2019-10-11T12:42:12-05:00 2018-11-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2017-12-01 743001674 LONE STAR CIRCLE OF CARE LONE 5126860523 205 EAST UNIVERSITY AVENUE NO 200 GEORGETOWN TX 78626 JON CALVIN CHIEF FINANCIAL OFFICER 5126860523 2019-10-11 1 MICHAEL LUMSDEN P01262236 4159561500 2019-10-07 12.129.4.211 2019-10-11 11:24:36 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 32BFBF1104AA8EEBC72962A0CCB0C2C16BC479E3 2017 2020-03-31 21:24:44Z RHONDA MUNDHENK 205 EAST UNIVERSITY AVENUE NO 200 GEORGETOWN TX 78626 79398161 0 X HTTPS://LONESTARCARES.ORG/ X 2001 TX LONE STAR CIRCLE OF CARE PROVIDES EXCEPTIONAL & ACCESSIBLE PATIENT CENTERED HEALTHCARE FOR OUR TEXAS NEIGHBORS, FOCUSING ON THE UNDERSERVED. 13 13 616 13 0 0 17794696 19979953 53509223 59357844 47032 57415 -180 200 71350771 79395412 0 0 0 0 41508386 45185771 0 0 1940579 23905088 26557233 65413474 71743004 5937297 7652408 40330495 46765059 10288570 9070726 30041925 37694333 X LONE STAR CIRCLE OF CARE PROVIDES EXCEPTIONAL AND ACCESSIBLE PATIENT CENTERED HEALTHCARE FOR OUR TEXAS NEIGHBORS. 0 0 52803012 47113397 MEDICAL PROGRAMS: LONE STAR CIRCLE OF CARE (LSCC) HAS MULTIPLE MEDICAL SERVICE LINES THAT PROVIDE PRIMARY & ACUTE MEDICAL CARE INCLUDING PREVENTION, DIAGNOSIS, AND TREATMENT OF CHRONIC CONDITIONS. IN THE PAST YEAR, LSCC PROVIDED 118,933 PEDIATRIC PATIENT VISITS, 68,051 FAMILY MEDICINE PATIENT VISITS, 8,903 SENIOR CARE PATIENT VISITS, 45,403 OB/GYN PATIENT VISITS (INCLUDING 1,703 BABY DELIVERIES), 2,023 OPTOMETRY VISITS, ONE CONVENIENT CARE VISIT, AND FILLED 170,905 PRESCRIPTIONS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION ABOUT THE SERVICES PROVIDED. 6104884 8632260 INTEGRATED BEHAVIORAL HEALTH: LSCC'S INTEGRATED BEHAVIORAL HEALTH MODEL ADDRESSES THE COMPLETE PRIMARY MEDICAL AND MENTAL HEALTH NEEDS OF ADULT, ADOLESCENT, SENIOR, AND PEDIATRIC PATIENTS. BY PROVIDING CONTINUOUS ACCESS TO TREATMENT AND MEDICATIONS, LSCC IS HELPING TO REDUCE EMERGENCY ROOM VISITS AND CRISES RELATED TO UNTREATED MENTAL HEALTH ISSUES. SERVICES PROVIDED INCLUDE PSYCHIATRY, PSYCHOTHERAPY, AND COUNSELING FOR SENIORS, ADULTS, ADOLESCENTS, AND CHILDREN. THE BEHAVIORAL HEALTH CLINICS PROVIDED 61,114 PATIENT VISITS LAST YEAR. 3325516 2257074 DENTAL CARE: LSCC PROVIDES GENERAL DENTISTRY SERVICES FOR ADULTS AND CHILDREN IN THE CENTRAL TEXAS COMMUNITY. LSCC'S GCC DENTAL CENTER IN GEORGETOWN AND DENTAL CLINICS IN ROUND ROCK, MARBLE FALLS, AND BASTROP ARE DEDICATED TO PROVIDING AFFORDABLE, ACCESSIBLE CARE TO THE UNINSURED AND UNDER-SERVED. LSCC PROVIDED 17,531 PATIENT VISITS IN THE PAST YEAR. 1355113 OTHER PROGRAM REVENUES INCLUDE QUALITY INCENTIVE REVENUES, ELECTRONIC HEALTH RECORDS INCENTIVE REVENUE, AND MISCELLANEOUS ANCILLARY REVENUE. 1355113 62233412 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 0 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 1 34 0 1 616 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JON CALVIN CFO 5126860523 205 E UNIVERSITY AVE STE 200 GEORGETOWN TX 78626 JACK HUNNICUTT BOARD MEMBER - CHAIR 1.00 X X 0 0 0 SCOTT ALARCON BOARD MEMBER - VICE PRESIDENT 1.00 X X 0 0 0 CYNTHIA BRIEN BOARD MEMBER - VICE PRESIDENT 1.00 X X 0 0 0 STEVE PENA BOARD MEMBER - TREASURER 1.00 X X 0 0 0 KAREN COLE BOARD MEMBER - SECRETARY 1.00 X X 0 0 0 DOAK FLING BOARD MEMBER 1.00 X 0 0 0 JOHN GUSTAINIS BOARD MEMBER 1.00 X 0 0 0 ELIZABETH JOHNSON BOARD MEMBER 1.00 X 0 0 0 AMY MEDRANO BOARD MEMBER 1.00 X 0 0 0 RUDOLPH METAYER BOARD MEMBER 1.00 X 0 0 0 SOFIA NELSON BOARD MEMBER 1.00 X 0 0 0 MARK SCHROEDER BOARD MEMBER 1.00 X 0 0 0 ROLAND VALLE BOARD MEMBER 1.00 X 0 0 0 RHONDA MUNDHENK CHIEF EXECUTIVE OFFIVER 55.00 X 387000 0 14382 JONATHAN CALVIN CHIEF FINANCIAL OFFIER 55.00 X 284467 0 18296 KATHLEEN BUTLER CMO/CHIEF QUALITY OFFICER 40.00 X 357474 0 15228 MELISSA VALDEZ MD - DIR. OF PSYCH & BEHAV HEALTH 40.00 X 265519 0 14840 ADEYOYIN OKUNADE MD - FAMILY PRACTICE MEDICAL DIR. 40.00 X 220819 0 15674 ANDREW MAHAFFEY VP OF OB/GYN SERVICES 40.00 X 427459 0 18446 KIMBERLEE COLEMAN-HENDERSON MD - OB/GYN 40.00 X 305708 0 14861 DAVID BILLUE MD - OB/GYN 40.00 X 278306 0 13595 TARA HEYLIGER DO - OB/GYN (THROUGH 3/2018) 40.00 X 287743 0 15228 RICHARD SHEA MD - OB/GYN 40.00 X 293891 0 14379 3108386 0 154929 92 0 1 0 QUEST DIAGNOSTICS PO BOX 841725 DALLAS TX 752841725 LAB SERVICES 713911 ITENTIVE HEALTHCARE SOLUTIONS 1 PIERCE PLACE ITASCA IL 60143 HOSTING AND MAINTENANCE 635781 COLOMETRO INC PO BOX 340399 AUSTIN TX 78734 BROADBAND SERVICES 592080 NORTHSTAR ELITE CONSTRUCTION & CONSULTIN 36250 FM 3156 NEW BRAUNFELS TX 78132 CONSTRUCTION SERVICES 462635 AMERICAN INTERNATIONAL TRANSLATORS PO BOX 90848 AUSTIN TX 78709 TRANSLATION SERVICES 425385 13 8750110 11229843 4098015 19979953 PATIENT SERVICE REV 624100 58002731 58002731 QUALITY INCENTIVE REVENUE 621400 624551 624551 EHR REVENUE 621400 476000 476000 OTHER REVENUE 621400 254562 254562 59357844 59464 59464 200 0 200 200 200 700 2749 -2049 -2049 -2049 79395412 59357844 0 57615 1803894 370739 1148046 285109 36376269 32343920 3233556 798793 860365 771686 78603 10076 3450611 3010157 380024 60430 2694632 2321401 320206 53025 23191 23191 92273 92273 3428912 2755285 486818 186809 262533 202328 39754 20451 1701051 1314921 259159 126971 1573507 1264530 293029 15948 5902279 5117122 637273 147884 229632 176972 34772 17888 100183 77209 15170 7804 188826 63841 69350 55635 2067668 1817360 204177 46131 296342 217511 59315 19516 PHARMACEUTICAL SUPPLIES 6769515 6764170 5345 BAD DEBT EXPENSE 1538433 1538433 MEDICAL SUPPLIES 972383 959133 10864 2386 DUES & SUBSCRIPTIONS 360859 278105 54643 28111 1049646 868589 123445 57612 71743004 62233412 7569013 1940579 274087 1428790 13650468 19131158 6296769 7296514 6043871 5721365 987090 1263607 488261 602583 22727200 11904268 9960097 10822932 2629852 498110 40330495 46765059 4141904 6255494 28330 25000 298419 665296 4758799 1159833 1061118 965103 10288570 9070726 X 22794748 29953180 7247177 7741153 30041925 37694333 40330495 46765059 7652408 0 X 0 1 X 1 1 1 X 19740595 18112617 16070902 17794696 19979953 91698763 19740595 18112617 16070902 17794696 19979953 91698763 36588150 55110613 132680 1790 35522 47265 59664 276921 91975684 264026153 0.59920 0.99530 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 0 0 PART II-B, LINE 1: THE ORGANIZATION PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) AND THE TEXAS ASSOCIATION OF COMMUNITY HEALTH CENTERS (TACHC). A PORTION OF THESE DUES MAY BE USED FOR LOBBYING PURPOSES. 0 1 X 336850 336850 5446363 1209422 4236941 5207388 3279763 1927625 10651033 7268214 3382819 1085566 146869 938697 10822932 DEFERRED RENT LIABILITY 965103 965103 78039837 182858 -1538433 -1355575 79395412 0 79395412 70387429 182858 182858 70204571 1538433 1538433 71743004 PART IV, LINE 2B: THE ORGANIZATION SERVES AS A CUSTODIAN FOR FUNDS RECEIVED FROM ST. DAVID'S FOUNDATION, WHICH WILL BE USED TO PAY SPECIALISTS TO WHOM LSCC AND TWO ADDITIONAL FEDERALLY QUALIFIED HEALTH CENTERS REFER PATIENTS. IN ADDITION, THE ORGANIZATION SERVES AS A CUSTODIAN FOR DEFERRED COMPENSATION PLAN ASSETS, HELD TO BENEFIT CERTAIN EMPLOYEES OF THE ORGANIZATION. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -1,538,433. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 1,538,433. X X X 0 0 0 0 0 0 0 1 0 RHONDA MUNDHENK CHIEF EXECUTIVE OFFIVER 386580 0 0 0 420 0 4725 0 9657 0 401382 0 0 0 JONATHAN CALVIN CHIEF FINANCIAL OFFIER 279131 0 5000 0 336 0 4725 0 13571 0 302763 0 0 0 KATHLEEN BUTLER CMO/CHIEF QUALITY OFFICER 355668 0 0 0 1806 0 4725 0 10503 0 372702 0 0 0 MELISSA VALDEZ MD - DIR. OF PSYCH & BEHAV HEALTH 264889 0 0 0 630 0 4725 0 10115 0 280359 0 0 0 ADEYOYIN OKUNADE MD - FAMILY PRACTICE MEDICAL DIR. 220189 0 0 0 630 0 1300 0 14374 0 236493 0 0 0 ANDREW MAHAFFEY VP OF OB/GYN SERVICES 420367 0 4320 0 2772 0 4725 0 13721 0 445905 0 0 0 KIMBERLEE COLEMAN-HENDERSON MD - OB/GYN 305288 0 0 0 420 0 4725 0 10136 0 320569 0 0 0 DAVID BILLUE MD - OB/GYN 275747 0 0 0 2559 0 0 0 13595 0 291901 0 0 0 TARA HEYLIGER DO - OB/GYN (THROUGH 3/2018) 287113 0 0 0 630 0 4725 0 10503 0 302971 0 0 0 RICHARD SHEA MD - OB/GYN 292925 0 0 0 966 0 0 0 14379 0 308270 0 0 0 PART I, LINE 7 THE CHIEF FINANCIAL OFFICER RECEIVED A DISCRETIONARY BONUS WHICH WAS APPROVED BY THE CHIEF EXECUTIVE OFFICER. X 1 4098015 FMV 0 0 1 0 PART I, COLUMN (B): ALL NON-CASH CONTRIBUTIONS RECEIVED WERE IN THE FORM OF VACCINES, WHICH WERE RECEIVED FROM ONE DONOR. FORM 990, PART III, LINE 1: ORGANIZATION'S MISSION: LONE STAR CIRCLE OF CARE PROVIDES EXCEPTIONAL AND ACCESSIBLE PATIENT CENTERED HEALTHCARE FOR OUR TEXAS NEIGHBORS. VISION STATEMENT: WE WILL ELIMINATE HEALTH INEQUALITIES TO FACILITATE WELLNESS AND OPTIMAL LIVING FOR ALL, HELPING STRENGTHEN OUR COMMUNITIES. CORE VALUES: COMPASSION, INTEGRITY, RESPECT, SERVICE, INNOVATION, EXCELLENCE LONE STATE CIRCLE OF CARE (LSCC) IS A 501(C)(3) NONPROFIT, FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER (FQHC) NETWORK THAT PROVIDES A PATIENT-CENTERED HEALTH CARE HOME TO UNINSURED AND UNDERINSURED RESIDENTS OF CENTRAL TEXAS. IN 2018, LSCC OPERATED CLINICS THROUGHOUT WILLIAMSON, TRAVIS, BELL, BASTROP, AND BURNETT COUNTIES. SERVICES INCLUDE: PRIMARY MEDICAL CARE THAT IS FOCUSED BY AGE GROUP (PEDIATRICS, ADOLESCENTS, ADULTS, AND SENIORS); COMPREHENSIVE OB/GYN SERVICES; GENERAL DENTISTRY; OPTOMETRY; PHARMACY SERVICES; AND ENABLING SERVICES SUCH AS INTERPRETERS AND INSURANCE ELIGIBILITY SCREENERS. A ROBUST AND FULLY INTEGRATED BEHAVIORAL HEALTH PROGRAM, WITH APPROXIMATELY 33 CLINICIANS ON STAFF, PROVIDES NECESSARY PSYCHIATRIC AND PSYCHOTHERAPY SERVICES TO PATIENTS WHO WOULD OTHERWISE NOT HAVE ACCESS TO CARE. LSCC ACCEPTS MEDICAID, CHILDREN'S HEALTH INSURANCE PROGRAM, MEDICARE AND OTHER PUBLICLY INSURED PATIENTS, AND UNINSURED PATIENTS PAY A SLIDING SCALE FEE BASED ON THEIR INCOME AND HOUSEHOLD SIZE. LSCC IS ACCREDITED BY THE JOINT COMMISSION (TJC) UNDER AMBULATORY CARE AND BEHAVIORAL HEALTH CARE STANDARDS. LSCC ALSO HOLDS PRIMARY CARE MEDICAL HOME (PCMH) CERTIFICATION FROM TJC. SINCE RECEIVING FQHC STATUS IN 2004, LSCC HAS FORGED NUMEROUS STRATEGIC PARTNERSHIPS, LEVERAGING FQHC BENEFITS WITH INVESTMENTS FROM OTHER STAKEHOLDERS, INCLUDING FOUNDATIONS, GOVERNMENT, AND HOSPITAL SYSTEMS. WITH THE SUPPORT OF THESE MANY PARTNERS, CAPACITY HAS GROWN FROM 10,000 VISITS IN 2002 TO 321,959 VISITS IN 2018. LSCC WILL CONTINUE IDENTIFYING OPPORTUNITIES TO COLLABORATE AND LEVERAGE ITS RESOURCES TO PROVIDE SUSTAINABLE, QUALITY PRIMARY HEALTH CARE FOR THE REGION. FORM 990, PART III, LINE 4A MEDICAL PROGRAMS: LONE STAR CIRCLE OF CARE (LSCC) HAS MULTIPLE MEDICAL SERVICE LINES THAT PROVIDE PRIMARY AND ACUTE MEDICAL CARE INCLUDING PREVENTION, DIAGNOSIS AND TREATMENT OF CHRONIC CONDITIONS. IN THE PAST YEAR, LSCC PROVIDED 321,959 PATIENT VISITS ACROSS ALL SERVICE LINES. LSCC SERVICE LINES INCLUDE: 1) PEDIATRIC: PRIMARY AND ACUTE MEDICAL CARE FOR CHILDREN AND ADOLESCENTS. IN THE PAST YEAR, LSCC PROVIDED 118,933 VISITS. 2) FAMILY MEDICINE AND SENIOR CARE: LSCC PROVIDES A PRIMARY CARE HOME FOR A LARGE, UNINSURED ADULT POPULATION. PATIENTS HAVE ACCESS TO ROUTINE AND ACUTE CARE AS WELL AS CHRONIC DISEASE PREVENTION, TREATMENT AND MANAGEMENT. IN THE PAST YEAR, LSCC PROVIDED 68,051 PATIENT VISITS. 3) WOMEN'S HEALTH: OBSTETRICS AND GYNECOLOGY, INCLUDING THOROUGH PRENATAL CARE, LABOR AND DELIVERY, AND POSTPARTUM CARE. OB/GYN PROVIDERS PROVIDED 45,403 PATIENT VISITS, INCLUDING DELIVERING 1,703 BABIES THIS YEAR. 4) INTEGRATED BEHAVIORAL HEALTH: PSYCHIATRY, PSYCHOTHERAPY, AND COUNSELING FOR ADULTS, SENIORS, ADOLESCENTS, AND CHILDREN. IN THE PAST YEAR, LSCC PROVIDED 61,114 BEHAVIORAL HEALTH VISITS. 5) SENIOR: MEDICAL SERVICES TAILORED FOR OLDER ADULTS. LSCC PROVIDED 8,903 SENIOR VISITS OVER THE PAST YEAR. 6) CONVENIENT CARE: LSCC PROVIDED ONE CONVENIENT CARE VISIT 7) DENTAL: LSCC'S DENTAL CLINIC PROVIDED 17,531 VISITS IN THE YEAR. 8) VISION: LSCC'S VISION CLINIC PROVIDED 2,023 VISITS IN THE YEAR. 9) HEALTH EDUCATION CLASSES: LSCC TEAMED UP WITH VARIOUS LOCAL PARTNERS TO PROVIDE FREE HEALTH EDUCATION CLASSES TO OUR PATIENTS AND THE LOCAL COMMUNITY. THESE CLASSES ARE A VALUABLE RESOURCE TO INDIVIDUALS AND FAMILIES WHO ARE: (I) LEARNING TO MANAGE DIABETES OR ASTHMA; (II) EXPECTING THEIR FIRST CHILD; (III) LEARNING ABOUT BEING ACTIVE AND EATING HEALTHY; AND (IV) TEACHING THEIR CHILDREN TO BE HEALTHY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. UPON RECEIPT OF THE FORM 990 FROM THE INDEPENDENT ACCOUNTANT, AND PRIOR TO SUBMISSION TO THE IRS, THE CFO REVIEWS THE RETURN FOR REASONABLENESS COMPARED TO THE FINAL AUDITED FINANCIAL STATEMENTS. THE FORM IS THEN DISTRIBUTED TO THE BOARD OF DIRECTORS FOR THEIR REVIEW AND FEEDBACK BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF DIRECTORS OR EXECUTIVE COMMITTEE SHALL COMPLETE AND SIGN A CONFLICT OF INTEREST CERTIFICATE ANNUALLY, AT THE START OF THE MEMBER'S TERM OR AT THE START OF THE CORPORATION'S FISCAL YEAR, WHICHEVER COMES FIRST. SHOULD A CONFLICT ARISE, THE BOARD MEMBER WILL ABSTAIN FROM PARTICIPATING IN VOTING RELATED TO THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE CEO COMPENSATION REVIEW WAS CONDUCTED BY THE EXECUTIVE COMMITTEE OF THE BOARD USING THIRD PARTY COMPENSATION RESOURCES FOR COMPARISON AND REASONABLENESS. A FORMAL EVALUATION OF THE CEO BY THE BOARD OF DIRECTORS WAS LAST COMPLETED ON JUNE 28, 2018. COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION WAS REVIEWED AND APPROVED BY THE CEO, WHO TAKES INTO ACCOUNT INDUSTRY COMPENSATION DATA, ALONG WITH THE SIZE AND COMPLEXITY OF THE COMPARABLE ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE MADE AVAILABLE UPON REQUEST. IN ADDITION, THE FORM 990 IS PUBLIC INFORMATION.