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COLLIER HEALTH SERVICES INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
COLLIER HEALTH SERVICES INC (EIN 59-1741277)
Tax period
2011-04-01 to 2012-03-31
Filed
2012-11-09
IRS object ID
201233149349302143
Schema version
2011v1.2
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)
Timestamp2012-11-09T14:41:16-06:00Timestamp
Tax Period End Date2012-03-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MYERS BRETTHOLTZ & COMPANY PABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line112671 WHITEHALL DRAddressLine1
CityFORT MYERSCity
StateFLState
ZIP Code339073626ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN591741277EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COLLIER HEALTH SERVICES INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOLLNameControl
Phone2396583000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11454 MADISON AVENUEAddressLine1
CityIMMOKALEECity
StateFLState
ZIP Code34142ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSANDY STEELEName
TitleCFOTitle
Phone2396583000Phone
Date Signed2012-08-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJOHN M LOPEZ CPAName
Phone2399395775Phone
Date Prepared2012-11-09DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRICHARD AKINNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11454 MADISON AVENUEAddressLine1
CityIMMOKALEECity
StateFLState
ZIP Code34142ZIPCode
FieldValueIRS element (for citing)
Gross Receipts29664603GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.COLLIER.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1977YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE A QUALITY HEALTHCARE HOME ACCESSIBLE TO EVERYONE IN COLLIER COUNTY.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees324TotalNbrEmployees
Total Nbr Volunteers55TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year8002981ContributionsGrantsPriorYear
Contributions Grants Current Year8323364ContributionsGrantsCurrentYear
Program Service Revenue Prior Year15412156ProgramServiceRevenuePriorYear
Program Service Revenue CY19405144ProgramServiceRevenueCY
Investment Income Prior Year56050InvestmentIncomePriorYear
Investment Income Current Year27791InvestmentIncomeCurrentYear
Other Revenue Prior Year1892403OtherRevenuePriorYear
Other Revenue Current Year1890601OtherRevenueCurrentYear
Total Revenue Prior Year25363590TotalRevenuePriorYear
Total Revenue Current Year29646900TotalRevenueCurrentYear
Grants And Similar Amnts CY27988GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year14611529SalariesEtcPriorYear
Salaries Etc Current Year16140994SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year284971TotalFundrsngExpCurrentYear
Other Expense Prior Year7127277OtherExpensePriorYear
Other Expenses Current Year8082497OtherExpensesCurrentYear
Total Expenses Prior Year21738806TotalExpensesPriorYear
Total Expenses Current Year24251479TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3624784RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5395421RevenuesLessExpensesCY
Total Assets BOY17164561TotalAssetsBOY
Total Assets EOY22118708TotalAssetsEOY
Total Liabilities BOY7313062TotalLiabilitiesBOY
Total Liabilities EOY6850471TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY9851499NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY15268237NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE A QUALITY HEALTHCARE HOME ACCESSIBLE TO EVERYONE IN COLLIER COUNTY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense21592189Expense
Grants27988Grants
DescriptionA PRIVATE, NOT-FOR-PROFIT "SAFETY NET" HEALTH CARE PROVIDER WITH 12 HEALTH CARE FACILITIES LOCATED THROUGHOUT COLLIER COUNTY, WHICH INCLUDES THE RONALD MCDONALD CARE MOBILE. OFFERING BASIC PRIMARY AND PREVENTATIVE MEDICAL AND DENTAL HEALTH CARE SERVICES, THE ORGNIZATION PROVIDED SERVICES TO OVER 43,000 PATIENTS (30,000 CHILDREN) FOR A TOTAL OF OVER 154,500 PATIENT VISITS.Description
Total Program Service Expense21592189TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109644NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees324NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSANDRA STEELENamePerson
Telephone Number2396583039TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11454 MADISON AVENUEAddressLine1
CityIMMOKALEECity
StateFLState
ZIP Code34142ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
MARTA COBURN
DIRECTOR2.00X000
DOUG CAMPBELL
DIRECTOR2.00X000
MARIA DELAROSA
DIRECTOR2.00X000
DOTTIE COOK
DIRECTOR2.00X000
RICHARD RICE
CHAIRMAN2.00X000X
JEAN CASNEL PAUL
DIRECTOR2.00X000X
EDWARD OLESKY
TREASURER2.00X000X
DENNIS BROWN
DIRECTOR2.00X000
RICHARD HEERS
SECRETARY2.00X000X
RICHARD AKIN
PRES / CEO40.00336910035802X
STEVE WEINMAN
VICE PRES /40.00256170039962X
JERRY WILLIAMSON
CMO40.00222955039322X
SANDY STEELE
CFO40.00106547011112X
JOSE QUERO
DOCTOR40.00202947031766X
RICHARD GONZALEZ
DOCTOR40.00165400018386X
CLAUDIA LENIS
DOCTOR40.00163598023320X
WILLIAM KUZBYT
DIR. OF PROF40.00161448026313X
ALICIA LANGER
DOCTOR40.00161312027379X
SHARON ARAGONA
FORMER VICE5879106621X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1836078TotalReportableCompFromOrg
Total Other Compensation259983TotalOtherCompensation
Number Individuals GT100 K15NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensationAddress Line2AddressOfContractor/AddressUS/AddressLine2
HENRY SCHEIN INC
PO BOX 371952PITTSBURGHPA15250DENTAL EQUIP1045544
COMMUNITY HEALTH CENTER ALLIANCE
140 FOUNTAIN PARKWAYSAINT PETERSBURGFL33716IT SUPPORT755520SUITE 210
COMMUNITY HEALTH CARE INC
PO BOX 413001NAPLESFL34101RENT285000
DIAGNOSTIC LABS INC
PO BOX 12140BURLINGTONNC27216LAB ANALYSIS218598
STAPLES
PO BOX 405386ATLANTAGA30384OFFICE SUPPLIES214036
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Government Grants6980503GovernmentGrants
All Other Contributions1342861AllOtherContributions
Noncash Contributions8662NoncashContributions
Total Contributions8323364TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE FEESDescription
Total Revenue Column19405144TotalRevenueColumn
Related Or Exempt Function Income19405144RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue19405144TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column27791TotalRevenueColumn
Exclusion$27,791ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events80215GrossIncomeFundraisingEvents
Fundraising Direct Expenses17703FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column62512TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
PEDIATRIC PRACTICE MGMT FEES1223538$1,223,538
OTHER INCOME604551$604,551
FieldValueIRS element (for citing)
Total Other Revenue1828089TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column29646900TotalRevenueColumn
Related Or Exempt Function Income19405144RelatedOrExemptFunctionIncome
Exclusion$1,855,880ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total27988Total
Program Services27988ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total986966Total
Program Services691978ProgramServices
Management And General283261ManagementAndGeneral
Fundraising11727Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total58791Total
Program Services32335ProgramServices
Management And General26456ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total10897036Total
Program Services9877406ProgramServices
Management And General800963ManagementAndGeneral
Fundraising218667Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3222198Total
Program Services2823676ProgramServices
Management And General375593ManagementAndGeneral
Fundraising22929Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total976003Total
Program Services865681ProgramServices
Management And General90769ManagementAndGeneral
Fundraising19553Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total360729Total
Program Services276160ProgramServices
Management And General84569ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total43270Total
Program Services28944ProgramServices
Management And General9664ManagementAndGeneral
Fundraising4662Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total98840Total
Program Services84464ProgramServices
Management And General9192ManagementAndGeneral
Fundraising5184Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total748701Total
Program Services715966ProgramServices
Management And General30486ManagementAndGeneral
Fundraising2249Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1188412Total
Program Services1059506ProgramServices
Management And General128906ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total157528Total
Program Services142878ProgramServices
Management And General14650ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total191340Total
Program Services131802ProgramServices
Management And General59538ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total662474Total
Program Services600864ProgramServices
Management And General61610ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total146942Total
Program Services97678ProgramServices
Management And General49264ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PATIENT CARE22390602239060
OTHER13261671078232247935
MAINTENANCE & REPAIRS35421232258831624
SUPPLIES28575226308922663

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total279070Total
Program Services231894ProgramServices
Management And General47176ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total24251479Total
Program Services21592189ProgramServices
Management And General2374319ManagementAndGeneral
Fundraising284971Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3290202BOY
EOY7226087EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2769001BOY
EOY2588210EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY637233BOY
EOY219083EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1839531BOY
EOY3162047EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY208651BOY
EOY196003EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY126712BOY
EOY82713EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis11475827LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4083610LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY7075812BOY
EOY7392217EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY574119BOY
EOY605522EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY146176BOY
EOY147994EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY497124BOY
EOY498832EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY17164561BOY
EOY22118708EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1281152BOY
EOY1374796EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY1038526BOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY2567336BOY
EOY2442108EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2426048BOY
EOY3033567EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY7313062BOY
EOY6850471EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY9387754BOY
EOY14815341EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY463745BOY
EOY452896EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9851499BOY
EOY15268237EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY17164561BOY
EOY22118708EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses5395421ReconcilationRevenueExpenses
Reconcilation Other Changes21317ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9569406CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8120694CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7995237CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9280231CurrentTaxYearMinus1Year
Current Tax Year9458648CurrentTaxYear
Total44424216Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9569406CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8120694CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7995237CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9280231CurrentTaxYearMinus1Year
Current Tax Year9458648CurrentTaxYear
Total44424216Total
FieldValueIRS element (for citing)
Public Support Total17044424216PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years118975CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years64415CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years22777CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year56050CurrentTaxYearMinus1Year
Current Tax Year27791CurrentTaxYear
Total290008Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years516179CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1290426CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1663060CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1892403CurrentTaxYearMinus1Year
Current Tax Year1890601CurrentTaxYear
Total7252669Total
FieldValueIRS element (for citing)
Total Support51966893TotalSupport
Gross Receipts From Admissions Etc19485359GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.85490PublicSupportPertcentage170
Public Support Pertcent Prior Year0.86980PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
General ExplanationPART II, LINE 1 - GIFTS, GRANTS, CONTRIBUTIONS & MEMBERSHIP FEES DETAIL AMOUNTS INCLUDE IN-KIND CONTRIBUTIONS FOR SERVICES AND FACILITIES AS FOLLOWS: 2007 2008 2009 2010 2011 TOTAL --------- --------- --------- --------- --------- ---------- CONTRIB/ GRANTS 8,912,692 6,944,118 6,602,504 8,002,981 8,001,973 38,464,268 IN-KIND 656,714 1,176,576 1,392,733 1,277,250 1,456,675 5,959,948 --------- --------- --------- --------- --------- ---------- TOTAL 9,569,406 8,120,694 7,995,237 9,280,231 9,458,648 44,424,216 PART II, LINE 10 - OTHER INCOME FEES DETAIL 2007 2008 2009 2010 2011 TOTAL --------- --------- ---------- --------- --------- ---------- OTHER 516,179 690,426 1,063,060 838,988 604,551 3,713,204 MANAGEMENT FEES - 600,000 600,000 929,126 1,223,538 3,352,664 FUND RAISING, NET 124,289 62,512 186,801 --------- --------- --------- --------- --------- ---------- TOTAL 516,179 1,290,426 1,663,060 1,892,403 1,890,601 7,252,679GeneralExplanation

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

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis445000OtherCostOrOtherBasis
Book Value445000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5285776OtherCostOrOtherBasis
Depreciation919352Depreciation
Book Value4366424BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2030172OtherCostOrOtherBasis
Depreciation516146Depreciation
Book Value1514026BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3060353OtherCostOrOtherBasis
Depreciation2136769Depreciation
Book Value923584BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis654526OtherCostOrOtherBasis
Depreciation511343Depreciation
Book Value143183BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings7392217TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
COMPENSATED ABSENCES$1,513,232
ACCRUED LIABILITIES$852,685
DEFERRED COMPENSATION$428,080
PENSION PLAN PAYABLE$239,570
FieldValueIRS element (for citing)
Total Of Amounts3033567TotalOfAmounts
Total Revenue29646900TotalRevenue
Total Expenses24251479TotalExpenses
Excess Or Deficit For Year5395421ExcessOrDeficitForYear
Net Unrealized GL On Investments21317NetUnrealizedGLOnInvestments
Other$2,086,765OtherAmount
Total Adjustments2108082TotalAdjustments
Excess Or Deficit Per FS7503503ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt69899351TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments21317NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities1456675DonatedSrvcAndUseOfFacilities
Other Revenues42224363OtherRevenues
Revenue Not Rptd F99043702355RevenueNotRptdF990
Revenue Subtotal26196996RevenueSubtotal
Other Revenues Not Included3449904OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt3449904RevenueNotRptdOnFinStmt
Total Revenue Per Form99029646900TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt62395848TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities1456675DonatedServicesUseOfFacilities
Other Expenses Included40155301OtherExpensesIncluded
Expenses Not Rptd F99041611976ExpensesNotRptdF990
Expenses Subtotal20783872ExpensesSubtotal
Other Expenses Not Included3467607OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt3467607ExpensesNotRptdOnFinStmt
Total Expenses Per Form99024251479TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RECONCILIATION OF CHANGES - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 8CHS HEALTHCARE FOUNDATION INCOME 55,460 INTEGRAL HEALTH PLAN INCOME 42,168,903 DIRECT FUNDRAISING EXPENSES 17,703 INTERCOMPANY ELIMINATIONS -3,467,607 CHS HEALTHCARE FOUNDATION EXPENSES -82,771 INTEGRAL HEALTH PLAN EXPENSES -40,054,827 DIRECT FUNDRAISING EXPENSES -17,703 INTERCOMPANY ELIMINATIONS 3,467,607
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 2DCHS HEALTHCARE FOUNDATION INCOME 55,460 INTEGRAL HEALTH PLAN INCOME 42,168,903
REVENUE AMOUNTS INCLUDED ON RETURN - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 4BDIRECT FUNDRAISING EXPENSES -17,703 INTERCOMPANY ELIMINATIONS 3,467,607
EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XIII, LINE 2DCHS HEALTHCARE FOUNDATION EXPENSES 82,771 INTEGRAL HEALTH PLAN EXPENSES 40,054,827 DIRECT FUNDRAISING EXPENSES 17,703
EXPENSE AMOUNTS INCLUDED ON RETURN - OTHERSCHEDULE D, PAGE 4, PART XIII, LINE 4BINTERCOMPANY ELIMINATIONS 3,467,607

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Licensed StatesFLLicensedStates

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENTNameOfEvent1
Gross Receipts Event180215GrossReceiptsEvent1
Gross Revenue Event180215GrossRevenueEvent1
Rent Facility Costs Event116482RentFacilityCostsEvent1
Other Direct Expenses Event11221OtherDirectExpensesEvent1
Gross Receipts Total80215GrossReceiptsTotal
Gross Revenue Total Events80215GrossRevenueTotalEvents
Rent Facility Costs Total Events16482RentFacilityCostsTotalEvents
Other Direct Expenses Total Events1221OtherDirectExpensesTotalEvents
Direct Expense Summary Events17703DirectExpenseSummaryEvents
Net Income Summary62512NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY FOUNDATION OF COLLIER COUBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12400 TAMIAMI TRAIL N SUITE 300AddressLine1
CityNAPLESCity
StateFLState
ZIP Code34103ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient592396243EINOfRecipient
IRC Section501IRCSection
Amount Of Cash Grant20011AmountOfCashGrant
Purpose Of GrantCOLLIER 211 INFORMATPurposeOfGrant

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
RICHARD AKIN
31154725363282417561372712
STEVE WEINMAN
237094190762824111721296132
JERRY WILLIAMSON
2226293262760111721262277
JOSE QUERO
2019471000243237443234713
RICHARD GONZALEZ
16448791318386183786
CLAUDIA LENIS
1587724826180805240186918
WILLIAM KUZBYT
161285163183867927187761
ALICIA LANGER
1519669346189218458188691
SHARON ARAGONA
58791662165412

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTSIdentifier
Return ReferenceSCHEDULE J, PAGE 1, PART I, LINE 4ReturnReference
ExplanationMARTA COBURN 0 1 0Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BCFO REVIEWS A DRAFT COPY OF THE TAX RETURN FOR ACCURACY AND COMPLETENESS PRIOR TO SIGNING THE TAX RETURN. IN ADDITION, THE ORGANIZATION'S FINANCE COMMITTEE REVIEWS THE TAX RETURN AND THE FULL BOARD RECEIVES COPIES OF THE TAX RETURN BEFORE FILING.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CPROCUREMENT AND CONTRACTING POLICIES INCLUDE REFERENCES TO CONFLICT OF INTEREST POLICY AND PROCUREMENT AND CONTRACTING STAFF MONITORS TRANSACTIONS CLOSELY FOR COMPLIANCE.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15AAN INDEPENDENT COMPENSATION CONSULTANT'S SERVICES WERE UTILIZED TO REVIEW SALARIES.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BAN INDEPENDENT COMPENSATION CONSULTANT'S SERVICES WERE UTILIZED TO REVIEW SALARIES.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST WITHOUT CHARGE.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1INTEGRAL HEALTH PLAN INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11454 MADISON AVEAddressLine1
CityIMMOKALEECity
StateFLState
ZIP Code34142ZIPCode
FieldValueIRS element (for citing)
EIN800420631EIN
Primary ActivitiesHEALTHCAREPrimaryActivities
Legal Domicile StateFLLegalDomicileState
Exempt Code Section501C3ExemptCodeSection
Public Charity Status7PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
INTEGRAL HEALTH PLAN INC
K3422607COST
CHS HEALTHCARE FOUNDATION
O3448COST