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FIRST CHOICE PRIMARY CARE INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
FIRST CHOICE PRIMARY CARE INC (EIN 20-4391090)
Tax period
2011-05-01 to 2012-04-30
Filed
2012-09-17
IRS object ID
201242619349300304
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-09-17T07:29:25-07:00Timestamp
Tax Period End Date2012-04-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1TERRY HORNE CPA & ASSOCIATESBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1732 WEST MAIN STREETAddressLine1
CityLEBANONCity
StateTNState
ZIP Code37087ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-05-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN204391090EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1FIRST CHOICE PRIMARY CARE INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFIRSNameControl
Phone4787874266Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 6497AddressLine1
CityMACONCity
StateGAState
ZIP Code31208ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKATHERINE MCLEODName
TitleCHIEF EXECUTIVE OFFICERTitle
Phone4787874266Phone
Date Signed2012-08-27DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTERRY HORNEName
Phone6154447293Phone
Date Prepared2012-09-17DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKATHERINE MCLEODNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 4363AddressLine1
CityMACONCity
StateGAState
ZIP Code31208ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1641578GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2005YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionTHE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees41TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year1425001ContributionsGrantsPriorYear
Contributions Grants Current Year849461ContributionsGrantsCurrentYear
Program Service Revenue Prior Year583261ProgramServiceRevenuePriorYear
Program Service Revenue CY791641ProgramServiceRevenueCY
Investment Income Prior Year49InvestmentIncomePriorYear
Investment Income Current Year476InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year2008311TotalRevenuePriorYear
Total Revenue Current Year1641578TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1165963SalariesEtcPriorYear
Salaries Etc Current Year1044054SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year701945OtherExpensePriorYear
Other Expenses Current Year544856OtherExpensesCurrentYear
Total Expenses Prior Year1867908TotalExpensesPriorYear
Total Expenses Current Year1588910TotalExpensesCurrentYear
Revenues Less Expenses Prior Year140403RevenuesLessExpensesPriorYear
Revenues Less Expenses CY52668RevenuesLessExpensesCY
Total Assets BOY897749TotalAssetsBOY
Total Assets EOY1016718TotalAssetsEOY
Total Liabilities BOY196876TotalLiabilitiesBOY
Total Liabilities EOY263177TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY700873NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY753541NetAssetsOrFundBalancesEOY
Mission DescriptionTHE ORGANIZATION PROVIDES HEALTH CAREMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense1021738Expense
Revenue791641Revenue
DescriptionTHE ORGANIZATION PROVIDES HEALTH CARE REGARDLESS OF THE INDIVIDUALS ABILITY TO PAY. THESE MEDICAL SERVICES ARE PROVIDED IN AREAS THAT HAVE A SHORTAGE OF HEALTH CARE PROVIDERS. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. OVER 12,200 VISITS WERE PROVIDED DURING THE YEAR.Description
Total Program Service Expense1021738TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10962NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees41NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKATHERINE MCLEODNamePerson
Telephone Number4787874266TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1770 WALNUT STREETAddressLine1
CityMACONCity
StateGAState
ZIP Code312017307ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
CAMILLE HOPE
PRESIDENT1.00X000
MARC WHITFIELD
VICE PRESIDENT1.00X000
THOMAS DUVAL
TREASURER1.00X000
DAVID PARISH
SECRETARY1.00X000
JONATHAN ALDERMAN
BOARD MEMBER1.00X000
MABLE P WHEELER
BOARD MEMBER1.00X000
LINDA HOLLAND
BOARD MEMBER1.00X000
STEVE CORKERY
BOARD MEMBER1.00X000
MARVIN RIGGINS
BOARD MEMBER1.00X000
HELEN S WILLOUGHBY
BOARD MEMBER1.00X000
KATHERINE MCLEOD
CHIEF EXECUTIVE OFFICER40.007111004802X
TIM GRAVES
MEDICAL DIRECTOR40.0010834104802X
PAUL GROGAN
CHIEF FINANCIAL OFFICER40.007034004802X
FieldValueIRS element (for citing)
Total Reportable Comp From Org249791TotalReportableCompFromOrg
Total Other Compensation14406TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Government Grants761255GovernmentGrants
All Other Contributions88206AllOtherContributions
Total Contributions849461TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT FEESDescription
Business Code621110BusinessCode
Total Revenue Column791641TotalRevenueColumn
FieldValueIRS element (for citing)
Total Program Service Revenue791641TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column476TotalRevenueColumn
Exclusion$476ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1641578TotalRevenueColumn
Related Or Exempt Function Income791641RelatedOrExemptFunctionIncome
Exclusion$476ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total249791Total
Program Services108341ProgramServices
Management And General141450ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total640878Total
Program Services498094ProgramServices
Management And General142784ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total91782Total
Program Services62547ProgramServices
Management And General29235ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total61603Total
Program Services41890ProgramServices
Management And General19713ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total14275Total
Program Services0ProgramServices
Management And General14275ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total164936Total
Program Services95477ProgramServices
Management And General69459ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total193987Total
Program Services103602ProgramServices
Management And General90385ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total93364Total
Program Services84028ProgramServices
Management And General9336ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total14139Total
Program Services13154ProgramServices
Management And General985ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total44788Total
Program Services6738ProgramServices
Management And General38050ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total19367Total
Program Services7867ProgramServices
Management And General11500ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1588910Total
Program Services1021738ProgramServices
Management And General567172ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY44180BOY
EOY69499EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY103576BOY
EOY223900EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY62608BOY
EOY66660EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY9889BOY
EOY11039EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis776227LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec130607LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY677496BOY
EOY645620EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY897749BOY
EOY1016718EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY107666BOY
EOY115980EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY89210BOY
EOY147197EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY196876BOY
EOY263177EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY700873BOY
EOY753541EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY700873BOY
EOY753541EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY897749BOY
EOY1016718EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses52668ReconcilationRevenueExpenses
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years763259CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years915087CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years913344CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1425001CurrentTaxYearMinus1Year
Current Tax Year849461CurrentTaxYear
Total4866152Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years763259CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years915087CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years913344CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1425001CurrentTaxYearMinus1Year
Current Tax Year849461CurrentTaxYear
Total4866152Total
FieldValueIRS element (for citing)
Public Support Total1704866152PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years20CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years153CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year49CurrentTaxYearMinus1Year
Current Tax Year476CurrentTaxYear
Total707Total
FieldValueIRS element (for citing)
Total Support4866859TotalSupport
Gross Receipts From Admissions Etc2114190GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.99990PublicSupportPertcentage170
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
Public Support Total5090PublicSupportTotal509
Public Support Percentage5090PublicSupportPercentage509
Investment Income Percentage0InvestmentIncomePercentage

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis560825InvestmentCostOrOtherBasis
Depreciation37043Depreciation
Book Value523782BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis215402InvestmentCostOrOtherBasis
Depreciation93564Depreciation
Book Value121838BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings645620TotalOfBookValueLandBuildings
Total Revenue1641578TotalRevenue
Total Expenses1588910TotalExpenses
Excess Or Deficit For Year52668ExcessOrDeficitForYear
Excess Or Deficit Per FS52668ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt1641578TotRevenueEtcAuditedFinclStmt
Revenue Subtotal1641578RevenueSubtotal
Total Revenue Per Form9901641578TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt1588910TotExpensesEtcAuditedFinclStmt
Expenses Subtotal1588910ExpensesSubtotal
Total Expenses Per Form9901588910TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierExplanationExplanation
Pt VI, Line 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST
POLICY AND FORM 990 AVAILABLE UPON WRITTEN REQUEST.
Pt VI, Line 11aTHE FORM 990 WILL BE GIVEN TO THE BOARD OF DIRECTORS FOR
REVIEW AT A REGULARLY SCHEDULED MEETING PRIOR TO FILING.
Pt VI, Line 12cWHEN OR IF A TRANSACTION OF MATERIAL NATURE WITH A POTENTIAL CONFLICT
OF INTEREST SHOULD ARRISE, THE TRANSACTION WOULD BE PRESENTED
TO THE FULL BOARD FOR DISCUSSION AND THE BOARD WOULD VOTE (BY ELECTRONIC BALLOT).
Pt VI, Line 15STATE AND NATIONAL SALARY COMPARISONS ARE USED TO ESTABLISH SALARY LIMITS
FOR TOP MANAGEMENT OFFICIALS. PERFORMANCE EVALUATION ARE PERFORMED ANNUALLY
AND SALARY INCREASES ARE BOARD APPROVED.
Pt XII, Line 2cTHE CEO, CFO AND FINANCE COMMITTEE OVERSEE FINANCIAL STATEMENT PREPARATION
AND AUDIT ENGAGEMENT.