Jackson Hospital Qalicb Inc is located in Marianna, FL. According to its NTEE Classification (S99) the organization is classified as: Community Improvement & Capacity Building N.E.C., under the broad grouping of Community Improvement & Capacity Building and related organizations. This organization is an independent organization and not affiliated with a larger national or regional group of organizations. Jackson Hospital Qalicb Inc is a 501(c)(3) and as such, is described as a "Charitable or Religous organization or a private foundation" by the IRS.
Form
990
Mission & Program ActivityExcerpts From the 990 Filing
TAX YEAR
2021
Describe the Organization's Mission:
Part 3 - Line 1
TO REDUCE THE BURDENS OF GOVERNMENT BY SERVING AS A TYPE III SUPPORTING ORGANIZATION FOR THE BENEFIT OF AND TO SUPPORT THE JACKSON HOSPITAL BOARD OF TRUSTEES AND THE GOVERNING BODY OF THE JACKSON COUNTY HOSPITAL DISTRICT.
Describe the Organization's Program Activity:
Part 3 - Line 4a
A. APPLICANT WAS FORMED UNDER THE FLORIDA NONPROFIT CORPORATION ACT TO SERVE AS A TYPE 3 FUNCTIONALLY INTEGRATED SUPPORTING ORGANIZATION WITHIN THE MEANING OF SECTION 509(A)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED (THE CODE), TREASURY REGULATIONS SECTION 1.509(A)-4(I), AND NOTICE 2014-4 THAT IS OPERATED IN CONNECTION WITH AND FOR THE BENEFIT OF THE JACKSON COUNTY HOSPITAL DISTRICT, A PUBLIC, NON-PROFIT INDEPENDENT SPECIAL DISTRICT ESTABLISHED UNDER CHAPTER 2003-363 OF THE LAWS OF FLORIDA (THE HOSPITAL DISTRICT). APPLICANT WAS FORMED TO REDUCE THE BURDENS OF GOVERNMENT BY SERVING AS A QUALIFIED ACTIVE LOW-INCOME COMMUNITY BUSINESS OR QALICB (AS DEFINED IN CODE SECTION 45D(D)(2)) TO FACILITATE THE FINANCING OF (I) CERTAIN REPAIRS TO THE JACKSON COUNTY HOSPITAL (THE HOSPITAL), WHICH SUFFERED SIGNIFICANT DAMAGE AS A RESULT OF HURRICANE MICHAEL IN 2018, (II) THE RELOCATION AND EXPANSION OF THE HOSPITAL'S NUCLEAR MEDICINE DEPARTMENT, AND (III) THE ACQUISITION OF MEDICAL EQUIPMENT FOR USE IN THE HOSPITAL (THE FOREGOING IS COLLECTIVELY REFERRED TO IN THIS APPLICATION AS THE PROJECT). IN CONNECTION WITH THE PROJECT, APPLICANT WILL LEASE THE HOSPITAL BUILDING AND THE REAL PROPERTY ON WHICH THE HOSPITAL IS LOCATED (THE PROJECT PROPERTY) PURSUANT TO A LONG-TERM GROUND LEASE WITH THE HOSPITAL DISTRICT. APPLICANT WILL THEN SUBLEASE THE COMPLETED PROJECT (INCLUDING THE NEWLY ACQUIRED EQUIPMENT) BACK TO THE HOSPITAL DISTRICT PURSUANT TO A SUBLEASE. THE HOSPITAL DISTRICT WILL CONTINUE TO OPERATE THE HOSPITAL.
Name (title) | Role | Hours | Compensation |
---|---|---|---|
Jorge Garcia Secretary | OfficerTrustee | 0 | $0 |
Robert Reiff Treasurer | OfficerTrustee | 0 | $0 |
Keith Williams President | OfficerTrustee | 1 | $0 |
Statement of Revenue | |
---|---|
Federated campaigns | $0 |
Membership dues | $0 |
Fundraising events | $0 |
Related organizations | $0 |
Government grants | $0 |
All other contributions, gifts, grants, and similar amounts not included above | $0 |
Noncash contributions included in lines 1a–1f | $0 |
Total Revenue from Contributions, Gifts, Grants & Similar | $0 |
Total Program Service Revenue | $0 |
Investment income | $0 |
Tax Exempt Bond Proceeds | $0 |
Royalties | $0 |
Net Rental Income | -$799,948 |
Net Gain/Loss on Asset Sales | $0 |
Net Income from Fundraising Events | $0 |
Net Income from Gaming Activities | $0 |
Net Income from Sales of Inventory | $0 |
Miscellaneous Revenue | $0 |
Total Revenue | -$799,948 |
Statement of Expenses | |
---|---|
Grants and other assistance to domestic organizations and domestic governments. | $0 |
Grants and other assistance to domestic individuals. | $0 |
Grants and other assistance to Foreign Orgs/Individuals | $0 |
Benefits paid to or for members | $0 |
Compensation of current officers, directors, key employees. | $0 |
Compensation of current officers, directors, key employees. | $0 |
Compensation to disqualified persons | $0 |
Other salaries and wages | $0 |
Pension plan accruals and contributions | $0 |
Other employee benefits | $0 |
Payroll taxes | $0 |
Fees for services: Management | $0 |
Fees for services: Legal | $0 |
Fees for services: Accounting | $0 |
Fees for services: Lobbying | $0 |
Fees for services: Fundraising | $0 |
Fees for services: Investment Management | $0 |
Fees for services: Other | $0 |
Advertising and promotion | $0 |
Office expenses | $0 |
Information technology | $0 |
Royalties | $0 |
Occupancy | $0 |
Travel | $0 |
Payments of travel or entertainment expenses for any federal, state, or local public officials | $0 |
Conferences, conventions, and meetings | $0 |
Interest | $0 |
Payments to affiliates | $0 |
Depreciation, depletion, and amortization | $0 |
Insurance | $0 |
All other expenses | $0 |
Total functional expenses | $0 |
Balance Sheet | |
---|---|
Cash—non-interest-bearing | $2,321,451 |
Savings and temporary cash investments | $0 |
Pledges and grants receivable | $0 |
Accounts receivable, net | $0 |
Loans from Officers, Directors, or Controlling Persons | $0 |
Loans from Disqualified Persons | $0 |
Notes and loans receivable | $0 |
Inventories for sale or use | $0 |
Prepaid expenses and deferred charges | $0 |
Net Land, buildings, and equipment | $34,043,002 |
Investments—publicly traded securities | $0 |
Investments—other securities | $0 |
Investments—program-related | $0 |
Intangible assets | $780,804 |
Other assets | $0 |
Total assets | $37,145,257 |
Accounts payable and accrued expenses | $12,000 |
Grants payable | $0 |
Deferred revenue | $0 |
Tax-exempt bond liabilities | $0 |
Escrow or custodial account liability | $0 |
Loans and other payables to any current Officer, Director, or Controlling Person | $0 |
Secured mortgages and notes payable | $13,500,000 |
Unsecured mortgages and notes payable | $0 |
Other liabilities | $0 |
Total liabilities | $13,512,000 |
Net assets without donor restrictions | $0 |
Net assets with donor restrictions | $0 |
Capital stock or trust principal, or current funds | $0 |
Paid-in or capital surplus, or land, building, or equipment fund | $24,433,205 |
Retained earnings, endowment, accumulated income, or other funds | -$799,948 |
Total liabilities and net assets/fund balances | $37,145,257 |
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