PRIMARY CARE OF SOUTHWEST GEORGIA: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- PRIMARY CARE OF SOUTHWEST GEORGIA (EIN 31-1840668)
- Tax period
- 2016-05-01 to 2017-04-30
- Filed
- 2017-09-21
- IRS object ID
- 201712649349300906
- Schema version
- 2016v3.0
- 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 | 2017-09-21T07:28:20-07:00 | ReturnTs |
| Tax Period End | 2017-04-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DENMARK AND BROWN PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 123 N MAIN ST | AddressLine1Txt |
| City | STATESBORO | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 304585700 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-05-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311840668 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRIMARY CARE OF SOUTHWEST GEORGIA INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PRIM | BusinessNameControlTxt |
| Phone | 2297232660 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 360 COLLEGE ST | AddressLine1Txt |
| City | BLAKELY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 39823 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EDWIN JAMES | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2017-09-21 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | FRANK DENMARK CPA | PreparerPersonNm |
| PTIN | P00090471 | PTIN |
| Phone | 9127644123 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,560,313 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.pcswga.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2005 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | THE 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 Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 75 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $3,613,153 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,412,362 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,395,344 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,740,804 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $259,709 | PYOtherRevenueAmt |
| CY Other Revenue | $407,147 | CYOtherRevenueAmt |
| PY Total Revenue | $7,268,206 | PYTotalRevenueAmt |
| CY Total Revenue | $7,560,313 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,042,869 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,869,347 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,236,821 | PYOtherExpensesAmt |
| CY Other Expenses | $2,504,859 | CYOtherExpensesAmt |
| PY Total Expenses | $6,279,690 | PYTotalExpensesAmt |
| CY Total Expenses | $7,374,206 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $988,516 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $186,107 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,658,022 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,246,364 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $354,146 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $756,381 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,303,876 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,489,983 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE 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 Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $4,949,434 | ExpenseAmt |
| Desc | THE 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 | $4,949,434 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | false | ScheduleORequiredInd |
| IRP Document | 9 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 75 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | false | MinutesOfGoverningBodyInd |
| Minutes Of Committees | false | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PRIMARY CARE OF SOUTHWEST GA | PersonNm |
| Phone | 2297232660 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 360 COLLEGE ST | AddressLine1Txt |
| City | BLAKELY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 39823 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| REGINA BARRON | |||||||||
| MEMBER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| KENNETH CODY | |||||||||
| MEMBER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| NORMA HARRIS GREAT | |||||||||
| MEMBER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MATTIE GRIMES | |||||||||
| member | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| BUCK GRIST | |||||||||
| MEMBER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHERYN MITCHELL | |||||||||
| MEMBER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| KEVIN TAYLOR | |||||||||
| MEMBER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JAY GREEN | |||||||||
| MEMBER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| WAYNE LAWSON | |||||||||
| MEMBER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DAN PROVENCE | |||||||||
| MEMBER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ETHEL WILLS | |||||||||
| MEMBER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JACK WATSON | |||||||||
| vice chair | 5.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| WALLACE O'NEAL | |||||||||
| Chairman | 5.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| JOAN SIMPSON | |||||||||
| SEC/TREAS | 5.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| EDWIN JAMES | |||||||||
| CFO | 50.00 | 0.00 | $104,385 | $0 | $4,788 | Yes (X) | |||
| DR BRENDA A ADDISON | |||||||||
| CEO | 50.00 | 0.00 | $167,315 | $0 | $12,354 | Yes (X) | |||
| DR LUIS MURRAIN | |||||||||
| MEDICAL DIRECTOR | 40.00 | 0.00 | $243,128 | $0 | $7,925 | Yes (X) | |||
| DR MICHAEL SCHMIDT | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $153,804 | $0 | $6,140 | Yes (X) | |||
| DR MURALI YELUGAPURI | |||||||||
| PEDIATRICIAN | 40.00 | 0.00 | $190,678 | $0 | $7,465 | Yes (X) | |||
| GREGORY DODSON | |||||||||
| Phys Assistant | 40.00 | 0.00 | $127,012 | $0 | $3,714 | Yes (X) | |||
| DR JOY ABLORDEPPEY | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $196,144 | $0 | $7,800 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,182,466 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $50,186 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ADP INSURANCE AGENCY - STATE HEALTH INSURANCE | |||||
| PNC BANK PO BOX 531613 | ATLANTA | GA | 30353 | INSURANCE | $589,115 |
| MCKESSON | |||||
| 5595 WINDWARD PKWY | ALPHARETTA | GA | 30005 | MEDICAL SUPPLIES | $209,610 |
| BLOUGH TECH INC | |||||
| 119 SOUTH BROAD ST | CAIRO | GA | 39828 | COMPUTER SERVICES | $175,568 |
| AMERISOURCE BERGEN | |||||
| 1300 MORRIS DR | CHESTERBROOK | PA | 19087 | PHARMACEUTICALS | $114,145 |
| SHAW CENTER | |||||
| 918 SOUTH BROAD ST | THOMASVILLE | GA | 31792 | PHYSICIAN SERVICES | $348,414 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,008,945 | GovernmentGrantsAmt |
| All Other Contributions | $403,417 | AllOtherContributionsAmt |
| Total Contributions | $3,412,362 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| MEANINGFUL USE | $21,974 | $21,974 |
| medicare cost rpt refund | $126,123 | $126,123 |
| PATIENT SERVICE REVENUE | $3,592,707 | $3,592,707 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,740,804 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| 340 B DRUG PROGRAM | $364,104 | $364,104 |
| MEDICAL RECORDS FEES | $8,253 | $8,253 |
| RENT | $26,000 | $26,000 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,790 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,790 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $407,147 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,560,313 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,147,951 | RelatedOrExemptFuncIncomeAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $539,895 | TotalAmt |
| Program Services | $200,842 | ProgramServicesAmt |
| Management And General | $339,053 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,439,822 | TotalAmt |
| Program Services | $2,584,960 | ProgramServicesAmt |
| Management And General | $854,862 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $889,630 | TotalAmt |
| Program Services | $622,741 | ProgramServicesAmt |
| Management And General | $266,889 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,834 | TotalAmt |
| Management And General | $77,834 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,810 | TotalAmt |
| Management And General | $116,810 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $390,634 | TotalAmt |
| Program Services | $195,317 | ProgramServicesAmt |
| Management And General | $195,317 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $176,013 | TotalAmt |
| Program Services | $132,010 | ProgramServicesAmt |
| Management And General | $44,003 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,676 | TotalAmt |
| Program Services | $60,289 | ProgramServicesAmt |
| Management And General | $86,387 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,815 | TotalAmt |
| Management And General | $112,815 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,453 | TotalAmt |
| Program Services | $60 | ProgramServicesAmt |
| Management And General | $10,393 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $455,716 | $455,716 | |
| MEDICAL AND DENTAL CONTRACTS | $416,432 | $416,432 | |
| CONSULTING & PROFESSIONAL | $220,324 | $152,265 | $68,059 |
| TELEPHONE AND COMMUNICATIONS | $106,144 | $21,229 | $84,915 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $275,008 | TotalAmt |
| Program Services | $107,573 | ProgramServicesAmt |
| Management And General | $167,435 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,374,206 | TotalAmt |
| Program Services | $4,949,434 | ProgramServicesAmt |
| Management And General | $2,424,772 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,622,822 | BOYAmt |
| EOY | $1,741,329 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $240,019 | BOYAmt |
| EOY | $328,258 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,931 | BOYAmt |
| EOY | $60,185 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,115 | BOYAmt |
| EOY | $91,841 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,657,974 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $713,450 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $755,969 | BOYAmt |
| EOY | $944,524 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,166 | BOYAmt |
| EOY | $80,227 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,658,022 | BOYAmt |
| EOY | $3,246,364 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $332,594 | BOYAmt |
| EOY | $617,198 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,931 | BOYAmt |
| EOY | $139,182 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,620 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1 | BOYAmt |
| EOY | $1 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $354,146 | BOYAmt |
| EOY | $756,381 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,303,876 | BOYAmt |
| EOY | $2,489,983 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,303,876 | BOYAmt |
| EOY | $2,489,983 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,658,022 | BOYAmt |
| EOY | $3,246,364 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $186,107 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 | false | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,396,450 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,130,161 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $794,410 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,613,153 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,412,362 | CurrentTaxYearAmt |
| Total | $11,346,536 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,396,450 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,130,161 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $794,410 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,613,153 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,412,362 | CurrentTaxYearAmt |
| Total | $11,346,536 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $11,346,536 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $191,455 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $139,169 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $56,782 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $259,709 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $555,244 | CurrentTaxYearAmt |
| Total | $1,202,359 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $12,548,895 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $12,444,265 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.90420 | PublicSupportCY170Pct |
| Public Support PY170 | 0.90820 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 | $15,000 | OtherCostOrOtherBasisAmt |
| Book Value | $15,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $185,725 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,869 | DepreciationAmt |
| Book Value | $181,856 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $396,528 | OtherCostOrOtherBasisAmt |
| Depreciation | $124,769 | DepreciationAmt |
| Book Value | $271,759 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,288 | OtherCostOrOtherBasisAmt |
| Depreciation | $32,288 | DepreciationAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,028,433 | OtherCostOrOtherBasisAmt |
| Depreciation | $552,524 | DepreciationAmt |
| Book Value | $475,909 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $944,524 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Rounding | Desc |
| Amt | $1 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
| Rebuttable Presumption Proc | false | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt |
|---|---|---|---|---|---|
| DR BRENDA A ADDISON | |||||
| CEO | $154,420 | $12,895 | $12,354 | $179,669 | |
| DR JOY ABLORDEPPEY | |||||
| PHYSICIAN | $195,000 | $7,800 | $203,944 | $1,144 | |
| DR LUIS MURRAIN | |||||
| MEDICAL DIRECTOR | $198,123 | $7,925 | $251,053 | $45,005 | |
| DR MICHAEL SCHMIDT | |||||
| PHYSICIAN | $153,489 | $6,140 | $159,944 | $315 | |
| DR MURALI YELUGAPURI | |||||
| PEDIATRICIAN | $186,624 | $7,465 | $198,143 | $4,054 | |
Schedule M IRS990ScheduleM
Real Estate Commercial RealEstateCommercialGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $138,776 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b: Form 990 Review Process | REVIEWED BY CEO & CFO & PRESENTED TO BOARD OF DIRECTORS BEFORE FILING. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | EVERY 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 Employees | THE 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 Available | No documents available to the public. |