2020-10-13T09:17:49-05:00 2019-12-31 352102008 CNA TAX PROFESSIONALS INC 10475 CROSSPOINT BOULEVARD SUITE 200 INDIANAPOLIS IN 46256 990 2019-01-01 870778393 KNOX WINAMAC COMMUNITY HEALTH CENTERS INC KNOX 5747726030 1002 SOUTH EDGEWOOD DR KNOX IN 46534 KATHY ROBB EXECUTIVE DIRECTOR 5747726030 2020-10-13 1 SHAWN D DREIMAN CPA P00380913 3178413393 2020-10-13 96.90.28.109 2020-10-13 10:17:37 ED P 69954AB7B88365E85264179B0021FE71187A4A62 69954AB7B88365E85264179B0021FE71187A4A62 2019 2021-01-29 14:40:06Z KATHY ROBB 1002 SOUTH EDGEWOOD DR KNOX IN 46534 2795695 0 X NA X 2006 IN THE ORGANIZATION PROVIDES PRIMARY AND PREVENTIVE HEALTH SERVICES TO THE AREA'S UNDER-SERVED AND MOST VULNERABLE POPULATIONS THROUGH HIGH QUALITY CLINICAL CARE WITH A DEMONSTRATED IMPACT ON THE HEALTH OUTCOMES OF THE COMMUNITIES WE SERVE. 11 11 31 2 0 0 0 0 2620369 2733396 -4320 0 30188 62299 2646237 2795695 0 0 0 0 1338619 1442149 0 0 0 898536 1164768 2237155 2606917 409082 188778 708745 776680 755209 634366 -46464 142314 THE ORGANIZATION PROVIDES PRIMARY AND PREVENTIVE HEALTH SERVICES TO THE AREA'S UNDER-SERVED AND MOST VULNERABLE POPULATIONS THROUGH HIGH QUALITY CLINICAL CARE WITH A DEMONSTRATED IMPACT ON THE HEALTH OUTCOMES OF THE COMMUNITIES WE SERVE. 0 0 1987082 2733396 THE ORGANIZATION PROVIDES AN ARRAY OF HEALTH CARE SERVICES THAT ARE AVAILABLE TO ALL PERSONS, REGARDLESS OF THE ABILITY TO PAY. WE HAVE A TEAM OF DOCTORS AND NURSE PRACTITIONERS WHO STAFF OUR OFFICE IN KNOX. OUR TEAM OF PROFESSIONALS OFFERS LOCAL ACCESS TO A COMPREHENSIVE RANGE OF AFFORDABLE PREVENTIVE AND PRIMARY HEALTH CARE SERVICES. ADDITIONALLY, THE ORGANIZATION PROVIDES MENTAL HEALTH CARE SERVICES, WHICH ENCOMPASSES, AMONG OTHER THINGS, SUBSTANCE ABUSE. THE ORGANIZATION ALSO PROVIDES SERVICES FOR MOTHERS AND MOTHERS-TO-BE. DURING CALENDAR YEAR 2019, OUR OFFICE PROVIDED CARE FOR 2,653 PERSONS, OF WHOM 894 WERE MEDICAID ELIGIBLE, 740 WERE MEDICARE ELIGIBLE, 769 WERE COVERED UNDER SOME FORM OF INSURANCE, AND 250 WERE UNINSURED. 1987082 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 5 0 1 31 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X EILEEN BLANKE 5747726030 1002 SOUTH EDGEWOOD DR KNOX IN 46534 JUDY CAUDILL DIRECTOR 1.00 X 0 0 0 PAUL LISOWSKI DIRECTOR 1.00 X 0 0 0 BILL DUBLIN DIRECTOR 1.00 X 0 0 0 AJ GAPPA DIRECTOR 1.00 X 0 0 0 DEBRA TROIKE DIRECTOR 1.00 X 0 0 0 JEFF HOUSTON MEMBER 1.00 X 0 0 0 RUTH ANN CONNER SECRETARY 1.00 X 0 0 0 ROSEANNE VONBAMPUS TREASURER 1.00 X 0 0 0 GAYLE SMITH PRESIDENT 1.00 X 0 0 0 NANCY DEMBOWSKI VICE PRESIDENT 1.00 X 0 0 0 KATHLEEN ROBB EXECUTIVE DIR. 40.00 X 82461 0 5569 EILEEN BLANKE CFO 40.00 X 76185 0 5569 DR WALTER E FRITZ MEDICAL DIRECTOR 40.00 X 206821 0 12999 TRACY L HADDIX NURSE PRACTITIONER 40.00 X 103440 0 0 KIM M MCCULLOUGH NURSE PRACTITIONER 40.00 X 106091 0 0 574998 0 24137 3 0 1 0 OMEGA HEALTHCARE INVESTORS 200 INTL CIRCLE STE 3500 HUNT VALLEY MD 21030 RENT 163268 NORTH AMERICAN HEALTHCARE MANAGEMENT SER 9245 WATSON INDUSTRIAL PARK ST LOUIS MO 63126 BILLING SERVICE 138113 DR ALEXANDER GATZIMOS 212 W EDISON RD MISHAWAKA IN 46545 PROFESSIONAL SERV. 136150 CARDINAL HEALTH 7000 CARDINAL PLACE DUBLIN OH 43017 340 B MEDICINES 117172 4 PATIENT SERVICE FEE 900099 2733396 2733396 2733396 CANCELLATION OF DEBT 900099 46000 46000 OTHER INCOME 900099 16299 16299 62299 2795695 2733396 0 62299 X 596135 430434 165701 846014 610858 235156 17313 17313 18410 18410 312451 312451 41255 29808 11447 28260 28260 213409 145039 68370 2756 1257 1499 630 -1655 2285 27624 8985 18639 142605 88913 53692 CONTRACT LABOR 169874 153916 15958 BAD DEBT 80328 80328 MEDICAL LAB FEES 57304 57304 MISCELLANEOUS 40289 22491 17798 12260 11230 1030 2606917 1987082 619835 0 408171 467100 246307 203869 13465 13651 149630 57570 40802 92060 708745 776680 208750 147073 341231 342984 205228 144309 755209 634366 X -46464 142314 -46464 142314 708745 776680 188778 0 X 0 1 X 1 0 X 54165 31125 23040 95465 26445 69020 92060 OTHER LONG-TERM LIABILITIES 144309 144309 X 2831695 36000 36000 2795695 0 2795695 2642917 36000 36000 2606917 0 2606917 PART X, LINE 2: FIN 48 FOOTNOTE THE ORGANIZATION ADOPTED THE ACCOUNTING POLICY TO RECOGNIZE A TAX BENEFIT ONLY IF IT IS MORE LIKELY THAN NOT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED WILL BE THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE MORE LIKELY-THAN-NOT TEST, NO TAX BENEFIT WILL BE RECORDED. THE ORGANIZATION HAS EXAMINED THIS ISSUE AND HAS DETERMINED THERE ARE NO MATERIAL CONTINGENT TAX LIABILITIES. THE ORGANIZATIONS FEDERAL EXEMPT ORGANIZATION INCOME TAX RETURNS (FORM 990) ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY ARE FILED. X 0 0 0 0 0 0 0 0 0 DR WALTER E FRITZ MEDICAL DIRECTOR 206821 0 0 0 0 0 0 0 12999 0 219820 0 0 0 SEE BELOW FAMILY OF MANAGEMENT 33848 SEE BELOW 0 PART IV, LN 1 AT TIMES, THE ORGANIZATION OBTAINS MANUAL LABOR SERVICES FROM OUTSIDE VENDORS THAT ARE FAMILY MEMBERS TO MANAGEMENT. AMOUNTS PAID TO SUCH VENDORS, IN AGGREGATE, WERE $33,848 AND $7,334 FOR THE YEARS ENDED DECEMBER 31, 2019 AND 2018,RESPECTIVELY. FORM 990, PART VI, SECTION B, LINE 11B LINE 11B EXPLANATION - COPIES OF THE FINAL FORM 990 ARE PROVIDED TO THE BOARD MEMBERS THROUGH EMAIL WITH INSTRUCTIONS THAT THEY ARE TO RESPOND IMMEDIATELY WITH QUESTIONS DUE TO TIMELINESS OF FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR THE CFO PROVIDES CONFLICT OF INTEREST STATEMENTS TO ALL BOARD MEMBERS FOR THEIR REVIEW AND SIGNATURES. THE CORPORATION AVOIDS ACTIVE PARTICIPATION OF ANY DIRECTOR IN A MANNER THAT POSES A CONFLICT OF INTEREST WITH RESPECT TO THAT DIRECTOR. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS USES COMPARATIVE COMPENSATION DATA AND HISTORICAL FINANCIAL DATA FROM THE CLINIC TO DETERMINE AN APPROPRIATE SALARY FOR THE ORGANIZATION OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST. FORM 990, PART IX, LINE 11G BILLING SERVICES: PROGRAM SERVICE EXPENSES 312,451. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 312,451.