Skip to content
Nonprofiteer
← GOOD SAMARITAN HEALTH CLINIC OF PASCO INC

Form 990 for tax year 2022

Filed by GOOD SAMARITAN HEALTH CLINIC OF PASCO INC.

Totals

Total revenue
$614,891
Total expenses
$627,583
Contributions and grants received
$483,140
Grants paid
$0
Program service revenue
$0
Investment income
$29
Other revenue
$131,722
Total assets, end of year
$1,243,207
Total liabilities, end of year
$31,293
Net assets or fund balances, end of year
$1,211,914
Program services expenses (Part IX)
$514,059
Management and general expenses
$48,165
Fundraising expenses
$65,359
Program service expenses (Part III)
$514,059

Program services were 81.9% 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.

  • 1a · Federated campaigns

    $28,700

  • 1e · Government grants (contributions)

    $45,640

  • 1f · All other contributions, gifts and grants

    $408,800

  • 3 · Investment income

    total $29 · unrelated business $0 · excluded $29

  • 8a · Fundraising events: gross income

    $181,330

  • 8b · Fundraising events: direct expenses

    $56,028

  • 8c · Net income from fundraising events

    total $125,302 · unrelated business $0 · excluded $125,302

  • 11a · Other revenue: Miscellaneous

    total $6,420 · related or exempt $0 · unrelated business $0 · excluded $6,420

  • 11e · Other revenue, total

    $6,420

Functional expenses

Part IX, the statement of functional expenses.

  • 6 · Compensation of disqualified persons

    total $75,450 · program services $60,360 · management and general $6,036 · fundraising $9,054

  • 7 · Other salaries and wages

    total $268,172 · program services $214,537 · management and general $21,454 · fundraising $32,181

  • 9 · Other employee benefits

    total $25,084 · program services $20,067 · management and general $2,007 · fundraising $3,010

  • 10 · Payroll taxes

    total $30,333 · program services $24,266 · management and general $2,427 · fundraising $3,640

  • 11c · Fees: accounting

    total $8,900 · program services $7,120 · management and general $712 · fundraising $1,068

  • 11g · Fees: other

    total $38,129 · program services $34,897 · management and general $1,293 · fundraising $1,939

  • 13 · Office expenses

    total $17,474 · program services $12,869 · management and general $2,704 · fundraising $1,901

  • 16 · Occupancy

    total $26,110 · program services $20,887 · management and general $2,254 · fundraising $2,969

  • 17 · Travel

    total $1,975 · program services $296 · management and general $790 · fundraising $889

  • 19 · Conferences, conventions and meetings

    total $1,941 · program services $1,359 · management and general $388 · fundraising $194

  • 20 · Interest

    total $739 · program services $0 · management and general $739 · fundraising $0

  • 22 · Depreciation, depletion and amortization

    total $59,143 · program services $47,315 · management and general $4,731 · fundraising $7,097

  • 23 · Insurance

    total $8,424 · program services $6,739 · management and general $1,685 · fundraising $0

  • 24a · Other expenses: Program Supplies

    total $8,212 · program services $8,212 · management and general $0 · fundraising $0

  • 24b · Other expenses: Pharmaceuticals

    total $31,010 · program services $31,010 · management and general $0 · fundraising $0

  • 24c · Other expenses: Lab fees

    total $14,175 · program services $14,175 · management and general $0 · fundraising $0

  • 24d · Other expenses: Fees and licenses

    total $4,785 · program services $3,828 · management and general $383 · fundraising $574

  • 24e · All other expenses

    total $7,527 · program services $6,122 · management and general $562 · fundraising $843

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $355,722 · end of year $348,713

  • 3 · Pledges and grants receivable

    beginning of year $13,107 · end of year $35,340

  • 9 · Prepaid expenses and deferred charges

    beginning of year $2,395 · end of year $32,175

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

    $1,479,646

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

    $814,514

  • 10c · Land, buildings and equipment, net

    beginning of year $688,752 · end of year $665,132

  • 12 · Investments: other securities

    beginning of year $192,556 · end of year $161,847

  • 17 · Accounts payable and accrued expenses

    beginning of year $10,518 · end of year $4,818

  • 19 · Deferred revenue

    end of year $1,000

  • 24 · Unsecured notes and loans payable

    beginning of year $25,807 · end of year $25,475

  • 27 · Net assets without donor restrictions

    beginning of year $1,023,651 · end of year $1,050,067

  • 28 · Net assets with donor restrictions

    beginning of year $192,556 · end of year $161,847

Mission and programs · 2022

Mission

To provide top quality primary medical and dental services free of charge to eligible residents of Pasco County, Florida.

  • The Organization is committed to providing top quality medical and dental services to Pasco County, Florida residents who do not qualify for public assistance and cannot purchase private health insurance. In 2022, 3,930 patients received services at the Clinic. 62 of those patients received dental services and over 5,200 prescriptions were filled at the in-house pharmacy.

    Expenses $514,059

As filed on the 2022 return.

Listed in Part VII

  • Mike Singer

    Executive Director

    Total calculated
    $82,650
    From this org
    $75,450
    From related orgs
    $0
    Other
    $7,200
    Hours/week
    40

  • Jennifer Cook MD

    Chairman

    Total calculated
    $0
    Hours/week
    3

  • Terri Haffner ARNP

    Vice Chair

    Total calculated
    $0
    Hours/week
    3

  • Paul Manuel PE

    Treasurer

    Total calculated
    $0
    Hours/week
    3

  • Jennifer Selk

    Secretary

    Total calculated
    $0
    Hours/week
    3

  • Anna FarrellEsq

    Director

    Total calculated
    $0
    Hours/week
    2

  • Angie Gardner

    Director

    Total calculated
    $0
    Hours/week
    2

  • Shelly May Johnson Esq

    Director

    Total calculated
    $0
    Hours/week
    2

  • Nelson Ohihoin RPh

    Director

    Total calculated
    $0
    Hours/week
    2

  • Juli Skillman

    Director

    Total calculated
    $0
    Hours/week
    2

  • Andrew Wilson MD

    Director

    Total calculated
    $0
    Hours/week
    2

  • Alene A Wright MD

    Director

    Total calculated
    $0
    Hours/week
    2

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.

Grants on this return

No itemized grants to organizations on this return.

Provenance

Return type
form_990
Tax year
2022
Filed
19 July 2023
IRS schema version
2022v5.0
Source object
202302009349300345

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.