RAPHAEL HEALTH CENTER INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- RAPHAEL HEALTH CENTER INC (EIN 35-1948768)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-09-18
- IRS object ID
- 201242629349300319
- Schema version
- 2011v1.2
- 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) |
|---|---|---|
| Timestamp | 2012-09-18T13:32:18-07:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Gauthier & Kimmerling LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7340 Shadeland Station Suite 100 | AddressLine1 |
| City | Indianapolis | City |
| State | IN | State |
| ZIP Code | 46256 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351948768 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Raphael Health Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | RAPH | NameControl |
| Phone | 3179261507 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 E 34th St | AddressLine1 |
| City | Indianapolis | City |
| State | IN | State |
| ZIP Code | 46205 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Hoagland Elliott | Name |
| Title | Executive Director | Title |
| Date Signed | 2012-09-18 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Rickey Roysdon CPA | Name |
| Phone | 3175721130 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Hoagland Elliott | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 E 34th St | AddressLine1 |
| City | Indianapolis | City |
| State | IN | State |
| ZIP Code | 46205 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 3439691 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.rhc.npowercomet.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | To provide community-based, full-service health care for all people regardless of religious affiliation , geographical residence, or payment ability. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 54 | TotalNbrEmployees |
| Total Nbr Volunteers | 13 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 1646221 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1290748 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 2076085 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 2120331 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 11069 | InvestmentIncomePriorYear |
| Investment Income Current Year | 9430 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 19182 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 3733375 | TotalRevenuePriorYear |
| Total Revenue Current Year | 3439691 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 2428109 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2491809 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1089032 | OtherExpensePriorYear |
| Other Expenses Current Year | 967660 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 3517141 | TotalExpensesPriorYear |
| Total Expenses Current Year | 3459469 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 216234 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -19778 | RevenuesLessExpensesCY |
| Total Assets BOY | 2301487 | TotalAssetsBOY |
| Total Assets EOY | 2295842 | TotalAssetsEOY |
| Total Liabilities BOY | 238448 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 159843 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2063039 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2135999 | NetAssetsOrFundBalancesEOY |
| Mission Description | To provide community-based, full-service health care for all people regardless of religious affiliation , geographical residence, or payment ability. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 2779534 | Expense |
| Revenue | 2120331 | Revenue |
| Description | Providing medical services to indigent individuals. | Description |
| Total Program Service Expense | 2779534 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | false | ComplianceWithBackupWitholding |
| Number Of Employees | 54 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Michael Weaver CFO | NamePerson |
| Telephone Number | 3179261507 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 E 34th St | AddressLine1 |
| City | Indianapolis | City |
| State | IN | State |
| ZIP Code | 46205 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Robert Weller MD | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Terry Webster Sr | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Doris Webster | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Lloyd Tucker | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Ann Reynolds | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Stanley Reed MD | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Terrence Harper Sr | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Patricia Froyd | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Howard Foltz Jr | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Don E Fledderjohn | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Velmar Clark | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Jamie Cottingham | ||||||||
| Treasurer | 2.00 | X | 0 | 0 | 0 | X | ||
| Doris Watts | ||||||||
| Secretary | 2.00 | X | 0 | 0 | 0 | X | ||
| Tara Melton | ||||||||
| Vice President | 2.00 | X | 0 | 0 | 0 | X | ||
| Michael Weaver | ||||||||
| President | 2.00 | X | 0 | 0 | 0 | X | ||
| Daniel Ent | ||||||||
| Int CFO | 40.00 | 13872 | 0 | 1582 | X | |||
| Kimberly Hopkins | ||||||||
| CFO | 40.00 | 69042 | 0 | 7875 | X | |||
| Hoagland Elliott | ||||||||
| Executive Direc | 32.00 | 92793 | 0 | 10585 | X | |||
| Louis Winternheimer MD | ||||||||
| Med Director | 40.00 | 174109 | 0 | 19860 | X | |||
| Nathan Roth MD | ||||||||
| Physician | 40.00 | 140819 | 0 | 16063 | X | |||
| Theordore Park MD | ||||||||
| Dentist | 40.00 | 131116 | 0 | 14956 | X | |||
| Rhonda Stephens DDS | ||||||||
| Physician | 40.00 | 113332 | 0 | 12928 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 735083 | TotalReportableCompFromOrg |
| Total Other Compensation | 83849 | TotalOtherCompensation |
| Number Individuals GT100 K | 4 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Government Grants | 1230648 | GovernmentGrants |
| All Other Contributions | 60100 | AllOtherContributions |
| Total Contributions | 1290748 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient services | Description |
| Business Code | 621300 | BusinessCode |
| Total Revenue Column | 2120331 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2120331 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 2120331 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9430 | TotalRevenueColumn |
| Exclusion | $9,430 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Miscellaneous | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 19182 | TotalRevenueColumn |
| Exclusion | $19,182 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 19182 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3439691 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2120331 | RelatedOrExemptFunctionIncome |
| Exclusion | $28,612 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 349816 | Total |
| Program Services | 284249 | ProgramServices |
| Management And General | 65567 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1700384 | Total |
| Program Services | 1381676 | ProgramServices |
| Management And General | 318708 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43336 | Total |
| Program Services | 35213 | ProgramServices |
| Management And General | 8123 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 233862 | Total |
| Program Services | 190029 | ProgramServices |
| Management And General | 43833 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 164411 | Total |
| Program Services | 133595 | ProgramServices |
| Management And General | 30816 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53461 | Total |
| Management And General | 53461 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 56912 | Total |
| Program Services | 21436 | ProgramServices |
| Management And General | 35476 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80633 | Total |
| Program Services | 64687 | ProgramServices |
| Management And General | 15946 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 130368 | Total |
| Program Services | 111510 | ProgramServices |
| Management And General | 18858 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 607 | Total |
| Program Services | 607 | ProgramServices |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 187798 | Total |
| Program Services | 150658 | ProgramServices |
| Management And General | 37140 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13872 | Total |
| Management And General | 13872 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Maint & Custodial | 64680 | 51889 | 12791 |
| Laboratory | 37568 | 37568 | |
| Dues & subscriptions | 34854 | 27961 | 6893 |
| Clinic supplies and medicines | 252516 | 252516 | |
| Bad debt expense | 19759 | 19759 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34632 | Total |
| Program Services | 16181 | ProgramServices |
| Management And General | 18451 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3459469 | Total |
| Program Services | 2779534 | ProgramServices |
| Management And General | 679935 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 853748 | BOY |
| EOY | 888288 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 673871 | BOY |
| EOY | 723835 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61517 | BOY |
| EOY | 68504 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 131300 | BOY |
| EOY | 249195 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61014 | BOY |
| EOY | 41131 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1014764 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 703723 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 416162 | BOY |
| EOY | 311041 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 103875 | BOY |
| EOY | 13848 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2301487 | BOY |
| EOY | 2295842 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 238448 | BOY |
| EOY | 159843 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 238448 | BOY |
| EOY | 159843 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2063039 | BOY |
| EOY | 2135999 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2063039 | BOY |
| EOY | 2135999 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2301487 | BOY |
| EOY | 2295842 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -19778 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 92738 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1530411 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1884422 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1735023 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1646221 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1290748 | CurrentTaxYear |
| Total | 8086825 | Total |
Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1530411 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1884422 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1735023 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1646221 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1290748 | CurrentTaxYear |
| Total | 8086825 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 159005 | AmountsSubstContributorsTotal |
| Public Support Total170 | 7927820 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 19830 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 7756 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5079 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 11069 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9430 | CurrentTaxYear |
| Total | 53164 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 19182 | CurrentTaxYear |
| Total | 19182 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 8159171 | TotalSupport |
| Gross Receipts From Admissions Etc | 9322519 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.97160 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.97700 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 611434 | OtherCostOrOtherBasis |
| Depreciation | 435477 | Depreciation |
| Book Value | 175957 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 403330 | OtherCostOrOtherBasis |
| Depreciation | 268246 | Depreciation |
| Book Value | 135084 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 311041 | TotalOfBookValueLandBuildings |
| Total Revenue | 3439691 | TotalRevenue |
| Total Expenses | 3459469 | TotalExpenses |
| Excess Or Deficit For Year | -19778 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 11738 | NetUnrealizedGLOnInvestments |
| Other | $81,000 | OtherAmount |
| Total Adjustments | 92738 | TotalAdjustments |
| Excess Or Deficit Per FS | 72960 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 3458988 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 11738 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 7556 | DonatedSrvcAndUseOfFacilities |
| Other Revenues | 3 | OtherRevenues |
| Revenue Not Rptd F990 | 19297 | RevenueNotRptdF990 |
| Revenue Subtotal | 3439691 | RevenueSubtotal |
| Total Revenue Per Form990 | 3439691 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 3458456 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 7556 | DonatedServicesUseOfFacilities |
| Other Expenses Included | 72431 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 79987 | ExpensesNotRptdF990 |
| Expenses Subtotal | 3378469 | ExpensesSubtotal |
| Other Expenses Not Included | 81000 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 81000 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 3459469 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part X | Part X : FIN48 Footnote | 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 2008. |
| Part XIII, Line 4b | Part XIII, Line 4b: Other revenue amounts included on 990 but not included in F/S | Intercompany consolidation elimination $81000 |
| Part XIII, Line 2d | Part XIII, Line 2d: Other expenses and losses per audited F/S | Raphael Realty Inc. Expenses $72431 |
| Part XII, Line 2d | Part XII, Line 2d: Other revenue amounts included in F/S but not included on form 990 | Raphael Realty Inc Revenues $3 |
| Part XI, Line 8 | Part XI, Line 8: Other Changes in Net Assets or Fund Balances | Transfers From related 501(c)(2) Tax Exempt Origanization $81000 Transfers to related 501(c)(2) Tax Exempt Origanization $ -0 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|
| Nathan Roth MD | ||
| 140819 | 16063 | 156882 |
| Louis Winternheimer MD | ||
| 174109 | 19860 | 193969 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 86894 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Schedule R; Part V-Transactions | 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 2011. | |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | 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 VI, Line 19 |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | 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, Line 15b |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | 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, Line 12c |
| Form 990, Part VI, Line 11: Form 990 Review Process | Raphael Health Center, Inc.'s Form 990 is reviewed by the Finance Committee. | Form 990, Part VI, Line 11 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Raphael Realty Inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 East 34th Street | AddressLine1 |
| City | Indianapolis | City |
| State | IN | State |
| ZIP Code | 46205 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 743093941 | EIN |
| Primary Activities | Real Estate | PrimaryActivities |
| Legal Domicile State | IN | LegalDomicileState |
| Exempt Code Section | 501(c) (2) | ExemptCodeSection |
| Public Charity Status | N/A | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | false | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Raphael Realty Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | j | TransactionType |
| Amount Involved | 81000 | AmountInvolved |