UNIVERSITY PEDIATRIC ASSOCIATES INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- UNIVERSITY PEDIATRIC ASSOCIATES INC (EIN 23-7328642)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-04-19
- IRS object ID
- 202411109349301206
- Schema version
- 2022v5.0
- 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) |
|---|---|---|
| Return | 2024-04-19T12:32:33-05:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 352123203 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KSM BUSINESS SERVICES INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 40857 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46240 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237328642 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY PEDIATRIC ASSOCIATES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIV | BusinessNameControlTxt |
| Phone | 3177776435 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1130 W MICHIGAN ST FESLER HALL 3 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46202 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR D WADE CLAPP | PersonNm |
| Person Title | CHAIRMAN OF THE BOARD | PersonTitleTxt |
| Phone | 3177776435 | PhoneNum |
| Signature | 2024-03-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DR | PersonFirstNm |
| Person Last | WADE CLAPP | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DONALD R BOEZEMAN | PreparerPersonNm |
| PTIN | P01000722 | PTIN |
| Phone | 3175802000 | PhoneNum |
| Preparation | 2024-03-08 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DR D WADE CLAPP | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1130 W MICHIGAN ST FESLER HALL 320 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $71,920,652 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION'S PRIMARY EXEMPT PURPOSE IS TO ENGAGE ACTIVELY AND CONTINUOUSLY IN MEDICAL RESEARCH AND TO PROVIDE MEDICAL EDUCATION AND MEDICAL RESEARCH IN CONJUNCTION WITH SERVING AS AN AUXILIARY TO THE OPERATION OF THE DEPARTMENT OF PEDIATRICS OF INDIANA UNIVERSITY SCHOOL OF MEDICINE AND ITS HOSPITALS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $98,443,340 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $69,423,557 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,204,440 | PYInvestmentIncomeAmt |
| CY Investment Income | $396,438 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,180,000 | PYOtherRevenueAmt |
| CY Other Revenue | $1,211,000 | CYOtherRevenueAmt |
| PY Total Revenue | $100,827,780 | PYTotalRevenueAmt |
| CY Total Revenue | $71,030,995 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $40,100 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $99,016,425 | PYOtherExpensesAmt |
| CY Other Expenses | $78,021,493 | CYOtherExpensesAmt |
| PY Total Expenses | $99,056,525 | PYTotalExpensesAmt |
| CY Total Expenses | $78,023,493 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,771,255 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$6,992,498 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $25,897,136 | TotalAssetsBOYAmt |
| Total Assets EOY | $20,048,332 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $25,897,136 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $20,048,332 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION'S PRIMARY EXEMPT PURPOSE IS TO ENGAGE ACTIVELY AND CONTINUOUSLY IN MEDICAL RESEARCH AND TO PROVIDE MEDICAL EDUCATION AND MEDICAL RESEARCH IN CONJUNCTION WITH SERVING AS AN AUXILIARY TO THE OPERATION OF THE DEPARTMENT OF PEDIATRICS OF INDIANA UNIVERSITY SCHOOL OF MEDICINE AND ITS HOSPITALS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $76,954,854 | ExpenseAmt |
| Revenue | $70,634,557 | RevenueAmt |
| Desc | VARIOUS PROGRAMS IN CONJUNCTION WITH THE INDIANA UNIVERSITY FOUNDATION AND THE INDIANA UNIVERSITY SCHOOL OF MEDICINE TO ADVANCE THE STATE OF PEDIATRIC RESEARCH, EDUCATION, AND SERVICE BY PROVIDING CLINICAL, EDUCATIONAL, RESEARCH, ADMINISTRATIVE, AND COLLECTION SERVICES FOR INDIANA UNIVERSITY SCHOOL OF MEDICINE PEDIATRIC PHYSICIANS AND FACULTY | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,000 | ExpenseAmt |
| Grant | $2,000 | GrantAmt |
| Desc | CHARITABLE CONTRIBUTIONS TO VARIOUS MEDICAL INSTITUTIONS | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,526 | ExpenseAmt |
| Desc | THE ORGANIZATION PROVIDES ADMINISTRATIVE AND COLLECTION SERVICES FOR INDIANA UNIVERSITY FACULTY AND PHYSICIANS | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SERVE THE PUBLIC GOOD BY ENSURING CHILDREN HAVE ACCESS TO EXCEPTIONAL HEALTHCARE | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $76,958,380 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 40 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TERESA HUTCHISON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3177776435 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1130 W MICHIGAN ST FESLER HALL STE | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| DR D WADE CLAPP | ||||||
| CHAIRMAN OF THE BOARD | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DR LAURA S HANELINE | ||||||
| PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DR LARRY W MARKHAM | ||||||
| SECRETARY/TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DR JAMES CHMIEL | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DR CELANIE K CHRISTENSEN | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DR LINDA A DIMEGLIO | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DR DAVID S HAINS | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DR SUSAN H BALLINGER | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DR CHANDY C JOHN | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DR RACHEL A KATZENELLENBOGEN | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DR EUGENIA P MOLLESTON | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DR BRIAN D WEISS | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DR EMILY K SCOTT | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DR ADNAN T BHUTTA | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HELEN BRODY | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1130 W MICHIGAN ST FESLER HALL 32 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | ADMINISTRATION | ServicesDesc |
| Compensation | $285,717 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICES | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $69,423,557 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $69,423,557 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $69,423,557 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $358,760 | TotalRevenueColumnAmt |
| Exclusion | $358,760 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $927,335 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $889,657 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $37,678 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,678 | TotalRevenueColumnAmt |
| Exclusion | $37,678 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SURGICAL CENTER INCOME | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $1,211,000 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,211,000 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,211,000 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $71,030,995 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $70,634,557 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $396,438 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,000 | TotalAmt |
| Program Services | $2,000 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,200 | TotalAmt |
| Management And General | $9,200 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,275 | TotalAmt |
| Management And General | $8,275 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,554 | TotalAmt |
| Management And General | $43,554 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $787,060 | TotalAmt |
| Program Services | $1,526 | ProgramServicesAmt |
| Management And General | $785,534 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,287 | TotalAmt |
| Management And General | $152,287 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,263 | TotalAmt |
| Management And General | $29,263 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHYSICIAN SERVICES | $76,954,854 | $76,954,854 | |
| HOSPITALITY | $29,743 | $29,743 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,257 | TotalAmt |
| Management And General | $7,257 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,023,493 | TotalAmt |
| Program Services | $76,958,380 | ProgramServicesAmt |
| Management And General | $1,065,113 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,764,948 | BOYAmt |
| EOY | $3,521,032 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,820,288 | BOYAmt |
| EOY | $13,220,185 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,036,900 | BOYAmt |
| EOY | $3,032,115 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $275,000 | BOYAmt |
| EOY | $275,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,897,136 | BOYAmt |
| EOY | $20,048,332 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,897,136 | BOYAmt |
| EOY | $20,048,332 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,897,136 | BOYAmt |
| EOY | $20,048,332 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,897,136 | BOYAmt |
| EOY | $20,048,332 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$6,992,498 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,143,694 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $71,409,271 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $79,956,969 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $86,930,644 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $98,443,340 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $69,423,557 | CurrentTaxYearAmt |
| Total | $406,163,781 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $71,409,271 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $79,956,969 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $86,930,644 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $98,443,340 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $69,423,557 | CurrentTaxYearAmt |
| Total | $406,163,781 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $406,163,781 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $535,127 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $461,024 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $316,015 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $710,929 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $358,755 | CurrentTaxYearAmt |
| Total | $2,381,850 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $535,127 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $461,024 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $316,015 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $710,929 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $358,755 | CurrentTaxYearAmt |
| Total | $2,381,850 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,120,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,090,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,160,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,180,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,211,000 | CurrentTaxYearAmt |
| Total | $5,761,000 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $73,064,398 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $81,507,993 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $88,406,659 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $100,334,269 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $70,993,312 | CurrentTaxYearAmt |
| Total | $414,306,631 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98030 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98050 | PublicSupportPY509Pct |
| Investment Income CY | 0.00570 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00620 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | ROC SURGERY CENTER K-1 INCOME - 2018 AMOUNT: $ 1,120,000. 2019 AMOUNT: $ 1,090,000. 2020 AMOUNT: $ 1,160,000. 2021 AMOUNT: $ 1,180,000. 2022 AMOUNT: $ 1,211,000. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTERNATIONAL SELECT INVESTMENTS LLC | Desc |
| Book Value | $3,032,115 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $3,032,115 | TotalBookValueSecuritiesAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990, WHICH IS PREPARED BY A CPA FIRM, IS REVIEWED IN DETAIL BY THE ORGANIZATION'S BUSINESS MANAGER, ADMINISTRATOR AND OTHER ACCOUNTING PERSONNEL. IN ADDITION, FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | UPA BOARD REVIEWS AND MONITORS ALL COMPLIANCE IN ACCORDANCE WITH UPA'S CONFLICT OF INTEREST POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15A | UPA BOARD WILL VOTE AND DETERMINE THE COMPENSATION BASED ON EXTERNAL AND INTERNAL FACTORS. |
| FORM 990, PART VI, SECTION C, LINE 18 | AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABLE UPON REQUEST |
Schedule R IRS990ScheduleR
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROC SURGERY LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 340 WEST 10TH STREET | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 271497960 | EIN |
| Primary Activities | AMBULATORY SURGERY CENTER PERFORMING ONLY OUTPATIENT PROCEDURES | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $1,211,000 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $275,000 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.12660 | OwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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