DIVINE MERCY CARE: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- DIVINE MERCY CARE (EIN 34-1985248)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-14
- IRS object ID
- 201243199349302804
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-14T10:57:06-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 260004395 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HALT BUZAS & POWELL LTD | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1199 NORTH FAIRFAX STREET 10TH FLOO | AddressLine1 |
| City | ALEXANDRIA | City |
| State | VA | State |
| ZIP Code | 22314 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341985248 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIVINE MERCY CARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | DIVI | NameControl |
| Phone | 7039345552 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11096-A LEE HIGHWAY NO 101 | AddressLine1 |
| City | FAIRFAX | City |
| State | VA | State |
| ZIP Code | 220305039 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KAREN CASSIDY | Name |
| Title | CHIEF OPERATIONS OFFICER | Title |
| Phone | 7039345552 | Phone |
| Date Signed | 2012-11-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CAROL MOUNT | Name |
| PTIN | P00699613 | PTIN |
| Phone | 7038361350 | Phone |
| Date Prepared | 2012-11-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | X | AddressChange |
| Name Of Principal Officer Person | JOHN T BRUCHALSKI | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11096-A LEE HIGHWAY NO 101 | AddressLine1 |
| City | FAIRFAX | City |
| State | VA | State |
| ZIP Code | 220305039 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 4499955 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.DIVINEMERCYCARE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2004 | YearFormation |
| State Legal Domicile | VA | StateLegalDomicile |
| Activity Or Mission Description | OUR MISSION IS TO CONVEY THE HEALING PRESENCE 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 THEIR FAITH, ETHNICITY, OR NATIONAL ORIGIN. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 35 | TotalNbrEmployees |
| Total Nbr Volunteers | 30 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 736826 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 678649 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4151028 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3762667 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 818 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1916 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 6167 | OtherRevenuePriorYear |
| Other Revenue Current Year | -6121 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 4894839 | TotalRevenuePriorYear |
| Total Revenue Current Year | 4437111 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 1953677 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2061763 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 104228 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2721906 | OtherExpensePriorYear |
| Other Expenses Current Year | 2445963 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 4675583 | TotalExpensesPriorYear |
| Total Expenses Current Year | 4507726 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 219256 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -70615 | RevenuesLessExpensesCY |
| Total Assets BOY | 701305 | TotalAssetsBOY |
| Total Assets EOY | 607432 | TotalAssetsEOY |
| Total Liabilities BOY | 447068 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 425000 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 254237 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 182432 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | OUR MISSION IS TO CONVEY THE HEALING PRESENCE 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 THEIR FAITH, ETHNICITY, OR NATIONAL ORIGIN. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 4224033 | Expense |
| Revenue | 3762667 | Revenue |
| Description | PROVIDING CULTURE OF LIFE CHARITABLE MEDICAL CARE, THROUGH THE TEPEYAC FAMILY CENTER LLC, TO APPROXIMATELY 15,000 WOMEN, INCLUDING INDIGENT WOMEN AND THOSE IN CRISIS PREGNANCIES. | Description |
| Total Program Service Expense | 4224033 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 7 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 35 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7039345552 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11096-A LEE HIGHWAY NO 101 | AddressLine1 |
| City | FAIRFAX | City |
| State | VA | State |
| ZIP Code | 220305039 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (12 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| JOHN T BRUCHALSKI MD | ||||||||
| CHAIRMAN, PRESIDENT | 40.00 | X | X | 179987 | 0 | 13419 | ||
| ADO MACHIDA | ||||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | ||
| MARY JULIANNE O'DONNELL | ||||||||
| SECRETARY | 3.00 | X | X | 0 | 0 | 0 | ||
| J PATRICK KEARNS | ||||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | ||
| JOSEPH G COSBY | ||||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| ROBERT LAIRD | ||||||||
| EXECUTIVE DIRECTOR | 1.00 | X | X | 49779 | 0 | 923 | ||
| EDWARD J GROGAN | ||||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| KAREN CASSIDY | ||||||||
| CHIEF OPERATIONS OFFICER | 60.00 | X | 65193 | 0 | 5472 | |||
| MARIE ANDERSON | ||||||||
| OB/GYN | 40.00 | 228429 | 0 | 14516 | X | |||
| DANIEL FISK | ||||||||
| OB/GYN | 40.00 | 221492 | 0 | 14516 | X | |||
| MIRIAM PEREIRA | ||||||||
| OB/GYN | 40.00 | 238017 | 0 | 6308 | X | |||
| LORNA CVETKOVICH | ||||||||
| OB/GYN | 40.00 | 194167 | 0 | 14033 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1177064 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 69187 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAPTURE BILLING | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 43063 PEACOCK MARKET PLAZA | AddressLine1 |
| City | SOUTH RIDING | City |
| State | VA | State |
| ZIP Code | 20152 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | BILLING SERVICES | DescriptionOfServices |
| Compensation | 133497 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Fundraising Events | 198564 | FundraisingEvents |
| All Other Contributions | 480085 | AllOtherContributions |
| Total Contributions | 678649 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PROFESSIONAL FEES | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 3762667 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3762667 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3762667 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 266 | TotalRevenueColumn |
| Exclusion | $266 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1650 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1650 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1650 | TotalRevenueColumn |
| Exclusion | $1,650 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 53510 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 198564 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 62844 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -9334 | TotalRevenueColumn |
| Exclusion | -$9,334 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER INCOME | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 3213 | TotalRevenueColumn |
| Exclusion | $3,213 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3213 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4437111 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3762667 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$4,205 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 793726 | Total |
| Program Services | 670559 | ProgramServices |
| Management And General | 84995 | ManagementAndGeneral |
| Fundraising | 38172 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1031604 | Total |
| Program Services | 1027672 | ProgramServices |
| Management And General | 3869 | ManagementAndGeneral |
| Fundraising | 63 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20909 | Total |
| Program Services | 20505 | ProgramServices |
| Fundraising | 404 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 104914 | Total |
| Program Services | 104914 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 110610 | Total |
| Program Services | 102466 | ProgramServices |
| Fundraising | 8144 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1639 | Total |
| Program Services | 1639 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 195514 | Total |
| Program Services | 154376 | ProgramServices |
| Management And General | 41138 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11626 | Total |
| Program Services | 10556 | ProgramServices |
| Management And General | 1070 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4124 | Total |
| Program Services | 833 | ProgramServices |
| Fundraising | 3291 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 169030 | Total |
| Program Services | 125628 | ProgramServices |
| Management And General | 19689 | ManagementAndGeneral |
| Fundraising | 23713 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10404 | Total |
| Program Services | 10404 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 285270 | Total |
| Program Services | 261566 | ProgramServices |
| Management And General | 23704 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3501 | Total |
| Program Services | 799 | ProgramServices |
| Management And General | 1373 | ManagementAndGeneral |
| Fundraising | 1329 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29788 | Total |
| Management And General | 3602 | ManagementAndGeneral |
| Fundraising | 26186 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8681 | Total |
| Program Services | 8681 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24404 | Total |
| Program Services | 21478 | ProgramServices |
| Fundraising | 2926 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 270866 | Total |
| Program Services | 270866 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PATIENT/INSURANCE/CHARI | 1398354 | 1398354 | |
| LAB FEES EXPENSE | 16210 | 16210 | |
| PATIENT REFUNDS | 14097 | 14097 | |
| TAXES | 2455 | 2430 | 25 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4507726 | Total |
| Program Services | 4224033 | ProgramServices |
| Management And General | 179465 | ManagementAndGeneral |
| Fundraising | 104228 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 197838 | BOY |
| EOY | 162913 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50000 | BOY |
| EOY | 93839 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 213318 | BOY |
| EOY | 121357 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40038 | BOY |
| EOY | 51644 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 133495 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 77350 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65390 | BOY |
| EOY | 56145 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10866 | BOY |
| EOY | 9859 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 119188 | BOY |
| EOY | 107008 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4667 | BOY |
| EOY | 4667 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 701305 | BOY |
| EOY | 607432 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 238692 | BOY |
| EOY | 223818 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23323 | BOY |
| EOY | 23323 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 185053 | BOY |
| EOY | 177859 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 447068 | BOY |
| EOY | 425000 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 238697 | BOY |
| EOY | 167392 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15540 | BOY |
| EOY | 15040 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 254237 | BOY |
| EOY | 182432 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 701305 | BOY |
| EOY | 607432 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -70615 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1190 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 627325 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 571587 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 797493 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 741386 | CurrentTaxYearMinus1Year |
| Current Tax Year | 480120 | CurrentTaxYear |
| Total | 3217911 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 73225 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 80567 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 88500 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 80220 | CurrentTaxYearMinus1Year |
| Current Tax Year | 252074 | CurrentTaxYear |
| Total | 574586 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 700550 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 652154 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 885993 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 821606 | CurrentTaxYearMinus1Year |
| Current Tax Year | 732194 | CurrentTaxYear |
| Total | 3792497 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 133764 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 32000 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 19000 | CurrentTaxYearMinus2Years |
| Total | 184764 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 133764 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 32000 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 19000 | CurrentTaxYearMinus2Years |
| Total | 184764 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 3607733 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 19080 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 12489 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 19655 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 818 | CurrentTaxYearMinus1Year |
| Current Tax Year | 266 | CurrentTaxYear |
| Total | 52308 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 19080 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 12489 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 19655 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 818 | CurrentTaxYearMinus1Year |
| Current Tax Year | 266 | CurrentTaxYear |
| Total | 52308 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 719630 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 664643 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 905648 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 822424 | CurrentTaxYearMinus1Year |
| Current Tax Year | 732460 | CurrentTaxYear |
| Total | 3844805 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.93830 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.87270 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.01360 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.01680 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 133495 | OtherCostOrOtherBasis |
| Depreciation | 77350 | Depreciation |
| Book Value | 56145 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 56145 | TotalOfBookValueLandBuildings |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | ANNUAL GALA | NameOfEvent1 |
| Gross Receipts Event1 | 235009 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 198564 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 36445 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 62844 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 235009 | GrossReceiptsTotal |
| Charitable Contributions Total | 198564 | CharitableContributionsTotal |
| Gross Revenue Total Events | 36445 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 62844 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 62844 | DirectExpenseSummaryEvents |
| Net Income Summary | -26399 | NetIncomeSummary |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN T BRUCHALSKI MD | |||||||||||||
| 179987 | 0 | 0 | 0 | 0 | 0 | 5211 | 0 | 8208 | 0 | 193406 | 0 | 0 | 0 |
| MARIE ANDERSON | |||||||||||||
| 228429 | 0 | 0 | 0 | 0 | 0 | 6308 | 0 | 8208 | 0 | 242945 | 0 | 0 | 0 |
| DANIEL FISK | |||||||||||||
| 221492 | 0 | 0 | 0 | 0 | 0 | 6308 | 0 | 8208 | 0 | 236008 | 0 | 0 | 0 |
| MIRIAM PEREIRA | |||||||||||||
| 238017 | 0 | 0 | 0 | 0 | 0 | 6308 | 0 | 0 | 0 | 244325 | 0 | 0 | 0 |
| LORNA CVETKOVICH | |||||||||||||
| 194167 | 0 | 0 | 0 | 0 | 0 | 5825 | 0 | 8208 | 0 | 208200 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JOHN T BRUCHALSKI | NamePerson |
| Purpose Of Loan | DEMAND LOAN FROM JOHN T. BRUCHALSKI, MD, PC | PurposeOfLoan |
| Loan To Organization | X | LoanToOrganization |
| Balance Due | 23323 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 23323 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | [EXPLANATION FOR MEMBERS THAT CAN ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY] | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 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. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE 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 15 | COMPENSATION FOR THE ORGANIZATION'S CHAIRMAN, EXECUTIVE DIRECTOR, AND KEY EMPLOYEES IS REVIEWED ON AN ANNUAL BASIS BY THE COMPENSATION COMMITTEE, WHICH INCLUDES INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. COMPENSATION IS EVALUATED IN LIGHT OF COMPARABILITY DATA FOR NORTHERN VIRGINIA. THE DELIBERATIONS AND DECISIONS OF THE INDEPENDENT COMMITTEE ARE DOCUMENTED IN THE ORGANIZATION'S MINUTES. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -1,189. ROUNDING -1. TOTAL TO FORM 990, PART XI, LINE 5: -1,190. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets |
|---|---|---|---|---|---|---|---|---|
| TEPEYAC FAMILY CENTER LLC | ||||||||
| 11096-A LEE HIGHWAY | FAIRFAX | VA | 22030 | 201963116 | OB/GYN SERVICES | VA | 3765073 | 369381 |
| DMC PHARMACY LLC | ||||||||
| 11096-A LEE HIGHWAY | FAIRFAX | VA | 22030 | 261906293 | PHARMACEUTICAL SERVICES | VA | 2231 | 14530 |