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FIRST CHOICE PRIMARY CARE INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
FIRST CHOICE PRIMARY CARE INC (EIN 20-4391090)
Tax period
2010-05-01 to 2011-04-30
Filed
2011-11-10
IRS object ID
201133149349302753
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)
Timestamp2011-11-10T12:18:03-08:00Timestamp
Tax Period End Date2011-04-30TaxPeriodEndDate

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 Date2010-05-01TaxPeriodBeginDate

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 Signed2011-08-16DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameTERRY HORNEName
Phone6154447293Phone
Date Prepared2011-11-10DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

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 Receipts2008311GrossReceipts
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 Employees30TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year913344ContributionsGrantsPriorYear
Contributions Grants Current Year1425001ContributionsGrantsCurrentYear
Program Service Revenue Prior Year513778ProgramServiceRevenuePriorYear
Program Service Revenue CY583261ProgramServiceRevenueCY
Investment Income Prior Year-177InvestmentIncomePriorYear
Investment Income Current Year49InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year1426945TotalRevenuePriorYear
Total Revenue Current Year2008311TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year844703SalariesEtcPriorYear
Salaries Etc Current Year1165963SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year437531OtherExpensePriorYear
Other Expenses Current Year701945OtherExpensesCurrentYear
Total Expenses Prior Year1282234TotalExpensesPriorYear
Total Expenses Current Year1867908TotalExpensesCurrentYear
Revenues Less Expenses Prior Year144711RevenuesLessExpensesPriorYear
Revenues Less Expenses CY140403RevenuesLessExpensesCY
Total Assets BOY735978TotalAssetsBOY
Total Assets EOY897749TotalAssetsEOY
Total Liabilities BOY175508TotalLiabilitiesBOY
Total Liabilities EOY196876TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY560470NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY700873NetAssetsOrFundBalancesEOY
Mission DescriptionTHE ORGANIZATION PROVIDES HEALTH CAREMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense1149480Expense
Revenue583261Revenue
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 11,700 VISITS WERE PROVIDED DURING THE YEAR.Description
Total Program Service Expense1149480TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
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 With10965NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees30NumberOfEmployees
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 PersonPAUL GROGANNamePerson
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
VALERIE BISKEY
BOARD MEMBER1.00X000
CHARISE STEPHENS
BOARD MEMBER1.00X000
HELEN S WILLOUGHBY
BOARD MEMBER1.00X000
KATHERINE MCLEOD
CHIEF EXECUTIVE OFFICER40.008000004770X
TIM GRAVES
MEDICAL DIRECTOR40.0010828004770X
PAUL GROGAN
CHIEF FINANCIAL OFFICER40.007000004770X
FieldValueIRS element (for citing)
Total Reportable Comp From Org258280TotalReportableCompFromOrg
Total Other Compensation14310TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CHRIS R SHERIDAN & COBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 4441AddressLine1
CityMACONCity
StateGAState
ZIP Code31208ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesRENOVATIONSDescriptionOfServices
Compensation193621Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Government Grants997222GovernmentGrants
All Other Contributions427779AllOtherContributions
Total Contributions1425001TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT FEESDescription
Business Code621110BusinessCode
Total Revenue Column583261TotalRevenueColumn
FieldValueIRS element (for citing)
Total Program Service Revenue583261TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column49TotalRevenueColumn
Exclusion$49ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2008311TotalRevenueColumn
Related Or Exempt Function Income583261RelatedOrExemptFunctionIncome
Exclusion$49ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total258280Total
Program Services108280ProgramServices
Management And General150000ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total734271Total
Program Services470908ProgramServices
Management And General263363ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total119797Total
Program Services69482ProgramServices
Management And General50315ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total53615Total
Program Services31097ProgramServices
Management And General22518ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total13500Total
Program Services0ProgramServices
Management And General13500ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total203702Total
Program Services127932ProgramServices
Management And General75770ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total240391Total
Program Services144423ProgramServices
Management And General95968ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total169428Total
Program Services152485ProgramServices
Management And General16943ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total19322Total
Program Services17324ProgramServices
Management And General1998ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total35743Total
Program Services15708ProgramServices
Management And General20035ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total19859Total
Program Services11841ProgramServices
Management And General8018ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1867908Total
Program Services1149480ProgramServices
Management And General718428ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY255844BOY
EOY147756EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY45332BOY
EOY62608EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY23835BOY
EOY9889EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis763337LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec85841LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY410967BOY
EOY677496EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY735978BOY
EOY897749EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY113352BOY
EOY107666EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY62156BOY
EOY89210EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY175508BOY
EOY196876EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY560470BOY
EOY700873EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY560470BOY
EOY700873EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY735978BOY
EOY897749EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses140403ReconcilationRevenueExpenses
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 Minus3 Years763259CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years915087CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year913344CurrentTaxYearMinus1Year
Current Tax Year1425001CurrentTaxYear
Total4016691Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years763259CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years915087CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year913344CurrentTaxYearMinus1Year
Current Tax Year1425001CurrentTaxYear
Total4016691Total
FieldValueIRS element (for citing)
Public Support Total1704016691PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years9CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years20CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year153CurrentTaxYearMinus1Year
Current Tax Year49CurrentTaxYear
Total231Total
FieldValueIRS element (for citing)
Total Support4016922TotalSupport
Gross Receipts From Admissions Etc1322549GrossReceiptsFromAdmissionsEtc
First5 Years170XFirst5Years170
Public Support Pertcentage1700PublicSupportPertcentage170
Public Support Total5090PublicSupportTotal509
Public Support Percentage5090PublicSupportPercentage509
Investment Income Percentage0InvestmentIncomePercentage

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis552301InvestmentCostOrOtherBasis
Depreciation23236Depreciation
Book Value529065BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis211036InvestmentCostOrOtherBasis
Depreciation62605Depreciation
Book Value148431BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings677496TotalOfBookValueLandBuildings
Total Revenue2008311TotalRevenue
Total Expenses1867908TotalExpenses
Excess Or Deficit For Year140403ExcessOrDeficitForYear
Excess Or Deficit Per FS140403ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt2008311TotRevenueEtcAuditedFinclStmt
Revenue Subtotal2008311RevenueSubtotal
Total Revenue Per Form9902008311TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt1867908TotExpensesEtcAuditedFinclStmt
Expenses Subtotal1867908ExpensesSubtotal
Total Expenses Per Form9901867908TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierExplanationExplanation
Pt VI-C, Line 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST
POLICY AND FORM 990 AVAILABLE UPON WRITTEN REQUEST.
Pt VI-B, Line 11aTHE FORM 990 WILL BE GIVEN TO THE BOARD OF DIRECTORS FOR
REVIEW AT A REGULARLY SCHEDULED MEETING PRIOR TO FILING.
Pt VI-B, 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-B, 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.