SOUTH BEND MEDICAL FOUNDATION INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- SOUTH BEND MEDICAL FOUNDATION INC (EIN 35-0868178)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-17
- IRS object ID
- 201443219349302874
- Schema version
- 2013v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-17T10:00:40-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE HORWATH LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 330 E JEFFERSON BLVD | AddressLine1 |
| Address Line2 | PO BOX 7 | AddressLine2 |
| City | SOUTH BEND | City |
| State | IN | State |
| ZIP Code | 466240007 | 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 | 350868178 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH BEND MEDICAL FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 5742045291 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 530 North Lafayette Blvd | AddressLine1 |
| City | South Bend | City |
| State | IN | State |
| ZIP Code | 46601 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT TOMEC MD | PersonNm |
| Person Title | PRESIDENT/EXECUTIVE VP | PersonTitleTxt |
| Signature | 2014-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KENNETH J KEBER | PreparerPersonNm |
| PTIN | P00240883 | PTIN |
| Phone | 5742323992 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Address PrincipalOfcrBusinessAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROBERT TOMEC MD | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 530 North Lafayette Blvd | AddressLine1 |
| City | South Bend | City |
| State | IN | State |
| ZIP Code | 46601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $101,226,342 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SBMF.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1946 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | SOUTH BEND MEDICAL FOUNDATION EXISTS FOR THE PURPOSE OF PROVIDING QUALITY AND COST EFFECTIVE LABORATORY AND BLOOD BANKING SERVICES TO HOSPITALS, PHYSICIANS, AND PATIENTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 846 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $429,028 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,736 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $99,026,282 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $99,699,838 | CYProgramServiceRevenueAmt |
| PY Investment Income | $140,634 | PYInvestmentIncomeAmt |
| CY Investment Income | $655,611 | CYInvestmentIncomeAmt |
| PY Other Revenue | $391,040 | PYOtherRevenueAmt |
| CY Other Revenue | $852,057 | CYOtherRevenueAmt |
| PY Total Revenue | $99,986,984 | PYTotalRevenueAmt |
| CY Total Revenue | $101,209,242 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,710,438 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,154,999 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $46,930,111 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $45,890,395 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $57,197 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $48,795,997 | PYOtherExpensesAmt |
| CY Other Expenses | $51,377,496 | CYOtherExpensesAmt |
| PY Total Expenses | $98,493,743 | PYTotalExpensesAmt |
| CY Total Expenses | $100,422,890 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,493,241 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $786,352 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $52,639,511 | TotalAssetsBOYAmt |
| Total Assets EOY | $51,455,515 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $47,569,581 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $34,700,809 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,069,930 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $16,754,706 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SOUTH BEND MEDICAL FOUNDATION EXISTS FOR THE PURPOSE OF PROVIDING QUALITY AND COST EFFECTIVE LABORATORY AND BLOOD BANKING SERVICES TO HOSPITALS, PHYSICIANS, AND PATIENTS. (CONTINUED IN SCHEDULE O). | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $84,560,492 | ExpenseAmt |
| Grant | $3,154,999 | GrantAmt |
| Revenue | $100,168,828 | RevenueAmt |
| Desc | SOUTH BEND MEDICAL FOUNDATION'S (SBMF) MORE THAN 750 EMPLOYEES PROVIDE A WIDE RANGE OF TOP-QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES FOR COMMUNITIES IN INDIANA, MICHIGAN, KENTUCKY, OHIO, AND ILLINOIS. BY WORKING TOGETHER WITH LOCAL HEALTH CARE PROVIDERS, SBMF PRESERVES THE CRITICAL RELATIONSHIP BETWEEN LABORATORY, PHYSICIAN AND PATIENT. UNLIKE MANY LARGE COMMERCIAL LABORATORIES, SBMF OFFERS ITS SERVICES 24 HOURS A DAY, 365 DAYS A YEAR. SBMF PERSONNEL ARE DEDICATED TO BEING A TRUSTED PHYSICIAN RESOURCE, HANDLING EVERYTHING FROM ROUTINE OUTPATIENT ORDERS TO PROVIDING INPATIENT SERVICES AT HOSPITAL AND OTHER HEALTH CARE FACILITIES THROUGHOUT THE REGION. SBMF'S COMMITMENT TO DELIVERING CONSISTENT, RELIABLE, QUALITY MEDICAL CARE HAS PLAYED AN INSTRUMENTAL ROLE IN HELPING THE FOUNDATION ACHIEVE ITS POSITION OF LEADERSHIP AMONG THE NATION'S DIAGNOSTIC LABORATORIES. (CONTINUED IN SCHEDULE O) | Desc |
| Total Program Service Expenses | $84,560,492 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 83 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 846 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | 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 | James B Myers | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5742045206 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 118 W Edison Road | AddressLine1 |
| City | Mishawaka | City |
| State | IN | State |
| ZIP Code | 46545 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (44 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| BILAL ANSARI MD | ||||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CHARLES E PETERSON MD | ||||||||
| VICE CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ALAN B ENGEL MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BARBARA L WILLIAMS MD | ||||||||
| BOARD MEMBER - PARTIAL YEAR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRIAN SUCHARETZA MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DANIEL E SCHERB MD | ||||||||
| BOARD MEMBER - PARTIAL YEAR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ERIC D KNAPP DO | ||||||||
| BOARD MEMBER - PARTIAL YEAR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| HENRY KIM MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN T RICE MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHELLE A MIGLIORE DO | ||||||||
| BOARD MEMBER - PARTIAL YEAR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SAMUEL BORRELLI MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SLOAN S SHAH MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STARLA D GRABER MD | ||||||||
| BOARD MEMBER - PARTIAL YEAR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WALTER H HALLORAN MD | ||||||||
| BOARD MEMBER - PARTIAL YEAR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANN SULLIVAN | ||||||||
| VP OF FINANCE | 40.00 | Yes (X) | $242,607 | $0 | $43,549 | |||
| DIANE JANOWIAK | ||||||||
| VP OF CENTRAL LAB OPERATIONS | 40.00 | Yes (X) | $240,976 | $0 | $30,828 | |||
| JAMES FRAIN | ||||||||
| VP OF HUMAN RESOURCES | 40.00 | Yes (X) | $244,273 | $0 | $40,922 | |||
| ROBERT KING | ||||||||
| SENIOR VP | 40.00 | Yes (X) | $280,613 | $0 | $34,765 | |||
| ROBERT TOMEC MD | ||||||||
| PRESIDENT/EXECUTIVE VP | 40.00 | Yes (X) | $383,991 | $0 | $37,697 | |||
| WILLIAM KALINEY MD | ||||||||
| VICE PRESIDENT/EXECUTIVE VP | 40.00 | Yes (X) | $383,763 | $0 | $42,823 | |||
| ALFONSO CARDENAS MD | ||||||||
| PATHOLOGIST | 40.00 | $238,227 | $0 | $40,289 | Yes (X) | |||
| AMOBI EZENEKWE MD | ||||||||
| PATHOLOGIST | 40.00 | $263,569 | $0 | $45,908 | Yes (X) | |||
| BLAIR CHRENKA MD | ||||||||
| PATHOLOGIST | 40.00 | $259,733 | $0 | $45,768 | Yes (X) | |||
| BOBBIE SUTTON MD | ||||||||
| PATHOLOGIST | 40.00 | $293,776 | $0 | $33,321 | Yes (X) | |||
| C K KIM MD | ||||||||
| PATHOLOGIST | 40.00 | $366,046 | $0 | $41,872 | Yes (X) | |||
| DAVID JENTZ MD | ||||||||
| PATHOLOGIST | 40.00 | $366,570 | $0 | $37,901 | Yes (X) | |||
| DERRICK FORCHETTI MD | ||||||||
| PATHOLOGIST | 40.00 | $271,943 | $0 | $39,520 | Yes (X) | |||
| FRANCISCO DEOGRACIAS MD | ||||||||
| PATHOLOGIST | 40.00 | $354,468 | $0 | $37,868 | Yes (X) | |||
| FRED BUSSE MD | ||||||||
| PATHOLOGIST | 40.00 | $269,756 | $0 | $38,224 | Yes (X) | |||
| JAMES DYER MD | ||||||||
| PATHOLOGIST | 40.00 | $260,495 | $0 | $21,584 | Yes (X) | |||
| JOHN LANDGRAF MD | ||||||||
| PATHOLOGIST | 40.00 | $271,719 | $0 | $35,724 | Yes (X) | |||
| JOSEPH PRAHLOW MD | ||||||||
| PATHOLOGIST | 40.00 | $281,457 | $0 | $41,153 | Yes (X) | |||
| JOYCE SIMPSON MD | ||||||||
| PATHOLOGIST | 40.00 | $155,811 | $0 | $10,220 | Yes (X) | |||
| KRISTEN JACOBS MD | ||||||||
| PATHOLOGIST | 24.00 | $219,491 | $0 | $41,362 | Yes (X) | |||
| LUIS GALUP MD | ||||||||
| PATHOLOGIST | 40.00 | $366,099 | $0 | $41,415 | Yes (X) | |||
| NICOLE ANEST MD | ||||||||
| PATHOLOGIST | 40.00 | $237,593 | $0 | $33,745 | Yes (X) | |||
| NITA GERIG MD | ||||||||
| PATHOLOGIST | 32.00 | $285,555 | $0 | $44,885 | Yes (X) | |||
| ODETA LAPKUS MD | ||||||||
| PATHOLOGIST | 40.00 | $266,690 | $0 | $37,247 | Yes (X) | |||
| RICKY HOOVER MD | ||||||||
| PATHOLOGIST | 40.00 | $348,239 | $0 | $44,065 | Yes (X) | |||
| CARRIE ROBINSON | ||||||||
| REGIONAL MARKETING DIRECTOR | 40.00 | $106,412 | $0 | $33,879 | Yes (X) | |||
| JANET AGLER | ||||||||
| REGIONAL MARKETING MANAGER | 40.00 | $102,032 | $0 | $28,628 | Yes (X) | |||
| PRENTISS JONES | ||||||||
| DIRECTOR - TOXICOLOGY | 40.00 | $153,989 | $0 | $28,185 | Yes (X) | |||
| QING LI | ||||||||
| DIRECTOR - NEW TEST DEVELOPMENT | 40.00 | $140,957 | $0 | $28,525 | Yes (X) | |||
| THOMAS LIDDELL | ||||||||
| VP - INFORMATION SYSTEMS | 40.00 | $154,253 | $0 | $23,106 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $7,811,103 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,084,978 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 31 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ASSOC REG AND UNIV PATHOLOGISTS | |||||
| PO BOX 27964 | SALT LAKE CITY | UT | 84127 | REFERENCE LAB | $2,602,725 |
| CERNER CORPORATION | |||||
| PO BOX 412702 | KANSAS CITY | MO | 64141 | EQUIPMENT MAINTENANCE / REPAIR | $1,005,731 |
| THERMO ASSET MANAGEMENT SERVICES INC | |||||
| PO BOX 712224 | CINCINNATI | OH | 452712224 | EQUIPMENT MAINTENANCE / REPAIR | $816,595 |
| PARKVIEW PROFESSIONAL PROGRAMS | |||||
| PO BOX 2504 | FORT WAYNE | IN | 468012504 | REFERENCE LAB | $785,269 |
| MICHIANA HEALTH INFORMATION NETWORK | |||||
| PO BOX 6471 | SOUH BEND | IN | 46660 | COMMUNITY BASED CLINICAL INFO SYSTEM | $733,511 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 16 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $1,736 | AllOtherContributionsAmt |
| Total Contributions | $1,736 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET OPERATING REVENUES | 621500 | $99,699,838 | $99,699,838 |
| $0 | |||
| $0 | |||
| $0 | |||
| $0 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $99,699,838 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $302,005 | TotalRevenueColumnAmt |
| Exclusion | $302,005 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $370,706 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $17,100 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $353,606 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $353,606 | TotalRevenueColumnAmt |
| Exclusion | $353,606 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| CLINICAL PATHOLOGY FEES | 621500 | $468,990 | $468,990 | |
| TEACHING FEES | 611430 | $76,407 | $76,407 | |
| RECORDS RETREIVAL FEES | 900099 | $4,173 | $4,173 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $302,487 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $302,487 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $852,057 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $101,209,242 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $100,168,828 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,038,678 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,346 | TotalAmt |
| Program Services | $101,346 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,053,653 | TotalAmt |
| Program Services | $3,053,653 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,809,153 | TotalAmt |
| Program Services | $6,926,774 | ProgramServicesAmt |
| Management And General | $1,882,379 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,566,362 | TotalAmt |
| Program Services | $21,716,049 | ProgramServicesAmt |
| Management And General | $4,850,313 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $392,000 | TotalAmt |
| Program Services | $320,421 | ProgramServicesAmt |
| Management And General | $71,579 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,848,518 | TotalAmt |
| Program Services | $6,415,379 | ProgramServicesAmt |
| Management And General | $1,433,139 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,274,362 | TotalAmt |
| Program Services | $1,843,279 | ProgramServicesAmt |
| Management And General | $431,083 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,692 | TotalAmt |
| Management And General | $97,692 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,773 | TotalAmt |
| Management And General | $77,773 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,207,059 | TotalAmt |
| Program Services | $1,370,650 | ProgramServicesAmt |
| Management And General | $836,409 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,637,455 | TotalAmt |
| Program Services | $1,255,904 | ProgramServicesAmt |
| Management And General | $1,381,551 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,941,501 | TotalAmt |
| Program Services | $1,806,301 | ProgramServicesAmt |
| Management And General | $135,200 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,299 | TotalAmt |
| Program Services | $81,772 | ProgramServicesAmt |
| Management And General | $35,527 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $642,225 | TotalAmt |
| Program Services | $7,319 | ProgramServicesAmt |
| Management And General | $634,906 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,323,199 | TotalAmt |
| Program Services | $2,871,613 | ProgramServicesAmt |
| Management And General | $451,586 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $783,555 | TotalAmt |
| Program Services | $128,773 | ProgramServicesAmt |
| Management And General | $654,782 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL LAB | $23,966,594 | $23,087,789 | $878,805 |
| REFERENCE LAB | $4,913,997 | $4,913,997 | |
| BAD DEBT | $4,068,801 | $4,068,801 | |
| BUILDING EQUIPMENT/MAINTENANCE | $3,844,643 | $2,464,737 | $1,379,906 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,755,703 | TotalAmt |
| Program Services | $2,125,935 | ProgramServicesAmt |
| Management And General | $629,768 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,422,890 | TotalAmt |
| Program Services | $84,560,492 | ProgramServicesAmt |
| Management And General | $15,862,398 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Joint Costs TotalJointCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $841 | BOYAmt |
| EOY | $750 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,566,851 | BOYAmt |
| EOY | $7,205,574 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,110,618 | BOYAmt |
| EOY | $12,336,442 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,117,948 | BOYAmt |
| EOY | $1,638,673 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,566,976 | BOYAmt |
| EOY | $1,419,645 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $95,589,071 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $67,667,576 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,562,793 | BOYAmt |
| EOY | $27,921,495 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $571,791 | BOYAmt |
| EOY | $809,890 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $141,693 | BOYAmt |
| EOY | $123,046 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,639,511 | BOYAmt |
| EOY | $51,455,515 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,693,485 | BOYAmt |
| EOY | $9,997,427 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,615,000 | BOYAmt |
| EOY | $9,585,000 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,261,096 | BOYAmt |
| EOY | $15,118,382 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,569,581 | BOYAmt |
| EOY | $34,700,809 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,069,930 | BOYAmt |
| EOY | $16,754,706 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,069,930 | BOYAmt |
| EOY | $16,754,706 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,639,511 | BOYAmt |
| EOY | $51,455,515 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $786,352 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $591,971 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $10,306,453 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $429,028 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,736 | CurrentTaxYearAmt |
| Total | $430,764 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $94,545,973 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $94,079,057 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $97,034,819 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $99,026,282 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $99,699,838 | CurrentTaxYearAmt |
| Total | $484,385,969 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $238,981 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $195,040 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $169,918 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $170,096 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $383,067 | CurrentTaxYearAmt |
| Total | $1,157,102 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $94,784,954 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $94,274,097 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $97,204,737 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $99,625,406 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $100,084,641 | CurrentTaxYearAmt |
| Total | $485,973,835 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,082 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $15,082 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,082 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $15,082 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $485,958,753 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | -$108,281 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | -$69,086 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $60,573 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $123,674 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $302,005 | CurrentTaxYearAmt |
| Total | $308,885 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | -$108,281 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | -$69,086 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $60,573 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $123,674 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $302,005 | CurrentTaxYearAmt |
| Total | $308,885 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $334,004 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $338,675 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $415,690 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $497,425 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $468,990 | CurrentTaxYearAmt |
| Total | $2,054,784 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $95,010,677 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $94,543,686 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $97,681,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $100,246,505 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $100,855,636 | CurrentTaxYearAmt |
| Total | $488,337,504 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99510 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99580 | PublicSupportPY509Pct |
| Investment Income CY | 0.00060 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00010 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part IV Form990ScheduleAPartIVGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part III, Line 12, Other Income | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION - CLINICAL PATHOLOGY FEES, COLUMN A - 334004, COLUMN B - 338675, COLUMN C - 415690, COLUMN D - 451445, COLUMN E - 468990, COLUMN F - 2008804; DESCRIPTION - FUNDRAISING GROSS RECEIPTS, COLUMN A - 0, COLUMN B - 0, COLUMN C - 0, COLUMN D - 45980, COLUMN E - 0, COLUMN F - 45980; | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,115,907 | OtherCostOrOtherBasisAmt |
| Book Value | $1,115,907 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $43,410,451 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,108,798 | DepreciationAmt |
| Book Value | $16,301,653 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $812,628 | OtherCostOrOtherBasisAmt |
| Depreciation | $471,688 | DepreciationAmt |
| Book Value | $340,940 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $46,762,045 | OtherCostOrOtherBasisAmt |
| Depreciation | $40,087,090 | DepreciationAmt |
| Book Value | $6,674,955 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,488,040 | OtherCostOrOtherBasisAmt |
| Book Value | $3,488,040 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $27,921,495 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| CAPITAL LEASE OBLIGATION | $41,479 |
| FAIR VALUE OF INTEREST RATE SWAP | $1,372,702 |
| ACCRUED PENSION AND POSTRETIREMENT BENEFITS | $13,704,201 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $15,118,382 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $104,985,212 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $591,971 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $10,306,453 | OtherRevenueAmt |
| Revenue Not Reported | $10,898,424 | RevenueNotReportedAmt |
| Revenue Subtotal | $94,086,788 | RevenueSubtotalAmt |
| Other Revenues Not Included | $7,122,454 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $7,122,454 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $101,209,242 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $93,300,436 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $93,300,436 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $7,122,454 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $7,122,454 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $100,422,890 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote | THE FOUNDATION IS A NOT-FOR-PROFIT ORGANIZATION PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES PURSUANT TO SECTION 501(A). ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REFLECTED IN THE FOUNDATION'S FINANCIAL STATEMENTS. THE FOUNDATION IS SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES FOR THE YEARS ENDED DECEMBER 31, 2010 THROUGH 2013. THE FOUNDATION FOLLOWS GUIDANCE ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD WITH RESPECT TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. A TAX POSITION IS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. MANAGEMENT HAS DETERMINED THAT THERE IS NO LIABILITY FOR UNCERTAIN TAX POSITIONS AND DOES NOT EXPECT THIS TO CHANGE OVER THE NEXT 12 MONTHS. |
| Schedule D, Part XI, Line 2d, Other revenues in audited financial statements not in form 990 | 2013 GALA RECEIPTS RECORDED IN 2012 - 103125; PENSION AND POSTRETIREMENT BENEFIT-RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST - 10203328; |
| Schedule D, Part XI, Line 4b, Other revenues in form 990 not in audited financial statements | INDIVIDUAL ASSISTANCE - 3053653; BAD DEBT - 4068801; |
| Schedule D, Part XII, Line 4b, Other expenses in form 990 not in audited financial statements | INDIVIDUAL ASSISTANCE - 3053653; BAD DEBT - 4068801; |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (8 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Address Line2USAddress/AddressLine2 |
|---|---|---|---|---|---|---|---|---|
| BOYS AND GIRLS CLUBS OF ST JOSEPH COUNTY | ||||||||
| 502 E SAMPLE STREET | SOUTH BEND | IN | 46601 | 351329625 | 501(C)(3) | $5,000 | GENERAL SUPPORT | |
| NORTHERN INDIANA HISTORICAL SOCIETY (CENTER FOR HISTORY) | ||||||||
| 808 W WASHINGTON STREET | SOUTH BEND | IN | 46601 | 351124156 | 501(C)(3) | $5,000 | GENERAL SUPPORT | |
| HOSPICE FOUNDATION | ||||||||
| 4220 EDISON LAKES PARKWAY | MISHAWAKA | IN | 46545 | 300433147 | 501(C)(3) | $5,000 | GENERAL SUPPORT | STE 210 |
| INDIANA UNIVERSITY FOUNDATION | ||||||||
| PO BOX 660245 | INDIANAPOLIS | IN | 46266 | 356018940 | 501(C)(3) | $5,000 | GENERAL SUPPORT | |
| LOGAN COMMUNITY RESOURCES INC | ||||||||
| 2505 E JEFFERSON BLVD | SOUTH BEND | IN | 46615 | 350965639 | 501(C)(3) | $7,600 | GENERAL SUPPORT | |
| THE FOUNDATION OF ST JOSEPH REGIONAL MEDICAL CENTER | ||||||||
| 837 E CEDAR STREET | SOUTH BEND | IN | 46617 | 351654543 | 501(C)(3) | $7,500 | GENERAL SUPPORT | SUITE 350 |
| SAINT MARY'S COLLEGE | ||||||||
| 110 LE MANS HALLS | NOTRE DAME | IN | 46556 | 350868158 | 501(C)(3) | $5,000 | GENERAL SUPPORT | |
| ST JOSEPH REGIONAL MEDICAL CENTER | ||||||||
| 5215 HOLY CROSS PARKWAY | MISHAWAKA | IN | 46545 | 350868157 | 501(C)(3) | $10,000 | GENERAL SUPPORT | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 8 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|
| PATIENT MEDICAL ASSISTANCE | $0 | $2,410,948 | BOOK VALUE | FREE OR REDUCED MEDICAL CARE |
| TIME OF SERVICE DISCOUNTS | $0 | $642,705 | BOOK VALUE | DISCOUNT PROVIDED AT TIME OF PAYMENT |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE I, PART III, COLUMN (B), NUMBER OF RECIPIENTS | CURRENTLY, SOUTH BEND MEDICAL FOUNDATION DOES NOT HAVE AN EFFECTIVE WAY TO TRACK THE UNDUPLICATED NUMBER OF PATIENTS THAT RECEIVE FREE OR REDUCED CARE AND TIME OF SERVICE DISCOUNTS. |
| Schedule I, Part I, Line 2, Procedures for monitoring use of grant funds | SOUTH BEND MEDICAL FOUNDATION (SBMF) PROVIDES FUNDING TO OTHER COMMUNITY NOT-FOR-PROFIT ORGANIZATIONS. GENERALLY, THESE ARE UNRESTRICTED CONTRIBUTIONS THAT THE RECEIVING ORGANIZATION CAN USE TO FURTHER THEIR MISSION AND PROGRAMS AT THEIR DISCRETION. THE USE OF THESE CONTRIBUTIONS IS NOT MONITORED. SBMF ALSO PROVIDES ASSISTANCE TO INDIVIDUALS IN THE FORM OF FREE OR REDUCED FEE MEDICAL CARE AT VARIOUS LOCATIONS THROUGHOUT THE COMMUNITIES SERVED. THESE INDIVIDUALS MEET SBMF'S CHARITY CARE ELIGIBILITY REQUIREMENTS, OR THE REQUIREMENTS OF THE REFERRING HEALTH CARE PROVIDER. DETERMINATION AND MONITORING OF CHARITY CARE IS PERFORMED ON A CASE-BY-CASE BASIS. SBMF ALSO PROVIDES DISCOUNTS FOR PAYMENT AT TIME OF SERVICE TO PATIENTS WHO DO NOT HAVE GOVERNMENT PROVIDED INSURANCE COVERAGE OR DO NOT WISH TO HAVE A CLAIM FILED WITH THEIR COMMERCIAL INSURANCE CARRIER. THERE IS NO ACTUAL EXCHANGE OF FUNDS, AS THE DISCOUNTS ARE CREDITED DIRECTLY TO THE PATIENTS' ACCOUNTS. TIME OF SERVICE DISCOUNTS ARE MONITORED AT THE ORGANIZATION LEVEL, IN THE AGGREGATE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (28 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DIANE JANOWIAK | ||||||||||||||
| VP OF CENTRAL LAB OPERATIONS | $235,694 | $0 | $5,000 | $0 | $282 | $0 | $7,119 | $0 | $23,709 | $0 | $271,804 | $0 | $0 | $0 |
| ODETA LAPKUS MD | ||||||||||||||
| PATHOLOGIST | $261,690 | $0 | $5,000 | $0 | $0 | $0 | $5,000 | $0 | $32,247 | $0 | $303,937 | $0 | $0 | $0 |
| NITA GERIG MD | ||||||||||||||
| PATHOLOGIST | $260,067 | $0 | $5,000 | $0 | $20,488 | $0 | $7,550 | $0 | $37,335 | $0 | $330,440 | $0 | $0 | $0 |
| DERRICK FORCHETTI MD | ||||||||||||||
| PATHOLOGIST | $266,943 | $0 | $5,000 | $0 | $0 | $0 | $7,550 | $0 | $31,970 | $0 | $311,463 | $0 | $0 | $0 |
| DAVID JENTZ MD | ||||||||||||||
| PATHOLOGIST | $358,543 | $0 | $5,000 | $0 | $3,027 | $0 | $7,550 | $0 | $30,351 | $0 | $404,471 | $0 | $0 | $0 |
| JAMES FRAIN | ||||||||||||||
| VP OF HUMAN RESOURCES | $234,076 | $0 | $5,000 | $0 | $5,197 | $0 | $7,033 | $0 | $33,889 | $0 | $285,195 | $0 | $0 | $0 |
| PRENTISS JONES | ||||||||||||||
| DIRECTOR - TOXICOLOGY | $150,989 | $0 | $3,000 | $0 | $0 | $0 | $4,498 | $0 | $23,687 | $0 | $182,174 | $0 | $0 | $0 |
| BOBBIE SUTTON MD | ||||||||||||||
| PATHOLOGIST | $288,776 | $0 | $5,000 | $0 | $0 | $0 | $7,550 | $0 | $25,771 | $0 | $327,097 | $0 | $0 | $0 |
| JOHN LANDGRAF MD | ||||||||||||||
| PATHOLOGIST | $246,279 | $0 | $5,000 | $0 | $20,440 | $0 | $7,550 | $0 | $28,174 | $0 | $307,443 | $0 | $0 | $0 |
| JAMES DYER MD | ||||||||||||||
| PATHOLOGIST | $252,575 | $0 | $5,000 | $0 | $2,920 | $0 | $6,856 | $0 | $14,728 | $0 | $282,079 | $0 | $0 | $0 |
| ALFONSO CARDENAS MD | ||||||||||||||
| PATHOLOGIST | $233,227 | $0 | $5,000 | $0 | $0 | $0 | $6,659 | $0 | $33,630 | $0 | $278,516 | $0 | $0 | $0 |
| JOSEPH PRAHLOW MD | ||||||||||||||
| PATHOLOGIST | $273,518 | $0 | $5,000 | $0 | $2,939 | $0 | $7,550 | $0 | $33,603 | $0 | $322,610 | $0 | $0 | $0 |
| WILLIAM KALINEY MD | ||||||||||||||
| VICE PRESIDENT/EXECUTIVE VP | $357,502 | $0 | $5,000 | $0 | $21,261 | $0 | $7,550 | $0 | $35,273 | $0 | $426,586 | $0 | $0 | $0 |
| ROBERT KING | ||||||||||||||
| SENIOR VP | $259,178 | $0 | $5,000 | $0 | $16,435 | $0 | $7,306 | $0 | $27,459 | $0 | $315,378 | $0 | $0 | $0 |
| RICKY HOOVER MD | ||||||||||||||
| PATHOLOGIST | $340,213 | $0 | $5,000 | $0 | $3,026 | $0 | $7,550 | $0 | $36,515 | $0 | $392,304 | $0 | $0 | $0 |
| ANN SULLIVAN | ||||||||||||||
| VP OF FINANCE | $225,040 | $0 | $5,000 | $0 | $12,567 | $0 | $7,119 | $0 | $36,430 | $0 | $286,156 | $0 | $0 | $0 |
| ROBERT TOMEC MD | ||||||||||||||
| PRESIDENT/EXECUTIVE VP | $357,960 | $0 | $5,000 | $0 | $21,031 | $0 | $7,550 | $0 | $30,147 | $0 | $421,688 | $0 | $0 | $0 |
| FRANCISCO DEOGRACIAS MD | ||||||||||||||
| PATHOLOGIST | $346,441 | $0 | $5,000 | $0 | $3,027 | $0 | $7,550 | $0 | $30,318 | $0 | $392,336 | $0 | $0 | $0 |
| KRISTEN JACOBS MD | ||||||||||||||
| PATHOLOGIST | $194,692 | $0 | $5,000 | $0 | $19,799 | $0 | $6,597 | $0 | $34,765 | $0 | $260,853 | $0 | $0 | $0 |
| FRED BUSSE MD | ||||||||||||||
| PATHOLOGIST | $244,268 | $0 | $5,000 | $0 | $20,488 | $0 | $7,550 | $0 | $30,674 | $0 | $307,980 | $0 | $0 | $0 |
| LUIS GALUP MD | ||||||||||||||
| PATHOLOGIST | $358,474 | $0 | $5,000 | $0 | $2,625 | $0 | $7,550 | $0 | $33,865 | $0 | $407,514 | $0 | $0 | $0 |
| AMOBI EZENEKWE MD | ||||||||||||||
| PATHOLOGIST | $238,226 | $0 | $5,000 | $0 | $20,343 | $0 | $7,550 | $0 | $38,358 | $0 | $309,477 | $0 | $0 | $0 |
| C K KIM MD | ||||||||||||||
| PATHOLOGIST | $358,020 | $0 | $5,000 | $0 | $3,026 | $0 | $7,550 | $0 | $34,322 | $0 | $407,918 | $0 | $0 | $0 |
| BLAIR CHRENKA MD | ||||||||||||||
| PATHOLOGIST | $252,176 | $0 | $5,000 | $0 | $2,557 | $0 | $4,674 | $0 | $41,094 | $0 | $305,501 | $0 | $0 | $0 |
| JOYCE SIMPSON MD | ||||||||||||||
| PATHOLOGIST | $152,523 | $0 | $3,288 | $0 | $0 | $0 | $1,546 | $0 | $8,674 | $0 | $166,031 | $0 | $0 | $0 |
| NICOLE ANEST MD | ||||||||||||||
| PATHOLOGIST | $229,830 | $0 | $5,000 | $0 | $2,763 | $0 | $5,513 | $0 | $28,232 | $0 | $271,338 | $0 | $0 | $0 |
| QING LI | ||||||||||||||
| DIRECTOR - NEW TEST DEVELOPMENT | $124,867 | $0 | $16,090 | $0 | $0 | $0 | $1,326 | $0 | $27,199 | $0 | $169,482 | $0 | $0 | $0 |
| THOMAS LIDDELL | ||||||||||||||
| VP - INFORMATION SYSTEMS | $147,452 | $0 | $5,000 | $0 | $1,801 | $0 | $1,536 | $0 | $21,570 | $0 | $177,359 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 4b, Supplemental nonqualified retirement plan | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION HAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THAT WAS DESIGNED TO REPLACE RETIREMENT BENEFITS LOST BY INDIVIDUALS DUE TO 1998 CHANGES IN PENSION LAWS AND A REDESIGN OF THE PENSION PLAN TO MAXIMIZE BENEFITS FOR LOWER COMPENSATED EMPLOYEES. THE ORGANIZATION'S BOARD OF DIRECTORS ELECTED TO FREEZE THIS PLAN, AND THEREFORE NO BENEFITS WERE PROVIDED DURING 2013. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHIANA HEMATOLOGY ONCOLOGY PC (MHO) | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | B. ANSARI (SBMF BOARD MEMBER) IS AN OFFICER/DIRECTOR OF MHO. | RelationshipDescriptionTxt |
| Transaction | $101,635 | TransactionAmt |
| Transaction | SBMF MADE $101,635 IN PAYMENTS (AT FMV) TO MHO FOR RENTAL OF SPACE | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 1, ORGANIZATION'S MISSION (CONTINUED FROM PART III) | TO FULFILL OUR MISSION WE SHALL: (I) PROVIDE THE HOSPITALS WE SERVICE WITH THE HIGHEST QUALITY LABORATORY RESOURCES AND--TAKING INTO ACCOUNT THAT LENGTH OF STAY IS CRUCIAL FOR INPATIENT CARE--WITH THE SHORTEST RESPONSE TIME WHILE ACHIEVING A HIGH DEGREE OF COST EFFECTIVENESS. (II) PROVIDE OUR PHYSICIAN CUSTOMERS WITH THE HIGHEST QUALITY LABORATORY RESULTS UTILIZING THE LATEST TECHNOLOGY AND MAKING AVAILABLE TO THEM READILY ACCESSIBLE CONSULTATIVE OPPORTUNITIES IN THE MEDICAL AND ADMINISTRATIVE ASPECTS OF THEIR PRACTICES. (III) CREATE AND MAINTAIN A WORK ENVIRONMENT WHERE EMPLOYEES CAN GROW PERSONALLY AND PROFESSIONALLY WITH COMPENSATION AND BENEFIT SYSTEMS THAT ARE COMPETITIVE, EQUITABLE AND COST EFFECTIVE AS WELL AS AN ENVIRONMENT WHERE EMPLOYEES ARE PROVIDED STABLE EMPLOYMENT AND EACH INDIVIDUAL IS TREATED WITH RESPECT AND DIGNITY. (IV) PROVIDE TO THE PATIENT POPULATION IN THE COMMUNITIES WE SERVE READILY ACCESSIBLE, REASONABLY PRICED LABORATORY SERVICES, WITH AS WIDE A SCOPE AND VARIETY AS POSSIBLE TO MEET ALL THEIR NEEDS LOCALLY. (V) RECOGNIZING OUR SOCIAL RESPONSIBILITIES TO THE COMMUNITY, PROVIDE SERVICES WITHIN OUR MEANS TO THOSE LESS FORTUNATE, AND SUPPORT PUBLIC AND PRIVATE EFFORTS DIRECTED TO IMPROVE OUR HEALTH CARE ENVIRONMENT. |
| FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED FROM PART III) | THE ALTRUISTIC ACTIVITIES OF THE ORGANIZATION ARE INTENDED TO RELIEVE DISEASE, SUFFERING, AND CONSTRAINT. MANY SERVICES ARE PROVIDED AS CHARITY OR PRO BONO. THE AMOUNT OF CHARITY CARE, PROVIDED AT SBMF'S ESTABLISHED RATES, WAS APPROXIMATELY $1,100,000 FOR THE YEAR ENDED DECEMBER 31, 2013. |
| Form 990, Part VI, Sec A, Line 1a, Delegate broad authority to a committee | THE ADMINISTRATIVE COMMITTEE SHALL CONSIST OF THE OFFICERS OF THE CORPORATION. SUBJECT TO THE CONTROL OF THE BOARD OF DIRECTORS, THE ADMINISTRATIVE COMMITTEE SHALL HAVE FULL AUTHORITY TO ACT FOR AND ON BEHALF OF THE CORPORATION AND EXERCISE ALL OF THE POWERS OF THE BOARD OF DIRECTORS THAT MAY BE LAWFULLY DELEGATED BY SUCH BOARD TO SUCH COMMITTEE EXCEPT, HOWEVER, THE ADMINISTRATIVE COMMITTEE SHALL HAVE NO POWER TO DONATE ANY PART OF THE ASSETS OF THE CORPORATION. THE ADMINISTRATIVE COMMITTEE SHALL RECEIVE STATUS REPORTS ON OTHER COMMITTEE ACTIVITIES AND DISCUSS ITEMS OF INTEREST TO THE GROUP AS A WHOLE OR TO INDIVIDUAL OFFICERS FOR THE PERFORMANCE OF THEIR DUTIES. THE ADMINISTRATIVE COMMITTEE SHALL KEEP MINUTES OF ITS MEETINGS. |
| Form 990, Part VI, Sec A, Line 2, Family/business relationships amongst interested persons | BOB SUTTON (HUSBAND OF BOBBIE SUTTON) AND FRED BUSSE - BUSINESS RELATIONSHIP, ANA CARDENAS (WIFE OF ALFONSO CARDENAS) AND JOHN JACOBS (HUSBAND OF KRISTEN JACOBS) - BUSINESS RELATIONSHIP |
| Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body | PRIOR TO NOVEMBER 17, 2014, EACH BOARD MEMBER WAS PROVIDED A COPY OF THE RETURN FOR THEIR REVIEW AND INSTRUCTED TO SUBMIT ANY QUESTIONS OR COMMENTS TO THE VP OF FINANCE. AFTER COMMENTS AND QUESTIONS ARE REVIEWED, THE RETURN WAS COMPLETED AND FILED WITH THE IRS ON OR BEFORE NOVEMBER 17, 2014. |
| Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy | ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES ARE COMPLETED BY ALL BOARD MEMBERS, OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES. THE ORGANIZATION'S VICE PRESIDENT OF FINANCE AND TAX ADVISERS REVIEW ALL RESPONSES TO DETERMINE WHETHER OR NOT A POTENTIAL OR ACTUAL CONFLICT OF INTEREST EXISTS. IF AN ACTUAL CONFLICT OF INTEREST IS DETERMINED TO EXIST, PERSONS WITH A CONFLICT ARE RECUSED FROM VOTING ON THE CONFLICTING ISSUE. |
| Form 990, Part VI, Sec B, Line 15a, Process to establish compensation of top management official | ON AN ANNUAL BASIS, THE ORGANIZATION'S COMPENSATION COMMITTEE REVIEWS AND APPROVES COMPENSATION FOR THE PRESIDENT/EXECUTIVE VICE PRESIDENT, AS WELL AS OTHER OFFICERS, ADMINISTRATORS, AND PROFESSIONAL STAFF, INCLUDING KEY EMPLOYEES. THE COMMITTEE REVIEWS CURRENT SALARIES AND PAY STRUCTURES AGAINST VARIOUS SOURCES OF COMPARABILITY DATA, INCLUDING: THE COLLEGE OF AMERICAN PATHOLOGY PATHOLOGISTS COMPENSATION SURVEY; PATHOLOGY COMPENSATION DATA FOR PATHOLOGISTS, WHICH OUTLINES PATHOLOGY AND PHYSICIAN SALARIES BY SPECIALTY, PROVIDED FROM MERRITT HAWKINS AND ASSOCIATES; THE GUIDESTAR NATIONAL COMPENSATION REPORT; AND COMPENSATION REPORTED ON LOCAL AREA HOSPITALS' FORMS 990. AFTER REVIEWING THE COMPARABILITY DATA, THE COMMITTEE DISCUSSES THE CURRENT ECONOMY AND FINANCIAL POSITION OF THE ORGANIZATION TO DETERMINE THE AMOUNT OF ANY COMPENSATION INCREASES AND/OR DECREASES, IF ANY, THAT WILL BE GIVEN. THIS PROCESS IS DOCUMENTED IN THE COMPENSATION COMMITTEE'S MEETING MINUTES. |
| Form 990, Part VI, Sec B, Line 15b, Process to establish compensation of other employees | SEE NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A. |
| Form 990, Part VI, Sec C, Line 19, Required documents available to the public | WHEN REQUESTS FOR THE ORGANIZATION'S FINANCIAL STATEMENTS ARE MADE, THE DATA IS PROVIDED ON SITE. WHEN REQUESTS FOR THE ORGANIZATION'S GOVERNING DOCUMENTS ARE MADE, THE PERSON IS REFERRED TO WWW.IRS.GOV, WHERE COPIES ARE AVAILABLE. THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC ON SITE. |
| Form 990 , Part XI, Line 9, Other changes in net assets or fund balances | PENSION AND POSTRETIREMENT BENEFIT-RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST - 10203328; 2013 GALA RECEIPTS RECORDED IN 2012 - 103125; |