FUNCTIONAL HEALTH INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: FUNCTIONAL HEALTH INC (EIN 01-0967384)
Tax period: 2014-01-01 to 2014-12-31
Filed: 2015-08-13
IRS object ID: 201542259349301274
Schema version: 2014v5.0
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
Form 990
Schedule A
Schedule L
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-08-13T10:13:34-05:00	ReturnTs
Tax Period End	2014-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	581790414	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	J D REESE & ASSOCIATES INC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	4360 CHAMBLEE DUNWOODY RD STE 510	AddressLine1Txt
City	ATLANTA	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	30341	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-01-01	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	6785967384	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	455 E PACES FERRY RD NE NO 201	AddressLine1Txt
City	ATLANTA	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	30305	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	HENRY JACOBS	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	6785967384	PhoneNum
Signature	2015-08-13	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JUDENE D REESE	PreparerPersonNm
PTIN	P01441192	PTIN
Phone	7704571040	PhoneNum
Preparation	2015-08-13	PreparationDt

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	HENRY JACOBS	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	455 E PACES FERRY RD NE NO 201	AddressLine1Txt
City	ATLANTA	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	30305	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$336,772	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	N/A	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2010	FormationYr
Legal Domicile State	GA	LegalDomicileStateCd
Activity Or Mission	TESTING MULTIPLE SCLEROSIS PATIENTS FOR POSSIBLE TREATMENTS TO ALLEVIATE SYMPTOMS OF CHRONIC CEREBROSPINAL VENOUS INSUFFICIENCY AND TO PROVIDE WELLNESS EVALUATIONS.	ActivityOrMissionDesc
Voting Members Governing Body	4	VotingMembersGoverningBodyCnt
Voting Members Independent	3	VotingMembersIndependentCnt
Total Employee	1	TotalEmployeeCnt
Total Volunteers	4	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$4,500	PYContributionsGrantsAmt
CY Contributions Grants	$7,069	CYContributionsGrantsAmt
PY Program Service Revenue	$222,112	PYProgramServiceRevenueAmt
CY Program Service Revenue	$329,703	CYProgramServiceRevenueAmt
PY Investment Income	$0	PYInvestmentIncomeAmt
CY Investment Income	$0	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$226,612	PYTotalRevenueAmt
CY Total Revenue	$336,772	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$0	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$58,084	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$0	PYOtherExpensesAmt
CY Other Expenses	$352,715	CYOtherExpensesAmt
PY Total Expenses	$0	PYTotalExpensesAmt
CY Total Expenses	$410,799	CYTotalExpensesAmt
PY Revenues Less Expenses	$226,612	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$74,027	CYRevenuesLessExpensesAmt
Total Assets BOY	$7,633	TotalAssetsBOYAmt
Total Assets EOY	$7,573	TotalAssetsEOYAmt
Total Liabilities BOY	$205,579	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$277,782	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	-$197,946	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	-$270,209	NetAssetsOrFundBalancesEOYAmt
Mission	TESTING MULTIPLE SCLEROSIS PATIENTS FOR POSSIBLE TREATMENTS TO ALLEVIATE SYMPTOMS OF CHRONIC CEREBROSPINAL VENOUS INSUFFICIENCY AND TO PROVIDE WELLNESS EVALUATIONS.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$410,799	ExpenseAmt
Revenue	$329,703	RevenueAmt
Desc	EXPENSES RELATED TO PROGRAM FUNCTIONS	Desc
Total Program Service Expenses	$410,799	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	0	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	0	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	Yes (1)	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	1	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	4	GoverningBodyVotingMembersCnt
Independent Voting Member	3	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	0	ConflictOfInterestPolicyInd
Whistleblower Policy	0	WhistleblowerPolicyInd
Document Retention Policy	0	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	GA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	HENRY JACOBS	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	4042330208	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	255 E PACES FERRY STE 201	AddressLine1Txt
City	ATLANTA	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	30305	ZIPCd

Field	Value	IRS element (for citing)
No Listed Persons Compensated	Yes (X)	NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (2 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
HENRY JACOBS
CEO	10.00	30.00	Yes (X)	$0	$0	$0
STEVE CLARK
CFO	5.00	0.00	Yes (X)	$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$0	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
All Other Contributions	$7,069	AllOtherContributionsAmt
Total Contributions	$7,069	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
SUPPLEMENTS	624100	$309,639	$309,639
TESTING	624100	$14,819	$14,819
PATIENT SERVICES	624100	$5,245	$5,245

Field	Value	IRS element (for citing)
Total Program Service Revenue	$329,703	TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$336,772	TotalRevenueColumnAmt
Related Or Exempt Func Income	$329,703	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$53,957	TotalAmt
Program Services	$53,957	ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$4,127	TotalAmt
Program Services	$4,127	ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$250	TotalAmt
Program Services	$250	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$47,032	TotalAmt
Program Services	$47,032	ProgramServicesAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$5,415	TotalAmt
Program Services	$5,415	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$9,000	TotalAmt
Program Services	$9,000	ProgramServicesAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,088	TotalAmt
Program Services	$1,088	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$7,832	TotalAmt
Program Services	$7,832	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$169	TotalAmt
Program Services	$169	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$3,556	TotalAmt
Program Services	$3,556	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
SUPPLEMENTS,LAB TESTING	$263,132	$263,132
MEDICAL EQUIP LEASE	$14,400	$14,400
BANK & MERCHANT FEES	$484	$484
DUES & SUBSCRIPTIONS	$200	$200

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$157	TotalAmt
Program Services	$157	ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$410,799	TotalAmt
Program Services	$410,799	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$7,633	BOYAmt
EOY	$7,573	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,633	BOYAmt
EOY	$7,573	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$134,102	BOYAmt
EOY	$186,305	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$71,477	BOYAmt
EOY	$91,477	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$205,579	BOYAmt
EOY	$277,782	EOYAmt

Field	Value	IRS element (for citing)
Org Does Not Follow SFAS117	Yes (X)	OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

Field	Value	IRS element (for citing)
BOY	$7,633	BOYAmt
EOY	$7,573	EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

Field	Value	IRS element (for citing)
BOY	-$205,579	BOYAmt
EOY	-$277,782	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	-$197,946	BOYAmt
EOY	-$270,209	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$7,633	BOYAmt
EOY	$7,573	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$74,027	ReconcilationRevenueExpnssAmt
Prior Period Adjustments	$1,764	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Cash	Yes (X)	MethodOfAccountingCashInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	0	FSAuditedInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus1 Year	$4,500	CurrentTaxYearMinus1YearAmt
Current Tax Year	$7,069	CurrentTaxYearAmt
Total	$11,569	TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus3 Years	$58,030	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$173,356	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$222,111	CurrentTaxYearMinus1YearAmt
Current Tax Year	$329,703	CurrentTaxYearAmt
Total	$783,200	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus3 Years	$58,030	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$173,356	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$226,611	CurrentTaxYearMinus1YearAmt
Current Tax Year	$336,772	CurrentTaxYearAmt
Total	$794,769	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total170	$794,769	PublicSupportTotal170Amt
Total Support	$794,769	TotalSupportAmt
First5 Years170	Yes (X)	First5Years170Ind

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

Field	Value	IRS element (for citing)
Person	HENRY JACOBS	PersonNm
Relationship With Org	CEO	RelationshipWithOrgTxt
Loan Purpose	TO ASSIST WITH NORMAL OPERATIONS	LoanPurposeTxt
Loan To Organization	Yes (X)	LoanToOrganizationInd
Original Principal	$47,000	OriginalPrincipalAmt
Balance Due	$91,477	BalanceDueAmt
Default	0	DefaultInd
Board Or Committee Approval	Yes (1)	BoardOrCommitteeApprovalInd
Written Agreement	0	WrittenAgreementInd

Field	Value	IRS element (for citing)
Total Balance Due	$91,477	TotalBalanceDueAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11	ALL FINANCIAL DATA WAS REVIEWED BY CEO & TREASURER.
FORM 990, PART VI, SECTION C, LINE 19	ALL DOCUMENTS ARE AVAILABLE UPON REQUEST
FORM 990, PART IX, LINE 11G	COMMISSIONS & FEES: PROGRAM SERVICE EXPENSES 47,032. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 47,032.