Form 990 for tax year 2022

Filed by 219 HEALTH NETWORK INC.

Totals

Total revenue: $19,818,318
Total expenses: $16,771,828
Contributions and grants received: $992,312
Grants paid: $0
Program service revenue: $15,208,792
Investment income: $5,060
Other revenue: $3,612,154
Total assets, end of year: $8,349,612
Total liabilities, end of year: $2,302,368
Net assets or fund balances, end of year: $6,047,244
Program services expenses (Part IX): $13,969,531
Management and general expenses: $2,802,297
Fundraising expenses: $0
Program service expenses (Part III): $13,969,531

Program services were 83.3% 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.

1a · Federated campaigns

$0
1b · Membership dues

$0
1c · Fundraising events

$0
1d · Related organizations

$0
1e · Government grants (contributions)

$989,333
1f · All other contributions, gifts and grants

$2,979
1g · Noncash contributions included above

$0
2a · Program service revenue: NET PATIENT SERVICE REVENUE

total $15,208,792 · related or exempt $15,208,792 · unrelated business $0 · excluded $0
2b · Program service revenue

total $0 · related or exempt $0 · unrelated business $0 · excluded $0
2c · Program service revenue

total $0 · related or exempt $0 · unrelated business $0 · excluded $0
2d · Program service revenue

total $0 · related or exempt $0 · unrelated business $0 · excluded $0
2e · Program service revenue

total $0 · related or exempt $0 · unrelated business $0 · excluded $0
2f · All other program service revenue

total $0 · related or exempt $0 · unrelated business $0 · excluded $0
3 · Investment income

total $5,060 · related or exempt $0 · unrelated business $0 · excluded $5,060
4 · Income from investment of tax-exempt bond proceeds

total $0 · related or exempt $0 · unrelated business $0 · excluded $0
5 · Royalties

total $0 · related or exempt $0 · unrelated business $0 · excluded $0
6a · Gross rents

real property $2,313 · personal property $0
6b · Less rental expenses

real property $0 · personal property $0
6c · Rental income or loss

real property $2,313 · personal property $0
6d · Net rental income or loss

total $2,313 · related or exempt $0 · unrelated business $0 · excluded $2,313
7a · Gross sales of assets other than inventory

securities $0 · other assets $0
7b · Less cost or other basis and sales expenses

securities $0 · other assets $0
7c · Gain or loss

securities $0 · other assets $0
7d · Net gain or loss

total $0 · related or exempt $0 · unrelated business $0 · excluded $0
8a · Fundraising events: gross income

$0
8a · Fundraising events: contributions included on line 1c

$0
8b · Fundraising events: direct expenses

$0
8c · Net income from fundraising events

total $0 · unrelated business $0 · excluded $0
9a · Gaming: gross income

$0
9b · Gaming: direct expenses

$0
9c · Net income from gaming

total $0 · related or exempt $0 · unrelated business $0 · excluded $0
10a · Gross sales of inventory

$0
10b · Cost of goods sold

$0
10c · Net income from sales of inventory

total $0 · related or exempt $0 · unrelated business $0 · excluded $0
11a · Other revenue: PHARMACY

total $3,569,295 · related or exempt $3,569,295 · unrelated business $0 · excluded $0
11b · Other revenue: QUALITY CARE INCENTIVE

total $34,622 · related or exempt $34,622 · unrelated business $0 · excluded $0
11c · Other revenue: COPY FEE REVENUE

total $4,395 · related or exempt $4,395 · unrelated business $0 · excluded $0
11d · All other revenue

total $1,529 · related or exempt $1,529 · unrelated business $0 · excluded $0
11e · Other revenue, total

$3,609,841

Functional expenses

Part IX, the statement of functional expenses.

1 · Grants to domestic organizations and governments

total $0 · program services $0
2 · Grants to domestic individuals

total $0 · program services $0
3 · Grants to foreign organizations and individuals

total $0 · program services $0
4 · Benefits paid to or for members

total $0 · program services $0
5 · Compensation of officers, directors and key employees

total $115,566 · program services $0 · management and general $115,566 · fundraising $0
6 · Compensation of disqualified persons

total $0 · program services $0 · management and general $0 · fundraising $0
7 · Other salaries and wages

total $454,147 · program services $318,548 · management and general $135,599 · fundraising $0
8 · Pension plan contributions

total $15,074 · program services $9,260 · management and general $5,814 · fundraising $0
9 · Other employee benefits

total $19,067 · program services $0 · management and general $19,067 · fundraising $0
10 · Payroll taxes

total $26,797 · program services $11,189 · management and general $15,608 · fundraising $0
11a · Fees: management

total $781,715 · program services $0 · management and general $781,715 · fundraising $0
11b · Fees: legal

total $155,757 · program services $0 · management and general $155,757 · fundraising $0
11c · Fees: accounting

total $124,033 · program services $0 · management and general $124,033 · fundraising $0
11d · Fees: lobbying

total $0 · program services $0 · management and general $0 · fundraising $0
11e · Fees: professional fundraising services

total $0 · fundraising $0
11f · Fees: investment management

total $0 · program services $0 · management and general $0 · fundraising $0
11g · Fees: other

total $11,264,530 · program services $10,396,415 · management and general $868,115 · fundraising $0
12 · Advertising and promotion

total $272,604 · program services $13,645 · management and general $258,959 · fundraising $0
13 · Office expenses

total $242,595 · program services $190,001 · management and general $52,594 · fundraising $0
14 · Information technology

total $148,176 · program services $118,541 · management and general $29,635 · fundraising $0
15 · Royalties

total $0 · program services $0 · management and general $0 · fundraising $0
16 · Occupancy

total $643,084 · program services $593,554 · management and general $49,530 · fundraising $0
17 · Travel

total $19,528 · program services $9,611 · management and general $9,917 · fundraising $0
18 · Travel or entertainment for public officials

total $0 · program services $0 · management and general $0 · fundraising $0
19 · Conferences, conventions and meetings

total $23,456 · program services $20,329 · management and general $3,127 · fundraising $0
20 · Interest

total $0 · program services $0 · management and general $0 · fundraising $0
21 · Payments to affiliates

total $0 · program services $0 · management and general $0 · fundraising $0
22 · Depreciation, depletion and amortization

total $24,389 · program services $19,436 · management and general $4,953 · fundraising $0
23 · Insurance

total $239,224 · program services $201,237 · management and general $37,987 · fundraising $0
24a · Other expenses: MEDICAL SUPPLIES

total $1,859,603 · program services $1,774,192 · management and general $85,411 · fundraising $0
24b · Other expenses: BAD DEBT

total $236,276 · program services $236,276 · management and general $0 · fundraising $0
24c · Other expenses: LICENSES AND FEES

total $36,935 · program services $13,206 · management and general $23,729 · fundraising $0
24d · Other expenses: DUES AND SUBSCRIPTIONS

total $16,095 · program services $15,630 · management and general $465 · fundraising $0
24e · All other expenses

total $53,177 · program services $28,461 · management and general $24,716 · fundraising $0
26 · Joint costs (an allocation of the lines above)

total $0 · program services $0 · management and general $0 · fundraising $0

Balance sheet

Part X, book values.

1 · Cash, non-interest-bearing

beginning of year $0 · end of year $0
2 · Savings and temporary cash investments

beginning of year $3,243,830 · end of year $4,765,249
3 · Pledges and grants receivable

beginning of year $0 · end of year $0
4 · Accounts receivable

beginning of year $892,804 · end of year $1,240,527
5 · Loans and receivables from officers and key people

beginning of year $0 · end of year $0
6 · Loans and receivables from disqualified persons

beginning of year $0 · end of year $0
7 · Other notes and loans receivable

beginning of year $0 · end of year $0
8 · Inventories for sale or use

beginning of year $0 · end of year $0
9 · Prepaid expenses and deferred charges

beginning of year $34,190 · end of year $43,865
10a · Land, buildings and equipment: cost or other basis

$235,921
10b · Land, buildings and equipment: accumulated depreciation

$43,038
10c · Land, buildings and equipment, net

beginning of year $209,327 · end of year $192,883
11 · Investments: publicly traded securities

beginning of year $0 · end of year $0
12 · Investments: other securities

beginning of year $0
13 · Investments: program-related

beginning of year $0
14 · Intangible assets

beginning of year $0 · end of year $0
15 · Other assets

beginning of year $1,206,192 · end of year $2,107,088
17 · Accounts payable and accrued expenses

beginning of year $1,549,070 · end of year $1,999,980
18 · Grants payable

beginning of year $0 · end of year $0
19 · Deferred revenue

beginning of year $0 · end of year $0
20 · Tax-exempt bond liabilities

beginning of year $0 · end of year $0
21 · Escrow or custodial account liability

beginning of year $0 · end of year $0
22 · Loans and payables to officers and key people

beginning of year $0 · end of year $0
23 · Secured mortgages and notes payable

beginning of year $939,156 · end of year $0
24 · Unsecured notes and loans payable

beginning of year $0 · end of year $0
25 · Other liabilities

beginning of year $94,176 · end of year $302,388
27 · Net assets without donor restrictions

beginning of year $2,994,829 · end of year $6,043,137
28 · Net assets with donor restrictions

beginning of year $9,112 · end of year $4,107
29 · Capital stock, trust principal or current funds

beginning of year $0 · end of year $0
30 · Paid-in or capital surplus, or land, building or equipment fund

beginning of year $0 · end of year $0
31 · Retained earnings, endowment or other funds

beginning of year $0 · end of year $0

Mission and programs · 2022

Mission

IT IS OUR MISSION TO PROVIDE THE HIGHEST QUALITY OF CARE AT THE MOST AFFORDABLE COST FOR THE COMMUNITIES WE SERVE. WE STRIVE TO PROVIDE THE NECESSARY PRIMARY CARE, BEHAVIORAL HEALTH, DENTAL, AND PREVENTATIVE CARE WITH RESPECT AND DIGNITY, REGARDLESS OF THE PATIENT'S SOCIO-ECONOMIC STATUS.

Activities or mission (Part I)

219 HEALTH NETWORK INC IS COMMITTED TO PROVIDING THE HIGHEST QUALITY CARE IN THE MOST COST-EFFICIENT MANNER, RESPECTING THE DIGNITY OF THE INDIVIDUAL.

219 HEALTH NETWORK, INC. WAS CREATED IN JULY 2017 TO SERVICE EAST CHICAGO, INDIANA AND SURROUNDING COMMUNITIES. EAST CHICAGO, LOCATED IN NW INDIANA, IS AN URBAN COMMUNITY WITH A DIVERSE RACIAL AND ETHNIC POPULATION. MANY OF OUR RESIDENTS LIVE AT OR BELOW THE FEDERAL POVERTY LEVEL. OUR GOAL IS TO BECOME A FEDERALLY QUALIFIED HEALTH CENTER (FQHC). WE WERE GRANTED LOOK-A-LIKE STATUS IN APRIL 2019. WE HAVE ALSO RECEIVED OVERWHELMING COMMUNITY SUPPORT AND COMMITMENT. OUR BOARD OF DIRECTORS IS COMPRISED OF PILLARS OF THE COMMUNITY. WE IDENTIFIED THROUGH CHNA'S OF LOCAL HOSPITALS THAT ACCESS TO CARE IS A MAJOR BARRIER TO CARE. IN FISCAL YEAR 2023 WE PROVIDED 87,335 VISITS TO THE COMMUNITY WE SERVE. WE ADDED 5 NEW LOCATIONS BRINGING OUR CURRENT TOTAL TO 15 LOCATIONS. WE ALSO OPERATE A MOBILE CLINIC TO ASSIST US IN OUR OUTREACH INTO THE COMMUNITIES WE SERVE. NW INDIANA RANKS AS ONE OF THE HIGHEST REGIONS IN THE STATE FOR INFANT MORTALITY, DIABETES AND ARTHRITIS. 219 HEALTH NETWORK, INC. CURRENTLY OFFERS A VARIETY OF SERVICES INCLUDING: FAMILY MEDICINE, INTERNAL MEDICINE, OB/GYN, BEHAVIORAL HEALTH, PEDIATRICS, ENDOCRINOLOGY, RHEUMATOLOGY AND DENTISTRY BY WAY OF REFERRAL. OUR GOAL IS TO POSITIVELY IMPACT THE COMMUNITIES WE SERVE AND TO ACHIEVE SIGNIFICANT IMPROVEMENT IN THE AREAS IDENTIFIED ABOVE.

Expenses $13,969,531 · Revenue $18,818,633

As filed on the 2022 return.

Listed in Part VII

Leo CorreaLEO CORREA

CHAIRMAN

Total calculated

$0

Hours/week

1
Luis MOLINA

TREASURER

Total calculated

$0

Hours/week

1
Sandra NoeSANDRA NOE

SECRETARY

Total calculated

$0

Hours/week

1
Andrea SherwinANDREA SHERWIN

DIRECTOR - TERM 10/28/2022

Total calculated

$0

Hours/week

1
Constantina MourtosCONSTANTINA MOURTOS

DIRECTOR - TERM 10/28/2022

Total calculated

$0

Hours/week

1
Gloria VelaGLORIA VELA

DIRECTOR

Total calculated

$0

Hours/week

1
Marjol Rush-ColletMARJOL RUSH-COLLET

DIRECTOR

Total calculated

$0

Hours/week

1
Martha Gonzalez

DIRECTOR - START 10/26/2022

Total calculated

$0

Hours/week

1
Milton ReedMILTON REED

DIRECTOR

Total calculated

$0

Hours/week

1
Richard PadzikRICHARD PADZIK

DIRECTOR

Total calculated

$0

Hours/week

1
Sara JiminezSARA JIMINEZ

DIRECTOR

Total calculated

$0

Hours/week

1
Sava Pavkovich

DIRECTOR - START 10/26/2022

Total calculated

$0

Hours/week

1
Patricia A JohnsonPATRICIA A JOHNSON

CEO

Total calculated

$177,257

From this org

$151,266

From related orgs

$0

Other

$25,991

Hours/week

40

Schedule J breakdown matched by us

Base

$137,177

Bonus

$13,440

Other

$649

Deferred

$5,712

Nontaxable benefits

$20,279

Filer's total

$177,257
Lisa Richardson MD

Physician

Total calculated

$348,075

From this org

$288,939

From related orgs

$0

Other

$59,136

Hours/week

40

Schedule J breakdown matched by us

Base

$209,066

Bonus

$78,813

Other

$1,060

Deferred

$8,760

Nontaxable benefits

$50,376

Filer's total

$348,075

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

3 · Compensation survey or study
7 · Other non-fixed payments

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
8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 7 Non-fixed payments: DISCRETIONARY BONUS IS PAID BASED ON FINANCIAL PERFORMANCE AND QUALITY INDICATORS TO CERTAIN EXECUTIVES AND PHYSICIANS.

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.

Provenance

Return type: form_990
Tax year: 2022
Filed: 14 May 2024
IRS schema version: 2022v5.0
Source object: 202421359349312147

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