GOOD SAMARITAN HEALTH CENTER OF COBB INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SAMARITAN HEALTH CENTER OF COBB INC (EIN 32-0045238)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201613199349302861
- Schema version
- 2015v2.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-14T09:14:41-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 050545616 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | POST & ASSOCIATES LLC CPA'S | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3475 DALLAS HWY STE 125 | AddressLine1Txt |
| City | MARIETTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30064 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | 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 | 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 | CYRL KITCHENS | PersonNm |
| Person Title | CHAIRMAN | PersonTitleTxt |
| Phone | 7704193120 | PhoneNum |
| Signature | 2016-11-14 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DANIEL L POST JR CPA | PreparerPersonNm |
| PTIN | P00058078 | PTIN |
| Phone | 6782905100 | PhoneNum |
| Preparation | 2016-11-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CYRL KITCHENS | 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 | $12,340,665 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://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 | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 43 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,545,763 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,607,328 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $648,875 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $528,832 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,451 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,176 | CYInvestmentIncomeAmt |
| PY Other Revenue | $13,793,670 | PYOtherRevenueAmt |
| CY Other Revenue | $10,161,071 | CYOtherRevenueAmt |
| PY Total Revenue | $15,989,759 | PYTotalRevenueAmt |
| CY Total Revenue | $12,298,407 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,300,652 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,295,855 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $6,041 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $6,278 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $81,773 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $14,418,196 | PYOtherExpensesAmt |
| CY Other Expenses | $10,936,662 | CYOtherExpensesAmt |
| PY Total Expenses | $15,724,889 | PYTotalExpensesAmt |
| CY Total Expenses | $12,238,795 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $264,870 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $59,612 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,387,345 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,468,867 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $34,662 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $56,572 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,352,683 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,412,295 | 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 | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $11,158,078 | ExpenseAmt |
| Grant | $838,565 | GrantAmt |
| Revenue | $528,832 | RevenueAmt |
| Desc | THE ORGANIZATION IS A PRIMARY HEALTHCARE CENTER FOR LOW-INCOME UNISURED INDIVIDUALS THAT INCLUDES MEDICAL, DENTAL, DISPENSARY, AND COUNSELING SERVICES. IT PROVIDED CARE FOR 19,295 PATIENT VISITS IN 2015 WITH EXPENSES OF 12.28 MILLION WHICH INCLUDES DONATED SERVICES OF 6.44 MILLION AND DONATED MEDICATIONS OF 3.65 MILLION. | Desc |
| Total Program Service Expenses | $11,158,078 | 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 | Yes (true) | 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 | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | Yes (true) | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| 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 | false | 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 43 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | 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 | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (true) | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | 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 |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GAYLE NELSON | PersonNm |
| Phone | 7704193120 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1605 ROBERTA DRIVE | AddressLine1Txt |
| City | MARIETTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30008 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|
| DAVID BOTTOMS | |||||
| BOARD OF DIR | Yes (X) | $0 | $0 | $0 | |
| JOHN SHEERER R RH | |||||
| SPIRITUAL HE | Yes (X) | $0 | $0 | $0 | |
| CYRL KITCHENS | |||||
| CHAIRMAN | Yes (X) | $0 | $0 | $0 | |
| TOM DOWNS CPA | |||||
| TREASURER | Yes (X) | $0 | $0 | $0 | |
| REVEREND GRANT COLE | |||||
| BOARD OF DIR | Yes (X) | $0 | $0 | $0 | |
| ISRAEL BROWN | |||||
| BOARD OF DIR | Yes (X) | $0 | $0 | $0 | |
| LYNDA AUSBURN | |||||
| FUNDRAISING | Yes (X) | $0 | $0 | $0 | |
| HICKS POOR | |||||
| BOARD OF DIR | Yes (X) | $0 | $0 | $0 | |
| JEFF FARMER | |||||
| SPIRITUAL HE | Yes (X) | $0 | $0 | $0 | |
| CHAN WILKES | |||||
| BOARD OF DIR | Yes (X) | $0 | $0 | $0 | |
| J MIKE KINNEY DDS | |||||
| BOARD AFFAIR | Yes (X) | $0 | $0 | $0 | |
| SUSAN PEARSON | |||||
| BOARD OF DIR | Yes (X) | $0 | $0 | $0 | |
| TERRY POOR PHD | |||||
| BOARD OF DIR | Yes (X) | $0 | $0 | $0 | |
| BRENDA GASKINS | |||||
| BOARD OF DIR | Yes (X) | $0 | $0 | $0 | |
| GREG GRIGGS | |||||
| BOARD OF DIR | Yes (X) | $0 | $0 | $0 | |
| REVEREND HECTOR GUZMAN | |||||
| BOARD OF DIR | Yes (X) | $0 | $0 | $0 | |
| BARRY TEAGUE | |||||
| BOARD OF DIR | Yes (X) | $0 | $0 | $0 | |
| MEL KOONTZ | |||||
| BOARD OF DIR | Yes (X) | $0 | $0 | $0 | |
| DAVID K LOEFFEL | |||||
| BOARD OF DIR | Yes (X) | $0 | $0 | $0 | |
| ROBBIE ODOM | |||||
| BOARD OF DIR | Yes (X) | $0 | $0 | $0 | |
| STEVEN HANSARD DDM MHE | |||||
| DENTAL DIREC | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Federated Campaigns | $768,763 | FederatedCampaignsAmt |
| Government Grants | $838,565 | GovernmentGrantsAmt |
| Total Contributions | $1,607,328 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| MEDICAL PROGRAM REVENUES | $243,736 | $243,736 |
| DENTAL PROGRAM REVENUES | $172,316 | $172,316 |
| DISPENSARY REVENUES | $112,780 | $112,780 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $528,832 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,176 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,176 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $46,554 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $17,358 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,196 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $53,973 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $24,900 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,073 | TotalRevenueColumnAmt |
| Exclusion | $29,073 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| DONATED SERVICES | $6,448,130 | $6,448,130 |
| DONATED MEDICATIONS | $3,654,127 | $3,654,127 |
| OTHER | $545 | $545 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $10,102,802 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,298,407 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,632,810 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $29,073 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,149,861 | TotalAmt |
| Program Services | $486,524 | ProgramServicesAmt |
| Management And General | $600,301 | ManagementAndGeneralAmt |
| Fundraising | $63,036 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,256 | TotalAmt |
| Program Services | $16,534 | ProgramServicesAmt |
| Management And General | $46,759 | ManagementAndGeneralAmt |
| Fundraising | $2,963 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,738 | TotalAmt |
| Program Services | $28,934 | ProgramServicesAmt |
| Management And General | $46,080 | ManagementAndGeneralAmt |
| Fundraising | $4,724 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,500 | TotalAmt |
| Management And General | $7,500 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,278 | TotalAmt |
| Fundraising | $6,278 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,772 | TotalAmt |
| Fundraising | $4,772 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,447 | TotalAmt |
| Management And General | $8,447 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,106 | TotalAmt |
| Program Services | $59,066 | ProgramServicesAmt |
| Management And General | $24,040 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,233 | TotalAmt |
| Program Services | $42,057 | ProgramServicesAmt |
| Management And General | $35,176 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DONATED SERVICES | $6,448,130 | $6,448,130 | |
| DONATED MEDICATIONS | $3,654,127 | $3,654,127 | |
| OTHER EXPENSES | $122,882 | $122,882 | |
| DENTAL SUPPLIES | $100,265 | $100,265 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $430,200 | TotalAmt |
| Program Services | $322,441 | ProgramServicesAmt |
| Management And General | $107,759 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,238,795 | TotalAmt |
| Program Services | $11,158,078 | ProgramServicesAmt |
| Management And General | $998,944 | ManagementAndGeneralAmt |
| Fundraising | $81,773 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,333 | BOYAmt |
| EOY | $89,176 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $914,084 | BOYAmt |
| EOY | $687,146 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,478 | BOYAmt |
| EOY | $119,034 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,989 | BOYAmt |
| EOY | $4,577 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,569 | BOYAmt |
| EOY | $27,062 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,322,210 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $780,338 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,385,892 | BOYAmt |
| EOY | $1,541,872 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,387,345 | BOYAmt |
| EOY | $2,468,867 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,769 | BOYAmt |
| EOY | $26,646 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,893 | BOYAmt |
| EOY | $29,926 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,662 | BOYAmt |
| EOY | $56,572 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,352,683 | BOYAmt |
| EOY | $2,412,295 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,352,683 | BOYAmt |
| EOY | $2,412,295 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,387,345 | BOYAmt |
| EOY | $2,468,867 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $59,612 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
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 | $775,634 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $769,648 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,129,078 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,545,763 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,607,328 | CurrentTaxYearAmt |
| Total | $5,827,451 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $361,242 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,367,513 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,275,837 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,386,311 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,679,364 | CurrentTaxYearAmt |
| Total | $48,070,267 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,136,876 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,137,161 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,404,915 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,932,074 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,286,692 | CurrentTaxYearAmt |
| Total | $53,897,718 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $161,155 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $57,215 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $230,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $169,015 | CurrentTaxYearMinus1YearAmt |
| Total | $617,385 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $161,155 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $57,215 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $230,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $169,015 | CurrentTaxYearMinus1YearAmt |
| Total | $617,385 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $53,280,333 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,410 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,253 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $962 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,451 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,176 | CurrentTaxYearAmt |
| Total | $7,252 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,410 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,253 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $962 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,451 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,176 | CurrentTaxYearAmt |
| Total | $7,252 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $30,841 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $44,152 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $68,326 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $28,073 | CurrentTaxYearAmt |
| Total | $171,392 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,139,286 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,169,255 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,450,029 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,001,851 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,315,941 | CurrentTaxYearAmt |
| Total | $54,076,362 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98530 | PublicSupportCY509Pct |
| Public Support PY509 | 0.97840 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | 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 | $580,552 | OtherCostOrOtherBasisAmt |
| Book Value | $580,552 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,117,642 | OtherCostOrOtherBasisAmt |
| Depreciation | $236,019 | DepreciationAmt |
| Book Value | $881,623 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $585,639 | OtherCostOrOtherBasisAmt |
| Depreciation | $507,753 | DepreciationAmt |
| Book Value | $77,886 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,377 | OtherCostOrOtherBasisAmt |
| Depreciation | $36,566 | DepreciationAmt |
| Book Value | $1,811 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,541,872 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED PAYROLL | $13,830 |
| ACCRUED TIME-OFF | $11,703 |
| OTHER WITHHOLDINGS | $4,393 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $29,926 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $12,298,407 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $12,298,407 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $12,298,407 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,238,795 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $12,238,795 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $12,238,795 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | BANQUET | Event1Nm |
| Gross Receipts Event1 | $46,554 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $46,554 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $17,358 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $46,554 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $46,554 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $17,358 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $17,358 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $29,196 | NetIncomeSummaryAmt |
Gaming Information GamingInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteer Labor Bingo | false | VolunteerLaborBingoInd |
| Volunteer Labor Pull Tabs | false | VolunteerLaborPullTabsInd |
| Gross Revenue Other Gaming | $53,973 | GrossRevenueOtherGamingAmt |
| Oth Direct Expnss Other Gaming | $24,900 | OthDirectExpnssOtherGamingAmt |
| Volunteer Labor Other Gaming | false | VolunteerLaborOtherGamingInd |
| Gross Revenue Total Gaming | $53,973 | GrossRevenueTotalGamingAmt |
| Oth Direct Expnss Total Gaming | $24,900 | OthDirectExpnssTotalGamingAmt |
| Direct Expense Summary Gaming | $24,900 | DirectExpenseSummaryGamingAmt |
| Net Gaming Income Summary | $29,073 | NetGamingIncomeSummaryAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed | Yes (true) | LicensedInd |
| License Suspended Etc | false | LicenseSuspendedEtcInd |
| Gaming With Nonmembers | false | GamingWithNonmembersInd |
| Member Of Other Entity | false | MemberOfOtherEntityInd |
| Individual With Books | GAYLE NELSON | IndividualWithBooksNm |
Persons With Books US Address PersonsWithBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1605 ROBERTA DRIVE | AddressLine1Txt |
| City | MARIETTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30008 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct With3rd Prty For Game Rev | false | CntrctWith3rdPrtyForGameRevInd |
| Charitable Distribution Rqr | false | CharitableDistributionRqrInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 5, PART V, LINE 3B | NOT REQUIRED |
| FORM 990, PAGE 6, PART VI, LINE 9 | LARRY HORNSBY, M. D. 1605 ROBERTA DRIVE SW MARIETTA, GA 30008-3855 |
| FORM 990, PAGE 6, PART VI, LINE 11B | RETURN WILL BE REVIEWED PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, 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, PAGE 6, PART VI, LINE 15A | EXECUTIVE BOARD RESEARCHES AND PROVIDES INFORMATION TO MAKE A RECOMMENDATION TO THE FULL BOARD FOR THE SALARY AND BENEFITS OF THE CEO BASED ON A REVIEW OF COMPARABLE DATA. THE BOARD THEN DOCUMENTS HOW IT REACHED ITS DECISION. |
| FORM 990, PAGE 6, PART VI, LINE 15B | EXECUTIVE BOARD RESEARCHES AND PROVIDES INFORMATION TO MAKE A RECOMMENDATION TO THE FULL BOARD FOR THE SALARY AND BENEFITS HIGHLY COMPENATED EMPLOYEES AND CONSULTANTS BASED ON A REVIEW OF COMPARABLE DATA. THE BOARD THEN DOCUMENTS HOW IT REACHED ITS DECISION. |
| FORM 990, PAGE 6, PART VI, LINE 19 | WEBSITE |