FURP.ORG / PUBLIC DATA EXPLORER

BLUE MOUNTAIN CLINIC INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
BLUE MOUNTAIN CLINIC INC (EIN 81-0365291)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-05-05
IRS object ID
201501259349300935
Schema version
2014v5.0
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)
Return2015-05-05T09:04:57-07:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

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 Begin2014-01-01TaxPeriodBeginDt

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)
PersonANNIE HANSENPersonNm
Person TitleExecutive Dir.PersonTitleTxt
Signature2015-05-05SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJaime Ward CPAPreparerPersonNm
PTINP00441760PTIN
Phone4067213555PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerANNIE HANSENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 N CALIFORNIA STAddressLine1Txt
CityMISSOULACityNm
State AbbreviationMTStateAbbreviationCd
ZIP59802ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,613,470GrossReceiptsAmt
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 (BMC) is to provide access to safe, affordable reproductive and primary health care;to provide education on health,reproductive choices and sexuality;to advocate for policies that improve reproductive justice and correct health disparities;and to empower individuals to actively participate in their health care.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee27TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$114,588PYContributionsGrantsAmt
CY Contributions Grants$102,063CYContributionsGrantsAmt
PY Program Service Revenue$1,308,714PYProgramServiceRevenueAmt
CY Program Service Revenue$1,480,175CYProgramServiceRevenueAmt
PY Investment Income$15PYInvestmentIncomeAmt
CY Investment Income-$20CYInvestmentIncomeAmt
PY Other Revenue$18,714PYOtherRevenueAmt
CY Other Revenue$17,803CYOtherRevenueAmt
PY Total Revenue$1,442,031PYTotalRevenueAmt
CY Total Revenue$1,600,021CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$861,923PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$913,883CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$58,212CYTotalFundraisingExpenseAmt
PY Other Expenses$555,719PYOtherExpensesAmt
CY Other Expenses$630,056CYOtherExpensesAmt
PY Total Expenses$1,417,642PYTotalExpensesAmt
CY Total Expenses$1,543,939CYTotalExpensesAmt
PY Revenues Less Expenses$24,389PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$56,082CYRevenuesLessExpensesAmt
Total Assets BOY$694,468TotalAssetsBOYAmt
Total Assets EOY$705,626TotalAssetsEOYAmt
Total Liabilities BOY$196,599TotalLiabilitiesBOYAmt
Total Liabilities EOY$151,675TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$497,869NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$553,951NetAssetsOrFundBalancesEOYAmt
MissionThe mission of Blue Mountain Clinic is to provide access to safe, affordable reproductive and primary health care; to provide education on health,reproductive choices and sexuality; to advocate for policies that improve reproductive justice and correct health disparities; and to empower individuals to actively participate in their health care.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,282,043ExpenseAmt
DescBlue Mountain Clinic (BMC) features quality clinicians and experienced staff who provide: Family practice - General medical services, pediatrics, mens health, and on-site lab servicesSexual and reproductive healthcare , including Vasectomy and cervical cancer treatmentMental health counseling LGBT Primary care and counseling First trimester abortion and counselingBMC has provided access to first trimester abortion care with an emphasis on options counseling and birth control selection for 38 years. In 2014, BMC was voted "Best Health Clinic" and Dr. Ravitz was voted "Best Doctor" for the 7th year in a row in the Missoula Independent's reader's poll "Best of Missoula" awards. Also during the year, the fundraiser entitled "Off the Rack" was again a great success. Over 900 supporters attended this fundraising fashion event designed to promote healthy sexuality that goes beyond barriers, gender and stigma. During 2014, BMC continued to expanded outreach efforts to activate support for and expand access to healthcare for all Montana area residents. We joined with the Montana Family Practice Residency program to train resident doctors within our family practice setting. Many of these residents will eventually practice in rural Montana areas. Continued steps were taken to create a network of advocates in rural health care delivery settings, to increase prevention awareness to underserved regions of Montana and surrounding states, and to improve access to women seeking care by identifying resources to offset financial constraints. Finally, our Outreach/Education Coordinator doubled the amount of student-led discussions about issues that are pertinent to them. Topics included bullying, birth control, healthy sexuality, bystander intervention, and substance abuse.Each year, BMC staff participates in 20-35 activities for education, advocacy and outreach. Ongoing initiatives include BMC's Montana Access Project launched ASKMAP, started in July 2010, an SMS(text) and web-based hotline to provide information on sexual health, education and resources. Users can send or text a question confidentially and anonymously and get answers and resources from a clinical professional using a technological medium that helps reduce shame and embarrassment.BMC sees about 9,000 patient visits every year. These visits breakdown as follows:Family Practice - 68%, Gynecology, Contraceptive and Sexual Health - 18%, Mental Health Counseling - 6%, Abortion Care - 8%Desc
Total Program Service Expenses$1,282,043TotalProgramServiceExpensesAmt
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 RequiredfalseScheduleJRequiredInd
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
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document12IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee27EmployeeCnt
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
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 (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
MEGAN DISHONG
Director2.000.00Yes (X)$0$0$0
SEAN JEFFERY
Director2.000.00Yes (X)$0$0$0
LUKE LAUGHLIN
Director2.000.00Yes (X)$0$0$0
ADRI RAMOS
Director40.000.00Yes (X)$22,335$0$0
VICKI THUESEN
Director2.000.00Yes (X)$0$0$0
ERIN GIEFER
Director2.000.00Yes (X)$0$0$0
JULIANNA CROWLEY
SecR./tREAS5.000.00$0$0$0Yes (X)
ERIN STEUER
President5.000.00$0$0$0Yes (X)
JASON PARANTO
Vice President5.000.00$0$0$0Yes (X)
ANNIE HANSEN
Executive Dir.40.000.00$50,860$0$0Yes (X)
ERIC A RAVITZ
STAFF40.000.00$117,330$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$190,525TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$102,063AllOtherContributionsAmt
Total Contributions$102,063TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescHEALTH CARE DELIVERYDesc
Business621110BusinessCd
Total Revenue Column$1,480,175TotalRevenueColumnAmt
Related Or Exempt Func Income$1,480,175RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,480,175TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$36TotalRevenueColumnAmt
Exclusion$36ExclusionAmt

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$950SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,006SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$56SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$56TotalRevenueColumnAmt
Related Or Exempt Func Income-$56RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$30,246FundraisingGrossIncomeAmt
Fundraising Direct Expenses$12,443FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,803TotalRevenueColumnAmt
Exclusion$17,803ExclusionAmt

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$1,600,021TotalRevenueColumnAmt
Related Or Exempt Func Income$1,480,119RelatedOrExemptFuncIncomeAmt
Exclusion$17,839ExclusionAmt

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$50,860TotalAmt
Management And General$38,145ManagementAndGeneralAmt
Fundraising$12,715FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$767,051TotalAmt
Program Services$651,993ProgramServicesAmt
Management And General$76,705ManagementAndGeneralAmt
Fundraising$38,353FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$25,813TotalAmt
Program Services$19,360ProgramServicesAmt
Management And General$6,453ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$70,159TotalAmt
Program Services$52,619ProgramServicesAmt
Management And General$17,540ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$4,505TotalAmt
Program Services$4,505ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$23,714TotalAmt
Management And General$23,714ManagementAndGeneralAmt

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$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$8,619TotalAmt
Program Services$5,602ProgramServicesAmt
Management And General$2,586ManagementAndGeneralAmt
Fundraising$431FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$14,524TotalAmt
Program Services$12,346ProgramServicesAmt
Management And General$1,452ManagementAndGeneralAmt
Fundraising$726FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$14,053TotalAmt
Program Services$11,242ProgramServicesAmt
Management And General$2,108ManagementAndGeneralAmt
Fundraising$703FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$78TotalAmt
Program Services$78ProgramServicesAmt

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$7,984TotalAmt
Program Services$7,984ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$31,494TotalAmt
Program Services$26,770ProgramServicesAmt
Management And General$3,149ManagementAndGeneralAmt
Fundraising$1,575FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$50,730TotalAmt
Program Services$41,465ProgramServicesAmt
Management And General$9,265ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$164,373$164,373
CONTRACT LABOR$93,528$93,528
LAB SUPPLIES$34,922$34,922
401K MATCH$28,371$21,278$7,093

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$153,161TotalAmt
Program Services$133,978ProgramServicesAmt
Management And General$15,474ManagementAndGeneralAmt
Fundraising$3,709FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,543,939TotalAmt
Program Services$1,282,043ProgramServicesAmt
Management And General$203,684ManagementAndGeneralAmt
Fundraising$58,212FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$17,046BOYAmt
EOY$40,232EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$53,211BOYAmt
EOY$100,024EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$63,654BOYAmt
EOY$34,877EOYAmt

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$1,126,379LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$600,886LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$555,557BOYAmt
EOY$525,493EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
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$694,468BOYAmt
EOY$705,626EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$45,870BOYAmt
EOY$32,061EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$150,729BOYAmt
EOY$119,614EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$196,599BOYAmt
EOY$151,675EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$497,869BOYAmt
EOY$553,951EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$497,869BOYAmt
EOY$553,951EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$694,468BOYAmt
EOY$705,626EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$56,082ReconcilationRevenueExpnssAmt
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$70,224CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$99,805CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$97,943CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$114,588CurrentTaxYearMinus1YearAmt
Current Tax Year$102,063CurrentTaxYearAmt
Total$484,623TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,158,746CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,170,365CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,203,577CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,308,714CurrentTaxYearMinus1YearAmt
Current Tax Year$1,480,175CurrentTaxYearAmt
Total$6,321,577TotalAmt

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$1,228,970CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,270,170CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,301,520CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,423,302CurrentTaxYearMinus1YearAmt
Current Tax Year$1,582,238CurrentTaxYearAmt
Total$6,806,200TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$52,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$80,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$69,750CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$78,600CurrentTaxYearMinus1YearAmt
Current Tax Year$72,000CurrentTaxYearAmt
Total$352,350TotalAmt

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$52,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$80,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$69,750CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$78,600CurrentTaxYearMinus1YearAmt
Current Tax Year$72,000CurrentTaxYearAmt
Total$352,350TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$6,453,850PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$145CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$22CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15CurrentTaxYearMinus1YearAmt
Current Tax Year-$20CurrentTaxYearAmt
Total$167TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$145CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$22CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15CurrentTaxYearMinus1YearAmt
Current Tax Year-$20CurrentTaxYearAmt
Total$167TotalAmt

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$1,229,115CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,270,175CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,301,542CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,423,317CurrentTaxYearMinus1YearAmt
Current Tax Year$1,582,218CurrentTaxYearAmt
Total$6,806,367TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.94820PublicSupportCY509Pct
Public Support PY5090.94710PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
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$833,370OtherCostOrOtherBasisAmt
Depreciation$407,078DepreciationAmt
Book Value$426,292BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$209,245OtherCostOrOtherBasisAmt
Depreciation$190,033DepreciationAmt
Book Value$19,212BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,775OtherCostOrOtherBasisAmt
Depreciation$3,775DepreciationAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$525,493TotalBookValueLandBuildingsAmt

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Agrmt Prof Fundraising ActyfalseAgrmtProfFundraisingActyInd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1OFF THE RACKEvent1Nm
Gross Receipts Event1$30,246GrossReceiptsEvent1Amt
Gross Revenue Event1$30,246GrossRevenueEvent1Amt
Rent Facility Costs Event1$2,471RentFacilityCostsEvent1Amt
Food And Beverage Event1$1,058FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$8,914OtherDirectExpensesEvent1Amt
Gross Receipts Total$30,246GrossReceiptsTotalAmt
Gross Revenue Total Events$30,246GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$2,471RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$1,058FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$8,914OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$12,443DirectExpenseSummaryEventsAmt
Net Income Summary$17,803NetIncomeSummaryAmt

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 SUBJECTED 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.