FURP.ORG / PUBLIC DATA EXPLORER

BLUE MOUNTAIN CLINIC INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BLUE MOUNTAIN CLINIC INC (EIN 81-0365291)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-06-28
IRS object ID
201321799349300737
Schema version
2012v2.0
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)
Timestamp2013-06-28T12:36:21-07:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Boyle Deveny & Meyer PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1305 South 4th East Suite 200AddressLine1
CityMissoulaCity
StateMTState
ZIP Code59801ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN810365291EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BLUE MOUNTAIN CLINIC INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBLUENameControl
Phone4067211646Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 N CALIFORNIA STAddressLine1
CityMISSOULACity
StateMTState
ZIP Code59802ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameANNIE HANSENName
TitleExecutive Dir.Title
Date Signed2013-06-28DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJaime Troiano CPAName
PTINP00441760PTIN
Phone4067213555Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonANNIE HANSENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1610 N CALIFORNIA STAddressLine1
CityMISSOULACity
StateMTState
ZIP Code59802ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1330933GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.bluemountainclinic.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1976YearFormation
State Legal DomicileMTStateLegalDomicile
Activity Or Mission DescriptionIt is the mission of Blue Mountain Clinic (BMC) to provide access to safe, affordable reproductive and primary health care; to provide accurate 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.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees23TotalNbrEmployees
Total Nbr Volunteers50TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year99805ContributionsGrantsPriorYear
Contributions Grants Current Year97943ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1170365ProgramServiceRevenuePriorYear
Program Service Revenue CY1203577ProgramServiceRevenueCY
Investment Income Prior Year5InvestmentIncomePriorYear
Investment Income Current Year22InvestmentIncomeCurrentYear
Other Revenue Prior Year13454OtherRevenuePriorYear
Other Revenue Current Year17322OtherRevenueCurrentYear
Total Revenue Prior Year1283629TotalRevenuePriorYear
Total Revenue Current Year1318864TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year753265SalariesEtcPriorYear
Salaries Etc Current Year801236SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year51525TotalFundrsngExpCurrentYear
Other Expense Prior Year510767OtherExpensePriorYear
Other Expenses Current Year542655OtherExpensesCurrentYear
Total Expenses Prior Year1264032TotalExpensesPriorYear
Total Expenses Current Year1343891TotalExpensesCurrentYear
Revenues Less Expenses Prior Year19597RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-25027RevenuesLessExpensesCY
Total Assets BOY727095TotalAssetsBOY
Total Assets EOY694301TotalAssetsEOY
Total Liabilities BOY228540TotalLiabilitiesBOY
Total Liabilities EOY220826TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY498555NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY473475NetAssetsOrFundBalancesEOY
Mission DescriptionIt is the mission of Blue Mountain Clinic (BMC) to provide access to safe, affordable reproductive and primary health care; to provide accurate 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.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense1115360Expense
DescriptionBlue Mountain Clinic (BMC) features quality clinicians and experienced staff who provide: Family practice - general medical services and on-site lab servicesSexual and reproductive health care Mental health counseling LGBT Primary care and counseling First trimester abortion and counseling BMC has provided access to first trimester abortion care with an emphasis on options counseling and birth control selection for 36 years. In 2012, BMC was voted "Best Health Clinic" and Dr. Ravitz was voted "Best Doctor" for the 5th year in a row in the Missoula Indepenent's reader's poll "Best of Missoula" awards. Each year BMC staff participate in 20-35 activities for education, advocacy and outreach.In 2012 BMC again put on "Off the Rack", a fund raising fashion event designed to promote healthy sexuality that goes beyond barriers, gender and stigma. This year about 900 supporters attended the event. In 2012, BMC continued to initiate expanded outreach efforts to develop the capacity to activate support and expand access. Continued steps were also 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.In July of 2010 BMC's Montana Access Project launched ASKMAP, 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 8,500 patient visits every year. These visits breakdown as follows:Family Practice - 68%, Gynecology, Contraceptive and Sexual Health - 18%, Mental Health Counseling - 7%, Abortion Care - 7%Description
Total Program Service Expense1115360TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109615NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees23NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonBLUE MOUNTAIN CLINICNamePerson
Telephone Number4067211646TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1610 N CALIFORNIA STAddressLine1
CityMISSOULACity
StateMTState
ZIP Code59802ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
ERIN GIEFER
Director2.000.00X000
AMANDA PATEL
Director2.000.00X000
Erica Woodahl
Director2.000.00X000
ANNIE HANSEN
Executive Dir.40.000.00X4576200
Trinda Rieck
Director2.000.00X000
JENESY DAHL
Director/Staff40.000.00X3754100
ERIN KLAHN
Director2.000.00X000
MEGAN DISHONG
Director2.000.00X000
Peet Mckinney
Treasurer2.000.00000X
Deanna Jenness
Vice President2.000.00000X
Keegan Flaherty
President2.000.00000X
ERIC A RAVITZ
STAFF40.000.0011108500X
FieldValueIRS element (for citing)
Total Reportable Comp From Org194388TotalReportableCompFromOrg
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions97943AllOtherContributions
Total Contributions97943TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionHEALTH CARE DELIVERYDescription
Business Code621110BusinessCode
Total Revenue Column1203577TotalRevenueColumn
Related Or Exempt Function Income1203577RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue1203577TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column22TotalRevenueColumn
Exclusion$22ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Fundraising Events29391GrossIncomeFundraisingEvents
Fundraising Direct Expenses12069FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column17322TotalRevenueColumn
Exclusion$17,322ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1318864TotalRevenueColumn
Related Or Exempt Function Income1203577RelatedOrExemptFunctionIncome
Exclusion$17,344ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total45763Total
Management And General34322ManagementAndGeneral
Fundraising11441Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total679326Total
Program Services577427ProgramServices
Management And General67933ManagementAndGeneral
Fundraising33966Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total19726Total
Program Services14795ProgramServices
Management And General4931ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total56421Total
Program Services42316ProgramServices
Management And General14105ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total19105Total
Management And General19105ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total7114Total
Program Services4624ProgramServices
Management And General2134ManagementAndGeneral
Fundraising356Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total13474Total
Program Services11453ProgramServices
Management And General1347ManagementAndGeneral
Fundraising674Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total13254Total
Program Services10603ProgramServices
Management And General1988ManagementAndGeneral
Fundraising663Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total9710Total
Program Services9710ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total34482Total
Program Services29310ProgramServices
Management And General3448ManagementAndGeneral
Fundraising1724Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total3669Total
Management And General3669ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
MALPRACTICE INSURANCE3441834418
LAB SUPPLIES4085740857
OUTSIDE SERVICES8670486704
MEDICAL SUPPLIES116627116627

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total163241Total
Program Services136516ProgramServices
Management And General24024ManagementAndGeneral
Fundraising2701Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1343891Total
Program Services1115360ProgramServices
Management And General177006ManagementAndGeneral
Fundraising51525Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY21294BOY
EOY14530EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY39322BOY
EOY45186EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY49824BOY
EOY52412EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5000BOY
EOY5000EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY27BOY
EOY27EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1128096LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec550950LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY611628BOY
EOY577146EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY727095BOY
EOY694301EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY18711BOY
EOY40080EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY209829BOY
EOY180746EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY228540BOY
EOY220826EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY498555BOY
EOY473475EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY498555BOY
EOY473475EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY727095BOY
EOY694301EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-25027ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-53ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years112513CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years80720CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years70224CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year99805CurrentTaxYearMinus1Year
Current Tax Year97943CurrentTaxYear
Total461205Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1059264CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1125776CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1158746CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1170365CurrentTaxYearMinus1Year
Current Tax Year1203577CurrentTaxYear
Total5717728Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1171777CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1206496CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1228970CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1270170CurrentTaxYearMinus1Year
Current Tax Year1301520CurrentTaxYear
Total6178933Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years86500CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years59197CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years52000CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year80000CurrentTaxYearMinus1Year
Current Tax Year69750CurrentTaxYear
Total347447Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years86500CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years59197CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years52000CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year80000CurrentTaxYearMinus1Year
Current Tax Year69750CurrentTaxYear
Total347447Total
FieldValueIRS element (for citing)
Public Support Total5095831486PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years468CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years228CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years145CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5CurrentTaxYearMinus1Year
Current Tax Year22CurrentTaxYear
Total868Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years468CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years228CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years145CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5CurrentTaxYearMinus1Year
Current Tax Year22CurrentTaxYear
Total868Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1172245CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1206724CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1229115CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1270175CurrentTaxYearMinus1Year
Current Tax Year1301542CurrentTaxYear
Total6179801Total
FieldValueIRS element (for citing)
Public Support Percentage5090.94360PublicSupportPercentage509
Prior Year Support Percentage0.93870PriorYearSupportPercentage
Investment Income Percentage0.00010InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00020PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis79989OtherCostOrOtherBasis
Book Value79989BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis833370OtherCostOrOtherBasis
Depreciation364342Depreciation
Book Value469028BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis210962OtherCostOrOtherBasis
Depreciation182833Depreciation
Book Value28129BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3775OtherCostOrOtherBasis
Depreciation3775Depreciation
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings577146TotalOfBookValueLandBuildings

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Agreement Ref FundraisingfalseAgreementRefFundraising

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1OFF THE RACKNameOfEvent1
Gross Receipts Event121909GrossReceiptsEvent1
Gross Revenue Event121909GrossRevenueEvent1
Rent Facility Costs Event11987RentFacilityCostsEvent1
Food And Beverage Event1508FoodAndBeverageEvent1
Other Direct Expenses Event14793OtherDirectExpensesEvent1
Gross Receipts Total21909GrossReceiptsTotal
Gross Revenue Total Events21909GrossRevenueTotalEvents
Rent Facility Costs Total Events1987RentFacilityCostsTotalEvents
Food And Beverage Total Events508FoodAndBeverageTotalEvents
Other Direct Expenses Total Events4793OtherDirectExpensesTotalEvents
Direct Expense Summary Events7288DirectExpenseSummaryEvents
Net Income Summary14621NetIncomeSummary

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (34 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesWORK COMP: Column (A) - Total = $5873; Column (B) - Program Services = $4405; Column (C) - Management & General = $1468; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesTRAINING: Column (A) - Total = $8993; Column (B) - Program Services = $8993; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesTELEPHONE: Column (A) - Total = $7953; Column (B) - Program Services = $6362; Column (C) - Management & General = $1193; Column (D) - Fundraising = $398
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesSUPPLIES: Column (A) - Total = $9913; Column (B) - Program Services = $6939; Column (C) - Management & General = $2974; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesSTAFF EXPENSE: Column (A) - Total = $3095; Column (B) - Program Services = $3095; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesSMALL TOOLS & EQUIPM: Column (A) - Total = $0; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesSID TAXES: Column (A) - Total = $10; Column (B) - Program Services = $0; Column (C) - Management & General = $10; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesSECURITY: Column (A) - Total = $484; Column (B) - Program Services = $484; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesREPAIRS & MAINTENANCE: Column (A) - Total = $2638; Column (B) - Program Services = $2638; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesPrinting and Publications: Column (A) - Total = $1634; Column (B) - Program Services = $1144; Column (C) - Management & General = $490; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesPostage and Shipping: Column (A) - Total = $3496; Column (B) - Program Services = $2971; Column (C) - Management & General = $175; Column (D) - Fundraising = $350
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesMISCELLANEOUS: Column (A) - Total = $125; Column (B) - Program Services = $125; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesMEDICAL WASTE: Column (A) - Total = $2204; Column (B) - Program Services = $2204; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesMARKETING & OUTREACH: Column (A) - Total = $14939; Column (B) - Program Services = $14939; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesLOBBYING EXPENSES : Column (A) - Total = $100; Column (B) - Program Services = $100; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesLICENSES: Column (A) - Total = $2955; Column (B) - Program Services = $2955; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesLAB FEES: Column (A) - Total = $616; Column (B) - Program Services = $616; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesFUNDRAISING EXPENSE: Column (A) - Total = $1953; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $1953
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesEQUIPMENT LEASE: Column (A) - Total = $7132; Column (B) - Program Services = $7132; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesEDUCATIONAL LITERATURE: Column (A) - Total = $232; Column (B) - Program Services = $232; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesDUES & SUBSCRIPTIONS: Column (A) - Total = $5960; Column (B) - Program Services = $5960; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesDONATION/CONTRIBTION: Column (A) - Total = $0; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesD&O INSURNACE: Column (A) - Total = $4472; Column (B) - Program Services = $0; Column (C) - Management & General = $4472; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesCOPY MACHINE LEASE AND EXPENSE: Column (A) - Total = $4754; Column (B) - Program Services = $0; Column (C) - Management & General = $4754; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesCONTRACTED SERVICES: Column (A) - Total = $21027; Column (B) - Program Services = $17873; Column (C) - Management & General = $3154; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesCONTINUING EDUCATION: Column (A) - Total = $2355; Column (B) - Program Services = $2355; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesBANK & CREDIT CARD CHARGES: Column (A) - Total = $8022; Column (B) - Program Services = $8022; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesADVERTISING: Column (A) - Total = $14389; Column (B) - Program Services = $14389; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other ExpensesAB ACCESS GRANTS: Column (A) - Total = $6582; Column (B) - Program Services = $6582; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24eForm 990, Part IX, Line 24e: Other Expenses401K MATCH: Column (A) - Total = $21335; Column (B) - Program Services = $16001; Column (C) - Management & General = $5334; Column (D) - Fundraising = $0
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableANY OF THESE DOCUMENTS ARE READILY AVAILIBLE UPON REQUEST.
Form 990, Part VI, Line 15bForm 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 12cForm 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 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessA FINANCE COMMITTEE CONSISTING OF THE CURRENT BOARD TREASURER AND THE CPA WHO PREPARES THE RETURN (ALSO A FORMER BOARD MEMBER) MEET TO REVIEW THE 990 IN DETAIL AND ANY CHANGES AND/OR SIGNIFICANT INFORMATION THAT IS RELEVANT TO BOARD MEMBERS IS PASSED ON TO THE BOARD FOR DISCUSSION PURPOSES VIA THE TREASURER.