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INDIANA HEALTHCARE PHYSICIAN SERVICES INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
INDIANA HEALTHCARE PHYSICIAN SERVICES INC (EIN 25-1842046)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-05-15
IRS object ID
201821359349311217
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)
Return2018-05-15T16:07:29-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Baker Tilly Virchow Krause LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11650 Market Street Suite 4500AddressLine1Txt
CityPhiladelphiaCityNm
State AbbreviationPAStateAbbreviationCd
ZIP191037341ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN251842046EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Indiana Healthcare PhysicianBusinessNameLine1Txt
Business Name Line2Services IncBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlINDIBusinessNameControlTxt
Phone7243577008PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 788AddressLine1Txt
CityIndianaCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15701ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRobert A GongawarePersonNm
Person TitleSenior VP FinancePersonTitleTxt
Phone7243577008PhoneNum
Signature2018-05-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJulius C Green CPAPreparerPersonNm
PTINP00350393PTIN
Phone2159720701PhoneNum
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 Line1IRMC Physician GroupBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerStephen A WolfePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 788AddressLine1Txt
CityIndianaCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15701ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$17,498,501GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.indianarmc.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2000FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionProvide Health ServicesActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee243TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$803,179TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$22,654NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$15,376,947PYProgramServiceRevenueAmt
CY Program Service Revenue$16,136,724CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$1,120,758PYOtherRevenueAmt
CY Other Revenue$1,361,777CYOtherRevenueAmt
PY Total Revenue$16,497,705PYTotalRevenueAmt
CY Total Revenue$17,498,501CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,691,824PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,384,460CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$13,658,677PYOtherExpensesAmt
CY Other Expenses$15,010,931CYOtherExpensesAmt
PY Total Expenses$21,350,501PYTotalExpensesAmt
CY Total Expenses$22,395,391CYTotalExpensesAmt
PY Revenues Less Expenses-$4,852,796PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$4,896,890CYRevenuesLessExpensesAmt
Total Assets BOY$2,778,573TotalAssetsBOYAmt
Total Assets EOY$2,318,779TotalAssetsEOYAmt
Total Liabilities BOY$679,274TotalLiabilitiesBOYAmt
Total Liabilities EOY$144,568TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,099,299NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,174,211NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionPREVENTIVE HEALTH SERVICES, GENERAL/OTHER: INDIANA HEALTHCARE PHYSICIAN SERVICES, INC IS A NON-PROFIT HOSPITAL-OWNED GROUP OF PRACTICES OWNED AND OPERATED TO SERVE THE RURAL AREAS OF INDIANA COUNTY AND SURROUNDING COMMUNITIES. ITS MISSION IS TO SUPPORT THE MISSIONS AND VALUES OF INDIANA REGIONAL MEDICAL CENTER IN PROVIDING HEALTH CARE AND EDUCATIONAL SERVICES TO ALL WHO SEEK HEALTHCARE WITHOUT DISCRIMINATION. WE PROVIDE ACCESSIBLE, COST EFFECTIVE, QUALITY HEALTHCARE WITHIN THE RURAL COMMUNITIES OF INDIANA AND SURROUNDING COUNTIES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$17,916,313ExpenseAmt
Grant$0GrantAmt
Revenue$16,136,724RevenueAmt
DescPreventative Health Services, General/Other:Indiana Healthcare Physician Services, Inc. ("IHPS") is a non-profit hospital owned group of practices owned and operated to serve the rural areas of Indiana and surrounding communities. Its mission is to support the missions and values of Indiana Regional Medical Center in providing health care and educational services to all who seek healthcare without discrimination. We provide accessible, cost effective quality healthcare within the rural communities of Indiana and surrounding counties. Charity care provided during the fiscal year ended June 30, 2017 was $87,954.OWNERSHIP OF PHYSICIAN OFFICES - IHPS FOCUSES ON REBUILDING THE REVENUE CYCLE AND COST STRUCTURE OF PHYSICIAN OFFICES WITHIN THE COMMUNITY. IHPS ALSO FOCUSES ON RECRUITING PHYSICIANS THAT OFFER A NEW OR NEEDED SERVICE WITHIN THE COMMUNITY.We support and work collaboratively with other non-profit agencies within our sites. Some of the services are listed below, but are not limited to:- Open Door Program - provides Drug and Alcohol rehabilitation and counseling- Healthy Women's Program - OB/GYN exams for all women with no limitations (regardless of race, age, creed, religious beliefs, or ability to pay).- Free health care for low income families through the "We Care" program.- Speaking engagements related to health issues or wellness to any and all community groups, churches, and or other non-profit organizations. Active participation in health programs within the schools. - Free parking for patients and employees.- Health screening participation with local agencies and non-profit fundraising events within the community.- Staff participates in the United Way Campaign.- EMPLOYEE/TIMESHARE SERVICES - IHPS FOCUSES ON PROVIDING QUALITY WELL-TRAINED SUPPORT STAFF TO MULTIPLE INDEPENDENT PHYSICIANS WITHIN THE COMMUNITY.- PHYSICIAN BILLING SERVICES - IHPS FOCUSES ON PROVIDING QUALITY BILLING SERVICES THAT MAXIMIZES REIMBURSEMENT TO MULTIPLE INDEPENDENT PHYSCIANS WITHIN THE COMMUNITY.Desc
Total Program Service Expenses$17,916,313TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee243EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonRobert A Gongaware SVP FinancePersonNm
Phone7243577008PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1835 Hospital RoadAddressLine1Txt
CityIndianaCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15701ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Beverly Gazza Esq
Chair1.002.00Yes (X)Yes (X)$0$0$0
Anne White
Vice Chair1.001.00Yes (X)Yes (X)$0$0$0
Joseph Geary
Treasurer1.001.00Yes (X)Yes (X)$0$0$0
nathan kovalchick
Secretary1.001.00Yes (X)Yes (X)$0$0$0
Stephen A Wolfe
President & CEO1.0039.00Yes (X)Yes (X)$0$413,504$110,684
Edward McDowell
Chairman, Network Operations Council40.0013.00Yes (X)Yes (X)$284,653$0$19,852
Mark E Boykiw MD
Board Member/Physician40.001.00Yes (X)$291,750$0$18,409
Todd Brice
board Member1.001.00Yes (X)$0$0$0
Bruce A Bush MD
Board Member1.0040.00Yes (X)$0$280,238$34,278
T Michael Price
Board Member1.001.00Yes (X)$0$0$0
Robert A Gongaware
SVP Finance1.0039.00Yes (X)$0$217,381$23,658
Dr Bosco Norohna
Physician40.0040.00$713,366$0$16,792Yes (X)
Dr Mohammed N Islam
Physician40.0040.00$428,155$0$58,831Yes (X)
Dr Leonard Maliver
Physician40.0040.00$405,110$0$12,299Yes (X)
Dr Andrew Billon
Physician40.0040.00$376,892$0$18,263Yes (X)
Dr Mushtaq Syed
Physician40.0040.00$376,548$0$20,907Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,876,474TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$911,123TotReportableCompRltdOrgAmt
Total Other Compensation$333,973TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K47IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MATT KLAIN MD
25 COLONY BLVD SUITE 102BLAIRSVILLEPA15717PRIMARY CARE SERVICES$363,911
Greenway Health
121 Green Way BlvdCarrolltonGA30117EMR and Information System$304,852
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescOutpatient RevenueDesc
Business621400BusinessCd
Total Revenue Column$16,136,724TotalRevenueColumnAmt
Related Or Exempt Func Income$16,136,724RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$16,136,724TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
Employee Timeshare Svcs541900$636,936$636,936
Insurance Incentives900099$370,714$370,714
Physician Billing Services561000$166,243$166,243

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$187,884TotalRevenueColumnAmt
Exclusion$187,884ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,361,777OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,498,501TotalRevenueColumnAmt
Related Or Exempt Func Income$16,136,724RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$803,179UnrelatedBusinessRevenueAmt
Exclusion$558,598ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,949,915TotalAmt
Program Services$3,959,932ProgramServicesAmt
Management And General$989,983ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$190,524TotalAmt
Program Services$152,419ProgramServicesAmt
Management And General$38,105ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,423,219TotalAmt
Program Services$1,138,575ProgramServicesAmt
Management And General$284,644ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$820,802TotalAmt
Program Services$656,642ProgramServicesAmt
Management And General$164,160ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$50,004TotalAmt
Program Services$40,003ProgramServicesAmt
Management And General$10,001ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$10,935,951TotalAmt
Program Services$8,748,762ProgramServicesAmt
Management And General$2,187,189ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$10,804TotalAmt
Program Services$8,643ProgramServicesAmt
Management And General$2,161ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$256,704TotalAmt
Program Services$205,363ProgramServicesAmt
Management And General$51,341ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$342,500TotalAmt
Program Services$274,000ProgramServicesAmt
Management And General$68,500ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,056,532TotalAmt
Program Services$845,226ProgramServicesAmt
Management And General$211,306ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$27,259TotalAmt
Program Services$21,807ProgramServicesAmt
Management And General$5,452ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$43,990TotalAmt
Program Services$35,192ProgramServicesAmt
Management And General$8,798ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$329,357TotalAmt
Program Services$263,486ProgramServicesAmt
Management And General$65,871ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$708,593TotalAmt
Program Services$566,874ProgramServicesAmt
Management And General$141,719ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$734,160$587,328$146,832
Bad Debt Expense$449,895$359,916$89,979
Dues & Subscriptions$50,488$40,390$10,098
Repairs & Maintenance$14,230$11,384$2,846

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$464TotalAmt
Program Services$371ProgramServicesAmt
Management And General$93ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$22,395,391TotalAmt
Program Services$17,916,313ProgramServicesAmt
Management And General$4,479,078ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,248BOYAmt
EOY$2,598EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$96,563BOYAmt
EOY$101,454EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,525,728BOYAmt
EOY$1,485,974EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$107,494BOYAmt
EOY$104,059EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,235,374LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,610,680LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,046,540BOYAmt
EOY$624,694EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,778,573BOYAmt
EOY$2,318,779EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$679,274BOYAmt
EOY$144,568EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$679,274BOYAmt
EOY$144,568EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,099,299BOYAmt
EOY$2,174,211EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,099,299BOYAmt
EOY$2,174,211EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,778,573BOYAmt
EOY$2,318,779EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$4,896,890ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$4,971,802OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,235,374OtherCostOrOtherBasisAmt
Depreciation$1,610,680DepreciationAmt
Book Value$624,694BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$624,694TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$22,020,408TotalRevEtcAuditedFinclStmtAmt
Other Revenue$4,521,907OtherRevenueAmt
Revenue Not Reported$4,521,907RevenueNotReportedAmt
Revenue Subtotal$17,498,501RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$17,498,501TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$21,945,496TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$21,945,496ExpensesSubtotalAmt
Other Expenses Not Included$449,895OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$449,895ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$22,395,391TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:The Corporation accounts for uncertainty in income taxes using a recognition threshold of more-likely-than-not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold is met. Management determined there were no tax uncertainties that met the recognition threshold in 2017 and 2016. The Corporation's policy is to recognize interest related to unrecognized tax benefits in interest expense and penalties in operating expenses.
Part XI, Line 2d - Other Adjustments:Bad Debt Expense netted to revenues on the financials -449,895. Transfer from Affiliate 4,971,802.
Part XII, Line 4b - Other Adjustments:Bad Debt Expense netted to revenues on the financials 449,895.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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
Stephen A Wolfe
President & CEO$0$413,504$0$0$0$0$0$78,425$0$32,259$0$524,188$0$0
Edward McDowell
Chairman, Network Operations Council$227,946$0$56,707$0$0$0$0$0$19,852$0$304,505$0$0$0
Mark E Boykiw MD
Board Member/Physician$291,750$0$0$0$0$0$0$0$18,409$0$310,159$0$0$0
Bruce A Bush MD
Board Member$0$280,238$0$0$0$0$0$0$0$34,278$0$314,516$0$0
Robert A Gongaware
SVP Finance$0$217,381$0$0$0$0$0$19,564$0$4,094$0$241,039$0$0
Dr Bosco Norohna
Physician$357,694$0$355,672$0$0$0$0$0$16,792$0$730,158$0$0$0
Dr Mohammed N Islam
Physician$428,155$0$0$0$0$0$32,692$0$26,139$0$486,986$0$0$0
Dr Leonard Maliver
Physician$319,135$0$85,975$0$0$0$0$0$12,299$0$417,409$0$0$0
Dr Andrew Billon
Physician$376,892$0$0$0$0$0$0$0$18,263$0$395,155$0$0$0
Dr Mushtaq Syed
Physician$247,770$0$128,778$0$0$0$0$0$20,907$0$397,455$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 1aINDIANA REGIONAL MEDICAL CENTER PAYS COUNTRY CLUB MEMBERSHIP DUES FOR PRESIDENT & CEO, STEPHEN A. WOLFE, WHICH ARE NOT INCLUDED IN HIS COMPENSATION. THE MEMBERSHIP IS A CORPORATE MEMBERSHIP USED FOR BUSINESS PURPOSES ONLY.
Part I, Line 3The following methods are used by Indiana Regional Medical Center (IRMC) to establish compensation of the President/CEO, as IRMC compensates the President/CEO for services to IRMC and all related entities: Compensation Committee, Independent compensation consultant, written employment contract, compensation survey or study, and approval by the board or compensation committee.
Part I, Line 4bIndiana Regional Medical Center has a supplemental, nonqualified retirement plan under IRC Section 457(f) for President & CEO Stephen Wolfe. No amounts were paid to him from this plan during 2016, and contributions to the plan were $41,350. Indiana Healthcare Physician Services has a 457(f) plan available for their physicians. Dr. Mohammed N. Islam was a member of this plan during 2016. No amounts were paid to him in 2016. Contributions to this plan were $32,692 in 2016.
Part I, Line 7Bonuses may be granted at the discretion of the board and are based on factors such as performance and meeting goals and objectives. Bonuses for physicians are determined by "RVU" productivity, profitability of practice, or quality incentives.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part V, lines 1 and 2THE ORGANIZATION DOES NOT FILE FORMS 1096 OR W-3. ALL VENDORS AND ALL EMPLOYEES ARE PAID THROUGH A COMMON PAYMASTER/REPORTING AGENT. THE COMMON PAYMASTER/REPORTING AGENT IS INDIANA REGIONAL MEDICAL CENTER, EIN: 25-0965404. INDIANA REGIONAL MEDICAL CENTER IS A RELATED, TAX-EXEMPT ORGANIZATION. The number of W-2's reported on Form 990, Part V, line 2 represents the number of W-2's filed by the common paymaster on behalf of this entity.
Form 990, Part VI, Section A, line 2The following board members have a business relationship: Todd Brice and Anne White.
Form 990, Part VI, Section A, line 6Indiana Healthcare Corporation ("IHC") is the sole corporate member of Indiana Healthcare Physician Services ("IHPS").
Form 990, Part VI, Section A, line 7aIHC has the power to fill vacancies, nominate and approve the election of, and approve removal of the board of directors of IHPS.
Form 990, Part VI, Section A, line 7bIHPS shall obtain the approval of IHC before action on any of the following matters becomes final and effective for IHPS: (1) amendment of the articles of incorporation and bylaws; (2) the sale, lease or exchange of all or substantially all of the property or assets of IHPS; (3) merger or consolidation with any other corporation; (4) dissolution of IHPS; (5) approval of an annual budget for IHPS; (6) any transfer of funds by grant, gift, or loan from IHPS; (7) any other matter that by law would require the approval of members of a nonprofit corporation.
Form 990, Part VI, Section B, line 11bThe return was reviewed in detail by the Director of Finance/Controller and reviewed by the CFO. Each board member was notified that the return was available for review on the "board shared drive" before filing with the IRS.
Form 990, Part VI, Section B, line 12cEvery member of the Board, and every individual appointed to the Board or Board committees, as well as all key management personnel and physician leaders, are required to execute a conflict of interest disclosure statement, which will be updated at least on an annual basis or as additional conflicting interests arise. In addition, every member of the Board will specifically acknowledge the conflict of interest policy and his or her attempt to abide by it by signing the acknowledgement form. Every Board committee member, officer, key management employee, and physician leader is required to sign this acknowledgment as well. The acknowledgment and disclosure forms will be kept on file by the Chief Executive Officer, and the Chairman and Vice-Chairman will be familar with the statements that are filed by Board members in order to guide their conduct in the event a conflict arises. Every person covered by this policy shall submit in writing to the CEO a Conflict of Interest Disclosure Statement listing all Financial and Conflicting Interests. Each statement will be resubmitted with any necessary changes each year or as any additional conflicting or financial intests arise. The Chairman of the Board shall become familiar with all such Disclosure statements in case a conflict arises. The Vice Chairman of the Board shall be familiar with the Disclosure Statement filed by the Chairman. Penalties for Non-Compliance Failure to comply with this policy shall constitute grounds for removal from office and, in the case of Key Management Personnel, termination of employment.
Form 990, Part VI, Section B, line 15POSITIONS FOR OFFICERS AND KEY EMPLOYEES ARE REVIEWED ON AN ANNUAL BASIS. APPROPRIATE COMPARISONS ARE MADE ON A REGIONAL AND NATIONAL LEVEL IN ORDER TO MAINTAIN A FAIR AND EQUITABLE COMPENSATION STRUCTURE. ALL RECOMMENDATIONS ARE APPROVED BY THE BOARD OF DIRECTORS AND DOCUMENTED IN THE BOARD MINUTES.
Form 990, Part VI, Section C, line 19Governing documents, conflict of interest policy, and financial statements are available to the public upon request.
Form 990, Part IX, line 11gOutside Printing: Program service expenses 10,930. Management and general expenses 2,732. Fundraising expenses 0. Total expenses 13,662. Physician Fees: Program service expenses 8,370,201. Management and general expenses 2,092,550. Fundraising expenses 0. Total expenses 10,462,751. Purchased Fees: Program service expenses 325,969. Management and general expenses 81,492. Fundraising expenses 0. Total expenses 407,461. Collections: Program service expenses 41,662. Management and general expenses 10,415. Fundraising expenses 0. Total expenses 52,077.
Form 990, Part XI, line 9:Transfer from Affiliate 4,971,802.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Indiana Regional medical Center
835 Hospital RoadIndianaPA15701250965404HospitalPA501(c)(3)Line 3Indiana Healthcare Corporation0
Indiana Healthcare Foundation
835 Hospital RoadIndianaPA15701251574302Fundraising in Support of Indiana Regional Medical CenterPA501(c)(3)Line 12a, IIndiana Healthcare Corporation0
Indiana Healthcare Properties
835 Hospital RoadIndianaPA15701251524635Hold & Manage Property in support of Indiana Regional Medical CenterPA501(c)(3)Line 12a, IIndiana Healthcare Corporation0
Indiana Healthcare Corporation
835 Hospital RoadIndianaPA15701251547379Parent CorporationPA501(c)(3)Line 70N/A
Indiana Jefferson Radiation Oncology Inc
835 Hospital RoadIndianaPA15701900406301Radiation Oncology ServicesPA501(c)(3)Line 12a, IIndiana Regional Medical Center0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
Indiana Ambulatory Surgical Associates LLC
841 Hospital RoadIndianaPA15701232923182Ambulatory SurgeryPAN/A
INDIANA REHABILITATION SERVICES LLC
855 SPRINGDALE DR STE 200EXTONPA19341202214391REHABILITATION SERVICESPAN/A
COSM REALTY GROUP LTD
1265 WAYNE AVENUE STE 307INDIANAPA15701030439684REAL ESTATEPAN/A
PENNSYLVANIA MOUNTAINS HEALTHCARE ALLIANCE LLC
150 MCCRACKEN RUN ROADDUBOISPA15801251852975HEALTHCARE SERVICESPAN/A
INDIANA TOTAL THERAPY LLC
120 IRMC DRIVE STE 160INDianaPA15701263843582THERAPY SERVICESPAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Indiana Healthcare EnterprisesBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1835 Hospital DriveAddressLine1Txt
CityIndianaCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15701ZIPCd
FieldValueIRS element (for citing)
EIN470973344EIN
Primary ActivitiesHealthcare RetailPrimaryActivitiesTxt
Legal Domicile StatePALegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset ExchangeYes (1)AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd