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Nonprofiteer
← SOUTHWELL AMBULATORY INC

Form 990 for tax year 2024

Filed by SOUTHWELL AMBULATORY INC.

Totals

Total revenue
$4,879,064
Total expenses
$9,371,586
Contributions and grants received
$200,927
Grants paid
$0
Program service revenue
$4,676,859
Investment income
$0
Other revenue
$1,278
Total assets, end of year
$5,408,253
Total liabilities, end of year
$935,802
Net assets or fund balances, end of year
$4,472,451
Program services expenses (Part IX)
$8,371,711
Management and general expenses
$999,875
Fundraising expenses
$0
Program service expenses (Part III)
$8,371,711

Program services were 89.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1e · Government grants (contributions)

    $200,927

  • 2a · Program service revenue: PATIENT REVENUE

    total $4,676,859 · related or exempt $4,676,859

  • 11a · Other revenue: DISCOUNTS

    total $1,278 · related or exempt $1,278

  • 11e · Other revenue, total

    $1,278

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $5,865,877 · program services $5,278,703 · management and general $587,174

  • 8 · Pension plan contributions

    total $131,340 · program services $118,193 · management and general $13,147

  • 9 · Other employee benefits

    total $859,433 · program services $773,404 · management and general $86,029

  • 10 · Payroll taxes

    total $282,250 · program services $253,997 · management and general $28,253

  • 11c · Fees: accounting

    total $7,965 · management and general $7,965

  • 11g · Fees: other

    total $268,577 · program services $4,927 · management and general $263,650

  • 12 · Advertising and promotion

    total $90 · management and general $90

  • 13 · Office expenses

    total $623,367 · program services $623,367

  • 14 · Information technology

    total $91,265 · program services $91,265

  • 16 · Occupancy

    total $90,093 · program services $81,985 · management and general $8,108

  • 17 · Travel

    total $2,896 · program services $2,896

  • 19 · Conferences, conventions and meetings

    total $8,052 · program services $8,052

  • 22 · Depreciation, depletion and amortization

    total $726,321 · program services $726,321

  • 23 · Insurance

    total $88,644 · program services $88,644

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $213,579 · program services $213,579

  • 24b · Other expenses: TAXES & LICENSES

    total $60,656 · program services $55,197 · management and general $5,459

  • 24c · Other expenses: LINEN AND OTHER

    total $21,110 · program services $21,110

  • 24d · Other expenses: REPAIRS & MAINTENANCE

    total $17,292 · program services $17,292

  • 24e · All other expenses

    total $12,779 · program services $12,779

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $428,200 · end of year $121,377

  • 4 · Accounts receivable

    beginning of year $606,482 · end of year $406,098

  • 9 · Prepaid expenses and deferred charges

    beginning of year $9,692 · end of year $30,383

  • 10a · Land, buildings and equipment: cost or other basis

    $7,542,191

  • 10b · Land, buildings and equipment: accumulated depreciation

    $2,762,581

  • 10c · Land, buildings and equipment, net

    beginning of year $5,325,886 · end of year $4,779,610

  • 14 · Intangible assets

    beginning of year $138,493

  • 15 · Other assets

    beginning of year $63,329 · end of year $70,785

  • 17 · Accounts payable and accrued expenses

    beginning of year $760,234 · end of year $935,802

  • 25 · Other liabilities

    beginning of year $32,515

  • 27 · Net assets without donor restrictions

    beginning of year $5,779,333 · end of year $4,472,451

Mission and programs · 2024

Mission

THE MISSION OF THE ORGANIZATION IS TO PROVIDE SPECIALTY PHYSICIAN AND MEDICAL SERVICES TO THE COMMUNITY IN A MANNER CONSISTENT WITH BEING A TAX- EXEMPT ORGANIZATION.

  • SOUTHWELL AMBULATORY, INC. IS A NON-PROFIT CORPORATION FORMED UNDER THE LAWS OF THE STATE OF GEORGIA TO PROVIDE SPECIALTY PHYSICIAN AND MEDICAL SERVICES TO THE COMMUNITY. THE ORGANIZATION BEGAN PROVIDES GASTROENTEROLOGY, ENDOSCOPY, PEDIATRIC AND INFECTIOUS DISEASES MEDICAL SERVICES.

    Expenses $8,371,711 · Revenue $4,678,137

As filed on the 2024 return.

Listed in Part VII

  • Christopher Dorman

    CEO

    Total calculated
    $1,260,271
    From this org
    $0
    From related orgs
    $1,174,864
    Other
    $85,407
    Hours/week
    1 + 42 related

    Schedule J breakdown matched by us

    Base
    not reported + $713,063 related
    Bonus
    not reported + $207,681 related
    Other
    not reported + $254,120 related
    Deferred
    not reported + $17,250 related
    Nontaxable benefits
    not reported + $68,157 related
    Filer's total
    not reported + $1,260,271 related

  • Eric Ward MD

    PHYSICIAN

    Total calculated
    $955,680
    From this org
    $894,335
    From related orgs
    $0
    Other
    $61,345
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $623,642
    Bonus
    $269,727
    Other
    $966
    Deferred
    $17,250
    Nontaxable benefits
    $44,095
    Filer's total
    $955,680

  • Joe Clifton MD

    PHYSICIAN

    Total calculated
    $738,637
    From this org
    $678,725
    From related orgs
    $0
    Other
    $59,912
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $582,689
    Bonus
    $93,264
    Other
    $2,772
    Deferred
    $17,250
    Nontaxable benefits
    $42,662
    Filer's total
    $738,637

  • Cameron Nixon MD

    SECRETARY/PH

    Total calculated
    $661,145
    From this org
    $0
    From related orgs
    $581,911
    Other
    $79,234
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    not reported + $508,544 related
    Bonus
    not reported + $59,474 related
    Other
    not reported + $13,893 related
    Deferred
    not reported + $17,250 related
    Nontaxable benefits
    not reported + $61,984 related
    Filer's total
    not reported + $661,145 related

  • Troy Brooks

    CFO

    Total calculated
    $654,931
    From this org
    $0
    From related orgs
    $596,787
    Other
    $58,144
    Hours/week
    1 + 42 related

    Schedule J breakdown matched by us

    Base
    not reported + $424,245 related
    Bonus
    not reported + $168,314 related
    Other
    not reported + $4,228 related
    Deferred
    not reported + $17,250 related
    Nontaxable benefits
    not reported + $40,894 related
    Filer's total
    not reported + $654,931 related

  • Edward Fricker MD

    PHYSICIAN

    Total calculated
    $532,259
    From this org
    $518,572
    From related orgs
    $0
    Other
    $13,687
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $435,003
    Bonus
    $80,797
    Other
    $2,772
    Deferred
    $13,687
    Nontaxable benefits
    not reported
    Filer's total
    $532,259

  • Lynn S Lee MD

    PHYSICIAN

    Total calculated
    $448,276
    From this org
    $431,026
    From related orgs
    $0
    Other
    $17,250
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $381,634
    Bonus
    $48,426
    Other
    $966
    Deferred
    $17,250
    Nontaxable benefits
    not reported
    Filer's total
    $448,276

  • Nancy Roe

    NURSE PRACTI

    Total calculated
    $132,020
    From this org
    $128,800
    From related orgs
    $0
    Other
    $3,220
    Hours/week
    40

  • William Bowen

    CHAIRMAN

    Total calculated
    $0
    Hours/week
    1 + 2.5 related

  • Kaine Brown MD

    MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Fortson Turner

    MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

None.

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

SCHEDULE J, PAGE 1, PART I, LINE 3
THE OFFICERS OF SOUTHWELL AMBULATORY, INC. ARE EMPLOYED AND COMPENSATED BY TIFT REGIONAL HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION. SOUTHWELL AMBULATORY RELIES UPON THE COMPENSATION PROCESSES ESTABLISHED BY TIFT REGIONAL HEALTH SYSTEM TO DETERMINE REASONABLENESS OF COMPENSATION.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • TIFT ENTERPRISES INC

    HOLDING CO · GA

  • SOUTHWELL PORTFOLIO INSURANCE CO

    SELF INSUR · CJ

Provenance

Return type
form_990
Tax year
2024
Filed
7 August 2026
IRS schema version
2024v5.0
Source object
202612229349301406

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