2017-02-21T09:23:11-05:00 2015-12-31 CANADY RICHBOURG WOODWARD LLP 5302 FREDERICK ST SUITE 200 SAVANNAH GA 314054823 990 2015-01-01 200314897 FAYETTE CARE CLINIC INC FAYE 7707199620 1260 HIGHWAY 54 W SUITE 101 FAYETTEVILLE GA 302144514 DR NIMISH DHRUVA INTERIM BOARD CHAIR 7707199620 2017-01-23 JOHN F WOODWARD P00839971 9123542910 2017-02-06 2015 2021-01-29 14:40:06Z X X DR NIMISH DHRUVA 20 FRANCIS WAY SUITE 101 200 SHARPSBURG GA 30277 473602 false X WWW.FAYETTECARECLINIC.COM X 2003 GA PROVIDE QUALITY HEALTHCARE TO THE UNINSURED RESIDENTS OF FAYETTE COUNTY WHOSE HOUSEHOLD INCOME DOES NOT EXCEED 200% OF THE FEDERAL POVERTY GUIDELINES. 11 11 6 140 0 254993 419707 790 5716 47 0 60584 29427 316414 454850 0 0 145134 113617 0 438 239406 252752 384540 366369 -68126 88481 60522 148961 791 749 59731 148212 PROVIDE QUALITY HEALTHCARE TO THE UNINSURED RESIDENTS OF FAYETTE COUNTY WHOSE HOUSEHOLD INCOME DOES NOT EXCEED 200% OF THE FEDERAL POVERTY GUIDELINES. false false 235851 5716 OUR MISSION IS TO PROMOTE HEALTH AND WELL-BEING BY REDUCING THE BARRIERS TO ACCESS HEALTHCARE FOR THE WORKING POOR AND UNINSURED POPULATION OF FAYETTE COUNTY, THAT MEET INCOME REQUIREMENTS, THROUGH COMPASSIONATE HEALTH CARE AND EDUCATION AND TO PROVIDE A GATEWAY TO OTHER COMMUNITY RESOURCES. 235851 true true false false false false false false false false true false false false false false true false false false false false false false true false false false false false false false false false false true false false true false false false false false false false false true 6 0 6 true false false false false false false false false false false false false X 11 11 false false false false false false false true true false false true true false false false false true true false GA X X JANIS WILLIAMS 7707194620 1260 HWY 54 W SUITE 101 FAYETTEVILLE GA 30214 X DR CHARLES BARBER DIRECTOR 1.00 X 0 0 0 DAYE BEXLEY BOARD VICE C 2.00 X X 0 0 0 ELIZABETH J CARAWAY DIRECTOR 1.00 X 0 0 0 DR NIMISH DHRUVA INTERIM BOAR 2.00 X X 0 0 0 TONY FERGUSON SECRETARY 2.00 X X 0 0 0 ALICE JONES DIRECTOR 1.00 X 0 0 0 SHERYL KLINK FINANCE CHAI 2.00 X X 0 0 0 GREGORY ALVAREZ MD DIRECTOR 1.00 X 0 0 0 MARYANNE MUJICA PAST BOARD C 1.00 X 0 0 0 SCOTT ROWLAND DIRECTOR 1.00 X 0 0 0 GIL WILLIAMS DIRECTOR 1.00 X 0 0 0 false false false 60200 359507 108464 419707 CLINIC FEES 4843 4843 PATIENT RECORD COPIES 873 873 5716 48179 18752 29427 29427 454850 5716 29427 X 102897 46254 56643 10720 4819 5901 12125 12125 67560 43979 23581 584 146 438 9901 9901 24590 19672 4918 794 794 9684 8715 969 6123 6123 DONATED SUPPLIES 100434 100434 SUPPLIES 7471 2564 4907 TELEPHONE/COMMUNICATIONS 4453 4453 BLDG MAINTENANCE/JANITOR 4254 3750 504 4779 1211 3568 366369 235851 130080 438 38138 122774 2250 12124 2500 99663 88100 20134 11563 60522 148961 791 749 791 749 X 59731 54287 93925 59731 148212 60522 148961 88481 X false true X true false X 190785 181259 274061 189500 419707 1255312 190785 181259 274061 189500 419707 1255312 1255312 74 47 121 42085 45478 66463 64822 48179 267027 1522460 5716 0.82450 0.81010 X PART II, LINE 10 GROSS FUND RAISING 218,848 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 99663 88100 11563 11563 1485800 1000898 30052 1030950 454850 454850 1397319 1000898 30052 1030950 366369 366369 SCHEDULE D, PAGE 4, PART XI, LINE 2D DIRECT COST OF FUND RAISING EVENTS 30,052 SCHEDULE D, PAGE 4, PART XII, LINE 2D DIRECT COST OF FUND RAISING EVENTS 30,052 DANCE 27930 27930 4524 GOLF TOURNMENT 20249 20249 14228 48179 48179 18752 18752 29427 GROUP SIX PROPERTIES 1 LTD LP 57529 MEMBER 93891 RENT OF FACILITIES false X 1 100434 X SOFTWARE 1 8030 false false false SCHEDULE M, PAGE 2, PART II NUMBER OF CONTRIBUTIONS BEING REPORTED FORM 990, PAGE 1, ITEM B AUDIT COMPLETED SUBSEQUENT TO ORIGINAL RETURN BEING FILED. RETURN AMENDED TO REFLECT AUDITED AMOUNTS. NO MATERIAL CHANGE IN REVENUES LESS EXPENSES, ASSETS,OR LIABILITIES. A PORTION OF UNRESTRICTED NET ASSETS WERE RECLASSIFIED TO RESTRICTED NET ASSETS. FORM 990 OUR MEDICAL PARTNERS PROVIDED OVER 907,000 IN SERVICES TO OUR PATIENTS IN 2015 CALCULATION OF ADMINISTRATIVE/FUNDRAISING EXPENSE PERCENTAGE: THIS CALCULATION AS PERFORMED ON PART IX STATEMENT OF FUNCTIONAL EXPENSES OF THIS FORM 990, RESULTS IN A PERCENTAGE OF 35.6%. HOWEVER, THE FAYETE CARE CLINIC IS DEPENDENT UNPON IT'S VOLUNTEERS AND HEALTH CARE PARTNERS DONATING SERVICES TO ACHIEVE IT'S MISSION. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE THESE DONATED SERVICES TO BE RECORDED INTO FAYETTE CARE CLINIC'S FINANCIAL STATEMENTS. HOWEVER PER INTERNAL REVENUE SERVICE REGULATIONS THESE SERVICES ARE NOT REPORTED AS PROGRAM EXPENSES ON THE FORM 990. SEE SCHEDULE D PARTS XI AND XII FOR A RECONCILATION OF THE AUDITED FINANCIAL STATEMENTS TO THIS FORM 990. CALCULATING THE ADMINSTRATIVE/FUNDRAISING PERCENTAGE PER THE STATEMENT OF FUNCTIONAL EXPENSES INCLUDED IN THE AUDITED FINANCIAL STATEMENTS, RESULTS IN AN ADMINISTRATIVE/FUNDRAISING EXPENSE PERCENTAGE OF 12.8%, WHICH FAYETTE CARE CLINIC BELIEVES TO BE A TRUE REPRESENTATION OF ITS ADMINISTRATIVE/FUNDRAISING PERCENTAGE. FORM 990, PAGE 1, PART I, LINE 6 FATETTE CARE CLINIC, INC IS DEPENDENT ON ITS VOLUNTEERS. VOLUNTEERS PROVIDE MEDICAL, DENTAL, EDUCATIONAL AND ADMINISTRATIVE SERVICES. FORM 990, PAGE 6, PART VI, LINE 11B A COPY OF THE RETURN IS GIVEN TO EACH MEMBER OF THE BOARD BEFORE THE RETURN IS FILED. IF NO CORRECTIONS ARE SUGGESTED, THE RETURN IS FILED. FORM 990, PAGE 6, PART VI, LINE 15A COMPENSATION OF THE EXECUTIVE DIRECTOR IS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. REFERENCE IS MADE TO COMPENSATION PAID BY COMPARABLE ORGANIZATIONS,BUT LIMITED BY BUDGET RESTRAINTS. FORM 990, PAGE 6, PART VI, LINE 15B N/A FORM 990, PAGE 6, PART VI, LINE 19 COPIED AND DISTRIBUTED UPON REQUEST. FORM 990, PART IX, LINE 11G SUB-CONTRACTOR FEE 43,979 23,581 0 FORM 990, PART XI, LINE 9 DIRECT COST OF FUND RAISING EVENTS 30,052 DIRECT COST OF FUND RAISING EVENTS -30,052