SPRING BRANCH COMMUNITY HEALTH CENTER: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- SPRING BRANCH COMMUNITY HEALTH CENTER (EIN 30-0198705)
- Tax period
- 2019-12-01 to 2020-11-30
- Filed
- 2021-10-13
- IRS object ID
- 202122869349302357
- Schema version
- 2019v5.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-10-13T18:38:40-05:00 | ReturnTs |
| Tax Period End | 2020-11-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14241 DALLAS PARKWAY SUITE 1100 | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-12-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 300198705 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Spring Branch Community Health Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % MARLEN J TRUJILLO | InCareOfNm |
| Business Name Control | SPRI | BusinessNameControlTxt |
| Phone | 7134626565 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 W Sam Houston Pkwy S Suite 200 | AddressLine1Txt |
| City | Houston | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 77042 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARLEN J TRUJILLO | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7134626565 | PhoneNum |
| Signature | 2021-10-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jeanette Verrelli | PreparerPersonNm |
| PTIN | P00742631 | PTIN |
| Phone | 9727028262 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARLEN J TRUJILLO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 W SAM HOUSTON PKWY S 200 | AddressLine1Txt |
| City | HOUSTON | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 77042 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,037,539 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SBCHC.NET | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | SPRING BRANCH COMMUNITY HEALTH CENTER (SBCHC) REDUCES AREA HEALTH DISPARITIES BY CREATING NEIGHBORHOOD-BASED HEALTH CENTERS TO PROVIDE...(SEE SCHEDULE O) | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 206 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,189,917 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,014,173 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,199,193 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,834,184 | CYProgramServiceRevenueAmt |
| PY Investment Income | $32,299 | PYInvestmentIncomeAmt |
| CY Investment Income | $37,888 | CYInvestmentIncomeAmt |
| PY Other Revenue | $108,660 | PYOtherRevenueAmt |
| CY Other Revenue | $140,712 | CYOtherRevenueAmt |
| PY Total Revenue | $13,530,069 | PYTotalRevenueAmt |
| CY Total Revenue | $13,026,957 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $240 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $6,503 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,953,800 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,722,547 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $175,590 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,129,426 | PYOtherExpensesAmt |
| CY Other Expenses | $4,398,957 | CYOtherExpensesAmt |
| PY Total Expenses | $12,083,466 | PYTotalExpensesAmt |
| CY Total Expenses | $14,128,007 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,446,603 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,101,050 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,975,451 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,121,798 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,700,351 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,947,748 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,275,100 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,174,050 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION IS TO INCREASE THE NUMBER OF HEALTHY FAMILIES IN OUR COMMUNITY BY PROVIDING HIGH QUALITY COMPREHENSIVE HEALTHCARE SERVICES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $11,525,998 | ExpenseAmt |
| Grant | $6,503 | GrantAmt |
| Revenue | $6,985,478 | RevenueAmt |
| Desc | SPRING BRANCH COMMUNITY HEALTH CENTER (SBCHC) IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) OPERATING SIX LOCATIONS IN HOUSTON AND HARRIS COUNTY. THREE CLINICS ARE LOCATED IN THE SPRING BRANCH AREA OF HOUSTON, AND THREE CLINICS ARE IN WEST HOUSTON. DURING THE 2020 FISCAL YEAR, SBCHC PROVIDED 44,554 VISITS, INCLUDING 15,488 VIRTUAL VISITS TO 16,294 INDIVIDUAL PATIENTS. The COVID-19 Pandemic impacted the number of people served in 2020. SBCHC QUICKLY IMPLEMENTED VIRTUAL VISITS FOR MEDICAL AND MENTAL HEALTH SERVICES, BUT THE NUMBER OF PATIENT VISITS DROPPED SIGNIFICANTLY FROM THE PRIOR YEAR. SBCHC PROVIDES PRIMARY MEDICAL CARE TO PATIENTS OF ALL AGES AND ETHNIC GROUPS, WITH A FOCUS ON PEDIATRIC, WOMEN'S HEALTH, AND ADULT MEDICINE. MENTAL HEALTH AND ORAL HEALTH SERVICES COMPLEMENT THE DELIVERY OF MEDICAL CARE, POSITIVELY AFFECTING THE COMPLETE WELLNESS OF THE PATIENT. SBCHC ALSO UTILIZES A MOBILE CLINIC TO CONDUCT OUTREACH, HEALTH SCREENINGS, AND HEALTH PROMOTION IN THE COMMUNITY. IN LATE 2020, SBCHC BEGAN PROVIDING RAPID REHOUSING SERVICES TO INDIVIDUALS EXPERIENCING HOMELESSNESS. | Desc |
| Total Program Service Expenses | $11,525,998 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 35 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 206 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARLEN J TRUJILLO | PersonNm |
| Phone | 7134626565 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 W SAM HOUSTON PKWY S SUITE 200 | AddressLine1Txt |
| City | HOUSTON | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 77042 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| DAVID KRUSLESKI MD | |||||||||
| CMO | 40.0 | 0.0 | Yes (X) | $211,296 | $0 | $26,131 | |||
| MARLEN J TRUJILLO | |||||||||
| CEO | 40.0 | 0.0 | Yes (X) | $184,282 | $0 | $26,003 | |||
| SASHA ROBEYE MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $175,674 | $0 | $23,313 | Yes (X) | |||
| MARITA OBENZA MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $157,426 | $0 | $23,687 | Yes (X) | |||
| EMAN ALHARBI MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $160,223 | $0 | $15,640 | Yes (X) | |||
| MICHAEL BSAIBES | |||||||||
| COO | 40.0 | 0.0 | Yes (X) | $137,807 | $0 | $15,229 | |||
| MEGHAN THOMEER DO | |||||||||
| PHYSICIAN | 30.0 | 0.0 | $137,218 | $0 | $10,937 | Yes (X) | |||
| LORI MCCAIN | |||||||||
| CFO | 40.0 | 0.0 | Yes (X) | $114,700 | $0 | $22,575 | |||
| BERNADETTE BONAPARTE MD | |||||||||
| PHYSICIAN | 24.0 | 0.0 | $133,609 | $0 | $1,089 | Yes (X) | |||
| David Hobson MD | |||||||||
| FORMER CMO | 28.5 | 0.0 | $131,239 | $0 | $0 | Yes (X) | |||
| GERARD PEPERONE | |||||||||
| CDO | 40.0 | 0.0 | Yes (X) | $86,038 | $0 | $13,074 | |||
| MICHAEL SMITH | |||||||||
| CPO | 40.0 | 0.0 | Yes (X) | $20,333 | $0 | $694 | |||
| AMY WRIGHT EDD | |||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| BILL GAUL | |||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| CARLOS A MORENO MD | |||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| IGNACIO PUJOL | |||||||||
| SECRETARY | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JOHN KEMPER | |||||||||
| CHAIRMAN | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JORGE SERA | |||||||||
| TREASURER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JOSE CARLOS INTERIANO MD | |||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| LESTER WILLIAMS | |||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| LOUIS FAILLACE MD | |||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| LYDIA JUNEK | |||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| MARIE-LOUISE ZELMAT | |||||||||
| VICE-CHAIR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| TERESA JACKSON | |||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,649,845 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $178,372 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| UT HEALTH SCIENCE CENTER DEPT OF OB | |||||
| 6431 FANNIN STREET | HOUSTON | TX | 77030 | CONTRACT PROVIDERS | $296,509 |
| LABORATORY CORPORATION OF AMERICA | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | LABORATORY TESTING | $177,208 |
| NEO RHINO LLC | |||||
| 710 N POST OAK RD STE 555 | HOUSTON | TX | 77024 | REMOTE IT MANAGEMENT | $138,751 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $33,848 | FundraisingAmt |
| Government Grants | $3,738,596 | GovernmentGrantsAmt |
| All Other Contributions | $2,241,729 | AllOtherContributionsAmt |
| Noncash Contributions | $743,366 | NoncashContributionsAmt |
| Total Contributions | $6,014,173 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Service Revenue | 621110 | $6,645,428 | $6,645,428 |
| Pharmacy Revenue | 446110 | $188,756 | $188,756 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,834,184 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,888 | TotalRevenueColumnAmt |
| Exclusion | $37,888 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $33,848 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $10,582 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$10,582 | TotalRevenueColumnAmt |
| Exclusion | -$10,582 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Miscellaneous Revenue | 900099 | $147,257 | $147,257 |
| Medical Records Revenue | 561000 | $4,037 | $4,037 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $151,294 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,026,957 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,985,478 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $27,306 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $602 | TotalAmt |
| Program Services | $602 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,901 | TotalAmt |
| Program Services | $5,901 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $995,536 | TotalAmt |
| Program Services | $296,250 | ProgramServicesAmt |
| Management And General | $621,720 | ManagementAndGeneralAmt |
| Fundraising | $77,566 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,542 | TotalAmt |
| Program Services | $163,542 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,061,899 | TotalAmt |
| Program Services | $6,182,852 | ProgramServicesAmt |
| Management And General | $806,161 | ManagementAndGeneralAmt |
| Fundraising | $72,886 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,123 | TotalAmt |
| Program Services | $59,031 | ProgramServicesAmt |
| Management And General | $14,726 | ManagementAndGeneralAmt |
| Fundraising | $2,366 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $935,249 | TotalAmt |
| Program Services | $840,905 | ProgramServicesAmt |
| Management And General | $83,898 | ManagementAndGeneralAmt |
| Fundraising | $10,446 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $490,198 | TotalAmt |
| Program Services | $457,426 | ProgramServicesAmt |
| Management And General | $22,585 | ManagementAndGeneralAmt |
| Fundraising | $10,187 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $600 | TotalAmt |
| Management And General | $600 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,195 | TotalAmt |
| Management And General | $56,195 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $855,718 | TotalAmt |
| Program Services | $618,794 | ProgramServicesAmt |
| Management And General | $236,924 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,911 | TotalAmt |
| Program Services | $1,881 | ProgramServicesAmt |
| Management And General | $7,030 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191,887 | TotalAmt |
| Program Services | $49,278 | ProgramServicesAmt |
| Management And General | $141,891 | ManagementAndGeneralAmt |
| Fundraising | $718 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $359,884 | TotalAmt |
| Program Services | $156,123 | ProgramServicesAmt |
| Management And General | $203,390 | ManagementAndGeneralAmt |
| Fundraising | $371 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $709,395 | TotalAmt |
| Program Services | $629,001 | ProgramServicesAmt |
| Management And General | $80,394 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,498 | TotalAmt |
| Program Services | $6,355 | ProgramServicesAmt |
| Management And General | $16,014 | ManagementAndGeneralAmt |
| Fundraising | $129 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,876 | TotalAmt |
| Program Services | $4,748 | ProgramServicesAmt |
| Management And General | $3,118 | ManagementAndGeneralAmt |
| Fundraising | $10 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,360 | TotalAmt |
| Program Services | $30,479 | ProgramServicesAmt |
| Management And General | $1,881 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $411,604 | TotalAmt |
| Program Services | $408,003 | ProgramServicesAmt |
| Management And General | $3,601 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,332 | TotalAmt |
| Program Services | $29,347 | ProgramServicesAmt |
| Management And General | $20,985 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical Supplies & Equipment | $1,272,694 | $1,239,461 | $33,233 | |
| Bad Debt Expense | $284,996 | $284,996 | ||
| RECRUITING & RETENTION | $60,297 | $29,874 | $30,423 | |
| DUES, LICENSES & PERMITS | $73,710 | $31,149 | $41,650 | $911 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,128,007 | TotalAmt |
| Program Services | $11,525,998 | ProgramServicesAmt |
| Management And General | $2,426,419 | ManagementAndGeneralAmt |
| Fundraising | $175,590 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $470,984 | BOYAmt |
| EOY | $453,712 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,648,580 | BOYAmt |
| EOY | $2,399,345 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,052,368 | BOYAmt |
| EOY | $1,380,783 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $721,206 | BOYAmt |
| EOY | $508,371 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,443 | BOYAmt |
| EOY | $172,348 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,095 | BOYAmt |
| EOY | $59,618 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $9,019,452 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,021,042 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,773,167 | BOYAmt |
| EOY | $6,998,410 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,608 | BOYAmt |
| EOY | $149,211 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,975,451 | BOYAmt |
| EOY | $12,121,798 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $727,357 | BOYAmt |
| EOY | $749,955 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $841,043 | BOYAmt |
| EOY | $1,488,761 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $131,951 | BOYAmt |
| EOY | $1,709,032 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,700,351 | BOYAmt |
| EOY | $3,947,748 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,002,647 | BOYAmt |
| EOY | $6,104,862 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,272,453 | BOYAmt |
| EOY | $2,069,188 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,275,100 | BOYAmt |
| EOY | $8,174,050 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,975,451 | BOYAmt |
| EOY | $12,121,798 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,101,050 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,303,314 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,926,376 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,157,419 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,189,917 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,014,173 | CurrentTaxYearAmt |
| Total | $30,591,199 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,303,314 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,926,376 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,157,419 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,189,917 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,014,173 | CurrentTaxYearAmt |
| Total | $30,591,199 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $740,389 | SubstantialContributorsTotAmt |
| Public Support Total170 | $29,850,810 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,531 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,119 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,163 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $32,299 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $37,888 | CurrentTaxYearAmt |
| Total | $75,000 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $42,507 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $31,222 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $24,481 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $34,292 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $132,502 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $30,798,701 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $31,099,350 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.96922 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99220 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $836,554 | OtherCostOrOtherBasisAmt |
| Book Value | $836,554 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,917,312 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,008,432 | DepreciationAmt |
| Book Value | $4,908,880 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $723,926 | OtherCostOrOtherBasisAmt |
| Depreciation | $409,570 | DepreciationAmt |
| Book Value | $314,356 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $961,454 | OtherCostOrOtherBasisAmt |
| Depreciation | $603,040 | DepreciationAmt |
| Book Value | $358,414 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $580,206 | OtherCostOrOtherBasisAmt |
| Book Value | $580,206 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,998,410 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| PAYCHECK PROTECTION PROGRAM LOAN | $1,521,400 |
| Deferred Rent | $32,849 |
| Tenant Improvement Allowance | $154,783 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,709,032 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $12,786,199 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $1,344,221 | OtherRevenueAmt |
| Revenue Not Reported | $1,344,221 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,441,978 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,584,979 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,584,979 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $13,026,957 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $13,853,593 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $10,582 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $10,582 | ExpensesNotReportedAmt |
| Expenses Subtotal | $13,843,011 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $284,996 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $284,996 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $14,128,007 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART XI, LINE 2D | RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: NET ASSETS RELEASED FROM RESTRICTION $1,629,217 BAD DEBT EXPENSE $(284,996) ------------- TOTAL $1,344,221 |
| SCHEDULE D, PART XI, LINE 4B | RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: CONTRIBUTIONS WITH DONOR RESTRICTIONS $1,536,289 FUNDRAISING EXPENSES $ (10,582) GRANTS FOR ACQUISITION OF P&e $ 59,272 ------------ TOTAL $1,584,979 |
| SCHEDULE D, PART XII, LINE 2D | RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS WITH RETURN: FUNDRAISING EXPENSES $10,582 |
| SCHEDULE D, PART XII, LINE 4B | RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS WITH RETURN: BAD DEBT EXPENSE $284,996 |
| SCHEDULE D, PART X, LINE 2 | ASC 740 FOOTNOTE: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | FALL HARVEST LU | Event1Nm |
| Gross Receipts Event1 | $33,848 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $33,848 | CharitableContriEvent1Amt |
| Other Direct Expenses Event1 | $10,582 | OtherDirectExpensesEvent1Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $33,848 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $33,848 | CharitableContributionsTotAmt |
| Oth Direct Expnss Total Events | $10,582 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $10,582 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$10,582 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Cash GrantCashGrantAmt |
|---|---|---|---|---|---|
| Transportation | 18 | $901 | FMV | Bus passes | |
| Cancer Care Program | 20 | $5,000 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, Line 2 | FormAndLineReferenceDesc |
| Explanation | PROCEDURES FOR MONITORING THE USE OF GRANTS FUNDS IN THE U.S.: The bus passes were provided to patients receiving substance use disorder therapy who did not have reliable transportation to get to the clinic for their sessions or medical visits. A log was maintained that included the date the bus pass was provided, the name of the recipient, and the number of passes received. SBCHC received a private foundation grant to assist patients undergoing cancer treatment. The donor specified that the funds were to be used for non-treatment related assistance. Assistance with utility bills, cell phone bills, groceries, and other housing-related services was provided. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARLEN J TRUJILLO | ||||||||||||||
| CEO | $183,782 | $0 | $500 | $0 | $0 | $0 | $9,473 | $0 | $16,530 | $0 | $210,285 | $0 | $0 | $0 |
| MICHAEL BSAIBES | ||||||||||||||
| COO | $137,307 | $0 | $500 | $0 | $0 | $0 | $6,991 | $0 | $8,238 | $0 | $153,036 | $0 | $0 | $0 |
| DAVID KRUSLESKI MD | ||||||||||||||
| CMO | $211,121 | $0 | $175 | $0 | $0 | $0 | $2,609 | $0 | $23,522 | $0 | $237,427 | $0 | $0 | $0 |
| EMAN ALHARBI MD | ||||||||||||||
| PHYSICIAN | $160,073 | $0 | $150 | $0 | $0 | $0 | $0 | $0 | $15,640 | $0 | $175,863 | $0 | $0 | $0 |
| MARITA OBENZA MD | ||||||||||||||
| PHYSICIAN | $157,426 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $23,687 | $0 | $181,113 | $0 | $0 | $0 |
| SASHA ROBEYE MD | ||||||||||||||
| PHYSICIAN | $175,549 | $0 | $125 | $0 | $0 | $0 | $0 | $0 | $23,313 | $0 | $198,987 | $0 | $0 | $0 |
| David Hobson MD | ||||||||||||||
| FORMER CMO | $131,064 | $0 | $175 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $131,239 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArtGrp | |
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp |
Books And Publications BooksAndPublicationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $2,258 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Clothing And Household Goods | ClothingAndHouseholdGoodsGrp | |
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp | |
| Securities Publicly Traded | SecuritiesPubliclyTradedGrp | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp | |
| Food Inventory | FoodInventoryGrp |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 39 | ContributionCnt |
| Noncash Contributions Rpt F990 | $726,283 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp |
Other Non Cash Contri Table OtherNonCashContriTableGrp (4 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | DISASTER RELIEF TENT | 1 | $524 | FMV |
| Yes (X) | DENTAL SUPPLIES | 2 | $5,790 | FMV |
| Yes (X) | VITAMINS & BLANKETS | 2 | $7,791 | RETAIL VALUE |
| Yes (X) | GIFT BASKETS | 1 | $720 | RETAIL VALUE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE M, PART 1, COLUMN B | Number of Contributions or items contributed: column B represents the number of contributions received. |
| SCHEDULE M, PART I, LINE 20, COLUMN (C) | VACCINES FROM THE STATE OF TEXAS "VACCINE FOR CHILDREN" (VFC) PROGRAM PROVIDES SBCHC. SBCHC MUST FOLLOW ELIGIBILITY GUIDELINES FROM THE STATE AND ADMINISTER THESE VACCINES TO ELIGIBLE PATIENTS. VACCINES ARE SHIPPED TO SBCHC DIRECTLY FROM PHARMACEUTICAL COMPANIES SUCH AS MERCK AND OTHER COMPANIES. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | PROCESS USED BY THE ORGANIZATION TO REVIEW FORM 990: BOTH THE CEO AND CFO REVIEW ALL THE INFORMATION ON THE FEDERAL FORM 990. THE FINAL FORM 990 IS DISTRIBUTED TO THE FULL BOARD FOR REVIEW AND APPROVAL BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING AND ENFORCEMENT OF CONFLICT OF INTEREST POLICY: EVERY BOARD MEMBER AND EVERY EMPLOYEE COMPLETES A CONFLICT OF INTEREST DISCLOSURE ANNUALLY. BOARD MEMBERS THAT HAVE A POTENTIAL CONFLICT OF INTEREST EXCUSE THEMSELVES FROM PARTICIPATING IN DISCUSSIONS PERTAINING TO THE CONFLICT AND ARE PROHIBITED FROM VOTING ON ANY ACTION ITEMS PERTAINING TO THE CONFLICT. MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM AND OTHER EMPLOYEES HAVING A POTENTIAL CONFLICT OF INTEREST ARE PROHIBITED FROM THE SELECTION, MANAGEMENT AND/OR SUPERVISION OF THE PARTY IN QUESTION. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | PROCESS FOR DETERMINING COMPENSATION OF CEO AND OTHER OFFICERS: CEO COMPENSATION IS REVIEWED AND DETERMINED BY A SPECIAL COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS THAT IS CHAIRED BY THE CHAIR OF THE BOARD. THE COMMITTEE USES ANNUAL SALARY SURVEYS FROM THE TEXAS ASSOCIATION OF COMMUNITY HEALTH CENTERS AS WELL AS COMPENSATION INFORMATION FROM THE FORM 990 OF OTHER HOUSTON AREA FQHCS. THE CEO COMPENSATION IS DOCUMENTED IN THE MINUTES OF THE COMMITTEE, APPROVED BY THE BOARD, AND IS INCLUDED IN THE CEO'S WRITTEN EMPLOYMENT AGREEMENT. THE CEO AND CFO REVIEW ANNUAL SALARY SURVEYS FROM THE TEXAS ASSOCIATION OF COMMUNITY HEALTH CENTERS AS WELL AS COMPENSATION INFORMATION FROM THE FORM 990 OF OTHER HOUSTON-AREA FQHCS FOR COMPARISON PURPOSES TO DETERMINE THE COMPENSATION OF ALL OTHER OFFICERS. ALL OFFICERS HAVE A WRITTEN EMPLOYMENT AGREEMENT THAT INCLUDES COMPENSATION INFORMATION. ALL EMPLOYMENT AGREEMENTS ARE FILED IN EACH PERSON'S INDIVIDUAL PERSONNEL FILE IN THE HUMAN RESOURCES DEPARTMENT. THE BOARD OF DIRECTORS APPROVES COMPENSATION FOR ALL OFFICERS AND EMPLOYEES AS PART OF THE PROCESS OF APPROVING THE ORGANIZATION'S ANNUAL OPERATING BUDGET. |
| FORM 990, PART VI, SECTION C, LINE 19 | PROCESS OF HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND THE FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part I, Line 1 | ORGANIZATION'S SIGNIFICANT ACTIVITIES: (CONTINUED FROM PAGE 1)... comprehensive primary health care services that are culturally competent, linguistically appropriate and client-driven in locations easily accessible by public transportation. SBCHC aims to decrease health disparities and increase the number of healthy individuals and healthy families in the communities it serves. SBCHC is an important component of the primary care safety-net in Houston and Harris County where approximately 1.4 million people (19.7% of residents) are uninsured and/or medically underserved. SBCHC's vision is to champion community wellness by providing integrated health services to all. SBCHC's commitment to quality of care remains one of its top priorities, providing comprehensive services across all of its specialties. SBCHC aims to shift the dynamic of care towards being patient centered, and becoming a preferred medical home for the community. SBCHC was formed in July 2003 and began seeing uninsured and underinsured patients in May 2004, specifically, the medically underserved population in the Spring Branch area of Houston. SBCHC was designated as a Federally Qualified Health Center in 2005. In December 2012, SBCHC became one of only 10% of the FQHCs in the United States with Joint Commission Accreditation and Primary Care Medical Home Certification. SBCHC earned the Joint Commission's Gold Seal of Approval by demonstrating compliance with the Joint Commission's national standards for health care quality and safety. SBCHC also received certification as a Primary Care Medical Home (PCMH). A PCMH must be patient-centered, provide comprehensive and coordinated care, and utilize a systems-based approach to quality and safety. To increase access to health care to those most in need, SBCHC expanded to West Houston in 2013, to Katy in 2016, and to Cypress in 2017. SBCHC also added an additional location in Spring Branch in 2017, inside the Mabee WholeLife Service Center, a multi-purpose facility that is a collaborative of several area non-profit organizations. SBCHC has grown from one to six clinic locations, and has a mobile clinic to further its reach and increase access in underserved areas. SBCHC added rapid rehousing services for individuals experiencing homelessness in late 2020. Throughout the COVID-19 Pandemic, SBCHC remained open to provide services both in-person and virtually. SBCHC is the only FQHC in the Spring Branch and West Houston service area providing comprehensive medical, dental, and mental health services at a discount to the underinsured and uninsured populations. Assistance for patients with additional social services such as application assistance for Medicaid, CHIP, Healthcare Marketplace, SNAP and WIC, is available at all clinic locations. Referral specialists/patient care coordinators assist patients with referrals to specialty services, and coordination of medical care. The majority of SBCHC staff are bilingual in order to create a welcoming and accommodating clinic environment. SBCHC sets itself apart from other organizations in its approach to support the whole wellbeing of its patients that extends beyond their medical needs. The patients that SBCHC treats have financial, educational, housing, mental health, and other needs. Through SBCHC's relationships with other organizations, it has been able to build strong collaborations and partnerships to provide support to each individual to address all the social determinants of health. Not only is SBCHC a Primary Care Medical Home, it is also a Community Centered Health Home, committed to ensuring that all community residents are healthy, and that it contributes to a healthier community. |