ST MARY MEDICAL CENTER INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ST MARY MEDICAL CENTER INC (EIN 35-2007327)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-14
- IRS object ID
- 201331349349307138
- Schema version
- 2011v1.5
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-14T18:06:16-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE SUITE 2600 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352007327 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % MARY ANN SHACKLETT | InCareOfName |
| Name Control | STMA | NameControl |
| Phone | 2199420551 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 S LAKE PARK AVENUE | AddressLine1 |
| City | HOBART | City |
| State | IN | State |
| ZIP Code | 46342 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARY ANN SHACKLETT | Name |
| Title | SR. VP & CFO | Title |
| Date Signed | 2013-05-14 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3176817000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MARY ANN SHACKLETT | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10010 DONALD POWERS DRIVE | AddressLine1 |
| City | MUNSTER | City |
| State | IN | State |
| ZIP Code | 46321 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 215181305 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.COMHS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1973 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | Community Healthcare System is committed to providing 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 Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1548 | TotalNbrEmployees |
| Total Nbr Volunteers | 234 | TotalNbrVolunteers |
| Total Gross UBI | 648643 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 44545 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 92000 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 748601 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 195333629 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 212440787 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 28193 | InvestmentIncomePriorYear |
| Investment Income Current Year | -72661 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2745412 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1353219 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 198199234 | TotalRevenuePriorYear |
| Total Revenue Current Year | 214469946 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1000000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 86011968 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 83157619 | 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 | 103037761 | OtherExpensePriorYear |
| Other Expenses Current Year | 114931503 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 189049729 | TotalExpensesPriorYear |
| Total Expenses Current Year | 199089122 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 9149505 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 15380824 | RevenuesLessExpensesCY |
| Total Assets BOY | 135984840 | TotalAssetsBOY |
| Total Assets EOY | 144249852 | TotalAssetsEOY |
| Total Liabilities BOY | 26567903 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 32291860 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 109416937 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 111957992 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | ST. MARY MEDICAL CENTER IS COMMITTED TO PROVIDING THE HIGHEST QUALITY CARE IN THE MOST COST-EFFICIENT MANNER, RESPECTING THE DIGNITY OF THE INDIVIDUAL, PROVIDING FOR THE WELL-BEING OF THE COMMUNITY AND SERVING THE NEEDS OF ALL PEOPLE, INCLUDING THE POOR AND DISADVANTAGED. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 31960553 | Expense |
| Revenue | 48872501 | Revenue |
| Description | Nursing: 63,131 Patient Days | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 30369402 | Expense |
| Revenue | 80202062 | Revenue |
| Description | IP/OP Surgeries: 46,682 Cases | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 19028009 | Expense |
| Revenue | 67246054 | Revenue |
| Description | Outpatient Services: 147,883 Patient Days | Description |
Activity Other ActivityOther (28 entries)
| ExpenseExpense | RevenueRevenue | DescriptionDescription |
|---|---|---|
| 15897622 | 58517473 | Pharmacy-4,448,518 Doses Administered |
| 14039504 | 18987769 | Physician-63,860 Visits |
| 12629356 | 47560065 | Cardio-28,075 Visits |
| 9695760 | 73281771 | Lab-762,717 Specimens Collected |
| 6130569 | 40356421 | ER-36,520 Visits & Admissions |
| 4932017 | 9302 | Dietary-254,273 IP Meals |
| 4872845 | 65403194 | Radiology-103,707 Procedures |
| 4448001 | Patient Services-59,039 Visits | |
| 4299535 | 14964432 | PT OT Speech-140,673 Procedures |
| 3958348 | 5625396 | ICU-3,740 Patient Days |
| 3578189 | 6548144 | IMCU-6,450 Patient Days |
| 3560550 | HIM-Medical Records Coded | |
| 3046055 | 16701138 | Respiratory Therapy-96,781 Procedures |
| 2774198 | 3248093 | Home Health-26,700 Visits |
| 2393087 | Admitting-12,037 IP Admission | |
| 1569937 | Medical Staff | |
| 1071569 | 6287286 | Nuclear Med-2,602 Procedures |
| 980791 | Public Relations | |
| 825785 | Security | |
| 793189 | Central Sterilization-Provide Sterile Instruments | |
| 782273 | -47 | Central Supply |
| 416813 | Social Services | |
| 253839 | 2398427 | EEG-5,170 Procedures |
| 62339 | POB | |
| 319 | Misc | |
| -316619256 | Contractuals | |
| -15135724 | Charity | |
| -11432057 | Bad Debt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 103012490 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 16701827 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 184370454 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 166 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1548 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | true | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MARY ANN SHACKLETT | NamePerson |
| Telephone Number | 2199348250 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10010 DONALD POWERS DRIVE | AddressLine1 |
| City | MUNSTER | City |
| State | IN | State |
| ZIP Code | 46321 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| SCOTT ANDREWS MD | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| PEGGY BUFFINGTON PHD | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| LINDA BUZINEC MAYOR | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| LISA FIELD | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| MILTON GASPARIS MD | ||||||||
| DIRECTOR | 1.0 | X | 770 | 0 | 0 | |||
| BILL JOINER | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| DONNA LAJIC | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| PETER MAVRELIS MD | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| JAMES MOODY JUDGE | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| MARK SIMAGA MD | ||||||||
| DIRECTOR | 1.0 | X | 0 | 249086 | 22884 | |||
| WILLIAM SCHENCK | ||||||||
| PRESIDENT | 1.0 | X | 0 | 40042 | 0 | X | ||
| SR MICHELE DVORAK PHJC | ||||||||
| VICE PRESIDENT | 1.0 | X | 0 | 0 | 0 | X | ||
| KEN KRUPINSKI CPA | ||||||||
| SECRETARY & TREASURER | 1.0 | X | 0 | 0 | 0 | X | ||
| JANICE RYBA | ||||||||
| ADMINISTRATOR | 41.0 | X | 0 | 459539 | 48414 | X | ||
| MARY ANN SHACKLETT | ||||||||
| SR VP & SYSTEM CFO | 1.0 | 0 | 546591 | 56960 | X | |||
| MARY SUDICKY | ||||||||
| VICE PRESIDENT OF FINANCE/CFO | 41.0 | 239164 | 0 | 71237 | X | |||
| TAMMIE JONES | ||||||||
| VP PATIENT CARE SERVICES/CNO | 40.0 | 247203 | 0 | 24376 | X | |||
| WALLACE SHERRITT DO | ||||||||
| PHYSICIAN | 40.0 | 464786 | 0 | 22703 | X | |||
| IBRAHIM ZABANEH MD | ||||||||
| PHYSICIAN | 40.0 | 285941 | 0 | 28857 | X | |||
| PAUL STANISH FACS | ||||||||
| PHYSICIAN | 40.0 | 284384 | 0 | 20825 | X | |||
| ROBERT CHEN MD | ||||||||
| PHYSICIAN | 40.0 | 243089 | 0 | 25101 | X | |||
| THOMAS DEVINE MD | ||||||||
| PHYSICIAN | 40.0 | 240637 | 0 | 27302 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2005974 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1295258 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 348659 | TotalOtherCompensation |
| Number Individuals GT100 K | 81 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Rehab Care Group Incorporated | |||||
| 7733 Forsyth Blvd Ste 1700 | ST LOUIS | MO | 63105 | Therapy Services | 3608219 |
| Lakeshore Anesthesia PC | |||||
| 1755 Fulton St | ELKHART | IN | 46614 | Anesthesia Services | 1959804 |
| Lake Porter Ambulartory LLC | |||||
| 7921 Grand Blvd | HOBART | IN | 46342 | Management Services | 832842 |
| AXS IMAGING | |||||
| PO Box 637528 | CINCINNATI | OH | 45263 | RADIOLOGY SERVICES | 811195 |
| Mayo Collaborative Services | |||||
| 200 SW First St | ROCHESTER | MN | 55905 | Laboratory Services | 464376 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 30 | NumberOfContractorsGT100K |
| Government Grants | 640000 | GovernmentGrants |
| All Other Contributions | 108601 | AllOtherContributions |
| Total Contributions | 748601 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 212440787 | TotalRevenueColumn |
| Related Or Exempt Function Income | 211792144 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 648643 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 212440787 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 179508 | TotalRevenueColumn |
| Exclusion | $179,508 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 634243 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 413657 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 220586 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 220586 | TotalRevenueColumn |
| Related Or Exempt Function Income | 220586 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 45533 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 297702 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -252169 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -252169 | TotalRevenueColumn |
| Exclusion | -$252,169 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| CAFETERIA | 721000 | 750689 | $750,689 | |
| EDUCATION AND TRAINING | 611430 | 201613 | 201613 | |
| MANAGED CARE AND OTHER REVENUE | 900099 | 159458 | 159458 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 20873 | TotalRevenueColumn |
| Exclusion | $20,873 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1132633 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 214469946 | TotalRevenueColumn |
| Related Or Exempt Function Income | 212373801 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 648643 | UnrelatedBusinessRevenue |
| Exclusion | $698,901 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1000000 | Total |
| Program Services | 1000000 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 579492 | Total |
| Program Services | 770 | ProgramServices |
| Management And General | 578722 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 76238 | Total |
| Management And General | 76238 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 65896700 | Total |
| Program Services | 62003144 | ProgramServices |
| Management And General | 3893556 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3108543 | Total |
| Program Services | 2899649 | ProgramServices |
| Management And General | 208894 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8980861 | Total |
| Program Services | 8453067 | ProgramServices |
| Management And General | 527794 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4515785 | Total |
| Program Services | 4212325 | ProgramServices |
| Management And General | 303460 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1098943 | Total |
| Management And General | 1098943 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 250045 | Total |
| Program Services | -2482 | ProgramServices |
| Management And General | 252527 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2617 | Total |
| Management And General | 2617 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14082521 | Total |
| Program Services | 13239847 | ProgramServices |
| Management And General | 842674 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 760799 | Total |
| Program Services | 749655 | ProgramServices |
| Management And General | 11144 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2481576 | Total |
| Program Services | 1890667 | ProgramServices |
| Management And General | 590909 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49353 | Total |
| Program Services | -13506 | ProgramServices |
| Management And General | 62859 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3860287 | Total |
| Program Services | 1992015 | ProgramServices |
| Management And General | 1868272 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 151084 | Total |
| Program Services | 127273 | ProgramServices |
| Management And General | 23811 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51382 | Total |
| Program Services | 43466 | ProgramServices |
| Management And General | 7916 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2653541 | Total |
| Program Services | 2653541 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43565 | Total |
| Program Services | 43565 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8940061 | Total |
| Program Services | 8339289 | ProgramServices |
| Management And General | 600772 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1623201 | Total |
| Program Services | 1514122 | ProgramServices |
| Management And General | 109079 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 38986768 | 38813178 | 173590 |
| CORPORATE ALLOCATION | 20340387 | 18973513 | 1366874 |
| MEDICAID ASSESSMENT FEE | 11914204 | 11914204 | |
| LEASE AND RENTAL | 1965104 | 1938487 | 26617 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5676065 | Total |
| Program Services | 3584665 | ProgramServices |
| Management And General | 2091400 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 199089122 | Total |
| Program Services | 184370454 | ProgramServices |
| Management And General | 14718668 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8391482 | BOY |
| EOY | 3151099 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28275318 | BOY |
| EOY | 29550155 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4768093 | BOY |
| EOY | 5215530 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4487697 | BOY |
| EOY | 3535969 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 162699766 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 66142697 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 89996635 | BOY |
| EOY | 96557069 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65615 | BOY |
| EOY | 6240030 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135984840 | BOY |
| EOY | 144249852 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25564853 | BOY |
| EOY | 17536740 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 258727 | BOY |
| EOY | 228813 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 744324 | BOY |
| EOY | 14526307 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26567903 | BOY |
| EOY | 32291860 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 109236409 | BOY |
| EOY | 111780899 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 180528 | BOY |
| EOY | 177093 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 109416937 | BOY |
| EOY | 111957992 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135984840 | BOY |
| EOY | 144249852 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 15380824 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -12839769 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $2,617 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 2617 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | IHA Dues | Identifier |
| Explanation | PT II-B Line 1I THE INDIANA HOSPITAL ASSOCIATION ESTIMATED THAT 5.44% OF ITS DUES ARE ATTRIBUTABLE TO LOBBYING. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8100855 | OtherCostOrOtherBasis |
| Book Value | 8100855 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 90888266 | OtherCostOrOtherBasis |
| Depreciation | 27439974 | Depreciation |
| Book Value | 63448292 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 756442 | OtherCostOrOtherBasis |
| Depreciation | 131125 | Depreciation |
| Book Value | 625317 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 50820837 | OtherCostOrOtherBasis |
| Depreciation | 35179670 | Depreciation |
| Book Value | 15641167 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12133366 | OtherCostOrOtherBasis |
| Depreciation | 3391928 | Depreciation |
| Book Value | 8741438 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 96557069 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| 3RD PARTY SETTLEMENTS | $6,874,270 |
| DEVELOPER REIMBURSEMENT | $3,647,146 |
| LEGAL CLAIM LIABILITIES | $1,842,627 |
| CAPITAL LEASES-CURRENT | $1,068,135 |
| CAPITAL LEASES-LT | $1,055,964 |
| LT DEFERRED GAIN | $38,165 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 14526307 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Explanation | The adoption of ASC 740 did not materially impact the financial statements. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4659 | PersonsServed |
| Total Community Benefit Expense | 4540884 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 141584 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4399300 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02200 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 17910 | PersonsServed |
| Total Community Benefit Expense | 29689721 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 20851541 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8838180 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04430 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 22569 | PersonsServed |
| Total Community Benefit Expense | 34230605 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 20993125 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13237480 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06630 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 446 | NumberOfActivitiesOrPrograms |
| Persons Served | 11380 | PersonsServed |
| Total Community Benefit Expense | 674890 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 674890 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00340 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 23 | NumberOfActivitiesOrPrograms |
| Persons Served | 558 | PersonsServed |
| Total Community Benefit Expense | 781413 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 781413 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00390 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 258 | PersonsServed |
| Total Community Benefit Expense | 545278 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 461536 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 83742 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 97 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 1119838 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1119838 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00560 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 566 | NumberOfActivitiesOrPrograms |
| Persons Served | 12196 | PersonsServed |
| Total Community Benefit Expense | 3121419 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 461536 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2659883 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01330 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 566 | NumberOfActivitiesOrPrograms |
| Persons Served | 34765 | PersonsServed |
| Total Community Benefit Expense | 37352024 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21454661 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15897363 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07960 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $3,404,032 | BadDebtExpenseAmount |
| Amount Attributable To | 34040 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 86509792 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 100583142 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -14073350 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKE PARK SURGICARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | OUTPATIENT SURGICAL PROCEDURE | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 1.00000 | OrganizationProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 SOUTH LAKE PARK AVENUE | AddressLine1 |
| City | HOBART | City |
| State | IN | State |
| ZIP Code | 46342 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | HOSPITAL | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 400. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 24 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (24 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Outpatient Surgery at Lake Park | ||||
| 7921 Grand Boulevard | Hobart | IN | 46342 | Outpatient Surgery |
| Center for Imaging and Radiation Oncolog | ||||
| 300 W 61st Avenue | Hobart | IN | 46342 | Radiology |
| OUTPATIENT REHABILITATION | ||||
| 320 W 61ST AVENUE | HOBART | IN | 46342 | REHABILITATION |
| WOMEN'S DIAGNOSTIC CENTER | ||||
| 320 W 61st Avenue | Hobart | IN | 46342 | DIAGNOSTIC CENTER |
| PORTAGE HEALTH CENTER II | ||||
| 3545 ARBORS STREET | PORTAGE | IN | 46368 | OUTPATIENT CENTER |
| WILLOWCREEK HEALTH CENTER | ||||
| 3170 WILLOWCREEK ROAD | PORTAGE | IN | 46368 | Outpatient Center |
| WINFIELD FAMILY HEALTH CENTER | ||||
| 10607 RANDOLPH STREET | CROWN POINT | IN | 46307 | Outpatient Center |
| Health & Rehabilitation Spectrum | ||||
| 1354 S Lake Park Avenue | Hobart | IN | 46342 | Outpatient Center |
| Home Health of St Mary Medical Center | ||||
| 1439 S Lake Park Avenue | Hobart | IN | 46342 | Home Health |
| INNOVATIVE WOMEN'S HEALTH | ||||
| 1400 SOUTH LAKE PARK AVE SUITE 20 | HOBART | IN | 46342 | PHYSICIAN PRACTICE |
| INNOVATIVE WOMEN'S HEALTH | ||||
| 3545 ARBORS STREET | PORTAGE | IN | 46368 | PHYSICIAN PRACTICE |
| INNOVATIVE WOMEN'S HEALTH | ||||
| 401 WALL STREET SUITE B | VALPARAISO | IN | 46383 | PHYSICIAN PRACTICE |
| INNOVATIVE WOMEN'S HEALTH | ||||
| 1551 SOUTH STURDY ROAD | VALPARAISO | IN | 46383 | PHYSICIAN PRACTICE |
| INNOVATIVE WOMEN'S HEALTH | ||||
| 10607 RANDOLPH ST SUITE C | CROWN POINT | IN | 46307 | PHYSICIAN PRACTICE |
| LAKE GEORGE MEDICAL CENTER | ||||
| 164 BRACKEN PARKWAY | HOBART | IN | 46342 | PHYSICIAN PRACTICE |
| PORTER COUNTY PRIMARY CARE | ||||
| 2000 ROOSEVELT ROAD SUITE 5 | VALPARAISO | IN | 46383 | PHYSICIAN PRACTICE |
| ST MARY CARE NETWORK | ||||
| 200 EAST 80TH PLACE SUITE 100E | MERRILLVILLE | IN | 46410 | PHYSICIAN PRACTICE |
| ST MARY CARE NETWORK | ||||
| 3170 WILLOWCREEK ROAD | PORTAGE | IN | 46368 | PHYSICIAN PRACTICE |
| ST MARY SURGICAL ASSOC | ||||
| 1400 SOUTH LAKE PARK AVE SUITE 20 | HOBART | IN | 46342 | PHYSICIAN PRACTICE |
| ST MARY CARE NETWORK | ||||
| 10607 RANDOLPH ST SUITE A | CROWN POINT | IN | 46307 | PHYSICIAN PRACTICE |
| ST MARY SURGICAL ASSOC | ||||
| 801 MACARTHUR BLVD SUITE 402 | MUNSTER | IN | 46321 | PHYSICIAN PRACTICE |
| ST MARY CARE NETWORK | ||||
| 1400 SOUTH LAKE PARK AVE SUITE 50 | HOBART | IN | 46342 | PHYSICIAN PRACTICE |
| ST MARY CARE NETWORK | ||||
| 1441 SOUTH LAKE PARK AVE | HOBART | IN | 46342 | PHYSICIAN PRACTICE |
| ST MARY CARE NETWORK | ||||
| 1400 SOUTH LAKE PARK AVE SUITE 10 | HOBART | IN | 46342 | PHYSICIAN PRACTICE |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUPPLEMENTAL INFORMATION - PART I | PART I, LINE 3C | N/A PART I, LINE 6A STATE FILING OF COMMUNITY BENEFIT REPORT (INDIANA). |
| SUPPLEMENTAL INFORMATION - PART I | PART I, LINE 7G | THE METHODOLOGY USED WAS THE COST TO CHARGE RATIO. IT IS FOR INPATIENT ONLY AND EXCLUDES MEDICAID, CHARITY AND BAD DEBT. |
| SUPPLEMENTAL INFORMATION - PART I | PART I, LINE 7, COLUMN F | BAD DEBT OF $11,432,057 IS EXCLUDED FROM THE CALCULATION. PART I, LINE 7 THE METHODOLOGY USED WAS THE COST TO CHARGE RATIO. IT IS FOR THE INPATIENTS ONLY AND EXCLUDES MEDICAID AND CHARITY. |
| SUPPLEMENTAL INFORMATION - PART III | PART III, LINE 4 | ST. MARY MEDICAL CENTER 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. ACOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE. ST. MARY'S 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. |
| SUPPLEMENTAL INFORMATION - PART III | PART III - LINE 8 | THE 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 $14,073,350 OF MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. |
| SUPPLEMENTAL INFORMATION - PART III | PART III, LINE 9B | COLLECTION 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. |
| PART V, LINE 1J | N/A PART V, LINE 3 N/A PART V, LINE 4 N/A PART V, LINE 5C N/A PART V, LINE 6I N/A PART V, LINE 7 N/A PART V, LINE 11H N/A PART V, LINE 13G N/A PART V, LINE 15E N/A PART V, LINE 16E N/A PART V, LINE 17E N/A PART V, LINE 18D N/A PART V, LINE 19D N/A PART V, LINE 20 N/A PART V, LINE 21 N/A NEEDS ASSESSMENT ST. MARY MEDICAL CENTER USED A THIRD-PARTY CONSULTING FIRM TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY. ST. MARY MEDICAL CENTER SERVES AN OLDER POPULATION WITH AN EXPECTED LOSS OF POPULATION IN THE NEXT FIVE YEARS. ST. MARY'S CONTINUES TO SEE GROWTH IN AREAS SUCH AS ORTHOPEDICS AND GENERAL AND BARIATRIC SURGERY. | |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI, LINE 3 | PATIENTS 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. |
| PROMOTION OF COMMUNITY HEALTH | PART VI, LINE 5 | Alzheimer's Support Group - Alzheimer's Support Group meets the third Tuesday of each month at St. Mary Medical Center. This group is for patients, family and friends dealing with Alzheimer's. Participants in support groups receive emotional support, practical assistance in coping with the issues they face and the latest information about research. Alzheimer's Symposium - Support and resources are provided to help caregivers and those in very early stages of Alzheimer's learn about and navigate the medical and legal issues of this diagnosis. A physician and attorney give a speech and participants may also browse a consortium of vendors providing information about everything from assisted living to home monitoring. Bariatric Seminar - Using a team approach to achieving weight loss, Dr.'s Paul Stanish and Hung Dang discuss the etiology of obesity, its effect on an individual's physical, emotional and psychological health. The goal is to improve the medical complications of life-threatening obesity. Blood Profile Screening - These screenings offer a way for those concerned about heart health to monitor cholesterol, HDL, triglycerides or glucose. No physician order is necessary for the screening. Blood Pressure Screeing - These are blood pressure screenings free to the public at the Portage YMCA. Participants are given educational material regarding blood pressure and how it relates to their health. BMI/Body Fat Analysis - These are BMI and body fat screenings free to the public at the Portage YMCA. Participants are given educational material regarding BMI and body fat percentage and how it relates to their health. Cancer Survivors Day - The Cancer Resource Centre and St. Mary Medical Center provide a local celebration of this national event, honoring the strength and courage of those who have lived - and continue to live - with cancer. Prizes are raffled and each attendee receives a strength gift and food and entertainment are also provided. Cardiac Rehab: Ask the Pharmacist - Informational session for patients to ask a pharmacist questions regarding their cardiac medications. Handouts are provided to patients comparing certain blood pressure medications. Clinical Education for Ministry - Training college students for pastoral care. Consoling Hearts Grief Support - Support offered to those suffering from the loss of a loved one. Cooking Demonstrations - Chef Ryan C. Smith demonstrates delectable appetizers, salads, entrees, desserts and more in these fun and interactive demonstrations. Coronary Health Appraisal - This appraisal helps to determine risk for heart disease and other related medical conditions. Screening includes: cholesterol (total, HDL, LDL, triglycerides), blood sugar, metabolic syndrome, blood pressure, body mass index and a Heart Health Profile. Coumadin Class - A pharmacist and dietician discuss appropriate diet and medications to avoid while taking Coumadin. Diabetes Class - This is a class that discusses diabetes management, the proper use of medication, glucose monitoring, meal planning and diabetes complications. Guided Meditation - This is a class put on by the hospital's Same Day Surgery department that discusses meditation and the healing touch. Happy Hearts - Happy Hearts is a monthly educational support group designed to meet the learning needs of the Heart Failure (HF) patient/family or friends. Each month a program is developed to help answer questions and to teach the self-care need to the HF patient. The group meets at St. Mary Medical Center for two hours a month. There are on average 12-15 participants at each meeting. Some of the topics include: self management of heart failure, pacemakers, medications, recipe sharing, inspiration and coping skills. Healing Touch - Healing Touch is a complementary caregiving technique that uses a hands-on and energy-based approach to balance and align the human energy field. Body, mind, spirit and emotion are touched through this therapeutic process and each individual is empowered to participate fully in his or her own healing journey. Healing Touch sessions are held at St. Mary Medical Center on Wednesdays and there are also weekend workshops that provide techniques at Level 1 and 2. Hearts of Hope - Crimson lights on the Hearts of Hope trees outside St. Mary Medical Center shine brightly during the holiday season with the help and support of donations to cardiac research. The Hearts of Hope trees are decorated with lights that represent contributions made in honor of or in memory or someone who has been affected by heart disease. Monies raised through donations fund vitally needed research for heart disease. Donors and honorees are invited to a Hearts of Hope tree lighting ceremony that celebrates cardiac research success stories of St. Mary Medical Center. Hope Network Cancer Support Group - The last Wednesday of each month this group meets for informative sessions where they can share thoughts and feelings in a comfortable and confidential atmosphere. IUN - HIT Summer Clinical - 10 days of free clinical nursing education and training for IUN nursing students. Knox Suite - Knox Suite is similar to a hotel room that is located on the fourth floor of the hospital and accommodates families that need a place to stay. Lamaze - Six educational classes are offered each session for those in their last trimester of pregnancy. Classes include informative lectures about comfort measures and medication available for pain. The last session focuses on management of breast-feeding and newborn behavior patterns. Look Good-Feel Better - This class helps improve the physical appearance of cancer patients by helping them with make-up and wigs to aide in their mental and emotional well being in their struggle with cancer. This class is put on by the Women's Diagnostic Center. Maria Reiner Health Fair - Blood Glucose screenings. Medical Student Internships - Medical students interested in learning more about a clinical hospital setting can spend their summer in a volunteer program at St. Mary Medical Center. This innovative program allows pre-med students to shadow the many departments and units of a community-based hospital to assist them in making important decisions regarding their future medical careers. Vijay Dave, M.D. is the director of medical education at St. Mary Medical Center and heads up the summer program which partners with Indiana University School of Medicine - Northwest and the Northwest Indiana Area Health Education Center. Mended Hearts - Mended Hearts is a national organization with a local Northwest Indiana chapter that meets on the third Tuesday of each month. It is made up of men and women who have experienced first-hand or have a close family member who has undergone Open Heart Surgery of Valve Replacement Surgery. Some of the volunteers visit patients in the hospital after they have had surgery. They are available to reinforce what healthcare providers have prescribed and recommended. They also are there to listen and be supportive to the patients and their families. The volunteer shares informational packets and encourages patients during recovery. Moving Forward - Stroke Education - Stroke survivors and caregivers learn to prevent future strokes through risk detection and management. This is a five-part series that meets every other week Monday - Friday from 4-5 p.m. PAD - What's It All About? - The Cardiac Rehabilitation Medical Director discusses peripheral arterial disease (PAD). Attendees learn the signs, symptoms, causes and treatment of this serious disease. Pulmonary Function Screeings - Free PFT screenings for the community and blood pressure and oxygen concentration levels. Participants are given educational materials regarding pulmonary function and how it relates to their health. Scouting for Food - St. Mary Medical Center employees help replenish the shelves of the Hobart Food Pantry. St. Mary Medical Center partners with Boy Scouts of America - Calumet Council to participate in this annual food drive campaign. Food collection and delivery are organized under the auspices of St. Mary Medical Center's Christian Awareness Committee. Skin Cancer Screenings - Physician examines any questionable areas of the body to look for indications of cancer or pre-cancerous conditions. This screening takes place at a participating St. Mary Medical Center physician's office on a monthly basis. Smoking Cessation: "I Quit!"- This is a behavior modification program to help individuals in their attempt to quit smoking. Stroke Class- This is a 5 day class reviewing all aspects of stroke by Nursing, OT, PT, SP and SW. Teen Childbirth Education (Lamaze) - Our certified childbirth educator teaches how to give baby a healthy start. Participants learn about labor and delivery, nutrition, pain relief options, recovery and valuable resources for support. Classes are designed specifically for teenagers, ages 13-19. Based in Hobart and the surrounding communities, these pr |
| AFFILIATED HEALTH CARE SYSTEM | ST. MARY MEDICAL CENTER 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. | |
| PART III, LINE 7 | Cost Report (3,517,991) Physician practices (2,252,609) Medicare Managed Care (960,804) Fee-based Outpatient charges (3,366,231) Disallowed Medicare expenses (3,975,715) Total (Shortfall) (14,073,350) | |
| PART V, LINE 19 | Our maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care is based on a sliding scale. Up to 200% of federal poverty guidelines (FPG) is 100% free care. 201% -250% is charged based on Medicare rates. 251%-300% is charged based on average of lowest managed care rates. 301%-400% is charged based on average managed care rates. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | false | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF HOBART | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 414 MAIN STREET | AddressLine1 |
| City | HOBART | City |
| State | IN | State |
| ZIP Code | 46342 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 356001058 | EINOfRecipient |
| Amount Of Cash Grant | 1000000 | AmountOfCashGrant |
| Method Of Valuation | FMV | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK SIMAGA MD | |||||||||||||
| 0 | 246764 | 0 | 0 | 0 | 2322 | 0 | 7350 | 0 | 15534 | 0 | 271970 | 0 | 0 |
| JANICE RYBA | |||||||||||||
| 0 | 348336 | 0 | 95618 | 0 | 15585 | 0 | 34787 | 0 | 13627 | 0 | 507953 | 0 | 0 |
| MARY ANN SHACKLETT | |||||||||||||
| 0 | 369682 | 0 | 148077 | 0 | 28832 | 0 | 34787 | 0 | 22173 | 0 | 603551 | 0 | 0 |
| MARY SUDICKY | |||||||||||||
| 203428 | 0 | 35316 | 0 | 420 | 0 | 34666 | 0 | 36571 | 0 | 310401 | 0 | 0 | 0 |
| TAMMIE JONES | |||||||||||||
| 181662 | 0 | 64685 | 0 | 856 | 0 | 8735 | 0 | 15641 | 0 | 271579 | 0 | 0 | 0 |
| WALLACE SHERRITT DO | |||||||||||||
| 306768 | 0 | 152224 | 0 | 5794 | 0 | 7350 | 0 | 15353 | 0 | 487489 | 0 | 0 | 0 |
| IBRAHIM ZABANEH MD | |||||||||||||
| 234091 | 0 | 50096 | 0 | 1754 | 0 | 7350 | 0 | 21507 | 0 | 314798 | 0 | 0 | 0 |
| PAUL STANISH FACS | |||||||||||||
| 273911 | 0 | 10000 | 0 | 473 | 0 | 7350 | 0 | 13475 | 0 | 305209 | 0 | 0 | 0 |
| ROBERT CHEN MD | |||||||||||||
| 242663 | 0 | 0 | 0 | 426 | 0 | 7350 | 0 | 17751 | 0 | 268190 | 0 | 0 | 0 |
| THOMAS DEVINE MD | |||||||||||||
| 240211 | 0 | 0 | 0 | 426 | 0 | 7350 | 0 | 19952 | 0 | 267939 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Explanation | PT I LINE 1A THE ORGANIZATION PAYS HEALTH/SOCIAL CLUB DUES ON BEHALF OF CERTAIN OFFICERS, KEY EMPLOYEES, AND FIVE HIGHEST PAID EMPLOYEES WHICH IS THEN TAXED AS A FRINGE BENEFIT TO THE INDIVIDUAL. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Carol Shingler | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Fam Member-Linda Buzinec | Relationship |
| Amount Of Transaction | 76328 | AmountOfTransaction |
| Description Of Transaction | Employment | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FORM 990, PT VI-A LINE 7A | DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS | COMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC IS THE PARENT COMPANY OF ST. MARY MEDICAL CENTER AND HAS CONTROL TO ELECT MEMBERS OF THEIR GOVERNING BODY. |
| FORM 990, PT VI-A LINE 7B | DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS | COMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC IS THE PARENT COMPANY OF ST MARY MEDICAL CENTER AND HAS RIGHTS TO APPROVE DECISIONS MADE BY ST MARY MEDICAL CENTER. |
| FORM 990, PT VI-A LINE 11A | DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 | 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 TO REVIEW PRIOR TO FILING. |
| FORM 990, PT VI-B LINE 12C | DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST | AS PART OF THE ORGANIZATION'S ANNUAL MONITORING AND ENFORCEMENT PROCEDURES RELATING TO ITS CONFLICT OF INTEREST POLICY, ALL CONFLICT OF INTEREST QUESTIONNAIRES ARE REVIEWED AND THOSE OFFICERS, DIRECTORS, OR KEY EMPLOYEES WHO DO NOT RETURN OR FULLY COMPLETE THE QUESTIONNAIRE ARE CONTACTED TO RECONCILE THE OMISSION. |
| FORM 990, PT VI-B LINE 15 | OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN | SMMC FOLLOWS THE PARENT COMPANY (CFNI) POLICY. THE SALARY AND BENEFIT COMMITTEE OF THE BOARD REQUEST A REVIEW OF THE COMPENSATION AND BENEFITS TO ASSESS THE REASONABLENESS COMPARED TO MARKET DATA ASSEMBLED BY AN INDEPENDENT THIRD PARTY COMPENSATION CONSULTING FIRM. THEIR PROCESS FOR COLLECTING AND ASSEMBLING MARKET DATA ARE CONSISTENT WITH THE REBUTTABLE PRESUMPTION CHECKLIST AND 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. |
| FORM 990, PT VI-C LINE 19 | AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC | ST MARY MEDICAL CENTER DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. IN ACCORDANCE WITH BOND COVENANTS, ST MARY MEDICAL CENTER THROUGH COMMUNITY FOUNDATION OF NORTHWEST INDIANA MAKES ITS FINANCIAL STATEMENTS AND DISCLOSURES AVAILABLE TO THE PUBLIC THROUGH EMMA DATABASE. . |
| FORM 990, PT VII SECTION A | HOURS FOR RELATED ORGANIZATIONS | CFNI SCH SMMC CH CVI TATC CVPA CCRF Total Milton Gasparis, MD 1 1 Mark Simaga, MD 20 1 21 William Schenck 1 1 1 1 4 Janice Ryba 41 41 Mary Ann Shacklett 41 1 1 1 1 1 1 1 48 Milton Gasparis, MD - Compensation is for hours worked as a Utilization Management Consultant Mark Simaga, MD - Related organization compensation is for hours worked as the system Chief Medical Information Officer William Schenck - Related organization compensation is for attending CFNI monthly BOD and committee meetings Janice Ryba - Related organization compensation is for hours worked as the Hospital Administrator Mary Ann Shacklett - Related organization compensation is for hours worked as the system CFO . |
| FORM 990, PT XI LINE 5 | RECONCILIATION OF NET ASSETS | TRANSFERS TO CFNI (PARENT) 12,839,609 Rounding 160 TOTAL CHANGE IN NET ASSETS 12,839,769 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY FOUNDATION OF NW INDIANA INC | ||||||||||
| 10010 DONALD POWERS DR | MUNSTER | IN | 46321 | 311128781 | SUPPORT ORG | IN | 501(c)(3) | 11(c) | NA | false |
| MUNSTER MEDICAL RESEARCH FOUNDATIONINC | ||||||||||
| 800 MACARTHUR BLVD | MUNSTER | IN | 46321 | 351107009 | HOSPITAL | IN | 501(c)(3) | 3 | CFNI | true |
| ST CATHERINE HOSPITAL INC | ||||||||||
| 4321 FIR STREET | EAST CHICAGO | IN | 46312 | 351738708 | HOSPITAL | IN | 501(c)(3) | 3 | CFNI | true |
| COMMUNITY CANCER RESEARCH FOUNDATION | ||||||||||
| 901 MACARTHUR BLVD | MUNSTER | IN | 46321 | 352146374 | Cancer Funds | IN | 501(c)(3) | 7 | MMRF | true |
| COMMUNITY VILLAGE INC | ||||||||||
| 10000 COLUMBIA AVE | MUNSTER | IN | 46321 | 351956395 | RETIRMT HOME | IN | 501(c)(3) | 9 | CFNI | true |
| CVPA HOLDING COMPANY | ||||||||||
| 905 RIDGE RD | MUNSTER | IN | 46321 | 351938136 | SUPPORT ORG | IN | 501(c)(2) | N/A | CFNI | true |
| THEATRE AT THE CENTER | ||||||||||
| 1040 RIDGE RD | MUNSTER | IN | 46321 | 351939427 | CONCERTS | IN | 501(c)(3) | 9 | CFNI | true |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VALPARAISO MED DEV | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 ST MARY DR | AddressLine1 |
| City | VALPARAISO | City |
| State | IN | State |
| ZIP Code | 46383 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453194502 | EIN |
| Primary Activity | REAL ESTATE | PrimaryActivity |
| Legal Domicile State | IN | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SMMC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disproportionate Allocations | false | DisproportionateAllocations |
| General Or Managing Partner | true | GeneralOrManagingPartner |
| Percentage Ownership | 0.50000 | PercentageOwnership |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY RESOURCES INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 907 RIDGE RD | AddressLine1 |
| City | MUNSTER | City |
| State | IN | State |
| ZIP Code | 46321 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351727711 | EIN |
| Primary Activity | MGMT SERVICES | PrimaryActivity |
| Legal Domicile State | IN | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C CORP | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | true | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Munster Medical Research Foundation | ||
| n | 813207 | FMV |
| ST CATHERINE HOSPITAL INC | ||
| N | 331189 | FMV |
| ST CATHERINE HOSPITAL INC | ||
| o | 128639 | FMV |
| MUNSTER MEDICAL RESEARCH FOUNDATION | ||
| o | 1682718 | FMV |
| MUNSTER MEDICAL RESEARCH FOUNDATION | ||
| p | 7405722 | FMV |
| ST CATHERINE HOSPITAL INC | ||
| P | 1236870 | FMV |