2013-11-22T06:58:11-08:00 2013-06-30 PRZYBYSZ & ASSOCIATES CPAS PC 4200 JENNY LIND SUITE B FORT SMITH AR 72901 990 2012-07-01 710863639 Good Samaritan Clinic GOOD 4797830233 615 North B Street Fort Smith AR 72901 Darrell Stovall 2013-11-22 true Marc Lux CPA P00588449 4796490888 2012 2015-11-30 17:44:51Z 531812 false false X www.good-sam-clinic.net X 2001 AR TO PROVIDE MEDICAL SERVICES AND MEDICATIONS AT REASONABLE COSTS TO THE WORKING POOR, UNINUSRED,ELDERLY & HOMELESS 18 18 13 0 551542 482055 25750 32533 8716 17093 5221 131 591229 531812 0 0 383387 411948 0 19084 223046 195381 606433 607329 -15204 -75517 1157950 1105514 29152 36096 1128798 1069418 TO PROVIDE MEDICAL SERVICES AND MEDICATIONS AT REASONABLE COSTS TO THE WORKING POOR, UNINUSRED,ELDERLY & HOMELESS false false 548681 THE CLINIC PROVIDES MEDICAL SERVICES AND MEDICATIONS AT REASONABLE COSTS TO THE WORKING POOR, UNINUSRED,ELDERLY & HOMELESS 548681 true true false false false false false false false false true true false false false true true false false false false false false false false false false false false false false false false false false false false false false false false false false false false false false false false false false true 0 0 false 13 true false false false false false false false false 0 false false false false false false false false false false X 18 18 false false false false false false false true false false false true true true true true true false false false AR X The Organization 4797830233 615 North B Street Fort Smith AR 72901 X Diane Arnold 1.00 0.00 X 0 0 0 John VinsonPh D 2.00 0.00 X X 0 0 0 Cathy Ulrich 1.00 0.00 X 0 0 0 Darrell Stovall 2.00 0.00 X X 0 0 0 Rosemary Wingfield 1.00 0.00 X 0 0 0 Rex Terry 1.00 0.00 X X 0 0 0 Harold MacDowell 1.00 0.00 X 0 0 0 Russ Aikman 1.00 0.00 X 0 0 0 Sister Rebecca Hendricks 1.00 0.00 X 0 0 0 Carolyn Mosley PhD 2.00 0.00 X 0 0 0 Michael Schluterman CPA 1.00 0.00 X 0 0 0 GaeVon Hoover 1.00 0.00 X 0 0 0 Diane Graham 1.00 0.00 X 0 0 0 Leslie Ziegler MD 1.00 0.00 X 0 0 0 Joel James 1.00 0.00 X 0 0 0 Judy Boreham 1.00 0.00 X 0 0 0 Ronnie Rouse 1.00 0.00 X 0 0 0 Norma Basinger MD 1.00 0.00 X 0 0 0 Evan Breedlove 40.00 0.00 X 55000 0 0 55000 0 false false false 0 482055 482055 Patient payments 32533 32533 32533 10238 10238 0 0 0 6855 6855 6855 6855 0 0 0 Miscellaneous Income 131 131 131 531812 32664 17093 0 0 0 0 55000 50600 4400 0 283624 247836 22690 13098 0 46236 42537 3699 27088 23762 2167 1159 0 0 0 0 0 0 11624 11624 1141 479 91 571 0 0 0 23247 21387 1860 72 66 6 0 0 0 0 15692 14437 1255 22288 21599 689 Pharmaceutical supplies 6894 6894 Office supplies 11826 7923 946 2957 Medical supplies 42116 42116 Laboratory test supplies 42350 42350 18131 15071 1761 1299 607329 548681 39564 19084 184124 163167 552617 485472 0 0 0 0 0 0 572 445 292713 146429 142827 146284 0 277810 310146 0 0 0 1157950 1105514 29152 36096 29152 36096 X 955687 810261 390 85436 172721 173721 1128798 1069418 1157950 1105514 -75517 16137 X true X true X true false X 408241 364413 348795 556763 482186 2160398 39115 35712 29831 25750 32533 162941 0 0 0 447356 400125 378626 582513 514719 2323339 0 0 2323339 -9260 18169 15352 10174 10238 44673 0 -9260 18169 15352 10174 10238 44673 0 0 438096 418294 393978 592687 524957 2368012 0.98110 0.01890 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 186812 61345 125467 105901 85084 20817 146284 310146 X 547949 16137 16137 531812 531812 607329 607329 607329 Part X Part X : FIN48 Footnote Generally accepted accounting principles require tax effects from an uncertain tax position to be recognized in the financial statements only if the position is more likely than not to be sustained if the position were to be challenged by a taxing authority. The assessment of the tax position is based solely on the technical merits of the position, without regard to the likelihood that the tax position may be challenged. If an uncertain tax position meets the more-likely-than-not threshold, the largest amount of tax benefit that is greater than 50% likely to be recognized upon ultimate settlement with the taxing authority is recorded. The Clinic's primary tax positions relate to its status as a not-for-profit entity exempt from income taxes and classification of activities related to its exempt purpose. Management has evaluated the tax positions reflected in the Clinic's tax filings and does not believe that any material uncertain tax positions exist. Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. Provide additional support to the organization Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available The Clinic has the financials and the Form 990 available for inspection at their physical location. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts Potential board members are questioned of any potential conflicts of interest. Form 990, Part VI, Line 11b Form 990, Part VI, Line 11b: Form 990 Review Process The Board of Directors reviews the Form 990 prior to filing.