INDIANAPOLIS COALITION FOR PATIENT SAFETY INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- INDIANAPOLIS COALITION FOR PATIENT SAFETY INC (EIN 27-0962095)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2011-11-30
- IRS object ID
- 201143349349300309
- Schema version
- 2010v3.4
- 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 | 2011-11-30T10:54:09-06:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BGBC PARTNERS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 N MERIDIAN ST STE 1100 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 270962095 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANAPOLIS COALITION FOR PATIENT SAFETY INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | INDI | NameControl |
| Phone | 3176161958 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10401 N MERIDIAN STREET SUITE 300 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46290 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CAROL BIRK RPH MS | Name |
| Title | PRESIDENT | Title |
| Phone | 3176161958 | Phone |
| Date Signed | 2011-11-28 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SHELLEY A MATTALIANO CPA | Name |
| Phone | 3176334700 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | GLENN BINGLE MD PHD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10401 N MERIDIAN STREET SUITE 300 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46290 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 278478 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | INDYPATIENTSAFETY.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2009 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 222430 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 61147 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 43662 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 207970 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1079 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 288 | OtherRevenuePriorYear |
| Other Revenue Current Year | 8282 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 266380 | TotalRevenuePriorYear |
| Total Revenue Current Year | 278478 | 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 | 784 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8147 | 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 | 67147 | OtherExpensePriorYear |
| Other Expenses Current Year | 206641 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 67931 | TotalExpensesPriorYear |
| Total Expenses Current Year | 214788 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 198449 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 63690 | RevenuesLessExpensesCY |
| Total Assets BOY | 198449 | TotalAssetsBOY |
| Total Assets EOY | 372173 | TotalAssetsEOY |
| Total Liabilities BOY | 0 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 110034 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 198449 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 262139 | NetAssetsOrFundBalancesEOY |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 209604 | Expense |
| Revenue | 207970 | Revenue |
| Description | UNDERTAKING PROJECTS THAT FOCUS ON PATIENT-CENTERED STRATEGIES TO IMPROVE SAFETY BY ADDRESSEING ALL OF THE BARRIERS OBSERVED BY PATIENTS AND PROVIDERS TO ACHIEVING A STANDARDIZED APPROACH TO PATIENT CARE. | Description |
| Total Program Service Expense | 209604 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | 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 | 0 | 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 | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | 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 | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | 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 | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | 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 | 4 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1 | 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 | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | 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 | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | 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 | CAROL BIRK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3176161958 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10401 N MERIDIAN STREET SUITE 300 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46290 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
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 |
|---|---|---|---|---|---|---|
| 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 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| All Other Contributions | 61147 | AllOtherContributions |
| Total Contributions | 61147 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MEMBERSHIP DUES | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 207970 | TotalRevenueColumn |
| Related Or Exempt Function Income | 207970 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 207970 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1079 | TotalRevenueColumn |
| Exclusion | $1,079 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISC. REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 8282 | TotalRevenueColumn |
| Exclusion | $8,282 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 8282 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 278478 | TotalRevenueColumn |
| Related Or Exempt Function Income | 207970 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $9,361 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6546 | Total |
| Program Services | 6546 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1601 | Total |
| Program Services | 1601 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 245 | Total |
| Management And General | 245 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4939 | Total |
| Management And General | 4939 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148430 | Total |
| Program Services | 148430 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1291 | Total |
| Program Services | 1291 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3367 | Total |
| Program Services | 3367 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33896 | Total |
| Program Services | 33896 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1548 | Total |
| Program Services | 1548 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7386 | Total |
| Program Services | 7386 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2532 | Total |
| Program Services | 2532 | ProgramServices |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS EXPENSES | Description |
| Total | 3007 | Total |
| Program Services | 3007 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 214788 | Total |
| Program Services | 209604 | ProgramServices |
| Management And General | 5184 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 198449 | BOY |
| EOY | 3548 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 365825 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 2800 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 198449 | BOY |
| EOY | 372173 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 614 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 109420 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 110034 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 198449 | BOY |
| EOY | 262139 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 198449 | BOY |
| EOY | 262139 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 198449 | BOY |
| EOY | 372173 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 63690 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (29 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 29 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
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 O IRS990ScheduleO
General Explanation GeneralExplanation (3 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| 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. | |
| 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 B, LINE 12C | |
| THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, POLICIES AND PROCEDURES, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 |