2023-02-15T10:09:40-06:00 2022-03-31 221478099 COHNREZNICK LLP 14 SYLVAN WAY PARSIPPANY NJ 070543801 990 2021-04-01 742357970 SU CLINICA FAMILIAR INC SUCL 9563656750 1706 TREASURE HILLS BLVD HARLINGEN TX 78550 ADAM SALDIVAR CHIEF FINANCIAL OFFICER 9563656750 2023-02-14 1 ADAM SALDIVAR 999009999 LORI ROTHE YOKOBOSKY CPA P01273422 9732283500 2023-02-13 3 AAL1 IAL1 2021 2023-03-07 01:45:13Z SU CLINICA ELENA MARIN MD 1706 TREASURE HILLS BLVD HARLINGEN TX 78550 37113425 0 X WWW.SUCLINICA.ORG X 1971 TX EXCELLENCE IN HEALTH CARE DELIVERY AND CLINICAL EDUCATION, AND BE RECOGNIZED AS A LEADER IN COMMUNITY HEALTH. 13 13 485 0 0 0 18123914 16137600 16583938 20762499 641 101 75069 213225 34783562 37113425 0 0 0 0 23441436 23800331 0 0 0 10413963 10757650 33855399 34557981 928163 2555444 25783888 25487361 10923653 8035560 14860235 17451801 X TO PROMOTE A HEALTHIER COMMUNITY BY PROVIDING ACCESS TO HIGH VALUE, COMPREHENSIVE, AND HOLISTIC HEALTHCARE SERVICES. 0 0 27206167 20975724 SU CLINICA FAMILIAR, INC. STRONGLY BELIEVES THAT THE TRUE WEALTH OF A COMMUNITY CAN BE JUDGED BY THE HEALTH OF ITS POPULATION. WE GO BEYOND THE TRADITIONAL DOCTORS OFFICE BY OFFERING A WIDE VARIETY OF COMMUNITY PROGRAMS AIMED AT INCREASING THE HEALTH STATUS OF THE ENTIRE COMMUNITY. WE BELIEVE THAT HEALTHY CITIZENS PERFORM BETTER IN OUR SCHOOLS, CONTRIBUTE MORE TO OUR ECONOMY AND ESTABLISH A STRONG FOUNDATION FOR THE COMMUNITY'S VIABILITY. IN THE PAST YEAR SU CLINICA SERVED 30,308 PATIENTS, OF WHICH 11,015 WERE UNINSURED. SU CLINICA'S COMMITMENT TO A HEALTHY SOCIETY INCLUDES PARTICIPATION IN A VARIETY OF DIFFERENT PROGRAMS, AS LISTED HERE.- DIABETES COLLABORATIVE - A NATIONAL PROGRAM TO PROVIDE PERSONALIZED CASE MANAGEMENT SERVICES TO DIABETES PATIENTS.- CHILD HEALTH INSURANCE PROGRAM (CHIP) OUTREACH PROGRAM - INFORMS LOW INCOME FAMILIES ON THE BENEFITS OF ENROLLING CHILDREN IN THE STATE CHIP PROGRAM.- PATIENT CENTERED MEDICAL HOME (PCMH) - SU CLINICA FAMILIAR HAS FOUR LEVEL 3 PCMH SITES CONSISTING OF OUR HARLINGEN, TEXAS, BROWNSVILLE, TEXAS, RAYMONDVILLE, TEXAS, AND SANTA ROSA, TEXAS LOCATION.- DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) 1115 WAIVER - THE CLINIC EXPECTS THAT THE USE OF ELECTRONIC MEDICAL RECORDS, HEALTH INFORMATION EXCHANGE, PATIENT CENTERED MEDICAL HOME AND COORDINATION WITH THE HOSPITAL WILL LEAD TO A PERCENTAGE REDUCTION IN THE NUMBER OF ADULT PATIENTS WITH TYPE 1 OR 2 DIABETES WHOSE HBA1C IS ABOVE 9.0%, OTHERWISE KNOWN AS POOR CONTROL.- HRSA OUTREACH AND ENROLLMENT PROGRAM - EXPAND CURRENT OUTREACH AND ENROLLMENT ASSISTANCE ACTIVITIES AND FACILITATE ENROLLMENT OF ELIGIBLE HEALTH CENTER PATIENTS AND SERVICE AREA RESIDENTS INTO AFFORDABLE HEALTH INSURANCE COVERAGE THROUGH THE HEALTH INSURANCE MARKETPLACES, MEDICAID, OR THE CHILDREN'S HEALTH INSURANCE PROGRAM.- ACCESS INCREASE IN MENTAL HEALTH AND SUBSTANCE USE - TO PROVIDE PRIMARY CARE MENTAL HEALTH AND SUBSTANCE USE SERVICES WITH A FOCUS ON OPIOID ABUSE TO INCREASE NUMBER OF STAFF WHO ARE PROVIDING MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES TO EXISTING PATIENTS. THE CLINIC WILL ALSO LEVERAGE HEALTH INFORMATION TECHNOLOGY (IT) AND PROVIDE TRAINING TO SUPPORT THE EXPANSION OF MH AND SA SERVICES FOCUSING ON THE TREATMENT, PREVENTION, AND AWARENESS OF OPIOID ABUSE, AND THEIR INTEGRATION INTO PRIMARY CARE.-DIABETES PREVENTION PROGRAM - THROUGH THE CDC-LED NATIONAL DIABETES PREVENTION PROGRAM (NATIONAL DPP), PUBLIC AND PRIVATE ORGANIZATIONS WILL WORK TOGETHER TO EXPAND THE INFRASTRUCTURE FOR THE NATIONWIDE DELIVERY OF AN EVIDENCE-BASED LIFESTYLE CHANGE PROGRAM TO PREVENT OR DELAY ONSET OF TYPE 2 DIABETES AMONG ADULTS WITH PRE-DIABETES. THE NATIONAL GOAL IS TO EXPAND THE NATIONAL DPP DELIVERY STRUCTURE, CLOSE THE ENROLLMENT GAP SO THAT MORE PARTICIPANTS WITH PREDIABETES SUCCESSFULLY COMPLETE THE CDC LIFESTYLE CHANGE PROGRAM, ACHIEVE 5-7 % WEIGHT LOSS, AND SIGNIFICANTLY REDUCE THEIR RISK FOR DEVELOPING TYPE 2 DIABETES. - INTEGRATED HEALTHCARE IMPROVEMENT - SERVE A PANEL OF 200 UNDERSERVED PATIENTS, EACH WITH 2 OR MORE CO-MORBIDITIES INCLUDING DIABETES, HYPERTENSION, OBESITY, AND DEPRESSION, WITH A FOCUS ON IMPROVING HEALTH OUTCOMES. PROVIDE DATA SHOWING THE RESULTS FOR THESE PATIENTS RELATED TO THE 4 CO-MORBIDITIES.- PROJECT DOC (DIABETES AND OBESITY COLLABORATION) - THE GOAL IS TO CREATE AN ECOSYSTEM IN WHICH THE PRIVATE SECTOR, HEALTHCARE, AND PATIENTS LEVERAGE TECHNOLOGY AND COLLABORATE TO CHANGE THE HEALTHCARE MODEL.- SI TEXAS - WORK WITH THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON - BROWNSVILLE REGIONAL CAMPUS TO FURTHER THE AIMS OF THE SI TEXAS PROJECT.GOAL 1: AT LEAST 45% OF SALUD Y VIDA PARTICIPANTS WHO WERE IDENTIFIED BY THE CHRONIC CARE MANAGEMENT TEAM AS NEEDING MTM SERVICES OR BH SERVICES WILL RECEIVE SAID SERVICES BY THE END OF YEAR 2.GOAL 2: AT LEAST 20% OF MTM PROGRAM PARTICIPANTS WILL ACHIEVE AN HBA1C OF BELOW 9% DURING THE 9 MONTHS FOLLOWING THE PROVISION OF SERVICES BY THE END OF YEAR 2.GOAL 3: AT LEAST 20% OF BEHAVIORAL HEALTH SERVICE PROGRAM PARTICIPANTS WILL ACHIEVE AN HBA1C OF BELOW 9% DURING THE 9 MONTHS FOLLOWING THE PROVISION OF SERVICES BY THE END OF YEAR 2. - DSRIP 1115 WAIVER - REDUCE THE OVERALL A1C AMONG THE TARGET POPULATION TO 32.90% OR BELOW, CONTINUE TO IMPROVE THE PROPORTION OF PATIENTS WITH UNCONTROLLED DIABETES AND WILL DEMONSTRATE AN IMPROVEMENT OF THIS PROPORTION FROM THE BASELINE AS DEFINED BY HHSC.- SU CLINICA IS PARTICIPATING IN HRSA'S ADVANCING PRECISION MEDICINE (APM) PROJECT. THIS PARTICIPATION OF THE HEALTH CENTER 'ALL OF US RESEARCH' PROGRAM (AOU) WILL HELP THE CENTER CONTRIBUTE TO THE ACHIEVEMENT OF THE AOU'S CENTRAL GOAL: TO ENROLL 1 MILLION INDIVIDUALS REFLECTING THE NATION'S RICH DIVERSITY AND PRODUCE MEANINGFUL HEALTH OUTCOMES FOR COMMUNITIES ACROSS THE COUNTRY, INCLUDING THOSE HISTORICALLY UNDERREPRESENTED IN BIOMEDICAL RESEARCH. THE APM WILL ALSO ASSIST IN THE ADVANCMENT OF THE HEALTH CENTERS' INTEROPERABILITY FUNCTIONALITY, PREPAREDNESS TO USE AND SHARE PATIENT DATA, AND CAPACITY TO PARTICIPATE IN FUTURE RESEARCH OPPORTUNITIES. - SU CLINICA HAS LAUNCHED A TELEMEDICINE PROGRAM IN WHICH THE CENTER MAKES AVAILABLE HEALTH CARE SERVICES VIA TELEMEDICINE AND TELEHEALTH TO MEDICAL AND BEHAVIORAL HEALTH CLINIC PATIENTS. - SU CLINICA HAS ACTIVELY BEEN PARTICIPATING IN THE FOLLOWING WITH REGARDS TO COVID: - COVID-19 VACCINATION CAPACITY SUPPORT TO PLAN, PREPARE FOR, PROMOTE, DISTRIBUTE, ADMINISTER, AND TRACK COVID-19 VACCINES, AND TO CARRY OUT OTHER VACCINE-RELATED ACTIVITIES, INCLUDING OUTREACH AND EDUCATION.- COVID-19 RESPONSE AND TREATMENT CAPACITY SUPPORT TO DETECT, DIAGNOSE, TRACE, MONITOR, AND TREAT COVID19 INFECTIONS AND RELATED ACTIVITIES NECESSARY TO MITIGATE THE SPREAD OF COVID19, INCLUDING OUTREACH AND EDUCATION.- MAINTAINING AND INCREASING CAPACITY SUPPORT TO ESTABLISH, MODIFY, ENHANCE, EXPAND, AND SUSTAIN THE ACCESSIBILITY AND AVAILABILITY OF COMPREHENSIVE PRIMARY CARE SERVICES TO MEET THE ONGOING AND EVOLVING NEEDS OF THE SERVICE AREA AND VULNERABLE PATIENT POPULATIONS.- RECOVERY AND STABILIZATION SUPPORT FOR ONGOING RECOVERY AND STABILIZATION, INCLUDING ENHANCING AND EXPANDING THE HEALTH CARE WORKFORCE AND SERVICES TO MEET PENT UP DEMAND DUE TO DELAYS IN PATIENTS SEEKING PREVENTIVE AND ROUTINE CARE; ADDRESS THE BEHAVIORAL HEALTH, CHRONIC CONDITIONS, AND OTHER NEEDS OF THOSE WHO HAVE BEEN OUT OF CARE; AND SUPPORT THE WELL-BEING OF PERSONNEL WHO HAVE BEEN ON THE FRONT LINES OF THE PANDEMIC. 27206167 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 42 0 1 485 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X ADAM SALDIVAR 9563656750 1706 TREASURE HILLS BLVD HARLINGEN TX 78550 AIDA CANTU BOARD MEMBER 1.00 1.00 X 0 0 0 AMANDA MOLINA BOARD MEMBER 1.00 X 0 0 0 ANISA RAMIREZ BOARD MEMBER 1.00 1.00 X 0 0 0 CARLOS GARZA SECRETARY 1.00 X X 0 0 0 CHRISTINA GARCIA ED D CHAIRPERSON 1.00 X X 0 0 0 DOROTHY GARZA TREASURER 1.00 X X 0 0 0 ESMERALDA CISNEROS BOARD MEMBER 1.00 X 0 0 0 FIDEL ATKINSON JR BOARD MEMBER 1.00 1.00 X 0 0 0 JESSICA GONZALEZ BOARD MEMBER 1.00 X 0 0 0 JOHNNY I PINEDA VICE CHAIRPERSON 1.00 1.00 X X 0 0 0 MARGARITA CERVANTES BOARD MEMBER 1.00 X 0 0 0 MATTHEW MONTEMAYOR BOARD MEMBER 1.00 1.00 X 0 0 0 ROSALEE NAJAR BOARD MEMBER 1.00 1.00 X 0 0 0 ELENA MARIN MD CHIEF EXECUTIVE OFFICER 38.00 2.00 X 324693 0 18399 JOSE ADAM SALDIVAR CHIEF FINANCIAL OFFICER 38.00 2.00 X 124817 0 19770 CHANDRASEKHER REDDY MD CHIEF MEDICAL OFFICER 40.00 X 285930 0 30640 ANSHU BHATLA PHYSICIAN 40.00 X 270163 0 29920 MARIA MUNOZ PHYSICIAN 40.00 X 261638 0 23640 MIGUEL MARTINEZ-VELA PEDIATRIC PHYSICIAN 40.00 X 236411 0 21456 RAMIRO MUNOZ MD OB/GYN PHYSICIAN 40.00 X 538833 0 42677 RICARDO ALANIZ PHYSICIAN 40.00 X 235191 0 29139 2277676 0 215641 51 0 1 0 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 AUDIT & TAX SERVICES 269105 ALBERT BERNARDONI MD PA 916 BALBOA AVE RANCHO VIEJO TX 78575 PROFESSIONAL MEDICAL SERVICES 269105 ALBERTO E VASQUEZ MD PA 2334 S 25TH ST HARLINGEN TX 78550 PROFESSIONAL MEDICAL SERVICES 226954 JOSEPH CAPORUSSO 812 LINDBURG AVE MCALLEN TX 78501 PROFESSIONAL MEDICAL SERVICES 160001 HARLINGEN OBSTETRICS AND GYNECOLGY 2230 HAINE DR HARLINGEN TX 78550 PROFESSIONAL MEDICAL SERVICES 143500 5 14853286 1284314 16137600 MEDICAID & MEDICAID MANAGED CARE 621400 10810563 10810563 SELF PAY 621400 3548539 3548539 340B PHARMACY REVENUE 621400 2997802 2997802 OTHER THIRD PARTY 621400 2112641 2112641 MEDICARE 621400 1292954 1292954 20762499 101 101 INSURANCE INCENTIVES 900099 183450 183450 MISCELLANEOUS INCOME 900099 29775 29775 213225 37113425 20975724 0 101 813315 599457 213858 19615049 14466428 5148621 591197 429892 161305 1293040 940243 352797 1487730 1081812 405918 9027 9027 1045780 840244 205536 1511283 1511283 422218 257572 164646 926324 816199 110125 1086961 1053173 33788 114664 92648 22016 81668 66968 14700 1187233 1087103 100130 217258 180806 36452 CONSUMABLE SUPPLIES 2201148 1991917 209231 LABORATORY 1211223 1211223 REPAIRS & MAINTENANCE 633857 573092 60765 DUES & REGISTRATION FEE 57600 6107 51493 51406 51406 34557981 27206167 7351814 0 5753215 5337903 524006 610602 64433 371951 2089781 1868661 241750 267059 139480 154229 29631932 12754976 16971223 16876956 25783888 25487361 2890057 3031967 341250 146250 4686000 4422000 3006346 435343 10923653 8035560 X 14860235 17451801 14860235 17451801 25783888 25487361 X 2555444 36122 X X 0 1 X 1 1 1 X 10328720 10953019 11521640 18123914 16137600 67064893 10328720 10953019 11521640 18123914 16137600 67064893 67064893 2354 7878 7445 641 101 18419 602321 393253 187088 75069 213225 1470956 68554268 107786376 0.97830 0.97150 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2017 AMOUNT: $ 415,321. 2018 AMOUNT: $ 257,253. 2019 AMOUNT: $ 187,088. 2020 AMOUNT: $ 75,069. 2021 AMOUNT: $ 29,775. MEANINGFUL USE INCENTIVE - 2017 AMOUNT: $ 187,000. 2018 AMOUNT: $ 136,000. INSURANCE INCENTIVES - 2021 AMOUNT: $ 183,450. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3550410 3550410 17424200 5267715 12156485 4537723 3854312 683411 4119599 3632949 486650 16876956 INTEREST RATE SWAP LIABILITY 146972 CAPITAL LEASE 288371 435343 X 37159666 46241 46241 37113425 0 37113425 34301476 -256505 -256505 34557981 0 34557981 PART X, LINE 2: THE ORGANIZATION HAS NO UNRECOGNIZED TAX BENEFITS AT MARCH 31, 2022. THE ORGANIZATION'S FEDERAL AND STATE INCOME TAX RETURNS PRIOR TO FISCAL YEAR 2019 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES ASSOCIATED WITH TAX MATTERS AS OPERATING EXPENSES AND INCLUDES ACCRUED INTEREST AND PENALTIES WITH ACCRUED EXPENSES IN THE CONSOLIDATED STATEMENT OF FINANCIAL POSITION. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION REVENUE 460,347. RELATED ORGANIZATION ELIMINATIONS -450,228. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 36,122. PART XII, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION EXPENSES 193,723. RELATED ORGANIZATION ELIMINATIONS -450,228. X X X X 0 0 0 0 0 0 0 1 0 RAMIRO MUNOZ MD OB/GYN PHYSICIAN 330000 0 27756 0 181077 0 16402 0 26275 0 581510 0 0 0 ELENA MARIN MD CHIEF EXECUTIVE OFFICER 303200 0 256 0 21237 0 9840 0 8559 0 343092 0 0 0 CHANDRASEKHER REDDY MD CHIEF MEDICAL OFFICER 270674 0 15256 0 0 0 8866 0 21774 0 316570 0 0 0 ANSHU BHATLA PHYSICIAN 173400 0 78336 0 18427 0 8386 0 21534 0 300083 0 0 0 MARIA MUNOZ PHYSICIAN 194872 0 66766 0 0 0 7994 0 15646 0 285278 0 0 0 RICARDO ALANIZ PHYSICIAN 193645 0 41546 0 0 0 7365 0 21774 0 264330 0 0 0 MIGUEL MARTINEZ-VELA PEDIATRIC PHYSICIAN 208655 0 27756 0 0 0 7355 0 14101 0 257867 0 0 0 PART I, LINE 7 INCLUDED ON SCHEDULE J, PART II, COLUMN B(II) ARE AMOUNTS REPRESENTING BONUS AND OTHER INCENTIVE PAYMENTS. THESE AMOUNTS WERE INCLUDED IN THE INDIVIDUALS 2021 W-2, AND APPROVED BY THE BOARD. PART II, COLUMN B(III): AMOUNTS IN COLUMN B(III) REPRESENTS OTHER COMPENSATION SUCH AS: PHYSICIAN ON CALL SERVICE, VACATION/OTHER PTO PAYOUT, AND ADMIN LEAVE. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE CHIEF FINANCIAL OFFICER REVIEWS THE 990 AND PRESENTS IT TO THE CHIEF EXECUTIVE OFFICER FOR SECONDARY REVIEW. A BOARD OF DIRECTORS MEETING IS THEN HELD FOR PRESENTATION AND APPROVAL OF THE RETURN PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL DIRECTORS AND EMPLOYEES ARE REQUIRED TO SIGN A CONFLICT OF INTEREST REVIEW ANNUALLY. THE FORM CLEARLY STATES THAT THEY COMPLY WITH THE POLICY. THE CENTER REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 A SALARY RANGE IS PREPARED AND APPROVED BY THE BOARD OF DIRECTORS. THIS SALARY RANGE IS COMPRISED OF INFORMATION OBTAINED FROM OTHER COMMUNITY HEALTH CENTERS AND THE LOCAL MARKET FOR THE CHIEF EXECUTIVE OFFICER. A SURVEY OF THE MAJOR COMMUNITY HEALTH CENTERS IS COMPILED USING THE BUDGET OF THE CENTER AS A KEY INDICATOR. THIS INFORMATION IS PRESENTED TO THE CHAIRMAN OF THE BOARD. THE BOARD, VIA EXECUTIVE SESSION, USES THIS INFORMATION TO DETERMINE THE CEO'S SALARY. IN ADDITION, THE BOARD REVIEWS THE SALARIES OF ALL INDIVIDUALS OVER $100K. PHYSICIANS' SALARIES ARE DETERMINED BY USING THE MGMA COMPENSATION AND PRODUCTIVITY INFORMATION. KEY PERSONNEL SALARIES ARE DETERMINED BY SURVEYING THE LOCAL MARKET AND HEALTH CENTER COMPENSATION GUIDE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THE CONFLICT OF INTEREST POLICY, ALL GOVERNING DOCUMENTS, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 36,122. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. SU CLINICA FAMILIAR MEDICAL FOUNDATION 1706 TREASURE HILLS BLVD HARLINGEN TX 78550 742965534 SUPPORT TX 501(C)(3) LINE 12A, I SU CLINICA 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 SU CLINICA FAMILIAR MEDICAL FOUNDATION K 450228 PER ANNUAL AGREEMENT