2024-10-07T14:03:48-05:00 2023-12-31 351178661 BLUE & CO LLC 12800 N MERIDIAN STREET SUITE 400 CARMEL IN 46032 990 2023-01-01 010945309 JANE PAULEY COMMUNITY HEALTH CENTER INC JANE 3173558704 8931 E 30TH STREET INDIANAPOLIS IN 46219 MICHAEL DALE CFO 3179340751 2024-10-07 1 1 TYLER K GREENE CPA P00057872 3178488920 2024-10-07 2023 2024-10-15 13:58:12Z MARC HACKETT CEO 8931 E 30TH STREET INDIANAPOLIS IN 46219 35571608 0 X JANEPAULEYCHC.COM X 2009 IN TO PROMOTE A HEALTHY COMMUNITY THROUGH THE PROVISION OF ACCESSIBLE, RESPECTFUL AND COLLABORATIVE PRIMARY HEALTH CARE WITH LOCAL PARTNERS TO ANY AND ALL INDIVIDUALS AND FAMILIES REGARDLESS OF INSURANCE STATUS. 14 14 323 17 0 0 8413890 6104566 24614291 29093410 -394316 91705 390555 279900 33024420 35569581 0 0 0 0 21105175 26394871 0 0 0 11172340 13053201 32277515 39448072 746905 -3878491 27648803 22584653 23174364 21988705 4474439 595948 TO PROMOTE A HEALTHY COMMUNITY THROUGH THE PROVISION OF ACCESSIBLE, RESPECTFUL AND COLLABORATIVE PRIMARY HEALTH CARE WITH LOCAL PARTNERS TO ANY AND ALL INDIVIDUALS AND FAMILIES REGARDLESS OF INSURANCE STATUS. 0 0 29297187 29185039 JANE PAULEY CHC PROVIDED PRIMARY HEALTH CARE SERVICES TO APPROXIMATELY 25,963 INDIVIDUALS INCLUDING APPROXIMATELY 3,796 UNINSURED INDIVIDUALS. WE PROVIDED APPROXIMATELY 1,000 PATIENTS ACCESS TO FREE OR REDUCED PRESCRIPTION MEDICATIONS. 29297187 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 13 0 1 323 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X X MICHAEL DALE 3179340751 1503 N MITTHOEFFER AVE INDIANAPOLIS IN 46229 BILL KALER CHAIR 2.00 X X 0 0 0 STEPHANIE MORAN VICE-CHAIR 1.00 X X 0 0 0 AUGUST ZEHNER TREASURER 1.00 X X 0 0 0 KELLY DILLON SECRETARY 2.00 0.00 X X 0 0 0 DEE AIME DIRECTOR 1.00 0.00 X 0 0 0 MARY BAKER-BOUDISSA DIRECTOR 1.00 0.00 X 0 0 0 VICKIE BANNON DIRECTOR 1.00 0.00 X 0 0 0 HOWARD DORSEY DIRECTOR 1.00 0.00 X 0 0 0 TIM HANSON DIRECTOR 1.00 0.00 X 0 0 0 KRYSTAL HUTCHINSON DIRECTOR 1.00 0.00 X 0 0 0 BILL KINGSTON DIRECTOR 1.00 0.00 X 0 0 0 KATHY KRUSIE DIRECTOR 1.00 0.00 X 0 0 0 ERIN KUROIWA DIRECTOR 1.00 0.00 X 0 0 0 CYNTHIA PARKES DIRECTOR 1.00 0.00 X 0 0 0 ROSALINE BARYOH DIRECTOR PARTIAL TERM 1.00 0.00 X 0 0 0 RACHEL BURKE CHAIR PARTIAL TERM/EX-OFFICIO 2.00 0.00 X X 0 0 0 DR JAMES BIEN CMO 40.00 0.00 X 333801 0 53969 MARC HACKETT CEO 40.00 0.00 X 259388 0 38670 MICHAEL DALE CFO 40.00 0.00 X 143578 0 38756 PATRICK WOOTEN COO 40.00 0.00 X 144031 0 26057 DR NILES CARTER PHYSICIAN 40.00 0.00 X 512523 0 55684 DR DANIEL FRICK PHYSICIAN 40.00 0.00 X 272055 0 58615 DR JASON HUA DENTIST 40.00 0.00 X 263583 0 58107 DR AKIRA BARHAMS REGIONAL SITE MEDICAL DIRECTOR 40.00 0.00 X 249302 0 51171 DR MICHAEL KHOULI PHYSICIAN 40.00 0.00 X 265258 0 27768 2443519 0 408797 47 0 1 0 REFLECTIONS UNLIMITED LLC 4811 S NEW COLUMBUS ROAD ANDERSON IN 46013 FACILITIES CLEANING SERVICES 441770 NAVNEET AULAKH 10396 YOSEMITE LN INDIANAPOLIS IN 46234 DENTAL SERVICES 116800 2 5546220 558346 6104566 NET PATIENT SERVICE REVENUE 621400 24569234 24569234 340B PROGRAM 900099 4524176 4524176 29093410 93732 93732 91629 0 91629 91629 91629 2027 -2027 -2027 -2027 OTHER REVENUE 900099 188271 188271 188271 35569581 29185039 0 279976 1038249 1038249 18388802 15419637 2969165 765500 607786 157714 4849053 3850012 999041 1353267 1074456 278811 118723 118723 180232 180232 3680068 2885828 794240 714533 39529 675004 141584 57831 83753 1528976 923711 605265 2418887 1798444 620443 227344 131327 96017 280762 41887 238875 462649 54047 408602 948435 462438 485997 113734 113734 MEDICAL SUPPLIES 1551723 1551723 MINOR EQUIPMENT 315086 146314 168772 DUES & SUBSCRIPTIONS 100012 57834 42178 270453 194383 76070 39448072 29297187 10150885 0 5513584 1222063 1887386 565890 1402394 2110808 276922 776163 16209092 6040671 8729237 10168421 9839280 7741308 27648803 22584653 1094984 2323752 22079380 19164953 0 500000 23174364 21988705 X 4474439 595948 4474439 595948 27648803 22584653 -3878491 0 X X 0 1 X 1 1 1 X 3921912 9032335 5153121 8413890 6104566 32625824 20303605 21040635 26037704 24627340 29106459 121115743 24225517 30072970 31190825 33041230 35211025 153741567 0 0 0 153741567 3202 1314 1099 6905 93732 106252 3202 1314 1099 6905 93732 106252 110593 61185 136057 152455 188271 648561 24339312 30135469 31327981 33200590 35493028 154496380 0.99510 0.99270 0.00070 0.00010 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2019 AMOUNT: $ 110,593. 2020 AMOUNT: $ 61,185. 2021 AMOUNT: $ 136,057. 2022 AMOUNT: $ 152,455. 2023 AMOUNT: $ 188,271. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6445200 2192042 4253158 5747868 2050694 3697174 2795196 1797935 997261 1220828 1220828 10168421 THIRD PARTY RECEIVABLE 1113181 RIGHT OF USE ASSETS 6628127 7741308 LINE OF CREDIT 500000 500000 X 35774836 203228 203228 35571608 -2027 -2027 35569581 39653327 203228 2027 205255 39448072 0 39448072 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CENTER AND RECOGNIZE A TAX LIABILITY IF THE CENTER HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 4B - OTHER ADJUSTMENTS: GAIN/LOSS ON SALE OF EQUIPMENT -2,027. PART XII, LINE 2D - OTHER ADJUSTMENTS: GAIN/LOSS ON SALE OF EQUIPMENT 2,027. X X 0 0 0 0 0 0 0 0 0 DR NILES CARTER PHYSICIAN 480611 0 31500 0 412 0 19800 0 35884 0 568207 0 0 0 DR JAMES BIEN CMO 331031 0 500 0 2270 0 19434 0 34535 0 387770 0 0 0 DR DANIEL FRICK PHYSICIAN 255315 0 16362 0 378 0 16724 0 41891 0 330670 0 0 0 DR JASON HUA DENTIST 253205 0 10000 0 378 0 16216 0 41891 0 321690 0 0 0 DR AKIRA BARHAMS REGIONAL SITE MEDICAL DIRECTOR 233004 0 15962 0 336 0 15287 0 35884 0 300473 0 0 0 MARC HACKETT CEO 226305 0 31634 0 1449 0 8640 0 30030 0 298058 0 0 0 DR MICHAEL KHOULI PHYSICIAN 265000 0 0 0 258 0 13454 0 14314 0 293026 0 0 0 MICHAEL DALE CFO 143067 0 0 0 511 0 8726 0 30030 0 182334 0 0 0 PATRICK WOOTEN COO 143853 0 0 0 178 0 0 0 26057 0 170088 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B JANE PAULEY COMMUNITY HEALTH CENTER, INC.'S FORM 990 ARE PRESENTED TO THE BOARD, AND REVIEWED AND APPROVED BY THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C JANE PAULEY COMMUNITY HEALTH CENTER, INC. HAS A WRITTEN CONFLICT OF INTEREST POLICY, WHICH EVERYBODY IS REQUIRED TO REVIEW AND SIGN ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 JANE PAULEY COMMUNITY HEALTH CENTER, INC. USES MARKET DATA, AND NATIONAL ASSOCIATION DATA TO ENSURE THAT COMPENSATION IS FAIR AND EQUITABLE FOR THE POSITIONS. JANE PAULEY COMMUNITY HEALTH CENTER, INC. HAS ALSO DEVELOPED A PAY RANGE SCALE BASED ON POSITION CATEGORIES, WHICH HAS BEEN BOARD APPROVED. JANE PAULEY COMMUNITY HEALTH CENTER, INC. ENSURES THAT ALL SALARIES ARE WITHIN THE APPROVED RANGES FOR THE POSITION. FORM 990, PART VI, SECTION C, LINE 19 JANE PAULEY COMMUNITY HEALTH CENTER, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS, AS APPLICABLE, AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, FORM XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. JPCHC REAL ESTATE LLC 1503 N MITTHOEFFER RD INDIANAPOLIS IN 46229 320442001 REAL ESTATE HOLDING & MANAGEMENT IN 99781 4910338 JANE PAULEY COMMUNITY HEALTH CENTER INC