2022-11-10T08:55:41-06:00 2021-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2021-01-01 432016287 MT ENTERPRISE COMMUNITY HEALTH CLINIC MTEN 9033928203 PO BOX 489 MT ENTERPRISE TX 75681 JESTIN STOWE CFO 9033928203 2022-11-02 1 JESTIN STOWE 999009999 KURT BENNION CPA P01469618 4252506100 2022-11-02 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z CROSSROADS FAMILY CARE KENNETH WHITE PO BOX 489 MT ENTERPRISE TX 75681 6791076 0 X HTTPS://CROSSROADSFAMILYCARE.COM X 2003 TX TO PROVIDE PREVENTIVE, ACUTE, AND PRIMARY CARE TO THE LOCAL COMMUNITY. 13 13 83 14 0 0 3028764 4195628 2336735 2571544 152 789 24216 23115 5389867 6791076 0 0 0 0 3994517 4000458 0 0 0 1178162 1537475 5172679 5537933 217188 1253143 2817189 3576225 925870 405401 1891319 3170824 TO PROVIDE PREVENTIVE, ACUTE, AND PRIMARY CARE TO THE LOCAL COMMUNITY. 0 0 4486833 0 2571544 AT THREE LOCATIONS (MT. ENTERPRISE, HENDERSON AND PALESTINE, TEXAS), MT. ENTERPRISE COMMUNITY HEALTH CLINIC (DBA: CROSSROADS FAMILY CARE) PROVIDES PRIMARY CARE, DENTAL, AND BEHAVIORAL HEALTH SERVICES TO ALL MEMBERS OF THE COMMUNITY, WITH AN EMPHASIS ON ENSURING MEDICAL CARE FOR THE LOW-INCOME AND UNINSURED POPULATION. IN 2021, THE HEALTH CENTER PROVIDED OVER 22,600 VISITS TO THE OVER 8,100 PATIENTS SERVED. 41% OF THESE PATIENTS DID NOT HAVE INSURANCE AT THE TIME OF THEIR VISIT AND 37% WERE BELOW 100% OF THE FEDERAL POVERTLY LEVEL. 4486833 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 16 0 83 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 1 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 0 0 X JESTIN STOWE 9033928203 PO BOX 489 MT ENTERPRISE TX 75681 LACEE PIERCE APRN FNP-C PROVIDER 40.00 X 146915 0 5877 ROBIN WATSON APRN PMHNP-BC PROVIDER 40.00 X 142069 0 9768 JEREMIAH SANDERS APRN PMHNP-C PROVIDER 40.00 X 138451 0 4085 TAREK ELMAJIE DDS PROVIDER 40.00 X 137314 0 4085 AMBERLY HOPSON APRN FNP-C PROVIDER 40.00 X 136831 0 4085 KENNETH WHITE CEO 40.00 X 117300 0 8777 JESTIN STOWE CFO 40.00 X 89244 0 7771 LEO GONZALEZ PRESIDENT 1.00 X X 0 0 0 BECKY ELDRIDGE-CLARK VICE PRESIDENT 1.00 X X 0 0 0 JOHN GRUBBS SECRETARY & BOARD MEMBER 1.00 X X 0 0 0 YOLANDA DELEON BOARD MEMBER & SECRETARY 1.00 X X 0 0 0 MICHELLE SIMMONS TREASURER 1.00 X X 0 0 0 PATSY FOGLEMAN BOARD MEMBER 1.00 X 0 0 0 MATT GHOLSON BOARD MEMBER (THROUGH APRIL 2021) 1.00 X 0 0 0 HARVEY GRAVES BOARD MEMBER 1.00 X 0 0 0 ROBERT HOLLENSHEAD BOARD MEMBER 1.00 X 0 0 0 J GUADALUPE OVIEDO BOARD MEMBER 1.00 X 0 0 0 CASSANDRA SHAW BOARD MEMBER 1.00 X 0 0 0 POLLY VARDEMAN BOARD MEMBER 1.00 X 0 0 0 RD WHITTNER BOARD MEMBER 1.00 X 0 0 0 JEAN WILLIAMS BOARD MEMBER 1.00 X 0 0 0 908124 0 44448 6 0 1 0 GENESIS PRIMECARE 1500 W GRAND STREET MARSHALL TX 75670 BILLING SERVICES 139054 MEDCON PO BOX 935 FORNEY TX 75126 MEDICAL SUPERVISION (CMO) SERVICES 135000 2 4164145 31483 67495 4195628 MEDICAL SERVICE INCOME 624100 2571544 2571544 2571544 789 789 OTHER REVENUE 624110 23115 23115 23115 6791076 2571544 0 23904 X 223092 223092 3272849 3022661 250188 52748 47917 4831 188412 154103 34309 263357 206448 56909 4160 4160 698704 601874 96830 173748 33610 140138 97451 85803 11648 185221 87661 97560 39523 612 38911 40148 18224 21924 3636 3636 118868 96307 22561 19019 19019 MEDICAL SUPPLIES 127664 120385 7279 REPAIRS & MAINTENANCE 26799 9072 17727 DUES & SEMINARS 2534 2156 378 5537933 4486833 1051100 0 1320166 1859665 116784 120769 46127 61205 3046 2843138 1311598 1334112 1531540 2817189 3576225 253447 255072 598700 87685 73723 62644 925870 405401 X 1891319 3170824 1891319 3170824 2817189 3576225 1253143 26362 0 X 0 1 X 1 0 X 1972114 2835367 2406136 3028764 4195628 14438009 1972114 2835367 2406136 3028764 4195628 14438009 14438009 75 95 49 152 789 1160 17198 73788 62963 24216 23115 201280 14640449 10920211 0.98620 0.98480 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 59320 59320 1299624 235098 1064526 595948 559979 35969 652861 516018 136843 235385 503 234882 1531540 X 6791076 0 6791076 0 6791076 5537933 0 5537933 0 5537933 PART X, LINE 2: THE ORGANIZATION HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE THAT STATES IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE ORGANIZATION EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF DECEMBER 31, 2021 AND 2020, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. ALL TAX-EXEMPT ENTITIES ARE SUBJECT TO REVIEW AND AUDIT BY FEDERAL, STATE, AND OTHER APPLICABLE STATE STATUTES. X X 0 0 0 0 0 0 0 0 0 LACEE PIERCE APRN FNP-C PROVIDER 146915 0 0 0 0 0 5877 0 0 0 152792 0 0 0 ROBIN WATSON APRN PMHNP-BC PROVIDER 142069 0 0 0 0 0 5683 0 4085 0 151837 0 0 0 X 12 67495 INVOICE PRICE 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD AND THE CEO. THE EXECUTIVE COMMITTEE SERVES IN PLACE OF THE FULL BOARD IN EMERGENCY SITUATIONS WHEN A FULL BOARD QUORUM AT AN EMERGENCY MEETING CANNOT BE PRESENT. THE EXECUTIVE COMMITTEE ALSO REVIEWS CERTAIN PROSPECTIVE BUSINESS TRANSACTIONS AND MAKES RECOMMENDATIONS ON SUCH MATTERS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 3 DURING 2020, MEDICAL MANAGEMENT SERVICES (THE CMO POSITION) WERE PROVIDED BY MEDCON. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CFO AND THE FINANCE COMMITTEE AND PROVIDED TO THE BOARD OF DIRECTORS BEFORE BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST FORMS ARE COMPLETED EVERY YEAR BY BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES. FORMS RECEIVED ARE REVIEWED BY THE CFO AND FINANCE COMMITTEE AND MONITORED AS NECESSARY. NO BOARD MEMBER MAY VOTE ON ANY MATTER IN WHICH THEY HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION OF THE CEO IS DISCUSSED AT LENGTH BY THE BOARD OF DIRECTORS YEARLY. AS PART OF THEIR ANNUAL EVALUATION/REVIEW OF THE CEO, THEY REVIEW WHETHER ESTABLISHED GOALS WERE MET AND REVIEW COMPENSATION IN COMPARISON WITH OTHER COMMUNITY HEALTH ORGANIZATION CEO'S WITH THE HELP OF AN ANNUAL SALARY COMPARISON REPORT ISSUED BY THE NATIONAL ORGANIZATION OF COMMUNITY HEALTH ORGANIZATIONS. ALL OF THESE DISCUSSIONS ARE DOCUMENTED IN THE ORGANIZATION'S BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER SERVICES: PROGRAM SERVICE EXPENSES 601,874. MANAGEMENT AND GENERAL EXPENSES 96,830. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 698,704.