2019-10-15T17:59:20-05:00 2018-11-30 BKD LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2017-12-01 300198705 Spring Branch Community Health Center % MARLEN J TRUJILLO SPRI 7134626565 800 W Sam Houston Pkwy S Suite 200 Houston TX 77042 LORI MCCAIN CFO 7134626565 2019-10-15 true Jeanette Verrelli P00742631 9727028262 167.68.126.162 75465920192885000255 2019-10-15 P C988406757BF59C0D5070F615BB02330D1B62B69 EB976710118F518B8933A72D91D1D85239D99EDA 2017 2020-01-14 16:20:31Z MARLEN J TRUJILLO 800 W SAM HOUSTON PKWY S 200 HOUSTON TX 77042 11663481 false X WWW.SBCHC.NET X 2003 TX SBCHC REDUCES AREA HEALTH DISPARITIES BY CREATING A NEIGHBORHOOD-BASED HEALTH CENTER TO PROVIDE COMPREHENSIVE PRIMARY HEALTH CARE SERVICES THAT ARE... (SEE SCHEDULE O) 11 11 150 65 0 0 9926376 4157419 4813859 7283838 -65334 -62080 19827 78575 14694728 11457752 424 0 0 0 6338844 7133521 0 0 42789 4359307 4073822 10698575 11207343 3996153 250409 9588640 10089798 2010552 2261301 7578088 7828497 The Mission is to increase the number of healthy families in our community by providing high quality comprehensive healthcare services. false false 8857284 7354418 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 2018 FISCAL YEAR, SBCHC PROVIDED 61,114 VISITS TO 18,840 INDIVIDUAL PATIENTS. SBCHC PROVIDES PRIMARY MEDICAL CARE TO PATIENTS OF ALL AGES, FOCUSING ON PEDIATRIC, WOMEN'S HEALTH, AND ADULT MEDICINE. THE SERVICES ARE COMPLEMENTED BY MENTAL HEALTH AND DENTAL SERVICES. SBCHC ALSO UTILIZES A MOBILE CLINIC TO CONDUCT OUTREACH, HEALTH SCREENINGS, AND HEALTH PROMOTION IN THE COMMUNITY. 8857284 true true false false false false false false false false true false false true true false true false false false false false false false true false false false false true false false false false false false false false true false false false false false false false false true 41 0 150 true false false false false false true true false false false false X 11 11 false false false false false false false true true false false true true true true true true true true false X MARLEN J TRUJILLO 7134626565 800 W SAM HOUSTON PKWY S SUITE 200 HOUSTON TX 77042 X JOHN KEMPER CHAIRMAN 2.0 0.0 X X 0 0 0 LOUIS FAILLACE MD VICE-CHAIR 1.0 0.0 X X 0 0 0 JORGE SERA TREASURER 1.0 0.0 X X 0 0 0 IGNACIO PUJOL SECRETARY 1.0 0.0 X X 0 0 0 MARIE-LOUISE ZELMAT DIRECTOR 1.0 0.0 X 0 0 0 CARLOS A MORENO MD DIRECTOR 1.0 0.0 X 0 0 0 TERESA JACKSON DIRECTOR 1.0 0.0 X 0 0 0 LYDIA JUNEK DIRECTOR 1.0 0.0 X 0 0 0 LESTER WILLIAMS DIRECTOR 1.0 0.0 X 0 0 0 FARAH BUCK RN DIRECTOR 1.0 0.0 X 0 0 0 MINGA HERRERA-FERNANDEZ DIRECTOR 1.0 0.0 X 0 0 0 RICARDO BARCELO DIRECTOR End: 12/2017 1.0 0.0 X 0 0 0 MARLEN J TRUJILLO CEO 40.0 0.0 X 194512 0 25358 MICHAEL BSAIBES COO 40.0 0.0 X 124474 0 13635 DAVID HOBSON MD CMO END: 03/2018 40.0 0.0 X 217701 0 3721 LORI MCCAIN CFO 40.0 0.0 X 110580 0 14256 MARY ELLEN MCEVOY CCO End: 10/2018 40.0 0.0 X 82959 0 24034 GERARD PEPERONE CDO 40.0 0.0 X 37297 0 2362 DAVID KRUSLESKI MD PHYSICIAN/CMO 40.0 0.0 X 176663 0 14529 MEGHAN THOMEER DO PHYSICIAN 40.0 0.0 X 165993 0 23381 MARITA OBENZA MD PHYSICIAN 40.0 0.0 X 114757 0 8734 ARBELIA ROMAN PA PHYSICIAN ASSISTANT 40.0 0.0 X 104198 0 9788 1329134 0 139798 8 false true false UT HEALTH SCIENCE CENTER DEPT OF OB 6431 FANNIN STREET HOUSTON TX 77030 CONTRACT PROVIDERS 282627 UNITED SOLUTIONS MSO 3030 EAST 29TH ST 101 BRYAN TX 77802 BILLING SERVICE 201353 ULTRASOUND SERVICES LLC 440 COBIA DRIVE STE 704 KATY TX 77494 ULTRASOUND SERVICES 135230 LABORATORY CORPORATION OF AMERICA PO BOX 12140 BURLINGTON NC 27216 LABORATORY TESTING 127922 UNITED CONSTRUCTORS OF TEXAS INC 6989 W LITTLE YORK STE F HOUSTON TX 77040 CONSTRUCTION 121632 7 X 35700 2805682 1316037 582932 4157419 Net Patient Service Revenue 621110 7179755 7179755 Pharmacy Revenue 446110 104083 104083 7283838 2163 2163 0 0 18000 18000 0 18000 18000 125000 189243 -64243 -64243 -64243 24481 35700 16486 7995 7995 0 0 0 0 0 0 Miscellaneous Revenue 900099 48269 48269 Medical Records Revenue 561000 4311 4311 52580 11457752 7354418 -54085 0 0 0 0 1058912 417747 598376 42789 0 5000236 4388171 612065 72088 71849 239 557755 481216 76539 444530 351179 93351 0 1414 1414 49789 49789 0 0 0 860548 598271 262277 12101 12101 341236 124167 217069 143416 87849 55567 0 739513 556891 182622 25277 25277 0 5504 5504 58603 46296 12307 0 380338 299211 81127 39783 28658 11125 Medical Supplies & Equipment 1086683 1086683 Bad Debt Expense 293780 293780 Staff Training 21113 14120 6993 Recruiting & Retention 13971 11196 2775 753 753 11207343 8857284 2307270 42789 649677 363401 805077 777987 119614 402823 514484 551298 0 0 0 0 0 0 254098 117508 86232 38094 8174910 1159198 7124464 7015712 0 0 0 0 0 0 0 0 34994 822975 9588640 10089798 955111 891817 0 0 0 0 0 0 0 0 0 0 873708 1160175 0 0 181733 209309 2010552 2261301 X 7075635 7291113 502453 537384 0 0 7578088 7828497 9588640 10089798 250409 X false true X true true true X 2151416 2854308 4303314 9926376 4157419 23392833 0 0 2151416 2854308 4303314 9926376 4157419 23392833 0 23392833 1676 1791 1531 1119 2163 8280 0 44616 42507 31222 24481 142826 23543939 24179876 0.99358 0.99600 X Schedule A, Part II, Line 10 836554 836554 5884052 519918 5364134 603344 187680 415664 850960 451600 399360 7015712 SECURITY DEPOSITS 34994 OTHER RECEIVABLES 71208 DUE FROM 3RD PARTY PAYERS 716773 822975 0 DEFERRED RENT 34671 TENANT IMPROVEMENT ALLOWANCE 174638 209309 11018937 9167 144926 154093 10864844 592908 592908 11457752 11003459 9167 80729 89896 10913563 293780 293780 11207343 SCHEDULE D, PART XI, LINE 2D RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: NET ASSETS RELEASED FROM RESTRICTION $438,706 BAD DEBT EXPENSE $(293,780) ------------- TOTAL $144,926 SCHEDULE D, PART XI, LINE 4B RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: LOSS ON DISPOSAL OF ASSETS $(64,243) CONTRIBUTIONS IN TRNA $673,637 FUNDRAISING EXPENSES $(16,486) ------------ TOTAL $592,908 SCHEDULE D, PART XII, LINE 2D RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS WITH RETURN: FUNDRAISING EXPENSES $16,486 LOSS ON DISPOSAL OF ASSETS $64,243 --------- TOTAL $80,729 SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS WITH RETURN: BAD DEBT EXPENSE $293,780 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. FALL HARVEST LU 60181 35700 24481 550 5002 7150 3784 0 60181 35700 24481 550 5002 7150 3784 16486 7995 X X X X false false false false false false false false false MARLEN J TRUJILLO CEO 193962 0 550 0 0 0 9959 0 15399 0 219870 0 0 0 DAVID HOBSON MD CMO END: 03/2018 217576 0 125 0 0 0 0 0 3721 0 221422 0 0 0 DAVID KRUSLESKI MD PHYSICIAN/CMO 176538 0 125 0 0 0 0 0 14529 0 191192 0 0 0 MEGHAN THOMEER DO PHYSICIAN 165743 0 250 0 0 0 8522 0 14859 0 189374 0 0 0 X 9650 FMV X 72 573282 FMV false false false SCHEDULE M, PART I, 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. 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, LINES 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 PRESIDENT OF THE BOARD. THE COMMITTEE USES ANNUAL SALARY SURVEYS FROM THE TEXAS ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE NATIONAL 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 AND THE NATIONAL 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)... culturally competent, linguistically appropriate and client-driven in a location 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 a modest, but important and growing component of the primary care safety-net in Houston and Harris County where approximately 1 million people are uninsured and/or medically underserved. Though the primary care safety-net has grown significantly since 2005 (In 2005, 2 FQHCs served Harris County, compared with 10 today), it still has far to go in serving the healthcare needs of a large, and growing, underserved population. SBCHCs vision is to be a champion in community wellness by providing integrated primary care services to all who seek it. SBCHCs commitment to quality of care will remain 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 (MUP) in the Spring Branch area of Houston. SBCHC was designated as a Federally Qualified Health Center (FQHC) in 2005. SBCHC became one of only 10% of the FQHCs in the United States with Joint Commission Accreditation and Primary Care Medical Home Certification in December 2012. SBCHC earned the Joint Commissions Gold Seal of Approval by demonstrating compliance with the Joint Commissions 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. In 2013 SBCHC expanded to West Houston, in 2016 expanded to Katy, and in 2017 expanded to Cypress. Also in 2017, SBCHC added a location in Spring Branch, 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 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 and CHIP, pharmacy assistance programs, SNAP and WIC, is available at all clinic locations. Referral specialists/patient care coordinators assist patients at each location 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 SBCHCs 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 builds a healthier community as a whole.