FUNCTIONAL HEALTH INC: Form 990EZ, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- FUNCTIONAL HEALTH INC (EIN 01-0967384)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202203199349211785
- Schema version
- 2021v4.0
- 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) |
|---|---|---|
| Return | 2022-11-15T17:15:09-07:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010967384 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FUNCTIONAL HEALTH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FUNC | BusinessNameControlTxt |
| Phone | 4049412000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 East Paces Ferry Rd NE STE 201 | AddressLine1Txt |
| City | Atlanta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30305 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Steven Clark | PersonNm |
| Person Title | Financial Officer | PersonTitleTxt |
| Phone | 6784627555 | PhoneNum |
| Signature | 2022-11-14 | SignatureDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| OOB Security Verification | 11 | OOBSecurityVerificationCd |
| Last Submission Rqr OOB | 1 | LastSubmissionRqrOOBCd |
| Authentication Assurance Level | AAL2 | AuthenticationAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Website Address | functionalhealth.net | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $70,974 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $20,570 | ContributionsGiftsGrantsEtcAmt |
| Program Service Revenue | $25,151 | ProgramServiceRevenueAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Investment Income | $0 | InvestmentIncomeAmt |
| Sale Of Assets Gross | $0 | SaleOfAssetsGrossAmt |
| Cost Or Other Basis Expense Sale | $0 | CostOrOtherBasisExpenseSaleAmt |
| Gain Or Loss From Sale Of Assets | $0 | GainOrLossFromSaleOfAssetsAmt |
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $0 | SpecialEventsDirectExpensesAmt |
| Special Events Net Income Loss | $0 | SpecialEventsNetIncomeLossAmt |
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
| Gross Profit Loss Sls Of Invntry | $0 | GrossProfitLossSlsOfInvntryAmt |
| Other Revenue Total | $25,253 | OtherRevenueTotalAmt |
| Total Revenue | $70,974 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $0 | GrantsAndSimilarAmountsPaidAmt |
| Benefits Paid To Or For Members | $0 | BenefitsPaidToOrForMembersAmt |
| Salaries Other Comp Empl Bnft | $33,820 | SalariesOtherCompEmplBnftAmt |
| Fees And Other Pymt To Ind Cntrct | $450 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $0 | OccupancyRentUtltsAndMaintAmt |
| Printing Publications Postage | $0 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $9,345 | OtherExpensesTotalAmt |
| Total Expenses | $43,615 | TotalExpensesAmt |
| Excess Or Deficit For Year | $27,359 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | -$264,767 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | -$237,408 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,404 | BOYAmt |
| EOY | $3,853 | EOYAmt |
Land And Buildings LandAndBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,000 | BOYAmt |
| EOY | $4,400 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,404 | BOYAmt |
| EOY | $8,253 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $273,171 | BOYAmt |
| EOY | $245,661 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$264,767 | BOYAmt |
| EOY | -$237,408 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | Functional health has as its primary purpose offering specialized Doppler ultrasound testing of multiple sclerosis patients and others with varied neurological challenges for the purpose of evaluating them for chronic cerebrospinal venous insufficiency (CCSVI). At present, Functional Health is the primary facility in North America offering these evaluations. In addition to CCSVI evaluations, various additional wellness evaluations have been offered. Functional Health has also been performing COVID related sanitary and hygiene services to offices. Functional Health's purpose as it specifically relates to CCSVI and multiple sclerosis and other neurological disorders is to advance the scientific understanding of these disorders and the possible connection between these neurological disorders and imbalances in the cerebrospinal circulatory system. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | Completed 15 pro bono chronic cerebrospinal venous insufficiency diagnostic ultrasound examinations in addition to paid patient exams. Various additional wellness evaluations have been offered. Functional Health has also been performing COVID related sanitary and hygiene services to offices. | DescriptionProgramSrvcAccomTxt |
| Grants And Allocations | $0 | GrantsAndAllocationsAmt |
| Program Service Expenses | $38,056 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $38,056 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (3 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| Henry Jacobs | ||||
| Director | 5 | $0 | ||
| Steven Clark | ||||
| Financial Officer | 5 | $0 | $0 | $0 |
| Elaine Fleet | ||||
| Stenographer Employee | 24 | $54,820 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | 0 | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | 0 | OrganizationHadUBIInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Form1120 Pol Filed | 0 | Form1120PolFiledInd |
| Made Loans To From Officers | Yes (1) | MadeLoansToFromOfficersInd |
| Loans To From Officers | $150,707 | LoansToFromOfficersAmt |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Henry Jacobs | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 E Paces Ferry ste 201 | AddressLine1Txt |
| City | Atlanta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30305 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4049412000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Donor Advised Fnds | 0 | DonorAdvisedFndsInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Tanning Services Provided | 0 | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| School Operating | 0 | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (1) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Henry Jacobs | PersonNm |
| Relationship With Org | Director | RelationshipWithOrgTxt |
| Loan Purpose | General Funding of Program Services | LoanPurposeTxt |
| Loan To Organization | Yes (X) | LoanToOrganizationInd |
| Original Principal | $10,000 | OriginalPrincipalAmt |
| Balance Due | $150,707 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $150,707 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990-EZ, Part I, Line 8 | 13,102 PPP 1st Draw 11,651 PPP2nd Draw 500 HHS Relief Grant as Health Care Provider |
| Form 990-EZ, Part I, Line 16 | Bank and Merchant Account Fees 343.67 dr Loan Interest Henry Jacobs Loan Outstd 4,680.78 dr Payroll Taxes 4,235.55 dr Dues & Subscriptions 85.00 dr Salaries Expense as been netted by 21K credit in the form of realized Employee Retention Tax Credit. - |
| Form 990-EZ, Part II, Line 24 | Accounts Receivable for 2022 expected receipt of remaining employee retention tax credit qualifying amount as 4400 |
| Form 990-EZ, Part II, Line 26 | Accounts Payable $93,606 Payroll Liabilities $1,348 Loan Outstanding $150,707 |
| Form 990-EZ, Part III, Line (28-31) | PRIMARY EXEMPT PURPOSE - Functional health has as its primary purpose offering specialized Doppler ultrasound testing of multiple sclerosis patients and others with varied neurological challenges for the purpose of evaluating them for chronic cerebrospinal venous insufficiency (CCSVI). At present, Functional Health is the primary facility in North America offering these evaluations. In addition, various additional wellness evaluations have been offered. Functional Health has also been performing COVID related sanitary and hygiene services to offices. Functional Health's purpose as it specifically relates to CCSVI and multiple sclerosis and other neurological disorders is to advance the scientific understanding of these disorders and the possible connection between these neurological disorders and imbalances in the cerebrospinal circulatory system. |