METHODIST PRIMARY CARE GROUP: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- METHODIST PRIMARY CARE GROUP (EIN 76-0556120)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-12
- IRS object ID
- 201243179349302149
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-12T13:12:19-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 BAGBY STREET SUITE 4500 | AddressLine1 |
| City | HOUSTON | City |
| State | TX | State |
| ZIP Code | 77002 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 760556120 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAN JACINTO FAMILY PRACTICE EDUCATION FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SANJ | NameControl |
| Phone | 2814208701 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4401 Garth Road | AddressLine1 |
| City | Baytown | City |
| State | TX | State |
| ZIP Code | 77521 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jonathan Sturgis | Name |
| Title | Treasurer | Title |
| Phone | 2814206114 | Phone |
| Date Signed | 2012-11-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Nancy Z Evetts | Name |
| PTIN | P00407310 | PTIN |
| Phone | 7139822000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Donna Gares | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4401 Garth Road | AddressLine1 |
| City | Baytown | City |
| State | TX | State |
| ZIP Code | 77521 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 5122109 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1996 | YearFormation |
| State Legal Domicile | TX | StateLegalDomicile |
| Activity Or Mission Description | See Schedule O. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 2 | NbrIndependentVotingMembers |
| Total Nbr Employees | 54 | TotalNbrEmployees |
| Total Nbr Volunteers | 3 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 476773 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 493330 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4368277 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 4568585 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 184566 | OtherRevenuePriorYear |
| Other Revenue Current Year | 60194 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5029616 | TotalRevenuePriorYear |
| Total Revenue Current Year | 5122109 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 7056345 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 7738187 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1962999 | OtherExpensePriorYear |
| Other Expenses Current Year | 2010601 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 9019344 | TotalExpensesPriorYear |
| Total Expenses Current Year | 9748788 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3989728 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -4626679 | RevenuesLessExpensesCY |
| Total Assets BOY | 107372 | TotalAssetsBOY |
| Total Assets EOY | 0 | TotalAssetsEOY |
| Total Liabilities BOY | 32965746 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 37485053 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -32858374 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -37485053 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | See Schedule O. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 8963364 | Expense |
| Revenue | 4617753 | Revenue |
| Description | See Schedule O. | Description |
| Total Program Service Expense | 8963364 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 54 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 2 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Jonathan Sturgis Treasurer | NamePerson |
| Telephone Number | 2814206114 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4401 Garth Road | AddressLine1 |
| City | Baytown | City |
| State | TX | State |
| ZIP Code | 77521 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| Bruce Kennedy MD | ||||||||
| Director | 3.00 | X | 0 | 309229 | 48587 | |||
| Rebecca Gladu MD | ||||||||
| Director | 50.00 | X | 222914 | 0 | 35431 | |||
| Clare Hawkins MD | ||||||||
| Director-Chairperson | 50.00 | X | 254437 | 0 | 48728 | X | ||
| John Rogers MD | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Paul Torre MD | ||||||||
| Director (ended 9/2011) | 2.00 | X | 0 | 0 | 0 | |||
| Ted Krell MD | ||||||||
| Director (began 9/2011) | 2.00 | X | 0 | 48612 | 0 | |||
| Mohammad Khoshnevis MD | ||||||||
| Director | 2.00 | X | 0 | 197683 | 0 | |||
| Bufford Moore MD | ||||||||
| Director | 2.00 | X | 0 | 124119 | 0 | |||
| Donna Gares | ||||||||
| President & CEO | 2.00 | 0 | 502152 | 42780 | X | |||
| Frances Love | ||||||||
| Secretary | 2.00 | 0 | 108239 | 26368 | X | |||
| Jonathan Sturgis | ||||||||
| Treasurer | 2.00 | 0 | 215574 | 39756 | X | |||
| Quynh Uyen Bui MD | ||||||||
| Physician | 50.00 | 251677 | 0 | 17713 | X | |||
| Louis Hughes MD | ||||||||
| Physician | 50.00 | 190405 | 0 | 34864 | X | |||
| Rosemary Obudulu MD | ||||||||
| Physician | 50.00 | 214205 | 0 | 44532 | X | |||
| Hubert Williston MD | ||||||||
| Physician | 50.00 | 210549 | 0 | 23602 | X | |||
| Isaac Goldberg MD | ||||||||
| Physician | 50.00 | 217889 | 0 | 43694 | X | |||
| Chris Siebenaler | ||||||||
| Former Officer | 2.00 | 0 | 480347 | 51330 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1562076 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1985955 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 457385 | TotalOtherCompensation |
| Number Individuals GT100 K | 15 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Government Grants | 493330 | GovernmentGrants |
| Total Contributions | 493330 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient Services | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 4568585 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4568585 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 4568585 | TotalProgramServiceRevenue |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| Intercompany Revenue | 900099 | 49168 | 49168 | |
| Miscellaneous Revenue | 900099 | 8090 | $8,090 | |
| Medical Records | 900099 | 2936 | $2,936 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 60194 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5122109 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4617753 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $11,026 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 561510 | Total |
| Program Services | 561510 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5846038 | Total |
| Program Services | 5795211 | ProgramServices |
| Management And General | 50827 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 173664 | Total |
| Program Services | 173664 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 752508 | Total |
| Program Services | 752508 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 404467 | Total |
| Program Services | 400950 | ProgramServices |
| Management And General | 3517 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 205560 | Total |
| Program Services | 204930 | ProgramServices |
| Management And General | 630 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2200 | Total |
| Program Services | 2200 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 204872 | Total |
| Program Services | 204800 | ProgramServices |
| Management And General | 72 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 485292 | Total |
| Program Services | 485292 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49380 | Total |
| Program Services | 49380 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66979 | Total |
| Program Services | 66979 | ProgramServices |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| Management Fees | 730139 | 730139 | |
| Bad Debt Expense | 118876 | 118876 | |
| Medical Supplies | 100618 | 115 | 100503 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46685 | Total |
| Program Services | 46561 | ProgramServices |
| Management And General | 124 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9748788 | Total |
| Program Services | 8963364 | ProgramServices |
| Management And General | 785424 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 107372 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 107372 | BOY |
| EOY | 0 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 141480 | BOY |
| EOY | 40946 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32824266 | BOY |
| EOY | 37444107 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32965746 | BOY |
| EOY | 37485053 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -32858374 | BOY |
| EOY | -37485053 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -32858374 | BOY |
| EOY | -37485053 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 107372 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -4626679 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | San Jacinto Methodist Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 741287015 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Amount | $0 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Due to Related Organizations | Description |
| Amount | $37,444,107 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 37444107 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of Uncertain Tax Positions Under FIN 48: | Identifier |
| Return Reference | Part X: | ReturnReference |
| Explanation | San Jacinto Family Practice Education Foundation's financial statements were audited by an independent accountant as part of a consolidated financial statement of the Methodist Hospital System (the "Organization"). The Organization did not recognize any adjustments related to uncertain tax positions as of December 31, 2011. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Bruce Kennedy MD | |||||||||||||
| 0 | 234708 | 0 | 57098 | 0 | 17423 | 0 | 20894 | 0 | 27693 | 0 | 357816 | 0 | 0 |
| Rebecca Gladu MD | |||||||||||||
| 219992 | 0 | 0 | 0 | 2922 | 0 | 19313 | 0 | 16118 | 0 | 258345 | 0 | 0 | 0 |
| Clare Hawkins MD | |||||||||||||
| 245911 | 0 | 0 | 0 | 8526 | 0 | 21000 | 0 | 27728 | 0 | 303165 | 0 | 0 | 0 |
| Mohammad Khoshnevis MD | |||||||||||||
| 0 | 197683 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 197683 | 0 | 0 |
| Donna Gares | |||||||||||||
| 0 | 342321 | 0 | 87003 | 0 | 72828 | 0 | 17608 | 0 | 25172 | 0 | 544932 | 0 | 0 |
| Jonathan Sturgis | |||||||||||||
| 0 | 166639 | 0 | 40414 | 0 | 8521 | 0 | 15268 | 0 | 24488 | 0 | 255330 | 0 | 0 |
| Quynh Uyen Bui MD | |||||||||||||
| 179787 | 0 | 0 | 0 | 71890 | 0 | 16200 | 0 | 1513 | 0 | 269390 | 0 | 0 | 0 |
| Louis Hughes MD | |||||||||||||
| 184301 | 0 | 0 | 0 | 6104 | 0 | 18248 | 0 | 16616 | 0 | 225269 | 0 | 0 | 0 |
| Rosemary Obudulu MD | |||||||||||||
| 168292 | 0 | 0 | 0 | 45913 | 0 | 15860 | 0 | 28672 | 0 | 258737 | 0 | 0 | 0 |
| Hubert Williston MD | |||||||||||||
| 198435 | 0 | 0 | 0 | 12114 | 0 | 14468 | 0 | 9134 | 0 | 234151 | 0 | 0 | 0 |
| Isaac Goldberg MD | |||||||||||||
| 207646 | 0 | 0 | 0 | 10243 | 0 | 19213 | 0 | 24481 | 0 | 261583 | 0 | 0 | 0 |
| Chris Siebenaler | |||||||||||||
| 0 | 337828 | 0 | 102501 | 0 | 40018 | 0 | 21000 | 0 | 30330 | 0 | 531677 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Return Reference | Part III | ReturnReference |
| Explanation | Part I, Line 3: The CEO of this organization is employed by a related organization who utilized the following items to establish compensation: (1)compensation committee; (2)independent compensation consultant; (3)compensation survey or study; (4)approval by the board or compensation committee. Form 990, Schedule J, Part I, Line 4a: The Methodist Hospital System has a formal severance plan. Eligible System employees include all staff including hourly staff up through senior vice presidents provided they work at least 20 hours per week and are not otherwise covered by a physician employment agreement. The plan only provides salary and benefits in the event an eligible employee is involuntarily terminated due to the elimination of their position or if their current position is significantly impacted by an organizational restructuring or change in requirement and a comparable position is not available within the organization. The eligible person must also sign a termination agreement in order to receive salary continuation and benefits under the plan to which they would not normally be eligible to receive under a voluntary resignation. No reportable individuals received payments from this plan in 2011. Form 990, Schedule J, Part I, Line 4b: Bruce Kennedy, MD: $15,058, Donna Gares: $43,512, Jonathan Sturgis: $3,393, and Chris Siebenaler: $17,257, all received monies from Supplemental Executive Retirement Plan (SERP) described below. The SERP is a non qualified employer funded plan. Contributions are made annually into a tax deferred account and are considered taxable upon vesting (i.e. completion of three years of vesting service). Once vested, each year's subsequent contribution is taxable within the calendar year in which the deposit was made. Account balances cannot be accessed until retirement or termination (whichever occurs first) and may be subject to non-revocable distribution options selected upon employment. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Mission Statement | Form 990, Part I and Part III, Line 1 | This organization is part of The Methodist Hospital System, whose mission is: To provide high quality, cost-effective health care that delivers the best value to the people we serve in a spiritual environment of caring in association with internationally recognized teaching and research. |
| Program Service Accomplishments | Form 990, Part III, Line 4a | In 2011, eight physicians sucessfully completed their residency program with San Jacinto Family Practice Education Foundation (SJFPEF). The residency program exists to take physicins (who have graduated from medical school) into the real world via a three year family medicine residency program. Of these, one joined as faculty with SJFPEF, two joined practices within Texas and four joined physician groups in other states. SJFPEF faculty and residents engaged in over 58,000 visits which included 39,000 clinic encounters, 8,900 inpatient encounters and over 150 deliveries. The clinic also provided healthcare to the indigent and underinsured population in San Jacinto Methodist Hospital's service area. These services are provided through the provision of charity care, a Texas State Department of Health Services grant and self-pay discounts. In 2011, individuals received over $300,000 in charity care and over $175,000 in grant write-offs which were based on medical and financial need. The Department of State Health Services provided $100,000 in funds through a Primary Healthcare Grant. The Foundation provided healthcare services to over 450 individual patients with over 1,800 outpatient visits. This was provided to patients who fell between 100 and 150% of federal poverty guidelines and did not quality for other types of state assistance. SJFPEF implemented an Electronic Health Record (EHR) in November 2011. The implementation of the EHR not only allows the department to be compliant with government expectations regarding EHR implementation but positions the department to enhance the quality of patient services and safety and demonstrate those improve outcomes with better data. |
| Form 990, Part VI, Section A, line 6 | San Jacinto Methodist Hospital is the Sole Member of this organization. The sole member of San Jacinto Methodist Hospital is The Methodist Hospital. | |
| Form 990, Part VI, Section A, line 7a | The Member of the Corporation (San Jacinto Methodist Hospital) appoints the Board of Directors. | |
| Form 990, Part VI, Section A, line 7b | The member of the corporation (San Jacinto Methodist Hospital) reserves the following powers: -Budgets: Annual capital and operating budgets for the Corporation and any financial expenditure which deviates therefrom if the sum of such deviating financial expenditure and the aggregate of all prior deviating financial expenditures for the fiscal year is greater than $5,000; -Debt: Any incurrence or guarantee of any debt, directly or indirectly, by the Corporation or by any subsidiary of the Corporation; -Corporate Modification: Any dissolution, merger, consolidation, sale or other modification of the Corporation or any creation, dissolution, merger, consolidation, sale or other modification of any subsidiary of the Corporation; -Property: Any acquisition, sale, lease, mortgage, or other transfer or encumbrance (i) of any real property of the Corporation or (ii) of any personal property of the Corporation of a value in excess of $10,000; -Financial Relations: Any affiliation, joint venture, contract, employment, retention, indemnification or other arrangements between the Corporation and any insurer, health maintenance organization, preferred provider organization, medical school, hospital, clinic, pharmacy, physician, or other provider of health or related services, including, without limitation, all service terms and compensation arrangements; -Compensation: Adoption or amendment of salaries or other compensation (including the awarding of any incentive compensation) with respect to the officers of the Corporation, physician employees of the Corporation, and physicians who are independent contractors to the Corporation; -Selections: Selection of the Corporation's auditors and legal counsel; -Grants: The giving, seeking or receiving of grants; -Litigation and Claims: The commencement of litigation or the settlement of litigation or other claims; -Fee Schedule: Approval of the adoption or amendment of fee schedules relating to patient services; and -Other Matters: Any other matters with respect to which exclusive authority is granted to the Member by the Statute, the Articles of the Bylaws. | |
| Form 990, Part VI, Section B, line 11 | Management, including certain Officers, works diligently to complete the Form 990 and attached schedules (Return) in a thorough manner. The Return is prepared by a Paid Preparer. | |
| Form 990, Part VI, Section B, line 12c | All Individuals serving in a significant decision making capacity complete a Conflict of Interest (COI) questionnaire annually. A comprehensive evaluation and thorough review of all disclosures is performed by a 6-member COI Committee comprised of executives, management, and staff. The results of the COI disclosures are reported to the parent corporation, The Methodist Hospital System's Audit & Compliance Committee and Board of Directors, including the actions being taken to protect the integrity of decision-making. In addition, disclosure results are also communicated to management and to affected committee chairs to promote transparency and to ensure that actions are taken and restrictions are imposed where appropriate. Conflicted individuals may not vote or exert self-serving influence on the disclosed matter. | |
| Form 990, Part VI, Section B, line 15a | The corporate member of this organization, San Jacinto Methodist Hospital, follows IRS regulations as it relates to establishing a rebuttable presumption of reasonableness related to total compensation of top officers of the organization listed below. It has established a rigorous process that includes the following elements: A separate committee of independent directors(the "Board Committee")that meets at least annually to review, deliberate and make recommendations to the full Board as it relates to any changes in total compensation including base pay, bonus awards from incentive programs or benefits and perquisites of the CEO. For 2011, the Board Committee reviewed and recommended the compensation package for the President and CEO, San Jacinto Methodist Hospital who also serves as the President/CEO of this organization. The Board Committee establishes that no member has any conflict of interest with regard to the executive compensation arrangements being approved. The Board Committee reviews and considers information provided by an external consultant engaged to ensure it has direct access to: -Compensation information paid by comparable organizations, for functionally comparable positions. -Compensation norms in the organization's immediate locale and from other independent compensation surveys by nationally recognized independent firms that represent the organization's logical peer group. -Compensation information that includes information on base salary, incentives, benefits and perquisites for total compensation comparison purposes to ensure reasonable competitive ranking. The Board Committee relies on the comparability data to reach consensus that its recommendations to the Board regarding executive compensation changes are reasonable and in line with the organization's overall total compensation philosophy for executive pay. The deliberation and decisions of the committee are contemporaneously substantiated. The compensation for positions held by the other compensated Officers, Directors and Key Employees listed on Part VII, is determined based on a thorough review of numerous compensation studies conducted by nationally recognized, independent firms that provide market data for total compensation for similar positions. The compensation information considered includes information on base salary, incentives, and benefits for total compensation purposes to ensure reasonable competitive ranking in order to meet recruitment and retention objectives that secure the talent required to contribute to organizational success. | |
| Form 990, Part VI, Section C, line 19 | The governing documents (except the Articles of Incorporation, which are on file with the Secretary of the State of Texas), conflict of interest policy and financial statements of the organization are not made available to the general public. | |
| Average Hours Per Week | Form 990, Part VII, Column B | Certain officers/directors of San Jacinto Family Practice Education Foundation are employees of San Jacinto Methodist Hospital. These officers and directors who are employed by San Jacinto Methodist Hospital work in excess of 50 hours per week on behalf of this entity and other entities of The Methodist Hospital System. The compensation shown on Part VII and Schedule J reflects the total compensation earned for the officer/director for the combined hours spent working for all the entities in the organization. However, the hours reflected in Part VII, Section A are the estimated hours spent working only on behalf of the filing entity. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Methodist Hospital Group | ||||||||||
| 6565 Fannin | Houston | TX | 77030 | 352410801 | Health Care | TX | 501 ( c ) (3) | Line 11b, II | The Methodist Hospital | 0 |
| Methodist Hospital Self-Insurance Trust | ||||||||||
| 6565 Fannin | Houston | TX | 77030 | 741948396 | Insurance Trust | TX | 501 ( c ) (3) | Line 11a, I | The Methodist Hospital | 0 |
| San Jacinto Medical Group | ||||||||||
| 4401 Garth Road | Baytown | TX | 77521 | 760516915 | Health Care | TX | 501 ( c ) (3) | Line 11a, I | San Jacinto Methodist Hospital | 0 |
| The Methodist Health Care System STD Plan Trust | ||||||||||
| 6565 Fannin | Houston | TX | 77030 | 766161019 | Insurance Trust | TX | Section 671 | The Methodist Hospital | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Medvest 1 Limited Partnership | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6565 Fannin | AddressLine1 |
| City | Houston | City |
| State | TX | State |
| ZIP Code | 77030 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 760534067 | EIN |
| Primary Activity | Health Care Investments | PrimaryActivity |
| Legal Domicile State | TX | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part IV Form990ScheduleRPartIV (12 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|
| Allied Methodist Hospital Physicians | |||||||||
| 6565 Fannin | Houston | TX | 77030 | 760551274 | Physician Group | TX | N/A | C | |
| Medvest Holdings Inc | |||||||||
| 6565 Fannin | Houston | TX | 77030 | 760667765 | Health Care Investments | TX | N/A | C | |
| Medvest Incorporated | |||||||||
| 6565 Fannin | Houston | TX | 77030 | 760182470 | Health Care Investments | TX | N/A | C | |
| Methodist International | |||||||||
| 6565 Fannin | Houston | TX | 77030 | 300347273 | Health Care Consulting | TX | N/A | C | |
| Methodist Willowbrook MOB Condominium Assoc | |||||||||
| 6565 Fannin | Houston | TX | 77030 | 680500294 | Condo Assoc | TX | N/A | C | |
| Methodist Willowbrook MOB Condominium Assoc II | |||||||||
| 6565 Fannin | Houston | TX | 77030 | 262137993 | Condo Assoc | TX | N/A | C | |
| San Jacinto Methodist - Alexander Condominium Assoc | |||||||||
| 6565 Fannin | Houston | TX | 77030 | 470921764 | Condo Assoc | TX | N/A | C | |
| SJMH Condominium Association | |||||||||
| 6565 Fannin | Houston | TX | 77030 | 412096917 | Condo Assoc | TX | N/A | C | |
| The Methodist Hospital Condominium Association | |||||||||
| 6565 Fannin | Houston | TX | 77030 | 861065871 | Condo Assoc | TX | N/A | C | |
| TMH Medical Office Buildings Condominium Assoc | |||||||||
| 6565 Fannin | Houston | TX | 77030 | 760287893 | Condo Assoc | TX | N/A | C | |
| Wesley Insurance Company SPC Ltd | |||||||||
| 6565 Fannin | Houston | TX | 77030 | 980405036 | Insurance | N/A | C | CJ | |
| Methodist West Houston Medical Office Building Assoc | |||||||||
| 6565 Fannin | Houston | TX | 77030 | 300655123 | Condo Assoc | TX | N/A | C | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
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