2025-08-11T22:26:16-05:00 2024-12-31 582475857 NICHOLS CAULEY & ASSOCIATES LLC 1300 BELLEVUE AVENUE DUBLIN GA 310214152 990 2024-01-01 320045238 GOOD SAMARITAN HEALTH CENTER OF COBB INC GOOD 7704193120 1605 ROBERTA DR SW MARIETTA GA 300083855 GAYLE NELSON CFO/INTERIM CEO 7704193120 2025-08-06 1 0 GREGORY M CHAPMAN P01019632 4782751163 2025-08-06 2024 2025-03-06 01:10:19Z GAYLE NELSON 1605 ROBERTA DR SW MARIETTA GA 300083855 13425929 0 X WWW.GOODSAMCOBB.ORG X 2002 GA THE ORGANIZATION'S MISSION IS TO SPREAD THE LOVE OF CHRIST BY PROVIDING QUALITY HEALTHCARE TO THOSE IN NEED. 10 10 65 41 0 0 13638445 11392421 1838812 1826281 40382 120572 50423 47568 15568062 13386842 0 0 0 0 3943291 4329338 0 0 21960 8497003 10270330 12440294 14599668 3127768 -1212826 10075897 8721842 355999 214770 9719898 8507072 THE ORGANIZATION'S MISSION IS TO SPREAD THE LOVE OF CHRIST BY PROVIDING QUALITY HEALTHCARE TO THOSE IN NEED. 0 0 12126175 1827412 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. 12126175 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 5 0 65 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 GA X GAYLE NELSON 7704193120 1605 ROBERTA DR SW MARIETTA GA 300083855 DR CHRIS SMITH CHAIRMAN OF BOARD 0.00 X 0 0 0 REV GRANT COLE SECRETARY 0.00 X 0 0 0 GREG GRIGGS TREASURER 0.00 X 0 0 0 LYNDA AUSBURN BOARD OF DIRECTORS 0.00 X 0 0 0 BRENDA GASKINS BOARD OF DIRECTORS 0.00 X 0 0 0 ANNA LONGACRE MD BOARD OF DIRECTORS 0.00 X 0 0 0 DR JOHN SHERRER BOARD OF DIRECTORS 0.00 X 0 0 0 MASHONDOLA VALDRY BOARD OF DIRECTORS 0.00 X 0 0 0 ALBERTO SCHIRMER BOARD OF DIRECTORS 0.00 X 0 0 0 JOSE VAZQUEZ BOARD OF DIRECTORS 0.00 X 0 0 0 GAYLE NELSON CFO/INTERIM CEO 40.00 X 168404 0 0 CYRL KITCHENS PREVIOUS CEO 40.00 X 342898 0 0 511302 0 0 2 1 1 0 0 2818578 8573843 7894806 11392421 MEDICAL PROGRAM REVENUES 621300 910852 910852 DENTAL PROGRAM REVENUES 621300 564817 564817 DISPENSARY REVENUES 621300 301833 301833 INSURANCE PAYMENTS 621300 41435 41435 MEDICARE AND MEDICAID 621300 5804 5804 1540 1540 1826281 120572 120572 85524 39087 46437 46437 OTHER 621300 1131 1131 1131 13386842 1827412 0 167009 168404 168404 3861074 2755960 1087902 17212 119593 55272 60855 3466 180267 93450 85535 1282 77422 77422 76201 37033 39168 36003 36003 107052 107052 46974 46974 30915 30915 284956 39507 245449 70772 731 70041 PROFESSIONAL SERVICES 4428268 4428268 DISPENSARY COSTS 3554364 3554364 BAD DEBTS 480076 480076 OTHER EXPENSES 316305 316305 761022 574462 186560 14599668 12126175 2451533 21960 2309535 1478817 2312477 1701828 676556 208781 8610 11863 56814 55736 7308934 2044117 4711905 5264817 10075897 8721842 234630 145206 121369 69564 355999 214770 X 9591067 8507072 128831 0 9719898 8507072 10075897 8721842 -1212826 0 X 0 1 X 1 1 1 X 9195817 9776048 11008849 13638445 11392421 55011580 1334940 1542047 1733287 1842089 1827412 8279775 10530757 11318095 12742136 15480534 13219833 63291355 0 0 0 63291355 709 5536 40382 120572 167199 709 5536 40382 120572 167199 69967 69967 10600724 11318804 12747672 15520916 13340405 63528521 0.99630 0.99720 0.00260 0.00070 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 402595 402595 5465225 1030051 4435174 1441114 1014066 427048 5264817 ACCRUED LEAVE 69564 69564 X 13425929 0 13425929 -39087 -39087 13386842 14638755 39087 39087 14599668 0 14599668 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. GOLF TOURNAMENT 85524 85524 39087 85524 85524 39087 39087 46437 0 0 0 0 0 0 0 0 0 CYRL KITCHENS PREVIOUS CEO 342898 0 0 0 0 0 0 0 0 0 342898 0 0 0 GAYLE NELSON CFO/INTERIM CEO 168404 0 0 0 0 0 0 0 0 0 168404 0 0 0 X MEDICAL SERVICES 0 7894806 0 0 0 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