PHYSICIANS CARE CLINIC INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
PHYSICIANS CARE CLINIC INC (EIN 58-2107579)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-08-06
IRS object ID
202022199349300107
Schema version
2019v5.1
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

FieldValueIRS element (for citing)
Return2020-08-06T08:56:11-04:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN811336355PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Michelle L McGlaun CPABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12385 Emerald DriveAddressLine1Txt
CityJonesboroCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30236ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN582107579EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Physicians Care Clinic IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPHYSBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12675 N Decatur RoadAddressLine1Txt
CityDecaturCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30033ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDee KeetonPersonNm
Person TitleExecutive DirecPersonTitleTxt
Phone7702710453PhoneNum
Signature2020-08-04SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMichelle L McGlaunPreparerPersonNm
PTINP01273842PTIN
Phone7708658067PhoneNum
Preparation2020-08-06PreparationDt
Self EmployedYes (X)SelfEmployedInd

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address216.166.21.4IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-08-06IPDt
IP Tm08:57:18IPTm
Federal Original Submission Id6190802020219lry5ubbFederalOriginalSubmissionId
Federal Original Submission Id2020-08-06FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdEF54249DA924441C0D4981A4F90F3C9ED1E328D4AtSubmissionCreationDeviceId
At Submission Filing Device IdEF54249DA924441C0D4981A4F90F3C9ED1E328D4AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$2,248,350GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.physicianscareclinic.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTo provide DeKalb Countys low income, uninsured adults quality, comprehensive, non-emergent medical care delivered with excellence, compassion and dignity.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee7TotalEmployeeCnt
Total Volunteers247TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$537,071PYContributionsGrantsAmt
CY Contributions Grants$2,219,361CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$2,092PYInvestmentIncomeAmt
CY Investment Income$28,989CYInvestmentIncomeAmt
PY Other Revenue$38,270PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$577,433PYTotalRevenueAmt
CY Total Revenue$2,248,350CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$148,074PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$154,760CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$34,630CYTotalFundraisingExpenseAmt
PY Other Expenses$407,391PYOtherExpensesAmt
CY Other Expenses$374,795CYOtherExpensesAmt
PY Total Expenses$555,465PYTotalExpensesAmt
CY Total Expenses$529,555CYTotalExpensesAmt
PY Revenues Less Expenses$21,968PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,718,795CYRevenuesLessExpensesAmt
Total Assets BOY$387,948TotalAssetsBOYAmt
Total Assets EOY$2,082,973TotalAssetsEOYAmt
Total Liabilities BOY$50,437TotalLiabilitiesBOYAmt
Total Liabilities EOY$26,666TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$337,511NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,056,307NetAssetsOrFundBalancesEOYAmt
MissionTo provide DeKalb Countys low income, uninsured adults quality, comprehensive, non-emergent medical care delivered with excellence, compassion and dignity.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$431,340ExpenseAmt
DescSee Schedule O.Desc
Total Program Service Expenses$431,340TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document7IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee7EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsYes (true)NondeductibleContributionsInd
Nondeductible Contri DisclYes (true)NondeductibleContriDisclInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDee KeetonPersonNm
Phone7702710453PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12675 N Decatur RoadAddressLine1Txt
CityDecaturCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30033ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeInd
Melissa Conner
Member1.000.00Yes (X)$0$0$0
Diana Evans Berman
Member1.000.00Yes (X)$0$0$0
Michael Baron
Member1.000.00Yes (X)$0$0$0
Andrew Dixon
Member1.000.00Yes (X)$0$0$0
Kay Entrekin
Member1.000.00Yes (X)$0$0$0
John Kennedy
Member1.000.00Yes (X)$0$0$0
Stephen Leff
Founder1.000.00Yes (X)$0$0$0
Adam Schnepp
Member1.000.00Yes (X)$0$0$0
Mark Stern
Member1.000.00Yes (X)$0$0$0
Roy Vandiver
Member1.000.00Yes (X)$0$0$0
Kristin Pierson
Member1.000.00Yes (X)$0$0$0
Leigh Coker
Member1.000.00Yes (X)$0$0$0
Scott Arant
Treasurer1.000.00$0$0$0Yes (X)
Gary Botstein
Founder and Board Chairman1.000.00$0$0$0Yes (X)
Kenneth Hoose
Medical Director1.000.00$0$0$0Yes (X)
Dee Keeton
Executive Director40.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$2,219,361AllOtherContributionsAmt
Noncash Contributions$226,450NoncashContributionsAmt
Total Contributions$2,219,361TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$28,989TotalRevenueColumnAmt
Related Or Exempt Func Income$28,989RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,248,350TotalRevenueColumnAmt
Related Or Exempt Func Income$28,989RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$88,300TotalAmt
Program Services$66,741ProgramServicesAmt
Management And General$21,559ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$55,428TotalAmt
Program Services$55,428ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$11,032TotalAmt
Program Services$9,377ProgramServicesAmt
Management And General$1,655ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$37,830TotalAmt
Management And General$6,165ManagementAndGeneralAmt
Fundraising$31,665FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$3,550TotalAmt
Management And General$3,550ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$3,793TotalAmt
Management And General$3,793ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$958TotalAmt
Fundraising$958FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$7,857TotalAmt
Management And General$7,590ManagementAndGeneralAmt
Fundraising$267FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,740TotalAmt
Fundraising$1,740FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$35TotalAmt
Management And General$35ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$5,289TotalAmt
Management And General$5,289ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,367TotalAmt
Management And General$1,367ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$33,851TotalAmt
Program Services$25,388ProgramServicesAmt
Management And General$8,463ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical supplies$255,758$255,758
Volunteer costs$6,562$6,562
Printing and postage$4,119$4,119
Education and awareness$3,767$3,767

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$8,319TotalAmt
Program Services$8,319ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$529,555TotalAmt
Program Services$431,340ProgramServicesAmt
Management And General$63,585ManagementAndGeneralAmt
Fundraising$34,630FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$365,232BOYAmt
EOY$556,738EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$7,728BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$6,277BOYAmt
EOY$583EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$5,051BOYAmt
EOY$3,611EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$31,929LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$29,636LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,660BOYAmt
EOY$2,293EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$1,519,748EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$387,948BOYAmt
EOY$2,082,973EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,437BOYAmt
EOY$7,666EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$45,000BOYAmt
EOY$19,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$50,437BOYAmt
EOY$26,666EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$337,511BOYAmt
EOY$2,056,307EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$337,511BOYAmt
EOY$2,056,307EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$387,948BOYAmt
EOY$2,082,973EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,718,795ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$1OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$472,510CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$463,216CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$417,712CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$537,071CurrentTaxYearMinus1YearAmt
Current Tax Year$2,219,361CurrentTaxYearAmt
Total$4,109,870TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$472,510CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$463,216CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$417,712CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$537,071CurrentTaxYearMinus1YearAmt
Current Tax Year$2,219,361CurrentTaxYearAmt
Total$4,109,870TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$4,109,870PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$87CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$587CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,291CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,092CurrentTaxYearMinus1YearAmt
Current Tax Year$32,324CurrentTaxYearAmt
Total$36,381TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$87CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$587CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,291CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,092CurrentTaxYearMinus1YearAmt
Current Tax Year$32,324CurrentTaxYearAmt
Total$36,381TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$472,597CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$463,803CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$419,003CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$539,163CurrentTaxYearMinus1YearAmt
Current Tax Year$2,251,685CurrentTaxYearAmt
Total$4,146,251TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99120PublicSupportCY509Pct
Public Support PY5090.99820PublicSupportPY509Pct
Investment Income CY0.01000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$17,733OtherCostOrOtherBasisAmt
Depreciation$17,233DepreciationAmt
Book Value$500BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,196OtherCostOrOtherBasisAmt
Depreciation$12,403DepreciationAmt
Book Value$1,793BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,293TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$3,920,388TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$79,808NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$1,596,023DonatedServicesAndUseFcltsAmt
Revenue Not Reported$1,675,831RevenueNotReportedAmt
Revenue Subtotal$2,244,557RevenueSubtotalAmt
Investment Expenses Not Incld$3,793InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$3,793RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$2,248,350TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$2,121,784TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$1,596,022DonatedServicesUseFcltsAmt
Expenses Not Reported$1,596,022ExpensesNotReportedAmt
Expenses Subtotal$525,762ExpensesSubtotalAmt
Investment Expenses Not Incld2$3,793InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$3,793ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$529,555TotalExpensesPerForm990Amt

Schedule G IRS990ScheduleG

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$218,670NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 governing body review Part VI line 11The organizations accountant provides a copy of Form 990 to the Board of Directors for review and approval prior to filing.
Conflict of interest policy compliance Part VI line 12cBoard of Directors sign a conflict of interest statement annually. This statement requires the directors to disclose any potential conflicts that may exist.
CEO executive director top management comp Part VI line 15aIn setting compensation, the organization may consider, among other things, external labor market rates, equuitable relationship with other jobs within the organization, and the organizations ability to pay. Each employee may be eligible for a salary review at the beginning of each fiscal year. The Board of Directors will determine the executive directors salary.
Governing documents etc available to public Part VI line 19The organizations accountant provides a copy of Form 990 specifically for public inspection. This copy is available upon request.
Explanation of other changes in net assets or fund balances Part XI line 9Rounding
List of other fees for services expenses Part IX line 11gOther fees consist of fees for professional services.
General explanation attachment2019 Highlights- PCC raised over $200,000 from foundations, individuals and direct support, and over $1.5M in in-kind contributions enabling us to maintain a strong balance sheet and absorb the increased demand for services. 2019 Statistics - Total patients enrolled 1,598- Total patient visits to the clinic 2,416- Total unduplicated visits 517- Referrals to specialty care 736- Prescriptions filled 2,759- Diagnostic tests provided 3,095- Surgeries provided 28 valued at $382,886- Adminstered 61 flu vaccines- DM/HTN education: 856 encounters (classes and/or one-on-one) Demographics - Ethnic origin at clinic: 9% Caucasian; 57% Black including African-Americans; 29% Asian; 5% Hispanic- Age distribution: 18-54 years 55%; 55+ years 45%- Sexual orientation: 59% Female; 41% Male- Top five zip codes served: 30021; 30032; 30033; 30034; 30038; 30058; 30083- Top three diagnosis: HTN 44%; HLD 19%; DM 26% Volunteer information: - PCC volunteers logged 3,934 in-clinic volunteer hours- Total in-clinic volunteers 247- Specialty care physician volunteers 60 Growth and sustainability - Ads placed in The Pulse and Neighbor Newspapers in Dekalb for nursing volunteers, which helped us recruit an additional volunteers and 50 new patients in 2019 partnership with Board of Health for mens clinic patients.- Continued collboration with Emory Decatur and the DeKalb Board of Health to ensure our patients received optimum health care- Partnerships with Northside FASP program for indigent care; Ben Massell dental clinic; Dekalb Community Service Board; Ryan Cameron Foundation; GA Lions Lighthouse Foundation.- Participated in health fairs at the FDHA annual health summit in October. Growth and sustainability (cont)- Continuous updates of website with patient information/links and patient newsletters.- Participated in social media with a FB account.- Contacted state representatives on behalf of legislation affecting GA charitable clinics.- Completed: Revised Board of Directors Manual w/ job descriptions, new strategic plan, written committee charters, governance documents and revised Board orientation manual- Successful 2019 audit.- Participated in GA Gives Day 2019. Diabetes and HTN data (using ADA guidelines)2018:66% had A1C below 7; 67% had BP below 140/80; 73% had triglycerides below 150; 45% had HDL > 50; 55% had LDL below 100; 75% received annual eye exam; 87% received a foot exam; and 93% received one on one or classroom education.

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.