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GEORGIA HIGHLANDS MEDICAL SERVICES INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
GEORGIA HIGHLANDS MEDICAL SERVICES INC (EIN 58-1338038)
Tax period
2010-06-01 to 2011-05-31
Filed
2011-10-17
IRS object ID
201112909349300321
Schema version
2010v3.2
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)
Timestamp2011-10-17T09:29:34-07:00Timestamp
Tax Period End Date2011-05-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1GRACE & ASSOCIATES PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line129 LENOX POINTE NEAddressLine1
CityATLANTACity
StateGAState
ZIP Code303243172ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-06-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN581338038EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Georgia Highlands Medical Services IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGEORNameControl
Phone7708871668Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1260 Elm Street P O Box 307AddressLine1
CityCummingCity
StateGAState
ZIP Code30028ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLinda P HowellName
TitleCFOTitle
Date Signed2011-10-17DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameJ N GraceName
Phone4043649000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts4934975GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.georgiahighlandsmedical.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1978YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionTo develop and administer a comprehensive primary health care system for citizens of Forsyth County, Georgia, surrounding communities and their citizens, regardless of the citizen's ability to pay for services.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees67TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year2535903ContributionsGrantsPriorYear
Contributions Grants Current Year2580362ContributionsGrantsCurrentYear
Program Service Revenue Prior Year2570446ProgramServiceRevenuePriorYear
Program Service Revenue CY2335465ProgramServiceRevenueCY
Investment Income Prior Year8590InvestmentIncomePriorYear
Investment Income Current Year4148InvestmentIncomeCurrentYear
Other Revenue Prior Year15000OtherRevenuePriorYear
Other Revenue Current Year15000OtherRevenueCurrentYear
Total Revenue Prior Year5129939TotalRevenuePriorYear
Total Revenue Current Year4934975TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3576460SalariesEtcPriorYear
Salaries Etc Current Year3417262SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1551750OtherExpensePriorYear
Other Expenses Current Year1495091OtherExpensesCurrentYear
Total Expenses Prior Year5128210TotalExpensesPriorYear
Total Expenses Current Year4912353TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1729RevenuesLessExpensesPriorYear
Revenues Less Expenses CY22622RevenuesLessExpensesCY
Total Assets BOY2739471TotalAssetsBOY
Total Assets EOY2652321TotalAssetsEOY
Total Liabilities BOY1386643TotalLiabilitiesBOY
Total Liabilities EOY1276871TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1352828NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1375450NetAssetsOrFundBalancesEOY
Mission DescriptionTo develop and administer a comprehensive primary health care system for citizens of Forsyth County, Georgia, surrounding communities and their citizens, regardless of the citizen's ability to pay for services.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense3797320Expense
Revenue2254393Revenue
DescriptionThe program provides health services to low income individuals. Patients are charged for medical services based on their income level. During the year 43,142 patient visits were provided.Description
Total Program Service Expense3797320TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
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 LiabilitiestrueReportOtherLiabilities
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 RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
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 ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10962NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees67NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
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
Policies Reference ChaptersfalsePoliciesReferenceChapters
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
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMrs Linda HowellNamePerson
Telephone Number7708871668TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1260 Elm StreetAddressLine1
CityCummingCity
StateGAState
ZIP Code30040ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekHighest Compensated EmployeeHighestCompensatedEmployeeReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerKey EmployeeKeyEmployee
Swapna Madhavan MD
Physiciain32.00X12356600
Scott Hansard
Director1.00000X
Safia Pirani MD
Physician40.00X15471000
Ruth Baumann
Secretary1.00000X
Pamela Kay Thompson
Director1.00000X
Nida Poole
Treasurer1.00000X
Marie Thompson
Pres. Elect1.00000X
Magdy Rezk MD
Physician0.00X16610500
Linda Howell
CFO40.0011641800X
Jesann Hendrix
President1.00000X
Gina Santos
Director1.00000X
Dr Scott Henderson
Director1.00000X
Dr Arif Patni DO
Medical Directo40.0020647200X
David Derrer MD
Physician40.00X17028900
Carlos Stapleton
CEO40.0012896000X
Burma Parks
Director1.00000X
Brinkley Goodson DO
Physician40.00X17370800
FieldValueIRS element (for citing)
Total Reportable Comp From Org1240228TotalReportableCompFromOrg
Number Individuals GT100 K8NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
State Health Benefit Plan
PO Box 931550AtlantaGA311931550Employee health ins.313706
Lincoln Financial Group
PO Box 2212Fort WayneIN46801Employee 403(b) plan154751
Laboratory Corporation of America
PO Box 12140BurlingtonNC272162140Laboratory services170933
Henry Schein
PO Box 382023PittsburghPA15250Medical Supplies114947
Carroll Daniel Construction
PO Box 1438GainsvilleGA30503Building Contractor317011
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Government Grants2292212GovernmentGrants
All Other Contributions288150AllOtherContributions
Noncash Contributions168150NoncashContributions
Total Contributions2580362TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Patient fees, net22543932254393
Other support and revenue8107281072
FieldValueIRS element (for citing)
Total Program Service Revenue2335465TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4148TotalRevenueColumn
Exclusion$4,148ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real15000Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real15000Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column15000TotalRevenueColumn
Related Or Exempt Function Income15000RelatedOrExemptFunctionIncome

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4934975TotalRevenueColumn
Related Or Exempt Function Income2350465RelatedOrExemptFunctionIncome
Exclusion$4,148ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total398088Total
Program Services159538ProgramServices
Management And General238550ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2414592Total
Program Services2172703ProgramServices
Management And General241889ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total604582Total
Program Services510217ProgramServices
Management And General94365ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total120373Total
Program Services116261ProgramServices
Management And General4112ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total15697Total
Program Services3355ProgramServices
Management And General12342ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total61241Total
Management And General61241ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total185478Total
Program Services161982ProgramServices
Management And General23496ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total22669Total
Management And General22669ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Supplies30625225217254080
Repairs and Maintenance99111495594156
Donated pharmaceuticals168652168652
Contractual370520224696145824
Communication58130485053280

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total86968Total
Program Services17939ProgramServices
Management And General69029ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4912353Total
Program Services3797320ProgramServices
Management And General1115033ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY16109BOY
EOY57783EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY223013BOY
EOY109039EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY622618BOY
EOY379116EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY27162BOY
EOY17520EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY475BOY
EOY8791EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis4026153LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1946081LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1850094BOY
EOY2080072EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2739471BOY
EOY2652321EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY301798BOY
EOY301426EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1083303BOY
EOY973911EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1542BOY
EOY1534EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1386643BOY
EOY1276871EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1352828BOY
EOY1375450EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1352828BOY
EOY1375450EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2739471BOY
EOY2652321EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses22622ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteefalseAuditCommittee
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 Years2022825CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1980778CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2158369CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2535369CurrentTaxYearMinus1Year
Current Tax Year2580362CurrentTaxYear
Total11277703Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2022825CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1980778CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2158369CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2535369CurrentTaxYearMinus1Year
Current Tax Year2580362CurrentTaxYear
Total11277703Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total0AmountsSubstContributorsTotal
Public Support Total17011277703PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years20774CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years35384CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years32717CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23590CurrentTaxYearMinus1Year
Current Tax Year19148CurrentTaxYear
Total131613Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years35181CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years79584CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years19257CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year49572CurrentTaxYearMinus1Year
Current Tax Year58649CurrentTaxYear
Total242243Total
FieldValueIRS element (for citing)
Total Support11651559TotalSupport
Gross Receipts From Admissions Etc9144132GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.96790PublicSupportPertcentage170
Public Support Pertcent Prior Year0.97150PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis200000OtherCostOrOtherBasis
Book Value200000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2894369OtherCostOrOtherBasis
Depreciation1297189Depreciation
Book Value1597180BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis78144OtherCostOrOtherBasis
Depreciation46774Depreciation
Book Value31370BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis853640OtherCostOrOtherBasis
Depreciation602118Depreciation
Book Value251522BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2080072TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionAccrued interestDescription
Amount$1,534Amount
FieldValueIRS element (for citing)
Total Of Amounts1534TotalOfAmounts
Total Revenue4934975TotalRevenue
Total Expenses4912353TotalExpenses
Excess Or Deficit For Year22622ExcessOrDeficitForYear
Excess Or Deficit Per FS22622ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt4934975TotRevenueEtcAuditedFinclStmt
Revenue Subtotal4934975RevenueSubtotal
Total Revenue Per Form9904934975TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt4912353TotExpensesEtcAuditedFinclStmt
Expenses Subtotal4912353ExpensesSubtotal
Total Expenses Per Form9904912353TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
Safia Pirani MD
154710154710
Magdy Rezk MD
166105166105159710
Dr Arif Patni DO
206472206472199702
David Derrer MD
170289170289135630
Brinkley Goodson DO
173708173708167028

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990168150NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThese documents are available on site and can be reviewed upon request.
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe organization utilizes a wage and salary scale for all employees. The scale is periodically revised and approved by the Board of Directors.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsThe conflict of interest policy is found in our organization ethics policy and the board member by-laws and is discussed in annual Board retreats each year. Members of the Board of Directors are prohibited from realizing any financial gain from their service as board members. No member of the Board shall be an employee of the Center, or spouse or child, parent, brother or sister by blood or marriage of such an employee. No members of the Board may have an employer-employee relationship. No members of the Board may be relatives such as spouse, brother, sister, son, daughter, cousin or in-laws.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessAfter the return is prepared by the outside CPA firm, and before being submitted to the Internal Revenue Service, it is reviewed by the CEO/CFO and forwarded to the Finance Committee and Board of Directors for review.
Client Note 1 - Georgia Highlands Medical Services, Inc. did not have any fundraising expenses during the year ended May 31, 2011.