2024-08-05T08:06:55-05:00 2023-12-31 582475857 NICHOLS CAULEY & ASSOCIATES LLC 1300 BELLEVUE AVENUE DUBLIN GA 310214152 990 2023-01-01 320045238 GOOD SAMARITAN HEALTH CENTER OF COBB INC GOOD 7704193120 1605 ROBERTA DR SW MARIETTA GA 300083855 CYRL KITCHENS CHIEF EXECUTIVE OFFICER 7704193120 2024-07-25 1 0 GREGORY M CHAPMAN P01019632 4782751163 2024-07-25 2023 2024-08-08 14:25:15Z CYRL KITCHENS 1605 ROBERTA DR SW MARIETTA GA 300083855 15621530 0 X WWW.GOODSAMCOBB.ORG X 2002 GA THE ORGANIZATION'S MISSION IS TO SPREAD THE LOVE OF CHRIST BY PROVIDING QUALITY HEALTHCARE TO THOSE IN NEED. 12 12 65 101 0 0 11008849 13638445 1730545 1838812 5536 40382 59342 50423 12804272 15568062 0 0 0 0 3555120 3943291 0 0 56937 8182555 8497003 11737675 12440294 1066597 3127768 6888651 10075897 296521 355999 6592130 9719898 THE ORGANIZATION'S MISSION IS TO SPREAD THE LOVE OF CHRIST BY PROVIDING QUALITY HEALTHCARE TO THOSE IN NEED. 0 0 10396829 1882471 THE ORGANIZATION PROVDIES PRIMARY MEDICAL, DENTAL AND COUNSELING SERVICES TO UNINSURED AND UNDERINSURED, WORKING POOR AND INDIGENT IN THE COMMUNITY. GOOD SAMARITAN'S FAMILY CENTERED APPROACH ENSURES THAT THEY DELIVER HIGH QUALITY AND PREVENTATIVE MEDICAL AND DENTAL SERVICES IN ADDITION TO COUNSELING, PHARMACEUTICAL, REFERRAL AND HEALTH EDUCATION PROGRAMS IN AN ATMOSPHERE OF DIGNITY, RESPECT, REGARDLESS OF RACE, ETHNICITY, RELIGION OR ABILTY TO PAY. 10396829 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 5 0 65 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 GA X GAYLE NELSON 7704193120 1605 ROBERTA DR SW MARIETTA GA 300083855 DR CHRIS SMITH CHAIRMAN OF BOARD 0.00 X 0 0 0 REV GRANT COLE SECRETARY 0.00 X 0 0 0 GREG GRIGGS TREASURER 0.00 X 0 0 0 BARRY TEAGUE BOARD OF DIRECTORS 0.00 X 0 0 0 LYNDA AUSBURN BOARD OF DIRECTORS 0.00 X 0 0 0 BRENDA GASKINS BOARD OF DIRECTORS 0.00 X 0 0 0 ANNA LONGACRE MD BOARD OF DIRECTORS 0.00 X 0 0 0 DR JOHN SHERRER BOARD OF DIRECTORS 0.00 X 0 0 0 ENERY LUCENA VELEZ BOARD OF DIRECTORS 0.00 X 0 0 0 MASHONDOLA VALDRY BOARD OF DIRECTORS 0.00 X 0 0 0 DIEGO SHAEFER BOARD OF DIRECTORS 0.00 X 0 0 0 ALBERTO SCHIRMER BOARD OF DIRECTORS 0.00 X 0 0 0 CYRL KITCHENS CEO 40.00 X 270363 0 0 GAYLE NELSON CFO 40.00 X 152984 0 0 MARY KIM DENTIST 1.00 X 134616 0 0 RYAN RANELLS NURSE PRACTIONER 1.00 X 104472 0 0 662435 0 0 4 0 1 0 0 3638157 10000288 6348644 13638445 MEDICAL PROGRAM REVENUES 621300 962715 962715 DENTAL PROGRAM REVENUES 621300 497836 497836 DISPENSARY REVENUES 621300 299793 299793 INSURANCE PAYMENTS 621300 64268 64268 MEDICARE AND MEDICAID 621300 8620 8620 5580 5580 1838812 40382 40382 100614 53468 47146 47146 OTHER 621300 3277 3277 3277 15568062 1882471 0 47146 3547573 2514004 990762 42807 209879 145125 53667 11087 185839 112790 70006 3043 114482 114482 56952 18828 38124 29582 29582 101920 101920 34610 34610 38190 38190 208899 36874 172025 69041 69041 PROFESSIONAL SERVICES 4097428 4097428 DISPENSARY COSTS 2353799 2353799 BAD DEBTS 479516 479516 OTHER EXPENSES 265713 265713 646871 536545 110326 12440294 10396829 1986528 56937 3576268 2309535 2312477 89681 676556 9045 8610 47451 56814 6471066 1759161 3166206 4711905 6888651 10075897 186647 234630 109874 121369 296521 355999 X 5940010 9591067 652120 128831 6592130 9719898 6888651 10075897 3127768 0 X X 0 1 X 1 1 1 X 17440282 9195817 9776048 11008849 13638445 61059441 1508117 1334940 1542047 1733287 1842089 7960480 18948399 10530757 11318095 12742136 15480534 69019921 0 0 0 69019921 709 5536 40382 46627 709 5536 40382 46627 74352 69967 144319 19022751 10600724 11318804 12747672 15520916 69210867 0.99720 0.99690 0.00070 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 402595 402595 4674053 828042 3846011 1256522 931119 325403 137896 137896 4711905 ACCRUED LEAVE 121369 121369 X 15621530 0 15621530 -53468 -53468 15568062 12493762 53468 53468 12440294 0 12440294 PART X, LINE 2: GOOD SAMARITAN HEALTH CENTER OF COBB, INC. IS ORGANIZED AS A GEORGIA NONPROFIT CORPORATIONS AND HAS BEEN RECOGNIZED BY THE IRS AS EXEMPT FROM FEDERAL INCOME TAXES UNDER IRC SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN IRC SECTION 501(C)(3), QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION, AND HAS BEEN DETERMINED NOT TO BE A PRIVATE FOUNDATION. THE ORGANIZATION IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, IT IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO OUR EXEMPT PURPOSES. WE HAVE DETERMINED THAT WE ARE NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAVE NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE ORGANIZATION'S FORM 990 IS SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER IT IS FILED. PART XI, LINE 4B - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSE -53,468. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSE 53,468. GOLF TOURNAMENT 100614 100614 53468 100614 100614 53468 53468 47146 0 0 0 0 0 0 0 0 0 CYRL KITCHENS CEO 270363 0 0 0 0 0 0 0 0 0 270363 0 0 0 GAYLE NELSON CFO 152984 0 0 0 0 0 0 0 0 0 152984 0 0 0 X MEDICAL SERVICES 0 6348644 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B RETURN WILL BE REVIEWED PRIOR TO FILING FORM 990, PART VI, SECTION B, LINE 12C THE OFFICERS, DIRECTORS AND KEY EMPLOYEES MUST SIGN THE DISCLOSURE FORM ANNUALLY. THESE FORMS ARE MATCHED AGAINST A LIST OF SUCH PEOPLE. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE BOARD RESEARCHES AND PROVIDES INFORMATION TO MAKE A RECOMMENDATION TO THE FULL BOARD FOR THE SALARY AND BENEFITS OF HIGHLY COMPENSATED EMPLOYEES AND CONSULTANTS BASED ON A REVIEW OF COMPARABLE DATA. THE BOARD THEN DOCUMENTS HOW IT REACHED ITS DECISION. FORM 990, PART VI, SECTION C, LINE 19 WEBSITE AUDIT COMMITTEE THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT OVERSEES THE INDEPENDENT AUDIT. THIS IS CONSISTENT WITH PRIOR YEAR.