2024-07-12T12:24:33-05:00 2023-08-31 410746749 CLIFTONLARSONALLEN LLP 475 REGENCY PARK SUITE 175 OFALLON IL 62269 990 2022-09-01 452578435 TYLER FAMILY CIRCLE OF CARE TYLE 9034052884 523 SOUTH FANNIN AVENUE TYLER TX 75702 JENNIFER BREEDLOVE CFO 9034052884 2024-07-12 1 JENNIFER BREEDLOVE 999009999 0 JEFF PARKER P00970069 6182331200 2024-07-12 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z JENNIFER BREEDLOVE 523 SOUTH FANNIN AVENUE TYLER TX 75702 24573486 0 X WWW.TYLERCIRCLEOFCARE.ORG X 2011 TX THROUGH DEDICATED TEAM MEMBERS WE WILL PROVIDE ACCESS TO COMPASSIONATE CARE FOR THE WHOLE FAMILY WITH UNSURPASSED QUALITY. AS A PREMIER MEDICAL HOME OF CHOICE, WE ENHANCE THE LIVES WE SERVE AND INSPIRE HOPE, THROUGH COMPREHENSIVE HEALTHCARE FOR YEARS TO COME. 10 10 264 14 0 0 7578922 7239160 15048599 16311634 21723 621981 636906 400711 23286150 24573486 0 0 0 0 15509327 17383667 0 0 0 5012680 6054934 20522007 23438601 2764143 1134885 25751131 27947569 1372532 2434085 24378599 25513484 THROUGH DEDICATED TEAM MEMBERS WE WILL PROVIDE ACCESS TO COMPASSIONATE CARE FOR THE WHOLE FAMILY WITH UNSURPASSED QUALITY. AS A PREMIER MEDICAL HOME OF CHOICE, WE ENHANCE THE LIVES WE SERVE AND INSPIRE HOPE, THROUGH COMPREHENSIVE HEALTHCARE FOR YEARS TO COME. 0 0 20064578 0 16311634 THROUGH DEDICATED TEAM MEMBERS WE WILL PROVIDE ACCESS TO COMPASSIONATE CARE FOR THE WHOLE FAMILY WITH UNSURPASSED QUALITY. AS A PREMIER MEDICAL HOME OF CHOICE, WE ENHANCE THE LIVES WE SERVE AND INSPIRE HOPE, THROUGH COMPREHENSIVE HEALTHCARE FOR YEARS TO COME. 20064578 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 42 0 264 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 0 0 X THE ORGANIZATION 9034052884 523 SOUTH FANNIN AVENUE TYLER TX 75702 NICANOR PESINA JR BOARD PRESIDENT 2.00 X X 0 0 0 CLINTON DAVIS BOARD VICE PRESIDENT 2.00 X X 0 0 0 DORETHA WILSON BOARD TREASURER/SECRETARY 2.00 X X 0 0 0 LAMOND DEAN BOARD MEMBER 2.00 X 0 0 0 KRISTI LEMMERTT BOARD MEMBER 2.00 X 0 0 0 ROBERT OGDEN BOARD MEMBER 2.00 X 0 0 0 YANIRA OLIVERAS ORTIZ BOARD MEMBER 2.00 X 0 0 0 AMBRA PHILLIPS BOARD MEMBER 2.00 X 0 0 0 ONA TOLLIVER BOARD MEMBER 2.00 X 0 0 0 IVETTE ZAVARCE BOARD MEMBER 2.00 X 0 0 0 JOYCE ARMSTRONG-SCURRY BOARD MEMBER (END TERM 10/22) 2.00 X 0 0 0 LEROY BIGGERS BOARD MEMBER (END TERM 10/22) 2.00 X 0 0 0 ANDREA ANDERSON BOARD MEMBER (END TERM 11/22) 2.00 X 0 0 0 LORETTA SWAN BOARD MEMBER (END TERM 10/22) 2.00 X 0 0 0 KRISTEN S HARRIS CHIEF EXECUTIVE OFFICER 40.00 X 221023 0 37263 JENNIFER BREEDLOVE CHIEF FINANCIAL OFFICER 40.00 X 135806 0 12758 JOSEPHINE PORTER CHIEF MEDICAL OFFICER/OBGYN PHYSICIAN 40.00 X 352665 0 27537 MICHAEL DONLEY GENERAL COUNSEL & CHIEF ADMIN OFFICER 40.00 X 19908 0 0 LINDA ISABELL CHIEF OPERATING OFFICER 40.00 X 156877 0 12782 NICHOLAS LUZIETTI OBGYN PHYSICIAN 40.00 X 339116 0 42269 ZAREH KHACHIKIAN OBGYN PHYSICIAN 38.00 X 319282 0 17895 RACHEL EVERSON OBGYN PHYSICIAN 38.00 X 288508 0 41031 RABIAH ZAFAR OBGYN PHYSICIAN 41.00 X 291991 0 6581 AMBER COOK FAMILY MEDICINE PHYSICIAN 25.00 X 256202 0 36549 2381378 0 234665 34 0 1 0 0 7112479 126681 7239160 PATIENT SERVICE REVENUE 621110 16311634 16311634 16311634 621981 621981 46728 0 46728 46728 46728 QUALITY INCENTIVES 621110 306132 306132 OTHER OPERATING REVENUE 621110 33625 33625 MEDICAL RECORDS FEE 621110 14226 14226 353983 24573486 16311634 0 1022692 X 985231 985231 12974638 12439776 534862 498150 425072 73078 1909423 1629312 280111 1016225 905568 110657 1945 1945 22375 22375 2661533 1956320 705213 78356 73804 4552 185237 174475 10762 217805 205151 12654 424853 384489 40364 117041 110241 6800 476841 476841 119098 112179 6919 MEDICAL SUPPLIES 1479631 1393670 85961 SERVICE CHARGES 108638 102327 6311 MEMBERSHIP DUES AND SUB 83588 78732 4856 REPAIRS & MAINTENANCE 60288 56786 3502 17705 16676 1029 23438601 20064578 3374023 0 18978571 3322315 13499035 314049 1268185 876292 1850497 292795 321883 8459381 1722701 5232769 6736680 56655 948974 25751131 27947569 1272532 1471013 100000 48940 0 914132 1372532 2434085 X 24378599 25513484 24378599 25513484 25751131 27947569 1134885 0 X 0 1 X 1 0 X PART I, LINE 3 IN TAX YEARS FILED PREVIOUSLY, THE ORGANIZATION HAS SELECTED BOX 7 AS A SECTION 170(B)(1)(A)(VI) IN ERROR. AS AN OUTPATIENT CLINIC, THE IRS DETERMINATION LETTER REPORTS THE ORGANIZATION DESCRIBED IN IRC SECTIONS 509(A)(1) AND 170(B)(1)(A)(III), THEREFORE, THE ORGANIZATION IS PROPERLY SELECTING BOX 3 FOR FYE23. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 109203 109203 5928942 1178514 4750428 1536773 544187 992586 884463 884463 6736680 OPERATING LEASE LIABILITY 914132 914132 X 24573486 0 24573486 0 24573486 23438601 0 23438601 0 23438601 PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION EVALUATES AND ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH FASB ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES (FORMERLY FASB INTERPRETATION 48 (FIN 48) ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES). THIS STANDARD REQUIRES CERTAIN DISCLOSURES ABOUT UNCERTAIN INCOME TAX POSITIONS. THE ORGANIZATION EVALUATES ANY UNCERTAIN TAX POSITIONS USING THE PROVISIONS OF ASC 450, CONTINGENCIES. AS A RESULT, MANAGEMENT DOES NOT BELIEVE THAT ANY UNCERTAIN TAX POSITIONS CURRENTLY EXIST AND NO LOSS CONTINGENCY HAS BEEN RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE ORGANIZATION HAS FILED ALL APPLICABLE TAX RETURNS. THE ORGANIZATION'S FORMS 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, FOR THE YEARS ENDED 2021, 2022, AND 2023 ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. X X X X 0 0 0 0 0 0 0 0 0 NICHOLAS LUZIETTI OBGYN PHYSICIAN 338366 0 750 0 0 0 16275 0 25994 0 381385 0 0 0 JOSEPHINE PORTER CHIEF MEDICAL OFFICER/OBGYN PHYSICIA 351915 0 750 0 0 0 15138 0 12399 0 380202 0 0 0 ZAREH KHACHIKIAN OBGYN PHYSICIAN 318532 0 750 0 0 0 0 0 17895 0 337177 0 0 0 RACHEL EVERSON OBGYN PHYSICIAN 287758 0 750 0 0 0 14556 0 26475 0 329539 0 0 0 RABIAH ZAFAR OBGYN PHYSICIAN 291241 0 750 0 0 0 0 0 6581 0 298572 0 0 0 AMBER COOK FAMILY MEDICINE PHYSICIAN 255452 0 750 0 0 0 10555 0 25994 0 292751 0 0 0 KRISTEN S HARRIS CHIEF EXECUTIVE OFFICER 221023 0 0 0 0 0 11269 0 25994 0 258286 0 0 0 LINDA ISABELL CHIEF OPERATING OFFICER 156127 0 750 0 0 0 6201 0 6581 0 169659 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE CEO AND CFO REVIEWS THE FEDERAL FORM 990 BEFORE SUBMITTING IT TO THE BOARD TO REVIEW. THE BOARD REVIEWS THE FEDERAL FORM 990 A WEEK BEFORE THE BOARD MEETING. ANY QUESTIONS THE BOARD MAY HAVE ARE THEN ADDRESSED AT THE BOARD MEETING. ONCE ALL QUESTIONS AND CONCERNS ARE ALLEVIATED, THEN A FORMAL MOTION IS MADE TO ACCEPT THE DOCUMENT SO IT CAN BE ELECTRONICALLY SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C WHEN WE BRING ON A NEW BOARD MEMBER, THE CEO GIVES THEM AN ORIENTATION. IT INCLUDES CONFLICT OF INTEREST TRAINING AND THE SIGNING OF A CONFLICT OF INTEREST DISCLOSURE STATEMENT. ANNUALLY, WE TRAIN THE BOARD OF DIRECTORS ON THE CONFLICT OF INTEREST POLICY AND THEY SIGN THE DISCLOSURE STATEMENT. WHEN THERE IS MATTER TO BE VOTED ON INVOLVING A POTENTIAL CONFLICT OF INTEREST, CEO KRISTEN HARRIS REQUESTS THE BOARD MEMBER RECUSE HIM/HERSELF FROM ANY DECISION-MAKING REGARDING THE ORGANIZATION OR INDIVIDUAL WITH THE POTENTIAL CONFLICT. THIS HAS OCCURRED SEVERAL TIMES AND ALL BOARD MEMBERS UNDERSTAND THEIR ROLES AND VOLUNTARILY RECUSE THEMSELVES. ANNUALLY WE TRAIN STAFF MEMBERS ON CONFLICT OF INTERESTS AS PART OF OUR CODE OF CONDUCT TRAINING. WE ASK THEM TO DISCLOSE ANY POTENTIAL CONFLICTS. IF ANYONE BELIEVES THERE IS AN UNDISCLOSED CONFLICT OF INTEREST, THEY MAY FILE AN INCIDENT REPORT FORM OR MAKE THE REPORT THROUGH LIGHTHOUSE SERVICES, OUR ANONYMOUS REPORTING SERVICE. FORM 990, PART VI, SECTION B, LINE 15A WE USE FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL OF THE BOARD GOVERNANCE COMMITTEE TO ESTABLISH COMPENSATION OF THE CEO. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: ACCOUNTING POLICY #1.45 PROVIDES THAT TFCC SHALL RESPOND TO REQUEST FOR INFORMATION PURSUANT TO IRC SECTION 301.6104(D). FORM 990, PART IX, LINE 11G FEES FOR PROFESSIONAL AND CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,956,320. MANAGEMENT AND GENERAL EXPENSES 705,213. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,661,533.