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Indiana University Health Proton: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
Indiana University Health Proton (EIN 35-2134193)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-01-11
IRS object ID
201340119349300424
Schema version
2011v1.2
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)
Timestamp2013-01-11T12:56:02-06:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN351178661EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE AMERICAN SQUARE 2200AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46282ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN352134193EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1INDIANA UNIVERSITY HEALTH PROTONBusinessNameLine1
Business Name Line2THERAPY CENTER LLCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlINDINameControl
Phone8123495074Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12425 N MILO B SAMPSON LANEAddressLine1
CityBLOOMINGTONCity
StateINState
ZIP Code474081368ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN R KERSTIENS CPAName
TitleCOO/CFOTitle
Phone8123495028Phone
Date Signed2013-01-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAMBER KOCHER CPAName
PTINP01286298PTIN
Phone3176334705Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1MIDWEST PROTON RADIOTHERAPY INSTITUTE LLCBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonDR PETER JOHNSTONENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12425 N MILO B SAMPSON LANEAddressLine1
CityBLOOMINGTONCity
StateINState
ZIP Code474081368ZIPCode
FieldValueIRS element (for citing)
Gross Receipts18773121GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.IUHEALTHPROTONTHERAPY.ORGWebSite
Type Of Organization OtherXTypeOfOrganizationOther
Type Of Org Other DescriptionLLC - LIMITED LIABILITY COMPANYTypeOfOrgOtherDescription
Year Formation2001YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionMEDICAL CLINIC THAT USES UNIQUE PROTON BEAM TECHNOLOGY TO TREAT CANCER VICTIMS.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees65TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year22792ContributionsGrantsPriorYear
Contributions Grants Current Year105982ContributionsGrantsCurrentYear
Program Service Revenue Prior Year17511463ProgramServiceRevenuePriorYear
Program Service Revenue CY18660957ProgramServiceRevenueCY
Investment Income Prior Year4731InvestmentIncomePriorYear
Investment Income Current Year3202InvestmentIncomeCurrentYear
Other Revenue Prior Year6121OtherRevenuePriorYear
Other Revenue Current Year2980OtherRevenueCurrentYear
Total Revenue Prior Year17545107TotalRevenuePriorYear
Total Revenue Current Year18773121TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year290GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY28500GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4516326SalariesEtcPriorYear
Salaries Etc Current Year4877556SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year13104248OtherExpensePriorYear
Other Expenses Current Year14394487OtherExpensesCurrentYear
Total Expenses Prior Year17620864TotalExpensesPriorYear
Total Expenses Current Year19300543TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-75757RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-527422RevenuesLessExpensesCY
Total Assets BOY27598376TotalAssetsBOY
Total Assets EOY24909929TotalAssetsEOY
Total Liabilities BOY18677833TotalLiabilitiesBOY
Total Liabilities EOY16516808TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8920543NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY8393121NetAssetsOrFundBalancesEOY
Mission DescriptionTO LEVERAGE OUR UNIQUE TECHNOLOGY TO IMPROVE OUR PATIENTS' HEALTH, AND PROMOTE INNOVATION IN EDUCATION AND RESEARCH.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense17903730Expense
Grants28500Grants
Revenue18660957Revenue
DescriptionIU HEALTH PROTON THERAPY CENTER USES PROTON BEAM ENERGY TO TREAT CANCER VICTIMS. OUR PATIENTS ARE SELECTED BASED ON TYPE OF CANCER, EFFICIENCY OF TREATMENT AND WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY. UNINSURED CARE WAS APPROXIMATELY $402,474 FOR THE YEAR ENDED JUNE 30, 2012.Description
Total Program Service Expense17903730TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10967NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees65NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JOHN KERSTIENS CPABusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8123495074TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12425 N MILO B SAMPSON LNAddressLine1
CityBLOOMINGTONCity
StateINState
ZIP Code47408ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
DR PETER JOHNSTONE
CEO/PRESIDENT & BOARD MEMBER16.00X000
JENNIFER M ALVEY
BOARD MEMBER1.00X000
TOM MARTIN
BOARD MEMBER1.00X000
DOUGLAS PRIEST
BOARD MEMBER1.00X000
JIM TERWILLIGER
BOARD MEMBER1.00X000
RICHARD S HELSPER
COO & BOARD MEMBER TERM END MAY 201240.00X122580012180X
MARVIN PEMBER
BOARD MEMBER TERM END JULY 20110.00X000
ISADORE RIVAS
CORPORATE TREASURER TERM END APRIL 20121.00000X
WILLIAM STEPHAN
CORPORATE SECRETARY1.00000X
JOHN KERSTIENS
COO/CFO40.00136946019634X
KARIN CAMPBELL
DIRECTOR, HR/ADMINISTRATIO40.0079781019634X
CHRIS ALLGOWER
SENIOR MEDICAL PHYSICIST40.00136490036958X
MARK WOLANSKI
SENIOR MEDICAL PHYSICIST40.00136461032419X
LI ZHAO
MEDICAL PHYSICIST40.00105108024173X
LENILSON COUTINHO
MEDICAL PHYSICIST40.00107565016693X
LEIA FANELLI
MEDICAL PHYSICIST40.00103027018270X
FieldValueIRS element (for citing)
Total Reportable Comp From Org927958TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation179961TotalOtherCompensation
Number Individuals GT100 K7NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
UNIVERSITY RADIATION ONCOLOGY ASSOC
535 BARNHILL DRIVEINDIANAPOLISIN46202PHYSICIAN AND PHYSICISTS2145838
BLOOMINGTON ANESTHESIOLOGISTS
PO BOX 2121 DEPT 1438MEMPHISTN38159ANESTHESIOLOGISTS386312
SIEMENS MEDICAL SOLUTIONS
PO BOX 120001 DEPT 0733DALLASTX75312MEDICAL EQUIPMENT SOLUTIONS/SERVICE199505
ELEKTA
13723 CORPORATE LAKE DRMARYLAND HEIGHTSMO63043COMPUTERIZED MEDICAL SYSTEM SERVICES152193
SLINGSHOT SEO
8900 KEYSTONE CROSSING STE 100INDIANAPOLISIN46240SEARCH ENGINE OPTIMIZATION121929
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
All Other Contributions105982AllOtherContributions
Noncash Contributions17025NoncashContributions
Total Contributions105982TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE REVENUDescription
Business Code621110BusinessCode
Total Revenue Column18660957TotalRevenueColumn
Related Or Exempt Function Income18660957RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue18660957TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3202TotalRevenueColumn
Exclusion$3,202ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER INCOMEDescription
Business Code541900BusinessCode
Total Revenue Column2980TotalRevenueColumn
Exclusion$2,980ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2980TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column18773121TotalRevenueColumn
Related Or Exempt Function Income18660957RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$6,182ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total28500Total
Program Services28500ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total366905Total
Program Services311869ProgramServices
Management And General55036ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3354960Total
Program Services3354960ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total359796Total
Program Services305827ProgramServices
Management And General53969ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total509136Total
Program Services432766ProgramServices
Management And General76370ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total286759Total
Program Services243745ProgramServices
Management And General43014ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total53105Total
Management And General53105ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total45990Total
Management And General45990ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5079387Total
Program Services5079387ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total40000Total
Management And General40000ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total491507Total
Program Services423653ProgramServices
Management And General67854ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1691786Total
Program Services1353429ProgramServices
Management And General338357ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total43070Total
Program Services43070ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total14795Total
Program Services14795ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total297367Total
Management And General297367ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2171675Total
Program Services1845924ProgramServices
Management And General325751ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total40972Total
Program Services40972ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
PROTON BEAM EXPENSE42230004223000
BAD DEBT139310139310
DUES & SUBSCRIPTIONS1820618206

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total44317Total
Program Services44317ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total19300543Total
Program Services17903730ProgramServices
Management And General1396813ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY100BOY
EOY75EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1864714BOY
EOY1850642EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2374916BOY
EOY1613545EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY76810BOY
EOY40140EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis21796964LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec7421904LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY15731836BOY
EOY14375060EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY7550000BOY
EOY6950000EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY80467EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY27598376BOY
EOY24909929EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1040115BOY
EOY924353EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY966794BOY
EOY598253EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY16670924BOY
EOY14994202EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY18677833BOY
EOY16516808EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY8920543BOY
EOY8312654EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY80467EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8920543BOY
EOY8393121EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY27598376BOY
EOY24909929EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-527422ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
General ExplanationSCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SCHEDULE A, PART I, LINE 3 HOSPITAL: IU HEALTH PROTON THERAPY CENTER HAS BEEN DETERMINED BY THE IRS TO BE A PUBLIC CHARITY UNDER INTERNAL REVENUE CODE SECTION 170(B)(1)(A)(III). PER SCHEDULE H INSTRUCTIONS ONLY ORGANIZATIONS THAT OPERATE AT LEAST ONE FACILITY THAT IS, OR IS REQUIRED TO BE, LICENSED, REGISTERED, OR SIMILARILY RECOGNIZED BY A STATE AS A HOSPITAL IS REQUIRED TO COMPLETE THIS SCHEDULE. IU HEALTH PROTON THERAPY IS A CANCER TREATMENT CENTER AND IS NOT LICENSED AS A HOSPITAL FOR THE STATE OF INDIANA.GeneralExplanation

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 D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Contributions85000Contributions
Other Expenditures4533OtherExpenditures
End Of Year Balance80467EndOfYearBalance
FieldValueIRS element (for citing)
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis14772495OtherCostOrOtherBasis
Depreciation4130450Depreciation
Book Value10642045BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4159073OtherCostOrOtherBasis
Depreciation2259732Depreciation
Book Value1899341BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2865396OtherCostOrOtherBasis
Depreciation1031722Depreciation
Book Value1833674BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings14375060TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO INDIANA UNIVERSITYDescription
Amount$14,994,202Amount
FieldValueIRS element (for citing)
Total Of Amounts14994202TotalOfAmounts
Total Revenue18773121TotalRevenue
Total Expenses19300543TotalExpenses
Excess Or Deficit For Year-527422ExcessOrDeficitForYear
Excess Or Deficit Per FS-527422ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt18773121TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal18773121RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99018773121TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt19300543TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal19300543ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99019300543TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:THE ORGANIZATION HAS TEMPORARILY RESTRICTED NET ASSETS AVAILABLE FOR THE PURPOSE OF PURCHASING EQUIPMENT.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:IUHPTC IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C) (3) OF THE INTERNAL REVENUE CODE AND, AS SUCH, IS NOT REQUIRED TO PAY FEDERAL OR STATE INCOME TAXES ON EXCESS REVENUES RELATED TO THEIR TAX-EXEMPT ACTIVITIES. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY IUHPTC AND RECOGNIZE A TAX LIABILITY IF IUHPTC HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY IUHPTC, AND HAS CONCLUDED THAT AS OF JUNE 30, 2012 AND 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. IUHPTC IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. IUHPTC IS GENERALLY EXEMPT FROM INCOME TAXES. HOWEVER, IUHPTC IS REQUIRED TO FILE FEDERAL FORM 990 - RETURN OF ORGANIZATION FROM INCOME TAX, WHICH IS AN INFORMATIONAL RETURN ONLY.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1JILL'S HOUSE INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1751 E TAMARACK TRAILAddressLine1
CityBLOOMINGTONCity
StateINState
ZIP Code47408ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient352139920EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant28500AmountOfCashGrant
Purpose Of GrantPATIENT SUPPORTPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: SUPPORT PROVIDED TO 501(C)(3) PUBLIC CHARITY FOR PATIENT SUPPORT. THE ORGANIZATION DOES NOT MONITOR THE USE OF THESE FUNDS BY THE PUBLIC CHARITY LISTED.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (3 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
JOHN KERSTIENS
1369460000013999056350156580000
CHRIS ALLGOWER
1364900000032140048180173448000
MARK WOLANSKI
136461000003172506940168880000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION IS ORGANIZED AS A DOMESTIC LIMITED LIABILITY COMPANY WITH TWO CORPORATE MEMBERS AND A BOARD OF MANAGERS.
FORM 990, PART VI, SECTION A, LINE 7ATHE CORPORATE MEMBERS INDIANA UNIVERSITY RESEARCH AND TECHNOLOGY CORPORATION AND INDIANA UNIVERSITY HEALTH, INC. EACH SELECT TWO BOARD MANAGERS AND UNANIMOUSLY VOTE ON ONE "ELECTED" MANAGER TO THE GOVERNING BOARD OF MANAGERS.
FORM 990, PART VI, SECTION B, LINE 11THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW OF THE FORM 990 BY THE ORGANIZATION'S CFO AND BY THE CORPORATE MEMBERS' TAX DEPARTMENTS. THE GOVERNING BODY REVIEWS AND APPROVES THE FORM 990 AND THE FINAL FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, ARE PROVIDED ELECTRONICALLY TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE IS ENFORCED BY THE DIRECTOR OF HUMAN RESOURCES/ ADMINISTRATION AND DIRECTOR'S TEAM. THE SCOPE OF THIS POLICY INCLUDES ALL MEMBERS OF THE ORGANIZATION'S BOARD OF MANAGERS, ALL EMPLOYEES, AND ALL CONTRACTED PROFESSIONALS. THE POLICY IS IN PLACE TO PREVENT ANY POTENTIAL CONFLICTS OF PERSONAL PROFIT OR GAIN, DIRECTLY OR INDIRECTLY, BY REASON OF HIS OR HER PARTICIPATION WITH OR EMPLOYMENT BY THE ORGANIZATION. IN ADDITION COVERED PERSONS ARE TO REFRAIN FROM OBTAINING ANY LIST OF THE ORGANIZATION'S PATIENTS, REFERRING PHYSICIANS AND VENDORS FOR PERSONAL OR PRIVATE SOLICITATION PURPOSES. A SELF DISCLOSURE FROM COVERED PERSONS TO THE ORGANIZATION'S LEADERSHIP IS REQUIRED ON ANY POTENTIAL INTEREST WITH VENDORS, PATIENTS OR OTHER MATTERS. ANY POTENTIAL CONFLICTS DISCLOSED ARE REVIEWED AND RESEARCHED BY COMPLIANCE PERSONNEL AND BROUGHT TO THE BOARD OF MANAGERS FOR REVIEW. THE COVERED PERSONS ARE TO RECUSE THEMSELVES FROM PARTICIPATING IN ANY DELIBERATION OR DECISION ON SUCH TRANSACTIONS.
FORM 990, PART VI, SECTION B, LINE 15BTHE CEO (TOP MANAGEMENT OFFICIAL) OF THE ORGANIZATION HAS BEEN SELECTED BY THE ORGANIZATION'S CORPORATE MEMBERS TO SERVE AS BOARD MEMBER AND MANAGEMENT OFFICIAL FOR THE ORGANIZATION. THIS OFFICER DOES NOT RECEIVE COMPENSATION FROM THE ORGANIZATION AND THEREFORE COMPENSATION DETERMINATION IS NOT REQUIRED BY THE ORGANIZATION. THE PROCESS FOR DETERMINING THE COMPENSATION OF THE COO AND ALL OTHER ORGANIZATION'S OFFICERS AND KEY EMPLOYEES INCLUDED A REVIEW AND APPROVAL BY THE GOVERNING BODY. COMPARISON WITH MEMBER INSTITUTIONS AND LOCAL PROVIDERS WAS MADE DURING THE REVIEW OF THE COMPENSATION. THE DELIBERATION AND DECISION MADE ON THE COMPENSATION WAS CONTEMPORANEOUSLY SUBSTANTIATED IN THE MINUTES OF THE BOARD OF MANAGERS. IN ADDITION A WRITTEN COMPENSATION AGREEMENT OUTLINES ALL COMPENSATION ARRANGEMENTS.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC. REQUESTS CAN BE MADE BY PHONE OR MAIL.
FORM 990, PART XII, LINE 2CTHE BOARD OF MANAGERS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR.OVERSIGHT OF THE AUDIT