Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 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...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| 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. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part I, Line 3 - Reason for Public Charity Status | Indiana Radiology Partners qualifies as a hospital under IRC |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Part III - Line 3 - Significant Changes or Ceasing of Program Services | Indiana Radiology Partners had significant changes in their program services as the company transferred all activity to Indiana University Health Care Associates, Inc. ("IU Health Physicians"), a 501(c)(3) tax-exempt organization, which is comprised of the most comprehensive network of primary care and specialty physicians. The transfer took place as of June 30, 2014. Indiana Radiology Partners will be an inactive tax-exempt organization going forward. |
| Part VI, Section A, Line 1b - Number of Voting Members that are Indepen. | Indiana Radiology Partners is part of a multi-entity hospital system controlled by IU Health, a 501(c)(3) tax-exempt organization whose board is comprised of voting members, of which substantially all are independent community members. |
| Part VI, Section A, Line 2 - Family or Business Relationships | John F. Fitzgerald, M.D. and John C. Kohne, M.D. served on the Board of Managers of Health Venture Management, LLC. No additional compensation was provided to these individuals for their service. |
| Part VI, Section A, Lines 6, 7a and 7b - Members or Stockholders | Line 6: The sole member of Indiana Radiology Partners is IU Health, a 501(c)(3) tax-exempt hospital. Line 7A: The control and management of the affairs of Indiana Radiology Partners is vested in a Board of Directors of five (5) directors due to the transfer of activity to IU Health Physicians. In previous years, a Board of Directors of eleven (11) directors had the control and management of the affairs of Indiana Radiology Partners vested in them. There are Appointed and Elected Directors. Such directors, each of whom have one vote, were selected as follows: Appointed Directors: - One (1) director shall be the IU Health Chief Medical Officer. - One (1) director shall be the Chairperson or Interim Chairperson of the Indiana University School of Medicine ("IUSOM") Department of Radiology. - One (1) director shall be the Geographic Chief/Medical Director of IU Health Methodist Hospital Radiology. - One (1) director shall be designated by IUSOM. - One (1) director shall be designated by Methodist Specialty Physicians, LLC. - One (1) director shall be designated by Indiana University Medical Group-Specialty Care. - Two (2) directors shall be appointed from the academic track radiologists by the Chairperson of the IUSOM Department of Radiology. Elected Directors: - Two (2) directors shall be elected by a majority vote of Clinical Radiologists. - One (1) director shall be elected by the Board of Directors from a list of candidates submitted to the Board by Indiana Radiology Partners' employed or contracted physicians who primarily work at Suburban area sites. Line 7B: Notwithstanding any other provisions of the Articles of Incorporation or any provision of the Corporation's Bylaws, the following matters require the approval of IU Health, as the sole member, prior to implementation, and IU Health shall not grant such approval without the agreement by the IUSOM Dean, which shall not be unreasonably withheld if such proposed action will not materially harm the IUSOM's educational or research mission: - Any amendment to the Articles of Incorporation or Bylaws of Indiana Radiology Partners; - Adoption or revision of the operating or capital budget of Indiana Radiology Partners and the plan of compensation for employed radiologists; - A merger or consolidation of Indiana Radiology Partners; - Any sale, lease, exchange, conveyance, mortgage, pledge or other disposition of a substantial portion of the property, assets or interests of Indiana Radiology Partners, other than pursuant to a budget approved by IU Health. - Any incurrence of debt by, or the creation of any lien upon the property or revenues of, Indiana Radiology Partners other than in the ordinary course of business or pursuant to a budget approved by IU Health. |
| Part VI, Section A, Line 11b - Review of Form 990 | The Secretary reviewed and approved the Form 990 prior to its filing. |
| Part VI, Section B, Lines 12, 13, 14, and 16b - Policies | Indiana Radiology Partners is part of the IU Health System. As the sole member and controlling parent of Indiana Radiology Partners, IU Health and its board of directors have mandated that certain policies be followed to ensure greater standardization throughout the system. Thus, Indiana Radiology Partners' board of directors was not required to separately adopt a conflict of interest, whistleblower, document retention and destruction and joint venture policies because IU Health's board of directors had already adopted and required these policies to be followed by its subsidiaries. |
| Part VI, Section B, 12c - Conflict of Interest Policy | Indiana Radiology Partners follows IU Health's Conflict of Interest Policy. IU Health's Conflict of Interest Policy includes the following provisions: All IU Health employees, associates, colleagues and contracted personnel, including employed physicians and paid medical directors ("IU Health Representatives") are covered by and subject to its Conflict of Interest Policy. IU Health regularly and consistently monitors and enforces compliance with the policy through the following procedures: (a) On an annual basis, each IU Health Representative at the level of Manager or above, together with every other person designated by the Corporate Compliance Department ("Department"), must complete, sign and submit a Conflict of Interest Questionnaire ("Questionnaire") to the Department. Governing board members, committee members, corporate officers, medical staff and researchers must comply with the administrative requirements noted in the respective policies and procedures relative to those areas. (b) An IU Health Representative must supplement a Questionnaire in writing, if after completion of the original Questionnaire, a situation arises, or may reasonably be expected to arise, that would change any answer or information on the original Questionnaire if the situation had existed or been anticipated at the time of completion of the original Questionnaire. (c) If a fully and properly completed Questionnaire reveals facts or other information that might reasonably indicate a Conflict of Interest or violation of the policy, the IU Health Representative completing the questionnaire must secure approval by his/her supervisor, evidenced in writing. (d) The Department will review each Questionnaire and determine whether a Conflict of Interest exists and, if so, whether and how it should or may be eliminated, avoided or managed in order to comply with the spirit of the policy and with the best interests of IU Health and its patients. In making the determination, the Corporate Compliance Department may consult with the IU Health Representative's supervisor and other appropriate individuals and groups. (e) The scope of the policy is not limited to those who are required to complete Questionnaires. If an IU Health Representative is involved in a situation or relationship that would constitute a violation of the policy in the absence of disclosure and approval as described above, then the IU Health Representative must disclose the matter to his/her supervisor, secure his/her supervisor's approval in writing, and disclose the matter to the Department. Otherwise, the IU Health Representative is in violation of the policy and subject to corrective action, up to and including termination. (f) The Chief Compliance Officer, in consultation with onsite Compliance personnel, may from time to time appoint standing or ad hoc committees to assist in resolving issues that arise under provisions of the policy. |
| Part VI, Section B, Line 15b - Process for Determining Compensation | Indiana Radiology Partners' COO was employed by IU Health Physicians for a portion of the year. The key employee will be employed by IU Health Physicians going forward. IU Health Physicians process for determining compensation is as follows: IU Health Physicians engages an independent compensation consultant who utilizes a variety of methods and procedures to establish market ranges for the CEO, CFO, COO and other executives. The market ranges provided by the independent consultant is used by the executive Compensation Committee to review and establish the yearly pay increases for the CEO. The Compensation Committee reviews the market data for the CFO, COO, and other executives; who then in turn delegate the annual pay increase decision to the CEO, who uses the market data to drive the annual pay increase decisions. |
| Part VI, Section C, Line 19 - Public Disclosure | Indiana Radiology Partners Articles of Incorporation are available to the public through the Indiana Secretary of State's web-site. IU Health Radiology's conflict of interest policy is described on Form 990, Schedule O. IU Health Radiology is a consolidated subsidiary in the consolidated financial statements for IU Health. The consolidated financial statements for IU Health are available to the public through its bond filings. |
| Part VII, Section A, Line 1a - Compensation of Off., Dir., Key Employees | Indiana Radiology Partners' key employees, highest compensated employees, and "former" officers report significant hours for both the filing organization and related organizations. Fifty hours is reported for the filing organization and Fifty five hours is reported for related organizations. Hours are reported this way as all key employees, highest compensated employees, and "former" officers were considered employees of Indiana Radiology Partners until 5/31/14. As of 6/1/14, all key employees, highest compensated employees, and "former" officers were considered employees of IU Health Physicians. |
| Part XI, Line 9 - Other Changes in Net Assets or Fund Balances | During 2014, IU Health, a related 501(c)(3) tax-exempt organization, made an equity transfer to Indiana Radiology Partners of $3,328,258. Throughout the existence of Indiana Radiology Partners, IU Health has provided funds to support Indiana Radiology Partners' exempt purpose. Although there was never any intent for Indiana Radiology Partners to repay IU Health, these amounts were recorded as intercompany balances rather than equity transfers. During 2014, IU Health and Indiana Radiology Partners made adjustments to their books and records to reflect these intercompany balances as equity transfers for both book and tax purposes. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:SHARED SERVICES/PROF. FEES TOTAL FEES:9117636 |
| Software ID: | |
| Software Version: |