2017-11-14T15:25:40-06:00 2016-12-31 351178661 Blue & Co LLC 500 N Meridian St Suite 200 Indianapolis IN 46204 990 2016-01-01 351642823 Union Hospital Foundation inc UNIO 8122387534 1606 North Seventh Street Terre Haute IN 478042780 Wayne Hutson Asst Treasurer 8122387000 2017-11-14 1 Amber Kocher CPA P01286298 3176334705 2017-11-14 38.109.186.2 2017-11-14 15:25:37 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 48BB13F909289851469C7DA648BAC11FC748AA42 2016 2017-02-10 21:41:12Z Union Health Foundation inc Troy Helman 1606 North Seventh Street Terre Haute IN 478042780 6684537 0 X www.unionhospitalfoundation.org X 1985 IN SUPPORT ADVANCES IN MEDICAL CARE AND INITIATIVES TO IMPROVE HEALTH FOR THE RESIDENTS OF WABASH VALLEY BY MAKING GRANTS TO UNION HOSPITAL, INC. UNION HOSPITAL HEALTH SERVICES, INC. AND OTHER QUALIFIED ORGANIZATIONS WHICH SERVE THIS PURPOSE. 25 21 4 60 0 0 485809 1568257 0 0 131550 843855 -17175 188120 600184 2600232 24208 622775 0 0 119735 353996 0 0 178197 107251 214491 251194 1191262 348990 1408970 14001256 16539014 4806612 5602042 9194644 10936972 Support advances in medical care and initiatives which improve health for the residents of the Wabash Valley by making grants to Union Hospital, Inc., Union Hospital Health Services, Inc. and other qualified organizations which serve this purpose. 0 0 695006 578800 0 PROGRAM EXPENSES RELATED TO SUPPORTING ADVANCES IN MEDICAL CARE AND INITIATIVES WHICH IMPROVE HEALTH FOR THE RESIDENTS OF THE WABASH VALLEY BY MAKING GRANTS TO UNION HOSPITAL, INC., UNION HOSPITAL HEALTH SERVICES, INC. AND OTHER QUALIFIED ORGANIZATIONS TO FURTHER THE DELIVERY OF HEALTHCARE SERVICES TO THE WABASH VALLEY.THE FOUNDATION RECEIVES MANY DONATIONS ON BEHALF OF UNION HOSPITAL AND OTHER CHARITABLE ORGANIZATIONS RELATED TO THE FOUNDATION'S MISSION. THESE DONATIONS HELD ON THE HOSPITAL'S BEHALF ARE RECORDED IN AGENCY LIABILITY ACCOUNTS ON THE FOUNDATION'S BALANCE SHEET. DURING THE YEAR THERE WAS APPROXIMATELY $390,000 IN AGENCY GRANTS APPROVED FOR DISBURSEMENT. 43975 43975 0 Academic Scholarship Awards to be applied to the tuition and related education expenses of numerous students attending various colleges and universities. 738981 1 1 0 0 0 0 0 0 0 1 1 1 0 1 0 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 13 0 1 4 1 0 0 0 0 0 1 1 0 0 0 0 X 25 21 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 0 0 IN X Wayne R Hutson 8122387601 1606 North Seventh Street Terre Haute IN 47804 Troy Helman Chairman 4.00 1.00 X X 0 0 0 Margot Gillespie Vice Chairperson 1.00 0.00 X X 0 0 0 Mary Doti Secretary 1.00 0.00 X X 0 0 0 Robert R Brown Treasurer 1.00 0.00 X X 0 0 0 Diann E Mckee Past Chairman 1.00 0.00 X X 0 0 0 Wayne R Hutson Assistant Treasurer 1.00 41.00 X X 0 432835 13032 Alexa Bilsland DIRECTOR 1.00 0.00 X 0 0 0 Richard Burger DIRECTOR 1.00 0.00 X 0 0 0 Ed Carne DIRECTOR 1.00 0.00 X 0 0 0 Mary Ann Carroll DIRECTOR 1.00 0.00 X 0 0 0 John W Dinkel DIRECTOR 1.00 0.00 X 0 0 0 Jo Einstandig DIRECTOR 1.00 0.00 X 0 0 0 Vern W Fellows DIRECTOR 1.00 0.00 X 0 0 0 Tom Goss DIRECTOR 1.00 0.00 X 0 0 0 Robert W Haerr MD DIRECTOR 1.00 0.00 X 0 0 0 Steven M Holman DIRECTOR 1.00 20.00 X 0 854950 23620 Ward M Hubbard DIRECTOR 1.00 2.00 X 0 0 0 John S Lukens DIRECTOR 1.00 2.00 X 0 0 0 Cindy Martin DIRECTOR 1.00 2.00 X 0 0 0 Santhana Naidu DIRECTOR 1.00 0.00 X 0 0 0 Aruna Namburi DIRECTOR 1.00 0.00 X 0 0 0 Donald Scott DiRECTOR 1.00 1.00 X 0 0 0 Randall L Stevens DIRECTOR 1.00 40.00 X 0 257749 23378 Daniel Tanoos DIRECTOR 1.00 0.00 X 0 0 0 JOEL HARBAUGH Executive Director 60.00 1.00 X X 0 118258 15238 0 1663792 75268 0 0 1 0 0 193861 115970 1258426 1568257 116503 116503 241220 177131 64089 64089 64089 4540100 3812748 727352 727352 727352 66217 193861 94426 -28209 -28209 4500 0 4500 4500 Miscellaneous Income 900099 77790 77790 Vending Income 900099 69950 69950 147740 2600232 0 0 1031975 578800 578800 43975 43975 281481 69487 121037 90957 52125 13031 22414 16680 20390 5098 8768 6524 1149 1149 68833 22715 23403 22715 29897 29897 17129 9885 7244 10468 6417 4051 19322 6376 6569 6377 23913 5978 17935 199 20 179 3646 912 2734 19280 19280 2140 1492 648 Licenses and Fees 5569 5569 Catering 4516 3916 600 Contribution Expenses 3950 3950 Dues & Subscriptions 3428 3428 1052 -501 1553 1191262 738981 274084 178197 743721 2081812 157976 277088 29739 32186 3289758 767312 2636429 2522446 6012688 6813111 3541925 3912962 878778 899409 14001256 16539014 54196 41776 297672 574746 18435 0 2193577 2838980 2242732 2146540 4806612 5602042 X 5078074 6128003 2975036 3667435 1141534 1141534 9194644 10936972 14001256 16539014 X 1408970 -397054 23066 707346 X X 0 1 X 1 0 X X 2 Union Hospital Inc 350876396 3 1 494037 0 Union Hospital Health Services Inc 351642805 10 1 0 0 2 494037 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 Part IV, SEction D, line 3, Significant Voice: The supported organization had a significant voice in directing the use of the organization's income through having board members from the supported organization serving on the organization's committees that direct the use of funds. Part IV, SEction E, line 2a, Direct Furtherance: The organization holds title to exempt assets for its supported organizations, Union Hospital. Part IV, SEction E, line 2b, But For: If the organization did not hold title to the Hospital's exempt assets the Hospital would be engaged in this activity. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 4099789 30827 177927 145792 4162751 4042011 11017 47173 412 4099789 4114790 17441 -13626 59574 17020 4042011 3663964 27985 471061 48220 4114790 3550725 30978 219782 137521 3663964 0.17930 0.54650 0.27420 0 0 51000 86250 137250 2761907 204382 618963 2347326 98446 87773 148349 37870 2522446 3912962 F 3912962 Charitable Remainder Trust 899409 899409 X Part IV, Line 2b: Union Hospital Foundation receives many donations on behalf of Union Hospital and other charitable organizations related to the foundation's mission. These donations held on the hospital's behalf are recorded in agency liability accounts on the foundation's books and the beneficiary organization is made aware of the funds held. Expenses related to charitable events on behalf of these other entities are netted from the agency liability balance. Investment income/expense allocated to these funds is also posted to the agency liability accounts. Part V, Line 4: THE FOUNDATION'S ENDOWMENT CONSISTS OF fifty-two INDIVIDUAL FUNDS (Nine PERMANENTLY RESTRICTED, thirty-two TEMPORARILY RESTRICTED, AND ELEVEN BOARD-DESIGNATED) THAT ARE GENERALLY ESTABLISHED FOR ONE OF THE FOLLOWING PURPOSES AS OF December 31, 2016: FOUNDATION OPERATING SUPPORT, SCHOLARSHIPS, SPECIFIC HOSPITAL DEPARTMENT SUPPORT, OR SPECIFIC HOSPITAL PATIENT SERVICE SUPPORT. Part X, Line 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION AND VNA AND RECOGNIZE A TAX LIABILITY IF THE FOUNDATION AND VNA HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FOUNDATION AND VNA, AND HAS CONCLUDED THAT AS OF December 31st, 2016, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE FOUNDATION AND VNA ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. Golf Tournament 127457 102998 24459 0 12088 0 4529 0 10149 Gala 81133 60733 20400 0 0 897 19768 1200 25955 4 51488 30130 21358 2000 2345 0 1690 0 13805 260078 193861 66217 2000 14433 897 25987 1200 49909 94426 -28209 1 Union Hospital 1606 N 7th Street TerrE HAUTE IN 47804 350876396 501 (C) 3 494037 Charitable Grant VNA of Wabash Valley 400 8th Avenue TerrE HAUTE IN 47804 350869064 501 (C) 3 74763 Charitable Grant for TEG Architect Expense Wabash Valley Health Center Inc 1436 Locust St TerrE HAUTE IN 47807 453023360 501 (C) 3 10000 Charitable Grant for Dental Clinic Expansion 3 0 Scholarships and Assistance 57 43975 Part I, Line 2: The foundation receives a "grant outcome report" from grant recipients. A great majority of the Foundation's grants are to Union Hospital, Inc. The Foundation's Board of Directors receives regular verbal reports from key members of the Hospital Administration. Scholarship recipients must provide grade reports showing satisfactory progress before 2nd semester scholarship awards are paid. X 0 0 0 0 0 0 0 0 0 Wayne R Hutson Assistant Treasurer 0 337404 0 81308 0 14123 0 12376 0 656 0 445867 0 0 Steven M Holman DIRECTOR 0 596833 0 175993 0 82124 0 12376 0 11244 0 878570 0 0 Randall L Stevens DIRECTOR 0 241174 0 12900 0 3675 0 12312 0 11066 0 281127 0 0 Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by the foundation's Executive Director, Assistant Treasurer, and accountants. The governing body receives the Form 990 and the final Form 990 including requested schedules, as ultimately filed with the IRS, prior to filing. Form 990, Part VI, Section B, line 12c The written conflict of interest policy is regularly and consistently monitored and compliance enforced by the foundation's executive director. The scope of this policy includes all leased employees of the foundation as well as board members who have an interest in the foundation's dealings. The policy is in place to detect potential conflicts of interest that may arise. A self disclosure from covered persons to the organization is required on any potential conflicts of interest. The remaining board, committee or subcommittee members shall decide if a conflict of interest exists. Form 990, Part VI, Section B, line 15a The executive director receives annual performance reviews from both the president and executive committee. Compensation of executive directors of similar organizations is researched and obtained for use in establishing the executive director's compensation. Form 990, Part VI, Section C, line 19 The foundation makes its governing documents, conflict of interest policies, and audited financial statements available upon request at the organization's office. Form 990, Part XI, line 9: Unrealized unitrust valuation change 20,631. Unrealized change in subsidiary 296,274. Agency Grant Funds Used 390,441. Form 990, Part XIi, Line 2c, oversight of audit: The audit committee assumes responsibility for oversight of the audit of the financial statements and no processes have changed from the prior year. VISITING NURSE ASSOCIATION of the Wabash Valley INC 400 8TH AVENUE TERRE HAUTE IN 47804 350869064 HOME HEALTH AND HOSPICE CARE IN 501(c)(3) Line 7 union Hospital Foundation Inc 1 UNION HOSPITAL INC 1606 N 7TH STREET TERRE HAUTE IN 478042706 350876396 HEALTH CARE IN 501(c)(3) Line 3 Union Health System 0 Union Hospital Health Services Inc 1606 N 7TH STREET FLOOR 4 TERRE HAUTE IN 478042706 351642805 HEALTH CARE IN 501(c)(3) Line 10 N/A 0 Service League of Union Hospital 1606 N 7TH STREET TerRE HAUTE IN 47804 351586347 Fundraising IN 501(c)(4) n/a N/A 0 0 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 0 0 1 Visiting Nurse Association of The Wabash Valley B 74763 Cash Paid