DEACONESS CLINIC INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- DEACONESS CLINIC INC (EIN 26-3083364)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-02-03
- IRS object ID
- 201100349349300300
- Schema version
- 2009v1.7
- 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 | 2011-02-03T07:32:45-06:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 44972 | AddressLine1 |
| City | Indianapolis | City |
| State | IN | State |
| ZIP Code | 462440972 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263083364 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deaconess Clinic Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | DEAC | NameControl |
| Phone | 8124502370 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 Mary Street | AddressLine1 |
| City | Evansville | City |
| State | IN | State |
| ZIP Code | 47747 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | David Christeson | Name |
| Title | Chief Physician Admin Officer | Title |
| Date Signed | 2011-02-01 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3176817000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DAVID D CHRISTESON MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 421 CHESTNUT STREET | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47713 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 48421774 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | DEACONESS.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2008 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | ATTACHMENT 2 | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 1 | NbrIndependentVotingMembers |
| Total Nbr Employees | 688 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 41320 | TotalGrossUBI |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 50420500 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 48105216 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3154 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 60821 | OtherRevenuePriorYear |
| Other Revenue Current Year | 39864 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 50481321 | TotalRevenuePriorYear |
| Total Revenue Current Year | 48148234 | 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 | 45803441 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 47392400 | 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 | 20731153 | OtherExpensePriorYear |
| Other Expenses Current Year | 21526026 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 66534594 | TotalExpensesPriorYear |
| Total Expenses Current Year | 68918426 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -16053273 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -20770192 | RevenuesLessExpensesCY |
| Total Assets BOY | 14411906 | TotalAssetsBOY |
| Total Assets EOY | 12242500 | TotalAssetsEOY |
| Total Liabilities BOY | 7336534 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7766003 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 7075372 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4476497 | NetAssetsOrFundBalancesEOY |
| Mission Description | Provide health care and health-related education for the benefit of the community in a systematic, integrated, and coordinated fashion with Deaconess Hospital and all other Deaconess Health System affiliates. The governing body has adopted the preceding Mission Statement. Form 990 - Part I, Line 1 - Organization's Most Significant Activities: Deaconess Clinic was organized exclusively for charitable, education, and scientific program purposes within the meaning of Section 501(c) (3) of the IRS code which include (among others): To deliver health care to the public; To carry out scientific research and research projects in the public interest in the fields of medical sciences, medical economics, public health, sociology, and related areas; To improve and develop the capabilities of individuals and institutions studying, teaching, and practicing medicine and other health occupations; To provide health care and health-related education for the benefit of the community in a systematic, int | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 58436528 | Expense |
| Revenue | 46419947 | Revenue |
| Description | Patient Service Revenue - Deaconess Clinic is a major source of medical services which encompasses a broad spectrum of expertise, representing more than 20 medical and surgical specialties. Deaconess Clinic employs 90 physicians and 365 full time nursing and administrative personnel. Deaconess Clinic serves a 25-county tri-state area in Southwestern Indiana, Western Kentucky, and Southeastern Illinois. The Clinic and its facilities have locations in Evansville, Newburgh, Mt. Vernon, Petersburg, Ft. Branch, Princeton, Oakland City, and Reo in Indiana. The Clinic also has locations in Henderson and Morganfield Kentucky. The Clinics served 386,664 patient visits from October 1, 2009 through September 2010. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1689196 | Expense |
| Revenue | 1685269 | Revenue |
| Description | The Research Institute of Deaconess Clinic assists Deaconess Clinic's 90 physicians in gaining access to leading edge medical science and new treatments for acute and chronic illnesses. The Institute was awarded 53 new clinical research grants this year to study investigational treatments across 12 fields of medicine including heart disease, cancer, diabetes, urological disorders, depression, and pain management. The new research grants will provide treatment opportunities for up to 1,025 patients. In all, the newly awarded grants this year totaled $4.8 million to cover the costs associated with the conduct of the clinical trials within the region. 413 patients were enrolled into clinical trials throughout the year, resulting in 4,839 research related patient visits. The Research Institute also successfully completed 3 inspections by the Food and Drug Administration. In addition, research conducted by the Research Institute and selected Deaconess Clinic Investigators received national recognition through publication in the New England Journal of Medicine, and the Journal of Allergy and Immunology in 2010. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 60125724 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | 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 |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | 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 | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | 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 | false | 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 | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 76 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 688 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| 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 | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 1 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | true | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | RICHARD PERRY | NamePerson |
| Telephone Number | 8124502370 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 MARY STREET | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47747 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| LINDA WHITE | ||||||||
| DIRECTOR | 5.0 | X | 0 | 2158468 | 178330 | |||
| BRUCE SCHNEIDER MD | ||||||||
| DIRECTOR | 50.0 | X | 1492211 | 0 | 27556 | |||
| RICHARD STIVERS | ||||||||
| SEC/ TREAS | 5.0 | X | 0 | 996331 | 53438 | |||
| ANNE MCLAUGHLIN MD | ||||||||
| DIRECTOR | 50.0 | X | 702331 | 0 | 21801 | |||
| DAVID CHRISTESON MD | ||||||||
| CPAO | 50.0 | X | 429073 | 0 | 45279 | X | ||
| MOHAMMED ALLAW MD | ||||||||
| DIRECTOR | 50.0 | X | 408584 | 0 | 27070 | |||
| BARRY PHILLIPS MD | ||||||||
| DIRECTOR | 50.0 | X | 340351 | 10320 | 26297 | |||
| GARY KEEPES MD | ||||||||
| DIRECTOR | 50.0 | X | 344367 | 0 | 25292 | |||
| GARY ERDY MD | ||||||||
| DIRECTOR | 50.0 | X | 326472 | 0 | 25073 | |||
| RUSTON STOLTZ MD | ||||||||
| DIRECTOR | 50.0 | X | 306267 | 0 | 7871 | |||
| ROBERT KAYLOR | ||||||||
| DIRECTOR | 50.0 | X | 260030 | 0 | 13999 | |||
| W ALLEN WHITE MD | ||||||||
| DIRECTOR | 50.0 | X | 250661 | 0 | 38473 | |||
| JAMES GUTMANN MD | ||||||||
| DIRECTOR | 50.0 | X | 239237 | 0 | 25185 | |||
| CHERYL WATHEN | ||||||||
| SEC/ TREAS | 5.0 | X | 0 | 216784 | 43422 | X | ||
| ROBERT WRIGHT | ||||||||
| CHAIRMAN | 5.0 | X | 0 | 0 | 0 | X | ||
| MAQBOOL AHMED MD | ||||||||
| MD | 50.0 | 1383103 | 0 | 27039 | X | |||
| PAUL SIAMI MD | ||||||||
| MD | 50.0 | 1073678 | 0 | 26088 | X | |||
| DANIEL SHIREY | ||||||||
| MD | 50.0 | 804283 | 0 | 19215 | X | |||
| JEFFREY MOORE MD | ||||||||
| MD | 50.0 | 723204 | 0 | 31669 | X | |||
| MAJED KOLEILAT MD | ||||||||
| MD | 50.0 | 667535 | 0 | 23443 | X | |||
| THOMAS W DAVIDSON | ||||||||
| MD | 50.0 | 280011 | 0 | 48451 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 10031398 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3381903 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 734991 | TotalOtherCompensation |
| Number Individuals GT100 K | 83 | 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 |
|---|---|---|---|---|---|
| SPHERIS | |||||
| 13552 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | TRANSCRIPTION | 332322 |
| BILL DUNBAR ASSOCIATES LLC | |||||
| 2601 FORTUNE CIRCLE EAST | INDIANAPOLIS | IN | 46241 | CONSULTING | 270650 |
| TRI-STATE ENT | |||||
| 350 W COLUMBIA ST | EVANSVILLE | IN | 47710 | MEDICAL | 233200 |
| THE HEART GROUP | |||||
| 415 W COLUMBIA ST | EVANSVILLE | IN | 47710 | MEDICAL | 209593 |
| ALVEY SIGN CO INC | |||||
| 13100 HIGHWAY 57 NORTH | EVANSVILLE | IN | 47725 | ADVERTISING | 199397 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REVENUE | 621110 | 46419947 | 46419947 |
| RESEARCH REVENUE | 621110 | 1685269 | 1685269 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 48105216 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3154 | TotalRevenueColumn |
| Exclusion | $3,154 | 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 |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 272084 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 273540 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -1456 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -1456 | TotalRevenueColumn |
| Exclusion | -$1,456 | ExclusionAmount |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | SKIN CARE PRODUCTS | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 41320 | TotalRevenueColumn |
| Unrelated Business Revenue | 41320 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 41320 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 48148234 | TotalRevenueColumn |
| Related Or Exempt Function Income | 48105216 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 41320 | UnrelatedBusinessRevenue |
| Exclusion | $1,698 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 5386866 | Total |
| Program Services | 4895568 | ProgramServices |
| Management And General | 491298 | 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 | 34991093 | Total |
| Program Services | 33510076 | ProgramServices |
| Management And General | 1481017 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 271451 | Total |
| Program Services | 265571 | ProgramServices |
| Management And General | 5880 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1384964 | Total |
| Program Services | 1215464 | ProgramServices |
| Management And General | 169500 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5358026 | Total |
| Program Services | 4790724 | ProgramServices |
| Management And General | 567302 | 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 | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 402014 | Total |
| Management And General | 402014 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18141 | Total |
| Program Services | 18141 | ProgramServices |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 4767485 | Total |
| Program Services | 590682 | ProgramServices |
| Management And General | 4176803 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 828467 | Total |
| Program Services | 393770 | ProgramServices |
| Management And General | 434697 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4470038 | Total |
| Program Services | 4366630 | ProgramServices |
| Management And General | 103408 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1587573 | Total |
| Program Services | 1418236 | ProgramServices |
| Management And General | 169337 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6276567 | Total |
| Program Services | 5941814 | ProgramServices |
| Management And General | 334753 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66534 | Total |
| Program Services | 42432 | ProgramServices |
| Management And General | 24102 | 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 | 277381 | Total |
| Program Services | 251593 | ProgramServices |
| Management And General | 25788 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1307 | Total |
| Program Services | 1307 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 851795 | Total |
| Program Services | 748217 | ProgramServices |
| Management And General | 103578 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 971566 | Total |
| Program Services | 672459 | ProgramServices |
| Management And General | 299107 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 1003040 | 1003040 | |
| UBI INCOME TAX | 4118 | 4118 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68918426 | Total |
| Program Services | 60125724 | ProgramServices |
| Management And General | 8792702 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1264781 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8657760 | BOY |
| EOY | 7638240 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 213137 | BOY |
| EOY | 284406 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 5773177 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1705021 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4029738 | BOY |
| EOY | 4068156 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 226140 | BOY |
| EOY | 231698 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20350 | BOY |
| EOY | 20000 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14411906 | BOY |
| EOY | 12242500 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7291051 | BOY |
| EOY | 7766003 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45483 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7336534 | BOY |
| EOY | 7766003 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7075372 | BOY |
| EOY | 4476497 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7075372 | BOY |
| EOY | 4476497 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14411906 | BOY |
| EOY | 12242500 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $18,141 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 18141 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE C | Identifier |
| Return Reference | PART II-B, LINE 1i | ReturnReference |
| Explanation | Lobbying expenditures consisted of a portion of membership dues to professional organizations in which Deaconess Clinic and its employees are members. The lobbying portion of the dues is noted on the membership application or billing statements. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Land | Land | |
| Buildings | Buildings |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2177476 | OtherCostOrOtherBasis |
| Depreciation | 558002 | Depreciation |
| Book Value | 1619474 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2794529 | OtherCostOrOtherBasis |
| Depreciation | 1147019 | Depreciation |
| Book Value | 1647510 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 801172 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 801172 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 4068156 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
| Total Of Amounts | 0 | TotalOfAmounts |
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 | false | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| 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 (20 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LINDA WHITE | |||||||||||||
| 0 | 597519 | 0 | 151669 | 0 | 1413280 | 0 | 161405 | 0 | 28335 | 0 | 2352208 | 0 | 1397694 |
| BRUCE SCHNEIDER MD | |||||||||||||
| 1475836 | 0 | 14671 | 0 | 1704 | 4200 | 5714 | 0 | 27157 | 0 | 1525082 | 4200 | 0 | 0 |
| RICHARD STIVERS | |||||||||||||
| 0 | 404777 | 0 | 90267 | 0 | 506688 | 0 | 37315 | 0 | 21439 | 0 | 1060486 | 0 | 491246 |
| ANNE MCLAUGHLIN MD | |||||||||||||
| 691055 | 0 | 9335 | 0 | 1941 | 0 | 2100 | 0 | 25017 | 0 | 729448 | 0 | 0 | 0 |
| DAVID CHRISTESON MD | |||||||||||||
| 341058 | 0 | 86074 | 0 | 1941 | 0 | 25113 | 0 | 25482 | 0 | 479668 | 0 | 0 | 0 |
| MOHAMMED ALLAW MD | |||||||||||||
| 367077 | 0 | 40470 | 0 | 1037 | 2163 | 8855 | 0 | 23530 | 0 | 440969 | 2163 | 0 | 0 |
| BARRY PHILLIPS MD | |||||||||||||
| 299601 | 0 | 38809 | 0 | 1941 | 10320 | 8082 | 0 | 23530 | 0 | 371963 | 10320 | 0 | 0 |
| GARY KEEPES MD | |||||||||||||
| 298973 | 0 | 43532 | 0 | 1862 | 0 | 8501 | 0 | 22106 | 0 | 374974 | 0 | 0 | 0 |
| GARY ERDY MD | |||||||||||||
| 274707 | 0 | 50140 | 0 | 1625 | 0 | 5581 | 0 | 24807 | 0 | 356860 | 0 | 0 | 0 |
| RUSTON STOLTZ MD | |||||||||||||
| 276243 | 0 | 29304 | 0 | 720 | 2713 | 7601 | 0 | 5585 | 0 | 319453 | 2713 | 0 | 0 |
| ROBERT KAYLOR | |||||||||||||
| 247947 | 0 | 11178 | 0 | 905 | 0 | 0 | 0 | 19315 | 0 | 279345 | 0 | 0 | 0 |
| W ALLEN WHITE MD | |||||||||||||
| 230906 | 0 | 18730 | 0 | 1025 | 0 | 22350 | 0 | 21439 | 0 | 294450 | 0 | 0 | 0 |
| JAMES GUTMANN MD | |||||||||||||
| 204194 | 0 | 33418 | 0 | 1625 | 0 | 4403 | 0 | 26097 | 0 | 269737 | 0 | 0 | 0 |
| CHERYL WATHEN | |||||||||||||
| 0 | 193664 | 0 | 21419 | 0 | 3901 | 0 | 22825 | 0 | 25912 | 0 | 267721 | 0 | 0 |
| MAQBOOL AHMED MD | |||||||||||||
| 1324151 | 0 | 57011 | 0 | 1941 | 0 | 2417 | 0 | 29937 | 0 | 1415457 | 0 | 0 | 0 |
| PAUL SIAMI MD | |||||||||||||
| 999341 | 0 | 72712 | 0 | 1625 | 0 | 6646 | 0 | 24757 | 0 | 1105081 | 0 | 0 | 0 |
| DANIEL SHIREY | |||||||||||||
| 803243 | 0 | 0 | 0 | 1040 | 0 | 0 | 0 | 24530 | 0 | 828813 | 0 | 0 | 0 |
| JEFFREY MOORE MD | |||||||||||||
| 678243 | 0 | 43020 | 0 | 1941 | 0 | 7677 | 0 | 29307 | 0 | 760188 | 0 | 0 | 0 |
| MAJED KOLEILAT MD | |||||||||||||
| 654209 | 0 | 11385 | 0 | 1941 | 0 | 2252 | 0 | 26506 | 0 | 696293 | 0 | 0 | 0 |
| THOMAS W DAVIDSON | |||||||||||||
| 255230 | 0 | 24061 | 0 | 720 | 0 | 30236 | 0 | 23530 | 0 | 333777 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PART III- OTHER ADDITIONAL INFORMATION | PART 1, LINE 1A | Social club dues are paid for Linda White for organization business only. Any personal use of the club must be paid by the employee. SEVERANCE, NONQUALIFIED, & EQUITY-BASED PAYMENTS PART I, LINE 4 SEVERANCE NONQUALIFIED EQUITY-BASED LINDA WHITE 0 16,500 0 RICHARD STIVERS 0 16,500 0 ANNE MCLAUGHLIN, MD 0 16,500 0 DAVID CHRISTESON, MD 0 16,500 0 GARY KEEPES, MD 0 16,500 0 GARY ERDY, MD 0 16,500 0 RUSTON STOLTZ, MD 0 16,500 0 W ALLEN WHITE, MD 0 16,500 0 JAMES GUTMANN, MD 0 16,500 0 MAQBOOL AHMED, MD 0 16,500 0 PAUL SIAMI, MD 0 16,500 0 JEFFREY MOORE, MD 0 16,500 0 MAJED KOLEILAT, MD 0 16,500 0 |
| Part 1, Line 4B | Linda White: Supplemental retirement payout of $1,309,125; contributions made to a supplemental accumulation account of $149,645; supplemental accumulation account payout of $88,569. Richard Stivers: Supplemental retirement payout of $433,225; supplemental accumulation account payout of $58,023. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Classes of Members or stockholders | Form 990, Part VI, Line 6 | Deaconess Clinic Inc has one member which is Deaconess Health System Inc. |
| Election of Members and their rights | Form 990, Part VI, Line 7a | The System must approve the chosen Deaconess Clinic Chief Physician Administrative Officer (CPAO). Decisions subject to approval of Members Form 990, Part VI, Line 7b Appointment of Chief Physician Administrative Officer (CPAO) requires approval of the member. Changes to physician compensation plan requires the approval of the member through its compensation committee which is comprised of independent members of the Deaconess Health System Board. |
| Officers Who Cannot Be Reached | Form 990, Part VI, Line 9 | Richard Stivers 9901 Browning Road Evansville IN 47725 |
| Organization's process to review form 990 | Form Part VI, Line 11A | The process that Deaconess Clinic utilizes to present the Form 990 to its governing body prior to filing Form 990. The Form 990 is reviewed by the organization's CEO, CFO, and internal audit department prior to presenting the Form 990 to the Board of Directors at the board meeting prior to the filing date of the Form 990. Any questions are answered and the final filing is then completed. |
| Enforcement of conflicts policy | Form 990, Part VI, Line 12c | Conflict of Interest review and compliance activities are conducted through out the year under direction of Deaconess Hospital's Corporate Compliance Officer. Upon appointment and, annually thereafter, officers, directors, trustees, and key employees, also known as interested persons, are required to complete The Conflicts of Interest Questionnaire and/or The Disclosure Questionnaire. These documents serve to ensure interested persons or committee members with board delegated powers have an appropriate and timely manner in which to disclose any potential conflicts. Conflicts are considered with respect to outside interest, investments, outside activities, and business interests among the interested persons as well as their family members. On a periodic basis, reviews occur to ensure Deaconess Clinic operates in a manner consistent with its charitable purpose. Subjects that are reviewed on a periodic basis include compensation, physician relationships, partnership and joint venture arrangements. |
| Compensation process for top officials | Form 990, Part VI, Line 15a | Deaconess Clinic utilizes the compensation committee of Deaconess Health System Inc to approve executive, director and physician compensation as well as executive and physician benefit programs. The Compensation Committee is appointed by the Board of Directors of Deaconess Health System Inc and must meet the independence requirements of the SEC. The Committee has the power and authority to, annually review and approve and recommend to the Board of Directors for its final approval for the CPAO and each other executive officer of the System all elements of executive compensation, monitor broadly the structure, philosophy or competitiveness of the system's general hiring or compensation practices, oversee the establishment and administration of the Company's broad-based benefits plans and programs, and review or approve significant amendments or changes to the plans and programs, to retain and terminate any compensation consultant to be used to assist in the evaluation of director, CPAO or executive officer compensation and shall have the sole authority to approve the consultant's fees and other retention terms. The Committee also has the authority to obtain advice and assistance from internal or external legal, accounting or other advisors, to approve all Physician and physician-related contracts and to make regular reports to the Board. |
| Compensation process for Officers | Form 990, Part VI, Line 15b | Deaconess Clinic utilizes the compensation committee of Deaconess Health System Inc to approve executive, director and physician compensation as well as executive and physician benefit programs. The Compensation Committee is appointed by the Board of Directors of Deaconess Health System Inc and must meet the independence requirements of the SEC. The Committee has the power and authority to, annually review and approve and recommend to the Board of Directors for its final approval for the CPAO and each other executive officer of the System all elements of executive compensation, monitor broadly the structure, philosophy or competitiveness of the system's general hiring or compensation practices, oversee the establishment and administration of the Company's broad-based benefits plans and programs, and review or approve significant amendments or changes to the plans and programs, to retain and terminate any compensation consultant to be used to assist in the evaluation of director, CPAO or executive officer compensation and shall have the sole authority to approve the consultant's fees and other retention terms. The Committee also has the authority to obtain advice and assistance from internal or external legal, accounting or other advisors, to approve all Physician and physician-related contracts and to make regular reports to the Board. |
| Governing Documents Disclosure Explanation | Form 990, Part VI, Line 19 | Deaconess Clinic does not make its governing documents, conflict of interest or financial statements available to the public. |
| Average hours per week | Form 990, Part VII, Section A (B) | The average worked hours of Ms. White, Ms. Wathen, and Mr. Stivers reported in column (B) is the portion of their hours reported as 50 hours per week on the Deaconess Hospital, Inc. return. A portion of those 50 hours relates to time devoted to Deaconess Clinic issues and concerns. |
| Additional Information | Schedule R, Part V, Section 2(1) | Deaconess Health System Inc is the only shareholder of Deaconess Clinic Inc and when needed contributes additional capital so Deaconess Clinic can pay expenses. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| DEACONESS HEALTH SYSTEMS | |||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 351532889 | HEALTHCARE | IN | 501(C)(3) | 11A | NA |
| DEACONESS HOSPITAL INC | |||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 350593390 | HEALTHCARE | IN | 501(C)(3) | 3 | NA |
Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|
| DEACONESS HEALTH PLANS LLC | |||||||||
| 350 W COLUMBIA SUITE 400 | EVANSVILLE | IN | 47710 | 383492529 | PERF PROV | IN | NA | false | false |
| HEARTCARE HEALTH SYSTEM LLC | |||||||||
| 415 W COLUMBIA | EVANSVILLE | IN | 47710 | 352038344 | HEALTHCARE | IN | NA | false | false |
| PROGRESSIVE HEALTH OF IN LLC | |||||||||
| 260 N ROSENBERGER | EVANSVILLE | IN | 47712 | 208480988 | OUTPATIENT | IN | NA | false | false |
| HEART HOSP DEAC GATEWAY LLC | |||||||||
| 4007 GATEWAY BLVD | NEWBURGH | IN | 47630 | 261766835 | HOSPITAL | DE | NA | false | false |
| TRI-STATE RADIATION ONCOLOGY LLC | |||||||||
| 1500 ROSECRANS AVE | MANHATTAN BEACH | CA | 90266 | 263706834 | OUTPATIENT | DE | NA | false | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRI-STATE MEDICAL MGMT INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 MARY STREET | AddressLine1 |
| City | EVANSVILLE | City |
| State | IN | State |
| ZIP Code | 47747 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351875888 | EIN |
| Primary Activity | PHYS MGMT | PrimaryActivity |
| Legal Domicile State | IN | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| DEACONESS HEALTH SYSTEM INC | |
| C | 18171317 |
| DEACONESS HEALTH SYSTEM INC | |
| J | 378555 |
| DEACONESS HOSPITAL INC | |
| J | 291485 |
| DEACONESS HOSPITAL INC | |
| O | 5499498 |