INDIANA INSTITUTE FOR MEDICAL RESEARCH INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
INDIANA INSTITUTE FOR MEDICAL RESEARCH INC (EIN 35-1781809)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-05-07
IRS object ID
201821279349300602
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

FieldValueIRS element (for citing)
Return2018-05-07T06:47:12-05:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN205520612PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1L M HENDERSON & COMPANY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1450 E 96TH ST STE 200AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46240ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN351781809EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1INDIANA INSTITUTE FOR MEDICALBusinessNameLine1Txt
Business Name Line2RESEARCH INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlINDIBusinessNameControlTxt
Phone3179889544PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11481 WEST 10TH STREET 151AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP462022803ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARY GRAYPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone3179889544PhoneNum
Signature2018-05-01SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHELLE L ZIMMERMANPreparerPersonNm
PTINP00266120PTIN
Phone3175661000PhoneNum
Preparation2018-05-01PreparationDt
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARY GRAYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11481 WEST 10TH STREET 151AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP462022803ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$278,835GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1989FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionTO PROMOTE THE RESEARCH AND EDUCATIONAL MISSION OF THE RICHARD L. ROUDEBUSH VA MEDICAL CENTER IN INDIANAPOLIS, INDIANA.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee3TotalEmployeeCnt
Total Volunteers3TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$121,481PYContributionsGrantsAmt
CY Contributions Grants$225,609CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$54,784PYInvestmentIncomeAmt
CY Investment Income$53,226CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$176,265PYTotalRevenueAmt
CY Total Revenue$278,835CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$136,748PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$140,623CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$218,714PYOtherExpensesAmt
CY Other Expenses$259,888CYOtherExpensesAmt
PY Total Expenses$355,462PYTotalExpensesAmt
CY Total Expenses$400,511CYTotalExpensesAmt
PY Revenues Less Expenses-$179,197PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$121,676CYRevenuesLessExpensesAmt
Total Assets BOY$2,839,819TotalAssetsBOYAmt
Total Assets EOY$2,657,199TotalAssetsEOYAmt
Total Liabilities BOY$34,574TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,393TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,805,245NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,654,806NetAssetsOrFundBalancesEOYAmt
MissionTO PROMOTE THE RESEARCH AND EDUCATIONAL MISSION OF THE RICHARD L. ROUDEBUSH VA MEDICAL CENTER IN INDIANAPOLIS, INDIANA.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$220,404ExpenseAmt
Revenue$168,305RevenueAmt
DescINDIANA INSTITUTE FOR MEDICAL RESEARCH SUPPORTS THE NEEDS OF INVESTIGATORS INVOLVED WITH RESEARCH PROJECTS THROUGH THE RICHARD L. ROUDEBUSH VA MEDICAL CENTER.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$14,967ExpenseAmt
Revenue$14,210RevenueAmt
DescINDIANA INSTITUTE FOR MEDICAL RESEARCH SUPPORTS FACULTY, STAFF, AND PATIENT EDUCATION AT THE RICHARD L. ROUDEBUSH VA MEDICAL CENTER.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$235,371TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee3EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonELIZABETH VERHAGENPersonNm
Phone3179882479PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11481 WEST 10TH STREETAddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46202ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
THOMAS SHARP MD
CHAIRMAN/DIR0.50Yes (X)Yes (X)$0$332,804$70,365
JOHN T CALLAGHAN
DIRECTOR0.50Yes (X)$0$237,367$39,594
BRIAN HANCOCK
DIRECTOR0.50Yes (X)$0$0$0
IMTIAZ MUNSHI
DIRECTOR0.50Yes (X)$0$0$0
MARY HARDEN
DIRECTOR0.50Yes (X)$0$0$0
MICHAEL NOONE
DIRECTOR0.50Yes (X)$0$0$0
LORI TANAKA
SECRETARY/TR0.50Yes (X)Yes (X)$0$0$0
DIONE FARRIA
DIRECTOR0.50Yes (X)$0$0$0
MARY GRAY
EXECUTIVE DI32.00Yes (X)$79,612$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$79,612TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$570,171TotReportableCompRltdOrgAmt
Total Other Compensation$109,959TotalOtherCompensationAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$225,609AllOtherContributionsAmt
Total Contributions$225,609TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$53,226TotalRevenueColumnAmt
Exclusion$53,226ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$278,835TotalRevenueColumnAmt
Exclusion$53,226ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$130,360TotalAmt
Management And General$130,360ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$10,263TotalAmt
Management And General$10,263ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$646TotalAmt
Program Services$646ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$9,150TotalAmt
Management And General$9,150ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$19,910TotalAmt
Program Services$15,629ProgramServicesAmt
Management And General$4,281ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$10,793TotalAmt
Program Services$10,697ProgramServicesAmt
Management And General$96ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,772TotalAmt
Management And General$2,772ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SERVICES$135,929$135,929
FURNITURE & EQUIPMENT$40,775$40,775
SUPPLIES$22,180$18,841$3,339
TUTION REIMBURSEMENT$6,770$6,770

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$10,963TotalAmt
Program Services$6,084ProgramServicesAmt
Management And General$4,879ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$400,511TotalAmt
Program Services$235,371ProgramServicesAmt
Management And General$165,140ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$254,326BOYAmt
EOY$208,117EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,563,713BOYAmt
EOY$2,385,657EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,175BOYAmt
EOY$49,662EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,026BOYAmt
EOY$2,016EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$10,579BOYAmt
EOY$11,747EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,839,819BOYAmt
EOY$2,657,199EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$34,574BOYAmt
EOY$2,393EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$34,574BOYAmt
EOY$2,393EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,639,759BOYAmt
EOY$2,453,001EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$165,486BOYAmt
EOY$201,805EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,805,245BOYAmt
EOY$2,654,806EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,839,819BOYAmt
EOY$2,657,199EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$121,676ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$28,763NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Medical Research OrganizationYes (X)MedicalResearchOrganizationInd

Hospital Name And Address HospitalNameAndAddressGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1RICHARD L ROUDEBUSH VA MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$250,072TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$28,763NetUnrealizedGainsInvstAmt
Revenue Not Reported-$28,763RevenueNotReportedAmt
Revenue Subtotal$278,835RevenueSubtotalAmt
Total Revenue Per Form990$278,835TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$400,511TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$400,511ExpensesSubtotalAmt
Total Expenses Per Form990$400,511TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 3, PART XFormAndLineReferenceDesc
ExplanationMANAGEMENT EVALUATES ALL TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS ANNUAL INFORMATION RETURNS, INCLUDING THE POSITION THAT THE INSTITUTE CONTINUES TO QUALIFY TO BE TREATED AS A SECTION 501(C)(3) ORGANIZATION FOR BOTH FEDERAL AND STATE PURPOSES. FOR THE YEARS ENDED DECEMBER 31, 2017 AND DECEMBER 31, 2016, MANAGEMENT DOES NOT FEEL IT HAS TAKEN ANY TAX POSITIONS THAT WOULD NOT BE SUSTAINED UNDER EXAMINATION. THEREFORE, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF DECEMBER 31, 2017 AND DECEMBER 31, 2016, OR THE PERIODS THEN ENDED. THE ANNUAL INFORMATION RETURNS FOR THE INSTITUTE ARE SUBJECT TO EXAMINATION BY TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE DATE THEY ARE FILED. AS OF DECEMBER 31, 2017, THE TAX YEARS 2016, 2015, AND 2014 REMAIN SUBJECT TO EXAMINATION.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
THOMAS SHARP MD
CHAIRMAN/DIRECTOR$321,554$11,250$44,053$26,312$403,169
JOHN T CALLAGHAN
DIRECTOR$226,261$11,106$30,998$8,596$276,961

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTHE FORM 990 WILL BE PROVIDED TO EACH DIRECTOR AT THE MAY 2018 BOARD MEETING FOR APPROVAL PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PAGE 6, PART VI, LINE 12CTHE INSTITUTE CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY BEING CONTINUOUSLY MONITORED BY THE BOARD OF DIRECTORS AND DISCUSSED AT BOARD MEETINGS. IF CONFLICTS ARISE PRIOR TO A MEETING, THEY ARE REVIEWED AND DISCUSSED AMONG THE BOARD OF DIRECTORS THROUGH VIRTUAL MEETINGS.
FORM 990, PAGE 6, PART VI, LINE 15ATHE REVIEW PROCESS AND APPROVAL OF COMPENSATION OF THE EXECUTIVE DIRECTOR IS REVIEWED AND APPROVED ANNUALLY BY THE BOARD OF DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 19THE INSTITUTE MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST BY MAIL OR TELEPHONE.
FORM 990, PART VIIREASONABLE EFFORTS BY THE ORGANIZATION WERE MADE TO OBTAIN AND ESTIMATE COMPENSATION INFORMATION FROM A RELATED ORGANIZATION. ANNUAL QUESTIONNAIRES DETAILING THE REQUIREMENTS FOR PART VII, SECTION A ARE DISTRIBUTED TO EACH BOARD MEMBER. THREE OF THE BOARD MEMBERS ELECTED NOT TO PROVIDE THEIR COMPENSATION RECEIVED FROM THE RICHARD L ROUDEBUSH VETERANS AFFAIRS MEDICAL CENTER ON FORM 990. AS A RESULT, THE COMPENSATION DISCLOSED FOR THESE INDIVIDUALS ON PART VII, COLUMNS E AND F ARE INCOMPLETE, AND SCHEDULE J MAY BE INCOMPLETE.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1RICHARD ROUDEBUSH VETERANS AFFAIRSBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11481 W 10TH STAddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46202ZIPCd
FieldValueIRS element (for citing)
EIN351906280EIN
Primary ActivitiesMEDICALPrimaryActivitiesTxt
Legal Domicile StateINLegalDomicileStateCd
Exempt Code Section501C1ExemptCodeSectionTxt
Public Charity StatusN/APublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

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