INDIANA HEALTH INFORMATION EXCHANGE INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- INDIANA HEALTH INFORMATION EXCHANGE INC (EIN 36-4550324)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-15
- IRS object ID
- 201343199349308914
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-15T15:25:38-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352123203 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KSM BUSINESS SERVICES INC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 40857 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 462400857 | 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 | 364550324 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA HEALTH INFORMATION EXCHANGE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | INDI | NameControl |
| Phone | 3176441720 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 846 N SENATE AVENUE NO 300 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46202 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRIAN MODIANO | Name |
| Title | CEO | Title |
| Phone | 3176441720 | Phone |
| Date Signed | 2013-11-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SCOTT A SCHUSTER | Name |
| PTIN | P00019243 | PTIN |
| Phone | 3175802000 | Phone |
| Date Prepared | 2013-11-15 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | HAROLD APPLE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 846 N SENATE AVE | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 13075200 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.IHIE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2004 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | OUR MISSION IS TO USE INFORMATION TECHNOLOGY AND SHARED CLINICAL INFORMATION TO: - IMPROVE THE QUALITY, SAFETY, AND EFFICIENCY OF HEALTH CARE - CREATE UNPARALLELED RESEARCH CAPABILITIES FOR HEALTH RESEARCHERS- EXHIBIT A SUCCESSFUL MODEL OF HEALTH INFORMATION EXCHANGE FOR THE REST OF THE COUNTRY | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 85 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 12828211 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 13024414 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 4963 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2073 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -71953 | OtherRevenuePriorYear |
| Other Revenue Current Year | 48713 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 12761221 | TotalRevenuePriorYear |
| Total Revenue Current Year | 13075200 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6674128 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 7013243 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 6115317 | OtherExpensePriorYear |
| Other Expenses Current Year | 6736180 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 12789445 | TotalExpensesPriorYear |
| Total Expenses Current Year | 13749423 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -28224 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -674223 | RevenuesLessExpensesCY |
| Total Assets BOY | 5301958 | TotalAssetsBOY |
| Total Assets EOY | 2917178 | TotalAssetsEOY |
| Total Liabilities BOY | 3239259 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1609308 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2062699 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1307870 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | OUR MISSION IS TO USE INFORMATION TECHNOLOGY AND SHARED CLINICAL INFORMATION TO: - IMPROVE THE QUALITY, SAFETY, AND EFFICIENCY OF HEALTH CARE - CREATE UNPARALLELED RESEARCH CAPABILITIES FOR HEALTH RESEARCHERS- EXHIBIT A SUCCESSFUL MODEL OF HEALTH INFORMATION EXCHANGE FOR THE REST OF THE COUNTRY | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 8728291 | Expense |
| Description | CLINICAL MESSAGING - PROVIDE PATIENTS ELECTRONIC MEDICAL INFORMATION AND TEST RESULTS TO INDIANA HOSPITALS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1540287 | Expense |
| Description | CLINICAL QUALITY - TO PROVIDE MEASUREMENT OF CLINICS TREATMENT OF PATIENTS - GOAL IS TO IMPROVE HEALTH CARE. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 10268578 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 13 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 85 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAROLD APPLE CEO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3176441720 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 846 N SENATE AVENUE SUITE 110 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46202 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 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 |
|---|---|---|---|---|---|---|---|---|
| VINCENT C CAPONI | ||||||||
| CHAIR | 2.00 | X | X | 0 | 2799320 | 53508 | ||
| WILLIAM R CAST | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| DAVID COOK | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| DANIEL F EVANS JR | ||||||||
| DIRECTOR | 2.00 | X | 0 | 1413834 | 865442 | |||
| MATTHEW R GUTWEIN | ||||||||
| DIRECTOR | 2.00 | X | 0 | 324453 | 26875 | |||
| DAVID L JOHNSON | ||||||||
| SECRETARY/TREASURER | 2.00 | X | X | 0 | 404673 | 23574 | ||
| NED LAMKIN | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| TERESA L LOVINS | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| BRYAN A MILLS | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| WILLIAM R TIERNEY | ||||||||
| VICE CHAIR | 2.00 | X | X | 0 | 323158 | 95974 | ||
| D CRAIG BRATER | ||||||||
| DIRECTOR | 2.00 | X | 0 | 594186 | 20000 | |||
| ROBERT BRODY | ||||||||
| DIRECTOR | 2.00 | X | 0 | 888412 | 719857 | |||
| VIRGINIA CAINE | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| WAYNE DEVEYDT | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| JOHN ELLIS | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| DOUGLAS J LEONARD | ||||||||
| DIRECTOR | 2.00 | X | 0 | 691022 | 177433 | |||
| HAROLD APPLE | ||||||||
| PRESIDENT/CEO | 40.00 | X | 253846 | 0 | 7056 | |||
| THOMAS P PENNO | ||||||||
| CHIEF OPERATING OFFICER | 40.00 | X | 110758 | 0 | 4 | |||
| BRIAN MODIANO | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | X | 171995 | 0 | 12060 | |||
| JANE NIEDERBERGER | ||||||||
| VICE PRESIDENT, CLIENT SERVICE | 40.00 | 155817 | 0 | 10119 | X | |||
| JAMES S HILL | ||||||||
| VICE PRESIDENT, SALES | 40.00 | 184174 | 0 | 8966 | X | |||
| KENT HILLER | ||||||||
| VICE PRESIDENT, DS&A | 40.00 | 160378 | 0 | 8966 | X | |||
| KESHIA COOPER | ||||||||
| DIRECTOR, PMO | 40.00 | 151797 | 0 | 10022 | X | |||
| KEITH W KELLEY | ||||||||
| VICE PRESIDENT, PROFESSIONAL SERVICES | 40.00 | 166708 | 0 | 12040 | X | |||
| ERIC T THIEME | ||||||||
| GENERAL COUNSEL AND COMPLI | 40.00 | 148700 | 0 | 14066 | X | |||
| JOHN P KANSKY | ||||||||
| VICE PRESIDENT, STRATEGY AND PLANNING | 40.00 | 185029 | 0 | 16258 | X | |||
| JOSH NELSON | ||||||||
| CMO | 40.00 | 175560 | 0 | 6556 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1864762 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 7439058 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 2088776 | TotalOtherCompensation |
| Number Individuals GT100 K | 25 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| REGENSTRIEF INSTITUTE | |||||
| 410 WEST 10TH STREET STE 2000 | INDIANAPOLIS | IN | 46202 | HEALTHCARE RESEARCH | 3644377 |
| AT&T | |||||
| PO BOX 5019 | CAROL STREAM | IL | 60197 | COMMUNICATION SERVICES | 621462 |
| ST VINCENT HEALTH | |||||
| 10330 NORTH MERIDIAN STREET | INDIANAPOLIS | IN | 46290 | IMPLEMENTATION AND PROJECT MANAGEMENT | 321094 |
| ANCHOR POINT TECHNOLOGY RESOURCES | |||||
| 8440 WOODFIELD CROSSING BLVD STE | INDIANAPOLIS | IN | 46240 | TECHNOLOGY STAFFING | 236378 |
| HEALTHCARE OPTIONS INC | |||||
| 3901 WEST 86TH STREET SUITE 270 | INDIANAPOLIS | IN | 46268 | BEACON PROJECT MANAGEMENT & DEVELOPMENT | 170484 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| CLINICAL MESSAGING | 519100 | 6316466 | 6316466 |
| PROGRAM REVENUE | 519100 | 5067559 | 5067559 |
| ANALYTICAL SERVICES | 519100 | 1138825 | 1138825 |
| CONSULTING | 541900 | 501564 | 501564 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 13024414 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2073 | TotalRevenueColumn |
| Exclusion | $2,073 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER INCOME | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 48713 | TotalRevenueColumn |
| Related Or Exempt Function Income | 48713 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 48713 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13075200 | TotalRevenueColumn |
| Related Or Exempt Function Income | 13073127 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $2,073 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1084139 | Total |
| Program Services | 41484 | ProgramServices |
| Management And General | 1042655 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4763397 | Total |
| Program Services | 3946560 | ProgramServices |
| Management And General | 816837 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 127599 | Total |
| Program Services | 87023 | ProgramServices |
| Management And General | 40576 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 574653 | Total |
| Program Services | 391916 | ProgramServices |
| Management And General | 182737 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 463455 | Total |
| Program Services | 316078 | ProgramServices |
| Management And General | 147377 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 90909 | Total |
| Program Services | 27072 | ProgramServices |
| Management And General | 63837 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 122188 | Total |
| Management And General | 122188 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48105 | Total |
| Management And General | 48105 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61903 | Total |
| Program Services | 45193 | ProgramServices |
| Management And General | 16710 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89969 | Total |
| Program Services | 4466 | ProgramServices |
| Management And General | 85503 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35801 | Total |
| Management And General | 35801 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 881804 | Total |
| Program Services | 835261 | ProgramServices |
| Management And General | 46543 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 276039 | Total |
| Management And General | 276039 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 147843 | Total |
| Program Services | 48421 | ProgramServices |
| Management And General | 99422 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 538936 | Total |
| Program Services | 256370 | ProgramServices |
| Management And General | 282566 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37295 | Total |
| Management And General | 37295 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| CONSULTANTS | 4240358 | 4209539 | 30819 |
| EQUIPMENT LEASING | 61422 | 44055 | 17367 |
| TRAINING | 27212 | 12495 | 14717 |
| TELEPHONE | 19135 | 19135 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57261 | Total |
| Program Services | 2645 | ProgramServices |
| Management And General | 54616 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13749423 | Total |
| Program Services | 10268578 | ProgramServices |
| Management And General | 3480845 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1208009 | BOY |
| EOY | 197418 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 691422 | BOY |
| EOY | 1207 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 716631 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1562162 | BOY |
| EOY | 573406 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 499096 | BOY |
| EOY | 546048 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 2480751 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1301175 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1381138 | BOY |
| EOY | 1179576 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -899002 | BOY |
| EOY | -978858 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 839623 | BOY |
| EOY | 662240 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19510 | BOY |
| EOY | 19510 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5301958 | BOY |
| EOY | 2917178 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2280645 | BOY |
| EOY | 1289770 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 958614 | BOY |
| EOY | 319538 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3239259 | BOY |
| EOY | 1609308 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2062699 | BOY |
| EOY | 1307870 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2062699 | BOY |
| EOY | 1307870 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5301958 | BOY |
| EOY | 2917178 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -674223 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -80606 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (12 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| INDIANA UNIVERSITY HEALTH | |||||
| 351955872 | LINE 3 | 1 | 1 | 1 | $0 |
| COMMUNITY HOSPITALS OF INDIANA | |||||
| 350983617 | LINE 3 | 1 | 1 | 1 | $0 |
| HEALTH & HOSPITAL CORPORATION | |||||
| 356065697 | LINE 6 | 1 | 1 | 1 | $0 |
| INDIANA STATE MEDICAL ASSOCIATION | |||||
| 350411650 | LINE 9 | 1 | 1 | 1 | $0 |
| INDIANA UNIVERSITY | |||||
| 356001673 | LINE 6 | 1 | 1 | 1 | $0 |
| THE INDIANAPOLIS MEDICAL SOCIETY | |||||
| 127566088 | LINE 9 | 1 | 1 | 1 | $0 |
| MARION COUNTY HEALTH DEPARTMENT | |||||
| 356065697 | LINE 6 | 1 | 1 | 1 | $0 |
| SISTERS OF ST FRANCIS HEALTH SERVICES | |||||
| 350913537 | LINE 3 | 1 | 1 | 1 | $0 |
| ST VINCENT HOSPITAL & HEALTH CARE | |||||
| 352052591 | LINE 3 | 1 | 1 | 1 | $0 |
| CENTRAL INDIANA CORPORATE PARTNERSHIP | |||||
| 352065459 | LINE 9 | 1 | 1 | 1 | $0 |
| INDIANA HOSPITAL ASSOCIATION INC | |||||
| 350988753 | LINE 9 | 1 | 1 | 1 | $0 |
| INDIANA STATE DEPARTMENT OF HEALTH | |||||
| 356000158 | LINE 6 | 1 | 1 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 12 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $48,105 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 48105 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | THE ORGANIZATION ENGAGES A REGISTERED LOBBYIST IN THE STATE OF INDIANA TO REPRESENT ITS INTERESTS AT THE STATE LEGISLATIVE AND EXECUTIVE BRANCHES. WHILE THE ORGANIZATION ENGAGES A LOBBYIST ON A MONTHLY BASIS, NOT ALL ACTIVITIES CONDUCTED ARE "LOBBYING" UNDER THE DEFINITION IN INTERNAL REVENUE CODE (IRC) SECTION 4911 BECAUSE NOT ALL SUCH ACTIVITIES CONSTITUTE "INFLUENCING LEGISLATION," AS DEFINED IN IRC SECTION 4911(D)(1); HOWEVER, THE ORGANIZATION IS REPORTING HEREIN THE ENTIRE EXPENDITURE, WHICH NEVERTHELESS REPRESENTS AN INSUBSTANTIAL PART OF THE ORGANIZATION'S OVERALL EXPENDITURES. | Explanation |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 65199 | OtherCostOrOtherBasis |
| Depreciation | 40505 | Depreciation |
| Book Value | 24694 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2415552 | OtherCostOrOtherBasis |
| Depreciation | 1260670 | Depreciation |
| Book Value | 1154882 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1179576 | TotalOfBookValueLandBuildings |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 12994594 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -80606 | OtherRevenues |
| Revenue Not Rptd F990 | -80606 | RevenueNotRptdF990 |
| Revenue Subtotal | 13075200 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 13075200 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 13749423 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 13749423 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 13749423 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | IHIE IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. IN ADDITION, IHIE HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE NOT TO BE A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE INTERNAL REVENUE CODE. THERE WAS NO UNRELATED BUSINESS INCOME FOR THE YEARS ENDED DECEMBER 31, 2012 AND 2011. THE ORGANIZATION FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTION AND IN THE STATE OF INDIANA. THE ORGANIZATION IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2009. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | LOSS ON MERGETICS SHOWN IN FINANCIAL STATEMENTS -80,606. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (18 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VINCENT C CAPONI | ||||||||||||||
| CHAIR | 0 | 911900 | 0 | 1885605 | 0 | 1815 | 0 | 39978 | 0 | 13530 | 0 | 2852828 | 0 | 0 |
| DANIEL F EVANS JR | ||||||||||||||
| DIRECTOR | 0 | 1043576 | 0 | 313408 | 0 | 56850 | 0 | 838555 | 0 | 26887 | 0 | 2279276 | 0 | 0 |
| MATTHEW R GUTWEIN | ||||||||||||||
| DIRECTOR | 0 | 324453 | 0 | 0 | 0 | 0 | 0 | 16250 | 0 | 10625 | 0 | 351328 | 0 | 0 |
| DAVID L JOHNSON | ||||||||||||||
| SECRETARY/TREASURER | 0 | 369553 | 0 | 35000 | 0 | 120 | 0 | 0 | 0 | 23574 | 0 | 428247 | 0 | 0 |
| WILLIAM R TIERNEY | ||||||||||||||
| VICE CHAIR | 0 | 250000 | 0 | 8158 | 0 | 65000 | 0 | 47654 | 0 | 48320 | 0 | 419132 | 0 | 0 |
| D CRAIG BRATER | ||||||||||||||
| DIRECTOR | 0 | 509284 | 0 | 0 | 0 | 84902 | 0 | 344476 | 0 | 16273 | 0 | 954935 | 0 | 0 |
| ROBERT BRODY | ||||||||||||||
| DIRECTOR | 0 | 837337 | 0 | 0 | 0 | 51075 | 0 | 688603 | 0 | 31254 | 0 | 1608269 | 0 | 0 |
| DOUGLAS J LEONARD | ||||||||||||||
| DIRECTOR | 0 | 677648 | 0 | 0 | 0 | 13374 | 0 | 155436 | 0 | 21997 | 0 | 868455 | 0 | 0 |
| HAROLD APPLE | ||||||||||||||
| PRESIDENT/CEO | 253846 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 7056 | 0 | 260902 | 0 | 0 | 0 |
| BRIAN MODIANO | ||||||||||||||
| CHIEF FINANCIAL OFFICER | 171995 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 12060 | 0 | 184055 | 0 | 0 | 0 |
| JANE NIEDERBERGER | ||||||||||||||
| VICE PRESIDENT, CLIENT SERVICE | 155817 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 10119 | 0 | 165936 | 0 | 0 | 0 |
| JAMES S HILL | ||||||||||||||
| VICE PRESIDENT, SALES | 184174 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 8966 | 0 | 193140 | 0 | 0 | 0 |
| KENT HILLER | ||||||||||||||
| VICE PRESIDENT, DS&A | 160378 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 8966 | 0 | 169344 | 0 | 0 | 0 |
| KESHIA COOPER | ||||||||||||||
| DIRECTOR, PMO | 151797 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 10022 | 0 | 161819 | 0 | 0 | 0 |
| KEITH W KELLEY | ||||||||||||||
| VICE PRESIDENT, PROFESSIONAL SERVICE | 166708 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 12040 | 0 | 178748 | 0 | 0 | 0 |
| ERIC T THIEME | ||||||||||||||
| GENERAL COUNSEL AND COMPLI | 148700 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 14066 | 0 | 162766 | 0 | 0 | 0 |
| JOHN P KANSKY | ||||||||||||||
| VICE PRESIDENT, STRATEGY AND PLANNIN | 185029 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 16258 | 0 | 201287 | 0 | 0 | 0 |
| JOSH NELSON | ||||||||||||||
| CMO | 175560 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 6556 | 0 | 182116 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Return Reference | PART III | ReturnReference |
| Explanation | PART I, LINE 4(A) A SEVERANCE PAYMENT WAS PAID TO THOMAS PENNO, FORMER CHIEF OPERATING OFFICER. THE AMOUNT OF SEVERANCE WAS $94,441. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS SUBMITTED TO THE FINANCE & AUDIT COMMITTEE FOR REVIEW AND APPROVAL. THE RETURN IS THEN SUBMITTED TO THE BOARD BEFORE FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF DIRECTORS OF INDIANA HEALTH INFORMATION EXCHANGE, INC. (THE CORPORATION), HAS ADOPTED A CONFLICT OF INTEREST POLICY (THE "POLICY") THAT REQUIRES EACH DIRECTOR, OFFICER AND MEMBER OF A BOARD COMMITTEE (DEFINED IN THE POLICY) TO PROVIDE THE CORPORATION AN ANNUAL DISCLOSURE OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST THAT ARISE AS A RESULT OF AN INDIVIDUAL SERVING AS A DIRECTOR, OFFICER OR MEMBER OF A BOARD COMMITTEE. THE POLICY ALSO REQUIRES CERTAIN ACTIONS TO APPROVE OR RATIFY A CONTRACT OR OTHER TRANSACTION BETWEEN THE CORPORATION AND AN INTERESTED PERSON (DEFINED IN THE POLICY). TO HELP ENSURE REGULAR AND CONSISTENT COMPLIANCE WITH THE POLICY, THE CORPORATION'S MANAGEMENT HAS ADOPTED THIS CONFLICT OF INTEREST MONITORING AND COMPLIANCE PROCEDURE. RESPONSIBLE INDIVIDUAL: THE CORPORATION'S CHIEF OPERATING OFFICER (THE "COO"). PROCEDURE: 1. THE COO WILL ANNUALLY COLLECT A WRITTEN DISCLOSURE OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST FROM EACH DIRECTOR, OFFICER AND MEMBER OF A BOARD COMMITTEE. 2. THE COO WILL PREPARE AND DISTRIBUTE TO EACH DIRECTOR, OFFICER AND MEMBER OF A BOARD COMMITTEE A LIST OF ALL ACTUAL AND POTENTIAL CONFLICTS DISCLOSED TO THE CORPORATION. 3. AT EACH MEETING OF THE BOARD OF DIRECTORS AND EACH BOARD COMMITTEE MEETING, THE COO WILL BE RESPONSIBLE FOR MONITORING COMPLIANCE WITH AND ENFORCING THE POLICY. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CORPORATION'S BYLAWS PROVIDE THAT THE CORPORATION'S EXECUTIVE COMMITTEE SHALL SERVE AS THE CORPORATION'S COMPENSATION COMMITTEE AND SHALL REVIEW AND, IF IN THE BEST INTEREST OF THE CORPORATION, APPROVE ALL COMPENSATION ARRANGEMENTS WITH KEY EMPLOYEES OF THE CORPORATION, PROVIDED, HOWEVER, THAT (1) EMPLOYMENT OF A PRESIDENT/CEO REQUIRES THE AFFIRMATIVE VOTE OF 2/3 OF THE CORPORATION'S DIRECTORS, (2) ANY COMPENSATION ARRANGEMENT IN EXCESS OF $100,000 AND LESS THAN $500,000 MUST BE APPROVED BY THE CORPORATION'S FINANCE AND AUDIT COMMITTEE AND (3) ANY COMPENSATION ARRANGEMENT IN EXCESS OF $500,000 MUST BE APPROVED BY 2/3 OF THE CORPORATION'S DIRECTORS. THE CORPORATION'S EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE CORPORATION AND TWO ADDITIONAL MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS ELECTED BY SUCH OFFICERS. THE PRESIDENT/CEO OF THE CORPORATION IS A NON VOTING, EX OFFICIO MEMBER OF THE EXECUTIVE COMMITTEE. THE PRESIDENT/CEO HAS NO INVOLVEMENT IN THE PROCESS OF SETTING HIS OR HER OWN COMPENSATION. | |
| FORM 990, PART VI, SECTION C, LINE 18 | THE CORPORATION'S FORM 990 AND FORM 1023 ARE AVAILABLE TO THE PUBLIC UPON REQUEST IN ACCORDANCE WITH APPLICABLE LAW. THE PUBLIC CAN ALSO ACCESS THE CORPORATION'S FORM 990 AT WWW.GUIDESTAR.ORG. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE CORPORATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC THROUGH THE INDIANA SECRETARY OF STATE'S WEBSITE AT HTTPS://SECURE.IN.GOV/SOS/BUS_SERVICE/ONLINE_CORPS/NAME_SEARCH.ASPX. THE CORPORATION'S BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS MAY BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST ON A CASE-BY-CASE BASIS. | |
| FORM 990, PART XI, LINE 9: | LOSS ON MERGETICS -80,606. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C | THE FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT AUDITOR. | OVERSIGHT OF FINANCIAL STATEMENTS: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (12 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Public Charity StatusPublicCharityStatus |
|---|---|---|---|---|---|---|---|---|---|---|
| CENTRAL INDIANA CORPORATE PARTNERSHIP INC | ||||||||||
| 111 MONUMENT CIRCLE STE 1800 | INDIANAPOLIS | IN | 46204 | 352065459 | PROMOTE GROWTH AND OPPORTUNITY IN CENTRAL INDIANA | IN | 501(C)(6) | N/A | 0 | |
| INDIANA UNIVERSITY HEALTH | ||||||||||
| 950 NORTH MERIDAN ST GATEWAY | INDIANAPOLIS | IN | 46204 | 351955872 | PROVISION OF HEALTHCARE SERVICES | IN | 501(C)(3) | N/A | 0 | 509(A)(1) |
| COMMUNITY HOSPITAL OF INDIANA INC | ||||||||||
| 1500 N RITTER AVE | INDIANAPOLIS | IN | 46219 | 350983617 | PROVISION OF HEALTHCARE SERVICES | IN | 501(C)(3) | N/A | 0 | 509(A)(1) |
| INDIANA STATE MEDICAL ASSOCIATION | ||||||||||
| 322 CANAL WALK | INDIANAPOLIS | IN | 46202 | 350411650 | EXTEND MEDICAL KNOWLEDGE, ADVANCE MEDICAL SCIENCE, PROMOTE HEALTH CARE | IN | 501(C)(3) | N/A | 0 | 509(A)(2) |
| SISTERS OF ST FRANCIS HEALTH SERVICES INC | ||||||||||
| 1515 DRAGOON TRL | MISHAWAKA | IN | 46544 | 350913537 | PROVISION OF CHARITABLE HEALTHCARE | IN | 501(C)(3) | N/A | 0 | 509(A)(1) |
| ST VINCENT HOSPITAL & HEALTH CARE | ||||||||||
| 2001 W 86TH ST | INDIANAPOLIS | IN | 46260 | 352052591 | PROVISION OF HEALTHCARE SERVICES | IN | 501(C)(3) | N/A | 0 | 509(A)(1) |
| INDIANA HOSPITAL ASSOCIATION INC | ||||||||||
| ONE AMERICA SQUARE NO 1900 | INDIANAPOLIS | IN | 46282 | 350988753 | EXTEND MEDICAL KNOWLEDGE, ADVANCE MEDICAL SCIENCE, PROMOTE HEALTH CARE | IN | 501(C)(6) | N/A | 0 | |
| HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY DBA WISHARD HEALTH SERVIC | ||||||||||
| 1001 W TENTH STREET | INDIANAPOLIS | IN | 46202 | 356065597 | EXTEND MEDICAL KNOWLEDGE, ADVANCE MEDICAL SCIENCE, PROMOTE HEALTH CARE | IN | 501(C)(3) | N/A | 0 | 509(A)(1) |
| INDIANA UNIVERSITY | ||||||||||
| 107 S INDIANA AVE | BLOOMINGTON | IN | 47405 | 356001673 | EDUCATION | IN | 501(C)(3) | N/A | 0 | 509(A)(1) |
| THE INDIANAPOLIS MEDICAL SOCIETY INC | ||||||||||
| 631 E NEW YORK ST | INDIANAPOLIS | IN | 46202 | 127566088 | EXTEND MEDICAL KNOWLEDGE, ADVANCE MEDICAL SCIENCE, PROMOTE HEALTH CARE | IN | 501(C)(3) | N/A | 0 | 509(A)(2) |
| MARION COUNTY HEALTH DEPARTMENT | ||||||||||
| 3838 NORTH RURAL ST | INDIANAPOLIS | IN | 46205 | 356065697 | EXTEND MEDICAL KNOWLEDGE, ADVANCE MEDICAL SCIENCE, PROMOTE HEALTH CARE | IN | 501(C)(3) | N/A | 0 | 509(A)(1) |
| INDIANA STATE DEPARTMENT OF HEALTH | ||||||||||
| 402 W WASHINGTON ST | INDIANAPOLIS | IN | 46202 | 356000158 | EXTEND MEDICAL KNOWLEDGE, ADVANCE MEDICAL SCIENCE, PROMOTE HEALTH CARE | IN | 501(C)(3) | N/A | 0 | 509(A)(1) |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERGETICS INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 846 NORTH SENATE AVENUE STE 300 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 261566118 | EIN |
| Primary Activity | HEALTH INFORMATION | PrimaryActivity |
| Legal Domicile State | IN | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA HEALTH INFORMATION EXCHANGE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of EOY Assets | 8030 | ShareOfEOYAssets |
| Percentage Ownership | 0.93000 | PercentageOwnership |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (17 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| MERGETICS INC | ||
| P | 106 | FMV |
| INDIANA UNIVERSITY HEALTH | ||
| L | 1839327 | FMV |
| ST FRANCIS HOSPITAL & HEALTH CENTERS | ||
| L | 1155449 | FMV |
| ST VINCENT HOSPITAL & HEALTH CARE CENTER INC | ||
| L | 1046388 | FMV |
| HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY DBA WISHARD HEALTH SERV | ||
| L | 200000 | FMV |
| COMMUNITY HOSPITAL OF INDIANA INC | ||
| L | 689782 | FMV |
| CENTRAL INDIANA CORPORATE PARTNERSHIP INC | ||
| L | FMV | |
| INDIANA STATE MEDICAL ASSOCIATION | ||
| L | FMV | |
| THE INDIANAPOLIS MEDICAL SOCIETY INC | ||
| L | FMV | |
| MARION COUNTY HEALTH DEPARTMENT | ||
| L | FMV | |
| INDIANA STATE DEPARTMENT OF HEALTH | ||
| L | FMV | |
| INDIANA UNIVERSITY | ||
| L | 16000 | FMV |
| INDIANA UNIVERSITY | ||
| D | 16000 | FMV |
| ST FRANCIS HOSPITAL & HEALTH CENTERS | ||
| D | 96287 | FMV |
| HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY DBA WISHARD HEALTH SERV | ||
| D | 50000 | FMV |
| INDIANA UNIVERSITY HEALTH | ||
| D | 29485 | FMV |
| COMMUNITY HOSPITAL OF INDIANA INC | ||
| D | 59020 | FMV |