Civic Intelligence

Impact Mental Health

990 • Fiscal year 2016 • EIN 57-1241243

Jan 01, 2016 to Dec 31, 2016 • Filed on Nov 15, 2017

515 East 4500 SouthSalt Lake City, UT 84107

(801) 590-9557

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

56th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2016 filings • 501(c)3 • <$500k nonprofits • Source year 2016

Liabilities / Revenue

55th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2016 filings • 501(c)3 • <$500k nonprofits • Source year 2016

Net Margin

79th percentile

23%

Higher net margin than 79% of similar nonprofits.

2016 filings • 501(c)3 • <$500k nonprofits • Source year 2016

Top Officer Pay

94th percentile

$60,000

Higher top officer pay than 94% of similar nonprofits.

Top officer pay equals 25.6% of source-year revenue.

2016 filings • 501(c)3 • <$500k nonprofits • Source year 2016

Asset Growth

90th percentile

85%

Faster asset growth than 90% of similar nonprofits.

2016 filings • 501(c)3 • <$500k nonprofits • Annualized from 2015 to 2016

Revenue Growth

68th percentile

14%

Faster revenue growth than 68% of similar nonprofits.

2016 filings • 501(c)3 • <$500k nonprofits • Annualized from 2015 to 2016

Assets

Up

$107,155

Up $49,235 (+85%) from 2015

Net Assets

Up

$107,155

Up $53,748 (+101%) from 2015

Liabilities

Down

$0

Down $4,513 (-100%) from 2015

Revenue

Up

$234,214

Up $28,606 (+14%) from 2015

Expenses

Down

$180,466

Down $15,712 (-8.0%) from 2015

Net Income

Up

$53,748

Up $44,318 (+470%) from 2015

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$600K$400K$200K$0Assets 2013: $74,047Liabilities 2013: $3,432Net Assets 2013: $70,6152013Assets 2014: $54,224Liabilities 2014: $10,247Net Assets 2014: $43,9772014Assets 2015: $57,920Liabilities 2015: $4,513Net Assets 2015: $53,4072015Assets 2016: $107,155Liabilities 2016: $0Net Assets 2016: $107,1552016Assets 2017: $146,180Liabilities 2017: $1,024Net Assets 2017: $145,1562017Assets 2018: $153,478Liabilities 2018: $500Net Assets 2018: $152,9782018Assets 2019: $232,042Liabilities 2019: $0Net Assets 2019: $232,0422019Assets 2020: $349,007Liabilities 2020: $0Net Assets 2020: $349,0072020Assets 2021: $476,502Liabilities 2021: $0Net Assets 2021: $476,5022021Assets 2022: $523,300Liabilities 2022: $3,496Net Assets 2022: $519,8042022Assets 2023: $0Net Assets 2023: $02023

Highlighted filing

2016

Assets$107,155
Liabilities$0
Net Assets$107,155

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$1.0M$500K$0-$500K-$1.0MRevenue 2013: $163,078Expenses 2013: $96,289Net Income 2013: $66,7892013Revenue 2014: $90,702Expenses 2014: $117,336Net Income 2014: -$26,6342014Revenue 2015: $205,608Expenses 2015: $196,178Net Income 2015: $9,4302015Revenue 2016: $234,214Expenses 2016: $180,466Net Income 2016: $53,7482016Revenue 2017: $292,734Expenses 2017: $254,733Net Income 2017: $38,0012017Revenue 2018: $406,099Expenses 2018: $366,309Net Income 2018: $39,7902018Revenue 2019: $679,850Expenses 2019: $600,786Net Income 2019: $79,0642019Revenue 2020: $731,663Expenses 2020: $614,698Net Income 2020: $116,9652020Revenue 2021: $887,661Expenses 2021: $760,166Net Income 2021: $127,4952021Revenue 2022: $826,444Expenses 2022: $783,142Net Income 2022: $43,3022022Revenue 2023: $18,813Expenses 2023: $531,424Net Income 2023: -$512,6112023

Highlighted filing

2016

Revenue$234,214
Expenses$180,466
Net Income$53,748
Jump To
Filing Snapshot
Filing Period
Jan 1, 2016 to Dec 31, 2016
Signed
Nov 15, 2017
Return Version
2016v3.0
Gross Receipts
$234,214
Mission and Program Overview

Mission

The Polizzi Clinic provides no-cost, community-based psychiatric care to low-income, uninsured children, adolescents and adults. The Polizzi Clinic is a safety net: A bridge to existing community health services for Utahns most in need.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$51,735$63,007▲ $11,272
Pledges and Grants Receivable$4,000$41,963▲ $37,963
Land, Buildings, and Equipment, Net$685$685→ $0
Savings and Temporary Cash Investments-$0-
Accounts Receivable-$0-
Other Notes and Loans Receivable, Net-$0-
Receivable From Disqualified Prsn-$0-
Receivables From Officers Etc-$0-
Investments Other Securities-$0-
Investments Program Related-$0-
Investments in Publicly Traded Securities-$0-
Intangible Assets-$0-
Inventories for Sale or Use-$0-
Prepaid Expenses and Deferred Charges-$0-
Total Assets$57,920$107,155▲ $49,235
Other Assets Total$1,500$1,500→ $0
Liabilities
Other Liabilities$3,013--
Accounts Payable and Accrued Expenses$1,500--
Total Liabilities$4,513$0▼ $4,513
Net Assets / Fund Balance
Unrestricted Net Assets$42,447$63,942▲ $21,495
Temporarily Rstr Net Assets$10,960$43,213▲ $32,253
Total Net Assets Fund Balance$53,407$107,155▲ $53,748
Total Liabilities and Net Assets / Fund Balance$57,920$107,155▲ $49,235

Asset Categories

AssetBook ValueDepreciationBasis
Buildings$685$2,387$3,072
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseTotal
Noel C Gardner MDMedical DirectorPT$60,000$60,000

Board Members and Trustees

Revenue and Support

Revenue Composition

Contributions and Grants
$234,212
Program Service Revenue
$0
Investment Income
$2
Other Revenue
$0
All Other Contributions
$234,212
Change in Net Assets
$53,748

Audited Revenue Reconciliation

Revenue per Audited Statements
$234,214
Total Revenue per Audited Statements
$234,214
Total Revenue per Form 990
$234,214
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$101,945
Salaries, Compensation, and Employee Benefits$78,521
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Current Officers, Directors, Trustees, and Key Employees$60,000--$60,000
Other Salaries and Wages$18,521--$18,521
Occupancy$18,180--$18,180
Other Expenses$1,501--$1,501
All Other Expenses$427--$427
Total Functional Expenses$180,466$0$0$180,466

Audited Expense Reconciliation

Line ItemAmount
Expenses per Audited Statements$180,466
Total Expenses per Audited Statements$180,466
Total Expenses per Form 990$180,466
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Receivables from Disqualified Persons-$0-
Receivables from Officers, Directors, Trustees, and Key Employees-$0-
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Backup withholding compliance
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Line 11B: Form 990 Review Process

The Executive Director of the Polizzi Foundation reviewed the exempt organization tax return.

Form 990, Part VI, Line 12C: Explanation of Monitoring and Enforcement of Conflicts

Each officer, director and key employee must annually renew and sign a contract with the Polizzi Clinic. Before signing, each individual must disclose any potential conflicts of interest.

Form 990, Part VI, Line 19: Other Organization Documents Publicly Available

No documents available to the public.

Filing and Contact Details

Filer

Filer Name
Polizzi Foundation
EIN
57-1241243
Phone
8015909557
Address
515 East 4500 South, Salt Lake City, UT 84107

Signing Officer

Name
Liz Kociolek MSEd
Title
Executive Director
Signed
2017-11-15
Discuss with paid preparer
Yes

Organization Details

Legal Domicile
Ut
Voting Board Members
9
Independent Board Members
7
Employees
6
Volunteers
23

Preparer

Firm
Simmons & Company A Professional CPA Corp
Address
2494 South 1300 East, Salt Lake City, UT 84106-3156
Preparer
Marc L Simmons
Phone
8014862731
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IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus1YearAmt0166330
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus2YearsAmt090603
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus3YearsAmt0163073
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus4YearsAmt024047
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/TotalAmt0620942
IRS990ScheduleA/GovtFurnSrvcFcltsVl509Grp/TotalAmt00
IRS990ScheduleA/GrossInvestmentIncome509Grp/TotalAmt00
IRS990ScheduleA/GrossReceiptsAdmissionsGrp/TotalAmt00
IRS990ScheduleA/GrossReceiptsNonUnrltBusGrp/TotalAmt00
IRS990ScheduleA/InvestmentIncomeCYPct00.00000
IRS990ScheduleA/NetIncomeFromOtherUBIGrp/TotalAmt00
IRS990ScheduleA/OtherIncome509Grp/TotalAmt00
IRS990ScheduleA/Post1975UBTIGrp/TotalAmt00
IRS990ScheduleA/PubliclySupportedOrg509a2Ind0X
IRS990ScheduleA/PublicSupportCY509Pct00.85180
IRS990ScheduleA/PublicSupportPY509Pct00.79280
IRS990ScheduleA/PublicSupportTotal509Amt0528942
IRS990ScheduleA/SubstAndDsqlfyPrsnsTotGrp/CurrentTaxYearMinus2YearsAmt050000
IRS990ScheduleA/SubstAndDsqlfyPrsnsTotGrp/CurrentTaxYearMinus3YearsAmt042000
IRS990ScheduleA/SubstAndDsqlfyPrsnsTotGrp/TotalAmt092000
IRS990ScheduleA/SubstantialContributorsAmtGrp/CurrentTaxYearMinus2YearsAmt050000
IRS990ScheduleA/SubstantialContributorsAmtGrp/CurrentTaxYearMinus3YearsAmt042000
IRS990ScheduleA/SubstantialContributorsAmtGrp/TotalAmt092000
IRS990ScheduleA/TaxRevLeviedOrgnztnlBnft509Grp/TotalAmt00
IRS990ScheduleA/ThirtyThrPctSuprtTestsCY509Ind0X
IRS990ScheduleA/Total509Grp/CurrentTaxYearAmt0176889
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus1YearAmt0166330
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt090603
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt0163073
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt024047
IRS990ScheduleA/Total509Grp/TotalAmt0620942
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearAmt0176889
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus1YearAmt0166330
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus2YearsAmt090603
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus3YearsAmt0163073
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus4YearsAmt024047
IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt0620942
IRS990ScheduleB/ContributorInformationGrp/ContributorBusinessName/BusinessNameLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorNum0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine20RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/City0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/State0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/ZIPCode0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/TotalContributionsAmt0RESTRICTED
IRS990/ScheduleBRequiredInd0true
IRS990ScheduleD/BuildingsGrp/BookValueAmt0685
IRS990ScheduleD/BuildingsGrp/DepreciationAmt02387
IRS990ScheduleD/BuildingsGrp/OtherCostOrOtherBasisAmt03072
IRS990ScheduleD/ExpensesSubtotalAmt0180466
IRS990ScheduleD/RevenueSubtotalAmt0234214
IRS990ScheduleD/TotalBookValueLandBuildingsAmt0685
IRS990ScheduleD/TotalExpensesPerForm990Amt0180466
IRS990ScheduleD/TotalRevenuePerForm990Amt0234214
IRS990ScheduleD/TotalRevEtcAuditedFinclStmtAmt0234214
IRS990ScheduleD/TotExpnsEtcAuditedFinclStmtAmt0180466
IRS990/ScheduleJRequiredInd0false
IRS990/ScheduleORequiredInd0false
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0The Executive Director of the Polizzi Foundation reviewed the exempt organization tax return.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1Each officer, director and key employee must annually renew and sign a contract with the Polizzi Clinic. Before signing, each individual must disclose any potential conflicts of interest.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2No documents available to the public.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0Form 990, Part VI, Line 11b: Form 990 Review Process
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
IRS990/SchoolOperatingInd0false
IRS990/SignificantChangeInd0false
IRS990/SignificantNewProgramSrvcInd0false
IRS990/SubjectToProxyTaxInd0false
IRS990/TaxableDistributionsInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TemporarilyRstrNetAssetsGrp/BOYAmt010960
IRS990/TemporarilyRstrNetAssetsGrp/EOYAmt043213
IRS990/TempOrPermanentEndowmentsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt057920
IRS990/TotalAssetsEOYAmt0107155
IRS990/TotalAssetsGrp/BOYAmt057920
IRS990/TotalAssetsGrp/EOYAmt0107155
IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalContributionsAmt0234212
IRS990/TotalEmployeeCnt06
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt00
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt0180466
IRS990/TotalFunctionalExpensesGrp/TotalAmt0180466
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt04513
IRS990/TotalLiabilitiesEOYAmt00
IRS990/TotalLiabilitiesGrp/BOYAmt04513
IRS990/TotalLiabilitiesGrp/EOYAmt00
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt053407
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt0107155
IRS990/TotalProgramServiceExpensesAmt0180466
IRS990/TotalProgramServiceRevenueAmt00
IRS990/TotalReportableCompFromOrgAmt060000
IRS990/TotalRevenueGrp/ExclusionAmt02
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0234214
IRS990/TotalVolunteersCnt023
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt057920
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt0107155
IRS990/TransactionWithControlEntInd0false
IRS990/TravelGrp/TotalAmt00
IRS990/TrnsfrExmptNonChrtblRltdOrgInd0false
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UnrestrictedNetAssetsGrp/BOYAmt042447
IRS990/UnrestrictedNetAssetsGrp/EOYAmt063942
IRS990/UponRequestInd0X
IRS990/VotingMembersGoverningBodyCnt09
IRS990/VotingMembersIndependentCnt07
IRS990/WebsiteAddressTxt0polizziclinic.org
IRS990/WhistleblowerPolicyInd0false

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