2015-06-28T13:37:26-05:00 2014-11-30 752570395 DURBIN & COMPANY LLP 2950 50TH STREET LUBBOCK TX 79413 990 2013-12-01 752113670 CROSS TIMBER HEALTH CLINICS INC CROS 2548935895 1100 WEST REYNOSA DE LEON TX 76444 JOY SLOAN CFO 2548935895 2015-06-28 1 GAYLE DE HAAS P01774581 8067911591 2013 2016-02-25 16:41:14Z JOY SLOAN 1100 WEST REYNOSA DE LEON TX 76444 7340557 0 X WWW.CROSSTIMBERSINC.ORG X 1986 TX CROSS TIMBERS HEALTH CLINICS PROVIDES AFFORDABLE, PROFESSIONAL HEALTHCARE TO ALL. 11 11 105 0 0 0 3438367 3459221 3987679 3840963 129 -55540 6113 40210 7432288 7284854 0 0 0 0 4414338 4566288 0 0 0 2579130 2645243 6993468 7211531 438820 73323 4283889 4282355 1784637 1709780 2499252 2572575 CROSS TIMBERS HEALTH CLINICS PROVIDES AFFORDABLE, PROFESSIONAL HEALTHCARE TO ALL. 0 0 6312151 3819819 PROVIDED PRIMARY CARE HEALTH AND DENTAL SERVICES TO ITS SERVICE AREA WITH OVER 34,000 PATIENT ENCOUNTERS FUNDED BY A GRANT FROM THE PUBLIC HEALTH SERVICE (SECTION 330 GRANT), MEDICAID AND MEDICARE. 6312151 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 16 0 1 105 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 TX X JOY SLOAN 2548935895 1100 WEST REYNOSA DE LEON TX 76444 WENDI CONWAY PRESIDENT 1.00 X X 0 0 0 TOM LETZ VICE PRESIDENT 1.00 X X 0 0 0 VERL HALLMARK TREASURER 1.00 X X 0 0 0 JENNIFER NICHOLAS SECRETARY 1.00 X X 0 0 0 LANELL WILLIAMS DIRECTOR 1.00 X 0 0 0 CHARLIE ROBITAILLE DIRECTOR 1.00 X 0 0 0 CRAIG WILLINGHAM DIRECTOR 1.00 X 0 0 0 HIRAM SMITH DIRECTOR 1.00 X 0 0 0 ROSA ELIZONDO DIRECTOR 1.00 X 0 0 0 SANDY BLACKWOOD DIRECTOR 1.00 X 0 0 0 KIM BURKE DIRECTOR (FORMER) 1.00 X 0 0 0 CLAUDIA STEVENS DIRECTOR 1.00 X 0 0 0 SHERRY HILL CEO 40.00 X 105397 0 5511 JOY SLOAN CFO 40.00 X 78803 0 0 VICKIE WILLIAMS COO 40.00 X 80569 0 2494 DR MOLLY GRAY CMO 40.00 X 174207 0 5400 JEFFERY KAZE DENTAL DIRECTOR 40.00 X 143122 0 11214 RONALD LIVINGSTON PHYSICIAN 40.00 X 169585 0 17695 GREGORY MILLAR DENTIST 40.00 X 116250 0 0 867933 0 42314 5 0 1 0 0 3266179 193042 185995 3459221 NET PATIENT SERVICE RE 621110 3840963 3840963 3840963 163 163 55703 -55703 -55703 -55703 BONUS/INCENTIVES 621110 29798 29798 MEDICAL RECORDS FEES 621110 5651 5651 ACO INCOME 621110 4761 4761 40210 7284854 3819819 0 5814 910246 457866 452380 2916495 2786676 129819 60378 51321 9057 354792 301573 53219 324377 275720 48657 17170 17170 311554 263644 47910 51916 51916 320850 196631 124219 98536 98536 348872 348872 93241 93241 39439 33471 5968 68111 68111 305651 305651 64668 53687 10981 BAD DEBT 441222 441222 MEDICAL AND DENTAL SUPP 437013 437013 DUES AND SUBSCRIPTIONS 38871 38871 FOOD BANK EXPENSE 6507 6507 1622 1622 7211531 6312151 899380 0 256748 149671 199122 180640 66588 241933 283664 492653 13110 8766 42718 14971 5479113 2299970 3408397 3179143 13542 14578 4283889 4282355 415982 393200 1368655 1316580 1784637 1709780 X 2499252 2558591 13984 2499252 2572575 4283889 4282355 73323 0 X X 1 X 1 X 1 1 1 X 3676825 3646368 3709437 3438367 3459221 17930218 3676825 3646368 3709437 3438367 3459221 17930218 17930218 2113 6399 520 179 163 9374 5804 74999 44124 10769 40210 175906 18115498 3875608 0.98980 0.99200 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MEDICAL RECORDS FEES - 2010 AMOUNT: $ 7,954. 2011 AMOUNT: $ 9,338. 2012 AMOUNT: $ 6,063. 2013 AMOUNT: $ 5,651. OTHER INCOME - 2009 AMOUNT: $ 5,804. 2010 AMOUNT: $ 67,045. 2011 AMOUNT: $ 34,786. 2012 AMOUNT: $ 4,706. BONUS/INCENTIVES - 2013 AMOUNT: $ 29,798. ACO INCOME - 2013 AMOUNT: $ 4,761. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 229686 229686 2820751 615325 2205426 2428676 1684645 744031 3179143 X 6843632 0 6843632 441222 441222 7284854 6770309 0 6770309 441222 441222 7211531 PART X, LINE 2: CTHC IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CTHC EVALUATES AND ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES (FORMERLY FASB INTERPRETATION 48 (FIN 48) ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THIS STANDARD REQUIRES CERTAIN DISCLOSURES ABOUT UNCERTAIN INCOME TAX POSITIONS. CTHC EVALUATES ANY UNCERTAIN TAX POSITIONS USING THE PROVISIONS OF ASC 450, CONTINGENCIES. AS A RESULT, MANAGEMENT DOES NOT BELIEVE THAT ANY UNCERTAIN TAX POSITIONS CURRENTLY EXIST AND NO LOSS CONTINGENCY HAS BEEN RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. CTHC HAS FILED ALL APPLICABLE TAX RETURNS. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE X X 0 0 0 0 0 0 0 0 0 DR MOLLY GRAY CMO 174207 0 0 0 0 0 5400 0 0 0 179607 0 0 0 JEFFERY KAZE DENTAL DIRECTOR 143122 0 0 0 0 0 11214 0 0 0 154336 0 0 0 RONALD LIVINGSTON PHYSICIAN 169585 0 0 0 0 0 17695 0 0 0 187280 0 0 0 PART I, LINE 3 COMPENSATION FOR THE ORGANIZATION'S CEO IS REVIEWED BY THE BOARD OF DIRECTORS ANNUALLY. X 36 185995 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY ALL OFFICERS AND ACCOUNTING PERSONNEL OF CROSS TIMBERS HEALTH CLINICS, INC. ANY QUESTIONS OR CONCERNS ARE ADDRESSED AND ANY NEEDED CORRECTIONS OR CLARIFICATIONS ARE MADE. THE 990 IS THEN PROVIDED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING THE 990. ANY QUESTIONS OR CONCERNS ARE ADDRESSED AND ANY NEEDED CORRECTIONS OR CLARIFICATIONS ARE MADE. THE FINAL 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CORPORATION'S CONFLICT OF INTEREST POLICY ENCOMPASSES OFFICERS, BOARD MEMBERS, AND EMPLOYEES. BOARD MEMBERS SIGN AN AGREEMENT TO COMPLY WITH THE TERMS OF THE BYLAWS WHEN THEY BECOME BOARD MEMBERS. THE BYLAWS STATE IF A DIRECTOR HAS A FINANCIAL INTEREST IN A MATTER THAT COMES BEFORE THE BOARD, THE DIRECTOR MUST EXCUSE HIM OR HERSELF FROM VOTING. WITH ANY CONFLICT OF INTEREST, THE BOARD MEMBER WILL ANNOUNCE IT BEFORE THE DISCUSSION OF THE MATTER, WILL ABSTAIN FROM ANY DISCUSSION, AND LEAVE THE ROOM DURING THE VOTE. ADDITIONALLY, IT STATES THE CLINIC DOES NOT EMPLOY MEMBERS OF THE BOARD OF DIRECTORS OR THEIR FAMILY MEMBERS. THE COMPANY SELF MONITORS AND INVESTIGATES ANY OCCURRENCES THAT IS BROUGHT TO THE COMPANY'S ATTENTION. FOR EMPLOYEES, THE CEO, CFO, OR COO WILL EVALUATE THE CONFLICT DEPENDING ON THE EMPLOYEE. NEITHER WILL MAKE A DETERMINATION IF IT IS AN EMPLOYEE THAT REPORTS TO THEM. IF THE CONFLICT IS WITH THE COO OR CFO, THE OTHER ONE WILL MAKE THE DETERMINATION AND IF IT IS BOTH COO AND CFO, THE CEO WILL DECIDE. IF THE CONFLICT IS WITH THE CEO, THE BOARD WILL DECIDE. FORM 990, PART VI, SECTION B, LINE 15 THE CEO IS SELECTED AND EVALUATED ANNUALLY THROUGH A PERFORMANCE REVIEW BY THE BOARD OF DIRECTORS. DIRECTORS SHALL SERVE WITHOUT COMPENSATION. HOWEVER, REASONABLE EXPENSES INCURRED IN ATTENDANCE AT MEETINGS OR FUNCTIONS WITH THE CORPORATION MAY BE REIMBURSED IF APPROVED IN ADVANCE BY THE BOARD OF DIRECTORS. REIMBURSEMENTS WILL BE AT THE RATES AFFORDED THE CORPORATION EMPLOYEES AND IN ACCORDANCE WITH CORPORATION POLICIES AND PROCEDURES. A BENCHMARK SALARY RANGE FOR ALL CLINIC POSITIONS IS ESTABLISHED BASED UPON INDEPENDENT SALARY SURVEYS DONE BY PROFESSIONAL MEDICAL MANAGEMENT ASSOCIATIONS SUCH AS MGMA. THE COMPANY MAINTAINS DOCUMENTATION OF THE RESULTS OF THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONAL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C CTHC DID NOT CHANGE ITS OVERSIGHT PROCESS OF THE AUDIT, REVIEW OR COMPLIATION OF ITS FINANCIAL STATEMENTS NOR ITS SELECTION PROCESS OF AN INDEPENDENT ACCOUNTANT DURING THE TAX YEAR.