2022-10-09T21:41:23-05:00 2021-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2021-01-01 208998983 VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER INC VALL 7658281003 777 S MAIN STREET SUITE 100 CLINTON IN 47842 TERRY WARREN CEO 7658281003 2022-10-09 1 TERRY WARREN 999009999 ANGELA N CRAWFORD CPA P00573197 3176334705 2022-10-09 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z TERRY WARREN 777 S MAIN STREET SUITE 100 CLINTON IN 47842 30608577 0 X VALLEYPROHEALTH.ORG X 2007 IN VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER PROVIDES COMPREHENSIVE-INTEGRATED HEALTH CARE FOR ALL INDIVIDUALS AND FAMILIES, WHILE PROMOTING EDUCATIONAL OPPORTUNITIES. 15 15 280 15 0 0 6360016 8128805 18039714 22261947 16052 6830 104824 210995 24520606 30608577 0 0 0 0 15829267 17865956 0 0 0 6901660 8426687 22730927 26292643 1789679 4315934 18639670 23208599 8295610 8548605 10344060 14659994 VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER PROVIDES COMPREHENSIVE-INTEGRATED HEALTH CARE FOR ALL INDIVIDUALS AND FAMILIES, WHILE PROMOTING EDUCATIONAL OPPORTUNITIES. 0 0 16384406 14456063 TO PROVIDE PRIMARY HEALTH CARE AND RELATED SERVICES TO THOSE IN NEED OF MEDICAL CARE, INCLUDING THE MEDICALLY UNDER SERVED AND VULNERABLE POPULATIONS OF VERMILLION, PARKE, VIGO, AND MONTGOMERY COUNTIES IN INDIANA, WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY. 711576 3435854 SCHOOL BASED MOBILE CLINICS OFFERS SCHOOL-BASED PRIMARY CARE AND BEHAVIORAL HEALTH SERVICES MAKING IT EVEN EASIER TO ACCESS QUALITY AND AFFORDABLE HEALTH CARE. EVERY STUDENT IS ELIGIBLE TO RECEIVE HEALTH CARE SERVICES , WITHOUT REGARD TO THE ABILITY TO PAY. 3522229 4581025 THE 340B PHARMACEUTICALS PROGRAM PROVIDES REDUCED COST PRESCRIPTIONS TO QUALIFIED PATIENTS. 20618211 1 1 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 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 37 0 1 280 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X TERRY WARREN 7658321001 777 S MAIN ST 100 CLINTON IN 47842 MIKE MILLER PRESIDENT 1.00 X X 0 0 0 DOUGLAS FAUBER VICE PRESIDENT 1.00 X X 0 0 0 LOU BONOMO TREASURER 1.00 X X 0 0 0 MARY HELDERMAN SECRETARY 1.00 X X 0 0 0 KRISTIN CRAIG MEMBER 1.00 X 0 0 0 DAVE CHAPMAN MEMBER 1.00 X 0 0 0 JERRY HAWKINS MEMBER 1.00 X 0 0 0 CINDY HEIN MEMBER 1.00 X 0 0 0 LORETTA JOHNSON MEMBER 1.00 X 0 0 0 JACKIE MATHIS MEMBER 1.00 X 0 0 0 CHERYL MONTGOMERY MEMBER 1.00 X 0 0 0 JILL PASTORE MEMBER 1.00 X 0 0 0 MARK RUSSELL MEMBER-TERM BEGAN JAN'21 1.00 X 0 0 0 JEFF WILLIAMSON MEMBER 1.00 X 0 0 0 YALE YAGER MEMBER 1.00 X 0 0 0 DR STEVEN WALTZ VP & CMO 40.00 X 317300 0 28850 TERRY WARREN PRESIDENT & CEO 40.00 X 219205 0 21666 SCOTT ANDRITSCH VP & CFO 40.00 X 148905 0 18004 THOMAS MCFARLAND VP & COO-TERM ENDED JUL'21 40.00 X 115703 0 7812 TIFFANI MARTIN VP & CHIEF HR/LEGAL OFFICER 40.00 X 143457 0 17783 AMY REED VP MARKETING 40.00 X 104026 0 18597 STEPHANIE JEFFERY VP & CHIEF QUALITY OFFICER 40.00 X 137321 0 11795 DR JULIA WERNZ VP & CHIEF BEHAVIORAL HEALTH OFFICER 40.00 X 162042 0 19635 LORI MOON VP & COO-TERM BEGAN OCT'21 40.00 X 36521 0 773 CHRISTOPHER FITZSIMMONS PHYSICIAN 40.00 X 256396 0 14758 PAUL TARASKA PSYCHOLOGIST 40.00 X 254010 0 24908 BING GALE PHYSICIAN 40.00 X 235665 0 17112 DANIELLE CUNDIFF PHYSICIAN 40.00 X 228902 0 14937 ANGELA HATFIELD PHYSICIAN 40.00 X 211059 0 20999 2570512 0 237629 32 0 1 0 UNION HOSPITAL 1606 N 7TH STREET TERRE HAUTE IN 47804 NETWORK, RENT AND RESIDENCY PROGRAM COST 1214056 ECLINICAL WORKS PO BOX 847950 BOSTON MA 02284 SOFTWARE VENDOR 533745 CDI INC 600 WABASH AVENUE TERRE HAUTE IN 47807 GENERAL CONTRACTOR 313415 CHAD'S COMMUNICATION SOLUTION 15 HUNTER CT CLINTON IN 47842 IT AND NETWORK SUPPORT 296771 EXPERIAN HEALTH INC PO BOX 846133 LOS ANGELES CA 90084 SOFTWARE VENDOR 241516 8 7869824 258981 8128805 NET PATIENT SERVICE REVENUE 621300 17680922 17680922 PATIENT REVENUE-340B PHARMACY 900099 4581025 4581025 22261947 6830 6830 210995 210995 210995 30608577 22472942 0 6830 1529395 1279341 250054 12895443 10787057 2108386 455933 364713 91220 2005027 1603873 401154 980158 784054 196104 7980 1356 6624 47812 8125 39687 1831161 311180 1519981 241194 59769 181425 557371 311415 245956 651740 431643 220097 79922 19805 60117 115490 28619 86871 155665 155665 741944 645324 96620 94198 23343 70855 340B DISPENSING FEE 2674663 2674663 MEDICAL SUPPLIES 1035483 1028096 7387 DENTAL, RX AND PATIENT 69896 69896 DUES AND SUBSCRIPTIONS 67771 16794 50977 54397 13480 40917 26292643 20618211 5674432 0 64801 613712 4418667 8597634 601991 978430 176702 132626 16424111 3860312 10890557 12563799 2486952 322398 18639670 23208599 1156969 1499933 7087662 6178800 50979 869872 8295610 8548605 X 10206688 14317244 137372 342750 10344060 14659994 18639670 23208599 4315934 0 X X 0 1 X 1 1 1 X 4265470 4048623 5199729 6360016 8128805 28002643 4265470 4048623 5199729 6360016 8128805 28002643 28002643 194 166 13900 16052 6830 37142 190319 228394 133708 104824 210995 868240 28908025 85740605 0.96870 0.96920 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2017 AMOUNT: $ 190,319. 2018 AMOUNT: $ 228,394. 2019 AMOUNT: $ 133,708. 2020 AMOUNT: $ 104,824. 2021 AMOUNT: $ 210,995. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 145752 145752 4772365 539268 4233097 7011129 1408464 5602665 3993401 1912580 2080821 501464 501464 12563799 DUE TO UNION HOSPITAL, INC. 2062 DEFERRED RENT OBLIGATION 152581 ESTIMATED THIRD-PARTY SETTLEMENTS 715229 869872 X 27086348 -3522229 -3522229 30608577 0 30608577 22770414 0 22770414 3522229 3522229 26292643 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CENTER AND RECOGNIZE A TAX LIABILITY IF THE CENTER HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2021 AND 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: 340B EXPENSES -3,522,229. PART XII, LINE 4B - OTHER ADJUSTMENTS: 340B EXPENSES 3,522,229. X X X X X 0 0 0 0 0 1 0 0 0 DR STEVEN WALTZ VP & CMO 308050 0 9250 0 0 0 17134 0 11716 0 346150 0 0 0 PAUL TARASKA PSYCHOLOGIST 248760 0 5250 0 0 0 15434 0 9474 0 278918 0 0 0 CHRISTOPHER FITZSIMMONS PHYSICIAN 247146 0 9250 0 0 0 14338 0 420 0 271154 0 0 0 BING GALE PHYSICIAN 227665 0 8000 0 0 0 13799 0 3313 0 252777 0 0 0 DANIELLE CUNDIFF PHYSICIAN 220652 0 8250 0 0 0 13108 0 1829 0 243839 0 0 0 TERRY WARREN PRESIDENT & CEO 198701 0 20504 0 0 0 12417 0 9249 0 240871 0 0 0 ANGELA HATFIELD PHYSICIAN 202059 0 9000 0 0 0 12569 0 8430 0 232058 0 0 0 DR JULIA WERNZ VP & CHIEF BEHAVIORAL HEALTH OFFICER 152042 0 10000 0 0 0 9610 0 10025 0 181677 0 0 0 SCOTT ANDRITSCH VP & CFO 138905 0 10000 0 0 0 8774 0 9230 0 166909 0 0 0 TIFFANI MARTIN VP & CHIEF HR/LEGAL OFFICER 133457 0 10000 0 0 0 8453 0 9330 0 161240 0 0 0 PART I, LINE 6 END OF YEAR BONUSES WERE CONTINGENT ON NET EARNINGS OF THE CENTER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WILL BE PRESENTED TO THE FINANCE COMMITTEE AND RECOMMENDED TO BE PUT BEFORE THE BOARD. AT THE FOLLOWING BOARD MEETING, THE 990 WILL BE PRESENTED AND VOTED ON BY THE BOARD OF DIRECTORS. WHEN APPROVED, THE 990 WILL BE FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CEO WITH THE ASSISTANCE OF OTHER KEY STAFF WILL INVESTIGATE ANY CONCERN REGARDING A CONFLICT BREACH. THE RESULTS WILL BE PRESENTED TO THE KEY STAFF AND BOARD. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE CEO WAS DETERMINED AND COMPLETED BY THE ENTIRE BOARD OF DIRECTORS. THE BOARD CHAIR LED THESE EFFORTS. ANNUAL REVIEW IS PERFORMED BY THE BOARD. EMPLOYEE EVALUATIONS ARE REVIEWED AND PREPARED BY THE CEO ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. VALLEY PROFESSIONALS REALTY LLC 777 S MAIN ST STE 100 CLINTON IN 47842 HOLDING COMPANY IN 94560 4768635 VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER INC