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DIVINE MERCY CARE: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
DIVINE MERCY CARE (EIN 34-1985248)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-17
IRS object ID
201403219349311195
Schema version
2013v3.0
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

FieldValueIRS element (for citing)
Return2014-11-17T20:43:58-06:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN521511275PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RAFFA PCBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11899 L STREET NW SUITE 900AddressLine1
CityWASHINGTONCity
StateDCState
ZIP Code20036ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN341985248EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DIVINE MERCY CAREBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlDIVIBusinessNameControlTxt
Phone7039345552PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line111096-A LEE HIGHWAY NO 101AddressLine1
CityFAIRFAXCity
StateVAState
ZIP Code22030ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN T BRUCHALSKI MDPersonNm
Person TitleCHAIRMAN & PRESIDENTPersonTitleTxt
Phone7039345552PhoneNum
Signature2014-11-17SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonFRANK H SMITHPreparerPersonNm
PTINP00639053PTIN
Phone2028225000PhoneNum
Preparation2014-11-17PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJOHN T BRUCHALSKI MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line111096-A LEE HIGHWAY NO 101AddressLine1
CityFAIRFAXCity
StateVAState
ZIP Code22030ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$3,487,981GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.DIVINEMERCYCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2000FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionTO TRANSFORM HEARTS THROUGH HEALTHCARE.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee41TotalEmployeeCnt
Total Volunteers46TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$614,007PYContributionsGrantsAmt
CY Contributions Grants$559,411CYContributionsGrantsAmt
PY Program Service Revenue$4,354,676PYProgramServiceRevenueAmt
CY Program Service Revenue$2,886,802CYProgramServiceRevenueAmt
PY Investment Income$282PYInvestmentIncomeAmt
CY Investment Income$284CYInvestmentIncomeAmt
PY Other Revenue-$17,910PYOtherRevenueAmt
CY Other Revenue-$45,151CYOtherRevenueAmt
PY Total Revenue$4,951,055PYTotalRevenueAmt
CY Total Revenue$3,401,346CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,123,126PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,276,973CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$123,463CYTotalFundraisingExpenseAmt
PY Other Expenses$2,722,862PYOtherExpensesAmt
CY Other Expenses$879,207CYOtherExpensesAmt
PY Total Expenses$4,845,988PYTotalExpensesAmt
CY Total Expenses$3,156,180CYTotalExpensesAmt
PY Revenues Less Expenses$105,067PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$245,166CYRevenuesLessExpensesAmt
Total Assets BOY$506,172TotalAssetsBOYAmt
Total Assets EOY$754,299TotalAssetsEOYAmt
Total Liabilities BOY$268,596TotalLiabilitiesBOYAmt
Total Liabilities EOY$269,165TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$237,576NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$485,134NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionOUR MISSION IS TO CONVEY THE HEALING PRESCENCE 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 FAITH TRADITION, ETHNICITY, NATIONAL ORIGIN OR BACKGROUND.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$2,567,375ExpenseAmt
Revenue$2,886,802RevenueAmt
DescPROVIDING CULTURE OF LIFE AND CHARITABLE MEDICAL CARE, THROUGH THE TEPAYAC FAMILY CENTER LLC, TO APPROXIMATELY 15,000 WOMEN, INCLUDING INDIGENT WOMEN AND THOSE IN CRISIS PREGNANCIES.Desc
Total Program Service Expenses$2,567,375TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document10IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee41EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOHN T BRUCHALSKI MDBusinessNameLine1
FieldValueIRS element (for citing)
Phone7039345552PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line111096-A LEE HIGHWAY NO 101AddressLine1
CityFAIRFAXCity
StateVAState
ZIP Code22030ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
JOHN T BRUCHALSKI MD
CHAIRMAN & PRESIDENT40.00Yes (X)Yes (X)$202,534$0$15,919
ADO A MACHIDA
VICE CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
KATHRYN A DOHERTY PHD
SECRETARY3.00Yes (X)Yes (X)$0$0$0
MARY JULIANNE O'DONNELL
SECRETARY (UNTIL 1/2013)3.00Yes (X)Yes (X)$0$0$0
J PATRICK KEARNS
TREASURER1.00Yes (X)Yes (X)$0$0$0
JOSEPH G COSBY
MEMBER1.00Yes (X)$0$0$0
EDWARD J GROGAN
MEMBER1.00Yes (X)$0$0$0
KAREN CASSIDY
CHIEF OPERATIONS OFFICER60.00Yes (X)$99,640$0$6,520
MARIE ANDERSON
OB/GYN40.00$226,505$0$14,777Yes (X)
DANIEL FISK
OB/GYN40.00$219,449$0$18,967Yes (X)
LORNA CVETKOVICH
OB/GYN40.00$193,326$0$11,500Yes (X)
MIRIAM PEREIRA
OB/GYN40.00$233,267$0$20,014Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,174,721TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$87,697TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$134,344FundraisingAmt
All Other Contributions$425,067AllOtherContributionsAmt
Noncash Contributions$14,531NoncashContributionsAmt
Total Contributions$559,411TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PROFESSIONAL FEES621110$2,865,103$2,865,103
SPEAKING EVENTS900099$21,699$21,699
FieldValueIRS element (for citing)
Total Program Service Revenue$2,886,802TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$284TotalRevenueColumnAmt
Exclusion$284ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$39,302FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$134,344ContriRptFundraisingEventAmt
Fundraising Direct Expenses$86,635FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$47,333TotalRevenueColumnAmt
Exclusion-$47,333ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business900099BusinessCd
Total Revenue Column$2,182TotalRevenueColumnAmt
Exclusion$2,182ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,182OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,401,346TotalRevenueColumnAmt
Related Or Exempt Func Income$2,886,802RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$44,867ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$804,311TotalAmt
Program Services$750,924ProgramServicesAmt
Management And General$25,601ManagementAndGeneralAmt
Fundraising$27,786FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,238,559TotalAmt
Program Services$1,169,603ProgramServicesAmt
Management And General$11,334ManagementAndGeneralAmt
Fundraising$57,622FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$14,031TotalAmt
Program Services$12,719ProgramServicesAmt
Management And General$83ManagementAndGeneralAmt
Fundraising$1,229FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$97,773TotalAmt
Program Services$91,036ProgramServicesAmt
Management And General$1,664ManagementAndGeneralAmt
Fundraising$5,073FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$122,299TotalAmt
Program Services$113,363ProgramServicesAmt
Management And General$2,854ManagementAndGeneralAmt
Fundraising$6,082FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$774TotalAmt
Program Services$774ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$45,370TotalAmt
Program Services$37,255ProgramServicesAmt
Management And General$8,115ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,761TotalAmt
Program Services$1,761ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$270TotalAmt
Program Services$50ProgramServicesAmt
Fundraising$220FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$84,707TotalAmt
Program Services$60,120ProgramServicesAmt
Management And General$4,976ManagementAndGeneralAmt
Fundraising$19,611FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$29,564TotalAmt
Program Services$20,555ProgramServicesAmt
Management And General$9,009ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$258,347TotalAmt
Program Services$208,782ProgramServicesAmt
Management And General$49,565ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$56TotalAmt
Fundraising$56FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$94,166TotalAmt
Management And General$7,531ManagementAndGeneralAmt
Fundraising$86,635FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$42,621TotalAmt
Program Services$23,264ProgramServicesAmt
Management And General$19,357ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$231,804TotalAmt
Program Services$231,804ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
PATIENT/INS/MEDICAL EXP$74,895$74,895
LICENSES & PERMITS$9,205$1,834$7,371
MISCELLANEOUS$5,667$5,667
OVERHEAD ALLOCATION$0-$231,364$312,215-$80,851

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,156,180TotalAmt
Program Services$2,567,375ProgramServicesAmt
Management And General$465,342ManagementAndGeneralAmt
Fundraising$123,463FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$236,481BOYAmt
EOY$238,169EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$70,531BOYAmt
EOY$72,666EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$50,317BOYAmt
EOY$216,777EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$20,433BOYAmt
EOY$12,346EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$265,486LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$134,051LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$26,888BOYAmt
EOY$131,435EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$5,146BOYAmt
EOY$4,552EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$94,876BOYAmt
EOY$76,854EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,500BOYAmt
EOY$1,500EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$506,172BOYAmt
EOY$754,299EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$173,238BOYAmt
EOY$251,351EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$95,358BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$17,814EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$268,596BOYAmt
EOY$269,165EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$222,536BOYAmt
EOY$464,262EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$15,040BOYAmt
EOY$20,872EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$237,576BOYAmt
EOY$485,134EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$506,172BOYAmt
EOY$754,299EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$245,166ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$594NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments$2,986PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewYes (1)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
FS Audited0FSAuditedInd
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$797,493CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$736,826CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$678,649CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$614,007CurrentTaxYearMinus1YearAmt
Current Tax Year$598,713CurrentTaxYearAmt
Total$3,425,688TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,992,762CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,231,248CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,816,177CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,392,426CurrentTaxYearMinus1YearAmt
Current Tax Year$2,886,802CurrentTaxYearAmt
Total$20,319,415TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,790,255CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,968,074CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,494,826CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,006,433CurrentTaxYearMinus1YearAmt
Current Tax Year$3,485,515CurrentTaxYearAmt
Total$23,745,103TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$19,000CurrentTaxYearMinus4YearsAmt
Total$19,000TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$19,000CurrentTaxYearMinus4YearsAmt
Total$19,000TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$23,726,103PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$19,655CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,218CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$266CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$151CurrentTaxYearMinus1YearAmt
Current Tax Year$284CurrentTaxYearAmt
Total$21,574TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$19,655CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,218CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$266CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$151CurrentTaxYearMinus1YearAmt
Current Tax Year$284CurrentTaxYearAmt
Total$21,574TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$3,213CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,129CurrentTaxYearMinus1YearAmt
Current Tax Year$2,182CurrentTaxYearAmt
Total$10,524TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,809,910CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,969,292CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,498,305CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,011,713CurrentTaxYearMinus1YearAmt
Current Tax Year$3,487,981CurrentTaxYearAmt
Total$23,777,201TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99790PublicSupportCY509Pct
Public Support PY5090.97770PublicSupportPY509Pct
Investment Income CY0.00090InvestmentIncomeCYPct
Investment Income PY0.00880InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part IV Form990ScheduleAPartIVGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationOTHER INCOME - 2011 AMOUNT: $ 3,213. 2012 AMOUNT: $ 5,129. 2013 AMOUNT: $ 2,182.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,056OtherCostOrOtherBasisAmt
Depreciation$7,415DepreciationAmt
Book Value$2,641BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$231,981OtherCostOrOtherBasisAmt
Depreciation$117,914DepreciationAmt
Book Value$114,067BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$23,449OtherCostOrOtherBasisAmt
Depreciation$8,722DepreciationAmt
Book Value$14,727BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$131,435TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDEFERRED RENTDesc
Amt$17,814Amt
FieldValueIRS element (for citing)
Total Liability$17,814TotalLiabilityAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Name Of Event1DINNER & AUCTIONNameOfEvent1Amt
Gross Receipts Event1$173,646GrossReceiptsEvent1Amt
Charitable Contri Event1$134,344CharitableContriEvent1Amt
Gross Revenue Event1$39,302GrossRevenueEvent1Amt
Food And Beverage Event1$45,317FoodAndBeverageEvent1Amt
Entertainment Event1$18,460EntertainmentEvent1Amt
Other Direct Expenses Event1$22,858OtherDirectExpensesEvent1Amt
Gross Receipts Total$173,646GrossReceiptsTotalAmt
Charitable Contributions Tot$134,344CharitableContributionsTotAmt
Gross Revenue Total Events$39,302GrossRevenueTotalEventsAmt
Food And Beverage Total Events$45,317FoodAndBeverageTotalEventsAmt
Entertainment Total Events$18,460EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$22,858OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$86,635DirectExpenseSummaryEventsAmt
Net Income Summary-$47,333NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JOHN T BRUCHALSKI MD
CHAIRMAN & PRESIDENT$202,534$0$0$0$0$0$6,128$0$9,791$0$218,453$0$0$0
MARIE ANDERSON
OB/GYN$226,505$0$0$0$0$0$6,308$0$8,469$0$241,282$0$0$0
DANIEL FISK
OB/GYN$219,449$0$0$0$0$0$10,800$0$8,167$0$238,416$0$0$0
LORNA CVETKOVICH
OB/GYN$193,326$0$0$0$0$0$11,500$0$0$0$204,826$0$0$0
MIRIAM PEREIRA
OB/GYN$233,267$0$0$0$0$0$11,500$0$8,514$0$253,281$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 7AIF THE OFFICE OF ANY DIRECTOR OR DIRECTORS BECOMES VACANT, THE REMAINING DIRECTORS, THOUGH LESS THAN A QUORUM, SHALL BE AUTHORIZED TO SELECT A SUCCESSOR OR SUCCESSORS, WHO SHALL BE APPOINTED UPON THE AFFIRMATIVE VOTE OF A THREE-FOURTHS MAJORITY OF THE REMAINING DIRECTORS OF THE CORPORATION TO SERVE THE UNEXPIRED TERMS OF THE VACATED DIRECTORSHIPS.
FORM 990, PART VI, SECTION B, LINE 11THE 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 PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12CTHE 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 15COMPENSATION FOR THE ORGANIZATION'S CHAIRMAN, EXECUTIVE DIRECTOR, AND KEY EMPLOYEES IS REVIEWED ON AN ANNUAL BASIS BY THE COMPENSTION COMMITTEE, WHICH INCLUDES INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. COMPENSATION IS EVALUATED IN LIGHT OF COMPARABILITY DATA FOR NORTHEN VIRGINIA. THE DELIBERATIONS AND DECISIONS OF THE INDEPENDENT COMMITTEE ARE DOCUMENTED IN THE ORGANIZATION'S MINUTES.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
TEPEYAC FAMILY CENTER LLC
11096-A LEE HIGHWAY SUITE 101FAIRFAXVA22030201963116OB/GYN SERVICESVA$2,871,204$590,747DIVINE MERCY CARE
DMC PHARMACY LLC
11096-A LEE HIGHWAY SUITE 101FAIRFAXVA22030261906293PHARMACEUTICAL SERVICESVA$0$0DIVINE MERCY CARE