Form 990 for tax year 2023
Filed by CLOVER FORK OUTPATIENT MEDICAL PROJECT INC.
Totals
- Total revenue
- $6,679,042
- Total expenses
- $4,188,289
- Contributions and grants received
- $132,637
- Grants paid
- $0
- Program service revenue
- $2,144,021
- Investment income
- $1,030,005
- Other revenue
- $3,372,379
- Total assets, end of year
- $24,073,465
- Total liabilities, end of year
- $424,742
- Net assets or fund balances, end of year
- $23,648,723
- Program services expenses (Part IX)
- $2,990,481
- Management and general expenses
- $1,197,808
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $2,990,481
Program services were 71.4% 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)
$132,637
-
2a · Program service revenue
total $2,144,021 · related or exempt $2,144,021
-
3 · Investment income
total $1,030,005 · related or exempt $1,030,005
-
10a · Gross sales of inventory
$5,107,802
-
10b · Cost of goods sold
$1,735,423
-
10c · Net income from sales of inventory
total $3,372,379 · related or exempt $3,372,379
Functional expenses
Part IX, the statement of functional expenses.
-
7 · Other salaries and wages
total $2,618,143 · program services $2,026,351 · management and general $591,792
-
8 · Pension plan contributions
total $405,699 · program services $315,025 · management and general $90,674
-
10 · Payroll taxes
total $188,289 · program services $144,756 · management and general $43,533
-
11c · Fees: accounting
total $12,852 · program services $11,603 · management and general $1,249
-
11g · Fees: other
total $116,006 · program services $41,598 · management and general $74,408
-
13 · Office expenses
total $58,390 · program services $160 · management and general $58,230
-
16 · Occupancy
total $41,215 · program services $39,098 · management and general $2,117
-
17 · Travel
total $1,634 · program services $1,054 · management and general $580
-
22 · Depreciation, depletion and amortization
total $121,688 · management and general $121,688
-
23 · Insurance
total $47,197 · program services $21,952 · management and general $25,245
-
24a · Other expenses: SCHEDULE
total $577,176 · program services $388,884 · management and general $188,292
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $10,059,506 · end of year $9,992,874
-
2 · Savings and temporary cash investments
beginning of year $2,108,570 · end of year $2,193,167
-
4 · Accounts receivable
beginning of year $600,319 · end of year $689,489
-
8 · Inventories for sale or use
beginning of year $331,677 · end of year $335,882
-
10a · Land, buildings and equipment: cost or other basis
$4,134,699
-
10b · Land, buildings and equipment: accumulated depreciation
$2,528,029
-
10c · Land, buildings and equipment, net
beginning of year $1,628,608 · end of year $1,606,670
-
11 · Investments: publicly traded securities
beginning of year $6,873,451 · end of year $9,255,383
-
17 · Accounts payable and accrued expenses
beginning of year $444,161 · end of year $424,742
-
27 · Net assets without donor restrictions
beginning of year $17,807,970 · end of year $20,298,723
-
28 · Net assets with donor restrictions
beginning of year $3,350,000 · end of year $3,350,000
Mission and programs · 2023
Mission
MEDICAL & DENTAL CLINIC SERVICE
Activities or mission (Part I)
MEDICAL AND DENTAL CLINIC OFFICE
-
OUTPATIENT MEDICAL & DENTAL CLINIC
Expenses $2,990,481 · Revenue $6,679,042
As filed on the 2023 return.
Listed in Part VII
-
Kristen M NashKRISTEN M NASH
PHYSICIAN
- Total calculated
- $260,797
- From this org
- $248,378
- From related orgs
- $0
- Other
- $12,419
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $248,378
- Bonus
- not reported
- Other
- not reported
- Deferred
- $12,419
- Nontaxable benefits
- not reported
- Filer's total
- $260,797
-
Sharon ColtonSHARON COLTON
PHYSICIAN
- Total calculated
- $213,058
- From this org
- $202,912
- From related orgs
- $0
- Other
- $10,146
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $202,912
- Bonus
- not reported
- Other
- not reported
- Deferred
- $10,146
- Nontaxable benefits
- not reported
- Filer's total
- $213,058
-
Jack A MiniardJACK A MINIARD
CEO
- Total calculated
- $182,523
- From this org
- $173,831
- From related orgs
- $0
- Other
- $8,692
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $173,831
- Bonus
- not reported
- Other
- not reported
- Deferred
- $8,692
- Nontaxable benefits
- not reported
- Filer's total
- $182,523
-
Tom McCurryTOM MCCURRY
PHARMACIST
- Total calculated
- $170,966
- From this org
- $162,825
- From related orgs
- $0
- Other
- $8,141
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $162,825
- Bonus
- not reported
- Other
- not reported
- Deferred
- $8,141
- Nontaxable benefits
- not reported
- Filer's total
- $170,966
-
Kimberly BrownKIMBERLY BROWN
CHAIRMAN OF
- Total calculated
- $0
- Hours/week
- 1
-
Tammie ChapmanTAMMIE CHAPMAN
MD MEMBER-ED
- Total calculated
- $0
- Hours/week
- 1
-
Wayne CollettWAYNE COLLETT
SECRETARY
- Total calculated
- $0
- Hours/week
- 1
-
Bobbie DixonBOBBIE DIXON
VICE CHAIR O
- Total calculated
- $0
- Hours/week
- 1
-
Eugene EnixEUGENE ENIX
BD EMEMBER-B
- Total calculated
- $0
- Hours/week
- 1
-
Jerry HaynesJERRY HAYNES
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
John HensonJOHN HENSON
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
Sonya LawsonSONYA LAWSON
BD MEMBER-ED
- Total calculated
- $0
- Hours/week
- 1
-
Darlene LemarrDARLENE LEMARR
DIRECTOR - B
- Total calculated
- $0
- Hours/week
- 1
-
Barry MartinBARRY MARTIN
DIRECTOR - H
- Total calculated
- $0
- Hours/week
- 1
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
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.
Provenance
- Return type
- form_990
- Tax year
- 2023
- Filed
- 4 May 2025
- IRS schema version
- 2023v6.0
- Source object
- 202511329349304576
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