2019-11-15T11:58:38-06:00 2018-12-31 311119890 Barnes Dennig & Co LTD 5750 Castle Creek Pkwy Ste 245 Indianapolis IN 46250 990 2018-01-01 351948768 Raphael Health Center Inc RAPH 3179261507 401 E 34th St Indianapolis IN 46205 Sherry Gray CEO 3179261507 2019-11-14 1 Paula Hume P00537516 3175721130 216.196.129.6 2019-11-14 13:00:07 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 1CA9B4A504D0314FA2A13CFD5AFE390DEF715523 2018 2020-04-17 16:48:07Z Sherry Gray 401 E 34th St Indianapolis IN 46205 6849349 0 1 X www.raphaealhc.org X 1994 IN To provide community-based, full-service health care for all people regardless of religious affiliation, geographical residence, or payment ability. 11 11 76 12 0 0 2526515 3559974 3128114 3265230 31327 24145 0 0 5685956 6849349 0 0 0 0 4382737 5157532 0 0 124871 1331059 1581241 5713796 6738773 -27840 110576 3112366 4745639 875842 2327250 2236524 2418389 To provide community-based, full-service health care for all people regardless of religious affiliation, geographical residence, or payment ability. 0 0 5359106 3265230 Providing Medical, Dental and Mental Health services to indigent individuals. 5359106 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 1 0 0 0 0 1 0 0 0 1 68 0 1 76 1 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 X Terry Turman Interim CFO 3179261507 401 E 34th St Indianapolis IN 46205 Stanley Reed President 2.00 X X 0 0 0 Janell Gurney Vice President 2.00 X X 0 0 0 Paula Shana Secretary 2.00 X X 0 0 0 Sharon Marshall Treasurer 2.00 X X 0 0 0 Vincent Hannon III Director 1.00 X 0 0 0 Dawna Peterson Director 1.00 X 0 0 0 Dr Robert Weller Director 1.00 X 0 0 0 Janice Williamson-Cox Director 1.00 X 0 0 0 Thomas Spradling Director 1.00 X 0 0 0 Rita SiSi Lwin Director 1.00 X 0 0 0 Terry Turman Interim CFO - Started 5/19 1.00 X X 0 0 0 Michael Weaver CFO - Exited 4/18 40.00 2.00 X 35194 0 7153 Sherry Gray CEO 40.00 2.00 X 135191 0 27477 Victoria Downs CFO - Exited 5/19 40.00 2.00 X 76467 0 15541 Nathan V Roth Physician 40.00 X 186628 0 37931 Mitchell Krathwohl Physician 40.00 X 179782 0 36539 Suzanne Montgomery Physician 40.00 X 164749 0 33484 Dorothy Boersma Physician 40.00 X 134611 0 27359 Ross Bowen Physician 40.00 X 134503 0 27337 1047125 0 212821 6 0 1 0 0 2991961 568013 190481 3559974 Patient services 621300 3265230 3265230 3265230 24145 24145 6849349 3265230 0 24145 297023 234875 57297 4851 3781878 2990562 729544 61772 89268 70590 17220 1458 679367 537217 131053 11097 309996 245133 59800 5063 58322 42315 16007 95419 30528 64243 648 117352 94542 20802 2008 196498 158608 34554 3336 1453 1170 258 25 16256 16256 100372 80863 17791 1718 29187 23514 5174 499 Clinic supplies and med 397555 385004 674 11877 Bad debt expense 232705 232705 Dues & subscriptions 100871 81264 17881 1726 Maint & Custodial 96225 77521 17057 1647 139026 115010 22877 1139 6738773 5359106 1254796 124871 1409725 583515 610829 535307 30677 86217 409870 506384 55190 88065 4300572 1380587 561717 2919985 34358 26166 3112366 4745639 375842 402428 0 1424822 500000 500000 875842 2327250 X 2136968 2357482 99556 60907 2236524 2418389 3112366 4745639 X 110576 -22131 93420 X X 0 1 X 1 1 1 X 1615085 2116787 2509162 2526515 3559974 12327523 1615085 2116787 2509162 2526515 3559974 12327523 12327523 42606 39360 31183 31327 24145 168621 12496144 13800323 0.98650 0.98240 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7191 3475 3716 1029456 738257 291199 3263925 638855 2625070 2919985 Third Party Payable 500000 500000 X 6594513 -22131 -22131 6616644 232705 232705 6849349 6505149 0 6505149 233624 233624 6738773 Part X, Line 2: Raphael Health Center, Inc. (Center) has been recognized by the Internal Revenue Service as a not-for-profit corporation as described in Internal Revenue Code Section 501(c)(3). The corporation is exempt from federal income taxes unless tax on unrelated business income is applicable. Management believes that the Center has adequately addressed all relevant tax positions and that there are no unrecorded tax liabilities. Part XI, Line 4b - Other Adjustments: Reclass Bad Debt Written Off 232,705. Part XII, Line 4b - Other Adjustments: Raphael Realty Inc. Net Expenses 919. Reclass Bad Debts Written Off 232,705. 0 0 0 0 0 0 0 0 0 Sherry Gray CEO 135191 0 0 0 0 0 0 0 27477 0 162668 0 0 0 Nathan V Roth Physician 186628 0 0 0 0 0 0 0 37931 0 224559 0 0 0 Mitchell Krathwohl Physician 179782 0 0 0 0 0 0 0 36539 0 216321 0 0 0 Suzanne Montgomery Physician 164749 0 0 0 0 0 0 0 33484 0 198233 0 0 0 Dorothy Boersma Physician 134611 0 0 0 0 0 0 0 27359 0 161970 0 0 0 Ross Bowen Physician 134503 0 0 0 0 0 0 0 27337 0 161840 0 0 0 X Vaccines 1 178604 FMV X Backpacks/Bags 1 11250 FMV X Miscellaneous 1 627 0 0 0 Form 990, Part VI, Section B, line 11b Line 11a explanation - 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 through 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. Form 990, Part XI, line 9: Transfers to related 501(c)(2) Tax Exempt Organization 93,420. Form 990, Part XII, Line 2c: No changes in process from the prior year. Raphael Realty Inc 401 East 34th Street Indianapolis IN 46205 743093941 Real Estate IN 501(c) (2) N/A 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 94200 See Sched. R Supplimental Info. Raphael Realty Inc R 93420 Cash