UNION HOSPITAL FOUNDATION INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- UNION HOSPITAL FOUNDATION INC (EIN 35-1642823)
- Tax period
- 2009-09-01 to 2010-08-31
- Filed
- 2011-06-20
- IRS object ID
- 201141719349300009
- Schema version
- 2009v1.7
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-06-20T08:11:47-05:00 | Timestamp |
| Tax Period End Date | 2010-08-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Blue & Co LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | One American Square 2200 | AddressLine1 |
| City | Indianapolis | City |
| State | IN | State |
| ZIP Code | 46282 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-09-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351642823 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Union Hospital Foundation inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | UNIO | NameControl |
| Phone | 8122387534 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1606 North Seventh Street | AddressLine1 |
| City | Terre Haute | City |
| State | IN | State |
| ZIP Code | 478042780 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Wayne R Hutson | Name |
| Title | Assistant Treasurer | Title |
| Phone | 8122387601 | Phone |
| Date Signed | 2011-06-17 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Angela L Zirkelbach CPA | Name |
| Phone | 3176334705 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | WAYNE HUTSON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1606 North Seventh Street | AddressLine1 |
| City | Terre Haute | City |
| State | IN | State |
| ZIP Code | 478042780 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 3175300 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.unionhospitalfoundation.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1985 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | Support advances in medical care and initiatives to improve health for the residents of Wabash Valley by making grants to Union Hospital, Inc. Union Hospital Health Services, Inc. and other qualified organizations which serve this purpose. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 36 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 32 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 60 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 689132 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 685524 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 73719 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 31631 | InvestmentIncomePriorYear |
| Investment Income Current Year | 49414 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -118369 | OtherRevenuePriorYear |
| Other Revenue Current Year | 104310 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 676113 | TotalRevenuePriorYear |
| Total Revenue Current Year | 839248 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 220665 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 744323 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6229 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 347599 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 109721 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 1875 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 161123 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 568031 | OtherExpensePriorYear |
| Other Expenses Current Year | 338981 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 904646 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1432778 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -228533 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -593530 | RevenuesLessExpensesCY |
| Total Assets BOY | 16492141 | TotalAssetsBOY |
| Total Assets EOY | 13669907 | TotalAssetsEOY |
| Total Liabilities BOY | 9840696 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7103922 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6651445 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 6565985 | NetAssetsOrFundBalancesEOY |
| Mission Description | Support advances in medical care and initiatives which improve health for the residents of the Wabash Valley by making grants to Union Hospital, Inc., Union Hospital Health Services, Inc. and other qualified organizations which serve this purpose. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 677935 | Expense |
| Grants | 677935 | Grants |
| Revenue | 0 | Revenue |
| Description | Various grants to Union Hospital, Inc. to further its delivery of healthcare services to the Wabash Valley. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 23758 | Expense |
| Grants | 23758 | Grants |
| Revenue | 0 | Revenue |
| Description | Academic Scholarship Award to be applied to the tuition and related education expenses of numerous students attending various colleges and universities. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 23755 | Expense |
| Grants | 23755 | Grants |
| Revenue | 0 | Revenue |
| Description | Grants to St. Ann's Clinic for the payment of insurance premiums. St. Ann's Clinic serves approximately 7,000 patients per year at its present level of operation. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 18875 | Expense |
| Grants | 18875 | Grants |
| Revenue | 0 | Revenue |
| Description | Grants to organizations, memorials, and individuals to support various activities. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 18875 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 18875 | TotalOfOtherProgramServiceGrnt |
| Total Program Service Expense | 744323 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 7 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 36 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 32 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wayne R Hutson | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8122387601 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1606 North Seventh Street | AddressLine1 |
| City | Terre Haute | City |
| State | IN | State |
| ZIP Code | 47804 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (35 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| Cindy Martin | ||||||
| chairman | 4.00 | X | X | 0 | 0 | 0 |
| Mark Fuson | ||||||
| vice chairman | 1.00 | X | X | 0 | 0 | 0 |
| david doerr | ||||||
| president | 6.00 | X | X | 0 | 489408 | 22775 |
| diann mckee | ||||||
| secretary | 1.00 | X | X | 0 | 0 | 0 |
| mary doti | ||||||
| treasurer | 1.00 | X | X | 0 | 0 | 0 |
| RIchard BURGER | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| MARY ANN CARROLL | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| JOHN DINKEL | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| JERRY EINSTANDIG | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| VERN FELLOWS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| MARGOT GILLESPIE | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| WILLIAM GRIMES | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ROBERT HAERR MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| TROY HELMAN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| WARD HUBBARD | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| W EDWARD JUKES | ||||||
| DIREctor | 1.00 | X | 0 | 0 | 0 | |
| BASHAR KASHLAN md | ||||||
| DIREctor | 1.00 | X | 0 | 0 | 0 | |
| JANet KORZINEK | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| ARNold KOSOFSKY | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| SALLY LOWERY | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| John Lukens | ||||||
| Director | 2.00 | X | 0 | 0 | 0 | |
| ROBERT MEISSEL MD | ||||||
| DIrector | 1.00 | X | 0 | 0 | 0 | |
| BETTY MOONEY | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Fred Rubey | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Don Scott | ||||||
| DIREctor | 1.00 | X | 0 | 0 | 0 | |
| RANDY STEVENS MD | ||||||
| Director | 1.00 | X | 0 | 173386 | 0 | |
| DAVID SULLIVAN | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| DANIEL TANOOS | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| ANN WELCH | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| John Chironna Jr | ||||||
| DIrector | 1.00 | X | 0 | 0 | 0 | |
| Richard Conrad | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| William F Meehling | ||||||
| DIrector | 1.00 | X | 0 | 0 | 0 | |
| Alice Anne Perry | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| John N Royse | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| jIM bERTOLI | ||||||
| Executive Director | 60.00 | X | 0 | 109359 | 18839 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 772153 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 41614 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| All Other Contributions | 685524 | AllOtherContributions |
| Noncash Contributions | 25651 | NoncashContributions |
| Total Contributions | 685524 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 158219 | TotalRevenueColumn |
| Exclusion | $158,219 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 122600 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 120883 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1717 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1717 | TotalRevenueColumn |
| Exclusion | $1,717 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2106364 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2215169 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -108805 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -108805 | TotalRevenueColumn |
| Exclusion | -$108,805 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Vending Income | 999999 | 74557 | $74,557 |
| Remainder Trust Change | 999999 | 26582 | $26,582 |
| Retail Revenue | 999999 | 1454 | $1,454 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 102593 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 839248 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $153,724 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 720565 | Total |
| Program Services | 720565 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23758 | Total |
| Program Services | 23758 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 260991 | Total |
| Management And General | 260991 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68332 | Total |
| Management And General | 68332 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18276 | Total |
| Management And General | 18276 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2231 | Total |
| Management And General | 2231 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 93433 | Total |
| Management And General | 93433 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1875 | Total |
| Fundraising | 1875 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27852 | Total |
| Management And General | 27852 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 728 | Total |
| Management And General | 728 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12071 | Total |
| Fundraising | 12071 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64858 | Total |
| Management And General | 7457 | ManagementAndGeneral |
| Fundraising | 57401 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17207 | Total |
| Management And General | 17207 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18824 | Total |
| Management And General | 6481 | ManagementAndGeneral |
| Fundraising | 12343 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9472 | Total |
| Management And General | 9472 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5453 | Total |
| Management And General | 5453 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 935 | Total |
| Management And General | 935 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | FundraisingFundraising | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Recognition Expense | 56358 | 56358 | |
| Catering | 17041 | 17041 | |
| Dues & Subscriptions | 3032 | 3032 | |
| Contribution Expenses | 2853 | 2853 | |
| Licenses and Fees | 1467 | 1467 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5166 | Total |
| Management And General | 1132 | ManagementAndGeneral |
| Fundraising | 4034 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1432778 | Total |
| Program Services | 744323 | ProgramServices |
| Management And General | 527332 | ManagementAndGeneral |
| Fundraising | 161123 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2029126 | BOY |
| EOY | 334068 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5148601 | BOY |
| EOY | 3325344 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6200 | BOY |
| EOY | 113887 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 761986 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 219699 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 424901 | BOY |
| EOY | 542287 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5664237 | BOY |
| EOY | 6147714 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 2487363 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3219076 | BOY |
| EOY | 719244 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16492141 | BOY |
| EOY | 13669907 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1013593 | BOY |
| EOY | 750462 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8827103 | BOY |
| EOY | 6296179 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 57281 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9840696 | BOY |
| EOY | 7103922 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4307340 | BOY |
| EOY | 4096660 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1297674 | BOY |
| EOY | 1422889 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1046431 | BOY |
| EOY | 1046436 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6651445 | BOY |
| EOY | 6565985 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16492141 | BOY |
| EOY | 13669907 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type3 Func Int | X | SupportingOrg509a3Type3FuncInt |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (3 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| Union Hospital Inc | |||||
| 350876396 | 3 | 0 | 1 | 1 | $677,935 |
| Union Hospital Health Services Inc | |||||
| 351642805 | 9 | 0 | 1 | 1 | $0 |
| Visiting Nurse Association Inc | |||||
| 350869064 | 7 | 0 | 1 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 3 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 677935 | 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) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2876487 | BeginningOfYearBalance |
| Contributions | 180566 | Contributions |
| Investment Earnings Or Losses | 126601 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 81994 | GrantsOrScholarships |
| End Of Year Balance | 3101660 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3260052 | BeginningOfYearBalance |
| Contributions | 141735 | Contributions |
| Investment Earnings Or Losses | -291787 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 233513 | GrantsOrScholarships |
| End Of Year Balance | 2876487 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.20390 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.45880 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.33740 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 51000 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 45834 | OtherCostOrOtherBasis |
| Book Value | 96834 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 339000 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 237382 | OtherCostOrOtherBasis |
| Depreciation | 162559 | Depreciation |
| Book Value | 413823 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 88770 | OtherCostOrOtherBasis |
| Depreciation | 57140 | Depreciation |
| Book Value | 31630 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 542287 | TotalOfBookValueLandBuildings |
Closely Held Equity Interests CloselyHeldEquityInterests
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 2487363 | BookValue |
| Method Of Valuation | C | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 2487363 | TotalOfBookValueSecurities |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Charitable Remainder Trust | Description |
| Book Value | 719244 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 719244 | TotalBookValueOtherAssets |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Part IV, Line 2b: | Union Hospital Foundation receives many donations on behalf of Union Hospital and other charitable organizations related to the foundation's mission. These donations held on the hospital's behalf are recorded in agency liability accounts on the foundation's books and the beneficiary organization is made aware of the funds held. Expenses related to charitable events on behalf of these other entities are netted from the agency liability balance. Investment income/expense allocated to these funds is also posted to the agency liability accounts. | |
| Part V, Line 4: | The Foundation's endowment consists of approximately twenty-six individual funds that are generally established for one of the following purposes at August 31, 2010: Foundation operating support, scholarships, specific hospital department support, or specific hospital patient service support. | Description of Intended Use of Endowment Funds: |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| SAINT ANN CLINIC - PROVIDENCE SELF SUFFICIENCY MINISTRIES | |||||||
| 1436 LOCUST STREET | TERRE HAUTE | IN | 47807 | 351947580 | 501 (C) 3 | 23755 | Payment of Insurance Premiums and Technology Upgrades |
| THE MAPLE CENTER | |||||||
| 1801 N 6TH STREET | TERRE HAUTE | IN | 47804 | 200840169 | 501 (C) 3 | 10000 | Community Support |
| Union Hospital | |||||||
| 1606 N 7th Street | TerrE HAUTE | IN | 47804 | 350876396 | 501 (C) 3 | 677935 | Charitable Grant |
| Service League of Union Hospital | |||||||
| 1606 N 7th Street | TerRE HAUTE | IN | 47804 | 351586347 | 501 (C) 4 | 8875 | Margaret Carroll Scholarship Fund |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | Scholarships | TypeOfGrant |
| Number Of Recipients | 43 | NumberOfRecipients |
| Amount Of Cash Grant | 23758 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: The foundation receives a "grant outcome report" from grant recipients. A great majority of the Foundation's grants are to Union Hospital, Inc. The Foundation's Board of Directors receives regular verbal reports from key members of the Hospital Administration. Scholarship recipients must provide grade reports showing satisfactory progress before 2nd semester scholarship awards are paid. The Executive Director of Union Hospital Foundation serves on the St. Ann Clinic Advisory Board. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| david doerr | |||||||||||||
| 0 | 339694 | 0 | 0 | 0 | 149714 | 0 | 0 | 0 | 22775 | 0 | 512183 | 0 | 0 |
| RANDY STEVENS MD | |||||||||||||
| 0 | 173386 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 173386 | 0 | 0 |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTraded
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 3 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 25651 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | Fair Market Value | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 1 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | John Lukens and Sally Lowery have a business relationship. | |
| Form 990, Part VI, Section B, line 11 | The Form 990 is reviewed by the foundation's Executive Director, Assistant Treasurer, and accountants. The governing body receives the Form 990 and the final Form 990 including requested schedules, as ultimately filed with the IRS, prior to filing. | |
| Form 990, Part VI, Section B, line 12c | The written conflict of interest policy is regularly and consistently monitored and compliance enforced by the foundation's executive director. The scope of this policy includes all leased employees of the foundation as well as board members who have an interest in the foundation's dealings. The policy is in place to detect potential conflicts of interest that may arise. A self disclosure from covered persons to the organization is required on any potential conflicts of interest. The Executive Director is aware of all reported conflicts of interest and considers the potential impact of these conflicts at all times. | |
| Form 990, Part VI, Section B, line 15a | The executive director receives annual performance reviews from both the president and executive committee. Compensation of executive directors of similar organizations is researched and obtained for use in establishing the executive director's compensation. | |
| Form 990, Part VI, Section C, line 19 | The foundation makes its governing documents, conflict of interest policies, and audited financial statements available upon request at the organization's office. | |
| Form 990, Part XI, Line 2c | The audit committee assumes responsibility for oversight of the audit of the financial statements and no processes have changed from the prior year. | Oversight of Audit |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|
| Union Hospital Health Services Inc | ||||||||||
| 1606 N 7TH STREET FLOOR 4 | TERRE HAUTE | IN | 478042706 | 351642805 | HEALTH CARE | IN | 501(c)(3) | Line 9 | N/A | |
| UNION HOSPITAL INC | ||||||||||
| 1606 N 7TH STREET | TERRE HAUTE | IN | 478042706 | 350876396 | HEALTH CARE | IN | 501(c)(3) | Line 3 | Union Hospital Health Services Inc | |
| VISITING NURSE ASSOCIATION of the Wabash Valley INC | ||||||||||
| 400 8TH AVENUE | TERRE HAUTE | IN | 47804 | 350869064 | HOME HEALTH AND HOSPICE CARE | IN | 501(c)(3) | Line 7 | union Hospital Foundation Inc | |
| Service League of Union Hospital | ||||||||||
| 1606 N 7TH STREET | TerRE HAUTE | IN | 47804 | 351586347 | Fundraising | IN | 501(c)(4) | n/a | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Vistiting Nurse Association of the Wabash Valley Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | N | TransactionType |
| Amount Involved | 64850 | AmountInvolved |
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