COMMUNITY HOSPITAL ANDERSON FOUNDATION INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HOSPITAL ANDERSON FOUNDATION INC (EIN 86-1053152)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-12
- IRS object ID
- 201203179349302005
- Schema version
- 2011v1.2
- 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) |
|---|---|---|
| Timestamp | 2012-11-12T12:31:10-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CASKEY & DAILY PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4745 STATESMEN DRIVE SUITE C | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46250 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861053152 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL ANDERSON FDN | BusinessNameLine1 |
| Business Name Line2 | INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COMM | NameControl |
| Phone | 7652985133 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 N MADISON AVENUE | AddressLine1 |
| City | ANDERSON | City |
| State | IN | State |
| ZIP Code | 46011 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KEITH TRENT | Name |
| Title | CHIEF FOUNDATION OFFICER | Title |
| Phone | 7652985133 | Phone |
| Date Signed | 2012-11-07 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES A CASKEY CPA CFP | Name |
| Phone | 3175852647 | Phone |
| Date Prepared | 2012-11-07 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KEITH TRENT | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 N MADISON AVENUE | AddressLine1 |
| City | ANDERSON | City |
| State | IN | State |
| ZIP Code | 46011 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1196620 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.COMMUNITYANDERSON.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2001 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | COMMUNITY HOSPITAL ANDERSON FOUNDATION, INC. IS ENGAGED IN FUND RAISING ACTIVITIES TO ACQUIRE MONIES TO FURTHER THE PURPOSES AND MISSION OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. IN PROVIDING QUALITY MEDICAL CARE AND TREATMENT TO CITIZENS OF ANDERSON AND MADISON COUNTY, INDIANA. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 2 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 480908 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 464916 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -36099 | InvestmentIncomePriorYear |
| Investment Income Current Year | 59280 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 6171 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 444809 | TotalRevenuePriorYear |
| Total Revenue Current Year | 530367 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 8000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 446967 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 157555 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 146658 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 710263 | OtherExpensePriorYear |
| Other Expenses Current Year | 100687 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 875818 | TotalExpensesPriorYear |
| Total Expenses Current Year | 694312 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -431009 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -163945 | RevenuesLessExpensesCY |
| Total Assets BOY | 3770941 | TotalAssetsBOY |
| Total Assets EOY | 3588833 | TotalAssetsEOY |
| Total Liabilities BOY | 14704 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 124912 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3756237 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3463921 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | COMMUNITY HOSPITAL ANDERSON FOUNDATION, INC. IS ENGAGED IN FUND RAISING ACTIVITIES TO ACQUIRE MONIES TO FURTHER THE PURPOSES AND MISSION OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. IN PROVIDING QUALITY MEDICAL CARE AND TREATMENT TO CITIZENS OF ANDERSON AND MADISON COUNTY, INDIANA. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 442077 | Expense |
| Grants | 440967 | Grants |
| Description | A) PROVIDE CAPITAL IMPROVEMENTS & MEDICAL EQUIPMENT FOR USE BY COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. AND B) PROVIDE PROGRAMS DESIGNED TO EDUCATE THE PATIENTS OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. CONCERNING THEIR HEALTH NEEDS AND AVAILABLE MEDICAL TREATMENT. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 26481 | Expense |
| Description | PROVIDE FINANCIAL ASSISTANCE TO COMMUNITY HOSPITAL ANDERSON EMPLOYEES THROUGH THE HEALTHCARE EMPLOYEES LOAN PROGRAM. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6000 | Expense |
| Grants | 6000 | Grants |
| Description | PROVIDE SCHOLARSHIPS AND EDUCATION ASSISTANCE TO COMMUNITY HOSPITAL ANDERSON EMPLOYEES. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 474558 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | false | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | true | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 8 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 2 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | true | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | false | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KEITH TRENT | NamePerson |
| Telephone Number | 7652985414 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 N MADISON AVENUE | AddressLine1 |
| City | ANDERSON | City |
| State | IN | State |
| ZIP Code | 46011 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| PATRICIA WOODS | ||||||
| DIRECTOR | 5.00 | X | 0 | 97127 | 10216 | |
| SHARON ANTRIM | ||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |
| DOUG BANNING | ||||||
| TREASURER | 5.00 | X | 0 | 0 | 0 | X |
| ROGER BROCKMAN MD | ||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |
| BRIAN DONAHUE | ||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |
| CRAIG DUNKIN | ||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |
| MARSHA MUSTIN | ||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |
| WILLIAM O'NEAL PHD | ||||||
| CHAIRMAN | 5.00 | X | 0 | 0 | 0 | X |
| QUINN RICKER | ||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |
| JACK ROBINSON | ||||||
| SECRETARY | 5.00 | X | 0 | 0 | 0 | X |
| JR ROSENCRANS | ||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |
| PAM SHOOT | ||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |
| TONY THANAS | ||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |
| GEORGEANN WHITWORTH | ||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |
| BETTY WILLIAMS | ||||||
| VICE CHAIRMA | 5.00 | X | 0 | 0 | 0 | X |
| KEITH TRENT | ||||||
| DIRECTOR/CH | 45.00 | 91093 | 22773 | 58050 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 91093 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 119900 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 68266 | TotalOtherCompensation |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Government Grants | 33303 | GovernmentGrants |
| All Other Contributions | 431613 | AllOtherContributions |
| Total Contributions | 464916 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 137695 | TotalRevenueColumn |
| Exclusion | $137,695 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 580414 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 658829 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -78415 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -78415 | TotalRevenueColumn |
| Exclusion | -$78,415 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 13595 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 7424 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6171 | TotalRevenueColumn |
| Exclusion | $6,171 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 530367 | TotalRevenueColumn |
| Exclusion | $65,451 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 440967 | Total |
| Program Services | 440967 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6000 | Total |
| Program Services | 6000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 91093 | Total |
| Management And General | 91093 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44948 | Total |
| Management And General | 44948 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 342 | Total |
| Management And General | 342 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10275 | Total |
| Management And General | 10275 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4510 | Total |
| Management And General | 4510 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14612 | Total |
| Management And General | 14612 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39897 | Total |
| Management And General | 39897 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 493 | Total |
| Management And General | 493 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8511 | Total |
| Management And General | 8511 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 569 | Total |
| Management And General | 569 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| "HELP" LOANS | 26481 | 26481 | |
| DUES & LICENSES | 4504 | 4504 | |
| DONOR MEETINGS | 1110 | 1110 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 694312 | Total |
| Program Services | 474558 | ProgramServices |
| Management And General | 219754 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 165762 | BOY |
| EOY | 86706 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3605179 | BOY |
| EOY | 3502127 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3770941 | BOY |
| EOY | 3588833 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14704 | BOY |
| EOY | 2369 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 122543 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14704 | BOY |
| EOY | 124912 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3756237 | BOY |
| EOY | 3463921 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3756237 | BOY |
| EOY | 3463921 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3770941 | BOY |
| EOY | 3588833 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -163945 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -128371 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type2 | X | SupportingOrg509a3Type2 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSP OF ANDERSON & MADISON COUNTY INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351069822 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | false | ListedInGoverningDoc |
| Supported Organization Notified | false | SupportedOrganizationNotified |
| Organized In US | false | OrganizedInUS |
| Amount | $440,967 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 440967 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3438442 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -66313 | InvestmentEarningsOrLosses |
| Administrative Expenses | 13434 | AdministrativeExpenses |
| End Of Year Balance | 3358695 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3435272 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 404254 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 81823 | GrantsOrScholarships |
| Other Expenditures | 305450 | OtherExpenditures |
| Administrative Expenses | 13811 | AdministrativeExpenses |
| End Of Year Balance | 3438442 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2930191 | BeginningOfYearBalance |
| Contributions | 5000 | Contributions |
| Investment Earnings Or Losses | 793869 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 30987 | GrantsOrScholarships |
| Other Expenditures | 250250 | OtherExpenditures |
| Administrative Expenses | 12551 | AdministrativeExpenses |
| End Of Year Balance | 3435272 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3744020 | BeginningOfYearBalance |
| Contributions | 457384 | Contributions |
| Investment Earnings Or Losses | -1144762 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 89235 | GrantsOrScholarships |
| Other Expenditures | 20999 | OtherExpenditures |
| Administrative Expenses | 16217 | AdministrativeExpenses |
| End Of Year Balance | 2930191 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.73000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.27000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO AFFILIATES | Description |
| Amount | $122,543 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 122543 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | INTENDED USES FOR ENDOWMENT FUNDS | Identifier |
| Return Reference | SCHEDULE D, PAGE 2, PART V, LINE 4 | ReturnReference |
| Explanation | THE INTENDED USES OF THE ENDOWMENT FUNDS ARE TO PROVIDE EQUIPMENT FOR COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. ("CHA") AND THE SURROUNDING COMMUNITY. THE FOUNDATION ALSO PROVIDES SCHOLARSHIPS AND OTHER EDUCATIONAL SUPPORT. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMM HOSP OF ANDERSON & MADISON CTY | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 NORTH MADISON AVENUE | AddressLine1 |
| City | ANDERSON | City |
| State | IN | State |
| ZIP Code | 46011 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 351069822 | EINOfRecipient |
| IRC Section | 501 | IRCSection |
| Amount Of Cash Grant | 440967 | AmountOfCashGrant |
| Purpose Of Grant | PURCHASE EQUIP/OTHER | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | SCHOLARSHIPS | TypeOfGrant |
| Number Of Recipients | 6 | NumberOfRecipients |
| Amount Of Cash Grant | 6000 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES | Identifier |
| Return Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | ReturnReference |
| Explanation | SCHOLARSHIPS ARE PAID DIRECTLY TO THE UNIVERSITY FOR A STUDENT IN THE MEDICAL OR NURSING FIELD OF STUDY. TRANSCRIPTS ARE REQUIRED FROM THE SCHOLARSHIP RECIPIENTS AT THE END OF EACH SEMESTER. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KEITH TRENT | NamePerson |
| Base Compensation Filing Org | 82907 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 20727 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 6728 | BonusFilingOrg |
| Bonus Related Orgs | 1682 | BonusRelatedOrgs |
| Other Compensation Filing Org | 1458 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 364 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 33650 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 8412 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 12790 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 3198 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 137533 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 34383 | TotalCompensationRelatedOrgs |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FRINGE OR EXPENSE EXPLANATION | SCHEDULE J, PAGE 1, PART I, LINE 1A | THE CHIEF FOUNDATION OFFICER WAS PROVIDED SOCIAL CLUB DUES BY COMMUNITY HOSPITAL ANDERSON FOUNDATION. THIS WAS NOT TAXABLE COMPENSATION. |
| RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION | SCHEDULE J, PAGE 1, PART I, LINE 3 | COMMUNITY HOSPITAL ANDERSON FOUNDATION, INC. CEO/EXECUTIVE DIRECTOR IS PAID BY COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. ("CHA"), A RELATED 501(C)(3) ORGANIZATION. CHA USES THE FOLLOWING IN DETERMINING THE CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE, 2) INDEPENDENT COMPENSATION CONSULTANT, 3) WRITTEN EMPLOYMENT CONTRACT, 4) COMPENSATION SURVEY OR STUDY, AND 5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| NON-FIXED PAYMENTS PROVIDED | SCHEDULE J, PAGE 1, PART I, LINE 7 | THE CHIEF FOUNDATION OFFICER PARTICIPATES IN A SENIOR LEADERSHIP INCENTIVE PROGRAM. THE PROGRAM WAS ADOPTED BY THE COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC.'S ("CHA") EXECUTIVE COMPENSATION COMMITTEE, AND IS INTENDED TO INFLUENCE OUTSTANDING PERFORMANCE, AS MEASURED AGAINST BOTH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE. THE PROGRAM IS REVIEWED ANNUALLY BY CHA'S EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPOSED OF EXTERNAL BOARD MEMBERS. THE INCENTIVE COMPENSATION THAT IS AWARDED IS INCLUDED IN TOTAL COMPENSATION TO THE EXECUTIVE. THE TOTAL COMPENSATION (INCLUDING ANY PAYMENTS UNDER THE PROGRAM) IS SUBJECT TO THE REVIEW AND APPROVAL OF THE EXECUTIVE COMPENSATION COMMITTEE AND INDEPENDENT COMPENSATION CONSULTANT, IN CONSIDERATION OF CODE SECTION 4958 (AND THE CORRESPONDING TREASURY REGULATIONS) TO ENSURE THAT IT REFLECTS ARMS LENGTH, FAIR MARKET TERMS. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | COMMUNITY HOSPITAL ANDERSON FOUNDATION, INC. IS ENGAGED IN FUND RAISING ACTIVITIES TO ACQUIRE MONIES TO FURTHER THE PURPOSES AND MISSION OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. IN PROVIDING QUALITY MEDICAL CARE AND TREATMENT TO CITIZENS OF ANDERSON AND MADISON COUNTY, INDIANA. |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | THE MEMBERS CONSIST OF THE BOARD OF DIRECTORS OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | THE FOUNDATION'S ARTICLES OF INCORPORATION STATE THE "MEMBERS" OF THE FOUNDATION ARE THE BOARD OF TRUSTEES OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. THEY ARE THE ONES WHO OFFICIALLY ELECT FOUNDATION BOARD OF DIRECTORS. THE BY-LAWS ALSO GIVE THE MEMBERS THE RIGHT TO FILL ANY VACANCY AMONG THE DIRECTORS AND THE RIGHT TO REMOVE ANY DIRECTOR. |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PAGE 6, PART VI, LINE 7B | THE FOUNDATION'S ARTICLES OF INCORPORATION STATE THE "MEMBERS" OF THE FOUNDATION ARE THE BOARD OF TRUSTEES OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. THEY ARE THE ONES WHO OFFICIALLY ELECT THE FOUNDATION BOARD OF DIRECTORS. THE MEMBERS ALSO MUST APPROVE ANY AMENDMENT TO THE ARTICLES OF INCORPORATION. THE FOUNDATION BOARD OF DIRECTORS APPROVE ALL OTHER MATTERS RELATED TO THE FOUNDATION WITHOUT AUTHORIZATION OR APPROVAL OF THE MEMBERS OF THE FOUNDATION. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE RETURN IS PREPARED BY AN OUTSIDE, INDEPENDENT ACCOUNTING FIRM. ALL SECTIONS OF THE FORM 990 ARE REVIEWED BY THE EXECUTIVE COMMITTEE OF THE FOUNDATION BOARD OF DIRECTORS. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | COMMUNITY HOSPITAL ANDERSON FOUNDATION, INC. MONITORS THE CONFLICT OF INTEREST POLICY BY MAKING SURE THAT THE FOUNDATION BOARD MEMBERS SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. THE EXECUTIVE COMMITTEE, WHICH CONSISTS OF THE OFFICERS, WOULD ADDRESS ANY CONFLICTS OF INTEREST. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE FOUNDATION OFFICER IS COMPENSATED BY COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. (CHA). CHA HAS A COMPENSATION COMMITTEE COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR EVALUATING AND DETERMINING COMPENSATION FOR CHA'S EXECUTIVE PERSONNEL. IN DISCHARGING THESE DUTIES, THE COMPENSATION COMMITTEE APPLIES THE PRINCIPLES OF THE REBUTTABLE PRESUMPTION AS OUTLINED IN CODE SECTION 4958 AND THE CORRESPONDING TREASURY REGULATIONS. MOST NOTABLY, THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABILITY DATA WHEN SETTING COMPENSATION AND CONTEMPORANEOUSLY DOCUMENTS ITS DECISIONS AND THE PROCESS THAT IT EMPLOYS IN WRITING. IN ADDITION, THE COMPENSATION COMMITTEE PERIODICALLY RETAINS AN OUTSIDE COMPENSATION CONSULTANT TO PROVIDE INPUT REGARDING THE APPROPRIATENESS OF CHA'S COMPENSATION DECISIONS. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | A) THE ARTICLES OF INCORPORATION AND CERTIFICATE OF EXISTENCE ARE ON FILE WITH THE INDIANA SECRETARY OF STATE AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE INDIANA SECRETARY OF STATE OR FREE OF CHARGE ON THE SECRETARY OF STATE'S WEBSITE. B) WHILE NOT AVAILABLE TO THE PUBLIC, THE CONFLICT OF INTEREST POLICY IS DESCRIBED IN PART VI, LINE 12C. C) COMMUNITY HOSPITAL ANDERSON FOUNDATION, INC. DOES NOT HAVE INDIVIDUALLY AUDITED FINANCIAL STATEMENTS. ITS FINANCIAL RESULTS ARE INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMUNITY HEALTH NETWORK, INC. AND AFFILIATES. AS SUCH, THERE ARE NO INDIVIDUAL FINANCIAL STATEMENTS TO POST. COMMUNITY HOSPITAL ANDERSON FOUDNATION, INC. DOES FILE THE 990 TAX RETURN ON AN ANNUAL BASIS WHICH IS AVAILABLE UPON REQUEST AND/OR AVAILABLE ON A DELAYED BASIS ON GUIDESTAR.COM. |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 5 | DECREASE IN INVESTMENT MARKET VALUE 128,371 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (12 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COMM HOSP OF ANDERSON & MADISON CTY | |||||||||||
| 1515 N MADISON AVENUE | ANDERSON | IN | 46011 | 351069822 | HOSPITAL | IN | 501C3 | 3 | CHI | false | |
| COMMUNITY LTC INC | |||||||||||
| 1031 MONTICELLO DRIVE | ANDERSON | IN | 46011 | 351877441 | HLTH CARE | IN | 501C3 | 9 | CHA | true | |
| COMMUNITY HEALTH NETWORK INC | |||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 311038302 | SUPPORT | IN | 501C3 | 11B | false | N/A | |
| COMMUNITY HEALTH NETWORK FOUNDATION | |||||||||||
| 1500 NORTH RITTER AVENUE | INDIANAPOLIS | IN | 46219 | 510181688 | CHARITY | IN | 501C3 | 11B | CHNW | true | |
| COMMUNITY HOME HEALTH SERVICES INC | |||||||||||
| 9894 EAST 121ST STREET | FISHERS | IN | 46037 | 350953467 | HLTH CARE | IN | 501C3 | 9 | CHNW | true | |
| COMMUNITY HOSPITALS OF INDIANA INC | |||||||||||
| 1500 NORTH RITTER AVENUE | INDIANAPOLIS | IN | 46219 | 350983617 | HOSPITAL | IN | 501C3 | 3 | CHNW | false | |
| COMMUNITY HOSPITAL SOUTH INC | |||||||||||
| 1402 E COUNTY LINE ROAD SOUTH | INDIANAPOLIS | IN | 46227 | 351088640 | HOSPITAL | IN | 501C3 | 3 | CHI | true | |
| COMMUNITY PHYSICIANS OF IN INC | |||||||||||
| 7240 SHADELAND STATION SUITE 300 | INDIANAPOLIS | IN | 46256 | 205392766 | PHY SRV | IN | 501C3 | 9 | CHI | true | |
| THE INDIANA HEART HOSPITAL LLC | |||||||||||
| 8075 NORTH SHADELAND AVENUE | INDIANAPOLIS | IN | 46250 | 352123783 | HOSPITAL | IN | 501C3 | 3 | CHI | true | |
| INDIANAPOLIS OSTEOPATHIC HOSPITAL | |||||||||||
| 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | 351094734 | HOSPITAL | IN | 501C3 | 3 | CHNW | true | |
| WESTVIEW HOSPITAL FOUNDATION INC | |||||||||||
| 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | 311036451 | SUPPORT | IN | 501C3 | 11B | IOH | true | |
| HEALTH INSTITUTE OF INDIANA INC | |||||||||||
| 3660 GUION ROAD | INDIANAPOLIS | IN | 46222 | 352022402 | FITNESS | IN | 501C3 | 9 | IOH | true | |
Form990 Schedule R Part III Form990ScheduleRPartIII (12 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|
| EAST CAMPUS SURGERY CENTER LLC | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 352028517 | SURGERY | IN | N/A | false | false |
| INDIANA SPECIALTY GROUP | |||||||||
| 7240 SHADELAND STATION SUITE 300 | INDIANAPOLIS | IN | 46256 | 351976258 | HLTH CARE | IN | N/A | false | false |
| MICHIGAN SURGERY INVESTMENT LLC | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 320147008 | SURG CTRS | IN | N/A | false | false |
| NORTH CAMPUS OFFICE ASSOCIATES LP | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 351808625 | RNTL PROP | IN | N/A | false | false |
| NORTH CAMPUS SURGERY CENTERS LLC | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 352147088 | SURGERY | IN | N/A | false | false |
| SURGICARE LLC | |||||||||
| 2907 MCINTIRE DRIVE | BLOOMINGTON | IN | 47403 | 351975122 | SURGERY | IN | N/A | false | false |
| EAST CAMPUS SURGERY CENTER LLC | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 352028517 | SURGERY | IN | N/A | false | false |
| INDIANA SPECIALTY GROUP | |||||||||
| 7240 SHADELAND STATION SUITE 300 | INDIANAPOLIS | IN | 46256 | 351976258 | HLTH CARE | IN | N/A | false | false |
| MICHIGAN SURGERY INVESTMENT LLC | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 320147008 | SURG CTRS | IN | N/A | false | false |
| NORTH CAMPUS OFFICE ASSOCIATES LP | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 351808625 | RNTL PROP | IN | N/A | false | false |
| NORTH CAMPUS SURGERY CENTERS LLC | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 352147088 | SURGERY | IN | N/A | false | false |
| SURGICARE LLC | |||||||||
| 2907 MCINTIRE DRIVE | BLOOMINGTON | IN | 47403 | 351975122 | SURGERY | IN | N/A | false | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV (12 entries)
| Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Direct Controlling Entity NADirectControllingEntityNA | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Legal Domicile StateLegalDomicileState |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CHN ASSURANCE COMPANY LTD | |||||||||||
| PO BOX 1051GT | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | |||||
| INDIANA PROHEALTH NETWORK INC | |||||||||||
| 351614719 | INSURANCE | N/A | 8180 CLEARVISTA PARKWAY SUITE 230 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VISIONARY ENTERPRISES INC | |||||||||||
| 351538433 | MGMT SRVCS | N/A | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VEI MICHIGAN INC | |||||||||||
| 300097377 | MGMT SRVCS | N/A | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| VEI-PRO HEALTH INC | |||||||||||
| 454037444 | INSURANCE | N/A | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| WESTVIEW DELIVERY SYSTEM | |||||||||||
| 351910292 | MGMT SRVCS | N/A | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | ||||
| CHN ASSURANCE COMPANY LTD | |||||||||||
| PO BOX 1051GT | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | |||||
| INDIANA PROHEALTH NETWORK INC | |||||||||||
| 351614719 | INSURANCE | N/A | 8180 CLEARVISTA PARKWAY SUITE 230 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VISIONARY ENTERPRISES INC | |||||||||||
| 351538433 | MGMT SRVCS | N/A | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VEI MICHIGAN INC | |||||||||||
| 300097377 | MGMT SRVCS | N/A | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| VEI-PRO HEALTH INC | |||||||||||
| 454037444 | INSURANCE | N/A | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| WESTVIEW DELIVERY SYSTEM | |||||||||||
| 351910292 | MGMT SRVCS | N/A | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
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