Civic Intelligence

Impact Mental Health

990 • Fiscal year 2021 • EIN 57-1241243

Jan 01, 2021 to Dec 31, 2021 • Filed on Nov 15, 2022

Organization Profileimpactmentalhealth.org
5373 South Green Street 650Murray, UT 84123

(801) 590-9557

Siviq Scores

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

Liabilities / Assets

29th percentile

0.00x

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

2021 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2021

Liabilities / Revenue

29th percentile

0.00x

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

2021 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2021

Net Margin

53rd percentile

14%

Higher net margin than 53% of similar nonprofits.

2021 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2021

Top Officer Pay

86th percentile

$93,000

Higher top officer pay than 86% of similar nonprofits.

Top officer pay equals 10.5% of source-year revenue.

2021 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2021

Asset Growth

78th percentile

37%

Faster asset growth than 78% of similar nonprofits.

2021 filings • 501(c)3 • $500k-$1M nonprofits • Annualized from 2020 to 2021

Revenue Growth

57th percentile

21%

Faster revenue growth than 57% of similar nonprofits.

2021 filings • 501(c)3 • $500k-$1M nonprofits • Annualized from 2020 to 2021

Balance Sheet
Liabilities / Assets29th percentile

Assets

Up

$476,502

Up $127,495 (+37%) from 2020

Net Assets

Up

$476,502

Up $127,495 (+37%) from 2020

Liabilities

Flat

$0

Flat from 2020

Revenue And Expenses
Liabilities / Revenue29th percentileNet Margin53rd percentile

Revenue

Up

$887,661

Up $155,998 (+21%) from 2020

Expenses

Up

$760,166

Up $145,468 (+24%) from 2020

Net Income

Up

$127,495

Up $10,530 (+9.0%) from 2020

Historical Trend

Balance Sheet Trend

Asset Growth78th percentile

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

2021

Assets$476,502
Liabilities$0
Net Assets$476,502
Open 2021 Filing

Operations Trend

Revenue Growth57th percentile

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

2021

Revenue$887,661
Expenses$760,166
Net Income$127,495
Open 2021 Filing
Jump To
Filing Snapshot
Filing Period
Jan 1, 2021 to Dec 31, 2021
Signed
Nov 15, 2022
Return Version
2021v4.1
Gross Receipts
$887,661
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.

Impact Mental Health provides no-cost, community-based psychiatric care to low-income, uninsured children, adolescents and adults. Impact Mental Health 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$346,301$473,797▲ $127,496
Savings and Temporary Cash Investments-$0-
Accounts Receivable-$0-
Other Notes and Loans Receivable, Net-$0-
Pledges and Grants Receivable-$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-
Land, Buildings, and Equipment, Net-$0-
Intangible Assets-$0-
Inventories for Sale or Use-$0-
Prepaid Expenses and Deferred Charges-$0-
Total Assets$349,007$476,502▲ $127,495
Other Assets Total$2,706$2,705▼ $1
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$349,007$476,502▲ $127,495
Total Net Assets Fund Balance$349,007$476,502▲ $127,495
Total Liabilities and Net Assets / Fund Balance$349,007$476,502▲ $127,495
Compensation and Service Providers
Top Officer Pay86th percentile

Employees

NameTitleFull / Part TimeBaseTotal
Noel C Gardner MDMedical DirectorPT$93,000$93,000
Carolyn TometichFormer Executive DirectorFT$46,667$46,667
Bridget Shears MBAFormer Executive DirectorFT$35,917$35,917

Board Members and Trustees

NameTitle
John ParrishBoard Chair
Zachary TuckerFinancial Chair
Tammer Attallah LCSW MBAMission Chair
Tricia Pannier SPHR SHRM-SCPVice Chair
Ashley SampsonBoard Member
Bryan Hayes MBABoard Member
Connie GardnerBoard Member
Cynthia ThroopBoard Member
Shawn C FerrinBoard Member
Zoe Robbins DNPBoard Member
Revenue and Support

Revenue Composition

Contributions and Grants
$887,533
Program Service Revenue
$0
Investment Income
$128
Other Revenue
$0
All Other Contributions
$887,533
Change in Net Assets
$127,495

Audited Revenue Reconciliation

Revenue per Audited Statements
$887,661
Total Revenue per Audited Statements
$887,661
Total Revenue per Form 990
$887,661
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$495,207
Salaries, Compensation, and Employee Benefits$264,959
Total Fundraising Expense$39,280
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$81,275$70,539$20,145$171,959
Current Officers, Directors, Trustees, and Key Employees$43,956$38,149$10,895$93,000
Occupancy$819$41,740-$42,559
Other Expenses$9,045$2,250$8,240$11,295
Total Functional Expenses$554,689$166,197$39,280$760,166

Audited Expense Reconciliation

Line ItemAmount
Expenses per Audited Statements$760,166
Total Expenses per Audited Statements$760,166
Total Expenses per Form 990$760,166
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
Audit committee
No
Backup withholding compliance
No
Business relationship with 35% controlled entity
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 Impact Mental Health's Board Chair and Medical Director 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 Impact Mental Health. 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
Impact Mental Health
EIN
57-1241243
Phone
8015909557
Address
5373 South Green Street 650, Murray, UT 84123

Signing Officer

Name
Noel C Gardner MD
Title
Medical Director
Signed
2022-11-15
Discuss with paid preparer
Yes

Organization Details

Legal Domicile
Ut
Voting Board Members
11
Independent Board Members
8
Employees
10
Volunteers
23

Preparer

Firm
Simmons & Company A Professional CPA Corp
Address
2494 South 1300 East, Salt Lake City, UT 84106
Preparer
Marc L Simmons CPA
Phone
8014862731
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IRS990/OtherExpensesGrp/FundraisingAmt08240
IRS990/OtherExpensesGrp/ManagementAndGeneralAmt013519
IRS990/OtherExpensesGrp/ManagementAndGeneralAmt12250
IRS990/OtherExpensesGrp/ProgramServicesAmt0402766
IRS990/OtherExpensesGrp/ProgramServicesAmt116828
IRS990/OtherExpensesGrp/ProgramServicesAmt29045
IRS990/OtherExpensesGrp/TotalAmt0402766
IRS990/OtherExpensesGrp/TotalAmt138587
IRS990/OtherExpensesGrp/TotalAmt211295
IRS990/OtherRevenueTotalAmt00
IRS990/OtherSalariesAndWagesGrp/FundraisingAmt020145
IRS990/OtherSalariesAndWagesGrp/ManagementAndGeneralAmt070539
IRS990/OtherSalariesAndWagesGrp/ProgramServicesAmt081275
IRS990/OtherSalariesAndWagesGrp/TotalAmt0171959
IRS990/OthNotesLoansReceivableNetGrp/EOYAmt00
IRS990/PartialLiquidationInd0false
IRS990/PaymentsToAffiliatesGrp/TotalAmt00
IRS990/PayPremiumsPrsnlBnftCntrctInd0false
IRS990/PayrollTaxesGrp/TotalAmt00
IRS990/PensionPlanContributionsGrp/TotalAmt00
IRS990/PledgesAndGrantsReceivableGrp/EOYAmt00
IRS990/PoliticalCampaignActyInd0false
IRS990/PrepaidExpensesDefrdChargesGrp/EOYAmt00
IRS990/ProfessionalFundraisingInd0false
IRS990/ProhibitedTaxShelterTransInd0false
IRS990/PYContributionsGrantsAmt0731453
IRS990/PYExcessBenefitTransInd0false
IRS990/PYInvestmentIncomeAmt0210
IRS990/PymtTravelEntrtnmntPubOfclGrp/TotalAmt00
IRS990/PYOtherExpensesAmt0420854
IRS990/PYRevenuesLessExpensesAmt0116965
IRS990/PYSalariesCompEmpBnftPaidAmt0193844
IRS990/PYTotalExpensesAmt0614698
IRS990/PYTotalRevenueAmt0731663
IRS990/QuidProQuoContributionsInd0false
IRS990/RcvblFromDisqualifiedPrsnGrp/EOYAmt00
IRS990/RcvFndsToPayPrsnlBnftCntrctInd0false
IRS990/ReceivablesFromOfficersEtcGrp/EOYAmt00
IRS990/ReconcilationRevenueExpnssAmt0127495
IRS990/RegularMonitoringEnfrcInd0true
IRS990/RelatedEntityInd0false
IRS990/RelatedOrganizationCtrlEntInd0false
IRS990/ReportInvestmentsOtherSecInd0false
IRS990/ReportLandBuildingEquipmentInd0false
IRS990/ReportOtherAssetsInd0false
IRS990/ReportOtherLiabilitiesInd0false
IRS990/ReportProgramRelatedInvstInd0false
IRS990/RevenueAmt0887533
IRS990/RoyaltiesGrp/TotalAmt00
IRS990/RoyaltiesRevenueGrp/TotalRevenueColumnAmt00
IRS990/SavingsAndTempCashInvstGrp/EOYAmt00
IRS990ScheduleA/AmountsRcvdDsqlfyPersonGrp/TotalAmt00
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearAmt0484767
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus1YearAmt0380783
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus2YearsAmt0348877
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus3YearsAmt0280453
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus4YearsAmt0215294
IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/TotalAmt01710174
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/PublicSupportCY509Pct01.00000
IRS990ScheduleA/PublicSupportPY509Pct01.00000
IRS990ScheduleA/PublicSupportTotal509Amt01710174
IRS990ScheduleA/SubstantialContributorsAmtGrp/TotalAmt00
IRS990ScheduleA/TaxRevLeviedOrgnztnlBnft509Grp/TotalAmt00
IRS990ScheduleA/ThirtyThrPctSuprtTestsCY509Ind0X
IRS990ScheduleA/Total509Grp/CurrentTaxYearAmt0484767
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus1YearAmt0380783
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt0348877
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt0280453
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt0215294
IRS990ScheduleA/Total509Grp/TotalAmt01710174
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearAmt0484767
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus1YearAmt0380783
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus2YearsAmt0348877
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus3YearsAmt0280453
IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus4YearsAmt0215294
IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt01710174
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/ExpensesSubtotalAmt0760166
IRS990ScheduleD/RevenueSubtotalAmt0887661
IRS990ScheduleD/TotalExpensesPerForm990Amt0760166
IRS990ScheduleD/TotalRevenuePerForm990Amt0887661
IRS990ScheduleD/TotalRevEtcAuditedFinclStmtAmt0887661
IRS990ScheduleD/TotExpnsEtcAuditedFinclStmtAmt0760166
IRS990ScheduleJ/AnyNonFixedPaymentsInd0false
IRS990ScheduleJ/CompBasedOnRevenueOfFlngOrgInd0false
IRS990ScheduleJ/CompBsdNetEarnsFlngOrgInd0false
IRS990ScheduleJ/CompBsdNetEarnsRltdOrgsInd0false
IRS990ScheduleJ/CompBsdOnRevRelatedOrgsInd0false
IRS990ScheduleJ/EquityBasedCompArrngmInd0false
IRS990ScheduleJ/InitialContractExceptionInd0false
IRS990/ScheduleJRequiredInd0true
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt035917
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt146667
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm0Bridget Shears MBA
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm1Carolyn Tometich
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt0Former Executive Dir.
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt1Former Executive Dir.
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt035917
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt146667
IRS990ScheduleJ/SeverancePaymentInd0false
IRS990ScheduleJ/SupplementalNonqualRtrPlanInd0false
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0The Impact Mental Health's Board Chair and Medical Director reviewed the exempt organization tax return.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1Each officer, director and key employee must annually renew and sign a contract with Impact Mental Health. 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/SubjectToExcsTaxNetInvstIncInd0false
IRS990/SubjectToProxyTaxInd0false
IRS990/SubjToTaxRmnrtnExPrchtPymtInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt0349007
IRS990/TotalAssetsEOYAmt0476502
IRS990/TotalAssetsGrp/BOYAmt0349007
IRS990/TotalAssetsGrp/EOYAmt0476502
IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalContributionsAmt0887533

Document Assets

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Filings

Displayed year

2021 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$476,502
Liabilities
$0
Net assets
$476,502
Revenue
$887,661
Expenses
$760,166
Net income
$127,495
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2023Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.19$5.31$5.13
2022Detailed filing. Detailed filing data is available for this year.$5.23$0.03$5.20$8.26$7.83$0.43
2021Detailed filing. Detailed filing data is available for this year.$4.77$0.00$4.77$8.88$7.60$1.27
2020Detailed filing. Detailed filing data is available for this year.$3.49$0.00$3.49$7.32$6.15$1.17
2019Detailed filing. Detailed filing data is available for this year.$2.32$0.00$2.32$6.80$6.01$0.79
2018Summary only. Only limited summary data is available for this year.$1.53$0.01$1.53$4.06$3.66$0.40
2017Detailed filing. Detailed filing data is available for this year.$1.46$0.01$1.45$2.93$2.55$0.38
2016Detailed filing. Detailed filing data is available for this year.$1.07$0.00$1.07$2.34$1.80$0.54
2015Detailed filing. Detailed filing data is available for this year.$0.58$0.05$0.53$2.06$1.96$0.09
2014Detailed filing. Detailed filing data is available for this year.$0.54$0.10$0.44$0.91$1.17$0.27
2013Detailed filing. Detailed filing data is available for this year.$0.74$0.03$0.71$1.63$0.96$0.67