COMMUNITY CARE CENTER FOR FORSYTH COUNTY: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY CARE CENTER FOR FORSYTH COUNTY (EIN 58-1403699)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-15
- IRS object ID
- 202343199349330004
- Schema version
- 2022v5.0
- Note
- A later return for the same period supersedes this one.
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-15T20:35:11-05:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 810896468 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KOHARI GONZALEZ ONEYEAR & BROWN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 326 S MAIN STREET | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581403699 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY CARE CENTER FOR FORSYTH C | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2135 NEW WALKERTOWN ROAD | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27101 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY CLONTZ | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 3367601235 | PhoneNum |
| Signature | 2023-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TIMOTHY | PersonFirstNm |
| Person Last | CLONTZ | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | REBECCA A ONEYEAR CPA | PreparerPersonNm |
| PTIN | P00710716 | PTIN |
| Phone | 3367610366 | PhoneNum |
| Preparation | 2023-11-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT P DIBELLA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2135 NEW WALKERTOWN ROAD | AddressLine1Txt |
| City | WINSTONSALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,034,657 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CCCFORSYTH.ORG | WebsiteAddressTxt |
| Type Of Organization Assoc | Yes (X) | TypeOfOrganizationAssocInd |
| Formation | 1980 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE FREE ON-SITE MEDICAL AND DENTAL CARE TO LOW INCOME FAMILIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 22 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 22 | VotingMembersIndependentCnt |
| Total Employee | 27 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $14,028,495 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,971,493 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $57,395 | CYProgramServiceRevenueAmt |
| PY Investment Income | $106 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,044 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,703 | PYOtherRevenueAmt |
| CY Other Revenue | $1,725 | CYOtherRevenueAmt |
| PY Total Revenue | $14,036,304 | PYTotalRevenueAmt |
| CY Total Revenue | $9,034,657 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $967,769 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $950,265 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $4,409 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,910,702 | PYOtherExpensesAmt |
| CY Other Expenses | $8,122,002 | CYOtherExpensesAmt |
| PY Total Expenses | $13,878,471 | PYTotalExpensesAmt |
| CY Total Expenses | $9,072,267 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $157,833 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$37,610 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,083,831 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,032,297 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $41,802 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $45,394 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,042,029 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,986,903 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE FREE ON-SITE MEDICAL AND DENTAL CARE TO LOW INCOME FAMILIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $5,825 | ExpenseAmt |
| Revenue | $57,395 | RevenueAmt |
| Desc | COMMUNITY CARE CENTER OF FORSYTH COUNTY, INC. IS A FREE MEDICAL CLINIC FOR FAMILIES WHO EARN LESS THAN 200% OF THE FEDERAL PROVERTY LEVEL AND ARE NOT ELIGIBLE FOR GOVERNMENT PROGRAMS AND HAVE NO MEDICAL INSURANCE. THE CENTER PROVIDES FREE ON-SITE MEDICAL AND DENTAL CARE TO LOW-INCOME FAMILIES, AS THE SOLE PROGRAM. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,928,337 | ExpenseAmt |
| Desc | COMMUNITY CARE CENTER OF FORSYTH COUNTY, INC. IS A FREE MEDICAL CLINIC FOR FAMILIES WHO EARN LESS THAN 200% OF THE FEDERAL PROVERTY LEVEL AND ARE NOT ELIGIBLE FOR GOVERNMENT PROGRAMS AND HAVE NO MEDICAL INSURANCE. THE CENTER PROVIDES FREE ON-SITE MEDICAL AND DENTAL CARE TO LOW-INCOME FAMILIES, AS THE SOLE PROGRAM. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $8,928,337 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $8,934,162 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | false | ScheduleORequiredInd |
| IRP Document | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 27 | EmployeeCnt |
| Employment Tax Returns Filed | false | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Governing Body Voting Members | 22 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 22 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY J CLONTZ | PersonNm |
| Phone | 3367601235 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2135 NEW WALKERTOWN RD | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| RUDY ALLEN | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| ANTHONY H BRETT | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| TIMOTHY CLONTZ | ||||||
| EXECUTIVE DI | Yes (X) | $0 | $0 | $0 | 40.00 | |
| ROBERT F COIL | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| YEN NGUYEN DDS | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| ROBERT P DIBELLA | ||||||
| BOARD CHAIR | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DR ROBERT V FORD | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| KIMBERLY W GREGG | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| BEN HOUGH | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| MARLON HUNTER | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| LUCINDA JONES | ||||||
| IMMEDIATE PA | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DR WILLIAM M SATTERWHITE JR | ||||||
| EMERITUS | Yes (X) | $0 | $0 | $0 | ||
| GILMOUR LAKE | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| LORAINE FRANK LIGHTFOOT | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| GREGORY G HOLTHUSEN MD | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| J BALDWIN SMITH MD | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| JAMES T ROBINSON | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| SARAH SABISTON | ||||||
| SECRETARY | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MILLIE SCHULTZ | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| DR NANCY SMITH | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| SHARON STORM | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| ALEX TURNER | ||||||
| TREASURER | Yes (X) | $0 | $0 | $0 | ||
| ALEX TURNER | ||||||
| FINANCE COMM | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CARL WESTSCOTT | ||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Federated Campaigns | $69,521 | FederatedCampaignsAmt |
| Government Grants | $163,246 | GovernmentGrantsAmt |
| All Other Contributions | $8,738,726 | AllOtherContributionsAmt |
| Noncash Contributions | $7,810,927 | NoncashContributionsAmt |
| Total Contributions | $8,971,493 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SPECIAL EVENT | Desc |
| Total Revenue Column | $57,395 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $57,395 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $57,395 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,044 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,044 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISC. REVENUE - RELATED | Desc |
| Total Revenue Column | $1,725 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,725 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,725 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,034,657 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $63,164 | RelatedOrExemptFuncIncomeAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $808,102 | TotalAmt |
| Program Services | $730,601 | ProgramServicesAmt |
| Management And General | $77,501 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,005 | TotalAmt |
| Program Services | $78,877 | ProgramServicesAmt |
| Management And General | $2,128 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,158 | TotalAmt |
| Program Services | $55,038 | ProgramServicesAmt |
| Management And General | $6,120 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,947 | TotalAmt |
| Management And General | $47,947 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,539 | TotalAmt |
| Program Services | $3,539 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,851 | TotalAmt |
| Program Services | $44,851 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,244 | TotalAmt |
| Program Services | $16,244 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,153 | TotalAmt |
| Program Services | $2,153 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,825 | TotalAmt |
| Program Services | $5,825 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,317 | TotalAmt |
| Program Services | $19,317 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICINES & MEDICAL SUPPL | $7,838,612 | $7,838,612 |
| REPAIRS | $73,339 | $73,339 |
| MISCELLANEOUS | $26,145 | $26,145 |
| LAB FEES & MEDICAL | $19,710 | $19,710 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,320 | TotalAmt |
| Program Services | $19,911 | ProgramServicesAmt |
| Fundraising | $4,409 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,072,267 | TotalAmt |
| Program Services | $8,934,162 | ProgramServicesAmt |
| Management And General | $133,696 | ManagementAndGeneralAmt |
| Fundraising | $4,409 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $693,386 | BOYAmt |
| EOY | $696,747 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $930,418 | BOYAmt |
| EOY | $928,828 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $134,493 | BOYAmt |
| EOY | $105,405 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,766 | BOYAmt |
| EOY | $19,766 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,264 | BOYAmt |
| EOY | $10,889 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $763,204 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $623,876 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140,007 | BOYAmt |
| EOY | $139,328 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,888 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,609 | BOYAmt |
| EOY | $131,334 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,083,831 | BOYAmt |
| EOY | $2,032,297 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,802 | BOYAmt |
| EOY | $45,394 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,802 | BOYAmt |
| EOY | $45,394 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,884,754 | BOYAmt |
| EOY | $1,852,906 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $157,275 | BOYAmt |
| EOY | $133,997 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,042,029 | BOYAmt |
| EOY | $1,986,903 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,083,831 | BOYAmt |
| EOY | $2,032,297 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$37,610 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$17,516 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,023,378 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,818,266 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,960,782 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,028,495 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,971,493 | CurrentTaxYearAmt |
| Total | $33,802,414 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,023,378 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,818,266 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,960,782 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,028,495 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,971,493 | CurrentTaxYearAmt |
| Total | $33,802,414 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $33,802,414 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | -$657 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,093 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,155 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $22,548 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | -$13,472 | CurrentTaxYearAmt |
| Total | $32,667 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $33,835,081 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $63,164 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99900 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99460 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $157,275 | BeginningYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $136,517 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $22,381 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $5,184 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $1,439 | AdministrativeExpensesAmt |
| End Year Balance | $152,275 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $134,815 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $8,169 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $5,200 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $1,267 | AdministrativeExpensesAmt |
| End Year Balance | $136,517 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $125,013 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $16,209 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $5,108 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $1,299 | AdministrativeExpensesAmt |
| End Year Balance | $134,815 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $132,032 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$639 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $5,056 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $1,324 | AdministrativeExpensesAmt |
| End Year Balance | $125,013 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $162,871 | OtherCostOrOtherBasisAmt |
| Depreciation | $31,372 | DepreciationAmt |
| Book Value | $131,499 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $594,038 | OtherCostOrOtherBasisAmt |
| Depreciation | $586,309 | DepreciationAmt |
| Book Value | $7,729 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,295 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,195 | DepreciationAmt |
| Book Value | $100 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $139,328 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| FUNDS HELD IN TRUST - ENDOWMENT | $128,997 |
| OTHER ASSETS | $2,337 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $131,334 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $9,017,141 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$17,516 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$17,516 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,034,657 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $9,034,657 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,072,267 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $9,072,267 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $9,072,267 | TotalExpensesPerForm990Amt |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $7,810,927 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4D | COMMUNITY CARE CENTER OF FORSYTH COUNTY, INC. IS A FREE MEDICAL CLINIC FOR FAMILIES WHO EARN LESS THAN 200% OF THE FEDERAL PROVERTY LEVEL AND ARE NOT ELIGIBLE FOR GOVERNMENT PROGRAMS AND HAVE NO MEDICAL INSURANCE. THE CENTER PROVIDES FREE ON-SITE MEDICAL AND DENTAL CARE TO LOW-INCOME FAMILIES, AS THE SOLE PROGRAM. |
| FORM 990, PAGE 6, PART VI, LINE 11B | NO REVIEW WAS OR WILL BE CONDUCTED. |
| FORM 990, PAGE 6, PART VI, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC |
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