2021-10-13T17:54:04-05:00 2020-11-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2019-12-01 743001674 LONE STAR CIRCLE OF CARE LONE 5126860523 205 EAST UNIVERSITY AVENUE NO 200 GEORGETOWN TX 78626 BRANDON TEENIER CHIEF FINANCIAL OFFICER 5126860523 2021-10-13 1 MICHAEL LUMSDEN P01262236 4159561500 2021-10-05 2019 2022-09-23 18:48:47Z JON CALVIN 205 EAST UNIVERSITY AVENUE NO 200 GEORGETOWN TX 78626 93558899 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. 14 14 791 14 0 0 21158710 28059515 65931929 64785626 168153 90375 0 620530 87258792 93556046 0 0 0 0 52273548 56732996 0 0 1672010 30598688 34819993 82872236 91552989 4386556 2003057 51881578 56592282 9800689 12508336 42080889 44083946 X LONE STAR CIRCLE OF CARE PROVIDES EXCEPTIONAL & ACCESSIBLE PATIENT CENTERED HEALTHCARE FOR OUR TEXAS NEIGHBORS, FOCUSING ON THE UNDERSERVED. 0 0 68415191 0 50794225 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 106,135 PEDIATRIC PATIENT VISITS, 88,192 FAMILY MEDICINE PATIENT VISITS, 8,580 SENIOR CARE PATIENT VISITS, 45,358 OB/GYN PATIENT VISITS (INCLUDING 1,841 BABY DELIVERIES), 1,847 OPTOMETRY VISITS, 2,048 CONVENIENT CARE VISITS, AND FILLED 203,967 PRESCRIPTIONS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION ABOUT THE SERVICES PROVIDED. 7385577 0 8536494 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 64,006 PATIENT VISITS LAST YEAR. 4137922 0 2296169 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, BASTROP, AND AUSTIN ARE DEDICATED TO PROVIDING AFFORDABLE, ACCESSIBLE CARE TO THE UNINSURED AND UNDER-SERVED. LSCC PROVIDED 16,363 PATIENT VISITS IN THE PAST YEAR. 0 0 3158738 OTHER PROGRAM REVENUES INCLUDE QUALITY INCENTIVE REVENUES AND MISCELLANEOUS ANCILLARY REVENUE. 0 0 3158738 79938690 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 39 0 1 791 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X BRANDON TEENIER 5126860523 205 E UNIVERSITY AVE STE 200 GEORGETOWN TX 78626 ANDREW MAHAFFEY MD VP OF OB/GYN SERVICES 40.00 X 435197 0 23217 RHONDA MUNDHENK JD MPH CHIEF EXECUTIVE OFFICER 55.00 X 387408 0 19850 KATHLEEN BUTLER MD MBA CMQ CPHQ CMO/CHIEF QUALITY OFFICER 40.00 X 383490 0 19850 KIMBERLEE COLEMAN-HENDERSON MD OB/GYN 40.00 X 329870 0 20774 JON CALVIN FACHE CPA CMA CHFP CHIEF FINANCIAL OFFICER 55.00 X 310936 0 24332 CRYSTAL KELLY LESTER MD OB/GYN THROUGH 11/2019 40.00 X 303824 0 9152 MELISSA R VALDEZ MD DIR OF PSYCH & BEHAVIORAL HEALTH 40.00 X 289758 0 16956 RICHARD SHEA MD OB/GYN 40.00 X 290909 0 14516 TILLERY STOUT JD CHIEF ADMIN OFFICER/GENERAL COUNSEL 40.00 X 283782 0 20342 ADEYOYIN OKUNADE MD FAAFP FAMILY PRACTICE MEDICAL DIRECTOR 40.00 X 258400 0 22316 LINDSEY TIPPIT MHA CHIEF OPERATING OFFICER 40.00 X 215993 0 15166 JACK HUNNICUTT BOARD MEMBER - CHAIR 1.00 X 0 0 0 SCOTT ALARCON BOARD MEMBER - VICE CHAIR 1.00 X 0 0 0 CYNTHIA BRIEN BOARD MEMBER - VICE CHAIR 1.00 X 0 0 0 KAREN COLE BOARD MEMBER - SECRETARY 1.00 X 0 0 0 STEVE PENA BOARD MEMBER - TREASURER 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 QUIANTA MOORE BOARD MEMBER 1.00 X 0 0 0 SOFIA NELSON BOARD MEMBER 1.00 X 0 0 0 SHIRLEY ROBINSON 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 3489567 0 206471 128 0 1 0 CLINICAL PATHOLOGY LABS INC PO BOX 141669 AUSTIN TX 78714 LAB SERVICES 952970 ITENTIVE HEALTHCARE SOLUTIONS 1 PIERCE PLACE STE 400E ITASCA IL 60143 SOFTWARE/IT SERVICES 881658 PRESIDIO NETWORKED SOLUTIONS GROUP LLC PO BOX 677638 DALLAS TX 75267 SOTWARE/IT/CLOUD SERVICES 659046 PRESS ONE AMP NETWORKS LLC 38-31 CRESCENT ST LONG ISLAND CITY NY 11101 VOICE OVER IP SERVICES 311869 ARSENAL ADVERTISING AND PUBLIC RELATIONS 3112 WINDSOR ROAD 327 AUSTIN TX 78703 ADVERTISING 310250 15 20751257 7308258 5021813 28059515 PATIENT SERVICE REV 624100 61626888 61626888 QUALITY INCENTIVE REV 621400 3064445 3064445 OTHER OPERATING REV 621400 94293 94293 64785626 93228 93228 2853 -2853 -2853 -2853 GAIN ON SETTLEMENT 900099 620530 620530 620530 93556046 64785626 0 710905 2060116 690061 1097051 273004 45390952 40383629 4432306 575017 564764 520031 44270 463 5508430 4839019 611364 58047 3208734 2798165 372397 38172 27817 27817 114468 114468 4749452 3674829 846698 227925 368482 285109 65690 17683 1525977 1180705 272040 73232 2591397 2005061 461975 124361 6391898 5587697 723798 80403 111969 86635 19961 5373 77796 60194 13869 3733 18356 6348 9970 2038 2571162 2321795 220507 28860 348294 269488 62091 16715 PHARMACEUTICAL SUPPLIES 8298510 8298510 MEDICAL SUPPLIES 2315327 2315327 BAD DEBT EXPENSE 2246277 2246277 DUES & SUBSCRIPTIONS 243372 188306 43387 11679 2819439 2181504 502630 135305 91552989 79938690 9942289 1672010 992832 643884 20332564 24697711 9371454 9595096 5824728 5915427 1693998 2185685 784334 812747 26985699 15198052 11684212 11787647 1197456 954085 51881578 56592282 7560565 9074267 408000 534212 157116 1403698 1675008 1496159 9800689 12508336 X 32436888 37869409 9644001 6214537 42080889 44083946 51881578 56592282 2003057 0 X 0 1 X 1 1 1 X 16070902 17794696 19979953 21158710 28059515 103063776 16070902 17794696 19979953 21158710 28059515 103063776 30636791 72426985 35522 47265 59664 183034 93228 418713 620530 620530 104103019 293134295 0.69570 0.60270 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: GAIN ON SETTLEMENT - 2015 AMOUNT: $ 0. 2016 AMOUNT: $ 0. 2017 AMOUNT: $ 0. 2018 AMOUNT: $ 0. 2019 AMOUNT: $ 620,530. 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 528057 528057 5700169 2081577 3618592 6426566 4324473 2102093 12410193 8571651 3838542 1920714 220351 1700363 11787647 DEFERRED RENT LIABILITY 1077542 DEFERRED COMPENSATION LIABILITY 418617 1496159 91492627 182858 -2246277 -2063419 93556046 0 93556046 89489570 182858 182858 89306712 2246277 2246277 91552989 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -2,246,277. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 2,246,277. X X X 0 0 0 0 0 0 0 1 0 ANDREW MAHAFFEY MD VP OF OB/GYN SERVICES 423785 0 8640 0 2772 0 9800 0 13417 0 458414 0 0 0 RHONDA MUNDHENK JD MPH CHIEF EXECUTIVE OFFICER 386778 0 0 0 630 0 9800 0 10050 0 407258 0 0 0 KATHLEEN BUTLER MD MBA CMQ CPHQ CMO/CHIEF QUALITY OFFICER 376684 0 5000 0 1806 0 9800 0 10050 0 403340 0 0 0 KIMBERLEE COLEMAN-HENDERSON MD OB/GYN 329240 0 0 0 630 0 9800 0 10974 0 350644 0 0 0 JON CALVIN FACHE CPA CMA CHFP CHIEF FINANCIAL OFFICER 305558 0 5000 0 378 0 9800 0 14532 0 335268 0 0 0 CRYSTAL KELLY LESTER MD OB/GYN THROUGH 11/2019 270325 0 21120 0 12379 0 0 0 9152 0 312976 0 0 0 MELISSA R VALDEZ MD DIR OF PSYCH & BEHAVIORAL HEALTH 284128 0 5000 0 630 0 5995 0 10961 0 306714 0 0 0 RICHARD SHEA MD OB/GYN 287293 0 1810 0 1806 0 0 0 14516 0 305425 0 0 0 TILLERY STOUT JD CHIEF ADMIN OFFICER/GENERAL COUNSEL 278362 0 5000 0 420 0 9800 0 10542 0 304124 0 0 0 ADEYOYIN OKUNADE MD FAAFP FAMILY PRACTICE MEDICAL DIRECTOR 257770 0 0 0 630 0 7800 0 14516 0 280716 0 0 0 LINDSEY TIPPIT MHA CHIEF OPERATING OFFICER 215664 0 0 0 329 0 7573 0 7593 0 231159 0 0 0 PART I, LINE 7 THE ORGANIZATION PROVIDED BONUS PAYMENTS TO CERTAIN INDIVIDUALS LISTED IN FORM 990, PART VII AND SCHEDULE J WHICH WERE DISCRETIONARY, AND THUS WOULD BE CONSIDERED "NON-FIXED PAYMENTS". X 1 191207 FMV X 2 4830606 FMV 0 0 1 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN SCHEDULE M, PART I, COLUMN (B). 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 INEQUITIES 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. DURING THE 11/30/2020 FISCAL YEAR, LSCC OPERATED CLINICS THROUGHOUT WILLIAMSON, TRAVIS, BELL, BASTROP, BURNET, AND HARRIS 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 40 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 332,529 VISITS DURING THE 11/30/2020 FISCAL YEAR. 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 332,529 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 106,135 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 88,192 PATIENT VISITS. 3) WOMEN'S HEALTH: OBSTETRICS AND GYNECOLOGY, INCLUDING THOROUGH PRENATAL CARE, LABOR AND DELIVERY, AND POSTPARTUM CARE. OB/GYN PROVIDERS PROVIDED 45,358 PATIENT VISITS, INCLUDING DELIVERING 1,841 BABIES THIS YEAR. 4) INTEGRATED BEHAVIORAL HEALTH: PSYCHIATRY, PSYCHOTHERAPY, AND COUNSELING FOR ADULTS, SENIORS, ADOLESCENTS, AND CHILDREN. IN THE PAST YEAR, LSCC PROVIDED 64,006 BEHAVIORAL HEALTH VISITS. 5) SENIOR: MEDICAL SERVICES TAILORED FOR OLDER ADULTS. LSCC PROVIDED 8,580 SENIOR VISITS OVER THE PAST YEAR. 6) CONVENIENT CARE: LSCC PROVIDED 2,048 CONVENIENT CARE VISITS. 7) DENTAL: LSCC'S DENTAL CLINIC PROVIDED 16,363 VISITS IN THE YEAR. 8) VISION: LSCC'S VISION CLINIC PROVIDED 1,847 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 NOVEMBER 12, 2020. 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.