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 (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 684,655 | 828,858 | 777,812 | 922,259 | 2,364,394 | 5,577,978 |
| 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...... | 13,568,803 | 14,189,130 | 11,788,950 | 10,064,822 | 9,529,393 | 59,141,098 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | 65,663 | 64,634 | 23,078 | 153,375 | ||
| 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. | 14,319,121 | 15,082,622 | 12,589,840 | 10,987,081 | 11,893,787 | 64,872,451 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 50,357 | 50,357 | ||||
| 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. | 1,179,496 | 1,889,775 | 1,059,595 | 4,128,866 | ||
| c | Add lines 7a and 7b.. | 1,179,496 | 1,889,775 | 1,109,952 | 4,179,223 | ||
| 8 | Public support. (Subtract line 7c from line 6.) | 60,693,228 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 14,319,121 | 15,082,622 | 12,589,840 | 10,987,081 | 11,893,787 | 64,872,451 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 811 | 142 | 131,943 | 178,667 | 163,209 | 474,772 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 811 | 142 | 131,943 | 178,667 | 163,209 | 474,772 |
| 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 VI.) .. | 34,174 | 45,963 | 80,137 | |||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 14,354,106 | 15,128,727 | 12,721,783 | 11,165,748 | 12,056,996 | 65,427,360 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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): |
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| 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 | ||||
| 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 2015 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-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART III, LINE 1 (CONTINUED FROM PART III) HOOVERWOOD, A NON-PROFIT, NON-SECTARIAN ORGANIZATION, GOVERNED BY A DEDICATED BOARD OF DIRECTORS, IS A CONSTITUENT AGENCY OF THE JEWISH FEDERATION OF GREATER INDIANAPOLIS. WITH THE VALUES AND TRADITIONS OF JUDAISM AS ITS FOUNDATION, HOOVERWOOD'S MISSION STATEMENT IS BASED ON FOUR CORE VALUES THAT TOGETHER CONTINUE HOOVERWOOD'S TRADITION OF HEALTHCARE EXCELLENCE. DIGNITY- TO UNDERSTAND OUR RESIDENTS AS INDIVIDUALS WITH THEIR OWN HISTORIES, VALUES, AND CONTRIBUTIONS, AND TO PROVIDE OPPORTUNITIES FOR CONTINUED GROWTH, INDEPENDENCE, AND FEELINGS OF SELF-WORTH. SPIRITUALITY - TO UPHOLD THE BELIEFS AND TRADITIONS OF THE JEWISH FAITH, WHILE PROVIDING FOR THE SPIRITUAL WELL-BEING OF RESIDENTS OF ALL FAITHS. COMMUNITY - TO PROVIDE A HOME-LIKE FRIENDLY ENVIRONMENT TO ALL RESIDENTS AND STAFF. VISION - TO PREPARE FOR THE FUTURE OF THE AGING POPULATION THROUGH A COMMITMENT TO EDUCATION, RESEARCH, AND QUALITY CARE. |
| PROGRAM SERVICE ACCOMPLISHMENTS | FORM 990, PART III, LINE 4A (CONTINUED FROM PART III, LINE 4A) AS A NON-PROFIT ORGANIZATION, CERTIFIED BY MEDICARE AND MEDICAID, HOOVERWOOD SPECIALIZES IN SHORT-TERM REHABILITATION FOLLOWING A HOSPITALIZATION, SKILLED NURSING CARE, AND MEDICAL SPECIALTIES INCLUDING GERIATRICS, GERIATRIC PSYCHIATRY, DENTISTRY AND PODIATRY. HOOVERWOOD'S DEPARTMENT OF REHABILITATION SERVICES PROVIDES PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES ON AN INPATIENT AND OUTPATIENT BASIS. HOOVERWOOD'S INTERDISCIPLINARY TEAM OF NURSES, NURSING ASSISTANTS, SOCIAL WORKERS, DIETITIANS, ACTIVITY STAFF AND THERAPISTS WORK TOGETHER TO COORDINATE RESIDENTS' OVERALL CARE AND PROVIDE ENCOURAGEMENT AND SUPPORT IN ORDER FOR OUR RESIDENTS TO REACH THEIR HIGHEST POTENTIAL. THE HOOVERWOOD TEAM TAKES GREAT PRIDE IN THE IMPRESSIVE NUMBER OF RESIDENTS WHO "GRADUATE" FROM THEIR REHABILITATION PROGRAM AND RETURN HOME TO THEIR PRIOR LEVEL OF FUNCTION AND INDEPENDENCE. HOOVERWOOD'S MEDICAL DIRECTORS ARE BOARD CERTIFIED GERIATRICIANS AND ARE AFFILIATED WITH THE ST. VINCENT CENTER FOR HEALTHLY AGING. OUR MEDICAL DIRECTORS HAVE BEEN PROVIDING MEDICAL CARE, CLINICAL LEADERSHIP, AND EDUCATION AT HOOVERWOOD FOR OVER 20 YEARS. A GERIATRIC NURSE PRACTITIONER IS ALSO A VITAL PART OR OUR CARE MODEL AND VISITS HOOVERWOOD ON A REGULAR BASIS. HOOVERWOOD'S GERIATRIC PSYCHIATRIST, AFFILIATED WITH HANCOCK REGIONAL HOSPITAL, PROVIDES EVALUATION AND TREATMENT OF A VARIETY OF MENTAL HEALTH ISSUES AND ASSISTS THE RESIDENTS AS THEY COPE WITH CHANGES AND CHALLENGES IN THEIR LIVES. HOOVERWOOD'S MEDICAL CLINIC OFFERS A FULL SERVICE, ON-SITE DENTAL CLINIC WITH WEEKLY VISITS FROM A DENTIST AND MONTHLY VISITS FROM A PODIATRIST. |
| MATERIAL DIFFERENCES IN VOTING RIGHTS | FORM 990, PART VI, QUESTION 1A THE EXECUTIVE COMMITIEE SHALL BE COMPOSED OF THE OFFICERS OF THE CORPORATION PLUS THE PRESIDENT OF THE HOOVERWOOD GUILD ALSO A MAXIMUM OF TWO (2) OTHER BOARD MEMBERS MAY BE APFOINTED BY THE PRESIDENT TO THE EXECUTIVE COMMITIEE IN HIS/HER SOLE DISCRETION, BUT NOTHING HEREIN SHALL REQUIRE THE PRESIDENT TO APFOINT SUCH ADDITIONAL MEMBERS TO SAID COMMITIEE THE IMMEDIATE PAST PRESIDENT AND THE CHAIRMAN OF THE HOOVERWOOD FOUNDATION COMMITTEE SHALL ALSO SERVE ON THE EXECUTIVE COMMITTEE THE EXECUTIVE COMMITTEE SHALL MEET WHEN DETERMINED NECESSARY BY THE PRESIDENT AND THE EXECUTIVE DIRECTOR/ADMINISTRATOR A MAJORITY OF THE EXECUTIVE COMMITTEE MUST BE PRESENT TO CONSTITUTE A QUORUM THE EXECUTIVE COMMITTEE SHALL ACT, WHEN NECESSARY, IN BETWEEN REGULAR MEETINGS OF THE BOARD ALL ACTION OF THE EXECUTIVE COMMITTEE SHALL BE REPORTED TO THE BOARD OF DIRECTORS AT THE BOARD'S NEXT MEETING, EITHER IN REGULAR OR EXECUTIVE SESSION THE EXECUTIVE COMMITTEE SHALL SPECIFICALLY HANDLE TOP MANAGEMENT LEVEL ISSUES, ADMINISTRATIVE COMPENSATION, SENSITIVE POLITICAL/COMMUNITY ISSUES, SENSITIVE LEGAL ISSUES, AND OTHER SUCH TYPE OF CONFIDENTIAL OR SENSITIVE ISSUES. |
| FAMILY/BUSINESS RELATIONSHIPS BETWEEN OFFICERS & KEY EMPLOYEES | FORM 990, PART VI, QUESTION 2 JILL BURNETT IS RELATED TO JANIE MAURER. HEATHER KULWIN IS RELATED TO SHIRLEY KULWIN. |
| MEMBERS OR STOCKHOLDERS WHO CAN ELECT MEMBERS OF THE GOVERNING BODY | FORM 990, PART VI, QUESTION 7A THE JEWISH FEDERATION OF GREATER INDIANAPOLIS, INC, THE JEWISH COMMUNITY CENTER ASSOCIATION, THE JEWISH COMMUNITY RELATIONS COUNCIL, AND THE BUREAU OF JEWISH EDUCATION HAVE THE RIGHT TO APPOINT ONE VOTING MEMBER TO THE BOARD. |
| PROCESS TO REVIEW THE FORM 990 | FORM 990, PART VI, QUESTION 11B THE FORM 990 IS REVIEWED IN DETAIL BY MANAGEMENT, THEN COPIES ARE PROVIDED TO EVERY MEMBER OF THE GOVERNING BODY BEFORE IT IS FILED WITH THE IRS. THE FORM 990 IS ALSO REVIEWED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. |
| PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY | FORM 990, PART VI, QUESTION 12C ALL DIRECTORS AND OFFICERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. THE STATEMENTS ARE REVIEWED BY THE CHIEF FINANCIAL OFFICER IF ANY CONFLICTS OF INTEREST ARE NOTED, THE EXECUTIVE DIRECTOR AND PRESIDENT OF THE BOARD ARE NOTIFIED. THE PRESIDENT OF THE BOARD ENSURES THAT ANY BOARD MEMBER WITH AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ABSTAINS FROM VOTING ON DECISIONS RELATED TO THE CONFLICT. |
| REVIEW OF CEO OR TOP MANAGEMENT OFFICIAL COMPENSATION | FORM 990, PART VI, QUESTION 15A & 15B EACH YEAR, THE COMPENSATION COMMITTEE IS SCHEDULED TO DISCUSS THE COMPENSATION OF THE EXECUTIVE DIRECTOR. THE COMPENSATION COMMITTEE CONSISTS OF MEMBERS FROM THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. THE COMMITTEE USES CURRENT COMPENSATION & FRINGE BENEFIT INFORMATION ALONG WITH OTHER COMPARATIVE DATA, AND PERFORMANCE EVALUATIONS TO ANALYZE COMPENSATION FOR THE EXECUTIVE DIRECTOR. THE DELIBERATION AND DECISION IS CONTEMPORANEOUSLY DOCUMENTED IN THE COMMITTEE MINUTES AFTER A CONSENSUS IS REACHED, THE DECISION IS DISCUSSED WITH THE EXECUTIVE DIRECTOR. THE SAME PROCESS IS ALSO COMPLETED FOR THE CHIEF FINANCIAL OFFICER. THE EXECUTIVE DIRECTOR'S COMPENSATION WAS LAST REVIEWED IN MAY 2015 AND THE CHIEF FINANCIAL OFFICER'S COMPENSATION WAS LAST REVIEWED IN JULY 2015. |
| GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC | FORM 990, PART VI, QUESTION 19 THE FINIANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| VOTING RIGHTS OF PAST PRESIDENTS | FORM 990, PART VII BYLAWS STATE THAT ALL PAST PRESIDENTS ARE HONORARY BOARD MEMBERS AND HAVE VOTING RIGHTS. |
| AGREEMENT WITH HANCOCK REGIONAL HOSPITAL | FORM 990, PART VIII AND IX ON MAY 10, 2013, THE ORGANIZATION EXECUTED SEPARATE SUBLEASE, MANAGEMENT AND LICENSE AGREEMENTS (AGREEMENTS) WITH HANCOCK REGIONAL HOSPITAL (HRH). THE SUBLEASE RESULTS IN A CHANGE OF OWNERSHIP FOR REGULATORY PURPOSES, WITH THE ORGANIZATION CONTINUING TO MANAGE DAY-TO-DAY OPERATIONS VIA THE MANAGEMENT AGREEMENT. THE AGREEMENTS EXPIRE IN 24 MONTHS AND AUTOMATICALLY RENEW FOR SUCCESSIVE TWO-YEAR TERMS UNLESS TERMINATED BY EITHER PARTY. THE SUBLEASE COVERS ALL REAL AND PERSONAL PROPERTY AND REQUIRES HRH TO REMIT MONTHLY LEASE PAYMENTS OF $88,000 AND PAY ALL EXECUTORY COSTS (TAXES, INSURANCE, UTILITIES, AND MAINTENANCE). THE MANAGEMENT AGREEMENT REQUIRES MONTHLY PAYMENTS BASED UPON NET PATIENT REVENUE AND AN ANNUAL QUALITY INCENTIVE PAYMENT DEPENDENT ON THE FACILITY MEETING CERTAIN QUALITY MEASURES. THE LICENSE AGREEMENT REQUIRES MONTHLY PAYMENTS OF $10,796. EITHER THE ORGANIZATION OR HRH HAS THE ABILITY TO TERMINATE THE AGREEMENTS PRIOR TO THE TERMINATION DATE BY PROVIDING 90 DAYS' NOTICE TO THE OTHER PARTY. AT THE TERMINATION OF THE AGREEMENTS, THE ORGANIZATION AND HRH ARE REQUIRED TO PERFORM CERTAIN ACTIONS AS DEFINED BY THE AGREEMENTS. |
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