GOOD SAMARITAN HEALTH CENTER OF COBB INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SAMARITAN HEALTH CENTER OF COBB INC (EIN 32-0045238)
- Tax period
- 2024-01-01 to 2024-12-31
- Filed
- 2025-08-11
- IRS object ID
- 202512249349300001
- Schema version
- 2024v5.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-08-11T22:26:16-05:00 | ReturnTs |
| Tax Period End | 2024-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 582475857 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NICHOLS CAULEY & ASSOCIATES LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 BELLEVUE AVENUE | AddressLine1Txt |
| City | DUBLIN | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 310214152 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320045238 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SAMARITAN HEALTH CENTER OF | BusinessNameLine1Txt |
| Business Name Line2 | COBB INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GOOD | BusinessNameControlTxt |
| Phone | 7704193120 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1605 ROBERTA DR SW | AddressLine1Txt |
| City | MARIETTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 300083855 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GAYLE NELSON | PersonNm |
| Person Title | CFO/INTERIM CEO | PersonTitleTxt |
| Phone | 7704193120 | PhoneNum |
| Signature | 2025-08-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | GREGORY M CHAPMAN | PreparerPersonNm |
| PTIN | P01019632 | PTIN |
| Phone | 4782751163 | PhoneNum |
| Preparation | 2025-08-06 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GAYLE NELSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1605 ROBERTA DR SW | AddressLine1Txt |
| City | MARIETTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 300083855 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,425,929 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GOODSAMCOBB.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION'S MISSION IS TO SPREAD THE LOVE OF CHRIST BY PROVIDING QUALITY HEALTHCARE TO THOSE IN NEED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 65 | TotalEmployeeCnt |
| Total Volunteers | 41 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $13,638,445 | PYContributionsGrantsAmt |
| CY Contributions Grants | $11,392,421 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,838,812 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,826,281 | CYProgramServiceRevenueAmt |
| PY Investment Income | $40,382 | PYInvestmentIncomeAmt |
| CY Investment Income | $120,572 | CYInvestmentIncomeAmt |
| PY Other Revenue | $50,423 | PYOtherRevenueAmt |
| CY Other Revenue | $47,568 | CYOtherRevenueAmt |
| PY Total Revenue | $15,568,062 | PYTotalRevenueAmt |
| CY Total Revenue | $13,386,842 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,943,291 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,329,338 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $21,960 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,497,003 | PYOtherExpensesAmt |
| CY Other Expenses | $10,270,330 | CYOtherExpensesAmt |
| PY Total Expenses | $12,440,294 | PYTotalExpensesAmt |
| CY Total Expenses | $14,599,668 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,127,768 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,212,826 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,075,897 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,721,842 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $355,999 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $214,770 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,719,898 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,507,072 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION'S MISSION IS TO SPREAD THE LOVE OF CHRIST BY PROVIDING QUALITY HEALTHCARE TO THOSE IN NEED. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $12,126,175 | ExpenseAmt |
| Revenue | $1,827,412 | RevenueAmt |
| Desc | THE ORGANIZATION PROVDIES PRIMARY MEDICAL, DENTAL AND COUNSELING SERVICES TO UNINSURED AND UNDERINSURED, WORKING POOR AND INDIGENT IN THE COMMUNITY. GOOD SAMARITAN'S FAMILY CENTERED APPROACH ENSURES THAT THEY DELIVER HIGH QUALITY AND PREVENTATIVE MEDICAL AND DENTAL SERVICES IN ADDITION TO COUNSELING, PHARMACEUTICAL, REFERRAL AND HEALTH EDUCATION PROGRAMS IN AN ATMOSPHERE OF DIGNITY, RESPECT, REGARDLESS OF RACE, ETHNICITY, RELIGION OR ABILTY TO PAY. | Desc |
| Total Program Service Expenses | $12,126,175 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 65 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GAYLE NELSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7704193120 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1605 ROBERTA DR SW | AddressLine1Txt |
| City | MARIETTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 300083855 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|
| DR CHRIS SMITH | |||||||
| CHAIRMAN OF BOARD | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| REV GRANT COLE | |||||||
| SECRETARY | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GREG GRIGGS | |||||||
| TREASURER | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| LYNDA AUSBURN | |||||||
| BOARD OF DIRECTORS | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BRENDA GASKINS | |||||||
| BOARD OF DIRECTORS | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ANNA LONGACRE MD | |||||||
| BOARD OF DIRECTORS | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DR JOHN SHERRER | |||||||
| BOARD OF DIRECTORS | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MASHONDOLA VALDRY | |||||||
| BOARD OF DIRECTORS | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ALBERTO SCHIRMER | |||||||
| BOARD OF DIRECTORS | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSE VAZQUEZ | |||||||
| BOARD OF DIRECTORS | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GAYLE NELSON | |||||||
| CFO/INTERIM CEO | 40.00 | $168,404 | $0 | $0 | Yes (X) | ||
| CYRL KITCHENS | |||||||
| PREVIOUS CEO | 40.00 | $342,898 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $511,302 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,818,578 | GovernmentGrantsAmt |
| All Other Contributions | $8,573,843 | AllOtherContributionsAmt |
| Noncash Contributions | $7,894,806 | NoncashContributionsAmt |
| Total Contributions | $11,392,421 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAL PROGRAM REVENUES | 621300 | $910,852 | $910,852 |
| DENTAL PROGRAM REVENUES | 621300 | $564,817 | $564,817 |
| DISPENSARY REVENUES | 621300 | $301,833 | $301,833 |
| INSURANCE PAYMENTS | 621300 | $41,435 | $41,435 |
| MEDICARE AND MEDICAID | 621300 | $5,804 | $5,804 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,540 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,540 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,826,281 | TotalProgramServiceRevenueAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $120,572 | TotalRevenueColumnAmt |
| Exclusion | $120,572 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $85,524 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $39,087 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,437 | TotalRevenueColumnAmt |
| Exclusion | $46,437 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER | Desc |
| Business | 621300 | BusinessCd |
| Total Revenue Column | $1,131 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,131 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,131 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,386,842 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,827,412 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $167,009 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,404 | TotalAmt |
| Management And General | $168,404 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,861,074 | TotalAmt |
| Program Services | $2,755,960 | ProgramServicesAmt |
| Management And General | $1,087,902 | ManagementAndGeneralAmt |
| Fundraising | $17,212 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,593 | TotalAmt |
| Program Services | $55,272 | ProgramServicesAmt |
| Management And General | $60,855 | ManagementAndGeneralAmt |
| Fundraising | $3,466 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,267 | TotalAmt |
| Program Services | $93,450 | ProgramServicesAmt |
| Management And General | $85,535 | ManagementAndGeneralAmt |
| Fundraising | $1,282 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,422 | TotalAmt |
| Management And General | $77,422 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,201 | TotalAmt |
| Program Services | $37,033 | ProgramServicesAmt |
| Management And General | $39,168 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,003 | TotalAmt |
| Management And General | $36,003 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,052 | TotalAmt |
| Program Services | $107,052 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,974 | TotalAmt |
| Management And General | $46,974 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,915 | TotalAmt |
| Management And General | $30,915 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $284,956 | TotalAmt |
| Program Services | $39,507 | ProgramServicesAmt |
| Management And General | $245,449 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,772 | TotalAmt |
| Program Services | $731 | ProgramServicesAmt |
| Management And General | $70,041 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROFESSIONAL SERVICES | $4,428,268 | $4,428,268 | |
| DISPENSARY COSTS | $3,554,364 | $3,554,364 | |
| BAD DEBTS | $480,076 | $480,076 | |
| OTHER EXPENSES | $316,305 | $316,305 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $761,022 | TotalAmt |
| Program Services | $574,462 | ProgramServicesAmt |
| Management And General | $186,560 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,599,668 | TotalAmt |
| Program Services | $12,126,175 | ProgramServicesAmt |
| Management And General | $2,451,533 | ManagementAndGeneralAmt |
| Fundraising | $21,960 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,309,535 | BOYAmt |
| EOY | $1,478,817 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,312,477 | BOYAmt |
| EOY | $1,701,828 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $676,556 | BOYAmt |
| EOY | $208,781 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,610 | BOYAmt |
| EOY | $11,863 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,814 | BOYAmt |
| EOY | $55,736 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,308,934 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,044,117 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,711,905 | BOYAmt |
| EOY | $5,264,817 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,075,897 | BOYAmt |
| EOY | $8,721,842 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $234,630 | BOYAmt |
| EOY | $145,206 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,369 | BOYAmt |
| EOY | $69,564 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $355,999 | BOYAmt |
| EOY | $214,770 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,591,067 | BOYAmt |
| EOY | $8,507,072 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,831 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,719,898 | BOYAmt |
| EOY | $8,507,072 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,075,897 | BOYAmt |
| EOY | $8,721,842 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,212,826 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,195,817 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,776,048 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,008,849 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,638,445 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,392,421 | CurrentTaxYearAmt |
| Total | $55,011,580 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,334,940 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,542,047 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,733,287 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,842,089 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,827,412 | CurrentTaxYearAmt |
| Total | $8,279,775 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,530,757 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,318,095 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,742,136 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,480,534 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,219,833 | CurrentTaxYearAmt |
| Total | $63,291,355 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $63,291,355 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $709 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,536 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $40,382 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $120,572 | CurrentTaxYearAmt |
| Total | $167,199 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $709 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,536 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $40,382 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $120,572 | CurrentTaxYearAmt |
| Total | $167,199 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $69,967 | CurrentTaxYearMinus4YearsAmt |
| Total | $69,967 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,600,724 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,318,804 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,747,672 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,520,916 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,340,405 | CurrentTaxYearAmt |
| Total | $63,528,521 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99630 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99720 | PublicSupportPY509Pct |
| Investment Income CY | 0.00260 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00070 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $402,595 | OtherCostOrOtherBasisAmt |
| Book Value | $402,595 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,465,225 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,030,051 | DepreciationAmt |
| Book Value | $4,435,174 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,441,114 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,014,066 | DepreciationAmt |
| Book Value | $427,048 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,264,817 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ACCRUED LEAVE | Desc |
| Amt | $69,564 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $69,564 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $13,425,929 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,425,929 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$39,087 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$39,087 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $13,386,842 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $14,638,755 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $39,087 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $39,087 | ExpensesNotReportedAmt |
| Expenses Subtotal | $14,599,668 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $14,599,668 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | GOOD SAMARITAN HEALTH CENTER OF COBB, INC. IS ORGANIZED AS A GEORGIA NONPROFIT CORPORATIONS AND HAS BEEN RECOGNIZED BY THE IRS AS EXEMPT FROM FEDERAL INCOME TAXES UNDER IRC SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN IRC SECTION 501(C)(3), QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION, AND HAS BEEN DETERMINED NOT TO BE A PRIVATE FOUNDATION. THE ORGANIZATION IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, IT IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO OUR EXEMPT PURPOSES. WE HAVE DETERMINED THAT WE ARE NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAVE NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE ORGANIZATION'S FORM 990 IS SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER IT IS FILED. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | DIRECT FUNDRAISING EXPENSE -39,087. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | DIRECT FUNDRAISING EXPENSE 39,087. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $85,524 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $85,524 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event2 | $39,087 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $85,524 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $85,524 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $39,087 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $39,087 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $46,437 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CYRL KITCHENS | ||||||||||||||
| PREVIOUS CEO | $342,898 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $342,898 | $0 | $0 | $0 |
| GAYLE NELSON | ||||||||||||||
| CFO/INTERIM CEO | $168,404 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $168,404 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | MEDICAL SERVICES | Desc |
| Contribution | 0 | ContributionCnt |
| Noncash Contributions Rpt F990 | $7,894,806 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | RETURN WILL BE REVIEWED PRIOR TO FILING |
| FORM 990, PART VI, SECTION B, LINE 12C | THE OFFICERS, DIRECTORS AND KEY EMPLOYEES MUST SIGN THE DISCLOSURE FORM ANNUALLY. THESE FORMS ARE MATCHED AGAINST A LIST OF SUCH PEOPLE. |
| FORM 990, PART VI, SECTION B, LINE 15 | EXECUTIVE BOARD RESEARCHES AND PROVIDES INFORMATION TO MAKE A RECOMMENDATION TO THE FULL BOARD FOR THE SALARY AND BENEFITS OF HIGHLY COMPENSATED EMPLOYEES AND CONSULTANTS BASED ON A REVIEW OF COMPARABLE DATA. THE BOARD THEN DOCUMENTS HOW IT REACHED ITS DECISION. |
| FORM 990, PART VI, SECTION C, LINE 19 | WEBSITE |