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COMMUNITY FOUNDATION OF NORTHWEST INDIANA INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY FOUNDATION OF NORTHWEST INDIANA INC (EIN 31-1128781)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-14
IRS object ID
201331349349307203
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-14T17:33:17-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 2600AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN311128781EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY FOUNDATION OF NORTHWEST INDIANABusinessNameLine1
Business Name Line2INCBusinessNameLine2
FieldValueIRS element (for citing)
In Care Of Name% MARY ANN SHACKLETTInCareOfName
Name ControlCOMMNameControl
Phone2199348250Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line110010 DONALD S POWERS DRIVEAddressLine1
CityMUNSTERCity
StateINState
ZIP Code46321ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARY ANN SHACKLETTName
TitleSR. VP & CFOTitle
Date Signed2013-05-14DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line110010 DONALD S POWERS DRIVEAddressLine1
CityMUNSTERCity
StateINState
ZIP Code46321ZIPCode
FieldValueIRS element (for citing)
Gross Receipts340302285GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.COMHS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionPROVIDES SUPPORT FOR ACTIVITIES OF THE AFFILIATED HOSPITALS TO ENGAGE IN THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITIES SERVED WITHIN NORTHWEST INDIANA.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees365TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI10920TotalGrossUBI
Net Unrelated Business Txbl Income-14249NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year60260ContributionsGrantsPriorYear
Contributions Grants Current Year61450ContributionsGrantsCurrentYear
Program Service Revenue Prior Year17655ProgramServiceRevenuePriorYear
Program Service Revenue CY30138ProgramServiceRevenueCY
Investment Income Prior Year10000148InvestmentIncomePriorYear
Investment Income Current Year8126356InvestmentIncomeCurrentYear
Other Revenue Prior Year62059242OtherRevenuePriorYear
Other Revenue Current Year80844454OtherRevenueCurrentYear
Total Revenue Prior Year72137305TotalRevenuePriorYear
Total Revenue Current Year89062398TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year407681GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY310177GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year25143304SalariesEtcPriorYear
Salaries Etc Current Year30055946SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year53859TotalFundrsngExpCurrentYear
Other Expense Prior Year45786946OtherExpensePriorYear
Other Expenses Current Year62249462OtherExpensesCurrentYear
Total Expenses Prior Year71337931TotalExpensesPriorYear
Total Expenses Current Year92615585TotalExpensesCurrentYear
Revenues Less Expenses Prior Year799374RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-3553187RevenuesLessExpensesCY
Total Assets BOY411953432TotalAssetsBOY
Total Assets EOY444488667TotalAssetsEOY
Total Liabilities BOY319649056TotalLiabilitiesBOY
Total Liabilities EOY303265334TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY92304376NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY141223333NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionCOMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC PROVIDES SUPPORT FOR ACTIVITIES OF THE AFFILIATED HOSPITALS TO ENGAGE IN THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITIES SERVED WITHIN NORTHWEST INDIANA. COMMUNITY FOUNDATION NORTHWEST INDIANA, INC HELPS COORDINATE ACTIVITIES FOR THE IMPROVED WELL BEING OF THE HOSPITALS AND THEIR PATIENTS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense72403180Expense
Revenue81412383Revenue
DescriptionTO COORDINATE AND SUPPORT ACTIVITIES OF AFFILIATED HOSPITALS TO ENGAGE IN ACTIVITIES FOR THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITIES SERVED. ALSO PROVIDE SUPPORT FOR COMMUNITY-BASED PROJECTS TO PROMOTE THE CULTURAL, EDUCATIONAL, AND CHARITABLE COMMUNITY OF NORTHWEST INDIANA.Description
Total Program Service Expense72403180TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingtrueGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgtrueTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096115NumberFormsTransmittedWith1096
Number W2 G Included13NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees365NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

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

Address US AddressUS

FieldValueIRS element (for citing)
Address Line110010 DONALD S POWERS DRIVEAddressLine1
CityMUNSTERCity
StateINState
ZIP Code46321ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (38 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
STEVEN BEERING MD
DIRECTOR1.0X2200000
DAVID BOCHNOWSKI
DIRECTOR1.0X2820000
JOSEPH COSTANZA
DIRECTOR1.0X3110000
DANIEL DUMEZICH
DIRECTOR1.0X1400000
RICHARD MCLAUGHRY
DIRECTOR1.0X43542250000
JOSEPH MORROW
DIRECTOR1.0X1630000
SR KATHLEEN QUINN
DIRECTOR1.0X3000000
WILLIAM SCHENCK
DIRECTOR1.0X4004200
JOSEPH SEMANCIK MONSIGNOR
DIRECTOR2.0X3040000
M NABIL SHABEEB MD FACS
DIRECTOR2.0X2800000
DONALD TORRENGA
DIRECTOR2.0X4985400
ROBERT WELSH
DIRECTOR1.0X2430000
EDWARD WILLIAMS PHD
DIRECTOR1.0X3831500
JOE WILLIAMSON
DIRECTOR2.0X3148400
JAY ZANDSTRA
DIRECTOR1.0X2650000
FRANKIE FESKO
CHAIRWOMAN7.0X79967180000X
HON JAMES RICHARDS
VICE CHAIRMAN21.0X47542240000X
DONALD S POWERS
DIRECTOR, PRESIDENT & CEO41.0X1217604048265X
WILLIAM HASSE III
SECRETARY1.0X3110000X
DAVID WICKLAND
TREASURER16.0X47542240000X
JOHN GORSKI
CHIEF OPERATING OFFICER41.0987561054663X
MARY ANN SHACKLETT
SR VP & SYSTEM CFO41.0546591056960X
CAROLE BEZAT
SR VP ADMINISTRATION41.0665976048879X
ANTHONY FERRACANE
VP HUMAN RESOURCES40.0443344050469X
KEVIN MYBECK
VP MANAGED CARE40.0215470034059X
CRAIG BOLDA
CHIEF OPERATING OFFICER SCH40.0216880052762X
ELIZABETH YEE
VP CLINICAL ANCILLARY SERVICES40.0222118050513X
ROSEMARY GARCIA
VP DIAG & THERAPEUTIC SVCS40.0217341019047X
NANCY MOSER
VP CORP COMPLIANCE & QUALITY40.0186866025134X
RAMONA FISSINGER
VP HEALTH DATA SUPPORT40.0138169033615X
MARK SIMAGA MD
CHIEF MEDICAL INFO OFFICER20.0249086022884X
GARY WEINER
VP & CIO40.0263066014380X
DAVID OTTE
VP ENGINEERING & SUPPORT40.0173548044033X
FELIX GOZO JR MD
MED DIR OF CV/CARDIO REHAB/QA40.0260737019284X
JOHN UTESCH
REG DIR OF MATERIAL MANAGEMENT40.0165624037086X
JEANNETTE FOLEY
REGIONAL DIRECTOR OF EDUCATION40.0156687018763X
KAREN SCHNEIDER
REGIONAL DIRECTOR OF PFS40.0153666039221X
KATHLEEN EDWARDS
REGIONAL DIRECTOR OF AP/PR40.0128922026831X
FieldValueIRS element (for citing)
Total Reportable Comp From Org7269444TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs91000TotalReportableCompFrmRltdOrgs
Total Other Compensation696848TotalOtherCompensation
Number Individuals GT100 K47NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
EPIC SYSTEMS CORPORATION
1979 MILKY WAYVERONAWI53593SOFTWARE SUPPORT7171604
LUCCA CONSULTING GROUP INC
601 WOODVIEW DRIVEWHITELANDIN46184CONSULTING6855615
DIVURGENT
4445 CORPORATION LANE STE 228VIRGINIA BEACHVA23462CONSULTING3749979
AFFILIATED COMPUTER SERVICES
PO BOX 201322DALLASTX75320CONSULTING2928547
ZARAYA CONSULTING LLC
550 W WELLINGTON AVE 2ECHICAGOIL60657CONSULTING1625747
FieldValueIRS element (for citing)
Number Of Contractors GT100 K48NumberOfContractorsGT100K
All Other Contributions61450AllOtherContributions
Total Contributions61450TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionCOPYING FEEDescription
Business Code900099BusinessCode
Total Revenue Column30138TotalRevenueColumn
Exclusion$30,138ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue30138TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column8179144TotalRevenueColumn
Exclusion$8,179,144ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real3212812Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real3761523Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-548711Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-548711TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities247141466Securities
Other197468Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities247154872Securities
Other236850Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-13406Securities
Other-39382Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-52788TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Gaming86642GrossIncomeGaming
Gaming Direct Expenses86642GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
IT REVENUE5182101092010920
EXP ALLOC TO SUBS9000998138654981386549
REGENCY REVENUE900099-4304-4304
FieldValueIRS element (for citing)
Total Other Revenue81393165TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column89062398TotalRevenueColumn
Related Or Exempt Function Income81382245RelatedOrExemptFunctionIncome
Unrelated Business Revenue10920UnrelatedBusinessRevenue
Exclusion$8,209,282ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total310177Total
Program Services310177ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total6970247Total
Program Services5091581ProgramServices
Management And General1878666ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total211415Total
Program Services211415ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total18493102Total
Program Services14780607ProgramServices
Management And General3660617ManagementAndGeneral
Fundraising51878Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total387792Total
Program Services310234ProgramServices
Management And General77558ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2539930Total
Program Services2031944ProgramServices
Management And General507986ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1453460Total
Program Services1162768ProgramServices
Management And General290692ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total899448Total
Management And General899448ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total848104Total
Management And General848104ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total90000Total
Management And General90000ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total624524Total
Management And General624524ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total18968439Total
Program Services15174751ProgramServices
Management And General3793688ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total442731Total
Program Services354185ProgramServices
Management And General88546ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1943399Total
Program Services1554708ProgramServices
Management And General388677ManagementAndGeneral
Fundraising14Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total9867545Total
Program Services7894036ProgramServices
Management And General1973509ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total240278Total
Program Services192222ProgramServices
Management And General48056ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total222678Total
Program Services176569ProgramServices
Management And General44142ManagementAndGeneral
Fundraising1967Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total143128Total
Program Services114502ProgramServices
Management And General28626ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total10269146Total
Program Services8215317ProgramServices
Management And General2053829ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total184500Total
Program Services147600ProgramServices
Management And General36900ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total11908531Total
Program Services9526825ProgramServices
Management And General2381706ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total577746Total
Program Services462196ProgramServices
Management And General115550ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
REPAIRS AND MAINTENANCE640945512756128189
EARLY EXT. OF DEBT32884263288426
VENDOR DISCOUNTS-23057-23057
OTHER1112951890361222590

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total92615585Total
Program Services72403180ProgramServices
Management And General20158546ManagementAndGeneral
Fundraising53859Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4886430BOY
EOY5925146EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY102318BOY
EOY49180EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY20085742BOY
EOY19352999EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2687960BOY
EOY3213274EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis150723397LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec79764920LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY82162108BOY
EOY70958477EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY256289941BOY
EOY308683551EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY45738933BOY
EOY36306041EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY411953432BOY
EOY444488667EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY19872060BOY
EOY14483352EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY18997BOY
EOY51167EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY269751046BOY
EOY218398433EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY62860007EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY30006953BOY
EOY7472375EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY319649056BOY
EOY303265334EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY91925819BOY
EOY140819849EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY378557BOY
EOY403484EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY92304376BOY
EOY141223333EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY411953432BOY
EOY444488667EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-3553187ReconcilationRevenueExpenses
Reconcilation Other Changes52472144ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (3 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
MUNSTER MEDICAL RESEARCH FOUNDATION INC
35110700903truetruetrue$2,249,418
ST MARY MEDICAL CENTER
35200732703truetruetrue$5,566,886
ST CATHERINE HOSPITAL INC
35173870803truetruetrue$3,948,962
FieldValueIRS element (for citing)
Total Number Of Supported Orgs3TotalNumberOfSupportedOrgs
Sum Of Amounts11765266SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$90,000OtherActivitiesAmount
Total Lobbying Expenditures IIB90000TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPART II-B LINE 1iIdentifier
ExplanationCOMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC. CONTRACTS WITH LOBBYIST TO INTERVENE ON OUR BEHALF.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2268306OtherCostOrOtherBasis
Book Value2268306BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis53770607OtherCostOrOtherBasis
Depreciation29203772Depreciation
Book Value24566835BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2173027OtherCostOrOtherBasis
Depreciation1077055Depreciation
Book Value1095972BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis88796003OtherCostOrOtherBasis
Depreciation48761135Depreciation
Book Value40034868BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3715454OtherCostOrOtherBasis
Depreciation722958Depreciation
Book Value2992496BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings70958477TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
DEBT SERVICE RESERVE FUND19866670
DEFERRED COSTS4882778
VETERANS MEMORIAL PARK3436120
INVESTMENT IN AFFILIATES5007511
LAND HELD FOR FUTURE USE3112962
FieldValueIRS element (for citing)
Total Book Value Other Assets36306041TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
CONSTRUCTION PAYABLE$6,080
CAPITAL LEASES$7,466,295
FieldValueIRS element (for citing)
Total Of Amounts7472375TotalOfAmounts

Schedule G IRS990ScheduleG

Gaming Information GamingInformation

FieldValueIRS element (for citing)
Gross Revenue Other Gaming86642GrossRevenueOtherGaming
Other Direct Expenses Other Gaming86642OtherDirectExpensesOtherGaming
Volunteer Labor Other GamingtrueVolunteerLaborOtherGaming
Volunteer Labor Prcnt Other Gaming1.00000VolunteerLaborPrcntOtherGaming
Gross Revenue Total Gaming86642GrossRevenueTotalGaming
Other Direct Expenses Total Gaming86642OtherDirectExpensesTotalGaming
Direct Expense Summary Gaming86642DirectExpenseSummaryGaming
FieldValueIRS element (for citing)
States Where Gaming ConductedINStatesWhereGamingConducted
LicensedtrueLicensed
License Suspended EtcfalseLicenseSuspendedEtc
Gaming With NonmembersfalseGamingWithNonmembers
Member Of Other EntityfalseMemberOfOtherEntity
Percentage Of Gaming Othr Facility1.00000PercentageOfGamingOthrFacility
Name Of Gaming Rec Keeper PersonSHERRI HOLTNameOfGamingRecKeeperPerson

Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS

FieldValueIRS element (for citing)
Address Line1905 RIDGE RDAddressLine1
CityMUNSTERCity
StateINState
ZIP Code46321ZIPCode
FieldValueIRS element (for citing)
Contract With3rd Party For Gam RevfalseContractWith3rdPartyForGamRev
Charitable Distrib RequiredfalseCharitableDistribRequired

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (16 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAddress Line2AddressUS/AddressLine2
LAKE AREA UNITED WAY
221 W RIDGE RDGRIFFITHIN46319237170019501(c)(3)40000ANNUAL CAMPAIGN
INDIANA UNIVERSITY NORTHWEST
3400 BROADWAYGARYIN46408356001673501(c)(3)51000CONTRIBUTION
VALPARAISO UNIVERSITY
1605 CAMPUS DRIVE EASTVALAPRAISOIN46383350868125501(c)(3)12000SCHOLARSHIP CONTRIB
NORTHWEST INDIANA SYMPHONY ORCHESTRA
1040 RIDGE RDMUNSTERIN46321351359750501(c)(3)13980SPONSORSHIP
SOUTH SHORE ARTS
1040 RIDGE RDMUNSTERIN46321237049722501(c)(3)15000SPONSORSHIP
CATHOLIC CHARITIES
176 S WEST STREETCROWN POINTIN46307351122204501(c)(3)11250CONTRIBUTION
SCHOOL TOWN OF MUNSTER
8808 COLUMBIA AVEMUNSTERIN46321356002675501(c)(3)15500CONTRIBUTION
PURDUE UNIVERSITY CALUMET
2200 169TH STREETHAMMONDIN46323356002041501(c)(3)34000CONTRIBUTION
CALUMET COLLEGE OF ST JOSEPH
2400 NEW YORK AVENUEWHITINGIN46394351087173501(c)(3)16700CONTRIBUTION
INDIAN AMERICAN CULTURAL CENTER
8605 MERRILLVILLE RDMERRILLVILLEIN46410351981658N/A21000SPONSORSHIP
HEALTHCARE GROUP ADVOCACY IN
1356 SOUTH LAKE PARK AVENUEHOBARTIN46342351996856501(C)(3)15000CONTRIBUTION
LEGACY FOUNDATION
1000 EAST 8TH PLACEMERRILLVILLEIN46410351872803501(C)(3)13700CONTRIBUTIONSUITE 302 - S
CALUMET COUNCIL BOY SCOUTS OF AMERICA
8751 CALUMET AVENUEMUNSTERIN46321350867968501(C)(3)6250SPONSORSHIP
TRADE WINDS SERVICES
5901 W 7TH AVENUEGARYIN46406351139485501(C)(3)5350CONTRIBUTION
MARCH OF DIMES
PO BOX 1657WILKESBARREPA18703351846366501(C)(3)5100SPONSORSHIP
GRANTS LESS THAN 5000
9567CONTRIBUTIONS
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants14TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
ExplanationA COMMITTEE WITHIN CFNI REVIEWS REQUESTS FOR DONATIONS FROM QUALIFIED 501(c)(3) CHARITIES AND UNIVERSITIES AND EVALUATES WHETHER THE POTENTIAL DONEE ORGANIZATION WILL USE THE FUNDS IN A MANNER CONSISTENT WITH THE CHARITABLE MISSION OF CFNI. WE MAKE DONATIONS/CONTRIBUTIONS TO 501(C)(3) ORGANIZATIONS LOCATED WITHIN OUR COMMUNITY OR LOCATED IN THE STATE OF INDIANA. OUR DONATIONS/CONTRIBUTIONS ARE PRIMARILY MADE TO LOCAL ORGANIZATIONS. IN FY12 WE MADE CONTRIBUTIONS TO 44 DIFFERENT ORGANIZATIONS TOTALING 310,177. SINCE THESE ARE CONTRIBUTIONS AND NOT GRANTS, THERE IS NO NEED TO MONITOR.Explanation

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (19 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DONALD S POWERS
93764602732140674403478701347801265869000
JOHN GORSKI
634550031800003501103478701987601042224000
MARY ANN SHACKLETT
36968201480770288320347870221730603551000
CAROLE BEZAT
3438860315723063670347870140920714855000
ANTHONY FERRACANE
24845801736020212840347870156820493813000
KEVIN MYBECK
2142260001244097030243560249529000
CRAIG BOLDA
187854027865011610307610220010269642000
ELIZABETH YEE
203864000182540357600147530272631000
ROSEMARY GARCIA
209632000770909159098880236388000
NANCY MOSER
185985000881084590166750212000000
RAMONA FISSINGER
13709600010730193620142530171784000
MARK SIMAGA MD
2467640002322073500155340271970000
GARY WEINER
257256000581007350070300277446000
DAVID OTTE
1727870007610245010195320217581000
FELIX GOZO JR MD
23387900026858011100081840280021000
JOHN UTESCH
16203400035900228320142540202710000
JEANNETTE FOLEY
1539860002701030900156730175450000
KAREN SCHNEIDER
15201800016480218550173660192887000
KATHLEEN EDWARDS
10912200019800017844089870155753000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Explanation1a The organization pays health/social club dues on behalf of certain officers, key employees and the five highest paid employees which is then taxed as a fringe benefit to the individual.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Indiana Health Facility Financing Authority
3516114094547977V72004-04-0859742964Construction & Purchase Equipmentfalsefalsefalse
Indiana Health and Educational Facility Financing
35161140945479RCM72007-06-28152135212Const/Equip Refund 2001 (10/17/01)falsefalsefalse
Indiana Financing Authority
35160231645471AAE22008-10-2227370000Const/Equip Refund 2008 (06/03/08)falsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Amount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
005952202540044260011948590054322740002006falsefalsetruetrue
001539745551116077300180251500839915225701974502009falsetruetruetrue
00274166120004601580020171177678527702010truefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsEngage Bond Counsel ResearchEngageBondCounselResearchPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsetruetruetruetruetrue0.000300.000000.00030true
falsetruetruetruetruetrue0.000000.000000.00000true
falsetruetruetruetruetrue0.000000.000000.00000true

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
0
falsefalsefalsefalsefalsefalse0falsefalse
0
falsefalsefalsefalsefalsefalse0falsefalse
0
falsetruefalsefalsefalsefalse0falsefalse

Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PART II, LINE 3 - TOTAL PROCEEDS OF ISSUE0DIFFER FROM ISSUE PRICE AS A RESULT OF INVESTMENT EARNINGS.
PART II, LINE 11 - THE PARTIAL REFUNDING OF 57M HAS BEEN MOVED FROM LINE 60TO LINE 11 BECAUSE THE 2001 ISSUE WAS CALLED AND PAID.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
DON POWERS AGENCY
OWNED BY JOE WILLIAMSON527929INDEPENDENT CONTRACTORfalse
HASSE CONSTRUCTION
OWNED BY WILLIAM HASSE497442INDEPENDENT CONTRACTORfalse
BRIAR RIDGE COUNTRY CLUB
DON POWERS & FRANKIE FESK38555FOOD AND ENTERTAINMENTfalse
BARBARA BOLDA
FAM MEM OF CRAIG BOLDA100040EMPLOYMENTfalse
KAY TORRENGA
FAM MEM OF DONALD TORRENG69376EMPLOYMENTfalse
LEONARD BEZAT
FAM MEM OF CAROLE BEZAT41999EMPLOYMENTfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierPart IVIdentifier
ExplanationTRANSACTIONS IN ITEMS 1-3 ARE MADE AT FAIR MARKET VALUE.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FAMILY AND BUSINESS RELATIONSHIPSPART VI-A, LINE 2FRANKIE FESKO, FAMILY MEMBER OF DONALD POWERS, BUSINESS RELATIONSHIP BETWEEN DONALD POWERS AND JOE WILLIAMSON.
DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990PART VI-B, LINE 11bTHE 990 IS SUBMITTED TO THE SENIOR VP AND CFO FOR REVIEW, ONCE THIS REVIEW IS COMPLETE THE RETURNS ARE THEN PRESENTED TO SENIOR LEADERSHIP FOR REVIEW. THE 990 IS ALSO REVIEWED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM BEFORE IT IS POSTED TO A SECURE WEBSITE TO ALLOW THE BOARD OF DIRECTORS ACCESS TO REVIEW PRIOR TO FILING.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTERESTPART VI-B, LINE 12CAS PART OF THE ORGANIZATION'S ANNUAL MONITORING & ENFORCEMENT PROCEDURE RELATING TO ITS CONFLICT OF INTEREST POLICY, ALL CONFLICT OF INTEREST QUESTIONNAIRES ARE REVIEWED BY THE VP OF CORPORATE COMPLIANCE AND THOSE OFFICERS, DIRECTORS OR KEY EMPLOYEES WHO DO NOT RETURN OR FULLY COMPLETE THE QUESTIONNAIRE ARE CONTACTED TO RECONCILE THE OMISSION.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUNPART VI-B, LINE 15THE CFNI BOARD HAS ADOPTED EXECUTIVE AND BOARD OF DIRECTORS COMPENSATION PHILOSOPHY AND REASONABLENESS STANDARDS. THIS IS TO ASCERTAIN THAT THESE STANDARDS ARE ADHERED TO. THEIR PROCESS FOR COLLECTING AND ASSEMBLING MARKET DATA IS CONSISTENT WITH THE REBUTTABLE PRESUMPTION CHECKLIST AND GUIDELINES ALONG WITH FAIR MARKET VALUE USED BY THE IRS IN CONDUCTING EXECUTIVE COMPENSATION REVIEWS AS WELL AS CONTEMPORARY COMPENSATION PRACTICES. ALL MARKET DATA IS ASSEMBLED FROM REPUTABLE COMMERCIALLY AVAILABLE SURVEYS.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLICPART VI-C, LINE 19COMMUNITY FOUNDATION OF NW IN INC DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. IN ACCORDANCE WITH BOND CONVENANTS, CFNI MAKES IT FINANCIAL STATEMENTS AND DISCLOSURES AVAILABLE TO THE PUBLIC THROUGH THE NRMSIRS DATABASE. .
PART VII, SECTION AAVERAGE HOURS WORK PER WEEKCFNI SCH SMMC CH CVI TATC CVPA CCRF Total David Bochnowski 1 1 2 Joseph Costanza 1 1 2 Richard McLaughry 1 1 1 3 Joseph Morrow 1 1 2 William Schenck 1 1 1 1 4 Joseph Semancik, Monsignor 1 1 2 M. Nabil Shabeeb, MD, FACS 1 1 1 3 Donald Torrenga 1 1 1 3 Edward Williams, PHD 1 1 2 Joe Williamson 1 1 2 Jay Zandstra 1 1 2 Frankie Fesko 7 1 1 1 1 1 12 Hon. James Richards 20 1 21 Donald S. Powers 41 1 1 43 William Hasse, III 1 1 2 David Wickland 15 1 16 John C. Gorski 41 1 42 Mary Ann Shacklett 41 1 1 1 1 1 1 1 48 Craig Bolda 41 41 Mark Simaga, MD 20 1 21 David Bochnowski - Related organization hours are for attending CH monthly BOD and committee meetings Joseph Costanza - Related organization hours are for attending SCH BOD and committee meetings Richard McLaughry - Related organization compensation is for serving as President of the BOD at CVI Joseph Morrow - Related organization hours are for attending CH monthly BOD and committee meetings William Schenck - Related organization hours are for attending SMMC, CH, and CVI monthly BOD and committee meetings Joseph Semancik, Monsignor - Related organization hours are for attending SCH BOD and committee meetings M. Nabil Shabeeb, MD, FACS - Related organization hours are for attending CH and CCRF monthly BOD and committee meetings Donald Torrenga - Related organization hours are for attending CH and CVI monthly BOD and committee meetings Edward Williams, PHD - Related organization hours are for attending SCH BOD and committee meetings Joe Williamson - Related organization hours are for attending TATC monthly BOD and committee meetings Jay Zandstra - Related organization hours are for attending CH monthly BOD and committee meetings Frankie Fesko - Related organization compensation is for attending CH BOD and CSC monthly committee meetings Hon. James Richards - Related organization compensation is for attending CSC monthly committee meetings Donald S. Powers - Compensation is for hours worked as the system President & CEO. Related organization hours are for attending CH and CCRF monthly BOD and committee meetings William Hasse, III - Related organization compensation is for attending CH monthly BOD and committee meetings David Wickland Related organization compensation is for attending CSC monthly committee meetings John C. Gorski - Compensation is for hours worked as the system COO. Related organization hours are for attending CVPA BOD and committee meetings Mary Ann Shacklett - Compensation is for hours worked as the system CFO. Related organization hours are for attending BOD and committee meetings Craig Bolda - Related organization compensation is for hours worked as the SCH COO Mark Simaga, MD - Compensation is for hours worked as the system Chief Medical Information Officer. Related organization hours are for attending SMMC BOD and committee meetings
RECONCILIATION OF NET ASSETSPART XI LINE 5TRANSFERS FROM RELATED ENTITIES 60,007,456 UNREALIZED INVESTMENT INCOME 2,556,000 TRANSFERS TO RELATED ENTITIES (12,054,935) ASSETS RELEASED FROM RESTRICTIONS (307,133) PERENNIAL BALL CONTRIBUTIONS FOR COMMUNITY CANCER RESEARCH FOUNDATION 270,760 TOTAL CHANGE IN NET ASSETS 52,472,144

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
MUNSTER MEDICAL RESEARCH FOUNDATION
901 MACARTHUR BLVDMUNSTERIN46321351107009HOSPITALIN501(C)(3)3NAtrue
ST CATHERINE HOSPITAL INC
4321 FIR STREETEAST CHICAGOIN46312351738708HOSPITALIN501(C)(3)3NAtrue
ST MARY MEDICAL CENTER
1500 S LAKE PARK AVENUEHOBARTIN46342352007327HOSPITALIN501(C)(3)3NAtrue
COMMUNITY CANCER RESEARCH FOUNDATION
901 MACARTHUR BLVDMUNSTERIN46321352146374CANCER FUNDRIN501(C)(3)7MMRFtrue
COMMUNITY VILLAGE INC
10000 COLUMBIA AVENUEMUNSTERIN46321351956395RETRMNT HOMEIN501(C)(3)9NAtrue
CVPA HOLDING COMPANY
905 RIDGE RDMUNSTERIN46321351938136SUPPORT ORGIN501(C)(2)N/ANAtrue
THEATRE AT THE CENTER
905 RIDGE RDMUNSTERIN46321351939427PLAYS&ARTSIN501(C)(3)9NAtrue

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
COMMUNITY RESOURCES INC
907 RIDGE ROADMUNSTERIN46321351727711MGMT SERVICESINNAC CORP2145383260161.00000
COMMUNITY MEDICAL & PROFESSIONAL CENTER
800 MACARTHUR BLVDMUNSTERIN46321237437942CONDO ASSOCIATIONINNAC CORP-11640176010.90940
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgtruePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (23 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MUNSTER MEDICAL RESEARCH FOUNDATION INC
a(iv)2300039FMV
ST MARY MEDICAL CENTER
b5566886FMV
ST CATHERINE HOSPITAL INC
b3948962FMV
MUNSTER MEDICAL RESEARCH FOUNDATION INC
b2249418FMV
THEATRE AT THE CENTER INC
b374918FMV
CVPA HOLDING COMPANY
B166500fmv
MUNSTER MEDICAL RESEARCH FOUNDATION INC
c42610413FMV
ST MARY MEDICAL CENTER
c18406495FMV
COMMUNITY VILLAGE INC
C1250000FMV
COMMUNITY VILLAGE INC
D30825000FMV
MUNSTER MEDICAL RESEARCH FOUNDATION INC
G255598FMV
ST CATHERINE HOSPITAL INC
J179711FMV
MUNSTER MEDICAL RESEARCH FOUNDATION INC
N12021267FMV
ST MARY MEDICAL CENTER
N7700612FMV
ST CATHERINE HOSPITAL INC
N5093329FMV
MUNSTER MEDICAL RESEARCH FOUNDATION INC
O6728519FMV
ST MARY MEDICAL CENTER
o1369506FMV
ST CATHERINE HOSPITAL INC
O1303603FMV
COMMUNITY CANCER RESEARCH FOUNDATION
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