UNION HOSPITAL INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
UNION HOSPITAL INC (EIN 35-0876396)
Tax period
2012-09-01 to 2013-08-31
Filed
2014-07-14
IRS object ID
201431959349301158
Schema version
2012v2.1
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)
Timestamp2014-07-14T12:44:43-05:00Timestamp
Tax Period End Date2013-08-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN351178661EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE AMERICAN SQUARE 2200AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46282ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-09-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN350876396EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1UNION HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlUNIONameControl
Phone8122387000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11606 NORTH SEVENTH STREETAddressLine1
CityTERRE HAUTECity
StateINState
ZIP Code47804ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWAYNE HUTSONName
TitleCFOTitle
Phone8122387000Phone
Date Signed2014-07-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAMBER KOCHER CPAName
PTINP01286298PTIN
Phone3176334705Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1SEE SCHEDULE OBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonWAYNE HUTSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11606 NORTH SEVENTH STREETAddressLine1
CityTERRE HAUTECity
StateINState
ZIP Code47804ZIPCode
FieldValueIRS element (for citing)
Gross Receipts412376691GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.UHHG.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1892YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionWE EXIST TO SERVE OUR PATIENTS WITH COMPASSIONATE HEALTH CARE OF THE HIGHEST QUALITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees2725TotalNbrEmployees
Total Nbr Volunteers253TotalNbrVolunteers
Total Gross UBI609977TotalGrossUBI
Net Unrelated Business Txbl Income-29831NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1653317ContributionsGrantsPriorYear
Contributions Grants Current Year1144196ContributionsGrantsCurrentYear
Program Service Revenue Prior Year420167469ProgramServiceRevenuePriorYear
Program Service Revenue CY402198279ProgramServiceRevenueCY
Investment Income Prior Year522520InvestmentIncomePriorYear
Investment Income Current Year648762InvestmentIncomeCurrentYear
Other Revenue Prior Year5054297OtherRevenuePriorYear
Other Revenue Current Year5416313OtherRevenueCurrentYear
Total Revenue Prior Year427397603TotalRevenuePriorYear
Total Revenue Current Year409407550TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year253127GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY355520GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year140973547SalariesEtcPriorYear
Salaries Etc Current Year154205283SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year258901608OtherExpensePriorYear
Other Expenses Current Year258432173OtherExpensesCurrentYear
Total Expenses Prior Year400128282TotalExpensesPriorYear
Total Expenses Current Year412992976TotalExpensesCurrentYear
Revenues Less Expenses Prior Year27269321RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-3585426RevenuesLessExpensesCY
Total Assets BOY482069093TotalAssetsBOY
Total Assets EOY467417016TotalAssetsEOY
Total Liabilities BOY337447866TotalLiabilitiesBOY
Total Liabilities EOY340745314TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY144621227NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY126671702NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionWE EXIST TO SERVE OUR PATIENTS WITH COMPASSIONATE HEALTH CARE OF THE HIGHEST QUALITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense386388530Expense
Grants355520Grants
Revenue402198279Revenue
DescriptionUNION HOSPITAL (UHI), UNION HOSPITAL CLINTON (UHC), AND OUR NETWORK OF PRIMARY CARE PHYSICIANS JOIN TOGETHER TO PROVIDE COMPREHENSIVE CARE TO RESIDENTS OF WEST CENTRAL INDIANA AND EASTERN ILLINOIS. OUR FACILITIES AT UNION HOSPITAL INCLUDE TWO HOSPITALS AND MORE THAN 40 PRIMARY AND SPECIALTY CARE PHYSICIANS AND MID-LEVEL PROVIDERS. WE ARE THE LARGEST PROVIDER OF NOT-FOR-PROFIT HEALTH CARE SERVICES BETWEEN INDIANAPOLIS AND ST. LOUIS ALONG THE I-70 CORRIDOR, SERVING VIGO, PARKE, VERMILLION, CLAY, SULLIVAN AND GREENE COUNTIES IN INDIANA, AND CLARK AND EDGAR COUNTIES IN ILLINOIS AS OUR PRIMARY SERVICE AREA. OUR SECONDARY SERVICE AREA INCLUDES CRAWFORD COUNTY IN ILLINOIS.CONTINUE TO SCHEDULE O: CLAY GREENE SULLIVAN PARKE VERMILLION VIGOPOPULATION 26,803 32,781 21,223 17,202 15,878 108,291RANK IN IND. 59TH 51ST 69TH 77TH 79TH 17TH SQ MILES 357.50 542.5 447.10 444.70 256.9 403.30POP/SQ MILE 74.97 60.43 47.47 38.68 63.81 268.51LARGEST CITY BRAZIL LINTON SULLIVAN ROCKVILLE CLINTON TERRE HAUTEPOPULATION 8,153 5,373 4,205 2,581 4,826 61,112MEDIAN AGE 40.5 42.1 40.1 41.7 42.1 35.9POVERTY RATE 15.6% 15.9% 18.2% 18.2% 14.6% 20.3%UNMPLYMNT RATE 8.7 8.5 10.1 8.6 10.6 9.5AVG HOUSEHOLD INCOME 44,230 42,684 41,223 41,311 42,709 40,091CHILDREN LIVING BELOW POVERTY 22.9% 22.0% 23.6% 28.7% 21.2% 29.0%UNION HOSPITAL HAS BEEN SERVING COMMUNITIES IN WEST CENTRAL INDIANA AND EAST CENTRAL ILLINOIS FOR THE PAST 120 YEARS. UNION HOSPITAL SERVES 275,000 PEOPLE IN BOTH URBAN AND RURAL AREAS; CLAY, GREENE, SULLIVAN, PARKE, VERMILLION AND VIGO COUNTIES IN INDIANA ALONG WITH CLARK AND CRAWFORD COUNTIES IN ILLINOIS MAKE UP OUR PRIMARY SERVICE AREA AS IT RELATES TO COMMUNITY BENEFIT. THE MAJORITY OF FAMILIES IN OUR SERVICE AREA FALL SIGNIFICANTLY BELOW THE NATIONAL AND STATE MEDIAN HOUSEHOLD INCOME. AS THE LARGEST NOT-FOR-PROFIT HEALTHCARE PROVIDER BETWEEN ST. LOUIS AND INDIANAPOLIS, WE ARE PROUD TO BE THE SAFETY NET HOSPITAL FOR OUR COMMUNITY PROVIDING OVER $80 MILLION IN TOTAL COMMUNITY BENEFITS, THAT INCLUDE $13 MILLION IN CHARITY CARE TO OUR COMMUNITY. THE PEOPLE WHO MAKE UP UHI ARE DEVOTED TO HELPING OTHERS. WHETHER THEY PROVIDE CARE TO PATIENTS IN OUR HOSPITALS AND CLINICS, VOLUNTEER FOR COMMUNITY SERVICE ORGANIZATIONS AND CAUSES, OR ORGANIZE BAKE SALES FOR FELLOW EMPLOYEES IN NEED, OUR EMPLOYEES EXEMPLIFY A SPIRIT OF CARING. THAT SPIRIT OF CARING IS HARDWIRED THROUGHOUT THE ORGANIZATION FROM OUR VOLUNTEER BOARD OF DIRECTORS TO OUR LEADERSHIP TEAM TO OUR STAFF, PHYSICIANS AND VOLUNTEERS. ALL AROUND THE COMMUNITIES WE SERVE, YOU WILL FIND OUR CARING PEOPLE SERVING AS LEADERS IN CHURCHES, SCHOOLS AND COMMUNITY ORGANIZATIONS. THAT WEB OF INVOLVEMENT PROVIDES A RICH CONNECTION TO THE NEEDS OF OUR COMMUNITY AND GUIDES OUR ACTIVITIES TO IMPROVE THE QUALITY OF LIFE FOR ALL THAT WE SERVE. OUR COMMUNITIES ARE BOTH URBAN AND RURAL BUT SHARE A COMMON TRAIT: HOUSEHOLD INCOMES THAT FALL FAR BELOW THE STATE AND NATIONAL AVERAGES. ACCESS TO CARE IS A CHALLENGE FOR THOSE LIVING IN URBAN POVERTY AND THOSE WHO LIVE IN THE RURAL COUNTRYSIDE. THE SERVICES AND PROGRAMS OUTLINED IN THIS COMMUNITY BENEFIT REPORT WERE DESIGNED TO MEET THE NEEDS OF THE POOR AND UNINSURED AND TO IMPROVE ACCESS TO HEALTH CARE IN OUR RURAL COMMUNITIES. THE RICHARD G. LUGAR CENTER FOR RURAL HEALTH IS AN INNOVATION CENTER DESIGNED TO GIVE PROVIDERS THE TOOLS AND TRAINING TO SUCCESSFULLY ESTABLISH MEDICAL PRACTICE IN RURAL AREAS. THE CLAY CITY CENTER FOR FAMILY MEDICINE IS A MODEL TRAINING SITE FOR FAMILY MEDICINE RESIDENTS AND A VITAL RURAL HEALTH CLINIC SERVING THE PEOPLE OF CLAY COUNTY, INDIANA. A MULTI-DISCIPLINARY TEAM APPROACH PROVIDES A HIGH LEVEL OF SERVICE TO THIS AREA AND HAS RESULTED IN IMPRESSIVE HEALTH IMPROVEMENTS FOR ITS PEOPLE. UHI ALSO PROVIDES PRE-NATAL CARE FOR INDIGENT POPULATIONS BY OFFERING THE FOLLOWING SERVICES ON A SLIDING PAY SCALE: PRENATAL CARE, SUPPORT AND DELIVERY ARE PROVIDED THROUGH A TEAM OF PHYSICIANS, NURSES, SOCIAL WORKERS, AND SUBSTANCE ABUSE COUNSELORS TO WOMEN. OUR SPIRIT OF CARING MAKES US NATURAL PARTNERS WITH PROVIDENCE SELF SUFFICIENCY MINISTRIES' ST. ANN CLINIC, A FREE PRIMARY CARE CLINIC SERVING THE CITY OF TERRE HAUTE'S POOREST POPULATION. UNION HOSPITAL AFFILIATED PHYSICIANS, NURSES AND OTHERS PROVIDE THOUSANDS OF VOLUNTEER HOURS EACH YEAR TO STAFF THE CLINIC. UPON SEEING THE GROWING NEED FOR CARE, UHI HAS PROVIDED FUNDING FOR A FULL-TIME NURSE PRACTITIONER TO SEE PATIENTS AT THE CLINIC. THE CLINIC HAS BEEN SUCCESSFUL IN HELPING PATIENTS WITH CHRONIC DISEASE MANAGEMENT. WE KNOW THAT MANY WOMEN WILL FOREGO BREAST HEALTH SCREENING TO PUT THE NEEDS OF THEIR FAMILIES FIRST. MANY MORE WOMEN ARE CONCERNED THAT IF A PROBLEM IS FOUND IT WILL PUT TERRIBLE FINANCIAL BURDENS ON THEIR FAMILIES. PARTNERSHIPS WITH THE STATE OF INDIANA AND THE SUSAN G. KOMEN FOUNDATION HAVE ALLOWED THE CLARA FAIRBANKS CENTER FOR WOMEN TO PROVIDE SCREENING AND DIAGNOSIS AS WELL AS FOLLOW-UP CARE TO AREA WOMEN IN NEED, PROVIDING PEACE OF MIND AND DETECTING BREAST CANCERS EARLY. A WOMAN RECENTLY SERVED EXCLAIMED, "YOU SAVED MY LIFE AND MY HOUSE!" ENCOURAGING ACTIVE, HEALTHY LIFESTYLES AND PROVIDING ROLE MODELS IS THE GOAL BEHIND THE PERFECT PARTNERS PROGRAM, A PARTNERSHIP BETWEEN UNION AND BENJAMIN FRANKLIN ELEMENTARY SCHOOL. THIS LOW-COST, HIGH-IMPACT PROGRAM SERVES THE AREA'S POOREST INNER-CITY SCHOOL WITH FITNESS AND NUTRITION PROGRAMS, HEALTH FAIRS AND CAREER DAYS.Description
Total Program Service Expense386388530TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096196NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2725NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1WAYNE HUTSON CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8122387000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11606 N SEVENTH STREETAddressLine1
CityTERRE HAUTECity
StateINState
ZIP Code47804ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
JOHN LUKENS
CHAIRMAN2.003.00XX000
MOLLY CALLAHAN
VICE CHAIRMAN2.000.00XX000
WILLIAM G GRIMES
SECRETARY2.003.00XX000
DAN DEBARD
TREASURER2.000.00XX000
FREDERICK BAUER
ASST. SECRETARY2.000.00X000
WARD HUBBARD
ASST. TREASURER2.001.00X000
CURTIS BRIGHTON
MEMBER2.002.00X000
DR ROBERT HAERR
MEMBER2.001.00X000
DR JACQUELINE HOLDER
MEMBER2.000.00X000
DR MARK LYNCH
MEMBER2.000.00X000
CINDY MARTIN
MEMBER2.000.00X000
ROBERT MCLAUGHLIN
MEMBER2.000.00X000
DR DAVID SOUTHWICK
MEMBER2.000.00X8010000
SCOTT TEFFETELLER
PRESIDENT & CEO40.004.00XX477766037395
WAYNE HUTSON
SR VP FINANCE/CFO40.005.00X280763026220
KYM PFRANK
VICE PRESIDENT/COO40.002.00X255577032296
JOHN BOLINGER
VICE PRESIDENT MED AFFAIRS40.000.00X441370022590
JEANNETTE SPRADLIN
VICE PRESIDENT40.000.00X141475017482
RHONDA SMITH
VICE PRESIDENT40.000.00X234583029268
SALLY ZUEL
VICE PRESIDENT40.000.00X198868019801
KRISTI WILLIAMS
SYSTEM DIRECTOR PHARMACY40.000.00154659032941X
PRADEEP NAROTAM
NEUROSURGEON40.000.00927807037395X
RAMESH TANK
RADIOLOGIST40.000.00912623038895X
LINGAN SIDDA
RADIOLOGIST40.000.00896722030386X
NABIL MNAYARJI
THORASIC SURGEON40.000.00827661036039X
GEORGE SPENCER
RADIOLOGIST40.000.00811545028622X
DAVID DOERR
FORMER PRESDIENT & CEO0.000.00294964043107X
FieldValueIRS element (for citing)
Total Reportable Comp From Org6936483TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation432437TotalOtherCompensation
Number Individuals GT100 K95NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
PROVIDENCE MEDICAL GROUP
2723 S 7TH STTERRE HAUTEIN47802MEDICAL SERVICES AND RENT18063088
CARDIOVASCULAR MANAGEMENT LLC
2723 S 7TH STTERRE HAUTEIN47802MEDICAL MANAGEMENT SERVICES16004946
AMBULATORY SURGERY MANAGEMENT
221 S 6TH STTERRE HAUTEIN47802MEDICAL MANAGEMENT SERVICES6371449
ONCOLOGY SERVICES GROUP LLC
6100 W 96TH STE 125INDIANAPOLISIN46278MEDICAL SERVICES2814773
FRESENIUS MEDICAL
16343 COLLECTION CENTER DRCHICAGOIL60693MEDICAL SERVICES1634320
FieldValueIRS element (for citing)
Number Of Contractors GT100 K57NumberOfContractorsGT100K
Related Organizations120600RelatedOrganizations
Government Grants1023596GovernmentGrants
Total Contributions1144196TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column402198279TotalRevenueColumn
Related Or Exempt Function Income402198279RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue402198279TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column709461TotalRevenueColumn
Exclusion$709,461ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1288871Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real2843756Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-1554885Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-1554885TotalRevenueColumn
Exclusion-$1,554,885ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other64686Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other125385Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-60699Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-60699TotalRevenueColumn
Exclusion-$60,699ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
CAFETERIA REVENUE9000992130385$2,130,385
AP & S PURCHASED SERVICES900099908544$908,544
CHILD DEVELOPMENT REVENUE624410623311$367,566255745

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column3308958TotalRevenueColumn
Unrelated Business Revenue354232UnrelatedBusinessRevenue
Exclusion$2,954,726ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue6971198TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column409407550TotalRevenueColumn
Related Or Exempt Function Income402198279RelatedOrExemptFunctionIncome
Unrelated Business Revenue609977UnrelatedBusinessRevenue
Exclusion$5,455,098ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total323120Total
Program Services323120ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total32400Total
Program Services32400ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2030402Total
Program Services472987ProgramServices
Management And General1557415ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total136935892Total
Program Services128582803ProgramServices
Management And General8353089ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total5230788Total
Program Services4911710ProgramServices
Management And General319078ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total989932Total
Program Services929546ProgramServices
Management And General60386ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total9018269Total
Program Services8468155ProgramServices
Management And General550114ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total24000Total
Program Services22536ProgramServices
Management And General1464ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total292369Total
Program Services274534ProgramServices
Management And General17835ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total2985Total
Program Services2803ProgramServices
Management And General182ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total6604617Total
Program Services6201735ProgramServices
Management And General402882ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total477011Total
Program Services447913ProgramServices
Management And General29098ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total13785831Total
Program Services12944895ProgramServices
Management And General840936ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total11587914Total
Program Services10881051ProgramServices
Management And General706863ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total456473Total
Program Services428628ProgramServices
Management And General27845ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total16224111Total
Program Services15234440ProgramServices
Management And General989671ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total9084494Total
Program Services8530340ProgramServices
Management And General554154ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total25665391Total
Program Services24099802ProgramServices
Management And General1565589ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total14228971Total
Program Services13361004ProgramServices
Management And General867967ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PURCHASED SERVICES79524789746737774851012
MEDICAL SUPPLIES59041250554397343601516
HAF FEE1592752114955942971579

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total5504446Total
Program Services5168675ProgramServices
Management And General335771ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total412992976Total
Program Services386388530ProgramServices
Management And General26604446ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY33228407BOY
EOY20779789EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY54497818BOY
EOY54591782EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4361427BOY
EOY4393058EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY5276747BOY
EOY5871523EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis499905007LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec213786665LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY295522271BOY
EOY286118342EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY76864206BOY
EOY82729377EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY3244483BOY
EOY5699744EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY5982856BOY
EOY4338399EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3090878BOY
EOY2895002EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY482069093BOY
EOY467417016EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY51832211BOY
EOY52391537EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY301122BOY
EOY210418EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY254340000BOY
EOY253064786EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY24480793BOY
EOY21915755EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY6493740BOY
EOY13162818EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY337447866BOY
EOY340745314EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY139069623BOY
EOY122155732EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4575246BOY
EOY3112147EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY976358BOY
EOY1403823EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY144621227BOY
EOY126671702EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY482069093BOY
EOY467417016EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-3585426ReconcilationRevenueExpenses
Reconciliation Unrealized Invest987602ReconciliationUnrealizedInvest
Reconcilation Other Changes-15351701ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$16,641OtherActivitiesAmount
Total Lobbying Expenditures IIB16641TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationPERCENTAGE OF INDIANA HOSPITAL ASSOCATION AND AMERICAN HOSPITAL ASSOCIATION DUES PAID ATTRIBUTABLE TO LOBBYING EXPENSES AS DEFINED IN FEDERAL LAW.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance976358BeginningOfYearBalance
Investment Earnings Or Losses427465InvestmentEarningsOrLosses
End Of Year Balance1403823EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance958444BeginningOfYearBalance
Investment Earnings Or Losses17914InvestmentEarningsOrLosses
End Of Year Balance976358EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance946496BeginningOfYearBalance
Investment Earnings Or Losses44026InvestmentEarningsOrLosses
Grants Or Scholarships20970GrantsOrScholarships
Administrative Expenses11108AdministrativeExpenses
End Of Year Balance958444EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance969067BeginningOfYearBalance
Investment Earnings Or Losses17441InvestmentEarningsOrLosses
Grants Or Scholarships27706GrantsOrScholarships
Administrative Expenses12306AdministrativeExpenses
End Of Year Balance946496EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1010484BeginningOfYearBalance
Investment Earnings Or Losses4129InvestmentEarningsOrLosses
Grants Or Scholarships33684GrantsOrScholarships
Administrative Expenses11862AdministrativeExpenses
End Of Year Balance969067EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis17530940OtherCostOrOtherBasis
Book Value17530940BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis351115270OtherCostOrOtherBasis
Depreciation115062066Depreciation
Book Value236053204BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis3140716OtherCostOrOtherBasis
Depreciation2038932Depreciation
Book Value1101784BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis125581430OtherCostOrOtherBasis
Depreciation96685667Depreciation
Book Value28895763BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2536651OtherCostOrOtherBasis
Book Value2536651BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings286118342TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
PENSION LIABILITY$10,707,839
ESTIMATED THIRD PARTY SETTLEMENTS$2,454,979
FieldValueIRS element (for citing)
Total Of Amounts13162818TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:THE CORPORATION'S ENDOWMENT CONSISTS OF INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES WHICH WERE DONOR-RESTRICTED. NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE CORPORATION TO FUNCTION AS ENDOWMENTS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY IF THE CORPORATION 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 CORPORATION, AND HAS CONCLUDED THAT AS OF AUGUST 31, 2012 AND 2011, 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 CORPORATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FILINGS ARE CURRENT THROUGH 2011. THE IMPACT OF THE SUBSIDIARIES TAX CONSEQUENCES IS IMMATERIAL TO THESE FINANCIAL STATEMENTS.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense12118696TotalCommunityBenefitExpense
Net Community Benefit Expense12118696NetCommunityBenefitExpense
Percent Of Total Expense0.02930PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense77408519TotalCommunityBenefitExpense
Direct Offsetting Revenue44603998DirectOffsettingRevenue
Net Community Benefit Expense32804521NetCommunityBenefitExpense
Percent Of Total Expense0.07940PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense175651462TotalCommunityBenefitExpense
Direct Offsetting Revenue135700142DirectOffsettingRevenue
Net Community Benefit Expense39951320NetCommunityBenefitExpense
Percent Of Total Expense0.09670PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense265178677TotalCommunityBenefitExpense
Direct Offsetting Revenue180304140DirectOffsettingRevenue
Net Community Benefit Expense84874537NetCommunityBenefitExpense
Percent Of Total Expense0.20540PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense6802751TotalCommunityBenefitExpense
Net Community Benefit Expense6802751NetCommunityBenefitExpense
Percent Of Total Expense0.01650PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense9310436TotalCommunityBenefitExpense
Direct Offsetting Revenue2651562DirectOffsettingRevenue
Net Community Benefit Expense6658874NetCommunityBenefitExpense
Percent Of Total Expense0.01610PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense10649270TotalCommunityBenefitExpense
Direct Offsetting Revenue4329824DirectOffsettingRevenue
Net Community Benefit Expense6319446NetCommunityBenefitExpense
Percent Of Total Expense0.01530PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense219676TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense219676NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense425614TotalCommunityBenefitExpense
Net Community Benefit Expense425614NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense27407747TotalCommunityBenefitExpense
Direct Offsetting Revenue6981386DirectOffsettingRevenue
Net Community Benefit Expense20426361NetCommunityBenefitExpense
Percent Of Total Expense0.04940PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense292586424TotalCommunityBenefitExpense
Direct Offsetting Revenue187285526DirectOffsettingRevenue
Net Community Benefit Expense105300898NetCommunityBenefitExpense
Percent Of Total Expense0.25480PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense259775TotalCommunityBuildingExpense
Net Community Building Expense259775NetCommunityBuildingExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense684124TotalCommunityBuildingExpense
Net Community Building Expense684124NetCommunityBuildingExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense15090TotalCommunityBuildingExpense
Net Community Building Expense15090NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense958989TotalCommunityBuildingExpense
Net Community Building Expense958989NetCommunityBuildingExpense
Percent Of Total Expense0.00230PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$31,155,783BadDebtExpenseAmount
Amount Reimbursed By Medicare135700142AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare180640520CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-44940378MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeWebsite AddressWebsiteAddressLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalEr24 HoursEr24HoursOtherOtherCritical Access HospitalCriticalAccessHospital
UNION HOSPITAL INC
11606 NORTH SEVENTH STREETTERRE HAUTEIN47804HTTP://WWW.MYUNIONHOSPITAL.ORG/UNIONHOXXXXPHYSICIAN PRACTICES, OFF CAMPUS THERAPY, RADIOLOGY
UNION HOSPITAL CLINTON
2801 S MAIN STCLINTONIN47842HTTP://WWW.MYUNIONHOSPITAL.ORG/UNIONHOXXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumberCHNA ConductedCHNAConductedCommunity DefinitionCommunityDefinitionCommunity DemographicsCommunityDemographicsExisting ResourcesExistingResourcesHow Data ObtainedHowDataObtainedCommunity Health NeedsCommunityHealthNeedsOther Health IssuesOtherHealthIssuesIdentifying ProcessIdentifyingProcessConsulting ProcessConsultingProcessInformation GapsInformationGapsNeeds Assessment ConductedNeedsAssessmentConductedTake Into AccountTakeIntoAccountOther FacilitiesOtherFacilitiesCHNA Widely AvailableCHNAWidelyAvailableOwn WebsiteOwnWebsiteOn RequestOnRequestAdopt Implement StrategyAdoptImplementStrategyExecute Implement StrategyExecuteImplementStrategyDevelop Community PlanDevelopCommunityPlanParticipate Community PlanParticipateCommunityPlanPrioritize Health NeedsPrioritizeHealthNeedsAll Needs AddressedAllNeedsAddressedOrganization Incur Excise TaxOrganizationIncurExciseTaxEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelMedical IndigencyMedicalIndigencyInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountMedicaid MedicareMedicaidMedicareExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresAttached To InvoicesAttachedToInvoicesActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
UNION HOSPITAL
11XXXXXXXXX12111XXXXXXX1011150.0000000000001250.0000000000001XXXXXX11X10100
UNION HOSPITAL CLINTON
21XXXXXXXXX12111XXXXXXX1011150.0000000000001250.0000000000001XXXXXX11X10100

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities14NumberOfOtherFacilities

Other Facilities OtherFacilities (14 entries)

Address Line1Address/AddressLine1Address Line2Address/AddressLine2CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
CLARA FAIRBANKS CENTER FOR WOMEN
1711 N 6 1/2 ST HUX CANCER CTR 3RDFLOORTERRE HAUTEIN47804MAMMOGRAPHY CENTER
CLAY CITY CENTER FOR FAMILY MEDICINE
315 LANKFORD ST PO BOX 96CLAY CITYIN47841FAMILY MEDICINE CENTER
IMAGING SERVICES - THOMAS PROF PLAZA
5500 S US HWY 41TERRE HAUTEIN47802OUTPATIENT THERAPY & IMAGING CENTER
PEDIATRIC THERAPY SERVICES
450 8TH AVETERRE HAUTEIN47804OUTPATIENT THERAPY CENTER
PROVIDENCE MEDICAL GROUP CATH LAB
2723 S 7TH STTERRE HAUTEIN47802OUTPATIENT CATH LAB
PROVIDENCE MEDICAL GROUP CHEMO THERAPY
2723 S 7TH STTERRE HAUTEIN47802CHEMO THERAPY/INFUSION CENTER
THERAPY SERVICES (UPA BONE & JOINT)
1725 N 5TH STTERRE HAUTEIN47804OUTPATIENT THERAPY CENTER
THERAPY SERVICES - PROFESSIONAL PLAZA
4001 E WABASH AVENUETERRE HAUTEIN47803OUTPATIENT THERAPY CENTER
THERAPY SERVICES - ST MARY OF THE WOODS
ONE SISTER OF PROVIDENCEST MARY OF THE WOODIN47876OUTPATIENT THERAPY CENTER
UNION FAMILY MEDICINE EAST
4001 E WABASH AVENUETERRE HAUTEIN47803FAMILY MEDICINE CENTER
UNION HOSPITAL FAMILY MEDICINE CENTER
1513 N 6 1/2 STTERRE HAUTEIN47807FAMILY MEDICINE CENTER
UNION HOSPTIAL HUX CANCER CENTER
1711 N 6 1/2 STTERRE HAUTEIN47804CANCER CARE CENTER
WABASH VALLEY SURGERY CENTER
1421 N 7TH STTERRE HAUTEIN47807SURGERY CENTER
PROFESSIONAL OFFICE BUILDING
1530 N 7TH STTERRE HAUTEIN47807P.E.T. SCANS

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: SCHEDULE H PART I LINE 3BDESCRIPTION OF FAMILY INCOME LIMIT FOR DISCOUNTED CARETHE ORGANIZATION PROVIDES PARTIAL ASSISTANCE FOR INCOME LEVELS BETWEEN 150% AND 200% OF FEDERAL POVERTY GUIDELINES, AND OFFERS DISCOUNTED CARE ON A SLIDING SCALE FOR INCOME LEVELS BETWEEN 250% AND 400% OF FEDERAL POVERTY GUIDELINES.
PART II: TO BETTER MEET THE NEEDS OF OUR COMMUNITIES UNION HOSPITAL PARTICIPATES IN COMMUNITY BUILDING ACTIVITIES TO IMPROVE THE HEALTH IN THE COMMUNITY. PROGRAMS HAVE BEEN DEVELOPED TO SPECIFICALLY HELP MEET THE NEEDS AS DEFINED BY OUR COMMUNITY HEALTH NEEDS ASSESSMENT. MANY OF THE PROGRAMS OR SERVICES DEVELOPED MEET SEVERAL DEFINED NEEDS AND SOME OF THEM ARE MORE FOCUSED ON A CENTRAL IDEA. ACCESS TO HEALTH CARE HAS ALSO BEEN IDENTIFIED AS A NEED IN OUR COMMUNITY. IN 1993 THE RICHARD G. LUGAR CENTER FOR RURAL HEALTH WAS ESTABLISHED TO HELP RECRUIT AND EDUCATE PHYSICIANS TO PRACTICE HEALTH CARE IN OUR RURAL COMMUNITIES. SINCE ITS INCEPTION THE LUGAR CENTER HAS WORKED TO DEVELOP PROGRAMS AND SERVICES THAT MAKE HEALTHCARE MORE ACCESSIBLE TO THOSE INDIVIDUALS LIVING IN RURAL COMMUNITIES. THE ESTABLISHMENT OF CLINICS SUCH AS THE CLAY CITY CENTER FOR FAMILY MEDICINE THAT SERVES AS A MEDICAL HOME FOR APPROXIMATELY 3,500 AREA RESIDENTS, DELIVERING OVER 8,000 VISITS ANNUALLY, IN ADDITION TO HOUSE CALLS. IN 2001, THE LUGAR CENTER DEVELOPED AND IMPLEMENTED A CHRONIC DISEASE MANAGEMENT PROGRAM AT THE CLINIC THAT IS STILL BEING INTEGRATED INTO CARE PLANS FOR PATIENTS AS APPROPRIATE. THIS EVIDENCE-BASED PROGRAM INCLUDES FIVE CHRONIC DISEASES-HYPERTENSION, DIABETES MELLITUS, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, CONGESTIVE HEART FAILURE, AND ASTHMA. THE LUGAR CENTER IN COORDINATION WITH THE FAMILY MEDICINE RESIDENCY HAS EXPANDED TRAINING CAPACITY FOR FUTURE RURAL HEALTH CARE PROVIDERS THROUGH COLLABORATIVE EFFORTS WITH RURAL PARTNERS AROUND THE WABASH VALLEY. THE RURAL HEALTH INNOVATION COLLABORATIVE IS ANOTHER PROGRAM THAT HAS BEEN DEVELOPED TO HELP IMPROVE ACCESS TO HEALTHCARE AMONG OTHER COMMUNITY BUILDING ACTIVITIES. IN 2008 UNION HOSPITAL'S LUGAR CENTER HELPED LAUNCH A RURAL HEALTH COLLABORATIVE AIMED AT IMPROVING AND EXPANDING HEALTH CARE IN OUR COMMUNITY. WHAT BEGAN AS AN INFORMAL EXERCISE IN CREATIVE PROBLEM-SOLVING HAS BECOME THE RHIC. FOUNDING PARTNERS INCLUDE INDIANA STATE UNIVERSITY (ISU), INDIANA UNIVERSITY SCHOOL OF MEDICINE (IUSM), UNION HOSPITAL AND IT'S RICHARD G. LUGAR CENTER FOR RURAL HEALTH (UH), THE TERRE HAUTE ECONOMIC DEVELOPMENT CORPORATION (THEDC), THE CITY OF TERRE HAUTE (THE CITY), AND IVY TECH COMMUNITY COLLEGE WABASH VALLEY (IVY TECH). THE MISSION OF THE RURAL HEALTH INNOVATION COLLABORATIVE (RHIC) IS TO IMPROVE AND EXPAND EDUCATION AND TRAINING OF HEALTH CARE PROFESSIONALS AND FUTURE HEALTH CARE PROFESSIONALS, ESPECIALLY FOR THOSE COMMITTED TO SERVING RURAL AND UNDERSERVED POPULATIONS. KEY COMPONENTS OF THIS MISSION INCLUDE: TO PROMOTE THE RETENTION OF HEALTH CARE PROFESSIONALS TO SERVE RURAL AND UNDERSERVED POPULATIONS; TO INVITE COMMUNITY REVITALIZATION BY PROMOTING THE ENHANCEMENT OF OPPORTUNITIES FOR EDUCATION, TRAINING, AND EXPERIENCE IN HEALTH-RELATED PROFESSIONS AND FIELDS; TO PROMOTE SOCIAL WELFARE AND TO ENCOURAGE AND COORDINATE COMMUNITY INITIATIVES TO ADDRESS CHALLENGES AFFECTING HEALTH CARE DELIVERY; TO PROMOTE THE EFFICIENT USE OF PUBLIC AND PRIVATE RESOURCES AND COLLABORATE WITH OTHER ENTITIES WITH SIMILAR OR COMPLEMENTARY PURPOSES; TO DESIGN AND IMPLEMENT INNOVATIVE BEST PRACTICES AND STRATEGIES THAT ARE CAPABLE OF REPLICATION IN OTHER AREAS OF THE UNITED STATES; AND TO DISSEMINATE EDUCATIONAL INFORMATION, THEREBY POTENTIALLY OR ACTUALLY BENEFITING THOSE OTHER AREAS.
PART III, LINE 4: FOOTNOTE TO ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSES CAN BE FOUND ON PAGE 13 AND PAGE 14 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER THE FINANCIAL FOOTNOTE "PATIENT ACCOUNTS RECEIVABLE, ESTIMATED THIRD PARTY SETTLMENT, AND NET PATIENT SERVICE REVENUE".EXPLANATION FOR LINE 2 AND 3 OR RATIONAL FOR INCLUDING OTHER BAD DEBT AMOUNT IN COMMUNITY BENEFIT: THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN CHARITY CARE CANDIDATES MUST COOPERATE FULLY. IN ADDITION THE HOSPITAL EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THIS REASON THE ORGANIZATION BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE.
PART III, LINE 8: THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED AUGUST 31, 2013 REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST.
PART III, LINE 9B: IF THE PATIENT DOES NOT QUALIFY FOR CHARITY, BUT QUALIFIES FOR LIMITED MEANS ASSISTANCE, A REDUCTION IN CHARGES WILL BE MADE TO THE ACCOUNT AND THE PATIENT WILL BE NOTIFIED VIA MAIL. AT THE PATIENT'S REQUEST, PAYMENT ARRANGEMENTS WILL BE MADE FOR THE REMAINING BALANCE.
PART V, SECTION B, LINE 3: AN ONLINE SURVEY WAS DEVELOPED FOR THE COMMUNITY TO RANK NEEDS BASED ON THE AREA CODE IN WHICH THEY RESIDE. THIS DATA HAS BEEN TAKEN INTO CONSIDERATION AND WILL HELP US PLAN AND IMPLEMENT PROGRAMS FOR COMMUNITY HEALTH IMPROVEMENT. ALSO, PUBLIC INPUT WAS SEEKED IN VARIOUS STAKEHOLDER MEETINGS THAT TAKE PLACE AT THE HOSPITAL ON A BI-MONTHLY BASIS. THOSE STAKEHOLDER MEETINGS CONSIST OF; COMMUNITY IMPACT COMMITTEE, PATIENT FAMILY ADVISORY, BOARD OF DIRECTORS ADVISORY AND VENDOR ADVISORY. THESE ADVISORY COMMITTEES WERE FORMED TO HELP THE HOSPITAL PERFORM A SWOT ANALYSIS AND GAIN DIFFERENT PERSPECTIVE FROM DIFFERENT INDIVIDUALS THAT THE HOSPITALS COME IN CONTACT WITH ON A DAILY BASIS. THIS ANALYSIS HAS BEEN COMPILED TO HELP WITH OUR STRATEGIC PLANNING PROCESS.UNION HOSPITAL
PART V, SECTION B, LINE 3: AN ONLINE SURVEY WAS DEVELOPED FOR THE COMMUNITY TO RANK NEEDS BASED ON THE AREA CODE IN WHICH THEY RESIDE. THIS DATA HAS BEEN TAKEN INTO CONSIDERATION AND WILL HELP US PLAN AND IMPLEMENT PROGRAMS FOR COMMUNITY HEALTH IMPROVEMENT. ALSO, PUBLIC INPUT WAS SEEKED IN VARIOUS STAKEHOLDER MEETINGS THAT TAKE PLACE AT THE HOSPITAL ON A BI-MONTHLY BASIS. THOSE STAKEHOLDER MEETINGS CONSIST OF; COMMUNITY IMPACT COMMITTEE, PATIENT FAMILY ADVISORY, BOARD OF DIRECTORS ADVISORY AND VENDOR ADVISORY. THESE ADVISORY COMMITTEES WERE FORMED TO HELP THE HOSPITAL PERFORM A SWOT ANALYSIS AND GAIN DIFFERENT PERSPECTIVE FROM DIFFERENT INDIVIDUALS THAT THE HOSPITALS COME IN CONTACT WITH ON A DAILY BASIS. THIS ANALYSIS HAS BEEN COMPILED TO HELP WITH OUR STRATEGIC PLANNING PROCESS.UNION HOSPITAL CLINTON
PART V, SECTION B, LINE 4: UNION HOSPITAL CLINTONTERRE HAUTE REGIONAL HOSPITALSULLIVAN COUNTY COMMUNITY HOSPITALUNION HOSPITAL
PART V, SECTION B, LINE 4: UNION HOSPITAL CLINTONTERRE HAUTE REGIONAL HOSPITALSULLIVAN COUNTY COMMUNITY HOSPITALUNION HOSPITAL CLINTON
PART V, SECTION B, LINE 5C: HTTP://WWW.MYUNIONHOSPITAL.ORG/UNIONHOSPITAL/INDEX.PHP/HEALTH-NEEDS-ASSESSMENT-CBUNION HOSPITAL
PART V, SECTION B, LINE 5C: HTTP://WWW.MYUNIONHOSPITAL.ORG/UNIONHOSPITAL/INDEX.PHP/HEALTH-NEEDS-ASSESSMENT-CBUNION HOSPITAL CLINTON
PART VI, LINE 2: AT UNION HOSPITAL, ASSESSING THE NEEDS OF OUR COMMUNITY IS AN ONGOING ACTIVITY. ON FEBRUARY 7, 2012, THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS OFFICIALLY LAUNCHED AND MADE AVAILABLE FOR PUBLIC USE. THE CHNA REPRESENTS A UNIQUE COLLABORATION BETWEEN THE TWO LARGEST HEALTHCARE PROVIDERS IN THE WABASH VALLEY (UNION HOSPITAL AND REGIONAL HOSPITAL), ALONG WITH THE TERRE HAUTE CHAMBER OF COMMERCE (THCC) AND ITS BETTER HEALTH WABASH VALLEY (BHWV) INITIATIVE. THE SIX COUNTIES ASSESSED INCLUDE CLAY, GREENE, PARKE, SULLIVAN, VERMILLION AND VIGO COUNTIES. HEALTHY COMMUNITY INSTITUTE (HCI) USES DATA FROM SECONDARY SOURCES BY COMPILING THE DATA INTO ONE CHNA REPORT PROVIDING NEARLY 100 INDICATORS MEASURING HEALTH AND WELLNESS, ECONOMIC FACTORS, EDUCATION, PUBLIC SAFETY AND SOCIAL ENVIRONMENT. THIS TOOL CAN BE USED BY MANY DIFFERENT SEGMENTS OF THE COMMUNITY. THE DATA IS AUTOMATICALLY UPDATED BY HCI REPRESENTATIVES AS NEW DATA IS MADE PUBLIC BY OTHER SECONDARY DATA SOURCES. THE CHNA INDICATORS EACH FEATURE A "DASHBOARD" REPRESENTING DATA THAT HAS BEEN COLLECTED FROM ROUGHLY 40 DIFFERENT SOURCES. EACH "DASHBOARD" HAS A NEEDLE POINTING TO ONE OF THREE COLORS REPRESENTING THE GOOD (GREEN), THE CAUTIONARY (YELLOW) AND THE SERIOUS CONDITION (RED) OF A PARTICULAR INDICATOR. SIDE-BY-SIDE COMPARISONS OF THE FIVE COUNTIES FEATURED ON THE WEBSITE, ALONG WITH STATEWIDE AND NATIONWIDE COMPARISONS ARE ALSO AVAILABLE. THE CHNA IS HOUSED ON THE THCC WEBSITE, TERREHAUTECHAMBER.COM AND CAN BE ACCESSED THROUGH BOTH THE TERRE HAUTE REGIONAL HOSPITAL AND UNION HOSPITAL WEBSITES. THE BHWV IMPLEMENTATION PLAN WAS DEVELOPED BY A SUB-COMMITTEE OF BHWV. MEMBERS OF THIS SUB-COMMITTEE HAVE KNOWLEDGE OF PUBLIC HEALTH AND REPRESENT THE COMMUNITY AS A WHOLE. THIS IMPLEMENTATION PLAN IS INTENDED TO BE A "COMMUNITY PLAN". NO SINGLE ORGANIZATION CAN IMPACT THE HEALTH OF THE COMMUNITY ALONE. IT IS BHWV VISION THAT EACH COMMUNITY INCLUDED IN THE CHNA SHOULD HAVE A SAY NOT ONLY IN WHAT NEEDS THEY WILL FOCUS ON BUT HOW THEY WILL GO ABOUT POSITIVELY IMPACTING THOSE NEEDS. THE EXPECTATION IS THAT MANY OF THE COUNTIES INCLUDED IN THE CHNA WILL HAVE SIMILAR NEEDS AND PROJECTS, PROGRAMS AND EDUCATION WILL BE DEVELOPED FOR IMPLEMENTATION ACROSS THE ENTIRE "REGION". THE IMPLEMENTATION PLAN WENT INTO EFFECT IN MAY 2013 AND WILL BE UPDATED/REVIEWED ON AN ANNUAL BASIS. THE PLAN IS A THREE YEAR PLAN WITH ANNUAL REVIEW OF EFFECTIVENESS, BENCHMARKS, PROGRAMS AND COMMUNITY HEALTH NEEDS. BHWV ORGANIZATIONS MAY FORMALLY CHOOSE TO ADOPT THE INITIATIVES OUTLINED IN THIS DOCUMENT. THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA) REQUIRES ALL NOT-FOR-PROFIT HOSPITALS TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT PRIOR TO MARCH 2012 AND ALSO COMPLETE AN IMPLEMENTATION PLAN, SEEKING INPUT FROM THE COMMUNITY AND BOARD APPROVAL OF THE PLAN IS REQUIRED. FAILURE TO COMPLY WITH THE PPACA COULD RESULT IN FORFEITURE OF TAX EXEMPT STATUS OR A $50,000 FINE UNTIL THE REQUIREMENTS ARE MET. UNION HOSPITAL, SULLIVAN COUNTY COMMUNITY HOSPITAL, GREENE COUNTY GENERAL HOSPITAL AND ST. VINCENT CLAY HOSPITAL ARE ALL PARTNERS IN THE BHWV INITIATIVE THAT HAVE REQUIREMENTS THEY HAVE TO FULFILL TO BE IN COMPLIANCE WITH THE PPACA. TO HELP SUPPLEMENT OUR INVOLVEMENT IN BHWV, UNION HOSPITAL OFFICIALS HAVE FORMED THE UNION HOSPITAL COMMUNITY HEALTH IMPROVEMENT IMPLEMENTATION PLAN WHICH INCORPORATES DATA FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT, INPUT FROM COMMUNITY LEADERS HAVING INTEREST AND KNOWLEDGE IN PUBLIC HEALTH THAT ARE MEMBERS OF BHWV, THE UNION HOSPITAL BOARD OF DIRECTORS AND THE COMMUNITY AS A WHOLE. ADDITIONALLY, TO HELP SUPPLEMENT OUR FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT, AN ONLINE SURVEY WAS DEVELOPED FOR THE COMMUNITY TO RANK NEEDS BASED ON THE AREA CODE IN WHICH THEY RESIDE. THIS DATA HAS BEEN TAKEN INTO CONSIDERATION AND WILL HELP US PLAN AND IMPLEMENT PROGRAMS FOR COMMUNITY HEALTH IMPROVEMENT. UNION HOSPITAL ALSO SEEKS PUBLIC INPUT IN VARIOUS STAKEHOLDER MEETINGS THAT TAKE PLACE AT THE HOSPITAL ON A BI-MONTHLY BASIS. THOSE STAKEHOLDER MEETINGS CONSIST OF; COMMUNITY IMPACT COMMITTEE, PATIENT FAMILY ADVISORY, BOARD OF DIRECTORS ADVISORY AND VENDOR ADVISORY. THESE ADVISORY COMMITTEES WERE FORMED TO HELP THE HOSPITAL PERFORM A SWOT ANALYSIS AND GAIN DIFFERENT PERSPECTIVE FROM DIFFERENT INDIVIDUALS THAT THE HOSPITALS COME IN CONTACT WITH ON A DAILY BASIS. THIS ANALYSIS HAS BEEN COMPILED TO HELP WITH OUR STRATEGIC PLANNING PROCESS. UNION EMPLOYS A FULL-TIME POSITION (COMMUNITY BENEFIT SPECIALIST) DEDICATED TO COMMUNITY BENEFIT ACTIVITIES FOR THE ORGANIZATION. THE COMMUNITY BENEFIT SPECIALIST TAKES ON THE LEAD ROLE IN COLLECTING DATA TO ASSIST IN ASSESSING THE NEEDS OF OUR COMMUNITY. THE WEB SITE STATSINDIANA.EDU HAS A WEALTH OF HEALTH, DEMOGRAPHIC AND INCOME DATA PROVIDING UNION WITH AN ASSESSMENT OF ALL INDIANA COUNTIES IN OUR SERVICE AREA. THE U.S. CENSUS BUREAU AND COUNTYHEALTHRANKINGS.ORG PROVIDED US MORE DATA THAT CAN BE DRILLED DOWN TO THE STATE, COUNTY AND CITY LEVELS TO HELP UNION OFFICIALS ACCURATELY ASSESS COMMUNITY HEALTH NEEDS. UNION ALSO WORKS CLOSELY WITH INDIANA STATE UNIVERSITY HEALTH AND HUMAN SERVICES AND THE VIGO COUNTY HEALTH DEPARTMENT. THE HOSPITAL UTILIZES NATIONAL RESEARCH CORPORATION (NRC) TO CONDUCT ITS PATIENT SATISFACTIONS SURVEY PROCESS, THE NRC PRODUCT PROVIDES UNION WITH COMMUNITY HEALTH NEEDS ASSESSMENT AND PROGRAM INDICATORS.
PART VI, LINE 3: UHI USES A VARIETY OF TOOLS TO EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. SIGNS ARE DISPLAYED IN THE ADMITTING AREAS, BROCHURES AND THE FINANCIAL ASSISTANCE POLICY IS ATTAINED ON OUR STATEMENTS. CLAIMAID IS AVAILABLE OF POINT OF SERVICE ONSITE MEDICAID ELIGIBILITY ADVISOR THAT ASSISTS OUR PATIENTS IN QUALIFYING FOR ANY MEDICAID PROGRAMS. ALL OF OUR FINANCIAL COUNSELORS ARE TRAINED AND SCRIPTED TO COMMUNICATE FINANCIAL ASSISTANCE PROGRAMS AND ASSIST IN SETTING UP MEETINGS FOR THE CLAIMAID STAFF. FINANCIAL COUNSELORS ARE LOCATED IN THE ADMITTING IN BOTH UNION HOSPITAL EAST AND WEST FACILITIES AND AT UNION CLINTON FACILITY TO ASSIST OUR PATIENTS. THIS INCLUDES STAFF THAT CAN SPEAK SPANISH TO ASSIST IN ANY INTERPRETATION FOR A SPANISH SPEAKING PATIENT.
PART VI, LINE 4: THE ORGANIZATION SERVES A SIX COUNTY "REGION" LOCATED IN WABASH VALLEY INCLUDING CLAY, GREEN, PARKE, SULLIVAN, VERMILLION, AND VIGO COUNTIES. FOLLOWING IS A DESCRIPTION OF THE COMMUNITY BY COUNTY.CLAY COUNTY - THE TOTAL POPULATION OF CLAY COUNTY IS 26,803, WHICH RANKS CLAY COUNTY AS 59TH IN INDIANA. THE LARGEST CITY IN CLAY COUNTY IS BRAZIL, WITH A POPULATION OF 8,073. THE COUNTY IS 357.54 SQUARE MILES, WHICH MAKES THE POPULATION PER SQUARE MILE 75.20. THERE ARE 1,558 PRESCHOOL CHILDREN AGES 0 TO 4; 4,698 SCHOOL CHILDREN AGES 5 TO 17; 2,236 COLLEGE AGES 18 TO 24; 6,508 YOUNG ADULTS AGES 25 TO 44; 7,605 OLDER ADULTS AGES 45 TO 64; AND 4,232 SENIORS AGES 65 AND OLDER. THE MEDIAN AGE OF PEOPLE IN CLAY COUNTY IS 40.5 YEARS OLD. IN CLAY COUNTY THERE ARE 26,296 WHITES, 312 HISPANICS, 127 BLACKS, 84 ASIANS, 71 AMERICAN INDIAN AND ALASKA NATIVE, 10 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 249 WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN 2012 WAS $44,230, WHICH RANKED 56TH IN THE STATE. THE POVERTY RATE IS 15.65%, WHICH RANKS 33TH IN THE STATE. THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 22.9%, WHICH RANKS 44TH IN THE STATE. IN 2013, THERE WAS AN AVERAGE OF 46 FAMILIES ON WELFARE EACH MONTH, WHICH IS 47ND IN THE STATE. THERE WERE 4,049 PEOPLE HAD FOOD STAMPS IN 2013, WHICH RANKS 50ND IN THE STATE. THERE WERE 2,288 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN 2013, WHICH RANKS 53TH IN THE STATE. IN CLAY COUNTY, 11,145 PEOPLE ARE EMPLOYED, WHICH RANKS 63ND IN THE STATE AND 1,060 PEOPLE ARE UNEMPLOYED, WHICH RANKS 56RD IN THE STATE. GREENE COUNTY - THE POPULATION IN GREENE COUNTY IS 32,781, WHICH RANKS THEM AS 51ST IN INDIANA. THE LARGEST CITY IN GREENE COUNTY IS LINTON, WITH A POPULATION OF 5,373. THE COUNTY IS 542.50 SQUARE MILES, WHICH MAKES THE POPULATION PER SQUARE MILE 60.43. THERE ARE 1,831 PRESCHOOL CHILDREN AGES 0 TO 4; 5,690 SCHOOL CHILDREN AGES 5 TO 17; 2,525 COLLEGE AGES 18 TO 24; 7,682 YOUNG ADULTS AGES 25 TO 44; 9,541 OLDER ADULTS AGES 45 TO 64; AND, 5,671 SENIORS AGES 65 AND OLDER. THE MEDIAN AGE IN GREENE COUNTY IS 42.1 YEARS OLD. IN GREENE COUNTY THERE ARE 32,346 WHITES, 351 HISPANICS, 82 BLACKS, 114 ASIANS, 106 AMERICAN INDIAN OR ALASKA NATIVE, 7 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 285 WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN 2010 WAS $42,684, WHICH IS RANKED 66TH IN THE STATE. THE POVERTY RATE IS 15.9%, WHICH RANKS 27ST IN INDIANA. THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 22.0%, WHICH RANKS 38TH IN THE STATE. IN 2013 THERE WAS AN AVERAGE OF 47 FAMILIES ON WELFARE EACH MONTH, WHICH IS 46TH IN THE STATE. THERE WERE 4,796 PEOPLE RECEIVING FOOD STAMPS IN 2013, WHICH RANKS 38TH IN THE STATE. THERE WERE 2,595 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN 2013; THIS IS 37TH IN THE STATE. IN GREENE COUNTY 13,652 PEOPLE ARE EMPLOYED, WHICH RANKS 53ND IN THE STATE. 1,261 PEOPLE ARE UNEMPLOYED, WHICH RANKS 44TH IN INDIANA. SULLIVAN COUNTY - THE TOTAL POPULATION IS JUST OVER 21,000, WHICH RANKS SULLIVAN 69TH IN INDIANA. THE LARGEST CITY IS SULLIVAN, WITH A POPULATION OF 4,205. THE COUNTY IS 447.10 SQUARE MILES, WHICH MAKES THE POPULATION PER SQUARE MILE 47.47. THERE ARE 1,105 PRESCHOOL CHILDREN AGES 0 TO 4; 3,374 SCHOOL CHILDREN AGES 5 TO 17; 1,882 COLLEGE AGES 18 TO 24; 5,660 YOUNG ADULTS AGES 25 TO 44; 6,870 OLDER ADULTS AGES 45 TO 64; AND, 3,297 SENIORS AGES 65 AND OLDER. THE MEDIAN AGE OF PEOPLE IN SULLIVAN COUNTY IS 40.1 YEARS OLD. IN SULLIVAN COUNTY THERE ARE 19,908 WHITES, 325 HISPANICS, 938 BLACKS, 52 ASIANS, 65 AMERICAN INDIAN AND ALASKA NATIVE, 1 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 224 WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN 2012 WAS $41,223, WHICH RANKED 78TH IN THE STATE. THE POVERTY RATE IS 18.20%, WHICH RANKS 12TH IN THE STATE. THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 23.6%, WHICH RANKS 17TH IN THE STATE. IN 2013, THERE WAS AN AVERAGE OF 31 FAMILIES ON WELFARE EACH MONTH, WHICH IS 60TH IN THE STATE. THERE WERE 3,060 PEOPLE RECEIVING FOOD STAMPS IN 2013, WHICH RANKS 66TH IN THE STATE. THERE WERE 1,613 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN 2013, WHICH RANKS 67TH IN THE STATE. IN SULLIVAN COUNTY 7,623 PEOPLE ARE EMPLOYED, WHICH RANKS 76TH IN THE STATE. 859 PEOPLE ARE UNEMPLOYED, WHICH RANKS 66TH IN THE STATE.PARKE/VERMILLION COUNTY - THE POPULATION IN PARKE COUNTY IS 17,202, WHICH RANKS 76TH IN THE STATE OF INDIANA. THE LARGEST CITY IS ROCKVILLE WITH A POPULATION OF 2,581 PEOPLE. PARKE COUNTY HAS 444.70 SQUARE MILES WITH 38.68 PEOPLE PER SQUARE MILE. THERE ARE 958 PRESCHOOL AGES 0 TO 4; 2,705 SCHOOL CHILDREN AGES 5 TO 17; 1,413 COLLEGE AGES 18 TO 24; 4,160 YOUNG ADULTS AGES 25 TO 44; 5,009 OLDER ADULTS AGES 45 TO 64; AND, 2,824 SENIORS AGES 65 AND OLDER. THE MEDIAN AGE IN PARKE COUNTY IS 41.7 YEARS OLD. THERE ARE 16,443 WHITES, 412 BLACKS, 214 HISPANICS, 74 AMERICAN INDIAN OR ALASKA NATIVE, 33 ASIAN, 4 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 103 PEOPLE WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN PARKE COUNTY IS $41,311, WHICH RANKS 77TH IN THE STATE. THE POVERTY RATE IS 18.2%, WHICH RANKS 12TH IN THE STATE, AND THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 28.7%, WHICH RANKS 8TH IN THE STATE. IN 2013, AN AVERAGE OF 35 FAMILIES EACH MONTH WAS ON WELFARE. THIS RANKS AS 56TH IN THE STATE OF INDIANA. THERE WERE 2,237 PEOPLE ON FOOD STAMPS IN 2013, WHICH IS 74TH IN THE STATE. THERE WERE 1,299 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN 2013, WHICH IS 74TH IN THE STATE OF INDIANA. THERE ARE 6,894 EMPLOYED PEOPLE IN PARKE COUNTY, WHICH RANKS 79TH IN THE STATE. THERE ARE 650 UNEMPLOYED PEOPLE, WHO RANKS 78TH IN THE STATE. THE POPULATION IN VERMILLION COUNTY IS 15,878, WHICH RANKS 79TH IN THE STATE. THE LARGEST CITY IN VERMILLION COUNTY IS CLINTON WITH A POPULATION OF 4,826 PEOPLE. VERMILLION COUNTY HAS 256.90 SQUARE MILES AND A POPULATION PER SQUARE MILE OF 61.81. THERE ARE 927 PRESCHOOL AGES 0 TO 4; 2,759 SCHOOL CHILDREN AGES 5 TO 17; 1,223 COLLEGE AGES 18 TO 24; 3,694 YOUNG ADULTS AGES 25 TO 44; 4,610 OLDER ADULTS AGES 45 TO 64; AND, 2,827 SENIORS AGES 65 AND OLDER. THE MEDIAN AGE IN VERMILLION COUNTY IS 42.1 YEARS OLD. IN VERMILLION COUNTY THERE ARE 15,777 WHITES, 160 HISPANICS, 44 BLACKS, 41 AMERICAN INDIAN OR ALASKA NATIVE, 34 ASIANS, 6 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 138 WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN 2010 IS $42,709, WHICH RANKS 64TH IN INDIANA. THE POVERTY RATE IN 2012 WAS 14.6%, WHICH RANKS 42ND IN THE STATE. THE POVERTY RATE AMONG CHILDREN FEWER THAN 18 IS 21.3%, WHICH RANKS 40TH IN INDIANA. IN 2013, THE AVERAGE NUMBER OF FAMILIES ON WELFARE EACH MONTH WAS 36, THIS IS 69TH IN THE STATE. THERE WERE 2,408 PEOPLE ON FOOD STAMPS IN 2013, WHICH RANKS 69TH IN INDIANA. THERE WERE 1,273 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN 2013. IN VERMILLION COUNTY, THERE ARE 6,638 PEOPLE EMPLOYED, WHICH RANKS 81ST IN THE STATE OF INDIANA AND THERE ARE 785 PEOPLE UNEMPLOYED, WHO RANKS 73RD IN THE STATE. VIGO COUNTY - THE TOTAL POPULATION OF VIGO COUNTY WAS 108,291 FOR 2013. VIGO COUNTY IS RANKED 17TH IN THE STATE OF INDIANA ACCORDING TO POPULATION. THERE ARE 6,263 PRESCHOOL AGES 0 TO 4; 16,485 SCHOOL AGE CHILDREN AGES 5 TO 17; 16,101 COLLEGE AGE ADULTS AGES 18 TO 24; 27,149 YOUNG ADULTS AGES 25 TO 44; 27,374 OLDER ADULTS AGES 45 TO 64; AND 15,056 SENIORS AGES 65 AND OVER. THE MEDIAN AGE FOR VIGO COUNTY IS 35.9 YEARS OLD. THE LARGEST CITY IN VIGO COUNTY IS TERRE HAUTE, WHICH HAS A POPULATION OF 61,112 PEOPLE. TERRE HAUTE IS THE HOME TO 56.4% OF THE COUNTY'S POPULATION. THE COUNTY'S POPULATION MAJORITY IS WHITE WITH 95,941 PEOPLE. THERE ARE 7,701 BLACKS, 2,004 ASIANS, 2,671 HISPANICS, 397 AMERICAN INDIAN OR ALASKA NATIVE, 41 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 2,344 PEOPLE WITH TWO OR MORE RACIAL GROUPS. THE AVERAGE HOUSEHOLD INCOME FOR VIGO COUNTY IS $40,091, WHICH RANKS 83RD IN THE STATE OF INDIANA. THE POVERTY RATE IS 20.3%, WHICH IS 6TH IN INDIANA AND THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 29.0%, WHICH IS 7TH IN INDIANA. IN 2013, THERE WERE 18,596 PEOPLE WHO RECEIVED FOOD STAMPS, WHICH IS 10TH IN THE STATE OF INDIANA. THERE ARE 8,451 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN VIGO COUNTY, WHICH IS 14TH IN INDIANA. IN 2013, THERE WAS AN AVERAGE OF 217 FAMILIES ON WELFARE EACH MONTH, WHICH IS 10TH IN THE STATE OF INDIANA. THERE ARE 44,750 PEOPLE EMPLOYED IN VIGO COUNTY, WHICH RANKS 16TH IN THE STATE AND 4,694 PEOPLE UNEMPLOYED, WHICH RANKS 11TH IN THE STATE. THE ANNUAL UNEMPLOYMENT RATE FOR 2013 WAS 9.5, WHICH IS 22ND IN THE STATE OF INDIANA.
PART VI, LINE 5: UNION HOSPITAL, ALONG WITH TERRE HAUTE REGIONAL HOSPITAL ARE FOUNDING MEMBERS OF THE TERRE HAUTE CHAMBER OF COMMERCE BETTER HEALTH WABASH VALLEY INITIATIVE (BHWV). THE ORIGINAL COMMITMENT WAS TO ASSIST IN THE PURCHASE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT DATA AND TO MAKE THAT DATA WIDELY AVAILABLE TO THE PUBLIC. BETTER HEALTH WABASH VALLEY NOW HAS ADDITIONAL SUPPORTING MEMBERS INCLUDING SULLIVAN COUNTY COMMUNITY HOSPITAL, HAMILTON CENTER AND UNITED WAY OF THE WABASH VALLEY. THESE ORGANIZATIONS HAVE MADE A FINANCIAL CONTRIBUTION TO BETTER HEALTH WABASH VALLEY. ALL MONIES CONTRIBUTED TO BETTER HEALTH WABASH VALLEY GO THROUGH THE TERRE HAUTE CHAMBER OF COMMERCE FOUNDATION WHICH IS A 501(C)(3) ORGANIZATION. BETTER HEALTH WABASH VALLEY'S MISSION IS TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY WHILE MAKING THE WABASH VALLEY A HEALTHIER COMMUNITY TO LIVE, WORK AND PLAY. BETTER HEALTH WABASH VALLEY IS REPRESENTED BY SEVERAL DIFFERENT ORGANIZATIONS IN THE COMMUNITY INCLUDING, HEALTHCARE AND MENTAL HEALTH ORGANIZATIONS, SCHOOL CORPORATIONS, UNIVERSITIES, NOT-FOR-PROFITS AND BUSINESSES. UNION HOSPITAL WILL REMAIN HEAVILY INVOLVED AND COMMITTED TO THE BETTER HEALTH WABASH VALLEY INITIATIVE OVER THE NEXT SEVERAL YEARS. AS EMPLOYERS IN THE WABASH VALLEY LOOK FOR WAYS TO KEEP HEALTH INSURANCE CLAIMS AT A MINIMUM WE WILL WORK WITH THEM ON EMPLOYEE WELLNESS STRATEGIES, ADDITIONALLY WE WILL ASSIST IN PROGRAM DEVELOPMENT THAT COULD BE IMPLEMENTED ON AN ORGANIZATIONAL LEVEL AT LITTLE TO NO COST TO THE EMPLOYER. AN EXAMPLE OF THIS MIGHT BE PROVIDING MATERIALS OR ONLINE RESOURCES FOR A WALKING PROGRAM. BETTER HEALTH WABASH VALLEY AND ITS MEMBERS HAVE DECIDED TO FOCUS ON CARDIOVASCULAR DISEASE, OBESITY AND CHILDHOOD OBESITY AS TOP ISSUES THAT THEY WILL FOCUS ON OVER THE NEXT THREE YEARS.
PART VI, LINE 6: THE ORGANIZATION IS PART OF AN AFFILATED HEALTH CARE SYSTEM TO PROVIDE VISION AND STRATEGIC DIRECTION IN THE FORMATION OF A REGIONAL HEALTH CARE SYSTEM TO EXPAND AND IMPROVE THE DELIVERY OF HEALTH CARE SERVCIES IN ORDER TO MEET THE HEALTH CARE NEEDS OF RESIDENTS IN THE SYSTEM'S SERVICE AREA.
INREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (17 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
MARION UNIVERSITY
3200 COLD SPRING RDINDIANAPOLISIN46222350868175501C340000MAKE HISTORY PLEDGE
IHA HOSPITAL ASSISTANCE FOUNDATION
1 AMERICAN SQINDIANAPOLISIN46282455573749501C339483GENERAL CONTRIBUTION FOR ASSISTANCE
UNITED WAY OF THE WABASH VALLEY
2901 OHIO BLVD STE 215TERRE HAUTEIN47803351008531501C325000GENERAL CONTRIBUTION
SAINT MARY-OF-THE-WOODS COLLEGE
1 ST MARY OF WOODS COLLSAINT MARY OF THE WOODIN47876351065063501C311000GENERAL CONTRIBUTION
AMERICAN LUNG ASSOCIATION
55 W WACKER DRIVECHICAGOIL60601131632524501C310000GENERAL CONTRIBUTION
TERRE HAUTE BOYS & GIRLS CLUB
924 N 13TH STTERRE HAUTEIN47807350868182501C310000GENERAL CONTRIBUTION
VIGO COUNTY SCHOOL CORPORATION
PO BOX 3703TERRE HAUTEIN47803356007261N/A10000GENERAL DONATION
TERRE HAUTE CHILDRENS MUSEUM
727 WABASH AVETERRE HAUTEIN47807311224051501C38000DONATION OF RENTAL OFFICE SPACE TO ORGANIZATION TO FURTHER ITS EXEMPT PURPOS
COALITION TO PROTECT AMERICA'S HEALTH CARE
PO BOX 30211BETHESDAMD20824522253225501C46000GENERAL CONTRIBUTION
SUSAN G KOMEN WABASH VALLEY
THE MEADOWS STE 19TERRE HAUTEIN47803752844615501C35000GENERAL CONTRIBUTION
ST VINCENT PEYTON MANNING CHILDREN'S HOSPITAL
10330 N MERIDIAN STINDIANAPOLISIN46290356088862501C35000GENERAL CONTRIBUTION
DOWNTOWN TERRE HAUTE
PO BOX 9445TERRE HAUTEIN47808352075017501C35000GENERAL CONTRIBUTION
AMERICAN CANCER SOCIETY
250 WILLIAMS STATLANTAGA30303131788491501C35000GENERAL CONTRIBUTION
INDIANA PUBLIC HEALTH FOUNDATION
8063 MADISON AVENUEINDIANAPOLISIN46227356048182501C35000GENERAL CONTRIBUTION
IVY TECH FOUNDATION
50 W FALL CREEK PARKWAY NORTH DRINDIANAPOLISIN46208237073977501C35000GENERAL CONTRIBUTION
ROSE-HULMAN INSTITUTE OF TECHNOLOGY
5500 WASBASH AVETERRE HAUTEIN47803350868149501C35000GENERAL CONTRIBUTION
TERRE HAUTE CROW COMMITTEE
PO BOX 3688TERRE HAUTEIN47803273875936501C35000GENERAL DONATION
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants15TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations2TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSCHOLARSHIPSTypeOfGrant
Number Of Recipients9NumberOfRecipients
Amount Of Cash Grant32400AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: GRANTS TO ENTITIES IN THE UNITED STATES AND SCHOLARSHIPS PROVIDED: GRANTS AND ASSISTANCE ARE PROVIDED TO ELIGIBLE 501(C)(3) PUBLIC CHARITIES, LOCAL SCHOOL CORPORATION FOR GENERAL SUPPORT, AND SCHOLARSHIPS FOR ELIGIBLE INDIVIDUALS. UNION HOSPITAL DOES NOT MONITOR THE USE OF THESE FUNDS BY THE ORGANIZATIONS OR INDIVIDUAL.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
SCOTT TEFFETELLER
PRESIDENT & CEO4139180475000163480115920258030515161000
WAYNE HUTSON
SR VP FINANCE/CFO2021810459380326440151050111150306983000
KYM PFRANK
VICE PRESIDENT/COO1796670483380275720156500166460287873000
JOHN BOLINGER
VICE PRESIDENT MED AFFAIRS327370099000015000071450154450463960000
JEANNETTE SPRADLIN
VICE PRESIDENT1139060224000516908258092240158957000
RHONDA SMITH
VICE PRESIDENT18295405162900019820272860263851000
SALLY ZUEL
VICE PRESIDENT14769305117500010136096650218669000
KRISTI WILLIAMS
SYSTEM DIRECTOR PHARMACY13893701572200074090255320187600000
PRADEEP NAROTAM
NEUROSURGEON6649220262885000115920258030965202000
RAMESH TANK
RADIOLOGIST4264530486170000115920273030951518000
LINGAN SIDDA
RADIOLOGIST4205460476176000115920187940927108000
NABIL MNAYARJI
THORASIC SURGEON6905350137126000115920244470863700000
GEORGE SPENCER
RADIOLOGIST401353041019200070340215880840167000
DAVID DOERR
FORMER PRESDIENT & CEO28826106703000160750270320338071000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 4ASEVERANCE PAYMENTS WERE MADE TO THE CURRENT AND FORMER PRESIDENT/CEO DURING FISCAL YEAR 2013 THAT WILL BE INCLUDED IN THE 12/31/2013 FORM W-2 AND REPORTED ON THE 8/31/2014 TAX YEAR RETURN.
PART I, LINE 7THE ORGANIZATION PROVIDES NON-FIXED PAYMENTS TO SEVERAL INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A. THESE NON-FIXED PAYMENTS ARE BASED ON THE ORGANIZATION'S ABILITY TO PAY AND ARE NOT CONSTRUED AS A CONTRACT BETWEEN UNION AND ITS EXECUTIVES. THE EXECUTIVE BONUS PLAN IS A MIXTURE OF OBJECTIVES, STANDARDS AND SUBJECTIVE STANDARDS THAT BOTH THE POLICY AND THE IMPLEMENTATION OF THE POLICY BY THE PERSONNEL COMMITTEE AND THE BOARD OF DIRECTORS APPROVES AND AWARDS DEPENDING ON UNION'S ABILITY TO PAY. THERE IS NO AUTOMATIC RIGHT TO A BONUS OR A SPECIFIC BONUS AMOUNT EVEN IF ALL CRITERIA ARE MET. THE PERFORMANCE MEASURE PLAN IS LINKED TO THE UNION STRATEGIC AND FISCAL-YEAR BUSINESS PLANNING PROCESS. THE PLAN IS INTENDED TO FOCUS PARTICIPANTS' ATTENTION ON MISSION-CRITICAL GOALS AND KEY STRATEGIC PRIORITIES. THE PLAN IS ALSO INTENDED TO ENHANCE THE PERFORMANCE OF UNION EXECUTIVES AND THE ORGANIZATION. PRIOR TO THE START OF THE FISCAL YEAR AND AS PART OF THE BUSINESS PLANNING PROCESS, THE UNION PRESIDENT AND CEO WILL FINALIZE A LIST OF GOALS, WEIGHTS AND MEASURES TO BE USED TO ASSESS PERFORMANCE DURING THE FISCAL YEAR. THE LIST IS PRESENTED TO AND DISCUSSED WITH THE COMMITTEE. THE COMMITTEE REVIEWS AND APPROVES THE BONUS PLAN GOALS, WEIGHTS, AND MEASURES. ORGANIZATION GOALS WILL BE ASSIGNED TO EACH PARTICIPANT HOSPITAL-WIDE. IN ADDITION TO HOSPITAL-WIDE GOALS INDIVIDUAL AND/OR FUNCTIONAL/DEPARTMENT GOALS MAY OR MAY NOT BE INCLUDED. AFTER THE CONCLUSION OF EACH FISCAL YEAR, THE PRESIDENT AND CEO WILL PREPARE AN ANNUAL BONUS PLAN REPORT FOR THE COMMITTEE. THE REPORT CONTAINS: AN APPRAISAL OF UNION AND HOSPITAL/OPERATING UNIT PERFORMANCE DURING THE RECENTLY-COMPLETED FISCAL YEAR; AND THE PRESIDENT AND CEO'S RECOMMENDED PAYOUT FOR EACH PLAN PARTICIPANT. THE BONUS RECOMMENDATIONS FOR ALL SR. MANAGEMENT ARE RECEIVED AND REVIEWED FIRST BY THE PERSONNEL COMMITTEE WHO THEN MAKE DECISIONS AND SUBMITS TO THE BOARD TO VOTE. THE COMMITTEE WILL DETERMINE AND SUBMIT THE PAYOUT FOR THE PRESIDENT AND CEO TO THE BOARD OF DIRECTORS WHO, ABSENT THE PRESIDENT AND CEO, WILL VOTE ON APPROVAL. AWARD DETERMINATIONS ARE CALCULATED AS PERCENTAGES OF PARTICIPANT'S SALARIES PAID FOR TIME WORKED DURING THE FISCAL YEAR. PAYOUT FOR THE PRESIDENT IS 0% TO 30%; CFO AND COO ARE 0% TO 25%; AND OTHER EXECUTIVES ARE 0% TO 20%. THE EXECUTIVE BONUS PLAN PAYOUTS ARE TO BE PAID WHEN DETERMINED BY THE PERSONNEL COMMITTEE, SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS.
PART IIIPART II, COLUMN (B)(III) - THE HOSPITAL PROVIDES SPLIT DOLLAR LIFE INSURANCE POLICIES TO CERTAIN OFFICERS, DIRECTORS, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES. FOR THE TAX YEAR 2012 THE FOLLOWING PAYMENTS WERE MADE TO PARTICIPATE IN THE POLICY AND ARE RECORDED AS NEGATIVE AMOUNT IN THE OTHER REPORTABLE COMPENSATION COLUMN (III): (2) WAYNE HUTSON $33,460 (4) SALLY ZUEL $14,622 (5) RAMESH TANK $14,199 (6) LINGAN SIDDA $13,891 (7) SANJAY PATHAK $14,298 (8) NABIL MNAYARJI $24,592 (10)DAVID DOEER $13,650SUPPLEMENTAL INFORMATION

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
HOSPITAL AUTHORITY OF VIGO COUNTY (REVENUE BONDS SERIES 2007)
A351656988926742BY22007-07-12176052475CONSTRUCT NEW HOSPITAL BUILDING000
HOSPITAL AUTHORITY OF VIGO COUNTY (REVENUE BONDS SERIES 2011)
B351656988926742CF22011-03-0253989054CAPITAL ASSET RENOVATION/CONSTRUCTION, REFUNDING OF BONDS000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindOther Spent ProceedsOtherSpentProceeds
A17605247515716590215152515818436020101110
B539890545504000107842617009396100130397232

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A01110000
B01110000

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A000000000
B000000000

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSERIES 2011 BONDS PURPOSE DETAILIdentifier
ExplanationTHE PROCEEDS FROM THE SALE OF THE SERIES 2011 BONDS, TOGETHER WITH CERTAIN OTHER MONEIES, WILL BE USED TO (I) FINANCE THE COST OF CONSTRUCTING, ACQUIRING, EQUIPPING OR RENOVATING CERTAIN CAPITAL ASSETS OF THE CORPORATION,(II) REFUND THE INDIANA HEALTH FACILITY FINANCING AUTHORITY VARIABLE RATE DEMAND REVENUE BONDS, SERIES 2002 AND THE INDIANA HEALTH AND EDUCATIONAL FACILITY FINANCING AUTHORITY VARIABLE RATE DEMAND REVENUE BONDS, SERIES 2006A, (III) FUND A DEBT SERVICE RESERVE FUND FOR THE SERIES 2011 BONDS, AND (IV) PAY A PORTION OF THE COST OF ISSUANCE OF THE SERIES 2011 BONDS.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
FOREST SHERER INC
SEE PART V BELOW906613SEE PART V0
AP&S CLINIC NORTH SIDE
SEE PART V BELOW1757014SEE PART V0
BUNCH NURSERIES INC
SEE PART V BELOW66656SEE PART V0

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
Explanation(A) NAME OF PERSON: FOREST SHERER, INC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: JOHN LUKENS IS THE UNION HOSPITAL BOARD CHAIRMAN AND PRESIDENT OF FORREST SHERER, INC.(D) DESCRIPTION OF TRANSACTION: THE HOSPITAL PURCHASES INSURANCE FROM THE INDEPENDENT INSURANCE AGENCY ON AN ARMS LENGTH BASIS.(A) NAME OF PERSON: AP&S CLINIC NORTHSIDE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: JACQUELINE HOLDER IS A UNION HOSPITAL BOARD MEMBER AND MEDICAL DOCTOR FOR AP&S CLINIC NORTHSIDE(D) DESCRIPTION OF TRANSACTION: THE HOSPITAL HAS A CONTRACTUAL ARRANGEMENT FOR SERVICES WHICH ARE PROVIDED ON AN ARMS LENGTH BASIS.A) NAME OF PERSON: BUNCH NURSERIES, INC.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: ENTITY IS MORE THAN 35% OWNED BY HUSBAND OF CINDY MARTIN, UNION BOARD MEMBER(D) DESCRIPTION OF TRANSACTION: ENTITY PROVIDED SERVICES TO THE HOSPITAL.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION MISSION STATEMENTFORM 990, PART I, DOING BUSINESS AS:CARDIAC REHAB GROUP OF UNION HOSPITAL CLARA FAIRBANKS CENTER FOR WOMEN CLAY CITY CENTER FOR FAMILY MEDICINE HEARTLAND MIDWIVES HUX CANCER CENTER RICHARD G. LUGAR CENTER FOR RURAL HEALTH UH REGISTERED DIETITIAN GROUP UNION CENTER FOR JOINT REPLACEMENT UNION CENTER FOR SPORTS MEDICINE UNION HOSPITAL CLINTON UNION HOSPITAL CLINTON WESTERN INDIANA RURAL MEDICINE UNION HOSPITAL CVT/NEURO GROUP UNION HOSPITAL FAMILY MEDICINE CENTER UNION HOSPITAL HEALTH GROUP UNION HOSPITAL HUX HEART CENTER UNION HOSPITAL MEDICAL GROUP UNION HOSPITAL NEUROSCIENCE UNION HOSPITAL TERRE HAUTE UNION HOSPITALISTS GROUP WABASH VALLEY SURGERY CENTER WEST CENTRAL COMMUNITY HOSPITAL
FORM 990, PART VI, SECTION A, LINE 6UNION HOSPITAL HAS ONE MEMBER, UNION HEALTH SYSTEM, INC., AN INDIANA NONPROFIT, TAX EXEMPT CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE ORGANIZATION'S MEMBER MAY APPOINT THE HOSPITAL BOARD DIRECTORS WITH THE RECOMMENDATION OF THE HOSPITAL'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BGOVERNING BODY DECISIONS SUBJECT TO APPROVAL BY THE MEMBER INCLUDE: 1. MISSION AND VISION STATEMENT CHANGES; 2. CHANGES TO THE GOVERNING DOCUMENT; 3. APPROVAL AND REMOVAL OF BOARD DIRECTORS; 4. INCURRING DEBT; 5. APPROVAL, SALE, TRANSFER OR SUBSTANTIAL CHANGE IN USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS; 6. FORMATION OF A SUBSIDIARY; 7. TRANSFER OR ENCUMBRANCE OF THE ASSETS; 8. APPROVAL OF ANNUAL OPERATING BUDGET, CAPITAL PLAN, STRATEGIC PLAN, AND BUSINESS PLAN; 9. APPOINTMENT OF THE CEO; 10. TRANSACTIONS OVER $250,000; AND 11. APPROVAL OF ANY MANAGEMENT AGREEMENTS.
FORM 990, PART VI, SECTION B, LINE 11THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW OF THE FORM 990 BY THE ORGANIZATION'S MANAGEMENT. THE GOVERNING BODY REVIEWS AND APPROVES THE FORM 990 AND THE FINAL FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, ARE PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 12CTHE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY THE CORPORATE COMPLIANCE OFFICER. THE SCOPE OF THIS POLICY INCLUDES DIRECTORS, OFFICERS, MANAGEMENT, AND EMPLOYEES. THE POLICY IS IN PLACE TO AVOID PERSONAL INTERESTS THAT CONFLICT, OR MAY APPEAR TO CONFLICT, WITH THE BEST INTERESTS OF UNION AND ITS AFFILIATES AND THE COMMUNITIES THEY SERVE. THE COVERED PERSONS ARE TO REFRAIN FROM PERSONAL INTERESTS, DIRECT OR INDIRECT WITH ANY THIRD PARTIES. IT IS THE RESPONSIBILITY OF OFFICERS, MANAGEMENT, AND EMPLOYEES TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES AND ACT ACCORDINGLY. A SELF-DISCLOSURE FROM COVERED PERSONS TO THE CORPORATE COMPLIANCE OFFICER IS REQUIRED ON ANY POTENTIAL CONFLICTS OF INTEREST. THE COVERED PERSONS ARE TO REFRAIN FROM PARTICIPATING IN ANY DELIBERATION OR DECISIONS ON SUCH TRANSACTIONS. THE CONFLICTS DISCLOSED ARE REVIEWED AND RESOLVED BY THE CORPORATE COMPLIANCE OFFICER.
FORM 990, PART VI, SECTION B, LINE 15THE PROCESS FOR DETERMINING COMPENSATION UNDER THE BY-LAWS OF UNION HOSPITAL INCLUDES A BOARD OF DIRECTORS PERSONNEL COMMITTEE WHOSE RESPONSIBILITIES INCLUDE IN CHARGE OF DOING THE APPROPRIATE REVIEW OF COMPENSATION FOR THE SR. MANAGEMENT TEAM, INCLUDING THE CEO. THEY GATHER INFORMATION AND FOLLOW THE STEPS SET FORTH BELOW AND IN TURN SUBMIT TO THE FULL BOARD OF DIRECTORS THE RECOMMENDATIONS IN TERMS OF COMPENSATION AND BENEFITS FOR THE CEO AND SR. MANAGEMENT. THE PERSONNEL COMMITTEE CONSISTS OF INDIVIDUALS WHO ARE DISINTERESTED. THE CEO IS EXCUSED FROM THE MEETING WHEN HIS COMPENSATION/BENEFITS ARE REVIEWED BOTH AT THE PERSONNEL COMMITTEE LEVEL AND THE BOARD LEVEL. NOTE: DURING THE CURRENT FISCAL YEAR, SALARY INCREASES WERE NOT GIVEN TO THE SR. MANAGEMENT TEAM INCLUDING THE CEO, AND THUS, AN ANALYSIS OF COMPENSATION WAS NOT COMPLETED. IN FUTURE PERIODS, THIS PROCEDURE WILL RESUME AS STATED IN THIS POLICY. THE STEPS INCLUDE: 1. THE PERSONNEL COMMITTEE RETAINS AN OUTSIDE INDEPENDENT CONSULTANT TO (1) PROVIDE THE COMMITTEE WITH INFORMATION, AND (2) TO REVIEW THE ACTIONS AND COMPENSATION/BENEFITS TO BE SURE THAT THERE IS NOT EXCESSIVE COMPENSATION. THE CONSULTANT THAT HAS BEEN USED THE PAST THREE (3) YEARS IS SULLIVAN COTTER & ASSOCIATES, INC. UNDER THE PROCESS, SULLIVAN COTTER FIRST IS PROVIDED WITH THE NAMES AND JOB DESCRIPTIONS FOR THE SR. MANAGEMENT TEAM THAT IS BEING EVALUATED. THE INDEPENDENT ADVISOR THEN SUBMITS TO THE PERSONNEL COMMITTEE COMPARABLE INFORMATION, SPECIFICALLY: > FIVE COMMERCIALLY AVAILABLE EXECUTIVE HEALTH CARE COMPENSATION SURVEYS PREPARED BY INDEPENDENT FIRMS, WERE REFERENCED TO OBTAIN MARKET DATA FOR THIS REVIEW - INTEGRATED HEALTHCARE STRATEGIES: 2009 HEALTHCARE EXECUTIVE COMPENSATION SURVEY - INDIANA HOSPITAL & HEALTH ASSOCIATION: 2009 COMPENSATION SURVEY REPORT - SULLIVAN, COTTER, AND ASSOCIATES: 2009 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS - WATSON WYATT DATA SERVICES: 2009/2010 HOSPITAL AND HEALTHCARE MANAGEMENT COMPENSATION REPORT - MERCER HUMAN RESOURCE CONSULTING: 2009 INTEGRATED HEALTH NETWORKS COMPENSATION SURVEY > MARKET DATA REFLECTING FUNCTIONALLY-COMPARABLE POSITIONS WERE OBTAINED FOR ALL SEVEN EXECUTIVE POSITIONS > DATA WERE ABSTRACTED FOR COMPARABLY-SIZED ORGANIZATIONS AS MEASURED BY NET REVENUE > THE DATA REPORTED REPRESENTED THE 50TH, 75TH, AND 90TH PERCENTILES OF BASE SALARY AND TOTAL CASH COMPENSATION (BASE SALARY PLUS ACTUAL ANNUAL INCENTIVE - ABBREVIATED TCC) > REGIONAL MARKET DATA WERE ALSO COLLECTED FROM THE PUBLISHED COMPENSATION SURVEYS AS WELL AS A SPECIAL CUT OF THE FOLLOWING INDIANA HOSPITALS FROM SULLIVAN COTTER'S 2009 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS - BALL MEMORIAL HOSPITAL - REID HOSPITAL & HEALTH CARE SERVICES - BLOOMINGTON HOSPITAL - RILEY HOSPITAL FOR CHILDREN - ELKHART GENERAL HOSPITAL - SAINT JOHN'S HEALTH SYSTEM - GOOD SAMARITAN HOSPITAL - SAINT JOSEPH REGIONAL MEDICAL CENTER - MEMORIAL HOSPITAL OF SOUTH BEND - SAINT MARY'S MEDICAL CENTER - METHODIST HOSPITALS - TERRE HAUTE REGIONAL HOSPITAL - PARKVIEW HOSPITAL > THAT DATA WAS ALSO REPORTED WITH NATIONAL AVERAGE, REGIONAL AVERAGE AND INDIANA AVERAGE. 2. THE PERSONNEL COMMITTEE OF UNION HOSPITAL'S BOARD OF DIRECTORS TAKES THE DATA PROVIDED BY THE INDEPENDENT CONSULTANTS AND FOLLOWING A REVIEW OF THE PERFORMANCE OF EACH INDIVIDUAL SUBMITS TO THE FULL BOARD FOR APPROVAL RECOMMENDATIONS IN TERMS OF SALARIES, BENEFITS, AND BONUSES. FINAL APPROVAL IS BY THE BOARD OF DIRECTORS. THE CEO DOES NOT TAKE PART IN THE DISCUSSION OR ACTION ON HIS SALARY, BENEFITS AND BONUS. 3. MINUTES OF THE PERSONNEL COMMITTEE AND THE BOARD MEETINGS ARE CONTEMPORANEOUSLY KEPT AND MAINTAIN WITH THE CORPORATE MINUTE BOOKS. 4. FOLLOWING THE ACTION OF THE BOARD OF DIRECTORS THE NEW PROPOSED SALARIES, BENEFITS AND BONUSES ARE SENT TO THE INDEPENDENT CONSULTANT (SULLIVAN COTTER) WHO SUBMITS BACK TO THE PERSONNEL COMMITTEE THEIR OPINION IN TERMS OF THE COMPENSATION BEING REASONABLE IN RELATION TO THE MARKET DATA AND MARKET PRACTICES. THIS REPORT IS ALSO RECEIVED AND REVIEWED BY THE BOARD PERSONNEL COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
CHANGES IN NET ASSETS OR FUND BALANCES:FORM 990, PART XI, LINE 9:CHANGE IN PERMANETLY RESTRICTED NET ASSETS 94,426. CHANGE IN PENSION LIABILITY -14,788,484. TRANSFER TO RELATED PARTY UNREALIZED CHANGE IN IPACS INVESTMENT 113,694. UNREALIZED CHANGE IN IHRRRG - RISK RETENTION GROUP 542,131. UNREALIZED CHANGE IN COH INVESTMENT 98,181. UNREALIZED CHANGE IN UAPC INVESTMENT -1,411,649.
OVERSIGHT OF AUDITPART XII, LINE 2CTHE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
IPACS INC
1606 N SEVENTH STTERRE HAUTEIN47804351720998CLINIC MANAGEMENTINUNION HOSPITAL
UNION ASSOCIATED PHYSICIANS CLINIC INC
1606 N SEVENTH STTERRE HAUTEIN47804270581401PHYSICIAN GROUPINUNION HEALTH SYSTEM

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
UNION HEALTH SYSTEMS
1606 N SEVENTH STTERRE HAUTEIN47804270581133MANAGEMENT ORGANIZATIONIN501(C)(3)LINE 11B, IIN/A0
CENTER FOR OCCUPATIONAL HEALTH
4001 WABASH AVETERRE HAUTEIN47803352118417OCCUPATIONAL HEALTH SERVICESIN501(C)(3)LINE 71UNION HOSPITAL
UNION HOSPITAL HEALTH SERVICES INC
1606 N SEVENTH STTERRE HAUTEIN47804351642805HEALTH SERVICESIN501(C)(3)LINE 91UNION HOSPITAL
UNION HOSPITAL FOUNDATION
1659 N SEVENTH STTERRE HAUTEIN47804351642823FUNDRAISINGIN501(C)(3)LINE 11C, III-FI0UNION HOSPITAL

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1UNION ASSOCIATED PHYSICIAN CLINIC INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11606 N SEVENTH STAddressLine1
CityTERRE HAUTECity
StateINState
ZIP Code47804ZIPCode
FieldValueIRS element (for citing)
EIN270581401EIN
Primary ActivityPHYSICIAN GROUPPrimaryActivity
Legal Domicile StateINLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1CENTER FOR OCCUPATIONAL HEALTHBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeOTransactionType
Amount Involved670150AmountInvolved
Method Of Amt DeterminationFAIR MARKET VALUE OF SERVICESMethodOfAmtDetermination

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