2014-05-13T16:06:51-05:00 2013-06-30 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 4000 INDIANAPOLIS IN 46204 990 2012-07-01 311128781 COMMUNITY FOUNDATION OF NORTHWEST INDIANA INC % MARY ANN SHACKLETT COMM 2199348250 10010 DONALD S POWERS DRIVE Suite 201 MUNSTER IN 46321 Mary Ann Shacklett 2199348250 2014-05-13 3176817000 2012 2015-11-30 17:44:51Z MARY ANN SHACKLETT 10010 DONALD S POWERS DR 201 MUNSTER IN 46321 811193127 false X WWW.COMHS.ORG X 1985 IN PROVIDES SUPPORT FOR ACTIVITIES OF THE AFFILIATED HOSPITALS TO ENGAGE IN THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITIES SERVED WITHIN NORTHWEST INDIANA. 20 11 403 52100 -27465 61450 42802 30138 23341 8126356 12772493 80844454 72372652 89062398 85211288 310177 277960 0 0 30055946 31432448 0 0 56133 62249462 65383807 92615585 97094215 -3553187 -11882927 444488667 597306630 303265334 414908440 141223333 182398190 X COMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC PROVIDES SUPPORT FOR ACTIVITIES OF THE AFFILIATED HOSPITALS TO ENGAGE IN THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITIES SERVED WITHIN NORTHWEST INDIANA. COMMUNITY FOUNDATION NORTHWEST INDIANA, INC HELPS COORDINATE ACTIVITIES FOR THE IMPROVED WELL BEING OF THE HOSPITALS AND THEIR PATIENTS. false false 76329777 72712519 TO COORDINATE AND SUPPORT ACTIVITIES OF AFFILIATED HOSPITALS TO ENGAGE IN ACTIVITIES FOR THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITIES SERVED. ALSO PROVIDE SUPPORT FOR COMMUNITY-BASED PROJECTS TO PROMOTE THE CULTURAL, EDUCATIONAL, AND CHARITABLE COMMUNITY OF NORTHWEST INDIANA. 76329777 true false false true false false false false false false true false false true true false false true false false false false false false false true false true false true true false false false false false false false true true true false false false false false true true true true false true 120 23 true 403 true true true false false false false false false false false false false false false X 20 11 true false false false false false false true true false false true true true true true true true true false IN X MARY ANN SHACKLETT 2199348250 10010 DONALD S POWERS DR 201 MUNSTER IN 46321 STEVEN BEERING MD 1.0 X 18000 0 0 DAVID BOCHNOWSKI 1.0 1.0 X 24200 0 0 JOSEPH COSTANZA 2.0 1.0 X 20900 0 0 DANIEL DUMEZICH 1.0 X 20200 0 0 RICHARD MCCLAUGHRY 1.0 2.0 X 38808 25000 0 JOSEPH MORROW 1.0 X 14200 0 0 SR KATHLEEN QUINN 1.0 X 24100 0 0 WILLIAM SCHENCK 1.0 3.0 X 39008 0 0 JOSEPH SEMANCIK MONSIGNOR 2.0 1.0 X 24400 450 0 M NABIL SHABEEB MD FACS 1.0 2.0 X 24100 0 0 DONALD TORRENGA 2.0 2.0 X 39008 0 0 ROBERT WELSH 1.0 1.0 X 18200 0 0 EDWARD WILLIAMS PHD 1.0 2.0 X 32639 0 0 JOE WILLIAMSON 1.0 1.0 X 39729 0 0 JAY ZANDSTRA 1.0 1.0 X 22800 0 0 FRANKIE FESKO 5.0 6.0 X X 79638 24000 0 HON JAMES RICHARDS 23.0 1.0 X X 48608 24000 0 DONALD S POWERS 40.0 3.0 X X 1328913 0 42160 WILLIAM HASSE III 1.0 1.0 X X 34000 0 0 DAVID WICKLAND 15.0 1.0 X X 48608 24000 0 JOHN GORSKI 40.0 2.0 X 1206818 0 48722 MARY ANN SHACKLETT 41.0 8.0 X 713202 0 52044 CAROLE BEZAT 40.0 X 774755 0 42846 ANTHONY FERRACANE 40.0 X 508853 0 44528 KEVIN MYBECK 40.0 X 250964 0 34701 CRAIG BOLDA 40.0 1.0 X 248451 0 51718 ELIZABETH YEE 40.0 1.0 X 267730 0 51665 ROSEMARY GARCIA 40.0 X 255128 0 27576 NANCY MOSER 40.0 X 229320 0 26487 RAMONA FISSINGER 40.0 X 172019 0 39376 MARK SIMAGA MD 20.0 20.0 X 163166 132727 32482 GARY WEINER 40.0 X 325984 0 13880 DAVID OTTE 40.0 X 226686 0 43438 GREGG FERLIN 40.0 X 182989 0 27563 FELIX GOZO JR MD 40.0 X 255646 0 19797 KAREN SCHNEIDER 40.0 X 167189 0 43319 KATHLEEN EDWARDS 40.0 X 156186 0 30160 MYLINDA CANE 40.0 X 141916 0 35136 ALICIA STANLEY 40.0 X 130680 0 23411 8317741 230177 731009 40 false true false EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 53593 SOFTWARE SUPPORT 3989640 AFFILIATED COMPUTER SERVICES PO BOX 201322 DALLAS TX 75320 CONSULTING 3855468 LUCCA CONSULTING GROUP INC 601 WOODVIEW DRIVE WHITELAND IN 46184 CONSULTING 2870850 ZARAYA CONSULTING LLC 550 W WELLINGTON AVE 2E CHICAGO IL 60657 CONSULTING 1379345 DIVURGENT 4445 CORPORATION LANE STE 228 VIRGINIA BEACH VA 23462 CONSULTING 1163785 42 42802 42802 COPYING FEE 900099 23341 23341 23341 9609541 9609541 0 0 739447 1055973 -316526 0 -316526 -316526 728044336 724880580 804 3163756 -804 3162952 3162952 0 44482 44482 0 0 EXP ALLOC TO SUBS 561000 72605218 72605218 CONSTRUCTION SERVICES 541300 58000 29000 29000 IT & TELECOM SERVICES 541519 21100 21100 4860 2860 2000 72689178 85211288 72637078 52100 12479308 277960 277960 0 0 0 7541605 5544369 1997236 267275 267275 18940121 15152097 3733581 54443 460979 368783 92196 2450646 1960517 490129 1771822 1417458 354364 0 869283 869283 1081301 1081301 94685 94685 0 796632 796632 11856003 9484802 2371201 553907 443126 110781 2139358 1710175 427544 1639 10248187 8198550 2049637 0 637041 509633 127408 272635 218090 54523 22 0 143812 115050 28762 16483634 13186907 3296727 200786 160629 40157 11743884 9395107 2348777 541338 433070 108268 EARLY EXTINGUISHMENT OF DEBT 6545733 6545733 TAXES 208818 167054 41764 REPAIRS AND MAINTENANCE 154774 123819 30955 LEASE AND RENTAL 102052 81618 20405 29 709944 567955 141989 97094215 76329777 20708305 56133 0 0 5925146 21353734 0 0 49180 166557 0 0 0 0 19352999 0 0 0 3213274 3172397 110989111 65967391 70958477 45021720 308683551 389435714 0 0 0 0 0 0 36306041 138156508 444488667 597306630 14483352 16536351 0 0 51167 46685 218398433 334188852 0 0 0 0 62860007 59540838 0 0 7472375 4595714 303265334 414908440 X 140819849 181983413 403484 414777 0 0 141223333 182398190 444488667 597306630 X -11882927 -3220302 56278086 X false true X true false X X X false false false MUNSTER MEDICAL RESEARCH FOUNDATION INC 351107009 03 true true true 16585222 ST MARY MEDICAL CENTER 352007327 03 true true true 353342 ST CATHERINE HOSPITAL INC 351738708 09 true true true 0 3 16938564 false false false false false false false false true 94685 94685 false false PART II-B LINE 1i COMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC. CONTRACTS WITH LOBBYISTS TO INTERVENE ON OUR BEHALF. 2302698 2302698 15317312 6939693 8377619 2160063 1306092 853971 74688044 50593128 24094916 16520994 7128478 9392516 45021720 PROJECT FUND 62817112 DUE FROM AFFILIATES 23687723 INTERCOMPANY LOAN 17071108 DEBT SERVICE RESERVE FUND 16705806 INVESTMENT IN AFFILIATES 6306738 DEFERRED COSTS 5166730 VETERANS MEMORIAL PARK 3288329 LAND HELD FOR FUTURE USE 3112962 138156508 0 CAPITAL LEASES 4595714 4595714 44482 44482 true 1.00000 44482 44482 44482 IN true false false false 1.00000 SHERRI HOLT 905 RIDGE RD MUNSTER IN 46321 false false false LAKE AREA UNITED WAY 221 WEST RIDGE ROAD GRIFFITH IN 46319 237170019 501(c)(3) 40000 ANNUAL CAMPAIGN PURDUE UNIVERSITY CALUMET 2200 169TH STREET HAMMOND IN 46323 356002041 501(c)(3) 28000 CONTRIBUTION INDIAN AMERICAN CULTURAL CENTER 8605 MERRILLVILLE RD MERRILLVILLE IN 46410 351981658 501(C)(3) 21000 SPONSORSHIP INDIAN MEDICAL ASSOCIATION OF NORTHWEST INDIANA 1109 LAHINCH COURT DYER IN 46311 314130002 501(c)(3) 15000 SPONSORSHIP SOUTH SHORE ARTS 1040 RIDGE ROAD MUNSTER IN 46321 237049722 501(c)(3) 15000 SPONSORSHIP SCHOOL TOWN OF MUNSTER 8808 CALUMET AVENUE MUNSTER IN 46321 356002675 501(c)(3) 15000 CONTRIBUTION CALUMET COLLEGE OF ST JOSEPH 2400 NEW YORK AVENUE WHITING IN 46394 351087173 501(c)(3) 14500 CONTRIBUTION NORTHWEST INDIANA SYMPHONY ORCHESTRA 1040 RIDGE ROAD MUNSTER IN 46321 351359750 501(c)(3) 13980 SPONSORSHIP VALPARAISO UNIVERSITY 1605 CAMPUS DRIVE EAST VALPARAISO IN 46383 350868125 501(c)(3) 10000 CONTRIBUTION ONE REGION 601 WEST 45TH AVENUE MUNSTER IN 46321 352117392 501(c)(3) 10000 CONTRIBUTION CATHOLIC CHARITIES 176 SOUTH WEST STREET CROWN POINT IN 46307 351122204 501(c)(3) 8000 CONTRIBUTION CALUMET COUNCIL BOY SCOUTS OF AMERICA 8751 CALUMET AVENUE MUNSTER IN 46321 350867968 501(c)(3) 5600 SPONSORSHIP TRADE WINDS SERVICES 5901 WEST 7TH AVENUE GARY IN 46406 351139485 501(c)(3) 5350 CONTRIBUTION EARLY LEARNING PARTNERSHIP OF NORTHWEST INDIANA 6530 NEW HAMPSHIRE AVE HAMMOND IN 46323 352109773 501(c)(3) 5340 SPONSORSHIP GRANTS OF 5000 OR LESS 71190 CONTRIBUTIONS 14 SUPPLEMENTAL INFORMATION REQUESTS 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. X true true X X X X X false false false false false false false true false DONALD S POWERS 815238 0 510959 0 2716 0 27800 0 14360 0 1371073 0 0 0 JOHN GORSKI 667985 0 503927 0 34906 0 27800 0 20922 0 1255540 0 0 0 MARY ANN SHACKLETT 412061 0 274998 0 26143 0 27800 0 24244 0 765246 0 0 0 CAROLE BEZAT 349103 0 421187 0 4465 0 27800 0 15046 0 817601 0 0 0 ANTHONY FERRACANE 257777 0 230092 0 20984 0 27800 0 16728 0 553381 0 0 0 KEVIN MYBECK 202970 0 47550 0 444 0 9605 0 25096 0 285665 0 0 0 CRAIG BOLDA 173923 0 74158 0 370 0 27800 0 23918 0 300169 0 0 0 ELIZABETH YEE 204599 0 44835 0 18296 0 35849 0 15816 0 319395 0 0 0 ROSEMARY GARCIA 190217 0 44988 0 19923 0 9548 0 18028 0 282704 0 0 0 NANCY MOSER 185430 0 42988 0 902 0 8538 0 17949 0 255807 0 0 0 RAMONA FISSINGER 137896 0 33022 0 1101 0 24058 0 15318 0 211395 0 0 0 MARK SIMAGA MD 151715 131610 10000 1451 1117 7999 7855 10248 6380 181413 146962 0 0 GARY WEINER 270472 0 54702 0 810 0 7350 0 6530 0 339864 0 0 0 DAVID OTTE 185463 0 40401 0 822 0 27800 0 15638 0 270124 0 0 0 GREGG FERLIN 182043 0 0 0 946 0 4503 0 23060 0 210552 0 0 0 FELIX GOZO JR MD 233788 0 0 0 21858 0 11100 0 8697 0 275443 0 0 0 KAREN SCHNEIDER 149471 0 16000 0 1718 0 23856 0 19463 0 210508 0 0 0 KATHLEEN EDWARDS 130887 0 5000 0 20299 0 21509 0 8651 0 186346 0 0 0 MYLINDA CANE 120425 0 20657 0 834 0 19910 0 15226 0 177052 0 0 0 ALICIA STANLEY 120443 0 10000 0 237 0 5939 0 17472 0 154091 0 0 0 SUPPLEMENTAL INFORMATION PART I, LINE 1A The organization pays health/social club dues on behalf of certain officers, key employees and the five highest paid employees 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. A Indiana Health and Educational Facility Financing 351611409 45479RCM7 2007-06-28 152135212 CONST/EQUIP REFUND 2001 (10/17/01) false false false B INDIANA FINANCE AUTHORITY 351602316 MULTIPLES 2012-11-09 175020000 CONST/EQUIP DEF 04A REF 06A&B, '08 false false false A 0 0 153825241 11084160 0 0 1802515 0 0 83918821 57019745 0 2009 false true true true B 0 0 187565378 0 0 0 2265994 0 0 12772305 109709967 62817112 true true false true A false true true true true true 0 false false 0.00000 false true B false true true true true true 0.00030 0.00000 0.00030 false false 0.00000 false true A true true false false 0 false 0 false true B false true false false 0 false 0 false true A true B true PART II, LINE 3 - TOTAL PROCEEDS OF ISSUE DIFFER FROM ISSUE PRICE AS A RESULT OF INVESTMENT EARNINGS. PART IV, LINE 2C REBATE COMPUTATIONS ARE PERFORMED ANNUALLY. THE MOST RECENT WAS 8/14/12. DON POWERS AGENCY OWNED BY JOE WILLIAMSON 606991 INDEPENDENT CONTRACTOR false MARKET SQUARE OWNED BY DONALD S. POWERS 64068 RENTAL OF OFFICE SPACE false HASSE CONSTRUCTION OWNED BY WILLIAM HASSE 29229 INDEPENDENT CONTRACTOR false ERNESTINA NGO FAM MEM OF ELIZABETH YEE 120289 EMPLOYMENT false BARBARA BOLDA FAM MEM OF CRAIG BOLDA 104986 EMPLOYMENT false LEONARD BEZAT FAM MEM OF CAROLE BEZAT 41999 EMPLOYMENT false Part IV TRANSACTIONS IN ITEMS 1-3 ARE MADE AT FAIR MARKET VALUE. FAMILY AND BUSINESS RELATIONSHIPS PART VI-A, LINE 2 Joe Williamson has family member with a business relationship with CFNI. Family relationship between Frankie Fesko and Donald S. Powers. Family relationship between Elizabeth Yee and Ernestina Ngo. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 PART VI-B, LINE 11b THE 990 IS SUBMITTED TO THE SENIOR VP AND CFO FOR REVIEW, ONCE THIS REVIEW IS COMPLETE THE RETURNS ARE THEN PRESENTED TO SENIOR LEADERSHIP FOR 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 ACCESS TO REVIEW PRIOR TO FILING. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PART VI-B, LINE 12C AS 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. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN PART VI-B, LINE 15 THE CFNI BOARD HAS 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. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC PART VI-C, LINE 19 COMMUNITY FOUNDATION OF NW IN INC DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. IN ACCORDANCE WITH BOND CONVENANTS, CFNI MAKES IT FINANCIAL STATEMENTS AND DISCLOSURES AVAILABLE TO THE PUBLIC THROUGH THE EMMA DATABASE. . RECONCILIATION OF NET ASSETS PART XI LINE 5 TRANSFERS FROM RELATED ENTITIES 110,588,812 TRANSFERS TO RELATED ENTITIES (54,313,526) ASSETS RELEASED FROM RESTRICTIONS 30,840 ASSETS RELEASED FUND TRANSFER (28,040) TOTAL CHANGE IN NET ASSETS 56,278,086 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING & OUTSIDE SERVICES TOTAL FEES:11856003 MUNSTER MEDICAL RESEARCH FOUNDATION 901 MACARTHUR BLVD MUNSTER IN 46321 351107009 HOSPITAL IN 501(c)(3) 3 NA true ST CATHERINE HOSPITAL INC 4321 FIR STREET EAST CHICAGO IN 46312 351738708 HOSPITAL IN 501(c)(3) 3 NA true ST MARY MEDICAL CENTER 1500 S LAKE PARK AVENUE HOBART IN 46342 352007327 HOSPITAL IN 501(c)(3) 3 NA true COMMUNITY CANCER RESEARCH FOUNDATION 901 MACARTHUR BLVD MUNSTER IN 46321 352146374 CANCER FUNDR IN 501(c)(3) 7 MMRF true COMMUNITY VILLAGE INC 10000 COLUMBIA AVENUE MUNSTER IN 46321 351956395 RETRMNT HOME IN 501(c)(3) 9 NA true CVPA HOLDING COMPANY 1040 RIDGE RD MUNSTER IN 46321 351938136 TITLE HLDG CO IN 501(c)(2) N/A NA true THEATRE AT THE CENTER 905 RIDGE RD MUNSTER IN 46321 351939427 PLAYS&ARTS IN 501(c)(3) 9 NA true COMMUNITY CARE NETWORK INC 901 MACARTHUR BOULEVARD MUNSTER IN 46321 454158203 PHYS SERVICES IN 501(c)(3) 3 MMRF SCH SMM true COMMUNITY RESOURCES INC 907 RIDGE ROAD MUNSTER IN 46321 351727711 MGMT SERVICES IN NA C CORP -83383 8385697 1.00000 true COMMUNITY MEDICAL & PROFESSIONAL CENTER 800 MACARTHUR BLVD MUNSTER IN 46321 237437942 CONDO ASSOCIA IN NA C CORP 12361 29961 0.90940 true true true true true false false false true false false false false false true true true false false MUNSTER MEDICAL RESEARCH FOUNDATION INC a(iv) 324792 FMV COMMUNITY CARE NETWORK INC a(iv) 62384 FMV MUNSTER MEDICAL RESEARCH FOUNDATION INC b 16585222 FMV ST MARY MEDICAL CENTER b 353342 FMV CVPA HOLDING COMPANY b 555000 FMV THEATRE AT THE CENTER b 374400 FMV COMMUNITY CANCER RESEARCH FOUNDATION b 55656 FMV COMMUNITY CARE NETWORK INC c 5506516 FMV MUNSTER MEDICAL RESEARCH FOUNDATION INC c 34569605 FMV ST CATHERINE HOSPITAL INC c 14478723 FMV ST MARY MEDICAL CENTER c 19355968 FMV COMMUNITY VILLAGE INC c 263278 FMV COMMUNITY VILLAGE INC d 17071108 FMV ST CATHERINE HOSPITAL INC i 184500 FMV MUNSTER MEDICAL RESEARCH FOUNDATION INC o 15685625 FMV ST CATHERINE HOSPITAL INC o 7792696 FMV ST MARY MEDICAL CENTER o 8919148 FMV COMMUNITY CARE NETWORK INC o 5662569 FMV MUNSTER MEDICAL RESEARCH FOUNDATION INC p 6926086 FMV ST CATHERINE HOSPITAL INC p 2019785 FMV ST MARY MEDICAL CENTER p 3021189 FMV COMMUNITY CARE NETWORK INC p 559086 FMV MUNSTER MEDICAL RESEARCH FOUNDATION INC q 45924410 FMV ST CATHERINE HOSPITAL INC q 16340911 FMV ST MARY MEDICAL CENTER q 25240682 FMV COMMUNITY VILLAGE INC q 981198 FMV COMMUNITY CARE NETWORK INC q 8394964 FMV