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Nonprofiteer
← SHALOM HEALTH CARE CENTER INC

Form 990 for tax year 2022

Filed by SHALOM HEALTH CARE CENTER INC.

Totals

Total revenue
$11,363,264
Total expenses
$11,268,684
Contributions and grants received
$6,379,151
Grants paid
$0
Program service revenue
$4,790,806
Investment income
$2,639
Other revenue
$190,668
Total assets, end of year
$5,738,853
Total liabilities, end of year
$3,752,791
Net assets or fund balances, end of year
$1,986,062
Program services expenses (Part IX)
$9,486,174
Management and general expenses
$1,782,510
Fundraising expenses
$0
Program service expenses (Part III)
$9,486,174

Program services were 84.2% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1e · Government grants (contributions)

    $5,373,345

  • 1f · All other contributions, gifts and grants

    $1,005,806

  • 1g · Noncash contributions included above

    $1,005,806

  • 2a · Program service revenue: NET PATIENT SERVICE

    total $3,399,091 · related or exempt $3,399,091

  • 2b · Program service revenue: SCHOOL CLINICS

    total $1,265,355 · related or exempt $1,265,355

  • 2c · Program service revenue: PHARMACY SALES

    total $126,360 · related or exempt $126,360

  • 3 · Investment income

    total $2,639 · excluded $2,639

  • 6a · Gross rents

    real property $242,921

  • 6b · Less rental expenses

    real property $375,863

  • 6c · Rental income or loss

    real property -$132,942

  • 6d · Net rental income or loss

    total -$132,942 · unrelated business -$132,942

  • 11a · Other revenue: OTHER INCOME

    total $323,610 · excluded $323,610

  • 11e · Other revenue, total

    $323,610

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $1,715,205 · program services $1,424,445 · management and general $290,760

  • 7 · Other salaries and wages

    total $6,285,479 · program services $5,219,969 · management and general $1,065,510

  • 11b · Fees: legal

    total $12,902 · program services $12,902

  • 11c · Fees: accounting

    total $86,919 · program services $86,919

  • 11g · Fees: other

    total $424,073 · program services $276,345 · management and general $147,728

  • 13 · Office expenses

    total $434,360 · program services $298,981 · management and general $135,379

  • 20 · Interest

    total $14,346 · program services -$743 · management and general $15,089

  • 22 · Depreciation, depletion and amortization

    total $123,100 · program services $123,100

  • 23 · Insurance

    total $33,744 · program services $4,027 · management and general $29,717

  • 24a · Other expenses: MEDICAL SUPPLIES & PHAR

    total $1,278,019 · program services $1,278,019

  • 24b · Other expenses: OTHER

    total $578,120 · program services $374,508 · management and general $203,612

  • 24c · Other expenses: LEASE & RENTALS

    total $357,309 · program services $314,012 · management and general $43,297

  • 24d · Other expenses: PLANT OPERATIONS

    total $97,173 · program services $73,690 · management and general $23,483

  • 24e · All other expenses

    total -$172,065 · management and general -$172,065

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $2,283,718 · end of year $862,636

  • 3 · Pledges and grants receivable

    beginning of year $164,087 · end of year $325,036

  • 4 · Accounts receivable

    beginning of year $319,726 · end of year $1,082,966

  • 9 · Prepaid expenses and deferred charges

    beginning of year $59,790 · end of year $65,907

  • 10a · Land, buildings and equipment: cost or other basis

    $5,082,125

  • 10b · Land, buildings and equipment: accumulated depreciation

    $2,560,120

  • 10c · Land, buildings and equipment, net

    beginning of year $2,522,384 · end of year $2,522,005

  • 15 · Other assets

    beginning of year $0 · end of year $880,303

  • 17 · Accounts payable and accrued expenses

    beginning of year $508,301 · end of year $969,016

  • 19 · Deferred revenue

    beginning of year $178,079 · end of year $134,657

  • 23 · Secured mortgages and notes payable

    beginning of year $1,951,450 · end of year $1,746,315

  • 25 · Other liabilities

    beginning of year $812,601 · end of year $902,803

  • 27 · Net assets without donor restrictions

    beginning of year $1,899,274 · end of year $1,986,062

Mission and programs · 2022

Mission

TO PROVIDE A FULL RANGE OF PRIMARY AND PREVENTIVE HEALTH CARE SERVICES TO ALL RESIDENTS, REGARDLESS OF THE ABILITY FOR PAYMENT.

  • PRIMARY AND PREVENTIVE HEALTH CARE SERVICES: WE ARE HERE AT SHALOM HEALTH CARE CENTER SUPPORT OUR MISSION OF PROVIDING PRIMARY HEALTH CARE TO THE UNDESERVED POPULATION THAT LIVE NEAR THE LAFAYETTE SQUARE AREA (WEST SIDE OF INDIANAPOLIS). IN 2021, SHALOM SERVED 14,567 PATIENTS AND HAD 91,052PATIENTS VISIT OUR PRIMARY CARE CENTERS AND TWENTY-NINE SCHOOL BASED CLINICS. OUR DEMOGRAPHIC DATA SHOWS THAT 84.78% OF THE PATIENTS ARE MINORITY, MANY OF THEM APPRECIATE THE FACT THAT WE OFFER BILINGUAL SERVICES TO THM AT NO ADDITIONAL COST. SCHOOL BASED CLINICS.

    Expenses $9,486,174 · Revenue $4,790,806

As filed on the 2022 return.

Listed in Part VII

  • EUGINA LONG

    BOARD

    Total calculated
    $0
    Hours/week
    1

  • CESAR ROMAN

    BOARD

    Total calculated
    $0
    Hours/week
    1

  • VIRNA DIAZ

    SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • CRISTIAN GUANDIQUE

    BOARD

    Total calculated
    $0
    Hours/week
    1

  • CASSANDRA HOOKS

    BOARD

    Total calculated
    $0
    Hours/week
    1

  • RICHARD PROCTOR II

    BOARD

    Total calculated
    $0
    Hours/week
    1

  • FRIEDA THOMPSON

    BOARD

    Total calculated
    $0
    Hours/week
    1

  • KENDREA DERRICK

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • HANS BERNABE

    TREASURER

    Total calculated
    $0
    Hours/week
    1

  • HANAKO GAVIA

    BOARD

    Total calculated
    $0
    Hours/week
    1

  • ARIELLE ZERGER

    CHAIR

    Total calculated
    $0
    Hours/week
    1

  • LEONARDO R ORTEGA MD MPH

    CEO

    Total calculated
    $226,273
    From this org
    $226,273
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $226,273
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $226,273

  • MICHAEL NINO

    CFO

    Total calculated
    $123,963
    From this org
    $117,367
    From related orgs
    $0
    Other
    $6,596
    Hours/week
    40

  • DR MARGARITA WIERSEMA

    CMO

    Total calculated
    $200,719
    From this org
    $180,219
    From related orgs
    $0
    Other
    $20,500
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $180,219
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $180,219

  • DR HEMALATHA HEMACHANDRA

    MEDICAL DIRECTOR

    Total calculated
    $196,553
    From this org
    $176,053
    From related orgs
    $0
    Other
    $20,500
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $176,053
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $176,053

  • LYNDSEY FURRY

    CHIEF CLINICAL OFFICER

    Total calculated
    $131,591
    From this org
    $120,229
    From related orgs
    $0
    Other
    $11,362
    Hours/week
    40

  • TERESA DRISKELL

    CNO

    Total calculated
    $134,545
    From this org
    $121,353
    From related orgs
    $0
    Other
    $13,192
    Hours/week
    40

  • MYRIAM BERESKY

    CNO

    Total calculated
    $112,838
    From this org
    $107,142
    From related orgs
    $0
    Other
    $5,696
    Hours/week
    40

  • LYLE CORTEZ

    PHYSICIAN

    Total calculated
    $171,035
    From this org
    $171,035
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $171,035
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $171,035

  • SCOTT CURTISS

    CHIEF INFORMATION OFFICER

    Total calculated
    $112,104
    From this org
    $112,104
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

  • STACI WALTERS

    CHIEF QUALITY AND COMPLIANCE OFFICER

    Total calculated
    $106,562
    From this org
    $101,139
    From related orgs
    $0
    Other
    $5,423
    Hours/week
    40

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

None.

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

  • SHALOM LLC

    HOLDING CO · IN · income -$132,942 · assets $2,349,992

    Directly controlled by SHALOM HEALTH

Provenance

Return type
form_990
Tax year
2022
Filed
15 November 2023
IRS schema version
2022v5.0
Source object
202333199349324038

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