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        <FormAndLineReferenceDesc>Schedule D, Part X, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>ASC 740 FOOTNOTE: THE UNIVERSITY AND ITS CONSOLIDATED ENTITIES ARE EXEMPT FROM FEDERAL INCOME TAXES EXCEPT TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME. IN ADDITION, THERE WERE NO UNCERTAIN INCOME TAX POSITIONS DURING THE REPORTING PERIODS. ACCORDINGLY, NO TAX LIABILITY OR TAX BENEFIT IS REQUIRED UNDER ASC 740, INCOME TAXES.</ExplanationTxt>
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        <PersonNm>Jayne Moschella DC</PersonNm>
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        <FormAndLineReferenceDesc>Schedule J, Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Management Compensation: PARKER UNIVERSITY, A RELATED ORGANIZATION, USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION OF THE TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Delegation of Management Duties: The organization has a management services agreement with Parker University, a related organization. In accordance with the management services agreement, Parker provides day-to-day assistance with operations management, administrative tasks, preparation of budgets, staffing plans, recruitment of personnel and other duties. Parker also provides marketing services and clinical personnel and equipment under this agreement. As Parker University is a related organization, the names and compensation of the individuals managing Synapse under this agreement are reported on Part VII.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Members: Parker University is the sole member of the organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>Power to appointment members of the governing body: Parker University, the sole member, has the power to appoint, elect and remove the directors of the Synapse board of directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>Governing decisions reserved for the member: As the sole member of the organization, Parker University has the power to do any of the following: (a) adoption of and approval of any alteration, amendment or repeal of the Certificate of Formation; (b) adoption of and approval of any alteration, amendment or repeal of these bylaws, subject to the approval of a majority of the Board of Directors; (c) creating or investing in any subsidiary entity; (d) establishing annual operating and capital budgets of the Corporation; (e) approval of any expenditure, or agreement leading to an expenditure, not included within an annual operating or capital budget; (f) purchase or acquisition of any real, personal, or mixed property not included within an amount designated in any operating or capital bud get; (g) any sale, gift, lease, mortgage or other transfer or encumbrance of any real, personal or mixed property of the Corporation; (h) the merger, acquisition, consolidation, liquidation or dissolution of the Corporation or any amendment, change, modification or supplement to, or waiver of, any merger, acquisition, consolidation, liquidation, or dissolution; (i) borrowing or lending of money or the creation of indebtedness through the guaranty of another's debt or similar action; (j) any granting or seeking of grants or funds to or from any person; (k) commencement, disposition, termination or settlement of claims or litigation, or of any claim or threat of litigation, not fully reimbursed by third-party insurance; (l) appointment and removal of the officers of the Corporation, other than the Chairman and the Vice Chairman (if any) of the Board who shall be appointed and removed by the Board, and any changes in their duties or responsibilities; (m) creation, ownership or acquisition of, or affiliation with, any other organization; (n) adoption or implementation of any strategic, business, or mission plan of the Corporation; (o) the execution of any contract or agreement enforceable against the Corporation, whether or not written, including employment contract, any contract to obtain services from independent contractors, or any contract under which the Corporation shall provide any services; (p) the change in the Corporation's fiscal year; and (q) any other matters with respect to the financial or business operations of the Corporation which are not inconsistent with the Texas Medical Practice Act, the Rules, the Amended and Restated Certificate of Formation, Section 501(c)(3) of the Code or these bylaws. Medical Practice Act, the Rules, the Amended and Restated Certificate of Formation, Section 501(c)(3) of the Code or these bylaws.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Process for Board Review of Form 990: The form 990 is reviewed by the Synapse Board of Directors prior to filing. a complete copy is provided to all Board members with adequate time for review.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: There is a conflict of interest policy and annually the Board members sign a statement that affirms that each person has received a copy of the policy, has read and understands the policy, and agrees to comply with the policy. WHEN A CONFLICT OF INTEREST ARISES, THE POLICY DICTATES THAT THE INTERESTED BOARD MEMBER HAS TO LEAVE THE ROOM DURING VOTING AND MUST ABSTAIN FROM THE MATTER CAUSING THE CONFLICT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>REVIEW OF OFFICER COMPENSATION: The compensation of the top management official and other officers is reviewed during the annual budget process. Parker University's compensation committee conducts an annual review documented in the meeting minutes reviewing independent consultant and comparability data to determine officer compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>AVAILABILITY OF DOCUMENTS: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC DURING THE TAX YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
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        <ExplanationTxt>NUMBER OF EMPLOYEES: THE SOLE MEMBER, PARKER UNIVERSITY, IS THE COMMON PAYMASTER AND ISSUES ALL W-2S OF THE ORGANIZATION. HOWEVER, SALARIES EXPENSES ARE ALLOCATED TO THE ORGANIZATION ON THE FUNCTIONAL EXPENSE SCHEDULE, SO WE HAVE REPORTED AN AMOUNT ON PART V, LINE 2A.</ExplanationTxt>
      </SupplementalInformationDetail>
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        <ExplanationTxt>DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:263855</ExplanationTxt>
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          <CityNm>Dallas</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
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