BLUE MOUNTAIN CLINIC INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- BLUE MOUNTAIN CLINIC INC (EIN 81-0365291)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-10-27
- IRS object ID
- 202013019349301036
- Schema version
- 2019v5.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-10-27T08:41:34-07:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 810390489 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Boyle Deveny & Meyer PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 305 South 4th East Suite 200 | AddressLine1Txt |
| City | Missoula | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810365291 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE MOUNTAIN CLINIC INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BLUE | BusinessNameControlTxt |
| Phone | 4067211646 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 N CALIFORNIA ST | AddressLine1Txt |
| City | MISSOULA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59802 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | tom roberts | PersonNm |
| Person Title | President | PersonTitleTxt |
| Signature | 2020-10-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jaime Ward CPA | PreparerPersonNm |
| PTIN | P00441760 | PTIN |
| Phone | 4067213555 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | tom roberts | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 N CALIFORNIA ST | AddressLine1Txt |
| City | MISSOULA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59802 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,112,543 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.bluemountainclinic.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1976 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | The mission of Blue Mountain Clinic is to provide individualized, choice-based healthcare that respects the power of personal connection. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 28 | TotalEmployeeCnt |
| Total Volunteers | 50 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $996,312 | PYContributionsGrantsAmt |
| CY Contributions Grants | $547,193 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,536,723 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,559,518 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$4,865 | PYInvestmentIncomeAmt |
| CY Investment Income | $130 | CYInvestmentIncomeAmt |
| PY Other Revenue | $15,880 | PYOtherRevenueAmt |
| CY Other Revenue | $5,702 | CYOtherRevenueAmt |
| PY Total Revenue | $2,544,050 | PYTotalRevenueAmt |
| CY Total Revenue | $2,112,543 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,161,247 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,180,724 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $74,560 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $791,920 | PYOtherExpensesAmt |
| CY Other Expenses | $812,562 | CYOtherExpensesAmt |
| PY Total Expenses | $1,953,167 | PYTotalExpensesAmt |
| CY Total Expenses | $1,993,286 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $590,883 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $119,257 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,826,125 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,878,448 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $614,482 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $547,548 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,211,643 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,330,900 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission of Blue Mountain Clinic is to provide individualized, choice-based healthcare that respects the power of personal connection. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,681,555 | ExpenseAmt |
| Desc | Blue 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 the only independent, non-government funded primary and family medicine clinic in the United States that has fully integrated family medicine, mental health counseling, abortion care, and comprehensive trans* care into our daily practice. We are not subsidized by any government money, are not a title X organization and do not offer a sliding fee scale for services. Because of this we are not eligible for many programs that offer amenities such as discounted birth control, sliding scales and large government grants. While such programs can be beneficial, we have always held the belief that we do not want federal regulations to influence how we care for our patients. This status does allow us to have complete autonomy in how we provide care while staying committed to our mission. BMC directly impacts the lives of over 10,000 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. Since 2013 the demand for our care has increased by almost 30%. Blue Mountain Clinic is called upon daily by those who need care for 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, and across the state, the retirement of several local family medicine doctors, anti-choice legislation, and most recently the expansion of Medicaid programs in Montana.In addition to our primary and reproductive care clients, we have been providing care to transgender patients throughout the Northern Rockies for over 16 years. In 2012, after receiving a grant from the Pride Foundation, we further strengthened our Trans* care through training, advocacy and marketing. Because of these trainings we have more than quadrupled the number of trans* identified patients we care for ranging in age from 9 to 72 years old. 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. The distribution of physicians in Montana is extremely uneven, with 37% of all primary care physicians practicing in only three cities and 40 of Montana's 56 counties are designated health professional shortage areas. As we witness these changes and prepare for great uncertainty in the landscape of our healthcare both regionally and nationally, 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 9th year providing critical gynecological training to residents in the Western Montana Family Medicine Residency Program. We train 10 residents a year preparing them to provide comprehensive reproductive and family medicine through our choice-based lens. We are striving to ensure these residents will continue to practice and provide care filling the need for healthcare in our rural areas, many of which Blue Mountain Clinic currently serves. | Desc |
| Total Program Service Expenses | $1,681,555 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 28 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BLUE MOUNTAIN CLINIC | PersonNm |
| Phone | 4067211646 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 N CALIFORNIA ST | AddressLine1Txt |
| City | MISSOULA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59802 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| ERIC A RAVITZ | |||||||
| STAFF | 40.00 | 0.00 | $144,264 | $0 | $0 | ||
| ANNIE HANSEN | |||||||
| Executive Dir. | 40.00 | 0.00 | $43,453 | $0 | $0 | Yes (X) | |
| darci thorsrud | |||||||
| Director | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| darcey fairchild | |||||||
| Director | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| HOLLY BIEHL | |||||||
| Director | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| juniper davis | |||||||
| Director | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| vasa parsons | |||||||
| Director/Staff | 40.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| montana james | |||||||
| Director | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| JAIME WARD | |||||||
| Treasurer | 4.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| elizabeth HUBBLE | |||||||
| President | 4.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| tom roberts | |||||||
| Vice President | 4.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $187,717 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $25,780 | GovernmentGrantsAmt |
| All Other Contributions | $521,413 | AllOtherContributionsAmt |
| Total Contributions | $547,193 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HEALTH CARE DELIVERY | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $1,559,518 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,559,518 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,559,518 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $130 | TotalRevenueColumnAmt |
| Exclusion | $130 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISC. REIMBURSEMENTS | Desc |
| Total Revenue Column | $5,702 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,702 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $5,702 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,112,543 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,565,220 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $130 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,453 | TotalAmt |
| Management And General | $32,590 | ManagementAndGeneralAmt |
| Fundraising | $10,863 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $981,505 | TotalAmt |
| Program Services | $834,279 | ProgramServicesAmt |
| Management And General | $98,151 | ManagementAndGeneralAmt |
| Fundraising | $49,075 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,079 | TotalAmt |
| Program Services | $22,559 | ProgramServicesAmt |
| Management And General | $7,520 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,168 | TotalAmt |
| Program Services | $31,626 | ProgramServicesAmt |
| Management And General | $10,542 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,519 | TotalAmt |
| Program Services | $62,639 | ProgramServicesAmt |
| Management And General | $20,880 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,000 | TotalAmt |
| Program Services | $10,000 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,118 | TotalAmt |
| Management And General | $40,118 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,065 | TotalAmt |
| Program Services | $7,065 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,359 | TotalAmt |
| Program Services | $3,483 | ProgramServicesAmt |
| Management And General | $1,608 | ManagementAndGeneralAmt |
| Fundraising | $268 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,501 | TotalAmt |
| Program Services | $22,526 | ProgramServicesAmt |
| Management And General | $2,650 | ManagementAndGeneralAmt |
| Fundraising | $1,325 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,093 | TotalAmt |
| Program Services | $16,096 | ProgramServicesAmt |
| Management And General | $1,498 | ManagementAndGeneralAmt |
| Fundraising | $499 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $663 | TotalAmt |
| Program Services | $663 | ProgramServicesAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,716 | TotalAmt |
| Program Services | $24,716 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,837 | TotalAmt |
| Program Services | $50,861 | ProgramServicesAmt |
| Management And General | $5,984 | ManagementAndGeneralAmt |
| Fundraising | $2,992 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,421 | TotalAmt |
| Program Services | $49,567 | ProgramServicesAmt |
| Management And General | $10,854 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $327,616 | $327,616 | |
| ELECTRONIC HEALTH RECORDS | $97,967 | $97,967 | |
| CONTRACTED SERVICES | $47,740 | $47,042 | $698 |
| DUES & SUBSCRIPTIONS | $15,895 | $15,895 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,571 | TotalAmt |
| Program Services | $56,955 | ProgramServicesAmt |
| Management And General | $4,078 | ManagementAndGeneralAmt |
| Fundraising | $9,538 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,993,286 | TotalAmt |
| Program Services | $1,681,555 | ProgramServicesAmt |
| Management And General | $237,171 | ManagementAndGeneralAmt |
| Fundraising | $74,560 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,137 | BOYAmt |
| EOY | $176,336 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,543 | BOYAmt |
| EOY | $86,741 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,200 | BOYAmt |
| EOY | $50,590 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $79,637 | BOYAmt |
| EOY | $98,618 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,000 | BOYAmt |
| EOY | $5,000 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,242,870 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $781,707 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,467,608 | BOYAmt |
| EOY | $1,461,163 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,826,125 | BOYAmt |
| EOY | $1,878,448 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,412 | BOYAmt |
| EOY | $56,144 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $482,070 | BOYAmt |
| EOY | $465,239 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $26,165 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $614,482 | BOYAmt |
| EOY | $547,548 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,211,643 | BOYAmt |
| EOY | $1,330,900 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,211,643 | BOYAmt |
| EOY | $1,330,900 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,826,125 | BOYAmt |
| EOY | $1,878,448 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $119,257 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $180,234 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $191,239 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $320,280 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $996,312 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $547,193 | CurrentTaxYearAmt |
| Total | $2,235,258 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,636,874 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,644,953 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,594,377 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,536,723 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,559,518 | CurrentTaxYearAmt |
| Total | $7,972,445 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,817,108 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,836,192 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,914,657 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,533,035 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,106,711 | CurrentTaxYearAmt |
| Total | $10,207,703 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $111,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $28,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $218,117 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $565,408 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $468,670 | CurrentTaxYearAmt |
| Total | $1,391,195 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $111,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $28,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $218,117 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $565,408 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $468,670 | CurrentTaxYearAmt |
| Total | $1,391,195 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $8,816,508 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $46 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $98 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $610 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,599 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $130 | CurrentTaxYearAmt |
| Total | $2,483 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $46 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $98 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $610 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,599 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $130 | CurrentTaxYearAmt |
| Total | $2,483 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,817,154 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,836,290 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,915,267 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,534,634 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,106,841 | CurrentTaxYearAmt |
| Total | $10,210,186 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.86350 | PublicSupportCY509Pct |
| Public Support PY509 | 0.85120 | PublicSupportPY509Pct |
| Investment Income CY | 0.00020 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00020 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $79,989 | OtherCostOrOtherBasisAmt |
| Book Value | $79,989 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,905,377 | OtherCostOrOtherBasisAmt |
| Depreciation | $544,969 | DepreciationAmt |
| Book Value | $1,360,408 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $232,871 | OtherCostOrOtherBasisAmt |
| Depreciation | $218,361 | DepreciationAmt |
| Book Value | $14,510 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,633 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,377 | DepreciationAmt |
| Book Value | $6,256 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,461,163 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | hopewell grant loan | Desc |
| Amt | $26,165 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $26,165 | TotalLiabilityAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b: Form 990 Review Process | THE 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, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | BOARD 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, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | COMPENSATION 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, Line 19: Other Organization Documents Publicly Available | ANY OF THESE DOCUMENTS ARE READILY AVAILIBLE UPON REQUEST. |