FURP.ORG / PUBLIC DATA EXPLORER

SOUTH BEND MEDICAL FOUNDATION INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
SOUTH BEND MEDICAL FOUNDATION INC (EIN 35-0868178)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-16
IRS object ID
201503209349302985
Schema version
2014v5.0
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)
Return2015-11-16T09:31:06-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CROWE HORWATH LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1330 E Jefferson BlvdAddressLine1Txt
Address Line2PO Box 7AddressLine2Txt
CitySouth BendCityNm
State AbbreviationINStateAbbreviationCd
ZIP466240007ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN350868178EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1South Bend Medical Foundation IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSOUTBusinessNameControlTxt
Phone5742045291PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1530 North Lafayette BlvdAddressLine1Txt
CitySouth BendCityNm
State AbbreviationINStateAbbreviationCd
ZIP46601ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJoyce Simpson MDPersonNm
Person TitlePRESIDENT/EXECUTIVE VPPersonTitleTxt
Signature2015-11-16SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKENNETH J KEBERPreparerPersonNm
PTINP00240883PTIN
Phone5742323992PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Joyce Simpson MDBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1530 North Lafayette BlvdAddressLine1Txt
CitySouth BendCityNm
State AbbreviationINStateAbbreviationCd
ZIP46601ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$95,901,736GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.sbmf.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1946FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionSouth Bend Medical Foundation exists for the purpose of providing quality and cost effective laboratory and blood banking services to hospitals, physicians, and patients.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee846TotalEmployeeCnt
Total Volunteers14TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,736PYContributionsGrantsAmt
CY Contributions Grants$2,032CYContributionsGrantsAmt
PY Program Service Revenue$99,699,838PYProgramServiceRevenueAmt
CY Program Service Revenue$94,707,654CYProgramServiceRevenueAmt
PY Investment Income$655,611PYInvestmentIncomeAmt
CY Investment Income$185,550CYInvestmentIncomeAmt
PY Other Revenue$852,057PYOtherRevenueAmt
CY Other Revenue$965,357CYOtherRevenueAmt
PY Total Revenue$101,209,242PYTotalRevenueAmt
CY Total Revenue$95,860,593CYTotalRevenueAmt
PY Grants And Similar Paid$3,154,999PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,594,948CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$45,890,395PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$43,619,228CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$51,377,496PYOtherExpensesAmt
CY Other Expenses$50,720,424CYOtherExpensesAmt
PY Total Expenses$100,422,890PYTotalExpensesAmt
CY Total Expenses$96,934,600CYTotalExpensesAmt
PY Revenues Less Expenses$786,352PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,074,007CYRevenuesLessExpensesAmt
Total Assets BOY$51,455,515TotalAssetsBOYAmt
Total Assets EOY$46,470,813TotalAssetsEOYAmt
Total Liabilities BOY$34,700,809TotalLiabilitiesBOYAmt
Total Liabilities EOY$38,491,594TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$16,754,706NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,979,219NetAssetsOrFundBalancesEOYAmt
MissionSouth Bend Medical Foundation exists for the purpose of providing quality and cost effective laboratory and blood banking services to hospitals, physicians, and patients. (Continued in Schedule O).MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$81,848,930ExpenseAmt
Grant$2,594,948GrantAmt
Revenue$95,336,976RevenueAmt
DescSOUTH BEND MEDICAL FOUNDATION'S (SBMF) MORE THAN 750 EMPLOYEES PROVIDE A WIDE RANGE OF TOP-QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES FOR COMMUNITIES IN INDIANA, MICHIGAN, KENTUCKY, OHIO, AND ILLINOIS. BY WORKING TOGETHER WITH LOCAL HEALTH CARE PROVIDERS, SBMF PRESERVES THE CRITICAL RELATIONSHIP BETWEEN LABORATORY, PHYSICIAN AND PATIENT. UNLIKE MANY LARGE COMMERCIAL LABORATORIES, SBMF OFFERS ITS SERVICES 24 HOURS A DAY, 365 DAYS A YEAR. SBMF PERSONNEL ARE DEDICATED TO BEING A TRUSTED PHYSICIAN RESOURCE, HANDLING EVERYTHING FROM ROUTINE OUTPATIENT ORDERS TO PROVIDING INPATIENT SERVICES AT HOSPITAL AND OTHER HEALTH CARE FACILITIES THROUGHOUT THE REGION. SBMF'S COMMITMENT TO DELIVERING CONSISTENT, RELIABLE, QUALITY MEDICAL CARE HAS PLAYED AN INSTRUMENTAL ROLE IN HELPING THE FOUNDATION ACHIEVE ITS POSITION OF LEADERSHIP AMONG THE NATION'S DIAGNOSTIC LABORATORIES. (CONTINUED IN SCHEDULE O)Desc
Total Program Service Expenses$81,848,930TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
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 OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
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 EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document74IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee846EmployeeCnt
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 Members12GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
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 OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
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 Line1James B MyersBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5742045206PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1118 W Edison RoadAddressLine1Txt
CityMishawakaCityNm
State AbbreviationINStateAbbreviationCd
ZIP46545ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (43 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
John T Rice MD
Chair1.00Yes (X)Yes (X)$0$0$0
Sloan S Shah MD
Vice Chair1.00Yes (X)Yes (X)$0$0$0
Bilal Ansari MD
Chair (through June 2014) / Board member1.00Yes (X)Yes (X)$0$0$0
CHARLES E PETERSON MD
Vice Chair (through June 2014)1.00Yes (X)Yes (X)$0$0$0
Henry Kim MD
Board Member1.00Yes (X)$0$0$0
Richard H Seall MD
Board Member1.00Yes (X)$0$0$0
Daniel E Scherb MD
BOARD MEMBER1.00Yes (X)$0$0$0
BRIAN SUCHARETZA MD
Board Member1.00Yes (X)$0$0$0
Samuel Borrelli MD
Board Member1.00Yes (X)$0$0$0
Mark A Thompson MD
Board Member1.00Yes (X)$0$0$0
Walter H Halloran MD
BOARD MEMBER1.00Yes (X)$0$0$0
ERIC D KNAPP DO
BOARD MEMBER1.00Yes (X)$0$0$0
ALAN B ENGEL MD
Board Member (through June 2014)1.00Yes (X)$0$0$0
Robert Tomec MD
President/Executive VP40.00Yes (X)$359,242$0$21,938
Joyce Simpson MD
VICE PRESIDENT/EXECUTIVE VP40.00Yes (X)$283,308$0$9,344
Robert King
Senior VP40.00Yes (X)$264,017$0$17,801
Ann Sullivan
VP of Finance40.00Yes (X)$229,765$0$27,407
THOMAS LIDDELL
VP - INFORMATION SYSTEMS40.00Yes (X)$219,634$0$27,295
James Frain
VP of Human Resources40.00Yes (X)$229,667$0$27,396
Diane Janowiak
VP of Central Lab Operations40.00Yes (X)$226,054$0$19,805
Odeta Lapkus MD
Pathologist40.00$252,116$0$25,227Yes (X)
Nita Gerig MD
Pathologist32.00$264,508$0$19,945Yes (X)
Derrick Forchetti MD
Pathologist40.00$256,721$0$27,854Yes (X)
David Jentz MD
Pathologist40.00$338,002$0$21,938Yes (X)
Bobbie Sutton MD
Pathologist40.00$280,918$0$21,938Yes (X)
John Landgraf MD
Pathologist40.00$258,709$0$21,852Yes (X)
James Dyer MD
Pathologist40.00$245,993$0$12,003Yes (X)
Joseph Prahlow MD
Pathologist40.00$269,858$0$27,827Yes (X)
William Kaliney MD
Pathologist40.00$223,575$0$21,541Yes (X)
Ricky Hoover MD
Pathologist40.00$323,669$0$28,176Yes (X)
Francisco Deogracias MD
Pathologist40.00$216,534$0$21,549Yes (X)
Kristen Jacobs MD
Pathologist24.00$200,653$0$17,787Yes (X)
Fred Busse MD
Pathologist40.00$254,868$0$21,842Yes (X)
Luis Galup MD
Pathologist40.00$386,394$0$14,184Yes (X)
Amobi Ezenekwe MD
Pathologist40.00$246,061$0$27,781Yes (X)
C K Kim MD
Pathologist40.00$218,830$0$21,340Yes (X)
Blair Chrenka MD
Pathologist40.00$231,846$0$17,508Yes (X)
Nicole Anest MD
Pathologist40.00$227,595$0$18,501Yes (X)
PRENTISS JONES
DIRECTOR - TOXICOLOGY40.00$150,676$0$19,818Yes (X)
Kay Beam
Director, Information Technology, Database Management40.00$109,047$0$2,615Yes (X)
QING LI
DIRECTOR - NEW TEST DEVELOPMENT40.00$131,437$0$17,966Yes (X)
James B Myers
Manager, Accounting40.00$105,081$0$26,661Yes (X)
Brett Colter
Director, General Laboratory Operations40.00$101,922$0$11,033Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$7,106,700TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$617,872TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K30IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmtAddress Line2ContractorAddress/USAddress/AddressLine2Txt
ASSOC REG AND UNIV PATHOLOGISTS
PO BOX 27964SALT LAKE CITYUT84127REFERENCE LAB$3,348,673
THERMO ASSET MANAGEMENT SERVICES INC
120 BISHOPS WAYBROOKFIELDWI53005EQUIPMENT MAINTENANCE / REPAIR$812,921
CERNER CORPORATION
PO BOX 412702KANSAS CITYMO64141EQUIPMENT MAINTENANCE / REPAIR$775,874
MICHIANA HEALTH INFORMATION NETWORK
220 W COLFAX AVESOUH BENDIN46601COMMUNITY BASED CLINICAL INFO SYSTEM$727,903SUITE 300
INDIANA UNIVERISTY MEDICAL GENETICS
975 W WALNUT STINDIANAPOLISIN462025251REFERENCE LAB$428,6071B-130
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K21CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
All Other Contributions$2,032AllOtherContributionsAmt
Total Contributions$2,032TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNet operating revenuesDesc
Business621500BusinessCd
Total Revenue Column$94,707,654TotalRevenueColumnAmt
Related Or Exempt Func Income$94,707,654RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$94,707,654TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$155,693TotalRevenueColumnAmt
Exclusion$155,693ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$71,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$41,143OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$29,857OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$29,857TotalRevenueColumnAmt
Exclusion$29,857ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Clinical Pathology Fees621500$629,322$629,322
Teaching Fees611430$76,407$76,407
Records Retreival Fees900099$5,455$5,455

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$254,173TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$254,173ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$965,357OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$95,860,593TotalRevenueColumnAmt
Related Or Exempt Func Income$95,336,976RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$521,585ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$183,775TotalAmt
Program Services$183,775ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$2,411,173TotalAmt
Program Services$2,411,173ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$7,660,320TotalAmt
Program Services$5,819,221ProgramServicesAmt
Management And General$1,841,099ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$26,699,294TotalAmt
Program Services$21,809,529ProgramServicesAmt
Management And General$4,889,765ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$163,799TotalAmt
Program Services$137,081ProgramServicesAmt
Management And General$26,718ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,828,025TotalAmt
Program Services$5,574,540ProgramServicesAmt
Management And General$1,253,485ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,267,790TotalAmt
Program Services$1,829,504ProgramServicesAmt
Management And General$438,286ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$66,607TotalAmt
Management And General$66,607ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$75,791TotalAmt
Management And General$75,791ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,001,579TotalAmt
Program Services$1,049,050ProgramServicesAmt
Management And General$952,529ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,406,655TotalAmt
Program Services$1,317,824ProgramServicesAmt
Management And General$1,088,831ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,997,101TotalAmt
Program Services$1,813,772ProgramServicesAmt
Management And General$183,329ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$96,798TotalAmt
Program Services$59,914ProgramServicesAmt
Management And General$36,884ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$533,211TotalAmt
Program Services$1,496ProgramServicesAmt
Management And General$531,715ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,522,394TotalAmt
Program Services$3,140,020ProgramServicesAmt
Management And General$382,374ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$771,510TotalAmt
Program Services$116,522ProgramServicesAmt
Management And General$654,988ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Lab$23,873,530$23,197,693$675,837
Reference Lab$4,570,678$4,570,678
Bad Debt$4,065,833$4,065,833
Building Equipment/Maintenance$4,157,245$2,659,839$1,497,406

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,581,492TotalAmt
Program Services$2,091,466ProgramServicesAmt
Management And General$490,026ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$96,934,600TotalAmt
Program Services$81,848,930ProgramServicesAmt
Management And General$15,085,670ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$750BOYAmt
EOY$1,250EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$7,205,574BOYAmt
EOY$3,490,177EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$12,336,442BOYAmt
EOY$12,679,569EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,638,673BOYAmt
EOY$1,365,902EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,419,645BOYAmt
EOY$1,087,074EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$97,160,991LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$70,333,321LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$27,921,495BOYAmt
EOY$26,827,670EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$809,890BOYAmt
EOY$911,741EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$123,046BOYAmt
EOY$107,430EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$51,455,515BOYAmt
EOY$46,470,813EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,997,427BOYAmt
EOY$9,019,103EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,585,000BOYAmt
EOY$8,470,000EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,118,382BOYAmt
EOY$21,002,491EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$34,700,809BOYAmt
EOY$38,491,594EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$16,754,706BOYAmt
EOY$7,979,219EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,754,706BOYAmt
EOY$7,979,219EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$51,455,515BOYAmt
EOY$46,470,813EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,074,007ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$323,560NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$8,025,040OtherChangesInNetAssetsAmt
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)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$429,028CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,736CurrentTaxYearMinus1YearAmt
Current Tax Year$2,032CurrentTaxYearAmt
Total$432,796TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$94,079,057CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$97,034,819CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$99,026,282CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$99,699,838CurrentTaxYearMinus1YearAmt
Current Tax Year$94,707,654CurrentTaxYearAmt
Total$484,547,650TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$195,040CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$169,918CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$170,096CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$383,067CurrentTaxYearMinus1YearAmt
Current Tax Year$336,035CurrentTaxYearAmt
Total$1,254,156TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$94,274,097CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$97,204,737CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$99,625,406CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$100,084,641CurrentTaxYearMinus1YearAmt
Current Tax Year$95,045,721CurrentTaxYearAmt
Total$486,234,602TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,082CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$15,082TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,082CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$15,082TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$486,219,520PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years-$69,086CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$60,573CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$123,674CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$302,005CurrentTaxYearMinus1YearAmt
Current Tax Year$155,693CurrentTaxYearAmt
Total$572,859TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years-$69,086CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$60,573CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$123,674CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$302,005CurrentTaxYearMinus1YearAmt
Current Tax Year$155,693CurrentTaxYearAmt
Total$572,859TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$338,675CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$415,690CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$497,425CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$468,990CurrentTaxYearMinus1YearAmt
Current Tax Year$629,322CurrentTaxYearAmt
Total$2,350,102TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$94,543,686CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$97,681,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$100,246,505CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$100,855,636CurrentTaxYearMinus1YearAmt
Current Tax Year$95,830,736CurrentTaxYearAmt
Total$489,157,563TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.9940PublicSupportCY509Pct
Public Support PY5090.9951PublicSupportPY509Pct
Investment Income CY0.0012InvestmentIncomeCYPct
Investment Income PY0.0006InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part III, Line 12 Other IncomeFormAndLineReferenceDesc
ExplanationDESCRIPTION - CLINICAL PATHOLOGY FEES, COLUMN A - 338675.0, COLUMN B - 415690.0, COLUMN C - 451445.0, COLUMN D - 468990.0, COLUMN E - 629322.0, COLUMN F - 2304122.0; DESCRIPTION - FUNDRAISING GROSS RECEIPTS, COLUMN A - 0.0, COLUMN B - 0.0, COLUMN C - 45980.0, COLUMN D - 0.0, COLUMN E - 0.0, COLUMN F - 45980.0;ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,115,906OtherCostOrOtherBasisAmt
Book Value$1,115,906BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$43,465,561OtherCostOrOtherBasisAmt
Depreciation$28,869,390DepreciationAmt
Book Value$14,596,171BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$812,628OtherCostOrOtherBasisAmt
Depreciation$553,034DepreciationAmt
Book Value$259,594BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$51,752,808OtherCostOrOtherBasisAmt
Depreciation$40,910,897DepreciationAmt
Book Value$10,841,911BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,088OtherCostOrOtherBasisAmt
Book Value$14,088BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$26,827,670TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Capital lease obligation$12,326
Fair value of interest rate swap$1,049,142
Accrued pension and postretirement benefits$19,941,023
FieldValueIRS element (for citing)
Total Liability$21,002,491TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$85,747,940TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$323,560NetUnrealizedGainsInvstAmt
Other Revenue-$8,025,040OtherRevenueAmt
Revenue Not Reported-$7,701,480RevenueNotReportedAmt
Revenue Subtotal$93,449,420RevenueSubtotalAmt
Other Revenues Not Included$2,411,173OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,411,173RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$95,860,593TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$94,523,427TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$0OtherExpensesIncludedAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$94,523,427ExpensesSubtotalAmt
Other Expenses Not Included$2,411,173OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,411,173ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$96,934,600TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteThe Foundation is a not-for-profit organization pursuant to Section 501(c)(3) of the Internal Revenue Code and is exempt from federal and state income taxes pursuant to Section 501(a). Accordingly, no provision for income taxes is reflected in the Foundation's financial statements. The Foundation is subject to examination by federal and state taxing authorities for the years ended December 31, 2011 through 2014. The Foundation follows guidance issued by the Financial Accounting Standards Board with respect to accounting for uncertainty in income taxes. A tax position is a benefit only if it is "more likely than not" that the tax position would be sustained in a tax examination, with a tax examination being presumed to occur. The amount recognized is the largest amount of tax benefit that is greater than 50% likely of being realized on examination. For tax positions not meeting the "more likely than not" test, no tax benefit is recorded. Management has determined that there is no liability for uncertain tax positions and does not expect this to change over the next 12 months.
Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990PENSION AND POSTRETIREMENT BENEFIT-RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST - -8025040
Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statementsFinancial assistance - 2411173
Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statementsFinancial assistance - 2411173

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (11 entries)

Address Line1USAddress/AddressLine1TxtAddress Line2USAddress/AddressLine2TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
100 BLACK MEN OF GREATER SOUTH BEND INC
2043 SOUTH BEND AVEPMB 345SOUTH BENDIN46637270295842501(C)(3)$7,000$0GENERAL ASSISTANCE
AMERICAN CANCER SOCIETY
130 RED COACH DRIVEMISHAWAKAIN46545131788491501(C)(3)$6,500$0GENERAL ASSISTANCE
CAMERON HOSPITAL FOUNDTION INC
416 EAST MAUMEEANGOLAIN46703351722087501(C)(3)$16,800$0GENERAL ASSISTANCE
NORTHERN INDIANA HISTORICAL SOCIETY (CENTER FOR HISTORY)
808 W WASHINGTON STREETSOUTH BENDIN46601351124156501(C)(3)$5,000$0GENERAL ASSISTANCE
ELKHART GENERAL HOSPITAL FOUNDATION INC
600 EAST BLVDELKHARTIN46514356061200501(C)(3)$10,000$0GENERAL ASSISTANCE
INDIANA UNIVERSITY FOUNDATION
PO BOX 500BLOOMINGTONIN47402356018940501(C)(3)$5,500$0GENERAL ASSISTANCE
LAKELAND HEALTH FOUNDATION NILES
1234 NAPIER AVENUEST JOSPEHMI49085383130558501(C)(3)$10,000$0GENERAL ASSISTANCE
LOGAN COMMUNITY RESOURCES INC
2505 EAST JEFFERSON BLVDSOUTH BENDIN46615350965639501(C)(3)$10,000$0GERERAL ASSISTANCE
THE FOUNDATION OF ST JOSEPH HEALTH SYSTEM
707 EAST CEDAR STREETSUITE 175SOUTH BENDIN46617351654543501(C)(3)$27,500$0GENERAL ASSISTANCE
UNITED WAY OF ST JOSEPH COUNTY INC
3517 EAST JEFFERSON BLVDSOUTH BENDIN46615351063368501(C)(3)$11,000$0GENERAL ASSISTANCE
CANCER SOCIETY OF ST JOSEPH COUNTY
919 EAST JEFFERSONSOUTH BENDIN46617350872359501(C)(3)$26,000$0GENERAL ASSISTANCE
FieldValueIRS element (for citing)
Total501c3 Org11Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxtCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDesc
PATIENT MEDICAL ASSISTANCE$0$1,864,654BOOK VALUEFREE OR REDUCED MEDICAL CARE
TIME OF SERVICE DISCOUNTS$0$546,519BOOK VALUEDISCOUNT PROVIDED AT TIME OF PAYMENT

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant FundsSouth Bend Medical Foundation (SBMF) provides funding to other community not-for-profit organizations. Generally, these are unrestricted contributions that the receiving organization can use to further their mission and programs at their discretion. The use of these contributions is not monitored. SBMF also provides assistance to individuals in the form of free or reduced fee medical care at various locations throughout the communities served. These individuals meet SBMF's charity care eligibility requirements, or the requirements of the referring health care provider. Determination and monitoring of charity care is performed on a case-by-case basis. SBMF also provides discounts for payment at time of service to patients who do not have government provided insurance coverage or do not wish to have a claim filed with their commercial insurance carrier. There is no actual exchange of funds, as the discounts are credited directly to the patients' accounts. Time of service discounts are monitored at the organization level, in the aggregate.
Schedule I, Part III, Column (b) NUMBER OF RECIPIENTSCURRENTLY, SOUTH BEND MEDICAL FOUNDATION DOES NOT HAVE AN EFFECTIVE WAY TO TRACK THE UNDUPLICATED NUMBER OF PATIENTS THAT RECEIVE FREE OR REDUCED CARE AND TIME OF SERVICE DISCOUNTS.
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.South Bend Medical Foundation (SBMF) provides funding to other community not-for-profit organizations. Generally, these are unrestricted contributions that the receiving organization can use to further their mission and programs at their discretion. The use of these contributions is not monitored. SBMF also provides assistance to individuals in the form of free or reduced fee medical care at various locations throughout the communities served. These individuals meet SBMF's charity care eligibility requirements, or the requirements of the referring health care provider. Determination and monitoring of charity care is performed on a case-by-case basis. SBMF also provides discounts for payment at time of service to patients who do not have government provided insurance coverage or do not wish to have a claim filed with their commercial insurance carrier. There is no actual exchange of funds, as the discounts are credited directly to the patients' accounts. Time of service discounts are monitored at the organization level, in the aggregate.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
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 (26 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
Robert Tomec MD
President/Executive VP$357,889$0$0$0$1,353$0$2,600$0$19,338$0$381,180$0$0$0
Joyce Simpson MD
VICE PRESIDENT/EXECUTIVE VP$283,308$0$0$0$0$0$2,600$0$6,744$0$292,652$0$0$0
Robert King
Senior VP$249,422$0$0$0$14,595$0$500$0$17,301$0$281,818$0$0$0
Ann Sullivan
VP of Finance$228,484$0$0$0$1,281$0$2,304$0$25,103$0$257,172$0$0$0
THOMAS LIDDELL
VP - INFORMATION SYSTEMS$218,491$0$0$0$1,143$0$2,232$0$25,063$0$246,929$0$0$0
James Frain
VP of Human Resources$228,484$0$0$0$1,183$0$2,293$0$25,103$0$257,063$0$0$0
Diane Janowiak
VP of Central Lab Operations$226,054$0$0$0$0$0$2,304$0$17,501$0$245,859$0$0$0
Odeta Lapkus MD
Pathologist$252,116$0$0$0$0$0$0$0$25,227$0$277,343$0$0$0
Nita Gerig MD
Pathologist$263,153$0$0$0$1,355$0$2,600$0$17,345$0$284,453$0$0$0
Derrick Forchetti MD
Pathologist$256,721$0$0$0$0$0$2,599$0$25,255$0$284,575$0$0$0
David Jentz MD
Pathologist$336,692$0$0$0$1,310$0$2,600$0$19,338$0$359,940$0$0$0
Bobbie Sutton MD
Pathologist$280,976$0$0$0-$58$0$2,600$0$19,338$0$302,856$0$0$0
John Landgraf MD
Pathologist$257,402$0$0$0$1,307$0$2,563$0$19,289$0$280,561$0$0$0
James Dyer MD
Pathologist$244,733$0$0$0$1,260$0$1,840$0$10,163$0$257,996$0$0$0
Joseph Prahlow MD
Pathologist$268,551$0$0$0$1,307$0$2,600$0$25,227$0$297,685$0$0$0
William Kaliney MD
Pathologist$223,443$0$0$0$132$0$2,203$0$19,338$0$245,116$0$0$0
Ricky Hoover MD
Pathologist$322,314$0$0$0$1,355$0$2,600$0$25,576$0$351,845$0$0$0
Francisco Deogracias MD
Pathologist$215,179$0$0$0$1,355$0$2,161$0$19,388$0$238,083$0$0$0
Kristen Jacobs MD
Pathologist$199,573$0$0$0$1,080$0$2,027$0$15,760$0$218,440$0$0$0
Fred Busse MD
Pathologist$253,559$0$0$0$1,309$0$2,550$0$19,292$0$276,710$0$0$0
Luis Galup MD
Pathologist$0$0$0$0$386,394$0$2,600$0$11,584$0$400,578$0$0$0
Amobi Ezenekwe MD
Pathologist$244,754$0$0$0$1,307$0$2,554$0$25,227$0$273,842$0$0$0
C K Kim MD
Pathologist$217,475$0$0$0$1,355$0$2,152$0$19,188$0$240,170$0$0$0
Blair Chrenka MD
Pathologist$231,728$0$0$0$118$0$0$0$17,508$0$249,354$0$0$0
Nicole Anest MD
Pathologist$226,395$0$0$0$1,200$0$877$0$17,624$0$246,096$0$0$0
PRENTISS JONES
DIRECTOR - TOXICOLOGY$150,676$0$0$0$0$0$1,525$0$18,293$0$170,494$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 4a Severance or change-of-control paymentLuis Galup, M.D. received severance payments totaling $386,394, per the terms of his employment contract, during the year ended December 31, 2014.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planThe organization has a supplemental nonqualified retirement plan that was designed to replace retirement benefits lost by individuals due to 1998 changes in pension laws and a redesign of the pension plan to maximize benefits for lower compensated employees. The organization's board of directors elected to freeze this plan, and therefore no benefits were provided during 2014.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MICHIANA HEMATOLOGY ONCOLOGY PC (MHO)BusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionB. ANSARI (SBMF BOARD MEMBER) IS AN OFFICER/DIRECTOR OF MHO.RelationshipDescriptionTxt
Transaction$109,309TransactionAmt
TransactionSBMF MADE $109,309 IN PAYMENTS (AT FMV) TO MHO FOR RENTAL OF SPACETransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 1 ORGANIZATION'S MISSION (CONTINUED FROM PART III)TO FULFILL OUR MISSION WE SHALL: (I) PROVIDE THE HOSPITALS WE SERVICE WITH THE HIGHEST QUALITY LABORATORY RESOURCES AND--TAKING INTO ACCOUNT THAT LENGTH OF STAY IS CRUCIAL FOR INPATIENT CARE--WITH THE SHORTEST RESPONSE TIME WHILE ACHIEVING A HIGH DEGREE OF COST EFFECTIVENESS. (II) PROVIDE OUR PHYSICIAN CUSTOMERS WITH THE HIGHEST QUALITY LABORATORY RESULTS UTILIZING THE LATEST TECHNOLOGY AND MAKING AVAILABLE TO THEM READILY ACCESSIBLE CONSULTATIVE OPPORTUNITIES IN THE MEDICAL AND ADMINISTRATIVE ASPECTS OF THEIR PRACTICES. (III) CREATE AND MAINTAIN A WORK ENVIRONMENT WHERE EMPLOYEES CAN GROW PERSONALLY AND PROFESSIONALLY WITH COMPENSATION AND BENEFIT SYSTEMS THAT ARE COMPETITIVE, EQUITABLE AND COST EFFECTIVE AS WELL AS AN ENVIRONMENT WHERE EMPLOYEES ARE PROVIDED STABLE EMPLOYMENT AND EACH INDIVIDUAL IS TREATED WITH RESPECT AND DIGNITY. (IV) PROVIDE TO THE PATIENT POPULATION IN THE COMMUNITIES WE SERVE READILY ACCESSIBLE, REASONABLY PRICED LABORATORY SERVICES, WITH AS WIDE A SCOPE AND VARIETY AS POSSIBLE TO MEET ALL THEIR NEEDS LOCALLY. (V) RECOGNIZING OUR SOCIAL RESPONSIBILITIES TO THE COMMUNITY, PROVIDE SERVICES WITHIN OUR MEANS TO THOSE LESS FORTUNATE, AND SUPPORT PUBLIC AND PRIVATE EFFORTS DIRECTED TO IMPROVE OUR HEALTH CARE ENVIRONMENT.
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED FROM PART III)THE ALTRUISTIC ACTIVITIES OF THE ORGANIZATION ARE INTENDED TO RELIEVE DISEASE, SUFFERING, AND CONSTRAINT. MANY SERVICES ARE PROVIDED AS CHARITY OR PRO BONO. THE AMOUNT OF CHARITY CARE, PROVIDED AT SBMF'S ESTABLISHED RATES, WAS APPROXIMATELY $851,000 FOR THE YEAR ENDED DECEMBER 31, 2014.
Form 990, Part VI, Line 1a Delegate broad authority to a committeeThe administrative committee shall consist of the officers of the corporation. Subject to the control of the board of directors, the administrative committee shall have full authority to act for and on behalf of the corporation and exercise all of the powers of the board of directors that may be lawfully delegated by such board to such committee except, however, the administrative committee shall have no power to donate any part of the assets of the corporation. The administrative committee shall receive status reports on other committee activities and discuss items of interest to the group as a whole or to individual officers for the performance of their duties. The administrative committee shall keep minutes of its meetings.
Form 990, Part VI, Line 2 Family/business relationships amongst interested personsBOB SUTTON (HUSBAND OF BOBBIE SUTTON) AND FRED BUSSE - Business relationship
Form 990, Part VI, Line 11b Review of form 990 by governing bodyPrior to November 16, 2015, each board member was provided a copy of the return for their review and instructed to submit any questions or comments to the VP of Finance. After comments and questions are reviewed, the return was completed and filed with the IRS on or before November 16, 2015.
Form 990, Part VI, Line 12c Conflict of interest policyAnnual conflict of interest questionnaires are completed by all board members, officers, key employees, and highest compensated employees. The organization's Vice President of Finance and tax advisers review all responses to determine whether or not a potential or actual conflict of interest exists. If an actual conflict of interest is determined to exist, persons with a conflict are recused from voting on the conflicting issue.
Form 990, Part VI, Line 15a Process to establish compensation of top management officialOn an annual basis, the organization's compensation committee reviews and approves compensation for the President/Executive Vice President, as well as other officers, administrators, and professional staff, including key employees. The committee reviews current salaries and pay structures against various sources of comparability data, including: the College of American Pathology Pathologists Compensation Survey; pathology compensation data for pathologists, which outlines pathology and physician salaries by specialty, provided from Merritt Hawkins and Associates; the Guidestar National Compensation Report; and compensation reported on local area hospitals' Forms 990. After reviewing the comparability data, the committee discusses the current economy and financial position of the organization to determine the amount of any compensation increases and/or decreases, if any, that will be given. This process is documented in the compensation committee's meeting minutes.
Form 990, Part VI, Line 15b Process to establish compensation of other employeesSee narrative for Form 990, Part VI, Section B, Line 15a.
Form 990, Part VI, Line 19 Required documents available to the publicFinancial statements, conflict of interest policies, and governing documents are not required disclosures pursuant to IRC Section 6104. These documents are not made available to the public.
Form 990, Part VIII, Line 11d Other Miscellaneous RevenueMiscellaneous - Total Revenue: 254173, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 254173;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesPENSION AND POSTRETIREMENT BENEFIT-RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST - -8025040;