HENRY COUNTY MEMORIAL HOSPITAL FOUNDATION INC: Form 990, tax year 2020
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- Organization
- HENRY COUNTY MEMORIAL HOSPITAL FOUNDATION INC (EIN 35-6042246)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-07-13
- IRS object ID
- 202141949349300419
- Schema version
- 2020v4.0
- 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 | 2021-07-13T09:19:05-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 352151701 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARANOWSKI & COMPANY | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 212 E LASALLE AVE STE 220 | AddressLine1Txt |
| City | SOUTH BEND | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 466173562 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 356042246 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRY COUNTY MEMORIAL HOSP FOUNDAT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HENR | BusinessNameControlTxt |
| Phone | 7655211501 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 490 | AddressLine1Txt |
| City | NEW CASTLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47362 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAUL JANSSEN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 7655211501 | PhoneNum |
| Signature | 2021-04-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | PAUL | PersonFirstNm |
| Person Last | JANSSEN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID P ARANOWSKI CPA | PreparerPersonNm |
| PTIN | P00240735 | PTIN |
| Phone | 5742894821 | PhoneNum |
| Preparation | 2021-03-25 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PAUL JANSSEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 490 | AddressLine1Txt |
| City | NEW CASTLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47362 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $17,958,177 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1954 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | CORPORATION HAS BEEN ORGANIZED TO AND OPERATES FOR THE USE AND BENEFIT OF THE HENRY COUNTY HOSPITAL, A COUNTY OWNED HOSPITAL IN NEW CASTLE, IN, AND OTHER FACILITIES AND SERVICES OPERATED AS NON-PROFITS THAT SERVE THE HEALTH CARE NEEDS OF THE CITIZENS OF HENRY COUNTY, IN. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 4 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $572,185 | PYContributionsGrantsAmt |
| CY Contributions Grants | $37,371 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $376,393 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $222,248 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,450,844 | PYInvestmentIncomeAmt |
| CY Investment Income | $642,534 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,682,174 | PYOtherRevenueAmt |
| CY Other Revenue | $2,710,531 | CYOtherRevenueAmt |
| PY Total Revenue | $5,081,596 | PYTotalRevenueAmt |
| CY Total Revenue | $3,612,684 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $306,912 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $116,802 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $166,611 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $163,375 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $900,515 | PYOtherExpensesAmt |
| CY Other Expenses | $1,044,440 | CYOtherExpensesAmt |
| PY Total Expenses | $1,374,038 | PYTotalExpensesAmt |
| CY Total Expenses | $1,324,617 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,707,558 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,288,067 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $59,877,541 | TotalAssetsBOYAmt |
| Total Assets EOY | $66,671,261 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,272,886 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,701,934 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $56,604,655 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $62,969,327 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CORPORATION HAS BEEN ORGANIZED TO AND OPERATES FOR THE USE AND BENEFIT OF THE HENRY COUNTY HOSPITAL, A COUNTY OWNED HOSPITAL IN NEW CASTLE, IN, AND OTHER FACILITIES AND SERVICES OPERATED AS NON-PROFITS THAT SERVE THE HEALTH CARE NEEDS OF THE CITIZENS OF HENRY COUNTY, IN. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $245,193 | ExpenseAmt |
| Revenue | $78,867 | RevenueAmt |
| Desc | LIFE LINE PROGRAM THE FOUNDATION RENTS LIFE LINE PERSONAL CALL UNITS TO RESIDENTS OF HENRY COUNTY. THE UNITS ARE LEASED AND THEN RENTED ON A MONTHLY BASIS TO ELDERLY PERSONS FOR USE IN THEIR HOMES SO THAT THEY ARE ABLE TO QUICKLY CALL AND RECEIVE MEDICAL AND OTHER TYPES OF ASSISTANCE. THIS SYSTEM IS DESIGNED TO KEEP PEOPLE IN THEIR HOMES LONGER RATHER THAN INCUR THE ADDITIONAL COSTS ASSOCIATED WITH AN ASSISTED LIVING FACILITY OR NURSING HOME. THE YEAR WAS STARTED WITH 757 SUBSCRIBERS AND ENDED WITH 700. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $96,419 | ExpenseAmt |
| Desc | SCHOLARSHIP AWARDS, MEDICAL EDUCATION-GRANT TO IVY TECH NURSING PROGRAM, MEDICATIONS FOR THE NEEDY, HOSPICE, AND OTHER SCHOLARSHIPS WERE AWARDED TO 15 HEALTHCARE PROGRAM UNDERGRADUATE STUDENTS. TO ENCOURAGE AND SUPPORT THE TRAINING OF NURSES WHO WOULD WANT TO PURSUE A CAREER IN THE NEW CASTLE COMMUNITY, THE FOUNDATION COMMITTED ON A LONG TERM BASIS TO SUPPORT THE ESTABLISHMENT OF LOCAL CLASSES. THE TOTAL AMOUNT GIVEN TO IVY TECH COMMUNITY COLLEGE DURING 2020 WAS 60,000 FOR THE SALARY OF AN INSTRUCTOR AND RENT OF OFFICE SPACE FOR THE PROGRAM. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $629,099 | ExpenseAmt |
| Desc | DIRECT SUPPORT FOR HOSPITAL THE FOUNDATION PAYS FOR PHYSICIAN RECRUITMENT EXPENSES AND FOR MARKETING & PUBLIC RELATIONS EXPENSES TO ATTRACT, RECRUIT AND HIRE PHYSICIANS NEEDED TO PROVIDE QUALITY CARE IN THE COMMUNITY AND TO ATTRACT AND ENCOURAGE MEMBERS OF THE COMMUNITY TO USE THE SERVICES PROVIDED BY THE HENRY COUNTY HOSPITAL. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $38,436 | ExpenseAmt |
| Desc | TO PROMOTE PUBLIC RELATIONS AND TO PROVIDE SERVICE EQUIPMENT TO THE HOSPITAL. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $38,436 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $1,009,147 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 4 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAUL JANSSEN | PersonNm |
| Phone | 7655211501 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 490 | AddressLine1Txt |
| City | NEW CASTLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47362 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| PAUL JANSSEN | ||||||
| PRESIDENT | 7.50 | Yes (X) | Yes (X) | $43,500 | $0 | $0 |
| VANESSA TUCKER | ||||||
| ASST SEC/TRE | 3.85 | Yes (X) | Yes (X) | $34,245 | $0 | $0 |
| DARIN BROWN | ||||||
| TREASURER | 3.50 | Yes (X) | Yes (X) | $20,000 | $0 | $0 |
| BETH CARR | ||||||
| CHAIRMAN | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BRIANNA CHAPMAN | ||||||
| VICE CHAIRMA | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BENJAMIN FRENCH | ||||||
| TRUSTEE | 0.20 | Yes (X) | $0 | $0 | $0 | |
| JOEL HARVEY | ||||||
| TRUSTEE | 0.20 | Yes (X) | $0 | $0 | $0 | |
| SCOTT KOONTZ | ||||||
| TRUSTEE | 0.20 | Yes (X) | $0 | $0 | $0 | |
| JANA LUELLEN | ||||||
| TRUSTEE | 0.20 | Yes (X) | $0 | $0 | $0 | |
| WYLIE MCGLOTHLIN MD | ||||||
| TRUSTEE | 0.20 | Yes (X) | $0 | $0 | $0 | |
| DAVID BARR MD | ||||||
| TRUSTEE | 0.20 | Yes (X) | $0 | $0 | $0 | |
| DEBBIE MARGISON | ||||||
| TRUSTEE | 0.20 | Yes (X) | $0 | $0 | $0 | |
| TODD MYERS | ||||||
| TRUSTEE | 0.20 | Yes (X) | $0 | $0 | $0 | |
| JOHN PIDGEON | ||||||
| TRUSTEE | 0.20 | Yes (X) | $0 | $0 | $0 | |
| DR NATHAN RICH | ||||||
| TRUSTEE | 0.20 | Yes (X) | $0 | $0 | $0 | |
| MARK TAYLOR | ||||||
| TRUSTEE | 0.20 | Yes (X) | $0 | $0 | $0 | |
| DEBI WARE | ||||||
| TRUSTEE | 0.20 | Yes (X) | $0 | $0 | $0 | |
| BRENDA WILKINSON | ||||||
| TRUSTEE | 0.20 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $97,745 | TotalReportableCompFromOrgAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WURSTER CONSTRUCTION CO INC | |||||
| 8463 CASTLEWOOD DR | INDIANAPOLIS | IN | 46250 | BUILDING CONTRA | $299,084 |
| DUKE ENERGY | |||||
| PO BOX 1326 | CHARLOTTE | NC | 28201 | UTILITIES | $229,745 |
| VALUED RELATIONSHIPS | |||||
| 1400 COMMERCE DRIVE | FRANKLIN | OH | 45005 | CONTRACT SERVIC | $127,738 |
| KIRK STRATEGIC MARKETING INC | |||||
| 1118 BRAMBLING COURT | BRADENTON | FL | 34212 | MARKETING | $114,719 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $37,371 | AllOtherContributionsAmt |
| Total Contributions | $37,371 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| LIFELINE SERVICES | 624100 | $112,248 | $112,248 |
| CONTRACT SERVICES | 900099 | $110,000 | $110,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $222,248 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,243,669 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $580,816 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $662,853 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,674,410 | RealAmt |
| Personal | $1,212,280 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,820,338 | RealAmt |
| Personal | $364,748 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,854,072 | RealAmt |
| Personal | $847,532 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,701,604 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,701,604 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $11,559,272 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,160,407 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$601,135 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$601,135 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$601,135 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $8,927 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,927 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $8,927 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,612,684 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,912,460 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $662,853 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,842 | TotalAmt |
| Program Services | $86,842 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,960 | TotalAmt |
| Program Services | $29,960 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,745 | TotalAmt |
| Management And General | $97,745 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,996 | TotalAmt |
| Program Services | $47,996 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,079 | TotalAmt |
| Program Services | $2,079 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,676 | TotalAmt |
| Program Services | $5,676 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,879 | TotalAmt |
| Program Services | $3,363 | ProgramServicesAmt |
| Management And General | $6,516 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,023 | TotalAmt |
| Management And General | $9,023 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,351 | TotalAmt |
| Program Services | $488 | ProgramServicesAmt |
| Management And General | $21,863 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,452 | TotalAmt |
| Management And General | $116,452 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $528,801 | TotalAmt |
| Program Services | $528,801 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,286 | TotalAmt |
| Program Services | $1,286 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OTHER OPERATING EXPENSES | $219,504 | $162,010 | $57,494 |
| PHYSICIAN RECRUITMENT | $106,171 | $106,171 | |
| SUPPLIES | $27,993 | $23,699 | $4,294 |
| MAINTENANCE | $6,565 | $6,565 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,294 | TotalAmt |
| Program Services | $4,211 | ProgramServicesAmt |
| Management And General | $2,083 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,324,617 | TotalAmt |
| Program Services | $1,009,147 | ProgramServicesAmt |
| Management And General | $315,470 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,171,442 | BOYAmt |
| EOY | $496,457 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $550,569 | BOYAmt |
| EOY | $1,580,483 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,758 | BOYAmt |
| EOY | $1,396 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $39,638,267 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,800,146 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,244,096 | BOYAmt |
| EOY | $26,838,121 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,894,395 | BOYAmt |
| EOY | $37,754,804 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,281 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,877,541 | BOYAmt |
| EOY | $66,671,261 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $362,866 | BOYAmt |
| EOY | $208,564 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,061,340 | BOYAmt |
| EOY | $978,728 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,848,680 | BOYAmt |
| EOY | $2,514,642 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,272,886 | BOYAmt |
| EOY | $3,701,934 | 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 | $55,501,343 | BOYAmt |
| EOY | $61,637,561 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,103,312 | BOYAmt |
| EOY | $1,331,766 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,604,655 | BOYAmt |
| EOY | $62,969,327 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,877,541 | BOYAmt |
| EOY | $66,671,261 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,288,067 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $4,076,605 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRY COUNTY HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | HENRY COUNTY HOSPITAL | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 356001583 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | false | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $629,099 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Other Support Sum | $629,099 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | false | MajorityDirTrstSupportedOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, SECTION C, LINE 1 | FormAndLineReferenceDesc |
| Explanation | THE HENRY COUNTY MEMORIAL HOSPITAL FOUNDATION, INC., IS A SIGNIFICANT COMPONENT UNIT OF HENRY COUNTY MEMORIAL HOSPITAL. THE HOSPITAL APPOINTS A VOTING MAJORITY OF THE FOUNDATION'S BOARD OF DIRECTORS. THE FOUNDATION BOARD OF DIRECTORS INCLUDE THE CEO OF THE HOSPITAL WHO SERVES AS PRESIDENT OF THE FOUNDATION, AND THE CFO OF THE HOSPITAL WHO SERVES AS THE TREASURER OF THE FOUNDATION'S BOARD OF DIRECTORS. IN ADDITION TO THE BOARD OF DIRECTORS OF THE FOUNDATION, THE FOUNDATION IS SUPPORTED AND MANAGED BY AN ACCOUNTANT THAT PREPARES THE BUDGETS AND FINANCIAL STATEMENTS. | ExplanationTxt |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,405,574 | OtherCostOrOtherBasisAmt |
| Book Value | $4,405,574 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $31,294,403 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,086,495 | DepreciationAmt |
| Book Value | $22,207,908 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,938,290 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,713,651 | DepreciationAmt |
| Book Value | $224,639 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $26,838,121 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO HCH | Desc |
| Amt | $2,514,642 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,514,642 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $9,757,923 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $4,076,605 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $2,185,086 | OtherRevenueAmt |
| Revenue Not Reported | $6,261,691 | RevenueNotReportedAmt |
| Revenue Subtotal | $3,496,232 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $116,452 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $116,452 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $3,612,684 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,393,251 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $2,185,086 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $2,185,086 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,208,165 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $116,452 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $116,452 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,324,617 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 3, PART X | THE FOUNDATION IS EXEMPT FROM INCOME TAXES AS A CHARITABLE ORGANIZATION UNDER SECTION 501(C)3 OF THE INTERNAL REVENUE CODE. MANAGEMENT HAS EVALUATED THE FOUNDATION'S TAX POSITIONS AND CONCLUDED THAT THE FOUNDATION HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PRIVISIONS OF ASC 740-10. PENALTIES AND INTEREST ASSESSED BY INCOME TAXING AUTHORITIES ARE INCLUDED IN OPERATING EXPENSES, IF INCURRED. WITH FEW EXCEPTIONS, THE FOUNDATION IS NO LONGER SUBJECT TO FEDERAL AND STATE INCOME TAX EXAMINATION FOR TAX YEARS BEFORE 2017. |
| SCHEDULE D, PAGE 4, PART XI, LINE 2D | RENTAL EXPENSES 2,185,086 |
| SCHEDULE D, PAGE 4, PART XII, LINE 2D | RENTAL EXPENSES 2,185,086 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IVY TECH COMMUNITY COLLEGE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3325 IN-3 | AddressLine1Txt |
| City | NEW CASTLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47362 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash Grant | $86,842 | CashGrantAmt |
| Purpose Of Grant | NURSE TRAINING PROGR | PurposeOfGrantTxt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 13 | RecipientCnt |
| Cash Grant | $29,960 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | SCHOLARSHIP PAYMENTS ARE MADE DIRECTLY TO EDUCATION INSTITUTIONS. STUDENT'S PROGRESS IS MONITORED TO OBTAIN SCHOLARSHIP REPAYMENTS WHEN STUDENTS DO NOT COMPLY WITH THE TERMS OF THEIR SCHOLARSHIP. GRANTS TO ORGANIZATIONS ARE MONITORED ON AN INFORMAL BASIS BY VERBAL REPORTS OF THE SPECIFIC PROGRAM OR EXPENSES TO BE FUNDED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | CORPORATION HAS BEEN ORGANIZED TO AND OPERATES FOR THE USE AND BENEFIT OF THE HENRY COUNTY HOSPITAL, A COUNTY OWNED HOSPITAL IN NEW CASTLE, IN, AND OTHER FACILITIES AND SERVICES OPERATED AS NON-PROFITS THAT SERVE THE HEALTH CARE NEEDS OF THE CITIZENS OF HENRY COUNTY, IN. |
| FORM 990, PAGE 2, PART III, LINE 4D | TO PROMOTE PUBLIC RELATIONS AND TO PROVIDE SERVICE EQUIPMENT TO THE HOSPITAL. |
| FORM 990, PAGE 6, PART VI, LINE 6 | ALL OF THE MEMBERS OF THE BOARD MUST BE RESIDENTS OF HENRY COUNTY, INDIANA AND BE PERSONS INTERESTED IN THE HEALTH, SAFETY AND GENERAL WELFARE OF THE CITIZENS OF HENRY COUNTY, INDIANA AND BE SUPPORTIVE OF THE POLICIES OF THE HENRY COUNTY HOSPITAL IN ITS PROGRAMS TO PROVIDE HIGH-QUALITY HOSPITAL CARE AND TO AID IN THE ALLEVIATION OF HUMAN SUFFERING OF ALL THOSE PERSONS USING THE FACILITIES OR SERVICES ORGANIZED, MANAGED OR OPERATED BY IT FOR SUCH PURPOSE. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS REVIEWED BY THE ASISTANT SEC/TREASURER, TREASURER, PRESIDENT, AND THE CHAIRMAN OF THE BOARD; AND THEN IT IS SIGNED AND FILED BY THE TREASURER. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE POLICY IS EXPLAINED AND DISCUSSED AT THE NEW BOARD MEMBER ORIENTATION MEETING AND AT THE ANNUAL MEETING OF BOARD HELD EACH YEAR DURING MARCH. E ACH MEMBER IS INFORMED THAT ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST BE APPROPRIATELY AND TIMELY DISCLOSED. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE ANNUAL COMPENSATION IS APPROVED BY THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE FOUNDATION PROVIDES COPIES OF IT'S GOVERNING DOCUMENTS, CONFLICT OF IN TEREST POLICY, AND FINANCIAL STATEMENTS TO ANY MEMBER OF THE PUBLIC WHO RE QUESTS SUCH INFORMATION. |
| FORM 990, PART XI, LINE 9 | RENTAL EXPENSES 2,185,086 RENTAL EXPENSES -2,185,086 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRY COUNTY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 N 16TH STREET | AddressLine1Txt |
| City | NEW CASTLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47362 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 356001583 | EIN |
| Primary Activities | COUNTY GOV | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HCMH DIVERSIFIED MANAGEMENT CORPORA | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 490 | AddressLine1Txt |
| City | NEW CASTLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47362 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351640749 | EIN |
| Primary Activities | PHYSICIANS | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| HENRY COUNTY HOSPITAL | ||
| J | $2,786,000 | AMOUNT RECEIVED |
| HENRY COUNTY HOSPITAL | ||
| L | $110,000 | AMOUNT RECEIVED |
| HENRY COUNTY HOSPITAL | ||
| M | $5,750 | AMOUNT PAID |
| HCMH DIVERSIFIED MGMT CORP | ||
| J | $227,225 | AMOUNT RECEIVED |
Comments