CARE FREE MEDICAL INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
CARE FREE MEDICAL INC (EIN 14-1909938)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-09-30
IRS object ID
201122739349300512
Schema version
2010v3.4
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

FieldValueIRS element (for citing)
Timestamp2011-09-30T10:39:59-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ABRAHAM & GAFFNEY PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13511 COOLIDGE ROAD SUITE 100AddressLine1
CityEAST LANSINGCity
StateMIState
ZIP Code48823ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN141909938EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CARE FREE MEDICAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCARENameControl
Phone5178875922Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line15135 S PENNSYLVANIA AVEAddressLine1
CityLANSINGCity
StateMIState
ZIP Code48911ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBARRY SALTMAN MDName
TitleEXECUTIVE DIRECTORTitle
Phone5178875922Phone
Date Signed2011-09-24DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone5173516836Phone
Date Prepared2011-09-24DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1CAREFREE MEDICAL AND DENTALBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonBARRY SALTMAN MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15135 S PENNSYLVANIA AVEAddressLine1
CityLANSINGCity
StateMIState
ZIP Code48911ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1076785GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CAREFREEMEDICAL.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2004YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionPROVIDE HIGH QUALITY COMPREHENSIVE PRIMARY AND PREVENTATIVE HEALTH SERVICES TO UNINSURED AND UNDERSERVED INDIVIDUALS IN THE GREATER LANSING MICHIGAN AREA.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees45TotalNbrEmployees
Total Nbr Volunteers120TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year308474ContributionsGrantsPriorYear
Contributions Grants Current Year363786ContributionsGrantsCurrentYear
Program Service Revenue Prior Year606306ProgramServiceRevenuePriorYear
Program Service Revenue CY647407ProgramServiceRevenueCY
Investment Income Prior Year2543InvestmentIncomePriorYear
Investment Income Current Year1946InvestmentIncomeCurrentYear
Other Revenue Prior Year64407OtherRevenuePriorYear
Other Revenue Current Year46330OtherRevenueCurrentYear
Total Revenue Prior Year981730TotalRevenuePriorYear
Total Revenue Current Year1059469TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year673524SalariesEtcPriorYear
Salaries Etc Current Year777302SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year687TotalFundrsngExpCurrentYear
Other Expense Prior Year214120OtherExpensePriorYear
Other Expenses Current Year319483OtherExpensesCurrentYear
Total Expenses Prior Year887644TotalExpensesPriorYear
Total Expenses Current Year1096785TotalExpensesCurrentYear
Revenues Less Expenses Prior Year94086RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-37316RevenuesLessExpensesCY
Total Assets BOY703726TotalAssetsBOY
Total Assets EOY654833TotalAssetsEOY
Total Liabilities BOY240358TotalLiabilitiesBOY
Total Liabilities EOY228781TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY463368NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY426052NetAssetsOrFundBalancesEOY
Mission DescriptionCARE FREE MEDICAL AND DENTAL PROVIDES HIGH QUALITY COMPREHENSIVE PRIMARY AND PREVENTATIVE HEALTH SERVICES TO UNINSURED AND UNDERSERVED INDIVIDUALS IN THE GREATER LANSING, MICHIGAN AREA.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense733663Expense
Revenue574473Revenue
DescriptionTHE TWO MEDICAL CLINICS HAD 11,163 PATIENT ENCOUNTERS DURING 2010.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense88694Expense
Revenue29188Revenue
DescriptionTHE DENTAL CLINIC HAD 1,043 PATIENT ENCOUNTERS IN 2010.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense34940Expense
Revenue43746Revenue
DescriptionTHE OPTOMETRY CLINIC HAD 483 PATIENT ENCOUNTERS IN 2010.Description
FieldValueIRS element (for citing)
Total Program Service Expense857297TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10965NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees45NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy0ConflictOfInterestPolicy
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SUSAN JENNINGSBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5178875922TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15135 S PENNSYLVANIA AVEAddressLine1
CityLANSINGCity
StateMIState
ZIP Code48911ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
BARRY SALTMAN
PRESIDENT, MEDICAL DIRECTO60.00XX4180200
LEONARD SILVERMAN
MEMBER1.00X000
JEAN YOUNG
INTERIM TREASURER1.00XX000
BRIAN KASER
INTERIM PRESIDENT5.00XX000
DIANE BYRUM
MEMBER1.00X000
BOB LOMBARDINI
MEMBER5.00X000
JANET JANKOWSKI
MEMBER20.00X000
SCOTT CLARK
MEMBER2.00X000
BARRY TONS
MEMBER2.00X000
MARY ODIE
MEMBER1.00X000
MARY ANNE SESTI
SECRETARY3.00XX000
KENNETH RUDMAN
MEMBER1.00X000
KAREN GALLAGHER
MEMBER1.00X000
JOHN SHASKI
MEMBER1.00X000
GEORGE SMITH
MEMBER1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org41802TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns49510FederatedCampaigns
Fundraising Events36588FundraisingEvents
Government Grants135424GovernmentGrants
All Other Contributions142264AllOtherContributions
Noncash Contributions17623NoncashContributions
Total Contributions363786TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICAL CLINIC621110567739567739
OPTOMETRY CLINIC6213004374643746
DENTAL CLINIC6213002918829188
MEDICAL RECORDS COPY F62111067346734
FieldValueIRS element (for citing)
Total Program Service Revenue647407TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1946TotalRevenueColumn
Exclusion$1,946ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events49268GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events36588CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses17316FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column31952TotalRevenueColumn
Exclusion$31,952ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHERDescription
Business Code900099BusinessCode
Total Revenue Column14378TotalRevenueColumn
Exclusion$14,378ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue14378TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1059469TotalRevenueColumn
Related Or Exempt Function Income647407RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$48,276ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total41802Total
Management And General41802ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total662805Total
Program Services561265ProgramServices
Management And General101429ManagementAndGeneral
Fundraising111Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total12548Total
Program Services8958ProgramServices
Management And General3590ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total60147Total
Program Services46862ProgramServices
Management And General13277ManagementAndGeneral
Fundraising8Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total6474Total
Management And General6474ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total100Total
Program Services100ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total85521Total
Program Services66727ProgramServices
Management And General18226ManagementAndGeneral
Fundraising568Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total37776Total
Program Services9053ProgramServices
Management And General28723ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total67596Total
Program Services65423ProgramServices
Management And General2173ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total44Total
Management And General44ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total4916Total
Program Services2449ProgramServices
Management And General2467ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total15050Total
Program Services14967ProgramServices
Management And General83ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total35539Total
Program Services26033ProgramServices
Management And General9506ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total30254Total
Program Services25754ProgramServices
Management And General4500ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
LAB FEES1456414564
LAUNDRY32003200
LICENSES AND FEES29122792120

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total15537Total
Program Services9150ProgramServices
Management And General6387ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1096785Total
Program Services857297ProgramServices
Management And General238801ManagementAndGeneral
Fundraising687Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY29351BOY
EOY43534EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY207495BOY
EOY151242EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis586256LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec126199LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY466880BOY
EOY460057EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY703726BOY
EOY654833EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY8491BOY
EOY11328EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY231867BOY
EOY217453EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY240358BOY
EOY228781EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY405846BOY
EOY394069EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY57522BOY
EOY31983EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY463368BOY
EOY426052EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY703726BOY
EOY654833EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-37316ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting OtherXMethodOfAccountingOther
Accountant Compile Or Review1AccountantCompileOrReview
FS Audited0FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years491003CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years310775CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years332938CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year308474CurrentTaxYearMinus1Year
Current Tax Year363786CurrentTaxYear
Total1806976Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years443618CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years491705CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year606306CurrentTaxYearMinus1Year
Current Tax Year647407CurrentTaxYear
Total2189036Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years24273CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years91412CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year208729CurrentTaxYearMinus1Year
Current Tax Year49268CurrentTaxYear
Total373682Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years491003CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years778666CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years916055CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1123509CurrentTaxYearMinus1Year
Current Tax Year1060461CurrentTaxYear
Total4369694Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total5094369694PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years251CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years806CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1744CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2543CurrentTaxYearMinus1Year
Current Tax Year1946CurrentTaxYear
Total7290Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years251CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years806CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1744CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2543CurrentTaxYearMinus1Year
Current Tax Year1946CurrentTaxYear
Total7290Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year4831CurrentTaxYearMinus1Year
Current Tax Year14378CurrentTaxYear
Total19209Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years491254CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years779472CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years917799CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1130883CurrentTaxYearMinus1Year
Current Tax Year1076785CurrentTaxYear
Total4396193Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99400PublicSupportPercentage509
Prior Year Support Percentage0.99730PriorYearSupportPercentage
Investment Income Percentage0.00170InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00140PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis403848OtherCostOrOtherBasis
Depreciation47190Depreciation
Book Value356658BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis67617OtherCostOrOtherBasis
Depreciation15778Depreciation
Book Value51839BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis106254OtherCostOrOtherBasis
Depreciation56044Depreciation
Book Value50210BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis8537OtherCostOrOtherBasis
Depreciation7187Depreciation
Book Value1350BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings460057TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
ExplanationFEDERAL TAX LAW PROVIDES TAX BENEFITS TO NONPROFIT ORGANIZATIONS RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE). THE CODE REQUIRES THAT TAX-EXEMPT ORGANIZATIONS MUST COMPLY WITH FEDERAL TAX LAW TO MAINTAIN TAX-EXEMPT STATUS AND AVOID PENALTIES. AS AN EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE CODE, THE ORGANIZATION IS ONLY SUBJECT TO TAX ON UNRELATED BUSINESS INCOME AS DEFINED BY SECTION 509(A)(1) OF THE CODE. THE ORGANIZATION HAS NO UNRELATED BUSINESS INCOME FOR THE YEAR ENDED DECEMBER 31, 2010. ACCORDINGLY, A PROVISION FOR INCOME TAXES HAS NOT BEEN MADE ON THE FINANCIAL STATEMENTS. THE AMOUNT OF INCOME TAX BENEFIT THAT MAY BE DISALLOWED BY THE INTERNAL REVENUE SERVICE (IRS), IF ANY, CANNOT BE DETERMINED AT THIS TIME ALTHOUGH THE ORGANIZATION EXPECTS SUCH AMOUNTS, IF ANY, TO BE IMMATERIAL. INTEREST AND/OR PENALTIES ON AN AMOUNT OF INCOME TAXES DEEMED UNDERPAID, IF ANY, WILL BE CLASSIFIED AS INCOME TAXES IN THE FINANCIAL STATEMENTS. THE ORGANIZATION HAS NOT RECOGNIZED ANY INTEREST OR PENALTIES PAYABLE IN THE STATEMENT OF NET ASSETS, LIABILITIES, AND NET ASSETS - MODIFIED CASH BASIS AS OF DECEMBER 31, 2010, OR INTEREST OR PENALTIES EXPENSE IN THE STATEMENT OF SUPPORT, REVENUE, AND EXPENSES - MODIFIED CASH BASIS FOR THE YEAR THEN ENDED. THE ORGANIZATION IS SUBJECT TO IRS AND STATE EXAMINATIONS FOR A PERIOD OF AT LEAST THREE (3) YEARS AFTER THE FORM 990 HAS BEEN FILED.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1DANCING WITH THE LOCAL STARSNameOfEvent1
Gross Receipts Event183033GrossReceiptsEvent1
Charitable Contributions Event136588CharitableContributionsEvent1
Gross Revenue Event146445GrossRevenueEvent1
Cash Prizes Event1620CashPrizesEvent1
Rent Facility Costs Event19220RentFacilityCostsEvent1
Entertainment Event11017EntertainmentEvent1
Other Direct Expenses Event14692OtherDirectExpensesEvent1
Gross Receipts Total83033GrossReceiptsTotal
Charitable Contributions Total36588CharitableContributionsTotal
Gross Revenue Total Events46445GrossRevenueTotalEvents
Cash Prizes Total Events620CashPrizesTotalEvents
Rent Facility Costs Total Events9220RentFacilityCostsTotalEvents
Entertainment Total Events1017EntertainmentTotalEvents
Other Direct Expenses Total Events4692OtherDirectExpensesTotalEvents
Direct Expense Summary Events15549DirectExpenseSummaryEvents
Net Income Summary30896NetIncomeSummary

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
SUZANNE SALTMAN
WIFE OF FOUNDER50078OWNS BUILDING AND RECEIVES RENTAL INCOME FROM CARE FREE MEDICAL MASON FACILITY.0
(no name)
289650
LISA SALTMAN
DAUGHTER OF FOUNDER BARRY SALTMAN9320EMPLOYED AS A SOCIAL WORKER BY CLINIC0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION B, LINE 11FORM 990 IS REVIEWED BY IN-HOUSE ACCOUNTANT AND EMAILED TO BOARD FOR REVIEW
GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE ON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION PRESENTS THEIR REVIEWED FINANCIAL STATEMENTS AND FORM 990 ON A MODIFIED CASH BASIS WHICH IS AN OTHER COMPREHENSIVE BASIS OF ACCOUNTING.FORM 990, PART XI, LINE 1
THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE REVIEWED FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT.FORM 990, PART XII, LINE 2C

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