2015-03-30T11:24:14-05:00 2014-06-30 BKD LLP 14241 DALLAS PKWY SUITE 1100 DALLAS TX 75254 990 2013-07-01 741153067 Clarity Child Guidance Center % MICHAEL BERNICK CLAR 8535 Tom Slick Drive Suite San Antonio TX 782293363 FREDERICK W HINES PRESIDENT/CEO 2106160300 2015-05-15 true Jeanette Verrelli P00742631 2106160300 2013 2016-02-25 16:41:14Z FREDERICK W HINES 8535 TOM SLICK DRIVE SAN ANTONIO TX 78229 22067536 false X WWW.CLARITYCGC.ORG X 1886 TX TO PROVIDE TREATMENT AND COUNSELING FOR children and adolescents with serious emotional and/or psychiatric disorders. 18 18 330 72 0 0 2478040 3586275 14509327 18221785 131438 138781 347825 11517 17466630 21958358 0 568169 0 0 11834341 13112028 0 0 477025 5625016 5406611 17459357 19086808 7273 2871550 16865147 20984687 6971745 7266160 9893402 13718527 TO HELP CHILDREN, ADOLESCENTS AND FAMILIES OVERCOME THE DISABLING EFFECTS OF MENTAL ILLNESS AND IMPROVE THEIR ABILITY TO FUNCTION SUCCESSFULLY AT HOME, AT SCHOOL AND IN THE COMMUNITY. false false 16665936 568169 18290883 PROVIDED TREATMENT FOR CHILDREN AND ADOLESCENTS SUFFERING FROM DEPRESSION, BIPOLAR DISORDER, TRAUMA-BASED DISORDERS, AND ADHD. SERVICES INCLUDED: PSYCHIATRIC EVALUATIONS; INDIVIDUAL, FAMILY, AND GROUP THERAPY; 24-HOUR CARE BY SPECIALLY TRAINED NURSES; THERAPeuTIC RECREATION; BEHAVIOR MANAGEMENT; HIGHLY STRUCTURED ENVIRONMENT; AND EDUCATIONAL PROGRAMS. MAINTAINED A LOW STAFF TO PATIENT RATIO OF 1:3, LOGGED 14,288 INPATIENT DAYS, 2,571 PARTIAL HOSPITALIZATION DAYS, 16,474 OUTPATIENT VISITS AND PROVIDED CHARITY CARE, INDIGENT HEALTH CARE AND OTHER COMMUNITY BENEFITS DURING THE FISCAL YEAR. 16665936 true true false true false false false false false false true false false true true false false true false false false false false false true false true true true false true true false false false false false false false false false false true false false false false true true true false false true 26 0 true 330 true false false false false false true true false false false false X 18 18 false false false false false false false true true false false true true true true true true true true false X MICHAEL BERNICK 2106160300 8535 TOM SLICK DRIVE SAN ANTONIO TX 78229 VANCE M ARNOLD CFA DIRECTOR 1.0 0.0 X 0 0 0 PAUL R BROCHU IMMEDIATE PAST CHAIR 1.0 0.0 X X 0 0 0 SHIRLEY CRANDALL DIRECTOR 1.0 0.0 X 0 0 0 MARIANNE FIORENZA CPA FINANCE COMMITTEE CHAIR 1.0 0.0 X X 0 0 0 MARK HOWARD CHAIR 1.0 0.0 X X 0 0 0 TONY LOBASSO CPA DIRECTOR 1.0 0.0 X 0 0 0 DANIEL L LOPEZ PHD DIRECTOR 1.0 0.0 X 0 0 0 CHARLES MCLANE DIRECTOR 1.0 0.0 X 0 0 0 LARRY MILLS DEVELOPMENT CO-CHAIR 1.0 0.0 X X 0 0 0 JANET S POLLOCK SPHR DIRECTOR 1.0 0.0 X 0 0 0 GEORGINA BENITEZ SCHMAHL DIRECTOR 1.0 0.0 X 0 0 0 BEN SCOTT VICE CHAIR/secretary 1.0 0.0 X X 0 0 0 KAY A SCROGGINS CHAIR-ELECT 1.0 0.0 X X 0 0 0 JOHN SEYBOLD DIRECTOR 1.0 0.0 X 0 0 0 ALLIE SHAPIRO DIRECTOR 1.0 0.0 X 0 0 0 MARK VICKERY DEVELOPMENT CO-CHAIR 1.0 0.0 X X 0 0 0 JOHN SOMMER JR DIRECTOR 1.0 0.0 X 0 0 0 STEVE JANSMA DIRECTOR 1.0 0.0 X 0 0 0 JACK CIVA DIRECTOR 1.0 0.0 X 0 0 0 Ruth Pina DIRECTOR 1.0 0.0 X 0 Peggy Deming Director 1.0 0.0 X FREDERICK HINES PRESIDENT/CEO 40.0 0.0 X 186761 0 10313 MICHAEL BERNICK VP FINANCE 40.0 0.0 X 165847 0 14105 GINA MASSEY VP HUMAN RESOURCES 40.0 0.0 X 113641 0 10546 SHAWN OWENS VP CNO 40.0 0.0 X 104404 0 10550 GEOFFREY GENTRY VP CLINICAL SVCS 40.0 0.0 X 137717 0 8406 CHRIS BRYAN VP INFORMATION TECH 40.0 0.0 X 107526 0 10958 REBECCA HELTERBRAND VP MARKETING/DEVELOP. 40.0 0.0 X 138815 0 11303 JOEL SCHNITZ PHARMACIST 40.0 0.0 X 113689 0 12016 KARL KOCH DIRECTOR-OUTPATIENT SVCS 40.0 0.0 X 113604 0 16439 GERARD MIGEON DIRECTOR-MARKETING 40.0 0.0 X 105825 0 13063 1287829 0 117699 10 false true false PRINCE FOOD SYSTEMS 11001 WILCREST DR SUITE 200 HOUSTON TX 77099 FOOD SERVICE 521949 UT HEALTH SCIENCE CENTER 7703 FLOYD CURL DRIVE SAN ANTONIO TX 78229 PHYSICIAN SERVICES 472630 SOUTHWEST PSYCHIATRIC PHYSICIANS 8535 TOM SLICK DR SAN ANTONIO TX 78229 PHYSICIAN SERVICES 799433 QUEST DIAGNOSTICS PO BOX 841725 DALLAS TX 75284 LAB SERVICES 123554 4 X 1025600 620942 72512 1867221 100000 3586275 NET PATIENT SERVICE REVENUE 621110 17652486 17652486 PHYSICIAN OFFICE RENTAL 531120 83034 83034 SUPPORT PERSONNEL/SERVICES 900099 486265 486265 18221785 138781 138781 0 0 0 0 0 0 51597 620942 109178 -57581 -57581 0 0 LUNCH TICKETS 721210 38344 38344 MEDICAL RECORDS 561000 10277 10277 MISCELLANEOUS REVENUE 900099 20477 20477 69098 21958358 18290883 81200 568169 568169 0 0 0 1141578 306554 751720 83304 0 10354707 9402568 654102 298037 152249 145322 3061 3866 632902 566585 49019 17298 830592 698251 103711 28630 0 62519 25000 37519 76822 76822 0 0 0 1719524 1692564 23395 3565 63960 55334 6197 2429 1472791 1381638 78214 12939 0 0 470475 426115 38385 5975 28281 17024 9555 1702 0 31963 24270 6201 1492 244314 226606 15323 2385 0 687991 623122 56132 8737 257532 236832 17353 3347 BAD DEBT EXPENSE 215471 215471 PROMOTIONS AND SPECIAL EVENTS 22069 21569 500 DUES AND PUBLICATIONS 23328 19666 2897 765 LICENSE AND REGISTRATION 21700 10201 11499 7871 3075 2242 2554 19086808 16665936 1943847 477025 575371 547801 659032 11842 0 0 1792710 1499547 0 0 0 0 508188 2904586 106757 92773 76508 88899 19465185 9417965 8675511 10047220 0 0 0 0 0 0 74919 65355 4396151 5726664 16865147 20984687 1977902 2209605 0 0 0 0 4178205 3701363 0 0 0 0 790365 530000 0 0 25273 825192 6971745 7266160 X 9893402 13224262 0 494265 0 0 9893402 13718527 16865147 20984687 X 2871550 658020 295555 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1310 1310 16664626 16665936 983297 245824 908772 858023 912309 983297 3662401 5493602 9550 1918 18262 1310 31040 227193 214506 228077 245824 915600 1373400 7447 1918 14048 1310 24723 319221 319221 13248649 6358098 6890551 78352 78352 0 3034369 2298692 735677 2784594 682823 2101771 10047220 BOARD DESIGNATED FUNDS 5395630 INVESTMENT IN SUBSIDIARY 331034 5726664 0 ESTIMATED AMT DUE TO 3RD PARTY 25505 DUE TO AFFILIATE 799687 825192 X 21289540 658020 80084 738104 20551436 1406922 1406922 21958358 18980515 109178 109178 18871337 215471 215471 19086808 schedule d, part x, line 2 liability for uncertain tax positions: The Center has been recognized as exempt from income taxes under Section 501 of the Internal Revenue Code and a similar provision of state law. However, the Center is subject to federal income tax on any unrelated business taxable income. The Center files tax returns in the U.S. federal jurisdiction. With a few exceptions, the Center is no longer subject to U.S. federal examinations by tax authorities for years prior to 2011. schedule d, part xi, line 2d Reconciliation of revenue per audited financial statements with return: Bad Debt Expense $(215,471) change in interest in net assets of SPP 211,047 change in fair value of interest rate swap agreement 84,508 -------------- total $ 80,084 schedule d, part xi, line 4b Reconciliation of revenue per audited financial statements with return: direct fundraising expense $(109,178) unreleased contributions in temporarily restricted net assets 494,265 contributions for acquisition of property and equipment 1,021,835 ------------- total $ 1,406,922 schedule d, part xii, line 2d reconciliation of expense per audited financial statements with return: direct fundraising expense $ 109,178 schedule d, part xii, line 4b reconciliation of expense per audited financial statements with return: bad debt expense $ 215,471 GALA 558460 526550 31910 3800 31910 2341 16888 CONFERENCE 62529 42842 19687 10494 19688 19807 1 51550 51550 54 2873 1323 672539 620942 51597 54 14294 54471 2341 38018 109178 -57581 true true true X true X 500. true false true true 342420 342420 0.01810 9065725 9649305 -583580 1162964 1021045 141919 0.00750 10571109 10670350 -99241 0.02560 157074 157074 0.00830 612346 612346 0.03240 40967 40967 0.00220 586244 586244 0.03110 1396631 1396631 0.07400 11967740 10670350 1297390 0.09960 false 215471 true false 1 1 CLARITY CHILD GUIDANCE CENTER 8535 TOM SLICK DRIVE SAN ANTONIO TX 78229 WWW.CLARITYCGC.ORG 000737 X X X CLARITY CHILD GUIDANCE CENTER 1 true X X X X X X X X 12 true false true X SEE PART V, Section c X X X X X false false true true 100 true 500. true X X X X X true true X X X X true false X X X X true X false false 2 CLARITY CHILD GUIDANCE CENTER - OPC 2135 BABCOCK RD SAN ANTONIO TX 78229 OUTPATIENT BEHAVIOR HEALTH CLINIC CLARITY CHILD GUIDANCE CLINIC - WH 10431 STATE HIGHWAY 151 SAN ANTONIO TX 78251 OUTPATIENT BEHAVIOR HEALTH CLINIC schedule h, part i, line 7, column f BAD DEBT EXCLUDED IN CALCULATION OF PATIENT CARE COST TO CHARGES: BAD DEBT EXPENSE IN THE AMOUNT OF $215,471 WAS INCLUDED ON FORM 990, PART IV, LINE 25 IN TOTAL EXPENSES. HOWEVER, THIS AMOUNT WAS EXCLUDED FOR PURPOSES OF CALCULATING THE PERCENTAGE OF PATIENT CARE COST TO CHARGES. schedule h, part iii, section a, line 2 bad debt expense: THE BAD DEBT EXPENSE OF $215,471 ON LINE 2 IS THE BAD DEBT EXPENSE REPORTED FROM THE AUDITED FINANCIAL STATEMENTS. schedule h, part iii, section a, line 3 bad debt attributable to patients eligible for financial assistance: THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. schedule h, part iii, section a, line 4 bad debt footnote: Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectibility of accounts receivable, the Center analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Center analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Center records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or provided by policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The Centers provision for uncollectible accounts decreased from fiscal year 2013 to fiscal year 2014, declining from approximately $454,000 for the year ended June 30, 2013, to approximately $347,000 for the year ended June 30, 2014. In addition, the Centers write-offs increased approximately $23,000 from approximately $145,000 for the year ended June 30, 2013, to approximately $168,000 for the year ended June 30, 2014. The decrease in the provision of uncollectible accounts is a result of positive trends from prior years experienced in the collection of amounts from patients in fiscal year 2014. schedule h, part iii, section c, line 9b collection practices: THE COLLECTION POLICY CURRENTLY DOES NOT CONTAIN EXPLICIT PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. HOWEVER, PATIENTS ARE ENCOURAGED TO APPLY FOR CHARITY CARE WHEN STAFF IS AWARE OF NEED. schedule h, part vi, line 2 needs assessment: PERIODICALLY, A SURVEY IS SENT TO AREA PROVIDERS, CLIENTS AND ORGANIZATIONS ASKING WHAT NEEDS ARE NOT BEING ADDRESSED IN THEIR AREAS OF PRACTICE. INFORMATION IS ALSO USED FROM THE HEALTH COLLABORATIVE STATE OF THE COUNTY REPORT, METRO HEALTH REPORTS AND THE TEXAS SUICIDE PREVENTION REPORTS. MARKET RESEARCH IS CURRENTLY BEING DONE TO TARGET HIGH NEED AREAS WITHIN THE CITY. schedule h, part vi, line 3 patient education of eligibility for assistance: EVERY FAMILY IS ASSIGNED A CASE MANAGER THAT WORKS WITH THE FAMILY TO DETERMINE ANY RESOURCES FOR WHICH THEY MAY BE ELIGIBLE. THE CASE WORKER THEN WORKS WITH THE FAMILY TO COMPLETE ANY PAPERWORK BEFORE DISCHARGE. ADDITIONALLY, ALL FAMILIES ARE OFFERED SLIDING SCALE SERVICE FEES IF THEY QUALIFY UNDER THE CURRENT FEDERAL POVERTY GUIDELINES. schedule h, part vi, line 4 community information: THE CENTER SERVES SAN ANTONIO LOCATED IN BEXAR COUNTY AND THE SURROUNDING COUNTIES OF SEGUIN, LAREDO, DEL RIO, AUSTIN AND VICTORIA. schedule h, part vi, line 5 promotion of community health: Clarity Child Guidance Center is the only nonprofit in all of South Texas that provides a continuum of services to children ages 3-17 in need of mental health services. In addition to assessments, the caring professionals at Clarity CGC delivered 38,667 outpatient therapy appointments for 5,946 kids, helping to heal young minds and hearts. Further, 16,859 days of care (inpatient hospitalization and day treatment) were provided for an additional 1,675 kids. In parent surveys, 90% reported that their child had improved as a result of treatment, and our clinical scores mirror those positive results! Clarity CGC has the region's largest concentration of professionals focused on children's mental health. As a result, we are compelled to provide learning opportunities for anyone in our community. Our website receives nearly 33,000 visits a year from professionals, families and donors looking for "warning signs" and other information. We also share knowledge by hosting free continuing education sessions on our campus. This year, 469 people from across the community attended these sessions to gain critical knowledge. We also provided 30 education sessions in other locations in the community to 1,264 attendees and hosted 34 benchmarking tours for 165 people. Clarity's YouTube channel and its library of topics routinely has more than 5,000 views a month, creating a tremendous impact. We continued providing education about children's mental health by hosting the second ClarityCon conference for professionals across the state. In June, nearly 300 professionals attended a 1.5 day event that featured more than 15 breakout session speakers, panelists, and two keynote speakers. Attendees gave the overall content offered at the event an incredible 95% satisfaction rating. This inspired us to make ClarityCon a recurring, annual event. Our One in Five Minds campaign to end the stigma of children's mental illness celebrated its one year anniversary. It has inspired 2,000 people to take the pledge to end stigma and increase awareness of mental illness. In addition, nearly 3,000 people visited the website to learn about the campaign. The social media component of the campaign created a multiplier effect from our online pledgers, with engagement from more than 10,000 people between Facebook and Twitter. The online efforts are amazing, and the campaign doesn't stop at the virtual world. One in Five Minds' message was presented directly at three events to a total of 700 attendees and many more via live-webcasting. In October 2013, Liza Long, a nationally acclaimed advocate and author, spoke about her experience raising a child with mental illness. She dedicated several pages in her book The Price of Silence to demonstrate how Clarity Child Guidance Center is a national best practice in community-based mental health care. In February, we organized a panel conversation on the funding of treatment in Texas featuring keynote speaker Justice Luz Elena Chapa. Then in June, One in Five Minds sponsored the ClarityCon luncheon's speaker, Kay Warren of Saddleback Church, who brought the nearly 300 attendees to tears as she challenged us all to save lives through treatment. Finally, our team of experts is integrated into the system of care, by chairing the Behavioral Health Learning Collaborative of the DSRIP/Medicaid 1115 Waiver for Region 6, Bexar Cares, the Bexar County Mental Health Consortium, the Health Collaborative, the Youth Mental Health Council, and the Children's Medical Director's Roundtable. This listing represents only a few of the committees and organizations we actively partner. When it comes to mental health, Clarity CGC experts are often a sought after resource for planning and execution of community wide initiatives. schedule h, part vi, line 6 affiliated health care system: CLARITY IS AN INDEPENDENT NOT-FOR-PROFIT MENTAL HEALTH AGENCY. THE ORGANIZATION DOES HAVE AN AFFILIATION WITH THE UT HEALTH SCIENCE CENTER SCHOOL OF MEDICINE THROUGH THE PROVISION OF A TEACHING ENVIRONMENT FOR MEDICAL RESIDENTS, PSYCHOLOGY INTERNS AND NURSING STUDENTS FROM SEVERAL AREA NURSING SCHOOLS. schedule h, part vi, line 7 state filing of community benefit report: texas true SERVICE ORGANIZATION OF SAN ANTONIO 2950 50TH STREET LUBBOCK TX 79413 371591815 501(c)(3) 568169 COMMUNITY HEALTHCARE 1 schedule i, part i, line 2 procedures for monitoring the use of grant funds in the U.S.: THE ORGANIZATION EVALUATES AND MONITORS DONEES BASED ON PUBLIC AND PRIVATE DATA. X X X false false false false false false false false false FREDERICK HINES PRESIDENT/CEO 186761 0 0 0 0 0 5531 0 4782 0 197074 0 0 0 MICHAEL BERNICK VP FINANCE 165847 0 0 0 0 0 5289 0 8816 0 179952 0 0 0 REBECCA HELTERBRAND VP MARKETING/DEVELOP. 138815 0 0 0 0 0 3621 0 7682 0 150118 0 0 0 A Roman FOrest Cultural Ed 270047012 xxxxxxxxx 2006-05-09 6000000 construction of new admin building false false false B Splendora Cultural Education Facilities Fin Corp 760664368 xxxxxxxxx 2014-10-28 8000000 campus expansion of facilities, be false false false A 0 0 6000000 0 0 3459074 120000 0 0 2420926 0 0 2008 false false true true B 0 0 8000000 0 0 0 160000 0 0 7840000 0 0 2015 false false true true A false false false false 0 false false false false B false false false false 0 false false false false A false false false true true true Frost Bank 15. false false false 0 false false B false true false false true true Frost Bank 10. false false false 0 false false A false B false schedule k, part iv, line 2c arbitrage: roman forest bonds - rebate computation performed 8/18/2008 X ground lease 1 100000 fmv of land lease false true false schedule m, part i, line 25 noncash contribution of ground lease: CLARITY CHILD GUIDANCE CENTER IS LOCATED ON LAND OWNED BY SAN ANTONIO MEDICAL FOUNDATION. THE FOUNDATION HAS PROVIDED A 50-YEAR LEASE, WITH A 20-YEAR OPTIONAL EXTENSION, TO THE CENTER AT NO COST. THE FAIR MARKET VALUE OF THE LEASE IS $100,000 PER YEAR. form 990, part vi, section b, line 11b PROCESS TO REVIEW THE FORM 990: THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM FOLLOWING THE COMPLETION OF AN AUDIT OF FINANCIAL STATEMENTS. AN ELECTRONIC COPY OF THE FORM 990 IS PROVIDED TO THE BOARD FOR REVIEW PRIOR TO FILING WITH THE IRS. form 990, part vi, section b, line 12c PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE CONFLICT OF INTEREST POLICY IS ADMINISTERED UNDER THE DIRECTION OF THE VICE PRESIDENT OF HUMAN RESOURCES. EMPLOYEES ARE OBLIGATED TO DISCLOSE ANY CONFLICTS AS DESCRIBED IN THE POLICY. THE VICE PRESIDENT OF HUMAN RESOURCES INVESTIGATES AND RESOLVES ANY CONCERNS. form 990, part vi, section b, line 15a REVIEW OF CEO OR TOP MGMT OFFICIAL COMPENSATION: THE CEO'S PERFORMANCE AND COMPENSATION IS REVIEWED BY THE COMPENSATION COMMITTEE USING FEEDBACK FROM OTHER KEY EMPLOYEES AND LOCAL AND NATIONAL SALARY SURVEYS INCLUDING THOSE FROM Texas hospital association, Werling & Associates inc., AND the UNITED WAY. ccgc also uses the San Antonio NFP Wage & Benefits survey during their review. form 990, part vi, section b, line 15b review of other officer and key employee compensation: OTHER OFFICERS AND KEY EMPLOYEES ARE REVIEWED FOR BOTH PERFORMANCE AND COMPENSATION BASED UPON THE NORMAL PROCESS OF MEASURING AGAINST JOB DESCRIPTION AND SPECIFIC OBJECTIVES. COMPETITIVE SALARY SURVEYS ARE ALSO USED FOR COMPARISON ON A LOCAL AND NATIONAL BASIS. form 990, part vi, section c, line 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. form 990, part xi, line 9 other changes in net assets: change in fair value of interest rate swap agreement $ 84,508 change in interest in net assets of SPP 211,047 ----------- total $ 295,555 UNIVERSITY CENTERS INC 8535 TOM SLICK DRIVE SAN ANTONIO TX 78229 742454683 SCH BEHV SPEC TX 501(C)(3) 3 CCGC true SOUTHWEST PSYCHIATRIC PHYSICIANS 8535 TOM SLICK DRIVE SAN ANTONIO TX 78229 742706271 PSYCH TRMT TX 501(C)(3) 3 CCGC true true false false true true false false false false false false true true true false false true true true southwest psychiatric physicians a 83034 FMV southwest psychiatric physicians M 799433 FMV southwest psychiatric physicians Q 486265 FMV