2025-03-11T17:24:43-05:00 2024-06-30 593204548 JAMES MOORE & CO PL 5931 NW 1ST PLACE GAINESVILLE FL 326072063 990 2023-07-01 592104510 CAPITAL MEDICAL SOCIETY FOUNDATION INC CAPI 8508779018 1204 MICCOSUKEE RD TALLAHASSEE FL 32308 TOM BLOCK EXECUTIVE DIRECTOR 8508779018 2025-03-10 1 MARK PAYNE P00005495 3523781331 2025-03-10 2023 2025-03-06 01:10:19Z TOM BLOCK 1204 MICCOSUKEE RD TALLAHASSEE FL 32308 1245243 0 X WWW.CAPMED.ORG X 1981 FL TO SUPPORT THE CHARITABLE EFFORTS OF PHYSICIANS AND OTHERS, INCREASE ACCESS TO HEALTHCARE, PROMOTE EDUCATION AND SERVE THE COMMUNITY'S HEALTH NEEDS THROUGH INNOVATIVE PROJECTS THAT ARE EXEMPLARY, AFFORDABLE AND DIGNIFIED. 22 22 10 375 0 0 742713 857220 11700 11750 32387 100052 -33555 -41149 753245 927873 75140 88778 0 0 371753 369599 0 0 67293 264368 250942 711261 709319 41984 218554 2483547 2778061 121706 117127 2361841 2660934 TO SUPPORT THE CHARITABLE EFFORTS OF PHYSICIANS AND OTHERS, INCREASE ACCESS TO HEALTHCARE, PROMOTE EDUCATION AND SERVE THE COMMUNITY'S HEALTH NEEDS THROUGH INNOVATIVE PROJECTS THAT ARE EXEMPLARY, AFFORDABLE AND DIGNIFIED. 0 0 434330 11750 COORDINATED OVER $5 MILLION IN DONATED SPECIALTY MEDICAL AND DENTAL CARE FOR LOW INCOME, UNINSURED PATIENTS WITHIN LEON, GADSDEN, JEFFERSON AND WAKULLA COUNTIES IN FLORIDA THROUGH A NETWORK OF VOLUNTEER PHYSICIANS, NURSES, HOSPITALS, AND OTHER ALLIED HEALTH CARE PROFESSIONALS. (I.E. WE CARE NETWORK)1,975 APPOINTMENTS WERE SCHEDULED AND 1,869 PATIENTS WERE SERVED WITH THE ACTIVE NETWORK OF DONATING PROVIDERS WHICH INCLUDED 300 SPECIALTY MEDICAL PHYSICIANS AND 40 DENTISTS.ALSO PROVIDED WELLNESS COACHING FOR LOCAL PHYSICIANS THROUGH THE CAPITAL MEDICAL SOCIETY FOUNDATION PHYSICIAN WELLNESS PROGRAM TOTALING $1,540. 68100 68100 SCHOLARSHIP FUNDS TO QUALIFIED MEDICAL STUDENTS - THE FOUNDATION PROVIDED SCHOLARSHIPS TO THIRTEEN QUALIFIED MEDICAL STUDENTS AT FSU COLLEGE OF MEDICINE TOTALING $67,100 AND TWO SCHOLARSHIPS TOTALING $1,000 FOR ROBIN MCDOUGALL ACCESS TO CARE AWARD FOR THE YEAR ENDED JUNE 30, 2024. 20678 20678 THE FOUNDATION PROVIDES FUNDS TO OTHER TAX EXEMPT ORGANIZATIONS INVOLVED WITH IMPROVING ACCESS TO HEALTHCARE FOR THE YEAR ENDED JUNE 30, 2024. IT PROVIDED ACCESS TO ELDER CARE SERVICES, INC., BIG BEND HOSPICE FOUNDATION, LIGHTHOUSE OF THE BIG BEND, LUTHERAN SOCIAL SERVICES OF NORTH FLORIDA, INC, AND FSU COLLEGE OF MEDICINE FOOD PANTRY. 523108 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 14 0 1 10 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 22 22 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X DAWNA BUNKER 8505213124 2615 CENTENNIAL BLVD SUITE 200 TALLAHASSEE FL 32308 TRACEY HELLGREN MD PRESIDENT 1.00 0.00 X X 0 0 0 WALTER COLON DMD VICE-PRESIDENT 1.00 0.00 X X 0 0 0 YVONNE BROWN SECRETARY 1.00 0.00 X X 0 0 0 DAVID STEWART MD TREASURER 1.00 0.00 X X 0 0 0 JOHN P MAHONEY MD IMMEDIDATE PAST PRESIDENT 1.00 0.00 X X 0 0 0 CLAUDIA BLACKBURN DIRECTOR 1.00 0.00 X 0 0 0 RUSSELL COLE MD DIRECTOR 1.00 2.00 X 0 0 0 J ALAN COX ESQ DIRECTOR 1.00 0.00 X 0 0 0 H AVON DOLL MD DIRECTOR 1.00 0.00 X 0 0 0 MARLISHA EDWARDS MD DIRECTOR 1.00 0.00 X 0 0 0 GERYL FORBES DIRECTOR 1.00 0.00 X 0 0 0 PAULA S FORTUNAS MA DIRECTOR 1.00 0.00 X 0 0 0 TERREZE GAMBLE MD DIRECTOR 1.00 0.00 X 0 0 0 PATRICIA HOLLIDAY DIRECTOR 1.00 0.00 X 0 0 0 BRITTANY JACKSON DIRECTOR 1.00 0.00 X 0 0 0 DAVID JONES MD DIRECTOR 1.00 0.00 X 0 0 0 ROHAN JOSEPH MD DIRECTOR 1.00 0.00 X 0 0 0 NANCY LOEFFLER MD DIRECTOR 1.00 0.00 X 0 0 0 FAISAL MUNASIFI MD DIRECTOR 1.00 0.00 X 0 0 0 HELEN PAULSON MD DIRECTOR 1.00 2.00 X 0 0 0 J BRIAN SHEEDY MD DIRECTOR 1.00 0.00 X 0 0 0 JAMES WALTON III DDS DIRECTOR 1.00 0.00 X 0 0 0 TOM BLOCK EXECUTIVE DIRECTOR AS OF 1/2/2024 14.00 26.00 X 4197 12590 175 PAM IRWIN EXECUTIVE DIRECTOR UNTILL 12/31/2023 14.00 26.00 X 34435 103306 32995 38632 115896 33170 0 0 1 0 0 50407 148225 453151 205437 26279 857220 PATIENT ASSISTANCE REV 900099 11750 11750 11750 37683 37683 29357 6636 22721 22721 22721 299962 237593 62369 62369 62369 9225 148225 73141 -63916 -63916 SALES TAX DISCOUNTS 900099 46 46 46 927873 11750 0 58903 20678 20678 68100 68100 41398 8280 16559 16559 280046 241788 17393 20865 7003 5725 655 623 17357 14188 1625 1544 23795 18636 2450 2709 8230 1863 6104 263 67755 15333 50255 2167 11158 11158 15664 7336 7984 344 3523 2795 117 611 21442 16565 964 3913 34075 26439 1585 6051 18509 14654 640 3215 1839 1427 85 327 3196 2480 149 567 2339 1755 93 491 8874 5669 517 2688 15058 11946 502 2610 PATIENT CARE EXPENSE 36217 36217 EMPLOYEE EXPENSES 3063 1234 83 1746 709319 523108 118918 67293 784113 890550 128398 120763 1700 545 23768 16166 526472 289332 252650 237140 1292714 1512897 204 0 2483547 2778061 25730 22340 10176 11148 85800 83639 121706 117127 X 1158736 1236526 1203105 1424408 2361841 2660934 2483547 2778061 218554 80539 0 X 0 1 X 1 0 X 636607 642080 847453 742713 857220 3726073 636607 642080 847453 742713 857220 3726073 314578 3411495 48294 41839 44795 56516 67040 258484 16188 110848 24840 151876 12083 3863 46 15992 4152425 110516 0.82160 0.78380 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 996688 103450 125943 1226081 894947 26100 75641 996688 922536 95950 -122039 1500 894947 751039 25000 146497 922536 689123 61916 751039 0.32910 0.67090 0 0 83718 83718 404755 256933 147822 37999 32399 5600 237140 X 6492643 80539 5442487 5523026 969617 11158 -52902 -41744 927873 6193550 5442487 52902 5495389 698161 11158 11158 709319 PART V, LINE 4: THE FOUNDATION HAS SIX ENDOWMENT FUNDS: 1. THE RONALD G PICKETT ENDOWMENT FUND WAS ESTABLISHED IN 1982 (AND AMENDED 12/15/2016) WITH A DONOR-RESTRICTED DONATION THAT WAS MATCHED BY THE BOARD OF DIRECTORS OF THE FOUNDATION. INVESTMENT INCOME GENERATED ON THESE FUNDS IS TO BE USED FOR SPECIFIC PURPOSES AS OUTLINED IN THE AGREEMENT. 2. THE CAPITAL MEDICAL SOCIETY FOUNDATION ENDOWMENT FUND WAS ESTABLISHED IN 2004 TO SUPPORT PROGRAMS AND OPERATIONS OF THE FOUNDATION. 3. THE WE CARE NETWORK ENDOWMENT FUND WAS ESTABLISHED IN 2005 TO SUPPLEMENT THE WE CARE NETWORK PROGRAM. 4. THE ANESTHESIOLOGY ASSOCIATES OF TALLAHASSEE SCHOLARSHIP ENDOWMENT FUND WAS ESTABLISHED IN AUGUST 2020 WITH A DONOR-RESTRICTED CONTRIBUTION TO ESTABLISH A MEANS OF INCENTIVIZING THE PRACTICE OF MEDICINE IN NORTH FLORIDA. 5. THE JULIE REVELL ST. PETERY, M.D. SCHOLARSHIP IN PEDIATRICS ENDOWMENT FUND WAS ESTABLISHED OCTOBER 2021 WITH A DONOR-RESTRICTED CONTRIBUTION TO ENCOURAGE THE PRACTICE OF PEDIATRIC MEDICINE. 6. THE CHARLES D. "PEDRO" WILLIAMS, M.D. SCHOLARSHIP ENDOWMENT FUND WAS ESTABLISHED IN JANUARY 2022 WITH A DONOR-RESTRICTED CONTRIBUTION TO ESTABLISH A MEANS OF INCENTIVIZING THE PRACTICE OF MEDICINE IN NORTH FLORIDA. PART X, LINE 2: THE FOUNDATION IS EXEMPT FROM INCOME TAXES ON INCOME FROM RELATED ACTIVITIES UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND CORRESPONDING STATE TAX LAW. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. DUE TO ITS TAX-EXEMPT STATUS, THE FOUNDATION IS NOT SUBJECT TO U.S. FEDERAL INCOME TAX OR STATE INCOME TAX. THE FOUNDATION'S FORM 990 HAS NOT BEEN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE OR THE STATE OF FLORIDA FOR THE LAST THREE (3) YEARS. PART XI, LINE 4B - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES REPORTED AS PART OF FORM 990, PART VII, LINE 8B -46,266. RENTAL DEPRECIATION EXPENSE REPORTED ON FORM 990, PART VII, LINE 6B -6,636. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES REPORTED AS PART OF FORM 990, PART VII, LINE 8B 46,266. RENTAL DEPRECIATION EXPENSE REPORTED ON FORM 990, PART VII, LINE 6B 6,636. HOLIDAY AUCTION 157450 148225 9225 2820 27831 42491 157450 148225 9225 2820 27831 42491 73142 -63917 0 SCHOLARSHIPS 13 67100 ROBIN MCDOUGALL ACCESS TO CARE AWARD 2 1000 PART I, LINE 2: SCHOLARSHIP AND AWARD PAYMENTS ARE MADE DIRECTLY TO THE UNIVERSITY ON BEHALF OF THE RECIPIENTS. X X X 0 0 0 0 0 0 0 0 0 PAM IRWIN EXECUTIVE DIRECTOR UNTILL 12/31/2023 31435 94306 3000 9000 0 0 4057 12172 4191 12575 42683 128053 0 0 X 1200 FAIR MARKET VALUE X AUCTION ITEMS 105 24105 FAIR MARKET VALUE X AUCTION SUPPLIES 2 974 FAIR MARKET VALUE 0 0 0 0 PART I, COLUMN (B): THE ORGANIZATION REPORTS THE NUMBER OF ITEMS CONTRIBUTED. FORM 990, PART VI, SECTION B, LINE 11B AT A BOARD MEETING, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL REVIEW OF CONFLICT OF INTEREST POLICY BY BOARD; ANNUAL REQUIREMENTS TO COMPLETE CONFLICT OF INTEREST DISCLOSURE FORM AND REVIEW OF POTENTIAL CONFLICTS IN REVIEWED PRIOR TO VOTE TO AWARD GRANTS. FORM 990, PART VI, SECTION B, LINE 15A THE EXECUTIVE DIRECTOR SUBMITS HIS OR HER PERFORMANCE EVALUATION. THE PRESIDENTS OF THE THREE ORGANIZATIONS MEET AND AGREE ON THE INCREASE IN COMPENSATION AND/OR BONUS TO BE GRANTED. IT IS THEN VOTED ON AND APPROVED BY THE FOUNDATION'S BOARD OF DIRECTORS; AND A PERFORMANCE ACTION REPORT SIGNED BY ALL THREE PRESIDENTS IS SUBMITTED TO THE ACCOUNTING FIRM RESPONSIBLE FOR PAYROLL. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION PROVIDES COPIES ON REQUEST AND FOR INSPECTION AT THE OFFICE. CAPITAL MEDICAL SOCIETY INC 1204 MICCOSUKEE ROAD TALLAHASSEE FL 32308 237026264 TRADE ASSOCIATION FL 501(C)(6) N/A 0 CAPITAL MEDICAL SERVICE CORP INC 1204 MICCOSUKEE ROAD TALLAHASSEE FL 32308 592127695 COMMUNICATIONS FL N/A C 44293 7356 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0