RAPHAEL HEALTH CENTER INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- RAPHAEL HEALTH CENTER INC (EIN 35-1948768)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201623199349300842
- Schema version
- 2015v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-14T10:18:53-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 311119890 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Barnes Dennig & Co LTD | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5750 Castle Creek Pkwy Ste 245 | AddressLine1Txt |
| City | Indianapolis | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46250 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351948768 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Raphael Health Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | RAPH | BusinessNameControlTxt |
| Phone | 3179261507 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 E 34th St | AddressLine1Txt |
| City | Indianapolis | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46205 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Michael Weaver | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3179261507 | PhoneNum |
| Signature | 2016-11-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Rickey Roysdon CPA | PreparerPersonNm |
| PTIN | P00645916 | PTIN |
| Phone | 3175721130 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Deanna Roudebush | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 E 34th St | AddressLine1Txt |
| City | Indianapolis | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46205 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,841,603 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| All Affiliates Included | Yes (1) | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.raphaealhc.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | To provide community-based, full-service health care for all people regardless of religious affiliation, geographical residence, or payment ability. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 53 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,615,085 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,116,787 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,833,478 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,685,456 | CYProgramServiceRevenueAmt |
| PY Investment Income | $42,606 | PYInvestmentIncomeAmt |
| CY Investment Income | $39,360 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $3,491,169 | PYTotalRevenueAmt |
| CY Total Revenue | $4,841,603 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,022,707 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,489,498 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,064,896 | PYOtherExpensesAmt |
| CY Other Expenses | $1,188,365 | CYOtherExpensesAmt |
| PY Total Expenses | $4,087,603 | PYTotalExpensesAmt |
| CY Total Expenses | $4,677,863 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$596,434 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $163,740 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,598,501 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,772,235 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $780,238 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $719,610 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,818,263 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,052,625 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To provide community-based, full-service health care for all people regardless of religious affiliation, geographical residence, or payment ability. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,733,449 | ExpenseAmt |
| Revenue | $2,685,456 | RevenueAmt |
| Desc | Providing medical services to indigent individuals. | Desc |
| Total Program Service Expenses | $3,733,449 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 36 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 53 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Michael Weaver CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3179261507 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 E 34th St | AddressLine1Txt |
| City | Indianapolis | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46205 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Daniel Gaafar | |||||||||
| President | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Liesel Mertes | |||||||||
| Vice President | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Abbie Smith | |||||||||
| Secretary | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Bloor Redding | |||||||||
| Treasurer | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Corey Parchman | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Horace Brown | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Melissa Purpura | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Claire Wiegel | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Dr Robert Weller | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Janice Williamson Cox | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Michael Weaver | |||||||||
| CFO | 40.00 | Yes (X) | $95,734 | $0 | $13,295 | ||||
| Deanna Roudebush | |||||||||
| Executive Direc | 40.00 | Yes (X) | $135,830 | $0 | $18,864 | 2.00 | |||
| Louis Winternheimer | |||||||||
| Medical Director | 40.00 | $191,840 | $0 | $26,642 | Yes (X) | ||||
| Nathan V Roth | |||||||||
| Physician | 40.00 | $157,248 | $0 | $21,838 | Yes (X) | ||||
| Laura Nader MD | |||||||||
| Physician | 40.00 | $143,895 | $0 | $19,984 | Yes (X) | ||||
| Dayna Ridderman | |||||||||
| Physician | 40.00 | $136,363 | $0 | $18,938 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $860,910 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $119,561 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,787,338 | GovernmentGrantsAmt |
| All Other Contributions | $329,449 | AllOtherContributionsAmt |
| Noncash Contributions | $211,785 | NoncashContributionsAmt |
| Total Contributions | $2,116,787 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient services | Desc |
| Business | 621300 | BusinessCd |
| Total Revenue Column | $2,685,456 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,685,456 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,685,456 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $39,360 | TotalRevenueColumnAmt |
| Exclusion | $39,360 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,841,603 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,685,456 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $39,360 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $483,344 | TotalAmt |
| Program Services | $390,892 | ProgramServicesAmt |
| Management And General | $92,452 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,443,000 | TotalAmt |
| Program Services | $1,975,712 | ProgramServicesAmt |
| Management And General | $467,288 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,900 | TotalAmt |
| Program Services | $46,825 | ProgramServicesAmt |
| Management And General | $11,075 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $281,377 | TotalAmt |
| Program Services | $227,556 | ProgramServicesAmt |
| Management And General | $53,821 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $223,877 | TotalAmt |
| Program Services | $181,054 | ProgramServicesAmt |
| Management And General | $42,823 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,568 | TotalAmt |
| Management And General | $74,568 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,166 | TotalAmt |
| Program Services | $23,245 | ProgramServicesAmt |
| Management And General | $59,921 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,596 | TotalAmt |
| Program Services | $71,862 | ProgramServicesAmt |
| Management And General | $18,734 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,717 | TotalAmt |
| Program Services | $134,132 | ProgramServicesAmt |
| Management And General | $33,585 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $762 | TotalAmt |
| Program Services | $762 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,940 | TotalAmt |
| Program Services | $52,996 | ProgramServicesAmt |
| Management And General | $11,944 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,833 | TotalAmt |
| Management And General | $13,833 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Clinic supplies and med | $348,576 | $348,576 | |
| Bad debt expense | $116,701 | $116,701 | |
| Maint & Custodial | $79,830 | $63,322 | $16,508 |
| Dues & subscriptions | $63,577 | $50,430 | $13,147 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,099 | TotalAmt |
| Program Services | $49,384 | ProgramServicesAmt |
| Management And General | $34,715 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,677,863 | TotalAmt |
| Program Services | $3,733,449 | ProgramServicesAmt |
| Management And General | $944,414 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $539,221 | BOYAmt |
| EOY | $468,881 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,552,783 | BOYAmt |
| EOY | $1,603,828 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,709 | BOYAmt |
| EOY | $60,100 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $279,920 | BOYAmt |
| EOY | $352,764 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,731 | BOYAmt |
| EOY | $32,534 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,330,451 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,097,401 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $141,511 | BOYAmt |
| EOY | $233,050 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,625 | BOYAmt |
| EOY | $21,078 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,598,501 | BOYAmt |
| EOY | $2,772,235 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,238 | BOYAmt |
| EOY | $219,610 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $592,000 | BOYAmt |
| EOY | $500,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $780,238 | BOYAmt |
| EOY | $719,610 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,818,263 | BOYAmt |
| EOY | $2,052,625 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,598,501 | BOYAmt |
| EOY | $2,772,235 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $163,740 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$9,914 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $80,536 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,290,748 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,361,187 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,391,858 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,615,085 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,116,787 | CurrentTaxYearAmt |
| Total | $7,775,665 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,290,748 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,361,187 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,391,858 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,615,085 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,116,787 | CurrentTaxYearAmt |
| Total | $7,775,665 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $7,775,665 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,430 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $29,177 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $37,684 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $42,606 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $39,360 | CurrentTaxYearAmt |
| Total | $158,257 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,182 | CurrentTaxYearMinus4YearsAmt |
| Total | $19,182 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $7,953,104 | TotalSupportAmt |
| Public Support CY170 | 0.97770 | PublicSupportCY170Pct |
| Public Support PY170 | 0.96650 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part II, Line 10, Explanation of Other Income: | FormAndLineReferenceDesc |
| Explanation | Miscellaneous - 2011 Amount: $ 19,182. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $801,324 | OtherCostOrOtherBasisAmt |
| Depreciation | $615,881 | DepreciationAmt |
| Book Value | $185,443 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $529,127 | OtherCostOrOtherBasisAmt |
| Depreciation | $481,520 | DepreciationAmt |
| Book Value | $47,607 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $233,050 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Third Party Payable | Desc |
| Amt | $500,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $500,000 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $4,719,398 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$9,914 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $4,408 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | -$116,699 | OtherRevenueAmt |
| Revenue Not Reported | -$122,205 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,841,603 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,841,603 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $4,558,102 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $4,408 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $73,532 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $77,940 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,480,162 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $197,701 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $197,701 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $4,677,863 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. Management believes it is no longer subject to income tax examination for years prior to 2012. |
| Part XI, Line 2d - Other Adjustments: | Raphael Realty Inc Revenues 2. Bad Debt Written Off -116,701. |
| Part XII, Line 2d - Other Adjustments: | Raphael Realty Inc. Expenses 73,532. |
| Part XII, Line 4b - Other Adjustments: | Intercompany consolidation elimination 81,000. Bad Debts Written Off 116,701. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Louis Winternheimer | ||||||||||||||
| Medical Director | $191,840 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $26,642 | $0 | $218,482 | $0 | $0 | $0 |
| Nathan V Roth | ||||||||||||||
| Physician | $157,248 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $21,838 | $0 | $179,086 | $0 | $0 | $0 |
| Laura Nader MD | ||||||||||||||
| Physician | $143,895 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,984 | $0 | $163,879 | $0 | $0 | $0 |
| Dayna Ridderman | ||||||||||||||
| Physician | $136,363 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $18,938 | $0 | $155,301 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | VAccines | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $211,785 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11 | 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. 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 Executive Director and other top management officers 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 Executive Director and received at our corporate office address. |
| Form 990, Part XI, line 9: | Transfers from related 501(c)(2) Tax Exempt Organization 80,536. |
| Form 990, Part XII, Line 2c: | The organization did not change its oversight or selection process during the current tax year. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Raphael Realty Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 East 34th Street | AddressLine1Txt |
| City | Indianapolis | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46205 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 743093941 | EIN |
| Primary Activities | Real Estate | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Exempt Code Section | 501(c) (2) | ExemptCodeSectionTxt |
| Public Charity Status | N/A | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Raphael Realty Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | J | TransactionTypeTxt |
| Involved | $81,000 | InvolvedAmt |
| Method Of Amount Determination | See Sched. R Supplimental Info. | MethodOfAmountDeterminationTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule R; Part V-Transactions | FormAndLineReferenceDesc |
| Explanation | Raphael Realty, Inc. is a related 501(c)(2) tax exempt organization whose mission and exempt purpose is to hold title to property for the use and benefit of Raphael Health Center, Inc. In the process of accomplishing this mission Raphael Health Center, Inc. and Raphael Realty, Inc. engage in certain arms-length transactions which are required to be disclosed in compliance with Schedule R; Part V - Transaction With Related Organizations as follows: Line 2(1)(j) In 2009 the Board of Directors of Raphael Realty, Inc. voted to start charging Raphael Health Center, Inc. rent in order to fund depreciation and maintenance costs of the building. The rent is based on a study provided by an outside independent professional appraiser at less than market rate, this rent totaled $81,000 for 2015. | ExplanationTxt |