PRESIDENT

2012-08-23T14:54:04-05:00 2012-06-30 205804172 BGBC PARTNERS LLP 300 N MERIDIAN ST STE 1100 INDIANAPOLIS IN 46204 990 2011-07-01 270962095 INDIANAPOLIS COALITION FOR PATIENT SAFETY INC INDI 3176161958 10401 N MERIDIAN STREET SUITE 300 INDIANAPOLIS IN 46290 CAROL BIRK RPH MS PRESIDENT 3176161958 2012-08-15 1 SHELLEY A MATTALIANO CPA P01278792 3176334700 2011 2016-02-24 21:20:13Z GLENN BINGLE MD PHD 10401 N MERIDIAN STREET SUITE 300 INDIANAPOLIS IN 46290 305551 0 X INDYPATIENTSAFETY.ORG X 2009 IN TO PROVIDE A FORUM FOR INDIANAPOLIS-AREA HOSPITALS TO SHARE INFORMATION ABOUT 'BEST PRACTICES' AND WORK TOGETHER TO SOLVE PATIENT SAFETY ISSUES IN INDIANAPOLIS AND SURROUNDING COUNTY HOSPITALS. 14 14 1 0 0 0 61147 75000 207970 227720 1079 1063 8282 1768 278478 305551 0 0 0 0 8147 22316 0 0 0 206641 216889 214788 239205 63690 66346 372173 378485 110034 50000 262139 328485 TO PROVIDE A FORUM FOR INDIANAPOLIS-AREA HOSPITALS TO SHARE INFORMATION ABOUT 'BEST PRACTICES' AND WORK TOGETHER TO SOLVE PATIENT SAFETY ISSUES IN INDIANAPOLIS AND SURROUNDING COUNTY HOSPITALS. 0 0 234051 227720 UNDERTAKING PROJECTS THAT FOCUS ON PATIENT-CENTERED STRATEGIES TO IMPROVE SAFETY BY ADDRESSING ALL OF THE BARRIERS OBSERVED BY PATIENTS AND PROVIDERS TO ACHIEVING A STANDARDIZED APPROACH TO PATIENT CARE. 234051 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3 0 1 1 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 IN X CAROL BIRK 3176161958 10401 N MERIDIAN STREET SUITE 300 INDIANAPOLIS IN 46290 X GLENN BINGLE MD PHD CHAIR 1.00 X X 0 0 0 JON RAHMAN MD CO CHAIR 1.00 X 0 0 0 CAROL BIRK RPH MS PRESIDENT 1.00 X X 0 0 0 KIMBERLY RADANT RN MS SECRETARY 1.00 X 0 0 0 SUSAN BROWN MS MBA TREASURER 1.00 X 0 0 0 MAUREEN BURGER MEMBER 1.00 X 0 0 0 ROBERT J BRODY MEMBER 1.00 X 0 0 0 VINCENT C CAPONI MEMBER 1.00 X 0 0 0 JULIE CARMICHAEL MEMBER 1.00 X 0 0 0 SAM ODLE MEMBER 1.00 X 0 0 0 LISA HARRIS MD MEMBER 1.00 X 0 0 0 THOMAS MATTICE MEMBER 1.00 X 0 0 0 BRYAN MILLS MEMBER 1.00 X 0 0 0 JAMES SCHNEIDER MEMBER 1.00 X 0 0 0 0 0 0 0 0 0 0 0 75000 75000 MEMBERSHIP DUES 900099 207970 207970 HPI MEETING 900099 19750 19750 227720 1063 1063 MISC. REVENUE 900099 1768 1768 1768 305551 227720 0 2831 20730 20730 1586 1586 5154 5154 135000 135000 2942 2942 923 923 34504 34504 5585 5585 30879 30879 1066 1066 MISCELLANEOUS EXPENSES 836 836 239205 234051 5154 0 3548 29217 365825 344252 2800 5016 372173 378485 614 109420 50000 110034 50000 X 0 0 0 0 262139 328485 262139 328485 372173 378485 66346 0 X 0 0 0 X X 0 0 0 INDIANA UNIVERSITY HEALTH INC 351955872 501(A)(1) 1 1 1 0 COMMUNITY HEALTH NETWORK INC 311038302 501(A)(1) 1 1 1 0 HANCOCK REGIONAL HOSPITAL 351092610 501(A)(1) 1 1 1 0 HENDRICKS REGIONAL HEALTH 351361243 501(A)(1) 1 1 1 0 HENRY COUNTY HOSPITAL 356001583 501(A)(1) 1 1 1 0 COMMUNITY HOSPITALS OF INDIANA INC 350983617 501(A)(1) 1 1 1 0 COMMUNITY HOSPITAL SOUTH INC 351088640 501(A)(1) 1 1 1 0 COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY INC 351069822 501(A)(1) 1 1 1 0 COMMUNITY LTC INC 351877441 501(A)(1) 1 1 1 0 COMMUNITY HOME HEALTH SERVICES INC 350953467 501(A)(1) 1 1 1 0 HEALTH AND HOSPITAL CORP OF MARION COUNTY DBA WISHARD HEALTH SERVICES 356005697 501(A)(1) 1 1 1 0 INDIANAPOLIS OSTEOPATHIC HOSPITAL INC DBA WESTVIEW MEDICAL CAMPUS 351094734 501(A)(1) 1 1 1 0 MORGAN HOSPITAL & MEDICAL CENTER 351129269 501(A)(1) 1 1 1 0 RICHARD ROUDEBUSH VETERANS AFFAIRS MEDICAL CENTER 351511916 501(A)(1) 1 1 1 0 RIVERVIEW HOSPITAL 351128943 501(A)(1) 1 1 1 0 ST VINCENT HEALTH INC 352052591 501(A)(1) 1 1 1 0 ST VINCENT HOSPITAL AND HEALTH CARE CENTER INC 350869066 501(A)(1) 1 1 1 0 ST VINCENT CARMEL HOSPITAL INC 743107055 501(A)(1) 1 1 1 0 SETON SPECIALTY HOSPITAL INC 351712001 501(A)(1) 1 1 1 0 ST JOSEPH HOSPITAL & HEALTH CENTER INC 350992717 501(A)(1) 1 1 1 0 ST VINCENT CLAY HOSPITAL INC 352112529 501(A)(1) 1 1 1 0 ST VINCENT FRANKFORT HOSPITAL INC 352099320 501(A)(1) 1 1 1 0 ST VINCENT JENNINGS HOSPITAL INC 351841606 501(A)(1) 1 1 1 0 ST VINCENT MADISON COUNTY HEALTH SYSTEM INC 350876389 501(A)(1) 1 1 1 0 ST VINCENT RANDOLPH HOSPITAL INC 352103153 501(A)(1) 1 1 1 0 ST VINCENT WILLIAMSPORT HOSPITAL INC 350784551 501(A)(1) 1 1 1 0 ST VINCENT NEW HOPE INC 351733591 501(A)(1) 1 1 1 0 FRANCISCAN ALLIANCE INC DBA FRANCISCAN ST FRANCIS HEALTH 351330472 501(A)(1) 1 1 1 0 WITHAM HEALTH SERVICES 351151208 501(A)(1) 1 1 1 0 29 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED FORM 990, PART VI, SECTION B, LINE 11 A COPY OF FORM 990 IS PROVIDED TO AND REVIEWED BY EACH MEMBER OF THE BOARD OF DIRECTORS UPON COMPLETION. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, OFFICER, AND EMPLOYEE OF THE ORGANIZATION IS REQUIRED TO PROVIDE AN ANNUAL DISCLOSURE OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST THAT ARISE AS A RESULT OF THAT PERSON'S ROLE WITH THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, POLICIES AND PROCEDURES, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.