2012-05-15T14:37:07-05:00 2011-06-30 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 2600 INDIANAPOLIS IN 46204 990 2010-07-01 311128781 COMMUNITY FOUNDATION OF NORTHWEST INDIANA INC COMM 2199348250 10010 DONALD S POWERS DRIVE MUNSTER IN 46321 MARY ANN SHACKLETT 2199348250 2012-05-10 3176817000 2010 2016-02-24 21:20:13Z MARY ANN SHACKLETT 10010 DONALD S POWERS DRIVE MUNSTER IN 46321 484868648 false X WWW.COMHS.ORG X 1985 IN PROVIDES SUPPORT FOR ACTIVITIES OF THE AFFILIATED HOSPITALS TO ENGAGE IN THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITIES SERVED WITHIN NORTHWEST INDIANA. 21 12 335 0 11015 -13216 48064 60260 2874870 17655 12622113 10000148 46134436 62059242 61679483 72137305 351017 407681 0 0 24257753 25143304 0 0 56329 33025376 45786946 57634146 71337931 4045337 799374 372425834 411953432 326378319 319649056 46047515 92304376 COMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC PROVIDES SUPPORT FOR ACTIVITIES OF THE AFFILIATED HOSPITALS TO ENGAGE IN THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITIES SERVED WITHIN NORTHWEST INDIANA. COMMUNITY FOUNDATION NORTHWEST INDIANA, INC HELPS COORDINATE ACTIVITIES FOR THE IMPROVED WELL BEING OF THE HOSPITALS AND THEIR PATIENTS. false false 54966935 62557577 TO COORDINATE AND SUPPORT ACTIVITIES OF AFFILIATED HOSPITALS TO ENGAGE IN ACTIVITIES FOR THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITIES SERVED. ALSO PROVIDE SUPPORT FOR COMMUNITY-BASED PROJECTS TO PROMOTE THE CULTURAL, EDUCATIONAL, AND CHARITABLE COMMUNITY OF NORTHWEST INDIANA. 54966935 true true false true false false false false false true false false true true false false true false false false false false false false true false true false true true false false false false false false false true true true true false false false false true true true true false true 90 19 true 335 true true true false false false false false true 1 false false false false false X 21 12 true false false false false false false true true false false true true true true true true true true false IN X MARY ANN SHACKLETT 2199348250 10010 DONALD S POWERS DRIVE MUNSTER IN 46321 STEVEN BEERING MD 1.0 X 16000 0 0 DAVID BOCHNOWSKI 1.0 X 16200 0 0 JOSEPH COSTANZA 1.0 X 17800 0 0 DANIEL DUMEZICH 4.0 X 0 0 0 WILLIAM HASSE 1.0 X 6000 0 0 RICHARD McCLAUGHRY 4.0 X 34333 25000 0 JOSEPH MORROW 1.0 X 11200 0 0 SISTER KATHLEEN QUINN 1.0 X 19000 0 0 DONALD SANDS 1.0 X 4100 0 0 WILLIAM SCHENCK 2.0 X 31733 0 0 MONSIGNOR JOSEPH SEMANCIK 1.0 X 19200 0 0 M NABIL SHABEEB 1.0 X 22000 0 0 DONALD TORRENGA 2.0 X 37031 0 0 ROBERT WELSH 1.0 X 15200 0 0 EDWARD WILLIAMS PhD 1.0 X 26363 0 0 JOE WILLIAMSON 1.0 X 26363 0 0 JAY ZANDSTRA 1.0 X 6000 0 0 JAMES RICHARDS 18.0 X X 46333 30000 0 DAVID WICKLAND 18.0 X X 46333 30000 0 FRANKIE FESKO 12.0 X X 76731 30000 0 DONALD POWERS 40.0 X X X 1272335 0 55994 JOHN GORSKI 40.0 X 1079860 0 62224 MARY ANN SHACKLETT 40.0 X 686997 0 64122 CAROLE BEZAT 40.0 X 719312 0 56641 ANTHONY FERRACANE 40.0 X 485467 0 58004 KEVIN MYBECK 40.0 X 242525 0 31086 ELIZABETH YEE 40.0 X 264595 0 42144 ROSEMARY GARCIA 40.0 X 239035 0 15882 NANCY MOSER 40.0 X 217099 0 21965 RAMONA FISSINGER 40.0 X 173788 0 44041 MARK SIMAGA 20.0 X 125060 0 6591 GARY WEINER 40.0 X 202575 0 12208 DAVID OTTE 40.0 X 166877 0 45165 CRAIG BOLDA 40.0 X 190605 0 56398 MYLINDA CANE 40.0 X 141431 0 38798 FELIX GOZO JR MD 40.0 X 292369 0 14752 KAREN SCHNEIDER 40.0 X 151134 0 43714 JOHN UTESCH 40.0 X 136370 0 37288 DEBASHISH MAZUMDER 40.0 X 133884 0 21696 7399238 115000 728713 33 false true false EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 53593 SOFTWARE SUPPORT 6306312 AFFILIATED COMPUTER SERVICES PO BOX 201322 DALLAS TX 75320 CONSULTING 1511784 DIVURGENT 4445 CORPORATION LANE STE 228 VIRGINIA BEACH VA 23462 CONSULTING 1312510 QUADRAMED CORPORATION PO BOX 347188 PITTSBURGH PA 152514188 CONSULTING 1005137 LUCCA CONSULTING GROUP INC 601 WOODVIEW DRIVE WHITELAND IN 46184 CONSULTING 970404 41 60260 30605 60260 COPYING FEE 900099 14838 14838 MISCELLANEOUS 900099 2817 2817 17655 8684604 8684604 0 0 3191331 3689666 -498335 -498335 410288683 6070 408979209 1309474 6070 1315544 0 62468 62468 0 0 IT REVENUE 518210 10920 10920 EXP ALLOC TO SUBS 900099 60015097 60015097 GAIN ON BOND REPURCHASE 900099 2531465 2531465 95 95 62557577 72137305 62546562 11015 8702259 407681 407681 0 0 0 7319065 5416907 1902158 146296 117037 29259 15192131 12185565 2956511 50055 373151 298521 74630 725765 580612 145153 1386896 1109517 277379 0 886077 886077 897213 897213 91134 91134 0 799835 799835 14899895 11919336 2979834 725 253710 202968 50742 1499165 1199332 299833 6246972 4993850 1248462 4660 0 249477 199582 49895 441505 352493 88123 889 0 41073 32858 8215 8811055 7048844 1762211 184500 147600 36900 6332504 5066003 1266501 521290 417032 104258 REPAIRS AND MAINTENANCE 853725 682980 170745 EARLY EXTINGUISHMENT OF DEBT 1829820 1829820 - - - 947996 758397 189599 71337931 54966935 16314667 56329 14718174 4886430 27401 102318 12863724 20085742 1840292 2687960 147713385 65551277 58547943 82162108 231840957 256289941 52587343 45738933 372425834 411953432 18705915 19872060 12023 18997 286728510 269751046 20931871 30006953 326378319 319649056 X 45659341 91925819 388174 378557 46047515 92304376 372425834 411953432 X 799374 45457487 X false true true X false X X X false false false MUNSTER MEDICAL RESEARCH FOUNDATION INC 351107009 03 true true true 3939330 ST MARY MEDICAL CENTER 352007327 03 true true true 13410171 ST CATHERINE HOSPITAL INC 351738708 03 true true true 2911005 3 20260506 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 91134 91134 false false PART II-B LINE 1i COMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC. CONTRACTS WITH LOBBYIST TO INTERVENE ON OUR BEHALF. 1795180 1795180 53517375 26716242 26801133 2003709 802711 1200998 68684656 37381719 31302937 21712465 650604 21061861 82162108 DEBT SERVICE RESERVE FUND 29115475 DEFERRED COSTS 5889076 VETERANS MEMORIAL PARK 3583910 INVESTMENT IN AFFILIATES 4037510 LAND HELD FOR FUTURE USE 3112962 45738933 0 BOND PAYABLE 2001B (TAXABLE) 19615000 CONSTRUCTION PAYABLE 149453 CAPITAL LEASES 10242500 30006953 62468 62468 true 1.00000 62468 62468 62468 IN true false false false 1.00000 SHERRI HOLT 905 RIDGE RD MUNSTER IN 46321 false false true LAKE AREA UNITED WAY 221 W RIDGE RD GRIFFITH IN 46319 237170019 501(c)(3) 40000 ANNUAL CAMPAIGN FRONTIER MANAGEMENT GROUP 9347 SOUTHVIEW AVE BROOKFIELD IL 60513 351773481 N/A 15000 CONTRIBUTION INDIANA UNIVERSITY NORTHWEST 3400 BROADWAY GARY IN 46408 356001673 501(c)(3) 50000 CONTRIBUTION VALPARAISO UNIVERSITY 1605 CAMPUS DRIVE EAST VALAPRAISO IN 46383 350868125 501(c)(3) 12000 SCHOLARSHIP CONTRIB NORTHWEST INDIANA SYMPHONY ORCHESTRA 1040 RIDGE RD MUNSTER IN 46321 351359750 501(c)(3) 13868 SPONSORSHIP SOUTH SHORE ARTS 1040 RIDGE RD MUNSTER IN 46321 237049722 501(c)(3) 10000 SPONSORSHIP CATHOLIC CHARITIES 176 S WEST STREET CROWN POINT IN 46307 351122204 501(c)(3) 16600 CONTRIBUTION SCHOOL TOWN OF MUNSTER 8808 COLUMBIA AVE MUNSTER IN 46321 356002675 501(c)(3) 15000 CONTRIBUTION PURDUE UNIVERSITY CALUMET 2200 169TH STREET HAMMOND IN 46323 356002041 501(c)(3) 44000 CONTRIBUTION CALUMET COLLEGE OF ST JOSEPH 2400 NEW YORK AVENUE WHITING IN 46394 351087173 501(c)(3) 13000 CONTRIBUTION INDIAN AMERICAN CULTURAL CENTER 8605 MERRILLVILLE RD MERRILLVILLE IN 46410 351981658 N/A 10000 SPONSORSHIP INDIAN MEDICAL ASSOCIATION OF NWI 9038B COLUMBIA AVE MUNSTER IN 46321 314130002 501(c)(3) 15000 CONTRIBUTION BRIAR RIDGE COUNTRY CLUB 123 COUNTRY CLUB DR SCHERERVILLE IN 46375 351511141 N/A 7965 BRIARFEST-BSA CONTRIBUTION BENEFITED THE BOY SCOUTS OF AMERICA PURDUE FOUNDATION 850 BEERING DR WEST LAFEYETTE IN 47907 310958507 501(c)(3) 7500 CONTRIBUTION AMERICAN CANCER SOCIETY 1551 E 85TH AVE MERRILLVILLE IN 46410 131788491 501(C)(3) 5070 CONTRIBUTION COMMUNITY CANCER RESEARCH FOUNDATION 901 MACARTHUR BLVD MUNSTER IN 46321 352146374 501(C)(3) 30868 CONTRIBUTION RIDGEWOOD ARTS FOUNDATION 905 RIDGE ROAD MUNSTER IN 46321 351939427 501(C)(3) 31600 CONTRIBUTION GRANTS 5000 70210 CONTRIBUTION 38 11 SUPPLEMENTAL INFORMATION A COMMITTEE WITHIN CFNI REVIEWS REQUESTS FOR DONATIONS FROM QUALIFIED 501(c)(3) CHARITIES AND UNIVERSITIES AND EVALUATES WHETHER THE POTENTIAL DONEE ORGANIZATION WILL USE THE FUNDS IN A MANNER CONSISTENT WITH THE CHARITABLE MISSION OF CFNI. X true true X X X X X false false false false false false false false false DONALD POWERS 784559 0 476188 0 11588 0 43516 0 12478 0 1328329 0 0 0 JOHN GORSKI 605941 0 466500 0 7419 0 43516 0 18708 0 1142084 0 0 0 MARY ANN SHACKLETT 434301 0 245277 0 7419 0 43516 0 20606 0 751119 0 0 0 CAROLE BEZAT 317751 0 389973 0 11588 0 43516 0 13125 0 775953 0 0 0 ANTHONY FERRACANE 262353 0 218601 0 4513 0 43516 0 14488 0 543471 0 0 0 KEVIN MYBECK 205703 0 35640 0 1182 0 7350 0 23736 0 273611 0 0 0 ELIZABETH YEE 229771 0 33082 0 1742 0 28619 0 13525 0 306739 0 0 0 ROSEMARY GARCIA 198116 0 33228 0 7691 0 7206 0 8676 0 254917 0 0 0 NANCY MOSER 184281 0 31930 0 888 0 6493 0 15472 0 239064 0 0 0 RAMONA FISSINGER 130204 0 42500 0 1084 0 30938 0 13103 0 217829 0 0 0 GARY WEINER 172001 0 30000 0 574 0 7350 0 4858 0 214783 0 0 0 DAVID OTTE 166206 0 0 0 671 0 29877 0 15288 0 212042 0 0 0 MYLINDA CANE 119494 0 20795 0 1142 0 25269 0 13529 0 180229 0 0 0 FELIX GOZO JR MD 281019 0 0 0 11350 0 7240 0 7512 0 307121 0 0 0 KAREN SCHNEIDER 141480 0 9000 0 654 0 27523 0 16191 0 194848 0 0 0 JOHN UTESCH 134723 0 0 0 1647 0 24192 0 13096 0 173658 0 0 0 DEBASHISH MAZUMDER 133801 0 0 0 83 0 3601 0 18095 0 155580 0 0 0 CRAIG BOLDA 163021 0 26460 0 1124 0 34693 0 21705 0 247003 0 0 0 SUPPLEMENTAL INFORMATION 1a The organization pays health/social club dues on behalf of certain officers, key employees and the five highest paid employees which is then taxed as a fringe benefit to the individual. INDIANA HEALTH FACILITY FINANCING AUTHORITY 351611409 4547977V7 2004-04-08 59742964 CONSTRUCTION & PURCHASE EQUIPMENT false false false INDIANA HEALTH AND EDUCATIONAL FACILITY FINANCING 351611409 45479RCM7 2007-06-28 152135212 CONST/EQP & REFUND 2001 (10/17/01) false false false INDIANA FINANCING AUTHORITY 351602316 45471AAE2 2008-10-22 27370000 CONST/EQP & REFUND 2008 (06/03/08) false false false 59742964 4020354 1194859 54061858 260862 2006 false false true true 154167345 11201078 57019745 1802515 83918821 72695 2009 false true true true 27416609 0 460158 20121330 6785277 49844 2010 true false true true false true true true true 0.00040 0.00000 0.00040 true false true true true true 0.00000 0.00000 0.00000 true false true true true true 0.00000 0.00000 0.00000 true false false false false false false false false false false false false false false false false false true false false false false false false Total Proceeds of Issue Part II, Line 3 The difference from issue price to total proceeds of issue is a result of investment earnings. DON POWERS AGENCY ENTITY MORE THAN OWNED BY JOE WILLIAMSON 550342 INDEPENDENT CONTRACTOR false LEONARD BEZAT F MEMBER OF CAROLE BEZAT 41999 EMPLOYMENT false BARBARA BOLDA F MEMBER OF CRAIG BOLDA 104297 EMPLOYMENT false HASSE CONSTRUCTION OWNED BY WILLIAM HASSE 906973 INDEPENDENT CONTRACTOR false BRIAR RIDGE COUNTRY CLUB DON POW FRANKIE FESKO PART OWNERS 108080 FOOD AND ENTERTAINMENT false X 1 30605 FMV 0 false true false FAMILY AND BUSINESS RELATIONSHIPS PART VI-A, LINE 2 FRANKIE FESKO, FAMILY MEMBER OF DONALD POWERS, BUSINESS RELATIONSHIP BETWEEN DONALD POWERS AND JOE WILLIAMSON. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 PART VI-B, LINE 11b THE 990 IS SUBMITTED TO THE SENIOR VP AND CFO FOR REVIEW, ONCE THIS REVIEW IS COMPLETE THE RETURNS ARE THEN PRESENTED TO SENIOR LEADERSHIP FOR REVIEW. THE 990 IS ALSO REVIEWED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM BEFORE IT IS POSTED TO A SECURE WEBSITE TO ALLOW THE BOARD OF DIRECTORS ACCESS TO REVIEW PRIOR TO FILING. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PART VI-B, LINE 12C AS PART OF THE ORGANIZATION'S ANNUAL MONITORING & ENFORCEMENT PROCEDURE RELATING TO ITS CONFLICT OF INTEREST POLICY, ALL CONFLICT OF INTEREST QUESTIONNAIRES ARE REVIEWED BY THE VP OF CORPORATE COMPLIANCE AND THOSE OFFICERS, DIRECTORS OR KEY EMPLOYEES WHO DO NOT RETURN OR FULLY COMPLETE THE QUESTIONNAIRE ARE CONTACTED TO RECONCILE THE OMISSION. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN PART VI-B, LINE 15 THE CFNI BOARD HAS ADOPTED EXECUTIVE AND BOARD OF DIRECTORS COMPENSATION PHILOSOPHY AND REASONABLENESS STANDARDS. THIS IS TO ASCERTAIN THAT THESE STANDARDS ARE ADHERED TO. THEIR PROCESS FOR COLLECTING AND ASSEMBLING MARKET DATA IS CONSISTENT WITH THE REBUTTABLE PRESUMPTION CHECKLIST AND GUIDELINES ALONG WITH FAIR MARKET VALUE USED BY THE IRS IN CONDUCTING EXECUTIVE COMPENSATION REVIEWS AS WELL AS CONTEMPORARY COMPENSATION PRACTICES. ALL MARKET DATA IS ASSEMBLED FROM REPUTABLE COMMERCIALLY AVAILABLE SURVEYS. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC PART VI-C, LINE 19 COMMUNITY FOUNDATION OF NW IN INC DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. IN ACCORDANCE WITH BOND CONVENANTS, CFNI MAKES IT FINANCIAL STATEMENTS AND DISCLOSURES AVAILABLE TO THE PUBLIC THROUGH THE NRMSIRS DATABASE. AVERAGE HOURS WORKED PER WEEK PART VII, LINE 1 THE AVERAGE HOURS PER WEEK INCLUDE ALL HOURS WORKED FOR THE FILING ORGANIZATION AND ALL RELATED ENTITIES. RECONCILIATION OF NET ASSETS PART XI LINE 5 TRANSFERS FROM RELATED ENTITIES 60,638,826 UNREALIZED INVESTMENT INCOME 7,487,371 TRANSFERS TO RELATED ENTITIES (22,661,300) ASSETS RELEASED FROM RESTRICTIONS (36,527) NON CASH DONATION (30,605) CHANGE IN TEMP RESTRICTED FUNDS ( 2,746) INTERCOMPANY TRANSFER ADJUSTMENT 62,468 TOTAL CHANGE IN NET ASSETS 45,457,487 MUNSTER MEDICAL RESEARCH FD 901 MACARTHUR BLVD MUNSTER IN 46321 351107009 HOSPITAL IN 501(c)(3) 3 NA ST CATHERINE HOSPITAL INC 4321 FIR STREET EAST CHICAGO IN 46312 351738708 HOSPITAL IN 501(c)(3) 3 NA ST MARY MEDICAL CENTER 1500 S LAKE PARK AVENUE HOBART IN 46342 352007327 HOSPITAL IN 501(c)(3) 3 NA COMMUNITY CANCER RESEARCH FD 901 MACARTHUR BLVD MUNSTER IN 46321 352146374 CANCER FUNDR IN 501(c)(3) 7 MUNSTER MED COMMUNITY VILLAGE INC 10000 COLUMBIA AVENUE MUNSTER IN 46321 351956395 RETRMNT HOME IN 501(c)(3) 9 NA CVPA HOLDING COMPANY 905 RIDGE ROAD MUNSTER IN 46321 351938136 SUPPORT ORG IN 501(c)(2) N/A NA RIDGEWOOD ARTS FOUNDATION 905 RIDGE ROAD MUNSTER IN 46321 351939427 PLAYS&ARTS IN 501(c)(3) 9 NA COMMUNITY RESOURCES INC 907 RIDGE ROAD MUNSTER IN 46321 351727711 MGMT SERVICES IN NA C CORP -1131263 8631000 1.00000 true true true true false false false false false true false false false true true true false false MUNSTER MEDICAL RESEARCH FOUNDATION INC a(iv) 2000278 COMMUNITY CANCER RESEARCH FOUNDATION a(iv) 78312 ST MARY MEDICAL CENTER b 13410171 MUNSTER MEDICAL RESEARCH FOUNDATION INC b 3939330 ST CATHERINE HOSPITAL INC b 2911005 CVPA HOLDING COMPANY b 559700 RIDGEWOOD ARTS FOUNDATION b 428000 MUNSTER MEDICAL RESEARCH FOUNDATION INC c 46360348 ST MARY MEDICAL CENTER c 13278478 ST CATHERINE HOSPITAL INC c 1402951 COMMUNITY VILLAGE INC c 1000000 ST CATHERINE HOSPITAL INC j 173580 MUNSTER MEDICAL RESEARCH FOUNDATION INC n 12845385 ST MARY MEDICAL CENTER n 6625134 ST CATHERINE HOSPITAL INC n 3928390 ST MARY MEDICAL CENTER o 5331350 ST CATHERINE HOSPITAL INC o 4068345 MUNSTER MEDICAL RESEARCH FOUNDATION INC o 3135394 COMMUNITY CANCER RESEARCH FOUNDATION o 262797 MUNSTER MEDICAL RESEARCH FOUNDATION INC p 21233300 ST MARY MEDICAL CENTER p 13557048 ST CATHERINE HOSPITAL INC p 8933579 COMMUNITY CANCER RESEARCH FOUNDATION p 259416