Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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 | |||||
| (A)
INDIANA UNIVERSITY HEALTH INC |
351955872 | 3 | Yes | 0 | 0 | |
| (B)
COMMUNITY HOSPITALS OF INDIANA INC |
350983617 | 3 | Yes | 0 | 0 | |
| (C)
HEALTH & HOSPITAL CORPORATION |
356065697 | 6 | Yes | 0 | 0 | |
| (D)
INDIANA STATE MEDICAL ASSOCIATION |
350411650 | 10 | Yes | 0 | 0 | |
| (E)
INDIANA UNIVERSITY |
356001673 | 6 | Yes | 0 | 0 | |
| (F)
THE INDIANAPOLIS MEDICAL SOCIETY |
127566088 | 10 | Yes | 0 | 0 | |
| (G)
MARION COUNTY HEALTH DEPARTMENT |
356065697 | 6 | Yes | 0 | 0 | |
| (H)
FRANCISCAN ALLIANCE INC |
350913537 | 3 | Yes | 0 | 0 | |
| (I)
ST VINCENT HOSPITAL & HEALTH CARE CENTER INC |
352052591 | 3 | Yes | 0 | 0 | |
| (J)
CENTRAL INDIANA CORPORATE PARTNERSHIP |
352065459 | 10 | Yes | 0 | 0 | |
| (K)
INDIANA HOSPITAL ASSOCIATION INC |
350988753 | 10 | Yes | 0 | 0 | |
| (L)
INDIANA STATE DEPARTMENT OF HEALTH |
356000158 | 6 | Yes | 0 | 0 | |
| (M)
INDIANA FAMILY AND SOCIAL SERVICES ADMINISTRATION |
356000158 | 6 | Yes | 0 | 0 | |
|
Total 13
|
0 | 0 | ||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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 on 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2022 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2023. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART IV, SECTION A, LINE 2, SUPPORTING ORGANIZATIONS: | THE FOLLOWING GOVERNMENTAL ENTITIES ARE IHIE-SUPPORTED ORGANIZATIONS: HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY D/B/A ESKENAZI HEALTH F/K/A WISHARD HEALTH SERVICES; INDIANA STATE DEPARTMENT OF HEALTH; INDIANA UNIVERSITY; AND MARION COUNTY HEALTH DEPARTMENT (THE "GOVERNMENT ENTITIES"). THE GOVERNMENT ENTITIES ARE EACH DESCRIBED IN INTERNAL REVENUE CODE ("CODE") SECTION 509(A)(1) BECAUSE EACH IS ALSO DESCRIBED IN CODE SECTION 170(B)(1)(A)(V). THE FOLLOWING ORGANIZATIONS DESCRIBED IN CODE SECTION 501(C)(6) ARE ALSO IHIE SUPPORTED ORGANIZATIONS: CENTRAL INDIANA CORPORATE PARTNERSHIP, INC.; INDIANA HOSPITAL ASSOCIATION, INC.; INDIANA STATE MEDICAL ASSOCIATION, INC.; AND INDIANAPOLIS MEDICAL SOCIETY, INC. (THE "501(C)(6) ENTITIES"). AS DESCRIBED BELOW, THE 501(C)(6) ENTITIES EACH SATISFY THE TEST IN CODE SECTION 509(A)(2) AND WOULD QUALIFY AS PUBLIC CHARITIES IF THEY WERE DESCRIBED IN CODE SECTION 501(C)(3). |
| PART IV, SECTION A, LINE 3B, SUPPORTING ORGANIZATIONS: | IHIE PERFORMED CALCULATIONS WITH RESPECT TO CENTRAL INDIANA CORPORATE PARTNERSHIP, INC; INDIANA STATE MEDICAL ASSOCIATION, INC.; INDIANAPOLIS MEDICAL SOCIETY, INC; AND INDIANA HOSPITAL ASSOCIATION. INC. TO VERIFY THAT THE PUBLIC SUPPORT TESTS UNDER CODE SECTION 509(A)(2) WERE SATISFIED. |
| PART IV, SECTION A, LINE 3C, SUPPORTING ORGANIZATIONS: | IHIE'S ARTICLES OF INCORPORATION PROVIDE THAT IHIE SHALL OPERATE EXCLUSIVELY TO BENEFIT, PERFORM, AND CARRY OUT THE CHARITABLE, EDUCATIONAL, AND OTHER EXEMPT PURPOSES OF ITS SUPPORTED ORGANIZATIONS, AS SUCH PURPOSES ARE DESCRIBED IN CODE SECTIONS 170(C)(2)(B), 501(C)(3), 2055(A)(2), AND 2522(A)(2). IHIE'S BOARD OF DIRECTORS AND MANAGMENT ENSURE STRICT COMPLIANCE WITH THE FOREGOING THROUGH VIGILIANT OVERSIGHT AND CONSULTATION WITH EXPERIENCED LEGAL COUNSEL AND ADVISORS. |
| PART IV, SECTION B, LINE 1, TYPE I SUPPORTING ORGANIZATIONS: | IHIE'S BYLAWS PROVIDE THAT EACH SUPPORTED ORGANIZATION HAS THE RIGHT TO APPOINT ONE INDIVIDUAL TO IHIE'S BOARD OF DIRECTORS. IHIE'S ARTICLES OF INCORPORATION AND BYLAWS PROVIDE THAT AT ALL TIMES THE MAJORITY OF DIRECTORS SHALL BE APPOINTED BY THE SUPPORTING ORGANIZATIONS. |
| PART VI, SECTION A, LINE 5A | FAMILY AND SOCIAL SERVICES ADMINSTRATION (35-6000158) WAS ADDED TO THE LIST OF SUPPORTED ORGANIZATIONS IN 2022. THIS ORGANIZATION WAS ADDED BY AN AMENDMENT TO THE ARTICLES OF INCORPORATION THAT WAS VOTED ON BY THE BOARD OF DIRECTORS AND ADOPTED IN MAY OF 2022. THE ORGANIZATION WAS ADDED TO THE LIST OF SUPPORTED ORGANIZATIONS TO BETTER ALIGN WITH ITS MISSION. |
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Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | THE FOLLOWING CHANGES WERE MADE TO THE ORGANIZATIONAL DOCUMENTS: INDIANA STATE MEDICAL ASSOCIATION, INDIANA UNIVERSITY, THE INDIANAPOLIS MEDICAL SOCIETY AND MARION COUNTY DEPARTMENT OF HEALTH WERE REMOVED AS SUPPORTED ORGANIZATION. INDIANA DEPARTMENT OF FAMILY AND SOCIAL SERVICES ADMINISTRATION WAS ADDED AS A SUPPORTED ORGANIZATION. CHANGES TO BYLAWS INCLUDED THE ADDITION OF A NOMINATING COMMITTEE, DETAILS OF BOARD ELECTIONS FOR NON-SUPPORTED ORGANIZATIONS AND CHANGE OF THE BOARD SEAT HELD BY THE STATE HEALTH COMMISSIONER TO A VOTING POSITION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS SUBMITTED TO THE EXECUTIVE & FINANACE COMMITTEE FOR REVIEW AND APPROVAL. THE RETURN IS THEN SUBMITTED TO THE BOARD BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF DIRECTORS HAS ADOPTED A CONFLICT OF INTEREST POLICY (THE "POLICY") THAT REQUIRES EACH DIRECTOR, OFFICER AND MEMBER OF A BOARD COMMITTEE (DEFINED IN THE POLICY) TO PROVIDE THE CORPORATION AN ANNUAL DISCLOSURE OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST THAT ARISE AS A RESULT OF AN INDIVIDUAL SERVING AS A DIRECTOR, OFFICER OR MEMBER OF A BOARD COMMITTEE. THE POLICY ALSO REQUIRES CERTAIN ACTIONS TO APPROVE OR RATIFY A CONTRACT OR OTHER TRANSACTION BETWEEN THE CORPORATION AND AN INTERESTED PERSON (DEFINED IN THE POLICY). TO HELP ENSURE REGULAR AND CONSISTENT COMPLIANCE WITH THE POLICY, MANAGEMENT HAS ADOPTED THIS CONFLICT OF INTEREST MONITORING AND COMPLIANCE PROCEDURE. RESPONSIBLE INDIVIDUAL: THE CORPORATION'S VP, GENERAL COUNSEL & COMPLIANCE OFFICER,(THE "COMPLIANCE OFFICER"). PROCEDURE: 1. THE COMPLIANCE OFFICER WILL ANNUALLY COLLECT A WRITTEN DISCLOSURE OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST FROM EACH DIRECTOR, OFFICER AND MEMBER OF A BOARD COMMITTEE. 2. THE COMPLIANCE OFFICER WILL PREPARE AND DISTRIBUTE TO EACH DIRECTOR, OFFICER AND MEMBER OF A BOARD COMMITTEE A LIST OF ALL ACTUAL AND POTENTIAL CONFLICTS DISCLOSED TO THE CORPORATION. 3. AT EACH MEETING OF THE BOARD OF DIRECTORS AND EACH BOARD COMMITTEE MEETING, THE COMPLIANCE OFFICER WILL BE RESPONSIBLE FOR MONITORING COMPLIANCE WITH AND ENFORCING THE POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BYLAWS PROVIDE THAT THE CORPORATION'S EXECUTIVE AND FINANCE COMMITTEE SHALL SERVE AS THE COMPENSATION COMMITTEE AND SHALL REVIEW AND, IF IN THE BEST INTEREST OF THE CORPORATION, APPROVE ALL COMPENSATION ARRANGEMENTS WITH KEY EMPLOYEES, PROVIDED, HOWEVER, THAT EMPLOYMENT OF A PRESIDENT/CEO REQUIRES THE AFFIRMATIVE VOTE OF 2/3 OF THE DIRECTORS. THE COMPENSATION DETERMINATION PROCESS INCLUDES REVIEW OF COMPARABILITY DATA. THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS AND TWO ADDITIONAL MEMBERS OF THE BOARD OF DIRECTORS ELECTED BY SUCH OFFICERS. THE PRESIDENT/CEO IS A NON VOTING, EX OFFICIO MEMBER OF THE EXECUTIVE COMMITTEE. THE PRESIDENT/CEO HAS NO INVOLVEMENT IN THE PROCESS OF SETTING HIS OR HER OWN COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE FORM 990 AND FORM 1023 ARE AVAILABLE TO THE PUBLIC UPON REQUEST IN ACCORDANCE WITH APPLICABLE LAW. THE PUBLIC CAN ALSO ACCESS THE FORM 990 AT WWW.GUIDESTAR.ORG. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC THROUGH THE INDIANA SECRETARY OF STATE'S WEBSITE. THE BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS MAY BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST ON A CASE-BY-CASE BASIS. |
| FORM 990, PART XII, LINE 2C | THE EXECUTIVE AND FINANACE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT AUDITOR. |
| FORM 990, PART V, LINE 2A | THE ORGANIZATION USED A PROFESSIONAL EMPLOYER ORGANIZATION FOR ITS PAYROLL. PAYROLL FORMS WERE FILED UNDER THE NAME AND EIN OF THE PEO. |
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