2022-07-15T13:57:20-05:00 2021-08-31 MIKESKA MONAHAN & PECKHAM PC 100 CONGRESS AVENUE SUITE 990 AUSTIN TX 78701 990 2020-09-01 264368737 JEFFERSON COUNTY CLINICAL SERVICES INC % STEPHEN ELWELL JEFF 5128993995 2801 VIA FORTUNA STE 500 AUSTIN TX 78746 PAUL TREVINO PRESIDENT 5128993939 2022-07-15 true PAUL TREVINO 999009999 KATHLEEN MONAHAN P00039626 5124761040 2022-07-11 3 2020 2022-09-23 18:48:47Z PAUL TREVINO PRESIDENT 2830 CALDER STREET BEAUMONT TX 77702 2380000 false X N/A X 2008 TX FACILITATE THE DELIVERY OF CHARITY HEALTH CARE SERVICES TO PERSONS IN JEFFERSON COUNTY, TEXAS. THE CORPORATION DOES NOT BILL OR COLLECT ANY FUNDS FOR CARE PROVIDED TO THE INDIGENT. 3 3 0 0 0 0 0 3275000 2380000 0 0 0 0 3275000 2380000 0 0 0 0 0 0 0 0 0 3331803 2487328 3331803 2487328 -56803 -107328 211467 112671 161031 169563 50436 -56892 FACILITATE THE DELIVERY OF CHARITY HEALTH CARE SERVICES TO THE INDIGENT IN JEFFERSON COUNTY, TEXAS. 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ITEM 2 - THE CORPORATION'S DIRECTORS ARE OR HAVE BEEN EITHER EMPLOYED OR HAVE MEDICAL STAFF PRIVILEGES AT THE CORPORATION'S MEMBERS OR AT AN ORGANIZATION AFFILIATED WITH A MEMBER OF THE CORPORATION. THE CORPORATION'S OFFICERS EACH SERVE AS AN OFFICER OF A MEMBER. THE CORPORATION DID NOT MAKE ANY PAYMENTS TO ANY OFFICER, DIRECTOR, OR OTHER INTERESTED PERSON THAT ARE REQUIRED TO BE DISCLOSED IN SCHEDULE L. ITEM 6 - THE CORPORATION IS ORGANIZED AS A MEMBER CORPORATION UNDER TEXAS LAW AND HAS THREE MEMBER HOSPITALS. THESE MEMBERS APPOINT THE DIRECTORS OF THE CORPORATION AND THE OFFICERS. EACH DIRECTOR AND SUCCESSOR DIRECTOR SHALL AT ALL TIMES BE A PHYSICIAN DULY LICENSED TO PRACTICE MEDICINE BY THE TEXAS MEDICAL BOARD AND ACTIVELY ENGAGED IN THE PRACTICE OF MEDICINE AND SHALL HAVE OR SATISFY SUCH OTHER QUALIFICATIONS AS MAY BE SET FORTH IN THE BYLAWS OF THE CORPORATION. ITEM 7a - NO PERSON SHALL BECOME A MEMBER OF THE CORPORATION WITHOUT THE UNANIMOUS VOTE OF THE THEN CURRENT MEMBERS. ITEM 7b - THE DECISIONS OF THE MEMBERS WITH RESPECT TO THE RETENTION OR TERMINATION OF A PHYSICIAN TO PROVIDE MEDICAL SERVICES, ARE SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS. ITEM 8b - THE CORPORATION HAS NO COMMITTEES AUTHORIZED TO ACT ON BEHALF OF THE GOVERNING BODY. ITEM 9a - OFFICER AND DIRECTOR ADDRESS Directors: BERTON BROWN, M.D. 3030 NORTH, SUITE 420 BEAUMONT, TX 77702 SUDHIR ALAMPUR, M.D. 2400 HWY. 365, SUITE 208 NEDERLAND, TX 77627 ANTONIO REMIREZ, M.D. 4222 COLLEGE STREET BEAUMONT, TX 77707 OFFICERS: DAVID PARMER, SECRETARY 3080 COLLEGE STREET BEAUMONT, TX 77701 PAUL TREVINO, PRESIDENT 2830 CALDER STREET BEAUMONT, TX 77702 P. CRAIG DESMOND, TREASURER 7400 BARLITE BOULEVARD SAN ANTONIO, TX 78224 ITEM 11 - A COPY OF THE FORM 990 WAS PROVIDED TO THE MEMBERS FOR THEIR REVIEW PRIOR TO FILING. LINE 12b - CONSISTENT WITH THE REQUIREMENTS OF THE TEXAS MEDICAL BOARD, THE DIRECTORS DISCLOSE INTERESTS BIENNIALLY. LINE 12c - BEFORE ENTERING ANY CONTRACTUAL OBLIGATIONS, THE CORPORATION'S OBLIGATIONS ARE REVIEWED BY OUTSIDE COUNSEL FOR CONFLICTS OF INTEREST. LINE 19 - THE CORPORATION PROVIDES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY UPON REQUEST.