UNION HOSPITAL FOUNDATION INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- UNION HOSPITAL FOUNDATION INC (EIN 35-1642823)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202213199349309776
- Schema version
- 2021v4.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-15T11:48:03-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 N MERIDIAN ST SUITE 200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351642823 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNION HOSPITAL FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIO | BusinessNameControlTxt |
| Phone | 8122387534 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1606 NORTH SEVENTH STREET | AddressLine1Txt |
| City | TERRE HAUTE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 478042780 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MATTHEW NEALON | PersonNm |
| Person Title | ASST TREASURER | PersonTitleTxt |
| Phone | 8122387000 | PhoneNum |
| Signature | 2022-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MATTHEW | PersonFirstNm |
| Person Last | NEALON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | NATHAN A RODGERS CPA | PreparerPersonNm |
| PTIN | P01568275 | PTIN |
| Phone | 3176334705 | PhoneNum |
| Preparation | 2022-11-14 | 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 | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNION HEALTH FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TROY HELMAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1606 NORTH SEVENTH STREET | AddressLine1Txt |
| City | TERRE HAUTE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 478042780 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,224,633 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UNIONHOSPITALFOUNDATION.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1985 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | SUPPORT ADVANCES IN MEDICAL CARE AND INITIATIVES TO IMPROVE HEALTH FOR THE RESIDENTS OF WABASH VALLEY BY MAKING GRANTS TO UNION HOSPITAL, INC. UNION HOSPITAL HEALTH SERVICES, INC. AND OTHER QUALIFIED ORGANIZATIONS WHICH SERVE THIS PURPOSE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 19 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 6 | TotalEmployeeCnt |
| Total Volunteers | 60 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $838,002 | PYContributionsGrantsAmt |
| CY Contributions Grants | $759,506 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,972,179 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,019,362 | CYInvestmentIncomeAmt |
| PY Other Revenue | $146,546 | PYOtherRevenueAmt |
| CY Other Revenue | $207,013 | CYOtherRevenueAmt |
| PY Total Revenue | $2,956,727 | PYTotalRevenueAmt |
| CY Total Revenue | $1,985,881 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $610,526 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $530,747 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $507,888 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $451,521 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $234,300 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $216,737 | PYOtherExpensesAmt |
| CY Other Expenses | $296,078 | CYOtherExpensesAmt |
| PY Total Expenses | $1,335,151 | PYTotalExpensesAmt |
| CY Total Expenses | $1,278,346 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,621,576 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $707,535 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $23,514,261 | TotalAssetsBOYAmt |
| Total Assets EOY | $25,634,737 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,851,596 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,127,789 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $17,662,665 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,506,948 | NetAssetsOrFundBalancesEOYAmt |
| Mission | SUPPORT ADVANCES IN MEDICAL CARE AND INITIATIVES WHICH IMPROVE HEALTH FOR THE RESIDENTS OF THE WABASH VALLEY BY MAKING GRANTS TO UNION HOSPITAL, INC., UNION HOSPITAL HEALTH SERVICES, INC. AND OTHER QUALIFIED ORGANIZATIONS WHICH SERVE THIS PURPOSE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $695,477 | ExpenseAmt |
| Grant | $498,422 | GrantAmt |
| Desc | PROGRAM EXPENSES RELATED TO SUPPORTING ADVANCES IN MEDICAL CARE AND INITIATIVES WHICH IMPROVE HEALTH FOR THE RESIDENTS OF THE WABASH VALLEY BY MAKING GRANTS TO UNION HOSPITAL, INC., UNION HOSPITAL HEALTH SERVICES, INC. AND OTHER QUALIFIED ORGANIZATIONS TO FURTHER THE DELIVERY OF HEALTHCARE SERVICES TO THE WABASH VALLEY.THE FOUNDATION RECEIVES MANY DONATIONS ON BEHALF OF UNION HOSPITAL AND OTHER CHARITABLE ORGANIZATIONS RELATED TO THE FOUNDATION'S MISSION. THESE DONATIONS HELD ON THE HOSPITAL'S BEHALF ARE RECORDED IN AGENCY LIABILITY ACCOUNTS ON THE FOUNDATION'S BALANCE SHEET. DURING THE YEAR THERE WAS APPROXIMATELY $272,935 IN AGENCY GRANTS APPROVED FOR DISBURSEMENT. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $32,325 | ExpenseAmt |
| Grant | $32,325 | GrantAmt |
| Desc | ACADEMIC SCHOLARSHIP AWARDS TO BE APPLIED TO THE TUITION AND RELATED EDUCATION EXPENSES OF NUMEROUS STUDENTS ATTENDING VARIOUS COLLEGES AND UNIVERSITIES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $727,802 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 6 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 19 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | 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 | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| 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 | MATTHEW NEALON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8122387601 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1606 NORTH SEVENTH STREET | AddressLine1Txt |
| City | TERRE HAUTE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47804 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| MARGOT GILLESPIE | |||||||
| CHAIRPERSON | 4.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARY DOTI | |||||||
| VICE-CHAIRMAN | 1.00 | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MICHELLE RUIZ | |||||||
| SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARLENE LENZ | |||||||
| ASSISTANT SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CINDY MARTIN | |||||||
| TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MATTHEW NEALON | |||||||
| ASST. TREASURER | 1.00 | 46.00 | Yes (X) | Yes (X) | $0 | $648,795 | $36,692 |
| ROBERT R BROWN | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| RICHARD BURGER | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MARY CUMMINS | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JO EINSTANDIG | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| ROBERT W HAERR MD | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| TROY HELMAN | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| STEVEN M HOLMAN | |||||||
| DIRECTOR | 1.00 | 39.00 | Yes (X) | $0 | $1,522,047 | $32,097 | |
| JOHN S LUKENS | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SANTHANA NAIDU | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DONALD SCOTT | |||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |
| ERIK SOUTHARD | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| RANDALL L STEVENS | |||||||
| DIRECTOR | 1.00 | 43.00 | Yes (X) | $0 | $260,572 | $30,372 | |
| JOEL HARBAUGH | |||||||
| EXECUTIVE DIRECTOR | 60.00 | 1.00 | Yes (X) | Yes (X) | $0 | $144,932 | $19,288 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,576,346 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $118,449 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $30,506 | FundraisingAmt |
| All Other Contributions | $729,000 | AllOtherContributionsAmt |
| Noncash Contributions | $38,462 | NoncashContributionsAmt |
| Total Contributions | $759,506 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $162,425 | TotalRevenueColumnAmt |
| Exclusion | $162,425 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $44,000 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $8,692 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $35,308 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,308 | TotalRevenueColumnAmt |
| Exclusion | $35,308 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,036,832 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,179,895 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $856,937 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $856,937 | TotalRevenueColumnAmt |
| Exclusion | $856,937 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $161,601 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $30,506 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $50,165 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $111,436 | TotalRevenueColumnAmt |
| Exclusion | $111,436 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | VENDING INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $60,269 | TotalRevenueColumnAmt |
| Exclusion | $60,269 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $60,269 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,985,881 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,226,375 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $498,422 | TotalAmt |
| Program Services | $498,422 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,325 | TotalAmt |
| Program Services | $32,325 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $365,794 | TotalAmt |
| Program Services | $89,355 | ProgramServicesAmt |
| Management And General | $142,417 | ManagementAndGeneralAmt |
| Fundraising | $134,022 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,925 | TotalAmt |
| Program Services | $18,686 | ProgramServicesAmt |
| Management And General | $22,106 | ManagementAndGeneralAmt |
| Fundraising | $18,133 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,802 | TotalAmt |
| Program Services | $6,836 | ProgramServicesAmt |
| Management And General | $9,713 | ManagementAndGeneralAmt |
| Fundraising | $10,253 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $300 | TotalAmt |
| Management And General | $300 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,930 | TotalAmt |
| Program Services | $23,079 | ProgramServicesAmt |
| Management And General | $53,851 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,824 | TotalAmt |
| Management And General | $56,824 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,651 | TotalAmt |
| Program Services | $25,707 | ProgramServicesAmt |
| Management And General | $1,944 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,462 | TotalAmt |
| Fundraising | $3,462 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,648 | TotalAmt |
| Program Services | $5,643 | ProgramServicesAmt |
| Management And General | $2,418 | ManagementAndGeneralAmt |
| Fundraising | $14,587 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,763 | TotalAmt |
| Program Services | $13,497 | ProgramServicesAmt |
| Management And General | $2,266 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,093 | TotalAmt |
| Program Services | $1,830 | ProgramServicesAmt |
| Management And General | $643 | ManagementAndGeneralAmt |
| Fundraising | $620 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,820 | TotalAmt |
| Management And General | $14,820 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,923 | TotalAmt |
| Management And General | $1,923 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|---|
| RECOGNITION EXPENSE | $8,843 | $8,824 | $19 | |
| DUES & SUBSCRIPTIONS | $7,190 | $3,598 | $2,895 | $697 |
| CONTRIBUTION EXPENSES | $2,550 | $2,550 | ||
| CATERING | $255 | $255 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,826 | TotalAmt |
| Management And General | $3,517 | ManagementAndGeneralAmt |
| Fundraising | $50,309 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,278,346 | TotalAmt |
| Program Services | $727,802 | ProgramServicesAmt |
| Management And General | $316,244 | ManagementAndGeneralAmt |
| Fundraising | $234,300 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,558,933 | BOYAmt |
| EOY | $1,155,837 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $155,500 | BOYAmt |
| EOY | $150,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,405,338 | BOYAmt |
| EOY | $35,242 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $760,404 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $485,289 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $298,626 | BOYAmt |
| EOY | $275,115 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,182,499 | BOYAmt |
| EOY | $16,496,717 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,913,365 | BOYAmt |
| EOY | $7,521,826 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,514,261 | BOYAmt |
| EOY | $25,634,737 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $142,171 | BOYAmt |
| EOY | $130,441 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $426,687 | BOYAmt |
| EOY | $415,397 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,282,738 | BOYAmt |
| EOY | $5,581,951 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,851,596 | BOYAmt |
| EOY | $6,127,789 | 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 | $13,789,173 | BOYAmt |
| EOY | $15,184,893 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,873,492 | BOYAmt |
| EOY | $4,322,055 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,662,665 | BOYAmt |
| EOY | $19,506,948 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,514,261 | BOYAmt |
| EOY | $25,634,737 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $707,535 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $561,967 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $574,781 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Supported Organizations | 2 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (2 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| UNION HOSPITAL INC | ||||
| 350876396 | 3 | Yes (1) | $390,477 | $0 |
| UNION HOSPITAL HEALTH SERVICES INC | ||||
| 351642805 | 10 | Yes (1) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 2 | SupportedOrganizationsTotalCnt |
| Support Sum | $390,477 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | 0 | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | Yes (1) | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (1) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | Yes (1) | SupportedOrgVoiceInvestmentInd |
Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Test | Yes (X) | ActivitiesTestInd |
| Activities Further Exempt Prps | Yes (1) | ActivitiesFurtherExemptPrpsInd |
| Activities Engaged Org Invlmnt | Yes (1) | ActivitiesEngagedOrgInvlmntInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, SECTION D, LINE 3, SIGNIFICANT VOICE: | THE SUPPORTED ORGANIZATION HAD A SIGNIFICANT VOICE IN DIRECTING THE USE OF THE ORGANIZATION'S INCOME THROUGH HAVING BOARD MEMBERS FROM THE SUPPORTED ORGANIZATION SERVING ON THE ORGANIZATION'S COMMITTEES THAT DIRECT THE USE OF FUNDS. |
| PART IV, SECTION E, LINE 2A, DIRECT FURTHERANCE: | THE ORGANIZATION RECEIVES DONATIONS ON BEHALF OF UNION HOSPITAL, INC. AND UNION HOSPITAL HEALTH SERVICES, INC. THESE DONATIONS ARE FORWARDED TO THE SUPPORTING ORGANIZATIONS IN THE FORM OF GRANTS. THESE GRANTS FURTHER THE DELIVERY OF HEALTHCARE SERVICES PROVIDED BY THESE SUPPORTING ORGANIZATIONS. THE ORGANIZATION'S BOARD AND COMMITTEES INCLUDE BOARD MEMBERS FROM THE SUPPORTING ORGANIZATIONS TO HELP DETERMINE THE USE OF FUNDS. GRANT MONITORING AND DISCLOSURE OF ACTIVITIES TO THE SUPPORTING ORGANIZATIONS ENSURES THESE ACTIVITIES CONSTITUTE SUBSTANTIALLY ALL OF ITS ACTIVITIES. |
| PART IV, SECTION E, LINE 2B, BUT FOR: | IF THE ORGANIZATION DID NOT PERFORM THE ACTIVITIES THAT FURTHER THE HOSPITAL'S EXEMPT PURPOSES, THE HOSPITAL WOULD NEED TO BE ENGAGED IN THIS ACTIVITY, WHICH WOULD DIVERT HOSPITAL RESOURCES FROM PROVIDING MORE MEDICAL CARE TO THE COMMUNITY. |
| PART IV, SECTION A, LINE 1: | THE ORGANIZATION PROVIDES FINANCIAL SUPPORT THROUGH CHARITABLE GIVING TO UNION HOSPITAL AND OTHER AFFILIATED NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS. |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,911,051 | BeginningYearBalanceAmt |
| Contributions | $105,680 | ContributionsAmt |
| Investment Earnings Or Losses | $665,884 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $36,735 | OtherExpendituresAmt |
| End Year Balance | $5,645,880 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,193,839 | BeginningYearBalanceAmt |
| Contributions | $47,090 | ContributionsAmt |
| Investment Earnings Or Losses | $852,751 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,182,629 | OtherExpendituresAmt |
| End Year Balance | $4,911,051 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,420,422 | BeginningYearBalanceAmt |
| Contributions | $41,565 | ContributionsAmt |
| Investment Earnings Or Losses | $696,306 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$35,546 | OtherExpendituresAmt |
| End Year Balance | $5,193,839 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,671,937 | BeginningYearBalanceAmt |
| Contributions | $9,996 | ContributionsAmt |
| Investment Earnings Or Losses | -$148,923 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $112,588 | OtherExpendituresAmt |
| End Year Balance | $4,420,422 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,162,751 | BeginningYearBalanceAmt |
| Contributions | $50,529 | ContributionsAmt |
| Investment Earnings Or Losses | $569,215 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $110,558 | OtherExpendituresAmt |
| End Year Balance | $4,671,937 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.29806 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.49975 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.20219 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $51,000 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $86,251 | OtherCostOrOtherBasisAmt |
| Book Value | $137,251 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $339,000 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $204,382 | OtherCostOrOtherBasisAmt |
| Depreciation | $407,776 | DepreciationAmt |
| Book Value | $135,606 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $79,771 | OtherCostOrOtherBasisAmt |
| Depreciation | $77,513 | DepreciationAmt |
| Book Value | $2,258 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $275,115 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $7,521,826 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $7,521,826 | TotalBookValueSecuritiesAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | UNION HOSPITAL FOUNDATION RECEIVES MANY DONATIONS ON BEHALF OF UNION HOSPITAL AND OTHER CHARITABLE ORGANIZATIONS RELATED TO THE FOUNDATION'S MISSION. THESE DONATIONS HELD ON THE HOSPITAL'S BEHALF ARE RECORDED IN AGENCY LIABILITY ACCOUNTS ON THE FOUNDATION'S BOOKS AND THE BENEFICIARY ORGANIZATION IS MADE AWARE OF THE FUNDS HELD. EXPENSES RELATED TO CHARITABLE EVENTS ON BEHALF OF THESE OTHER ENTITIES ARE NETTED FROM THE AGENCY LIABILITY BALANCE. INVESTMENT INCOME/EXPENSE ALLOCATED TO THESE FUNDS IS ALSO POSTED TO THE AGENCY LIABILITY ACCOUNTS. |
| PART V, LINE 4: | THE FOUNDATION'S ENDOWMENT CONSISTS OF FIFTY-FIVE INDIVIDUAL FUNDS (NINE PERMANENTLY RESTRICTED, THIRTY-TWO TEMPORARILY RESTRICTED, AND FOURTEEN BOARD-DESIGNATED) THAT ARE GENERALLY ESTABLISHED FOR ONE OF THE FOLLOWING PURPOSES AS OF DECEMBER 31, 2021: FOUNDATION OPERATING SUPPORT, SCHOLARSHIPS, SPECIFIC HOSPITAL DEPARTMENT SUPPORT, OR SPECIFIC HOSPITAL PATIENT SERVICE SUPPORT. |
| PART X, LINE 2: | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION AND VNA AND RECOGNIZE A TAX LIABILITY IF THE FOUNDATION OR VNA HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FOUNDATION AND VNA, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2021 AND 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE FOUNDATION AND VNA ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS IN PROGRESS. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $100,474 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $15,866 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $84,608 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $2,719 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $18,532 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $3,241 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $395 | OtherDirectExpensesEvent1Amt |
| Event2 | GALA | Event2Nm |
| Gross Receipts Event2 | $43,558 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $7,179 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $36,379 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $1,114 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 2 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $48,075 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $7,461 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $40,614 | GrossRevenueOtherEventsAmt |
| Rent Fclty Costs Other Events | $15,035 | RentFcltyCostsOtherEventsAmt |
| Food And Beverage Other Events | $3,000 | FoodAndBeverageOtherEventsAmt |
| Oth Direct Expnss Other Events | $6,129 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $192,107 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $30,506 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $161,601 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $2,719 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $33,567 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $6,241 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $7,638 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $50,165 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $111,436 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| UNION HOSPITAL | ||||||||
| 1606 N 7TH STREET | TERRE HAUTE | IN | 47804 | 350876396 | 501 (C) 3 | $390,477 | $0 | CHARITABLE GRANT |
| RURAL HEALTH INNOVATION COLLABORATIVE | ||||||||
| 1606 N 7TH STREET | TERRE HAUTE | IN | 47804 | 271374208 | 501 (C) 3 | $50,000 | $0 | CHARITABLE GRANT |
| VNA OF WABASH VALLEY | ||||||||
| 400 8TH AVENUE | TERRE HAUTE | IN | 47804 | 350869064 | 501 (C) 3 | $6,775 | $0 | CHARITABLE GRANT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS AND ASSISTANCE | GrantTypeTxt |
| Recipient | 47 | RecipientCnt |
| Cash Grant | $32,325 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE FOUNDATION RECEIVES A "GRANT OUTCOME REPORT" FROM GRANT RECIPIENTS. A GREAT MAJORITY OF THE FOUNDATION'S GRANTS ARE TO UNION HOSPITAL, INC. THE FOUNDATION'S BOARD OF DIRECTORS RECEIVES REGULAR VERBAL REPORTS FROM KEY MEMBERS OF THE HOSPITAL ADMINISTRATION. SCHOLARSHIP RECIPIENTS MUST PROVIDE GRADE REPORTS SHOWING SATISFACTORY PROGRESS BEFORE 2ND SEMESTER SCHOLARSHIP AWARDS ARE PAID. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEVEN M HOLMAN | ||||||||||||||
| DIRECTOR | $0 | $879,929 | $0 | $439,608 | $0 | $202,510 | $0 | $14,950 | $0 | $17,147 | $0 | $1,554,144 | $0 | $0 |
| MATTHEW NEALON | ||||||||||||||
| ASST. TREASURER | $0 | $454,069 | $0 | $150,866 | $0 | $43,860 | $0 | $12,597 | $0 | $24,095 | $0 | $685,487 | $0 | $0 |
| RANDALL L STEVENS | ||||||||||||||
| DIRECTOR | $0 | $246,620 | $0 | $7,000 | $0 | $6,952 | $0 | $15,690 | $0 | $14,682 | $0 | $290,944 | $0 | $0 |
| JOEL HARBAUGH | ||||||||||||||
| EXECUTIVE DIRECTOR | $0 | $144,932 | $0 | $0 | $0 | $0 | $0 | $12,120 | $0 | $7,168 | $0 | $164,220 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR IS DETERMINED BY A RELATED ORGANIZATION, VISITING NURSE ASSOCIATION OF THE WABASH VALLEY, INC., USING THE FOLLOWING METHODS: - ANNUAL REVIEW BY EXECUTIVE COMMITTEE BASED ON PERFORMANCE - RESEARCH COMPARISON WITH SIMILAR ORGANIZATIONS | ExplanationTxt |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | CUPCAKES | 1 | $23,880 | FMV |
| Yes (X) | GIFT BAGS/TOTES/MISC. ITEMS FOR PATIENTS | 34 | $14,582 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE AMOUNT IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY THE FOUNDATION'S EXECUTIVE DIRECTOR, ASSISTANT TREASURER, AND ACCOUNTANTS. THE GOVERNING BODY RECEIVES THE FORM 990 AND THE FINAL FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY THE FOUNDATION'S EXECUTIVE DIRECTOR. THE SCOPE OF THIS POLICY INCLUDES ALL LEASED EMPLOYEES OF THE FOUNDATION AS WELL AS BOARD MEMBERS WHO HAVE AN INTEREST IN THE FOUNDATION'S DEALINGS. THE POLICY IS IN PLACE TO DETECT POTENTIAL CONFLICTS OF INTEREST THAT MAY ARISE. A SELF DISCLOSURE FROM COVERED PERSONS TO THE ORGANIZATION IS REQUIRED ON ANY POTENTIAL CONFLICTS OF INTEREST. THE REMAINING BOARD, COMMITTEE OR SUBCOMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE DIRECTOR RECEIVES ANNUAL PERFORMANCE REVIEWS FROM BOTH THE PRESIDENT AND EXECUTIVE COMMITTEE OF UNION HEALTH FOUNDATION. COMPENSATION OF EXECUTIVE DIRECTORS OF SIMILAR ORGANIZATIONS IS RESEARCHED AND OBTAINED FOR USE IN ESTABLISHING THE EXECUTIVE DIRECTOR'S COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND AUDITED FINANCIAL STATEMENTS AVAILABLE UPON REQUEST AT THE ORGANIZATION'S OFFICE. |
| FORM 990, PART XI, LINE 9: | AGENCY GRANTS TO OTHERS 272,935. AGENCY CONTRIBUTIONS FROM OTHERS -356,924. INVESTMENT IN SUBSIDARY EARNINGS 608,461. AGENCY EXPENSES NOT INCLUDED IN AUDIT 50,309. |
| FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT: | THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CENTER FOR OCCUPATIONAL HEALTH | |||||||||||
| 4001 WABASH AVENUE | TERRE HAUTE | IN | 47803 | 352118417 | OCCUPATIONAL HEALTH SERVICES | IN | 501(C)(3) | LINE 3 | UNION HOSPITAL | Yes (1) | |
| UNION ASSOCIATED PHYSICIAN CLINIC INC | |||||||||||
| 1606 N 7TH STREET | TERRE HAUTE | IN | 47804 | 270581401 | PHYSICIAN GROUP | IN | 501(C)(3) | LINE 10 | UNION HEALTH SYSTEM | Yes (1) | |
| UNION HEALTH SYSTEMS | |||||||||||
| 1606 N 7TH STREET | TERRE HAUTE | IN | 47804 | 270581133 | MANAGEMENT ORGANIZATION | IN | 501(C)(3) | LINE 12B, II | 0 | N/A | |
| UNION HOSPITAL INC | |||||||||||
| 1606 N 7TH STREET | TERRE HAUTE | IN | 47804 | 350876396 | HOSPITAL | IN | 501(C)(3) | LINE 3 | UNION HEALTH SYSTEM | Yes (1) | |
| VISITING NURSE ASSOCIATION OF THE WABASH VALLEY INC | |||||||||||
| 400 8TH AVENUE | TERRE HAUTE | IN | 47804 | 350869064 | HOME HEALTH AND HOSPICE CARE | IN | 501(C)(3) | LINE 10 | UNION HOSPITAL FOUNDATION INC | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| UNION HOSPITAL THERAPY LLC | |||||||||
| 150 N ROSENBERGER | EVANSVILLE | IN | 47712 | 464357168 | REHABILITATION AND THERAPY SERVICES | IN | N/A | 0 | 0 |
| AMBULATORY SURGERY MGMT SVCS LLC II | |||||||||
| 1606 N 7TH STREET | TERRE HAUTE | IN | 47804 | 270818628 | MEDICAL SERVICES | IN | N/A | 0 | 0 |
| CARDIOVASCULAR MANAGEMENT LLC | |||||||||
| 2723 S 7TH STREET | TERRE HAUTE | IN | 47802 | 208742344 | MEDICAL SERVICES | IN | N/A | 0 | 0 |
| ONCOLOGY SERVICES GROUP LLC | |||||||||
| 6100 W 96TH STREET SUITE 125 | INDIANAPOLIS | IN | 46278 | 208567643 | MEDICAL SERVICES | IN | N/A | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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