Good Samaritan Health Center Inc in Atlanta, Georgia (GA)

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Good Samaritan Health Center Inc
Employer Identification Number (EIN)582373395
Name of OrganizationGood Samaritan Health Center Inc
In Care of NameWilliam C Warren Iii
Address1015 Donald Lee Hollowell Pkwy Nw, Atlanta, GA 30318-6653
ActivitiesDescribed in section 170(b)1)(a)(vi) of the Code, Health clinic
SubsectionCharitable Organization
Ruling Date03/1998
DeductibilityContributions are deductible
FoundationOrganization which receives a substantial part of its support from a governmental unit or the general public
OrganizationCorporation
Exempt Organization StatusUnconditional Exemption
Tax Period12/2013
Assets$10,000,000 to $49,999,999
Income$1,000,000 to $4,999,999
Filing Requirement990 (all other) or 990EZ return
Asset Amount$12,719,338
Amount of Income$4,717,150
Form 990 Revenue Amount$3,090,294
National Taxonomy of Exempt Entities (NTEE)Health - General and Rehabilitative: Ambulatory Health Center, Community Clinic


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Amount of income in 2013: $4,717,150
This organization: 

 $4,717,150
Other organizations performing similar types of work: 

 $11,586,981

Assets in 2013: $12,719,338
Good Samaritan Health Center Inc: 

 $12,719,338
Other organizations performing similar types of work: 

 $7,879,718

Expenses in 2012: $3,148,132
This organization: 

 $3,148,132
Other organizations performing similar types of work: 

 $11,640,907

Income to expenses ratio in 2012: 1.5
This organization: 

 1.5
Other organizations performing similar types of work: 

 1.0

Expenses allocated to program services in 2007: 76.4%
Good Samaritan Health Center Inc: 

 76.4%
Other organizations performing similar types of work: 

 83.9%

Number of employees in 2012: 51
This organization: 

 51
Other organizations performing similar types of work: 

 160

Employees paid over $100,000 in 2012: 3.9%
Good Samaritan Health Center Inc: 

 3.9%
Other organizations performing similar types of work: 

 0.0%

Grants share in income in 2012: 65.4%
This organization: 

 65.4%
Other organizations performing similar types of work: 

 29.2%

Financial snapshot ($)

Revenue for 2012

Functional expenses for 2012

Support schedule

Statements Regarding Other IRS Filings and Tax Compliance (for 2012)
Did the organization have unrelated business gross income of $1,000 or more during the year?No
Initiation fees and capital contributions$0
Gross receipts for public use of club facilities $0
Gross income from members or shareholders$0
Gross income from other sources$0
Statement of Revenue (for 2012)
Total revenue$3,336,135
Contributions, Gifts, Grants and Other Similar Amounts$2,180,897
Program Service Revenue$869,800
Other Revenue
Investment income (including dividends, interest, and other similar amounts)$143,346
Income from investment of tax-exempt bond proceeds$0
Royalties$0
Net rental income$7,350
Gross rents (Real / Personal)$7,350 / $0
Less: rental expenses (Real / Personal)$0 / $0
Rental income or (loss) (Real / Personal)$7,350 / $0
Net gain from sales of assets other than inventory$62,523
Gross amount from sales of assets other than inventory (Securities / Other)$79,552 / $0
Less: cost or other basis and sales expenses (Securities / Other)$0 / $17,029
Gain or (loss) (Securities / Other)$79,552 / $-17,029
Net income from fundraising events$72,219
Gross income from fundraising events$116,848
Less: direct expenses$44,629
Net income from gaming activities$0
Net income from sales of inventory$0
Miscellaneous Revenue$0
Statement of Functional Expenses (for 2012)
Total functional expenses$3,148,132
Compensation of current officers, directors, trustees, and key employees$0
Other salaries and wages$1,634,137
Payroll taxes$136,040
Professional fundraising services$0
Other$1,377,955
Balance Sheet (for 2012)
Total assets$12,864,612
Total liabilities$147,543
Tax-exempt bond liabilities$0
Secured mortgages and notes payable to unrelated third parties$0
Unsecured notes and loans payable to unrelated third parties$0
Other$147,543
Total net assets or fund balances$12,717,069
Retained earnings, endowment, accumulated income, or other funds$0
Reason for Public Charity Status (for 2012)
The organization is not a private foundation because it is:An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi)
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (for 2012)
2008 - 2012 Total
Total Support$14,251,093
Gifts, grants, contributions, and membership fees received$13,894,829
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf$0
The value of services or facilities furnished by a governmental unit to the organization without charge$0
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources$356,264
Gross receipts from related activities, etc.$0
Revenue, Expenses, and Changes in Net Assets or Fund Balances
20002001200220032004200520062007
Total revenue$1,314,712$3,764,377$1,252,962$1,453,066$1,553,212$2,192,399$2,195,175$6,036,269
Contributions, gifts, grants, and similar amounts received$1,149,929$3,443,941$954,889$1,101,305$1,114,006$1,642,484$1,548,921$5,231,532
Contributions to donor advised funds$0$0
Direct public support$1,149,929$3,443,941$954,889$1,101,305$1,114,006$1,642,484$1,548,921$5,231,532
Indirect public support$0$0$0$0$0$0$0$0
Government contributions (grants)$0$0$0$0$0$0$0$0
Program service revenue including government fees and contracts$119,925$260,888$258,646$310,784$346,722$480,916$545,002$639,441
Membership dues and assessments$0$0$0$0$0$0$0$0
Interest on savings and temporary cash investments$50,102$60,820$41,388$37,300$29,093$57,839$96,462$114,923
Dividends and interest from securities$0$0$39$0$0$0$0$0
Net rental income or (loss)$0$0$0$0$0$0$0$0
Gross rents$0$0$0$0$0$0$0$0
Less: rental expenses$0$0$0$0$0$0$0$0
Other investment income$0$0$0$0$0$0$0$0
Gain or (loss) from sales of assets other than inventory$-5,244$-1,792$-2,360$-2,108$-3,184$-1,295$-1,210$-995
Gross amount from sales of assets other than inventory$381,911$326,413$176,401$169,222$223,451$136,412$81,955$257,445
Less: cost or other basis and sales expenses$387,155$328,205$178,761$171,330$226,635$137,707$83,165$258,440
Net income or (loss) from special events and activities$0$0$0$0$0$0$0$51,368
Gross revenue$0$0$0$0$0$0$0$244,007
Less: direct expenses other than fundraising expenses$0$0$0$0$0$0$0$192,639
Gross profit or (loss) from sales of inventory$0$0$0$0$0$0$0$0
Gross sales of inventory, less returns and allowances$0$0$0$0$0$0$0$0
Less: cost of goods sold$0$0$0$0$0$0$0$0
Other revenue$0$520$360$5,785$66,575$12,455$6,000$0
Total expenses$876,997$1,279,791$1,504,998$1,738,459$1,970,410$1,958,211$2,244,607$2,453,426
Program services$710,268$1,058,968$1,257,452$1,427,894$1,608,625$1,526,501$1,778,014$1,875,266
Management and general$141,449$206,218$228,457$286,020$282,725$354,983$340,705$469,121
Fundraising$25,280$14,605$19,089$24,545$79,060$76,727$125,888$109,039
Payments to affiliates$0$0$0$0$0$0$0$0
Net assets or fund balances at end of year$2,843,940$5,320,482$5,071,749$4,742,397$4,276,745$4,453,646$4,371,105$8,003,976
Excess or (deficit) for the year$437,715$2,484,586$-252,036$-285,393$-417,198$234,188$-49,432$3,582,843
Net assets or fund balances at beginning of year$2,410,651$2,843,940$5,320,482$5,071,749$4,742,397$4,276,745$4,453,646$4,371,105
Other changes in net assets or fund balances$-4,426$-8,044$3,303$-43,959$-48,454$-57,287$-33,109$50,028
Statement of Functional Expenses (for 2007)
TotalProgram servicesManagement and generalFundraising
Total functional expenses$2,453,426$1,875,266$469,121$109,039
Grants paid from donor advised funds$0
Other grants and allocations$0
Specific assistance to individuals$0
Benefits paid to or for members$0
Compensation of current officers, directors, key employees, etc.$75,600$0$75,600$0
Compensation of former officers, directors, key employees, etc.$0$0$0$0
Compensation and other distributions, not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)$0$0$0$0
Salaries and wages of employees not included above$1,342,590$1,148,734$137,128$56,728
Pension plan contributions not included above$23,457$19,000$3,519$938
Employee benefits not included above$134,280$108,767$20,142$5,371
Payroll taxes$99,946$80,956$14,992$3,998
Professional fundraising fees$0$0$0$0
Accounting fees$19,000$0$15,200$3,800
Legal fees$0$0$0$0
Supplies$101,495$101,495$0$0
Telephone$0$0$0$0
Postage and shipping$0$0$0$0
Occupancy$68,878$14,847$54,031$0
Equipment rental and maintenance$0$0$0$0
Printing and publications$0$0$0$0
Travel$0$0$0$0
Conferences, conventions, and meetings$0$0$0$0
Interest$58,621$58,621$0$0
Depreciation, depletion, etc.$65,562$41,744$23,818$0
Other expenses not covered above$463,997$301,102$124,691$38,204
Balance Sheets
20002001200220032004200520062007
Total assets$2,854,569$5,330,558$5,136,264$4,771,366$4,309,160$4,507,723$4,431,837$8,074,096
Cash - non-interest-bearing$1,473,699$2,474,850$3,225,772$3,267,899$275,868$596,041$2,390,000$2,976,532
Savings and temporary cash investments$4,846$65,211$0$0$2,564,230$2,314,129$28,365$37,037
Accounts receivable less allowance for doubtful accounts$26,207$43,365$912$5,389$0$5,059$1,251$0
Pledges receivable less allowance for doubtful accounts$178,454$1,089,089$319,146$32,000$80,000$101,667$183,335$1,408,436
Grants receivable$0$0$0$0$0$0$0$0
Receivables from current and former officers, directors, trustees, and key employees$0$0$0$0$0$0$0$0
Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)$0$0
Other notes and loans receivable less allowance for doubtful accounts$0$0$0$0$0$0$0$0
Inventories for sale or use$0$0$0$0$0$0$16,235$0
Prepaid expenses and deferred charges$2,088$3,704$8,259$8,855$22,409$0$0$0
Investments - publicly-traded securities$0$0
Investments - other securities$0$5,430$0$0$16,204$20,009$0$0
Investments - land, buildings, and equipment less accumulated depreciation$0$0$0$0$0$0$0$0
Investments - other$0$0$0$0$0$0$400,000$300,000
Land, buildings, and equipment less accumulated depreciation$1,156,473$1,647,960$1,581,226$1,456,274$1,345,205$1,469,668$1,411,491$3,351,591
Other assets, including program-related investments$12,802$949$949$949$5,244$1,150$1,160$500
Total liabilities$10,629$10,076$64,515$28,969$32,415$54,077$60,732$70,120
Accounts payable and accrued expenses$9,981$7,893$64,515$28,969$32,415$54,077$55,232$70,120
Grants payable$648$0$0$0$0$0$0$0
Deferred revenue$0$0$0$0$0$0$5,500$0
Loans from officers, directors, trustees, and key employees$0$0$0$0$0$0$0$0
Tax-exempt bond liabilities$0$0$0$0$0$0$0$0
Mortgages and other notes payable$0$0$0$0$0$0$0$0
Other liabilities$0$2,183$0$0$0$0$0$0
Total liabilities and net assets/fund balances$2,854,569$5,330,558$5,136,264$4,771,366$4,309,160$4,507,723$4,431,837$8,074,096
Total net assets or fund balances$2,843,940$5,320,482$5,071,749$4,742,397$4,276,745$4,453,646$4,371,105$8,003,976
Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
20002001200220032004200520062007
Total revenue$1,314,712$3,764,377$1,252,962$1,453,066$1,553,212$2,192,399$2,195,175$6,036,269
Total revenue, gains, and other support per audited financial statements$1,661,812$3,990,177$1,629,352$1,736,791$1,971,296$2,545,445$2,623,795$6,857,650
Other expenses$347,100$225,800$374,070$281,617$414,900$351,751$427,410$820,386
Net unrealized gains on investments$0$0$0$0$1,741$7,304$1,579$7,406
Donated services and use of facilities$347,100$225,800$374,070$281,617$413,159$344,447$425,831$568,973
Recoveries of prior year grants$0$0$0$0$0$0$0$0
Other$0$0$0$0$0$0$0$244,007
Other revenue$0$0$-2,320$-2,108$-3,184$-1,295$-1,210$-995
Investment expenses$0$0$0$0$0$0$0$0
Other$0$0$-2,320$-2,108$-3,184$-1,295$-1,210$-995
Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
20002001200220032004200520062007
Total expenses$876,997$1,279,791$1,504,998$1,738,459$1,970,410$1,958,211$2,244,607$2,453,426
Total expenses and losses per audited financial statements$1,228,525$1,513,635$1,878,085$2,066,143$2,436,949$2,368,543$2,705,126$3,223,784
Other revenue$351,783$233,844$373,087$327,684$466,539$410,332$460,519$770,358
Donated services and use of facilities$347,100$225,800$374,070$281,617$413,159$343,265$420,331$568,973
Prior year adjustments$0$0$0$0$0$0$0$0
Losses$0$0$0$0$0$0$0$0
Other$4,683$8,044$-983$46,067$53,380$67,067$40,188$201,385
Other expenses$255$0$0$0$0$0$0$0
Investment expenses$0$0$0$0$0$0$0$0
Other$255$0$0$0$0$0$0$0
Current Officers, Directors, Trustees, and Key Employees
Average hours per week devoted to positionCompensationContributions to employee benefit plans & deferred compensation plansExpense account and other allowances
40$75,600$1,512$0
Total number of officers, directors, and trustees permitted to vote on organization business at board meetings15
Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, related to each other through family or business relationships?No
Do any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, receive compensation from any other organizations, whether tax exempt or taxable, that are related to the organization?No
Does the organization have a written conflict of interest policy?Yes
Other Information
Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return, and has it filed a tax return on Form 990-T for this year?No
Was there a liquidation, dissolution, termination, or substantial contraction during the year?No
Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization?No
Direct and indirect political expenditures$0
Did the organization file Form 1120-POL for this year?No
Were substantially all dues nondeductible by members?
Did the organization make only in-house lobbying expenditures of $2,000 or less?
Dues, assessments, and similar amounts from members$0
Section 162(e) lobbying and political expenditures$0
Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices$0
Taxable amount of lobbying and political expenditures$0
Does the organization elect to pay the section 6033(e) tax on the amount above?
If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount above to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year?
Initiation fees and capital contributions$0
Gross receipts for public use of club facilities$0
At any time during the year, did the organization, directly or indirectly, own a controlled entity within the meaning of section 512(b)(13)?No
Amount of tax imposed on the organization during the year under: section 4911$0
Amount of tax imposed on the organization during the year under: section 4912$0
Amount of tax imposed on the organization during the year under: section 4955$0
Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year?No
Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958$0
Amount of tax above, reimbursed by the organization$0
At any time during the tax year, was the organization a party to a prohibited tax shelter transaction?No
Did the organization acquire a direct or indirect interest in any applicable insurance contract?No
Did the supporting organization, or a fund maintained by a sponsoring organization, have excess business holdings at any time during the year?No
Number of employees employed in the pay period that includes March 12, 200644
Analysis of Income-Producing Activities (for 2007)
Unrelated business incomeExcluded by section 512, 513, or 514Related or exempt function income
Business codeAmountExclusion codeAmount
Total$0$113,928$690,809
Program service revenue
Program service revenue 1000000$000$0$619,441
Program service revenue 2000000$000$0$20,000
Program service revenue 3000000$000$0$0
Program service revenue 4000000$000$0$0
Program service revenue 5000000$000$0$0
Medicare/Medicaid payments000000$000$0$0
Fees and contracts from government agencies000000$000$0$0
Membership dues and assessments000000$000$0$0
Interest on savings and temporary cash investments000000$0Dividends, interest, payments with respect to securities loans, annuities, income from notional principal contracts, loan commitment fees, and other substantially similar income from ordinary and routine investments excluded by section 512(b)(1)$114,923$0
Dividends and interest from securities000000$000$0$0
Net rental income or (loss) from real estate
debt-financed property000000$000$0$0
not debt-financed property000000$000$0$0
Net rental income or (loss) from personal property000000$000$0$0
Other investment income000000$000$0$0
Gain or (loss) from sales of assets other than inventory000000$0Gain (or loss, to the extent allowed) from the sale of investments and other non-inventory property and from certain property acquired from financial institutions that are in conservatorship or receivership (sections 512(b)(5) and 512(b)(16)(A))$-995$0
Net income or (loss) from special events000000$000$0$51,368
Gross profit or (loss) from sales of inventory000000$000$0$0
Other revenue000000$000$0$0
Information Regarding Taxable Subsidiaries and Disregarded Entities (for 2007)
EIN of corporation, partnership, or disregarded entityPercentage of ownership interestTotal incomeEnd-of-year assets
0%$0$0
0%$0$0
0%$0$0
0%$0$0
Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (for 2007)
CompensationContributions to employee benefit plans & deferred compensationExpense account and other allowances
$59,845$1,197$0
$118,722$2,374$0
$121,200$2,424$0
$84,524$1,690$0
$78,317$1,566$0
Total number of other employees paid over $50,0000
Statements About Activities (for 2007)
Expenses paid or incurred in connection with the lobbying activities$0
Did the organization receive or hold an easement for conservation purposes, including easements to preserve open space, the environment, historic land areas or historic structures?No
Did the organization provide credit counseling, debt management, credit repair, or debt negotiation services?No
Did the organization maintain any donor advised funds?No
Did the organization make any taxable distributions under section 4966?No
Did the organization make a distribution to a donor, donor advisor, or related person?No
The total number of donor advised funds owned at the end of the tax year$0
The aggregate value of assets held in all donor advised funds owned at the end of the tax year$0
The total number of separate funds or accounts owned at the end of the tax year (excluding donor advised funds included above) where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts$0
The aggregate value of assets held in all funds or accounts included above at the end of the tax year$0
Reason for Non-Private Foundation Status
The organization is not a private foundation because it isOrganization that receives a substantial part of its support from a governmental unit or from the general public
Support Schedule
19992000200120022003200420052006
Total$1,233,712$1,299,400$3,706,845$1,333,430$1,453,066$1,471,752$2,055,695$2,189,175
Gifts, grants, and contributions received$1,168,069$1,149,929$3,443,941$954,889$1,101,305$1,114,006$1,540,817$1,548,921
Membership fees received$0$0$0$0$0$0$0$0
Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc., purpose$45,861$116,465$191,503$339,606$310,784$330,472$448,932$545,002
Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June 30, 1975$10,363$38,249$72,673$41,427$37,300$30,384$67,241$96,462
Net income from unrelated business activities not included above$0$0$0$0$0$0$0$0
Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf$0$0$0$0$0$0$0$0
The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge$0$0$0$0$0$0$0$0
Other income$9,419$-5,243$-1,272$-2,492$3,677$-3,110$-1,295$-1,210
Lobbying Expenditures by Electing Public Charities (for 2007)
Total exempt purpose expenditures$0
Total lobbying expenditures$0
Total lobbying expenditures to influence public opinion (grassroots lobbying)$0
Total lobbying expenditures to influence a legislative body (direct lobbying)$0
Other exempt purpose expenditures$0
Lobbying nontaxable amount$0
Grassroots nontaxable amount$0
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Number of organizations performing similar types of work
Alaska2
Alabama5
Arkansas6
Arizona7
California43
Colorado3
Connecticut5
District of Columbia1
Delaware1
Florida9
Georgia8
Hawaii2
Iowa3
Idaho2
Illinois12
Indiana4
Kentucky6
Louisiana6
Massachusetts14
Maryland5
Maine6
Michigan12
Minnesota7
Missouri7
Mississippi11
Montana1
North Carolina9
North Dakota3
Nebraska2
New Hampshire4
New Jersey7
New Mexico2
New York16
Ohio12
Oklahoma4
Oregon1
Pennsylvania17
Rhode Island1
South Carolina3
South Dakota1
Tennessee6
Texas18
Virginia5
Vermont1
Washington13
Wisconsin5
West Virginia4
Wyoming1
International6
Total329

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