2011-02-11T15:45:19-06:00 2010-06-30 MULLEN SONDBERG WIMBISH & STONE PA 2553 HOUSLEY ROAD SUITE 200 ANNAPOLIS MD 214016751 990 2009-07-01 521479917 MEDSOURCE COMMUNITY SERVICES INC MEDS 3018460214 308 WEST MAIN STREET MIDDLETOWN MD 21769 ROBERT CLAXTON 3018460214 2011-02-10 1 MARY K STONE CPA 4102244920 2009 2016-02-24 21:20:13Z ROBERT CLAXTON 308 WEST MAIN STREET MIDDLETOWN MD 21769 13106393 0 X N/A X 1986 MD HEALTH CARE PROVIDER 7 7 211 0 0 0 1585 1850 13074793 12996724 70474 7779 135902 99719 13282754 13106072 2287965 2735194 0 8435361 8148601 0 0 2176382 2085130 12899708 12968925 383046 137147 9846930 9879374 6912950 6794196 2933980 3085178 MEDSOURCE COMMUNITY SERVICES, INC. IS A PRIVATE NON-PROFIT PROVIDER OF THE HIGHEST QUALITY HEALTH AND HUMAN SERVICES. MEDSOURCE DESIGNS SUPPORTS THROUGH PERSON CENTERED PLANS, WHICH PROMOTE PERSONAL GROWTH, OPPORTUNITIES FOR INCREASED INDEPENDENCE, AND DEVELOPMENT OF RELATIONSHIPS. MEDSOURCE'S SUPPORT ENHANCE DIGNITY, RIGHTS, SAFETY, HEALTH, CHOICES, COMMUNITY MEMBERSHIP AND ECONOMIC SECURITY. 0 0 6349662 6929692 RESIDENTIAL - PROVIDED SUPPORT TO OVER 110 PEOPLE WITH DEVELOPMENTAL DISABILITIES IN AN INTEGRATED ENVIRONMENT. 2735194 2895724 FISCAL MANAGEMENT SERVICES(FMS) - MANAGED FINANCIAL SERVICES FOR OVER 50 PEOPLE TO MANAGE THEIR OWN SERVICES. 1308712 1389808 SENIOR HOME CARE(SHC) - PROVIDED SERVICES FOR AGED PARTICIPANTS TO LIVE IN THEIR OWN VERSUS A FACILITY. 1786783 1881219 OTHER PROGRAM SERVICES INCLUDE - FSS, ISS AND CSLA. 1786783 1881219 12180351 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 64 0 211 1 0 0 0 0 0 0 0 0 0 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X X THE ORGANIZATION 3018460214 308 WEST MAIN ST MIDDLETOWN MD 21769 SPENCER PRYOR 1.00 X X 0 0 0 john rock 1.00 X X 0 0 0 ALETA BAER 1.00 X 0 0 0 ALVERNA BAER 1.00 X 0 0 0 TINA CARTER 1.00 X 0 0 0 MELISSA HENSEL 1.00 X 0 0 0 FREDA MCINTYRE 1.00 X 0 0 0 ROBERT CLAXTON 40.00 X X 167558 0 4935 susanne poole NON-VOTIN 40.00 X 44051 0 19925 HAROLD BRANDENBURG 40.00 X 75284 0 3296 286893 0 28156 1 0 1 0 ROYAL ELECTRIC SERVICE INC 6910 BOWERS RD FREDRICK MD 21702 MAINTENANCE/BUILDER 222398 JARVIS & ASSOCIATES LLC 24615 WINDFIELD ROAD DAMASCUS MD 20872 DIRECT CARE 136620 WORLD B FREE USA INC 6900 BOCK ROAD FORT WASHINGTON MD 20744 DIRECT CARE 114838 SHARED SUPPORT MARYLAND INC 5115 EDMONDSON AVENUE BALTIMORE MD 21229 DIRECT CARE 101236 4 1850 1850 RESIDENTIAL 900099 6929692 6929692 FISCAL MANAGEMENT FEES 900099 2895724 2895724 OTHER GOVERNMENT FEES 900099 1781500 1781500 SENIOR HOME CARE 900099 1389808 1389808 12996724 8100 8100 321 -321 -321 -321 service fees 900099 99719 99719 99719 13106072 13096443 0 7779 2735194 2735194 286893 116904 169989 6645678 6342126 303552 26448 24597 1851 637681 594163 43518 551901 514203 37698 1088 1088 51255 9941 41314 166093 166093 202149 145277 56872 796125 753141 42984 112299 104094 8205 6857 2381 4476 299741 268737 31004 60961 47766 13195 food 302616 302616 PROGRAM ACTIVITIES 38819 38819 TRAINING 11458 5964 5494 EMPLOYEE RECRUITMENT 10689 1870 8819 DUES AND SUBSCRIPTIONS 10430 750 9680 14550 5715 8835 12968925 12180351 788574 0 64682 219853 3892187 3746374 435911 525179 81892 91311 7913158 3003650 5110717 4909508 133016 251395 128525 135754 9846930 9879374 825350 851474 2628571 2431318 3459029 3511404 6912950 6794196 X 2933980 3085178 2933980 3085178 9846930 9879374 X 0 1 1 X 0 X 1650 1350 3100 1585 1850 9535 8947350 10660220 11932993 13075098 12996724 57612385 8949000 10661570 11936093 13076683 12998574 57621920 0 0 0 57621920 20117 54800 65494 70474 7779 218664 20117 54800 65494 70474 7779 218664 166323 131964 102888 135597 99719 636491 9135440 10848334 12104475 13282754 13106072 58477075 0.98540 0.98390 0.00370 0.00410 X 1584740 1584740 5743668 2546653 3197015 37135 33632 3503 247199 172673 74526 300416 250692 49724 4909508 Due to State of MARYLAND 646674 REFUNDABLE ADVANCE 2435778 PARTICIPATION LIABILITY 428952 3511404 13106072 12968925 137147 14051 14051 151198 10384929 14051 -2735194 -2721143 13106072 0 13106072 10233731 -2735194 -2735194 12968925 0 12968925 Part XI, Line 8 - Other Adjustments: UNREALIZED GAIN (LOSS) ON INVESTMENTS Part XII, Line 2d - Other Adjustments: THIRD PARTY REIMBURSEMENT Part XIII, Line 2d - Other Adjustments: THIRD PARTY REIMBURSEMENT 1 FISCAL MANAGEMENT SERVICES 45 2735194 X X X 0 0 0 0 0 0 0 0 0 ROBERT CLAXTON 119558 0 0 0 48000 0 0 0 4935 0 172493 0 0 0 ROBERT CLAXTON PRESIDENT MANAGEMENT SERVICES - ROBERT CLAXTON IS THE PRESIDENT OF THE BOARD OF DIRECTORS AND CONTRACTED PRESIDENT OF FAMILY SERVICE FOUNDATION, INC. HE IS ALSO THE EXECUTIVE DIRECTOR OF MEDSOURCE COMMUNITY SERVICES, INC. FAMILY SERVICE FOUNDATION, INC. PAYS MEDSOURCE COMMUNITY SERVICES, INC. $8,000 A MONTH AS MANAGEMENT FEES FOR THE CONTRACTED CEO POSITION. MEDSOURCE COMMUNITY SERVICES, INC. IN TURN PAYS ROBERT CLAXTON $4,000 A MONTH WHICH IS INCLUDED ON HIS ANNUAL W-2. 0 Form 990, Part VI, Section B, line 11 THE 990 IS DISTRIBUTED TO MEMBERS AND DISCUSSED AT A MEETING. Form 990, Part VI, Section B, line 12c THE ORGANIZATION REQUIRES ALL DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO REVIEW THE CONFLICT OF INTEREST POLICY AND SIGN ANNUAL DISCLOSURE STATEMENTS. Form 990, Part VI, Section B, line 15 COMPENSATION LEVELS ARE DETERMINED BY A COMPENSATION COMMITTEE AND APPROVED BY THE BOARD OF DIRECTORS. COMPARABLE DATA WAS OBTAINED FROM GUIDESTAR.ORG FROM SIMILAR ORGANIZATIONS. Form 990, Part VI, Section C, line 18 FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATIONS PRINCIPAL PLACE OF BUSINESS AND ON GUIDESTAR.ORG. Form 990, Part VI, Section C, line 19 THE ORGANIZATIONS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST AND ON GUIDESTAR.ORG. THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.