TY 2021 Form 990

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

VISITING NURSE ASSOCIATION OF INDIANA COUNTY

Employer identification number

23-7042932

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2021

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2021

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .	234,311	410,942	339,379	207,084	680,180	1,871,896
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose	7,766,803	7,468,023	7,001,864	7,502,198	8,552,034	38,290,922
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5	8,001,114	7,878,965	7,341,243	7,709,282	9,232,214	40,162,818
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)						40,162,818

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
9	Amounts from line 6...	8,001,114	7,878,965	7,341,243	7,709,282	9,232,214	40,162,818
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	75,197	88,244	22,737	39,047	1,959	227,184
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.	75,197	88,244	22,737	39,047	1,959	227,184
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..	0	0	0	1,173,505	0	1,173,505
13	Total support. (Add lines 9, 10c, 11, and 12.)..	8,076,311	7,967,209	7,363,980	8,921,834	9,234,173	41,563,507

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

96.630 %

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

96.329 %

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

0.547 %

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

0.747 %

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2021

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2021

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
Schedule A, Part III, Line 1	Column (e) Fiscal Year Beginning in 2021 includes a Government Grant of $557,092 which was a Stimulus Payment from the CARES Act Provider Relief Fund and FEMA Grant.
Schedule A, Part III, Line 12	The Other Income received in the fiscal year beginning in 2020 was miscellaneous income and the recognition of the forgiveness of the Paycheck Protection Program (PPP) Loan from the Coronavirus Aid, Relief, and Economic Security Act (CARES Act).

Schedule A (Form 990) 2021

Additional Data

Software ID:	21013178
Software Version:	v1.00

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Name of the organization

VISITING NURSE ASSOCIATION OF INDIANA COUNTY

Employer identification number

23-7042932

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization VISITING NURSE ASSOCIATION OF INDIANA COUNTY

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization VISITING NURSE ASSOCIATION OF INDIANA COUNTY		Employer identification number 23-7042932

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization VISITING NURSE ASSOCIATION OF INDIANA COUNTY			Employer identification number 23-7042932
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2021)

Additional Data

Software ID:	21013178
Software Version:	v1.00

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

VISITING NURSE ASSOCIATION OF INDIANA COUNTY

Employer identification number

23-7042932

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	19,577	19,577	19,577	19,577	19,577
b	Contributions ...	0	0	0	0	0
c	Net investment earnings, gains, and losses	0	0	0	0	0
d	Grants or scholarships ...	0	0	0	0	0
e	Other expenditures for facilities and programs ...	0	0	0	0	0
f	Administrative expenses ....	0	0	0	0	0
g	End of year balance ......	19,577	19,577	19,577	19,577	19,577

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100 %

Term endowment SchDMd Bullet

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	0	0		0
b	Buildings ....	0	0	0	0
c	Leasehold improvements	0	0	0	0
d	Equipment ....	0	527,510	409,974	117,536
e	Other .....	0	1,950	0	1,950
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					119,486

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	212,208
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	9,227,968
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-1,373
b	Donated services and use of facilities .........	2b	0
c	Recoveries of prior year grants ...........	2c	0
d	Other (Describe in Part XIII.) ............	2d	3,912
e	Add lines 2a through 2d .....................			2e	2,539
3	Subtract line 2e from line 1..................			3	9,225,429
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a	0
b	Other (Describe in Part XIII.) ...........	4b	0
c	Add lines 4a and 4b....................			4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	9,225,429

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	8,074,466
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a	0
b	Prior year adjustments ............	2b	0
c	Other losses ................	2c	0
d	Other (Describe in Part XIII.) ............	2d	2,987
e	Add lines 2a through 2d....................			2e	2,987
3	Subtract line 2e from line 1...................			3	8,071,479
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a	0
b	Other (Describe in Part XIII.) ............	4b	0
c	Add lines 4a and 4b.....................			4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	8,071,479

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Schedule D, Part V, Line 4	Permanently Restricted Net Assets represent contributions received with the donor restriction that the principal be invested in perpetuity and that only the income earned thereon will be available for operations.
Schedule D, Part X, Line 2	The Organization is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code (Code) and has been recognized as tax exempt under Section 501(a) of the IRC. Accordingly, no provision for income taxes has been provided. Accounting principles generally accepted in the United States of America require management to evaluate tax positions taken by the Organization and recognize a tax liability or asset if the Organization has taken an uncertain position that more likely than not would be sustained upon examination by the Internal Revenue Services (IRS). The Organization has concluded that as of June 30, 2022 and 2021, there are no uncertain positions taken or expected to be taken that would require recognition of a liability, asset, or disclosure in the financial statements. Generally, tax returns for years ended June 30, 2019, and thereafter remain subject to examination by federal and state tax authorities.
Schedule D, Part XI, Line 2d	Other revenues included on the audited financial statements are $2,987 Direct Expenses to the Gross Income from Fundraising Events and $925 Net Assets Released from Restriction.
Schedule D, Part XII, Line 2d	Other expenses included on the audited financial statements are $2,987 Direct Expenses related to the Fundraising Event.

Schedule D (Form 990) 2021

Additional Data

Software ID:	21013178
Software Version:	v1.00

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization
VISITING NURSE ASSOCIATION OF INDIANA COUNTY

Employer identification number

23-7042932

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990) 2021

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 Butterfly Release (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	25,394	25,394
2	Less: Contributions . . . .	0	0
3	Gross income (line 1 minus line 2) . . . . . .	25,394	25,394

4	Cash prizes . . . . .	0		0
5	Noncash prizes . . . .	0		0
6	Rent/facility costs . . . .	0		0
7	Food and beverages . . .	0	0	0
8	Entertainment . . . .	0	0	0
9	Other direct expenses . . .	2,987		2,987
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .			2,987
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .			22,407

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990) 2021

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990) 2021

Additional Data

Software ID:	21013178
Software Version:	v1.00

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

VISITING NURSE ASSOCIATION OF INDIANA COUNTY

Employer identification number

23-7042932

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2021

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Martin Trettel - see Schedule O Board Chairman	(i) (ii)	0 ------------- 249,195	0 ------------- 12,100	0 ------------- 31,511	0 ------------- 18,324	0 ------------- 7,717	0 ------------- 318,847	0 ------------- 0
2Tammy Young - see Schedule O Board Member	(i) (ii)	0 ------------- 175,375	0 ------------- 5,950	0 ------------- 0	0 ------------- 11,629	0 ------------- 302	0 ------------- 193,256	0 ------------- 0

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Schedule J, Part I	All board members of Visiting Nurse Association of Indiana County serve on a purely volunteer basis. Any compensation to a board member by a related organization, reported on Part VII and Schedule J, is for his/her service as an employee of that organization and not for his/her service as a board member.
Schedule J, Part I, Line 3	On an annual basis, personnel committee does a study of wages using various data sources including Guidestar website data, an annual health care compensation data book purchased from the National Association of Home Care and Hospice organization, and PA Wage information from the PA Labor & Industry website. The committee presents their findings and recommendations to the board. The Executive Director was reviewed during the fiscal year associated with this return.
Schedule J, Part I, Line 4	Visiting Nurse Association of Indiana County participates in a non-qualified 457 deferred compensation plan for certain highly compensated employees. The Concordia Lutheran Ministries (EIN 20-5138278) Board of Directors and CEO approve all participants who are enrolled in the plan. Contributions are deferred and will fully vest in five years. Once disbursed, contributions will appear in Box 5 of the participant's W-2. In the calendar year 2020 the following participants were enrolled in the plan: Martin Trettel, Tammy Young, and Misty Ingram.

Schedule J (Form 990) 2021

Additional Data

Software ID:	21013178
Software Version:	v1.00

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

VISITING NURSE ASSOCIATION OF INDIANA COUNTY

Employer identification number

23-7042932

Return Reference	Explanation
Form 990, Part VI, Section A, Line 1b	The independent board members are independent due to the definition of control. These members are employed by the minority member (the member hospital). They serve purely on a volunteer basis. They are not compensated for their participation on the board of directors.
Form 990, Part VI, Section A, Line 3	Visiting Nurse Association of Indiana County (VNAIC) entered into a management services agreement with Concordia Community Support Services (CCSS) on 4/15/2020. CCSS will perform management and policy functions and is committed to developing strong leadership so that VNAIC can provide the highest quality of home health and hospice care from nursing and therapy to specialized services such as IV therapy, wound care, palliative care, and psychiatric care, all from the comfort of the patients' home. The management services are being provided so that VNAIC can provide education and direct care to an aging population. CCSS will be responsible for appointment of the administrator for the agency and supervise all aspects of the operations of the home health and hospice program.
Form 990, Part VI, Section A, Line 6	Beginning January 1, 2021, through an affiliation agreement dated April 15, 2020 with an effective date of January 1, 2021, Concordia Community Support Services (CCSS) became the majority and managing member of Visiting Nurse Association of Indiana County d/b/a Concordia-IRMC VNA. The Organization's members consist of CCSS and Indiana Regional Medical Center with membership interests of 51% and 49%, respectively.
Form 990, Part VI, Section A, Line 7a	Beginning January 1, 2021, through an affiliation agreement dated April 15, 2020 with an effective date of January 1, 2021, Concordia Community Support Services (CCSS) became the majority and managing member and Indiana Regional Medical Center (IRMC) became the minority member. From that point forward, three (3) to five (5) directors shall be appointed by CCSS, and two (2) to four (4) directors shall be appointed by IRMC. The VNAIC board of directors consists of a total of five (5) to nine (9) persons.
Form 990, Part VI, Section A, Line 7b	Beginning January 1, 2021, through an affiliation agreement dated April 15, 2020 with an effective date of January 1, 2021, Concordia Community Support Services (CCSS) became the majority and managing member and Indiana Regional Medical Center (IRMC) became the minority member. In addition to those rights and privileges otherwise accorded to the two Members under these Bylaws, the Corporation's Articles of Incorporation or Pennsylvania law, the two Members shall have the authority to appoint and remove certain Directors, and shall have certain reserved powers as stated in the Bylaws.
Form 990, Part VI, Section B, Line 11b	The Form 990 is prepared and reviewed by the accounting department for Concordia Community Support Services. The document is then reviewed by the CFO. The board is sent draft copies of the 990 prior to filing, in order to provide questions, comments, and feedback. Questions and comments are addressed accordingly. Upon board approval the final 990 is submitted to the taxing authorities. A copy of the final 990 is made available to all board members.
Form 990, Part VI, Section B, Line 12c	Board members must complete a conflict interest disclosure statement when they join the board and on an annual basis in subsequent years.
Form 990, Part VI, Section B, Line 15	On an annual basis, personnel committee does a study of wages using various data sources including Guidestar website data, an annual health care compensation data book purchased from the National Association of Home Care and Hospice organization, and PA Wage information from the PA Labor & Industry website. The committee presents their findings and recommendations to the board. The Executive Director was reviewed during the fiscal year associated with this return.
Form 990, Part VI, Section C, Line 19	Concordia Lutheran Ministries (EIN 20-5138278) publishes an annual report that summarizes the financial operations of the organization and its affiliates (including Visiting Nurse Association of Indiana County) which is mailed to all of its constituents and is available to the public upon request. The Visiting Nurse Association of Indiana County governing documents, conflict of interest policies, and financial statements are available to the public upon request.
Form 990, Part VII, Section A, Line 1a	All board members of Visiting Nurse Association of Indiana County serve on a purely volunteer basis. Any compensation to a board member by a related organization, reported on Part VII and Schedule J, is for his/her service as an employee of that organization and not for his/her service as a board member. Employment compensation for board members is as follows: Martin Trettel, Chief Executive Officer, Concordia Visiting Nurses; Tammy Young, Chief Financial Officer, Concordia Community Support Services and community-based affiliates; Misty Ingram, Chief Operating Officer, Concordia Community Support Services and community-based affiliates; Wendy Moore, Director of Clinical Operations, Good Samaritan Hospice of Pittsburgh; Mena Louies, Executive Director, Concordia Hospice of Washington; and Elizabeth Coe, Director of Business Operations, Concordia Community Support Services and community-based affiliates.
Form 990, Part XI, Line 9	Net Value of: Distribution to partners during current fiscal year ($500,000), Contributions with Donor Restriction received during the fiscal year that will carry over to the following fiscal year $663.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:	21013178
Software Version:	v1.00

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

VISITING NURSE ASSOCIATION OF INDIANA COUNTY

Employer identification number

23-7042932

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)Concordia Lutheran Health & Human Care 134 Marwood Road Cabot,PA16023 25-0969458	Provide skilled nursing, personal care, independent living, and rehabilitative services	PA	501(c)(3)	10	Concordia Lutheran Ministries		No
(2)Concordia Lutheran Ministries Foundation 134 Marwood Road Cabot,PA16023 20-5138266	Raise and receive funds for the furtherance of the mission and purposes of affiliated 501(c)(3) orgs	PA	501(c)(3)	12 Type II	Concordia Lutheran Ministries		No
(3)Rebecca Residence dba Concordia at Rebecca Residence3746 Cedar Ridge Road Allison Park,PA15101 25-0974311	Provide skilled nursing, personal care, independent living, and rehabilitative services	PA	501(c)(3)	10	Concordia Lutheran Health and Human Care		No
(4)Concordia Visiting Nurses of Ohio 613 North Pike Road Cabot,PA16023 46-3845269	Home Health Services	OH	501(c)(3)	10	Concordia Community Support Services		No
(5)Concordia Lutheran Ministries 134 Marwood Road Cabot,PA16023 20-5138278	Provides access to corp resources and expert support to carry out the purpose of the affiliates	PA	501(c)(3)	12 Type III	N/A		No
(6)Concordia of Monroeville 4363 Northern Pike Monroeville,PA15146 25-1475192	To provide skilled nursing, personal care, independent living and rehabilitation services	PA	501(c)(3)	10	Concordia Lutheran Ministries of Pittsburgh		No
(7)Good Samaritan Hospice of Pittsburgh 116 Browns Hill Road Suite 100 Valencia,PA16059 25-1818793	Provide inpatient and community hospice patient care	PA	501(c)(3)	10	Concordia Lutheran Health and Human Care		No
(8)Cedars Home Health Care Services 4363 Northern Pike Monroeville,PA15146 25-1875508	Home Health Services	PA	501(c)(3)	10	Concordia Tele CareGivers		No
(9)Concordia Community Support Services 613 North Pike Road Suite B Cabot,PA16023 47-3508524	Provide oversight, management and strategic planning	PA	501(c)(3)	12 Type II	Concordia Lutheran Ministries		No
(10)Concordia Lutheran Ministries of Pittsburgh 1300 Bower Hill Road Pittsburgh,PA15243 27-0209886	Provide skilled nursing, personal care, independent living, and rehabilitative services	PA	501(c)(3)	10	Concordia Lutheran Ministries		No
(11)Concordia Visiting Nurses 613 North Pike Road Cabot,PA16023 42-1704067	Provide home health care services	PA	501(c)(3)	10	Concordia Community Support Services		No
(12)Concordia Physician Practice 134 Marwood Road Cabot,PA16023 47-3951584	To provide primary physician services	PA	501(c)(3)	10	Concordia Lutheran Ministries		No
(13)Concordia Tele CareGivers 613 North Pike Road Suite A Cabot,PA16023 25-1881783	Provide private duty non-medical services	PA	501(c)(3)	10	Concordia Community Support Services		No
(14)Concordia Hospice of Washington 613 North Pike Road Suite B Cabot,PA16023 81-2448411	Provide inpatient and community hospice patient care	PA	501(c)(3)	10	Concordia Community Support Services		No
(15)Concordia of Ohio 970 Sumner Parkway Copley,OH44321 61-1682165	Provide skilled nursing, personal care, independent living, and rehabilitative services	OH	501(c)(3)	10	Concordia Lutheran Ministries		No
(16)Concordia of Florida 4100 E Fletcher Avenue Tampa,FL33613 37-1869372	Provide skilled nursing, personal care, independent living, and rehabilitative services	FL	501(c)(3)	10	Concordia Lutheran Ministries		No
(17)Concordia Medical Equipment 615 North Pike Road Cabot,PA16023 20-4386767	Rental/sales of medical equipment and supplies	PA	501(c)(3)	10	Concordia Lutheran Ministries		No
(18)Harmony Protection Group 134 Marwood Rd Cabot,PA16023 85-2377219	Provide insurance coverage to affiliated 501(c)(3) orgs	PA	501(c)(3)	12 Type II	Concordia Lutheran Ministries		No
(19)Concordia Ministries of New York Inc 134 Marwood Rd Cabot,PA16023 86-3586342	Youth recreation services	PA	501(c)(3)	PF	Concordia Lutheran Ministries		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) Providence Pharmacy Services 615 North Pike Road Cabot,PA16023 22-3885810	Provides institutional pharmacy services and consulting as the limited partnership	PA	Concordia Providence LLC	Related				No			No	0 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No

Schedule R (Form 990) 2021

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2021

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2021

Additional Data

Software ID:	21013178
Software Version:	v1.00

1	Briefly describe the organization’s mission or most significant activities: Families in Indiana County have been certain that they can depend on the Visiting Nurse Association to assist them at home after a hospitalization or nursing home stay, when an illness or injury occurs, or as they face the challenges at end of life through high-quality hospice care.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	4
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	118
6	Total number of volunteers (estimate if necessary) .............	6	24
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	207,084	680,180
9	Program service revenue (Part VIII, line 2g) .........	7,502,198	8,552,034
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	141,104	-3,798
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,170,220	-2,987
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	9,020,606	9,225,429
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	180	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	5,274,963	5,491,307
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 12,033
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	2,148,707	2,580,172
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	7,423,850	8,071,479
19	Revenue less expenses. Subtract line 18 from line 12.......	1,596,756	1,153,950
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	3,379,088	3,843,234
21	Total liabilities (Part X, line 26).............	1,022,518	833,424
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,356,570	3,009,810

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 4,009,961 including grants of $ 0 ) (Revenue $ 5,956,773 )
	The Visiting Nurse Association of Indiana County dba Concordia-IRMC VNA provides compassionate home health, hospice and palliative care as an integral part of the continuum of care for persons in and around Indiana County. The program service accomplishments of Visiting Nurse Association of Indiana County (VNAIC) are driven by the core mission to provide a comprehensive program for the residents of Indiana and Jefferson counties. The agency strives to succeed with an aging-in-place philosophy by providing a wide breadth of services in the home, preventing rehospitalization, enhancing home safety and monitoring chronic disease states. The agency also works to provide the highest quality care to everyone in need, regardless of their ability to pay. During the fiscal year ending June 30, 2022, 2,515 patients were served by VNAIC home health staff. There were 45,132 visits made to patients in our home health program during fiscal year ended June 30, 2022. VNAIC also offers palliative care services in the home. This is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious illnesses. The goal is to provide the care to the patient as well as the family as they journey towards a possible hospice plan of care. COVID-19 continued to weigh on the operations of Visiting Nurse Association of Indiana County. Throughout the COVID-19 PHE, the organization provided focused education on various related topics. These topics included what COVID-19 is, how to prevent the spread, how to care for patients that are positive for COVID-19, mitigation efforts, Personal Protective Equipment utilization and other infection control practices. This education was provided through varying platforms such as secure messaging, at virtual staff meetings and through the Learning Management Software, Elsevier. Staff have also been educated on COVID-19 vaccinations and the importance of vaccinations as a tool to help end the PHE. Some examples of our new initiatives include telehealth/telemedicine. CVN provides Tele-Health monitoring free of charge to patients with chronic diseases. Tele-Health monitoring is a non-billable service that was funded in the current fiscal year through a grant with Highmark. Tele-Health has been utilized over the past year to provide additional monitoring for COVID-19 positive patient vital sign trending. The pandemic also brought into effect the 1135 waivers. One of the waivers allowed a PT or ST to conduct the initial assessment when therapy was ordered rather than a Skilled Nurse. VNAIC employs a Transitional Nurse Liaison who serves the community by helping discharge planners to assess the patients' needs to obtain appropriate orders for the plan of care. This position also attends community gatherings to discuss programs and events sponsored by VNAIC. The goal is to reach as many people as possible in the community to promote wellness and teach prevention. Flu shots were provided at community Flu Clinics held at various sites. VNAIC spent a total of $3,105 on flu vaccines that were given to patients and employees. Total cost to the agency for sponsorships and donations for fiscal year ended 6/30/2022 equated $1,500 for the Indiana Healthcare Foundation Golf Outing sponsorship. Additional funding via distributions to 501(c)(3) member hospital systems at a total of $500,000 have expanded like-minded mission within the geographical communities we serve. Employees of VNAIC were given the opportunity to serve by participating in mission events organized by the parent company Concordia Community Support Services. Here are the mission event opportunities that VNAIC took part in during the fiscal year. In March 2022, The Concordia Family of Pennsylvania partnered with a company out of Moon Township called DTCare. This non-profit agency shipped much needed supplies to support those who have sought refuge in Poland as a result of the conflict in Ukraine. Employees purchased supplies such as toothbrushes, soap, diapers, socks and first aid supplies. Concordia Medical Equipment employees used their trucks to transport everything gathered to Moon Township. These sponsorships, distributions, and mission events are some of the many ways we serve God by providing for the needs of His people.

4b	(Code: ) (Expenses $ 2,019,589 including grants of $ 0 ) (Revenue $ 2,591,463 )
	The Visiting Nurse Association of Indiana County dba VNA Family Hospice's primary focus is helping individuals to live peacefully, positively and as fully as possible through caring, not curing. Hospice is not a place, but a concept for healthcare delivery. It focuses on creating a natural and comfortable end-of-life experience for those dealing with a life-limiting illness, all in the comfort of their own home. Whether the goal is relief from pain, desire to experience a meaningful event such as a wedding, the birth of a child, a birthday, resolving unfinished business, or is simply the hope for a restful night of sleep, the team at VNA Family Hospice can provide an array of support services. These include, but are not limited to: nursing and related services, personal care, counseling, companionship, spiritual services and bereavement care. Hospice program patients and bereavement families received services and were provided with 12,674 visits. In addition, hospice volunteers provided 460 hours of service to program recipients including support to the family of the hospice patient. The VNA Family Hospice provides bereavement counseling and grief support groups to members of the community grieving the loss of a loved one or friend at no charge. Also, a summer newsletter and bereavement mailings were sent offering spiritual support, coping techniques and education to hospice family members. The 12th annual VNAIC Butterfly Release was held in a modified drive-through style format on Sunday August 8, 2021, at Mack Park, Indiana, PA. This memorial event was open to anyone who wanted to honor and celebrate the memory of their loved ones, whether or not they were ever on service at VNAIC. 600 butterflies were sold for a donation to the Hospice for families to pick up and release at home. VNAIC offers a no cost program to the community called Hopeful Hearts. The mission of Hopeful Hearts is to improve the lives of grieving children and their families by providing support in a safe and caring environment, where all are welcome, and where families can grow through the healing process. Hopeful Hearts provides a safe and caring environment for grieving children and their families to come together and safely explore and share their experiences, feelings, and memories of the person who has died. Evening sessions are held twice a month for the family of the grieving child to meet for a meal, fellowship, and session led by trained bereavement volunteers. The program supported ten returning families and two new families. There were 12 adults and 24 children that were supported during this fiscal year. The participants are placed into age-appropriate groups (preschool, young child, middle child, teen and adult). Like all bereavement services provided by hospice, Hopeful Hearts supports the whole family on the grief journey over many months.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ 0 including grants of $ 0 ) (Revenue $ 0 )
4e	Total program service expenses6,029,550

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)		(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) Martin Trettel - see Schedule O...................................................................... Board Chairman	1 ................. 44	X	X	0	292,806	26,041
(2) Tammy Young - see Schedule O...................................................................... Board Member	1 ................. 44	X		0	181,325	11,931
(3) Misty Ingram - see Schedule O...................................................................... Board Member	1 ................. 44	X		0	129,050	16,531
(4) Wendy Moore - see Schedule O...................................................................... Board Member until Dec 2021	1 ................. 44	X		0	110,837	21,890
(5) Mena Louies - see Schedule O...................................................................... Board Member as of Jan 2022	1 ................. 44	X		0	116,756	13,608
(6) William Bellas...................................................................... Executive Director	45 ................. 0		X	0	110,400	7,185
(7) Elizabeth Coe - see Schedule O...................................................................... Board Member	1 ................. 44	X		0	107,497	7,335
(8) Jim Kinneer...................................................................... Vice Chair	1 ................. 0	X	X	0	0	0
(9) Jill Muir...................................................................... Board Member until May 2022	1 ................. 0	X		0	0	0
(10) Mark Volovic...................................................................... Board Member	1 ................. 0	X		0	0	0
(11) April Miller...................................................................... Board Member until Dec 2021	1 ................. 0	X		0	0	0
(12) Robert Gongaware...................................................................... Board Member as of Jan 2022	1 ................. 0	X		0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	1,048,671	104,521

(A) Name and business address	(B) Description of services	(C) Compensation
Concordia Community Support Services 613 North Pike Road Suite B Cabot,PA16023	Management Company	298,707
Strongerday Rehabilitation & Management Audiological & Speech Associates 270 Philadelphia Street Indiana,PA15701	Contracted Speech Therapy	105,778



2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 2

1a	Federated campaigns..		1a	16,142
b	Membership dues..		1b	0
c	Fundraising events..		1c	25,394
d	Related organizations		1d	353
e	Government grants (contributions)		1e	557,092

f	All other contributions, gifts, grants, and similar amounts not included above		1f	81,199

g	Noncash contributions included in lines 1a - 1f:$		1g	0

h Total. Add lines 1a-1f.......		680,180

		Business Code
2a	Home Care Patient Service Revenue	621610	5,959,166	5,959,166	0	0
b	Hospice Patient Service Revenue	621610	2,592,868	2,592,868	0	0
c
d
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		8,552,034

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,959	1,959	0	0
4 Income from investment of tax-exempt bond proceeds			0	0	0	0
5 Royalties...........			0	0	0	0
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	0	6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	0	0	7a
b	Less: cost or other basis and sales expenses	5,757	0	7b
c	Gain or (loss)	-5,757	0	7c
d	Net gain or (loss).........			-5,757	-5,757	0	0
8a	Gross income from fundraising events (not including $ 25,394of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	2,987
c	Net income or (loss) from fundraising events..			-2,987		0	-2,987
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See instructions.....			9,225,429	8,548,236	0	-2,987

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	4,363,208	3,714,507	648,701
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	118,376	93,709	24,667
9	Other employee benefits .......	610,049	522,053	87,996
10	Payroll taxes ...........	399,674	344,470	55,204
11	Fees for services (non-employees):
a	Management ......	298,707		298,707
b	Legal .........
c	Accounting ...........	192,531		192,531
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	627,235	201,753	415,131	10,351
12	Advertising and promotion ....	13,534		13,534
13	Office expenses .......	192,513	58,755	133,263	495
14	Information technology ......	136,795	92,303	44,492
15	Royalties ..
16	Occupancy ...........	176,164	149,973	26,191
17	Travel ............	342,040	337,940	4,100
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	6,768	5,154	1,614
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	39,280	33,440	5,840
23	Insurance ...	53,242	45,326	7,916
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Pharmacy & Medical Supplies	396,175	396,175	0	0
b	Other Supplies	55,820	10,329	44,304	1,187
c	Recruitment	16,349	13,253	3,096	0
d	Storage Expense	11,917	0	11,917	0
e	All other expenses	21,102	10,410	10,692
25	Total functional expenses. Add lines 1 through 24e	8,071,479	6,029,550	2,029,896	12,033
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1,356,637	1	1,960,695
2	Savings and temporary cash investments .........			158	2	177
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			1,038,373	4	1,108,409
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............				8
9	Prepaid expenses and deferred charges ......			74,603	9	40,173
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	529,460
b	Less: accumulated depreciation	10b	409,974	120,884	10c	119,486
11	Investments—publicly traded securities .			55,618	11	55,270
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			400,000	14	400,000
15	Other assets. See Part IV, line 11 ...........			332,815	15	159,024
16	Total assets. Add lines 1 through 15 (must equal line 33)...			3,379,088	16	3,843,234

17	Accounts payable and accrued expenses .....	483,879	17	441,230
18	Grants payable ...		18
19	Deferred revenue .........	163,849	19	179,986
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	0	23
24	Unsecured notes and loans payable to unrelated third parties ..	0	24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	374,790	25	212,208
26	Total liabilities. Add lines 17 through 25..	1,022,518	26	833,424

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	2,316,068	27	2,969,570
28	Net assets with donor restrictions ...........	40,502	28	40,240
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	2,356,570	32	3,009,810
33	Total liabilities and net assets/fund balances ........	3,379,088	33	3,843,234