Indiana University Health Proton: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- Indiana University Health Proton (EIN 35-2134193)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-01-28
- IRS object ID
- 201130289349301003
- 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 | 2011-01-28T13:24:15-06:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Blue & Co LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | One American Square 2200 | AddressLine1 |
| City | Indianapolis | City |
| State | IN | State |
| ZIP Code | 46282 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352134193 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDWEST PROTON RADIOTHERAPY INSTITUTE LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MIDW | NameControl |
| Phone | 8123495074 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2425 N MILO B SAMPSON LN | AddressLine1 |
| City | BLOOMINGTON | City |
| State | IN | State |
| ZIP Code | 474081368 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | John R Kerstiens | Name |
| Title | Operations Director, CFO | Title |
| Phone | 8123495028 | Phone |
| Date Signed | 2011-01-28 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Carrie A Merrill CPA | Name |
| Phone | 3176334705 | 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 | JOHN R KERSTIENS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2425 N MILO B SAMPSON LN | AddressLine1 |
| City | BLOOMINGTON | City |
| State | IN | State |
| ZIP Code | 474081368 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 18100442 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.mpri.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2001 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | MEDICAL CLINIC that uses unique proton beam technology to treat cancer victims. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 65 | TotalNbrEmployees |
| Total Nbr Volunteers | 5 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1700397 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1626408 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 22135448 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 16462551 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 26942 | InvestmentIncomePriorYear |
| Investment Income Current Year | 9368 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 3940 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2115 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 23866727 | TotalRevenuePriorYear |
| Total Revenue Current Year | 18100442 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 26477 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 8112 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5545109 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4980223 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 13175215 | OtherExpensePriorYear |
| Other Expenses Current Year | 13516484 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 18746801 | TotalExpensesPriorYear |
| Total Expenses Current Year | 18504819 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 5119926 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -404377 | RevenuesLessExpensesCY |
| Total Assets BOY | 29151131 | TotalAssetsBOY |
| Total Assets EOY | 29841210 | TotalAssetsEOY |
| Total Liabilities BOY | 19750454 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 20844910 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 9400677 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8996300 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO LEVERAGE OUR UNIQUE TECHNOLOGY TO IMPROVE OUR PATIENTS' HEALTH, AND PROMOTE INNOVATION IN EDUCATION AND RESEARCH. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 15702687 | Expense |
| Grants | 8112 | Grants |
| Revenue | 16462551 | Revenue |
| Description | Midwest Proton Radiotherapy Institute uses proton beam energy to treat cancer victims. Our patients are selected based on type of cancer, efficiency of treatment and without regard to the patients' ability to pay. Uninsured care was approximately $241,449 for the year ended June 30, 2010. | Description |
| Total Program Service Expense | 15702687 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 1 | 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 | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 4 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 65 | 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 |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | 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 | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | 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 | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | 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 | JOHN KERSTIENS CPA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8123495074 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2425 N Milo B Sampson LN | AddressLine1 |
| City | Bloomington | City |
| State | IN | State |
| ZIP Code | 47408 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (14 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 |
|---|---|---|---|---|---|---|---|---|
| Richard S Helsper | ||||||||
| COO & Board Member | 16.00 | X | X | 0 | 0 | 0 | ||
| Dr Peter Johnstone | ||||||||
| CEO/President & board Me | 16.00 | X | X | 0 | 0 | 0 | ||
| Thomas E O'Brien | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Marvin Pember | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Neil D Theobald | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Isadore Rivas | ||||||||
| Corporate Treasurer | 1.00 | X | 0 | 0 | 0 | |||
| William Stephan | ||||||||
| Corporate Secretary | 1.00 | X | 0 | 0 | 0 | |||
| John Kerstiens | ||||||||
| CFO & Operations Directo | 40.00 | X | 131240 | 0 | 19629 | |||
| Karin Campbell | ||||||||
| HR/Adminstration Directo | 40.00 | X | 71027 | 0 | 19452 | |||
| Edward Dickey | ||||||||
| Clinic Operations Direct | 40.00 | X | 149993 | 0 | 7426 | |||
| Dr Allan Thornton | ||||||||
| Medical Director | 40.00 | 844225 | 0 | 42543 | X | |||
| Chris Allgower | ||||||||
| Senior Medical Physicist | 40.00 | 128138 | 0 | 33809 | X | |||
| Mark Wolanski | ||||||||
| Senior Medical Physicist | 40.00 | 105015 | 0 | 30020 | X | |||
| Marybeth Sullivan-Dickey | ||||||||
| Chief Technical Therapis | 40.00 | 129477 | 0 | 20432 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1559115 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 173311 | TotalOtherCompensation |
| Number Individuals GT100 K | 6 | 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 |
|---|---|---|---|---|---|
| University Radiation Oncology Assoc | |||||
| 535 Barnhill Drive | Indianapolis | IN | 46202 | Physician and physicists | 1982676 |
| DUNlap Construction | |||||
| PO Box 328 | Columbus | IN | 47202 | Construction Services | 368011 |
| Siemens Medical Solutions | |||||
| PO Box 120001 Dept 0733 | Dallas | TX | 75312 | Medical Equipment Solutions/Service | 206497 |
| Bloom Physicians | |||||
| PO Box 2121 Dept 1438 | Memphis | TN | 38159 | Anestheiologists | 198985 |
| Comput IT Services | |||||
| 13723 Corporate Lake Dr | Maryland heights | MO | 63043 | Computerized Medical System Services | 172600 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| All Other Contributions | 1626408 | AllOtherContributions |
| Total Contributions | 1626408 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient service revenu | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 16462551 | TotalRevenueColumn |
| Related Or Exempt Function Income | 16462551 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 16462551 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9368 | TotalRevenueColumn |
| Exclusion | $9,368 | ExclusionAmount |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2115 | TotalRevenueColumn |
| Exclusion | $2,115 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2115 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 18100442 | TotalRevenueColumn |
| Related Or Exempt Function Income | 16462551 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $11,483 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8112 | Total |
| Program Services | 8112 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1004949 | Total |
| Program Services | 854207 | ProgramServices |
| Management And General | 150742 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3002615 | Total |
| Program Services | 3002615 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 322422 | Total |
| Program Services | 274059 | ProgramServices |
| Management And General | 48363 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 399977 | Total |
| Program Services | 339980 | ProgramServices |
| Management And General | 59997 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 250260 | Total |
| Program Services | 212721 | ProgramServices |
| Management And General | 37539 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 93330 | Total |
| Management And General | 93330 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37804 | Total |
| Management And General | 37804 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3518966 | Total |
| Program Services | 3518966 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50048 | Total |
| Management And General | 50048 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 419919 | Total |
| Program Services | 352732 | ProgramServices |
| Management And General | 67187 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1470955 | Total |
| Program Services | 1176764 | ProgramServices |
| Management And General | 294191 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 69817 | Total |
| Program Services | 69817 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6595 | Total |
| Program Services | 6595 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1686921 | Total |
| Management And General | 1686921 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1840064 | Total |
| Program Services | 1564054 | ProgramServices |
| Management And General | 276010 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 90269 | Total |
| Program Services | 90269 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| Proton Beam Expense | 4100004 | 4100004 |
| Bad Debt | 65847 | 65847 |
| Dues & Subscriptions | 14830 | 14830 |
| Recruiting | 13330 | 13330 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37785 | Total |
| Program Services | 37785 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18504819 | Total |
| Program Services | 15702687 | ProgramServices |
| Management And General | 2802132 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 157635 | BOY |
| EOY | 100 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2821281 | BOY |
| EOY | 2638865 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2594896 | BOY |
| EOY | 2512929 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45522 | BOY |
| EOY | 1387 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 20905979 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4368050 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14781797 | BOY |
| EOY | 16537929 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8750000 | BOY |
| EOY | 8150000 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29151131 | BOY |
| EOY | 29841210 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17323972 | BOY |
| EOY | 17091244 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2426482 | BOY |
| EOY | 3753666 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19750454 | BOY |
| EOY | 20844910 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9400677 | BOY |
| EOY | 8996300 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9400677 | BOY |
| EOY | 8996300 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29151131 | BOY |
| EOY | 29841210 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 14772495 | OtherCostOrOtherBasis |
| Depreciation | 2293456 | Depreciation |
| Book Value | 12479039 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4558130 | OtherCostOrOtherBasis |
| Depreciation | 2074594 | Depreciation |
| Book Value | 2483536 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1575354 | OtherCostOrOtherBasis |
| Book Value | 1575354 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 16537929 | TotalOfBookValueLandBuildings |
| Total Revenue | 18100442 | TotalRevenue |
| Total Expenses | 18504819 | TotalExpenses |
| Excess Or Deficit For Year | -404377 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | -404377 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 18100442 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 18100442 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 18100442 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 18504819 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 18504819 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 18504819 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part X: | Identifier |
| Return Reference | Description of Uncertain Tax Positions Under FIN 48: | ReturnReference |
| Explanation | line 2: not applicable. The current audited financial statements do not include a footnote regarding any uncertain tax positions. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
| No Grant More Than5000 | X | NoGrantMoreThan5000 |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: All grants are provided to 501(c)(3) public charities for general support. Midwest Proton Radiotherpahy Institute, LLC does not monitor the use of these funds by these public charities. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| John Kerstiens | |||||||||||||
| 131240 | 0 | 0 | 0 | 0 | 0 | 14420 | 0 | 5209 | 0 | 150869 | 0 | 0 | 0 |
| Edward Dickey | |||||||||||||
| 60957 | 0 | 0 | 0 | 89036 | 0 | 6140 | 0 | 1286 | 0 | 157419 | 0 | 0 | 0 |
| Dr Allan Thornton | |||||||||||||
| 844225 | 0 | 0 | 0 | 0 | 0 | 36662 | 0 | 5881 | 0 | 886768 | 0 | 0 | 0 |
| Chris Allgower | |||||||||||||
| 128138 | 0 | 0 | 0 | 0 | 0 | 32115 | 0 | 1694 | 0 | 161947 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 4a | ReturnReference |
| Explanation | Severance payment: Clinic Operations Directors $89,036. | Explanation |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | InKind Contribution: Forgiveness of Accrued Int. | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 1624105 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | Fair Market Value | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Method for Determining Number of Contributors: | Identifier |
| Return Reference | Part I, Column (b): | ReturnReference |
| Explanation | InKind Contribution: Forgiveness of accrued interest for fiscal year 2010 on accounts payable to Indiana University not payable within one year. The inkind contribution is estimated using the most current available interest rate and recorded as a revenue and expense on the audited financial statements. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | The organization is organized as a domestic limited liability company with two corporate members and a board of managers. | |
| Form 990, Part VI, Section A, line 7a | The corporate members Indiana University Research and Technology Corporation and Clarian Health Partners each select two board managers and unanimously vote on one "elected" manager to the governing board of managers. | |
| Form 990, Part VI, Section B, line 11 | The process of reviewing the Form 990 entails a detailed review of the Form 990 by MPRI's CFO and by the corporate members' tax departments. The governing body reviews and approves the Form 990 and the final Form 990 including requested schedules, as ultimately filed with the IRS, are provided electronically to each voting member of the organization's governing body prior to filing. | |
| Form 990, Part VI, Section B, line 12c | The written Conflict of interest policy is regularly and consistently monitored and compliance is enforced by the director of human resources/ administration and director's team. The scope of this policy includes all members of the MPRI board of managers, all employees, and all contracted professionals. The policy is in place to prevent any potential conflicts of personal profit or gain, directly or indirectly, by reason of his or her participation with or employment by MPRI. In addition covered persons are to refrain from obtaining any list of MPRI's patients, referring physicians and vendors for personal or private solicitation purposes. A self disclosure from covered persons to MPRI leadership is required on any potential interest with vendors, patients or other matters. Any potential conflicts disclosed are reviewed and researched by compliance personnel and brought to the board of managers for review. The covered persons are to recuse from participating in any deliberation or decision on such transactions. | |
| Form 990, Part VI, Section B, line 15b | The CEO and COO (top management official) of the organization have been selected by the organization's corporate members to serve as board members and management officials for the organization. These officers do not receive compensation from the organization and therefore compensation determination is not required by the organization. The process for determining the compensation of all other organization's officers and Key employees included a review and approval by the governing body. Comparison with member institutions and local providers was made during the review of the compensation. The deliberation and decision made on the compensation was contemporaneously substantiated in the minutes of the board of managers. In addition a written compensation agreement outlines all compensation arrangements. | |
| Form 990, Part VI, Section C, line 19 | Governing documents, conflict of interest policy, and financial statements are available to the public. Requests can be made by phone or mail. | |
| Form 990, Part XI, Line 2C | The board of managers assumes responsibility for oversight of the audit of the financial statements and no processes have changed from prior year. | Oversight of the Audit |
| Schedule A, Part I, Line 3 | MPRI has been determined by the IRS to be a public charity under IRS code section 170(b)(1)(A)(III). Per Schedule H instructions only organizations that operate at least one facility that is, or is required to be, licensed, registered, or similarly recognized by a State as a hospital is required to complete the schedule. MPRI is a cancer treatment center and is not licensed as a hospital for the State of Indiana. | Hospital |