SOUTH BEND MEDICAL FOUNDATION INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- SOUTH BEND MEDICAL FOUNDATION INC (EIN 35-0868178)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-14
- IRS object ID
- 201343189349304779
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-14T14:54:41-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE HORWATH LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 330 E Jefferson Blvd | AddressLine1 |
| Address Line2 | PO Box 7 | AddressLine2 |
| City | South Bend | City |
| State | IN | State |
| ZIP Code | 466240007 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350868178 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH BEND MEDICAL FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SOUT | NameControl |
| Phone | 5742045291 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 530 North Lafayette Blvd | AddressLine1 |
| City | South Bend | City |
| State | IN | State |
| ZIP Code | 46601 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ANN M SULLIVAN | Name |
| Title | VP OF FINANCE | Title |
| Date Signed | 2013-11-14 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KENNETH J KEBER | Name |
| PTIN | P00240883 | PTIN |
| Phone | 5742323992 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Name Of Principal Officer Business NameOfPrincipalOfficerBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROBERT TOMEC MD | BusinessNameLine1 |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 530 North Lafayette Blvd | AddressLine1 |
| City | South Bend | City |
| State | IN | State |
| ZIP Code | 46601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 100278370 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SBMF.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1946 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | SOUTH BEND MEDICAL FOUNDATION EXISTS FOR THE PURPOSE OF PROVIDING QUALITY AND COST EFFECTIVE LABORATORY AND BLOOD BANKING SERVICES TO HOSPITALS, PHYSICIANS, AND PATIENTS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 872 | TotalNbrEmployees |
| Total Nbr Volunteers | 14 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 429028 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 97034819 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 99026282 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 80602 | InvestmentIncomePriorYear |
| Investment Income Current Year | 140634 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 585608 | OtherRevenuePriorYear |
| Other Revenue Current Year | 391040 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 97701029 | TotalRevenuePriorYear |
| Total Revenue Current Year | 99986984 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 2374760 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 2710438 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 46509524 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 46930111 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 57197 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 57197 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 46468237 | OtherExpensePriorYear |
| Other Expenses Current Year | 48795997 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 95352521 | TotalExpensesPriorYear |
| Total Expenses Current Year | 98493743 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2348508 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1493241 | RevenuesLessExpensesCY |
| Total Assets BOY | 53629071 | TotalAssetsBOY |
| Total Assets EOY | 52639511 | TotalAssetsEOY |
| Total Liabilities BOY | 46010216 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 47569581 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 7618855 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 5069930 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SOUTH BEND MEDICAL FOUNDATION EXISTS FOR THE PURPOSE OF PROVIDING QUALITY AND COST EFFECTIVE LABORATORY AND BLOOD BANKING SERVICES TO HOSPITALS, PHYSICIANS, AND PATIENTS. (CONTINUED IN SCHEDULE O). | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 82010136 | Expense |
| Grants | 2710438 | Grants |
| Revenue | 99477727 | Revenue |
| Description | SOUTH BEND MEDICAL FOUNDATION'S (SBMF) MORE THAN 750 EMPLOYEES PROVIDE A WIDE RANGE OF TOP-QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES FOR COMMUNITIES IN INDIANA, MICHIGAN, KENTUCKY, OHIO, AND ILLINOIS. BY WORKING TOGETHER WITH LOCAL HEALTH CARE PROVIDERS, SBMF PRESERVES THE CRITICAL RELATIONSHIP BETWEEN LABORATORY, PHYSICIAN AND PATIENT. UNLIKE MANY LARGE COMMERCIAL LABORATORIES, SBMF OFFERS ITS SERVICES 24 HOURS A DAY, 365 DAYS A YEAR. SBMF PERSONNEL ARE DEDICATED TO BEING A TRUSTED PHYSICIAN RESOURCE, HANDLING EVERYTHING FROM ROUTINE OUTPATIENT ORDERS TO PROVIDING INPATIENT SERVICES AT HOSPITAL AND OTHER HEALTH CARE FACILITIES THROUGHOUT THE REGION. SBMF'S COMMITMENT TO DELIVERING CONSISTENT, RELIABLE, QUALITY MEDICAL CARE HAS PLAYED AN INSTRUMENTAL ROLE IN HELPING THE FOUNDATION ACHIEVE ITS POSITION OF LEADERSHIP AMONG THE NATION'S DIAGNOSTIC LABORATORIES. (CONTINUED IN SCHEDULE O) | Description |
| Total Program Service Expense | 82010136 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| 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 | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | 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 | true | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | true | 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 | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | 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 | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 77 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 872 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| 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 | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | true | QuidProQuoDisclosure |
| 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 | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | 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 | true | CompensationProcessCEO |
| Compensation Process Other | true | 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
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | James B Myers | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5742045206 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 118 W Edison Road | AddressLine1 |
| City | Mishawaka | City |
| State | IN | State |
| ZIP Code | 46545 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (44 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| BILAL ANSARI MD | ||||||||
| CHAIRMAN | 1.00 | X | X | 250 | 0 | 0 | ||
| CHARLES E PETERSON MD | ||||||||
| VICE CHAIRMAN | 1.00 | X | X | 250 | 0 | 0 | ||
| ALAN B ENGEL MD | ||||||||
| BOARD MEMBER | 1.00 | X | 250 | 0 | 0 | |||
| BARBARA L WILLIAMS MD | ||||||||
| BOARD MEMBER | 1.00 | X | 250 | 0 | 0 | |||
| BRIAN SUCHARETZA MD | ||||||||
| BOARD MEMBER | 1.00 | X | 250 | 0 | 0 | |||
| FREDERICK J FERLIC MD | ||||||||
| PARTIAL YEAR BOARD MEMBER | 1.00 | X | 200 | 0 | 0 | |||
| HENRY KIM MD | ||||||||
| BOARD MEMBER | 1.00 | X | 250 | 0 | 0 | |||
| JOHN T RICE MD | ||||||||
| BOARD MEMBER | 1.00 | X | 250 | 0 | 0 | |||
| KURT H STIVER | ||||||||
| PARTIAL YEAR BOARD MEMBER | 1.00 | X | 200 | 0 | 0 | |||
| MICHELLE A MIGLIORE DO | ||||||||
| BOARD MEMBER | 1.00 | X | 250 | 0 | 0 | |||
| SAMUEL BORRELLI MD | ||||||||
| BOARD MEMBER | 1.00 | X | 250 | 0 | 0 | |||
| SLOAN S SHAH MD | ||||||||
| BOARD MEMBER | 1.00 | X | 250 | 0 | 0 | |||
| STARLA D GRABER MD | ||||||||
| BOARD MEMBER | 1.00 | X | 250 | 0 | 0 | |||
| STEPHEN F MITROS MD | ||||||||
| PARTIAL YEAR BOARD MEMBER | 1.00 | X | 200 | 0 | 0 | |||
| ANN SULLIVAN | ||||||||
| VP OF FINANCE | 40.00 | X | 232773 | 0 | 42832 | |||
| DIANE JANOWIAK | ||||||||
| VP OF CENTRAL LAB OPERATIONS | 40.00 | X | 233474 | 0 | 29004 | |||
| JAMES FRAIN | ||||||||
| VP OF HUMAN RESOURCES | 40.00 | X | 232993 | 0 | 42092 | |||
| ROBERT KING | ||||||||
| SENIOR VP | 40.00 | X | 273442 | 0 | 34446 | |||
| ROBERT TOMEC MD | ||||||||
| PRESIDENT/EXECUTIVE VP | 40.00 | X | 385680 | 0 | 35498 | |||
| WILLIAM KALINEY MD | ||||||||
| VICE PRESIDENT/EXECUTIVE VP | 40.00 | X | 384015 | 0 | 36598 | |||
| ALFONSO CARDENAS MD | ||||||||
| PATHOLOGIST | 40.00 | 363033 | 0 | 39273 | X | |||
| AMOBI EZENEKWE MD | ||||||||
| PATHOLOGIST | 40.00 | 248662 | 0 | 45410 | X | |||
| BLAIR CHRENKA MD | ||||||||
| PATHOLOGIST | 40.00 | 232078 | 0 | 41510 | X | |||
| BOBBIE SUTTON MD | ||||||||
| PATHOLOGIST | 40.00 | 285108 | 0 | 31021 | X | |||
| C K KIM MD | ||||||||
| PATHOLOGIST | 40.00 | 366137 | 0 | 42073 | X | |||
| DAVID JENTZ MD | ||||||||
| PATHOLOGIST | 40.00 | 364018 | 0 | 34223 | X | |||
| DERRICK FORCHETTI MD | ||||||||
| PATHOLOGIST | 40.00 | 261709 | 0 | 36522 | X | |||
| FRANCISCO DEOGRACIAS MD | ||||||||
| PATHOLOGIST | 40.00 | 353125 | 0 | 35601 | X | |||
| FRED BUSSE MD | ||||||||
| PATHOLOGIST | 40.00 | 259123 | 0 | 35325 | X | |||
| JAMES DYER MD | ||||||||
| PATHOLOGIST | 40.00 | 248548 | 0 | 19286 | X | |||
| JOHN LANDGRAF MD | ||||||||
| PATHOLOGIST | 40.00 | 260223 | 0 | 33425 | X | |||
| JOSEPH PRAHLOW MD | ||||||||
| PATHOLOGIST | 40.00 | 266461 | 0 | 38655 | X | |||
| JOYCE SIMPSON MD | ||||||||
| PATHOLOGIST | 40.00 | 164462 | 0 | 15733 | X | |||
| KRISTEN JACOBS MD | ||||||||
| PATHOLOGIST | 24.00 | 571092 | 0 | 37994 | X | |||
| LUIS GALUP MD | ||||||||
| PATHOLOGIST | 40.00 | 362643 | 0 | 46064 | X | |||
| NICOLE ANEST MD | ||||||||
| PATHOLOGIST | 40.00 | 226510 | 0 | 32264 | X | |||
| NITA GERIG MD | ||||||||
| PATHOLOGIST | 32.00 | 285075 | 0 | 41887 | X | |||
| ODETA LAPKUS MD | ||||||||
| PATHOLOGIST | 40.00 | 254100 | 0 | 34260 | X | |||
| RICKY HOOVER MD | ||||||||
| PATHOLOGIST | 40.00 | 345369 | 0 | 43567 | X | |||
| CARRIE ROBINSON | ||||||||
| REGIONAL MARKETING DIRECTOR | 40.00 | 106412 | 0 | 33879 | X | |||
| DEBORAH SUN | ||||||||
| DIRECTOR - NEW TECHNOLOGY & TEST DEVELOPMENT (PARTIAL YEAR) | 40.00 | 108217 | 0 | 14633 | X | |||
| JANET AGLER | ||||||||
| REGIONAL MARKETING MANAGER | 40.00 | 102033 | 0 | 28629 | X | |||
| KAY BEAM | ||||||||
| DIRECTOR, INFORMATION TECHNOLOGY, DATABASE MANAGEMENT | 40.00 | 105866 | 0 | 5300 | X | |||
| PRENTISS JONES | ||||||||
| DIRECTOR - TOXICOLOGY | 40.00 | 145530 | 0 | 26223 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 8031261 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1013227 | TotalOtherCompensation |
| Number Individuals GT100 K | 31 | NumberIndividualsGT100K |
| Formers Listed | true | 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 |
|---|---|---|---|---|---|
| ASSOC REG AND UNIV PATHOLOGISTS | |||||
| PO BOX 27964 | SALT LAKE CITY | UT | 84127 | REFERENCE LAB | 2386480 |
| THERMO ASSET MANAGEMENT SERVICES INC | |||||
| PO BOX 712224 | CINCINNATI | OH | 452712224 | EQUIPMENT MAINTENANCE / REPAIR | 906100 |
| MICHIANA HEALTH INFORMATION NETWORK | |||||
| 220 W COLFAX AVENUE SUITE 300 | SOUH BEND | IN | 46601 | COMMUNITY BASED CLINICAL INFO SYSTEM | 776723 |
| CERNER CORPORATION | |||||
| PO BOX 412702 | KANSAS CITY | MO | 64141 | EQUIPMENT MAINTENANCE / REPAIR | 694128 |
| PARKVIEW PROFESSIONAL PROGRAMS | |||||
| PO BOX 2504 | FORT WAYNE | IN | 468012504 | REFERENCE LAB | 585269 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 16 | NumberOfContractorsGT100K |
| Fundraising Events | 414927 | FundraisingEvents |
| All Other Contributions | 14101 | AllOtherContributions |
| Total Contributions | 429028 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET OPERATING REVENUES | 621500 | 99026282 | 99026282 |
| 0 | |||
| 0 | |||
| 0 | |||
| 0 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 99026282 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 123674 | TotalRevenueColumn |
| Exclusion | $123,674 | 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 |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 31865 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 14905 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 16960 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16960 | TotalRevenueColumn |
| Exclusion | $16,960 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 45980 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 414927 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 276481 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -230501 | TotalRevenueColumn |
| Exclusion | -$230,501 | ExclusionAmount |
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 | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| CLINICAL PATHOLOGY FEES | 621500 | 451445 | 451445 | |
| TEACHING FEES | 611430 | 76407 | $76,407 | |
| 0 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 93689 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $93,689 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 621541 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 99986984 | TotalRevenueColumn |
| Related Or Exempt Function Income | 99477727 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $80,229 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 204633 | Total |
| Program Services | 204633 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2505805 | Total |
| Program Services | 2505805 | ProgramServices |
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 | 8151161 | Total |
| Program Services | 6652667 | ProgramServices |
| Management And General | 1498494 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27679891 | Total |
| Program Services | 21979761 | ProgramServices |
| Management And General | 5700130 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1073129 | Total |
| Program Services | 852172 | ProgramServices |
| Management And General | 220957 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7726682 | Total |
| Program Services | 6135758 | ProgramServices |
| Management And General | 1590924 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2299248 | Total |
| Program Services | 1833006 | ProgramServices |
| Management And General | 466242 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 56835 | Total |
| Management And General | 56835 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 81481 | Total |
| Management And General | 81481 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57197 | Total |
| Fundraising | 57197 | Fundraising |
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 | 1950240 | Total |
| Program Services | 1045591 | ProgramServices |
| Management And General | 904649 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2930381 | Total |
| Program Services | 1470067 | ProgramServices |
| Management And General | 1460314 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1887456 | Total |
| Program Services | 1789097 | ProgramServices |
| Management And General | 98359 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 121545 | Total |
| Program Services | 65077 | ProgramServices |
| Management And General | 56468 | 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 | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 658845 | Total |
| Program Services | 15256 | ProgramServices |
| Management And General | 643589 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3510158 | Total |
| Program Services | 3078042 | ProgramServices |
| Management And General | 432116 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 729599 | Total |
| Program Services | 99151 | ProgramServices |
| Management And General | 630448 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL LAB | 22653885 | 21870965 | 782920 |
| REFERENCE LAB | 4431550 | 4431550 | |
| BAD DEBT | 3635498 | 3635498 | |
| BUILDING EQUIPMENT/MAINTENANCE | 3635083 | 2431096 | 1203987 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2513441 | Total |
| Program Services | 1914944 | ProgramServices |
| Management And General | 598497 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 98493743 | Total |
| Program Services | 82010136 | ProgramServices |
| Management And General | 16426410 | ManagementAndGeneral |
| Fundraising | 57197 | Fundraising |
Total Joint Costs TotalJointCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 850 | BOY |
| EOY | 841 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11644739 | BOY |
| EOY | 9566851 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11361378 | BOY |
| EOY | 11110618 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1756111 | BOY |
| EOY | 2117948 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1240012 | BOY |
| EOY | 1566976 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 92583163 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 65020370 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26980187 | BOY |
| EOY | 27562793 | 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 | 490286 | BOY |
| EOY | 571791 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 155508 | BOY |
| EOY | 141693 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 53629071 | BOY |
| EOY | 52639511 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8208104 | BOY |
| EOY | 9693485 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11565000 | BOY |
| EOY | 10615000 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26237112 | BOY |
| EOY | 27261096 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46010216 | BOY |
| EOY | 47569581 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7618855 | BOY |
| EOY | 5069930 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7618855 | BOY |
| EOY | 5069930 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 53629071 | BOY |
| EOY | 52639511 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1493241 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 374373 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -4416539 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 429028 | CurrentTaxYear |
| Total | 429028 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 92391025 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 94545973 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 94079057 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 97034819 | CurrentTaxYearMinus1Year |
| Current Tax Year | 99026282 | CurrentTaxYear |
| Total | 477077156 | Total |
Gross Receipts From Non UBI GrossReceiptsFromNonUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 193765 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 238981 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 195040 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 169918 | CurrentTaxYearMinus1Year |
| Current Tax Year | 170096 | CurrentTaxYear |
| Total | 967800 | Total |
Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 92584790 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 94784954 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 94274097 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 97204737 | CurrentTaxYearMinus1Year |
| Current Tax Year | 99625406 | CurrentTaxYear |
| Total | 478473984 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 0 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 0 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 0 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 0 | CurrentTaxYearMinus1Year |
| Current Tax Year | 15082 | CurrentTaxYear |
| Total | 15082 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 0 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 0 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 0 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 0 | CurrentTaxYearMinus1Year |
| Current Tax Year | 0 | CurrentTaxYear |
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 0 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 0 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 0 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 0 | CurrentTaxYearMinus1Year |
| Current Tax Year | 15082 | CurrentTaxYear |
| Total | 15082 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 478458902 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 60887 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | -108281 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | -69086 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 60573 | CurrentTaxYearMinus1Year |
| Current Tax Year | 123674 | CurrentTaxYear |
| Total | 67767 | Total |
Post1975 UBTI Post1975UBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 60887 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | -108281 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | -69086 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 60573 | CurrentTaxYearMinus1Year |
| Current Tax Year | 123674 | CurrentTaxYear |
| Total | 67767 | Total |
Net Income From Other UBI NetIncomeFromOtherUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 353784 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 334004 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 338675 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 415690 | CurrentTaxYearMinus1Year |
| Current Tax Year | 497425 | CurrentTaxYear |
| Total | 1939578 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 92999461 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 95010677 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 94543686 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 97681000 | CurrentTaxYearMinus1Year |
| Current Tax Year | 100246505 | CurrentTaxYear |
| Total | 480481329 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99580 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99430 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00010 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00170 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
| General Explanation | OTHER INCOME, SCHEDULE A, PART III, LINE 12, DESCRIPTION - CLINICAL PATHOLOGY FEES, COLUMN A - 353784, COLUMN B - 334004, COLUMN C - 338675, COLUMN D - 415690, COLUMN E - 451445, COLUMN F - 1893598; DESCRIPTION - FUNDRAISING GROSS RECEIPTS, COLUMN A - 0, COLUMN B - 0, COLUMN C - 0, COLUMN D - 0, COLUMN E - 45980, COLUMN F - 45980;, | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1115907 | OtherCostOrOtherBasis |
| Book Value | 1115907 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 43197792 | OtherCostOrOtherBasis |
| Depreciation | 25593551 | Depreciation |
| Book Value | 17604241 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 807978 | OtherCostOrOtherBasis |
| Depreciation | 791390 | Depreciation |
| Book Value | 16588 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 46245230 | OtherCostOrOtherBasis |
| Depreciation | 38635429 | Depreciation |
| Book Value | 7609801 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1216256 | OtherCostOrOtherBasis |
| Book Value | 1216256 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 27562793 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED PENSION AND POSTRETIREMENT BENEFITS | $25,183,732 |
| FAIR VALUE OF INTEREST RATE SWAP | $1,964,673 |
| CAPITAL LEASE OBLIGATION | $112,691 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 27261096 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FIN 48 (ASC 740) footnote | Identifier |
| Return Reference | Schedule D, Part X, Line 2 | ReturnReference |
| Explanation | THE FOUNDATION IS A NOT-FOR-PROFIT ORGANIZATION PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES PURSUANT TO SECTION 501(A). ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REFLECTED IN THE FOUNDATION'S FINANCIAL STATEMENTS. THE FOUNDATION IS SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES FOR THE YEARS ENDED DECEMBER 31, 2009 THROUGH 2012. THE FOUNDATION FOLLOWS GUIDANCE ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD WITH RESPECT TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. A TAX POSITION IS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. MANAGEMENT HAS DETERMINED THAT THERE IS NO LIABILITY FOR UNCERTAIN TAX POSITIONS AND DOES NOT EXPECT THIS TO CHANGE OVER THE NEXT 12 MONTHS. | Explanation |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Special Fundraising Events | X | SpecialFundraisingEvents |
| Agreement Ref Fundraising | true | AgreementRefFundraising |
Fundraiser Activity Information FundraiserActivityInformation (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | ActivityActivity | Fundraiser Control Of FundsFundraiserControlOfFunds | Gross ReceiptsGrossReceipts | Amount Retained By ContractorAmountRetainedByContractor | Net To OrganizationNetToOrganization |
|---|---|---|---|---|---|---|---|---|
| DONNA KYLE | ||||||||
| 21556 LAKE STREET | CASSOPOLIS | MI | 49031 | FUNDRAISING EVENT CONSULTING & SOLICIATION | false | 460907 | 52197 | 408710 |
| LOU BEHRE | ||||||||
| 1660 SIGNAL POINT DRIVE | NILES | MI | 49120 | FUNDRAISING EVENT COORDINATOR | false | 5000 | -5000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | 460907 | TotalGrossReceipts |
| Total Retained By Contractors | 57197 | TotalRetainedByContractors |
| Total Net To Organization | 403710 | TotalNetToOrganization |
| Licensed States | IN | LicensedStates |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | 100TH ANNIVERSARY GALA | NameOfEvent1 |
| Gross Receipts Event1 | 460907 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 414927 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 45980 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 276481 | OtherDirectExpensesEvent1 |
| Gross Revenue Event2 | 0 | GrossRevenueEvent2 |
| Gross Revenue Other Events | 0 | GrossRevenueOtherEvents |
| Gross Receipts Total | 460907 | GrossReceiptsTotal |
| Charitable Contributions Total | 414927 | CharitableContributionsTotal |
| Gross Revenue Total Events | 45980 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 0 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 0 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 0 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 0 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 0 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 276481 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 276481 | DirectExpenseSummaryEvents |
| Net Income Summary | -230501 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (13 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance | Purpose Of GrantPurposeOfGrant | Address Line2AddressUS/AddressLine2 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| THE FOUNDATION OF ST JOSEPH REGIONAL MEDICAL CENTER | |||||||||||
| 837 EAST CEDAR STREET SUITE 350 | SOUTH BEND | IN | 466172069 | 351654543 | 501(C)(3) | 10000 | 0 | N/A | N/A | GENERAL SUPPORT | |
| BOYS AND GIRLS CLUB OF ST JOSEPH COUNTY | |||||||||||
| 1411 LINCOLNWAY W | MISHAWAKA | IN | 46544 | 351329625 | 501(C)(3) | 11000 | 0 | N/A | N/A | GENERAL SUPPORT | |
| NORTHERN INDIANA HISTORICAL SOCIETY | |||||||||||
| 808 W WASHINGTON ST | SOUTH BEND | IN | 46601 | 351124156 | 501(C)(3) | 5000 | 0 | N/A | N/A | GENERAL SUPPORT | |
| INDIANA UNIVERSITY FOUNDATION | |||||||||||
| PO BOX 500 | BLOOMINGTON | IN | 47204 | 356018940 | 501(C)(3) | 10000 | 0 | N/A | N/A | GENERAL SUPPORT - IU SCHOOL OF MEDICINE - SOUTH BEND | |
| LAKELAND HEALTH FOUNDATION NILES | |||||||||||
| 1234 NAPIER AVE | ST JOSEPH | MI | 49085 | 383130558 | 501(C)(3) | 5035 | 0 | N/A | N/A | GENERAL SUPPORT | |
| MARCH OF DIMES - INDIANA CHAPTER | |||||||||||
| 136 EAST MARKET STREET | INDIANAPOLIS | IN | 46204 | 131846366 | 501(C)(3) | 5000 | 0 | N/A | N/A | GENERAL SUPPORT | SUITE 500 |
| MEMORIAL HOSPITAL OF SOUTH BEND | |||||||||||
| 615 N MICHIGAN STREET | SOUTH BEND | IN | 46601 | 350868132 | 501(C)(3) | 5000 | 0 | N/A | N/A | GENERAL SUPPORT | |
| UNITED WAY OF ST JOSEPH COUNTY | |||||||||||
| 3517 E JEFFERSON BLVD | SOUTH BEND | IN | 46615 | 351063368 | 501(C)(3) | 5000 | 0 | N/A | N/A | GENERAL SUPPORT | |
| O'HANA HERITAGE FOUNDATION DBA A ROSIE PLACE | |||||||||||
| 53131 QUINCE ROAD | SOUTH BEND | IN | 46628 | 371523448 | 501(C)(3) | 5000 | 0 | N/A | N/A | GENERAL SUPPORT | |
| MEDICAL EDUCATION FOUNDATION | |||||||||||
| PO BOX 4394 | SOUTH BEND | IN | 46634 | 351291588 | 501(C)(3) | 5000 | 0 | N/A | N/A | GENERAL SUPPORT - IUSB CLINICAL TRAINING | |
| LOGAN COMMUNITY RESOURCES | |||||||||||
| 2505 E JEFFERSON BLVD | SOUTH BEND | IN | 46615 | 350965639 | 501(C)(3) | 5500 | 0 | N/A | N/A | GENERAL SUPPORT | |
| COMMUNITY FOUNDATION OF ST JOSEPH COUNTY | |||||||||||
| PO BOX 837 | SOUTH BEND | IN | 46624 | 237365930 | 501(C)(3) | 75540 | 0 | N/A | N/A | GENERAL SUPPORT | |
| CENTER FOR HOSPICE | |||||||||||
| 111 SUNNYBROOK CT | SOUTH BEND | IN | 46637 | 310952866 | 501(C)(3) | 5140 | 0 | N/A | N/A | GENERAL SUPPORT | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 13 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)
| Type Of GrantTypeOfGrant | Amount Of Cash GrantAmountOfCashGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance |
|---|---|---|---|---|
| PATIENT MEDICAL ASSISTANCE | 0 | 1919979 | BOOK VALUE | FREE OR REDUCED MEDICAL CARE |
| TIME OF SERVICE DISCOUNTS | 0 | 585826 | BOOK VALUE | DISCOUNT PROVIDED AT TIME OF PAYMENT |
Form990 Schedule I Part IV Form990ScheduleIPartIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| NUMBER OF RECIPIENTS | SCHEDULE I, PART III, COLUMN (B) | CURRENTLY, SOUTH BEND MEDICAL FOUNDATION DOES NOT HAVE AN EFFECTIVE WAY TO TRACK THE UNDUPLICATED NUMBER OF PATIENTS THAT RECEIVE FREE OR REDUCED CARE AND TIME OF SERVICE DISCOUNTS. |
| Procedures for monitoring use of grant funds | Schedule I, Part I, Line 2 | SOUTH BEND MEDICAL FOUNDATION (SBMF) PROVIDES FUNDING TO OTHER COMMUNITY NOT-FOR-PROFIT ORGANIZATIONS. GENERALLY, THESE ARE UNRESTRICTED CONTRIBUTIONS THAT THE RECEIVING ORGANIZATION CAN USE TO FURTHER THEIR MISSION AND PROGRAMS AT THEIR DISCRETION. THE USE OF THESE CONTRIBUTIONS IS NOT MONITORED. SBMF ALSO PROVIDES ASSISTANCE TO INDIVIDUALS IN THE FORM OF FREE OR REDUCED FEE MEDICAL CARE AT VARIOUS LOCATIONS THROUGHOUT THE COMMUNITIES SERVED. THESE INDIVIDUALS MEET SBMF'S CHARITY CARE ELIGIBILITY REQUIREMENTS, OR THE REQUIREMENTS OF THE REFERRING HEALTH CARE PROVIDER. DETERMINATION AND MONITORING OF CHARITY CARE IS PERFORMED ON A CASE-BY-CASE BASIS. SBMF ALSO PROVIDES DISCOUNTS FOR PAYMENT AT TIME OF SERVICE TO PATIENTS WHO DO NOT HAVE GOVERNMENT PROVIDED INSURANCE COVERAGE OR DO NOT WISH TO HAVE A CLAIM FILED WITH THEIR COMMERCIAL INSURANCE CARRIER. THERE IS NO ACTUAL EXCHANGE OF FUNDS, AS THE DISCOUNTS ARE CREDITED DIRECTLY TO THE PATIENTS' ACCOUNTS. TIME OF SERVICE DISCOUNTS ARE MONITORED AT THE ORGANIZATION LEVEL, IN THE AGGREGATE. |
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 |
| Compensation Committee | X | CompensationCommittee |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | 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 (26 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALFONSO CARDENAS MD | ||||||||||||||
| PATHOLOGIST | 362982 | 0 | 51 | 0 | 0 | 0 | 7350 | 0 | 31923 | 0 | 402306 | 0 | 0 | 0 |
| AMOBI EZENEKWE MD | ||||||||||||||
| PATHOLOGIST | 245633 | 0 | 73 | 0 | 2956 | 0 | 7350 | 0 | 38060 | 0 | 294072 | 0 | 0 | 0 |
| BLAIR CHRENKA MD | ||||||||||||||
| PATHOLOGIST | 229422 | 0 | 203 | 0 | 2453 | 0 | 4752 | 0 | 36758 | 0 | 273588 | 0 | 0 | 0 |
| BOBBIE SUTTON MD | ||||||||||||||
| PATHOLOGIST | 285035 | 0 | 73 | 0 | 0 | 0 | 7350 | 0 | 23671 | 0 | 316129 | 0 | 0 | 0 |
| C K KIM MD | ||||||||||||||
| PATHOLOGIST | 362916 | 0 | 73 | 0 | 3148 | 0 | 7350 | 0 | 34723 | 0 | 408210 | 0 | 0 | 0 |
| DAVID JENTZ MD | ||||||||||||||
| PATHOLOGIST | 360819 | 0 | 51 | 0 | 3148 | 0 | 7350 | 0 | 26873 | 0 | 398241 | 0 | 0 | 0 |
| DERRICK FORCHETTI MD | ||||||||||||||
| PATHOLOGIST | 261641 | 0 | 68 | 0 | 0 | 0 | 7350 | 0 | 29172 | 0 | 298231 | 0 | 0 | 0 |
| FRANCISCO DEOGRACIAS MD | ||||||||||||||
| PATHOLOGIST | 349926 | 0 | 51 | 0 | 3148 | 0 | 7350 | 0 | 28251 | 0 | 388726 | 0 | 0 | 0 |
| FRED BUSSE MD | ||||||||||||||
| PATHOLOGIST | 239114 | 0 | 53 | 0 | 19956 | 0 | 7350 | 0 | 27975 | 0 | 294448 | 0 | 0 | 0 |
| JAMES DYER MD | ||||||||||||||
| PATHOLOGIST | 245633 | 0 | 73 | 0 | 2842 | 0 | 4793 | 0 | 14493 | 0 | 267834 | 0 | 0 | 0 |
| JOHN LANDGRAF MD | ||||||||||||||
| PATHOLOGIST | 250977 | 0 | 51 | 0 | 9195 | 0 | 7350 | 0 | 26075 | 0 | 293648 | 0 | 0 | 0 |
| JOSEPH PRAHLOW MD | ||||||||||||||
| PATHOLOGIST | 263491 | 0 | 73 | 0 | 2897 | 0 | 7350 | 0 | 31305 | 0 | 305116 | 0 | 0 | 0 |
| JOYCE SIMPSON MD | ||||||||||||||
| PATHOLOGIST | 164462 | 0 | 0 | 0 | 0 | 0 | 6541 | 0 | 9192 | 0 | 180195 | 0 | 0 | 0 |
| KRISTEN JACOBS MD | ||||||||||||||
| PATHOLOGIST | 214547 | 0 | 51 | 0 | 356494 | 0 | 6594 | 0 | 31400 | 0 | 609086 | 0 | 353882 | 0 |
| LUIS GALUP MD | ||||||||||||||
| PATHOLOGIST | 359070 | 0 | 73 | 0 | 3500 | 0 | 7350 | 0 | 38714 | 0 | 408707 | 0 | 0 | 0 |
| NICOLE ANEST MD | ||||||||||||||
| PATHOLOGIST | 222550 | 0 | 68 | 0 | 3892 | 0 | 5433 | 0 | 26831 | 0 | 258774 | 0 | 0 | 0 |
| NITA GERIG MD | ||||||||||||||
| PATHOLOGIST | 265347 | 0 | 70 | 0 | 19658 | 0 | 7350 | 0 | 34537 | 0 | 326962 | 0 | 0 | 0 |
| ODETA LAPKUS MD | ||||||||||||||
| PATHOLOGIST | 254032 | 0 | 68 | 0 | 0 | 0 | 4900 | 0 | 29360 | 0 | 288360 | 0 | 0 | 0 |
| RICKY HOOVER MD | ||||||||||||||
| PATHOLOGIST | 342170 | 0 | 51 | 0 | 3148 | 0 | 7350 | 0 | 36217 | 0 | 388936 | 0 | 0 | 0 |
| ROBERT TOMEC MD | ||||||||||||||
| PRESIDENT/EXECUTIVE VP | 364977 | 0 | 51 | 0 | 20652 | 0 | 7350 | 0 | 28148 | 0 | 421178 | 0 | 0 | 0 |
| ROBERT KING | ||||||||||||||
| SENIOR VP | 270165 | 0 | 68 | 0 | 3209 | 0 | 7350 | 0 | 27096 | 0 | 307888 | 0 | 0 | 0 |
| WILLIAM KALINEY MD | ||||||||||||||
| VICE PRESIDENT/EXECUTIVE VP | 363477 | 0 | 51 | 0 | 20487 | 0 | 7350 | 0 | 29248 | 0 | 420613 | 0 | 0 | 0 |
| DIANE JANOWIAK | ||||||||||||||
| VP OF CENTRAL LAB OPERATIONS | 232699 | 0 | 73 | 0 | 702 | 0 | 6981 | 0 | 22023 | 0 | 262478 | 0 | 0 | 0 |
| ANN SULLIVAN | ||||||||||||||
| VP OF FINANCE | 229171 | 0 | 68 | 0 | 3534 | 0 | 6721 | 0 | 36111 | 0 | 275605 | 0 | 0 | 0 |
| JAMES FRAIN | ||||||||||||||
| VP OF HUMAN RESOURCES | 230171 | 0 | 68 | 0 | 2754 | 0 | 6981 | 0 | 35111 | 0 | 275085 | 0 | 0 | 0 |
| PRENTISS JONES | ||||||||||||||
| DIRECTOR - TOXICOLOGY | 145462 | 0 | 68 | 0 | 0 | 0 | 4447 | 0 | 21776 | 0 | 171753 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Health or social club dues or initiation fees | Schedule J, Part I, Line 1a | THE ORGANIZATION INCLUDES THE PERSONAL USE OF SOCIAL CLUB DUES IN TAXABLE COMPENSATION FOR THE ORGANIZATION'S VICE PRESIDENT OF FINANCE AND VICE PRESIDENT OF CENTRAL LAB OPERATIONS. PERSONAL USE IS DETERMINED BY SIGNED ACKNOWLEDGEMENT OF EACH OFFICER. |
| Supplemental nonqualified retirement plan | Schedule J, Part I, Line 4b | THE ORGANIZATION HAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THAT WAS DESIGNED TO REPLACE RETIREMENT BENEFITS LOST BY INDIVIDUALS DUE TO 1998 CHANGES IN PENSION LAWS AND A REDESIGN OF THE PENSION PLAN TO MAXIMIZE BENEFITS FOR LOWER COMPENSATED EMPLOYEES. THE ORGANIZATION'S BOARD OF DIRECTORS ELECTED TO FREEZE THIS PLAN, AND THEREFORE NO BENEFITS WERE PROVIDED DURING 2012. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| MICHIANA HEALTH INFORMATION NETWORK LLC (MHIN) | |||
| R. KING & R. TOMEC (SBMF OFFICERS) ARE MHIN BOARD MEMBERS | 803564 | SEE PART V | false |
| MICHIANA HEMATOLOGY ONCOLOGY PC (MHO) | |||
| B. ANSARI (SBMF BOARD MEMBER) IS AN OFFICER/DIRECTOR OF MHO. | 110053 | SEE PART V | false |
Form990 Schedule L Part V Form990ScheduleLPartV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF TRANSACTION (MHIN) | SCHEDULE L, PART IV, COLUMN (D) | SBMF OWNS AN INTEREST IN MHIN, A JOINT VENTURE THAT MAINTAINS A COMMUNITY-BASED MEDICAL INFORMATION SYSTEM AND CLINICAL DATA REPOSITORY. SBMF PURCHASED SERVICES AT FMV FROM MHIN AGGREGATING $756,000 DURING 2012. IN ADDITION, MHIN PURCHASED CERTAIN SERVICES AT FMV FROM SBMF AMOUNTING TO $47,564 DURING 2012. |
| DESCRIPTION OF TRANSACTION (MHO) | SCHEDULE L, PART IV, COLUMN (D) | SBMF MADE $110,053 IN PAYMENTS (AT FMV) TO MHO FOR RENTAL OF SPACE. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION (CONTINUED FROM PART III) | FORM 990, PART III, LINE 1 | TO FULFILL OUR MISSION WE SHALL: (I) PROVIDE THE HOSPITALS WE SERVICE WITH THE HIGHEST QUALITY LABORATORY RESOURCES AND--TAKING INTO ACCOUNT THAT LENGTH OF STAY IS CRUCIAL FOR INPATIENT CARE--WITH THE SHORTEST RESPONSE TIME WHILE ACHIEVING A HIGH DEGREE OF COST EFFECTIVENESS. (II) PROVIDE OUR PHYSICIAN CUSTOMERS WITH THE HIGHEST QUALITY LABORATORY RESULTS UTILIZING THE LATEST TECHNOLOGY AND MAKING AVAILABLE TO THEM READILY ACCESSIBLE CONSULTATIVE OPPORTUNITIES IN THE MEDICAL AND ADMINISTRATIVE ASPECTS OF THEIR PRACTICES. (III) CREATE AND MAINTAIN A WORK ENVIRONMENT WHERE EMPLOYEES CAN GROW PERSONALLY AND PROFESSIONALLY WITH COMPENSATION AND BENEFIT SYSTEMS THAT ARE COMPETITIVE, EQUITABLE AND COST EFFECTIVE AS WELL AS AN ENVIRONMENT WHERE EMPLOYEES ARE PROVIDED STABLE EMPLOYMENT AND EACH INDIVIDUAL IS TREATED WITH RESPECT AND DIGNITY. (IV) PROVIDE TO THE PATIENT POPULATION IN THE COMMUNITIES WE SERVE READILY ACCESSIBLE, REASONABLY PRICED LABORATORY SERVICES, WITH AS WIDE A SCOPE AND VARIETY AS POSSIBLE TO MEET ALL THEIR NEEDS LOCALLY. (V) RECOGNIZING OUR SOCIAL RESPONSIBILITIES TO THE COMMUNITY, PROVIDE SERVICES WITHIN OUR MEANS TO THOSE LESS FORTUNATE, AND SUPPORT PUBLIC AND PRIVATE EFFORTS DIRECTED TO IMPROVE OUR HEALTH CARE ENVIRONMENT. |
| PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED FROM PART III) | FORM 990, PART III, LINE 4A | THE ALTRUISTIC ACTIVITIES OF THE ORGANIZATION ARE INTENDED TO RELIEVE DISEASE, SUFFERING, AND CONSTRAINT. MANY SERVICES ARE PROVIDED AS CHARITY OR PRO BONO. THE AMOUNT OF CHARITY CARE, PROVIDED AT SBMF'S ESTABLISHED RATES, WAS APPROXIMATELY $881,500 FOR THE YEAR ENDED DECEMBER 31, 2012. |
| Delegate broad authority to a committee | Form 990, Part VI, Section A, Line 1a | THE ADMINISTRATIVE COMMITTEE SHALL CONSIST OF THE OFFICERS OF THE CORPORATION. SUBJECT TO THE CONTROL OF THE BOARD OF DIRECTORS, THE ADMINISTRATIVE COMMITTEE SHALL HAVE FULL AUTHORITY TO ACT FOR AND ON BEHALF OF THE CORPORATION AND EXERCISE ALL OF THE POWERS OF THE BOARD OF DIRECTORS THAT MAY BE LAWFULLY DELEGATED BY SUCH BOARD TO SUCH COMMITTEE EXCEPT, HOWEVER, THE ADMINISTRATIVE COMMITTEE SHALL HAVE NO POWER TO DONATE ANY PART OF THE ASSETS OF THE CORPORATION. THE ADMINISTRATIVE COMMITTEE SHALL RECEIVE STATUS REPORTS ON OTHER COMMITTEE ACTIVITIES AND DISCUSS ITEMS OF INTEREST TO THE GROUP AS A WHOLE OR TO INDIVIDUAL OFFICERS FOR THE PERFORMANCE OF THEIR DUTIES. THE ADMINISTRATIVE COMMITTEE SHALL KEEP MINUTES OF ITS MEETINGS. |
| Family/business relationships amongst interested persons | Form 990, Part VI, Section A, Line 2 | BOB SUTTON (HUSBAND OF BOBBIE SUTTON) AND FRED BUSSE - BUSINESS RELATIONSHIP, ANA CARDENAS (WIFE OF ALFONSO CARDENAS) AND JOHN JACOBS (HUSBAND OF KRISTEN JACOBS) - BUSINESS RELATIONSHIP, FREDERICK J. FERLIC, M.D. AND HENRY KIM, M.D. - BUSINESS RELATIONSHIP |
| Review of form 990 by governing body | Form 990, Part VI, Section B, Line 11b | PRIOR TO NOVEMBER 15, 2013, EACH BOARD MEMBER WAS PROVIDED A COPY OF THE RETURN FOR THEIR REVIEW AND INSTRUCTED TO SUBMIT ANY QUESTIONS OR COMMENTS TO THE VP OF FINANCE. AFTER COMMENTS AND QUESTIONS ARE REVIEWED, THE RETURN WAS COMPLETED AND FILED WITH THE IRS ON OR BEFORE NOVEMBER 15, 2013. |
| Conflict of interest policy | Form 990, Part VI, Section B, Line 12c | ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES ARE COMPLETED BY ALL BOARD MEMBERS, OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES. THE ORGANIZATION'S VICE PRESIDENT OF FINANCE AND TAX ADVISERS REVIEW ALL RESPONSES TO DETERMINE WHETHER OR NOT A POTENTIAL OR ACTUAL CONFLICT OF INTEREST EXISTS. IF AN ACTUAL CONFLICT OF INTEREST IS DETERMINED TO EXIST, PERSONS WITH A CONFLICT ARE RECUSED FROM VOTING ON THE CONFLICTING ISSUE. |
| Process used to establish compensation of top management official | Form 990, Part VI, Section B, Line 15a | ON AN ANNUAL BASIS, THE ORGANIZATION'S COMPENSATION COMMITTEE REVIEWS AND APPROVES COMPENSATION FOR THE PRESIDENT/EXECUTIVE VICE PRESIDENT, AS WELL AS OTHER OFFICERS, ADMINISTRATORS, AND PROFESSIONAL STAFF, INCLUDING KEY EMPLOYEES. THE COMMITTEE REVIEWS CURRENT SALARIES AND PAY STRUCTURES AGAINST VARIOUS SOURCES OF COMPARABILITY DATA, INCLUDING: THE COLLEGE OF AMERICAN PATHOLOGY PATHOLOGISTS COMPENSATION SURVEY; PATHOLOGY COMPENSATION DATA FOR PATHOLOGISTS, WHICH OUTLINES PATHOLOGY AND PHYSICIAN SALARIES BY SPECIALTY, PROVIDED FROM MERRITT HAWKINS AND ASSOCIATES; THE GUIDESTAR NATIONAL COMPENSATION REPORT; AND COMPENSATION REPORTED ON LOCAL AREA HOSPITALS' FORMS 990. AFTER REVIEWING THE COMPARABILITY DATA, THE COMMITTEE DISCUSSES THE CURRENT ECONOMY AND FINANCIAL POSITION OF THE ORGANIZATION TO DETERMINE THE AMOUNT OF ANY COMPENSATION INCREASES AND/OR DECREASES, IF ANY, THAT WILL BE GIVEN. THIS PROCESS IS DOCUMENTED IN THE COMPENSATION COMMITTEE'S MEETING MINUTES. THE COMPENSATION REVIEW COMMITTEE MET APRIL 26, 2012 AND REPORTED AT THE MAY BOARD OF DIRECTOR'S MEETING. |
| Process used to establish compensation of other officers/key employees | Form 990, Part VI, Section B, Line 15b | SEE NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A. |
| Governing documents, conflict of interest policy and financial statements available to the public | Form 990, Part VI, Section C, Line 19 | WHEN REQUESTS FOR THE ORGANIZATION'S FINANCIAL STATEMENTS ARE MADE, THE DATA IS PROVIDED ON SITE. WHEN REQUESTS FOR THE ORGANIZATION'S GOVERNING DOCUMENTS ARE MADE, THE PERSON IS REFERRED TO WWW.IRS.GOV, WHERE COPIES ARE AVAILABLE. THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC ON SITE. |
| Other changes in net assets or fund balances | Form 990 , Part XI, Line 9 | PENSION AND POSTRETIREMENT BENEFIT-RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST - -4313414; GALA 2013 RECEIPTS - -103125; |