INDIANAPOLIS COALITION FOR PATIENT SAFETY INC: Form 990, tax year 2013
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- Organization
- INDIANAPOLIS COALITION FOR PATIENT SAFETY INC (EIN 27-0962095)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2014-11-14
- IRS object ID
- 201413189349305276
- Schema version
- 2013v3.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-14T15:25:47-06:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 205804172 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BGBC PARTNERS LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 N MERIDIAN ST STE 1100 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 270962095 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANAPOLIS COALITION FOR PATIENT SAFETY INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | INDI | BusinessNameControlTxt |
| Phone | 3172233090 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 351 W 10TH STREET SUITE 342 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46202 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES FULLER PHARMD | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3172233090 | PhoneNum |
| Signature | 2014-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CYNTHIA M MCCULLOUGH CPA | PreparerPersonNm |
| PTIN | P01261354 | PTIN |
| Phone | 3176334700 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHARLES MIRAMONTI MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 351 W 10TH STREET SUITE 342 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $351,031 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | INDYPATIENTSAFETY.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2009 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE A FORUM FOR INDIANAPOLIS-AREA HOSPITALS TO SHARE INFORMATION ABOUT 'BEST PRACTICES' AND WORK TOGETHER TO SOLVE PATIENT SAFETY ISSUES IN INDIANAPOLIS AND SURROUNDING COUNTY HOSPITALS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $70,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $50,000 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $275,000 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $300,000 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,272 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,031 | CYInvestmentIncomeAmt |
| PY Other Revenue | $75 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $346,347 | PYTotalRevenueAmt |
| CY Total Revenue | $351,031 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $61,460 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $210,748 | PYOtherExpensesAmt |
| CY Other Expenses | $296,069 | CYOtherExpensesAmt |
| PY Total Expenses | $272,208 | PYTotalExpensesAmt |
| CY Total Expenses | $296,069 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $74,139 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $54,962 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $427,624 | TotalAssetsBOYAmt |
| Total Assets EOY | $482,586 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $25,000 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $25,000 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $402,624 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $457,586 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE A FORUM FOR INDIANAPOLIS-AREA HOSPITALS TO SHARE INFORMATION ABOUT 'BEST PRACTICES' AND WORK TOGETHER TO SOLVE PATIENT SAFETY ISSUES IN INDIANAPOLIS AND SURROUNDING COUNTY HOSPITALS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $293,769 | ExpenseAmt |
| Revenue | $300,000 | RevenueAmt |
| Desc | UNDERTAKING PROJECTS THAT FOCUS ON PATIENT-CENTERED STRATEGIES TO IMPROVE SAFETY BY ADDRESSING ALL OF THE BARRIERS OBSERVED BY PATIENTS AND PROVIDERS TO ACHIEVING A STANDARDIZED APPROACH TO PATIENT CARE. | Desc |
| Total Program Service Expenses | $293,769 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAMES FULLER PHARMD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3172233090 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10401 N MERIDIAN STREET SUITE 300 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46290 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| CHARLES MIRAMONTI MD | ||||||
| CHAIR | 6.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CLIF KNIGHT MD FAAFP | ||||||
| VICE-CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JAMES FULLER PHARMD | ||||||
| PRESIDENT | 40.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BILL CORLEY | ||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SUSAN BROWN MS MBA | ||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| VINCENT C CAPONI | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LISA HARRIS MD | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| THOMAS MATTICE | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BRYAN MILLS | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DAN EVANS | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BOB BRODY | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LEE ANN BLUE RN | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| PATRICIA CALVIN RN | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TRISHA SQROW | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $50,000 | AllOtherContributionsAmt |
| Total Contributions | $50,000 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEMBERSHIP DUES | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $300,000 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $300,000 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $300,000 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,031 | TotalRevenueColumnAmt |
| Exclusion | $1,031 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $351,031 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $300,000 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,031 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $178,736 | TotalAmt |
| Program Services | $178,736 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,300 | TotalAmt |
| Management And General | $2,300 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,440 | TotalAmt |
| Program Services | $78,440 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $225 | TotalAmt |
| Program Services | $225 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,589 | TotalAmt |
| Program Services | $1,589 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $284 | TotalAmt |
| Program Services | $284 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,043 | TotalAmt |
| Program Services | $13,043 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,180 | TotalAmt |
| Program Services | $4,180 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,746 | TotalAmt |
| Program Services | $6,746 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,174 | TotalAmt |
| Program Services | $2,174 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS EXPENSES | Desc |
| Total | $8,352 | TotalAmt |
| Program Services | $8,352 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $296,069 | TotalAmt |
| Program Services | $293,769 | ProgramServicesAmt |
| Management And General | $2,300 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49 | BOYAmt |
| EOY | $4,779 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $422,524 | BOYAmt |
| EOY | $472,756 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35 | BOYAmt |
| EOY | $35 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,016 | BOYAmt |
| EOY | $5,016 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $427,624 | BOYAmt |
| EOY | $482,586 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,000 | BOYAmt |
| EOY | $25,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,000 | BOYAmt |
| EOY | $25,000 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $402,624 | BOYAmt |
| EOY | $457,586 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $402,624 | BOYAmt |
| EOY | $457,586 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $427,624 | BOYAmt |
| EOY | $482,586 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $54,962 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Supported Org Information SupportedOrgInformationGrp (13 entries)
| EINEIN | Organization TypeOrganizationTypeDesc | Governing Document ListedGoverningDocumentListedInd | Supported Org NotifiedSupportedOrgNotifiedInd | US OrganizedUSOrganizedInd | SupportSupportAmt |
|---|---|---|---|---|---|
| INDIANA UNIVERSITY HEALTH INC | |||||
| 351955872 | 501(A)(1) | Yes (1) | Yes (1) | Yes (1) | $0 |
| COMMUNITY HEALTH NETWORK INC | |||||
| 311038302 | 501(A)(1) | Yes (1) | Yes (1) | Yes (1) | $0 |
| COMMUNITY HOSPITALS OF INDIANA INC | |||||
| 350983617 | 501(A)(1) | Yes (1) | Yes (1) | Yes (1) | $0 |
| COMMUNITY HOSPITAL SOUTH INC | |||||
| 351088640 | 501(A)(1) | Yes (1) | Yes (1) | Yes (1) | $0 |
| COMMUNITY LTC INC | |||||
| 351877441 | 501(A)(1) | Yes (1) | Yes (1) | Yes (1) | $0 |
| COMMUNITY HOME HEALTH SERVICES INC | |||||
| 350953467 | 501(A)(1) | Yes (1) | Yes (1) | Yes (1) | $0 |
| HEALTH AND HOSPITAL CORP OF MARION COUNTY DBA WISHARD HEALTH SERVICES | |||||
| 356005697 | 501(A)(1) | Yes (1) | Yes (1) | Yes (1) | $0 |
| RICHARD ROUDEBUSH VETERANS AFFAIRS MEDICAL CENTER | |||||
| 351511916 | 501(A)(1) | Yes (1) | Yes (1) | Yes (1) | $0 |
| ST VINCENT HEALTH INC | |||||
| 352052591 | 501(A)(1) | Yes (1) | Yes (1) | Yes (1) | $0 |
| ST VINCENT HOSPITAL AND HEALTH CARE CENTER INC | |||||
| 350869066 | 501(A)(1) | Yes (1) | Yes (1) | Yes (1) | $0 |
| ST VINCENT CARMEL HOSPITAL INC | |||||
| 743107055 | 501(A)(1) | Yes (1) | Yes (1) | Yes (1) | $0 |
| SETON SPECIALTY HOSPITAL INC | |||||
| 351712001 | 501(A)(1) | Yes (1) | Yes (1) | Yes (1) | $0 |
| FRANCISCAN ALLIANCE INC DBA FRANCISCAN ST FRANCIS HEALTH | |||||
| 351330472 | 501(A)(1) | Yes (1) | Yes (1) | Yes (1) | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 13 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF FORM 990 IS PROVIDED TO AND REVIEWED BY EACH MEMBER OF THE BOARD OF DIRECTORS UPON COMPLETION. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH DIRECTOR, OFFICER, AND EMPLOYEE OF THE ORGANIZATION IS REQUIRED TO PROVIDE AN ANNUAL DISCLOSURE OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST THAT ARISE AS A RESULT OF THAT PERSON'S ROLE WITH THE ORGANIZATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, POLICIES AND PROCEDURES, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACTOR & OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 78,440. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 78,440. |