2022-06-22T09:01:42-05:00 2021-12-31 752570395 DURBIN & COMPANY LLP 2950 50TH STREET LUBBOCK TX 79413 990 2021-01-01 752252866 HEALTH SERVICES OF NORTH TEXAS INC HEAL 9403811501 4401 NORTH I-35 SUITE 312 DENTON TX 76207 DOREEN RUE CEO 9403811501 2022-06-22 DOREEN RUE 999009999 BRENT FULLER P01974090 8067911591 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z DOREEN RUE 4401 NORTH I-35 SUITE 312 DENTON TX 76207 19687605 0 X WWW.HEALTHNTX.ORG X 1988 TX IMPROVING THE QUALITY OF LIFE FOR ALL NORTH TEXANS THROUGH MEDICAL CARE, SUPPORT SERVICES AND ADVOCACY. 12 12 196 0 0 0 6491514 6831380 7380951 12597726 -15623 2299 1286795 256200 15143637 19687605 2931353 4940231 0 0 8221118 9407409 0 0 0 3950212 4237619 15102683 18585259 40954 1102346 7063087 8344300 2825986 3004853 4237101 5339447 X HSNT IS COMMITTED TO PROVIDING QUALITY, AFFORDABLE HEALTHCARE FOR THE ENTIRE FAMILY FROM NEWBORNS TO SENIORS, INCLUDING PRENATAL CARE, WOMEN'S HEALTH, BEHAVIORAL HEALTH, A ROBUST PEDIATRIC PROGRAM, PRESCRIPTION ASSISTANCE AND INFECTIOUS DISEASE SPECIALTY CARE THROUGH SIX COMMUNITY HEALTH CENTERS WITH A COMBINED 24-26 PROVIDERS. THROUGH THESE SERVICES, AND PARTNERSHIPS WITH OTHER ORGANIZATIONS, HSNT IS MAKING SIGNIFICANT HEADWAY IN ACHIEVING OUR VISION OF, "A HEALTHY COMMUNITY." WE OFFER A SLIDING FEE SCALE BASED ON INCOME AND FAMILY SIZE, MAKING SERVICES AFFORDABLE, WE DO NOT TURN ANYONE AWAY DUE TO INABILITY TO PAY. 0 0 10939559 2901743 7980128 PRIMARY MEDICAL HEALTHCARE: QUALITY MEDICAL CARE IS PROVIDED AT SIX OF OUR HEALTH CENTER LOCATIONS FOR THE ENTIRE FAMILY WITH AN EMPHASIS ON ESTABLISHING A MEDICAL HOME FOR COMPREHENSIVE HEALTHCARE. SERVICES INCLUDE A FOCUS ON PREVENTATIVE CARE, PEDIATRICS, INFECTIOUS DISEASE DIAGNOSIS AND TREATMENT, WOMEN'S HEALTH, INCLUDING PRENATAL CARE, OB AND LABOR AND DELIVERY. TREATMENT IS AVAILABLE FOR A WIDE RANGE OF ACUTE AND CHRONIC PHYSICAL, MENTAL AND SOCIAL HEALTH CONDITIONS INCLUDING DIABETES, HYPERTENSION, DEPRESSION, AND ADHD TO NAME A FEW. TO SUPPORT PATIENT ADHERENCE TO TREATMENT RECOMMENDATIONS, HSNT OFFERS MULTIPLE PRESCRIPTION ASSISTANCE PROGRAMS AND CASE MANAGEMENT SERVICES. HSNT HAS A LONG HISTORY OF PROVIDING EXPERT SPECIALTY CARE FOR HIV/AIDS INCLUDING DISEASE MANAGEMENT AND TREATMENT ADHERENCE. THE CLINICAL TEAM INCLUDES PHYSICIANS, MID-LEVEL PROVIDERS, NURSES, LCSW'S, CERTIFIED MEDICAL ASSISTANTS, AND OTHER PROFESSIONALS WHO PROVIDE QUALITY, AFFORDABLE HEALTHCARE REGARDLESS OF ABILITY OF PAY. HEALTHCARE SERVICES INCLUDE ESTABLISHING ELIGIBILITY FOR AND GAINING ACCESS TO AFFORDABLE HEALTHCARE. 495077 213595 294168 BEHAVIORAL HEALTH SERVICES:INTEGRATED BEHAVIORAL HEALTH CARE SUPPORTS BOTH MENTAL AND PHYSICAL WELL-BEING FOR OPTIMAL HEALTH AND PRODUCTIVITY. COUNSELORS USE A COLLABORATIVE, COMPREHENSIVE TREATMENT APPROACH THAT CONSIDERS PSYCHOLOGICAL, SOCIAL, ENVIRONMENTAL AND BIOLOGICAL FACTORS FOR EMPOWERING CLIENTS TO IMPROVE THEIR ABILITY TO FUNCTION WITH LIFE CIRCUMSTANCES AND SITUATIONS. MENTAL HEALTH SCREENING, ASSESSMENTS AND THERAPY ARE AVAILABLE FOR ISSUES SUCH AS DEPRESSION, ANXIETY, RELATIONSHIP PROBLEMS, LIFE-SKILLS DEVELOPMENT, SUBSTANCE ABUSE, BEHAVIORAL DIAGNOSES, POST-TRAUMATIC STRESS, GRIEF AND THE CHALLENGES OF ACUTE OR CHRONIC HEALTH CONDITIONS. TREATMENT SERVICES INCLUDES INDIVIDUAL THERAPY, MARRIAGE AND FAMILY THERAPY, AND CRISIS INTERVENTIONS SERVICES. ALL PATIENTS THAT VISIT A PRIMARY CARE PROVIDER ARE ASKED TO COMPLETE A DEPRESSION SCREENING TO DETERMINE IF BEHAVIORAL HEALTH SERVICES ARE NEEDED. 507397 387212 1203 CASE MANAGEMENT SERVICES:CASE MANAGEMENT PROVIDES CLIENTS/PATIENTS GUIDANCE AND ASSISTANCE IN OBTAINING MEDICAL, MEDICATION, SOCIAL, COMMUNITY, LEGAL, FINANCIAL, AND OTHER NEEDED SERVICES. CASE MANAGERS ASSESS CLIENT NEEDS AND RESOURCES AND DESIGN AN INDIVIDUALIZED CLIENT/PATIENT CENTERED SERVICE PLAN TO ADDRESS CRISIS SITUATIONS, MINIMIZE PROBLEMS WITH RECEIVING SERVICES, AND STABILIZE LIFE CIRCUMSTANCES. LINKING PATIENTS TO NEEDED SERVICES AND ADDRESSING BARRIERS TO RECEIVING SERVICES ENABLES THEM TO FOCUS ON THEIR HEALTH. 3685444 210997 4334493 PHARMACEUTICAL ASSISTANCE:ASSIST WITH ACCESS TO AFFORDABLE PRESCRIPTION MEDICATIONS. 199077 171534 0 MEDICAL TRANSPORTATION:PROVIDES CLIENTS WITH DOOR-TO-DOOR VAN SERVICE TO AND FROM MEDICAL AND SOCIAL SERVICE APPOINTMENTS AND BUS TOKENS FOR LOCAL TRANSPORTATION WHERE AVAILABLE. 91740 89069 0 INSURANCE ASSISTANCE:ASSISTS WITH THE PAYMENT OF HEALTH INSURANCE PREMIUMS, DEDUCTIBLES, AND CO-PAYS FOR CLIENTS WHO MEET ELIGIBILITY CRITERIA. 620211 607802 0 HOUSING ASSISTANCE:PROVIDES ASSISTANCE TO LOW-INCOME PERSON LIVING WITH HIV WITH THE PAYMENT OF RENT AND UTILITIES (EMERGENCY AND LONG-TERM). LONG TERM PROGRAM REQUIRES ANNUAL CLIENT ELIGIBILITY RE-CERTIFICATION PROCESS OR IF THERE IS A SIGNIFICANT LIFE CHANGE THAT AGENCY BECOMES AWARE OF COULD CAUSE MORE THAN ONE RE-CERTIFICATION ANNUALLY. SHORT TERM PROGRAM REQUIRES ELIGIBILITY CERTIFICATION FOR EACH EVENT. 4596472 1079402 4334493 16538505 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 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 89 0 1 196 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X PAMELA BARNES CFO 9403811501 4401 NORTH I-35 SUITE 312 DENTON TX 76207 MICHAEL FOSTER CPA PRESIDENT AS OF 3/16 2.00 X X 0 0 0 TRANG DANG-LE VICE PRESIDENT 2.00 X X 0 0 0 DALE TAMPKE TREASURER 2.00 X X 0 0 0 JAMES HENDERSON SECRETARY 2.00 X X 0 0 0 HOWARD SHAW MD MEMBER 2.00 X 0 0 0 MELISSA ANN WINANS MBA-HCM MSN RN MEMBER 2.00 X 0 0 0 APRIL POWELL MEMBER 2.00 X 0 0 0 M HAMED HUSAIN MEMBER 2.00 X 0 0 0 LEE BROWN MEMBER 2.00 X 0 0 0 SARA SCHROEDER MEMBER 2.00 X 0 0 0 JUDGE CHANCE OLIVER MEMBER 2.00 X 0 0 0 BELINDA HERNANDEZ MEMBER 2.00 X 0 0 0 KIMBERLY MIDDLETON MD MEMBER 2.00 X 0 0 0 DOREEN RUE CEO 40.00 X 274237 0 0 PAMELA BARNES CFO 40.00 X 143813 0 0 DEBRA B LAYMAN COO 40.00 X 200802 0 0 CHRISTOPHER REDDEN CIO 40.00 X 153011 0 0 DR JASON SIEGEL MEDICAL DIRECTOR 40.00 X 302075 0 0 DR SHANNON STARR PHYSICIAN 40.00 X 222913 0 0 DR JYOTSNA KUPPANNAGARI PHYSICIAN 40.00 X 175126 0 0 JOSEPH HALLOCK NP NURSE PRACTIONER 40.00 X 150582 0 0 MARY LOYA NP NURSE PRACTIONER 40.00 X 137046 0 0 KERRY GAMBLE NP NURSE PRACTIONER 40.00 X 136902 0 0 DR PARUL KAUSHIK PHYSICIAN 40.00 X 131556 0 0 TABITHA MURIUKI NP NURSE PRACTIONER 40.00 X 123749 0 0 JANICE HILL NP NURSE PRACTIONER 40.00 X 129086 0 0 ANN ELLISON NP NURSE PRACTIONER 40.00 X 102893 0 0 VERONICA TERAN NP NURSE PRACTIONER 40.00 X 112761 0 0 SONIA ESTEP NP NURSE PRACTIONER 40.00 X 126590 0 0 BETHANY ISMAEL NP NURSE PRACTIONER 40.00 X 115382 0 0 BEVERLY JOHNSON PA PHYSICIAN ASSISTANT 40.00 X 124673 0 0 DR CRYSTAL MCLEOD PHYSICIAN 40.00 X 149564 0 0 NARGIZA ALIEV NP NURSE PRACTIONER 40.00 X 127534 0 0 3140295 0 0 23 0 1 0 R AND B BILLING SOLUTIONS PO BOX 1563 PILOT POINT TX 76258 MEDICAL BILLING 638013 EON CONSULTING 400 W OAK STREET STE 201 DENTON TX 76201 IT CONSULTING 390222 ECLINICALWORKS LLC PO BOX 847950 BOSTON MA 02284 ELECTRONIC HEALTH RECORD 241957 ANTONIO ASIS-HIGH RISK CLINIC AND L&D 2665 SCRIPTURE ST DENTON NORTH DENTON TX 76201 CONSULTING 154778 L&R PHYSICIAN SERVICES 7873 W DEAVER RD COLUMBUS IN 47201 E-PSYCHIATRY SERVICES 123500 5 5870352 961028 6831380 PATIENT SVC REVENUE 621400 12597726 12597726 12597726 2299 2299 MISCELLANEOUS INCOME 624200 256200 256200 256200 19687605 12853926 0 2299 4940231 4940231 3458585 2939797 518788 4458784 3789966 668818 887567 754432 133135 602473 512102 90371 79903 67918 11985 50093 42579 7514 1450329 1232780 217549 56569 48084 8485 215785 183417 32368 606273 515332 90941 4908 4172 736 45746 38884 6862 64298 54653 9645 136969 116424 20545 87519 74391 13128 MEDICAL SUPPLIES 747604 635463 112141 EQUIPMENT RENT & MAINTE 580443 493377 87066 OTHER OPERATING EXPENSE 111180 94503 16677 18585259 16538505 2046754 0 1946367 3368646 564649 566756 816078 669924 379022 312892 490675 685730 3366631 637708 2854867 2728923 11429 11429 7063087 8344300 1285677 1515394 10000 10000 1310680 1259830 219629 219629 2825986 3004853 X 4237101 5339447 4237101 5339447 7063087 8344300 1102346 0 X 0 0 0 X 5777507 6075654 5152757 6491514 6831380 30328812 5777507 6075654 5152757 6491514 6831380 30328812 30328812 4124 4652 5208 4934 2299 21217 7921 17766 4755 30442 30380471 30989352 0.99830 0.99780 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 257000 257000 2417426 497412 1920014 692205 140296 551909 2728923 MEDICAID WRAP PAYMENT SYSTEM LIABILITY 219629 219629 X PART X, LINE 2: HEALTH SERVICES OF NORTH TEXAS, INC. IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION EVALUATES AND ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES (FORMERLY FASB INTERPRETATION 48 (FIN 48) ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THIS STANDARD REQUIRES CERTAIN DISCLOSURES ABOUT UNCERTAIN INCOME TAX POSITIONS. THE ORGANIZATION EVALUATES ANY UNCERTAIN TAX POSITIONS USING THE PROVISIONS OF ASC 450, CONTINGENCIES. AS A RESULT, MANAGEMENT DOES NOT BELIEVE THAT ANY UNCERTAIN TAX POSITIONS CURRENTLY EXIST AND NO LOSS CONTINGENCY HAS BEEN RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE ORGANIZATION HAS FILED ALL APPLICABLE TAX RETURNS. 1 MEDICAL ASSISTANCE 16504 917419 BOOK HOUSING ASSISTANCE 60 465313 BOOK INSURANCE ASSISTANCE 30 55818 BOOK PHARMACEUTICAL ASSISTANCE 17018 2654492 BOOK PART I, LINE 2: INDIVIDUALS WHO RECEIVE ASSISTANCE FROM HSNT APPLY FOR ASSISTANCE. FUNDS ARE DISTRIBUTED TO SERVICE PROVIDERS ONLY AFTER THE INDIVIDUAL'S APPLICATION FOR ASSISTANCE HAS BEEN APPROVED. 0 0 0 0 0 0 0 0 0 DR JASON SIEGEL MEDICAL DIRECTOR 302075 0 0 0 0 0 0 0 0 0 302075 0 0 0 DOREEN RUE CEO 274237 0 0 0 0 0 0 0 0 0 274237 0 0 0 DR SHANNON STARR PHYSICIAN 222913 0 0 0 0 0 0 0 0 0 222913 0 0 0 DEBRA B LAYMAN COO 200802 0 0 0 0 0 0 0 0 0 200802 0 0 0 DR JYOTSNA KUPPANNAGARI PHYSICIAN 175126 0 0 0 0 0 0 0 0 0 175126 0 0 0 CHRISTOPHER REDDEN CIO 153011 0 0 0 0 0 0 0 0 0 153011 0 0 0 JOSEPH HALLOCK NP NURSE PRACTIONER 150582 0 0 0 0 0 0 0 0 0 150582 0 0 0 X 1 206000 FMV X USE OF BLDGS 2 146000 FMV 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT REVIEWS THE FORM 990. IT PRESENTS THE FORM 990 IN DETAIL TO THE BOARD OF DIRECTORS FINANCIAL COMMITTEE. THE CHAIR OF THE FINANCIAL COMMITTEE PRESENTS THE FORM 990 TO THE ENTIRE BOARD OF DIRECTORS FOR APPROVAL. AFTER BOARD APPROVAL, THE RETURN IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST IS INCLUDED IN HSNT'S BY-LAWS AND IN THE STANDARDS OF CONDUCT IN WHICH ALL BOARD MEMBER AND STAFF RECEIVE A COPY DURING THE ORIENTATION PROCESS. ALL BOARD MEMBERS SIGN A WRITTEN CONFLICT OF INTEREST DISCLOSING ALL CONFLICTS, IF ANY. THIS PROCESS IS RECERTIFIED ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15A THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO INCLUDES REVIEW AND APPROVAL BY THE BOARD OF DIRECTORS; USING COMPARABILTY DATA OF SIMILAR ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 INFORMATION ABOUT THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS REPORTED ON THE FORM 1023 AND FORM 990S IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST. ANY INFORMATION ON THESE DOCUMENTS THAT IS NOT INCLUDED ON THE FORM 1023 AND FORM 990S IS NOT MADE AVAIALBE TO THE PUBLIC.