Totals
- Total revenue
- $8,258,393
- Total expenses
- $13,977,028
- Contributions and grants received
- $0
- Grants paid
- $0
- Program service revenue
- $8,256,803
- Investment income
- $0
- Other revenue
- $1,590
- Total assets, end of year
- $8,021,707
- Total liabilities, end of year
- $1,202,929
- Net assets or fund balances, end of year
- $6,818,778
- Program services expenses (Part IX)
- $12,803,366
- Management and general expenses
- $1,173,662
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $12,803,366
Program services were 91.6% 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.
-
2a · Program service revenue: PATIENT REVENUE
total $8,256,803 · related or exempt $8,256,803
-
11a · Other revenue: DISCOUNTS
total $1,590 · related or exempt $1,590
-
11e · Other revenue, total
$1,590
Functional expenses
Part IX, the statement of functional expenses.
-
7 · Other salaries and wages
total $8,225,749 · program services $7,650,960 · management and general $574,789
-
8 · Pension plan contributions
total $212,765 · program services $197,893 · management and general $14,872
-
9 · Other employee benefits
total $1,221,226 · program services $1,135,862 · management and general $85,364
-
10 · Payroll taxes
total $409,035 · program services $380,443 · management and general $28,592
-
11c · Fees: accounting
total $1,575 · management and general $1,575
-
11g · Fees: other
total $446,889 · program services $1,967 · management and general $444,922
-
12 · Advertising and promotion
total $8,911 · management and general $8,911
-
13 · Office expenses
total $867,412 · program services $867,412
-
14 · Information technology
total $125,035 · program services $125,035
-
16 · Occupancy
total $92,427 · program services $84,109 · management and general $8,318
-
17 · Travel
total $19,998 · program services $19,998
-
19 · Conferences, conventions and meetings
total $4,808 · program services $4,808
-
22 · Depreciation, depletion and amortization
total $1,409,144 · program services $1,409,144
-
23 · Insurance
total $311,222 · program services $311,222
-
24a · Other expenses: MEDICAL SUPPLIES
total $448,579 · program services $448,579
-
24b · Other expenses: TAXES & LICENSES
total $70,210 · program services $63,891 · management and general $6,319
-
24c · Other expenses: REPAIRS & MAINTENANCE
total $60,693 · program services $60,693
-
24d · Other expenses: MISCELLANEOUS HOSPICE
total $23,540 · program services $23,540
-
24e · All other expenses
total $17,810 · program services $17,810
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $254,456 · end of year $201,340
-
4 · Accounts receivable
beginning of year $1,181,328 · end of year $705,320
-
9 · Prepaid expenses and deferred charges
beginning of year $39,413 · end of year $9,490
-
10a · Land, buildings and equipment: cost or other basis
$7,499,537
-
10b · Land, buildings and equipment: accumulated depreciation
$1,555,975
-
10c · Land, buildings and equipment, net
beginning of year $6,615,402 · end of year $5,943,562
-
14 · Intangible assets
beginning of year $1,663,286 · end of year $924,037
-
15 · Other assets
beginning of year $408,969 · end of year $237,958
-
17 · Accounts payable and accrued expenses
beginning of year $1,279,893 · end of year $1,042,765
-
25 · Other liabilities
beginning of year $284,046 · end of year $160,164
-
27 · Net assets without donor restrictions
beginning of year $8,598,915 · end of year $6,818,778
Mission and programs · 2022
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 $12,803,366 · Revenue $8,258,393
As filed on the 2022 return.
Listed in Part VII
-
Guillermo Saurina MDGUILLERMO SAURINA MD
PHYSICIAN
- Total calculated
- $926,595
- From this org
- $899,345
- From related orgs
- $0
- Other
- $27,250
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $585,616
- Bonus
- $310,957
- Other
- $2,772
- Deferred
- $15,250
- Nontaxable benefits
- $12,000
- Filer's total
- $926,595
-
Christopher DormanCHRISTOPHER DORMAN
CEO
- Total calculated
- $871,004
- From this org
- $0
- From related orgs
- $842,627
- Other
- $28,377
- Hours/week
- 1
Schedule J breakdown matched by us
- Base
- not reported + $643,600 related
- Bonus
- not reported + $108,741 related
- Other
- not reported + $90,286 related
- Deferred
- not reported + $15,250 related
- Nontaxable benefits
- not reported + $13,127 related
- Filer's total
- not reported + $871,004 related
-
Pamela Temples MDPAMELA TEMPLES MD
PHYSICIAN
- Total calculated
- $790,663
- From this org
- $763,413
- From related orgs
- $0
- Other
- $27,250
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $500,011
- Bonus
- $249,908
- Other
- $13,494
- Deferred
- $15,250
- Nontaxable benefits
- $12,000
- Filer's total
- $790,663
-
Eric Ward MDERIC WARD MD
PHYSICIAN
- Total calculated
- $782,276
- From this org
- $755,026
- From related orgs
- $0
- Other
- $27,250
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $618,753
- Bonus
- $135,475
- Other
- $798
- Deferred
- $15,250
- Nontaxable benefits
- $12,000
- Filer's total
- $782,276
-
Edward Fricker MDEDWARD FRICKER MD
PHYSICIAN
- Total calculated
- $754,662
- From this org
- $727,412
- From related orgs
- $0
- Other
- $27,250
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $484,493
- Bonus
- $240,147
- Other
- $2,772
- Deferred
- $15,250
- Nontaxable benefits
- $12,000
- Filer's total
- $754,662
-
Joe Clifton MDJOE CLIFTON MD
PHYSICIAN
- Total calculated
- $710,950
- From this org
- $683,700
- From related orgs
- $0
- Other
- $27,250
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $536,011
- Bonus
- $114,000
- Other
- $33,689
- Deferred
- $15,250
- Nontaxable benefits
- $12,000
- Filer's total
- $710,950
-
Cameron Nixon MDCAMERON NIXON MD
SECRETARY
- Total calculated
- $541,295
- From this org
- $0
- From related orgs
- $514,045
- Other
- $27,250
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- not reported + $486,310 related
- Bonus
- not reported + $27,375 related
- Other
- not reported + $360 related
- Deferred
- not reported + $15,250 related
- Nontaxable benefits
- not reported + $12,000 related
- Filer's total
- not reported + $541,295 related
-
Kim WillsKIM WILLS
CFO/TREAS(LE
- Total calculated
- $230,759
- From this org
- $0
- From related orgs
- $218,516
- Other
- $12,243
- Hours/week
- 1
Schedule J breakdown matched by us
- Base
- not reported + $144,864 related
- Bonus
- not reported + $45,053 related
- Other
- not reported + $28,599 related
- Deferred
- not reported + $7,243 related
- Nontaxable benefits
- not reported + $5,000 related
- Filer's total
- not reported + $230,759 related
-
Troy BrooksTROY BROOKS
CFO
- Total calculated
- $194,060
- From this org
- $0
- From related orgs
- $184,425
- Other
- $9,635
- Hours/week
- 1
Schedule J breakdown matched by us
- Base
- not reported + $168,270 related
- Bonus
- not reported
- Other
- not reported + $16,155 related
- Deferred
- not reported + $3,635 related
- Nontaxable benefits
- not reported + $6,000 related
- Filer's total
- not reported + $194,060 related
-
William BowenWILLIAM BOWEN
CHAIRMAN
- Total calculated
- $0
- Hours/week
- 1
-
George M D Hunt IVGEORGE M D HUNT IV
MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
Fortson TurnerFORTSON TURNER
MEMBER
- 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
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.
-
501C3 · PARENT · GA
Directly controlled by NA
-
TIFT REGIONAL HEALTH SYSTEM INC
501C3 · HOSPITAL · GA
Directly controlled by SOUTHWELL
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
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 10 August 2024
- IRS schema version
- 2022v5.0
- Source object
- 202402259349301755
Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.
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