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SOUTH BEND MEDICAL FOUNDATION INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
SOUTH BEND MEDICAL FOUNDATION INC (EIN 35-0868178)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-09
IRS object ID
201743139349304124
Schema version
2016v3.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-11-09T21:01:42-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CROWE HORWATH LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1330 E Jefferson Blvd PO Box 7AddressLine1Txt
CitySouth BendCityNm
State AbbreviationINStateAbbreviationCd
ZIP466240007ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN350868178EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1South Bend Medical Foundation IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSOUTBusinessNameControlTxt
Phone5742045291PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1530 North Lafayette BlvdAddressLine1Txt
CitySouth BendCityNm
State AbbreviationINStateAbbreviationCd
ZIP46601ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOYCE SIMPSON MDPersonNm
Person TitlePRESIDENTPersonTitleTxt
Signature2017-10-25SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKENNETH J KEBERPreparerPersonNm
PTINP00240883PTIN
Phone5742323992PhoneNum
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1The Medical FoundationBusinessNameLine1Txt

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Joyce Simpson MDBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1530 North Lafayette BlvdAddressLine1Txt
CitySouth BendCityNm
State AbbreviationINStateAbbreviationCd
ZIP46601ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$88,165,450GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.sbmf.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1946FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionSouth Bend Medical Foundation exists for the purpose of providing quality and cost effective laboratory and blood banking services to hospitals, physicians, and patients.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee803TotalEmployeeCnt
Total Volunteers14TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,021PYContributionsGrantsAmt
CY Contributions Grants$2,072CYContributionsGrantsAmt
PY Program Service Revenue$90,903,792PYProgramServiceRevenueAmt
CY Program Service Revenue$87,413,068CYProgramServiceRevenueAmt
PY Investment Income$99,937PYInvestmentIncomeAmt
CY Investment Income-$252,633CYInvestmentIncomeAmt
PY Other Revenue$823,628PYOtherRevenueAmt
CY Other Revenue$717,053CYOtherRevenueAmt
PY Total Revenue$91,829,378PYTotalRevenueAmt
CY Total Revenue$87,879,560CYTotalRevenueAmt
PY Grants And Similar Paid$1,980,310PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,475,695CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$41,016,819PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$39,283,873CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$48,930,546PYOtherExpensesAmt
CY Other Expenses$47,148,175CYOtherExpensesAmt
PY Total Expenses$91,927,675PYTotalExpensesAmt
CY Total Expenses$87,907,743CYTotalExpensesAmt
PY Revenues Less Expenses-$98,297PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$28,183CYRevenuesLessExpensesAmt
Total Assets BOY$43,264,513TotalAssetsBOYAmt
Total Assets EOY$41,409,672TotalAssetsEOYAmt
Total Liabilities BOY$39,137,662TotalLiabilitiesBOYAmt
Total Liabilities EOY$38,444,435TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,126,851NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,965,237NetAssetsOrFundBalancesEOYAmt
MissionSouth Bend Medical Foundation exists for the purpose of providing quality and cost effective laboratory and blood banking services to hospitals, physicians, and patients. (Continued in Schedule O).MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$72,992,187ExpenseAmt
Grant$1,475,695GrantAmt
Revenue$87,894,944RevenueAmt
DescSOUTH BEND MEDICAL FOUNDATION'S (SBMF) MORE THAN 800 EMPLOYEES PROVIDE A WIDE RANGE OF TOP-QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES FOR COMMUNITIES IN INDIANA, MICHIGAN, KENTUCKY, OHIO, AND ILLINOIS. BY WORKING TOGETHER WITH LOCAL HEALTH CARE PROVIDERS, SBMF PRESERVES THE CRITICAL RELATIONSHIP BETWEEN LABORATORY, PHYSICIAN AND PATIENT. UNLIKE MANY LARGE COMMERCIAL LABORATORIES, SBMF OFFERS ITS SERVICES 24 HOURS A DAY, 365 DAYS A YEAR. SBMF PERSONNEL ARE DEDICATED TO BEING A TRUSTED PHYSICIAN RESOURCE, HANDLING EVERYTHING FROM ROUTINE OUTPATIENT ORDERS TO PROVIDING INPATIENT SERVICES AT HOSPITAL AND OTHER HEALTH CARE FACILITIES THROUGHOUT THE REGION. SBMF'S COMMITMENT TO DELIVERING CONSISTENT, RELIABLE, QUALITY MEDICAL CARE HAS PLAYED AN INSTRUMENTAL ROLE IN HELPING THE FOUNDATION ACHIEVE ITS POSITION OF LEADERSHIP AMONG THE NATION'S DIAGNOSTIC LABORATORIES. (CONTINUED IN SCHEDULE O)Desc
Total Program Service Expenses$72,992,187TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document64IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee803EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1James B MyersBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5742045206PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1118 W Edison RoadAddressLine1Txt
CityMishawakaCityNm
State AbbreviationINStateAbbreviationCd
ZIP46545ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (38 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Joyce Simpson MD
President40.0Yes (X)Yes (X)$325,577$0$12,583
Amobi Ezenekwe MD
EXECUTIVE VP40.0Yes (X)Yes (X)$295,555$0$26,894
Bilal Ansari MD
Board member (through May 2016)1.0Yes (X)$0$0$0
BRIAN SUCHARETZA MD
Board member (through May 2016)1.0Yes (X)$0$0$0
CARLTON LYONS MD
BOARD MEMBER (BEGINNING MAY 2016)1.0Yes (X)$0$0$0
ROBIN ZON MD
BOARD MEMBER (BEGINNING MAY 2016)1.0Yes (X)$0$0$0
BINH TRAN
BOARD MEMBER1.0Yes (X)$0$0$0
Daniel E Scherb MD
BOARD MEMBER1.0Yes (X)$0$0$0
Walter H Halloran MD
BOARD MEMBER1.0Yes (X)$0$0$0
ERIC D KNAPP DO
BOARD MEMBER1.0Yes (X)$0$0$0
Mark A Thompson MD
Board Member1.0Yes (X)$0$0$0
SAMUEL MILLIGAN
BOARD MEMBER1.0Yes (X)$0$0$0
John T Rice MD
Chair1.0Yes (X)$0$0$0
Richard H Seall MD
Vice Chair (through May 2016)/Board Member1.0Yes (X)$0$0$0
Samuel Borrelli MD
Vice Chair (beginning May 2016)/Board Member1.0Yes (X)$0$0$0
Derrick Forchetti MD
Chief Medical Information Officer40.0Yes (X)$270,763$0$25,947
James Frain
VP of Human Resources40.0Yes (X)$234,779$0$21,027
Diane Janowiak
VP of Central Lab Operations (through April 2016)40.0Yes (X)$255,228$0$15,648
Robert King
Senior VP (through April 2016)40.0Yes (X)$291,968$0$13,579
Ann Sullivan
VP of Finance40.0Yes (X)$233,945$0$26,787
SHADIA ALAM MD
PATHOLOGIST40.0$238,991$0$12,059Yes (X)
Nicole Anest MD
Pathologist40.0$231,612$0$18,437Yes (X)
Fred Busse MD
Pathologist24.0$156,447$0$17,158Yes (X)
Francisco Deogracias MD
Pathologist20.0$172,180$0$20,062Yes (X)
James Dyer MD
Pathologist40.0$251,947$0$11,723Yes (X)
Blair Chrenka MD
PATHOLOGIST40.0$218,415$0$19,361Yes (X)
Nita Gerig MD
Pathologist32.0$262,789$0$19,319Yes (X)
Ricky Hoover MD
Pathologist40.0$322,793$0$21,853Yes (X)
Kristen Jacobs MD
Pathologist24.0$199,039$0$16,662Yes (X)
John Landgraf MD
Pathologist40.0$265,995$0$21,370Yes (X)
Odeta Lapkus MD
Pathologist40.0$257,243$0$24,529Yes (X)
Bobbie Sutton MD
Pathologist40.0$281,441$0$21,184Yes (X)
Erica Martin MD
PATHOLOGIST40.0$238,607$0$12,059Yes (X)
PRENTISS JONES
DIRECTOR - TOXICOLOGY40.0$132,589$0$14,423Yes (X)
QING LI
DIRECTOR - NEW TEST DEVELOPMENT40.0$128,467$0$17,719Yes (X)
PATRICIA MILLER-CANFIELD MD
PATHOLOGIST40.0$213,982$0$18,525Yes (X)
CARRIE ROBINSON
DIRECTOR - REGIONAL MARKETING40.0$128,994$0$24,278Yes (X)
DANIEL NUSSBAUM
DIRECTOR - SALES AND MARKETING40.0$133,567$0$23,214Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$5,742,913TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$476,400TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K30IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmtAddress Line2ContractorAddress/USAddress/AddressLine2Txt
ASSOC REG AND UNIV PATHOLOGISTS
PO BOX 27964SALT LAKE CITYUT84127REFERENCE LAB$2,989,626
THERMO ASSET MANAGEMENT SERVICES INC
120 BISHOPS WAYBROOKFIELDWI53005EQUIPMENT MAINTENANCE / REPAIR$833,655
AUREAUS RADIOLOGY LLC
13609 CALIFORNIA STREETOMAHANE68154TEMPORARY MEDICAL STAFFING$814,713
CERNER CORPORATION
PO BOX 412702KANSAS CITYMO64141SOFTWARE AND EQUIPMENT MAINTENANCE / REPAIR$796,527
MICHIANA HEALTH INFORMATION NETWORK LLC
220 W COLFAX AVESOUTH BENDIN46601COMMUNITY BASED CLINICAL INFO SYSTEM$626,400SUITE 300
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K20CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
All Other Contributions$2,072AllOtherContributionsAmt
Total Contributions$2,072TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNet operating revenuesDesc
Business621500BusinessCd
Total Revenue Column$87,413,068TotalRevenueColumnAmt
Related Or Exempt Func Income$87,413,068RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$87,413,068TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,013TotalRevenueColumnAmt
Exclusion$13,013ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$20,244OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$285,890OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other-$265,646OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$265,646TotalRevenueColumnAmt
Exclusion-$265,646ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Clinical Pathology Fees621500$481,876$481,876
Teaching Fees611430$38,204$38,204
Records Retrieval Fees900099$3,827$3,827

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$193,146TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$193,146ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$717,053OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$87,879,560TotalRevenueColumnAmt
Related Or Exempt Func Income$87,894,944RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$17,456ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$62,900TotalAmt
Program Services$62,900ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$1,412,795TotalAmt
Program Services$1,412,795ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$5,383,555TotalAmt
Program Services$3,863,141ProgramServicesAmt
Management And General$1,520,414ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$25,646,894TotalAmt
Program Services$20,246,889ProgramServicesAmt
Management And General$5,400,005ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$188,021TotalAmt
Program Services$148,631ProgramServicesAmt
Management And General$39,390ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,959,973TotalAmt
Program Services$4,711,359ProgramServicesAmt
Management And General$1,248,614ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,105,430TotalAmt
Program Services$1,644,841ProgramServicesAmt
Management And General$460,589ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$136,852TotalAmt
Management And General$136,852ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$71,996TotalAmt
Management And General$71,996ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,832,121TotalAmt
Program Services$1,961,785ProgramServicesAmt
Management And General$870,336ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,458,013TotalAmt
Program Services$917,749ProgramServicesAmt
Management And General$540,264ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,933,057TotalAmt
Program Services$1,769,739ProgramServicesAmt
Management And General$163,318ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$72,173TotalAmt
Program Services$52,917ProgramServicesAmt
Management And General$19,256ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$405,794TotalAmt
Management And General$405,794ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,075,804TotalAmt
Program Services$2,133,901ProgramServicesAmt
Management And General$941,903ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$747,839TotalAmt
Program Services$81,452ProgramServicesAmt
Management And General$666,387ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Lab$22,736,640$22,137,216$599,424
Reference Lab$4,947,375$4,947,375
Bad Debt$3,498,170$3,498,170
Building Equipment/Maintenance$3,660,338$2,244,646$1,415,692

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,572,003TotalAmt
Program Services$1,156,681ProgramServicesAmt
Management And General$415,322ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$87,907,743TotalAmt
Program Services$72,992,187ProgramServicesAmt
Management And General$14,915,556ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,250BOYAmt
EOY$750EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,819,451BOYAmt
EOY$4,121,165EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$11,614,102BOYAmt
EOY$12,085,361EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,749,280BOYAmt
EOY$1,496,163EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,079,634BOYAmt
EOY$816,609EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$96,101,400LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$74,180,802LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$23,966,018BOYAmt
EOY$21,920,598EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$994,132BOYAmt
EOY$827,988EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$40,646BOYAmt
EOY$141,038EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$43,264,513BOYAmt
EOY$41,409,672EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,466,153BOYAmt
EOY$9,591,584EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,260,000BOYAmt
EOY$5,950,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$22,411,509BOYAmt
EOY$22,902,851EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$39,137,662BOYAmt
EOY$38,444,435EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,126,851BOYAmt
EOY$2,965,237EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,126,851BOYAmt
EOY$2,965,237EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$43,264,513BOYAmt
EOY$41,409,672EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$28,183ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$277,840NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$1,411,271OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$429,028CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,736CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,032CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,021CurrentTaxYearMinus1YearAmt
Current Tax Year$2,072CurrentTaxYearAmt
Total$436,889TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$99,026,282CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$99,699,838CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$94,707,654CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$90,903,792CurrentTaxYearMinus1YearAmt
Current Tax Year$87,413,068CurrentTaxYearAmt
Total$471,750,634TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$170,096CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$383,067CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$336,035CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$219,490CurrentTaxYearMinus1YearAmt
Current Tax Year$235,177CurrentTaxYearAmt
Total$1,343,865TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$99,625,406CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$100,084,641CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$95,045,721CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$91,125,303CurrentTaxYearMinus1YearAmt
Current Tax Year$87,650,317CurrentTaxYearAmt
Total$473,531,388TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,082CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$15,082TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,082CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$15,082TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$473,516,306PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$123,674CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$302,005CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$155,693CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$101,397CurrentTaxYearMinus1YearAmt
Current Tax Year$13,013CurrentTaxYearAmt
Total$695,782TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$123,674CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$302,005CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$155,693CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$101,397CurrentTaxYearMinus1YearAmt
Current Tax Year$13,013CurrentTaxYearAmt
Total$695,782TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$497,425CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$468,990CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$629,322CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$604,138CurrentTaxYearMinus1YearAmt
Current Tax Year$481,876CurrentTaxYearAmt
Total$2,681,751TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$100,246,505CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$100,855,636CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$95,830,736CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$91,830,838CurrentTaxYearMinus1YearAmt
Current Tax Year$88,145,206CurrentTaxYearAmt
Total$476,908,921TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.9929PublicSupportCY509Pct
Public Support PY5090.9931PublicSupportPY509Pct
Investment Income CY0.0015InvestmentIncomeCYPct
Investment Income PY0.0015InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part III, Line 12 Other IncomeFormAndLineReferenceDesc
ExplanationDESCRIPTION - CLINICAL PATHOLOGY FEES, COLUMN A - 451445.0, COLUMN B - 468990.0, COLUMN C - 629322.0, COLUMN D - 604138.0, COLUMN E - 481876.0, COLUMN F - 2635771.0; DESCRIPTION - FUNDRAISING GROSS RECEIPTS, COLUMN A - 45980.0, COLUMN B - 0.0, COLUMN C - 0.0, COLUMN D - 0.0, COLUMN E - 0.0, COLUMN F - 45980.0;ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,115,906OtherCostOrOtherBasisAmt
Book Value$1,115,906BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$43,411,738OtherCostOrOtherBasisAmt
Depreciation$35,912,156DepreciationAmt
Book Value$7,499,582BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$772,568OtherCostOrOtherBasisAmt
Depreciation$671,556DepreciationAmt
Book Value$101,012BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$50,801,188OtherCostOrOtherBasisAmt
Depreciation$37,597,090DepreciationAmt
Book Value$13,204,098BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$21,920,598TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Fair value of interest rate swap$468,130
Accrued pension and postretirement benefits$22,434,721
FieldValueIRS element (for citing)
Total Liability$22,902,851TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$85,333,334TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$277,840NetUnrealizedGainsInvstAmt
Other Revenue-$1,411,271OtherRevenueAmt
Revenue Not Reported-$1,133,431RevenueNotReportedAmt
Revenue Subtotal$86,466,765RevenueSubtotalAmt
Other Revenues Not Included$1,412,795OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$1,412,795RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$87,879,560TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$86,494,948TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$0OtherExpensesIncludedAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$86,494,948ExpensesSubtotalAmt
Other Expenses Not Included$1,412,795OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$1,412,795ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$87,907,743TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteThe Foundation is a not-for-profit organization pursuant to Section 501(c)(3) of the Internal Revenue Code and is exempt from federal and state income taxes pursuant to Section 501(a). Accordingly, no provision for income taxes is reflected in the Foundation's financial statements. The Foundation is subject to examination by federal and state taxing authorities for the years ended December 31, 2013 through 2016. The Foundation follows guidance issued by the Financial Accounting Standards Board with respect to accounting for uncertainty in income taxes. A tax position is a benefit only if it is "more likely than not" that the tax position would be sustained in a tax examination, with a tax examination being presumed to occur. The amount recognized is the largest amount of tax benefit that is greater than 50% likely of being realized on examination. For tax positions not meeting the "more likely than not" test, no tax benefit is recorded. Management has determined that there is no liability for uncertain tax positions and does not expect this to change over the next 12 months.
Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990Pension and postretirement benefit-related changes other than net periodic benefit cost - -1411271
Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statementsFINANCIAL ASSISTANCE - 1412795
Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statementsFINANCIAL ASSISTANCE - 1412795

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
AMERICAN CANCER SOCIETY
130 Red Coach DriveMishawakaIN46545131788491501(C)(3)$5,000GENERAL ASSISTANCE
AMERICAN HEART ASSOCIATION
6100 WEST 96TH STREET SUITE 200INDIANAPOLISIN46278135613797501(C)(3)$5,050GENERAL ASSISTANCE
CONQUER CANCER FOUNDATION
2318 MILL ROAD SUITE 800ALEXANDRIAVA22314311667995501(C)(3)$5,000GENERAL ASSISTANCE
THE FOUNDATION OF SAINT JOSEPH HEALTH SYSTEM
707 E CEDAR SUITE 175SOUTH BENDIN46617351654543501(C)(3)$8,400GENERAL ASSISTANCE
FieldValueIRS element (for citing)
Total501c3 Org4Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxtCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDesc
PATIENT MEDICAL ASSISTANCE$0$977,262FMVFREE OR REDUCED MEDICAL CARE
TIME OF SERVICE DISCOUNTS$0$435,533FMVDISCOUNT PROVIDED AT TIME OF PAYMENT

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule I, Part III, Column (b) NUMBER OF RECIPIENTSCURRENTLY, SOUTH BEND MEDICAL FOUNDATION DOES NOT HAVE AN EFFECTIVE WAY TO TRACK THE UNDUPLICATED NUMBER OF PATIENTS THAT RECEIVE FREE OR REDUCED CARE AND TIME OF SERVICE DISCOUNTS.
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.South Bend Medical Foundation (SBMF) provides funding to other community not-for-profit organizations. Generally, these are unrestricted contributions that the receiving organization can use to further their mission and programs at their discretion. The use of these contributions is not monitored. SBMF also provides assistance to individuals in the form of free or reduced fee medical care at various locations throughout the communities served. These individuals meet SBMF's charity care eligibility requirements, or the requirements of the referring health care provider. Determination and monitoring of charity care is performed on a case-by-case basis. SBMF also provides discounts for payment at time of service to patients who do not have government provided insurance coverage or do not wish to have a claim filed with their commercial insurance carrier. There is no actual exchange of funds, as the discounts are credited directly to the patients' accounts. Time of service discounts are monitored at the organization level, in the aggregate.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (23 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Joyce Simpson MD
President$324,227$0$0$0$1,350$0$2,600$0$9,983$0$338,160$0$0$0
Amobi Ezenekwe MD
EXECUTIVE VP$294,205$0$0$0$1,350$0$2,600$0$24,294$0$322,449$0$0$0
Derrick Forchetti MD
Chief Medical Information Officer$270,763$0$0$0$0$0$2,600$0$23,347$0$296,710$0$0$0
James Frain
VP of Human Resources$233,713$0$0$0$1,066$0$2,369$0$18,658$0$255,806$0$0$0
Diane Janowiak
VP of Central Lab Operations (through April 2016)$91,992$0$0$0$163,236$0$1,046$0$14,602$0$270,876$0$0$0
Robert King
Senior VP (through April 2016)$94,508$0$0$0$197,460$0$1,338$0$12,241$0$305,547$0$0$0
Ann Sullivan
VP of Finance$232,879$0$0$0$1,066$0$2,369$0$24,418$0$260,732$0$0$0
SHADIA ALAM MD
PATHOLOGIST$238,856$0$0$0$135$0$2,285$0$9,774$0$251,050$0$0$0
Nicole Anest MD
Pathologist$230,666$0$0$0$946$0$901$0$17,536$0$250,049$0$0$0
Fred Busse MD
Pathologist$155,739$0$0$0$708$0$1,573$0$15,585$0$173,605$0$0$0
Francisco Deogracias MD
Pathologist$171,414$0$0$0$766$0$1,703$0$18,359$0$192,242$0$0$0
James Dyer MD
Pathologist$250,812$0$0$0$1,135$0$1,893$0$9,830$0$263,670$0$0$0
Blair Chrenka MD
PATHOLOGIST$217,438$0$0$0$977$0$0$0$19,361$0$237,776$0$0$0
Nita Gerig MD
Pathologist$261,574$0$0$0$1,215$0$2,033$0$17,286$0$282,108$0$0$0
Ricky Hoover MD
Pathologist$321,443$0$0$0$1,350$0$2,600$0$19,253$0$344,646$0$0$0
Kristen Jacobs MD
Pathologist$198,127$0$0$0$912$0$2,027$0$14,635$0$215,701$0$0$0
John Landgraf MD
Pathologist$264,818$0$0$0$1,177$0$2,600$0$18,770$0$287,365$0$0$0
Odeta Lapkus MD
Pathologist$257,243$0$0$0$0$0$0$0$24,529$0$281,772$0$0$0
Bobbie Sutton MD
Pathologist$281,441$0$0$0$0$0$2,600$0$18,584$0$302,625$0$0$0
Erica Martin MD
PATHOLOGIST$238,607$0$0$0$0$0$2,285$0$9,774$0$250,666$0$0$0
PATRICIA MILLER-CANFIELD MD
PATHOLOGIST$206,782$0$0$0$7,200$0$0$0$18,525$0$232,507$0$0$0
CARRIE ROBINSON
DIRECTOR - REGIONAL MARKETING$82,100$0$39,890$0$7,004$0$1,146$0$23,132$0$153,272$0$0$0
DANIEL NUSSBAUM
DIRECTOR - SALES AND MARKETING$94,767$0$31,000$0$7,800$0$0$0$23,214$0$156,781$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 4a Severance or change-of-control paymentTHE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING 2016: DIANE JANOWIAK - $138,495. ROBERT KING - $150,389.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planThe organization has a supplemental nonqualified retirement plan that was designed to replace retirement benefits lost by individuals due to 1998 changes in pension laws and a redesign of the pension plan to maximize benefits for lower compensated employees. The organization's board of directors elected to freeze this plan, and therefore no benefits were provided during 2016.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 1 ORGANIZATION'S MISSION (CONTINUED FROM PART III)TO FULFILL OUR MISSION WE SHALL: (I) PROVIDE THE HOSPITALS WE SERVICE WITH THE HIGHEST QUALITY LABORATORY RESOURCES AND--TAKING INTO ACCOUNT THAT LENGTH OF STAY IS CRUCIAL FOR INPATIENT CARE--WITH THE SHORTEST RESPONSE TIME WHILE ACHIEVING A HIGH DEGREE OF COST EFFECTIVENESS. (II) PROVIDE OUR PHYSICIAN CUSTOMERS WITH THE HIGHEST QUALITY LABORATORY RESULTS UTILIZING THE LATEST TECHNOLOGY AND MAKING AVAILABLE TO THEM READILY ACCESSIBLE CONSULTATIVE OPPORTUNITIES IN THE MEDICAL AND ADMINISTRATIVE ASPECTS OF THEIR PRACTICES. (III) CREATE AND MAINTAIN A WORK ENVIRONMENT WHERE EMPLOYEES CAN GROW PERSONALLY AND PROFESSIONALLY WITH COMPENSATION AND BENEFIT SYSTEMS THAT ARE COMPETITIVE, EQUITABLE AND COST EFFECTIVE AS WELL AS AN ENVIRONMENT WHERE EMPLOYEES ARE PROVIDED STABLE EMPLOYMENT AND EACH INDIVIDUAL IS TREATED WITH RESPECT AND DIGNITY. (IV) PROVIDE TO THE PATIENT POPULATION IN THE COMMUNITIES WE SERVE READILY ACCESSIBLE, REASONABLY PRICED LABORATORY SERVICES, WITH AS WIDE A SCOPE AND VARIETY AS POSSIBLE TO MEET ALL THEIR NEEDS LOCALLY. (V) RECOGNIZING OUR SOCIAL RESPONSIBILITIES TO THE COMMUNITY, PROVIDE SERVICES WITHIN OUR MEANS TO THOSE LESS FORTUNATE, AND SUPPORT PUBLIC AND PRIVATE EFFORTS DIRECTED TO IMPROVE OUR HEALTH CARE ENVIRONMENT.
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED FROM PART III)THE ALTRUISTIC ACTIVITIES OF THE ORGANIZATION ARE INTENDED TO RELIEVE DISEASE, SUFFERING, AND CONSTRAINT. MANY SERVICES ARE PROVIDED AS CHARITY OR PRO BONO. THE AMOUNT OF CHARITY CARE, PROVIDED AT SBMF'S ESTABLISHED RATES, WAS APPROXIMATELY $402,000 FOR THE YEAR ENDED DECEMBER 31, 2016.
Form 990, Part VI, Line 1a Delegate broad authority to a committeeThe administrative committee shall consist of the officers of the corporation. Subject to the control of the board of directors, the administrative committee shall have full authority to act for and on behalf of the corporation and exercise all of the powers of the board of directors that may be lawfully delegated by such board to such committee except, however, the administrative committee shall have no power to donate any part of the assets of the corporation. The administrative committee shall receive status reports on other committee activities and discuss items of interest to the group as a whole or to individual officers for the performance of their duties. The administrative committee shall keep minutes of its meetings.
Form 990, Part VI, Line 2 Family/business relationships amongst interested personsBOB SUTTON (HUSBAND OF BOBBIE SUTTON) AND FRED BUSSE - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholdersTHE ORGANIZATION CONSISTS OF ONE CLASS OF MEMBERS. EACH MEMBER MUST BE A PHYSICIAN, LICENSED TO PRACTICE MEDICINE AS SUCH IN EITHER THE STATE OF INDIANA OR THE STATE OF MICHIGAN AND RESIDING IN EITHER THE STATE OF INDIANA OR THE STATE OF MICHIGAN. EACH YEAR, AN INVITATION TO BECOME A MEMBER OF THE ORGANIZATION IS MAILED TO PHYSICIANS IN THE AREA. MEMBERS VOTE ON OPEN BOARD POSITIONS AND ARE ELIGIBLE FOR NOMINATION FOR OPEN BOARD POSITIONS.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyMEMBERS OF THE ORGANIZATION VOTE ON OPEN BOARD POSITIONS AND ARE ELIGIBLE FOR NOMINATION FOR OPEN BOARD POSITIONS.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyPrior to November 15, 2017, each board member is provided a copy of the return for their review and instructed to submit any questions or comments to the VP of Finance. After comments and questions are reviewed, the return will be completed and filed with the IRS on or before November 15, 2017.
Form 990, Part VI, Line 12c Conflict of interest policyAnnual conflict of interest questionnaires are completed by all board members, officers, key employees, and highest compensated employees. The organization's Vice President of Finance and tax advisers review all responses to determine whether or not a potential or actual conflict of interest exists. If an actual conflict of interest is determined to exist, persons with a conflict are recused from voting on the conflicting issue.
Form 990, Part VI, Line 15a Process to establish compensation of top management officialOn an annual basis, the organization's compensation committee reviews and approves compensation for the President/Executive Vice President, as well as other officers, administrators, and professional staff, including key employees. The committee reviews current salaries and pay structures against various sources of comparability data, including: the College of American Pathology Pathologists Compensation Survey; pathology compensation data for pathologists, which outlines pathology and physician salaries by specialty, provided from Merritt Hawkins and Associates; the Guidestar National Compensation Report; and compensation reported on local area hospitals' Forms 990. After reviewing the comparability data, the committee discusses the current economy and financial position of the organization to determine the amount of any compensation increases and/or decreases, if any, that will be given. This process is documented in the compensation committee's meeting minutes.
Form 990, Part VI, Line 15b Process to establish compensation of other employeesSee narrative for Form 990, Part VI, Section B, Line 15a.
Form 990, Part VI, Line 19 Required documents available to the publicFinancial statements, conflict of interest policies, and governing documents are not required disclosures pursuant to IRC Section 6104. These documents are not made available to the public.
Form 990, Part VIII, Line 11d Other Miscellaneous RevenueDeposition Income - Total Revenue: 193, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 193; Miscellaneous Income - Total Revenue: 192953, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 192953;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesPENSION AND POSTRETIREMENT BENEFIT-RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST - -1411271;