SOUTHSIDE MEDICAL CENTER INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHSIDE MEDICAL CENTER INC (EIN 58-1131002)
- Tax period
- 2017-06-01 to 2018-05-31
- Filed
- 2019-03-27
- IRS object ID
- 201900869349300930
- Schema version
- 2017v2.3
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-03-27T17:47:29-05:00 | ReturnTs |
| Tax Period End | 2018-05-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-06-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581131002 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHSIDE MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % CLAUDIO AZZARITI CFO | InCareOfNm |
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 4045647009 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1046 RIDGE AVE SW | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 303151640 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CLAUDIO AZZARITI | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2018-12-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Krystal K Creach | PreparerPersonNm |
| PTIN | P01248198 | PTIN |
| Phone | 4178658701 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.126.162 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 43032920190865000012 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-03-27 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | AECC51588B8B05B8A6088E029F5570AF8FA04FA6 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | AECC51588B8B05B8A6088E029F5570AF8FA04FA6 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID WILLIAMS CEO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1046 RIDGE AVE SW | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 303151640 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $25,965,215 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SOUTHSIDEMEDICAL.NET | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1970 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTH SERVICES TO THE MEDICALLY UNDER SERVED AND UNDER INSURED CLIENTS. SEE SCHEDULE O FOR ADDITIONAL DETAILS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 301 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | -$216,041 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$215,573 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $10,320,283 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,864,532 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,297,031 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,946,178 | CYProgramServiceRevenueAmt |
| PY Investment Income | $71,522 | PYInvestmentIncomeAmt |
| CY Investment Income | $103,242 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$61,863 | PYOtherRevenueAmt |
| CY Other Revenue | -$57,284 | CYOtherRevenueAmt |
| PY Total Revenue | $23,626,973 | PYTotalRevenueAmt |
| CY Total Revenue | $25,856,668 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,784,550 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,548,973 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,320,200 | PYOtherExpensesAmt |
| CY Other Expenses | $11,111,349 | CYOtherExpensesAmt |
| PY Total Expenses | $23,104,750 | PYTotalExpensesAmt |
| CY Total Expenses | $24,660,322 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $522,223 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,196,346 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,149,713 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,210,976 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,764,871 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,671,636 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,384,842 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $13,539,340 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO BE A LEADER IN ORGANIZING, PROVIDING AND SUPPORTING AFFORDABLE HEALTH CARE AND RELATED SERVICES TO THE PUBLIC THROUGH DIVERSIFIED BUSINESS ACTIVITIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $16,329,445 | ExpenseAmt |
| Revenue | $12,417,470 | RevenueAmt |
| Desc | PRIMARY CARE SERVICES - PRIMARY CARE SERVICES INCLUDE THE ORGANIZATION'S ADULT MEDICINE, WOMEN'S HEALTH, AND PEDIATRICS AND TEEN HEALTH DEPARTMENTS. SEE SCHEDULE O FOR MORE INFORMATION. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,222,246 | ExpenseAmt |
| Revenue | $1,450,736 | RevenueAmt |
| Desc | DENTISTRY - THE MOST REQUESTED DENTAL SERVICES ARE OBTAINABLE IN THIS DEPARTMENT - EXAMS, FILLINGS, CLEANINGS, AND EXTRACTIONS, AS WELL AS REFERRALS FOR DENTURES AND PARTIALS. OUR PROVIDERS ENCOURAGE PARENTS TO START THEIR CHILDREN'S DENTAL CARE AT AGE 3 WITH A GENERAL EXAM BY THE HYGIENIST AND THEN A COMPLETE EXAM, AND TREATMENT IF NECESSARY, AT AGE 5 BY THE DENTIST. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,324,823 | ExpenseAmt |
| Revenue | $796,454 | RevenueAmt |
| Desc | SOUTHSIDE BEHAVIORAL LIFESTYLE ENRICHMENT CENTER - SOUTHSIDE BEHAVIORAL LIFESTYLE ENRICHMENT CENTER (SBLEC) SERVES ALL MEN AND WOMEN, AGED 18 AND OLDER, WHO SEEK TO OVERCOME THE USE OF ANY TYPE OF DRUG OR ALCOHOL. ALL OF THOSE WHO DESIRE TO LIVE IN A DRUG-FREE LIFESTYLE, NO MATTER WHAT WALK OF LIFE A CLIENT IS FROM, ARE WELCOMED. WE BELIEVE HIS JOURNEY TO RECOVERY CAN START HERE. SEE SCHEDULE O FOR MORE INFORMATION. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $367,181 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $281,518 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $20,243,695 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | 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 |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 131 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 301 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | 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 |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CLAUDIO AZZARITI CFO | PersonNm |
| Phone | 4045647009 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1046 RIDGE AVE SW | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 303151640 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JANIS WARE | ||||||||
| CHAIRMAN | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MELVIN PRESTON | ||||||||
| VICE CHAIRMAN | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GREG TAYLOR | ||||||||
| SECRETARY | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ERIC MATHIS | ||||||||
| MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| MARIO TENORIO | ||||||||
| MEMBER BEG 08/17 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| GERALDINE ELDER | ||||||||
| MEMBER BEG 08/17 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| STEVE BARNES | ||||||||
| MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DR NEIL KALIN | ||||||||
| MEMBER END 10/17 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| VAUGHN REID | ||||||||
| TREASURER | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RUSSELL MOOLMON | ||||||||
| MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| ANDREA RIGGS | ||||||||
| MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| ERIC MORROW | ||||||||
| MEMBER END 10/17 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DR DAVID WILLIAMS | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.0 | 1.0 | Yes (X) | $216,648 | $0 | $12,805 | ||
| DR DONNA SINCLAIR | ||||||||
| CHEIF MEDICAL OFFICER | 40.0 | 0.0 | Yes (X) | $264,437 | $0 | $12,880 | ||
| CLAUDIO AZZARITI | ||||||||
| CHIEF FINANCIAL OFFICER | 40.0 | 1.0 | Yes (X) | $200,888 | $0 | $10,531 | ||
| DR TIMOTHY BROWN | ||||||||
| OB/GYN PHYSICIAN | 40.0 | 0.0 | $182,744 | $0 | $7,828 | Yes (X) | ||
| DR AFRICA ALVAREZ-MCLEOD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $179,544 | $0 | $2,357 | Yes (X) | ||
| DR ENOCH KOTEI | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $176,895 | $0 | $1,915 | Yes (X) | ||
| BARBARA MCMILLAN-PERSAUD | ||||||||
| FAMILY MEDICINE | 40.0 | 0.0 | $172,723 | $0 | $4,322 | Yes (X) | ||
| DR JOHN HOUSER | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $176,657 | $0 | $4,720 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,570,536 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $57,358 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| XTEND HEALTHCARE | |||||
| POBOX 1709 | HENDERSONVILLE | TN | 37077 | BILLING SERVICES | $687,264 |
| ACE HEALTH CONSULTANTS | |||||
| 1015 STELLA VARA DRIVE | LUTZ | FL | 33548 | PHARMACY SERVICES | $452,939 |
| TELEMED INC | |||||
| PO BOX 740038 | ATLANTA | GA | 30374 | PATIENT APPT. SVS | $308,374 |
| UNIVERSAL MEDICAL BILLING AND CONSU | |||||
| 600 GEORGIETOWN LANE | ATLANTA | GA | 30331 | BILLING SERVICES | $185,347 |
| OCEAN MANAGEMENT SVS | |||||
| 2945 BUFORD HIGHWAY | ATLANTA | GA | 30329 | PROFESSIONAL SERVICE | $139,539 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $86,000 | FederatedCampaignsAmt |
| Fundraising | $14,810 | FundraisingAmt |
| Government Grants | $9,739,417 | GovernmentGrantsAmt |
| All Other Contributions | $1,024,305 | AllOtherContributionsAmt |
| Total Contributions | $10,864,532 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICES REVENUE | 624100 | $14,850,508 | $14,850,508 |
| MISCELLANEOUS REVENUE | 624100 | $95,670 | $95,670 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,946,178 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $98,559 | TotalRevenueColumnAmt |
| Exclusion | $98,559 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $85,050 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $91,469 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$6,419 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$6,419 | TotalRevenueColumnAmt |
| Exclusion | -$6,419 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,683 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,683 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,683 | TotalRevenueColumnAmt |
| Exclusion | $4,683 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $5,270 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $14,810 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $17,078 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$11,808 | TotalRevenueColumnAmt |
| Exclusion | -$11,808 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| LOSS FROM INVESTMENT IN EQUITY INVESTEE | 900099 | -$89,516 | -$216,041 | $126,525 |
| GAIN ON INSURANCE PROCEED | 900099 | $50,459 | $50,459 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$39,057 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,856,668 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,946,178 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$216,041 | UnrelatedBusinessRevenueAmt |
| Exclusion | $261,999 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $718,189 | TotalAmt |
| Program Services | $277,317 | ProgramServicesAmt |
| Management And General | $440,872 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,447 | TotalAmt |
| Program Services | $101,447 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,803,346 | TotalAmt |
| Program Services | $8,825,369 | ProgramServicesAmt |
| Management And General | $1,977,977 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,510 | TotalAmt |
| Program Services | $48,159 | ProgramServicesAmt |
| Management And General | $21,351 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,002,600 | TotalAmt |
| Program Services | $700,208 | ProgramServicesAmt |
| Management And General | $302,392 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $853,881 | TotalAmt |
| Program Services | $679,910 | ProgramServicesAmt |
| Management And General | $173,971 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,166 | TotalAmt |
| Management And General | $47,166 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,935 | TotalAmt |
| Management And General | $95,935 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,833,471 | TotalAmt |
| Program Services | $3,292,233 | ProgramServicesAmt |
| Management And General | $541,238 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,281 | TotalAmt |
| Program Services | $10,768 | ProgramServicesAmt |
| Management And General | $14,513 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $593,086 | TotalAmt |
| Program Services | $399,879 | ProgramServicesAmt |
| Management And General | $193,207 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $751,962 | TotalAmt |
| Program Services | $710,329 | ProgramServicesAmt |
| Management And General | $41,633 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,886 | TotalAmt |
| Program Services | $81,604 | ProgramServicesAmt |
| Management And General | $107,282 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,362 | TotalAmt |
| Program Services | $48,349 | ProgramServicesAmt |
| Management And General | $43,013 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,024 | TotalAmt |
| Program Services | $48,011 | ProgramServicesAmt |
| Management And General | $12,013 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $521,090 | TotalAmt |
| Program Services | $419,353 | ProgramServicesAmt |
| Management And General | $101,737 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $206,811 | TotalAmt |
| Program Services | $156,830 | ProgramServicesAmt |
| Management And General | $49,981 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $2,650,447 | $2,650,447 | |
| LICENSES, DUES, SUBSCRIPTIONS | $1,121,241 | $988,238 | $133,003 |
| BAD DEBT | $578,830 | $578,830 | |
| REPAIRS & MAINTENANCE | $334,286 | $219,252 | $115,034 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,471 | TotalAmt |
| Program Services | $7,162 | ProgramServicesAmt |
| Management And General | $4,309 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,660,322 | TotalAmt |
| Program Services | $20,243,695 | ProgramServicesAmt |
| Management And General | $4,416,627 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $907,826 | BOYAmt |
| EOY | $1,702,605 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $552,057 | BOYAmt |
| EOY | $1,029,146 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $672,966 | BOYAmt |
| EOY | $838,032 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,476,300 | BOYAmt |
| EOY | $1,206,643 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,999,000 | BOYAmt |
| EOY | $6,999,000 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,390 | BOYAmt |
| EOY | $116,716 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,208 | BOYAmt |
| EOY | $139,446 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,104,936 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,463,464 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,531,283 | BOYAmt |
| EOY | $4,641,472 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $338,311 | BOYAmt |
| EOY | $366,206 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $950,198 | BOYAmt |
| EOY | $860,432 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $444,174 | BOYAmt |
| EOY | $311,278 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,149,713 | BOYAmt |
| EOY | $18,210,976 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,966,201 | BOYAmt |
| EOY | $3,065,069 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $678,182 | BOYAmt |
| EOY | $538,140 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $760,502 | BOYAmt |
| EOY | $701,242 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $359,986 | BOYAmt |
| EOY | $367,185 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,764,871 | BOYAmt |
| EOY | $4,671,636 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,624,016 | BOYAmt |
| EOY | $13,111,493 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $760,826 | BOYAmt |
| EOY | $427,847 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,384,842 | BOYAmt |
| EOY | $13,539,340 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,149,713 | BOYAmt |
| EOY | $18,210,976 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,196,346 | ReconcilationRevenueExpnssAmt |
| Donated Services And Use Fclts | -$41,848 | DonatedServicesAndUseFcltsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1I | FormAndLineReferenceDesc |
| Explanation | OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS ANNUAL DUES TO NACHC, AND A PORTION OF THESE DUES MAY BE ATTRIBUTABLE TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,333,128 | OtherCostOrOtherBasisAmt |
| Book Value | $1,333,128 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,900,132 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,322,824 | DepreciationAmt |
| Book Value | $1,577,308 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $339,977 | OtherCostOrOtherBasisAmt |
| Depreciation | $90,889 | DepreciationAmt |
| Book Value | $249,088 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,102,154 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,049,751 | DepreciationAmt |
| Book Value | $1,052,403 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $429,545 | OtherCostOrOtherBasisAmt |
| Book Value | $429,545 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,641,472 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $25,808,880 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $448,945 | OtherRevenueAmt |
| Revenue Not Reported | $448,945 | RevenueNotReportedAmt |
| Revenue Subtotal | $25,359,935 | RevenueSubtotalAmt |
| Other Revenues Not Included | $496,733 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $496,733 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $25,856,668 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $24,321,403 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $41,848 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $198,063 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $239,911 | ExpensesNotReportedAmt |
| Expenses Subtotal | $24,081,492 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $578,830 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $578,830 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $24,660,322 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART X, LINE 2 | UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| SCHEDULE D, PART XI, LINE 2D | AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FROM 990, PART VIII, LINE 12: $( 578,830) BAD DEBT EXPENSE 1,027,775 NET ASSETS RELEASED ------------- $ 448,945 |
| SCHEDULE D, PART XI, LINE 4B | AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 694,796 TEMPORARILY RESTRICTED NET ASSETS ( 89,516) LOSS ON INVESTMENT IN EQUITY INVESTEES ( 91,469) RENTAL EXPENSES ( 17,078) SPECIAL EVENT EXPENSES ------------- $ 496,733 |
| SCHEDULE D, PART XII, LINE 2D | AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ 89,516 LOSS ON INVESTMENT IN EQUITY INVESTEES 91,469 RENTAL EXPENSES 17,078 SPECIAL EVENT EXPENSES ------------- $ 198,063 |
| SCHEDULE D, PART XII, LINE 4B | AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT LINE 1: $ 578,830 BAD DEBT EXPENSE |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $11,466 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $9,000 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $2,466 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $5,856 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $722 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $1,056 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $5,068 | OtherDirectExpensesEvent1Amt |
| Event2 | EMPLOYEE BANQUE | Event2Nm |
| Gross Receipts Event2 | $5,180 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $4,500 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $680 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $4,376 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $16,646 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $13,500 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $3,146 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $5,856 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $722 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $1,056 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $9,444 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $17,078 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$13,932 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR DAVID WILLIAMS | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $198,392 | $0 | $0 | $0 | $18,256 | $0 | $5,233 | $0 | $7,572 | $0 | $229,453 | $0 | $0 | $0 |
| DR DONNA SINCLAIR | ||||||||||||||
| CHEIF MEDICAL OFFICER | $262,791 | $0 | $1,646 | $0 | $0 | $0 | $5,308 | $0 | $7,572 | $0 | $277,317 | $0 | $0 | $0 |
| CLAUDIO AZZARITI | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $188,237 | $0 | $0 | $0 | $12,651 | $0 | $4,777 | $0 | $5,754 | $0 | $211,419 | $0 | $0 | $0 |
| DR TIMOTHY BROWN | ||||||||||||||
| OB/GYN PHYSICIAN | $181,834 | $0 | $910 | $0 | $0 | $0 | $3,456 | $0 | $4,372 | $0 | $190,572 | $0 | $0 | $0 |
| DR AFRICA ALVAREZ-MCLEOD | ||||||||||||||
| PHYSICIAN | $177,084 | $0 | $2,460 | $0 | $0 | $0 | $0 | $0 | $2,357 | $0 | $181,901 | $0 | $0 | $0 |
| DR ENOCH KOTEI | ||||||||||||||
| PHYSICIAN | $153,989 | $0 | $22,906 | $0 | $0 | $0 | $1,825 | $0 | $90 | $0 | $178,810 | $0 | $0 | $0 |
| BARBARA MCMILLAN-PERSAUD | ||||||||||||||
| FAMILY MEDICINE | $171,026 | $0 | $1,697 | $0 | $0 | $0 | $0 | $0 | $4,322 | $0 | $177,045 | $0 | $0 | $0 |
| DR JOHN HOUSER | ||||||||||||||
| PHYSICIAN | $159,454 | $0 | $17,203 | $0 | $0 | $0 | $0 | $0 | $4,720 | $0 | $181,377 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 1A | HEALTH CLUB DUES: HEALTH CLUB DUES WERE PAID FOR THE CEO AND CFO. THE AMOUNT OF BENEFIT IS INCLUDED IN THE W-2 OF THESE EMPLOYEES AS TAXABLE INCOME. DR. DAVID WILLIAMS - $1,056 CLAUDIO AZZARITI - $1,362 |
| SCHEDULE J, PART I, LINE 7 | BONUS PAYMENTS: EMPLOYEES RECEIVED BONUSES BASED ON MONTHLY/ANNUAL INDIVIDUAL AND DEPARTMENTAL PRODUCTIVITY PERFORMANCE, TEAM WORK, AS WELL AS HIGH QUALITY OF CARE THAT SUPPORTS THE ORGANIZATION'S MISSION. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEVELOPMENT AUTHORITY OF FULTON COUNTY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 581506878 | BondIssuerEIN |
| Bond Issued | 2010-08-19 | BondIssuedDt |
| Issue Price | $5,100,000 | IssuePriceAmt |
| Purpose | REFUND FLTON CTY BONDS SERIES 2002 | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $4,561,860 | RetiredAmt |
| Bond Defeased | $0 | BondDefeasedAmt |
| Total Proceeds | $5,100,000 | TotalProceedsAmt |
| In Reserve Fund | $0 | InReserveFundAmt |
| Capitalized Interest | $0 | CapitalizedInterestAmt |
| Refunding Escrow | $5,010,778 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $89,222 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $0 | CreditEnhancementAmt |
| Working Capital Expenditures | $0 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $0 | CapitalExpendituresAmt |
| Other Spent Proceeds | $0 | OtherSpentProceedsAmt |
| Unspent | $0 | UnspentAmt |
| Substantial Completion | 2010 | SubstantialCompletionYr |
| Current Refunding | Yes (true) | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Private Bus Use By Others | 0 | PrivateBusUseByOthersPct |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | Yes (true) | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | Yes (true) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
GIC Provider Name GICProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | false | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | false | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR ROBERT WILLIAMS | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FATHER OF CEO | RelationshipDescriptionTxt |
| Transaction | $101,447 | TransactionAmt |
| Transaction | COMPENSATION | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 | ORGANIZATION'S MISSION: MISSION: TO BE A LEADER IN ORGANIZING, PROVIDING AND SUPPORTING AFFORDABLE HEALTH CARE AND RELATED SERVICES TO THE PUBLIC THROUGH DIVERSIFIED BUSINESS ACTIVITIES. VISION: TO SET THE STANDARD IN THE PROVISION OF HEALTH CARE. CORE VALUES: COMPASSION - WE PROVIDE SERVICES IN A CARING MANNER, WITH A SYMPATHETIC CONSCIOUSNESS OF OTHERS' DISTRESS TOGETHER WITH A DESIRE TO ALLEVIATE IT. WE TREAT ALL PATIENTS AND FAMILIES WITH THE UTMOST DIGNITY AND COMPASSION. ACCOUNTABILITY - WE PERFORM IN A MANNER AT ALL TIMES THAT MAKES US ACCOUNTABLE, RESPONSIBLE, AND ANSWERABLE TO PATIENTS AND THEIR FAMILIES, OUT LEADERS, AND EMPLOYEES. RESPECT - WE TREAT PATIENTS AND EACH OTHER WITH DIGNITY, KINDNESS AND SIGNIFICANCE; VALUING DIVERSITY, ENSURING AN INTERESTING AND INCLUSIVE ENVIRONMENT AND TREATING PEOPLE AS WE WOULD LIKE TO BE TREATED OURSELVES. EXCELLENCE - WE COMMIT TO HIGH STANDARDS, NOT ACCEPT MEDIOCRITY AND STRIVE TO EXCEED OUT PATIENTS' EXPECTATIONS. SERVICES - WE PROVIDE AN ARRAY OF SERVICES DESIGNED TO IMPROVE THE QUALITY OF LIFE FOR INDIVIDUALS AND STRENGTHENING COMMUNITY TIES. IN ADDITION, WE PROVIDE EXCELLENT CUSTOMER SERVICE AS WE VALUE PATIENT SAFETY AND CONFIDENTIALITY. |
| FORM 990, PART I, LINE 6 | NUMBER OF VOLUNTEERS: TOTAL NUMBER OF VOLUNTEERS INCLUDING NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS. |
| FORM 990, PART III, LINE 4A | PROGRAM SERVICE ACHIEVEMENTS: THE MAIN PURPOSE OF THE ORGANIZATION IS TO PROVIDE HEALTH SERVICES TO THE MEDICALLY UNDERSERVED AND UNDER INSURED PATIENT THROUGH SERVICES SUCH AS ADULT MEDICINE, WOMEN'S HEALTH, PEDIATRICS, TEEN HEALTH, DENTISTRY, AND OPTOMETRY. DURING THE FISCAL YEAR, ALL THESE PROGRAMS ACHIEVED THIS PURPOSE. THE HOURS OPERATIONS WERE M - F, 8:00 AM - 8:00 PM AND SATURDAY, 9:00 AM - 2:00 PM. SOUTHSIDE SERVED 43,362 PATIENTS, OF WHICH 12,833 INDIVIDUALS WERE SERVED THROUGH MEDICAID, 16,574 THROUGH SELF PAY, 10,498 PATIENTS THROUGH INSURANCE, AND 3,457 THROUGH MEDICARE. ADULT MEDICINE - ANY ADULT OVER 18 YEARS OF AGE MAY COME TO THE ADULT MEDICINE DEPARTMENT TO RECEIVE CARE FROM AN INTERNAL MEDICINE OR FAMILY PRACTITIONER. A FEW OF THE PRIMARY CARE SERVICES OFFERED, IN ADDITION TO GENERAL PHYSICAL EXAMS, INCLUDED FLU SHOTS; TREATMENT AND COUNSELING FOR HEART DISEASE, DIABETES AND HYPERTENSION; DRUG TESTING FOR NEW JOB HIRES; TESTING FOR THOSE SEEKING TO GET MARRIED; MEN'S HEALTH CONCERNS AND REFERRALS TO SPECIALISTS. WOMEN'S HEALTH - PATIENTS IN OUR OB/GYN DEPARTMENT FEEL WELL CARED FOR WHETHER THEY ARE RECEIVING PRENATAL OR GYNECOLOGICAL CARE. OUR PHYSICIANS DELIVER THAT CARE WITH COMPASSION, PROFESSIONALISM AND CONFIDENTIALITY. ALL PROVIDERS, AS IN THE REST OF THE ORGANIZATION, ARE BOARD CERTIFIED AND SERVE ON THE STAFF OF ALL THE MAJOR METROPOLITAN HOSPITALS. SO WOMEN HAVE A CHOICE ABOUT WHERE TO HAVE THEIR SURGERIES PERFORMED OR THEIR BABIES DELIVERED. PEDIATRICS AND TEEN HEALTH - REGULAR CHECK-UPS ARE IMPORTANT FOR THE HEALTH AND WELL BEING OF CHILDREN. OUR PEDIATRICS DEPARTMENT TREATS ILLNESSES COMMON TO CHILDREN, PROVIDES HEALTH CHECK SCREENINGS AND ALL IMMUNIZATIONS FOR CHILDREN UP TO AGE 17, AND OFFERS SPORTS PHYSICALS UPON REQUEST. REFERRALS ARE MADE FROM THIS AREA TO THE DENTIST, OPTOMETRIST, ASTHMA DEPARTMENT OR OTHER SPECIALIST AS NEEDED. EACH YEAR THE PEDIATRICS DEPARTMENT SPONSORS ON ANNUAL IMMUNIZATION DRIVE WHERE, FOR ONE DAY ONLY, CHILDREN MAY RECEIVE ALL OF THEIR SHOTS AND DENTAL AND HEARING SCREENINGS FREE OF CHARGE. THIS FESTIVE OCCASION ALSO FEATURES CARTOON CHARACTERS IN COSTUME, FOOD, MUSIC, GAMES AND FREE SCHOOL SUPPLIES TO A LIMITED NUMBER OF ATTENDEES. |
| FORM 990, PART III, LINE 4C | PROGRAM SERVICE ACHIEVEMENTS: SOUTHSIDE BEHAVIORAL LIFESTYLE ENRICHMENT CENTER IS BASED ON THE BELIEF THAT RECOVERY FROM ANY TYPE OF DRUG ABUSE AND ADDICTION IS POSSIBLE THROUGH THE USE OF A WELL-INTEGRATED COMBINATION OF THERAPIES AND SERVICES. WE BELIEVE ADDICTION IS A CHRONIC, PROGRESSIVE, PRIMARY ILLNESS AFFECTING THE PHYSICAL, EMOTIONAL, AND SPIRITUAL WELL-BRING OF THE INDIVIDUAL AND FAMILY. THEREFORE, WE TREAT DRUG ABUSE AND ADDITION IN A HOLISTIC AND INDIVIDUAL MANNER, MANAGING IT THROUGH EDUCATION, THERAPY, STRUCTURE AND SUPPORT. WE ENDEAVOR TO MATCH CLIENT NEEDS TO TREATMENT, WHEREIN THE INTENSITY OF MEDICAL, COUNSELING AND REHABILITATIVE SERVICES PROVIDED VARIES DEPENDING UPON THE CLIENT'S LENGTH OF SOBRIETY, SKILLS ACQUIRED, AND GOALS MET. WE OFFER FIVE PHASES OF TREATMENT: STABILIZATION, EARLY RECOVERY, ACTIVE RECOVERY, MAINTENANCE OR TRANSITION, AND AFTERCARE. |
| FORM 990, PART III, LINE 4D | OTHER PROGRAM SERVICES: OPTOMETRY - A WIDE SELECTION OF FASHIONABLE EYEWEAR TO CHOOSE FROM AND A QUICK TURN-AROUND IN THE FILLING OF EYEGLASS AND CONTACT LENS PRESCRIPTIONS MAKE THIS ONE OF OUR MOST POPULAR DEPARTMENTS. CONVENIENTLY LOCATED, THE OPTOMETRY DEPARTMENT OFFERS COMPLETE EYE EXAMS. |
| FORM 990, PART VI, SECTION B, LINE 11B | 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE FINANCE DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, THE CFO REVIEWS A TENTATIVE DRAFT OF THE FORM 990 IN DETAIL WITH THE ORGANIZATION'S INDEPENDENT ACCOUNTING FIRM. A FINAL DRAFT IS THEN PRESENTED TO THE ORGANIZATION'S FINANCE COMMITTEE. THE FULL BOARD OF DIRECTORS IS PROVIDED A COPY TO REVIEW. IN THE EVENT THAT THE NEXT BOARD MEETING IS NOT SCHEDULED UNTIL AFTER THE FILING DATE, THE FINAL RETURN IS ELECTRONICALLY MAILED TO ALL BOARD MEMBERS AND THE PRESENTATION OCCURS AT THE NEXT SCHEDULED BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: BOARD MEMBERS MUST GUARD AGAINST ANY POSSIBILITY OF CONFLICTS THAT DEVELOP BETWEEN THEIR PERSONAL INTEREST AND THOSE OF THE CORPORATION. TO ENSURE THAT CONFLICTS OF INTEREST ARE AVOIDED, A BOARD MEMBER MUST ANNUALLY DECLARE HIS OR HER PERSONAL INTEREST IN A MATTER OR TRANSACTION BEFORE IT IS CONSIDERED BY THE BOARD; DESCRIBE THE NATURE OF THE INTEREST AND ANY SIGNIFICANT REASON AS TO WHY THE TRANSACTION MAY NOT BE IN THE BOARD'S BEST INTEREST; AND REFRAIN FROM VOTING OR INFLUENCING THE BOARD'S DELIBERATIONS IN THE MATTER. ORGANIZATION OFFICERS AND KEY EMPLOYEES ALSO ANNUALLY COMPLETE A CONFLICT OF INTEREST REVIEW. ANY POTENTIAL CONFLICTS IDENTIFIED AMONG EMPLOYEES AND OFFICERS ARE REVIEWED BY THE HUMAN RESOURCES DEPARTMENT AND THE BOARD OF DIRECTORS, AS NECESSARY. RESTRICTIONS ARE IMPOSED ON INTERESTED PERSONS ON A CASE BY CASE BASIS BY THE HUMAN RESOURCES DEPARTMENT AND ARE COMMENSURATE TO THE CONFLICT IDENTIFIED. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | COMPENSATION REVIEW POLICY: TO DETERMINE, REVIEW AND APPROVE COMPENSATION OF THE CEO, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS COMPARABLE CHC DATA FROM THE AREA ON AN ANNUAL BASIS AND THIS PROCESS IS DOCUMENTED ACCORDINGLY. ADDITIONALLY THE CEO REVIEWS COMPARABLE CHC SALARY DATA FROM THE AREA TO DETERMINE, REVIEW AND APPROVE COMPENSATION OF TOP MANAGEMENT AND OFFICERS. THIS PROCESS IS DOCUMENTED AND CONDUCTED ON AN ANNUAL BASIS. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: GOVERNING DOCUMENTS, CONFLICT OF INTEREST, AND/OR FINANCIAL STATEMENTS WILL BE PROVIDED, VIA MAIL, UPON REQUEST. ALL REQUESTS MUST BE FOR A LEGITIMATE BUSINESS PURPOSE, AS DETERMINED BY TOP MANAGEMENT. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:2301454 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PATIENT CARE CONSULTING TOTAL FEES:729658 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:NON-PROVIDER CONSULTING TOTAL FEES:327056 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL SERVICES TOTAL FEES:272915 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER CONTRACTED SERVICES TOTAL FEES:202388 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHOICE HEALTHCARE FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1046 RIDGE AVE SW STE 5 | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30315 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 464828720 | EIN |
| Primary Activities | SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 12 B (II) | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SMC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHOICE HEALTHCARE FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | K | TransactionTypeTxt |
| Involved | $144,000 | InvolvedAmt |
| Method Of Amount Determination | COST | MethodOfAmountDeterminationTxt |
Comments