2020-07-12T11:55:48-05:00 2019-08-31 752393478 WHITLEY PENN LLP 640 TAYLOR STREET SUITE 2200 FT WORTH TX 76102 990 2018-09-01 752655008 UT SOUTHWESTERN MONCRIEF CANCER CENTER MONCRIEF CANCER INSTITUTE UTSO 8172889800 400 W MAGNOLIA AVE FORT WORTH TX 76104 ARNIM E DONTES SECRETARY AND TREASURER 8172889800 2020-06-25 1 CHRISTY CATES P00440503 8172599100 71.131.70.48 2020-06-25 16:15:59 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 C9CC508B603D8A41B6E0CF17653875976BD10DA7 2018 2020-09-23 17:36:50Z MONCRIEF CANCER INSTITUTE ARNIM E DONTES 400 W MAGNOLIA AVE FORT WORTH TX 76104 12458154 0 X WWW.MONCRIEF.COM X 1958 TX TO PROVIDE COUNSELING AND SUPPORT RESOURCES TO CANCER PATIENTS AND THEIR FAMILIES. 4 1 0 5 0 0 10148799 10219484 0 0 53827 84692 2458767 2153978 12661393 12458154 144967 119471 0 0 0 0 0 0 49709 13616225 13423310 13761192 13542781 -1099799 -1084627 37935781 36374478 2360564 1975138 35575217 34399340 TO BE A LEADER IN OUR COMMUNITY'S EFFORTS TO FIGHT CANCER AND REDUCE ITS BURDEN THROUGHOUT THE CONTINUUM OF CARE SETTING, USING EDUCATION, AWARENESS, PREVENTION, EARLY DETECTION, BEHAVIORAL AND NUTRITIONAL SCIENCES AND RESEARCH. 0 0 4771490 66450 MONCRIEF CANCER INSTITUTE'S BREAST AND CERVICAL CANCER SCREENING PROGRAM OFFERS MAMMOGRAMS, CLINICAL BREAST EXAMS, AND PAP TESTS TO UNDERSERVED/UNINSURED WOMEN. THE PROGRAM HAS A COMPREHENSIVE PATIENT NAVIGATION PROCESS TO ENSURE PATIENTS WITH LIMITED ACCESS ARE ABLE TO OBTAIN THE RECOMMENDED SCREENING. PATIENTS WITH POSITIVE FINDINGS ARE NAVIGATED TO OBTAIN FURTHER STUDIES AND THERAPEUTIC OPTIONS SHOULD THEY BE REQUIRED. MONCRIEF PARTNERS WITH OVER 50 HOSPITALS, CLINICS AND HEALTHCARE PROVIDERS IN MORE THAN 30 COUNTIES ACROSS NORTH TEXAS. IN 2019, THE PROGRAM PROVIDED OVER 9,000 BREAST CANCER SCREENINGS AND 800 CERVICAL CANCER SCREENINGS. 1044487 53021 MONCRIEF CANCER INSTITUTE'S SURVIVORSHIP & SUPPORT SERVICES PROVIDES A WIDE RANGE OF SERVICES TO CANCER PATIENTS AND SURVIVORS. THE PROGRAM INCLUDES FERTILITY PRESERVATION, GENETIC COUNSELING, NUTRITION PLANNING AND COOKING CLASSES TO PROMOTE HEALING AND WELLNESS, ONEONONE AND GROUP EXERCISE SESSIONS, PSYCHOLOGISTS & SOCIAL WORKERS TO ASSIST WITH EMOTIONAL AND FINANCIAL CHALLENGES. MONCRIEF CANCER INSTITUTE ALSO HAS A PROGRAM SPECIFICALLY DESIGNED FOR ADOLESCENTS AND YOUNG ADULTS DEALING WITH CANCER. MONCRIEF'S 18WHEELER MOBILE CLINIC IS ABLE TO PROVIDE BREAST CANCER SCREENINGS AND OTHER SUPPORT SERVICES TO THE RURAL UNDERSERVED POPULATION. OVER THE PAST SIX YEARS, MORE THAN 4,000 CANCER PATIENTS AND SURVIVORS HAVE RECEIVED SERVICES THROUGH THESE PROGRAMS. 1222662 MONCRIEF CANCER INSTITUTE'S COLORECTAL CANCER SCREENING PROGRAM IS AVAILABLE AT NO COST FOR INDIVIDUALS WHO ARE UNDERSERVED/UNINSURED AND MEET THE CLINICAL ELIGIBILITY REQUIREMENTS. PATIENTS ARE MAILED AN ATHOME COLON CANCER SCREENING TEST. PATIENTS WITH POSITIVE FINDINGS ARE NAVIGATED TO OBTAIN A COLONOSCOPY. MONCRIEF PARTNERS WITH HOSPITALS, CLINICS AND HEALTHCARE PROVIDERS IN MORE THAN 20 COUNTIES ACROSS NORTH TEXAS. IN 2019 OVER 21,000 ATHOME COLON CANCER SCREENING TESTS WERE MAILED, AND OVER 250 PATIENTS HAD COLONOSCOPIES COMPLETED. 1583609 1583609 8622248 1 1 0 0 0 0 0 1 0 1 1 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 145 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 1 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X KEITH ARGENBRIGHT MD 8172889800 400 W MAGNOLIA AVE FORT WORTH TX 76104 WILLIS MADDREY MD PRESIDENT AND CHAIRMAN 1.00 40.00 X X 0 611664 47383 ARNIM DONTES SECRETARY AND TREASURER 1.00 40.00 X X 0 782352 42780 KIT MONCRIEF DIRECTOR 1.00 1.00 X 0 0 0 CARLOS ARTEAGA MD DIRECTOR 1.00 40.00 X 0 846364 75326 MICHAEL SERBER ASSISTANT TREASURER 1.00 40.00 X 0 380662 42411 KEITH ARGENBRIGHT MD MEDICAL DIRECTOR FOR MCI 1.00 40.00 X 0 414156 37354 0 3035198 245254 0 0 1 0 UT SOUTHWESTERN MEDICAL CENTER 5323 HARRY HINES BLVD DALLAS TX 75390 MEDICAL SERVICES 901483 MEDCO CONSTRUCTION LLC 4005 CRUTCHER ST STE 200 DALLAS TX 75246 CONSTRUCTION SERVICES 878388 ROSE IMAGING SPECIALISTS PA PO BOX 203268 DALLAS TX 75320 MEDICAL SERVICES 270463 KELLY HART & HALLMAN LLP 201 MAIN ST SUITE 2500 FORT WORTH TX 76102 LEGAL SERVICES 159025 TARRANT COUNTY HOSPITAL DISTRICT 1500 S MAIN ST FORT WORTH TX 76104 MEDICAL SERVICES 153622 9 4237683 5981801 10219484 84692 84692 817 817 2153161 0 2153161 2153161 2153161 12458154 0 0 2238670 X 66450 66450 53021 53021 50510 50510 219378 219378 56029 56029 9784756 7720624 2014423 49709 263123 237703 25420 360014 210130 149884 166149 39366 126783 701509 15423 686086 87604 64967 22637 1334632 1334632 105768 105768 MEDICAL SUPPLIES 119149 119149 MISCELLANEOUS 88504 25623 62881 AUTOMOBILE 56764 56764 CERTIFICATIONS & CONTIN 29421 13028 16393 13542781 8622248 4870824 49709 1860465 764067 915086 1209196 67931 52184 47664004 17671486 31327151 29992518 3765148 4356513 37935781 36374478 2182043 1900725 178521 74413 2360564 1975138 X 33916047 32831418 1659170 1567922 35575217 34399340 37935781 36374478 -1084627 -91250 0 X 0 1 X 0 1 1 X X 1 UT SOUTHWESTERN MEDICAL CENTER 756002868 6 1 6066739 0 1 6066739 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 518965 0 1659170 -91248 1567922 1563838 95332 1659170 1460569 103269 1563838 1517561 -56992 1460569 1630134 -112573 1517561 1.00000 0 0 4285018 4285018 41100052 16128342 24971710 1284044 1126756 157288 994890 416388 578502 29992518 BENEFICIAL INTEREST IN PERPETUAL TRUST 1567922 DUE FROM MONCRIEF CANCER FOUNDATION 1725963 ACCOUNTS RECEIVABLE - RELATED PARTY 1062628 4356513 X 12458154 0 12458154 0 12458154 13542781 0 13542781 0 13542781 PART X, LINE 2: MONCRIEF IS GENERALLY EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE CODE, AS AN ORGANIZATION OTHER THAN A PRIVATE FOUNDATION. GAAP REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY MONCRIEF AND RECOGNIZE A TAX LIABILITY IF MONCRIEF HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY MONCRIEF AND HAS CONCLUDED THAT, AS OF AUGUST 31, 2019, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS, MONCRIEF IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 0 AMERICAN CANCER SOCIETY 1300 SUMMIT AVENUE SUITE 350 FORT WORTH TX 76102 131788491 501(C)(3) 7500 GENERAL ASSISTANCE CAREITY FOUNDATION PO BOX 126038 FORT WORTH TX 76126 061704800 501(C)(3) 15000 GENERAL ASSISTANCE FORT WORTH ADOLESCENT AND YOUNG ADULT CANCER COALITION PO BOX 471332 FORT WORTH TX 76147 473205260 501(C)(3) 7500 GENERAL ASSISTANCE FORT WORTH SOUTH DEVELOPMENT DISTRICT INC 1606 MISTLETOE BOULEVARD FORT WORTH TX 76104 752640191 501(C)(4) 5000 GENERAL ASSISTANCE SUSAN G KOMEN GREATER FORT WORTH 2216 GREEN OAKS ROAD FORT WORTH TX 76116 752445070 501(C)(3) 22500 GENERAL ASSISTANCE DONOR DESIGNATED FUNDS 400 W MAGNOLIA AVENUE FORT WORTH TX 76104 752655008 501(C)(3) 8950 GENERAL ASSISTANCE PROVIDED TO OUTSIDE ORGANIZATIONS UNDER $5,000 PER ORGANIZATION 5 1 ASSISTANCE FOR INDIGENT CARE 58 53021 0 0 0 0 0 0 0 0 0 WILLIS MADDREY MD PRESIDENT AND CHAIRMAN 0 471166 0 139778 0 720 0 40257 0 7126 0 659047 0 0 ARNIM DONTES SECRETARY AND TREASURER 0 591715 0 189917 0 720 0 23375 0 19405 0 825132 0 0 CARLOS ARTEAGA MD DIRECTOR 0 695644 0 150000 0 720 0 55921 0 19405 0 921690 0 0 MICHAEL SERBER ASSISTANT TREASURER 0 259677 0 120265 0 720 0 23006 0 19405 0 423073 0 0 KEITH ARGENBRIGHT MD MEDICAL DIRECTOR FOR MCI 0 394156 0 20000 0 0 0 23375 0 13979 0 451510 0 0 ARNIM DONTES AND MICHAEL SERBER OFFICER - UT SOUTHWESTERN MONCRIEF CANCER CTR & UT SOUTHWESTERN MEDICAL C 6066739 MONCRIEF CANCER INSTITUTE HAS TRANSACTIONS WITH UT SOUTHWESTERN AS PART OF THE MASTER SERVICES AGREEMENT FOR SHARING OF EMPLOYEES AND OTHER RESOURCES RELATED TO INFORMATION RESOURCES, IT, ADVERTISING & PRINTING, CONSULTING AND MANAGEMENT. ARNIM DONTES AND MICHAEL SERBER ARE OFFICERS OF UT SOUTHWESTERN AND OFFICERS & DIRECTORS OF MONCRIEF CANCER INSTITUTE. 0 FORM 990, PART VI, SECTION A, LINE 6 DR. PODOLSKY, AS PRESIDENT OF UT SOUTHWESTERN, IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A DR. PODOLSKY, IN HIS CAPACITY AS MEMBER, HAS THE SOLE AUTHORITY TO APPOINT DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY MICHAEL SERBER, ASSISTANT TREASURER, AND ARNIM E. DONTES, SECRETARY AND TREASURER, BEFORE SUBMISSION TO DR. WILLIS MADDREY, PRESIDENT AND CHAIRMAN, FOR REVIEW. ALL BOARD MEMBERS CAN REQUEST A COPY OF THE 990. FORM 990, PART VI, SECTION B, LINE 12C MONCRIEF CANCER INSITUTE FOLLOWS THE WRITTEN CONFLICT OF INTEREST POLICY OF UT SOUTHWESTERN WHICH REQUIRES THE DIRECTORS AND OFFICERS TO SIGN CONFLICT OF INTEREST STATEMENTS WHICH ARE THEN REVIEWED BY THE BOARD. ANYONE WITH A CONFLICT IS RECUSED FROM DISCUSSION AND VOTING ON THE TRANSACTION, WITH THE CONFLICT BEING DOCUMENTED IN THE MINUTES. THE CONFLICT OF INTEREST STATEMENTS ARE A PART OF THE MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 3,419,959. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,419,959. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 19,285. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,285. TRANSLATION SERVICES: PROGRAM SERVICE EXPENSES 41,562. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,562. BENEFITS: PROGRAM SERVICE EXPENSES 881,671. MANAGEMENT AND GENERAL EXPENSES 355,536. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,237,207. ADMIN SERVICE FEE: PROGRAM SERVICE EXPENSES 301,920. MANAGEMENT AND GENERAL EXPENSES 145,191. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 447,111. LEASED EMPLOYEES WAGES: PROGRAM SERVICE EXPENSES 2,901,179. MANAGEMENT AND GENERAL EXPENSES 1,398,993. FUNDRAISING EXPENSES 49,709. TOTAL EXPENSES 4,349,881. CONSULTING: PROGRAM SERVICE EXPENSES 73,301. MANAGEMENT AND GENERAL EXPENSES 82,325. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 155,626. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 95,274. MANAGEMENT AND GENERAL EXPENSES 13,093. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 108,367. PATIENT SUPPORT: PROGRAM SERVICE EXPENSES 5,758. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,758. MONCRIEF CANCER FOUNDATION 5323 HARRY HINES BLVD DALLAS TX 75390 752429817 ORGANIZED AND OPERATED FOR THE BENEFIT OF UT SOUTHWESTERN MEDICAL CENTER. TX 501(C)(3) 509(A)(3) 0 UT SOUTHWESTERN MEDICAL CENTER 5323 HARRY HINES BLVD DALLAS TX 75390 756002868 HIGHER EDUCATION, RESEARCH, AND PROVISION OF MEDICAL CARE. TX 501(C)(3) LINE 6 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 1 MONCRIEF CANCER FOUNDATION C 3038054 FMV UT SOUTHWESTERN MEDICAL CENTER J 1082090 FMV UT SOUTHWESTERN MEDICAL CENTER N 233093 FMV UT SOUTHWESTERN MEDICAL CENTER O 5833646 FMV UT SOUTHWESTERN MEDICAL CENTER S 1199629 FMV