2024-09-25T15:28:25-05:00 2023-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2023-01-01 351948768 RAPHAEL HEALTH CENTER INC RAPH 3178603961 401 E 34TH ST INDIANAPOLIS IN 46205 SHERRY GRAY CEO 3178603961 2024-09-25 1 1 TYLER K GREENE CPA P00057872 3176334705 2024-09-25 2023 2024-08-08 14:25:15Z SHERRY GRAY 401 E 34TH ST INDIANAPOLIS IN 46205 8955850 0 X WWW.RAPHAELHC.ORG X 1994 IN TO PROVIDE COMMUNITY-BASED, FULL-SERVICE HEALTHCARE OF THE HIGHEST QUALITY WITH RESPECT AND DIGNITY FOR ALL PEOPLE INCLUDING THE UNDERSERVED AND UNINSURED WITHIN A SETTING THAT SHARES THE LOVE AND HEALING OF JESUS CHRIST. 10 10 90 10 0 0 3667446 3875593 4146261 4784369 13305 142058 105635 153830 7932647 8955850 0 0 0 0 5055434 5236040 0 0 182055 2397895 2889601 7453329 8125641 479318 830209 7691049 8762319 443664 681395 7247385 8080924 TO PROVIDE COMMUNITY-BASED, FULL-SERVICE HEALTHCARE OF THE HIGHEST QUALITY WITH RESPECT AND DIGNITY FOR ALL PEOPLE INCLUDING THE UNDERSERVED AND UNINSURED WITHIN A SETTING THAT SHARES THE LOVE AND HEALING OF JESUS CHRIST. 0 0 6170367 4938199 PROVIDING MEDICAL, DENTAL, VISION AND MENTAL HEALTH SERVICES TO INDIGENT INDIVIDUALS. 6170367 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 0 1 0 0 0 1 19 0 1 90 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X PAUL UTTERBACK CFO 3178603961 401 E 34TH ST INDIANAPOLIS IN 46205 SANFORD GARNER PRESIDENT 2.00 2.00 X X 0 0 0 SARAH NOEL VICE PRESIDENT 2.00 2.00 X X 0 0 0 PAT CASANOVA SECRETARY 2.00 2.00 X X 0 0 0 ERIN GREEN DIRECTOR - PARTIAL TERM 1.00 0.00 X 0 0 0 RHONDA GARRISON DIRECTOR 1.00 0.00 X 0 0 0 JANICE HICKS-SLAUGHTER DIRECTOR 1.00 0.00 X 0 0 0 SHELLY LLOYD-HANKINSON DIRECTOR - PARTIAL TERM 1.00 0.00 X 0 0 0 AARON ROBERTS DIRECTOR 1.00 0.00 X 0 0 0 DANIELLE STILES-POLK DIRECTOR 1.00 0.00 X 0 0 0 DR BOB WHITMORE DIRECTOR 1.00 0.00 X 0 0 0 WADDELL HAMER JR DIRECTOR - PARTIAL TERM 1.00 0.00 X 0 0 0 BERNICE CORLEY DIRECTOR 1.00 0.00 X 0 0 0 THOMAS FISHER DIRECTOR 1.00 0.00 X 0 0 0 SHERRY GRAY CEO 40.00 2.00 X 171065 0 23012 PAUL UTTERBACK CFO 40.00 2.00 X 121462 0 18560 NATHAN V ROTH PHYSICIAN 40.00 0.00 X 219980 0 28435 DINO DIEUDONNE DENTIST 40.00 0.00 X 155463 0 24024 RACHEL ZIEGLER BEHAVIORAL HEALTH SUPERVIS 40.00 0.00 X 134329 0 20307 TARA WAKEFIELD PHYSICIAN 40.00 0.00 X 169252 0 19105 AUDREY DICKERSON PHYSICIAN ASSISTANT 40.00 0.00 X 113284 0 18412 1084835 0 151855 13 0 1 0 QUATRIS HEALTHCO LLC 7657 SW MOHAWK ST TUALATIN OR 97062 EMR/BILLING SYSTEM 200321 TAYLORED SYSTEMS INC 14701 CUMBERLAND RD UNIT 100 NOBLESVILLE IN 46060 IT SUPPORT 177071 HALL RENDER KILLIAN HEATH & LYMAN P 500 N MERIDIAN STREET SUITE 400 INDIANAPOLIS IN 46204 LEGAL SERVICES 107395 3 3540518 335075 248455 3875593 PATIENT SERVICES 621300 4616972 4616972 340B REVENUE 621300 167397 167397 4784369 142058 142058 OTHER INCOME 621300 153830 153830 153830 8955850 4938199 0 142058 334599 250949 76958 6692 3703638 2777728 851837 74073 107213 80410 24659 2144 797283 597962 183376 15945 293307 219980 67461 5866 154153 123322 30831 255593 204475 51118 245843 179019 44698 22126 163988 122992 29517 11479 533767 427014 96078 10675 401796 321436 72323 8037 48368 35221 8794 4353 81 65 14 2 88235 81168 6360 707 41870 31696 9337 837 OTHER MEDICAL EXPENSES 675346 506510 155329 13507 DUES & SUB. 113887 85415 26194 2278 LAB/X-RAYS 83675 62756 19245 1674 STAFF DEVELOPMENT 82999 62249 19090 1660 8125641 6170367 1773219 182055 3301164 4053450 278993 517281 63835 17751 257563 223387 27862 30670 47680 75313 2034212 1896793 210786 137419 3503166 3707048 7691049 8762319 443664 431395 0 250000 443664 681395 X 7247385 8080924 7247385 8080924 7691049 8762319 830209 3330 0 X X 0 1 X 1 1 1 X 2875815 3200338 4316004 3667446 3875593 17935196 2875815 3200338 4316004 3667446 3875593 17935196 17935196 24037 14427 14071 17826 142058 212419 14777 18466 52879 105635 153830 345587 18493202 19178907 0.96980 0.98400 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2019 AMOUNT: $ 14,777. 2020 AMOUNT: $ 18,466. 2021 AMOUNT: $ 52,879. 2022 AMOUNT: $ 105,635. 2023 AMOUNT: $ 153,830. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1992268 1896793 95475 41944 41944 137419 INVESTMENT IN RAPHAEL REALTY 3531761 ESTIMATED THIRD PARTY SETTLEMENTS 175287 3707048 REFUNDABLE ADVANCE 250000 250000 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, 2023 AND 2022, 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 0 0 0 0 0 0 0 0 0 NATHAN V ROTH PHYSICIAN 219730 0 250 0 0 0 8799 0 19636 0 248415 0 0 0 SHERRY GRAY CEO 170815 0 250 0 0 0 6843 0 16169 0 194077 0 0 0 TARA WAKEFIELD PHYSICIAN 169252 0 0 0 0 0 6770 0 12335 0 188357 0 0 0 DINO DIEUDONNE DENTIST 155213 0 250 0 0 0 6219 0 17805 0 179487 0 0 0 RACHEL ZIEGLER BEHAVIORAL HEALTH SUPERVIS 134079 0 250 0 0 0 5373 0 14934 0 154636 0 0 0 X 27 248080 FMV 0 0 0 PART I, COLUMN (B): THE AMOUNT IN COLUMN (B) REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART VI, SECTION B, LINE 11B RAPHAEL HEALTH CENTER, INC.'S FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 12C RAPHAEL HEALTH CENTER PASSES OUT A QUESTIONNAIRE ABOUT CONFLICT OF INTEREST TO BE FILLED OUT AND RETURNED BY EACH DIRECTOR, OFFICER AND STAFF MEMBER. THE POLICY INCLUDES STATEMENTS ABOUT OTHER EMPLOYMENT AND BEING RELATED TO ANYONE ON THE BOARD OF DIRECTORS AND OTHER ITEMS THAT MAY BE AN ISSUE. POTENTIAL ISSUES ARE IDENTIFIED, EVALUATED AND DISCUSSED WITH THE APPROPRIATE LEVEL OF MANAGEMENT OR MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 RAPHAEL HEALTH CENTER, INC.'S BOARD OF DIRECTORS' HR COMMITTEE ESTABLISH ALL STAFFING COMPENSATION PLANS AFTER A THOROUGH REVIEW OF ALL RELATED ISSUES, CONSULTATION WITH INDEPENDENT PERSONS, REVIEW OF COMPARABLE DATA AND DELIBERATION. IT ALSO CONDUCTS AN ANNUAL PERFORMANCE REVIEW OF THE OTHER OFFICERS AND KEY EMPLOYEES IN CONSIDERING THEIR COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 RAPHAEL HEALTH CENTER, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS, AS APPLICABLE, AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST MADE TO THE ATTENTION OF OUR CHIEF EXECUTIVE OFFICER (CEO) AND RECEIVED AT OUR CORPORATE OFFICE ADDRESS. RAPHAEL REALTY INC 401 EAST 34TH STREET INDIANAPOLIS IN 46205 743093941 REAL ESTATE IN 501(C)(2) N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 RAPHAEL REALTY INC K 239400 BOOK RAPHAEL REALTY INC R 522984 CASH