2020-11-03T17:03:40-06:00 2019-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2019-01-01 208998983 VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER INC VALL 7658281003 777 S MAIN STREET SUITE 100 CLINTON IN 47842 TERRY WARREN CEO 7658281003 2020-10-25 1 ANGELA N CRAWFORD CPA P00573197 3176334705 2020-10-25 184.170.167.139 2020-10-25 15:53:07 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AF923E04E140C4DE71FD41AF2127CF5344A3E036 2019 2021-01-29 14:40:06Z TERRY WARREN 777 S MAIN STREET SUITE 100 CLINTON IN 47842 23137228 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. 14 14 225 0 0 0 3940818 5199729 10794339 17789891 166 13900 2824373 133708 17559696 23137228 0 0 0 0 12790641 14436668 0 0 0 5691612 6633538 18482253 21070206 -922557 2067022 9808527 12448551 3321168 3894170 6487359 8554381 VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER PROVIDES COMPREHENSIVE-INTEGRATED HEALTH CARE FOR ALL INDIVIDUALS AND FAMILIES, WHILE PROMOTING EDUCATIONAL OPPORTUNITIES. 0 0 13935252 13833906 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. 685865 610881 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. 2158041 3478812 THE 340B PHARMACEUTICALS PROGRAM PROVIDES REDUCED COST PRESCRIPTIONS TO QUALIFIED PATIENTS. 16779158 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 38 0 1 225 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 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 0.00 X X 0 0 0 DOUGLAS FAUBER VICE PRESIDENT 1.00 0.00 X X 0 0 0 LOU BONOMO TREASURER 1.00 0.00 X X 0 0 0 MARY HELDERMAN SECRETARY 1.00 0.00 X X 0 0 0 JON BEARDSLEY MEMBER 1.00 0.00 X 0 0 0 DAVE CHAPMAN MEMBER 1.00 0.00 X 0 0 0 JERRY HAWKINS MEMBER 1.00 0.00 X 0 0 0 CINDY HEIN MEMBER 1.00 0.00 X 0 0 0 JACKIE MATHIS MEMBER 1.00 0.00 X 0 0 0 JEFF WILLIAMSON MEMBER 1.00 0.00 X 0 0 0 YALE YAGER MEMBER 1.00 0.00 X 0 0 0 DIANA CAROLE HART MEMBER 1.00 0.00 X 0 0 0 GREG HARBISON MEMBER 1.00 0.00 X 0 0 0 THOM FRANTZ TREASURER 1.00 0.00 X X 0 0 0 DR STEVEN WALTZ CMO 40.00 0.00 X 314102 0 18056 TERRY WARREN CEO 40.00 0.00 X 197602 0 14041 SCOTT ANDRITSCH CFO 40.00 0.00 X 129328 0 5087 THOMAS MCFARLAND COO 40.00 0.00 X 112851 0 4783 TIFFANI MARTIN DIRECTOR OF HR & COMPLIANCE 40.00 0.00 X 110846 0 8876 AMY REED DIRECTOR OF DEVELOPMENT 40.00 0.00 X 73997 0 10916 NICOLE HALL NP, DIRECTOR OF CLINICAL PROGRAMS 40.00 0.00 X 151373 0 4381 STEPHANIE JEFFERY DIRECTOR OF QUALITY 40.00 0.00 X 99016 0 5940 DR JULIA WERNZ PSYCHOLOGIST, DIRECTOR OF BEH. HEALTH 40.00 0.00 X 149025 0 12861 PAUL TARASKA PSYCHIATRIST 33.00 0.00 X 255627 0 14110 PATRICK L FOLEY PHYSICIAN 28.00 0.00 X 236038 0 0 GALE BING PHYSICIAN 40.00 0.00 X 217339 0 9975 CHRISTOPHER FITZSIMMONS PHYSICIAN 40.00 0.00 X 263366 0 7678 DANIELLE CUNDIFF PHYSICIAN 40.00 0.00 X 205761 0 1949 2516271 0 118653 23 0 1 0 UNION HOSPITAL 801 S MAIN STREET CLINTON IN 47842 NETWORK, RENT AND RESIDENCY PROGRAM COST 1287535 ECLINICAL WORKS 2 TECHNOLOGY DR WESTBOROUGH MA 01581 SOFTWARE VENDOR 499264 CHIROPRACTIC SERVICES OF INDIANA LLC 3961 GOLD BAG LANE TERRE HAUTE IN 47802 CHIROPRACTIC SERVICES 203250 CHAD'S COMMUNICATION SOLUTION 15 HUNTER CT CLINTON IN 47842 IT AND NETWORK SUPPORT 190344 JOINK LLC PO BOX 3529 TERRE HAUTE IN 47802 FIBER, IT AND NETWORK SUPPORT 183366 5 4686213 513516 455162 5199729 NET PATIENT SERVICE REVENUE 621300 14311079 14311079 PATIENT REVENUE-340B PHARMACY 900099 3478812 3478812 17789891 13900 13900 133708 133708 133708 23137228 17923599 0 13900 1432080 1232454 199626 10503585 9039432 1464153 160830 111510 49320 1535509 1064628 470881 804664 557905 246759 12169 3118 9051 30736 7875 22861 1306849 334815 972034 76689 25302 51387 639666 317288 322378 504875 324466 180409 137905 45498 92407 140022 46197 93825 116598 116598 384471 384471 69805 23031 46774 MEDICAL SUPPLIES 1640616 1638980 1636 340B DISPENSING FEE 1430204 1430204 DUES AND SUBSCRIPTIONS 64603 21314 43289 DENTAL, RX AND PATIENT 41815 41815 36515 12257 24258 21070206 16779158 4291048 0 2401124 177223 141938 3027128 928572 801769 88276 224281 9194407 2633042 4764677 6561365 1483940 1656785 9808527 12448551 1127489 1848333 2070582 1964567 123097 81270 3321168 3894170 X 6487359 8496027 58354 6487359 8554381 9808527 12448551 2067022 0 X X 0 1 X 1 1 1 X 3415801 3763276 4265470 4048623 5199729 20692899 3415801 3763276 4265470 4048623 5199729 20692899 20692899 121 132 194 166 13900 14513 74711 64431 190319 228394 133708 691563 21398975 63630343 0.96700 0.72580 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2015 AMOUNT: $ 74,711. 2016 AMOUNT: $ 64,431. 2017 AMOUNT: $ 190,319. 2018 AMOUNT: $ 228,394. 2019 AMOUNT: $ 133,708. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 145752 145752 3520301 304982 3215319 2224702 952736 1271966 1902104 1375324 526780 1401548 1401548 6561365 ESTIMATED THIRD-PARTY SETTLEMENTS 1397629 OTHER RECEIVABLES 259156 1656785 DUE TO UNION HOSPITAL, INC. 81270 81270 X 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, 2019 AND 2018, 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. X X X X X 0 0 0 0 0 1 0 0 0 DR STEVEN WALTZ CMO 304352 0 9750 0 0 0 8848 0 9208 0 332158 0 0 0 TERRY WARREN CEO 179038 0 18564 0 0 0 5526 0 8515 0 211643 0 0 0 NICOLE HALL NP, DIRECTOR OF CLINICAL PROGRAMS 141373 0 10000 0 0 0 4245 0 136 0 155754 0 0 0 DR JULIA WERNZ PSYCHOLOGIST, DIRECTOR OF BEH. HEALT 141225 0 7800 0 0 0 4488 0 8373 0 161886 0 0 0 PAUL TARASKA PSYCHIATRIST 251939 0 3688 0 0 0 7427 0 6683 0 269737 0 0 0 PATRICK L FOLEY PHYSICIAN 227688 0 8350 0 0 0 0 0 0 0 236038 0 0 0 GALE BING PHYSICIAN 213089 0 4250 0 0 0 6504 0 3471 0 227314 0 0 0 CHRISTOPHER FITZSIMMONS PHYSICIAN 254116 0 9250 0 0 0 7632 0 46 0 271044 0 0 0 DANIELLE CUNDIFF PHYSICIAN 196011 0 9750 0 0 0 0 0 1949 0 207710 0 0 0 PART I, LINE 6 END OF YEAR BONUSES WERE CONTINGENT ON NET EARNINGS OF THE CENTER. X 6916 455162 FAIR MARKET VALUE 0 1 0 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 96260 1833296 VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER INC