UNION ASSOCIATED PHYSICIANS CLINIC LLC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- UNION ASSOCIATED PHYSICIANS CLINIC LLC (EIN 27-0581401)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-15
- IRS object ID
- 202123199349300642
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-15T07:13:19-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 N MERIDIAN ST SUITE 200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 270581401 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNION ASSOCIATED PHYSICIANS CLINIC LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIO | BusinessNameControlTxt |
| Phone | 8122387601 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1606 N 7TH STREET | AddressLine1Txt |
| City | TERRE HAUTE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47804 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MATTHEW NEALON | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8122387601 | PhoneNum |
| Signature | 2021-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MATTHEW | PersonFirstNm |
| Person Last | NEALON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | NATHAN A RODGERS CPA | PreparerPersonNm |
| PTIN | P01568275 | PTIN |
| Phone | 3176334705 | PhoneNum |
| Preparation | 2021-11-05 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MATTHEW NEALON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1606 N 7TH STREET | AddressLine1Txt |
| City | TERRE HAUTE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47804 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $76,800,960 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UHHG.ORG | WebsiteAddressTxt |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Other Organization Dsc | LIMITED LIABILITY COMPANY | OtherOrganizationDsc |
| Formation | 2009 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE AND COORDINATE INPATIENT AND OUTPATIENT MEDICAL CARE FOR THE PATIENTS AND COMMUNITY MEMBERS SERVED BY UNION HOSPITAL TERRE HAUTE, UNION HOSPITAL CLINTON, AND THE SYSTEM'S OTHER HEALTH CARE PROVIDERS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 1060 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,940,405 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $48,490,045 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $45,462,692 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,667 | PYInvestmentIncomeAmt |
| CY Investment Income | $9,588 | CYInvestmentIncomeAmt |
| PY Other Revenue | $26,312,343 | PYOtherRevenueAmt |
| CY Other Revenue | $29,388,275 | CYOtherRevenueAmt |
| PY Total Revenue | $74,809,055 | PYTotalRevenueAmt |
| CY Total Revenue | $76,800,960 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $51,558 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $29,419 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $76,577,642 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $76,036,720 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $31,547,770 | PYOtherExpensesAmt |
| CY Other Expenses | $31,697,718 | CYOtherExpensesAmt |
| PY Total Expenses | $108,176,970 | PYTotalExpensesAmt |
| CY Total Expenses | $107,763,857 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$33,367,915 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$30,962,897 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $35,153,954 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,907,028 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $36,491,616 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $16,842,991 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$1,337,662 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $13,064,037 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE AND COORDINATE INPATIENT AND OUTPATIENT MEDICAL CARE FOR THE PATIENTS AND COMMUNITY MEMBERS SERVED BY UNION HOSPITAL TERRE HAUTE, UNION HOSPITAL CLINTON, AND THE SYSTEM'S OTHER HEALTH CARE PROVIDERS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $92,269,537 | ExpenseAmt |
| Grant | $29,419 | GrantAmt |
| Revenue | $61,704,176 | RevenueAmt |
| Desc | UNION ASSOCIATED PHYSICIANS CLINIC, LLC (UAPC) IS THE LARGEST MULTI-SPECIALTY PROVIDER GROUP IN THE WABASH VALLEY AND IS AN INTEGRAL PART OF UNION HEALTH SYSTEM THAT ALSO INCLUDES UNION HOSPITAL IN TERRE HAUTE AND UNION HOSPITAL CLINTON. UAPC (FORMERLY UAP CLINIC AND AP&S CLINIC) HAS PROVIDED QUALITY HEALTHCARE IN THE WABASH VALLEY FOR MORE THAN 100 YEARS. TODAY, UAPC CONSISTS OF OVER 140 PROVIDERS IN 20 SPECIALTIES PRACTICING AT MULTIPLE LOCATIONS THROUGHOUT WESTERN INDIANA AND EASTERN ILLINOIS. AS PART OF UNION HEALTH, UAPC CONTINUES TO MEET THE AREA'S CURRENT AND EMERGING HEALTH NEEDS. | Desc |
| Total Program Service Expenses | $92,269,537 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 47 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1060 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MATTHEW NEALON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8122387601 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1606 N 7TH STREET | AddressLine1Txt |
| City | TERRE HAUTE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47804 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| DAN DEBARD | |||||||||
| CHAIR | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DON SCOTT | |||||||||
| VICE CHAIR | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SARA SMITH | |||||||||
| SECRETARY | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| WARD HUBBARD | |||||||||
| TREASURER | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| AMY HOCK | |||||||||
| ASST. SECRETARY | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ROBERT COONS | |||||||||
| ASST. TREASURER | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOHN AIDOO | |||||||||
| MEMBER-TERM BEGAN JAN'20 | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MOLLY CALLAHAN | |||||||||
| MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHLEEN COUTINHO MD | |||||||||
| MEMBER | 2.00 | 42.00 | Yes (X) | $0 | $344,553 | $37,668 | |||
| MARY DOTI | |||||||||
| MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN ETLING | |||||||||
| MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK LYNCH MD | |||||||||
| MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $22,002 | $0 | |||
| KRISHNA NAMBURI MD | |||||||||
| MEMBER | 42.00 | 2.00 | Yes (X) | $1,177,378 | $0 | $37,515 | |||
| RANDALL STEVENS MD | |||||||||
| MEMBER | 2.00 | 42.00 | Yes (X) | $0 | $279,781 | $26,303 | |||
| TIM SULLIVAN | |||||||||
| MEMBER-TERM BEGAN JAN'20 | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| LUKE TERRY | |||||||||
| MEMBER-TERM BEGAN JAN'20 | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| GRANT HAMMONS MD | |||||||||
| MEMBER-TERM ENDED DEC'20 | 42.00 | 2.00 | Yes (X) | $565,845 | $0 | $38,332 | |||
| STEVEN HOLMAN | |||||||||
| PRESIDENT & CEO | 20.00 | 20.00 | Yes (X) | $0 | $1,585,924 | $169,259 | |||
| MATTHEW NEALON | |||||||||
| SR VP FINANCE/CFO | 7.00 | 40.00 | Yes (X) | $0 | $618,170 | $25,926 | |||
| JAMES SCHRADER | |||||||||
| VP PHYSICIAN SERVICES | 40.00 | 0.00 | Yes (X) | $387,248 | $0 | $37,356 | |||
| JOHN GILBREATH | |||||||||
| SR. DIRECTOR | 40.00 | 0.00 | $260,985 | $0 | $14,792 | Yes (X) | |||
| PAMELA SMITH | |||||||||
| DIRECTOR | 40.00 | 0.00 | $165,948 | $0 | $14,614 | Yes (X) | |||
| SHANTILAL PATEL | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $990,215 | $0 | $31,247 | Yes (X) | |||
| GIRISHH KUNAPAREDDY | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $1,435,980 | $0 | $35,332 | Yes (X) | |||
| STEPHEN FERN | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $1,618,720 | $0 | $31,301 | Yes (X) | |||
| PREASHANT PATEL | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $1,071,714 | $0 | $37,332 | Yes (X) | |||
| JEREMIAH PALMER | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $908,657 | $0 | $33,332 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $8,582,690 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,850,430 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $570,309 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 92 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SYCAMORE ANESTHESIA SERVICES | |||||
| 1421 N 7TH STREET | TERRE HAUTE | IN | 47804 | ANETHESIA SERVICES | $1,371,959 |
| STEVES CLEANING SERVICES | |||||
| 5060 OLD PARIS ROAD | W TERRE HAUTE | IN | 47885 | HOUSEKEEPING SERVICES | $713,023 |
| SOUTHEASTERN INDIANA HEALTH OPERATIONS | |||||
| 417 WASHINGTON ST | COLUMBUS | IN | 47201 | HEALTH INSURANCE MANAGEMENT | $349,060 |
| LOCUMTENENS HOLDINGS | |||||
| PO BOX 405547 | ATLANTA | GA | 30384 | MEDICAL SERVICES | $206,279 |
| HEALTHCARE FUTURES LP | |||||
| 300 PARK BLVD SUITE 200 | ITASCA | IL | 60143 | CONSULTING SERVICES | $145,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,940,405 | GovernmentGrantsAmt |
| Total Contributions | $1,940,405 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $45,462,692 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $45,462,692 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $45,462,692 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,288 | TotalRevenueColumnAmt |
| Exclusion | $4,288 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $469,564 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $469,564 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $469,564 | TotalRevenueColumnAmt |
| Exclusion | $469,564 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,300 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,300 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,300 | TotalRevenueColumnAmt |
| Exclusion | $5,300 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| LEASED EMPLOYEE REVENUE | 900099 | $14,200,577 | $14,200,577 | |
| PHARMACY SALES | 900099 | $3,491,667 | $3,491,667 | |
| JOINT VENTURE INCOME | 900099 | $2,040,907 | $2,040,907 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,185,560 | TotalRevenueColumnAmt |
| Exclusion | $9,185,560 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $28,918,711 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $76,800,960 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $61,704,176 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $13,156,379 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,419 | TotalAmt |
| Program Services | $29,419 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,700,013 | TotalAmt |
| Program Services | $2,329,956 | ProgramServicesAmt |
| Management And General | $370,057 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,802,368 | TotalAmt |
| Program Services | $55,057,757 | ProgramServicesAmt |
| Management And General | $8,744,611 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,428,220 | TotalAmt |
| Program Services | $1,232,471 | ProgramServicesAmt |
| Management And General | $195,749 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,734,797 | TotalAmt |
| Program Services | $4,085,856 | ProgramServicesAmt |
| Management And General | $648,941 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,371,322 | TotalAmt |
| Program Services | $2,909,256 | ProgramServicesAmt |
| Management And General | $462,066 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,591 | TotalAmt |
| Program Services | $39,342 | ProgramServicesAmt |
| Management And General | $6,249 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,269 | TotalAmt |
| Program Services | $41,653 | ProgramServicesAmt |
| Management And General | $6,616 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,895,048 | TotalAmt |
| Program Services | $7,675,913 | ProgramServicesAmt |
| Management And General | $1,219,135 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,446 | TotalAmt |
| Program Services | $102,212 | ProgramServicesAmt |
| Management And General | $16,234 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $948,522 | TotalAmt |
| Program Services | $818,520 | ProgramServicesAmt |
| Management And General | $130,002 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $629,918 | TotalAmt |
| Program Services | $543,583 | ProgramServicesAmt |
| Management And General | $86,335 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,664,680 | TotalAmt |
| Program Services | $4,888,292 | ProgramServicesAmt |
| Management And General | $776,388 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,819 | TotalAmt |
| Program Services | $38,676 | ProgramServicesAmt |
| Management And General | $6,143 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,694 | TotalAmt |
| Program Services | $56,690 | ProgramServicesAmt |
| Management And General | $9,004 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,187,249 | TotalAmt |
| Management And General | $2,187,249 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,856,101 | TotalAmt |
| Program Services | $1,601,708 | ProgramServicesAmt |
| Management And General | $254,393 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,045,756 | TotalAmt |
| Program Services | $902,427 | ProgramServicesAmt |
| Management And General | $143,329 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $8,456,236 | $8,456,236 | |
| HOUSEKEEPING & LAUNDRY | $816,142 | $704,283 | $111,859 |
| DUES & LICENSES | $98,144 | $84,693 | $13,451 |
| SALES TAX | $1,099 | $948 | $151 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $776,004 | TotalAmt |
| Program Services | $669,646 | ProgramServicesAmt |
| Management And General | $106,358 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,763,857 | TotalAmt |
| Program Services | $92,269,537 | ProgramServicesAmt |
| Management And General | $15,494,320 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,844,770 | BOYAmt |
| EOY | $8,790,379 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,771,582 | BOYAmt |
| EOY | $7,272,426 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,534 | BOYAmt |
| EOY | $56,930 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $387,883 | BOYAmt |
| EOY | $492,120 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $701,907 | BOYAmt |
| EOY | $622,679 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,227,515 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,174,197 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,332,837 | BOYAmt |
| EOY | $4,053,318 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,677,197 | BOYAmt |
| EOY | $7,266,472 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,343,244 | BOYAmt |
| EOY | $1,352,704 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,153,954 | BOYAmt |
| EOY | $29,907,028 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,172,853 | BOYAmt |
| EOY | $16,840,486 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,316,758 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,005 | BOYAmt |
| EOY | $2,505 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,491,616 | BOYAmt |
| EOY | $16,842,991 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,337,662 | BOYAmt |
| EOY | $13,064,037 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,337,662 | BOYAmt |
| EOY | $13,064,037 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,153,954 | BOYAmt |
| EOY | $29,907,028 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$30,962,897 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $45,364,596 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $1,940,405 | CurrentTaxYearAmt |
| Total | $1,940,405 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $48,085,153 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $48,490,045 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $45,462,692 | CurrentTaxYearAmt |
| Total | $142,037,890 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $48,085,153 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $48,490,045 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $47,403,097 | CurrentTaxYearAmt |
| Total | $143,978,295 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $143,978,295 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $469,038 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $523,259 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $473,852 | CurrentTaxYearAmt |
| Total | $1,466,149 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $469,038 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $523,259 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $473,852 | CurrentTaxYearAmt |
| Total | $1,466,149 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $17,870,179 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $25,795,751 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $28,918,711 | CurrentTaxYearAmt |
| Total | $72,584,641 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $66,424,370 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $74,809,055 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $76,795,660 | CurrentTaxYearAmt |
| Total | $218,029,085 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | Yes (X) | First5Years509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS INCOME - 2018 AMOUNT: $ 4,634,012. 2019 AMOUNT: $ 4,431,650. 2020 AMOUNT: $ 9,185,560. PHARMACY INCOME - 2018 AMOUNT: $ 2,224,318. 2019 AMOUNT: $ 2,631,249. 2020 AMOUNT: $ 3,491,667. LEASED EMPLOYEE REVENUE - 2018 AMOUNT: $ 5,413,849. 2019 AMOUNT: $ 13,577,389. 2020 AMOUNT: $ 14,200,577. JOINT VENTURE INCOME - 2018 AMOUNT: $ 5,598,000. 2019 AMOUNT: $ 5,155,463. 2020 AMOUNT: $ 2,040,907. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,024 | OtherCostOrOtherBasisAmt |
| Book Value | $53,024 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,700,909 | OtherCostOrOtherBasisAmt |
| Depreciation | $536,051 | DepreciationAmt |
| Book Value | $1,164,858 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,467,122 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,638,146 | DepreciationAmt |
| Book Value | $2,828,976 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,460 | OtherCostOrOtherBasisAmt |
| Book Value | $6,460 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,053,318 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT IN JOINT VENTURES | Desc |
| Book Value | $7,266,472 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $7,266,472 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO/FROM RELATED PARTY | Desc |
| Amt | $2,505 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,505 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY UHS, THE CORPORATION, AND UAPC, AND RECOGNIZE A TAX LIABILITY IF UHS, THE CORPORATION, AND UAPC HAVE TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY UHS, THE CORPORATION, AND UAPC, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2020 AND 2019, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. UHS, THE CORPORATION, AND UAPC ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FILINGS ARE CURRENT THROUGH 2019. THE IMPACT OF THE SUBSIDIARIES TAX CONSEQUENCES IS IMMATERIAL TO THESE CONSOLIDATED FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| SHEPHERDS OF GRIFFIN BIKE PARK INC | |||||||
| 7854 SOUTH PERSIMMON ST | TERRE HAUTE | IN | 47802 | 841872240 | 501C3 | $7,500 | CHARITABLE CONTRIBUTION |
| TERRE HAUTE SYMPHONY ASSOCIATION INC | |||||||
| 25 NORTH 6TH STREET | TERRE HAUTE | IN | 47807 | 351120529 | 501C3 | $5,000 | CHARITABLE CONTRIBUTION |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | GRANTS TO ENTITIES IN THE UNITED STATES AND SCHOLARSHIPS PROVIDED: GRANTS AND ASSISTANCE ARE PROVIDED TO ELIGIBLE 501C3 PUBLIC CHARITIES, LOCAL SCHOOL CORPORATION FOR GENERAL SUPPORT, AND SCHOLARSHIPS FOR ELIGIBLE INDIVIDUALS. UNION ASSOCIATION PHYSICIANS CLINIC, LLC DOES NOT MONITOR THE USE OF THESE FUNDS BY THE ORGANIZATIONS OR INDIVIDUALS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEVEN HOLMAN | ||||||||||||||
| PRESIDENT & CEO | $0 | $812,202 | $0 | $347,488 | $0 | $426,234 | $0 | $151,716 | $0 | $17,543 | $0 | $1,755,183 | $0 | $0 |
| STEPHEN FERN | ||||||||||||||
| PHYSICIAN | $518,994 | $0 | $1,099,726 | $0 | $0 | $0 | $6,519 | $0 | $24,782 | $0 | $1,650,021 | $0 | $0 | $0 |
| GIRISHH KUNAPAREDDY | ||||||||||||||
| PHYSICIAN | $906,717 | $0 | $529,263 | $0 | $0 | $0 | $9,750 | $0 | $25,582 | $0 | $1,471,312 | $0 | $0 | $0 |
| KRISHNA NAMBURI MD | ||||||||||||||
| MEMBER | $950,037 | $0 | $227,341 | $0 | $0 | $0 | $14,200 | $0 | $23,315 | $0 | $1,214,893 | $0 | $0 | $0 |
| PREASHANT PATEL | ||||||||||||||
| PHYSICIAN | $532,407 | $0 | $539,307 | $0 | $0 | $0 | $12,550 | $0 | $24,782 | $0 | $1,109,046 | $0 | $0 | $0 |
| SHANTILAL PATEL | ||||||||||||||
| PHYSICIAN | $815,050 | $0 | $175,165 | $0 | $0 | $0 | $14,200 | $0 | $17,047 | $0 | $1,021,462 | $0 | $0 | $0 |
| JEREMIAH PALMER | ||||||||||||||
| PHYSICIAN | $556,548 | $0 | $352,109 | $0 | $0 | $0 | $8,550 | $0 | $24,782 | $0 | $941,989 | $0 | $0 | $0 |
| MATTHEW NEALON | ||||||||||||||
| SR VP FINANCE/CFO | $0 | $453,845 | $0 | $138,113 | $0 | $26,212 | $0 | $1,032 | $0 | $24,894 | $0 | $644,096 | $0 | $0 |
| GRANT HAMMONS MD | ||||||||||||||
| MEMBER-TERM ENDED DEC'20 | $495,317 | $0 | $70,528 | $0 | $0 | $0 | $14,200 | $0 | $24,132 | $0 | $604,177 | $0 | $0 | $0 |
| JAMES SCHRADER | ||||||||||||||
| VP PHYSICIAN SERVICES | $304,239 | $0 | $63,062 | $0 | $19,947 | $0 | $12,462 | $0 | $24,894 | $0 | $424,604 | $0 | $0 | $0 |
| KATHLEEN COUTINHO MD | ||||||||||||||
| MEMBER | $0 | $287,709 | $0 | $56,844 | $0 | $0 | $0 | $14,200 | $0 | $23,468 | $0 | $382,221 | $0 | $0 |
| RANDALL STEVENS MD | ||||||||||||||
| MEMBER | $0 | $257,250 | $0 | $15,000 | $0 | $7,531 | $0 | $11,417 | $0 | $14,886 | $0 | $306,084 | $0 | $0 |
| JOHN GILBREATH | ||||||||||||||
| SR. DIRECTOR | $220,577 | $0 | $32,651 | $0 | $7,757 | $0 | $6,347 | $0 | $8,445 | $0 | $275,777 | $0 | $0 | $0 |
| PAMELA SMITH | ||||||||||||||
| DIRECTOR | $151,410 | $0 | $14,538 | $0 | $0 | $0 | $5,669 | $0 | $8,945 | $0 | $180,562 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE COMPENSATION FOR THE ORGANIZATION'S CEO IS DETERMINED BY A RELATED ORGANIZATION (UNION HOSPITAL, INC.). UNION HOSPITAL, INC. USES THE FOLLOWING METHODS TO DETERMINE THE CEO'S COMPENSATION: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION COMMITTEE -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 7 | THE ORGANIZATION PROVIDES NON-FIXED PAYMENTS TO SEVERAL INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A. THESE NON-FIXED PAYMENTS ARE BASED ON THE ORGANIZATION'S ABILITY TO PAY AND ARE NOT CONSTRUED AS A CONTRACT BETWEEN UNION AND ITS EXECUTIVES. THE EXECUTIVE BONUS PLAN IS A MIXTURE OF OBJECTIVES, STANDARDS AND SUBJECTIVE STANDARDS THAT BOTH THE POLICY AND THE IMPLEMENTATION OF THE POLICY BY THE PERSONNEL COMMITTEE AND THE BOARD OF DIRECTORS APPROVES AND AWARDS DEPENDING ON UNION'S ABILITY TO PAY. THERE IS NO AUTOMATIC RIGHT TO A BONUS OR A SPECIFIC BONUS AMOUNT EVEN IF ALL CRITERIA ARE MET. THE PERFORMANCE MEASURE PLAN IS LINKED TO THE UNION STRATEGIC AND FISCAL-YEAR BUSINESS PLANNING PROCESS. THE PLAN IS INTENDED TO FOCUS PARTICIPANTS' ATTENTION ON MISSION-CRITICAL GOALS AND KEY STRATEGIC PRIORITIES. THE PLAN IS ALSO INTENDED TO ENHANCE THE PERFORMANCE OF UNION EXECUTIVES AND THE ORGANIZATION. PRIOR TO THE START OF THE FISCAL YEAR AND AS PART OF THE BUSINESS PLANNING PROCESS, THE UNION PRESIDENT AND CEO WILL FINALIZE A LIST OF GOALS, WEIGHTS AND MEASURES TO BE USED TO ASSESS PERFORMANCE DURING THE FISCAL YEAR. THE LIST IS PRESENTED TO AND DISCUSSED WITH THE COMMITTEE. THE COMMITTEE REVIEWS AND APPROVES THE BONUS PLAN GOALS, WEIGHTS, AND MEASURES. ORGANIZATION GOALS WILL BE ASSIGNED TO EACH PARTICIPANT HOSPITAL-WIDE. IN ADDITION TO HOSPITAL-WIDE GOALS INDIVIDUAL AND/OR FUNCTIONAL/DEPARTMENT GOALS MAY OR MAY NOT BE INCLUDED. AFTER THE CONCLUSION OF EACH FISCAL YEAR, THE PRESIDENT AND CEO WILL PREPARE AN ANNUAL BONUS PLAN REPORT FOR THE COMMITTEE. THE REPORT CONTAINS: AN APPRAISAL OF UNION AND HOSPITAL/OPERATING UNIT PERFORMANCE DURING THE RECENTLY-COMPLETED FISCAL YEAR; AND THE PRESIDENT AND CEO'S RECOMMENDED PAYOUT FOR EACH PLAN PARTICIPANT. THE BONUS RECOMMENDATIONS FOR ALL SR. MANAGEMENT ARE RECEIVED AND REVIEWED FIRST BY THE PERSONNEL COMMITTEE WHO THEN MAKE DECISIONS AND SUBMITS TO THE BOARD TO VOTE. THE COMMITTEE WILL DETERMINE AND SUBMIT THE PAYOUT FOR THE PRESIDENT AND CEO TO THE BOARD OF DIRECTORS WHO, ABSENT THE PRESIDENT AND CEO, WILL VOTE ON APPROVAL. AWARD DETERMINATIONS ARE CALCULATED AS PERCENTAGES OF PARTICIPANT'S SALARIES PAID FOR TIME WORKED DURING THE FISCAL YEAR. PAYOUT FOR THE PRESIDENT IS 0% TO 30%; CFO AND COO ARE 0% TO 25%; AND OTHER EXECUTIVES ARE 0% TO 20%. THE EXECUTIVE BONUS PLAN PAYOUTS ARE TO BE PAID WHEN DETERMINED BY THE PERSONNEL COMMITTEE, SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| SYCAMORE INSURANCE ASSOCIATION | |||
| BOARD MEMBER OF UAPC, DON SCOTT, IS AN OFFICER AND OWNER | $15,490 | SYCAMORE INSURANCE PROVIDES INSURANCE PRODUCTS TO THE ORGANIZATION. | 0 |
| SYCAMORE ENGINEERING | |||
| BOARD MEMBER OF UAPC, SARA SMITH, IS A FAMILY MEMBER OF >35% OWNER | $76,868 | SYCAMORE ENGINEERING PROVIDES SERVICES TO THE ORGANIZATION | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | UNION ASSOCIATED PHYSICIANS CLINIC HAS TWO MEMBERS, UNION HOSPITAL INC. AND UNION HEALTH SYSTEMS, WHICH ARE INDIANA NONPROFIT, TAX EXEMPT CORPORATIONS. |
| FORM 990, PART VI, SECTION A, LINE 7A | UNION HEALTH SYSTEMS AND UNION HOSPITAL, INC. ARE THE PARENT CORPORATIONS AND MEMBERS OF UNION ASSOCIATED PHYSICIANS CLINIC, LLC. THE MEMBERS HAVE THE RIGHT TO ELECT THE DIRECTORS OF THIS COMPANY AND REMOVE, WITH OR WITHOUT CAUSE, ANY DIRECTOR OF THIS COMPANY PRIOR TO EXPIRATION OF THE DIRECTOR'S TERM. THE MEMBERS HAVE THE RIGHT TO FILL ANY VACANCY FOR THE OFFICE OF VOTING DIRECTOR. |
| FORM 990, PART VI, SECTION A, LINE 7B | POWERS RESERVED TO MEMBERS: A) APPROVE THE MISSION, VISION AND VALUES STATEMENTS FOR THE COMPANY, B) MAKE AND APPROVE CHANGES TO THE GOVERNING DOCUMENTS OF THE COMPANY WITH THE FAVORABLE VOTE OF SYSTEM BOARD MEMBERS REPRESENTING MORE THAN SEVENTY-FIVE (75%) OF THE SYSTEM BOARD POSITIONS INCLUSIVE OF VACANCIES, C) APPROVE THE INCURRENCE OF DEBT OF THE COMPANY IN ACCORDANCE WITH SYSTEM POLICIES, D) APPROVE THE SALE, TRANSFER OR SUBSTANTIAL CHANGE IN USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE COMPANY AND DIVESTITURE, DISSOLUTION, CLOSURE, MERGER, CONSOLIDATION, CHANGE IN COMPANY MEMBERSHIP OR OWNERSHIP, OR OTHER REORGANIZATION OF THE COMPANY PROVIDED SUCH ACTION HAS BEEN APPROVED BY SYSTEM BOARD MEMBERS COMPRISING MORE THAN SEVENTY-FIVE (75%) OF THE SYSTEM BOARD POSITIONS INCLUSIVE OF VACANCIES, E) APPROVE THE FORMATION OF A COMPANY SUBSIDIARY ORGANIZATION, AND THE SALE, TRANSFER OR SUBSTANTIAL CHANGE IN USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF A COMPANY SUBSIDIARY ORGANIZATION, OR THE DIVESTITURE, DISSOLUTION, CLOSURE, MERGER, CONSOLIDATION OR CHANGE IN CORPORATE MEMBERSHIP OR OWNERSHIP OF A COMPANY SUBSIDIARY ORGANIZATION, F) APPROVE THE TRANSFER OR ENCUMBRANCE OF THE ASSETS OF THE COMPANY IN ACCORDANCE WITH SYSTEM POLICIES PROVIDED THAT THE TRANSFER OF ASSETS EXCEPT IN CONNECTION WITH SYSTEM BORROWING WILL REQUIRE THE FAVORABLE VOTE OF SYSTEM BOARD MEMBERS COMPRISING MORE THAN SEVENTY-FIVE (75%) OF THE SYSTEM BOARD POSITIONS INCLUSIVE OF VACANCIES, G) APPROVE THE ANNUAL OPERATING BUDGET, CAPITAL PLAN, STRATEGIC PLAN, AND BUSINESS PLAN FOR THE COMPANY, H) APPROVE ANY TRANSACTIONS OF THE COMPANY HAVING AN INDIVIDUAL COST GREATER THAN $250,000 OR AN AGGREGATE COST GREATER THAN $500,000 WHICH ARE NOT OTHERWISE INCLUDED IN THE COMPANY'S OPERATING OR CAPITAL BUDGETS, AS APPROVED, AMENDED OR MODIFIED FROM TIME TO TIME BY UHS, I) RESOLVE ANY ISSUES BETWEEN THE COMPANY AND ANY SUBSIDIARY ORGANIZATION AS TO PARTICIPATION, OR FAILURE TO PARTICIPATE, IN SPECIFIC MANAGED CARE AGREEMENTS AND THE TERMS THEREOF, AND J) APPROVE ANY MANAGEMENT AGREEMENT FOR THE MANAGEMENT OF ALL OR ANY SUBSTANTIAL PARTY OF THE COMPANY'S OPERATIONS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW OF THE FORM 990 BY THE ORGANIZATION'S MANAGEMENT. THE GOVERNING BODY REVIEWS AND APPROVES THE FORM 990 AND THE FINAL FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, ARE PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION FOLLOWS UNION HOSPITAL'S POLICIES AND PROCEDURES INCLUDING THE CONFLICT OF INTEREST POLICY. THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY THE CORPORATE COMPLIANCE OFFICER. THE SCOPE OF THIS POLICY INCLUDES DIRECTORS, OFFICERS, MANAGEMENT, AND EMPLOYEES. THE POLICY IS IN PLACE TO AVOID PERSONAL INTERESTS THAT CONFLICT, OR MAY APPEAR TO CONFLICT, WITH THE BEST INTERESTS OF UNION AND ITS AFFILIATES AND THE COMMUNITIES THEY SERVE. THE COVERED PERSONS ARE TO REFRAIN FROM PERSONAL INTERESTS, DIRECT OR INDIRECT WITH ANY THIRD PARTIES. IT IS THE RESPONSIBILITY OF OFFICERS, MANAGEMENT, AND EMPLOYEES TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES AND ACT ACCORDINGLY. A SELF-DISCLOSURE FROM COVERED PERSONS TO THE CORPORATE COMPLIANCE OFFICER IS REQUIRED ON ANY POTENTIAL CONFLICTS OF INTEREST. THE COVERED PERSONS ARE TO REFRAIN FROM PARTICIPATING IN ANY DELIBERATION OR DECISIONS ON SUCH TRANSACTIONS. THE CONFLICTS DISCLOSED ARE REVIEWED AND RESOLVED BY THE CORPORATE COMPLIANCE OFFICER. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS FOR DETERMINING COMPENSATION OF SR. EXECUTIVE OR SR. ADMINISTRATIVE POSITIONS INCLUDES A SUBCOMMITTEE OF THE BOARD OF DIRECTORS' EXECUTIVE COMMITTEE CONSISTING OF INDEPENDENT BOARD MEMBERS WHOSE RESPONSIBILITY INCLUDES SUCH REVIEW, INCLUDING REVIEW OF THE CEO'S COMPENSATION. THEY GATHER INFORMATION AND FOLLOW THE STEPS SET FORTH BELOW AND IN TURN SUBMIT TO THE FULL BOARD OF DIRECTORS THE RECOMMENDATIONS IN TERMS OF COMPENSATION AND BENEFITS FOR THE CEO AND SR. MANAGEMENT. A SUBCOMMITTEE OF THE BOARD OF DIRECTORS' EXECUTIVE COMMITTEE CONSISTS OF INDIVIDUALS WHO ARE INDEPENDENT AND DISINTERESTED BOARD MEMBERS. THE CEO IS EXCUSED FROM THE MEETING WHEN HIS/HER COMPENSATION/BENEFITS ARE REVIEWED BOTH AT THE COMMITTEE LEVEL AND THE BOARD LEVEL. THE STEPS INCLUDE: 1. THE EXECUTIVE/COMPENSATION SUBCOMMITTEE INSTRUCTS THE VP OF HUMAN RESOURCES TO RETAIN AN OUTSIDE INDEPENDENT CONSULTANT TO (1) PROVIDE THE COMMITTEE WITH INFORMATION, AND (2) TO REVIEW THE ACTIONS AND COMPENSATION/BENEFITS TO BE SURE THAT THERE IS NOT EXCESSIVE COMPENSATION. THE CONSULTANT THAT HAS BEEN USED THE PAST SEVERAL YEARS IS SULLIVAN COTTER & ASSOCIATES, INC. UNDER THE PROCESS, SULLIVAN COTTER FIRST IS PROVIDED WITH THE NAMES AND JOB DESCRIPTIONS FOR THE SR. MANAGEMENT TEAM THAT IS BEING EVALUATED. THE INDEPENDENT ADVISOR THEN SUBMITS TO THE EXECUTIVE/COMPENSATION SUBCOMMITTEE COMPARABLE INFORMATION, SPECIFICALLY: > FOUR (4) COMMERCIALLY AVAILABLE EXECUTIVE HEALTH CARE COMPENSATION SURVEYS PREPARED BY INDEPENDENT FIRMS, WERE REFERENCED TO OBTAIN MARKET DATA FOR THIS REVIEW: - INTEGRATED HEALTHCARE STRATEGIES: 2020 HEALTHCARE EXECUTIVE COMPENSATION SURVEY - ADVISORY BOARD BENCHMARK DATA 2020 SURVEY - INDIANA HOSPITAL & HEALTH ASSOCIATION: 2020 COMPENSATION SURVEY REPORT - SULLIVAN COTTER & ASSOCIATES: 2020 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS > MARKET DATA REFLECTING FUNCTIONALLY-COMPARABLE POSITIONS WERE OBTAINED FOR ALL TEN EXECUTIVE POSITIONS > DATA WERE ABSTRACTED FOR COMPARABLY-SIZED ORGANIZATIONS AS MEASURED BY NET REVENUE > THE DATA REPORTED REPRESENTED THE 50TH, 75TH, AND 90TH PERCENTILES OF BASE SALARY AND TOTAL CASH COMPENSATION (BASE SALARY PLUS ACTUAL ANNUAL INCENTIVE - ABBREVIATED TCC) > REGIONAL MARKET DATA WERE ALSO COLLECTED FROM THE PUBLISHED COMPENSATION SURVEYS AS WELL AS A SPECIAL CUT OF THE FOLLOWING INDIANA HOSPITALS FROM SULLIVAN COTTER'S 2020 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS: - BALL MEMORIAL HOSPITAL - REID HOSPITAL & HEALTH CARE SERVICES - BLOOMINGTON HOSPITAL - RILEY HOSPITAL FOR CHILDREN - ELKHART GENERAL HOSPITAL - SAINT JOHN'S HEALTH SYSTEM - GOOD SAMARITAN HOSPITAL - SAINT JOSEPH REGIONAL MEDICAL CENTER - MEMORIAL HOSPITAL OF SOUTH BEND - SAINT MARY'S MEDICAL CENTER - METHODIST HOSPITALS - TERRE HAUTE REGIONAL HOSPITAL - PARKVIEW HOSPITAL > THAT DATA WAS ALSO REPORTED WITH NATIONAL AVERAGE, REGIONAL AVERAGE AND INDIANA AVERAGE. 2. THE EXECUTIVE/COMPENSATION SUBCOMMITTEE OF UNION HOSPITAL'S BOARD OF DIRECTORS TAKES THE DATA PROVIDED BY THE INDEPENDENT CONSULTANTS AND FOLLOWING A REVIEW OF THE PERFORMANCE OF EACH INDIVIDUAL SUBMITS TO THE FULL BOARD FOR APPROVAL RECOMMENDATIONS IN TERMS OF SALARIES, BENEFITS, AND BONUSES. FINAL APPROVAL IS BY THE BOARD OF DIRECTORS. THE CEO DOES NOT TAKE PART IN THE DISCUSSION OR ACTION ON HIS/HER SALARY, BENEFITS AND BONUS. 3. MINUTES OF THE EXECUTIVE/COMPENSATION SUBCOMMITTEE AND THE BOARD MEETINGS ARE CONTEMPORANEOUSLY KEPT AND MAINTAIN WITH THE CORPORATE MINUTE BOOKS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9: | EQUITY TRANSFER FROM SYSTEM 45,364,596. |
| FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT: | THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|
| UNION HEALTH SYSTEMS | ||||||||||
| 1606 N SEVENTH ST | TERRE HAUTE | IN | 47804 | 270581133 | MANAGEMENT ORGANIZATION | IN | 501C3 | LINE 12B, II | 0 | |
| CENTER FOR OCCUPATIONAL HEALTH | ||||||||||
| 4001 WABASH AVE | TERRE HAUTE | IN | 47803 | 352118417 | OCCUPATIONAL HEALTH SERVICES | IN | 501C3 | LINE 7 | Yes (1) | UNION HOSPITAL |
| UNION HOSPITAL FOUNDATION | ||||||||||
| 1659 N SEVENTH ST | TERRE HAUTE | IN | 47804 | 351642823 | FUNDRAISING | IN | 501C3 | LINE 12C, III-FI | 0 | |
| UNION HOSPITAL INC | ||||||||||
| 1606 N SEVENTH ST | TERRE HAUTE | IN | 47804 | 350876396 | HOSPITAL | IN | 501C3 | LINE 3 | Yes (1) | UNION HEALTH SYSTEMS |
| VISITING NURSE ASSOCIATION OF THE WABASH VALLEY INC | ||||||||||
| 400 8TH AVENUE | TERRE HAUTE | IN | 47804 | 350869064 | HOME HEALTH AND HOSPICE CARE | IN | 501C3 | LINE 10 | Yes (1) | UNION HOSPITAL FOUNDATION |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| UNION HOSPITAL THERAPY LLC | ||||||||||||||
| 150 N ROSENBERGER | EVANSVILLE | IN | 47712 | 464357168 | REHABILITATION AND THERAPY SERVICES | IN | N/A | 0 | 0 | |||||
| AMBULATORY SURGERY MGMT SVCS LLC II | ||||||||||||||
| 1606 N 7TH STREET | TERRE HAUTE | IN | 47804 | 270818628 | MEDICAL SERVICES | IN | 0 | Yes (1) | UNION ASSOCIATED PHYSICIANS CLINIC LLC | RELATED | $908,088 | $1,017,005 | 0.73800 | |
| CARDIOVASCULAR MANAGEMENT LLC | ||||||||||||||
| 2723 S 7TH STREET | TERRE HAUTE | IN | 47802 | 208742344 | MEDICAL SERVICES | IN | N/A | 0 | 0 | RELATED | $3,136,569 | 0.50000 | ||
| ONCOLOGY SERVICES GROUP LLC | ||||||||||||||
| 6100 W 96TH STREET SUITE 125 | INDIANAPOLIS | IN | 46278 | 208567643 | MEDICAL SERVICES | IN | 0 | 0 | UNION ASSOCIATED PHYSICIANS CLINIC LLC | RELATED | $139,553 | $224,838 | 0.62500 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IPACS INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1606 N SEVENTH ST | AddressLine1Txt |
| City | TERRE HAUTE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47804 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351720998 | EIN |
| Primary Activities | COLLECTION AGENCY | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| AMBULATORY SURGERY MGMT SVCS LLC II | ||
| A | $638 | FMV |
| ONCOLOGY SERVICES GROUP LLC | ||
| A | $178 | FMV |