UNIVERSITY PEDIATRIC ASSOCIATES INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
UNIVERSITY PEDIATRIC ASSOCIATES INC (EIN 23-7328642)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-02-03
IRS object ID
201710349349300101
Schema version
2015v3.0
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

FieldValueIRS element (for citing)
Return2017-02-03T06:54:59-06:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN352123203PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KSM BUSINESS SERVICES INCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 40857AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP462400857ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN237328642EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UNIVERSITY PEDIATRIC ASSOCIATES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlUNIVBusinessNameControlTxt
Phone3177776435PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16640 INTECH BOULEVARD NO 300AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46278ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDR D WADE CLAPPPersonNm
Person TitleCHAIRMAN OF THE BOARDPersonTitleTxt
Phone3177776435PhoneNum
Signature2017-01-24SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDONALD R BOEZEMANPreparerPersonNm
PTINP01000722PTIN
Phone3175802000PhoneNum
Preparation2017-01-24PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDR D WADE CLAPPPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line16640 INTECH BOULEVARD SUITE 300AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46278ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$82,815,388GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1973FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionTHE ORGANIZATION'S PRIMARY EXEMPT PURPOSE IS TO ENGAGE ACTIVELY AND CONTINUOUSLY IN MEDICAL RESEARCH AND TO PROVIDE MEDICAL EDUCATION AND MEDICAL RESEARCH IN CONJUNCTION WITH SERVING AS AN AUXILIARY TO THE OPERATION OF THE DEPARTMENT OF PEDIATRICS OF INDIANA UNIVERSITY SCHOOL OF MEDICINE AND ITS HOSPITALS.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee170TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,186,027PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$73,865,782PYProgramServiceRevenueAmt
CY Program Service Revenue$62,497,669CYProgramServiceRevenueAmt
PY Investment Income$236,100PYInvestmentIncomeAmt
CY Investment Income$1,100,770CYInvestmentIncomeAmt
PY Other Revenue$1,141,628PYOtherRevenueAmt
CY Other Revenue$790,000CYOtherRevenueAmt
PY Total Revenue$76,429,537PYTotalRevenueAmt
CY Total Revenue$64,388,439CYTotalRevenueAmt
PY Grants And Similar Paid$16,857,427PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$136,991CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$9,793,449PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,660,330CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$48,282,490PYOtherExpensesAmt
CY Other Expenses$63,072,898CYOtherExpensesAmt
PY Total Expenses$74,933,366PYTotalExpensesAmt
CY Total Expenses$64,870,219CYTotalExpensesAmt
PY Revenues Less Expenses$1,496,171PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$481,780CYRevenuesLessExpensesAmt
Total Assets BOY$24,513,771TotalAssetsBOYAmt
Total Assets EOY$22,615,823TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$24,513,771NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$22,615,823NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE ORGANIZATION'S PRIMARY EXEMPT PURPOSE IS TO ENGAGE ACTIVELY AND CONTINUOUSLY IN MEDICAL RESEARCH AND TO PROVIDE MEDICAL EDUCATION AND MEDICAL RESEARCH IN CONJUNCTION WITH SERVING AS AN AUXILIARY TO THE OPERATION OF THE DEPARTMENT OF PEDIATRICS OF INDIANA UNIVERSITY SCHOOL OF MEDICINE AND ITS HOSPITALS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$61,273,538ExpenseAmt
Grant$98,000GrantAmt
Revenue$62,501,643RevenueAmt
DescVARIOUS CONTRIBUTIONS TO INDIANA UNIVERSITY FOUNDATION AND INDIANA UNIVERSITY SCHOOL OF MEDICINEDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$38,991ExpenseAmt
Grant$38,991GrantAmt
Revenue$39,772RevenueAmt
DescCHARITABLE CONTRIBUTIONS TO VARIOUS MEDICAL INSTITUTIONSDesc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$7,745ExpenseAmt
Revenue$7,900RevenueAmt
DescTHE ORGANIZATION PROVIDES ADMINISTRATIVE AND COLLECTION SERVICES FOR INDIANA UNIVERSITY FACULTY AND PHYSICIANSDesc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$723,845ExpenseAmt
Revenue$738,354RevenueAmt
DescPHYSICIAN CONTRACTS FOR RESEARCH, EDUCATION, AND PATIENT CAREDesc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$723,845TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$738,354TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$62,044,119TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document17IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee170EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TERESA HUTCHISONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3177776435PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16640 INTECH BOULEVARD SUITE 300AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46278ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DR D WADE CLAPP
CHAIRMAN OF THE BOARD40.00Yes (X)Yes (X)$87,250$0$7,947
DR DAVID A INGRAM JR
PRESIDENT40.00Yes (X)Yes (X)$75,000$0$7,500
DR RANDALL L CALDWELL
SECRETARY/TREASURER40.00Yes (X)Yes (X)$0$0$0
DR SHARON P ANDREOLI
BOARD MEMBER40.00Yes (X)$0$0$0
DR JOHN C CHRISTENSON
BOARD MEMBER40.00Yes (X)$0$0$0
DR STEPHANIE DAVIS
BOARD MEMBER40.00Yes (X)$0$0$0
DR STEPHEN M DOWNS
BOARD MEMBER40.00Yes (X)$0$0$0
DR ERICA A EUGSTER
BOARD MEMBER40.00Yes (X)$0$0$0
JAMIE L RENBARGER
BOARD MEMBER40.00Yes (X)$0$0$0
J DENNIS FORTENBERRY
BOARD MEMBER40.00Yes (X)$0$0$0
THOMAS M LOCK
BOARD MEMBER40.00Yes (X)$10,927$0$0
DR EUGENIA P MOLLESTON
BOARD MEMBER40.00Yes (X)$0$0$0
DR MARA NITU
BOARD MEMBER40.00Yes (X)$0$0$0
DR KATHLEEN O'NEILL
BOARD MEMBER40.00Yes (X)$0$0$0
DR JAMES A LEMONS
EMERITUS BOARD MEMBER40.00Yes (X)$0$0$0
DR RICHARD L SCHREINER
EMERITUS BOARD MEMBER40.00Yes (X)$0$0$0
ANDREAS DEYMANN
PHYSICIAN40.00$131,250$0$4,375Yes (X)
KENNETH HERRMANN
PHYSICIAN40.00$183,272$0$2,618Yes (X)
NADINE LEE
PHYSICIAN40.00$153,868$0$0Yes (X)
SUSAN QUIGLEY
PHYSICIAN40.00$122,500$0$1,750Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$764,067TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$24,190TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K4IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HELEN P BRODY
6640 INTECH BLVD SUITE 300INDIANAPOLISIN46278ADMINISTRATION$209,333
CHARLES JOSEPH DIETZEN MD PSC
6640 INTECH BLVD SUITE 300INDIANAPOLISIN46278PATIENT CARE SERVICES$139,350
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICESDesc
Business621110BusinessCd
Total Revenue Column$62,497,669TotalRevenueColumnAmt
Related Or Exempt Func Income$62,497,669RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$62,497,669TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$485,743TotalRevenueColumnAmt
Exclusion$485,743ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$19,041,976SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$18,426,949SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$615,027SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$615,027TotalRevenueColumnAmt
Exclusion$615,027ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescROC SURGERY CENTER K-1Desc
Business621400BusinessCd
Total Revenue Column$790,000TotalRevenueColumnAmt
Related Or Exempt Func Income$790,000RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$790,000OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$64,388,439TotalRevenueColumnAmt
Related Or Exempt Func Income$63,287,669RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,100,770ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$136,991TotalAmt
Program Services$136,991ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$162,250TotalAmt
Management And General$162,250ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$162,747TotalAmt
Management And General$162,747ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,335,333TotalAmt
Management And General$1,335,333ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$29,248TotalAmt
Management And General$29,248ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$53,980TotalAmt
Management And General$53,980ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$566,145TotalAmt
Program Services$7,745ProgramServicesAmt
Management And General$558,400ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$104,091TotalAmt
Management And General$104,091ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$9,899TotalAmt
Management And General$9,899ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PHYSICIAN SERVICES$61,175,538$61,175,538
PHYSICIAN CONTRACTS$723,845$723,845
MISCELLANEOUS$263,325$263,325
LOSS ON JOINT VENTURE$77,475$77,475

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$69,352TotalAmt
Management And General$69,352ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$64,870,219TotalAmt
Program Services$62,044,119ProgramServicesAmt
Management And General$2,826,100ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$7,244,132BOYAmt
EOY$12,276,723EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$16,899,061BOYAmt
EOY$10,064,100EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$370,578BOYAmt
EOY$275,000EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$24,513,771BOYAmt
EOY$22,615,823EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$24,513,771BOYAmt
EOY$22,615,823EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$24,513,771BOYAmt
EOY$22,615,823EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$24,513,771BOYAmt
EOY$22,615,823EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$481,780ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,416,168NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,422,306CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,346,861CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,217,283CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,186,027CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$8,172,477TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,422,306CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,346,861CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,217,283CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,186,027CurrentTaxYearMinus1YearAmt
Total$8,172,477TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$8,172,477PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$803,349CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$476,094CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$471,442CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$406,459CurrentTaxYearMinus1YearAmt
Current Tax Year$485,743CurrentTaxYearAmt
Total$2,643,087TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$366,062CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$465,596CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$867,651CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,141,628CurrentTaxYearMinus1YearAmt
Current Tax Year$790,000CurrentTaxYearAmt
Total$3,630,937TotalAmt
FieldValueIRS element (for citing)
Total Support$14,446,501TotalSupportAmt
Gross Receipts Rltd Activities$370,661,132GrossReceiptsRltdActivitiesAmt
Public Support CY1700.56570PublicSupportCY170Pct
Public Support PY1700.62620PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationOTHER REVENUE - 2011 AMOUNT: $ 366,062. 2012 AMOUNT: $ 465,596. 2013 AMOUNT: $ 867,651. 2014 AMOUNT: $ 1,141,628. 2015 AMOUNT: $ 790,000.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$62,894,796TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$1,416,168NetUnrealizedGainsInvstAmt
Other Revenue-$77,475OtherRevenueAmt
Revenue Not Reported-$1,493,643RevenueNotReportedAmt
Revenue Subtotal$64,388,439RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$64,388,439TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$64,792,744TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included-$77,475OtherExpensesIncludedAmt
Expenses Not Reported-$77,475ExpensesNotReportedAmt
Expenses Subtotal$64,870,219ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$64,870,219TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:UPA IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. IN ADDITION, UPA HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE NOT TO BE A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE INTERNAL REVENUE CODE. THERE WAS NO UNRELATED BUSINESS INCOME FOR THE YEARS ENDED JUNE 30, 2016 AND 2015. UPA FILES U.S. FEDERAL AND STATE OF INDIANA INFORMATION RETURNS. UPA IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE OF INDIANA TAX EXAMINATIONS BY TAX AUTHORITIES FOR FISCAL YEARS BEFORE 2013.
PART XI, LINE 2D - OTHER ADJUSTMENTS:LOSS FROM JOINT VENTURE -77,475.
PART XII, LINE 2D - OTHER ADJUSTMENTS:LOSS FROM JOINT VENTURE -77,475.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
INDIANA UNIV FOUNDATION
S STATE ROAD 46BLOOMINGTONIN47401356018940501(C)(3)$123,141TO PROVIDE MEDICAL EDUCATION AND MEDICAL RESEARCH IN CONJUNCTION WITH SERVING AS AN AUXILIARY TO THE OPERATION OF THE DEPARTMENT OF PEDIATRICS OF INDIANA UNIVERSITY SCHOOL OF MEDICINE AND ITS HOSPITALS.
(no name)
TO PROVIDE MEDICAL EDUCATION AND MEDICAL RESEARCH IN CONJUNCTION WITH SERVING AS AN AUXILIARY TO THE OPERATION OF THE DEPARTMENT OF PEDIATRICS OF INDIANA UNIVERSITY SCHOOL OF MEDICINE AND ITS HOSPITALS.
FieldValueIRS element (for citing)
Total501c3 Org4Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTERESA HUTCHISON RECEIVES REQUESTS FROM PEDIATRIC DEPARTMENTS TO SET UP PURCHASE ORDERS FOR PHYSICIANS UPA SALARIES ON FEDERAL AND NON-FEDERAL GRANTS. TERESA HUTCHISON THEN REQUESTS PURCHASE ORDERS WITH APPROVAL GOING THROUGH THE REQUESTING DEPARTMENT. ONCE APPROVAL OF THE PURCHASE ORDER IS RECEIVED, TERESA BILLS BASED ON THE IU SALARY PERCENTAGE CHARGED TO THE ACCOUNT. THE REQUESTING DEPARTMENT MONITORS THE OVERALL SPENDING OF THE GRANT ACCOUNTS. THE BILLING OF THE SALARY BY TERESA CANNOT EXCEED THE AMOUNT OF THE INITIAL PURCHASE ORDER.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ANDREAS DEYMANN
PHYSICIAN$131,250$0$0$0$0$0$0$0$4,375$0$135,625$0$0$0
KENNETH HERRMANN
PHYSICIAN$183,272$0$0$0$0$0$0$0$2,618$0$185,890$0$0$0
NADINE LEE
PHYSICIAN$153,868$0$0$0$0$0$0$0$0$0$153,868$0$0$0
SUSAN QUIGLEY
PHYSICIAN$122,500$0$0$0$0$0$0$0$1,750$0$124,250$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART III:FormAndLineReferenceDesc
ExplanationCOMPENSATION RELATES TO MEDICAL SERVICES PROVIDED, NOT AS COMPENSATION FOR SERVING ON THE BOARD.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11FORM 990, WHICH IS PREPARED BY A CPA FIRM, IS REVIEWED IN DETAIL BY THE ORGANIZATION'S BUSINESS MANAGER, ADMINISTRATOR AND OTHER ACCOUNTING PERSONNEL. IN ADDITION, FORM 990 IS PRESENTED TO THE BOARD OF DIRECTOR'S FOR REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CUPA BOARD REVIEWS AND MONITORS ALL COMPLIANCE IN ACCORDANCE WITH UPA'S CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15AUPA BOARD WILL VOTE AND DETERMINE THE COMPENSATION BASED ON EXTERNAL AND INTERNAL FACTORS.
FORM 990, PART VI, SECTION C, LINE 18AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19AVAILABLE UPON REQUEST
FROM 990, PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ROC SURGERY LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1340 WEST 10TH STREETAddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46202ZIPCd
FieldValueIRS element (for citing)
EIN271497960EIN
Primary ActivitiesAMBULATORY SURGERY CENTER PERFORMING ONLY OUTPATIENT PROCEDURESPrimaryActivitiesTxt
Legal Domicile StateINLegalDomicileStateCd
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income$790,000ShareOfTotalIncomeAmt
Share Of EOY Assets$275,000ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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