FURP.ORG / PUBLIC DATA EXPLORER

BLUE MOUNTAIN CLINIC INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
BLUE MOUNTAIN CLINIC INC (EIN 81-0365291)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-10-29
IRS object ID
201903029349302005
Schema version
2018v3.1
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)
Return2019-10-29T14:10:51-07:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

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 Begin2018-01-01TaxPeriodBeginDt

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)
Personelizabeth hubblePersonNm
Person TitlePresidentPersonTitleTxt
Signature2019-10-29SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJaime Ward CPAPreparerPersonNm
PTINP00441760PTIN
Phone4067213555PhoneNum
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal Officerelizabeth HUBBLEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 N CALIFORNIA STAddressLine1Txt
CityMISSOULACityNm
State AbbreviationMTStateAbbreviationCd
ZIP59802ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,609,951GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
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 Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee26TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$320,280PYContributionsGrantsAmt
CY Contributions Grants$996,312CYContributionsGrantsAmt
PY Program Service Revenue$1,594,377PYProgramServiceRevenueAmt
CY Program Service Revenue$1,536,723CYProgramServiceRevenueAmt
PY Investment Income$610PYInvestmentIncomeAmt
CY Investment Income-$4,865CYInvestmentIncomeAmt
PY Other Revenue$31,753PYOtherRevenueAmt
CY Other Revenue$15,880CYOtherRevenueAmt
PY Total Revenue$1,947,020PYTotalRevenueAmt
CY Total Revenue$2,544,050CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,126,535PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,161,247CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$79,703CYTotalFundraisingExpenseAmt
PY Other Expenses$791,746PYOtherExpensesAmt
CY Other Expenses$791,920CYOtherExpensesAmt
PY Total Expenses$1,918,281PYTotalExpensesAmt
CY Total Expenses$1,953,167CYTotalExpensesAmt
PY Revenues Less Expenses$28,739PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$590,883CYRevenuesLessExpensesAmt
Total Assets BOY$809,137TotalAssetsBOYAmt
Total Assets EOY$1,826,125TotalAssetsEOYAmt
Total Liabilities BOY$188,377TotalLiabilitiesBOYAmt
Total Liabilities EOY$614,482TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$620,760NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,211,643NetAssetsOrFundBalancesEOYAmt
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$1,636,497ExpenseAmt
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 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. MEDICAL TEAMROLEDOHEric Ravitz Medical Director10/1/2000Kelly Polus PAC8/1/2004Alison Charman ARNP11/1/2011Vasa Parsons LCSW10/23/2017Deanna Phinney MD1/21/2019Caitlin Blau DO8/1/2019Nicole MuskettPAC10/7/2019Per 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.Blue Mountain Clinic advocates for its clients, community and region in the following areas:We are starting our 8th 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. Dr. Eric Ravitz has served as the Medical Director for the Missoula Youth Homes for the past 12 years. The Youth Homes provide transitional and long-term housing and services to Montanas youth- from all over the state. Having Dr. Ravitz as their medical director enables them to offer a mental health component ensuring the whole health and safety of our most vulnerable populations.We recently completed a much-needed expansion to our current location. This expansion and reconfiguration of space has given us 3 additional exam rooms, an expanded in-house lab, larger waiting room, and a separate room off the waiting room for patients who are need of a private place to have discussions related to their healthcare. On the newly added second floor, we gained 6 offices for clinicians and administrative staff and a conference room to host meetings, trainings, and enTRUST YOUth board meetings.Desc
Total Program Service Expenses$1,636,497TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
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 ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
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 With Officer EntfalseBusinessRlnWithOfficerEntInd
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 Document19IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee26EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
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
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
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 Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
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 (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
darci thorsrud
Director2.000.00Yes (X)$0$0$0
darcey fairchild
Director2.000.00Yes (X)$0$0$0
tom roberts
Director2.000.00Yes (X)$0$0$0
KATIE DUBOSQUE
Director/Staff40.000.00Yes (X)$0$0$0
KAT WERNER
Director2.000.00Yes (X)$0$0$0
FRANK SHEEHY
Director2.000.00Yes (X)$0$0$0
JAIME WARD
Treasurer4.000.00$0$0$0Yes (X)
elizabeth HUBBLE
President4.000.00$0$0$0Yes (X)
HOLLY BIEHL
Vice President4.000.00$0$0$0Yes (X)
ANNIE HANSEN
Executive Dir.40.000.00$55,173$0$0Yes (X)
ERIC A RAVITZ
STAFF40.000.00$141,367$0$0Yes (X)
JOEY BANKS
STAFF40.000.00$150,962$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$347,502TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$996,312AllOtherContributionsAmt
Total Contributions$996,312TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescHEALTH CARE DELIVERYDesc
Business621110BusinessCd
Total Revenue Column$1,536,723TotalRevenueColumnAmt
Related Or Exempt Func Income$1,536,723RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,536,723TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,600TotalRevenueColumnAmt
Exclusion$1,600ExclusionAmt

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

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$59,436SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$65,901SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$6,465SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$6,465TotalRevenueColumnAmt
Related Or Exempt Func Income-$6,465RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$15,880FundraisingGrossIncomeAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,880TotalRevenueColumnAmt
Exclusion$15,880ExclusionAmt

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

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,544,050TotalRevenueColumnAmt
Related Or Exempt Func Income$1,530,258RelatedOrExemptFuncIncomeAmt
Exclusion$17,480ExclusionAmt

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$55,173TotalAmt
Management And General$41,380ManagementAndGeneralAmt
Fundraising$13,793FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$960,782TotalAmt
Program Services$816,665ProgramServicesAmt
Management And General$96,078ManagementAndGeneralAmt
Fundraising$48,039FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$32,672TotalAmt
Program Services$24,504ProgramServicesAmt
Management And General$8,168ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$37,643TotalAmt
Program Services$28,232ProgramServicesAmt
Management And General$9,411ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$74,977TotalAmt
Program Services$56,233ProgramServicesAmt
Management And General$18,744ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$32,325TotalAmt
Management And General$32,325ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

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$0TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$7,718TotalAmt
Program Services$7,718ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,375TotalAmt
Program Services$2,194ProgramServicesAmt
Management And General$1,012ManagementAndGeneralAmt
Fundraising$169FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$34,691TotalAmt
Program Services$29,487ProgramServicesAmt
Management And General$3,469ManagementAndGeneralAmt
Fundraising$1,735FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$64,972TotalAmt
Program Services$62,424ProgramServicesAmt
Management And General$1,911ManagementAndGeneralAmt
Fundraising$637FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$610TotalAmt
Program Services$610ProgramServicesAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$7,782TotalAmt
Program Services$7,782ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$30,771TotalAmt
Program Services$26,155ProgramServicesAmt
Management And General$3,077ManagementAndGeneralAmt
Fundraising$1,539FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$59,143TotalAmt
Program Services$47,164ProgramServicesAmt
Management And General$11,979ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$258,882$258,882
ELECTRONIC HEALTH RECORDS$98,230$98,230
LAB SUPPLIES$49,019$49,019
CONTRACTED SERVICES$29,894$28,590$1,304

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$114,508TotalAmt
Program Services$92,608ProgramServicesAmt
Management And General$8,109ManagementAndGeneralAmt
Fundraising$13,791FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,953,167TotalAmt
Program Services$1,636,497ProgramServicesAmt
Management And General$236,967ManagementAndGeneralAmt
Fundraising$79,703FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,326BOYAmt
EOY$11,137EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$167,499BOYAmt
EOY$150,543EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$112,200EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$77,532BOYAmt
EOY$79,637EOYAmt

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)
BOY$5,000BOYAmt
EOY$5,000EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,189,478LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$721,870LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$514,136BOYAmt
EOY$1,467,608EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$40,644BOYAmt
EOY$0EOYAmt

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$809,137BOYAmt
EOY$1,826,125EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$78,731BOYAmt
EOY$132,412EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$36,485BOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$73,161BOYAmt
EOY$482,070EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$188,377BOYAmt
EOY$614,482EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$620,760BOYAmt
EOY$1,211,643EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$620,760BOYAmt
EOY$1,211,643EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$809,137BOYAmt
EOY$1,826,125EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$590,883ReconcilationRevenueExpnssAmt
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$102,063CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$180,234CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$191,239CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$320,280CurrentTaxYearMinus1YearAmt
Current Tax Year$996,312CurrentTaxYearAmt
Total$1,790,128TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,480,175CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,636,874CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,644,953CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,594,377CurrentTaxYearMinus1YearAmt
Current Tax Year$1,536,723CurrentTaxYearAmt
Total$7,893,102TotalAmt

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$1,582,238CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,817,108CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,836,192CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,914,657CurrentTaxYearMinus1YearAmt
Current Tax Year$2,533,035CurrentTaxYearAmt
Total$9,683,230TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$72,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$151,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$118,000CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$223,117CurrentTaxYearMinus1YearAmt
Current Tax Year$874,502CurrentTaxYearAmt
Total$1,438,619TotalAmt

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$72,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$151,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$118,000CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$223,117CurrentTaxYearMinus1YearAmt
Current Tax Year$874,502CurrentTaxYearAmt
Total$1,438,619TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$8,244,611PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years-$20CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$46CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$98CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$610CurrentTaxYearMinus1YearAmt
Current Tax Year$1,599CurrentTaxYearAmt
Total$2,333TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years-$20CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$46CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$98CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$610CurrentTaxYearMinus1YearAmt
Current Tax Year$1,599CurrentTaxYearAmt
Total$2,333TotalAmt

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$1,582,218CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,817,154CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,836,290CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,915,267CurrentTaxYearMinus1YearAmt
Current Tax Year$2,534,634CurrentTaxYearAmt
Total$9,685,563TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.85120PublicSupportCY509Pct
Public Support PY5090.92500PublicSupportPY509Pct
Investment Income CY0.00020InvestmentIncomeCYPct
Investment Income PY0.00010InvestmentIncomePYPct
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 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$1,851,985OtherCostOrOtherBasisAmt
Depreciation$494,228DepreciationAmt
Book Value$1,357,757BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$232,871OtherCostOrOtherBasisAmt
Depreciation$213,437DepreciationAmt
Book Value$19,434BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$24,633OtherCostOrOtherBasisAmt
Depreciation$14,205DepreciationAmt
Book Value$10,428BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,467,608TotalBookValueLandBuildingsAmt

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Agrmt Prof Fundraising ActyfalseAgrmtProfFundraisingActyInd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1CROSS COUNTRY BENEFITEvent1Nm
Gross Receipts Event1$15,880GrossReceiptsEvent1Amt
Gross Revenue Event1$15,880GrossRevenueEvent1Amt
Gross Receipts Total$15,880GrossReceiptsTotalAmt
Gross Revenue Total Events$15,880GrossRevenueTotalEventsAmt
Net Income Summary$15,880NetIncomeSummaryAmt

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
Rebuttable Presumption ProcfalseRebuttablePresumptionProcInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonJOEY BANKSPersonNm
TitleSTAFFTitleTxt
Base Compensation Filing Org$150,962BaseCompensationFilingOrgAmt
Total Compensation Filing Org$150,962TotalCompensationFilingOrgAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review ProcessTHE 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 ConflictsBOARD 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 EmployeesCOMPENSATION 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 AvailableANY OF THESE DOCUMENTS ARE READILY AVAILIBLE UPON REQUEST.