2025-10-11T12:14:50-05:00 2024-11-30 390859910 BAKER TILLY ADVISORY GROUP LP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2023-12-01 743001674 LONE STAR CIRCLE OF CARE LONE 8778005722 2423 WILLIAMS DRIVE 107 GEORGETOWN TX 78628 NICHOLE COOK CHIEF FINANCIAL OFFICER 8778005722 2025-10-10 1 1 MICHAEL LUMSDEN P01262236 4159561500 2025-10-10 2023 2025-03-06 01:10:19Z X JON CALVIN 2423 WILLIAMS DRIVE 107 GEORGETOWN TX 78628 92588413 0 X HTTPS://LONESTARCARES.ORG/ X 2001 TX LONE STAR CIRCLE OF CARE PROVIDES EXCEPTIONAL AND ACCESSIBLE PATIENT CENTERED HEALTHCARE FOR OUR TEXAS NEIGHBORS, FOCUSING ON THE UNDERSERVED. 11 11 1003 113 0 0 36478879 28746055 67709661 62519816 762473 912667 39040 39821 104990053 92218359 0 0 0 0 61694287 66241317 0 0 2622058 34929545 35392307 96623832 101633624 8366221 -9415265 82228765 80347274 24814158 31429731 57414607 48917543 X LONE STAR CIRCLE OF CARE PROVIDES EXCEPTIONAL AND ACCESSIBLE PATIENT CENTERED HEALTHCARE FOR OUR TEXAS NEIGHBORS, FOCUSING ON THE UNDERSERVED. 0 0 74968007 0 53323276 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 119,753 PEDIATRIC PATIENT VISITS, 82,487 FAMILY MEDICINE PATIENT VISITS, 8,953 SENIOR CARE PATIENT VISITS, 34,432 OB/GYN PATIENT VISITS (INCLUDING 2,149 BABY DELIVERIES), 1,737 OPTOMETRY VISITS, 2,885 CONVENIENT CARE VISITS, AND 3,946 MOBILE MAMMOGRAPHY VISITS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION ABOUT THE SERVICES PROVIDED. 8139320 0 5789339 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 52,326 PATIENT VISITS LAST YEAR. 4790236 0 3407201 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 19,344 PATIENT VISITS IN THE PAST YEAR. 87897563 1 1 0 1 0 0 0 0 0 0 1 0 0 1 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 1 67 0 1 1003 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X NICHOLE COOK 5126860207 2423 WILLIAMS DRIVE SUITE 107 GEORGETOWN TX 78628 JONATHAN CALVIN FACHE CPA CMA CHIEF EXECUTIVE OFFICER 55.00 X 541350 0 22501 KATHLEEN V BUTLER MD MBA CMQ CPH CHIEF MED OFFICER/CHIEF QUAL OFFICER 55.00 X 426321 0 17360 BETH THAI MD MD - OB/GYN 40.00 X 432065 0 8637 ANDREW MAHAFFEY MD VP OF OB/GYN SERVICES 40.00 X 420070 0 19215 RACHEL PANTOJA MD MD - OB/GYN 40.00 X 415232 0 15668 HELIO ZAPATA MD MD - OB/GYN 40.00 X 385479 0 21264 SHAYLA MATTHEWS-JACKSON MD MD - OB/GYN 40.00 X 348986 0 21264 TILLERY STOUT JD CHIEF ADMIN OFFICER & GEN COUNSEL 55.00 X 331770 0 18427 MELISSA R VALDEZ MD DIR OF PSYCH & BEHAV HEALTH / CCIO 55.00 X 299038 0 18364 LINDSEY TIPPIT MHA MSHCT CHIEF OPERATING OFFICER 55.00 X 283628 0 16484 ADEYOYIN OKUNADE MD FAAFP FAMILY PRACTICE MEDICAL DIRECTOR 55.00 X 269975 0 22271 RAJ DIWAN DDS MAGD MBA DIRECTOR OF DENTAL SERVICES 55.00 X 239516 0 13940 BRANDON TEENIER CPA FORMER CFO (THRU 10/2023) 55.00 X 244302 0 8203 RODOLFO SZOKE CHCIO CDHE CSM CSPO CHIEF INFORMATION OFFICER 55.00 X 234030 0 18236 NICHOLE COOK CFO (START 8/2024) 55.00 X 0 0 0 STEVE PENA BOARD MEMBER - CHAIR 1.00 X X 0 0 0 ELIZABETH JOHNSON BOARD MEMBER - VICE PRESIDENT 1.00 X X 0 0 0 SCOTT ALARCON BOARD MEMBER - TREASURER 1.00 X X 0 0 0 RUDY METAYER BOARD MEMBER - SECRETARY 1.00 X X 0 0 0 SASHA BULKLEY BOARD MEMBER 1.00 X 0 0 0 JO CARCEDO BOARD MEMBER 1.00 X 0 0 0 JOHN GUSTAINIS BOARD MEMBER 1.00 X 0 0 0 JACK HUNNICUTT BOARD MEMBER 1.00 X 0 0 0 ALTON MCCALLUM 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 4871762 0 241834 109 1 1 0 BRIGGS & STIERMAN LLC 2765 BEE CAVES RD 205 AUSTIN TX 78746 CONSTRUCTION SERVICES 3789535 CLINICAL PATHOLOGY LABS INC PO BOX 141669 AUSTIN TX 78714 LAB SERVICES 1178919 ARSENAL ADVERTISING AND PUBLIC RELATIONS 3112 WINDSOR ROAD 327 AUSTIN TX 78703 MARKETING / ADVERTISING SERVICES 906376 DAS HEALTH VENTURES LLC 1000 N ASHLEY DR 300 TAMPA FL 33602 INFORMATION TECHNOLOGY SERVICES 901509 LANGUAGE SERVICES ASSOCIATES PO BOX 829752 PHILADEPHIA PA 19182 TRANSLATION SERVICES 402242 20 12015660 16730395 3861119 28746055 PATIENT SERVICE REV 624100 60738606 60738606 PAY FOR PERFORMANCE 624100 1781210 1781210 62519816 887902 887902 39821 0 39821 39821 39821 394819 361822 8232 32997 -8232 24765 24765 92218359 62519816 0 952488 2977212 1142856 1834356 52834660 47105136 4373742 1355782 743498 666883 62351 14264 5685540 4969878 611487 104175 4000407 3466385 461911 72111 71304 71304 163028 163028 3880345 2824054 777615 278676 607997 336543 177988 93466 1553061 859662 454651 238748 2921173 2178678 652366 90129 7285569 6715592 502457 67520 339686 188026 99441 52219 140256 77636 41059 21561 233544 88601 82756 62187 3046880 2696201 328003 22676 565342 409002 116296 40044 PHARMACY SUPPLIES 8861138 8861138 MEDICAL/ANCILLIARY SUPP 2975404 2951310 17436 6658 DISPENSING/ADMIN FEES 1214583 1214583 DUES & SUBSCRIPTIONS 433098 239732 126787 66579 1099899 905667 158969 35263 101633624 87897563 11114003 2622058 1212502 2228929 16457725 8945262 12384963 8783484 7602547 14256875 2489092 2524387 1532794 1028078 46273910 23442975 21662412 22830935 5013381 6059046 13873349 13690278 82228765 80347274 8063123 8588479 2451391 8934581 14299644 13906671 24814158 31429731 X 43274714 39115058 14139893 9802485 57414607 48917543 82228765 80347274 -9415265 918201 0 X 0 1 X 1 1 1 X 28059515 30329782 29399212 36478879 28746055 153013443 28059515 30329782 29399212 36478879 28746055 153013443 35671972 117341471 93228 83441 168407 890044 927723 2162843 620530 49805 670335 155846621 332998166 0.75290 0.72720 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: GAIN ON SETTLEMENT - 2019 AMOUNT: $ 620,530. 2021 AMOUNT: $ 49,805. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 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. 4471085 4471085 14468910 4629229 9839681 8904173 7200893 1703280 15337762 11044755 4293007 3091980 568098 2523882 22830935 ASSETS LIMITED AS TO USE - DEFERRED COMP PLAN ASSETS 376948 OPERATING LEASE RIGHT-OF-USE ASSETS 12710418 FINANCE LEASE RIGHT-OF-USE ASSETS 602912 13690278 DEFERRED COMPENSATION LIABILITY 376948 OPERATING LEASE LIABILITIES 12943919 FINANCE LEASE LIABILITIES 585804 13906671 X 93714671 918201 578111 1496312 92218359 0 92218359 102211735 578111 578111 101633624 0 101633624 PART X, LINE 2: THE HEALTH CENTER HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE HEALTH CENTER IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. X X X 0 0 0 0 0 0 0 1 0 JONATHAN CALVIN FACHE CPA CMA CHIEF EXECUTIVE OFFICER 458119 0 79000 0 4231 0 6600 0 15901 0 563851 0 0 0 KATHLEEN V BUTLER MD MBA CMQ CPH CHIEF MED OFFICER/CHIEF QUAL OFFICER 393766 0 32555 0 0 0 6600 0 10760 0 443681 0 0 0 BETH THAI MD MD - OB/GYN 292395 0 129031 0 10639 0 6600 0 2037 0 440702 0 0 0 ANDREW MAHAFFEY MD VP OF OB/GYN SERVICES 389939 0 29006 0 1125 0 6600 0 12615 0 439285 0 0 0 RACHEL PANTOJA MD MD - OB/GYN 266870 0 131359 0 17003 0 6600 0 9068 0 430900 0 0 0 HELIO ZAPATA MD MD - OB/GYN 241996 0 129783 0 13700 0 6600 0 14664 0 406743 0 0 0 SHAYLA MATTHEWS-JACKSON MD MD - OB/GYN 263713 0 84286 0 987 0 6600 0 14664 0 370250 0 0 0 TILLERY STOUT JD CHIEF ADMIN OFFICER & GEN COUNSEL 301577 0 30193 0 0 0 6600 0 11827 0 350197 0 0 0 MELISSA R VALDEZ MD DIR OF PSYCH & BEHAV HEALTH / CCIO 299038 0 0 0 0 0 6600 0 11764 0 317402 0 0 0 LINDSEY TIPPIT MHA MSHCT CHIEF OPERATING OFFICER 259790 0 23838 0 0 0 6168 0 10316 0 300112 0 0 0 ADEYOYIN OKUNADE MD FAAFP FAMILY PRACTICE MEDICAL DIRECTOR 259512 0 10463 0 0 0 6360 0 15911 0 292246 0 0 0 RAJ DIWAN DDS MAGD MBA DIRECTOR OF DENTAL SERVICES 225916 0 13032 0 568 0 4947 0 8993 0 253456 0 0 0 BRANDON TEENIER CPA FORMER CFO (THRU 10/2023) 229527 0 0 0 14775 0 0 0 8203 0 252505 0 0 0 RODOLFO SZOKE CHCIO CDHE CSM CSPO CHIEF INFORMATION OFFICER 213193 0 20837 0 0 0 4996 0 13240 0 252266 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 51649 3861119 FAIR MARKET VALUE 0 0 1 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF ITEMS CONTRIBUTED 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 11/30/2024 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 23 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 325,863 VISITS DURING THE 11/30/2024 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 325,863 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 119,753 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 82,487 PATIENT VISITS. 3) WOMEN'S HEALTH: OBSTETRICS AND GYNECOLOGY, INCLUDING THOROUGH PRENATAL CARE, LABOR AND DELIVERY, AND POSTPARTUM CARE. OB/GYN PROVIDERS PROVIDED 34,432 PATIENT VISITS, INCLUDING DELIVERING 2,149 BABIES THIS YEAR. 4) INTEGRATED BEHAVIORAL HEALTH: PSYCHIATRY, PSYCHOTHERAPY, AND COUNSELING FOR ADULTS, SENIORS, ADOLESCENTS, AND CHILDREN. IN THE PAST YEAR, LSCC PROVIDED 52,326 BEHAVIORAL HEALTH VISITS. 5) SENIOR: MEDICAL SERVICES TAILORED FOR OLDER ADULTS. LSCC PROVIDED 8,953 SENIOR VISITS OVER THE PAST YEAR. 6) CONVENIENT CARE: LSCC PROVIDED 2,885 CONVENIENT CARE VISITS IN THE YEAR. 7) DENTAL: LSCC'S DENTAL CLINIC PROVIDED 19,344 VISITS IN THE YEAR. 8) VISION: LSCC'S VISION CLINIC PROVIDED 1,737 VISITS IN THE YEAR. 9) MOBILE MAMMOGRAPHY VISITS: LSCC PROVIDED 3,946 MOBILE MAMMOGRAPHY VISITS IN THE YEAR. 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 IN DECEMBER 2023. 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.