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