As the practice manager for our mid$-$sized primary care clinic in a rural Virginia area, I am pleased to present this strategic planning report to the executive leadership team. Considering our clinic's distinctive challenges and opportunities within the broader nonprofit healthcare system, this report offers valuable insights and recommendations for the upcoming year's budget and strategic plan. To develop a successful strategic plan, it is crucial to consider various factors, including economic conditions, financial considerations, cultural influences, workforce management, and regulatory policies