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MACON VOLUNTEER CLINIC INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MACON VOLUNTEER CLINIC INC (EIN 74-3055376)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-15
IRS object ID
201143199349308159
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)
Timestamp2011-11-15T13:36:08-08:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1GARRETT WOOD HALL & ASSOC PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 13557AddressLine1
CityMACONCity
StateGAState
ZIP Code31208ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN743055376EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MACON VOLUNTEER CLINIC INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMACONameControl
Phone4787551110Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1376 ROGERS AVEAddressLine1
CityMACONCity
StateGAState
ZIP Code31204ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCILE LINDName
TitleEXECUTIVE DIRECTORTitle
Phone4787551110Phone
Date Signed2011-11-15DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameSTANLEY W HALLName
Phone4787419966Phone
Date Prepared2011-11-15DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCILE LINDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1376 ROGERS AVEAddressLine1
CityMACONCity
StateGAState
ZIP Code31204ZIPCode
FieldValueIRS element (for citing)
Gross Receipts355025GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteMACONVOLUNTEERCLINIC.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2002YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionProvide free medical care to individuals that do not qualify for public assistance and cannot afford to purchase health insurance.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees10TotalNbrEmployees
Total Nbr Volunteers100TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year311618ContributionsGrantsPriorYear
Contributions Grants Current Year352646ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year191InvestmentIncomePriorYear
Investment Income Current Year89InvestmentIncomeCurrentYear
Other Revenue Prior Year538OtherRevenuePriorYear
Other Revenue Current Year2290OtherRevenueCurrentYear
Total Revenue Prior Year312347TotalRevenuePriorYear
Total Revenue Current Year355025TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year207249SalariesEtcPriorYear
Salaries Etc Current Year222862SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year29281TotalFundrsngExpCurrentYear
Other Expense Prior Year92571OtherExpensePriorYear
Other Expenses Current Year115954OtherExpensesCurrentYear
Total Expenses Prior Year299820TotalExpensesPriorYear
Total Expenses Current Year338816TotalExpensesCurrentYear
Revenues Less Expenses Prior Year12527RevenuesLessExpensesPriorYear
Revenues Less Expenses CY16209RevenuesLessExpensesCY
Total Assets BOY503172TotalAssetsBOY
Total Assets EOY522269TotalAssetsEOY
Total Liabilities EOY2888TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY503172NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY519381NetAssetsOrFundBalancesEOY
Mission DescriptionProvide free medical careMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense239964Expense
DescriptionTHE ORGANIZATION PROVIDES FREE MEDICAL AND DENTAL CARE TO INDIVIDUALS WHO DO NOT QUALIFY FOR PUBLIC ASSISTANCE AND CANNOT AFFORD TO PURCHASE MEDICAL INSURANCE. LOCAL PHYSICIANS AND HEALTH CARE WORKERS VOLUNTEER TO PROVIDE SERVICES FREE OF CHARGE.Description
Total Program Service Expense239964TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
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 AssetstrueReportOtherAssets
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 With10961NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees10NumberOfEmployees
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 Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
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 BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCILE LINDNamePerson
Telephone Number4787551110TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1376 ROGERS AVENUEAddressLine1
CityMACONCity
StateGAState
ZIP Code31204ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
CHAPIN HENLEY MD
Chairman1.00X000
W JOHN O'SHAUGHNESSEYMD
Vice Chairman1.00X000
JOHN ANDERSON
Director1.00X000
EVELYN BICKLEYMD
Director1.00X000
ALLISON TURK
Director1.00X000
SANDRA HIGGISON
Director1.00X000
YVONNE HOLMES
Director1.00X000
ADAM HENLEY
Director1.00X000
JACK MENENDEZ MD
Director1.00X000
JOY HULGAN
Director1.00X000
JIMMY SMITH MD
Director1.00X000
VALERIE BISKEY
Ex. Director40.002450200XX
LYNN DENNY
Medical Director20.007550000XX
WESLEY ULRICH
Interim Ex Director20.002450200X
SARAH PAYTON
Director1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org124504TotalReportableCompFromOrg
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns79036FederatedCampaigns
All Other Contributions273610AllOtherContributions
Total Contributions352646TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column89TotalRevenueColumn
Exclusion$89ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMedical Records FeesDescription
Business Code900099BusinessCode
Total Revenue Column2290TotalRevenueColumn
Related Or Exempt Function Income2290RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue2290TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column355025TotalRevenueColumn
Related Or Exempt Function Income2290RelatedOrExemptFunctionIncome
Exclusion$89ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total124504Total
Program Services95102ProgramServices
Management And General29402ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total81808Total
Program Services42933ProgramServices
Management And General18875ManagementAndGeneral
Fundraising20000Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total16550Total
Program Services11585ProgramServices
Management And General2979ManagementAndGeneral
Fundraising1986Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5688Total
Program Services0ProgramServices
Management And General5688ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total1477Total
Program Services1241ProgramServices
Management And General162ManagementAndGeneral
Fundraising74Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total13402Total
Program Services786ProgramServices
Management And General7141ManagementAndGeneral
Fundraising5475Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2551Total
Program Services2142ProgramServices
Management And General281ManagementAndGeneral
Fundraising128Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total18478Total
Program Services15521ProgramServices
Management And General2033ManagementAndGeneral
Fundraising924Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total385Total
Program Services385ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total13886Total
Program Services11664ProgramServices
Management And General1528ManagementAndGeneral
Fundraising694Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total12398Total
Program Services10916ProgramServices
Management And General1482ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Medical Services347443474400
Medical Supplies129451294500

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total338816Total
Program Services239964ProgramServices
Management And General69571ManagementAndGeneral
Fundraising29281Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY290355BOY
EOY270456EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY119470BOY
EOY119590EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY400BOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis174968LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec134555LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY44181BOY
EOY40413EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY48766BOY
EOY91810EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY503172BOY
EOY522269EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
EOY2888EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY2888EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY422840BOY
EOY387110EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY80332BOY
EOY132271EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY503172BOY
EOY519381EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY503172BOY
EOY522269EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses16209ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
Public Support Total1700PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Pertcentage1700PublicSupportPertcentage170
Public Support Total5090PublicSupportTotal509
Public Support Percentage5090PublicSupportPercentage509
Investment Income Percentage0InvestmentIncomePercentage

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

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis22031OtherCostOrOtherBasis
Depreciation10404Depreciation
Book Value11627BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis145342OtherCostOrOtherBasis
Depreciation116556Depreciation
Book Value28786BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7595OtherCostOrOtherBasis
Depreciation7595Depreciation
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings40413TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
Central Georgia Community foundation48766
Medcen Foundation43044
FieldValueIRS element (for citing)
Total Book Value Other Assets91810TotalBookValueOtherAssets
Total Revenue355025TotalRevenue
Total Expenses338816TotalExpenses
Excess Or Deficit For Year16209ExcessOrDeficitForYear
Excess Or Deficit Per FS16209ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt702943TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities347918DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F990347918RevenueNotRptdF990
Revenue Subtotal355025RevenueSubtotal
Total Revenue Per Form990355025TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt686735TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities347919DonatedServicesUseOfFacilities
Expenses Not Rptd F990347919ExpensesNotRptdF990
Expenses Subtotal338816ExpensesSubtotal
Total Expenses Per Form990338816TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifierExplanationExplanation
Pt VI-B, Line 11aA copy of form 990 is provided to all board members by
Pt VI-B, Line 11aeletronic media or at the monthly board meeting.
Pt VI-B, Line 12cBoard members are required to complete annual questionnaires
Pt VI-B, Line 12cto determine if conflicts exist.
Pt VI-B, Line 15The board of directors reviews and approves compensation of
Pt VI-B, Line 15key employees annually and documents in the minutes of meetings.
Pt VI-C, Line 19All governing and financial documents are made available
Pt VI-C, Line 19to the public upon request at their office.
Pt VI-A, Line 2One director was the lineal descendant of the another director.
Form 990EZ, Part I, Line 8MISCELLANEOUS
Form 990EZ, Part I, Line 16INSURANCE SUPPLIES TELEPHONE CONFERENCES & MEETINGS MISCELLANEOUS
Form 990EZ, Part II, Line 24BUILDING IMPROVEMENTS OFFICE EQUIPMENT MEDICAL EQUIPMENT FURNITURE & FIXTURES COMMUNITY FOUNDATION
Form 990EZ, Part II, Line 26ACCOUNTS PAYABLE