GOSHEN HEALTH SYSTEM INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- GOSHEN HEALTH SYSTEM INC (EIN 35-1974765)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-11
- IRS object ID
- 201443159349302749
- Schema version
- 2013v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-11T14:25:02-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE SUITE 2000 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 462045108 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351974765 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOSHEN HEALTH SYSTEM INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GOSH | BusinessNameControlTxt |
| Phone | 5745352665 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HIGH PARK AVENUE | AddressLine1 |
| City | GOSHEN | City |
| State | IN | State |
| ZIP Code | 46526 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AMY FLORIA | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5745332141 | PhoneNum |
| Signature | 2014-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SAMANTHA BOKORI | PreparerPersonNm |
| PTIN | P01057347 | PTIN |
| Phone | 3174648600 | PhoneNum |
| Preparation | 2014-11-07 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IU HEALTH GOSHEN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RANDAL CHRISTOPHEL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HIGH PARK AVENUE | AddressLine1 |
| City | GOSHEN | City |
| State | IN | State |
| ZIP Code | 46526 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $36,176,724 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.IUHEALTH.ORG/GOSHEN | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH OF OUR COMMUNITIES BY PROVIDING INNOVATIVE, OUTSTANDING CARE AND SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 22 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 17 | VotingMembersIndependentCnt |
| Total Employee | 369 | TotalEmployeeCnt |
| Total Volunteers | 18 | TotalVolunteersCnt |
| Total Gross UBI | -$37,154 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$136,984 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $9,661,063 | PYContributionsGrantsAmt |
| CY Contributions Grants | $11,338,514 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $21,961,335 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,085,684 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$14,796 | PYInvestmentIncomeAmt |
| CY Investment Income | -$58,746 | CYInvestmentIncomeAmt |
| PY Other Revenue | $987,759 | PYOtherRevenueAmt |
| CY Other Revenue | $811,272 | CYOtherRevenueAmt |
| PY Total Revenue | $32,595,361 | PYTotalRevenueAmt |
| CY Total Revenue | $36,176,724 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $23,509,371 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $26,144,027 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,251,536 | PYOtherExpensesAmt |
| CY Other Expenses | $10,239,568 | CYOtherExpensesAmt |
| PY Total Expenses | $32,760,907 | PYTotalExpensesAmt |
| CY Total Expenses | $36,383,595 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$165,546 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$206,871 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,280,005 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,154,194 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,624,962 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,875,202 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,655,043 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,278,992 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF IU HEALTH GOSHEN IS TO IMPROVE THE HEALTH OF OUR COMMUNITIES BY PROVIDING INNOVATIVE, OUTSTANDING CARE AND SERVICES, THROUGH EXCEPTIONAL PEOPLE DOING EXCEPTIONAL WORK. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $33,227,016 | ExpenseAmt |
| Revenue | $24,557,892 | RevenueAmt |
| Desc | IU HEALTH GOSHEN IS A NON-DENOMINATIONAL NON-FOR-PROFIT ORGANIZATION PROVIDING HEALTH CARE SERVICES FOR THE GENERAL PUBLIC. SEE SCHEDULE O FOR ADDITIONAL DETAIL.THE MISSION OF IU HEALTH GOSHEN IS TO IMPROVE THE HEALTH OF OUR COMMUNITIES BY PROVIDING INNOVATIVE, OUTSTANDING CARE AND SERVICE, THROUGH EXCEPTIONAL PEOPLE DOING EXCEPTIONAL WORK. THE SYSTEM'S VALUES INCLUDE: COMPASSION - AND COMMITMENT TO SERVICE WITH EMPATHY. ACCOUNTABILITY - WITH INTEGRITY AND ACTION. RESPECT - THROUGH TREATING OTHERS AS YOU WISH TO BE TREATED. EXCELLENCE - IN ALL WE DO.BUILDING UPON OUR MISSION AND VALUES, IU HEALTH GOSHEN WILL DELIVER EXCEPTIONAL HEALTHCARE IN AN INTEGRATED MODEL TO THE COMMUNITIES WE SERVE, ACHIEVING PREEMINENCE WITH COMMITMENT TO QUALITY, LEADERSHIP, AND INNOVATION. BY 2015, WE WILL ACHIEVE ALL ELEMENTS OF THIS VISION BY FOCUSING ON THE FOLLOWING KEY AREAS:- LEAD THE REGION WITH OUR CANCER SERVICES.- CREATE AN ENVIRONMENT IN WHICH EACH COLLEAGUE CAN FULFILL HIS OR HER PERSONAL MISSION.- EMPHASIZE THE BENEFITS OF HEALTH AND WELLNESS.- RESPOND STRATEGICALLY TO THE EVOLVING HEALTH NEEDS OF OUR COMMUNITY.- BECOME THE GENESIS FOR CREATING A NEW ECONOMIC BASE IN THE GREATER GOSHEN COMMUNITY.KEY COMPONENTS OF IU HEALTH GOSHEN INCLUDE THE OPERATIONS OF A MULTI-SPECIALTY PHYSICIAN NETWORK OR IU HEALTH GOSHEN PHYSICIANS. THE PHYSICIAN NETWORK EMPLOYS HEALTHCARE PROVIDERS DEDICATED TO MEETING THE HEALTH CARE NEEDS OF AREA RESIDENTS, YOUNG AND OLD. THE NETWORK OF BOTH PRIMARY CARE AND SPECIALTY PROVIDERS ENHANCES THE SYSTEM'S ABILITY TO CARE FOR THE COMMUNITY. IU HEALTH GOSHEN PHYSICIANS REPRESENT THE FOLLOWING CARE AREAS: FAMILY PRACTICE, NEUROLOGY, CARDIOLOGY, ADULT INTERNAL MEDICINE, PEDIATRICS, ORTHOPEDICS, OBSTETRICS AND GYNECOLOGY, BARIATRICS, GASTROENTEROLOGY, INFECTION CONTROL, AND ONCOLOGY.IU HEALTH GOSHEN EXCELS AT MEETING THE HEALTH CARE NEEDS OF ITS PATIENTS AS MEASURED BY PRESS GANEY AND NRC PICKER, NATIONALLY RECOGNIZED COMPANIES THAT PARTNER WITH HEALTHCARE FACILITIES TO MEASURE THE LEVEL OF CUSTOMER SATISFACTION AND IMPROVE THEIR QUALITY OF HEALTH CARE DELIVERY. IN 2012, IU HEALTH GOSHEN PHYSICIANS RANKED ABOVE THE 90TH PERCENTILE IN OVERALL PATIENT SATISFACTION. IU HEALTH GOSHEN CENTER FOR CANCER CARE GOES ABOVE AND BEYOND TRADITIONAL TEAMWORK IN ORDER TO HEAL EVERY PERSON THAT ENTERS OUR DOORS. OUR HOLISTIC, FULLY INTEGRATED CARE MODEL RECENTLY RECEIVED NATIONAL RECOGNITION AS A HOPE AWARD WINNER BY HEMATOLOGY & ONCOLOGY NEWS & ISSUES MAGAZINE. THE NATIONAL PUBLICATION NAMED IU HEALTH GOSHEN CENTER FOR CANCER CARE AS "THE BEST EXAMPLE OF INTEGRATION OF CARE AMONG ENTRIES IN MEDIUM-SIZED COMMUNITY-BASED ONCOLOGY PRACTICES." IU HEALTH GOSHEN CENTER FOR CANCER CARE ALSO HAS BEEN AWARDED THE OUTSTANDING ACHIEVEMENT AWARD BY THE AMERICAN COLLEGE OF SURGEONS' COMMISSION ON CANCER (COC). ONLY SEVEN PERCENT OF APPROVED CANCER PROGRAMS IN THE UNITED STATES EARN THIS DISTINCTION.IU HEALTH GOSHEN EARNED THE 2013 APEX WORKPLACE OF DISTINCTION AWARD FROM MOREHEAD ASSOCIATES. THE APEX AWARD RECOGNIZES THE INDUSTRY'S TOP EMPLOYERS, DETERMINED BY OBJECTIVE DATA GATHERED FROM EMPLOYEE SURVEYS. OUR NATIONAL HEALTH CARE PERCENTILE RANKING FOR WORKFORCE COMMITMENT IN 2013 WAS 69TH. IU HEALTH GOSHEN HAS BEEN NAMED ONE OF INDIANA'S BEST PLACES TO WORK BY THE INDIANA CHAMBER OF COMMERCE, AND WAS NAMED TO THE LIST OF "100 BEST PLACES TO WORK IN HEALTHCARE" BY MODERN HEALTHCARE AND BECKER'S HOSPITAL REVIEW. IU HEALTH GOSHEN PHYSICIANS PROVIDES HEALTH CARE SERVICES TO ALL MEMBERS OF THE COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY. THE NETWORK OFFERS FINANCIAL ASSISTANCE TO THOSE PATIENTS UNABLE TO PAY ALL OR A PORTION OF THEIR BILL AND WHO ARE UNABLE TO QUALIFY FOR ASSISTANCE THROUGH FEDERAL AND STATE GOVERNMENT ASSISTANCE PROGRAMS. PATIENTS ARE ASKED TO PROVIDE FINANCIAL INFORMATION TO ASSESS THEIR FINANCIAL POSITION. IN 2013, THE NETWORK PROVIDED APPROXIMATELY $820,744 OF CHARITY CARE TO PATIENTS. | Desc |
| Total Program Service Expenses | $33,227,016 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 87 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 369 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 22 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 17 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIRECTOR OF FINANCE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5745352665 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HIGH PARK | AddressLine1 |
| City | GOSHEN | City |
| State | IN | State |
| ZIP Code | 46526 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| RANDY CHRISTOPHEL | ||||||||||
| PRESIDENT AND CEO | 1.00 | 41.00 | Yes (X) | Yes (X) | $0 | $596,505 | $31,823 | |||
| EDWARD BOYTS MD | ||||||||||
| TREASURER | 40.00 | 0.00 | Yes (X) | Yes (X) | $292,997 | $0 | $28,780 | |||
| RICHARD B HOSTETTER MD | ||||||||||
| SECRETARY | 1.00 | 40.00 | Yes (X) | Yes (X) | $561,831 | $0 | $48,810 | |||
| DELMAR G GOOD PHD | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| GERALD A TROLZ | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| GEORGE MARLOW | ||||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| ALAN R TEHAN | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| STEPHEN FIDLER | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| PARIS BALL-MILLER | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| MICHAEL L KUBACKI | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| DENISE DAVIS ESQ | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| WES HERSCHBERGER | ||||||||||
| VICE CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| NEIL PICKETT | ||||||||||
| DIRECTOR - IU HEALTH | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| MARK KING PHD | ||||||||||
| CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| MARK DICKEN | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| GRETCHEN LUND | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| JAMES ALVAREZ | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| SHERYL EAKINS | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN LEAVITT | ||||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DERALD BONTRAGER | ||||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| LINDA BAXLEY | ||||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DAVID KORONKIEWICZ MD | ||||||||||
| DIRECTOR - PARTIAL YEAR | 1.00 | 40.00 | Yes (X) | $393,423 | $0 | $29,323 | ||||
| DANIEL BERGER MD | ||||||||||
| DIRECTOR | 40.00 | 1.00 | Yes (X) | $237,554 | $0 | $18,754 | ||||
| AMY FLORIA | ||||||||||
| CFO | 1.00 | 40.00 | Yes (X) | $0 | $478,030 | $46,498 | ||||
| RANDALL CAMMENGA MD | ||||||||||
| COO | 1.00 | 40.00 | Yes (X) | $0 | $633,410 | $59,353 | ||||
| LARRY ALLEN MD | ||||||||||
| CMO | 8.00 | 32.00 | Yes (X) | $0 | $310,126 | $30,476 | ||||
| ALAN WELDY | ||||||||||
| V/P OF HR | 1.00 | 40.00 | Yes (X) | $0 | $585,225 | $54,841 | ||||
| MARGARET S FRANGER | ||||||||||
| V/P OF CANCER SERVICES | 1.00 | 40.00 | $0 | $226,876 | $39,580 | Yes (X) | ||||
| PAM KARSEN | ||||||||||
| V/P OF NURSING | 1.00 | 40.00 | $0 | $316,118 | $36,555 | Yes (X) | ||||
| MARK SMUCKER MD | ||||||||||
| PHYSICIAN | 1.00 | 40.00 | $741,037 | $0 | $34,281 | Yes (X) | ||||
| PETER KIM MD | ||||||||||
| PHYSICIAN | 1.00 | 40.00 | $625,824 | $0 | $28,149 | Yes (X) | ||||
| GARY CORNETTE DO | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $627,831 | $0 | $23,084 | Yes (X) | ||||
| JAMES DUNNICK MD | ||||||||||
| PHYSICIAN | 1.00 | 40.00 | $615,058 | $0 | $32,461 | Yes (X) | ||||
| BINOY OUSEPH MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $560,461 | $0 | $25,315 | Yes (X) | ||||
| JAMES DAGUE | ||||||||||
| FORMER OFFICER | 0.00 | 0.00 | $0 | $700,411 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,656,016 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,846,701 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $568,083 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 49 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GNKL PROPERTIES | |||||
| 1824 DORCHESTER COURT | GOSHEN | IN | 46526 | RENT | $371,420 |
| AJJM LLC | |||||
| 2523 MESSICK DRIVE | GOSHEN | IN | 46526 | RENT | $174,263 |
| LARRY ALLEN MD | |||||
| 13275 N EAST SHORE DRIVE | SYRACUSE | IN | 46567 | RENT | $150,175 |
| QUEST DIAGNOSTICS | |||||
| PO BOX 12989 | CHICAGO | IL | 60693 | MEDICAL SERVICES | $136,072 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $11,338,514 | RelatedOrganizationsAmt |
| Total Contributions | $11,338,514 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HEALTHCARE SERVICES | 621110 | $24,038,692 | $24,038,692 |
| EKG REVENUE | 621110 | $46,992 | $46,992 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,085,684 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$58,746 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$37,154 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$21,592 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $110,239 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $110,239 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $110,239 | TotalRevenueColumnAmt |
| Exclusion | $110,239 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| BILLINGS | 561000 | $228,825 | $228,825 | |
| TEAM BARIATRICS | 621110 | $31,440 | $31,440 | |
| SPECIALIST X-RAY | 621500 | $24,255 | $24,255 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $416,513 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $416,513 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $701,033 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $36,176,724 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,557,892 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$37,154 | UnrelatedBusinessRevenueAmt |
| Exclusion | $317,472 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,485,805 | TotalAmt |
| Program Services | $1,485,805 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,635,656 | TotalAmt |
| Program Services | $18,117,790 | ProgramServicesAmt |
| Management And General | $1,517,866 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,164,364 | TotalAmt |
| Program Services | $1,069,537 | ProgramServicesAmt |
| Management And General | $94,827 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,732,238 | TotalAmt |
| Program Services | $2,354,145 | ProgramServicesAmt |
| Management And General | $378,093 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,125,964 | TotalAmt |
| Program Services | $1,000,891 | ProgramServicesAmt |
| Management And General | $125,073 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,464 | TotalAmt |
| Program Services | $77,464 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,516,491 | TotalAmt |
| Program Services | $1,516,491 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,943,932 | TotalAmt |
| Program Services | $1,867,598 | ProgramServicesAmt |
| Management And General | $76,334 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,373 | TotalAmt |
| Program Services | $225,411 | ProgramServicesAmt |
| Management And General | $62,962 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $729,397 | TotalAmt |
| Program Services | $563,857 | ProgramServicesAmt |
| Management And General | $165,540 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $480,589 | TotalAmt |
| Program Services | $480,389 | ProgramServicesAmt |
| Management And General | $200 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CLINICAL SUPPLIES | $1,970,086 | $1,968,737 | $1,349 | $0 |
| PURCHASED SERVICES | $1,609,179 | $874,844 | $734,335 | $0 |
| BAD DEBT EXPENSE | $1,406,538 | $1,406,538 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $217,519 | TotalAmt |
| Program Services | $217,519 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,383,595 | TotalAmt |
| Program Services | $33,227,016 | ProgramServicesAmt |
| Management And General | $3,156,579 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,332,273 | BOYAmt |
| EOY | $1,957,361 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $593,638 | BOYAmt |
| EOY | $542,974 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,339,421 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,553,838 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,861,775 | BOYAmt |
| EOY | $1,785,583 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,492,319 | BOYAmt |
| EOY | $2,116,267 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $752,009 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,280,005 | BOYAmt |
| EOY | $7,154,194 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,624,962 | BOYAmt |
| EOY | $4,875,202 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,624,962 | BOYAmt |
| EOY | $4,875,202 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,655,043 | BOYAmt |
| EOY | $2,278,992 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,655,043 | BOYAmt |
| EOY | $2,278,992 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,280,005 | BOYAmt |
| EOY | $7,154,194 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$206,871 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$43,374 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$3,125,806 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Certification | Yes (X) | CertificationInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOSHEN HOSPITAL ASSOCIATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 356001540 | EIN |
| Organization Type | 3 | OrganizationTypeDesc |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Supported Org Notified | Yes (1) | SupportedOrgNotifiedInd |
| US Organized | Yes (1) | USOrganizedInd |
| Support | $11,940,806 | SupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $11,940,806 | SupportSumAmt |
Form990 Schedule A Part IV Form990ScheduleAPartIVGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART I, LINE 11H: | FormAndLineReferenceDesc |
| Explanation | GOSHEN HEALTH SYSTEM, INC. HAS FUNDED SOME OF THE OPERATING EXPENSES OF GOSHEN HOSPITAL ASSOCIATION, INC. THE AMOUNT OF FUNDING DURING 2013 WAS $11,940,806. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,339,421 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,553,838 | DepreciationAmt |
| Book Value | $1,785,583 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,785,583 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SPECTRON LAND, LLC, SPECTRON MRC, LLC, SPECTRON EQUIPMENT, LLC | Desc |
| Book Value | $2,116,267 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $2,116,267 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTERCOMPANY RECEIVABLES | Desc |
| Book Value | $752,009 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $752,009 | TotalBookValueOtherAssetsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RANDY CHRISTOPHEL | ||||||||||||||
| PRESIDENT AND CEO | $0 | $419,461 | $0 | $141,765 | $0 | $35,279 | $0 | $25,315 | $0 | $6,508 | $0 | $628,328 | $0 | $0 |
| EDWARD BOYTS MD | ||||||||||||||
| TREASURER | $140,647 | $0 | $152,250 | $0 | $100 | $0 | $20,561 | $0 | $8,219 | $0 | $321,777 | $0 | $0 | $0 |
| RICHARD B HOSTETTER MD | ||||||||||||||
| SECRETARY | $451,001 | $0 | $69,581 | $0 | $41,249 | $0 | $42,302 | $0 | $6,508 | $0 | $610,641 | $0 | $0 | $0 |
| DAVID KORONKIEWICZ MD | ||||||||||||||
| DIRECTOR - PARTIAL YEAR | $252,754 | $0 | $140,669 | $0 | $0 | $0 | $25,315 | $0 | $4,008 | $0 | $422,746 | $0 | $0 | $0 |
| DANIEL BERGER MD | ||||||||||||||
| DIRECTOR | $162,160 | $0 | $75,394 | $0 | $0 | $0 | $16,419 | $0 | $2,335 | $0 | $256,308 | $0 | $0 | $0 |
| AMY FLORIA | ||||||||||||||
| CFO | $0 | $264,300 | $0 | $80,272 | $0 | $133,458 | $0 | $41,704 | $0 | $4,794 | $0 | $524,528 | $0 | $0 |
| RANDALL CAMMENGA MD | ||||||||||||||
| COO | $0 | $329,590 | $0 | $123,447 | $0 | $180,373 | $0 | $50,742 | $0 | $8,611 | $0 | $692,763 | $0 | $0 |
| LARRY ALLEN MD | ||||||||||||||
| CMO | $0 | $261,348 | $0 | $35,640 | $0 | $13,138 | $0 | $27,207 | $0 | $3,269 | $0 | $340,602 | $0 | $0 |
| ALAN WELDY | ||||||||||||||
| V/P OF HR | $0 | $330,460 | $0 | $103,605 | $0 | $151,160 | $0 | $50,833 | $0 | $4,008 | $0 | $640,066 | $0 | $0 |
| MARGARET S FRANGER | ||||||||||||||
| V/P OF CANCER SERVICES | $0 | $175,666 | $0 | $50,400 | $0 | $810 | $0 | $27,427 | $0 | $12,153 | $0 | $266,456 | $0 | $0 |
| PAM KARSEN | ||||||||||||||
| V/P OF NURSING | $0 | $233,767 | $0 | $69,989 | $0 | $12,362 | $0 | $34,682 | $0 | $1,873 | $0 | $352,673 | $0 | $0 |
| MARK SMUCKER MD | ||||||||||||||
| PHYSICIAN | $691,037 | $0 | $50,000 | $0 | $0 | $0 | $25,315 | $0 | $8,966 | $0 | $775,318 | $0 | $0 | $0 |
| PETER KIM MD | ||||||||||||||
| PHYSICIAN | $576,160 | $0 | $675 | $0 | $48,989 | $0 | $19,815 | $0 | $8,334 | $0 | $653,973 | $0 | $0 | $0 |
| GARY CORNETTE DO | ||||||||||||||
| PHYSICIAN | $575,928 | $0 | $51,903 | $0 | $0 | $0 | $19,815 | $0 | $3,269 | $0 | $650,915 | $0 | $0 | $0 |
| JAMES DUNNICK MD | ||||||||||||||
| PHYSICIAN | $544,780 | $0 | $20,833 | $0 | $49,445 | $0 | $25,315 | $0 | $7,146 | $0 | $647,519 | $0 | $0 | $0 |
| BINOY OUSEPH MD | ||||||||||||||
| PHYSICIAN | $509,417 | $0 | $10,468 | $0 | $40,576 | $0 | $25,315 | $0 | $0 | $0 | $585,776 | $0 | $0 | $0 |
| JAMES DAGUE | ||||||||||||||
| FORMER OFFICER | $0 | $0 | $0 | $125,000 | $0 | $575,411 | $0 | $0 | $0 | $0 | $0 | $700,411 | $0 | $575,411 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | GOSHEN HOSPITAL ASSOCIATION, INC., A RELATED TAX-EXEMPT ORGANIZATION OF GOSHEN HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 4A: | AS PER OUR EMPLOYMENT AGREEMENT, UPON A QUALIFYING TERMINATION DEFINED AS AN INVOLUNTARY SEPARATION FROM SERVICE OTHER THAN FOR CAUSE, THE EMPLOYEE IS ENTITLED TO SEVERANCE PAY BASED UPON YEARS OF SERVICE. THE TERMS AND CONDITIONS TO RECEIVE SEVERANCE PAYMENTS REQUIRE THE EMPLOYEE TO SIGN A RELEASE OF CLAIMS FORM THAT COVERS ALL SITUATIONS SURROUNDING THE EMPLOYEE'S EMPLOYMENT AND SEPARATION FROM IU HEALTH GOSHEN. JAMES DAGUE $575,411 |
| PART I, LINE 4B: | ELIGIBLE EXECUTIVES PARTICIPATE IN VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. THE FOLLOWING INDIVIDUALS RECEIVED CURRENT YEAR DISTRIBUTIONS OF: AMY FLORIA $102,959 RICHARD B. HOSTETTER $23,749 ALAN WELDY $138,118 RANDALL CAMMENGA, MD $153,915 LARRY ALLEN, MD $6,349 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | THE FOLLOWING OFFICERS, BOARD MEMBERS, AND KEY EMPLOYEES ARE EMPLOYEES OF IU HEALTH GOSHEN OR ITS RELATED ORGANIZATIONS, AND SERVE ON OTHER RELATED TAXABLE BOARDS: RANDY CHRISTOPHEL AMY FLORIA ALAN WELDY |
| FORM 990, PART VI, SECTION A, LINE 6 | IU HEALTH IS THE SOLE MEMBER OF IU HEALTH GOSHEN. |
| FORM 990, PART VI, SECTION A, LINE 7A | IU HEALTH, AS THE SOLE MEMBER OF IU HEALTH GOSHEN, HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF IU HEALTH GOSHEN. |
| FORM 990, PART VI, SECTION A, LINE 7B | ITEMS THAT REQUIRE APPROVAL OF IU HEALTH GOSHEN INCLUDE ANY AMENDMENT OF THE OPERATING AGREEMENT, DISSOLUTION OF THE ORGANIZATION OR THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11 | A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AND THE AUDIT COMMITTEE IN OCTOBER FOR REVIEW AND QUESTIONS BEFORE THE RETURN IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH BOARD MEMBER COMPLETES AN ANNUAL DISCLOSURE OF KNOWN OR POTENTIAL CONFLICTS. THE DISCLOSURES ARE REVIEWED BY THE VP-LEGAL. ADDITIONALLY, WHEN AGENDA ITEMS ARE DISCUSSED AT MEETINGS, IT IS ASKED IF THERE ARE ANY KNOWN OR POTENTIAL CONFLICTS OF INTEREST, AND CONFLICTED PARTIES MUST RECUSE THEMSELVES. |
| FORM 990, PART VI, SECTION B, LINE 15 | IU HEALTH GOSHEN'S TOP MANAGEMENT OFFICIALS AND OTHER OFFICERS ARE COMPENSATED BY IU HEALTH GOSHEN HOSPITAL, A RELATED TAX-EXEMPT ORGANIZATION. AN INDEPENDENT COMMITTEE APPROVES THE COMPENSATION WHICH IS DETERMINED TO BE REASONABLE BASED UPON INDEPENDENT COMPARABILITY DATA. APPROVAL OF AMOUNTS ARE DOCUMENTED IN THE BOARD MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | IU HEALTH GOSHEN WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | EQUITY TRANSFER -3,125,806. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Direct Controlling NADirectControllingNACd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|
| NAPPANEE CLINIC LLC | ||||||||||
| 200 HIGH PARK AVENUE | GOSHEN | IN | 46526 | 201068334 | HEALTHCARE | IN | $0 | $0 | N/A | |
| INDIANA LAKES MANAGED CARE ORG LLC | ||||||||||
| 200 HIGH PARK AVENUE | GOSHEN | IN | 46526 | 351946663 | HEALTHCARE | IN | -$32,594 | $315,798 | GGH | |
| INDIANA LAKES ACCOUNTABLE CARE ORG LLC | ||||||||||
| 200 HIGH PARK AVENUE | GOSHEN | IN | 46526 | 455450141 | HEALTHCARE | IN | -$111,685 | $0 | GGH | |
| PILR INC | ||||||||||
| 200 HIGH PARK AVENUE | GOSHEN | IN | 46526 | 204294750 | DEVELOPMENT | IN | $0 | $0 | N/A | |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (42 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CLARIAN TRANSPLANT INSTITUTE INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 134350599 | HEALTHCARE | IN | 501(C)(3) | 9 | IUH | Yes (1) | |
| GOSHEN HOSPITAL ASSOCIATION INC | |||||||||||
| 200 HIGH PARK AVE | GOSHEN | IN | 46526 | 356001540 | HEALTHCARE | IN | 501(C)(3) | 3 | GHS | Yes (1) | |
| HEALTHLINC INC | |||||||||||
| 714 S ROGERS ST | BLOOMINGTON | IN | 47402 | 263571507 | HEALTHCARE | IN | 501(C)(3) | 9 | IUHB | Yes (1) | |
| INDIANA RADIOLOGY PARTNERS INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 201017034 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| INDIANA UNIVERSITY HEALTH INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351955872 | HEALTHCARE | IN | 501(C)(3) | 3 | 0 | N/A | |
| IU HEALTH ARNETT FOUNDATION INC | |||||||||||
| 2600 GREENBUSH ST | LAFAYETTE | IN | 47904 | 356079797 | FUNDRAISING | IN | 501(C)(3) | 11 I | IUHA | Yes (1) | |
| IU HEALTH ARNETT INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 263162145 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH BALL MEMORIAL HOSPITAL INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 350867958 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH BALL MEMORIAL PHYSICIANS INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351925641 | HEALTHCARE | IN | 501(C)(3) | 9 | IUHBMH | Yes (1) | |
| IU HEALTH BEDFORD INC | |||||||||||
| 2900 W 16TH ST | BEDFORD | IN | 47421 | 237042323 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH BLACKFORD HOSPITAL INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 010646166 | HEALTHCARE | IN | 501(C)(3) | 3 | IUHBMH | Yes (1) | |
| IU HEALTH BLOOMINGTON INC | |||||||||||
| PO BOX 1149 | BLOOMINGTON | IN | 47403 | 351720796 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH BMH FOUNDATION INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 311111784 | FUNDRAISING | IN | 501(C)(3) | 11 I | IUHBMH | Yes (1) | |
| IU HEALTH CARE ASSOCIATES INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351747218 | HEALTHCARE | IN | 501(C)(3) | 9 | IUH | Yes (1) | |
| IU HEALTH LAPORTE HOSPITAL INC | |||||||||||
| PO BOX 250 | LAPORTE | IN | 46352 | 351125434 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH LAPORTE PHYSICIANS INC | |||||||||||
| PO BOX 250 | LAPORTE | IN | 46352 | 311070868 | HEALTHCARE | IN | 501(C)(3) | 3 | IUHLH | Yes (1) | |
| IU HEALTH MORGAN HOSPITAL INC | |||||||||||
| 2209 JOHN R WOODEN DR | MARTINSVILLE | IN | 46151 | 273533027 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH NORTH HOSPITAL INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351932442 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH PAOLI HOSP FOUNDATION INC | |||||||||||
| PO BOX 499 | PAOLI | IN | 47454 | 310992486 | FUNDRAISING | IN | 501(C)(3) | 11 III-O | IUHP | Yes (1) | |
| IU HEALTH PAOLI INC | |||||||||||
| PO BOX 499 | PAOLI | IN | 47454 | 352090919 | HEALTHCARE | IN | 501(C)(3) | 3 | IUHB | Yes (1) | |
| IU HEALTH TIPTON HOSPITAL INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 262772226 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH WEST HOSPITAL INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351814660 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH WHITE MEMORIAL HOSPITAL INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 273532963 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU MEDICAL GROUP FOUNDATION INC | |||||||||||
| 340 W 10TH ST NO FS5100 | INDIANAPOLIS | IN | 46202 | 201093251 | FUNDRAISING | IN | 501(C)(3) | 11 II | 0 | N/A | |
| METHODIST HEALTH FOUNDATION INC | |||||||||||
| 1800 N CAPITOL AVE | INDIANAPOLIS | IN | 46202 | 356043086 | FUNDRAISING | IN | 501(C)(3) | 11 I | IUH | Yes (1) | |
| METHODIST HEALTH GROUP INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 350876390 | HEALTHCARE | IN | 501(C)(3) | 11 III-FI | 0 | N/A | |
| METHODIST MEDICAL GROUP INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351945384 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| METHODIST OCCUP HEALTH CENTERS INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351844176 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| METHODIST RESEARCH INSTITUTE INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 352023710 | HEALTHCARE | IN | 501(C)(3) | 11 I | IUH | Yes (1) | |
| MH HEALTHCARE INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351766531 | HEALTHCARE | IN | 501(C)(3) | 3 | MMG | Yes (1) | |
| MORGAN CO MEM HOSP FOUNDATION INC | |||||||||||
| 2209 JOHN R WOODEN DR | MARTINSVILLE | IN | 46151 | 352035162 | FUNDRAISING | IN | 501(C)(3) | 11 II | IUHMH | Yes (1) | |
| MORGAN CO MEM HOSP GUILD INC | |||||||||||
| 2209 JOHN R WOODEN DR | MARTINSVILLE | IN | 46151 | 310886844 | FUNDRAISING | IN | 501(C)(3) | 11 III-FI | IUHMH | Yes (1) | |
| MORGAN HEALTH SERVICES INC | |||||||||||
| 1949 HOSPITAL DR | MARTINSVILLE | IN | 46151 | 351968564 | HEALTHCARE | IN | 501(C)(3) | 3 | IUHMH | Yes (1) | |
| WHITE CO MEM HOSP FOUNDATION INC | |||||||||||
| PO BOX 952 | MONTICELLO | IN | 47960 | 351671806 | FUNDRAISING | IN | 501(C)(3) | 11 III-O | IUHWMH | Yes (1) | |
| UNIVERSITY FAMILY PHYSICIANS INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 237427350 | HEALTHCARE | IN | 501(C)(3) | 9 | IUHCA | Yes (1) | |
| REHABILITATION HOSPITAL OF INDIANA INC | |||||||||||
| 4141 SHORE DRIVE | INDIANAPOLIS | IN | 46254 | 351786005 | HEALTHCARE | IN | 501(C)(3) | 3 | MHH | Yes (1) | |
| RHI FOUNDATION INC | |||||||||||
| 4141 SHORE DRIVE | INDIANAPOLIS | IN | 46254 | 351932349 | FUNDRAISING | IN | 501(C)(3) | 11 I | RHI | Yes (1) | |
| IU HEALTH GOSHEN FOUNDATION INC | |||||||||||
| 200 HIGH PARK AVE | GOSHEN | IN | 46526 | 462565300 | FUNDRAISING | IN | 501(C)(3) | 11 I | GHS | Yes (1) | |
| LAPORTE HOSPITAL FOUNDATION INC | |||||||||||
| PO BOX 250 | LAPORTE | IN | 46352 | 310952775 | FUNDRAISING | IN | 501(C)(3) | 11 I | 0 | N/A | |
| THE CHEER GUILD OF RILEY HOSP FOR CHILDREN | |||||||||||
| 705 RILEY HOSPITAL DR | INDIANAPOLIS | IN | 46202 | 356018517 | FUNDRAISING | IN | 501(C)(3) | 11 III-FI | 0 | N/A | |
| INDIANA HEALTH INFORMATION EXCHANGE INC | |||||||||||
| 846 N SENATE AVE | INDIANAPOLIS | IN | 46202 | 364550324 | HEALTHCARE | IN | 501(C)(3) | 11 I | 0 | N/A | |
| GOSHEN HOSPITAL & HEALTH CARE FOUNDATION INC | |||||||||||
| 1926 W LINCOLN AVENUE SUITE A | GOSHEN | IN | 46526 | 237092692 | FUNDRAISING | IN | 501(C)(3) | 11 III-FI | 0 | N/A | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (21 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| BALL OUTPATIENT SURGERY CENTER LLC | |||||||
| 3000 RIVERCHASE GALLERIA STE 500 | BIRMINGHAM | AL | 35244 | 270275794 | HEALTHCARE | IN | N/A |
| BELTWAY SURGERY CENTERS LLC | |||||||
| 3000 RIVERCHASE GALLERIA STE 500 | BIRMINGHAM | AL | 35244 | 352072586 | HEALTHCARE | IN | N/A |
| BLOOMINGTON ENDOSCOPY CENTERS LLC | |||||||
| PO BOX 1149 | BLOOMINGTON | IN | 47402 | 352117943 | HEALTHCARE | IN | N/A |
| BMH OUTPATIENT SURGERY SERVICES LLC | |||||||
| 2401 W UNIVERSITY AVE | MUNCIE | IN | 47303 | 204567998 | HEALTHCARE | IN | N/A |
| BOSC HOLDINGS LLC | |||||||
| 3000 RIVERCHASE GALLERIA STE 500 | BIRMINGHAM | AL | 35244 | 454147343 | HEALTHCARE | IN | N/A |
| CARDINAL HEALTH INITIATIVES LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 300102702 | PURCHASING | IN | N/A |
| CHV FUND I LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 262523206 | VENTURE CAPITAL | IN | N/A |
| CHV FUND MANAGEMENT LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 262523151 | VENTURE CAPITAL | IN | N/A |
| CLARIAN HEALTH NETWORK LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 352055030 | HEALTHCARE | IN | N/A |
| EAGLE HIGHLANDS SURGERY CENTER LLC | |||||||
| 3000 RIVERCHASE GALLERIA STE 500 | BIRMINGHAM | AL | 35244 | 352259204 | HEALTHCARE | IN | N/A |
| EHSC HOLDINGS LLC | |||||||
| 3000 RIVERCHASE GALLERIA STE 500 | BIRMINGHAM | AL | 35244 | 454147879 | HEALTHCARE | IN | N/A |
| HEALTH VENTURE MANAGEMENT LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 205740218 | MANAGEMENT | IN | N/A |
| IEC HOLDINGS LLC | |||||||
| 3000 RIVERCHASE GALLERIA STE 500 | BIRMINGHAM | AL | 35244 | 454148032 | HEALTHCARE | IN | N/A |
| INDIANA ENDOSCOPY CENTERS LLC | |||||||
| 3000 RIVERCHASE GALLERIA STE 500 | BIRMINGHAM | AL | 35244 | 208398421 | HEALTHCARE | IN | N/A |
| BSC HOLDINGS LLC | |||||||
| 3000 RIVERCHASE GALLERIA STE 500 | BIRMINGHAM | AL | 35244 | 452314634 | HEALTHCARE | IN | N/A |
| MID-AMERICA SURGERY CENTER LLC | |||||||
| 2401 W UNIVERSITY AVE | MUNCIE | IN | 47303 | 352002953 | HEALTHCARE | IN | N/A |
| ROC SURGERY LLC | |||||||
| 3000 RIVERCHASE GALLERIA STE 500 | BIRMINGHAM | AL | 35244 | 271497960 | HEALTHCARE | IN | N/A |
| ROCS HOLDINGS LLC | |||||||
| 3000 RIVERCHASE GALLERIA STE 500 | BIRMINGHAM | AL | 35244 | 454148369 | HEALTHCARE | IN | N/A |
| SENATE STREET SURGERY CENTER LLC | |||||||
| 3000 RIVERCHASE GALLERIA STE 500 | BIRMINGHAM | AL | 35244 | 421709357 | HEALTHCARE | IN | N/A |
| SSSC HOLDINGS LLC | |||||||
| 3000 RIVERCHASE GALLERIA STE 500 | BIRMINGHAM | AL | 35244 | 454148167 | HEALTHCARE | IN | N/A |
| CARDINAL HEALTH ALLIANCE LLC | |||||||
| 2401 W UNIVERSITY AVE | MUNCIE | IN | 47303 | 351966281 | MANAGED CARE | IN | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (22 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1 | CityForeignAddress/City | CountryForeignAddress/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BMH MEDICAL PAVILION ASSOCIATION INC | |||||||||||||||||
| 2525 W UNIVERSITY AVE | MUNCIE | IN | 47303 | 351858408 | CONDO MANAGEMENT | IN | N/A | C | Yes (1) | ||||||||
| CARDINAL HEALTH VENTURES INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351611424 | MANAGEMENT | IN | N/A | C | Yes (1) | ||||||||
| CHV CAPITAL INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 260752507 | VENTURE CAPITAL | IN | N/A | C | Yes (1) | ||||||||
| IU HEALTH ACO INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 454421020 | HEALTHCARE | IN | N/A | C | Yes (1) | ||||||||
| IU HEALTH BOARD DESIGNATED TRUST | |||||||||||||||||
| 400 HOWARD ST | SAN FRANCISCO | CA | 94105 | 306309021 | INVESTMENTS | IN | N/A | T | Yes (1) | ||||||||
| IU HEALTH NTGI S&P500 FUND CF | |||||||||||||||||
| PO BOX 804358 | CHICAGO | IL | 60680 | 306298263 | INVESTMENTS | IN | N/A | T | Yes (1) | ||||||||
| IU HEALTH PLANS INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 262127080 | HMO | IN | N/A | C | Yes (1) | ||||||||
| IU HEALTH RISK PURCHASING GROUP INC | |||||||||||||||||
| 151 MEETING ST STE 301 | CHARLESTON | SC | 29401 | 260202446 | INSURANCE | IN | N/A | C | Yes (1) | ||||||||
| IU HEALTH RISK RETENTION GROUP INC | |||||||||||||||||
| 151 MEETING ST STE 301 | CHARLESTON | SC | 29401 | 201107674 | INSURANCE | SC | N/A | C | Yes (1) | ||||||||
| IU HEALTH SOUTHERN IN PHYSICIANS INC | |||||||||||||||||
| PO BOX 1149 | BLOOMINGTON | IN | 47402 | 351913875 | HEALTHCARE | IN | N/A | C | Yes (1) | ||||||||
| IUH ASSURANCE LTD | |||||||||||||||||
| 980395429 | INSURANCE | N/A | C | Yes (1) | 720 W BAY RD PO BOX 69 | GRAND CAYMAN | CJ | CJ | |||||||||
| OCC-HEALTH REVENUE SYSTEMS INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 203308057 | WORK COMP PPO | IN | N/A | C | Yes (1) | ||||||||
| PARKMOR DRUG INC | |||||||||||||||||
| 1501 S MAIN ST | GOSHEN | IN | 46526 | 131394980 | PHARMACY SALES | IN | C | Yes (1) | GHS | $388,976 | $3,405,383 | 1.00000 | |||||
| RADIATION ONCOLOGY RESOURCES INC | |||||||||||||||||
| 200 HIGH PARK AVE | GOSHEN | IN | 46526 | 262008424 | HEALTHCARE | IN | C | Yes (1) | GHS | -$528,771 | $223,273 | 1.00000 | |||||
| SCANS INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 453080392 | HEALTHCARE | IN | N/A | C | Yes (1) | ||||||||
| UNIVERSITY HEALTH MANAGEMENT INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 272891143 | MANAGEMENT | IN | N/A | C | Yes (1) | ||||||||
| UNIVERSITY HEALTH MGMT (CHINA) INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 273891311 | MANAGEMENT | IN | N/A | C | Yes (1) | ||||||||
| PROTEUO FUND LP | |||||||||||||||||
| 981075227 | INVESTMENTS | N/A | C | Yes (1) | PO BOX 31106 89 NEXUS WAY | GRAND CAYMAN | CJ | CJ | |||||||||
| INDIANA UNIVERSITY HEALTH PLANS HOLDING COMPANY INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 463794815 | INSURANCE | IN | N/A | C | Yes (1) | ||||||||
| INDIANA UNIVERSITY HEALTH PLANS NFP INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 463803873 | INSURANCE | IN | N/A | C | Yes (1) | ||||||||
| UNIVERSITY HEALTH (SHANGHAI) MANAGEMENT CONSULTING CO LTD | |||||||||||||||||
| MANAGEMENT | N/A | C | Yes (1) | 88 CENTURY AVE | SHANGHAI | CH | CH | ||||||||||
| GUGGENHEIM HIGH-YIELD PLUS FUND SPC | |||||||||||||||||
| INVESTMENTS | N/A | C | Yes (1) | PO BOX 309 UGLAND HOUSE | GRAND CAYMAN | CJ | CJ | ||||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| GOSHEN HOSPITAL ASSOCIATION INC | ||
| C | $11,338,514 | FMV |
| GOSHEN HOSPITAL ASSOCIATION INC | ||
| O | $11,569,821 | FMV |
| GOSHEN HOSPITAL ASSOCIATION INC | ||
| R | $11,940,806 | FMV |
Comments