TY 2022 Form 990

(A)
Name and title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(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

(1) Timothy Dunn......................................................................
Executive Director

45
.................
0

127,680

19,114

(2) Joe Palmiero......................................................................
Board Chairman

1
.................
0

(3) Hollie Wolfe......................................................................
Vice Chair

1
.................
0

(4) Tammy Young......................................................................
Secretary/Treasurer

1
.................
0

(5) Martin Trettel......................................................................
Board Member

1
.................
0

(6) Kimberly Kepple......................................................................
Board Member

1
.................
0

(7) Brian Mailliard......................................................................
Board Member

1
.................
0

(8) Robin Knight......................................................................
Board Member

1
.................
0

(9) Chris Wright......................................................................
Board Member

1
.................
0

(10) Brian Nageotte......................................................................
Board Member

1
.................
0

(11) Melissa Porter......................................................................
Board Member - until December 2022

1
.................
0

(12) Tracy Meure......................................................................
Board Member

1
.................
0

(13) Philip Pandolph......................................................................
Board Member

1
.................
0

(14) Alishia Stevenson......................................................................
Board Member - as of January 2023

1
.................
0

(A)
Name and title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(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 business address

(B)
Description of services

Concordia Care Network
Concordia Community Support Services
613 North Pike Road
Suite B
Cabot,PA16023

Management Company

280,987

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

- 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

2022

Open to Public
Inspection

Name of the organization

ALLIANCE VISITING NURSES

Employer identification number

25-1764544

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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 2022 (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—2022. 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—2021. 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—2022. 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—2021. 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .	25	231,800	0	492,147	175	724,147
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	5,671,494	6,778,070	8,296,189	8,737,275	9,329,671	38,812,699
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	5,671,519	7,009,870	8,296,189	9,229,422	9,329,846	39,536,846
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..	0	0	0	0	0	0
8	Public support. (Subtract line 7c from line 6.)						39,536,846

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
9	Amounts from line 6...	5,671,519	7,009,870	8,296,189	9,229,422	9,329,846	39,536,846
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	11,033	12,332	3,742	13,813	140,832	181,752
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.	11,033	12,332	3,742	13,813	140,832	181,752
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	655,602	0	655,602
13	Total support. (Add lines 9, 10c, 11, and 12.)..	5,682,552	7,022,202	8,299,931	9,898,837	9,470,678	40,374,200

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 2022 (line 8, column (f) divided by line 13, column (f)) .........

97.926 %

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

98.051 %

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

0.450 %

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

0.120 %

19a

33 1/3% support tests-2022. 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—2021. 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) 2022

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) 2022

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) 2022

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) 2022

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 2022 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-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

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 (b) Fiscal Year Beginning in 2019 includes a Government Grant of $231,100 which was a Stimulus Payment from the CARES Act Provider Relief Fund. Column (d) Fiscal Year Beginning in 2021 includes a Government Grant of $478,470 which was a Stimulus Payment from the CARES Act Provider Relief Fund and a FEMA Grant. Column (e) Fiscal Year Beginning in 2022 includes a donation from the Network for Good.
Schedule A, Part III, Line 12	The other income received in Fiscal Year Beginning in 2021 was the recognition of the forgiveness of the Paycheck Protection Program (PPP) Loan from the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) and a Realized Loss on Investment held by Affiliate.

Return Reference

Explanation

Schedule A, Part III, Line 1

Column (b) Fiscal Year Beginning in 2019 includes a Government Grant of $231,100 which was a Stimulus Payment from the CARES Act Provider Relief Fund. Column (d) Fiscal Year Beginning in 2021 includes a Government Grant of $478,470 which was a Stimulus Payment from the CARES Act Provider Relief Fund and a FEMA Grant. Column (e) Fiscal Year Beginning in 2022 includes a donation from the Network for Good.

Schedule A, Part III, Line 12

The other income received in Fiscal Year Beginning in 2021 was the recognition of the forgiveness of the Paycheck Protection Program (PPP) Loan from the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) and a Realized Loss on Investment held by Affiliate.

Schedule A (Form 990) 2022

Additional Data

Software ID:	22015720
Software Version:	v1.00

	(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 ........


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


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

(a) Description	(b) Book value
(1)Due From Affiliates	2,155,664
(2)Right of Use Assets	310,351
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........	2,466,015

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	339,642
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

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	9,470,678
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	0
b	Donated services and use of facilities .........	2b	0
c	Recoveries of prior year grants ...........	2c	0
d	Other (Describe in Part XIII.) ............	2d	0
e	Add lines 2a through 2d .....................	2e	0
3	Subtract line 2e from line 1..................	3	9,470,678
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	9,470,678

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	7,113,223
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	0
e	Add lines 2a through 2d....................	2e	0
3	Subtract line 2e from line 1...................	3	7,113,223
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	7,113,223

Return Reference	Explanation
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, 2023 and 2022, 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, 2020, and thereafter remain subject to examination by federal and state tax authorities.

- 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

ALLIANCE VISITING NURSES

Employer identification number

25-1764544

Return Reference	Explanation
Form 990, Part VI, Section A, Line 3	Alliance Visiting Nurses dba VNA Alliance (VNAA) entered into a management services agreement with Concordia Community Support Services (CCSS) on 9/1/15. CCSS will perform management and policy functions and is committed to developing strong leadership so that VNAA can provide the highest quality of 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 VNAA 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 program.
Form 990, Part VI, Section A, Line 4	Grove City Medical Center released its membership back to Alliance Visiting Nurses.
Form 990, Part VI, Section A, Line 6	The members are Concordia Care Network dba Concordia Community Support Services Wesbury United Methodist Retirement Community, St Paul Homes, Meadville Medical Center, and Grove City Medical Center. Each member has a 20% membership of Alliance Visiting Nurses up until 11/15/2022, the date which Grove City Medical Center released its membership. After that date, the members are Concordia Care Network dba Concordia Community Support Services Wesbury United Methodist Retirement Community, St Paul Homes, Meadville Medical Center. Each member has a 25% membership of Alliance Visiting Nurses.
Form 990, Part VI, Section A, Line 7a	Each member of Alliance Visiting Nurses may elect or appoint a maximum of 3 (three) board members.
Form 990, Part VI, Section A, Line 7b	The Meadville Medical Center has certain reserve powers and decisions of the governing body related to those powers are subject to their approval.
Form 990, Part VI, Section B, Line 11b	The Form 990 is prepared and reviewed by the accounting department for Concordia Care Network dba Concordia Community Support Services the entity holding the management agreement. The document is then reviewed by the CFO. The board is sent draft copies of the 990 prior to filing, in order to assess 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	The corporate compliance officer attends at least 1 (one) board meeting a year. All officers, directors or trustees, and key employees are educated on compliance policies and procedures with the corporate compliance officer. Updates on corporate compliance are addressed in scheduled meetings during the year with all staff (including management). Specific corporate compliance goals and objectives are reviewed and evaluated on an ongoing basis during the year with the corporate compliance officer. Additionally, board members are required to disclose any potential conflict of interest prior to discussion on a topic where a conflict may exist. The Board will determine if a conflict exists and act accordingly, which may include the conflicted board member recusing himself/herself from discussion and any votes related to the matter. VNAA has launched a robust Quality Assessment Performance Improvement (QAPI) program which has seen objective improvements in the data-driven analysis of hospitalization percentages and VNAA patient experience reporting via HH-CAHPS review.
Form 990, Part VI, Section B, Line 15	The organization reviews national and state salary surveys for various non-profit organizations. Compensation is then appropriately determined based upon experience and comparison to the benchmarks. The personnel committee reviews the efforts and accomplishments of the Executive Director and recommends any adjustment to the board for approval. The Alliance Visiting Nurses board of directors has final authority/responsibility for approving any salary adjustment for the Executive Director. The Executive Director was reviewed during the fiscal year associated with this return.
Form 990, Part VI, Section C, Line 19	Alliance Visiting Nurses publishes an annual report that summarizes the financial and operational accomplishments of the organization, which is forwarded to Alliance Visiting Nurses constituents and is available to the public upon request. The Alliance Visiting Nurses 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 Alliance Visiting Nurses serve on a purely volunteer basis.
Form 990, Part XI, Line 9	Monies were distributed to the members during the year.

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:	22015720
Software Version:	v1.00

1	Briefly describe the organization’s mission or most significant activities: Health care delivery & management: Provide community based programs, services, and facilities to seniors, disabled and ill persons in their homes and communities. Includes nursing, therapy, home health aide, medical social work, and related services.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	108
6	Total number of volunteers (estimate if necessary) .............	6	13
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) .........	492,147	175
9	Program service revenue (Part VIII, line 2g) .........	8,737,275	9,329,671
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-7,585	140,832
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	655,602	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	9,877,439	9,470,678
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	4,900	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)	4,869,047	5,253,617
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,685,276	1,859,606
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	6,559,223	7,113,223
19	Revenue less expenses. Subtract line 18 from line 12.......	3,318,216	2,357,455
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	9,133,627	5,919,871
21	Total liabilities (Part X, line 26).............	1,058,383	1,121,442
22	Net assets or fund balances. Subtract line 21 from line 20.....	8,075,244	4,798,429

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 5,361,705 including grants of $ 0 ) (Revenue $ 9,470,503 )
	VNA Alliance (VNAA) is an independent, voluntary, nonprofit home health agency licensed in Pennsylvania. All services are available without regard to race, religion, creed, color, age, ancestry, national origin, sex, sexual preference, lifestyle, socioeconomic status, veteran's status, or handicap. The agency strives to operate in a Christian manner in all interactions with consumers, staff, and the community. The provision of care to consumers recognizes and supports consumers' rights and the inherent worth and dignity of everyone. The agency seeks to provide care to all consumers in need of its services while recognizing its goal to maintain financial viability. Service delivery is based on the belief that quality health care can be delivered using efficient, effective, and ethical business practices. During the 2022-2023 fiscal year, the VNA Alliance completed over 61,000 home health care visits and maintained an average daily census of 494 patients. For fiscal year ending 06/30/2023, a total of $3,710 in services was rendered as benevolent care. Many exciting opportunities and changes occurred at the VNA Alliance over the past fiscal year. The conclusion of the public health emergency (PHE) ushered in a sizable reduction in reportable events. During this time, the VNA Alliance witnessed a 34% reduction the number of reportable events, largely due to a 51% reduction in the number of COVID-19 positive patient and staff cases. Across a five-county region of Northwest PA, over 3,000 individualized patient care plans were created during the past fiscal year, each with the goal of achieving clinically relevant outcomes, or preventing harmful outcomes-for each patient. Our guiding principles of employee development, risk management, strategic planning, and organizational performance ensure VNAA will remain a valuable resource for our community for years to come. VNA Alliance continues to provide a wealth of community services to the residents, organizations and various groups in Mercer, Crawford, Venango and parts of Erie, Lawrence, and Butler Counties. During the past year, two dynamic health fairs were provided to the community residents of St. Paul Homes and the assisted living facility, Juniper Village, of Meadville, PA. Engaging education was provided pertaining to fall reduction, medication management, functional mobility standards and healthy aging strategies. On January 1st, 2023, the home health care world experienced a significant overhaul to the OASIS data collection instrument. As a requirement set forth within the 2014 IMPACT act, CMS was obligated to align the home health data collection instrument, OASIS, with all post-acute care setting requirements-with the goal of standardizing the data collection process across this continuum. OASIS-E ushered in 159 data element changes and 6 new categories of assessment types to the industry. The OASIS data collection tool has seen a change from volume biased care to outcome driven-valued based care prioritizing meaningfulness and acuity over visit count. Understanding health as a multifaceted concept that extends beyond one's genetics or physiology, the updated OASIS-E document incorporated the need for effective communication during care transitions between health care settings to: 1) Improve care coordination 2) Improve quality of care 3) Help subsequent providers reconcile medications 4) Mitigate adverse outcomes related to medications. For several months, the VNA Alliance prepared for this expansive update. Over three hours of OASIS-E training was developed, produced, recorded, and distributed to the VNAA OASIS data collectors for independent study and completion. OASIS-E proficiency was validated and remediation training provided when necessary. During the past year, two VNA Alliance Physical Therapists earned their wound certification credentialling. Also, the VNAA saw one Physical Therapist earn their Vestibular Rehabilitation credentialling. Occupational Therapy was also called upon to elevate their practice this year. Since the onset of the benefit, Medicare home health rules prohibited Occupational Therapy from being the sole qualifying discipline for admission to home health care. In January of 2022, The Medicare Home Health Flexibility Act was passed by Congress, which included a provision that allows Occupational Therapists to perform the initial and comprehensive assessments that are necessary to start home health care services. It must be noted that this provision applies to therapy only cases. The VNAA worked diligently in preparing many of its OT team to be effective and efficient admission clinicians. The entire OT team exceeded agency averages for activity of daily living and mobility magnitude changes, as well as risk adjusted composite outcomes as VNAA admission clinicians. The past fiscal year launched the first Performance Year for the Home Health Value-Based Purchasing (VBP) model. This year, the VNA Alliance launched its "Call us First" campaign with the goal of mitigating unnecessary trips to the emergency room. Many ambulatory care sensitive conditions, such as congestive heart failure and chronic obstructive pulmonary disease, can be effectively managed within the post-acute space, avoiding higher cost centers of care. Our on-call team was enhanced to provide more, after hour, site visit capacity. We expanded our telehealth monitoring system-now covering over 12% of our entire census, compared to 5% one year ago. We hired our first CRNP who addresses our high risk, high volume, problem prone conditions with a fresh level of sophistication and skill. This past year, we also expanded the use of tele rehab virtual visits that function to augment traditional plan of cares with supportive education and guidance. Compared to the previous year, the VNA Alliance experienced an 18% increase in high-risk patients served. Despite the increase in patient complexity-the agency managed to slightly lower its re-admission percentage. The VNA Alliance will continue to work on lowering its claims-based metrics of acute care hospitalization and emergency department use without hospitalization, for these two metrics show the greatest opportunity for improvement. In 2022, 12.9% of our patients sought emergent care at some point during their home health experience, and were not admitted to the hospital. To be ranked with the best agencies in the county, this value would need lowered to 4.7%. Regarding 60-day hospitalizations, our 2022 percentage of 11.6% would need lowered to 7.7% to be considered the "best of the best". The VNA Alliance will continue to strive for excellence in assisting our patients to "age in place." Based on 2022 data, the implementation year for the VBP program, the VNAA has performed in the highest (best performing) quartile within the large cohort pool of 6,838 agencies. (July 2023 Interim Performance Report CMS) The final area of TPS scoring comes from the patient experience, or HHCAHPS survey. "The 5 cs" of the patient survey are: 1) Compassion 2) Communication 3) Care Quality 4) Consumer Report 5) Consumer Loyalty The VNAA has made steady progress regarding its HHCAHPS scoring with the greatest progress in "consumer loyalty," with over 83% of our patients saying they would "definitely recommend" the VNA Alliance! VNA Alliance had the opportunity to sponsor six Golf Outings during the tax year: Kiwanis Club of Greenville (July 2022), Meadville Medical Center Foundation (August 2024), Titusville Area Hospital Foundation (May 2023), Hospice of Crawford County (May 2023), Wesbury Foundation (May 2023), and Kiwanis Club of Greenville (May 2023). Other local sponsorships include supporting the Meadville area Bolts and Bytes 4-H club at the Penn State Cooperative Extension in Crawford County as well as a donation to the Power of the Purse Fundraising event benefiting Good Samaritan Hospice. The cost to the agency for these sponsorships and donations are a total of $4,025 and benefit the local community that we serve. Employees of VNAA were given the opportunity to participate in several mission events organized by the home and community-based agencies of Concordia. In August and September 2022, employees across all Concordia locations in Pennsylvania including VNAA, participated in a donation-based mission to support Midwestern Intermediate Unit IV, a program that services 27 school districts and 3 vo-techs in Butler, Lawrence and Mercer Counties. Employees purchased a total of 274 backpacks with essential school supplies including notebooks, pencils, erasers, markers, glue sticks, binders and folders. VNA Alliance employees participated in the Angel Tree Christmas Mission by sponsoring three children who are experiencing homelessness to purchase and wrap Christmas gifts to provide them with a wonderful Christmas in 2022. These mission events are some of the many ways we serve God by providing for the needs of His people.

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












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 expenses5,361,705

		Business Code
2a	Clinical Services	621610	9,333,187	9,333,187	0	0
b	Contracted Revenue	621610	194	194	0	0
c	Benevolent Care	621610	-3,710	-3,710	0	0
d
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		9,329,671

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	127,680	0	19,114

1a	Federated campaigns..		1a	0
b	Membership dues..		1b	0
c	Fundraising events..		1c	0
d	Related organizations		1d	0
e	Government grants (contributions)		1e	0

f	All other contributions, gifts, grants, and similar amounts not included above		1f	175

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

h Total. Add lines 1a-1f.......		175

3 Investment income (including dividends, interest, and othersimilar amounts) ......			140,832	140,832	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			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)	0	0	7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ 0of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
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.....			9,470,678	9,470,503	0	0

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 ...........	152,634		152,634
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........	4,179,510	3,659,549	519,961
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	186,830	162,650	24,180
9	Other employee benefits .......	388,176	314,991	73,185
10	Payroll taxes ...........	346,467	291,591	54,876
11	Fees for services (non-employees):
a	Management ......	280,987		280,987
b	Legal .........
c	Accounting ...........	167,734		167,734
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)	349,495	133,049	216,446
12	Advertising and promotion ....	13,404		13,404
13	Office expenses .......	131,626	59,845	71,781
14	Information technology ......	130,645	76,796	53,849
15	Royalties ..
16	Occupancy ...........	80,197	70,220	9,977
17	Travel ............	263,877	260,084	3,793
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	2,874	759	2,115
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	72,963	63,886	9,077
23	Insurance ...	47,561	41,644	5,917
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	131,245	131,245	0	0
b	Equipment Rental	48,564	47,040	1,524	0
c	Other Supplies	35,950	3,179	32,771	0
d	Recruitment/Help Want Ads	32,376	24,202	8,174
e	All other expenses	70,108	20,975	49,133
25	Total functional expenses. Add lines 1 through 24e	7,113,223	5,361,705	1,751,518	0
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 ........			1,792,168	1	976,488
2	Savings and temporary cash investments .........			10,205	2	161,214
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			1,255,002	4	1,508,298
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 ......			109,601	9	119,197
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	636,808
b	Less: accumulated depreciation	10b	298,149	314,652	10c	338,659
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			350,000	14	350,000
15	Other assets. See Part IV, line 11 ...........			5,301,999	15	2,466,015
16	Total assets. Add lines 1 through 15 (must equal line 33)...			9,133,627	16	5,919,871

17	Accounts payable and accrued expenses .....	430,954	17	523,700
18	Grants payable ...		18
19	Deferred revenue .........	214,754	19	258,100
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 ..		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	412,675	25	339,642
26	Total liabilities. Add lines 17 through 25..	1,058,383	26	1,121,442

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	8,075,244	27	4,798,429
28	Net assets with donor restrictions ...........	0	28	0
	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 ...........	8,075,244	32	4,798,429
33	Total liabilities and net assets/fund balances ........	9,133,627	33	5,919,871

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

1a	Land .....	0	0		0
b	Buildings ....	0	50,000	5,278	44,722
c	Leasehold improvements	0	0	0	0
d	Equipment ....	0	586,808	292,871	293,937
e	Other .....	0	0	0	0
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					338,659

(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.)

(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.)