FURP.ORG / PUBLIC DATA EXPLORER

BLUE MOUNTAIN CLINIC INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
BLUE MOUNTAIN CLINIC INC (EIN 81-0365291)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-09-26
IRS object ID
202322699349301332
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-09-26T14:40:38-07:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN810390489PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Boyle Deveny & Meyer PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1305 South 4th East Suite 200AddressLine1Txt
CityMissoulaCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59801ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN810365291EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BLUE MOUNTAIN CLINIC INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBLUEBusinessNameControlTxt
Phone4067211646PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 N CALIFORNIA STAddressLine1Txt
CityMISSOULACityNm
State AbbreviationMTStateAbbreviationCd
ZIP59802ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonNICOLE SMITHPersonNm
Person TitleExecutive DirectorPersonTitleTxt
Signature2023-09-26SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstNICOLEPersonFirstNm
Person LastSMITHPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJaime Ward CPAPreparerPersonNm
PTINP00441760PTIN
Phone4067213555PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
Federated Assurance LevelFAL1FederatedAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerNICOLE SMITHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 N CALIFORNIA STAddressLine1Txt
CityMISSOULACityNm
State AbbreviationMTStateAbbreviationCd
ZIP59802ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,579,893GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.bluemountainclinic.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1976FormationYr
Legal Domicile StateMTLegalDomicileStateCd
Activity Or MissionThe mission of Blue Mountain Clinic is to provide individualized, choice-based healthcare that respects the power of personal connection.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee31TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$363,146PYContributionsGrantsAmt
CY Contributions Grants$989,768CYContributionsGrantsAmt
PY Program Service Revenue$1,600,632PYProgramServiceRevenueAmt
CY Program Service Revenue$1,577,369CYProgramServiceRevenueAmt
PY Investment Income$66PYInvestmentIncomeAmt
CY Investment Income$12,756CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,963,844PYTotalRevenueAmt
CY Total Revenue$2,579,893CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,210,530PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,333,969CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$86,196CYTotalFundraisingExpenseAmt
PY Other Expenses$687,276PYOtherExpensesAmt
CY Other Expenses$1,104,892CYOtherExpensesAmt
PY Total Expenses$1,897,806PYTotalExpensesAmt
CY Total Expenses$2,438,861CYTotalExpensesAmt
PY Revenues Less Expenses$66,038PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$141,032CYRevenuesLessExpensesAmt
Total Assets BOY$2,367,708TotalAssetsBOYAmt
Total Assets EOY$2,441,558TotalAssetsEOYAmt
Total Liabilities BOY$972,032TotalLiabilitiesBOYAmt
Total Liabilities EOY$954,465TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,395,676NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,487,093NetAssetsOrFundBalancesEOYAmt
MissionThe mission of Blue Mountain Clinic is to provide individualized, choice-based healthcare that respects the power of personal connection.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$2,061,453ExpenseAmt
DescBlue Mountain Clinic is a mission-driven 501(c)3 non-profit corporation organized in the state of Montana and is governed by a volunteer board of directors. Located at 610 N California Street in Missoula, MT, we are one of the only independent, family medicine clinics in the United States that has fully integrated primary care, mental health counseling, contraceptive and abortion care, and comprehensive gender affirming care into our daily practice. BMC directly impacts the lives of over 4,000 patients per year who access a wide range of health services within our choice-based, primary medicine model. This is evidenced by the fact that 25% of our clients are traveling 100 miles or more to receive care at BMC. Blue Mountain Clinic is called upon daily by those who need care for themselves or their families, at an ever-increasing rate. This is a direct reflection of changes in our current healthcare environment; expanded services at BMC, lack of access due to clinic closures both in our region, across the state, and across the country. Per the US Census Bureau, Montana and the Northern Rockies are home to some of the least populated regions, resulting in a large concentration of rural areas. These sparsely populated areas often result in very limited access to many of lifes necessities, including health care. Reports released by the American Medical Association and the American Academy of Family Physicians indicate that we will continue to experience a critical shortage of family medicine clinicians and clinics. The shortage is due in part to retiring physicians as well as a recent trend emerging where providers are choosing specialty areas of medicine over family medicine because they offer much higher salaries. In a report released by the Montana Office of Rural Health (MORH) a serious shortage of primary care physician services is cited in Montana. It is of the utmost importance that we remain a sound presence to ensure access to independent, choice-based health care that respects the power of personal connection.We are starting our 12th year providing critical gynecological training to residents in the Western Montana Family Medicine Residency Program. We train approximately 10 residents a year preparing them to provide reproductive and family medical care through our choice-based lens. We strive to ensure that these residents will continue to practice and provide comprehensive healthcare in our rural areas, many of which Blue Mountain Clinic currently serves.Throughout 2022, we continued to face challenges in health care delivery due to the COVID-19 pandemic. Our clinic has responded rapidly and decisively with a combination of telemedicine and in-person access. We have been and will continue to meet the primary care, gender affirming, and reproductive health care needs of our community.Desc
Total Program Service Expenses$2,061,453TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document11IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee31EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBLUE MOUNTAIN CLINICPersonNm
Phone4067211646PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 N CALIFORNIA STAddressLine1Txt
CityMISSOULACityNm
State AbbreviationMTStateAbbreviationCd
ZIP59802ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
CAITLIN BLAU
STAFF40.000.00$165,066$0$0
ERIC A RAVITZ
STAFF40.000.00$163,555$0$0
KELLY POLUS
STAFF40.000.00$101,664$0$0
NICOLE SMITH
Executive Dir.40.000.00$101,038$0$0Yes (X)
darci thorsrud
Director2.000.00$0$0$0Yes (X)
AMY SMITH
Director2.000.00$0$0$0Yes (X)
DANIELLE STANDLEY
Director2.000.00$0$0$0Yes (X)
sarah Kries
Director2.000.00$0$0$0Yes (X)
Caitlin Martin-Wagar MD
Treasurer2.000.00$0$0$0Yes (X)
tom roberts
President4.000.00$0$0$0Yes (X)
juniper davis
Vice President4.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$531,323TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K4IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$182,500GovernmentGrantsAmt
All Other Contributions$807,268AllOtherContributionsAmt
Total Contributions$989,768TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescHEALTH CARE DELIVERYDesc
Business621110BusinessCd
Total Revenue Column$1,577,369TotalRevenueColumnAmt
Related Or Exempt Func Income$1,577,369RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,577,369TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,756TotalRevenueColumnAmt
Exclusion$12,756ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISC. REIMBURSEMENTSDesc
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,579,893TotalRevenueColumnAmt
Related Or Exempt Func Income$1,577,369RelatedOrExemptFuncIncomeAmt
Exclusion$12,756ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$101,039TotalAmt
Management And General$75,779ManagementAndGeneralAmt
Fundraising$25,260FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,060,496TotalAmt
Program Services$901,421ProgramServicesAmt
Management And General$106,050ManagementAndGeneralAmt
Fundraising$53,025FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$36,403TotalAmt
Program Services$27,302ProgramServicesAmt
Management And General$9,101ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$50,380TotalAmt
Program Services$37,785ProgramServicesAmt
Management And General$12,595ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$85,651TotalAmt
Program Services$64,238ProgramServicesAmt
Management And General$21,413ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$5,638TotalAmt
Program Services$5,638ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$12,533TotalAmt
Management And General$12,533ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$166,938TotalAmt
Program Services$166,938ProgramServicesAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$32,281TotalAmt
Program Services$22,676ProgramServicesAmt
Management And General$8,233ManagementAndGeneralAmt
Fundraising$1,372FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,233TotalAmt
Program Services$2,233ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,791TotalAmt
Program Services$3,764ProgramServicesAmt
Management And General$1,737ManagementAndGeneralAmt
Fundraising$290FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$43,358TotalAmt
Program Services$32,466ProgramServicesAmt
Management And General$8,726ManagementAndGeneralAmt
Fundraising$2,166FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$10,841TotalAmt
Program Services$8,673ProgramServicesAmt
Management And General$1,626ManagementAndGeneralAmt
Fundraising$542FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$10,529TotalAmt
Program Services$10,529ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$33,458TotalAmt
Program Services$33,458ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$55,814TotalAmt
Program Services$47,442ProgramServicesAmt
Management And General$5,581ManagementAndGeneralAmt
Fundraising$2,791FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$118,121TotalAmt
Program Services$94,256ProgramServicesAmt
Management And General$23,865ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL SUPPLIES$203,357$203,357
RETRICTED GRANT EXPENSES$172,547$172,547
ELECTRONIC HEALTH RECORDS$111,483$111,483
REPAIRS & MAINTENANCE$46,814$46,814

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$73,156TotalAmt
Program Services$68,433ProgramServicesAmt
Management And General$3,973ManagementAndGeneralAmt
Fundraising$750FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,438,861TotalAmt
Program Services$2,061,453ProgramServicesAmt
Management And General$291,212ManagementAndGeneralAmt
Fundraising$86,196FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$464,063BOYAmt
EOY$298,500EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$409,014BOYAmt
EOY$134,111EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$62,039BOYAmt
EOY$80,290EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$37,165BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,252,630LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$954,146LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,354,298BOYAmt
EOY$1,298,484EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$41,129BOYAmt
EOY$630,173EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,367,708BOYAmt
EOY$2,441,558EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$69,040BOYAmt
EOY$46,450EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$206,804EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$902,992BOYAmt
EOY$689,039EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
EOY$12,172EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$972,032BOYAmt
EOY$954,465EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,395,676BOYAmt
EOY$1,487,093EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,395,676BOYAmt
EOY$1,487,093EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,367,708BOYAmt
EOY$2,441,558EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$141,032ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$49,615NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$996,312CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$547,193CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$373,055CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$363,146CurrentTaxYearMinus1YearAmt
Current Tax Year$989,768CurrentTaxYearAmt
Total$3,269,474TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,536,723CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,559,518CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,549,637CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,600,632CurrentTaxYearMinus1YearAmt
Current Tax Year$1,577,369CurrentTaxYearAmt
Total$7,823,879TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,533,035CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,106,711CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,922,692CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,963,778CurrentTaxYearMinus1YearAmt
Current Tax Year$2,567,137CurrentTaxYearAmt
Total$11,093,353TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$565,408CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$468,670CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$227,956CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$104,751CurrentTaxYearMinus1YearAmt
Current Tax Year$679,818CurrentTaxYearAmt
Total$2,046,603TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$565,408CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$468,670CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$227,956CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$104,751CurrentTaxYearMinus1YearAmt
Current Tax Year$679,818CurrentTaxYearAmt
Total$2,046,603TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$9,046,750PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,599CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$130CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$273CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$66CurrentTaxYearMinus1YearAmt
Current Tax Year$12,756CurrentTaxYearAmt
Total$14,824TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,599CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$130CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$273CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$66CurrentTaxYearMinus1YearAmt
Current Tax Year$12,756CurrentTaxYearAmt
Total$14,824TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,534,634CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,106,841CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,922,965CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,963,844CurrentTaxYearMinus1YearAmt
Current Tax Year$2,579,893CurrentTaxYearAmt
Total$11,108,177TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.81440PublicSupportCY509Pct
Public Support PY5090.84800PublicSupportPY509Pct
Investment Income CY0.00130InvestmentIncomeCYPct
Investment Income PY0.00030InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed Section4955 TaxfalseForm4720FiledSection4955TaxInd
Correction MadefalseCorrectionMadeInd

Total Grassroots Lobbying TotalGrassrootsLobbyingGrp

FieldValueIRS element (for citing)
Filing Organizations Total$166,938FilingOrganizationsTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$166,938FilingOrganizationsTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$2,271,923FilingOrganizationsTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$2,438,861FilingOrganizationsTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Filing Organizations Total$271,943FilingOrganizationsTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Filing Organizations Total$67,986FilingOrganizationsTotalAmt

Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp

FieldValueIRS element (for citing)
Filing Organizations Total$98,952FilingOrganizationsTotalAmt
FieldValueIRS element (for citing)
Form4720 FiledfalseForm4720FiledInd

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Current Year$271,943CurrentYearAmt
Total$271,943TotalAmt
FieldValueIRS element (for citing)
Lobbying Ceiling$407,915LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year$166,938CurrentYearAmt
Total$166,938TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Current Year$67,986CurrentYearAmt
Total$67,986TotalAmt
FieldValueIRS element (for citing)
Grassroots Ceiling$101,979GrassrootsCeilingAmt

Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year$166,938CurrentYearAmt
Total$166,938TotalAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$79,989OtherCostOrOtherBasisAmt
Book Value$79,989BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,905,377OtherCostOrOtherBasisAmt
Depreciation$698,104DepreciationAmt
Book Value$1,207,273BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$232,871OtherCostOrOtherBasisAmt
Depreciation$229,783DepreciationAmt
Book Value$3,088BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$34,393OtherCostOrOtherBasisAmt
Depreciation$26,259DepreciationAmt
Book Value$8,134BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,298,484TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescACCESS FUNDDesc
Amt$12,172Amt
FieldValueIRS element (for citing)
Total Liability$12,172TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
CAITLIN BLAU
STAFF$165,066$165,066
ERIC A RAVITZ
STAFF$163,555$163,555

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, Line 11bTHE CURRENT BOARD TREASURER REVIEWS THE 990 IN DETAIL WITH THE EXECUTIVE DIRECTOR. A DRAFT OF THE 990 IS THEN PRESENTED TO THE EXECUTIVE COMMITTEE. ANY CHANGES AND/OR SIGNIFICANT INFORMATION THAT IS RELEVANT TO BOARD MEMBERS IS PASSED ON TO THE BOARD FOR DISCUSSION PURPOSES VIA THE TREASURER.
Form 990, Part VI, Section B, Line 12cBOARD MEMBERS AND KEY STAFF MEMBERS ARE ASKED TO DIVULGE ANY POTENTIAL CONFLICTS OF INTEREST PRIOR TO JOINING THE BOARD OR COMMENCING EMPLOYMENT AT THE CLINIC. BOTH BOARD AND STAFF MEMBERS UNDERGO A THOROUGH APPLICATION PROCESS DESIGNED TO PREVENT AND AVOID ANY POTENTIAL CONFLICTS OF INTEREST.
Form 990, Part VI, Section B, Line 15bCOMPENSATION OF THE EXECUTIVE DIRECTOR AND THE MEDICAL DIRECTOR IS SUBJECT TO ANNUAL REVIEW AND APPROVAL BY THE BOARD OF DIRECTORS. CHANGES TO COMPENSATION BASED ON PERFORMANCE EVALUATIONS, COST OF LIVING INCREASE, OR ANNUAL BUDGET CONSTRAINTS ARE REVIEWED AND VOTED ON BY THE BOARD AS A WHOLE.
Form 990, Part VI, Section C, Line 19ANY OF THESE DOCUMENTS ARE READILY AVAILIBLE UPON REQUEST.