2023-08-16T07:06:23-05:00 2022-12-31 351307701 KRUGGEL LAWTON & COMPANY LLC 317 W FRANKLIN ST ELKHART IN 46516 990 2022-01-01 351749398 MAPLE CITY HEALTH CARE CENTER INC MAPL 5745343300 213 MIDDLEBURY ST GOSHEN IN 465282956 JAIME ALVAREZ DIRECTOR OF FINANCE 5745343300 2023-08-10 1 JAIME ALVAREZ 999009999 1 MARGENE ZINK P01222961 5742642247 2023-08-10 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z VISTA COMMUNITY HC NORTHSIDE COMMUNITY HC AND MAPLE CITY DENTAL JAIME ALVAREZ 213 MIDDLEBURY ST GOSHEN IN 465282956 10047304 0 X WWW.MCHCC.ORG X 1988 IN THE MISSION OF MAPLE CITY HEALTH CARE CENTER IS TO FOSTER HEALTHY COMMUNITY IN OUR NEIGHBORHOODS BY PROVIDING AND PROMOTING AFFORDABLE, ACCESSIBLE, AND INTEGRATED QUALITY CARE, AND TO ARTICULATE AND PROMOTE OUR EXPERIENCE AS A SUSTAINABLE MODEL. 10 10 137 4 0 0 7599658 4612199 4499584 5420321 5669 6203 7000 8581 12111911 10047304 5000 5000 0 0 7729491 7893821 0 0 0 2748059 2784048 10482550 10682869 1629361 -635565 5934046 5367814 982148 1051481 4951898 4316333 THE MISSION OF MAPLE CITY HEALTH CARE CENTER IS TO FOSTER HEALTHY COMMUNITY IN OUR NEIGHBORHOODS BY PROVIDING AND PROMOTING AFFORDABLE, ACCESSIBLE, AND INTEGRATED QUALITY CARE, AND TO ARTICULATE AND PROMOTE OUR EXPERIENCE AS A SUSTAINABLE MODEL. 0 0 8592091 5000 5428902 FOSTERING HEALTHY COMMUNITY IN OUR NEIGHBORHOODS BY PROVIDING AND PROMOTING AFFORDABLE, ACCESSIBLE, AND INTEGRATED QUALITY CARE. WE PROVIDE MEDICAL, BEHAVIOR HEALTH, DENTAL, VISION, AND SOCIAL SERVICES. 8592091 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 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 1 1 0 0 0 1 9 0 137 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X KAREN MILLER RUSH 5745343300 213 MIDDLEBURY ST GOSHEN IN 46528 ADAM SCHARF TREASURER 1.00 X X 0 0 5640 MIGUEL MILLAN BOARD MEMBER 1.00 X 0 0 536 IRMA PEREZ BOARD MEMBER 1.00 X 0 0 1330 JENNY MARTINEZ SECRETARY 1.00 X X 0 0 0 ROEL CERVANTES BOARD MEMBER 1.00 X 0 0 60 DENICE METTERT BOARD MEMBER 1.00 X 0 0 60 KEVIN FARMWALD BOARD MEMBER 1.00 X 0 0 1595 SARAH METZLER PRESIDENT 2.00 X X 0 0 25 YEIMI PEREZ GARCIA BOARD MEMBER 1.00 X 0 0 3877 MAX MERTZ VICE PRESIDENT 1.00 X X 0 0 0 KAREN MILLER RUSH DIRECTOR OF FINANCE 42.00 X 76191 0 15253 CHARLENE MAST INTERIM EXECUTIVE DIRECTOR 45.00 X 94887 0 20802 PAUL SHETLER FAST EXECUTIVE DIRECTOR 45.00 X 23483 0 3172 STEPHEN HARMON GUARDIAN OF MEDICAL SERVICE 45.00 X 159454 0 25819 ANNA GRADY DOCTOR 45.00 X 120291 0 25237 THOMAS KREIDER PSYCHIATRIST 40.00 X 140092 0 20584 REBECCA JOHNSON NURSE MIDWIFE 45.00 X 107435 0 9337 721833 0 133327 4 0 1 0 MG TRUST COMPANY PO BOX 3144 MOBILE AL 36652 RETIREMENT BENEFITS 806831 OCHIN INC 1881 SW NAITO PARKWAY PORTLAND OR 97201 ELECTRONIC MEDICAL RECORD SYSTEM 449717 MCKESSON MEDICAL SURGICAL PO BOX 634404 CINCINNATI OH 452634404 MEDICINE, VACCINES & MISC MEDICAL SUPPLI 250781 3 3867107 745092 550941 4612199 NET PATIENT SERVICE FEES 621400 5173269 5173269 PHARMACY 621400 169143 169143 MHS CONTRACTS 621400 67080 67080 CAPITATION 621400 10829 10829 5420321 6203 6203 MISC. REVENUE-RELATED-990 621110 8581 8581 8581 10047304 5428902 0 6203 5000 5000 233787 233787 5548958 4370343 1178615 433957 341646 92311 1255829 992388 263441 421290 334838 86452 37766 37766 27641 27641 149774 149774 124227 83171 41056 743964 591297 152667 166508 150166 16342 69734 61631 8103 8428 8428 167804 150689 17115 17640 17640 MEDICAL SUPPLIES 635751 635751 VACCINES 550941 550941 PROFESSIONAL DUES 53933 42866 11067 MISCELLANEOUS PATIENT S 29937 29937 10682869 8592091 2090778 0 112741 229553 1302580 504805 120855 32288 867447 1297400 136456 110479 211736 102138 4159519 1068368 3182231 3091151 5934046 5367814 759813 845714 222335 205767 982148 1051481 X 4951898 4316333 4951898 4316333 5934046 5367814 -635565 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 440827 440827 2013670 222889 1790781 766352 375321 391031 510320 282654 227666 428350 187504 240846 3091151 X 10054842 7538 7538 10047304 0 10047304 10690407 7538 7538 10682869 0 10682869 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 INTERNAL REVENUE SERVICE (IRS) HAS DETERMINED THAT THE ORGANIZATION IS NOT A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A). THE INCOME TAXES TOPIC, FASB ASC 740, CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. ASC 740 REQUIRES AN ENTITY TO DISCLOSE THE NATURE OF UNCERTAIN TAX POSITIONS TAKEN, IF ANY, WHEN FILING ITS INCOME TAX RETURN UTILIZING A TWO-STEP PROCESS TO RECOGNIZE AND MEASURE ANY UNCERTAIN TAX POSITIONS TAKEN. THE ENTITY RECOGNIZES A TAX BENEFIT ONLY IF IT IS MORE LIKELY THAN NOT THE POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. NO TAX BENEFIT WILL BE RECORDED ON TAX POSITIONS NOT MEETING THE MORE LIKELY THAN NOT TEST. INTEREST AND PENALTIES ACCRUED OR INCURRED, IF ANY, AS A RESULT OF APPLYING ASC 740 WILL BE RECORDED TO INTEREST EXPENSE AND OTHER EXPENSE, RESPECTIVELY. BASED ON ITS EVALUATION, THE ORGANIZATION HAS CONCLUDED THAT THERE ARE NO UNCERTAIN TAX POSITIONS REQUIRING RECOGNITION IN ITS FINANCIAL STATEMENTS. THE ORGANIZATION'S EVALUATION WAS PERFORMED FOR ALL FEDERAL AND STATE TAX PERIODS STILL SUBJECT TO EXAMINATION. THE ORGANIZATION'S 2019 THROUGH 2021 FEDERAL AND STATE EXEMPT ORGANIZATION RETURNS REMAIN SUBJECT TO EXAMINATION BY THE IRS AND STATE TAXING AUTHORITIES. X 0 0 0 0 0 0 0 0 0 STEPHEN HARMON GUARDIAN OF MEDICAL SERVICE 159454 0 0 0 0 0 0 0 25819 0 185273 0 0 0 THOMAS KREIDER PSYCHIATRIST 140092 0 0 0 0 0 0 0 20584 0 160676 0 0 0 PART I, LINE 3 THE GUARDIAN OF MEDICAL SERVICE'S COMPENSATION IS SET USING THE SAME STANDARD MCHCC / VCHC WAGE SCALE USED FOR ESTABLISHING COMPENSATION FOR ALL OF OUR STAFF. THIS WAGE SCALE FACTORS IN: EDUCATION AND TRAINING, EXPERIENCE, LANGUAGE, CALL (IF APPLICABLE) AND MOST IMPORTANTLY RESPONSIBILITY LEVEL. EACH FACTOR IS ASSIGNED A POINT VALUE WHICH THEN TRANSLATES INTO HOURLY WAGE AMOUNTS. ALL NEW STAFF LEVELS ARE EVALUATED BY TWO STAFF MEMBERS AND A WRITTEN EMPLOYMENT CONTRACT IS ISSUED. IN SUBSEQUENT YEARS, ALL STAFF RECEIVE A LETTER INDICATING THEIR ANNUAL PAY INCREASE. ANNUAL INCREASES ARE BASED ON EXPERIENCE RAISES AND ANNUAL COST OF LIVING RAISES. X 12 550941 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S MEMBERSHIP INCLUDES HEALTH CARE CENTER STAFF AND PATIENTS AND IS OPEN TO ANYONE ELSE INTERESTED IN FURTHERING THE PURPOSE OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS ON THE BOARD OF DIRECTORS APPOINT NEW MEMBERS TO THE BOARD OF DIRECTORS AFTER A CONSULTATION PROCESS. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE FORM 990 IS EMAILED TO BOARD MEMBERS BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS REVIEWS CONFLICTS OF INTEREST ANNUALLY. STAFF IS MADE AWARE OF THE POLICY AND IN RELEVANT SITUATIONS, THE POLICY IS REVIEWED. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS A POINT SYSTEM TO DETERMINE SALARY LEVELS FOR ALL STAFF INCLUDING ALL MANAGEMENT PERSONNEL. THE POINT SYSTEM IS BASED ON: EDUCATION, EXPERIENCE, LANGUAGE ABILITY, RESPONSIBILITY LEVEL, AND WHETHER OR NOT THEY HAVE CALL RESPONSIBILITIES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PAGE 12, LINE 2C THE ORGANIZATION DOES HAVE A COMMITTEE THAT OVERSEES THE FINANCIAL STATEMENT PREPARATION PROCESS AND THE SELECTION OF EXTERNAL ACCOUNTANTS. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. NORTHSIDE COMMUNITY HEALTH CENTER INC 808 NORTH THIRD STREET GOSHEN IN 46528 473368774 TO PROVIDE HEALTH CARE IN THE GOSHEN, INDIANA COMMUNITY IN 501(C)(3) LINE 3 MAPLE CITY HEALTH CARE CENTER INC DBA VISTA COMMUNITY HEALTH CENTER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0