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MUNSTER MEDICAL RESEARCH FOUNDATION INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MUNSTER MEDICAL RESEARCH FOUNDATION INC (EIN 35-1107009)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-13
IRS object ID
201411339349305901
Schema version
2012v2.3
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)
Timestamp2014-05-13T17:24:36-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 4000AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN351107009EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MUNSTER MEDICAL RESEARCH FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% MARY ANN SHACKLETTInCareOfName
Name ControlMUNSNameControl
Phone2198361600Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1901 MACARTHUR BOULEVARDAddressLine1
Address Line2SuiteAddressLine2
CityMUNSTERCity
StateINState
ZIP Code46321ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARY ANN SHACKLETTName
TitleSR VP FINANCE & CFOTitle
Phone2198361600Phone
Date Signed2014-05-13DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARY ANN SHACKLETTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line110010 DONALD S POWERS DR 201AddressLine1
CityMUNSTERCity
StateINState
ZIP Code46321ZIPCode
FieldValueIRS element (for citing)
Gross Receipts450231729GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.comhs.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1964YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionCOMMUNITY HOSPITAL IS COMMITTED TO PROVIDE THE HIGHEST QUALITY CARE IN THE MOST COST-EFFICIENT MANNER, RESPECTING THE DIGNITY OF THE INDIVIDUAL, PROVIDING FOR THE (CONTINUED ON Part III, LINE 1)ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees3490TotalNbrEmployees
Total Nbr Volunteers170TotalNbrVolunteers
Total Gross UBI2691065TotalGrossUBI
Contributions Grants Prior Year1528783ContributionsGrantsPriorYear
Contributions Grants Current Year6810416ContributionsGrantsCurrentYear
Program Service Revenue Prior Year450681002ProgramServiceRevenuePriorYear
Program Service Revenue CY430222270ProgramServiceRevenueCY
Investment Income Prior Year1068207InvestmentIncomePriorYear
Investment Income Current Year302984InvestmentIncomeCurrentYear
Other Revenue Prior Year11616552OtherRevenuePriorYear
Other Revenue Current Year12616068OtherRevenueCurrentYear
Total Revenue Prior Year464894544TotalRevenuePriorYear
Total Revenue Current Year449951738TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year80000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY112479GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year212743702SalariesEtcPriorYear
Salaries Etc Current Year203119789SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year218925948OtherExpensePriorYear
Other Expenses Current Year223143074OtherExpensesCurrentYear
Total Expenses Prior Year431749650TotalExpensesPriorYear
Total Expenses Current Year426375342TotalExpensesCurrentYear
Revenues Less Expenses Prior Year33144894RevenuesLessExpensesPriorYear
Revenues Less Expenses CY23576396RevenuesLessExpensesCY
Total Assets BOY253047288TotalAssetsBOY
Total Assets EOY263153559TotalAssetsEOY
Total Liabilities BOY166649435TotalLiabilitiesBOY
Total Liabilities EOY162116076TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY86397853NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY101037483NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE NEEDS OF ALL PEOPLE, INCLUDING THE POOR AND DISADVANTAGED.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense69130497Expense
Revenue189789340Revenue
DescriptionMunster Medical Research Foundation performed 23,974 surgeries. Munster Medical Research Foundation offers a wide range of surgical services, including gastroenterology, orthopedics, general surgery, bariatric surgery, urology, cardiovascular and gynecology. Our outpatient surgery center also includes services in ophthalmology, pain management, plastics and cosmetic.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense66930909Expense
Revenue104215475Revenue
DescriptionMunster Medical Research Foundation has a 427 bed capacity. Nursing staff work to ensure the delivery of optimal patient care and excellent patient care services in population and acuity specific areas ranging from ICU, IMCU, telemetry, medical, surgical, pediatric, labor and delivery, and neonatology.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense43130707Expense
Revenue176052466Revenue
DescriptionMunster Medical Research Foundation had 266,745 outpatient visits from it's three locations. The majority of these visits were for laboratory services and radiology servics.Description

Activity Other ActivityOther (30 entries)

ExpenseExpenseRevenueRevenueDescriptionDescription
32661378103398425PHARMACY
30394973111537347CARDIOLOGY
20959341151424231LABORATORY
1806853932705919IMCU
14619092149583909RADIOLOGY
12180297HEALTH INFORMATION MANAGEMENT
1209017637326432PT OT SPEECH
1181273178160590EMERGENCY DEPARTMENT
994121519610DIETARY
68975908662277ICU
63902234340417MEDICAL BASED FITNESS CENTER
611827229644108RESPIRATORY THERPAY
5879921613240ADMITTING
5786358CENTRAL STERILIZATION
50708216292839HOME HEALTH
3657104PATIENT FINANCIAL AND REGISTRATION SERVICES
35353575093183CVU
263682113579327NUCLEAR MEDICINE
2320448SECURITY
1371149CENTRAL SUPPLY
1250509MEDICAL STAFF
1104792SOCIAL SERVICES
891733CANCER RESEARCH
863271POB
857480PUBLIC RELATIONS
3265284910017EEG
19235Physician
-19404417Bad Debt
-26557110Charity Care
-720591306Contractuals
FieldValueIRS element (for citing)
Total Of Other Program Service Exp217705354TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev-29260962TotalOfOtherProgramServiceRev
Total Program Service Expense396897467TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgtrueTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096211NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees3490NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMARY ANN SHACKLETTNamePerson
Telephone Number2199348250TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line110010 DONALD S POWERS DR 201AddressLine1
CityMunsterCity
StateINState
ZIP Code463212959ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
THOMAS BRUBAKER MD
DIRECTOR1.0X1560900
STEVE CHOVANEC
DIRECTOR1.0X000
ERIC COMPTON DDS
DIRECTOR1.0X000
FRANKIE FESKO
DIRECTOR1.0X2400079638010.0
WILLIAM HASSE III
DIRECTOR1.0X03400001.0
R LITCHFIELD DO
DIRECTOR1.0X000
S N MAKAM MD
DIRECTOR1.0X860073100
DONNA PANICH
DIRECTOR1.0X000
DONALD S POWERS
DIRECTOR1.0X013289134216042.0
HON JAMES RICHARDS
DIRECTOR1.0X2400048608023.0
NITIN SARDESAI MD
DIRECTOR1.0X000
WILLIAM SCHENCK
DIRECTOR1.0X03900803.0
M NABIL SHABEEB MD FACS
DIRECTOR1.0X02410002.0
DONALD TORRENGA
DIRECTOR1.0X03900803.0
JAY ZANDSTRA
DIRECTOR1.0X02280001.0
DAVID WICKLAND
PRESIDENT1.0X2400048608015.0X
JOSEPH MORROW
VICE PRESIDENT1.0X01420001.0X
RICHARD MCLAUGHRY
SECRETARY1.0X06380802.0X
DAVID BOCHNOWSKI
TREASURER1.0X02420001.0X
DONALD P FESKO
ADMINISTRATOR41.0X0591270382632.0X
MARY ANN SHACKLETT
SR VP & SYSTEM CFO1.007132025204448.0X
LUIS MOLINA
VP OF FINANCE/CFO40.05527640601891.0X
RONDA MCKAY
VP & CNO40.028230109811X
RICHARD BERKOWITZ MD
MEDICAL DIRECTOR40.0557790057202X
PANTHIRUVELIL S MOHAN-THOMAS MD
PHYSICIAN40.0425208034203X
ROBERT JOSEPH GRONEMEYER MD
PHYSICIAN40.0423044036204X
AZAD CHALLAPALLI MD
PHYSICIAN40.0427760047662X
MICHAEL A BRODY MD
PHYSICIAN40.0421772052904X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3186848TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3078673TotalReportableCompFrmRltdOrgs
Total Other Compensation430642TotalOtherCompensation
Number Individuals GT100 K182NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Rehabcare Group Inc
PO Box 502096ST LOUISMO63150Rehab Care Services4751068
Alliance Healthcare Services Inc
PO Box 6600NEWPORT BEACHCA92658Imaging1756842
Siemens Medical Solutions
51 Valley Stream ParkwayMALVERNPA19355Medical Svc/Repairs1389251
Franciscan St Margaret Health
5454 Hohman AveHAMMONDIN46320Laundry Services1166548
Mayo Collaborative Services Inc
200 SW First StROCHESTERMN55905Laboratory Services1062912
FieldValueIRS element (for citing)
Number Of Contractors GT100 K48NumberOfContractorsGT100K
Info In Schedule O Part VIIIXInfoInScheduleOPartVIII
Related Organizations288325RelatedOrganizations
Government Grants6492818GovernmentGrants
All Other Contributions29273AllOtherContributions
Total Contributions6810416TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Business Code621500BusinessCode
Total Revenue Column430222270TotalRevenueColumn
Related Or Exempt Function Income429643834RelatedOrExemptFunctionIncome
Unrelated Business Revenue578436UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue430222270TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column321068TotalRevenueColumn
Exclusion$321,068ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1688772Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real207689Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real1481083Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1481083TotalRevenueColumn
Related Or Exempt Function Income1481083RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other54218Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other72302Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-18084Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-18084TotalRevenueColumn
Exclusion-$18,084ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
PHARMACY SALES446110462805730653531629788
FITNESS/SPA POINTE REVENUE90009943404173857576482841
CAFETERIA9000992006875$2,006,875

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column159636TotalRevenueColumn
Related Or Exempt Function Income57408RelatedOrExemptFunctionIncome
Exclusion$35,148ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue11134985TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column449951738TotalRevenueColumn
Related Or Exempt Function Income438105254RelatedOrExemptFunctionIncome
Unrelated Business Revenue2691065UnrelatedBusinessRevenue
Exclusion$2,345,007ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total112479Total
Program Services112479ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total974853Total
Program Services0ProgramServices
Management And General974853ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total1995100Total
Program Services1995100ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total152224832Total
Program Services142420610ProgramServices
Management And General9804222ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total18224523Total
Program Services16948466ProgramServices
Management And General1276057ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total18734496Total
Program Services17445765ProgramServices
Management And General1288731ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total10965985Total
Program Services10198161ProgramServices
Management And General767824ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1300730Total
Management And General1300730ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total536845Total
Management And General536845ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total143374Total
Management And General143374ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total20954233Total
Program Services17047740ProgramServices
Management And General3906493ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1188467Total
Program Services920276ProgramServices
Management And General268191ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4843416Total
Program Services3877879ProgramServices
Management And General965537ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total278759Total
Program Services271203ProgramServices
Management And General7556ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4916815Total
Program Services4593138ProgramServices
Management And General323677ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total165342Total
Program Services143480ProgramServices
Management And General21862ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total176918Total
Program Services160153ProgramServices
Management And General16765ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2544Total
Management And General2544ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total327092Total
Program Services232616ProgramServices
Management And General94476ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total20326571Total
Program Services18903331ProgramServices
Management And General1423240ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2587620Total
Program Services2406438ProgramServices
Management And General181182ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES8095633380956333
CORP SUPP SRVCS ALLOCATION39044818363109512733867
HAF2172629521726295
PHYSICIAN ALLOCATION94897248825266664458

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total14177178Total
Program Services11401787ProgramServices
Management And General2775391ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total426375342Total
Program Services396897467ProgramServices
Management And General29477875ManagementAndGeneral
Fundraising0Fundraising
FieldValueIRS element (for citing)
Info In Schedule O Part XXInfoInScheduleOPartX

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY13076610BOY
EOY11305828EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY62562812BOY
EOY60717463EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY8253829BOY
EOY8171911EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2323256BOY
EOY1230251EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis481331306LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec306966017LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY155033757BOY
EOY174365289EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

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BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

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BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

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BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

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BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY11797024BOY
EOY7362817EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY253047288BOY
EOY263153559EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY42618032BOY
EOY46078983EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY72826BOY
EOY457175EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY123958577BOY
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Total Liabilities TotalLiabilities

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EOY162116076EOY
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Unrestricted Net Assets UnrestrictedNetAssets

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EOY100793125EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

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EOY142012EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

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BOY102346BOY
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Total Net Assets Fund Balances TotalNetAssetsFundBalances

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EOY101037483EOY

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BOY253047288BOY
EOY263153559EOY
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Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses23576396ReconcilationRevenueExpenses
Reconcilation Other Changes-8936766ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

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Financial Statement ConsolidatedXFinancialStatementConsolidated
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Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

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Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

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Contributor Name Business ContributorNameBusiness

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Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
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Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

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Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

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Current Year Minus2 Years CurrentYearMinus2Years

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Current Year Minus4 Years CurrentYearMinus4Years

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Land Land

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Book Value3056583BookValue

Buildings Buildings

FieldValueIRS element (for citing)
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Depreciation206686330Depreciation
Book Value121233248BookValue

Leasehold Improvements LeaseholdImprovements

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Equipment Equipment

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Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
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Total Of Book Value Land Buildings174365289TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
PENSION LIABILITY$92,662,614
DUE TO AFFILIATES$9,890,133
EST 3RD PARTY SETTLEMENTS$6,811,325
ACCRUED CLAIMS LIABILITY$3,368,630
CAPITAL LEASES$1,356,534
ACCRUED CONSTRUCTION PAYABLE$1,115,599
ASSET RETIREMENT OBLIGATION$375,083
FieldValueIRS element (for citing)
Total Of Amounts115579918TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
ExplanationPT V LINE 4 ENDOWMENT FUNDS ARE TO BE USED TO SUPPORT THE NEEDS OF MMRF, INCExplanation

Schedule H IRS990ScheduleH

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Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
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Pcent200XPcent200
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Expenses Exceeded BudgettrueExpensesExceededBudget
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Charity Care At Cost CharityCareAtCost

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Total Community Benefit Expense8179218TotalCommunityBenefitExpense
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Percent Of Total Expense0.01920PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

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Total Community Benefit Expense56502591TotalCommunityBenefitExpense
Direct Offsetting Revenue35658047DirectOffsettingRevenue
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Percent Of Total Expense0.04880PercentOfTotalExpense

Total Charity Care TotalCharityCare

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Net Community Benefit Expense29023762NetCommunityBenefitExpense
Percent Of Total Expense0.06800PercentOfTotalExpense

Community Health Services CommunityHealthServices

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Persons Served7684PersonsServed
Total Community Benefit Expense654006TotalCommunityBenefitExpense
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Net Community Benefit Expense643202NetCommunityBenefitExpense
Percent Of Total Expense0.00150PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

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Persons Served686PersonsServed
Total Community Benefit Expense542846TotalCommunityBenefitExpense
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Percent Of Total Expense0.00130PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

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Research Research

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Percent Of Total Expense0.00210PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

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Total Other Benefits TotalOtherBenefits

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Percent Of Total Expense0.00660PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

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Percent Of Total Expense0.07460PercentOfTotalExpense

Community Support CommunitySupport

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Leadership Development LeadershipDevelopment

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Total Total

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Medicare Surplus Or Shortfall-38335968MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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FieldValueIRS element (for citing)
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Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

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Name Name

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Address Address

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CityMUNSTERCity
StateINState
ZIP Code46321ZIPCode
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General Medical And SurgicalXGeneralMedicalAndSurgical
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Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

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FieldValueIRS element (for citing)
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Needs Assessment Conducted13NeedsAssessmentConducted
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Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities6NumberOfOtherFacilities

Other Facilities OtherFacilities (6 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
COMMUNITY SURGERY CENTER
801 MACARTHUR BLVDMUNSTERIN46321OUTPATIENT SURGERY
COMMUNITY DIAGNOSTIC CENTER
10020 DONALD S POWERS DRIVEMUNSTERIN46321DIAGNOSTIC CENTER
ST JOHN OUTPATIENT CENTER
9660 WICKER AVEST JOHNIN46373OUTPATIENT CENTER
COMMUNITY CARDIOLOGY CENTER
801 MACARTHUR BLVDMUNSTERIN46321OUTPATIENT CENTER
FITNESS POINTE
9550 COLUMBIA AVEMUNSTERIN46321REHABILITATION
COMMUNITY HOME HEALTH SERVICES
9104 COLUMBIA AVEMUNSTERIN46321HOME HEALTH

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
REQUIRED DESCRIPTIONSPART I, LINE 3CN/A
REQUIRED DESCRIPTIONSPART I, LINE 6ATHE STATE OF INDIANA ACCEPTS FORM 990 SCHEDULE H IN LIEU OF COMMUNITY BENEFITS REPORT.
REQUIRED DESCRIPTIONSPART I, LINE 7ABAD DEBT OF $19,404,417 IS EXCLUDED FROM THE CALCULATION. THE METHODOLOGY USED WAS THE COST TO CHARGE RATIO. IT IS FOR INPATIENT ONLY AND EXCLUDES MEDICAID, CHARITY AND BAD DEBT.
REQUIRED DESCRIPTIONSPART III, LINE 4COMMUNITY HOSPITAL EVALUATES THE COLLECTIBILITY OF ITS ACCOUNTS RECEVIABLE BASED ON THE LENGTH OF TIME THE RECEIVABLE IS OUTSTANDING AND THE ANTICIPATED FUTURE UNCOLLECTIBLE AMOUNTS BASED ON HISTORICAL EXPERIENCE. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE. COMMUNITY HOSPITAL DOES NOT REQUIRE COLLATERAL. THE COST TO CHARGE RATIO WAS USED TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT ARE REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. AS A TAX-EXEMPT HOSPITAL, WE MUST PROVIDE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICE PROVIDED. WE ESTIMATED A PERCENTAGE OF BAD DEBTS BASED UPON THE PORTION OF UNINSURED INDIVIDUALS THAT WOULD BE ELIGIBLE FOR THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. THIS AMOUNT ENTERED ON PART III, LINE 3 SHOULD BE COUNTED AS A COMMUNITY BENEFIT.
REQUIRED DESCRIPTIONSPART III - LINE 8THE TOTAL REVENUE RECEIVED FROM MEDICARE WAS CALCULATED BY USING INFORMATION FROM THE COST ACCOUNTING SYSTEM. WE PROVIDE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICE PROVIDED OR THE REIMBUSEMENT RECEIVED FROM MEDICARE, QUALIFYING THE $38,335,968 OF MEDICARE SHORTFALL AS A COMMUNITY BENEFIT.
REQUIRED DESCRIPTIONSPART III, LINE 9BCOLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. PATIENTS ARE SCREENED FOR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE COLLECTION PROCEDURES BEGIN. IF AT ANY POINT IN THE COLLECTION PROCESS, DOCUMENTATION IS RECEIVED THAT INDICATES THE PATIENT IS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT APPLIED FOR IT, THE ACCOUNT IS REFERRED BACK FOR A FINANCIAL ASSISTANCE REVIEW.
REQUIRED DESCRIPTIONSLINE 1J - N/A LINE 3 - FOCUS GROUPS WITH COMMUNITY AND BUSINESS LEADERS LINE 4 - FRANCISCAN ALLIANCE AND THE METHODIST HOSPITALS LINE 5C - N/A LINE 6I - N/A LINE 7 - Community Health Needs: Areas Not Addressed The Community Health Needs assessment conducted by the hospitals of the Community Healthcare System identified areas of concern not identified in the hospital's implementation plan. These areas include: Community Hospital Service Areas: " Access to Health Services " Cancer " Chronic Kidney Disease " Educational & Community-Based Programs " Family Planning " Injury & Violence Prevention " Mental Health & Mental Disorders " Oral Health " Substance Abuse " Tobacco Use Many of these areas are being addressed by the hospitals of the Community Healthcare System as well as by other community organizations. For example, Community Healthcare System supports a large cancer program with a separate research foundation focused on improving access to clinical trials for area residents as well as providing free support and mind-body services through its Cancer Resource Centre. All hospitals provide routine low-cost and free screening programs for a variety of cancers. One of the three hospitals in the Community Healthcare System has a behavior health program and has recently expanded its outpatient services to improve access to mental health services. As the hospital focuses on lifestyle, education, prevention and access to care issues surrounding its four focused areas, positive outcomes will likely have positive effects on the health needs not addressed. To have the greatest impact, however, the hospital has chosen to focus on three of the most serious diseases and the related lifestyle issues facing our community as well investing in the health of the most vulnerable residents - our newborns. LINE 10 - N/A LINE 11 - N/A LINE 12H - N/A LINE 14G - N/A LINE 16E - N/A LINE 17E - N/A LINE 18E - N/A LINE 19C - N/A LINE 19D - N/A LINE 20D - SEE PART V, LINE 20D IN SUPPLEMENTAL INFORMATION LINE 21 - N/A LINE 22 - N/A
NEEDS ASSESSMENTIN COLLABORATION WITH FRANCISCAN ALLIANCE AND THE METHODIST HOSPITALS, COMMUNITY HOSPITAL CONTRACTED WITH A THIRD PARTY TO PERFORM OUR COMMUNITY HEALTH NEEDS ASSESSMENT AS PER REGULATION 501(R).
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPATIENTS WHO ARE ADMITTED WITHOUT INSURANCE ARE DIRECTED TO THE HOSPITAL'S FINANCIAL COUNSELORS. THE FINANCIAL COUNSELORS PERFORM AN INTERVIEW WITH THE PATIENTS TO EXPLAIN TO THEM THE PROCESS NECESSARY TO RECEIVE FINANCIAL ASSISTANCE. THIS PROCESS INCLUDES APPLYING FOR MEDICAID OR OTHER GOVERNMENT AID. THE APPLICANT THEN MUST FILL OUT A FINANCIAL INFORMATION WORKSHEET AND SUBMIT VARIOUS INFORMATION TO DETERMINE IF THEY QUALIFY FOR FINANCIAL ASSISTANCE IN ACCORDANCE WITH THE FINANCIAL ASSISTANCE POLICY. THE POLICY IS POSTED IN THE EMERGENCY ROOM AREA AS WELL AS AT EACH INPATIENT WAITING DESK. THE INFORMATION IS ALSO AVAILABLE ON OUR WEBSITE.
COMMUNITY INFORMATIONTHE COMMUNTIY SERVED INCLUDES NORTHWEST INDIANA AND ADJACENT COMMUNITIES IN ILLINOIS. OUR MARKET SHARE FOR THE CORE AREA IS 72.2%. THE POPULATION IS OLDER THAN MOST MARKETS BUT HAS A HIGHER MEDIAN HOUSEHOLD INCOME. COMMUNITY'S POPULATION CONSISTS OF AN UNINSURED POPULATION OF 9.9% AND MEDICAID OF 11.3%.
PROMOTION OF COMMUNITY HEALTHI. 2012-2013 ANNUAL PROGRESS REPORT A. THE COMMUNITY HOSPITAL FITNESS POINTE THE GOAL OF FITNESS POINTE IS TO PROVIDE OPPORTUNITIES FOR PERSONS OF NORTHWEST INDIANA TO IMPROVE AND MAINTAIN THEIR HEALTHY LIFE-STYLE HABITS, LOWERING THEIR RISKS FOR HEART DISEASE, STROKES, AND DIABETES. THE FACILITY WAS DEVELOPED TO ADDRESS FINDINGS OF OUR 1995 HEALTH ASSESSMENT THAT IDENTIFIED OPPORTUNITIES TO IMPROVE THE HEALTH STATUS OF OUR COMMUNITY. THE COMMUNITY HOSPITAL OPENED FITNESS POINTE ON NOVEMBER 1, 1998. THE 73,191 SQ. FT. FACILITY HOUSES THE HOSPITAL'S OUTPATIENT PHYSICAL THERAPY , OUTPATIENT DIETARY COUNSELING,OUTPATIENT DIABETIC EDUCATION, CARDIAC REHABILITATION PHASE III AND REHAB PLUS, AND THE FITNESS POINTE DEPARTMENTS. FITNESS POINTE PROGRAMS ADDRESS HEALTH EDUCATION/WELLNESS, AND FITNESS-RELATED CONTENT AREAS. THE COMMUNITY EDUCATION OFFERINGS AND THE CONTRIBUTIONS OF THE HOSPITAL EMPLOYEES AND MEDICAL STAFF ARE VITAL PIECES IN ADDRESSING THE HEALTH DISPARITIES IN LAKE COUNTY, SUPPORTING A VARIETY OF DISEASE PREVENTION GOALS. MANY OF THE COMMUNITY EDUCATION CLASSES ORIGINALLY DEVELOPED AT FITNESS POINTE ARE NOW ALSO OFFERED AT THE COMMUNITY HOSPITAL OUTPATIENT CENTRE IN ST. JOHN, FURTHER EXPANDING THE SCOPE OF SERVICES. HEALTH EDUCATION/WELLNESS SERVICES THE COMMUNITY HEALTH ASSESSMENT INDICATED LAKE COUNTY RESIDENTS HAVE INCREASED RISK FOR HEART DISEASE AND CANCER COMPARED TO STATE AND NATIONAL STATISTICS. A VARIETY OF HEALTH EDUCATION AND WELLNESS PROGRAMS ARE OFFERED TO THE COMMUNITY AT LITTLE OR NO CHARGE TO IMPROVE KNOWLEDGE AND AWARENESS OF LIFE-STYLE RELATED RISKS FOR THESE DISEASES. FITNESS POINTE PROVIDES A SUPPORTIVE ENVIRONMENT FOR AREA RESIDENTS TO MAINTAIN HEALTHY HABITS. RESEARCH INDICATES CERTAIN INDIVIDUALS ARE AT GREATER RISK FOR LIFE-STYLE RELATED DISEASES SUCH AS HEART DISEASE AND DIABETES BASED ON PHYSICAL MEASURES. FITNESS POINTE SCREENINGS FOR THESE RISKS DURING MANDATORY FITNESS PROFILES ARE PERFORMED ON ALL NEW PROGRAM PARTICIPANTS. IN A STUDY IN CONJUNCTION WITH VALPARAISO UNIVERSITY AND THE HEART CENTER AT COMMUNITY, FITNESS POINTE IDENTIFIED 1,321 INDIVIDUALS AT A SIGNIFICANTLY INCREASED RISK FOR DIABETES AND HEART DISEASE. OF THESE INDIVIDUALS, 700 OF THEM AT THE HIGHEST RISK LEVELS FOR HEART DISEASE AND DIABETES WERE INVITED TO UNDERGO ADDITIONAL SCREENING FOR BLOOD CHOLESTEROL, BODY MASS INDEX AND BLOOD PRESSURE. SOME OTHERS AT MODERATE TO HIGH RISK WERE TARGETED, THROUGH ADDITIONAL SCREENING AND LIFE-STYLE MODIFICATION, FOR INTERVENTION TO REDUCE THEIR RISK OF DISEASE. WITH 25% OF WHITE CHILDREN AND 33% OF AFRICAN AMERICAN AND HISPANIC CHILDREN BEING OVERWEIGHT ACCORDING TO 2001 STATISTICS, FITNESS POINTE HAS DEVELOPED PROGRAMS TO HELP ADDRESS THIS ISSUE. "FIT TRIP" IS A PROGRAM THAT BRINGS 1ST-3RD GRADE STUDENTS TO FITNESS POINTE FOR A 90 MINUTE INTRODUCTION AND EXPERIENCE WITH DIFFERENT TYPES OF EXERCISE COMBINED WITH BASIC NUTRITION TIPS. "TAKE 5 FOR LIFE" IS A PROGRAM DEVELOPED FOR 5TH GRADERS TO TEACH GOOD HEALTH, NUTRITION AND FITNESS HABITS WITHIN THE SCHOOL SETTING, AS WELL AS TO ENCOURAGE ACTIVITY. BASED ON THE HEALTH NEEDS AND INTERESTS OF THOSE PROGRAM ATTENDEES, PROGRAMS WERE DEVELOPED IN THE AREAS OF: WOMEN'S HEALTH, NUTRITION AND HEALTHY COOKING, RELAXATION, WEIGHT MANAGEMENT, SENIOR HEALTH, BACK AND OTHER ORTHOPEDIC HEALTH ISSUES, DIABETES MANAGEMENT, CANCER AWARENESS AND PREVENTION, HEART DISEASE RISK FACTOR AWARENESS AND SCREENING, MENTAL HEALTH, AND SMOKING CESSATION. THROUGH THE COLLABORATIVE EFFORTS OF THE COMMUNITY HOSPITAL'S WELLNESS SERVICES, PUBLIC RELATIONS, DIETARY SERVICES THERAPY, REHABILITATION, EDUCATION DEPARTMENT, NURSING SERVICES AND OTHERS, A QUARTERLY COMMUNITY EDUCATION CALENDAR CALLED "TAKE CARE!" IS CREATED. THE CALENDAR IS DISTRIBUTED TO MORE THAN 75,000 HOUSEHOLDS IN THE HOSPITAL'S SERVICE AREA, AND TO COMMUNITY CENTERS, PHYSICIAN OFFICERS, LIBRARIES AND OTHER PUBLIC LOCATIONS. IT FEATURES EDUCATIONAL AND SUPPORT PROGRAMS DESIGNED TO IMPROVE THE PHYSICAL, MENTAL, SAFETY, NUTRITIONAL AND SOCIAL WELL-BEING OF THE COMMUNITY. WELLNESS EDUCATION PROGRAM AREAS 1. HEART DISEASE-RELATED PROGRAMMING INCLUDES ONGOING DAILY BLOOD PRESSURE SCREENING BY THE EXERCISE STAFF, BLOOD PRESSURE SCREENING OFFERED DURING PERIODIC EVENTS, A COMPREHENSIVE SERIES ABOUT CHOLESTEROL THAT INCLUDES A SCREENING AND EDUCATION ON CHOLESTEROL MANAGEMENT, SMOKING CESSATION CLASS, A STROKE AWARENESS LECTURE, A PRESENTATION ON NEW ADVANCED GENETIC TESTING FOR HEART DISEASE, PERIPHERAL ARTERIAL DISEASE SCREENINGS, AND A CLASS THAT HELPS INDIVIDUALS MAINTAIN THEIR HEALTH WHILE ON HEART MEDICATIONS. HEART DISEASE-RELATED SUPPORT GROUPS INCLUDE A HEART FAILURE SUPPORT GROUP, A GROUP FOR WOMEN WITH HEART DISEASE, AND MENDED HEARTS - A NATIONAL ORGANIZATION THAT WHEREBY SEASONED HEART DISEASE PATIENTS VISIT NEWLY DIAGNOSED PATIENTS IN THE HOSPITAL AFTER SURGERY OR A PROCEDURE. OTHER COMMUNITY PROGRAMS RELATED TO THE HEART INCLUDED HOW TO RAISE A HEART-SMART CHILD, PROPER NUTRITION FOR LOWERING CHOLESTEROL, INFANT-CHILD CPR, DIABETES AS IT RELATES TO THE HEART, AND A SERIES OF PROGRAMS AND WOMEN AND HEART DISEASE. 2. CANCER AWARENESS AND PREVENTION PROGRAMS INCLUDE: A DAY OF CANCER AWARENESS WITH SKIN CANCER SCREENINGS, AND A VAST PUBLIC AWARENESS CAMPAIGN ABOUT THE LATEST ADVANCES IN PROSTATE CANCER DETECTION AND TREATMENT, INCLUDING THE VALUE OF EARLY DETECTION AND FREE SCREENING SESSIONS. THE COMMUNITY HOSPITAL CANCER RESEARCH FOUNDATION LAUNCHED THE CANCER RESOURCE CENTRE, WHICH HOSTS A VARIETY OF FREE PROGRAMS, CLASSES AND SUPPORT GROUPS ABOUT LIVING WITH CANCER. A SPECIAL SEGMENT OF CLASSES WAS BORN WITH THE OPENING OF THE CANCER RESOURCE CENTRE - A SUPPORT PROGRAM OF THE COMMUNITY HOSPITAL CANCER RESEARCH FOUNDATION. HERE, THOSE FACING CANCER ATTEND FREE CLASSES SUCH AS YOGA, BREATHING THROUGH PAIN, LEARNING ABOUT COMPLEMENTARY THERAPIES, AND A VARIETY OF SUPPORT GROUPS. 3. DIABETES EDUCATION EFFORTS HAVE EXPANDED TO INCLUDE DIABETES MANAGEMENT CLASSES IN CONJUNCTION WITH EXERCISE. THIS IS IN ADDITION TO A BASIC DIABETES EDUCATION CLASS AND A DIABETES MANAGEMENT CLASS CERTIFIED BY THE AMERICAN DIABETES ASSOCIATION. 4. SENIOR TOPICS OFFERED AT FITNESS POINTE INCLUDE FALL PREVENTION, UNDERSTANDING MANAGED CARE, UNDERSTANDING ADVANCED DIRECTIVES, UNDERSTANDING HOSPICE AND MEDICARE BENEFITS, HELP WITH DIZZINESS, MAKING SENSE OF MEDICAL TECHNOLOGY, MEDICATION SAFETY, URINARY INCONTINENCE PRESENTATION, A GRANDPARENT CLASS, AND A PROGRAM ON OSTEOPOROSIS. 5. ORTHOPEDIC PROGRAMS INCLUDE ARTHRITIS, TENDONITIS AND BURSITIS RECOGNITION AND MANAGEMENT, PREVENTION OF NECK AND LOW BACK PAIN, ATHLETIC FOOT AND ANKLE PROBLEMS, THE CARE AND TREATMENT OF KNEE, HIP, FOOT AND SHOULDER PROBLEMS, CERVICAL AND LUMBAR DISK PROBLEMS, A FALL PREVENTION AND BALANCE SCREENING PROGRAM, AND SPORTS INJURY PREVENTION. 6. NUTRITION PROGRAMS INCLUDE INDIVIDUAL NUTRITIONAL COUNSELING WITH A REGISTERED DIETITIAN, GROUP WEIGHT MANAGEMENT PROGRAMS, LUNCH & LEARN COOKING DEMONSTRATIONS, A CLASS ABOUT EMOTIONAL EATING, AND A CLASS ABOUT FAD DIETS AND PROPER NUTRITION. 7. MENTAL HEALTH RELATED PROGRAMS INCLUDE RELAXATION, STRESS MANAGEMENT, BREATHING EXERCISES, PROGRAMS ON COMPLEMENTARY THERAPIES, RECOGNIZING AND UNDERSTANDING DEPRESSION, AND LIFE MAPPING. 8. WOMEN'S WELLNESS PROGRAMS INCLUDE PRE-AND POST-NATAL EXERCISE, A SERIES ABOUT NUTRITION, SCREENING AND TREATMENT RELATED TO OSTEOPOROSIS, A COMPLETE HEALTH RETREAT FOR WOMEN, FIBROMYALGIA, GENETIC LINKS AND TESTING FOR CANCER, HORMONE REPLACEMENT THERAPY, STRENGTH TRAINING FOR WOMEN, AND HEADACHES IN WOMEN. 9. FAMILY HEALTH PROGRAMS INCLUDE A PRENATAL CLASS, SIBLING CLASS, TAKING CARE OF BABY, KEEPING BABY SAFE AND HEALTHY, INFANT GROWTH AND DEVELOPMENT, FAMILY AND FRIENDS CPR, BREAST FEEDING CLASSES AND LACTATION CONSULTATIONS, LAMAZE, TEEN CHILDBIRTH EDUCATION, GRANDPARENT EDUCATION, FILMS ABOUT CESAREAN SECTIONS, POISON PREVENTION AND TREATMENT, ASK THE PEDIATRICIAN AND HOW TO RAISE A HEART-SMART CHILD, AND A PARENT SUPPORT GROUP. PARTICIPATION IN HEALTH EDUCATION/WELLNESS PROGRAMS RANGES FROM AN AVERAGE OF 300-350 ATTENDEES A MONTH. APPROXIMATELY 20-30% OF THESE ATTENDEES ARE MEMBERS OF THE FITNESS POINTE FACILITY WHILE 70-80% ARE NON-MEMBERS FROM THE GENERAL COMMUNITY. FITNESS PROGRAM AREAS THE AMERICAN HEART ASSOCIATION RECOGNIZES THE LACK OF REGULAR PHYSICAL EXERCISE AS A MAJOR RISK FACTOR FOR HEART DISEASE. REGULAR EXERCISE IS ASSOCIATED WITH BETTER HEART HEALTH, MENTAL WELL-BEING, WEIGHT MANAGEMENT, CANCER PREVENTION, DIABETES CONTROL, LOW BACK PAIN PREVENTION/RELIEF AND OTHER LIFESTYLE-RELATED DISEASES. FITNESS POINTE'S GENERAL FITNESS MEMBERSHIP PROGRAM OFFERS A VARIETY OF EXERCISE PROGRAM OPTIONS DESIGNED TO MEET THE INDIVIDUAL NEEDS. INDIVIDUALS FROM THE COMMUNITY WHO TAKE ADVANTAGE OF THE GENERAL FACILITY MEMBERSHIP PROGRAM INCLUDE TRANSFERS FROM CARDIAC REHABILITATION AND PHYSICAL THERAPY, AND THOSE REFERRED BY THEIR PERSONAL PHYSICIAN. IN ADDITION, MANY ARE CORP
AFFILIATED HEALTH CARE SYSTEMCOMMUNITY HOSPITAL IS PART OF AN AFFILIATED SYSTEM. EACH HOSPITAL IN THE SYSTEM PROVIDES MEDICAL SERVICES TO THEIR COMMUNITIES AND ADJOINING COMMUNITIES. EACH ENTITY'S PURPOSE IS TO PROVIDE HEALTH CARE TO THOSE WHO NEED IT, INCLUDING THE UNINSURED OR UNDERINSURED.
STATE FILING OF COMMUNITY BENEFIT REPORTINDIANA
FACILITY REPORTING GROUPSSEE REQUIRED DESCRIPTIONS
PART III, LINE 8Cost Report (14,800,993) Medicare Managed Care (3,025,980) Fee-based Outpatient charges (5,406,902) Disallowed Medicare expenses (15,102,093) Total (Shortfall) (38,335,968)
PART V, LINE 20DOur maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care are based on a sliding scale. Up to 200% of federal poverty guidelines (FPG) is 100% free care. 201% -250% is discounted 80%. 251%-300% is discounted 60%. Patients may also be eligible for self-pay/prompt pay discounts regardless of the federal poverty level. We offer 30% discount to true self-pay accounts and a 10% discount to prompt pay accounts.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrantAmount Of Cash GrantAmountOfCashGrant
THE LONG ISLAND COMMUNITY FOUNDATION
1864 MUTTONTOWN ROADSYOSSETNY11791136089923501(C)311094FMVSUPPLIESCONTRIBUTION SUPPLIES FOR HURRICANE SANDY RELIEF EFFORT
TOWN OF MUNSTER
1005 RIDGE ROADMUNSTERIN46321356001128GOVERNMENTCONTRIBUTION10000
CHINMAYA MISSION OF NW IN
8605 MERRILLVILLE RDMERRILLVILLEIN46410275550095501(c)3CONTRIBUTION8500
CALUMET COUNCIL BOY SCOUTS OF AMERICA
8751 CALUMET AVENUEMUNSTERIN46321350867968501(c)3CONTRIBUTION7000
FRIENDS OF HOSPICE
600 SUPERIOR AVEMUNSTERIN46321351519392501(c)3CONTRIBUTION5420
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants5TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
ExplanationREQUESTS FOR DONATIONS FROM QUALIFIED 501(C)(3) CHARITIES AND UNIVERSITIES ARE EVALUATED AS TO WHETHER THE POTENTIAL DONEE ORGANIZATION WILL USE THE FUNDS IN A MANNER CONSISTENT WITH OUR CHARITABLE MISSION AND THE INTENTION OF THE CONTRIBUTION. OUR DONATIONS/CONTRIBUTIONS ARE PRIMARILY MADE TO LOCAL ORGANIZATIONS. SINCE THESE ARE NOT GRANTS, THERE IS NO NEED TO MONITOR.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DONALD S POWERS
DIRECTOR08152380510959027160278000143600137107300
DONALD P FESKO
ADMINISTRATOR04102950155625025350011100027163062953300
MARY ANN SHACKLETT
SR VP & SYSTEM CFO04120610274998026143027800024244076524600
LUIS MOLINA
VP OF FINANCE/CFO33188602107860100920408660193230612953000
RONDA MCKAY
VP & CNO1872160937820130307161026500292112000
RICHARD BERKOWITZ MD
MEDICAL DIRECTOR55546800023220278000294020614992000
PANTHIRUVELIL S MOHAN-THOMAS MD
PHYSICIAN42221200029960111000231030459411000
ROBERT JOSEPH GRONEMEYER MD
PHYSICIAN42109200019520111000251040459248000
AZAD CHALLAPALLI MD
PHYSICIAN406994000207660278000198620475422000
MICHAEL A BRODY MD
PHYSICIAN4210910006810278000251040474676000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART I, LINE 1AReturnReference
ExplanationTHE ORGANIZATION PAYS HEALTH/SOCIAL CLUB DUES ON BEHALF OF THE INDIVIDUAL WHICH IS THEN TAXED AS A FRINGE BENEFIT TO THE INDIVIDUAL. PART I, LINE 7 DESCRETIONARY BONUS IS PAID BASED ON FINANCIAL PERFORMANCE AND QUALITY INDICATORS TO CERTAIN EXECUTIVES.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (9 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
COMMUNITY CARDIOLOGY CENTER
SN MAKAM PRTNR MORE THAN5649198INDEPENDENT CONTRACTORfalse
COMM CARD CTNR CON'T
5% OWNEDINDEPENDENT CONTRACTOR
HASSE CONSTRUCTION
OWNED BY WILLIAM HASSE361947INDEPENDENT CONTRACTORfalse
SARN II
DR. SHABEEB PART-OWNER228201RENTAL OF OFFICE SPACEfalse
CARDIOLOGY ASSOC OF NW IN
SN MAKAM OFFICER103430INDEPENDENT CONTRACTORfalse
KAY TORRENGA
FAM MEM OF DONALD TORRENG69521EMPLOYMENTfalse
GARY MCKAY
FAM MEM OF RONDA MCKAY64187EMPLOYMENTfalse
STEVEN PAUL CHOVANEC
FAM MEM STEVEN G CHOVANEC47865EMPLOYMENTfalse
RYAN TORRENGA
FAM MEM OF DONALD TORRENG12544EMPLOYMENTfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FAMILY OR BUSINESS RELATIONSHIPSPART VI LINE 2 Frankie Fesko is a family member of Donald Fesko and Donald S. Powers Members or Stockholders PART VI LINE 6 Community Foundation of Northwest Indiana, Inc. (CFNI) is the sole member or stockholder.
DESCRIPTION OF THE CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTSCOMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC IS THE PARENT COMPANY OF MUNSTER MEDICAL RESEARCH FOUNDATION, INC AND HAS CONTROL TO ELECT MEMBERS OF THEIR GOVERNING BODY.PT VI-A, LINE 7A
DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTSCOMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC IS THE PARENT COMPANY OF MUNSTER MEDICAL RESEARCH FOUNDATION, INC AND HAS RIGHTS TO APPROVE DECISIONS MADE BY MMRF.PT VI-A, LINE 7B
DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990THE 990 IS SUBMITTED TO THE SENIOR VP AND CFO FOR REVIEW. ONCE THIS REVIEW IS COMPLETE THE RETURNS ARE THEN PRESENTED TO SENIOR LEADERSHIP TO REVIEW. THE 990 IS ALSO REVIEWED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM BEFORE IT IS POSTED TO A SECURE WEBSITE TO ALLOW THE BOARD OF DIRECTORS TO REVIEW PRIOR TO FILING.PT VI-A, LINE 11A
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTERESTAS PART OF THE ORGANIZATION'S ANNUAL MONITORING & ENFORCEMENT PROCEDURE RELATING TO ITS CONFLICT OF INTEREST POLICY, ALL CONFLICT OF INTEREST QUESTIONNAIRES ARE REVIEWED BY THE VP OF CORPORATE COMPLIANCE AND THOSE OFFICERS, DIRECTORS OR KEY EMPLOYEES WHO DO NOT RETURN OR FULLY COMPLETE THE QUESTIONNAIRE ARE CONTACTED TO RECONCILE THE OMISSION.PT VI-B, LINE 12C
OFFICERS & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUNIN 2003, THE PARENT COMPANY (CFNI) BOARD ADOPTED EXECUTIVE AND BOARD OF DIRECTORS COMPENSATION PHILOSOPHY AND REASONABLENESS STANDARDS. THIS IS TO ASCERTAIN THAT THESE STANDARDS ARE ADHERED TO. THEIR PROCESS FOR COLLECTING AND ASSEMBLING MARKET DATA IS CONSISTENT WITH THE REBUTTABLE PRESUMPTION CHECKLIST AND GUIDELINES ALONG WITH FAIR MARKET VALUE USED BY THE IRS IN CONDUCTING EXECUTIVE COMPENSATION REVIEWS AS WELL AS CONTEMPORARY COMPENSATION PRACTICES. ALL MARKET DATA IS ASSEMBLED FROM REPUTABLE COMMERCIALLY AVAILABLE SURVEYS.PART VIB, LINE 15
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLICMUNSTER MEDICAL RESEARCH FOUNDATION, INC DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. IN ACCORDANCE WITH BOND COVENANTS, MMRF THROUGH CFNI MAKES IT FINANCIAL STATEMENTS AND DISCLOSURES AVAILABLE TO THE PUBLIC THROUGH THE EMMA DATABASE.PT VI-C, LINE 19
PROGRAM SERVICE ACCOMPLISHMENTSTHE DESIGNATED POPULATION THAT THE COMMUNITY HOSPITAL IS FOCUSING ON INCLUDES THOSE INDIVIDUALS WHOSE LIFE-STYLE BEHAVIORS PUT THEM AT RISK FOR DISEASE AND ILLNESS. OUR PRIMARY FOCUS CONTINUES THIS YEAR ON TWO DISEASES THAT HAVE BEEN IDENTIFIED AS HEALTH DISCREPANCIES IN LAKE COUNTY, INDIANA - CANCER AND HEART DISEASE. THE INCIDENCE OF THESE DISEASES IN OUR REGION SURPASSED STATE AND NATIONAL AVERAGES, AND THEREFORE DEMANDED OUR PRIMARY FOCUS. THE COMMUNITY HOSPITAL HAS INVESTED GREATLY IN RECENT YEARS IN THESE TREATMENT PROGRAMS AND IN OFFERING PATIENTS ACCESS TO TREATMENTS NOT AVAILABLE ELSEWHERE IN THE COUNTY. THE FOCUS OF OUR COMMUNITY BENEFIT IS TO USE RESOURCES TO REACH BEYOND THE TREATMENT OF THESE DISEASES TO HELP EDUCATE, SUPPORT AND EMPOWER INDIVIDUALS TO LOWER THEIR RISKS.PART III, LINE 4A
PART XI, LINE 5OTHER CHANGES IN NET ASSETS INCLUDE THE FOLLOWING: MINIMUM PENSION LIABILITY ADJUSTMENT 10,588,038 TRANSFER FROM RELATED ORGANIZATION (17,984,383) TRANSFER FROM RELATED ORGANIZATION (1,173,943) TRANSFER FROM RELATED ORGANIZATION (80,000) TEMP RESTRICTED FUND TRANSFER (288,315) TEMP RESTRICTED ENDOWMENT FUND RELEASE 1,837 TOTAL CHANGES IN NET ASSETS (8,936,766)

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
COMMUNITY FOUNDATION OF NW INDIANA INC
10010 DONALD POWERS DRIVEMUNSTERIN46321311128781SUPPORTNG ORGIN501(c)(3)11(c)NAfalse
ST CATHERINE HOSPITAL INC
4321 FIR STREETEAST CHICAGOIN46312351738708HOSPITALIN501(c)(3)3CFNItrue
ST MARY MEDICAL CENTER INC
1500 S LAKE PARK AVEHOBARTIN46342352007327HOSPITALIN501(c)(3)3CFNItrue
COMMUNITY CANCER RESEARCH FOUNDATION
901 MACARTHUR BLVDMUNSTERIN46321352146374CANCER FUNDRAIN501(c)(3)7MMRFtrue
COMMUNITY VILLAGE INC
10000 COLUMBIA AVEMUNSTERIN46321351956395RETRMT HOMEIN501(c)(3)9CFNItrue
CVPA HOLDING COMPANY
1040 RIDGE RDMUNSTERIN46321351938136TITLE HLDG COIN501(c)(2)N/ACFNItrue
THEATRE AT THE CENTER
905 RIDGE RDMUNSTERIN46321351939427PLAYS & ARTSIN501(c)(3)9CFNItrue
COMMUNITY CARE NETWORK INC
901 MACARTHUR BLVDMUNSTERIN46321454158203PHYS SERVICESIN501(c)(3)3MMRF SCH SMMtrue

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY RESOURCES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1907 RIDGE ROADAddressLine1
CityMUNSTERCity
StateINState
ZIP Code46321ZIPCode
FieldValueIRS element (for citing)
EIN351727711EIN
Primary ActivityMGMT SERVICESPrimaryActivity
Legal Domicile StateINLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgtruePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (16 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
THEATRE AT THE CENTER
B80000FMV
COMMUNITY CARE NETWORK
B1173943FMV
COMMUNITY CANCER RESEARCH FOUNDATION
C280825FMV
COMMUNITY CARE NETWORK
H52884FMV
COMMUNITY CARE NETWORK
J163441FMV
ST CATHERINE HOSPITAL
O1016011FMV
ST MARY MEDICAL CENTER
O769010FMV
COMMUNITY CANCER RESEARCH FOUNDATION
O227490FMV
COMMUNITY CARE NETWORK
O5076571FMV
ST CATHERINE HOSPITAL
P2942364FMV
ST MARY MEDICAL CENTER
P7300385FMV
COMMUNITY CANCER RESEARCH FOUNDATION
P118450FMV
COMMUNITY CARE NETWORK
P7439002FMV
ST CATHERINE HOSPITAL
Q977247FMV
ST MARY MEDICAL CENTER
Q1882525FMV
COMMUNITY CARE NETWORK
Q1566559FMV