JOHNSON COUNTY HEALTH FOUNDATION INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- JOHNSON COUNTY HEALTH FOUNDATION INC (EIN 35-1635296)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-14
- IRS object ID
- 201813189349309801
- Schema version
- 2017v2.3
- 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 | 2018-11-14T15:57:30-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 352140590 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HASH CPA GROUP LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 637 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 461310637 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351635296 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHNSON COUNTY HEALTH FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JOHN | BusinessNameControlTxt |
| Phone | 3177362657 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 549 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 461310549 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DOUG STEWART | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3177362657 | PhoneNum |
| Signature | 2018-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DENNIS J HASH | PreparerPersonNm |
| PTIN | P00381730 | PTIN |
| Phone | 3177382366 | PhoneNum |
| Preparation | 2018-11-13 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.16.49 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-14 | IPDt |
| IP Tm | 14:57:30 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | C31A8EC2A33DED74E1585005B3581F7861D4C6B0 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 2E30C34C23FC928CE6527A5FD889EDB09BC60595 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHNSON MEMORIAL HOSPITAL FDN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DOUG STEWART | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 549 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46131 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,323,372 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1985 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | TO RAISE CHARITABLE FUNDS TO BENEFIT JOHNSON MEMORIAL HOSPITAL IN IMPROVING THE HEALTH OF OUR COMMUNITY | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 40 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $72,469 | PYContributionsGrantsAmt |
| CY Contributions Grants | $147,059 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $36,518 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $42,872 | CYProgramServiceRevenueAmt |
| PY Investment Income | $22,594 | PYInvestmentIncomeAmt |
| CY Investment Income | $361,956 | CYInvestmentIncomeAmt |
| PY Other Revenue | $42,144 | PYOtherRevenueAmt |
| CY Other Revenue | $59,850 | CYOtherRevenueAmt |
| PY Total Revenue | $173,725 | PYTotalRevenueAmt |
| CY Total Revenue | $611,737 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $70,068 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $101,721 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,786 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $181,061 | PYOtherExpensesAmt |
| CY Other Expenses | $172,557 | CYOtherExpensesAmt |
| PY Total Expenses | $251,129 | PYTotalExpensesAmt |
| CY Total Expenses | $274,278 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$77,404 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $337,459 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,622,098 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,835,418 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,955 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $28,603 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,602,143 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,806,815 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO RAISE CHARITABLE FUNDS TO BENEFIT JOHNSON MEMORIAL HOSPITAL IN IMPROVING THE HEALTH OF OUR COMMUNITY | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $59,175 | ExpenseAmt |
| Grant | $49,077 | GrantAmt |
| Desc | NURSING SCHOLARSHIPS AND EDUCATION GRANTS FOR 26 RECIPIENTS, AND FUNDING FOR HOSPITAL EDUCATION REIMBURSEMENT PROGRAM ASSISTED 23 EMPLOYEES | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $135,086 | ExpenseAmt |
| Grant | $52,644 | GrantAmt |
| Desc | SUPPORT OF HEALTHIER COMMUNITY PROGRAMS AND SERVICES, INCLUDING TO PROMOTE AND SUPPORT SERVICES OF THE HOSPITAL AND AFFILIATES, AND ASSIST DEPARTMENTS WITH NEW TECHNOLOGY UPDATES. PROVIDE HOSPITAL STAFF WITH INFORMATION AND RESOURCES FOR PROMOTING HEALTHY LIVING AND PROVIDING QUALITY CARE. PROMOTE AWARENESS, CARING, AND UNITY AMONG HOSPITAL STAFF. PROMOTE LOCAL ORGANIZATIONS THAT PROVIDE PROGRAMS FOR HEALTHY FAMILIES, SCHOOL, AND REHAB SERVICES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $40,699 | ExpenseAmt |
| Revenue | $42,872 | RevenueAmt |
| Desc | BEGAN WORKING WITH COMMUNITY LEADERS IN 2014 TO SERVE AS FISCAL AGENT FOR WOMENS OUTDOOR WELLNESS CHALLENGE TRIP. THIS ANNUAL WEEK LONG ADVENTURE TRIP IS AVAILABLE TO ALL WOMEN, AND PROVIDES A WEEK OF ORGANIZED OUTDOOR ACTIVITIES TO MOTIVATE AND ENCOURAGE HEALTHY LIFESTYLES. BY SERVING AS THE FISCAL AGENT, WE GENERATE AWARENESS OF THE FOUNDATION'S MISSION AND DEVELOP RELATIONSHIPS THAT CULTIVATE FUTURE DONORS AND CONNECT WITH CURRENT DONORS. IN AUGUST 2017, 54 WOMEN PARTICIPATED IN THE WELLNESS TRIP TO SHENANDOAH, VIRGINIA. DURING THE TRIP AN INFORMAL PRESENTATION ABOUT THE FOUNDATION WAS GIVEN. AFTERWARDS, APPROXIMATELY 50 WOMEN REGISTERED TO PARTICIPATE IN THE AUGUST 2018 TRIP TO MAINE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $234,960 | 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 | Yes (true) | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| 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 | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | 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 | false | 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 | false | 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 | JENNIFER PRICE-TENNELL | PersonNm |
| Phone | 3177362657 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1125 W JEFFERSON ST | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46131 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| JERRY ENGLE | |||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JOHN W AULD JR | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JEFFREY OWEN | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DAVID DUNKLE MD | |||||||
| V.P. | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| SANDI HUDDLESTON | |||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JOHN NORRIS MD | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| LARRY HEYDON | |||||||
| SECRETARY/TR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| LYNN GRAY | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DOUG STEWART | |||||||
| PRESIDENT | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| DAVID WIPPERMANN MD | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| TOM THOMPSON | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JENNIFER L PRICE-TENNELL | |||||||
| EXECUTIVE DI | 40.00 | 0.00 | $0 | $62,067 | $2,790 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Reportable Comp Rltd Org | $62,067 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,790 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Fundraising | $97,500 | FundraisingAmt |
| Related Organizations | $30 | RelatedOrganizationsAmt |
| All Other Contributions | $49,529 | AllOtherContributionsAmt |
| Noncash Contributions | $875 | NoncashContributionsAmt |
| Total Contributions | $147,059 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | WOMENS OUTDOOR WELLNESS | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $42,872 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $42,872 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $42,872 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $64,298 | TotalRevenueColumnAmt |
| Exclusion | $64,298 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,855,653 | SecuritiesAmt |
| Other | $66,717 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,624,712 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $230,941 | SecuritiesAmt |
| Other | $66,717 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $297,658 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $296,620 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,038 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $146,773 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $97,500 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $86,923 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $59,850 | TotalRevenueColumnAmt |
| Exclusion | $59,850 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $611,737 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $339,492 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $125,186 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,589 | TotalAmt |
| Program Services | $52,589 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,132 | TotalAmt |
| Program Services | $49,132 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,402 | TotalAmt |
| Program Services | $65,834 | ProgramServicesAmt |
| Management And General | $16,880 | ManagementAndGeneralAmt |
| Fundraising | $1,688 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,365 | TotalAmt |
| Program Services | $2,319 | ProgramServicesAmt |
| Management And General | $3,046 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,462 | TotalAmt |
| Program Services | $9,549 | ProgramServicesAmt |
| Management And General | $14,913 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $875 | TotalAmt |
| Program Services | $875 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $910 | TotalAmt |
| Program Services | $513 | ProgramServicesAmt |
| Management And General | $397 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,888 | TotalAmt |
| Program Services | $3,812 | ProgramServicesAmt |
| Management And General | $978 | ManagementAndGeneralAmt |
| Fundraising | $98 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,050 | TotalAmt |
| Program Services | $630 | ProgramServicesAmt |
| Management And General | $420 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,595 | TotalAmt |
| Program Services | $957 | ProgramServicesAmt |
| Management And General | $638 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| WOMENS OUTDOOR WELLNESS | $40,699 | $40,699 | |
| POOH BEAR EXPENSE | $2,827 | $2,827 | |
| LOVING LIGHTS EXPENSE | $2,451 | $2,451 | |
| CATERING | $1,301 | $1,041 | $260 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,732 | TotalAmt |
| Program Services | $1,732 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,278 | TotalAmt |
| Program Services | $234,960 | ProgramServicesAmt |
| Management And General | $37,532 | ManagementAndGeneralAmt |
| Fundraising | $1,786 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,089 | BOYAmt |
| EOY | $70,281 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,740 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,740 | LandBldgEquipAccumDeprecAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,460,998 | BOYAmt |
| EOY | $1,640,386 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,011 | BOYAmt |
| EOY | $124,751 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,622,098 | BOYAmt |
| EOY | $1,835,418 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $613 | BOYAmt |
| EOY | $4,123 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,342 | BOYAmt |
| EOY | $24,480 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,955 | BOYAmt |
| EOY | $28,603 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,333,623 | BOYAmt |
| EOY | $1,534,592 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $159,520 | BOYAmt |
| EOY | $163,223 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $109,000 | BOYAmt |
| EOY | $109,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,602,143 | BOYAmt |
| EOY | $1,806,815 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,622,098 | BOYAmt |
| EOY | $1,835,418 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $337,459 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$132,787 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHNSON MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351166081 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (true) | GoverningDocumentListedInd |
| Support | $65,166 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $65,166 | SupportSumAmt |
| Other Support Sum | $0 | 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 |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (true) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | false | OperateBenefitNonSuprtOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SUPPLEMENTAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | DURING THE TAX YEAR, THE JOHNSON COUNTY HEALTH FOUNDATION SUPPORTED JOHNSON MEMORIAL HOSPITAL BY SUPPORTING THE STAFF AND PROVIDING OTHER OPERATIONS SUPPORT. THEY ALSO ADMINISTERED FUNDS TO UPDATE HOSPITAL DEPARTMENTS AND AFFILIATES WITH NEW TECHNOLOGY TO PROVIDE QUALITY CARE; AND OBTAINED FUNDING FOR HARP MUSIC THERAPY IN HOSPITAL WAITING AREA. | ExplanationTxt |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Donor Advised Funds Held | 1 | DonorAdvisedFundsHeldCnt |
| Funds And Other Accounts Held | 9 | FundsAndOtherAccountsHeldCnt |
| Donor Advised Funds Contri | $18,646 | DonorAdvisedFundsContriAmt |
| Funds And Other Accounts Contri | $9,034 | FundsAndOtherAccountsContriAmt |
| Donor Advised Funds Grants | $21,000 | DonorAdvisedFundsGrantsAmt |
| Funds And Other Accounts Grants | $40,367 | FundsAndOtherAccountsGrantsAmt |
| Donor Advised Funds Vl EOY | $27,899 | DonorAdvisedFundsVlEOYAmt |
| Funds And Other Accounts Vl EOY | $1,190,843 | FundsAndOtherAccountsVlEOYAmt |
| Disclosed Org Leg Ctrl | false | DisclosedOrgLegCtrlInd |
| Disclosed For Charitable Prps | Yes (true) | DisclosedForCharitablePrpsInd |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,740 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,740 | DepreciationAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| JCCF ENDOWMENT - GENERAL FD | $72,130 |
| JCCF ENDOWMENT - MORGAN TR | $51,529 |
| JMH RECEIVABLE | $750 |
| PREPAID EXPENSE - WOW TRIP | $342 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $124,751 | TotalBookValueOtherAssetsAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GALA | Event1Nm |
| Gross Receipts Event1 | $204,051 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $97,500 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $106,551 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $700 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $6,267 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $8,638 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $43,812 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $4,100 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $8,313 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF TOURNAMENT | Event2Nm |
| Gross Receipts Event2 | $40,222 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $40,222 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $1,400 | CashPrizesEvent2Amt |
| Non Cash Prizes Event2 | $5,848 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $3,600 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $4,051 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $194 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $244,273 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $97,500 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $146,773 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $2,100 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $12,115 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $12,238 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $47,863 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $4,100 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $8,507 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $86,923 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $59,850 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| ST THOMAS CLINIC | |||||||
| 600 PAUL HAND BLVD | FRANKLIN | IN | 46131 | 351449379 | 3 | $7,500 | OPERATION SUPPORT |
| JOHNSON MEMORIAL HOSPITAL | |||||||
| 1125 W JEFFERSON | FRANKLIN | IN | 46131 | 351166081 | $45,089 | OPERATIONS / DEPT. | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (4 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| SCHOLAR. - HEALTH FIELD | 21 | $21,000 |
| SCHOLAR. - NURSING DEGREE | 5 | $8,000 |
| EDUC. ASSIST. - BSN/NURSE | 23 | $20,077 |
| MEDICAL EXPENSE ASSIST. | 1 | $55 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION REVIEWS APPLICATIONS TO DETERMINE WHICH SCHOLARSHIP RECIPIENTS WOULD MOST BE IN LINE WITH THE ORGANIZATION'S MISSION. ONCE SCHOLARSHIPS ARE AWARDED, THE CHECKS ARE WRITTEN DIRECTLY TO THE SCHOOL TO GUARANTEE THAT FUNDS ARE USED FOR THEIR INTENDED PURPOSE. THE ORGANIZATION WORKS CLOSELY WITH ST THOMAS CLINIC AND THE JOHNSON MEMORIAL HOSPITAL AND CAN OBSERVE THE PROGRAMS FIRST HAND. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS DISTRIBUTED TO ALL BOARD MEMBERS WHEN COMPLETE. WHEN THE BOARD MEMBERS ARE SATISFIED WITH ITS CONTENT, THE RETURN IS FILED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | SITUATIONS THAT GIVE RISE TO POSSIBLE CONFLICTS OF INTEREST ARE DISCUSSED AS THEY OCCUR TO DETERMINE THE BEST COURSE OF ACTION. EACH BOARD MEMBER COMPLETES AN ANNUAL CONFLICT OF INTEREST STATEMENT. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND ANNUAL FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHNSON MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1125 W JEFFERSON | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46131 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351166081 | EIN |
| Primary Activities | CO HOSPITA | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Exempt Code Section | GOVT | ExemptCodeSectionTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | 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 | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
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