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CAMILLUS HEALTH CONCERN INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
CAMILLUS HEALTH CONCERN INC (EIN 65-0063921)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-13
IRS object ID
201111339349302581
Schema version
2009v1.7
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)
Timestamp2011-05-13T11:11:22-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1RSM MCGLADREY INCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11185 AVENUE OF THE AMERICASAddressLine1
CityNEW YORKCity
StateNYState
ZIP Code100362602ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN650063921EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CAMILLUS HEALTH CONCERN INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCAMINameControl
Phone3053741065Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1336 NW 5TH STREET POBOX 012408AddressLine1
CityMIAMICity
StateFLState
ZIP Code33101ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRaphael MieszalaName
TitleDIRECTORTitle
Phone3053741065Phone
Date Signed2011-05-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone2123721000Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRAY KAYAL SRNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1336 nw 5th street po box 012408AddressLine1
CitymiamiCity
StateFLState
ZIP Code33101ZIPCode
FieldValueIRS element (for citing)
Gross Receipts4381736GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitecamillushouse.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1988YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionCAMILLUS HEALTH CONCERN, INC. IS A NOT-FOR-PROFIT ORGANIZATION INCORPORATED IN THE STATE OF FLORIDA FOR THE PURPOSE OF PROVIDING READILY ACCESSIBLE PRIMARY HEALTHCARE AND RELATED SERVICES TO THE HOMELESS AND INDIGENT POPULATIONS OF MIAMI DADE COUNTY, FLORIDA. THE CENTER SERVED APPROXIMATELY 4,287 PATIENTS WHO HAD A TOTAL OF APPROXIMATELY 25,503 VISITS FOR THE YEAR ENDED 6/30/10.ActivityOrMissionDescription
Nbr Voting Members Governing Body45NbrVotingMembersGoverningBody
Nbr Independent Voting Members45NbrIndependentVotingMembers
Total Nbr Employees62TotalNbrEmployees
Total Nbr Volunteers45TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3423365ContributionsGrantsPriorYear
Contributions Grants Current Year3763506ContributionsGrantsCurrentYear
Program Service Revenue Prior Year375441ProgramServiceRevenuePriorYear
Program Service Revenue CY388257ProgramServiceRevenueCY
Investment Income Prior Year21107InvestmentIncomePriorYear
Investment Income Current Year19993InvestmentIncomeCurrentYear
Other Revenue Prior Year172210OtherRevenuePriorYear
Other Revenue Current Year209980OtherRevenueCurrentYear
Total Revenue Prior Year3992123TotalRevenuePriorYear
Total Revenue Current Year4381736TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3019468SalariesEtcPriorYear
Salaries Etc Current Year3199016SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year969776OtherExpensePriorYear
Other Expenses Current Year984628OtherExpensesCurrentYear
Total Expenses Prior Year3989244TotalExpensesPriorYear
Total Expenses Current Year4183644TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2879RevenuesLessExpensesPriorYear
Revenues Less Expenses CY198092RevenuesLessExpensesCY
Total Assets BOY1550108TotalAssetsBOY
Total Assets EOY1702087TotalAssetsEOY
Total Liabilities BOY385675TotalLiabilitiesBOY
Total Liabilities EOY339562TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1164433NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1362525NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MISSION OF CAMILLUS HEALTH CONCERN IS TO PROVIDE CHRISTIAN HOSPITALITY AND RESPECT FOR LIFE THROUGH DIRECT SERVICE OF BEHAVIORAL HEALTH AND HEALTH CARE TO PERSONS WHO ARE POOR AND HOMELESS IN SOUTH FLORIDA.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense1452617Expense
Revenue268512Revenue
DescriptionPrimary Care Services: Adult Primary Health Services encompass the full range of services, including preventive care, episodic care for acute illness, chronic disease management, and specialty and surgical referrals as needed. Pediatric Primary Health Services include immunizations, health maintenance, disease prevention, and education. Women's Preventive Health Services focus on health maintenance and prevention, providing cervical and breast cancer screenings. In 2010, services were provided to 3,485 users for a total of 13,159 visits.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense433405Expense
Revenue77604Revenue
DescriptionMental Health Services: Mental Health Services include individual and group counseling by psychology interns and other Mental Health staff, and a psychiatric service that provides medication management. The Mental Health Services are fully integrated with the primary health care and case management components of CHC, ensuring continuity of care for patients. In 2010, services were provided to 984 users for a total of 5,467 visits.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense275546Expense
Revenue42141Revenue
DescriptionOral Health Services: Oral Health Services include preventive and basic services, including dental hygiene and education, temporary restorations (fillings), gum treatment, x-rays, and extractions, as well as dentures. In 2010, services were provided to 863 users for a total of 2,697 visits.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense1276146Expense
FieldValueIRS element (for citing)
Total Of Other Program Service Exp1276146TotalOfOtherProgramServiceExp
Total Program Service Expense3437714TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10964NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees62NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members45NbrVotingGoverningBodyMembers
Number Independent Voting Members45NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure0WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledFLStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JOSE ZIRENABusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3055774840TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1336 NW 5TH STREETAddressLine1
CitymiamiCity
StateFLState
ZIP Code33128ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (53 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
PAUL AHR
CONSULTANT10.00X293322951656584
ROBERT DICKINSON
CHAIRMAN1.00X000X
ROGER CARLTON
VICE CHAIRMAN1.00X000X
CHIP VANDENBERG
TREASURER1.00X000X
PEDRO JOSE GREER JR MD
CHAIRMAN EMERITUS1.00X000X
CRYSTAL CONNOR ESQ
SECRETARY1.00X000X
MARIA ALONSO
BOARD MEMBER1.00X000
JAMES ANGLETON
BOARD MEMBER1.00X000
KATE M CALLAHAN PHD
BOARD MEMBER1.00X000
MICHAEL CARRICARTE
BOARD MEMBER1.00X000
MARK S CAVALIERE
BOARD MEMBER1.00X000
ALBERTO COSIO
BOARD MEMBER1.00X000
PAUL DIMARE
BOARD MEMBER1.00X000
MIGUEL G FARRA CPA JD
BOARD MEMBER1.00X000
RENE GARCIA
BOARD MEMBER1.00X000
ALAN GREER ESQ
BOARD MEMBER1.00X000
MARY HELEN HAYDAN EDD
BOARD MEMBER1.00X000
ROD A HILDEBRANT
BOARD MEMBER1.00X000
RONALD KOHN CCIM
BOARD MEMBER1.00X000
STEVEN MARIN
BOARD MEMBER1.00X000
BROTHER RICHARD MCPHEE
BOARD MEMBER1.00X000
ALFREDO MESA
BOARD MEMBER1.00X000
BROTHER RAPHAEL MIESZALA BGS
BOARD MEMBER1.00X000
DANIEL OSMAN
BOARD MEMBER1.00X000
REP YOLLY ROBERSON
BOARD MEMBER1.00X000
WILLIAM D TALBERT III CDME
BOARD MEMBER1.00X000
MARC A WILLIAMS
BOARD MEMBER1.00X000
FATHER EDUARDO ALVAREZ SJ
BOARD MEMBER1.00X000
MARK D BLOOM
BOARD MEMBER1.00X000
CHARLIE CANOVA
BOARD MEMBER1.00X000
RAY CASAS
BOARD MEMBER1.00X000
JOHN W CHIDSEY
BOARD MEMBER1.00X000
ROBERT F COTTER
BOARD MEMBER1.00X000
JOHN DUBOIS
BOARD MEMBER1.00X000
SUE GALLAGHER
BOARD MEMBER1.00X000
THEODORE GELMAN
BOARD MEMBER1.00X000
JULIE GRIMES
BOARD MEMBER1.00X000
EUGENIO GENE HERNANDEZ
BOARD MEMBER1.00X000
EDITH HUDSON
BOARD MEMBER1.00X000
JACQUELINE LARRALDE-SANCHEZ
BOARD MEMBER1.00X000
RAYFIELD M MCGHEE
BOARD MEMBER1.00X000
MANNY MEDINA
BOARD MEMBER1.00X000
JOHN T MESTEPEY
BOARD MEMBER1.00X000
ALBERT R MOLINA
BOARD MEMBER1.00X000
WILLIAM H PARKER
BOARD MEMBER1.00X000
REV JEREMIAH A SINGLETON
BOARD MEMBER1.00X000
LEE I WEINTRAUB ESQ
BOARD MEMBER1.00X000
HIRUT KASSAYE
EXecutive director40.009081009267X
THOMAS GOLDRING
DIRECTOR OF FINANCE/OPERATIONS40.0081215011881X
ROSENDO COLLAZO
DIRECTOR OF HEALTH SERVICES40.0019066107700X
JAVIER HIRIART
CHIEF MEDICAL DIRECTOR40.0012968009328X
CARMEN DE LA TORRE
DENTAL DIRECTOR40.0012479105863X
FRANCIS QUITO
PHYSICIAN40.00119581027863X
FieldValueIRS element (for citing)
Total Reportable Comp From Org766070TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs295165TotalReportableCompFrmRltdOrgs
Total Other Compensation78486TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Related Organizations133540RelatedOrganizations
Government Grants3544090GovernmentGrants
All Other Contributions85876AllOtherContributions
Total Contributions3763506TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICAID900099248537248537
SELF PAY - LOW INCOME9000999165591655
MEDICARE9000994806548065
FieldValueIRS element (for citing)
Total Program Service Revenue388257TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column19993TotalRevenueColumn
Exclusion$19,993ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionACT REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column209980TotalRevenueColumn
Exclusion$209,980ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue209980TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4381736TotalRevenueColumn
Related Or Exempt Function Income388257RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$229,973ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total223380Total
Management And General223380ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2450371Total
Program Services2218994ProgramServices
Management And General231377ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2535Total
Program Services2217ProgramServices
Management And General318ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total335307Total
Program Services311670ProgramServices
Management And General23637ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total187423Total
Program Services163875ProgramServices
Management And General23548ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3895Total
Program Services2898ProgramServices
Management And General997ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total27681Total
Program Services20592ProgramServices
Management And General7089ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total414643Total
Program Services308458ProgramServices
Management And General106185ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total172562Total
Program Services165552ProgramServices
Management And General7010ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total40457Total
Program Services40457ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total4307Total
Program Services3040ProgramServices
Management And General1267ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total18894Total
Program Services13334ProgramServices
Management And General5560ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total24870Total
Program Services23725ProgramServices
Management And General1145ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total71888Total
Program Services30109ProgramServices
Management And General41779ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
EQUIPMENT RENTAL AND MA992968418615110
MISCELLANEOUS691114798921122
DUES & SUBSCRIPTIONS3702461836406

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4183644Total
Program Services3437714ProgramServices
Management And General745930ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY500BOY
EOY500EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1033665BOY
EOY909870EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY213033BOY
EOY291734EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7343BOY
EOY39776EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY131164BOY
EOY154039EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2000535LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1820367LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY33450BOY
EOY180168EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY126000BOY
EOY126000EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4953BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1550108BOY
EOY1702087EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY358579BOY
EOY287000EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY27096BOY
EOY52562EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY385675BOY
EOY339562EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1164433BOY
EOY1362525EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1164433BOY
EOY1362525EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1550108BOY
EOY1702087EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3453624CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4911015CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3332207CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3434365CurrentTaxYearMinus1Year
Current Tax Year3629966CurrentTaxYear
Total18761177Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3453624CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4911015CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3332207CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3434365CurrentTaxYearMinus1Year
Current Tax Year3629966CurrentTaxYear
Total18761177Total
FieldValueIRS element (for citing)
Public Support Total17018761177PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11132CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years38805CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years20840CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21107CurrentTaxYearMinus1Year
Current Tax Year19993CurrentTaxYear
Total111877Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9024CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years21028CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14489CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year172210CurrentTaxYearMinus1Year
Current Tax Year343520CurrentTaxYear
Total560271Total
FieldValueIRS element (for citing)
Total Support19433325TotalSupport
Gross Receipts From Admissions Etc1903207GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.96540PublicSupportPertcentage170
Public Support Pertcent Prior Year0.98300PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

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

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1154281OtherCostOrOtherBasis
Depreciation1118545Depreciation
Book Value35736BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis846254OtherCostOrOtherBasis
Depreciation701822Depreciation
Book Value144432BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings180168TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionPRESTIGE HEALTH CHOICES, LLC.Description
Book Value126000BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related126000TotalOfBookValueProgramRelated
Total Revenue4381736TotalRevenue
Total Expenses4183644TotalExpenses
Excess Or Deficit For Year198092ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS198092ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt4690117TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities308381DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F990308381RevenueNotRptdF990
Revenue Subtotal4381736RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9904381736TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt4492025TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities308381DonatedServicesUseOfFacilities
Expenses Not Rptd F990308381ExpensesNotRptdF990
Expenses Subtotal4183644ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9904183644TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart X:Identifier
Return ReferenceDescription of Uncertain Tax Positions Under FIN 48:ReturnReference
ExplanationFIN 48 FINANCIAL STATEMENT FOOTNOTE: THE CENTER ADOPTED ACCOUNTING GUIDANCE RELATED TO THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ON JULY 1, 2009. THE CENTER FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAXES). WHEN THE RETURN IS FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH CENTERS INCLUDE SUCH MATTERS AS THE FOLLOWING: TAX-EXEMPT STATUS OF THE ENTITY, THE CONTINUED TAX-EXEMPT STATUS OF BOND ISSUED BY THE ORGANIZATION, THE NATURE, CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME ("UBIT"). UBIT IS REPORTED ON INTERNAL REVENUE SERVICE FORM 990-T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIFELY THAN NOT THE TAX POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH THE TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AT JUNE 30, 2010, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
PAUL AHR
29332295165000000065842933230174900
ROSENDO COLLAZO
190661000007700016510200012000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 6Membership in the Corporation shall at all times be limited to those persons who are the Brother General and members of the General Council of the Little Brothers of the Good Shepherd.
Form 990, Part VI, Section A, line 7aThe Members shall approve the appointment of all Directors. The Members may remove any Director at any time for any reason which the Membership, in its sole discretion, deems to be in the best interest of the Corporation.
Form 990, Part VI, Section A, line 7bThe Members reserve to themselves the articulation of and mediation of the operating philosophy and mission statement that underlie the charitable ministry of Camillus Health Concern. Included within this reserved power shall be all decisions regarding major policy changes and long range planning.
Form 990, Part VI, Section B, line 11The Directors of Finance of both Camillus Health Concern and Health Choice Network review the 990 with the Finance Committee of the Board of Directors, and the Finance Committee approves the 990 prior to filing with the IRS. The Board of Directors then approves the 990 as presented per the recommendation of the Finance Committee.
Form 990, Part VI, Section B, line 12cTHE CONFLICT OF INTEREST POLICY IS PART OF THE ORGANIZATION BY-LAWS AND IS CONTINUALLY REVIEWED AND MONITORED. AT ELECTION TIME, DIRECTORS ARE REQUIRED TO REVIEW, SIGN AND ABIDE BY THE ORGANIZATION'S BYLAWS AND POLICIES.
Form 990, Part VI, Section B, line 15Periodically, Executive Management reviews job functions and requirements of each position to determine an appropriate wage or salary range. Compensation is also based on the following factors: 1. Prevailing rates for similar work in other nonprofit and commercial organizations; 2. National as well as local salary patterns; 3. Applicable legal requirements; 4. Standards established by professional organizations, and; 5. The financial ability of CHC to compensate its staff.
Form 990, Part VI, Section C, line 19Camillus Health Concern makes its governing documents, conflict of interest policy and financial statements available to the general public upon request.
FORM 990, PART VII, SECTION A, COLUMN EPAUL AHR - 50 HOURSHOURS SPENT DEVOTED TO RELATED ENTITIES
FORM 990, PART XI, LINE 2CTHE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF INDEPENDENT ACCOUNTANTS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1CAMILLUS HOUSEBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1336 NW 5TH STREETAddressLine1
CityMIAMICity
StateFLState
ZIP Code33128ZIPCode
FieldValueIRS element (for citing)
EIN650032862EIN
Primary ActivitiesPROVIDING CHRISTIAN HOSPITALITY TO PERSONS THAT ARE HOMELESSPrimaryActivities
Legal Domicile StateFLLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity StatusLine 7PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1PRESTIGE HEALTH CHOICE LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line19064 NW 13TH TERRACEAddressLine1
CityDORALCity
StateFLState
ZIP Code33172ZIPCode
FieldValueIRS element (for citing)
EIN450563075EIN
Primary ActivityTO IMPROVE THE HEALTH STATUS OF OUR COMMUNITIESPrimaryActivity
Legal Domicile StateFLLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Predominant Income TypeINVESTMENTPredominantIncomeType
Share Of EOY Assets13436ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
CAMILLUS HOUSE
M226740
CAMILLUS HOUSE
L81641
cAMILLUS HOUSE
C133540