2012-11-01T16:58:55-05:00 2011-12-31 750882037 BOLINGER SEGARS GILBERT AND MOSS LLP 8215 NASHVILLE AVENUE LUBBOCK TX 79423 990 2011-01-01 752424925 COMMUNITY HEALTH CENTER OF LUBBOCK INC COMM 8067652611 1313 BROADWAY STE 5 LUBBOCK TX 79401 MICHAEL SULLIVAN 8067652611 2012-10-23 1 Matt R Willis P00419741 8067473806 2012-10-23 2011 2016-02-24 21:20:13Z MICHAEL SULLIVAN 1313 BROADWAY STE 5 LUBBOCK TX 79401 12498484 0 X WWW.CHCLUBBOCK.ORG X 1992 TX PROVIDE QUALITY PRIMARY AND PREVENTATIVE HEALTH CARE SERVICES TO THOSE IN NEED. 9 9 173 33 0 0 5967522 7127459 5655735 5350831 31444 20194 0 0 11654701 12498484 0 0 0 0 7390901 7593600 0 0 0 4620069 4441646 12010970 12035246 -356269 463238 6371588 7262975 2915295 3343444 3456293 3919531 PROVIDE QUALITY PRIMARY AND PREVENTATAIVE HEALTH CARE SERVICES TO THOSE IN NEED. 0 0 11077571 5350831 PROVIDED HEALTH CARE SERVICES FOR UNDERPRIVILEGED ADULTS AND CHILDREN INCLUDING WOMENS HEALTH SERVICES, PRENATAL SERVICES, EYE CARE SERVICES, SENIOR SERVICES, PEDIATRIC AND ADULT DENTAL SERVICES, SOCIAL SERVICES PROGRAMS AND OUTREACH SERVICES. THE ORGANIZATION SERVES FIVE COUNTIES IN THE WEST TEXAS AREA. THE FIVE COUNTIES ARE LUBBOCK, CROSBY, LYNN, TERRY AND GARZA. THE ORGANIZATION ALSO OPERATES MOBILE MEDICAL AND DENTAL VANS. DURING 2011 THE ORGANIZATION PROVIDED MEDICAL SERVICES TO APPROXIMATELY 25,424 INDIVIDUALS AND CHILDREN. 11077571 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 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 0 1 15 0 173 1 0 0 0 0 0 0 0 0 0 0 X 9 9 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MICHAEL SULLIVAN CEO 8067652611 1313 BROADWAY STE 5 LUBBOCK TX 79401 NATALIA CAMPOS 2.00 X X 0 0 0 PILAR MARTINEZ 2.00 X X 0 0 0 LORENZA ONTIVEROS 2.00 X X 0 0 0 CHRIS COMER 1.00 X X 0 0 0 KATHIE KARNES 111 - 511 4.50 X 0 0 0 BERTHA MARTINEZ 2.00 X 0 0 0 ERMINIA MARTINEZ 0.70 X 0 0 0 MARGARET GAINES 1.00 X 0 0 0 PATRICIA HAWKINS 1.00 X 0 0 0 BRIDGET FAULKENBERRY 111 - 811 1.00 X 0 0 0 JAMES JOHNSON 1.00 X 0 0 0 MICHAEL SULLIVAN 50.00 X 150927 0 26295 GINGER RIEWE 50.00 X 97847 0 13977 ELIZABETH LOPEZ 50.00 X 96484 0 14975 JEFF MALPIEDE 40.00 X 74637 0 6782 DARNEL DABU 40.00 X 155092 0 19850 XOCHITL ANDERTON 40.00 X 128099 0 24937 CHERRY MAXIMO 40.00 X 139861 0 10076 SUVIPA WIRI 40.00 X 152824 0 16112 MAURICE ASMUSSEN 40.00 X 136584 0 8162 1132355 0 141166 7 0 1 0 0 6341677 785782 609653 7127459 MEDICAL & PROGRAM FEES 621400 4331281 4331281 MEDICARE & MEDICAID 621400 770353 770353 GOVERNMENTAL FEES 621400 249197 249197 5350831 20194 20194 12498484 5350831 0 20194 481924 443370 38554 5590902 5230885 360017 356729 328191 28538 724915 589184 135731 439130 374835 64295 10000 1121 8879 36000 36000 1127914 1044891 83023 268329 236460 31869 69941 62100 7841 640758 577551 63207 85335 48954 36381 209503 178400 31103 104088 104088 258454 255279 3175 61746 55674 6072 MEDICAL SUPPLIES 1172793 1158080 14713 BAD DEBTS 258272 258272 EQUIP. RENTALS & REPAIR 89975 87895 2080 LICENSE & DUES 41684 35612 6072 6854 6729 125 12035246 11077571 957675 0 1270 1170 2278540 2386807 80044 171891 720199 283514 304167 335161 119320 144432 5792238 2108892 2852448 3683346 15600 256654 6371588 7262975 216910 753257 2215336 2073078 483049 517109 2915295 3343444 X 989067 2198256 2467226 1721275 3456293 3919531 6371588 7262975 463238 0 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1196901 1196901 1796626 111600 1685026 217908 194606 23302 2580803 1802686 778117 3683346 ACCRUED WAGES 239593 ACCRUED VACATION 248016 ACCRUED AUDIT FEE 29500 517109 12498484 12035246 463238 463238 12520935 22451 22451 12498484 0 12498484 12057697 22451 22451 12035246 0 12035246 Description of Uncertain Tax Positions Under FIN 48: Part X: CHCL FOLLOWS THE "UNCERTAIN TAX POSITIONS" PROVISIONS OF ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. THE PRIMARY TAX POSITION OF CHCL IS ITS FILING STATUS AS A TAX EXEMPT ENTITY. CHCL DETERMINED THAT IT IS MORE LIKELY THAN NOT THAT THEIR TAX POSITIONS WILL BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS), OR OTHER STATE TAXING AUTHORITY AND THAT ALL TAX BENEFITS ARE LIKELY TO BE REALIZED UPON SETTLEMENT WITH TAXING AUTHORITIES. Part IX THE AMOUNT OF OTHER ASSETS ON FORM 990, PAGE 11, PART X, LINE 15 DOES NOT EQUAL OR EXCEED 5 PERCENT OF THE TOTAL ASSETS ON FORM 990, PAGE 11, PART X, LINE 16, COLUMN B. CONSEQUENTLY IN ACCORDANCE WITH IRS INSTRUCTIONS SCHEDULE D, PART IX HAS BEEN LEFT BLANK. X X 0 0 0 0 0 0 0 0 0 MICHAEL SULLIVAN 142084 0 200 0 8643 0 13440 0 12855 0 177222 0 0 0 DARNEL DABU 155092 0 0 0 0 0 4207 0 15643 0 174942 0 0 0 XOCHITL ANDERTON 128099 0 0 0 0 0 11467 0 13470 0 153036 0 0 0 SUVIPA WIRI 152824 0 0 0 0 0 4076 0 12036 0 168936 0 0 0 X 34 609653 DONOR-PROVIDED INVOICES 0 0 0 Form 990, Part VI, Section A, line 2 DIRECTORS PILAR MARTINEZ AND BERTHA MARTINEZ ARE HUSBAND AND WIFE. Form 990, Part VI, Section B, line 11 MANAGEMENT PRESENTED A COPY OF THE FORM 990 TO THE BOARD FOR DISCUSSION, REVIEW AND APPROVAL PRIOR TO FILING. THE DISCUSSION AND REVIEW WAS PERFORMED AT THE BOARD MEETING IMMEDIATELY BEFORE FILING THE FORM 990. Form 990, Part VI, Section B, line 12c ALL EMPLOYEES, OFFICERS AND DIRECTORS ARE REQUIRED TO ANNUALLY REVIEW THE CONFLICT OF INTEREST POLICY AND COMPLETE AN ATTACHMENT DETAILING ANY POSSIBLE CONFLICTS. Form 990, Part VI, Section B, line 15 THE BOARD OF DIRECTORS USE A SALARY COMPARISON REPORT PREPARED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS WHEN DETERMINING THE CEO'S SALARY. THE REPORT PROVIDES COMPARATIVE SALARY INFORMATION FOR HEALTH CENTERS BASED ON SIZE AND LOCATION. THE BOARD OF DIRECTORS AND CEO USE A SALARY COMPARISON REPORT PREPARED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS WHEN DETERMINING THE OTHER EMPLOYEE OFFICER'S SALARY. THE REPORT PROVIDES COMPARATIVE SALARY INFORMATION FOR HEALTH CENTERS BASED ON SIZE AND LOCATION. Form 990, Part VI, Section C, line 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR VIEWING BY THE PUBLIC AT THE ORGANIZATION'S OFFICE IN LUBBOCK, TX. AUDIT COMMITTEE Form 990, Part XII, Line 2c THE BOARD OF DIRECTORS HAVE ASSIGNED MEMBERS TO AN AUDIT COMMITTEE TO OVERSEE THE FINANCIAL STATEMENT AUDIT AND SELECT THE INDEPENDENT FINANCIAL STATEMENT AUDITOR.