Civic Intelligence

Good Samaritan Clinic Inc

EIN 55-0708491 • 501(c)3 • Parkersburg, WV

Profile

To provide the underinsured with access to a patient-centered medical home that facilitates quality care through partnerships between the individual and their health care team.

418 Grand Park Drive No 311Parkersburg, WV 26105

goodsamaritanclinicparkersburgwv.com

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on the latest valid filing.

Source year 2017

Liabilities / Revenue

61st percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

501(c)3 • <$500k nonprofits • Source year 2017

Net Margin

4th percentile

-389%

Higher net margin than 4% of similar nonprofits.

501(c)3 • <$500k nonprofits • Source year 2017

Top Officer Pay

Score unavailable

No value available

No filing with officer rows is available for this organization yet.

Asset Growth

9th percentile

-100%

Faster asset growth than 9% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2016 to 2017

Revenue Growth

7th percentile

-87%

Faster revenue growth than 7% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2016 to 2017

Balance Sheet
Liabilities / AssetsScore unavailable

Assets

Down

$0

Down $232,138 (-100%) from 2016

Liabilities

Down

$0

Down $10,824 (-100%) from 2016

Net Assets

Down

$0

Down $221,314 (-100%) from 2016

Operations
Liabilities / Revenue61st percentileNet Margin4th percentile

Revenue

Down

$15,294

Down $98,501 (-87%) from 2016

Expenses

Down

$74,747

Down $165,007 (-69%) from 2016

Net Income

Up

-$59,453

Up $66,506 (+53%) from 2016

Trend Graphs

Balance Sheet Trend

Asset Growth9th percentile

Grouped bars show assets, liabilities, and net assets across loaded filings.

$600K$400K$200K$0Assets 2011: $499,371Liabilities 2011: $10,262Net Assets 2011: $489,1092011Assets 2012: $503,005Liabilities 2012: $12,573Net Assets 2012: $490,4322012Assets 2013: $468,368Liabilities 2013: $14,610Net Assets 2013: $453,7582013Assets 2014: $425,370Liabilities 2014: $14,314Net Assets 2014: $411,0562014Assets 2015: $376,126Liabilities 2015: $11,295Net Assets 2015: $364,8312015Assets 2016: $232,138Liabilities 2016: $10,824Net Assets 2016: $221,3142016Assets 2017: $0Liabilities 2017: $0Net Assets 2017: $02017

Highlighted filing

2017

Assets$0
Liabilities$0
Net Assets$0
Open 2017 Filing

Operations Trend

Revenue Growth7th percentile

Revenue, expenses, and net income by year, with the latest filing highlighted.

$600K$400K$200K$0-$200KRevenue 2011: $325,281Expenses 2011: $319,417Net Income 2011: $5,8642011Revenue 2012: $329,118Expenses 2012: $323,285Net Income 2012: $5,8332012Revenue 2013: $305,045Expenses 2013: $348,085Net Income 2013: -$43,0402013Revenue 2014: $451,787Expenses 2014: $494,489Net Income 2014: -$42,7022014Revenue 2015: $227,537Expenses 2015: $273,762Net Income 2015: -$46,2252015Revenue 2016: $113,795Expenses 2016: $239,754Net Income 2016: -$125,9592016Revenue 2017: $15,294Expenses 2017: $74,747Net Income 2017: -$59,4532017

Highlighted filing

2017

Revenue$15,294
Expenses$74,747
Net Income-$59,453
Open 2017 Filing

Filings

Most recent year

2017 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$0
Liabilities
$0
Net assets
$0
Revenue
$15,294
Expenses
$74,747
Net income
-$59,453
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2017Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.00$0.15$0.75$0.59
2016Detailed filing. Detailed filing data is available for this year.$2.32$0.11$2.21$1.14$2.40$1.26
2015Detailed filing. Detailed filing data is available for this year.$3.76$0.11$3.65$2.28$2.74$0.46
2014Detailed filing. Detailed filing data is available for this year.$4.25$0.14$4.11$4.52$4.94$0.43
2013Summary only. Only limited summary data is available for this year.$4.68$0.15$4.54$3.05$3.48$0.43
2012Summary only. Only limited summary data is available for this year.$5.03$0.13$4.90$3.29$3.23$0.06
2011Summary only. Only limited summary data is available for this year.$4.99$0.10$4.89$3.25$3.19$0.06
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jul 1, 2016 to Jun 30, 2017
Signed
Jun 19, 2017
Return Version
2016v3.0
Gross Receipts
$15,294
Mission and Program Overview

Mission

To provide the underinsured with access to a patient-centered medical home that facilitates quality care through partnerships between the individual and their health care team.

Free primary care health clinic for patients who have no insurance, medicare or medicaid and who fall within federal poverty guidelines.

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments in Publicly Traded Securities$194,378$0▼ $194,378
Cash and Non-Interest-Bearing Accounts$19,793$0▼ $19,793
Prepaid Expenses and Deferred Charges$13,586$0▼ $13,586
Land, Buildings, and Equipment, Net$2,852$0▼ $2,852
Pledges and Grants Receivable$1,529$0▼ $1,529
Savings and Temporary Cash Investments-$0-
Accounts Receivable-$0-
Other Notes and Loans Receivable, Net-$0-
Receivable From Disqualified Prsn-$0-
Receivables From Officers Etc-$0-
Investments Other Securities-$0-
Investments Program Related-$0-
Intangible Assets-$0-
Inventories for Sale or Use-$0-
Total Assets$232,138$0▼ $232,138
Other Assets Total-$0-
Liabilities
Other Liabilities$7,868$0▼ $7,868
Accounts Payable and Accrued Expenses$2,956--
Total Liabilities$10,824$0▼ $10,824
Net Assets / Fund Balance
Unrestricted Net Assets$221,314$0▼ $221,314
Total Net Assets Fund Balance$221,314$0▼ $221,314
Total Liabilities and Net Assets / Fund Balance$232,138$0▼ $232,138
Compensation and Service Providers
Top Officer PayScore unavailable

Employees

NameTitleFull / Part TimeBaseTotal
Cindy MooreExecutive DirectorFT$30,787$30,787

Board Members and Trustees

NameTitle
Amy ArnoldPresident
Elizabeth StroblVice President
Angie SmithBoard Member
Leah HopkinsBoard Member
Robert LincicomeBoard Member
Alita SellersSecretary/treasurer
John StiltnerTreasurer
Revenue and Support

Revenue Composition

Contributions and Grants
$9,283
Program Service Revenue
$0
Investment Income
$6,011
Other Revenue
$0
All Other Contributions
$337
Change in Net Assets
$-59,453
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$49,960
Other Expenses$24,787
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Current Officers, Directors, Trustees, and Key Employees-$30,787-$30,787
Other Salaries and Wages-$15,666-$15,666
Occupancy-$9,932-$9,932
Fees for Services Accounting-$3,500-$3,500
Depreciation Depletion-$2,852-$2,852
Payroll Taxes-$2,757-$2,757
Office Expenses-$1,900-$1,900
Advertising-$826-$826
Other Employee Benefits-$750-$750
Fees for Service Investment Mgmnt Fees-$729-$729
Other Expenses-$433-$433
Insurance-$355-$355
Conferences and Meetings-$312-$312
Total Functional Expenses$0$74,747$0$74,747
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Receivables from Disqualified Persons-$0-
Receivables from Officers, Directors, Trustees, and Key Employees-$0-
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section B, Line 11B

“Form 990 is received and reviewed by the executive director and the executive committee of the board of directors prior to signing and filing with the internal revenue service.”

Form 990, Part VI, Section B, Line 12C

“The conflict of interest policy is distributed and explained to all board members.”

Form 990, Part VI, Section C, Line 19

“The agency makes its form 990 available upon request at its administrative offices.”

Filing and Contact Details

Filer

Filer Name
Good Samaritan Clinic Inc
EIN
55-0708491
Phone
3048343986
Address
418 GRAND PARK DRIVE NO 311, PARKERSBURG, WV 26105

Signing Officer

Name
Cindy Moore
Title
Executive Director
Phone
3048343986
Signed
2017-06-19
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Cindy Moore
Formed
1991
Legal Domicile
Wv
Voting Board Members
7
Independent Board Members
7
Employees
6
Volunteers
0

Preparer

Firm
PERRY & ASSOCIATES CPA'S AC
Address
104 SOUTH SUGAR STREET, SAINT CLAIRSVILLE, OH 43950
Preparer
Michael a Musilli CPA
Phone
7406951569
Supplemental Narrative

Additional Explanations

FORM 990, PART XI, LINE 9:

“Transfer of funds -165,144.”

FORM 990, PART XII, LINE 2C:

“The process has not changed since the prior year”

Raw XML AppendixShowing 400 of 430 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990ScheduleA/GrossInvestmentIncome509Grp/CurrentTaxYearMinus2YearsAmt05642
IRS990ScheduleA/GrossInvestmentIncome509Grp/CurrentTaxYearMinus3YearsAmt021133
IRS990ScheduleA/GrossInvestmentIncome509Grp/CurrentTaxYearMinus4YearsAmt03463
IRS990ScheduleA/GrossInvestmentIncome509Grp/TotalAmt043410
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearAmt05479
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus1YearAmt04579
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus2YearsAmt09452
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus3YearsAmt017915
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus4YearsAmt010483
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/TotalAmt047908
IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/CurrentTaxYearAmt0532
IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/CurrentTaxYearMinus1YearAmt012640
IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/CurrentTaxYearMinus2YearsAmt05642
IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/CurrentTaxYearMinus3YearsAmt021133
IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/CurrentTaxYearMinus4YearsAmt03463
IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/TotalAmt043410
IRS990ScheduleA/InvestmentIncomeCYPct00.03730
IRS990ScheduleA/InvestmentIncomePYPct00.02160
IRS990ScheduleA/PubliclySupportedOrg509a2Ind0X
IRS990ScheduleA/PublicSupportCY509Pct00.96270
IRS990ScheduleA/PublicSupportPY509Pct00.97840
IRS990ScheduleA/PublicSupportTotal509Amt01120115
IRS990ScheduleA/SubstAndDsqlfyPrsnsTotGrp/TotalAmt00
IRS990ScheduleA/SubstantialContributorsAmtGrp/TotalAmt00
IRS990ScheduleA/ThirtyThrPctSuprtTestsCY509Ind0X
IRS990ScheduleA/Total509Grp/CurrentTaxYearAmt014762
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus1YearAmt0101155
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt0215238
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt0488289
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt0300671
IRS990ScheduleA/Total509Grp/TotalAmt01120115
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearAmt015294
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus1YearAmt0113795
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus2YearsAmt0220880
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus3YearsAmt0509422
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus4YearsAmt0304134
IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt01163525
IRS990ScheduleB/ContributorInformationGrp/ContributorBusinessName/BusinessNameLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorNum0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine20RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/City0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/State0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/ZIPCode0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/TotalContributionsAmt0RESTRICTED
IRS990/ScheduleBRequiredInd01
IRS990/ScheduleJRequiredInd00
IRS990ScheduleN/AssetsDistributedInd01
IRS990ScheduleN/AttorneyGeneralNotifiedInd01
IRS990ScheduleN/BondsOutstandingInd00
IRS990ScheduleN/DirectorOfSuccessorInd00
IRS990ScheduleN/EmployeeOfSuccessorInd00
IRS990ScheduleN/LiabilitiesPaidInd01
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/AssetsDistriOrExpnssPaidDesc0CASH FROM THREE INVESTMENT ACCOUNTS HELD BY CFD INVESTMENTS
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine1Txt0PARKERSBURG AREA COMMUNITY FOUNDATION
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt02017-02-07
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/EIN0550748246
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/FairMarketValueOfAssetAmt0158599
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/IRCSectionTxt0SINGLE 501(C)(3) PUBLIC CHARITY
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/MethodOfFMVDeterminationTxt0FAIR MARKET VALUE AT DATE OF DISTRIBUTION
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine1Txt01620 PARK AVENUE
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/CityNm0PARKERSBURG
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/StateAbbreviationCd0WV
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/ZIPCd026102
IRS990ScheduleN/OwnerOfSuccessorInd00
IRS990ScheduleN/ReceiveCompensationInd00
IRS990ScheduleN/RequiredToNotifyAGInd00
IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0FORM 990 IS RECEIVED AND REVIEWED BY THE EXECUTIVE DIRECTOR AND THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS PRIOR TO SIGNING AND FILING WITH THE INTERNAL REVENUE SERVICE.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED AND EXPLAINED TO ALL BOARD MEMBERS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2THE AGENCY MAKES ITS FORM 990 AVAILABLE UPON REQUEST AT ITS ADMINISTRATIVE OFFICES.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3TRANSFER OF FUNDS -165,144.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION B, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION B, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION C, LINE 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PART XI, LINE 9:
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990, PART XII, LINE 2C:
IRS990/SchoolOperatingInd00
IRS990/SignificantChangeInd00
IRS990/SignificantNewProgramSrvcInd00
IRS990/StatesWhereCopyOfReturnIsFldCd0WV
IRS990/SubjectToProxyTaxInd00
IRS990/TaxablePartyNotificationInd00
IRS990/TaxExemptBondsInd00
IRS990/TempOrPermanentEndowmentsInd00
IRS990/TerminateOperationsInd01
IRS990/TotalAssetsBOYAmt0232138
IRS990/TotalAssetsEOYAmt00
IRS990/TotalAssetsGrp/BOYAmt0232138
IRS990/TotalAssetsGrp/EOYAmt00
IRS990/TotalCompGreaterThan150KInd00
IRS990/TotalContributionsAmt09283
IRS990/TotalEmployeeCnt06
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt074747
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt00
IRS990/TotalFunctionalExpensesGrp/TotalAmt074747
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt010824
IRS990/TotalLiabilitiesEOYAmt00
IRS990/TotalLiabilitiesGrp/BOYAmt010824
IRS990/TotalLiabilitiesGrp/EOYAmt00
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt0221314
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt00
IRS990/TotalOtherCompensationAmt00
IRS990/TotalReportableCompFromOrgAmt030787
IRS990/TotalRevenueGrp/ExclusionAmt00
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt06011
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt015294
IRS990/TotalRevenueGrp/UnrelatedBusinessRevenueAmt00
IRS990/TotalVolunteersCnt00
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt0232138
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt00
IRS990/TotReportableCompRltdOrgAmt00
IRS990/TrnsfrExmptNonChrtblRltdOrgInd00
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd00
IRS990/UnrestrictedNetAssetsGrp/BOYAmt0221314
IRS990/UnrestrictedNetAssetsGrp/EOYAmt00
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt0418 GRAND PARK DRIVE NO 311
IRS990/USAddress/CityNm0PARKERSBURG
IRS990/USAddress/StateAbbreviationCd0WV
IRS990/USAddress/ZIPCd026105
IRS990/VotingMembersGoverningBodyCnt07
IRS990/VotingMembersIndependentCnt07
IRS990/WebsiteAddressTxt0GOODSAMARITANCLINICPARKERSBURGWV.COM
IRS990/WhistleblowerPolicyInd01
ReturnHeader/BuildTS02017-02-10 21:41:12Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd01
ReturnHeader/BusinessOfficerGrp/PersonNm0CINDY MOORE
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0EXECUTIVE DIRECTOR

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