2019-11-13T07:10:45-06:00 2018-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2018-01-01 208998983 VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER INC VALL 7658281003 777 S MAIN STREET SUITE 100 CLINTON IN 47842 TERRY WARREN CEO 7658281003 2019-11-12 1 MARGOT BURKE P01588992 3176334705 2019-11-11 47.227.233.166 2019-11-12 18:09:12 ES P 38D9E49CC0CA71BE8938C550DFC6219FF2DB8390 B19D0506B86ED19F1A0FD2AFEEB91090E576B51F 2018 2020-03-31 21:24:44Z TERRY WARREN 777 S MAIN STREET SUITE 100 CLINTON IN 47842 17559696 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. 13 13 217 0 0 0 4265470 3940818 12479676 10794339 194 166 1969328 2824373 18714668 17559696 0 0 0 0 10980121 12790641 0 0 0 6385127 5691612 17365248 18482253 1349420 -922557 11664244 9808527 4362133 3321168 7302111 6487359 VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER PROVIDES COMPREHENSIVE-INTEGRATED HEALTH CARE FOR ALL INDIVIDUALS AND FAMILIES, WHILE PROMOTING EDUCATIONAL OPPORTUNITIES. 0 0 11947246 11586928 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. 1909655 1852070 TO PROVIDE BEHAVIORAL HEALTH SERVICES TO THOSE IN NEED OF 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. 185302 179714 TO PROVIDE DENTAL HEALTH SERVICES TO THOSE IN NEED OF CARE, INCLUDING THE MEDICALLY UNDER SERVED AND VULNERABLE POPULATIONS OF VERMILLION, PARKE, AND VIGO COUNTIES IN INDIANA, WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY. 14042203 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 33 0 1 217 1 0 0 0 0 0 0 0 0 0 0 X 13 13 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 JON BEARDSLEY PRESIDENT 1.00 X X 0 0 0 MIKE MILLER VICE PRESIDENT 1.00 X X 0 0 0 THOM FRANTZ TREASURER 1.00 X X 0 0 0 DOUGLAS FAUBER SECRETARY 1.00 X X 0 0 0 LOU BONOMO MEMBER 1.00 X 0 0 0 DIANA CAROLE HART MEMBER 1.00 X 0 0 0 GREG HARBISON MEMBER 1.00 X 0 0 0 JERRY HAWKINS MEMBER 1.00 X 0 0 0 CINDY HEIN MEMBER - TERM STARTED JAN. 2018 1.00 X 0 0 0 JACKIE MATHIS MEMBER 1.00 X 0 0 0 LISA TAYLOR MEMBER 1.00 X 0 0 0 JEFF WILLIAMSON MEMBER 1.00 X 0 0 0 YALE YAGER MEMBER 1.00 X 0 0 0 AMY NEWLIN MEMBER - TERM ENDED JUL. 2018 1.00 X 0 0 0 GARY COWAN MEMBER - TERM ENDED DEC. 2018 1.00 X 0 0 0 RONDA FOSTER MEMBER - TERM ENDED SEP. 2018 1.00 X 0 0 0 DR STEVEN WALTZ CMO 40.00 X 309983 0 5306 TERRY WARREN CEO 40.00 X 186076 0 5661 PAUL UTTERBACK CFO - TERM ENDED JUN. 2018 40.00 X 57047 0 1734 SCOTT ANDRITSCH CFO - TERM STARTED JUL. 2018 40.00 X 49095 0 0 THOMAS MCFARLAND COO 40.00 X 105530 0 3283 TIFFANI MARTIN DIRECTOR OF HR AND COMPLIANCE 40.00 X 103661 0 3043 AMY REED DIRECTOR OF DEVELOPMENT 40.00 X 83323 0 2618 NICOLE HALL NP, DIRECTOR OF CLINICAL PROGRAMS 40.00 X 142928 0 4300 STEPHANIE JEFFERY DIRECTOR OF QUALITY 40.00 X 91556 0 398 DR JULIA WERNZ PSYCHOLOGIST, DIRECTOR OF BEH. HEALTH 36.00 X 140179 0 4452 PAUL TARASKA PSYCHIATRIST 40.00 X 311045 0 9250 GALE BING PHYSICIAN 40.00 X 209727 0 6398 CHRISTOPHER FITZSIMMONS PHYSICIAN 40.00 X 253529 0 1785 DANIELLE CUNDIFF PHYSICIAN 40.00 X 206488 0 0 PATRICK L FOLEY PHYSICIAN 40.00 X 184401 0 0 2434568 0 48228 26 0 1 0 UNION HOSPITAL 801 S MAIN STREET CLINTON IN 47842 NETWORK, RENT AND RESIDENCY PROGRAM COST 1150446 ECLINICAL WORKS 2 TECHNOLOGY DR WESTBOROUGH MA 01581 SOFTWARE VENDOR 596646 CHAD'S COMMUNICATION SOLUTION 15 HUNTER CT CLINTON IN 47842 IT AND NETWORK SUPPORT 124028 JOINK LLC PO BOX 3529 TERRE HAUTE IN 47802 FIBER, IT AND NETWORK SUPPORT 115816 4 3512808 428010 428010 3940818 NET PATIENT SERVICE REVENUE 621300 10794339 10794339 10794339 166 166 340B PHARMACY REVENUE 900099 2595979 2595979 228394 228394 2824373 17559696 13618712 0 166 1300174 1098638 201536 9180210 7757214 1422996 130911 91101 39810 1474218 1025906 448312 705128 490698 214430 12196 12196 75743 75743 1241636 139150 1102486 69539 20513 49026 537940 189748 348192 586063 445272 140791 144565 42645 101920 99972 29490 70482 87424 66423 21001 309773 235354 74419 64144 18922 45222 MEDICAL SUPPLIES 1246274 1241336 4938 340B DISPENSING FEE 1102778 1102778 DUES AND SUBSCRIPTIONS 54519 16082 38437 DENTAL, RX AND PATIENT 19170 19170 39876 11763 28113 18482253 14042203 4440050 0 2736466 2543062 351714 52006 2648034 928572 153753 88276 7013248 2248571 3784596 4764677 1937675 1483940 11664244 9808527 1300812 1127489 1307247 2070582 1754074 123097 4362133 3321168 X 7302111 6487359 7302111 6487359 11664244 9808527 -922557 107805 0 X 0 1 X 1 1 1 X 1981762 3415801 3763276 4265470 4048623 17474932 1981762 3415801 3763276 4265470 4048623 17474932 17474932 121 121 132 194 166 734 74606 489695 1243052 1969328 2824373 6601054 24076720 43097970 0.72580 0.78930 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2014 AMOUNT: $ 59,053. 2015 AMOUNT: $ 74,711. 2016 AMOUNT: $ 64,431. 2017 AMOUNT: $ 190,319. 2018 AMOUNT: $ 228,394. OTHER MEDICAL REVENUE - 2014 AMOUNT: $ 15,553. 2015 AMOUNT: $ 414,984. 2016 AMOUNT: $ 1,178,621. 2017 AMOUNT: $ 1,779,009. 2018 AMOUNT: $ 2,595,979. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 86574 86574 3300132 221335 3078797 2073480 810952 1262528 1553062 1216284 336778 4764677 ESTIMATED THIRD-PARTY SETTLEMENTS 1242062 OTHER RECEIVABLES 241878 1483940 DUE TO UNION HOSPITAL, INC. 123097 123097 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, 2018 AND 2017, 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 301983 0 8000 0 0 0 5306 0 0 0 315289 0 0 0 TERRY WARREN CEO 171516 0 14560 0 0 0 5661 0 0 0 191737 0 0 0 PAUL TARASKA PSYCHIATRIST 304045 0 7000 0 0 0 9250 0 0 0 320295 0 0 0 GALE BING PHYSICIAN 201727 0 8000 0 0 0 6398 0 0 0 216125 0 0 0 CHRISTOPHER FITZSIMMONS PHYSICIAN 245529 0 8000 0 0 0 1785 0 0 0 255314 0 0 0 DANIELLE CUNDIFF PHYSICIAN 198488 0 8000 0 0 0 0 0 0 0 206488 0 0 0 PATRICK L FOLEY PHYSICIAN 184401 0 0 0 0 0 0 0 0 0 184401 0 0 0 PART I, LINE 6 END OF YEAR BONUSES WERE CONTINGENT ON NET EARNINGS OF THE CENTER. X 6860 428010 FAIR MARKET VALUE 0 1 0 PART I, COLUMN (B): THE AMOUNT IN COLUMN (B) REPRESENTS THE NUMBER OF ITEMS RECIEVED. 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. VALLEY PROFESSIONALS REALTY LLC 777 S MAIN ST STE 100 CLINTON IN 47842 HOLDING COMPANY IN 107185 1817772 VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER INC