Indiana University Health Proton: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- Indiana University Health Proton (EIN 35-2134193)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-01-29
- IRS object ID
- 201420299349300022
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2014-01-29T12:42:44-06:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351178661 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & COMPANY | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE AMERICAN SQUARE 2200 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46282 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352134193 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA UNIVERSITY HEALTH PROTON | BusinessNameLine1 |
| Business Name Line2 | THERAPY CENTER LLC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | INDI | NameControl |
| Phone | 8123495074 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2425 N MILO B SAMPSON LANE | AddressLine1 |
| City | BLOOMINGTON | City |
| State | IN | State |
| ZIP Code | 474081368 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN R KERSTIENS CPA | Name |
| Title | COO/CFO | Title |
| Phone | 8123495028 | Phone |
| Date Signed | 2014-01-24 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | AMBER KOCHER CPA | Name |
| PTIN | P01286298 | PTIN |
| Phone | 3176334705 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDWEST PROTON RADIOTHERAPY INSTITUTE LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DR PETER JOHNSTONE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2425 N MILO B SAMPSON LANE | AddressLine1 |
| City | BLOOMINGTON | City |
| State | IN | State |
| ZIP Code | 474081368 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 17963884 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.IUHEALTHPROTONTHERAPY.ORG | WebSite |
| Type Of Organization Other | X | TypeOfOrganizationOther |
| Type Of Org Other Description | LLC - LIMITED LIABILITY COMPANY | TypeOfOrgOtherDescription |
| Year Formation | 2001 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | CANCER TREATMENT CENTER THAT UTILIZES UNIQUE PROTON BEAM TECHNOLOGY TO TREAT CANCER PATIENTS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 71 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 105982 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1736112 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 18660957 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 16221548 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3202 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3090 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2980 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3134 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 18773121 | TotalRevenuePriorYear |
| Total Revenue Current Year | 17963884 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 28500 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 8873 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4877556 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5124374 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 14394487 | OtherExpensePriorYear |
| Other Expenses Current Year | 15166827 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 19300543 | TotalExpensesPriorYear |
| Total Expenses Current Year | 20300074 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -527422 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -2336190 | RevenuesLessExpensesCY |
| Total Assets BOY | 24909929 | TotalAssetsBOY |
| Total Assets EOY | 22671251 | TotalAssetsEOY |
| Total Liabilities BOY | 16516808 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 16614320 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8393121 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 6056931 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO LEVERAGE OUR UNIQUE TECHNOLOGY TO IMPROVE OUR PATIENTS' HEALTH AND PROMOTE INNOVATION IN EDUCATION AND RESEARCH. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 18945547 | Expense |
| Grants | 8873 | Grants |
| Revenue | 16221548 | Revenue |
| Description | IU HEALTH PROTON THERAPY CENTER (THE CENTER) USES PROTON BEAM ENERGY TO TREAT CANCER PATIENTS. OUR PATIENTS ARE SELECTED BASED ON TYPE OF CANCER, EFFICIENCY OF TREATMENT AND WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY. UNINSURED CARE WAS APPROXIMATELY $659,465 FOR THE YEAR ENDED JUNE 30, 2013.THE CENTER IS AN ACADEMIC AND RESEARCH-ORIENTED HEALTHCARE FACILITY THAT WORKS IN CLOSE PARTNERSHIP WITH INDIANA UNIVERSITY SCHOOL OF MEDICINE, ONE OF THE LARGEST MEDICAL SCHOOLS IN THE COUNTRY. WE PROVIDE A PATIENT ORIENTED EXPERIENCE THAT IS EFFECTIVE, INFORMATIVE AND COMFORTABLE. WE STRIVE TO MAKE THE OVERALL PATIENT EXPERIENCE POSITIVE AND UPLIFTING RATHER THAN WORRISOME AND OFF-PUTTING. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OUR FRIENDLY, KNOWLEDGEABLE STAFF MEMBERS ARE ENTHUSIASTIC ABOUT PATIENTS' CARE AND RECOVERY AND ARE DEDICATED TO THEIR HEALTH AND WELL-BEING. WE ONLY EMPLOY HIGHLY SKILLED AND PROFICIENT TEAM MEMBERS THAT WORK TOGETHER FOR THE COMMON GOOD OF THE PATIENT.PROTON BEAM THERAPY IS A UNIQUE TREATMENT THAT HAS PROVED TO BE AS EFFECTIVE AS, AND IN SOME CASES MORE EFFECTIVE THAN, OTHER FORMS OF CANCER TREATMENT. IT IS A HIGHLY PRECISE, NON-INVASIVE, NON-SURGICAL PROCEDURE. THIS FORM OF RADIATION THERAPY TARGETS THE TUMOR AND CAUSES MINIMAL DAMAGE TO SURROUNDING TISSUES AS COMPARED TO CONVENTIONAL RADIATION THERAPY. THE RESULTS ARE HIGHLY EFFECTIVE, AND THE SIDE EFFECTS ARE GENERALLY MINIMAL OR NON-EXISTENT. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | THIS COMBINATION OF EFFECTIVENESS AND REDUCED SIDE EFFECTS HAS LED THOUSANDS OF PEOPLE WORLD-WIDE TO CHOOSE PROTON THERAPY INSTEAD OF SURGERY OR OTHER FORMS OF RADIATION THERAPY. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 18945547 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 5 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 71 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN KERSTIENS CPA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8123495074 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2425 N MILO B SAMPSON LN | AddressLine1 |
| City | BLOOMINGTON | City |
| State | IN | State |
| ZIP Code | 47408 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| DR PETER JOHNSTONE | |||||||
| CEO/PRESIDENT & BOARD MEMB | 16.00 | X | X | 0 | 0 | 0 | |
| HOLLY GOE | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| TOM MARTIN | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JOAN HAGEN | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| ERIN LEWIS | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| TONY ARMSTRONG | |||||||
| CORPORATE OFFICER | 1.00 | X | 0 | 0 | 0 | ||
| JOHN KERSTIENS | |||||||
| COO/CFO | 40.00 | X | 177258 | 0 | 22296 | ||
| KARIN CAMPBELL | |||||||
| DIRECTOR, HR/ADMINISTRATIO | 40.00 | X | 89992 | 0 | 23225 | ||
| AMANDA BURNHAM | |||||||
| DIRECTOR, MARKETING AND DEVELOPMENT | 40.00 | X | 76812 | 0 | 14706 | ||
| MARK WOLANSKI | |||||||
| DIRECTOR, MEDICAL PHYSICS | 40.00 | X | 147655 | 0 | 33830 | ||
| CHRIS ALLGOWER | |||||||
| SENIOR MEDICAL PHYSICIST | 40.00 | 142502 | 0 | 38107 | X | ||
| LENILSON COUTINHO | |||||||
| MEDICAL PHYSICIST | 40.00 | 106933 | 0 | 20245 | X | ||
| LEIA FANELLI | |||||||
| MEDICAL PHYSICIST | 40.00 | 107045 | 0 | 19260 | X | ||
| LI ZHAO | |||||||
| MEDICAL PHYSICIST | 40.00 | 101617 | 0 | 33466 | X | ||
| TERESA OLDHAM | |||||||
| RADIATION ONCOLOGIST | 40.00 | 142291 | 0 | 22146 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1092105 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 227281 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| UNIVERSITY RADIATION ONCOLOGY ASSOC | |||||
| 535 BARNHILL DRIVE | INDIANAPOLIS | IN | 46202 | PHYSICIAN AND PHYSICISTS | 2361310 |
| BLOOMINGTON ANESTHESIOLOGISTS | |||||
| PO BOX 2121 DEPT 1438 | MEMPHIS | TN | 38159 | ANESTHESIOLOGISTS | 337799 |
| VARIAN MEDICAL SYSTEMS | |||||
| 8900 KEYSTONE CROSSING STE 100 | INDIANAPOLIS | IN | 46240 | COMPUTERIZED MEDICAL SYSTEM SERVICES | 214456 |
| SIEMENS MEDICAL SOLUTIONS | |||||
| PO BOX 120001 DEPT 0733 | DALLAS | TX | 75312 | MEDICAL EQUIPMENT SOLUTIONS/SERVICE | 200000 |
| ELEKTA | |||||
| 13723 CORPORATE LAKE DR | MARYLAND HEIGHTS | MO | 63043 | COMPUTERIZED MEDICAL SYSTEM SERVICES | 114480 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| All Other Contributions | 1736112 | AllOtherContributions |
| Noncash Contributions | 1695389 | NoncashContributions |
| Total Contributions | 1736112 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUE | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 16221548 | TotalRevenueColumn |
| Related Or Exempt Function Income | 16221548 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 16221548 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3090 | TotalRevenueColumn |
| Exclusion | $3,090 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER INCOME | Description |
| Business Code | 541900 | BusinessCode |
| Total Revenue Column | 3134 | TotalRevenueColumn |
| Exclusion | $3,134 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3134 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17963884 | TotalRevenueColumn |
| Related Or Exempt Function Income | 16221548 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $6,224 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8873 | Total |
| Program Services | 8873 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 293781 | Total |
| Program Services | 249714 | ProgramServices |
| Management And General | 44067 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3585081 | Total |
| Program Services | 3585081 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 369113 | Total |
| Program Services | 313746 | ProgramServices |
| Management And General | 55367 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 602621 | Total |
| Program Services | 512228 | ProgramServices |
| Management And General | 90393 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 273778 | Total |
| Program Services | 232711 | ProgramServices |
| Management And General | 41067 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40442 | Total |
| Management And General | 40442 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47356 | Total |
| Management And General | 47356 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4087126 | Total |
| Program Services | 4087126 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37755 | Total |
| Management And General | 37755 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 399904 | Total |
| Program Services | 335919 | ProgramServices |
| Management And General | 63985 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1737745 | Total |
| Program Services | 1390196 | ProgramServices |
| Management And General | 347549 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50941 | Total |
| Program Services | 50941 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11493 | Total |
| Program Services | 11493 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 237445 | Total |
| Management And General | 237445 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2327343 | Total |
| Program Services | 1978242 | ProgramServices |
| Management And General | 349101 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49188 | Total |
| Program Services | 49188 | ProgramServices |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| PROTON BEAM EXPENSE | 6030362 | 6030362 |
| DUES & SUBSCRIPTIONS | 68690 | 68690 |
| RECRUITING | 6312 | 6312 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34725 | Total |
| Program Services | 34725 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20300074 | Total |
| Program Services | 18945547 | ProgramServices |
| Management And General | 1354527 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75 | BOY |
| EOY | 75 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1850642 | BOY |
| EOY | 1899757 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1613545 | BOY |
| EOY | 1549113 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40140 | BOY |
| EOY | 136714 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 21859224 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 9149247 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14375060 | BOY |
| EOY | 12709977 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6950000 | BOY |
| EOY | 6350000 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 80467 | BOY |
| EOY | 25615 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24909929 | BOY |
| EOY | 22671251 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 924353 | BOY |
| EOY | 578204 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 598253 | BOY |
| EOY | 681444 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14994202 | BOY |
| EOY | 15354672 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16516808 | BOY |
| EOY | 16614320 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8312654 | BOY |
| EOY | 6031316 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 80467 | BOY |
| EOY | 25615 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8393121 | BOY |
| EOY | 6056931 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24909929 | BOY |
| EOY | 22671251 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -2336190 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| General Explanation | SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: THE IRS HAS DETERMINED THAT IU HEALTH PROTON THERAPY CENTER IS A PUBLIC CHARITY UNDER INTERNAL REVENUE CODE SECTION 107(B)(1)(A)(III). PER SCHEDULE H INSTRUCTIONS, ONLY ORGANIZATIONS THAT OPERATE AT LEAST ONE FACILITY THAT IS, OR IS REQUIRED TO BE LICENSED, REGISTERED, OR SIMILARLY RECOGNIZED BY A STATE AS A HOSPITAL ARE REQUIRED TO COMPLETE THIS SCHEDULE. IU HEALTH PROTON THERAPY CENTER IS A CANCER TREATMENT CENTER AND IS NOT LICENSED AS A HOSPITAL BY THE STATE OF INDIANA. | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 80467 | BeginningOfYearBalance |
| Other Expenditures | 54852 | OtherExpenditures |
| End Of Year Balance | 25615 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | 85000 | Contributions |
| Other Expenditures | 4533 | OtherExpenditures |
| End Of Year Balance | 80467 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment EOY Balance | 1.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 14772495 | OtherCostOrOtherBasis |
| Depreciation | 5048947 | Depreciation |
| Book Value | 9723548 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5766687 | OtherCostOrOtherBasis |
| Depreciation | 2947574 | Depreciation |
| Book Value | 2819113 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1320042 | OtherCostOrOtherBasis |
| Depreciation | 1152726 | Depreciation |
| Book Value | 167316 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 12709977 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | RELATED PARTY PAYABLES | Description |
| Amount | $15,354,672 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 15354672 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 17963884 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 17963884 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 17963884 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 20300074 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 20300074 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 20300074 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE ORGANIZATION HAS TEMPORARILY RESTRICTED NET ASSETS AVAILABLE FOR THE PURPOSE OF PURCHASING EQUIPMENT. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | IUHPTC IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, AS SUCH, IS NOT REQUIRED TO PAY FEDERAL OR STATE INCOME TAXES ON EXCESS REVENUES RELATED TO THEIR TAX-EXEMPT ACTIVITIES. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY IUHPTC AND RECOGNIZE A TAX LIABILITY IF IUHPTC HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY IUHPTC, AND HAS CONCLUDED THAT AS OF JUNE 30, 2013 AND 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. IUHPTC IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. IUHPTC IS GENERALLY EXEMPT FROM INCOME TAXES. HOWEVER, IUHPTC IS REQUIRED TO FILE FEDERAL FORM 990 - RETURN OF ORGANIZATION FROM INCOME TAX, WHICH IS AN INFORMATIONAL RETURN ONLY. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JILL'S HOUSE | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 751 E TAMARACK TRAIL | AddressLine1 |
| City | BLOOMINGTON | City |
| State | IN | State |
| ZIP Code | 47408 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 352139920 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 8873 | AmountOfCashGrant |
| Purpose Of Grant | PATIENT SUPPORT | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: SUPPORT PROVIDED TO 501(C)(3) PUBLIC CHARITY FOR PATIENT SUPPORT. THE ORGANIZATION DOES NOT MONITOR THE USE OF THESE FUNDS BY THE PUBLIC CHARITY LISTED. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN KERSTIENS | ||||||||||||||
| COO/CFO | 177258 | 0 | 0 | 0 | 0 | 0 | 15752 | 0 | 6544 | 0 | 199554 | 0 | 0 | 0 |
| MARK WOLANSKI | ||||||||||||||
| DIRECTOR, MEDICAL PHYSICS | 147655 | 0 | 0 | 0 | 0 | 0 | 16295 | 0 | 17535 | 0 | 181485 | 0 | 0 | 0 |
| CHRIS ALLGOWER | ||||||||||||||
| SENIOR MEDICAL PHYSICIST | 142502 | 0 | 0 | 0 | 0 | 0 | 16335 | 0 | 21772 | 0 | 180609 | 0 | 0 | 0 |
| TERESA OLDHAM | ||||||||||||||
| RADIATION ONCOLOGIST | 142291 | 0 | 0 | 0 | 0 | 0 | 20963 | 0 | 1183 | 0 | 164437 | 0 | 0 | 0 |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | IN-KIND CONTRIBUTION:CONSTRUCTION LOAN FORGIVENESS | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 1680671 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | METHOD FOR DETERMINING NUMBER OF CONTRIBUTIONS: | Identifier |
| Return Reference | PART I, COLUMN (B): | ReturnReference |
| Explanation | INKIND CONTRIBUTION: FORGIVENESS OF CONSTRUCTION LOAN PAYMENTS FOR FISCAL YEAR 2013 ON ACCOUNTS PAYABLE TO INDIANA UNIVERSITY. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION IS ORGANIZED AS A DOMESTIC LIMITED LIABILITY COMPANY WITH TWO CORPORATE MEMBERS AND A BOARD OF MANAGERS. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION'S CORPORATE MEMBERS, INDIANA UNIVERSITY RESEARCH AND TECHNOLOGY CORPORATION AND INDIANA UNIVERSITY HEALTH, INC., EACH APPOINT TWO INDIVIDUAL BOARD MANAGERS TO SERVE ON THE GOVERNING BOARD OF MANAGERS. TOGETHER THE FOUR APPOINTED INDIVIDUALS ELECT ONE ADDITIONAL UNRELATED INDIVIDUAL TO SERVE ON THE GOVERNING BOARD OF MANAGERS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE PROCESS FOR REVIEWING THE FORM 990 INCLUDES A DETAILED REVIEW OF THE FORM 990 BY THE ORGANIZATION'S COO/CFO AND EACH CORPORATE MEMBERS' TAX DEPARTMENTS. THE ORGANIZATION'S GOVERNING BODY REVIEWS AND APPROVES THE FORM 990. PRIOR TO FILING EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY IS PROVIDED AN ELECTRONIC COPY OF THE FINAL FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY, THE PURPOSE OF WHICH IS, TO PREVENT ANY POTENTIAL FOR PERSONAL PROFIT OR GAIN, EITHER DIRECTLY OR INDIRECTLY, BY REASON OF AN INDIVIDUAL?S ASSOCIATION WITH OR EMPLOYMENT BY THE ORGANIZATION. THE SCOPE OF THE POLICY INCLUDES ALL MEMBERS OF THE ORGANIZATION?S BOARD OF MANAGERS, OFFICERS, EMPLOYEES, AND INDEPENDENT CONTRACTORS. THE POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND ENFORCED FOR COMPLIANCE BY THE OFFICE OF THE DIRECTOR OF HUMAN RESOURCES/ADMINISTRATION. A COVERED INDIVIDUAL IS REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST TO THE ORGANIZATION'S LEADERSHIP AND REFRAIN FROM OBTAINING ANY LIST OF THE ORGANIZATION'S PATIENTS, REFERRING PHYSICIANS, AND VENDORS FOR ANY PERSONAL OR PRIVATE USE. ANY POTENTIAL CONFLICT OF INTEREST IS REVIEWED BY THE ORGANIZATION'S COMPLIANCE PERSONNEL AND BOARD OF MANAGERS. IF THE DISCLOSURE IS MADE BY A COVERED INDIVIDUAL SERVING ON THE BOARD OF MANAGERS, SUCH INDIVIDUAL IS REQUIRED TO RECUSE THEMSELVES FROM PARTICIPATION IN THE GOVERNING BODY'S REVIEW REGARDING SUCH DISCLOSURE. | |
| FORM 990, PART VI, SECTION B, LINE 15B | THE CEO (TOP MANAGEMENT OFFICIAL) OF THE ORGANIZATION HAS BEEN SELECTED BY THE ORGANIZATION'S CORPORATE MEMBERS TO SERVE AS BOARD MEMBER AND TOP MANAGEMENT OFFICIAL FOR THE ORGANIZATION. THE CEO DOES NOT RECEIVE COMPENSATION FROM THE ORGANIZATION AND THEREFORE, NO COMPENSATION DETERMINATION PROCESS IS USED FOR THE CEO BY THE ORGANIZATION. THE PROCESS ESTABLISHED FOR DETERMINING THE COMPENSATION OF THE COO AND ALL OTHER ORGANIZATION'S OFFICERS AND KEY EMPLOYEES INCLUDES OBTAINING COMPARABLE COMPENSATION DATA FROM ITS CORPORATE MEMBERS AND LOCAL PROVIDERS AND USING WRITTEN EMPLOYMENT CONTRACTS DOCUMENTING APPLICABLE COMPENSATION ARRANGEMENTS. ALL COMPENSATION ARRANGEMENTS ARE SUBJECT TO THE REVIEW AND APPROVAL OF THE ORGANIZATION'S GOVERNING BODY WITH ANY DELIBERATION BEING CONTEMPORANEOUSLY DOCUMENTED IN THE MINUTES OF THE BOARD OF MANAGERS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC. SUCH REQUESTS CAN BE MADE EITHER BY PHONE OR MAIL. | |
| FORM 990, PART IX, LINE 11G | PURCHASED PROFESSIONAL SERVICES : PROGRAM SERVICE EXPENSES 248,152. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 248,152. PROFESSIONAL MEDICAL FEES : PROGRAM SERVICE EXPENSES 3,838,974. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,838,974. | OTHER FEES |
| FORM 990, PART XII, LINE 2C | THE BOARD OF MANAGERS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. | OVERSIGHT OF THE AUDIT |