GREENVILLE FREE MEDICAL CLINIC: Form 990, tax year 2011
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- Organization
- GREENVILLE FREE MEDICAL CLINIC (EIN 57-0855205)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-09
- IRS object ID
- 201213149349301416
- Schema version
- 2011v1.2
- 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) |
|---|---|---|
| Timestamp | 2012-11-09T10:39:37-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JENNINGS COOK & CO CPA'S PA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 25937 | AddressLine1 |
| City | GREENVILLE | City |
| State | SC | State |
| ZIP Code | 29616 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 570855205 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREENVILLE FREE MEDICAL CLINIC INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GREE | NameControl |
| Phone | 8642321470 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 ARLINGTON AVENUE | AddressLine1 |
| City | GREENVILLE | City |
| State | SC | State |
| ZIP Code | 29601 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES M AUSTIN | Name |
| Title | CHAIRMAN AUDIT COMMITTEE | Title |
| Phone | 8642321470 | Phone |
| Date Signed | 2012-10-12 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DOUGLAS P SCHMIEDING | Name |
| Phone | 8642974700 | Phone |
| Date Prepared | 2012-11-09 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | SUZIE J FOLEY EXECUTIVE DIRECTOR | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8993 | AddressLine1 |
| City | GREENVILLE | City |
| State | SC | State |
| ZIP Code | 29604 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 5486439 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | GREENVILLEFREECLINIC.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1987 | YearFormation |
| State Legal Domicile | SC | StateLegalDomicile |
| Activity Or Mission Description | TO PROMOTE WELLNESS AND TO PROVIDE CARING, QUALITY PRIMARY MEDICAL CARE AND DENTAL SERVICES, HEALTH EDUCATION AND PRESCRIPTION MEDICATIONS WITHOUT CHARGE TO ELIGIBLE GREENVILLE COUNTY RESIDENTS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 16 | NbrIndependentVotingMembers |
| Total Nbr Employees | 22 | TotalNbrEmployees |
| Total Nbr Volunteers | 600 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 5151665 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 5149995 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 51071 | InvestmentIncomePriorYear |
| Investment Income Current Year | 47491 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 77630 | OtherRevenuePriorYear |
| Other Revenue Current Year | 69258 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5280366 | TotalRevenuePriorYear |
| Total Revenue Current Year | 5266744 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 613507 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 562523 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 69163 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4662266 | OtherExpensePriorYear |
| Other Expenses Current Year | 4864295 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 5275773 | TotalExpensesPriorYear |
| Total Expenses Current Year | 5426818 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4593 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -160074 | RevenuesLessExpensesCY |
| Total Assets BOY | 2148031 | TotalAssetsBOY |
| Total Assets EOY | 1949609 | TotalAssetsEOY |
| Total Liabilities EOY | 1085 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2148031 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1948524 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROMOTE WELLNESS AND TO PROVIDE CARING, QUALITY PRIMARY MEDICAL CARE AND DENTAL SERVICES, HEALTH EDUCATION AND PRESCRIPTION MEDICATIONS WITHOUT CHARGE TO ELIGIBLE GREENVILLE COUNTY RESIDENTS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 5166962 | Expense |
| Revenue | 5278845 | Revenue |
| Description | SEE MISSION STATEMENT 2011 ACCOMPLISHMENTS: 7,400 MEDICAL CARE VISITS 2,420 DENTAL CLNIC VISITS OVER 30,000 PRECRIPTIONS/REFILLS DISPENSED OVER 6,000 DIAGNOSTIC TESTS PROVIDED 1,100 NURSE CONSULTS OVER 400 DIABETES CLASS VISITS OVER 100 HEALTH PRESENTATIONS | Description |
| Total Program Service Expense | 5166962 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | true | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 20 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 22 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 16 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | true | LocalChapters |
| Policies Reference Chapters | true | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | SUZIE J FOLEY | NamePerson |
| Telephone Number | 8642321470 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 ARLINGTON AVE | AddressLine1 |
| City | GREENVILLE | City |
| State | SC | State |
| ZIP Code | 29601 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | TitleTitle | OfficerOfficer |
|---|---|---|---|---|---|---|
| WAYNE ADAMS PHARMD | ||||||
| 2.00 | X | 0 | 0 | 0 | ||
| JAMES M AUSTIN | ||||||
| 2.00 | X | 0 | 0 | 0 | CHAIR | |
| MERCEDES BARTOW | ||||||
| 2.00 | X | 0 | 0 | 0 | SECRETARY | |
| SCOTT CHRISTOPHER | ||||||
| 2.00 | X | 0 | 0 | 0 | ||
| PHIL FEISAL | ||||||
| 2.00 | X | 0 | 0 | 0 | ||
| SAMUEL ERWIN | ||||||
| 2.00 | X | 0 | 0 | 0 | ||
| BEVERLY HAINES | ||||||
| 2.00 | X | 0 | 0 | 0 | ||
| TERI FICICCHY | ||||||
| 2.00 | X | 0 | 0 | 0 | ||
| DR DONALD RIDGELL | ||||||
| 2.00 | X | 0 | 0 | 0 | ||
| DR PETER MAURIDES | ||||||
| 2.00 | X | 0 | 0 | 0 | ||
| DR STEVE NEWMAN | ||||||
| 2.00 | X | 0 | 0 | 0 | PAST CHAIR | |
| MATTHEW UTECHT | ||||||
| 2.00 | X | 0 | 0 | 0 | ||
| SUSAN ROBBINS | ||||||
| 2.00 | X | 0 | 0 | 0 | ||
| DAVID SLADE | ||||||
| 2.00 | X | 0 | 0 | 0 | VICE CHAIR | |
| MAXIM WILLIAMS | ||||||
| 2.00 | X | 0 | 0 | 0 | ||
| SAKO ZADOIAN | ||||||
| 2.00 | X | 0 | 0 | 0 | ||
| SUZIE J FOLEY | ||||||
| 40.00 | 81464 | 0 | 0 | EXECUTIVE DI | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 81464 | TotalReportableCompFromOrg |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Government Grants | 75833 | GovernmentGrants |
| All Other Contributions | 5074162 | AllOtherContributions |
| Noncash Contributions | 4395000 | NoncashContributions |
| Total Contributions | 5149995 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 25476 | TotalRevenueColumn |
| Exclusion | $25,476 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 229609 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 207594 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 22015 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22015 | TotalRevenueColumn |
| Related Or Exempt Function Income | 22015 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 81359 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 12101 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 69258 | TotalRevenueColumn |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5266744 | TotalRevenueColumn |
| Related Or Exempt Function Income | 22015 | RelatedOrExemptFunctionIncome |
| Exclusion | $25,476 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 470080 | Total |
| Program Services | 359109 | ProgramServices |
| Management And General | 63704 | ManagementAndGeneral |
| Fundraising | 47267 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54715 | Total |
| Program Services | 41583 | ProgramServices |
| Management And General | 7660 | ManagementAndGeneral |
| Fundraising | 5472 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37728 | Total |
| Program Services | 28673 | ProgramServices |
| Management And General | 5282 | ManagementAndGeneral |
| Fundraising | 3773 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4997 | Total |
| Management And General | 4997 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50935 | Total |
| Program Services | 28398 | ProgramServices |
| Management And General | 18375 | ManagementAndGeneral |
| Fundraising | 4162 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 62112 | Total |
| Program Services | 49690 | ProgramServices |
| Management And General | 12422 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24129 | Total |
| Management And General | 24129 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| DONATED GOODS/SUPPLIES | 4393595 | 4393595 | |
| PRESCRIPTIONS | 187557 | 187557 | |
| MEDICAL & DENTAL SUPPLIES | 35637 | 35637 | |
| CONTRACTED SERVICES | 19182 | 19182 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 86151 | Total |
| Program Services | 42720 | ProgramServices |
| Management And General | 34942 | ManagementAndGeneral |
| Fundraising | 8489 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5426818 | Total |
| Program Services | 5166962 | ProgramServices |
| Management And General | 190693 | ManagementAndGeneral |
| Fundraising | 69163 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 210539 | BOY |
| EOY | 317853 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8771 | BOY |
| EOY | 5100 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1943539 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1154497 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 824148 | BOY |
| EOY | 789042 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 724485 | BOY |
| EOY | 737126 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 380088 | BOY |
| EOY | 100488 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2148031 | BOY |
| EOY | 1949609 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 1085 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 1085 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1098716 | BOY |
| EOY | 964551 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 899315 | BOY |
| EOY | 833973 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 150000 | BOY |
| EOY | 150000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2148031 | BOY |
| EOY | 1948524 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2148031 | BOY |
| EOY | 1949609 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -160074 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -39433 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 918012 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 941410 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 789158 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1032631 | CurrentTaxYearMinus1Year |
| Current Tax Year | 836354 | CurrentTaxYear |
| Total | 4517565 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 918012 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 941410 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 789158 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1032631 | CurrentTaxYearMinus1Year |
| Current Tax Year | 836354 | CurrentTaxYear |
| Total | 4517565 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 4517565 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 48845 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 50336 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 53759 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 31623 | CurrentTaxYearMinus1Year |
| Current Tax Year | 25476 | CurrentTaxYear |
| Total | 210039 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 4727604 | TotalSupport |
| Gross Receipts From Admissions Etc | 81359 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.95560 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.95370 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 706935 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 3079 | InvestmentEarningsOrLosses |
| Administrative Expenses | 7529 | AdministrativeExpenses |
| End Of Year Balance | 702485 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 650618 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 63302 | InvestmentEarningsOrLosses |
| Administrative Expenses | 6985 | AdministrativeExpenses |
| End Of Year Balance | 706935 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 565827 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 91139 | InvestmentEarningsOrLosses |
| Administrative Expenses | 6348 | AdministrativeExpenses |
| End Of Year Balance | 650618 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.78650 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.21350 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | true | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 20000 | OtherCostOrOtherBasis |
| Book Value | 20000 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 647935 | OtherCostOrOtherBasis |
| Depreciation | 567009 | Depreciation |
| Book Value | 80926 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 83237 | OtherCostOrOtherBasis |
| Depreciation | 81223 | Depreciation |
| Book Value | 2014 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 102940 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CERTIFICATES OF DEPOSIT | Description |
| Book Value | 100488 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 100488 | TotalOfBookValueSecurities |
| Total Revenue | 5266744 | TotalRevenue |
| Total Expenses | 5426818 | TotalExpenses |
| Excess Or Deficit For Year | -160074 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -39433 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -39433 | TotalAdjustments |
| Excess Or Deficit Per FS | -199507 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 7828831 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -39433 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 2601520 | DonatedSrvcAndUseOfFacilities |
| Revenue Not Rptd F990 | 2562087 | RevenueNotRptdF990 |
| Revenue Subtotal | 5266744 | RevenueSubtotal |
| Total Revenue Per Form990 | 5266744 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 8028338 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 2601520 | DonatedServicesUseOfFacilities |
| Expenses Not Rptd F990 | 2601520 | ExpensesNotRptdF990 |
| Expenses Subtotal | 5426818 | ExpensesSubtotal |
| Total Expenses Per Form990 | 5426818 | TotalExpensesPerForm990 |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | BUBBLE Q | NameOfEvent1 |
| Gross Receipts Event1 | 67331 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 67331 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 9842 | OtherDirectExpensesEvent1 |
| Name Of Event2 | WALK WITH THE D | NameOfEvent2 |
| Gross Receipts Event2 | 14028 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 14028 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 2259 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 81359 | GrossReceiptsTotal |
| Gross Revenue Total Events | 81359 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 12101 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 12101 | DirectExpenseSummaryEvents |
| Net Income Summary | 69258 | NetIncomeSummary |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 5 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 4395000 | NoncashContribsRptdF990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| POLICIES AND PROCEDURES GOVERNING CHAPTERS | FORM 990, PAGE 6, PART VI, LINE 10B | THE CLINIC HAS THE FOLLOWING SATELLITE LOCATIONS: NORTHWEST CRESCENT CLINIC 925 N. FRANKLIN ROAD GREENVILLE, SC 29617 GREER FREE CLINIC J. VERNE SMITH CENTER 202 VICTORIA STREET GREER, SC 29650 GOLDEN STRIP FREE CLINIC 1102 HOWARD DRIVE, BLDG. 3 SIMPSONVILLE, SC 29681 ALL LOCATIONS FOLLOW THE SAME POLICES AND PROCEDURES. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE AUDIT COMMITTEE REVIEWS FORM 990. AFTER THE COMMITTEE'S REVIEW THE FORM 990 IS SUBMITTED TO THE ENTIRE BOARD OF DIRECTORS FOR FINAL APPROVAL. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | POLICY: 4.5 POLICY TITLE: BOARD MEMBER'S CODE OF CONDUCT PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST: THE CHAIR OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CLININC CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE CEO COMMITTEE REVIEWS THE EXECUTIVE DIRECTOR'S PERFORMANCE ANNUALLY TO DETERMINE IF THE EXECUTIVE DIRECTOR IS IN COMPLIANCE WITH THE CLINIC'S STATED POLICIES. THE COMMITTEE MAKES RECOMMENDATIONS OF COMPENSATION TO THE BOARD BASED ON THE RESULTS OF THE THEIR PERFORMANCE REVIEW. THE BOARD OF DIRECTORS GIVES FINAL APPROVAL OF THE EXECUTIVE DIRECTOR'S COMPENSATION. THE CEO EVALUATION COMMITTEE CONSISTS OF THREE BOARD MEMBERS. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE PUBLIC IS INVITED TO ALL BOARD MEETINGS AND MAY REVIEW ALL DOCUMENTS. ALL DOCUMENTS ARE ALSO AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. |
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