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PRIMARY CARE OF SOUTHWEST GEORGIA: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
PRIMARY CARE OF SOUTHWEST GEORGIA (EIN 31-1840668)
Tax period
2018-05-01 to 2019-04-30
Filed
2019-08-30
IRS object ID
201922429349300202
Schema version
2018v3.1
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

FieldValueIRS element (for citing)
Return2019-08-30T05:38:22-07:00ReturnTs
Tax Period End2019-04-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN201995691PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DENMARK AND BROWN PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1123 N MAIN STAddressLine1Txt
CitySTATESBOROCityNm
State AbbreviationGAStateAbbreviationCd
ZIP304585700ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-05-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN311840668EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PRIMARY CARE OF SOUTHWEST GEORGIA INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPRIMBusinessNameControlTxt
Phone2297232660PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1360 COLLEGE STAddressLine1Txt
CityBLAKELYCityNm
State AbbreviationGAStateAbbreviationCd
ZIP39823ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonEDWIN JAMESPersonNm
Person TitleCFOPersonTitleTxt
Signature2019-08-30SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSTEVE BROWN CPAPreparerPersonNm
PTINP01242921PTIN
Phone9127644123PhoneNum
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

US Address USAddress

FieldValueIRS element (for citing)
Address Line1360 COLLEGE STAddressLine1Txt
CityBLAKELYCityNm
State AbbreviationGAStateAbbreviationCd
ZIP39823ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$11,196,038GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.pcswga.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2005FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTHE MISSION OF THE CENTER IS TO PROVIDE PRIMARY AND PREVENTATIVE HEALTH CARE TO MEET THE NEEDS OF THE MEDICALLY UNDERSERVED RESIDENTS OF EARLY, THOMAS, DECATUR, BROOKS AND SURROUNDING COUNTIES.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee115TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$4,452,506PYContributionsGrantsAmt
CY Contributions Grants$5,222,583CYContributionsGrantsAmt
PY Program Service Revenue$4,034,314PYProgramServiceRevenueAmt
CY Program Service Revenue$4,439,944CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$987,022PYOtherRevenueAmt
CY Other Revenue$1,533,511CYOtherRevenueAmt
PY Total Revenue$9,473,842PYTotalRevenueAmt
CY Total Revenue$11,196,038CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,125,117PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,190,294CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,789,399PYOtherExpensesAmt
CY Other Expenses$3,700,606CYOtherExpensesAmt
PY Total Expenses$8,914,516PYTotalExpensesAmt
CY Total Expenses$9,890,900CYTotalExpensesAmt
PY Revenues Less Expenses$559,326PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,305,138CYRevenuesLessExpensesAmt
Total Assets BOY$3,753,924TotalAssetsBOYAmt
Total Assets EOY$4,953,282TotalAssetsEOYAmt
Total Liabilities BOY$704,615TotalLiabilitiesBOYAmt
Total Liabilities EOY$598,835TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,049,309NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,354,447NetAssetsOrFundBalancesEOYAmt
MissionTHE MISSION OF THE CENTER IS TO PROVIDE PRIMARY AND PREVENTATIVE HEALTH CARE TO MEET THE NEEDS OF THE MEDICALLY UNDERSERVED RESIDENTS OF EARLY, THOMAS, DECATUR, BROOKS AND SURROUNDING COUNTIES.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$7,041,620ExpenseAmt
DescTHE CLINIC PROVIDES MEDICAL CARE AND BEHAVIORAL HEALTH TO THE UNDERSERVED CHILDREN AND ADULTS OF DECATUR, EARLY, THOMAS, BROOKS AND SURROUNDING COUNTIES.Desc
Total Program Service Expenses$7,041,620TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredfalseScheduleORequiredInd
IRP Document7IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee115EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyfalseMinutesOfGoverningBodyInd
Minutes Of CommitteesfalseMinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonPRIMARY CARE OF SOUTHWEST GAPersonNm
Phone2297232660PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1360 COLLEGE STAddressLine1Txt
CityBLAKELYCityNm
State AbbreviationGAStateAbbreviationCd
ZIP39823ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
REGINA BARRON
MEMBER5.000.00Yes (X)$0$0$0
KENNETH CODY
MEMBER5.000.00Yes (X)$0$0$0
NORMA HARRIS GREAT
MEMBER5.000.00Yes (X)$0$0$0
KELLY HANKS
MEMBER5.000.00Yes (X)$0$0$0
KATHERYN MITCHELL
MEMBER5.000.00Yes (X)$0$0$0
KEVIN TAYLOR
MEMBER5.000.00Yes (X)$0$0$0
JAY GREEN
MEMBER5.000.00Yes (X)$0$0$0
WAYNE LAWSON
MEMBER5.000.00Yes (X)$0$0$0
DAN PROVENCE
MEMBER5.000.00Yes (X)$0$0$0
ETHEL WILLS
MEMBER5.000.00Yes (X)$0$0$0
JACK WATSON
vice chair5.000.00$0$0$0Yes (X)
WALLACE O'NEAL
Chairman5.000.00$0$0$0Yes (X)
JOAN SIMPSON
SEC/TREAS5.000.00$0$0$0Yes (X)
EDWIN JAMES
CFO50.000.00$98,994$0$10,881Yes (X)
ANGIE MCVEY
CEO50.000.00$0$0$0Yes (X)
DR LUIS MURRAIN
MEDICAL DIRECTOR40.000.00$0$0$0Yes (X)
DR MICHAEL SCHMIDT
PHYSICIAN40.000.00$185,831$0$9,100Yes (X)
DR MURALI YELUGAPURI
PEDIATRICIAN40.000.00$0$0$0Yes (X)
FRANTZ FELIX
PHYSICIAN40.000.00$232,316$0$0Yes (X)
MICHAEL SOPT
PHYSICIAN40.000.00$252,273$0$0Yes (X)
KATHRYN NELSON
PHYSICIAN40.000.00$137,774$0$5,000Yes (X)
DR ANN ADDISON
CEO (PRIOR YEAR)40.000.00$94,220$0$9,750Yes (X)
LADON TOOLE
CEO (PRIOR YEAR)40.000.00$59,639$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,061,047TotalReportableCompFromOrgAmt
Total Other Compensation$34,731TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K4IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
STATE HEALTH BENEFIT PLAN INSURANCE
PO BOX 531613ATLANTAGA30353INSURANCE$748,838
AIG
PO BOX 35423NEWARKNJ07193RETIREMENT$295,735
AMERISOURCE BERGEN
1300 MORRIS DRCHESTERBROOKPA19087PHARMACEUTICALS$265,539
PDC CONSTRUCTION
1612 PIERCE STBAINBRIDGEGA39817CONSTRUCTION$771,130
SHAW CENTER
918 SOUTH BROAD STTHOMASVILLEGA31792PHYSICIAN SERVICES$287,960
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Government Grants$4,350,670GovernmentGrantsAmt
All Other Contributions$871,913AllOtherContributionsAmt
Noncash Contributions$863,063NoncashContributionsAmt
Total Contributions$5,222,583TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Total Revenue Column$4,439,944TotalRevenueColumnAmt
Related Or Exempt Func Income$4,439,944RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$4,439,944TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
340 B DRUG PROGRAM$1,288,839$1,288,839
MEANINGFUL USE$77,410$77,410
MEDICARE COST REPT REFUND$90,930$90,930

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$76,332TotalRevenueColumnAmt
Related Or Exempt Func Income$76,332RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,533,511OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,196,038TotalRevenueColumnAmt
Related Or Exempt Func Income$5,973,455RelatedOrExemptFuncIncomeAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$296,245TotalAmt
Management And General$296,245ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,881,744TotalAmt
Program Services$3,831,712ProgramServicesAmt
Management And General$1,050,032ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$73,763TotalAmt
Program Services$54,585ProgramServicesAmt
Management And General$19,178ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$576,343TotalAmt
Program Services$426,494ProgramServicesAmt
Management And General$149,849ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$362,199TotalAmt
Program Services$268,027ProgramServicesAmt
Management And General$94,172ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$76,650TotalAmt
Management And General$76,650ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$99,755TotalAmt
Management And General$99,755ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$454,048TotalAmt
Program Services$227,024ProgramServicesAmt
Management And General$227,024ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$179,385TotalAmt
Program Services$134,539ProgramServicesAmt
Management And General$44,846ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$178,737TotalAmt
Program Services$51,997ProgramServicesAmt
Management And General$126,740ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$143,513TotalAmt
Management And General$143,513ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$18,282TotalAmt
Management And General$18,282ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$1,204,472$1,204,472
MEDICAL AND DENTAL CONTRACTS$444,292$444,292
CONSULTING & PROFESSIONAL$325,657$185,544$140,113
TELEPHONE AND COMMUNICATIONS$201,246$40,249$160,997

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$374,569TotalAmt
Program Services$172,685ProgramServicesAmt
Management And General$201,884ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$9,890,900TotalAmt
Program Services$7,041,620ProgramServicesAmt
Management And General$2,849,280ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,943,702BOYAmt
EOY$2,396,832EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$287,407BOYAmt
EOY$402,925EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$125,854BOYAmt
EOY$47,039EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$17,892BOYAmt
EOY$58,383EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,993,757LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$969,515LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$931,006BOYAmt
EOY$2,024,242EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$448,063BOYAmt
EOY$23,861EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,753,924BOYAmt
EOY$4,953,282EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$370,435BOYAmt
EOY$430,127EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$206,554BOYAmt
EOY$47,039EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$20,091BOYAmt
EOY$14,135EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$107,535BOYAmt
EOY$107,534EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$704,615BOYAmt
EOY$598,835EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,049,309BOYAmt
EOY$4,354,447EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,049,309BOYAmt
EOY$4,354,447EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,753,924BOYAmt
EOY$4,953,282EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,305,138ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$794,410CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,613,153CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,412,362CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,452,506CurrentTaxYearMinus1YearAmt
Current Tax Year$5,222,583CurrentTaxYearAmt
Total$17,495,014TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$794,410CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,613,153CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,412,362CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,452,506CurrentTaxYearMinus1YearAmt
Current Tax Year$5,222,583CurrentTaxYearAmt
Total$17,495,014TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$17,495,014PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$56,782CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$259,709CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$555,244CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$976,022CurrentTaxYearMinus1YearAmt
Current Tax Year$1,533,511CurrentTaxYearAmt
Total$3,381,268TotalAmt
FieldValueIRS element (for citing)
Total Support$20,876,282TotalSupportAmt
Gross Receipts Rltd Activities$16,630,252GrossReceiptsRltdActivitiesAmt
Public Support CY1700.83800PublicSupportCY170Pct
Public Support PY1700.87880PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$40,000OtherCostOrOtherBasisAmt
Book Value$40,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,388,100OtherCostOrOtherBasisAmt
Depreciation$25,680DepreciationAmt
Book Value$1,362,420BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$422,332OtherCostOrOtherBasisAmt
Depreciation$172,828DepreciationAmt
Book Value$249,504BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$36,878OtherCostOrOtherBasisAmt
Depreciation$12,907DepreciationAmt
Book Value$23,971BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,106,447OtherCostOrOtherBasisAmt
Depreciation$758,100DepreciationAmt
Book Value$348,347BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,024,242TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO 3RD PARTY PAYORSDesc
Amt$107,534Amt
FieldValueIRS element (for citing)
Total Liability$107,534TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd
Rebuttable Presumption ProcfalseRebuttablePresumptionProcInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmt
DR ANN ADDISON
CEO (PRIOR YEAR)$94,220$9,750$103,970
DR MICHAEL SCHMIDT
PHYSICIAN$185,831$9,100$194,931
FRANTZ FELIX
PHYSICIAN$200,000$232,316$32,316
LADON TOOLE
CEO (PRIOR YEAR)$59,639$59,639
MICHAEL SOPT
PHYSICIAN$215,000$252,273$37,273

Schedule M IRS990ScheduleM

Real Estate Commercial RealEstateCommercialGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$214,266NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$561,351NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review ProcessREVIEWED BY CEO & CFO & PRESENTED TO BOARD OF DIRECTORS BEFORE FILING.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsEVERY YEAR, DURING THE ANNUAL BOARD STRATEGIC MEETING, THE BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST STATEMENT.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesTHE HEALTH CENTER UTILIZES COMPARABLE COMPENSATION DATA FROM THE NACHC SALARY SURVEY AS WELL AS THE GAPHC SALARY SURVEY.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableNo documents available to the public.