IHA HOSPITAL ASSISTANCE FOUNDATION INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- IHA HOSPITAL ASSISTANCE FOUNDATION INC (EIN 45-5573749)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-12
- IRS object ID
- 201443169349301729
- 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 | 2014-11-12T09:20:49-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE AMERICAN SQUARE 2200 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46282 | 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 | 455573749 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IHA HOSPITAL ASSISTANCE FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | IHAH | BusinessNameControlTxt |
| Phone | 3176334870 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 AMERICAN SQUARE NO 1900 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46282 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID WIESMAN | PersonNm |
| Person Title | VICE PRESIDENT | PersonTitleTxt |
| Phone | 3176334870 | PhoneNum |
| Signature | 2014-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMBER KOCHER CPA | PreparerPersonNm |
| PTIN | P01286298 | PTIN |
| Phone | 3176334705 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DOUGLAS J LEONARD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 AMERICAN SQUARE NO 1900 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46282 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,453,575 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | PROVIDING FINANCIAL ASSISTANCE TO INDIANA HOSPITALS TO HELP ADDRESS THE FINANCIAL DIFFICULTIES ATTRIBUTABLE TO THE PROVISION OF UNDERCOMPENSATED OR CHARITY HEALTH CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,453,327 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $248 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $1,000 | PYTotalRevenueAmt |
| CY Total Revenue | $1,453,575 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,453,327 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $150 | PYOtherExpensesAmt |
| CY Other Expenses | $0 | CYOtherExpensesAmt |
| PY Total Expenses | $150 | PYTotalExpensesAmt |
| CY Total Expenses | $1,453,327 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $850 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $248 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $850 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,088 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $990 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $850 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,098 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PROVIDING FINANCIAL ASSISTANCE TO INDIANA HOSPITALS TO HELP ADDRESS THE FINANCIAL DIFFICULTIES ATTRIBUTABLE TO THE PROVISION OF UNDERCOMPENSATED OR CHARITY HEALTH CARE, THEREBY ENABLING HOSPITALS TO BETTER SERVE THE NEEDS OF THEIR COMMUNITIES, TO BETTER PROVIDE RELIEF FROM SICKNESS OR DISEASE, AND TO LESSEN THE BURDENS OF GOVERNMENT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,453,327 | ExpenseAmt |
| Grant | $1,453,327 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | THE IHA HOSPITAL ASSISTANCE FOUNDATION'S (THE FOUNDATION) PROGRAM SERVICE ACCOMPLISHMENTS IMPROVE ACCESS TO QUALITY HEALTH CARE FOR THE PEOPLE OF INDIANA AND PROVIDE FINANCIAL ASSISTANCE TO QUALIFYING INDIANA HOSPITALS TO ADDRESS DIFFICULTIES RELATED TO UNDERCOMPENSATED AND CHARITY HEALTH CARE THROUGH SUPPORTING THE ACTIVITIES OF INDIANA HOSPITAL ASSOCIATION. THE FOUNDATION INITIATED AND CARRIED ON PROGRAMS TO SUPPORT THE IMPROVEMENT OF THE CARE AND TREATMENT OF INDIANA HOSPITAL PATIENTS AND ENSURE ACCESS TO SUCH CARE AND TREATMENT FOR THE GENERAL PUBLIC THAT USE INDIANA HOSPITALS. THE FOUNDATION'S MAIN PROGRAM IS TO LESSEN THE BURDENS OF INDIANA HOSPITALS RESULTING FROM THE INDIANA MEDICAID PROGRAM. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THE INDIANA MEDICAID PROGRAM IS A SIGNIFICANT CAUSE OF FINANCIAL DISTRESS AFFECTING INDIANA HOSPITALS, THEIR COMMUNITIES, AND THEIR PATIENTS NOT ONLY BECAUSE THE MAJORITY OF INDIANA HOSPITALS RECEIVE LESS THAN THEIR COST TO TREAT MEDICAID RECIPIENTS BUT ALSO BECAUSE OF THE DISPARATE IMPACT OF THE MEDICAID PROGRAM ON VARIOUS HOSPITALS IN THE INDIANA HOSPITAL COMMUNITY THAT SERVE MEDICAID PATIENTS. THE RESULTING FINANCIAL DISTRESS ON SOME INDIANA HOSPITALS WILL DIMINISH THEIR ABILITY TO PROVIDE HEALTH CARE SERVICES TO THEIR PATIENTS AND COMMUNITIES. THE FOUNDATION HAS ESTABLISHED A PROGRAM UNDER WHICH INDIANA HOSPITALS WILL BE ASKED TO VOLUNTARILY CONTRIBUTE TO A FUND OR FUNDS, THE PROCEEDS OF WHICH WILL BE USED TO PROVIDE FINANCIAL ASSISTANCE TO CERTAIN INDIANA HOSPITALS TO HELP ADDRESS THE DISPARATE | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | AND NEGATIVE EFFECTS OF THE INDIANA MEDICAID PROGRAM AND THEREBY ENABLE RECIPIENT HOSPITALS TO BE BETTER SERVE THE NEEDS OF THEIR COMMUNITIES. THE FOUNDATION IS AIDING HOSPITALS IN THEIR MISSION TO PROVIDE QUALITY HEALTH CARE TO THEIR COMMUNITIES AND PATIENTS AND WILL SUPPORT THE STATE OF INDIANA IN ITS EFFORTS TO ENSURE THAT HOSPITAL SERVICES ARE AVAILABLE TO MEDICAID RECIPIENTS AND THE GENERAL PUBLIC. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $1,453,327 | 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 | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | Yes (1) | 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 | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | 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 | 0 | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| 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 | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| 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 | DAVID WIESMAN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3174237741 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 AMERICAN SQUARE SUITE 1900 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46282 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| DOUGLAS J LEONARD | |||||||
| PRESIDENT, DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $699,303 | $173,662 | |
| BRADFORD W DYKES | |||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DANIEL F EVANS JR | |||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MICHAEL J PACKNETT | |||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MARTIN PADGETT | |||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DAVID WIESMAN | |||||||
| VICE PRESIDENT | 1.00 | 40.00 | $0 | $239,388 | $54,617 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $938,691 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $228,279 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $1,453,327 | AllOtherContributionsAmt |
| Total Contributions | $1,453,327 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $248 | TotalRevenueColumnAmt |
| Exclusion | $248 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,453,575 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $248 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,453,327 | TotalAmt |
| Program Services | $1,453,327 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,453,327 | TotalAmt |
| Program Services | $1,453,327 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $850 | BOYAmt |
| EOY | $2,088 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $850 | BOYAmt |
| EOY | $2,088 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $990 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $990 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $850 | BOYAmt |
| EOY | $1,098 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $850 | BOYAmt |
| EOY | $1,098 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $850 | BOYAmt |
| EOY | $2,088 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $248 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | 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 | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $1,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,453,327 | CurrentTaxYearAmt |
| Total | $1,454,327 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $1,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,453,327 | CurrentTaxYearAmt |
| Total | $1,454,327 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $1,454,327 | PublicSupportTotal170Amt |
| Total Support | $1,454,327 | TotalSupportAmt |
| First5 Years170 | Yes (X) | First5Years170Ind |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FUNDS HELD FOR OTHERS | Desc |
| Amt | $990 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $990 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | CONSOLIDATED FOOTNOTE FOR UNCERTAIN TAX POSITIONS UNDER FIN 48: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ASSOCIATION AND FOUNDATION AND RECOGNIZE A TAX LIABILITY IF THE ASSOCIATION OR FOUNDATION HAVE 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 ASSOCIATION AND FOUNDATION, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2013 AND 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE ASSOCIATION AND FOUNDATION ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| ADAMS COUNTY MEMORIAL HOSPITAL | |||||||
| 1100 MERCER AVENUE | DECATUR | IN | 46733 | 351470257 | 501C3 | $577,905 | FINANCIAL ASSISTANCE RELATED TO ECONOMIC BURDEN EXPERIENCED AS A RESULT OF THE INDIANA MEDICAID PROGRAM. |
| INDIANA ORTHOPAEDIC | |||||||
| 8141 S EMERSON AVE STE A | INDIANAPOLIS | IN | 46237 | N/A - FORPROFIT | $163,539 | FINANCIAL ASSISTANCE RELATED TO ECONOMIC BURDEN EXPERIENCED AS A RESULT OF THE INDIANA MEDICAID PROGRAM. | |
| PINNACLE HOSPITAL | |||||||
| 9301 CONNECTICUT DRIVE | CROWN POINT | IN | 46307 | N/A - FORPROFIT | $502,207 | FINANCIAL ASSISTANCE RELATED TO ECONOMIC BURDEN EXPERIENCED AS A RESULT OF THE INDIANA MEDICAID PROGRAM. | |
| HANCOCK REGIONAL HEALTH SYSTEM | |||||||
| 801 N STATE ST | GREENFIELD | IN | 46140 | 351092610 | 501C3 | $118,811 | FINANCIAL ASSISTANCE RELATED TO ECONOMIC BURDEN EXPERIENCED AS A RESULT OF THE INDIANA MEDICAID PROGRAM. |
| UNITY MEDICAL AND SURGICAL HOSPITAL | |||||||
| 4455 EDISON LAKES PARKWAY | MISHAWAKA | IN | 46545 | N/A - FORPROFIT | $86,402 | FINANCIAL ASSISTANCE RELATED TO ECONOMIC BURDEN EXPERIENCED AS A RESULT OF THE INDIANA MEDICAID PROGRAM. | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 3 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 2: | THE FOUNDATION DISTRIBUTES FUNDS TO INDIANA HOSPITALS THAT HAVE BEEN NEGATIVELY IMPACTED BY THE INDIANA MEDICAID PROGRAM. THE DISTRIBUTIONS ARE INTENDED TO MAKE UP FOR ANY SHORTFALLS, RELATIVE TO THE COST OF PROVIDING CARE, IN THE MEDICAID PAYMENTS RECEIVED BY SUCH HOSPITALS. BY REDUCING THE ECONOMIC BURDEN EXPERIENCED BY CERTAIN INDIANA HOSPITALS AS A RESULT OF PROVIDING CARE TO MEDICAID PATIENTS, THE FOUNDATION WILL HELP ENSURE ACCESS TO MEDICAL CARE FOR THOSE MEMBERS OF THE COMMUNITY THAT MIGHT OTHERWISE GO WITHOUT SERVICES IF FINANCIAL PRESSURES CAUSE THE CLOSURE OF HOSPITALS IN THE STATE OF INDIANA. THE FOUNDATION DISTRIBUTED FUNDS TO INDIANA HOSPITALS WHO REQUESTED FINANCIAL ASSISTANCE RELATED TO THE ECONOMIC BURDENS EXPERIENCED AS A RESULT OF THE INDIANA MEDICAID PROGRAM. THE INDIANA HOSPITALS SEEKING FUNDS TO OFFSET FINANCIAL HARDSHIPS RESULTING FROM THE OPERATIONS OF THE INDIANA MEDICAID PROGRAM AGREE, IN CONNECTION WITH THEIR REQUEST FOR FINANCIAL SUPPORT, TO USE THE FUNDS IN FURTHERANCE OF THE EXEMPT PURPOSES OF THE FOUNDATION AND MUST FURTHER AGREE TO RETAIN DOCUMENTATION NECESSARY TO DEMONSTRATE THAT USE. |
| PART II, COLUMN (H), PURPOSE OF GRANT OR ASSISTANCE: | ALL RECEIPIENTS RECEIVED FINANCIAL ASSISTANCE RELATED TO ECONOMIC BURDEN EXPERIENCED AS A RESULT OF THE INDIANA MEDICAID PROGRAM. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DOUGLAS J LEONARD | ||||||||||||||
| PRESIDENT, DIRECTOR | $0 | $690,463 | $0 | $0 | $0 | $8,840 | $0 | $156,043 | $0 | $17,619 | $0 | $872,965 | $0 | $0 |
| DAVID WIESMAN | ||||||||||||||
| VICE PRESIDENT | $0 | $233,528 | $0 | $0 | $0 | $5,860 | $0 | $30,766 | $0 | $23,851 | $0 | $294,005 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | IHA HOSPITAL ASSISTANCE FOUNDATION (THE FOUNDATION) HAS ONE CLASS OF MEMBERSHIP COMPRISED OF CORPORATE MEMBERS. THE MEMBERS OF THE BOARD OF DIRECTORS OF THE INDIANA HOSPITAL ASSOCIATION, INC. (IHA) COMPRISE THE FOUNDATION'S MEMBERS. THE MEMBER'S MEMBERSHIP TERMINATES WHEN THE PERSON CEASES TO BE A DIRECTOR ON IHA'S BOARD OF DIRECTORS; AND, THE MEMBERSHIP IS TRANSFERRED TO HIS OR HER SUCCESSOR ON IHA'S BOARD OF DIRECTORS. THE PRESIDENT OF IHA IS CONSIDERED A CORPORATE MEMBER OF THE FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE FOUNDATION'S CORPORATE MEMBERS HAVE THE RIGHT TO APPOINT OR REMOVE DIRECTORS OF THE FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOUNDATION'S CORPORATE MEMBERS HAVE THE RIGHT TO AMEND ARTICLES OR BYLAWS OF THE FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 8A | THE ORGANIZATION DID NOT HAVE SEPARATE MEETING MINUTES DURING 2013 FOR THE IHA HOSPITAL ASSISTANCE FOUNDATION. THE MEMBERS OF THE BOARD OF DIRECTORS OF THE INDIANA HOSPITAL ASSOCIATION, INC. (IHA) COMPRISE THE FOUNDATION'S MEMBERS AND THE OFFICERS OF THE FOUNDATION ARE THE EXECUTIVE COMMITTEE MEMBERS OF THE INDIANA HOSPITAL ASSOCIATION, THE FOUNDATION'S PARENT. DURING 2013 THE ACTIVITIES OF THE FOUNDATION WERE REPORTED AND DOCUMENTED IN THE MINUTES OF IHA'S MINUTES. |
| FORM 990, PART VI, SECTION A, LINE 8B | DURING 2013 THERE WAS NO COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE PROCESS OF REVIEWING THE FORM 990 INCLUDES A REVIEW BY THE FINANCIAL OFFICER OF INDIANA HOSPITAL ASSOCIATION, RELATED ORGANIZATION, AND REVIEW BY THE FOUNDATION'S BOARD OF DIRECTORS PRIOR TO FILING THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY THE BOARD OF DIRECTORS. THE SCOPE OF THE POLICY INCLUDES INTERESTED PERSON WHICH INCLUDE: ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST. THE POLICY IS IN PLACE TO PROTECT THE INTEREST OF THE FOUNDATION WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE FOUNDATION OR MIGHT RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION. ADDITIONALLY, THE POLICY IS INTENDED TO SUPPLEMENT BUT NOT REPLACE ANY APPLICABLE STATE AND FEDERAL LAWS GOVERNING CONFLICT OF INTEREST APPLICABLE TO NONPROFIT AND CHARITABLE ORGANIZATOINS. THE COVERED PERSONS ARE TO DISCLOSE THE EXISTENCE OF ANY ACTUAL OR POSSIBLE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS OR COMMITTEE MEMBERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE COVERED PERSONS ARE TO RECUES FROM PARTICIPATING IN ANY DELIBERATION OR DECISIONS ON SUCH TRANSACTIONS. EACH INTERESTED PERSON SIGNS AN ANNUAL STATEMENT AFFIRMING COMPLIANCE WITH THE POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | DURING 2013 THE FOUNDATION DID NOT HAVE AN EXECUTIVE DIRECTOR OR OTHER OFFICERS/ KEY EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| INDIANA HOSPITAL ASSOCIATION INC | |||||||||||
| 1 AMERICAN SQUARE 1900 | INDIANAPOLIS | IN | 46282 | 350988753 | HOSPITAL ASSOCIATION | IN | 501(C)(6) | N/A | N/A | 0 | |
| THE ALBERT & GRACE HAHN FOUNDATION | |||||||||||
| 1 AMERICAN SQUARE 1900 | INDIANAPOLIS | IN | 46282 | 356020062 | RESEARCH & EDUCATION | IN | 501(C)(3) | PF | Yes (1) | INDIANA HOSPITAL ASSOCIATION | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA HOSPITAL SERVICE CORP | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 AMERICAN SQUARE 1900 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46282 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351185736 | EIN |
| Primary Activities | CONSULTING | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| 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 | 0 | 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 | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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