2020-11-16T13:25:32-06:00 2019-12-31 742900215 MAXWELL LOCKE & RITTER LLP 401 CONGRESS AVENUE SUITE 1100 AUSTIN TX 787019682 990 2019-01-01 742865171 GEORGETOWN HEALTHCARE COMMUNITY SERVICES GEOR 5129312221 2425 WILLIAMS DRIVE NO 101 GEORGETOWN TX 786283206 SCOTT ALARCON CEO 5129312221 2020-11-14 1 SEAN HOLCOMB P01249221 5123703200 2020-11-14 168.215.174.114 2020-11-14 11:18:43 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 756F3E812B54EFE2FB3A1EFCD71C893746B6C6A5 2019 2021-01-29 14:40:06Z SCOTT ALARCON 2425 WILLIAMS DRIVE NO 101 GEORGETOWN TX 786283206 3068817 0 X N/A X 1997 TX THE ORGANIZATION ASSISTS GEORGETOWN HEALTHCARE SYSTEM IN ITS EFFORTS TO IMPROVE THE SOCIAL DETERMINANTS OF HEALTH IN OUR LOCAL COMMUNITY. THE ORGANIZATION ASSISTS GEORGETOWN HEALTHCARE SYSTEM IN THEIR WORK WITH OTHER NON-PROFT ORGANIZATIONS. TOGETHER, OUR TWO ORGANIZATIONS PROVIDE FOR THE UNMET NEEDS OF OUR COMMUNITY, IN PART, BY OFFERING SPACE TO NON-PROFIT ORGANIZATIONS AT SUBSTANTIALLY LESS THAN FAIR MARKET VALUE. ADDITIONALLY, OUR TWO ORGANIZATIONS HAVE COLLABORATED WITH A LOCAL FEDERALLY QUALIFIED HEALTH CENTER TO CREATE A ONE STOP MEDICAL HOME FOR THE UNINSURED AND UNDERINSURED COMMUNITY POPULATION. 13 13 0 0 0 0 0 0 1600746 1646622 5956 4380 238670 174750 1845372 1825752 388826 922400 0 0 0 0 0 0 0 1065453 1062851 1454279 1985251 391093 -159499 12994049 12075966 10884130 10126747 2109919 1949219 X THE ORGANIZATION ASSISTS GEORGETOWN HEALTHCARE SYSTEM IN ITS EFFORTS TO IMPROVE THE SOCIAL DETERMINANTS OF HEALTH IN OUR LOCAL COMMUNITY. THE ORGANIZATION ASSISTS GEORGETOWN HEALTHCARE SYSTEM IN THEIR WORK WITH OTHER NON-PROFT ORGANIZATIONS. TOGETHER, OUR TWO ORGANIZATIONS PROVIDE FOR THE UNMET NEEDS OF OUR COMMUNITY, IN PART, BY OFFERING SPACE TO NON-PROFIT ORGANIZATIONS AT SUBSTANTIALLY LESS THAN FAIR MARKET VALUE. ADDITIONALLY, OUR TWO ORGANIZATIONS HAVE COLLABORATED WITH A LOCAL FEDERALLY QUALIFIED HEALTH CENTER TO CREATE A ONE STOP MEDICAL HOME FOR THE UNINSURED AND UNDERINSURED COMMUNITY POPULATION. 0 0 1861416 922400 1646622 UTILIZE REAL ESTATE HOLDINGS TO ASSIST OTHER COMMUNITY NON-PROFIT ORGANIZATIONS THAT PROVIDE SAFETY NET SERVICES FOR THE GEORGETOWN COMMUNITY BY PROVIDING LEASE SPACE AT LESS THAN FAIR MARKET VALUE. 51628 EXPENSES RELATED TO THE MANAGEMENT OF ASSETS HELD BY THE ORGANIZATION AND UTILIZED TO FURTHER THE GRANT MAKING ACTIVITIES OF GEORGETOWN HEALTHCARE SYSTEM. 1913044 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 33 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X SAM SCHULTZ CFO 5129312221 2425 WILLIAMS DRIVE NO 101 GEORGETOWN TX 786283206 ALMA MOLLEUR CHAIR 2.00 X 0 0 0 JIM DONOVAN MD CHAIR-ELECT 1.50 X 0 0 0 DARRICK MCGILL PAST CHAIR 1.50 X 0 0 0 D SCOTT MATTHEW SECRETARY 1.50 X 0 0 0 ASHLIE KOENIG BOARD MEMBER 1.50 X 0 0 0 J BRAD CURLEE BOARD MEMBER 1.00 X 0 0 0 TIM HARRIS BOARD MEMBER 1.00 X 0 0 0 CINDY LOCKE BOARD MEMBER 1.00 X 0 0 0 STACEY MATHEWS BOARD MEMBER 1.00 X 0 0 0 SOFIA NELSON BOARD MEMBER 1.00 X 0 0 0 BRADLEY SMITH BOARD MEMBER 1.00 X 0 0 0 JOHN STOCK BOARD MEMBER 1.00 X 0 0 0 STEVE WEST BOARD MEMBER 1.00 X 0 0 0 M SCOTT ALARCON CEO 40.00 X 0 318573 25341 RICHARD SCHULTZ CFO 40.00 X 0 265104 27848 0 583677 53189 0 0 1 0 0 FACILITY RENTAL TO COMM HEALTH SE 900099 1646622 1646622 1646622 4380 4380 1417815 1243065 174750 174750 174750 1825752 1646622 0 179130 922400 922400 14628 14628 1385 942 443 391710 376990 14720 651035 594134 56901 4093 3950 143 1985251 1913044 72207 0 243050 460976 82412 59390 46472 64999 26854664 15364063 12622115 11490601 12994049 12075966 481631 523474 3223629 2824403 7178870 6778870 10884130 10126747 X 2109919 1949219 2109919 1949219 12994049 12075966 X -159499 -1201 X X 0 1 X 1 0 X X 1 GEORGETOWN HEALTHCARE SYSTEM INC 742427148 3 1 600000 0 1 600000 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2607577 2607577 23766549 15093985 8672564 271258 149372 121886 130125 120706 9419 79155 79155 11490601 DUE TO AFFILIATED ENTITIES 6778870 6778870 X PART X, LINE 2: GEORGETOWN HEALTHCARE SYSTEM, INC. ("GHS") AND GEORGETOWN HEALTHCARE COMMUNITY SERVICES ("GHCS") ARE NONPROFIT ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT TO THE EXTENT OF ANY UNRELATED BUSINESS INCOME. NO EXPENSE HAS BEEN PROVIDED FOR INCOME TAXES IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS; HOWEVER, THERE MAY BE IMMATERIAL TAXES DUE TO DEBT FINANCED PRIVATE PURPOSE ACTIVITIES, THAT MANAGEMENT HAS ELECTED NOT TO RECORD AS A LIABILITY. GHS AND GHCS DID NOT INCUR ANY SIGNIFICANT TAX LIABILITIES DUE TO UNRELATED BUSINESS INCOME DURING THE YEARS ENDED DECEMBER 31, 2019 OR 2018. GHS AND GHCS FILE FORM 990 TAX RETURNS IN THE U.S. FEDERAL JURISDICTION, AND ARE SUBJECT TO ROUTINE EXAMINATIONS OF THEIR RETURNS. 1 GEORGETOWN HEALTHCARE SYSTEM 2425 WILLIAMS DR SUITE 101 GEORGETOWN TX 78628 742427148 501(C)(3) 600000 TO PROVIDE ASSISTANCE TO ACHIEVE ORGANIZATION MISSION BLUEBONNET TRAILS COMMUNITY MHMR CENTER 711 N COLLEGE GEORGETOWN TX 78628 742795332 170 227400 TO PROVIDE ASSISTANCE TO ACHIEVE ORGANIZATION MISSION OVERTON INDEPENDENT SCHOOL DISTRICT (OISD) 111 E MCKAY OVERTON TX 75684 756002177 170 95000 TO PROVIDE ASSISTANCE TO ACHIEVE ORGANIZATION MISSION 3 PART I, LINE 2: THE FUNDS THIS ORGANIZATION PROVIDED TO GEORGETOWN HEALTHCARE SYSTEM (GHS) WERE USED TO AUGMENT THAT ORGANIZATION'S GRANT ACTIVITIES. THE GRANT PROCESS IMPLEMENTED BY GHS MONITORS THE USE OF GRANT FUNDS BY REQUIRING ANY GRANTEES RECEIVING IN EXCESS OF $10,000 TO PROVIDE INTERIM AND FINAL REPORTS WITHIN THEIR GRANT PERIOD. GRANT PERIODS ARE TYPICALLY 1-2 YEARS IN DURATION. THE REPORTS MUST IDENTIFY PROGRAM GOALS AND OUTCOME MEASUREMENTS. GRANT APPLICANTS SEEKING FUNDS IN EXCESS OF $10,000 ARE REQUIRED TO SUBMIT FINANCIAL STATEMENTS AS PART OF THE APPLICATION PROCESS AND MUST SUBMIT CURRENT FINANCIAL STATEMENTS AS PART OF THEIR INTERIM AND FINAL REPORTS. SCHEDULE I, PART II, LINE 1, COMMUNITY SUPPORT: IN 2018, THE TEXAS HEALTH AND HUMAN SERVICES COMMISSION AWARDED HB 13 FUNDS TO BLUEBONNET TRAILS COMMUNITY SERVICES (BTCS) TO SUPPORT SYSTEMS OF CARE FOSTERING COLLABORATIONS AMONG COMMUNITY PARTNERS IN EXPANDING ACCESS TO HEALTHCARE SERVICES. THE LEGISLATION REQUIRED DEMONSTRATION OF A 50% MATCH FROM THE COMMUNITY SUPPORTING STATE DOLLARS. IN 2019, THE REPORTING ORGANIZATION PROVIDED A GRANT TO BTCS WHICH HAS ENABLED THEM TO SECURE THE MATCHING FUNDS. IN DOING SO, BTCS HAS EXPANDED THE USE OF ITS CRISIS RESPITE UNIT, WHICH IN TURN HAS ENABLED THEM TO EXPAND SERVICES FOR FAMILIES IN WILLIAMSON COUNTY. COMMUNITY RESOURCES NOW AVAILABLE AT THIS LOCATION INCLUDE: 12 BEDS FOR INDIVIDUALS MANAGING MENTAL HEALTH CHALLENGES THAT REQUIRE COUNSELING, MEDICATION MANAGEMENT, EMPLOYMENT SERVICES, AND SKILLS BUILDING WITH SUPPORT FROM CERTIFIED PEERS AND LICENSED PROFESSIONALS. AVERAGE LENGTH OF STAY: 3-20 DAYS. 4 BEDS DEDICATED TO PERSONS BENEFITTING FROM DETOXIFICATION FROM SUBSTANCE ABUSE ADDICTIONS. AVERAGE LENGTH OF STAY: 24 HOURS-5 DAYS. 750 SQUARE FEET FOR AN INTENSIVE OUTPATIENT PROGRAM FOR YOUTH AND ADULTS. AVERAGE LENGTH OF OUTPATIENT TREATMENT: 8-12 WEEKS. 13 OFFICES FOR LICENSED COUNSELORS, CERTIFIED PEER SPECIALISTS, EMPLOYMENT SPECIALISTS, QUALIFIED MENTAL HEALTH PROFESSIONALS, LICENSED CRISIS STAFF, ADVANCE NURSE PRACTITIONER, AND PSYCHIATRIST. IN 2019, THE REPORTING ORGANIZATION ENTERED INTO AN AGREEMENT WITH THE OVERTON, TX INDEPENDENT SCHOOL DISTRICT TO CREATE A CAREER AND TECHNOLOGY CENTER FOR HIGH SCHOOL STUDENTS. THE DISTRICT CREATED AN INTER-LOCAL AGREEMENT WITH FOUR OTHER AREA SCHOOL DISTRICTS; ARP, WEST RUSK, LEVERETTS CHAPEL, AND CARLISLE. THROUGH A GRANT PROVIDED BY THE REPORTING ORGANIZATION THESE SCHOOL DISTRICTS WERE ABLE TO LEASE A FACILITY AND CONSOLIDATE THE CAREER AND TECHNOLOGY COURSE OFFERINGS TO THEIR COMBINED STUDENT POPULATION. ADDITIONALLY, BY WAY OF THE INTER-LOCAL AGREEMENT, THE DISTRICTS WERE ABLE TO PARTNER WITH KILGORE COLLEGE AND THE UNIVERSITY OF TEXAS AT TYLER TO PROVIDE ON SITE DUAL CREDIT COURSE INSTUCTORS FOR THEIR STUDENTS. THE SCHOOL DISTRICTS IN THE INTER-LOCAL AGREEMENT SERVE A RURAL, AND UNDERPRIVLEDGED DEMOGRAPHIC. AS A RESULT OF THIS NEW CENTER, APPROXIMATELY 100 STUDENTS ARE ENROLLED IN EITHER DUAL CREDIT COLLEGE COURSES OR COURSES THAT WILL ENABLE THEM TO FIND EMPLOYMENT IMMEDIATELY UPON GRADUATION IN CAREERS THAT PAY A LIVING WAGE. 0 0 0 0 0 0 0 0 0 M SCOTT ALARCON CEO 0 311073 0 0 0 7500 0 15383 0 9958 0 343914 0 0 RICHARD SCHULTZ CFO 0 257904 0 0 0 7200 0 12079 0 15769 0 292952 0 0 PART I, LINE 3 GEORGETOWN HEALTHCARE COMMUNITY SERVICES DOES NOT HAVE EMPLOYEES, BUT IS ADMINISTERED AND RUN BY EMPLOYEES OF GEORGETOWN HEALTHCARE SYSTEM, INC. SCHEDULE J, PART II, ROW (II): RELATED ORGANIZATION: GEORGETOWN HEALTHCARE SYSTEM, INC. 74-2427148 FORM 990, PART VI, SECTION A, LINE 7A THE GOVERNING BOARD OF DIRECTORS OF THE REPORTING ORGANIZATION IS APPOINTED BY THE BOARD OF DIRECTORS OF GEORGETOWN HEALTHCARE SYSTEM, WHICH IS THE SUPPORTED ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S TAX RETURN IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. AN INITIAL DRAFT OF THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS AND MANAGEMENT PRIOR TO FINALIZATION. AFTER ANY CHANGES RESULTING FROM THE REVIEW HAVE BEEN MADE, THE FINAL VERSION OF FORM 990 IS FILED AND A COPY OF THE FILED FORM IS DISTRIBUTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S BOARD OF DIRECTORS AND KEY EMPLOYEES REVIEW THE CONFLICT OF INTEREST POLICY ANNUALLY. EACH INDIVIDUAL IS REQUIRED TO COMPLETE AND SIGN A DOCUMENT PROVIDED BY THE ORGANIZATION DISCLOSING ANY INTEREST THEY MAY HAVE WHICH COULD GIVE RISE TO A CONFLICT OF INTEREST. THE ORGANIZATION COMPILES A LIST OF ALL DISCLOSURES AND REPORTS IT TO ALL MEMBERS OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 GEORGETOWN HEALTHCARE COMMUNITY SERVICES DOES NOT HAVE EMPLOYEES, BUT IS ADMINISTERED AND RUN BY EMPLOYEES OF GEORGETOWN HEALTHCARE SYSTEM (GHS). THE COMPENSATION COMMITTEE OF GHS FOLLOWS AN EXECUTIVE COMPENSATION PLAN DEVELOPED AND RATIFIED BY THE GHS BOARD WHEN DETERMINING ANNUAL COMPENSATION OF THE GHS CHIEF EXECUTIVE. THIS PHILOSOPHY IS UTILIZED TO DETERMINE THE ANNUAL COMPENSATION OF THE CHIEF EXECUTIVE OFFICER (CEO) AND THE CHIEF FINANCIAL OFFICER (CFO). AS PART OF THIS PROCESS, THE GHS BOARD CONTRACTED WITH SMITHPILOT IN 2019 TO ASSIST IN THE DEVELOPMENT OF FAIR MARKET VALUE EXECUTIVE COMPENSATION. SMITHPILOT IS A COMPANY THAT SPECIALIZES IN EXECUTIVE COMPENSATION ISSUES IN THE NON-PROFIT AREA. SMITHPILOT CREATED AN EXECUTIVE COMPENSATION GUIDELINE FOR THE GHS CEO AND CFO USING COMPARATIVE DATA FROM MULTIPLE NATIONAL PUBLIC INFORMATION SECTORS. THOSE SOURCES INCLUDED: THE GUIDESTAR NONPROFIT COMPENSATION REPORT, PRM'S MANAGEMENT COMPENSATION REPORT FOR NOT-FOR-PROFIT ORGANIZATIONS, COUNCIL ON FOUNDATIONS, GRANTMAKERS SALARY AND BENEFITS SURVEY AND REPORT, INSIDENGO SALARY AND BENEFITS SURVEY AND TOWERS WATSON'S SURVEYS OF TOP MANAGEMENT COMPENSATION; OFFICE AND BUSINESS SUPPORT. MARKET SALARY AVERAGES (GEOGRAPHICALLY FACTORED) FOR BOTH THE GHS CEO AND CFO WERE ESTABLISHED USING THIS DATA. THE GHS COMPENSATION COMMITTEE'S RECOMMENDATIONS FOR THE GHS CEO AND CFO WERE RATIFIED BY THE FULL BOARD OF GEORGETOWN HEALTHCARE SYSTEM. FORM 990, PART VI, SECTION C, LINE 19 THE REPORTING ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: UNREALIZED GAIN/-LOSS ON INTEREST RATE SWAP -1,201. FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S OVERSIGHT PROCESS AND ITS PROCESS FOR SELECTION OF AN INDEPENDENT ACCOUNTANT DID NOT CHANGE DURING THE TAX YEAR. GEORGETOWN HEALTHCARE SYSTEM 2425 WILLIAMS DRIVE GEORGETOWN TX 78628 742427148 HOSPITAL TX 501(C)(3) LINE 3 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0