2019-02-15T12:40:55-06:00 2018-03-31 221478099 COHNREZNICK LLP 4 BECKER FARM ROAD ROSELAND NJ 07068 990 2017-04-01 742357970 SU CLINICA FAMILIAR INC SUCL 9563656750 1706 TREASURE HILLS BLVD HARLINGEN TX 78550 ADAM SALDIVAR CHIEF FINANCIAL OFFICER 9563656750 2019-02-14 1 LORI ROTHE YOKOBOSKY CPA P01273422 9732283500 2019-02-13 209.59.242.22 2019-02-14 13:36:59 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 A999648B7C0F94429496C189B46642AFC33E1A30 2017 2019-02-21 02:37:17Z ELENA MARIN MD 1706 TREASURE HILLS BLVD HARLINGEN TX 78550 35182085 0 X WWW.SUCLINICA.ORG X 1971 TX EXCELLENCE IN HEALTH CARE DELIVERY AND CLINICAL EDUCATION, AND BE RECOGNIZED AS A LEADER IN COMMUNITY HEALTH. 13 13 466 37 0 0 10442383 10328720 23106270 24248690 182 -2315 526540 602321 34075375 35177416 0 0 0 0 21916917 21200351 0 0 0 13188786 12646512 35105703 33846863 -1030328 1330553 22539692 22858714 11391718 10240713 11147974 12618001 X TO PROMOTE A HEALTHIER COMMUNITY BY PROVIDING ACCESS TO HIGH QUALITY COMPREHENSIVE MEDICAL CARE, HEALTH EDUCATION AND SUPPORT SERVICES. 0 0 25906548 24851011 SU CLINICA FAMILIAR, INC. STRONGLY BELIEVES THAT THE TRUE WEALTH OF A COMMUNITY CAN BE JUDGED BY THE HEALTH OF ITS POPULATION. WE GO BEYOND THE TRADITIONAL DOCTORS OFFICE BY OFFERING A WIDE VARIETY OF COMMUNITY PROGRAMS AIMED AT INCREASING THE HEALTH STATUS OF THE ENTIRE COMMUNITY. WE BELIEVE THAT HEALTHY CITIZENS PERFORM BETTER IN OUR SCHOOLS, CONTRIBUTE MORE TO OUR ECONOMY AND ESTABLISH A STRONG FOUNDATION FOR THE COMMUNITY'S VIABILITY. IN THE PAST YEAR SU CLINICA SERVED 32,604 PATIENTS, OF WHICH 14,815 WERE UNINSURED. SU CLINICA'S COMMITMENT TO A HEALTHY SOCIETY INCLUDES PARTICIPATION IN A VARIETY OF DIFFERENT PROGRAMS, AS LISTED HERE.- DIABETES COLLABORATIVE - A NATIONAL PROGRAM TO PROVIDE PERSONALIZED CASE MANAGEMENT SERVICES TO DIABETES PATIENTS.- CHILD HEALTH INSURANCE PROGRAM (CHIP) OUTREACH PROGRAM - INFORMS LOW INCOME FAMILIES ON THE BENEFITS OF ENROLLING CHILDREN IN THE STATE CHIP PROGRAM.- REACH OUT AND READ - MAKES EARLY LITERACY PART OF PEDIATRIC PRACTICE BY PROVIDING BOOKS TO CHILDREN WHOSE FAMILIES HAVE LIMITED RESOURCES AND BY PROVIDING READING MENTORS IN OUR PEDIATRIC WAITING ROOM.- PATIENT CENTERED MEDICAL HOME (PCMH) - SU CLINICA FAMILIAR HAS FOUR LEVEL 3 PCMH SITES CONSISTING OF OUR HARLINGEN, TEXAS, BROWNSVILLE, TEXAS, RAYMONDVILLE, TEXAS, AND SANTA ROSA. TEXAS LOCATION.- ACCOUNTABLE CARE ORGANIZATION (ACO) - SU CLINICA FAMILIAR IS ENGAGED IN AN ACO WHICH IS CHARACTERIZED BY A PAYMENT AND CARE DELIVERY MODEL THAT SEEKS TO TIE PROVIDER REIMBURSEMENTS TO QUALITY METRICS AND REDUCTIONS IN THE TOTAL COST OF CARE FOR ITS MEDICARE PATIENT POPULATION. THE ACO IS ACCOUNTABLE TO THE PATIENTS AND THE THIRD-PARTY PAYER FOR THE QUALITY, APPROPRIATENESS AND EFFICIENCY OF THE HEALTH CARE PROVIDED.- DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) 1115 WAIVER THE CLINIC EXPECTS THAT THE USE OF ELECTRONIC MEDICAL RECORDS, HEALTH INFORMATION EXCHANGE, PATIENT CENTERED MEDICAL HOME AND COORDINATION WITH THE HOSPITAL WILL LEAD TO A PERCENTAGE REDUCTION IN THE NUMBER OF ADULT PATIENTS WITH TYPE 1 OR 2 DIABETES WHOSE HBA1C IS ABOVE 9.0%, OTHERWISE KNOWN AS POOR CONTROL.- RETINOPATHY SCREENING -SU CLINICA FAMILIAR PARTICIPATES IN A DIABETIC RETINOPATHY SCREENING PROGRAM WHICH INVOLVES A UNIQUE PARTNERSHIP AMONG SU CLINICA FAMILIAR, UTHSCSA, AND LOCAL SPECIALISTS. THE INITIATIVE IS DESIGNED TO EXPAND THE MEDICAL HOME MODEL TO INCLUDE IN-HOUSE RETINOPATHY SCREENING WHICH WOULD RESULT IN GREATER ACCESS TO CARE FOR UNINSURED DIABETIC PATIENTS IDENTIFYING POTENTIAL SHORT TERM OR LONG TERM VISION COMPLICATION, WHILE DECREASING HEALTH CARE COSTS AND INCREASING PATIENTS' QUALITY OF LIFE.- HRSA OUTREACH AND ENROLLMENT PROGRAM - EXPAND CURRENT OUTREACH AND ENROLLMENT ASSISTANCE ACTIVITIES AND FACILITATE ENROLLMENT OF ELIGIBLE HEALTH CENTER PATIENTS AND SERVICE AREA RESIDENTS INTO AFFORDABLE HEALTH INSURANCE COVERAGE THROUGH THE HEALTH INSURANCE MARKETPLACES, MEDICAID, OR THE CHILDREN'S HEALTH INSURANCE PROGRAM.ACCESS INCREASE IN MENTAL HEALTH AND SUBMSTANCE ABUSE - TO PROVIDE PRIMARY CARE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES WITH A FOCUS ON OPIOID ABUSE.TO INCREASE NUMBER OF STAFF WHO ARE PROVIDING MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES TO EXISTING PATIENTS. THE CLINIC WILL ALSO LEVERAGE HEALTH INFORMATION TECHNOLOGY (IT) AND PROVIDE TRAINING TO SUPPORT THE EXPANSION OF MH AND SA SERVICES FOCUSING ON THE TREATMENT, PREVENTION, AND AWARENESS OF OPIOID ABUSE, AND THEIR INTEGRATION INTO PRIMARY CARE. - -DIEBETES PREVENTION PROGRAM - THROUGH THE CDC-LED NATIONAL DIABETES PREVENTION PROGRAM (NATIONAL DPP), PUBLIC AND PRIVATE ORGANIZATIONS WILL WORK TOGETHER TO EXPAND THE INFRASTRUCTURE FOR THE NATIONWIDE DELIVERY OF AN EVIDENCE-BASED LIFESTYLE CHANGE PROGRAM TO PREVENT OR DELAY ONSET OF TYPE 2 DIABETES AMONG ADULTS WITH PRE-DIABETES. THE NATIONAL GOAL IS TO EXPAND THE NATIONAL DPP DELIVERY STRUCTURE, CLOSE THE ENROLLMENT GAP SO THAT MORE PARTICIPANTS WITH PREDIABETES SUCCESSFULLY COMPLETE THE CDC LIFESTYLE CHANGE PROGRAM, ACHIEVE 5 7 % WEIGHT LOSS, AND SIGNIFICANTLY REDUCE THEIR RISK FOR DEVELOPING TYPE 2 DIABETES. - INTGRATED HEALTHCARE IMPROVEMENT - SERVE A PANEL OF 200 UNDERSERVED PATIENTS, EACH WITH 2 OR MORE CO-MORBIDITIES INCLUDING DIABETES, HYPERTENSION, OBESITY, AND DEPRESSION, WITH A FOCUS ON IMPROVING HEALTH OUTCOMES. PROVIDE DATA SHOWING THE RESULTS FOR THESE PATIENTS RELATED TO THE 4 CO-MORBIDITIES. WE WILL RECEIVE 80% REIMBURSEMENT FOR ENROLLING PATIENTS AND A POTENTIAL 20% ADDITIONAL FUNDING AT THE END OF THE YEAR FOR MEETING INCENTIVE GOALS THAT DEMONSTRATE IMPROVEMENT IN HEALTH OUTCOMES.PROJECT DOC (DIABETES AND OESITY COLLABORATION- THE GOAL IS TO CREATE AN ECOSYSTEM IN WHICH THE PRIVATE SECTOR, HEALTHCARE, AND PATIENTS LEVERAGE TECHNOLOGY AND COLLABORATE TO CHANGE THE HEALTHCARE MODEL.SI TEXAS-WORK WITH THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON - BROWNSVILLE REGIONAL CAMPUS TO FURTHER THE AIMS OF THE SITEXAS PROJECT.GOAL 1: AT LEAST 45% OF SALUD Y VIDA PARTICIPANTS WHO WERE IDENTIFIED BY THE CHRONIC CARE MANAGEMENT TEAM AS NEEDING MTM SERVICES OR BH SERVICES WILL RECEIVE SAID SERVICES BY THE END OF YEAR 2.GOAL 2: AT LEAST 20% OF MTM PROGRAM PARTICIPANTS WILL ACHIEVE AN HBA1C OF BELOW 9% DURING THE 9 MONTHS FOLLOWING THE PROVISION OF SERVICES BY THE END OF YEAR 2.GOAL 3: AT LEAST 20% OF BEHAVIORAL HEALTH SERVICE PROGRAM PARTICIPANTS WILL ACHIEVE AN HBA1C OF BELOW 9% DURING THE 9 MONTHS FOLLOWING THE PROVISION OF SERVICES BY THE END OF YEAR 2. - DSRIP 1115WAIVER- REDUCE THE OVERALL A1C AMONG THE TARGET POPULATION TO 32.90% BY SEPTEMBER 30, 2018.CONTINUE TO IMPROVE THE PROPORTION OF PATIENTS WITH UNCONTROLLED DIABETES AND WILL DEMONSTRATE AN IMPROVEMENT OF THIS PROPORTION FROM THE BASELINE AS DEFINED BY HHSC. 25906548 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 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 37 0 1 466 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X ADAM SALDIVAR 9563656750 1706 TREASURE HILLS BLVD HARLINGEN TX 78550 ARTURO CAVAZOS ED D BOARD MEMBER 1.00 X 0 0 0 CHRISTINA GARCIA ED D BOARD MEMBER 1.00 X 0 0 0 CLAUDIA U SAENZ BOARD MEMBER 1.00 1.00 X 0 0 0 DENISE ALMON CPA BOARD MEMBER 1.00 X 0 0 0 FIDEL ATKINSON JR BOARD MEMBER 1.00 1.00 X 0 0 0 IRMA LINDA LOPEZ BOARD MEMBER 1.00 1.00 X 0 0 0 LUCIA AGUILAR BOARD MEMBER 1.00 1.00 X 0 0 0 ROBERT D RODRIGUEZ TREASURER 1.00 X X 0 0 0 ROBERT L GUERRA JD VICE CHAIRPERSON 1.00 X X 0 0 0 ROSALEE NAJAR BOARD MEMBER 1.00 1.00 X 0 0 0 ROSAURA AGUILAR SECRETARY 1.00 1.00 X X 0 0 0 SUSANA ANZALDUA BOARD MEMBER 1.00 1.00 X 0 0 0 TINA BRIONES EDD RN CHAIRPERSON 1.00 X X 0 0 0 ADAM SALDIVAR CHIEF FINANCIAL OFFICER 38.00 2.00 X 100435 0 9631 ELENA MARIN MD CHIEF EXECUTIVE OFFICER 38.00 2.00 X 260520 0 15472 RITA VILLANUEVA MD CHIEF MEDICAL OFFICER 40.00 X 266091 0 13056 CHANDRASEKHER REDDY MD PHYSICIAN 40.00 X 305064 0 16779 DAVID DE LA LLATA PHYSICIAN 40.00 X 254221 0 12368 MIGUEL MARTINEZ VELA PHYSICIAN 40.00 X 241012 0 11475 RAMIRO MUNOZ MD PHYSICIAN 40.00 X 474625 0 22397 ROSE GOWAN MD PHYSICIAN 40.00 X 266904 0 8939 2168872 0 110117 41 0 1 0 ALBERTO E VASQUEZ MD PA 2334 S 25TH ST HARLINGEN TX 78550 PROFESSIONAL MEDICAL SERVICES 252350 ALBERT BERNARDONI MD PA 2808 CHINSBERRY PARK LN LEAGUE CITY TX 77573 PROFESSIONAL MEDICAL SERVICES 245000 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 AUDIT, FINANCIAL SERVICES 226725 HARLINGEN OBSTETRICS AND GYNECOLGY 2230 HAINE DR HARLINGEN TX 78550 PROFESSIONAL MEDICAL SERVICES 215920 BRYAN J PRUKOP DPM 812 LINDBURG AVE MCALLEN TX 78501 PROFESSIONAL MEDICAL SERVICES 140000 5 9473594 855126 20748 10328720 MEDICAID & MEDICAID MANAGED CARE 621400 16046467 16046467 SELF PAY 621400 3680524 3680524 340B PHARMACY REVENUE 621400 1896644 1896644 OTHER THIRD PARTY 621400 1456839 1456839 MEDICARE 621400 1168216 1168216 24248690 2354 2354 4669 -4669 -4669 -4669 PHYSICIAN INCENTIVES 621400 219098 219098 MISCELLANEOUS INCOME 900099 196223 196223 MEANINGFUL USE INCENTIVE 900099 187000 187000 602321 35177416 24851011 0 -2315 751384 532717 218667 17797488 12636103 5161385 433409 300846 132563 915701 635624 280077 1302369 904024 398345 25228 25228 560544 560544 1598503 1598503 596312 349520 246792 564200 564200 986945 871168 115777 217808 97402 120406 383488 314460 69028 1111306 985030 126276 221426 14592 206834 BAD BEBTS 2630031 2630031 CONSUMABLE SUPPLIES 1851240 1761194 90046 LABORATORY 1124982 1124982 REPAIRS & MAINTENANCE 616622 551081 65541 157877 35071 122806 33846863 25906548 7940315 0 1032047 2293264 556686 268102 2181460 1664562 201574 178442 242984 353962 28890872 10790490 18324941 18100382 22539692 22858714 3682329 3049746 175730 5676000 5412000 2033389 1603237 11391718 10240713 X 11082504 12554106 65470 63895 11147974 12618001 22539692 22858714 X 1330553 139474 X X 0 1 X 1 1 1 X 9491738 10138521 10517190 10442383 10328720 50918552 9491738 10138521 10517190 10442383 10328720 50918552 50918552 5441 1635 1316 182 2354 10928 477982 497621 510288 526540 602321 2614752 53544232 109502595 0.95100 0.96100 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2013 AMOUNT: $ 307,982. 2014 AMOUNT: $ 217,121. 2015 AMOUNT: $ 234,038. 2016 AMOUNT: $ 318,290. 2017 AMOUNT: $ 415,321. MEANINGFUL USE INCENTIVE - 2013 AMOUNT: $ 170,000. 2014 AMOUNT: $ 280,500. 2015 AMOUNT: $ 276,250. 2016 AMOUNT: $ 208,250. 2017 AMOUNT: $ 187,000. 2962027 2962027 16628920 3411480 13217440 5180230 4219225 961005 4119695 3159785 959910 18100382 LINE OF CREDIT 850000 INTEREST RATE SWAP LIABILITY 263144 CAPITAL LEASE 490093 1603237 X 32555562 -2626523 -2626523 35182085 -4669 -4669 35177416 31162018 -54814 -54814 31216832 2630031 2630031 33846863 PART X, LINE 2: THE ORGANIZATION HAS NO UNRECOGNIZED TAX BENEFITS AT MARCH 31, 2018. THE ORGANIZATION'S FEDERAL AND STATE INCOME TAX RETURNS PRIOR TO FISCAL YEAR 2015 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES ASSOCIATED WITH TAX MATTERS AS OPERATING EXPENSES AND INCLUDES ACCRUED INTEREST AND PENALTIES WITH ACCRUED EXPENSES IN THE CONSOLIDATED STATEMENT OF FINANCIAL POSITION. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION REVENUE 453,736. RELATED ORGANIZATION ELIMINATIONS -450,228. PROVISION FOR BAD DEBT -2,630,031. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF FIXED ASSETS -4,669. PART XII, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION EXPENSES 390,745. RELATED ORGANIZATION ELIMINATIONS -450,228. LOSS ON DISPOSAL OF FIXED ASSETS 4,669. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 2,630,031. X X X X X 0 0 0 0 0 0 0 1 0 ELENA MARIN MD CHIEF EXECUTIVE OFFICER 259211 0 358 0 951 0 9386 0 6086 0 275992 0 0 0 RITA VILLANUEVA MD CHIEF MEDICAL OFFICER 250038 0 15102 0 951 0 9661 0 3395 0 279147 0 0 0 CHANDRASEKHER REDDY MD PHYSICIAN 253275 0 25307 0 26482 0 10692 0 6087 0 321843 0 0 0 DAVID DE LA LLATA PHYSICIAN 163011 0 30339 0 60871 0 8973 0 3395 0 266589 0 0 0 MIGUEL MARTINEZ VELA PHYSICIAN 210103 0 23679 0 7230 0 8505 0 2970 0 252487 0 0 0 RAMIRO MUNOZ MD PHYSICIAN 211948 0 22654 0 240023 0 16310 0 6087 0 497022 0 0 0 ROSE GOWAN MD PHYSICIAN 200474 0 25779 0 40651 0 8939 0 0 0 275843 0 0 0 PART I, LINE 7 INCLUDED ON SCHEDULE J, PART II, COLUMN B(II) ARE AMOUNTS REPRESENTING BONUS AND OTHER INCENTIVE PAYMENTS. THESE AMOUNTS WERE INCLUDED IN THE INDIVIDUALS 2017 W-2, AND APPROVED BY THE BOARD. PART II, COLUMN B(III): AMOUNTS IN COLUMN B REPRESENT OTHER COMPENSATION SUCH AS VACATION/OTHER PTO PAYOUT, CLINIC/ON CALL DUTY, ADMIN LEAVE, AND FAMILY MEDICAL LEAVE. X 1 20748 FMV 0 0 0 PART I, COLUMN (B): AMOUNT IN COLUMN B REPRESENT THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE CHIEF FINANCIAL OFFICER REVIEWS THE 990 AND PRESENTS IT TO THE CHIEF EXECUTIVE OFFICER FOR SECONDARY REVIEW. A BOARD OF DIRECTORS MEETING IS THEN HELD FOR PRESENTATION AND APPROVAL OF THE RETURN PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL DIRECTORS AND EMPLOYEES ARE REQUIRED TO SIGN A CONFLICT OF INTEREST REVIEW ANNUALLY. THE FORM CLEARLY STATES THAT THEY COMPLY WITH THE POLICY. THE CENTER REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 A SALARY RANGE IS PREPARED AND APPROVED BY THE BOARD OF DIRECTORS. THIS SALARY RANGE IS COMPRISED OF INFORMATION OBTAINED FROM OTHER COMMUNITY HEALTH CENTERS AND THE LOCAL MARKET FOR THE CHIEF EXECUTIVE OFFICER. A SURVEY OF THE MAJOR COMMUNITY HEALTH CENTERS IS COMPILED USING THE BUDGET OF THE CENTER AS A KEY INDICATOR. THIS INFORMATION IS PRESENTED TO THE CHAIRMAN OF THE BOARD. THE BOARD, VIA EXECUTIVE SESSION, USES THIS INFORMATION TO DETERMINE THE CEO'S SALARY. IN ADDITION, THE BOARD REVIEWS THE SALARIES OF ALL INDIVIDUALS OVER $100K. PHYSICIANS' SALARIES ARE DETERMINED BY USING THE MGMA COMPENSATION AND PRODUCTIVITY INFORMATION. KEY PERSONNEL SALARIES ARE DETERMINED BY SURVEYING THE LOCAL MARKET AND HEALTH CENTER COMPENSATION GUIDE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THE CONFLICT OF INTEREST POLICY, ALL GOVERNING DOCUMENTS, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 139,474. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. SU CLINICA FAMILIAR MEDICAL FOUNDATION 1706 TREASURE HILLS BLVD HARLINGEN TX 78550 742965534 SUPPORT TX 501(C)(3) LINE 12A, I SU CLINICA 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0