SOUTHSIDE MEDICAL CENTER INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
SOUTHSIDE MEDICAL CENTER INC (EIN 58-1131002)
Tax period
2016-06-01 to 2017-05-31
Filed
2018-04-03
IRS object ID
201840939349300314
Schema version
2016v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-04-03T10:12:28-05:00ReturnTs
Tax Period End2017-05-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMOStateAbbreviationCd
ZIP658062523ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-06-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN581131002EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SOUTHSIDE MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% CLAUDIO AZZARITI CFOInCareOfNm
Business Name ControlSOUTBusinessNameControlTxt
Phone4045647009PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11046 RIDGE AVE SWAddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP303151640ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCLAUDIO AZZARITIPersonNm
Person TitleCFOPersonTitleTxt
Signature2018-04-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKrystal K CreachPreparerPersonNm
PTINP01248198PTIN
Phone4178658701PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.126.162IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id43032920180935000024FederalOriginalSubmissionId
Federal Original Submission Id2018-04-03FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id35B2FEF9FD89B74F90B63698513A1BB518488CA1AtSubmissionCreationDeviceId
At Submission Filing Device Id9ED1AFD43ECA266599EA2022F4AABFE45DA09571AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDAVID WILLIAMS CEOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11046 RIDGE AVE SWAddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP303151640ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$23,773,825GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SOUTHSIDEMEDICAL.NETWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1970FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTH SERVICES TO THE MEDICALLY UNDERSERVED AND UNDER INSURED CLIENTS. SEE SCHEDULE O FOR ADDITIONAL DETAILS.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee292TotalEmployeeCnt
Total Volunteers11TotalVolunteersCnt
Total Gross UBI-$202,294TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$202,294NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$9,495,873PYContributionsGrantsAmt
CY Contributions Grants$10,320,283CYContributionsGrantsAmt
PY Program Service Revenue$12,256,118PYProgramServiceRevenueAmt
CY Program Service Revenue$13,297,031CYProgramServiceRevenueAmt
PY Investment Income$97,844PYInvestmentIncomeAmt
CY Investment Income$71,522CYInvestmentIncomeAmt
PY Other Revenue-$91,525PYOtherRevenueAmt
CY Other Revenue-$61,863CYOtherRevenueAmt
PY Total Revenue$21,758,310PYTotalRevenueAmt
CY Total Revenue$23,626,973CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$13,272,890PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$12,784,550CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$7,974,487PYOtherExpensesAmt
CY Other Expenses$10,320,200CYOtherExpensesAmt
PY Total Expenses$21,247,377PYTotalExpensesAmt
CY Total Expenses$23,104,750CYTotalExpensesAmt
PY Revenues Less Expenses$510,933PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$522,223CYRevenuesLessExpensesAmt
Total Assets BOY$15,371,899TotalAssetsBOYAmt
Total Assets EOY$17,149,713TotalAssetsEOYAmt
Total Liabilities BOY$3,453,485TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,764,871TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$11,918,414NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$12,384,842NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO 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 SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$15,024,017ExpenseAmt
Revenue$10,970,074RevenueAmt
DescPRIMARY 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

FieldValueIRS element (for citing)
Expense$2,339,376ExpenseAmt
Revenue$1,175,254RevenueAmt
DescDENTISTRY - 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

FieldValueIRS element (for citing)
Expense$1,428,121ExpenseAmt
Revenue$914,622RevenueAmt
DescSOUTHSIDE 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
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$429,188TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$237,081TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$19,220,702TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document133IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee292EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCLAUDIO AZZARITI CFOPersonNm
Phone4045647009PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11046 RIDGE AVE SWAddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP303151640ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
JANIS WARE
CHAIRMAN1.01.0Yes (X)Yes (X)$0$0$0
MELVIN PRESTON
VICE CHAIRMAN1.00.0Yes (X)Yes (X)$0$0$0
GREG TAYLOR
SECRETARY1.00.0Yes (X)Yes (X)$0$0$0
ERIC MATHIS
MEMBER1.00.0Yes (X)$0$0$0
WARREN CHEEKS
MEMBER1.00.0Yes (X)$0$0$0
ERIC MORROW
MEMBER1.00.0Yes (X)$0$0$0
ANDREA RIGGS
MEMBER1.00.0Yes (X)$0$0$0
STEVE BARNES
MEMBER1.00.0Yes (X)$0$0$0
DR NEIL KALIN
MEMBER1.00.0Yes (X)$0$0$0
VAUGHN REID
TREASURER1.01.0Yes (X)Yes (X)$0$0$0
RUSSELL MOOLMON
MEMBER1.00.0Yes (X)$0$0$0
DR DAVID WILLIAMS
CHIEF EXECUTIVE OFFICER40.01.0Yes (X)$347,878$0$9,349
DR DONNA SINCLAIR
CHEIF MEDICAL OFFICER40.00.0Yes (X)$275,064$0$3,774
CLAUDIO AZZARITI
CHIEF FINANCIAL OFFICER40.01.0Yes (X)$194,368$0$3,774
DR TIMOTHY BROWN
OB/GYN PHYSICIAN40.00.0$219,508$0$17,852Yes (X)
DR JAMES K BAILEY
PHYSICIAN40.00.0$160,493$0$9,737Yes (X)
DR TRESSA SCINEAUX
PHYSICIAN40.00.0$182,713$0$3,589Yes (X)
OBIAJULU OKAFOR
OB/GYN PHYSICIAN40.00.0$221,411$0$4,482Yes (X)
DR KELVIN WHITE
PHYSICIAN40.00.0$202,172$0$10,046Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,803,607TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$62,603TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K18IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
XTEND HEALTHCARE
POBOX 1709HENDERSONVILLETN37077BILLING SERVICES$633,805
ACE HEALTH CONSULTANTS
1015 STELLA VARA DRIVELUTZFL33548PHARMACY SERVICES$456,686
UNIVERSAL MEDICAL BILLING CONSULT
600 GEORGIETOWN LANEATLANTAGA30331BILLING SERVICES$222,981
SOLSTAS LAB PARTNERS
4380 FEDERAL DRIVE SUITE 100GREENSBORONC27410LABORATORY SERVICES$189,032
DENTAL FIX RX
4780 ASHFORD DUNWOODY ROAD SUITS AATLANTAGA30338MED EQUIP MAINTENANC$101,636
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Federated Campaigns$60,864FederatedCampaignsAmt
Fundraising$14,568FundraisingAmt
Government Grants$9,158,764GovernmentGrantsAmt
All Other Contributions$1,086,087AllOtherContributionsAmt
Total Contributions$10,320,283TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICES REVENUE624100$12,947,375$12,947,375
MISCELLANEOUS REVENUE624100$349,656$349,656
FieldValueIRS element (for citing)
Total Program Service Revenue$13,297,031TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$95,530TotalRevenueColumnAmt
Exclusion$95,530ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$80,516RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$101,171RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$20,655RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$20,655TotalRevenueColumnAmt
Exclusion-$20,655ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$24,008OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$24,008OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$24,008TotalRevenueColumnAmt
Exclusion-$24,008ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$4,760FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$14,568ContriRptFundraisingEventAmt
Fundraising Direct Expenses$21,673FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$16,913TotalRevenueColumnAmt
Exclusion-$16,913ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
LOSS FROM INVESTMENT IN EQUITY INVESTEE900099-$173,718-$202,294$28,576
GAIN ON INSURANCE PROCEED900099$149,423$149,423
FieldValueIRS element (for citing)
Other Revenue Total-$24,295OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,626,973TotalRevenueColumnAmt
Related Or Exempt Func Income$13,297,031RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue-$202,294UnrelatedBusinessRevenueAmt
Exclusion$211,953ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$834,207TotalAmt
Program Services$278,838ProgramServicesAmt
Management And General$555,369ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$92,400TotalAmt
Program Services$92,400ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$10,058,346TotalAmt
Program Services$8,169,916ProgramServicesAmt
Management And General$1,888,430ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$21,998TotalAmt
Program Services$14,555ProgramServicesAmt
Management And General$7,443ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$976,432TotalAmt
Program Services$770,600ProgramServicesAmt
Management And General$205,832ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$801,167TotalAmt
Program Services$650,969ProgramServicesAmt
Management And General$150,198ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$62,123TotalAmt
Management And General$62,123ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$111,679TotalAmt
Management And General$111,679ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,266,737TotalAmt
Program Services$3,057,094ProgramServicesAmt
Management And General$209,643ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$626,141TotalAmt
Program Services$401,026ProgramServicesAmt
Management And General$225,115ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$702,359TotalAmt
Program Services$668,730ProgramServicesAmt
Management And General$33,629ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$135,266TotalAmt
Program Services$72,978ProgramServicesAmt
Management And General$62,288ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$88,429TotalAmt
Program Services$65,239ProgramServicesAmt
Management And General$23,190ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$34,039TotalAmt
Program Services$21,680ProgramServicesAmt
Management And General$12,359ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$448,156TotalAmt
Program Services$329,078ProgramServicesAmt
Management And General$119,078ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$186,296TotalAmt
Program Services$140,135ProgramServicesAmt
Management And General$46,161ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS$2,779,357$2,779,357
LICENSES, DUES, SUBSCRIPTIONS$1,010,171$909,780$100,391
BAD DEBT$578,829$578,829
REPAIRS & MAINTENANCE$260,809$208,227$52,582

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$29,809TotalAmt
Program Services$11,271ProgramServicesAmt
Management And General$18,538ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$23,104,750TotalAmt
Program Services$19,220,702ProgramServicesAmt
Management And General$3,884,048ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$407,323BOYAmt
EOY$907,826EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$641,865BOYAmt
EOY$552,057EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,345,420BOYAmt
EOY$672,966EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$621,243BOYAmt
EOY$1,476,300EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$6,999,000BOYAmt
EOY$6,999,000EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$118,110BOYAmt
EOY$176,390EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$270,090BOYAmt
EOY$101,208EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$10,477,373LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,946,090LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,253,612BOYAmt
EOY$4,531,283EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$310,740BOYAmt
EOY$338,311EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,123,916BOYAmt
EOY$950,198EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$97,642BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$182,938BOYAmt
EOY$444,174EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$15,371,899BOYAmt
EOY$17,149,713EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,286,382BOYAmt
EOY$2,966,201EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$814,176BOYAmt
EOY$678,182EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$760,502EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$352,927BOYAmt
EOY$359,986EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,453,485BOYAmt
EOY$4,764,871EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,028,279BOYAmt
EOY$11,624,016EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$890,135BOYAmt
EOY$760,826EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,918,414BOYAmt
EOY$12,384,842EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,371,899BOYAmt
EOY$17,149,713EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$522,223ReconcilationRevenueExpnssAmt
Donated Services And Use Fclts-$55,795DonatedServicesAndUseFcltsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1IFormAndLineReferenceDesc
ExplanationOTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS ANNUAL DUES TO NACHC, AND A PORTION OF THESE DUES MAY BE ATTRIBUTABLE TO LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,333,128OtherCostOrOtherBasisAmt
Book Value$1,333,128BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,819,895OtherCostOrOtherBasisAmt
Depreciation$1,214,271DepreciationAmt
Book Value$1,605,624BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$306,245OtherCostOrOtherBasisAmt
Depreciation$65,737DepreciationAmt
Book Value$240,508BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,818,271OtherCostOrOtherBasisAmt
Depreciation$4,666,082DepreciationAmt
Book Value$1,152,189BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$199,834OtherCostOrOtherBasisAmt
Book Value$199,834BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,531,283TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescINVESTMENT IN EQUITY INVESTEESDesc
Book Value$950,198BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$950,198TotalBookValueSecuritiesAmt
Total Rev Etc Audited Fincl Stmt$23,348,600TotalRevEtcAuditedFinclStmtAmt
Other Revenue$515,993OtherRevenueAmt
Revenue Not Reported$515,993RevenueNotReportedAmt
Revenue Subtotal$22,832,607RevenueSubtotalAmt
Other Revenues Not Included$794,366OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$794,366RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$23,626,973TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$22,752,863TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$55,795DonatedServicesUseFcltsAmt
Other Expenses Included$171,147OtherExpensesIncludedAmt
Expenses Not Reported$226,942ExpensesNotReportedAmt
Expenses Subtotal$22,525,921ExpensesSubtotalAmt
Other Expenses Not Included$578,829OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$578,829ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$23,104,750TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART X, LINE 2UNCERTAIN 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 2DAMOUNTS INCLUDED ON LINE 1 BUT NOT ON FROM 990, PART VIII, LINE 12: $( 578,829) BAD DEBT EXPENSE 1,094,822 NET ASSETS RELEASED ------------- $ 515,993
SCHEDULE D, PART XI, LINE 4BAMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 965,513 TEMPORARILY RESTRICTED NET ASSETS 149,423 GAIN ON INSURANCE PROCEED ( 173,718) LOSS ON INVESTMENT IN EQUITY INVESTEES ( 101,171) RENTAL EXPENSES ( 24,008) LOSS ON SALE OF ASSET ( 21,673) SPECIAL EVENT EXPENSES ------------- $ 794,366
SCHEDULE D, PART XII, LINE 2DAMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ 173,718 LOSS ON INVESTMENT IN EQUITY INVESTEES 101,171 RENTAL EXPENSES 24,008 LOSS ON SALE OF ASSET 21,673 SPECIAL EVENT EXPENSES ( 149,423) GAIN ON INSURANCE PROCEED ------------- $ 171,147
SCHEDULE D, PART XII, LINE 4BAMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT LINE 1: $ 578,829 BAD DEBT EXPENSE

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF CLASSICEvent1Nm
Gross Receipts Event1$14,404GrossReceiptsEvent1Amt
Charitable Contri Event1$10,968CharitableContriEvent1Amt
Gross Revenue Event1$3,436GrossRevenueEvent1Amt
Rent Facility Costs Event1$5,595RentFacilityCostsEvent1Amt
Food And Beverage Event1$722FoodAndBeverageEvent1Amt
Entertainment Event1$678EntertainmentEvent1Amt
Other Direct Expenses Event1$4,895OtherDirectExpensesEvent1Amt
Event2EMPLOYEE BANQUEEvent2Nm
Gross Receipts Event2$4,924GrossReceiptsEvent2Amt
Charitable Contri Event2$3,600CharitableContriEvent2Amt
Gross Revenue Event2$1,324GrossRevenueEvent2Amt
Non Cash Prizes Event2$1,428NonCashPrizesEvent2Amt
Rent Facility Costs Event2$5,285RentFacilityCostsEvent2Amt
Food And Beverage Event2$1,663FoodAndBeverageEvent2Amt
Entertainment Event2$1,035EntertainmentEvent2Amt
Other Direct Expenses Event2$372OtherDirectExpensesEvent2Amt
Other Events Total0OtherEventsTotalCnt
Gross Receipts Total$19,328GrossReceiptsTotalAmt
Charitable Contributions Tot$14,568CharitableContributionsTotAmt
Gross Revenue Total Events$4,760GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$1,428NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$10,880RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$2,385FoodAndBeverageTotalEventsAmt
Entertainment Total Events$1,713EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$5,267OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$21,673DirectExpenseSummaryEventsAmt
Net Income Summary-$16,913NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DR DAVID WILLIAMS
CHIEF EXECUTIVE OFFICER$271,217$0$23,098$0$53,563$0$0$0$9,349$0$357,227$0$0$0
DR DONNA SINCLAIR
CHEIF MEDICAL OFFICER$272,682$0$450$0$1,932$0$0$0$3,774$0$278,838$0$0$0
CLAUDIO AZZARITI
CHIEF FINANCIAL OFFICER$172,558$0$12,500$0$9,310$0$0$0$3,774$0$198,142$0$0$0
DR TIMOTHY BROWN
OB/GYN PHYSICIAN$217,821$0$1,300$0$387$0$0$0$17,852$0$237,360$0$0$0
DR JAMES K BAILEY
PHYSICIAN$139,283$0$20,962$0$248$0$0$0$9,737$0$170,230$0$0$0
DR TRESSA SCINEAUX
PHYSICIAN$173,710$0$8,877$0$126$0$0$0$3,589$0$186,302$0$0$0
OBIAJULU OKAFOR
OB/GYN PHYSICIAN$220,351$0$925$0$135$0$0$0$4,482$0$225,893$0$0$0
DR KELVIN WHITE
PHYSICIAN$176,849$0$24,833$0$490$0$0$0$10,046$0$212,218$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1AHEALTH 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 -$1,332
SCHEDULE J, PART I, LINE 7BONUS 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

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1DEVELOPMENT AUTHORITY OF FULTON COUNTYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN581506878BondIssuerEIN
Bond Issued2010-08-19BondIssuedDt
Issue Price$5,100,000IssuePriceAmt
PurposeREFUND FLTON CTY BONDS SERIES 2002PurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$4,421,818RetiredAmt
Bond Defeased$0BondDefeasedAmt
Total Proceeds$5,100,000TotalProceedsAmt
In Reserve Fund$0InReserveFundAmt
Capitalized Interest$0CapitalizedInterestAmt
Refunding Escrow$5,010,778RefundingEscrowAmt
Issuance Costs From Proceeds$89,222IssuanceCostsFromProceedsAmt
Credit Enhancement$0CreditEnhancementAmt
Working Capital Expenditures$0WorkingCapitalExpendituresAmt
Capital Expenditures$0CapitalExpendituresAmt
Other Spent Proceeds$0OtherSpentProceedsAmt
Unspent$0UnspentAmt
Substantial Completion2010SubstantialCompletionYr
Current RefundingYes (true)CurrentRefundingInd
Advance RefundingfalseAdvanceRefundingInd
Final Allocation MadeYes (true)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Private Bus Use By Others0PrivateBusUseByOthersPct

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetfalseRebateNotDueYetInd
Exception To RebateYes (true)ExceptionToRebateInd
No Rebate DuefalseNoRebateDueInd
Variable Rate IssueYes (true)VariableRateIssueInd
Hedge Identified In Bks And RecfalseHedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionfalseProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonDR ROBERT WILLIAMSPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionFATHER OF CEORelationshipDescriptionTxt
Transaction$92,400TransactionAmt
TransactionCOMPENSATIONTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 1ORGANIZATION'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, OUR 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 OUR 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 6NUMBER OF VOLUNTEERS: TOTAL NUMBER OF VOLUNTEERS INCLUDES NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART III, LINE 4APROGRAM 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 41,190 PATIENTS, OF WHICH 11,699 INDIVIDUALS WERE SERVED THROUGH MEDICAID, 17,530 THROUGH SELF PAY, 8,728 PATIENTS THROUGH INSURANCE, AND 3,233 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, INCLUDE 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 AN 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 4CPROGRAM 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-BEING OF THE INDIVIDUAL AND FAMILY. THEREFORE, WE TREAT DRUG ABUSE AND ADDICTION 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 4DOTHER 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 11B990 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 12CCONFLICT 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 & 15BCOMPENSATION 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 19DOCUMENT 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 11GOTHER FEES FOR SERVICE: $ 2,035,280 OUTSIDE SERVICES 601,826 PATIENT CARE CONSULTING SERVICES 289,552 OTHER CONTRACTED SERVICES 222,671 NON-PROVIDER CONTRACTED SERVICES 117,408 PROFESSIONAL SERVICES ----------- $ 3,226,737

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1CHOICE HEALTHCARE FOUNDATION INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11046 RIDGE AVE SW STE 5AddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP30315ZIPCd
FieldValueIRS element (for citing)
EIN464828720EIN
Primary ActivitiesSUPPORTPrimaryActivitiesTxt
Legal Domicile StateGALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity Status12 B (II)PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SMCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (true)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CHOICE HEALTHCARE FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeKTransactionTypeTxt
Involved$144,000InvolvedAmt
Method Of Amount DeterminationCOSTMethodOfAmountDeterminationTxt

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