PHYSICIANS CARE CLINIC INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- PHYSICIANS CARE CLINIC INC (EIN 58-2107579)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-08-08
- IRS object ID
- 201802219349301020
- Schema version
- 2017v2.2
- 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 | 2018-08-08T18:47:05-04:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Michelle L McGlaun CPA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2385 Emerald Drive | AddressLine1Txt |
| City | Jonesboro | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30236 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 582107579 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Physicians Care Clinic Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PHYS | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2675 N Decatur Road | AddressLine1Txt |
| City | Decatur | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30033 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dee Keeton | PersonNm |
| Person Title | Executive Direc | PersonTitleTxt |
| Phone | 7702710453 | PhoneNum |
| Signature | 2018-08-01 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Michelle L McGlaun | PreparerPersonNm |
| PTIN | P01273842 | PTIN |
| Phone | 7708658067 | PhoneNum |
| Preparation | 2018-08-08 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $419,003 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.physicianscareclinic.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | To provide DeKalb Countys low income, uninsured adults quality, comprehensive, non-emergent medical care delivered with excellence, compassion and dignity. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 17 | VotingMembersIndependentCnt |
| Total Employee | 9 | TotalEmployeeCnt |
| Total Volunteers | 202 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $463,216 | PYContributionsGrantsAmt |
| CY Contributions Grants | $417,712 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $587 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,291 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $463,803 | PYTotalRevenueAmt |
| CY Total Revenue | $419,003 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $157,867 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $181,023 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $24,369 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $302,814 | PYOtherExpensesAmt |
| CY Other Expenses | $280,567 | CYOtherExpensesAmt |
| PY Total Expenses | $460,681 | PYTotalExpensesAmt |
| CY Total Expenses | $461,590 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,122 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$42,587 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $390,147 | TotalAssetsBOYAmt |
| Total Assets EOY | $383,481 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $32,017 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $67,938 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $358,130 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $315,543 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To provide DeKalb Countys low income, uninsured adults quality, comprehensive, non-emergent medical care delivered with excellence, compassion and dignity. | MissionDesc |
| Expense | $363,401 | ExpenseAmt |
| Desc | See Schedule O. | Desc |
| Total Program Service Expenses | $363,401 | 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 |
| 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 | 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 9 | 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 |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 17 | 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 | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dee Keeton | PersonNm |
| Phone | 7702710453 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2675 N Decatur Road | AddressLine1Txt |
| City | Decatur | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Duane Barclay | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Diana Evans Berman | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Michael Baron | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Andrew Dixon | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Kay Entrekin | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Beverly Hutchinson | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| John Kennedy | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Raanan Pritzker | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Adam Schnepp | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Mark Stern | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Roy Vandiver | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Dan Silverboard | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Melissa Conner | ||||||||
| Treasurer | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Scott Arant | ||||||||
| President | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Gary Botstein | ||||||||
| Founder and Board Chairman | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Kenneth Hoose | ||||||||
| Medical Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Stephen Leff | ||||||||
| Founder and Secretary | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Dee Keeton | ||||||||
| Executive Director | 40.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| All Other Contributions | $417,712 | AllOtherContributionsAmt |
| Noncash Contributions | $171,783 | NoncashContributionsAmt |
| Total Contributions | $417,712 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,291 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,291 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $419,003 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,291 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,083 | TotalAmt |
| Program Services | $66,661 | ProgramServicesAmt |
| Management And General | $25,422 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,084 | TotalAmt |
| Program Services | $76,084 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,856 | TotalAmt |
| Program Services | $10,914 | ProgramServicesAmt |
| Management And General | $1,942 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,246 | TotalAmt |
| Management And General | $16,063 | ManagementAndGeneralAmt |
| Fundraising | $22,183 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,753 | TotalAmt |
| Management And General | $13,753 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,118 | TotalAmt |
| Management And General | $2,118 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,374 | TotalAmt |
| Program Services | $6,374 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $792 | TotalAmt |
| Management And General | $792 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,293 | TotalAmt |
| Management And General | $3,293 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,960 | TotalAmt |
| Program Services | $14,220 | ProgramServicesAmt |
| Management And General | $4,740 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|
| Medical supplies | $175,241 | $175,241 | |
| Volunteer costs | $7,274 | $7,274 | |
| Printing and postage | $2,186 | $2,186 | |
| Education and awareness | $6,633 | $6,633 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,697 | TotalAmt |
| Management And General | $5,697 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $461,590 | TotalAmt |
| Program Services | $363,401 | ProgramServicesAmt |
| Management And General | $73,820 | ManagementAndGeneralAmt |
| Fundraising | $24,369 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $277,145 | BOYAmt |
| EOY | $346,361 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,692 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,021 | BOYAmt |
| EOY | $26,870 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,658 | BOYAmt |
| EOY | $3,253 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $31,929 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $24,932 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,631 | BOYAmt |
| EOY | $6,997 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $390,147 | BOYAmt |
| EOY | $383,481 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,517 | BOYAmt |
| EOY | $3,338 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,500 | BOYAmt |
| EOY | $64,600 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,017 | BOYAmt |
| EOY | $67,938 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $343,505 | BOYAmt |
| EOY | $303,543 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,625 | BOYAmt |
| EOY | $12,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $358,130 | BOYAmt |
| EOY | $315,543 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $390,147 | BOYAmt |
| EOY | $383,481 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$42,587 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $329,891 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $338,546 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $472,510 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $463,216 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $433,561 | CurrentTaxYearAmt |
| Total | $2,037,724 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $329,891 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $338,546 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $472,510 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $463,216 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $433,561 | CurrentTaxYearAmt |
| Total | $2,037,724 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $2,037,724 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $53 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $50 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $87 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $587 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,291 | CurrentTaxYearAmt |
| Total | $2,068 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $53 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $50 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $87 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $587 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,291 | CurrentTaxYearAmt |
| Total | $2,068 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $329,944 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $338,596 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $472,597 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $463,803 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $434,852 | CurrentTaxYearAmt |
| Total | $2,039,792 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99900 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99960 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,733 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,711 | DepreciationAmt |
| Book Value | $3,022 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,196 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,221 | DepreciationAmt |
| Book Value | $3,975 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,997 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $1,937,529 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $1,518,526 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $1,518,526 | RevenueNotReportedAmt |
| Revenue Subtotal | $419,003 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $419,003 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,980,116 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $1,518,526 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $1,518,526 | ExpensesNotReportedAmt |
| Expenses Subtotal | $461,590 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $461,590 | TotalExpensesPerForm990Amt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 46 | ContributionCnt |
| Noncash Contributions Rpt F990 | $187,632 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| 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 (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 governing body review Part VI line 11 | The 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 12c | Board 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 15a | In 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 19 | The organizations accountant provides a cpy of Form 990 specifically for public inspection. This copy is available upon request. |
| List of other fees for services expenses Part IX line 11g | Other fees consist of fees for professional services. |
| General explanation attachment | 2016 Highlights- PCC raised over $200,000 from foundations, individuals and direct support, and over $1M in in-kind contributions enabling us to maintain a strong balance sheet and absorb the increased demand for services. 2017 Statistics- Total patients enrolled 1,158- Total patient visits to the clinic 2,052- Total unduplicated visits 468- Referrals to specialty care 682- Prescriptions filled 2,806- Diagnostic tests provided 2,880- Surgeries provided 18 valued at $164,000- Adminstered 43 flu vaccines- DM/HTN education: 726 encounters (classes and/or one-on-one) Demographics- Ethnic origin at clinic: 8% Caucasian; 71% Black including African-Americans; 17% Asian; 4% Hispanic- Age distribution: 18-54 years 48%; 55+ years 52%- Sexual orientation: 71% Female; 28% Male- Top five zip codes served: 30083; 30058; 30032; 30034; 30021- Top four diagnosis: HTN 44%; HLD 20%; DJD/OA 16%; DM 14% Volunteer information:- PCC volunteers logged 4,107 in-clinic volunteer hours- Total in-clinic volunteers 202- Specialty care physician volunteers 65 Growth and sustainability- Ads placed in The Pulse and Neighbor Newspapers in Dekalb for nursing volunteers, which helped us recruit an additional 66 new volunteers and 140 new patients in 2017- Continued collboration with DeKalb Medical 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 a health fair at the FDHA annual health summit in August. Growth and sustainability (cont)- Served on the United Way DeKalb Thrive think group.- 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: Succession Plan; Board of Directors Manual w/ job descriptions, new strategic plan, committee charters, governance documents and Board orientation manual- Participated in NCQA customer survey in June.- Successful 2016 audit.- Participated in GA Gives Day 2017, raising over $12,000 for the clinic. Diabetes and HTN data (using ADA guidelines)2017:72% had A1C 7; 58% had BP 140/80; 76% had triglycerides 150; 50% had HDL >50; 48% had LDL 100; 58% received annual eye exam; 84% received a foot exam; and 95% received one on one or classroom education. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dekalb Medical Society Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4850 Golden Parkway No B-418 | AddressLine1Txt |
| City | Buford | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30518 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 580961919 | EIN |
| Primary Activities | Healthcare | PrimaryActivitiesTxt |
| Exempt Code Section | 501c6 | ExemptCodeSectionTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
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