2011-05-13T11:11:22-05:00 2010-06-30 RSM MCGLADREY INC 1185 AVENUE OF THE AMERICAS NEW YORK NY 100362602 990 2009-07-01 650063921 CAMILLUS HEALTH CONCERN INC CAMI 3053741065 336 NW 5TH STREET POBOX 012408 MIAMI FL 33101 Raphael Mieszala 3053741065 2011-05-13 1 2123721000 2009 2016-02-24 21:20:13Z RAY KAYAL SR 336 nw 5th street po box 012408 miami FL 33101 4381736 0 X camillushouse.org X 1988 FL CAMILLUS 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. 45 45 62 45 0 0 3423365 3763506 375441 388257 21107 19993 172210 209980 3992123 4381736 0 0 3019468 3199016 0 0 969776 984628 3989244 4183644 2879 198092 1550108 1702087 385675 339562 1164433 1362525 THE 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. 0 0 1452617 268512 Primary 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. 433405 77604 Mental 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. 275546 42141 Oral 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. 1276146 1276146 3437714 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 4 0 1 62 1 0 0 0 0 0 0 0 0 0 45 45 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 FL X JOSE ZIRENA 3055774840 336 NW 5TH STREET miami FL 33128 PAUL AHR 10.00 X 29332 295165 6584 ROBERT DICKINSON 1.00 X X 0 0 0 ROGER CARLTON 1.00 X X 0 0 0 CHIP VANDENBERG 1.00 X X 0 0 0 PEDRO JOSE GREER JR MD 1.00 X X 0 0 0 CRYSTAL CONNOR ESQ 1.00 X X 0 0 0 MARIA ALONSO 1.00 X 0 0 0 JAMES ANGLETON 1.00 X 0 0 0 KATE M CALLAHAN PHD 1.00 X 0 0 0 MICHAEL CARRICARTE 1.00 X 0 0 0 MARK S CAVALIERE 1.00 X 0 0 0 ALBERTO COSIO 1.00 X 0 0 0 PAUL DIMARE 1.00 X 0 0 0 MIGUEL G FARRA CPA JD 1.00 X 0 0 0 RENE GARCIA 1.00 X 0 0 0 ALAN GREER ESQ 1.00 X 0 0 0 MARY HELEN HAYDAN EDD 1.00 X 0 0 0 ROD A HILDEBRANT 1.00 X 0 0 0 RONALD KOHN CCIM 1.00 X 0 0 0 STEVEN MARIN 1.00 X 0 0 0 BROTHER RICHARD MCPHEE 1.00 X 0 0 0 ALFREDO MESA 1.00 X 0 0 0 BROTHER RAPHAEL MIESZALA BGS 1.00 X 0 0 0 DANIEL OSMAN 1.00 X 0 0 0 REP YOLLY ROBERSON 1.00 X 0 0 0 WILLIAM D TALBERT III CDME 1.00 X 0 0 0 MARC A WILLIAMS 1.00 X 0 0 0 FATHER EDUARDO ALVAREZ SJ 1.00 X 0 0 0 MARK D BLOOM 1.00 X 0 0 0 CHARLIE CANOVA 1.00 X 0 0 0 RAY CASAS 1.00 X 0 0 0 JOHN W CHIDSEY 1.00 X 0 0 0 ROBERT F COTTER 1.00 X 0 0 0 JOHN DUBOIS 1.00 X 0 0 0 SUE GALLAGHER 1.00 X 0 0 0 THEODORE GELMAN 1.00 X 0 0 0 JULIE GRIMES 1.00 X 0 0 0 EUGENIO GENE HERNANDEZ 1.00 X 0 0 0 EDITH HUDSON 1.00 X 0 0 0 JACQUELINE LARRALDE-SANCHEZ 1.00 X 0 0 0 RAYFIELD M MCGHEE 1.00 X 0 0 0 MANNY MEDINA 1.00 X 0 0 0 JOHN T MESTEPEY 1.00 X 0 0 0 ALBERT R MOLINA 1.00 X 0 0 0 WILLIAM H PARKER 1.00 X 0 0 0 REV JEREMIAH A SINGLETON 1.00 X 0 0 0 LEE I WEINTRAUB ESQ 1.00 X 0 0 0 HIRUT KASSAYE 40.00 X 90810 0 9267 THOMAS GOLDRING 40.00 X 81215 0 11881 ROSENDO COLLAZO 40.00 X 190661 0 7700 JAVIER HIRIART 40.00 X 129680 0 9328 CARMEN DE LA TORRE 40.00 X 124791 0 5863 FRANCIS QUITO 40.00 X 119581 0 27863 766070 295165 78486 6 0 1 0 0 133540 3544090 85876 3763506 MEDICAID 900099 248537 248537 SELF PAY - LOW INCOME 900099 91655 91655 MEDICARE 900099 48065 48065 388257 19993 19993 ACT REVENUE 900099 209980 209980 209980 4381736 388257 0 229973 223380 223380 2450371 2218994 231377 2535 2217 318 335307 311670 23637 187423 163875 23548 3895 2898 997 27681 20592 7089 414643 308458 106185 172562 165552 7010 40457 40457 4307 3040 1267 18894 13334 5560 24870 23725 1145 71888 30109 41779 EQUIPMENT RENTAL AND MA 99296 84186 15110 MISCELLANEOUS 69111 47989 21122 DUES & SUBSCRIPTIONS 37024 618 36406 4183644 3437714 745930 0 500 500 1033665 909870 213033 291734 7343 39776 131164 154039 2000535 1820367 33450 180168 126000 126000 4953 0 1550108 1702087 358579 287000 27096 52562 385675 339562 X 1164433 1362525 0 1164433 1362525 1550108 1702087 X 0 1 1 X 1 1 X 3453624 4911015 3332207 3434365 3629966 18761177 3453624 4911015 3332207 3434365 3629966 18761177 18761177 11132 38805 20840 21107 19993 111877 9024 21028 14489 172210 343520 560271 19433325 1903207 0.96540 0.98300 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1154281 1118545 35736 846254 701822 144432 180168 PRESTIGE HEALTH CHOICES, LLC. 126000 F 126000 4381736 4183644 198092 0 198092 4690117 308381 308381 4381736 0 4381736 4492025 308381 308381 4183644 0 4183644 Part X: Description of Uncertain Tax Positions Under FIN 48: FIN 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. X X X 0 0 0 0 0 0 0 0 0 PAUL AHR 29332 295165 0 0 0 0 0 0 0 6584 29332 301749 0 0 ROSENDO COLLAZO 190661 0 0 0 0 0 7700 0 1651 0 200012 0 0 0 Form 990, Part VI, Section A, line 6 Membership 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 7a The 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 7b The 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 11 The 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 12c THE 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 15 Periodically, 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 19 Camillus 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 E HOURS SPENT DEVOTED TO RELATED ENTITIES PAUL AHR - 50 HOURS FORM 990, PART XI, LINE 2C THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF INDEPENDENT ACCOUNTANTS. CAMILLUS HOUSE 336 NW 5TH STREET MIAMI FL 33128 650032862 PROVIDING CHRISTIAN HOSPITALITY TO PERSONS THAT ARE HOMELESS FL 501(C)(3) Line 7 N/A PRESTIGE HEALTH CHOICE LLC 9064 NW 13TH TERRACE DORAL FL 33172 450563075 TO IMPROVE THE HEALTH STATUS OF OUR COMMUNITIES FL N/A INVESTMENT 13436 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 CAMILLUS HOUSE M 226740 CAMILLUS HOUSE L 81641 cAMILLUS HOUSE C 133540