Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
INDIANA ORGAN PROCUREMENT ORGANIZATION INC
Employer identification number
35-1746358
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization?
................
11g(i)
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (see instructions)
..................
12
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here........................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2012.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2011.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2011.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
0
17,853
38,857
0
0
56,710
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
23,859,966
25,021,972
25,384,718
25,394,354
28,117,555
127,778,565
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
0
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
0
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
6
Total. Add lines 1 through 5.
23,859,966
25,039,825
25,423,575
25,394,354
28,117,555
127,835,275
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
0
0
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
0
0
0
0
c
Add lines 7a and 7b..
0
0
0
0
8
Public support (Subtract line 7c from line 6.)
127,835,275
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
9
Amounts from line 6...
23,859,966
25,039,825
25,423,575
25,394,354
28,117,555
127,835,275
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
135,752
101,274
168,415
178,352
227,346
811,139
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
0
c
Add lines 10a and 10b.
135,752
101,274
168,415
178,352
227,346
811,139
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
0
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
0
13
Total support. (Add lines 9, 10c, 11, and 12.)..
23,995,718
25,141,099
25,591,990
25,572,706
28,344,901
128,646,414
14
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
99.369 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
99.382 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
0.630 %
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
0.618 %
19a
33 1/3% support tests—2012.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2011.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information.
Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2012
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
INDIANA ORGAN PROCUREMENT ORGANIZATION INC
Employer identification number
35-1746358
Identifier
Return Reference
Explanation
SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS
FORM 990, PART VI, QUESTION 4
THE BYLAWS OF THE GOVERNING BOARD WERE AMENDED TO ALLOW FOR STAGGERED TERMS OF THE MEMBERS OF THE GOVERNING BOARD; TO CONFIRM THE EXECUTIVE COMMITTEE AND QUALITY COMMITTEE AS STANDING COMMITTEES OF THE GOVERNING BOARD; TO SET THE TERM FOR THE CHAIR OF THE GOVERNING BOARD AT THREE YEARS; TO CREATE THE POSITIONS AND DEFINE THE DUTIES FOR THE VICE CHAIR OF THE GOVERNING BOARD, CHIEF OPERATING OFFICER, AND TREASURER; AND TO REMOVE THE POSITIONS AND DUTIES OF ALL MEDICAL OFFICERS OTHER THAN THE CHIEF MEDICAL OFFICER.
CLASSES OF MEMBERS OR STOCKHOLDERS WHO CAN ELECT GOVERNING BODY
FORM 990, PART VI, QUESTION 6, 7A & 7B
IOPO HAS MEMBERS WHO ELECT THE GOVERNING BOARD INCLUDING THE PRESIDENT OF INDIANA UNIVERSITY HEALTH PARTNERS INC. WHO ELECTS 4 DIRECTORS OF THE GOVERNING BOARD, INCLUDING AT LEAST 2 AT-LARGE DIRECTORS; AND THE FOLLOWING MEMBERS WHO EACH ELECT 2 DIRECTORS, INCLUDING AT LEAST 1 AT-LARGE DIRECTOR: THE DEAN OF THE INDIANA UNIVERSITY SCHOOL OF MEDICINE; THE CHANCELLOR OF INDIANA UNIVERSITY-PURDUE UNIVERSITY AT INDIANAPOLIS; THE PRESIDENT OF ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.; AND THE PRESIDENT OF LUTHERAN HOSPITAL OF INDIANA. THE MEMBERS OF IOPO APPROVE CHANGES TO THE ARTICLES OF INCORPORATION, BOARD MEMBERS, AND MEDICAL DIRECTORS.
PROCESS TO REVIEW THE FORM 990
FORM 990, PART VI, QUESTION 11A
THE FINANCE COMMITTEE DOES A DETAILED REVIEW OF THE FORM 990. THE DRAFT OF THE 990 IS THEN EMAILED TO BOARD MEMBERS FOR THEIR REVIEW, FOLLOWED BY A CONFERENCE CALL TO DISCUSS COMMENTS ON THE DRAFT. THE DRAFT IS ALSO REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. LASTLY, THE FINANCE DIRECTOR DOES A FINAL REVIEW OF THE 990 BEFORE FILING.
PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY
FORM 990, PART VI, QUESTION 12C
THERE IS ANNUAL DISCUSSION/TRAINING AND INDIVIDUAL DISCLOSURE OF CONFLICTS OF INTEREST. THE HUMAN RESOURCES DIRECTOR RECEIVES AND REVIEWS THE CONFLICT OF INTEREST POLICIES, AND THE CEO AND BOARD CHAIR REVIEW ANY CONFLICTS THAT ARISE. THE CONFLICT OF INTEREST POLICY IS ENFORCED BY REQUIRING OFFICERS, DIRECTORS, AND KEY EMPLOYEES TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS AFFECTED BY THE CONFLICT.
REVIEW OF CEO OR TOP MGMT OFFICIAL COMPENSATION
FORM 990, PART VI, QUESTION 15A & 15B
THE FINANCE/COMPENSATION COMMITTEE MET AND REVIEWED THE TOTAL COMPENSATION FOR THE DIRECTORS PER THE IRS SANCTIONS, AND FOUND THAT ALL DIRECTORS AND THE CEO WERE IN LINE WITH THE MARKET SURVEYS ON TOTAL COMPENSATION. COMPENSATION WAS LAST REVIEWED IN FEBRUARY 2013.
GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC
FORM 990, PART VI, QUESTION 19
THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.