Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
Do not enter social security numbers on this form as it may be made public.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
A For the 2023 calendar year, or tax year beginning 01-01-2023 , and ending 12-31-2023
BCheck if applicable:
CName of organization
UNION HOSPITAL INC
 
 
Doing business as
SEE SCHEDULE O
 
Number and street (or P.O. box if mail is not delivered to street address)
1606 NORTH SEVENTH STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
TERRE HAUTE, IN47804
D Employer identification number

35-0876396
E Telephone number

G Gross receipts $ 702,078,743
F Name and address of principal officer:
MATTHEW NEALON
1606 NORTH SEVENTH STREET
TERRE HAUTE,IN47804
I
Tax-exempt status: (   ) (insert no.) or
J
Website:
WWW.UHHG.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number  
K Form of organization:  
L Year of formation: 1892
M State of legal domicile: IN
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: WE EXIST TO SERVE OUR PATIENTS WITH COMPASSIONATE HEALTH CARE OF THE HIGHEST QUALITY.
2 Check this box
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 12
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 9
5 Total number of individuals employed in calendar year 2023 (Part V, line 2a) ...... 5 3,669
6 Total number of volunteers (estimate if necessary) ............. 6 304
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 10,550,936 2,508,551
9 Program service revenue (Part VIII, line 2g) ......... 613,092,640 671,767,400
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 5,721,707 8,201,766
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 17,597,988 17,306,628
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 646,963,271 699,784,345
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 317,095 738,335
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 183,766,658 192,768,635
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) 0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 398,281,752 422,024,782
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 582,365,505 615,531,752
19 Revenue less expenses. Subtract line 18 from line 12....... 64,597,766 84,252,593
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 699,022,259 748,462,224
21 Total liabilities (Part X, line 26)............. 360,594,886 357,605,158
22 Net assets or fund balances. Subtract line 21 from line 20..... 338,427,373 390,857,066
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
Signature of officer Date
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name

Firm's EIN
Firm's address



Phone no.
May the IRS discuss this return with the preparer shown above? See Instructions. ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2023)
Form 990 (2023)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: WE EXIST TO SERVE OUR PATIENTS WITH COMPASSIONATE HEALTH CARE OF THE HIGHEST QUALITY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 548,710,687 including grants of $ 738,335 ) (Revenue $ 672,637,861 )
UNION HOSPITAL (UHI), UNION HOSPITAL CLINTON (UHC), AND OUR NETWORK OF PRIMARY CARE PHYSICIANS JOIN TOGETHER TO PROVIDE COMPREHENSIVE CARE TO RESIDENTS OF WEST CENTRAL INDIANA AND EASTERN ILLINOIS. OUR FACILITIES AT UNION HOSPITAL INCLUDE TWO HOSPITALS AND MORE THAN 40 PRIMARY AND SPECIALTY CARE PHYSICIANS AND MID-LEVEL PROVIDERS. WE ARE THE LARGEST PROVIDER OF NOT-FOR-PROFIT HEALTH CARE SERVICES BETWEEN INDIANAPOLIS AND ST. LOUIS ALONG THE I-70 CORRIDOR, SERVING VIGO, PARKE, VERMILLION, CLAY, SULLIVAN AND GREENE COUNTIES IN INDIANA, AND CLARK AND EDGAR COUNTIES IN ILLINOIS AS OUR PRIMARY SERVICE AREA. OUR SECONDARY SERVICE AREA INCLUDES CRAWFORD COUNTY IN ILLINOIS.CONTINUE TO SCHEDULE O: CLAY GREENE SULLIVAN PARKE VERMILLION VIGOPOPULATION 26,170 32,006 20,690 16,927 15,479 107,386RANK IN IND. 60TH 53RD 70TH 76TH 79TH 17TH SQ MILES 357.50 542.5 447.10 444.70 256.9 403.30POP/SQ MILE 74.30 60.32 47.08 38.75 61.09 268.22LARGEST CITY BRAZIL LINTON SULLIVAN ROCKVILLE CLINTON TERRE HAUTEPOPULATION 8,064 5,210 4,097 2,499 4,717 60,753MEDIAN AGE 41.1 43.7 41.3 42.1 43.0 36.3POVERTY RATE 11.2% 11.6% 14.6% 14.3% 13.3% 19.4%UNMPLYMNT RATE 2.9% 3.2% 3.5% 3.1% 4.2% 3.6%AVG HOUSEHOLD INCOME 50,756 59,347 59,347 48,537 46,330 42,030CHILDREN LIVING BELOW POVERTY 18.1% 18.8% 14.6% 19.5% 17.9% 25.0%UNION HOSPITAL HAS BEEN SERVING COMMUNITIES IN WEST CENTRAL INDIANA AND EAST CENTRAL ILLINOIS FOR THE PAST 131 YEARS. UNION HOSPITAL SERVES 275,000 PEOPLE IN BOTH URBAN AND RURAL AREAS; CLAY, GREENE, SULLIVAN, PARKE, VERMILLION AND VIGO COUNTIES IN INDIANA ALONG WITH CLARK AND CRAWFORD COUNTIES IN ILLINOIS MAKE UP OUR PRIMARY SERVICE AREA AS IT RELATES TO COMMUNITY BENEFIT. THE MAJORITY OF FAMILIES IN OUR SERVICE AREA FALL SIGNIFICANTLY BELOW THE NATIONAL AND STATE MEDIAN HOUSEHOLD INCOME. AS THE LARGEST NOT-FOR-PROFIT HEALTHCARE PROVIDER BETWEEN ST. LOUIS AND INDIANAPOLIS, WE ARE PROUD TO BE THE SAFETY NET HOSPITAL FOR OUR COMMUNITY PROVIDING OVER $71 MILLION IN TOTAL COMMUNITY BENEFITS, THAT INCLUDE $8.9 MILLION IN CHARITY CARE TO OUR COMMUNITY. THE PEOPLE WHO MAKE UP UHI ARE DEVOTED TO HELPING OTHERS. WHETHER THEY PROVIDE CARE TO PATIENTS IN OUR HOSPITALS AND CLINICS, PERFORM FREE HEALTH SCREENINGS AT COMMUNITY HEALTH FAIRS, VOLUNTEER FOR COMMUNITY SERVICE ORGANIZATIONS AND CAUSES, OR ORGANIZE FUNDRAISERS FOR FELLOW EMPLOYEES IN NEED, OUR EMPLOYEES EXEMPLIFY A SPIRIT OF CARING.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expenses548,710,687
Form 990 (2023)
Form 990 (2023)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment
List of Attached Documents:
// Content
.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment
List of Attached Documents:
// Content
.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment
List of Attached Documents:
// Content
..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment
List of Attached Documents:
// Content
.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
List of Attached Documents:
// Content
....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment
List of Attached Documents:
// Content
..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment
List of Attached Documents:
// Content
..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment
List of Attached Documents:
// Content
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment
List of Attached Documents:
// Content
.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment
List of Attached Documents:
// Content
.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment
List of Attached Documents:
// Content
............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment
List of Attached Documents:
// Content
......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
List of Attached Documents:
// Content
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
List of Attached Documents:
// Content
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
List of Attached Documents:
// Content
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
List of Attached Documents:
// Content
21
Yes
 
Form 990 (2023)
Form 990 (2023)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
List of Attached Documents:
// Content
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
List of Attached Documents:
// Content
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
List of Attached Documents:
// Content
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
List of Attached Documents:
// Content
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment
List of Attached Documents:
// Content
...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment
List of Attached Documents:
// Content
.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
List of Attached Documents:
// Content
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
List of Attached Documents:
// Content
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
List of Attached Documents:
// Content
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
List of Attached Documents:
// Content
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
List of Attached Documents:
// Content
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
List of Attached Documents:
// Content
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
List of Attached Documents:
// Content
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
204
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2023)
Form 990 (2023)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
3,669
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country:
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, or any disqualified or other person engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2023)
Form 990 (2023)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
12
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
9
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
 
No
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filed
IN
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MATTHEW NEALON1606 N SEVENTH STREET   TERRE HAUTE,IN47804 (812) 238-7000
Form 990 (2023)
Form 990 (2023)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, box 6 of Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) ROBERT COONS......................................................................
CHAIR
2.00
.................
2.00
X   X       0 0 0
(2) MOLLY CALLAHAN......................................................................
VICE CHAIR
2.00
.................
2.00
X   X       0 0 0
(3) MARY DOTI......................................................................
SECRETARY
2.00
.................
2.00
X   X       0 0 0
(4) LUKE TERRY......................................................................
TREASURER
2.00
.................
2.00
X   X       0 0 0
(5) TIM SULLIVAN......................................................................
MEMBER
2.00
.................
2.00
X           0 0 0
(6) DAN DEBARD......................................................................
MEMBER
2.00
.................
2.00
X           0 0 0
(7) JOHN AIDOO......................................................................
MEMBER
2.00
.................
2.00
X           0 0 0
(8) KATHLEEN COUTINHO MD......................................................................
MEMBER
42.00
.................
2.00
X           399,714 0 23,753
(9) KENNETH KIGORWE MD......................................................................
MEMBER
42.00
.................
2.00
X           272,282 0 41,448
(10) SARA SMITH......................................................................
MEMBER
2.00
.................
2.00
X           0 0 0
(11) JOHN ETLING......................................................................
MEMBER
2.00
.................
2.00
X           0 0 0
(12) DON SCOTT......................................................................
PAST CHAIR
2.00
.................
2.00
X           0 0 0
(13) MICHELE JOHNSON......................................................................
NON-VOTING ASST. SECRETARY
40.00
.................
2.00
    X       119,069 0 30,930
(14) STEVEN HOLMAN......................................................................
PRESIDENT & CEO
20.00
.................
20.00
    X       1,647,478 0 40,333
(15) JACK HILL......................................................................
VICE PRES./COO
42.00
.................
2.00
    X       581,896 0 39,530
(16) MATTHEW NEALON......................................................................
SR VP FINANCE/CFO/ASST TREASURER
40.00
.................
7.00
    X       740,221 0 44,768
(17) AMY HOCK......................................................................
CHIEF LEGAL OFFICER
40.00
.................
2.00
    X       471,148 0 39,986
Form 990 (2023)
Form 990 (2023)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) JAMES SCHRADER........................................................................
CHIEF STRATEGY/BUSINESS DEV.
40.00
.......................0.00
    X       476,753 0 39,026
(19) REBECCA LYNCH........................................................................
VICE PRESIDENT/CMO
40.00
.......................0.00
    X       391,065 0 12,072
(20) RHONDA SMITH........................................................................
VICE PRESIDENT
40.00
.......................1.00
    X       488,602 0 26,701
(21) STEPHANIE LAWS........................................................................
VICE PRESIDENT
40.00
.......................0.00
    X       337,710 0 32,774
(22) VIJAY KUMAR........................................................................
VICE PRESIDENT/CIO
40.00
.......................0.00
    X       546,658 0 18,018
(23) LAURA STARKS........................................................................
VICE PRESIDENT
40.00
.......................0.00
    X       377,493 0 20,910
(24) NABIL MNAYARJI........................................................................
PHYSICIAN
40.00
.......................0.00
        X   1,308,060 0 40,102
(25) VANNARA SAKBUN........................................................................
PHYSICIAN
40.00
.......................0.00
        X   959,889 0 39,002
(26) VUPPAA REDDY........................................................................
PHYSICIAN
40.00
.......................0.00
        X   732,150 0 15,526
(27) MARY ABERNATHY........................................................................
PHYSICIAN
40.00
.......................0.00
        X   660,150 0 37,845
(28) FRANCES MADDEN........................................................................
PHYSICIAN
40.00
.......................0.00
        X   609,763 0 44,671




1b Sub-Total..............
c Total from continuation sheets to Part VII, Section A..
d Total (add lines 1b and 1c)......... 11,120,101 0 587,395
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization 323
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
PROVIDENCE MEDICAL GROUP

2723 S 7TH ST
TERRE HAUTE,IN46804
PSA/ONCOLOGY SERVICES 24,969,530
MEDICAL SOLUTIONS LLC

PO BOX 850737
MINNEAPOLIS,MN55485
NURSING 19,312,488
ENSEMBLE RCM LLC

PO BOX 639076
CINCINNATI,OH45263
PATIENT SERVICES 18,643,640
PROVIDENCE CARDIOVASCULAR SUPPLY COMPANY

2723 S 7TH ST
TERRE HAUTE,IN47802
CARDIOLOGY SERVICES 18,499,944
UNION HOSPITAL THERAPY LLC

PO BOX 6890
EVANSVILLE,IN47719
THERAPY SERVICES 11,170,567
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 53
Form 990 (2023)
Form 990 (2023)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 477,625
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f 2,030,926
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f....... 2,508,551
 Program Service RevenueAmt Business Code
2a NET PATIENT REVENUE 900099 659,541,471 659,541,471    
b 340B PHARMACY SETTLEMENT 900099 12,225,929 12,225,929    
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f ..... 671,767,400
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ...... 8,215,488     8,215,488
4 Income from investment of tax-exempt bond proceeds        
5 Royalties...........        
(i) Real (ii) Personal
6a Gross rents 6a 6,161,689  
b Less: rental expenses 6b 2,258,800  
c Rental income or (loss) 6c 3,902,889  
d Net rental income or (loss)....... 3,902,889     3,902,889
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 7a 21,876  
b Less: cost or other basis and sales expenses 7b 35,598  
c Gain or (loss) 7c -13,722  
d Net gain or (loss)......... -13,722     -13,722
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..        
 OtherRevenueMiscAmt
Business Code
11a LEASED EMPLOYEE REVENUE 900099 2,353,583     2,353,583
b CAFETERIA REVENUE 900099 1,962,115     1,962,115
c CHILD DEVELOPMENT REVENUE 624410 960,860     960,860
d All other revenue .... 8,127,181 870,461   7,256,720
e Total. Add lines 11a–11d ...... 13,403,739
12 Total revenue. See instructions..... 699,784,345 672,637,861 0 24,637,933
Form 990 (2023)
Form 990 (2023)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 738,335 738,335
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 6,946,605 5,882,049 1,064,556  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 151,107,859 127,950,831 23,157,028  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 5,439,390 4,605,813 833,577  
9 Other employee benefits ....... 18,444,661 15,618,047 2,826,614  
10 Payroll taxes ........... 10,830,120 9,170,422 1,659,698  
11 Fees for services (non-employees):        
a Management ...... 38,993,802 33,018,067 5,975,735  
b Legal ......... 1,108,435 938,569 169,866  
c Accounting ........... 461,835 391,060 70,775  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 116,680,877 98,799,727 17,881,150  
12 Advertising and promotion .... 423,949 358,980 64,969  
13 Office expenses ....... 9,309,634 7,104,422 2,205,212  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 16,204,859 13,721,492 2,483,367  
17 Travel ............ 465,536 394,193 71,343  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 43,830 37,113 6,717  
20 Interest ........... 10,323,225 8,741,208 1,582,017  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 26,920,542 22,795,013 4,125,529  
23 Insurance ... 3,345,740 2,833,011 512,729  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 142,267,844 142,267,844    
b HAF FEE 41,052,188 41,052,188    
c SOFTWARE FEES 11,152,199 9,443,143 1,709,056  
d LICENSES, DUES & SUBSCR 1,321,847 1,119,276 202,571  
e All other expenses 1,948,440 1,729,884 218,556  
25 Total functional expenses. Add lines 1 through 24e 615,531,752 548,710,687 66,821,065 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).        
Form 990 (2023)
Form 990 (2023)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........   1  
2 Savings and temporary cash investments ......... 50,053,658 2 66,394,247
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 99,468,958 4 96,706,672
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ........... 24,972 7 0
8 Inventories for sale or use ............ 8,459,432 8 10,855,001
9 Prepaid expenses and deferred charges ...... 15,828,023 9 18,778,864
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 701,640,561
b Less: accumulated depreciation 10b 431,575,823 277,074,955 10c 270,064,738
11 Investments—publicly traded securities . 241,685,829 11 277,697,244
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 6,426,432 15 7,965,458
16 Total assets. Add lines 1 through 15 (must equal line 33)... 699,022,259 16 748,462,224
Liabilities 17 Accounts payable and accrued expenses ..... 63,295,113 17 64,438,756
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities ......... 259,508,701 20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties .. 21,308,290 23 271,390,587
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 16,482,782 25 21,775,815
26 Total liabilities. Add lines 17 through 25.. 360,594,886 26 357,605,158
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 329,266,262 27 381,698,503
28 Net assets with donor restrictions ........... 9,161,111 28 9,158,563
Organizations that do not follow FASB ASC 958, check here right arrow and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 338,427,373 32 390,857,066
33 Total liabilities and net assets/fund balances ........ 699,022,259 33 748,462,224
Form 990 (2023)
Form 990 (2023)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
699,784,345
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
615,531,752
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
84,252,593
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
338,427,373
5
Net unrealized gains (losses) on investments ...............
5
26,035,641
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-57,858,541
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
390,857,066
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Uniform Guidance, 2 C.F.R. Part 200, Subpart F?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2023)
Form 990 (2023)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

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.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public
Inspection
Name of the organization
UNION HOSPITAL INC
 
Employer identification number

35-0876396
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 12, check only one box.)
1
A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).
2
A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)
3
A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).
4
A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

5
An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)
6
A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).
7
An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)
8
A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)
9
An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:
10
An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% 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.)
11
12
An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.
a
Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.
b
Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.
c
Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.
d
Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.
e
Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(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
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
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 failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2019 (b) 2020 (c) 2021 (d) 2022 (e) 2023 (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.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2019 (b) 2020 (c) 2021 (d) 2022 (e) 2023 (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  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
33 1/3% support test—2023. 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 .......................right arrow
b
33 1/3% support test—2022. 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 ..................... right arrow
17a
10%-facts-and-circumstances test—2023. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
b
10%-facts-and-circumstances test—2022. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
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 ..................................................... right arrow
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) right arrow (a) 2019 (b) 2020 (c) 2021 (d) 2022 (e) 2023 (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.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2019 (b) 2020 (c) 2021 (d) 2022 (e) 2023 (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.)..            
14
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2023. 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 ....... right arrow
b
33 1/3 % support tests—2022. 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 ..... right arrow
20
Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
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  
7
Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)
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 2023 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-2023
(iii)
Distributable
Amount for 2023
1 Distributable amount for 2023 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2023:
a From 2018.......  
b From 2019.......  
c From 2020.......  
d From 2021.......  
e From 2022.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2023 distributable amount  
i Carryover from 2018 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2023 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2023 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2023, 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 2023. 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 2024. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2019.....  
b Excess from 2020.....  
c Excess from 2021.....  
d Excess from 2022.....  
e Excess from 2023.....  
Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 


Return Reference Explanation
Schedule A (Form 990) 2023


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2023
Name of the organization
UNION HOSPITAL INC
 
Employer identification number

35-0876396
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990) (2023)
Schedule B (Form 990) (2023) Page 2
Name of organization
UNION HOSPITAL INC
 
Employer identification number
35-0876396
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)
Schedule B (Form 990) (2023)
Page 3
Name of organization
UNION HOSPITAL INC
 
Employer identification number

35-0876396
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
Schedule B (Form 990) (2023)
Schedule B (Form 990) (2023)
Page 4
Name of organization
UNION HOSPITAL INC
 
Employer identification number

35-0876396
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990) (2023)
Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

right arrow Complete if the organization is described below. right arrow Attach to Form 990 or Form 990-EZ.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
UNION HOSPITAL INC
 
Employer identification number

35-0876396
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................right arrow
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................right arrow
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................right arrow
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................right arrow

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........right arrow

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990) 2022

Schedule C (Form 990) 2022
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check right arrowexpenses, and share of excess lobbying expenditures).
B Check right arrow
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2019 (b) 2020 (c) 2021 (d) 2022 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990) 2022


Schedule C (Form 990) 2022
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
29,997
j
Total. Add lines 1c through 1i ....................................................................................................
29,997
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: PERCENTAGE OF INDIANA HOSPITAL ASSOCATION AND AMERICAN HOSPITAL ASSOCIATION DUES PAID ATTRIBUTABLE TO LOBBYING EXPENSES AS DEFINED IN FEDERAL LAW.
Schedule C (Form 990) 2022


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
right arrow Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow Attach to Form 990.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
UNION HOSPITAL INC
 
Employer identification number

35-0876396
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow  
4
Number of states where property subject to conservation easement is located right arrow  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................right arrow $  
(ii)
Assets included in Form 990, Part X ...............................right arrow $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................right arrow $  
b
Assets included in Form 990, Part X ...............................right arrow $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2022

Schedule D (Form 990) 2022
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment right arrow  
b
Permanent endowment right arrow  
c
Term endowment right arrow  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   18,617,534 18,617,534
b Buildings ....   449,844,279 242,732,583 207,111,696
c Leasehold improvements   3,955,480 3,376,571 578,909
d Equipment ....   220,170,284 185,466,669 34,703,615
e Other .....   9,052,984   9,052,984
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..right arrow 270,064,738
Schedule D (Form 990) 2022

Schedule D (Form 990) 2022
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)right arrow  
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)right arrow  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........right arrow  
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
ESTIMATED THIRD PARTY SETTLEMENTS 21,521,530
RELATED PARTY PAYABLES 254,285







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)right arrow 21,775,815
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2022

Schedule D (Form 990) 2022
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ........... 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ........... 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY UHS, THE CORPORATION, AND UAPC, AND RECOGNIZE A TAX LIABILITY IF UHS, THE CORPORATION, AND UAPC HAVE TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY UHS, THE CORPORATION, AND UAPC, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. UHS, THE CORPORATION, AND UAPC ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FILINGS ARE CURRENT THROUGH 2022. THE IMPACT OF THE SUBSIDIARIES TAX CONSEQUENCES IS IMMATERIAL TO THESE CONSOLIDATED FINANCIAL STATEMENTS.
Schedule D (Form 990) 2022


Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
Medium right arrow Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow Attach to Form 990.
Medium right arrow Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
Name of the organization
UNION HOSPITAL INC
 
Employer identification number

35-0876396
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    1,597,113   1,597,113 0.260 %
b Medicaid (from Worksheet 3, column a) . . . . .     140,737,923 103,212,130 37,525,793 6.100 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     273,333,477 289,531,410 0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     415,668,513 392,743,540 39,122,906 6.360 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     11,816,257   11,816,257 1.920 %
f Health professions education (from Worksheet 5) . . .     12,410,668 5,289,495 7,121,173 1.160 %
g Subsidized health services (from Worksheet 6) . . . .     15,468,815 3,265,619 12,203,196 1.980 %
h Research (from Worksheet 7) .     137,672   137,672 0.020 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     735,638   735,638 0.120 %
j Total. Other Benefits . .     40,569,050 8,555,114 32,013,936 5.200 %
k Total. Add lines 7d and 7j .     456,237,563 401,298,654 71,136,842 11.560 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
40,403,183
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
143,844,254
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
135,555,005
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
8,289,249
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?2Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 UNION HOSPITAL INC
1606 NORTH SEVENTH STREET
TERRE HAUTE,IN47804
HTTP://WWW.MYUNIONHOSPITAL.ORG
18-005022-1
X X   X     X   PHYSICIAN PRACTICES, OFF CAMPUS THERAPY, RADIOLOGY A
2 UNION HOSPITAL CLINTON
801 S MAIN ST
CLINTON,IN47842
HTTP://WWW.MYUNIONHOSPITAL.ORG
18-005055-1
X       X   X     A
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, PAGE 8
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, PAGE 8
b
SEE PART V, PAGE 8
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 6
Part VFacility Information (continued)

Billing and Collections
FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
PART V, SECTION B FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: UNION HOSPITAL, INC, - FACILITY 2: UNION HOSPITAL CLINTON
GROUP A-FACILITY 1 -- UNION HOSPITAL PART V, SECTION B, LINE 5: AN ONLINE SURVEY WAS DEVELOPED FOR THE COMMUNITY TO RANK NEEDS BASED ON THE AREA CODE IN WHICH THEY RESIDE. THIS DATA HAS BEEN TAKEN INTO CONSIDERATION AND WILL HELP US PLAN AND IMPLEMENT PROGRAMS FOR COMMUNITY HEALTH IMPROVEMENT. ALSO, PUBLIC INPUT WAS SOUGHT IN VARIOUS STAKEHOLDER MEETINGS THAT TAKE PLACE AT THE HOSPITAL ON A BI-MONTHLY BASIS. THOSE STAKEHOLDER MEETINGS CONSIST OF; COMMUNITY IMPACT COMMITTEE, PATIENT FAMILY ADVISORY, BOARD OF DIRECTORS ADVISORY AND VENDOR ADVISORY. THESE ADVISORY COMMITTEES WERE FORMED TO HELP THE HOSPITAL PERFORM A SWOT ANALYSIS AND GAIN DIFFERENT PERSPECTIVE FROM DIFFERENT INDIVIDUALS THAT THE HOSPITALS COME IN CONTACT WITH ON A DAILY BASIS. THIS ANALYSIS HAS BEEN COMPILED TO HELP WITH OUR STRATEGIC PLANNING PROCESS.
GROUP A-FACILITY 1 -- UNION HOSPITAL PART V, SECTION B, LINE 6A: UNION HOSPITAL CLINTONTERRE HAUTE REGIONAL HOSPITALSULLIVAN COUNTY COMMUNITY HOSPITAL
GROUP A-FACILITY 1 -- UNION HOSPITAL PART V, SECTION B, LINE 11: BASED ON PRIMARY AND SECONDARY RESEARCH, THE UNION HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT 2021 SHOWS A CHANGE IN HEALTH CARE NEEDS IN THE WABASH VALLEY. OBESITYTOBACCO USAGEHEART DISEASE & STROKEDIABETESINFANT MORTALITYOBESITYCONTINUED SUCCESSFUL INTERVENTIONS:-UNION HEALTH EMPLOYEE OPPORTUNITIES THAT ENCOURAGE HEALTHY INTERVENTIONS TO IMPROVE OVERALL EMPLOYEE HEALTH-UNION HEALTH SPONSORED FREE TENNIS LESSONS AT THREE LOCATIONS FOR SIX MONTHS, WAS A PRIMARY SPONSOR FOR YOUTH SOCCER LEAGUE TO ENCOURAGE PHYSICAL ACTIVITY FOR AREA YOUTH, AND A TERRE HAUTE TURKEY TROT-TIMED RUN THAT WAS HELD ON THE THANKSGIVING MORNING FOR ADULTS AND CHILDREN.-UNION HEALTH COMMUNITY GARDEN THAT IS OPEN TO UNION EMPLOYEES AND COMMUNITY MEMBERS-BREAST FEEDING EDUCATIONAL SUPPORT CONTINUED IN THE MOTHER BABY UNITS-SUPPORT THE YMCA "WHY MAKE WAVES" POOL RENOVATION FOR PUBLIC SWIMMING PROGRAMS THROUGHOUT THE YEAR.NEW / EXPANDED INTERVENTIONS:-UNION HEALTH RAN "EAT HEALTHY TONIGHT!" ADS ALONG WITH IMAGES OF FRUITS AND VEGETABLES ON THROUGHOUT THE COMMUNITY.-UNION HEALTH PARTNERED WITH UNITED WAY TO IMPROVE OBESITY RATES-PROMOTE A PRIMARY CARE MESSAGE WITHIN NEW PATIENT FOLDERS TO ENCOURAGE ROUTINE EVALUATIONS.TOBACCO USECONTINUED SUCCESSFUL INTERVENTIONS:-RETRAINING OCCURRED WITH CLINICAL STAFF TO DIRECT PATIENTS TO THE SMOKING INDIANA & ILLINOIS QUIT LINES.-UNION HEALTH JOINED CHANCES AND SERVICES FOR YOUTH (CASY) FOR THE GREAT AMERICAN SMOKE OUT DAY USING INTERNAL NEWSLETTER AIMED AT 3,000 EMPLOYEES AS WELL AS MULTIPLE SOCIAL MEDIA PLATFORMS.-CONTINUED DISPLAYING "LIFE IS BETTER WITHOUT TOBACCO" POSTER IN CLINIC WAITING ROOMS THAT INCLUDED OUR PHYSICIAN QUOTES.-CONTINUED EMPLOYER OUTREACH.NEW / EXPANDED INTERVENTIONS:-BEGINNING IN 2021 UNION HOSPITAL CARRIED A NEW SMOKE-FREE MESSAGE LEADING PATIENTS TO THE FREE SMOKING QUIT LINE INSIDE THE PATIENT FOLDER THAT WILL BE SEEN BY EVERY IN-PATIENT.-ANTI-SMOKING MESSAGES FOR PREGNANT MOMS WITH HEADLINES "SMOKING CAN AFFECT YOUR CHILD'S HEALTH BEFORE AND AFTER DELIVERY" RAN IN THE WAITING ROOM TV'S AND EXAM ROOM WALLBOARDS SEVERAL TIMES PER HOUR. EACH MESSAGE STEERED MOMS TO THE INDIANA AND ILLINOIS QUIT LINE.-ANTI-SMOKING MESSAGES TITLED "THE GIFT OF HEALTH" THAT RAN AT CHRISTMAS AND "NEW BEGINNINGS" THAT RAN DURING THE NEW YEAR'S TIMEFRAME ON TWO ELECTRONIC MESSAGE BOARD ADS THAT DIRECTED VIEWERS TO THE INDIANA QUIT LINE.-PARTNERED WITH UNITED WAY TO IMPROVE SMOKING RATES.-SUPPORT ANTI-VAPING MESSAGES WITH CASY.HEART DISEASE & STROKECONTINUED SUCCESSFUL INTERVENTIONS:-SYSTEM-WIDE PROMOTIONAL MESSAGING OF WORLD STROKE DAY IN OCTOBER 2021.-HEART & STROKE PREVENTION MESSAGING INCLUDED ON OUR 2021 VOICE ON HOLD MESSAGING.-WE RAN ADS AND BILLBOARD MESSAGES FOR HEART ATTACK (CONTROL CHOLESTEROL) AND STROKE (SHOVELING).-ON-GOING HEART SCANS CAMPAIGN CONTINUED AT UNION HOSPITAL CLINTON TO ENCOURAGE THE PUBLIC TO IDENTIFY THEIR HEART RISKS.-IMPROVE STROKE OUTREACH WITH CRITICAL ACCESS HOSPITALS IN OUR REGION.NEW / EXPANDED INTERVENTIONS:-ENCOURAGE EXPANDED WELLNESS PROGRAMS-INCLUDE A HEART AND VASCULAR MESSAGE WITHIN THE NEW PATIENT FOLDERS-RECORD AND PROMOTE PHYSICIAN INTERVIEWS REGARDING STROKEDIABETESCONTINUED SUCCESSFUL INTERVENTIONS:-FREE DIABETES EDUCATIONAL CLASSES CONTINUED AT UNION HEALTH AND WERE PROMOTED HEAVILY THROUGHOUT THE WABASH VALLEY.-EMPLOYER OUTREACH.NEW / EXPANDED INTERVENTIONS:-UNION HEALTH INTERVIEWED TWO NURSE EDUCATORS ABOUT PREDIABETES AND RAN COMMERCIALS AND MESSAGING ON THE WAITING ROOM MONITORS THROUGHOUT THE SYSTEM.-INCREASE REACH AND PARTICIPATION LEVELS FOR PRE-DIABETES (BORDERLINE) PATIENTS.-NEW PRINT AND SOCIAL MEDIA ADS WITH HEADLINES "REVERSE THE COURSE OF PREDIABETES AND TYPE 2 DIABETES AND "IT'S TIME TO TAKE CONTROL" RAN INTERNALLY AND EXTERNALLY.INFANT MORTALITYCONTINUED SUCCESSFUL INTERVENTIONS:-SAFE SLEEP EDUCATION CONTINUED WITH THE ABC'S OF SAFE SLEEP IN THE COMMUNITY: ALONE, BACK AND CRIB. (INFANTS SHOULD SLEEP ALONE, LIE ON BACK AND NOT IN AN ADULT BED.)-WE CONTINUED TO WORK WITH THE "BABY & ME TOBACCO-FREE ORGANIZATION IN 2021 TO CONTINUE EDUCATIONAL AND PROMOTIONAL OPPORTUNITIES WITHIN OUR POPULATION. -WE CONTINUED TO PROMOTE OUR PRENATAL NAVIGATORS TO THE PUBLIC. -CONTINUE OUR REFERRAL PROMOTION.-WE CONTINUE OUR BREASTFEEDING SUPPORT/EDUCATION.-PARTICIPATE IN CHILD SAFETY SEAT INSTALLATIONS, WHILE TRAINING NEW INSTALLERS.NEW / EXPANDED INTERVENTIONS:-WE CREATED A POSTER AND OTHER MESSAGES THAT ASKED THE PUBLIC AS A TOOL TO EDUCATE HOW CRIBS SHOULD BE PREPARED FOR INFANTS. "WHAT DOES YOUR CRIB LOOK LIKE?" (NO LOOSE BLANKETS, NO BUMPER PADS AND NO STUFFED ANIMALS)
GROUP A-FACILITY 1 -- UNION HOSPITAL PART V, SECTION B, LINE 13H: DESCRIPTION OF FAMILY INCOME LIMIT FOR ELIGIBILITY:THE ORGANIZATION PROVIDES FULL FINANCIAL ASSISTANCE FOR INCOME LEVELS BELOW 200% OF FEDERAL POVERTY INCOME GUIDELINES (FPIG), PROVIDED THEY HAVE NO OTHER SOURCES FOR PAYMENT [SUCH AS HEALTH INSURANCE, MEDICAID ELIGIBILTY, OR LIABILITY CLAIMS], AND GRANTS PARTIAL FINANCIAL ASSISTANCE TO INDIVIDUALS AND FAMILIES WITH AN ANNUAL HOUSEHOLD INCOME LEVELS BETWEEN 201% AND 300% OF FPIG. INDIVIDUALS AND FAMILIES WITH AN ANNUAL HOUSEHOLD INCOME EXCEEDING 301% OF FPIG SHALL NOT BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ABSENT UNUSUAL CIRCUMSTANCES AS APPROVED BY THE FINANCIAL ASSISTANCE COMMITTEE. ALL UNINSURED PATIENTS, REGARDLESS OF FINANCIAL NEED, WILL BE ELIGIBLE FOR AN INITIAL AUTOMATIC DISCOUNT TO THE AGB, AS CALCULATED CONSISTENTLY WITH THE CREDIT AND COLLECTION POLICY. ADDITIONALLY, AN UNINSURED INDIVIDUAL, ELIGIBLE FOR THE AUTOMATIC DISCOUNT, MAY ALSO BE AN ELIGIBLE INDIVIDUAL FOR PURPOSE OF RECEIVING ADDITIONAL FINANCIAL ASSISTANCE.
GROUP A-FACILITY 2 -- UNION HOSPITAL CLINTON PART V, SECTION B, LINE 5: AN ONLINE SURVEY WAS DEVELOPED FOR THE COMMUNITY TO RANK NEEDS BASED ON THE AREA CODE IN WHICH THEY RESIDE. THIS DATA HAS BEEN TAKEN INTO CONSIDERATION AND WILL HELP US PLAN AND IMPLEMENT PROGRAMS FOR COMMUNITY HEALTH IMPROVEMENT. ALSO, PUBLIC INPUT WAS SOUGHT IN VARIOUS STAKEHOLDER MEETINGS THAT TAKE PLACE AT THE HOSPITAL ON A BI-MONTHLY BASIS. THOSE STAKEHOLDER MEETINGS CONSIST OF; COMMUNITY IMPACT COMMITTEE, PATIENT FAMILY ADVISORY, BOARD OF DIRECTORS ADVISORY AND VENDOR ADVISORY. THESE ADVISORY COMMITTEES WERE FORMED TO HELP THE HOSPITAL PERFORM A SWOT ANALYSIS AND GAIN DIFFERENT PERSPECTIVE FROM DIFFERENT INDIVIDUALS THAT THE HOSPITALS COME IN CONTACT WITH ON A DAILY BASIS. THIS ANALYSIS HAS BEEN COMPILED TO HELP WITH OUR STRATEGIC PLANNING PROCESS.
GROUP A-FACILITY 2 -- UNION HOSPITAL CLINTON PART V, SECTION B, LINE 6A: UNION HOSPITAL, INC.TERRE HAUTE REGIONAL HOSPITALSULLIVAN COUNTY COMMUNITY HOSPITAL
GROUP A-FACILITY 2 -- UNION HOSPITAL CLINTON PART V, SECTION B, LINE 11: BASED ON PRIMARY AND SECONDARY RESEARCH, THE UNION HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT 2021 SHOWS A CHANGE IN HEALTH CARE NEEDS IN THE WABASH VALLEY. OBESITYTOBACCO USAGEHEART DISEASE & STROKEDIABETESINFANT MORTALITYOBESITYCONTINUED SUCCESSFUL INTERVENTIONS:-UNION HEALTH EMPLOYEE OPPORTUNITIES THAT ENCOURAGE HEALTHY INTERVENTIONS TO IMPROVE OVERALL EMPLOYEE HEALTH-UNION HEALTH SPONSORED FREE TENNIS LESSONS AT THREE LOCATIONS FOR SIX MONTHS, WAS A PRIMARY SPONSOR FOR YOUTH SOCCER LEAGUE TO ENCOURAGE PHYSICAL ACTIVITY FOR AREA YOUTH, AND A TERRE HAUTE TURKEY TROT-TIMED RUN THAT WAS HELD ON THE THANKSGIVING MORNING FOR ADULTS AND CHILDREN.-UNION HEALTH COMMUNITY GARDEN THAT IS OPEN TO UNION EMPLOYEES AND COMMUNITY MEMBERS-BREAST FEEDING EDUCATIONAL SUPPORT CONTINUED IN THE MOTHER BABY UNITS-SUPPORT THE YMCA "WHY MAKE WAVES" POOL RENOVATION FOR PUBLIC SWIMMING PROGRAMS THROUGHOUT THE YEAR.NEW / EXPANDED INTERVENTIONS:-UNION HEALTH RAN "EAT HEALTHY TONIGHT!" ADS ALONG WITH IMAGES OF FRUITS AND VEGETABLES ON THROUGHOUT THE COMMUNITY.-UNION HEALTH PARTNERED WITH UNITED WAY TO IMPROVE OBESITY RATES-PROMOTE A PRIMARY CARE MESSAGE WITHIN NEW PATIENT FOLDERS TO ENCOURAGE ROUTINE EVALUATIONS.TOBACCO USECONTINUED SUCCESSFUL INTERVENTIONS:-RETRAINING OCCURRED WITH CLINICAL STAFF TO DIRECT PATIENTS TO THE SMOKING INDIANA & ILLINOIS QUIT LINES.-UNION HEALTH JOINED CHANCES AND SERVICES FOR YOUTH (CASY) FOR THE GREAT AMERICAN SMOKE OUT DAY USING INTERNAL NEWSLETTER AIMED AT 3,000 EMPLOYEES AS WELL AS MULTIPLE SOCIAL MEDIA PLATFORMS.-CONTINUED DISPLAYING "LIFE IS BETTER WITHOUT TOBACCO" POSTER IN CLINIC WAITING ROOMS THAT INCLUDED OUR PHYSICIAN QUOTES.-CONTINUED EMPLOYER OUTREACH.NEW / EXPANDED INTERVENTIONS:-BEGINNING IN 2021 UNION HOSPITAL CARRIED A NEW SMOKE-FREE MESSAGE LEADING PATIENTS TO THE FREE SMOKING QUIT LINE INSIDE THE PATIENT FOLDER THAT WILL BE SEEN BY EVERY IN-PATIENT.-ANTI-SMOKING MESSAGES FOR PREGNANT MOMS WITH HEADLINES "SMOKING CAN AFFECT YOUR CHILD'S HEALTH BEFORE AND AFTER DELIVERY" RAN IN THE WAITING ROOM TV'S AND EXAM ROOM WALLBOARDS SEVERAL TIMES PER HOUR. EACH MESSAGE STEERED MOMS TO THE INDIANA AND ILLINOIS QUIT LINE.-ANTI-SMOKING MESSAGES TITLED "THE GIFT OF HEALTH" THAT RAN AT CHRISTMAS AND "NEW BEGINNINGS" THAT RAN DURING THE NEW YEAR'S TIMEFRAME ON TWO ELECTRONIC MESSAGE BOARD ADS THAT DIRECTED VIEWERS TO THE INDIANA QUIT LINE.-PARTNERED WITH UNITED WAY TO IMPROVE SMOKING RATES.-SUPPORT ANTI-VAPING MESSAGES WITH CASY.HEART DISEASE & STROKECONTINUED SUCCESSFUL INTERVENTIONS:-SYSTEM-WIDE PROMOTIONAL MESSAGING OF WORLD STROKE DAY IN OCTOBER 2021.-HEART & STROKE PREVENTION MESSAGING INCLUDED ON OUR 2021 VOICE ON HOLD MESSAGING.-WE RAN ADS AND BILLBOARD MESSAGES FOR HEART ATTACK (CONTROL CHOLESTEROL) AND STROKE (SHOVELING).-ON-GOING HEART SCANS CAMPAIGN CONTINUED AT UNION HOSPITAL CLINTON TO ENCOURAGE THE PUBLIC TO IDENTIFY THEIR HEART RISKS.-IMPROVE STROKE OUTREACH WITH CRITICAL ACCESS HOSPITALS IN OUR REGION.NEW / EXPANDED INTERVENTIONS:-ENCOURAGE EXPANDED WELLNESS PROGRAMS-INCLUDE A HEART AND VASCULAR MESSAGE WITHIN THE NEW PATIENT FOLDERS-RECORD AND PROMOTE PHYSICIAN INTERVIEWS REGARDING STROKEDIABETESCONTINUED SUCCESSFUL INTERVENTIONS:-FREE DIABETES EDUCATIONAL CLASSES CONTINUED AT UNION HEALTH AND WERE PROMOTED HEAVILY THROUGHOUT THE WABASH VALLEY.-EMPLOYER OUTREACH.NEW / EXPANDED INTERVENTIONS:-UNION HEALTH INTERVIEWED TWO NURSE EDUCATORS ABOUT PREDIABETES AND RAN COMMERCIALS AND MESSAGING ON THE WAITING ROOM MONITORS THROUGHOUT THE SYSTEM.-INCREASE REACH AND PARTICIPATION LEVELS FOR PRE-DIABETES (BORDERLINE) PATIENTS.-NEW PRINT AND SOCIAL MEDIA ADS WITH HEADLINES "REVERSE THE COURSE OF PREDIABETES AND TYPE 2 DIABETES AND "IT'S TIME TO TAKE CONTROL" RAN INTERNALLY AND EXTERNALLY.INFANT MORTALITYCONTINUED SUCCESSFUL INTERVENTIONS:-SAFE SLEEP EDUCATION CONTINUED WITH THE ABC'S OF SAFE SLEEP IN THE COMMUNITY: ALONE, BACK AND CRIB. (INFANTS SHOULD SLEEP ALONE, LIE ON BACK AND NOT IN AN ADULT BED.)-WE CONTINUED TO WORK WITH THE "BABY & ME TOBACCO-FREE ORGANIZATION IN 2021 TO CONTINUE EDUCATIONAL AND PROMOTIONAL OPPORTUNITIES WITHIN OUR POPULATION. -WE CONTINUED TO PROMOTE OUR PRENATAL NAVIGATORS TO THE PUBLIC. -CONTINUE OUR REFERRAL PROMOTION.-WE CONTINUE OUR BREASTFEEDING SUPPORT/EDUCATION.-PARTICIPATE IN CHILD SAFETY SEAT INSTALLATIONS, WHILE TRAINING NEW INSTALLERS.NEW / EXPANDED INTERVENTIONS:-WE CREATED A POSTER AND OTHER MESSAGES THAT ASKED THE PUBLIC AS A TOOL TO EDUCATE HOW CRIBS SHOULD BE PREPARED FOR INFANTS. "WHAT DOES YOUR CRIB LOOK LIKE?" (NO LOOSE BLANKETS, NO BUMPER PADS AND NO STUFFED ANIMALS)
GROUP A-FACILITY 2 -- UNION HOSPITAL CLINTON PART V, SECTION B, LINE 13H: DESCRIPTION OF FAMILY INCOME LIMIT FOR ELIGIBILITY:THE ORGANIZATION PROVIDES FULL FINANCIAL ASSISTANCE FOR INCOME LEVELS BELOW 200% OF FEDERAL POVERTY INCOME GUIDELINES (FPIG), PROVIDED THEY HAVE NO OTHER SOURCES FOR PAYMENT [SUCH AS HEALTH INSURANCE, MEDICAID ELIGIBILTY, OR LIABILITY CLAIMS], AND GRANTS PARTIAL FINANCIAL ASSISTANCE TO INDIVIDUALS AND FAMILIES WITH AN ANNUAL HOUSEHOLD INCOME LEVELS BETWEEN 201% AND 300% OF FPIG. INDIVIDUALS AND FAMILIES WITH AN ANNUAL HOUSEHOLD INCOME EXCEEDING 301% OF FPIG SHALL NOT BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ABSENT UNUSUAL CIRCUMSTANCES AS APPROVED BY THE FINANCIAL ASSISTANCE COMMITTEE. ALL UNINSURED PATIENTS, REGARDLESS OF FINANCIAL NEED, WILL BE ELIGIBLE FOR AN INITIAL AUTOMATIC DISCOUNT TO THE AGB, AS CALCULATED CONSISTENTLY WITH THE CREDIT AND COLLECTION POLICY. ADDITIONALLY, AN UNINSURED INDIVIDUAL, ELIGIBLE FOR THE AUTOMATIC DISCOUNT, MAY ALSO BE AN ELIGIBLE INDIVIDUAL FOR PURPOSE OF RECEIVING ADDITIONAL FINANCIAL ASSISTANCE.
UNION HOSPITAL, INC. & UNION HOSPITAL CLINTON: SCHEDULE H, PART V, LINE 7A:HTTPS://WWW.UNION.HEALTH/ABOUT-US/SERVING-OUR-COMMUNITY/HEALTH-NEEDS-ASSESSMENT/
UNION HOSPITAL, INC. & UNION HOSPITAL CLINTON: SCHEDULE H, PART V, LINE 10A:HTTPS://WWW.UNION.HEALTH/ABOUT-US/SERVING-OUR-COMMUNITY/HEALTH-NEEDS-ASSESSMENT/
UNION HOSPITAL, INC. & UNION HOSPITAL CLINTON: SCHEDULE H, PART V, LINE 16A:HTTPS://WWW.UNION.HEALTH/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-AND-INSURANCE/POLICIESSCHEDULE H, PART V, LINE 16B:HTTPS://WWW.UNION.HEALTH/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-AND-INSURANCE/POLICIESSCHEDULE H, PART V, LINE 16C:HTTPS://WWW.UNION.HEALTH/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-AND-INSURANCE/POLICIES
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?20
Name and address Type of Facility (describe)
1 1 - CLARA FAIRBANKS CENTER FOR WOMEN
1711 N 6 1/2 ST HUX CANCER CTR 3RD
FLOOR
TERRE HAUTE,IN47804
MAMMOGRAPHY CENTER
2 2 - CLAY CITY CENTER FOR FAMILY MEDICINE
315 LANKFORD ST PO BOX 96
CLAY CITY,IN47841
FAMILY MEDICINE CENTER
3 3 - CORK MEDICAL CENTER
408 N 2ND ST
MARSHALL,IL62441
FAMILY MEDICAL SERVICES
4 4 - DR WALTZ MD
727 N LINCOLN RD
ROCKVILLE,IN47872
FAMILY MEDICAL SERVICES
5 5 - HERITAGE FAMILY MEDICINE
7500 STATE ROAD 46
RILEY,IN47871
FAMILY MEDICAL SERVICES
6 6 - ILLIANA INTERNAL MEDICINE LLC
1332 N 7TH ST
TERRE HAUTE,IN47807
INTERNAL MEDICINE
7 7 - IMAGING SERVICES - THOMAS PROF PLAZA
5500 S US HWY 41
TERRE HAUTE,IN47802
OUTPATIENT THERAPY & IMAGING CENTER
8 8 - PEDIATRIC THERAPY SERVICES
450 8TH AVE
TERRE HAUTE,IN47804
OUTPATIENT THERAPY CENTER
9 9 - PROFESSIONAL OFFICE BUILDING
1530 N 7TH ST
TERRE HAUTE,IN47807
P.E.T. SCANS
10 10 - PROVIDENCE MEDICAL GROUP CATH LAB
2723 S 7TH ST
TERRE HAUTE,IN47802
OUTPATIENT CATH LAB
11 11 - PROVIDENCE MEDICAL GROUP CHEMO THERAPY
2723 S 7TH ST
TERRE HAUTE,IN47802
CHEMO THERAPY/INFUSION CENTER
12 12 - RICHARD G LUGAR CENTER FOR RURAL HEALTH
1433 NORTH 6 1/2 ST
TERRE HAUTE,IN47807
CENTER FOR MEDICAL EDUCATION
13 13 - THERAPY SERVICES - PROFESSIONAL PLAZA
4001 E WABASH AVENUE
TERRE HAUTE,IN47803
OUTPATIENT THERAPY CENTER
14 15 - THERAPY SERVICES (UAP BONE & JOINT)
1725 N 5TH ST
TERRE HAUTE,IN47804
OUTPATIENT THERAPY CENTER
15 16 - UNION FAMILY MEDICINE EAST
4001 E WABASH AVENUE
TERRE HAUTE,IN47803
THERAPY SERVICES
16 17 - UNION HOSPITAL FAMILY MEDICINE CENTER
1530 N 7TH ST STE 200
TERRE HAUTE,IN47807
FAMILY MEDICINE CENTER
17 18 - UNION HOSPTIAL HUX CANCER CENTER
1711 N 6 1/2 ST
TERRE HAUTE,IN47804
CANCER CARE CENTER
18 19 - WABASH VALLEY SURGERY CENTER
1421 N 7TH ST
TERRE HAUTE,IN47807
SURGERY CENTER
19 20 - BRAZIL FAMILY MEDICINE
115 S MURPHY AVENUE
BRAZIL,IN47834
FAMILY MEDICAL SERVICES
20 21 - ILLIANA INTERNAL MEDICINE LLC
601 E SURGERY DR
TERRE HAUTE,IN47807
INTERNAL MEDICINE
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 3C: DESCRIPTION OF FAMILY INCOME LIMIT FOR ELIGIBILITY:THE ORGANIZATION PROVIDES FULL FINANCIAL ASSISTANCE FOR INCOME LEVELS BELOW 200% OF FEDERAL POVERTY INCOME GUIDELINES (FPIG), PROVIDED THEY HAVE NO OTHER SOURCES FOR PAYMENT [SUCH AS HEALTH INSURANCE, MEDICAID ELIGIBILTY, OR LIABILITY CLAIMS], AND GRANTS PARTIAL FINANCIAL ASSISTANCE TO INDIVIDUALS AND FAMILIES WITH AN ANNUAL HOUSEHOLD INCOME LEVELS BETWEEN 201% AND 300% OF FPIG. INDIVIDUALS AND FAMILIES WITH AN ANNUAL HOUSEHOLD INCOME EXCEEDING 301% OF FPIG SHALL NOT BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ABSENT UNUSUAL CIRCUMSTANCES AS APPROVED BY THE FINANCIAL ASSISTANCE COMMITTEE. ALL UNINSURED PATIENTS, REGARDLESS OF FINANCIAL NEED, WILL BE ELIGIBLE FOR AN INITIAL AUTOMATIC DISCOUNT TO THE AGB, AS CALCULATED CONSISTENTLY WITH THE CREDIT AND COLLECTION POLICY. ADDITIONALLY, AN UNINSURED INDIVIDUAL, ELIGIBLE FOR THE AUTOMATIC DISCOUNT, MAY ALSO BE AN ELIGIBLE INDIVIDUAL FOR PURPOSE OF RECEIVING ADDITIONAL FINANCIAL ASSISTANCE.
PART I, LINE 7: A COST-TO-CHARGE RATIO METHODOLOGY WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE FOR PART 1, LINE 7. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 OF THE 2022 IRS INSTRUCTIONS FOR SCHEDULE H.
PART II, COMMUNITY BUILDING ACTIVITIES: TO BETTER MEET THE NEEDS OF OUR COMMUNITIES UNION HOSPITAL PARTICIPATES IN COMMUNITY BUILDING ACTIVITIES TO IMPROVE THE HEALTH IN THE COMMUNITY. PROGRAMS HAVE BEEN DEVELOPED TO SPECIFICALLY HELP MEET THE NEEDS AS DEFINED BY OUR COMMUNITY HEALTH NEEDS ASSESSMENT. MANY OF THE PROGRAMS OR SERVICES DEVELOPED MEET SEVERAL DEFINED NEEDS AND SOME OF THEM ARE MORE FOCUSED ON A CENTRAL IDEA. ACCESS TO HEALTH CARE HAS ALSO BEEN IDENTIFIED AS A NEED IN OUR COMMUNITY. IN 1993 THE RICHARD G. LUGAR CENTER FOR RURAL HEALTH WAS ESTABLISHED TO HELP RECRUIT AND EDUCATE PHYSICIANS TO PRACTICE HEALTH CARE IN OUR RURAL COMMUNITIES. SINCE ITS INCEPTION THE LUGAR CENTER HAS WORKED TO DEVELOP PROGRAMS AND SERVICES THAT MAKE HEALTHCARE MORE ACCESSIBLE TO THOSE INDIVIDUALS LIVING IN RURAL COMMUNITIES. THE ESTABLISHMENT OF CLINICS SUCH AS THE CLAY CITY CENTER FOR FAMILY MEDICINE THAT SERVES AS A MEDICAL HOME FOR APPROXIMATELY 3,500 AREA RESIDENTS, DELIVERING OVER 8,000 VISITS ANNUALLY, IN ADDITION TO HOUSE CALLS. IN 2001, THE LUGAR CENTER DEVELOPED AND IMPLEMENTED A CHRONIC DISEASE MANAGEMENT PROGRAM AT THE CLINIC THAT IS STILL BEING INTEGRATED INTO CARE PLANS FOR PATIENTS AS APPROPRIATE. THIS EVIDENCE-BASED PROGRAM INCLUDES FIVE CHRONIC DISEASES-HYPERTENSION, DIABETES MELLITUS, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, CONGESTIVE HEART FAILURE, AND ASTHMA. THE LUGAR CENTER IN COORDINATION WITH THE FAMILY MEDICINE RESIDENCY HAS EXPANDED TRAINING CAPACITY FOR FUTURE RURAL HEALTH CARE PROVIDERS THROUGH COLLABORATIVE EFFORTS WITH RURAL PARTNERS AROUND THE WABASH VALLEY. THE RURAL HEALTH INNOVATION COLLABORATIVE IS ANOTHER PROGRAM THAT HAS BEEN DEVELOPED TO HELP IMPROVE ACCESS TO HEALTHCARE AMONG OTHER COMMUNITY BUILDING ACTIVITIES. IN 2008 UNION HOSPITAL'S LUGAR CENTER HELPED LAUNCH A RURAL HEALTH COLLABORATIVE AIMED AT IMPROVING AND EXPANDING HEALTH CARE IN OUR COMMUNITY. WHAT BEGAN AS AN INFORMAL EXERCISE IN CREATIVE PROBLEM-SOLVING HAS BECOME THE RHIC. FOUNDING PARTNERS INCLUDE INDIANA STATE UNIVERSITY (ISU), INDIANA UNIVERSITY SCHOOL OF MEDICINE (IUSM), UNION HOSPITAL AND IT'S RICHARD G. LUGAR CENTER FOR RURAL HEALTH (UH), THE TERRE HAUTE ECONOMIC DEVELOPMENT CORPORATION (THEDC), THE CITY OF TERRE HAUTE (THE CITY), AND IVY TECH COMMUNITY COLLEGE WABASH VALLEY (IVY TECH). THE MISSION OF THE RURAL HEALTH INNOVATION COLLABORATIVE (RHIC) IS TO IMPROVE AND EXPAND EDUCATION AND TRAINING OF HEALTH CARE PROFESSIONALS AND FUTURE HEALTH CARE PROFESSIONALS, ESPECIALLY FOR THOSE COMMITTED TO SERVING RURAL AND UNDERSERVED POPULATIONS. KEY COMPONENTS OF THIS MISSION INCLUDE: TO PROMOTE THE RETENTION OF HEALTH CARE PROFESSIONALS TO SERVE RURAL AND UNDERSERVED POPULATIONS; TO INVITE COMMUNITY REVITALIZATION BY PROMOTING THE ENHANCEMENT OF OPPORTUNITIES FOR EDUCATION, TRAINING, AND EXPERIENCE IN HEALTH-RELATED PROFESSIONS AND FIELDS; TO PROMOTE SOCIAL WELFARE AND TO ENCOURAGE AND COORDINATE COMMUNITY INITIATIVES TO ADDRESS CHALLENGES AFFECTING HEALTH CARE DELIVERY; TO PROMOTE THE EFFICIENT USE OF PUBLIC AND PRIVATE RESOURCES AND COLLABORATE WITH OTHER ENTITIES WITH SIMILAR OR COMPLEMENTARY PURPOSES; TO DESIGN AND IMPLEMENT INNOVATIVE BEST PRACTICES AND STRATEGIES THAT ARE CAPABLE OF REPLICATION IN OTHER AREAS OF THE UNITED STATES; AND TO DISSEMINATE EDUCATIONAL INFORMATION, THEREBY POTENTIALLY OR ACTUALLY BENEFITING THOSE OTHER AREAS.
PART III, LINE 2: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
PART III, LINE 3: UNION HOSPITAL DOES NOT ATTRIBUTE ANY BAD DEBT EXPENSE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP), THEREFORE NO PORTION OF BAD DEBT ATTRIBUTABLE TO FAP-ELIGIBLE INDIVIDUALS IS CONSIDERED A COMMUNITY BENEFIT.
PART III, LINE 4: FOOTNOTE TO ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSES CAN BE FOUND ON PAGE 9 THROUGH 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER THE FINANCIAL FOOTNOTE "PATIENT ACCOUNTS RECEIVABLE, NET PATIENT SERVICE REVENUE AND ESTIMATED THIRD-PARTY SETTLEMENTS".
PART III, LINE 8: THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED DECEMBER 31, 2023 REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST.
PART III, LINE 9B: IF THE PATIENT DOES NOT QUALIFY FOR CHARITY, BUT QUALIFIES FOR LIMITED MEANS ASSISTANCE, A REDUCTION IN CHARGES WILL BE MADE TO THE ACCOUNT AND THE PATIENT WILL BE NOTIFIED VIA MAIL. AT THE PATIENT'S REQUEST, PAYMENT ARRANGEMENTS WILL BE MADE FOR THE REMAINING BALANCE.
PART VI, LINE 2: AT UNION HOSPITAL, ASSESSING THE NEEDS OF OUR COMMUNITY IS AN ONGOING ACTIVITY. ON FEBRUARY 7, 2012, THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS OFFICIALLY LAUNCHED AND MADE AVAILABLE FOR PUBLIC USE. THE CHNA REPRESENTS A UNIQUE COLLABORATION BETWEEN THE TWO LARGEST HEALTHCARE PROVIDERS IN THE WABASH VALLEY (UNION HOSPITAL AND REGIONAL HOSPITAL), ALONG WITH THE TERRE HAUTE CHAMBER OF COMMERCE (THCC) AND ITS BETTER HEALTH WABASH VALLEY (BHWV) INITIATIVE. THE SIX COUNTIES ASSESSED INCLUDE CLAY, GREENE, PARKE, SULLIVAN, VERMILLION AND VIGO COUNTIES. HEALTHY COMMUNITY INSTITUTE (HCI) USES DATA FROM SECONDARY SOURCES BY COMPILING THE DATA INTO ONE CHNA REPORT PROVIDING NEARLY 100 INDICATORS MEASURING HEALTH AND WELLNESS, ECONOMIC FACTORS, EDUCATION, PUBLIC SAFETY AND SOCIAL ENVIRONMENT. THIS TOOL CAN BE USED BY MANY DIFFERENT SEGMENTS OF THE COMMUNITY. THE DATA IS AUTOMATICALLY UPDATED BY HCI REPRESENTATIVES AS NEW DATA IS MADE PUBLIC BY OTHER SECONDARY DATA SOURCES. THE CHNA INDICATORS EACH FEATURE A "DASHBOARD" REPRESENTING DATA THAT HAS BEEN COLLECTED FROM ROUGHLY 40 DIFFERENT SOURCES. EACH "DASHBOARD" HAS A NEEDLE POINTING TO ONE OF THREE COLORS REPRESENTING THE GOOD (GREEN), THE CAUTIONARY (YELLOW) AND THE SERIOUS CONDITION (RED) OF A PARTICULAR INDICATOR. SIDE-BY-SIDE COMPARISONS OF THE FIVE COUNTIES FEATURED ON THE WEBSITE, ALONG WITH STATEWIDE AND NATIONWIDE COMPARISONS ARE ALSO AVAILABLE. THE CHNA IS HOUSED ON THE THCC WEBSITE, TERREHAUTECHAMBER.COM AND CAN BE ACCESSED THROUGH BOTH THE TERRE HAUTE REGIONAL HOSPITAL AND UNION HOSPITAL WEBSITES. THE BHWV IMPLEMENTATION PLAN WAS DEVELOPED BY A SUB-COMMITTEE OF BHWV. MEMBERS OF THIS SUB-COMMITTEE HAVE KNOWLEDGE OF PUBLIC HEALTH AND REPRESENT THE COMMUNITY AS A WHOLE. THIS IMPLEMENTATION PLAN IS INTENDED TO BE A "COMMUNITY PLAN". NO SINGLE ORGANIZATION CAN IMPACT THE HEALTH OF THE COMMUNITY ALONE. IT IS BHWV VISION THAT EACH COMMUNITY INCLUDED IN THE CHNA SHOULD HAVE A SAY NOT ONLY IN WHAT NEEDS THEY WILL FOCUS ON BUT HOW THEY WILL GO ABOUT POSITIVELY IMPACTING THOSE NEEDS. THE EXPECTATION IS THAT MANY OF THE COUNTIES INCLUDED IN THE CHNA WILL HAVE SIMILAR NEEDS AND PROJECTS, PROGRAMS AND EDUCATION WILL BE DEVELOPED FOR IMPLEMENTATION ACROSS THE ENTIRE "REGION". THE IMPLEMENTATION PLAN WENT INTO EFFECT IN MAY 2013 AND WILL BE UPDATED/REVIEWED ON AN ANNUAL BASIS. THE PLAN IS A THREE YEAR PLAN WITH ANNUAL REVIEW OF EFFECTIVENESS, BENCHMARKS, PROGRAMS AND COMMUNITY HEALTH NEEDS. BHWV ORGANIZATIONS MAY FORMALLY CHOOSE TO ADOPT THE INITIATIVES OUTLINED IN THIS DOCUMENT. THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA) REQUIRES ALL NOT-FOR-PROFIT HOSPITALS TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT PRIOR TO MARCH 2012 AND ALSO COMPLETE AN IMPLEMENTATION PLAN, SEEKING INPUT FROM THE COMMUNITY AND BOARD APPROVAL OF THE PLAN IS REQUIRED. FAILURE TO COMPLY WITH THE PPACA COULD RESULT IN FORFEITURE OF TAX EXEMPT STATUS OR A $50,000 FINE UNTIL THE REQUIREMENTS ARE MET. UNION HOSPITAL, SULLIVAN COUNTY COMMUNITY HOSPITAL, GREENE COUNTY GENERAL HOSPITAL AND ST. VINCENT CLAY HOSPITAL ARE ALL PARTNERS IN THE BHWV INITIATIVE THAT HAVE REQUIREMENTS THEY HAVE TO FULFILL TO BE IN COMPLIANCE WITH THE PPACA. TO HELP SUPPLEMENT OUR INVOLVEMENT IN BHWV, UNION HOSPITAL OFFICIALS HAVE FORMED THE UNION HOSPITAL COMMUNITY HEALTH IMPROVEMENT IMPLEMENTATION PLAN WHICH INCORPORATES DATA FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT, INPUT FROM COMMUNITY LEADERS HAVING INTEREST AND KNOWLEDGE IN PUBLIC HEALTH THAT ARE MEMBERS OF BHWV, THE UNION HOSPITAL BOARD OF DIRECTORS AND THE COMMUNITY AS A WHOLE. ADDITIONALLY, TO HELP SUPPLEMENT OUR FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT, AN ONLINE SURVEY WAS DEVELOPED FOR THE COMMUNITY TO RANK NEEDS BASED ON THE AREA CODE IN WHICH THEY RESIDE. THIS DATA HAS BEEN TAKEN INTO CONSIDERATION AND WILL HELP US PLAN AND IMPLEMENT PROGRAMS FOR COMMUNITY HEALTH IMPROVEMENT. UNION HOSPITAL ALSO SEEKS PUBLIC INPUT IN VARIOUS STAKEHOLDER MEETINGS THAT TAKE PLACE AT THE HOSPITAL ON A BI-MONTHLY BASIS. THOSE STAKEHOLDER MEETINGS CONSIST OF; COMMUNITY IMPACT COMMITTEE, PATIENT FAMILY ADVISORY, BOARD OF DIRECTORS ADVISORY AND VENDOR ADVISORY. THESE ADVISORY COMMITTEES WERE FORMED TO HELP THE HOSPITAL PERFORM A SWOT ANALYSIS AND GAIN DIFFERENT PERSPECTIVE FROM DIFFERENT INDIVIDUALS THAT THE HOSPITALS COME IN CONTACT WITH ON A DAILY BASIS. THIS ANALYSIS HAS BEEN COMPILED TO HELP WITH OUR STRATEGIC PLANNING PROCESS. UNION EMPLOYS A FULL-TIME POSITION (COMMUNITY BENEFIT SPECIALIST) DEDICATED TO COMMUNITY BENEFIT ACTIVITIES FOR THE ORGANIZATION. THE COMMUNITY BENEFIT SPECIALIST TAKES ON THE LEAD ROLE IN COLLECTING DATA TO ASSIST IN ASSESSING THE NEEDS OF OUR COMMUNITY. THE WEB SITE STATSINDIANA.EDU HAS A WEALTH OF HEALTH, DEMOGRAPHIC AND INCOME DATA PROVIDING UNION WITH AN ASSESSMENT OF ALL INDIANA COUNTIES IN OUR SERVICE AREA. THE U.S. CENSUS BUREAU AND COUNTYHEALTHRANKINGS.ORG PROVIDED US MORE DATA THAT CAN BE DRILLED DOWN TO THE STATE, COUNTY AND CITY LEVELS TO HELP UNION OFFICIALS ACCURATELY ASSESS COMMUNITY HEALTH NEEDS. UNION ALSO WORKS CLOSELY WITH INDIANA STATE UNIVERSITY HEALTH AND HUMAN SERVICES AND THE VIGO COUNTY HEALTH DEPARTMENT. THE HOSPITAL UTILIZES NATIONAL RESEARCH CORPORATION (NRC) TO CONDUCT ITS PATIENT SATISFACTIONS SURVEY PROCESS, THE NRC PRODUCT PROVIDES UNION WITH COMMUNITY HEALTH NEEDS ASSESSMENT AND PROGRAM INDICATORS.
PART VI, LINE 3: UHI USES A VARIETY OF TOOLS TO EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR FINICAL ASSISTANCE. SIGNS ARE DISPLAYED IN THE ADMITTING AREAS, BROCHURES AND THE FINANCIAL ASSISTANCE POLICY IS ATTAINED ON OUR STATEMENTS. CLAIMAID IS AVAILABLE OF POINT OF SERVICE ONSITE MEDICAID ELIGIBILITY ADVISOR THAT ASSISTS OUR PATIENTS IN QUALIFYING FOR ANY MEDICAID PROGRAMS. ALL OF OUR FINANCIAL COUNSELORS ARE TRAINED AND SCRIPTED TO COMMUNICATE FINICAL ASSISTANCE PROGRAMS AND ASSIST IN SETTING UP MEETINGS FOR THE CLAIMAID STAFF. FINANCIAL COUNSELORS ARE LOCATED IN THE ADMITTING IN BOTH UNION HOSPITAL EAST AND WEST FACILITIES TO ASSIST OUR PATIENTS. THIS INCLUDES STAFF THAT CAN SPEAK SPANISH TO ASSIST IN ANY INTERPRETATION FOR A SPANISH-SPEAKING PATIENT.
PART VI, LINE 4: THE ORGANIZATION SERVES A SIX COUNTY "REGION" LOCATED IN WABASH VALLEY INCLUDING CLAY, GREEN, PARKE, SULLIVAN, VERMILLION, AND VIGO COUNTIES. FOLLOWING IS A DESCRIPTION OF THE COMMUNITY BY COUNTY. CLAY COUNTY - THE TOTAL POPULATION OF CLAY COUNTY IS 26,170, WHICH RANKS CLAY COUNTY AS 60TH IN INDIANA. THE LARGEST CITY IN CLAY COUNTY IS BRAZIL, WITH A POPULATION OF 8,064. THE COUNTY IS 357.50 SQUARE MILES, WHICH MAKES THE POPULATION PER SQUARE MILE 74.3. THERE ARE 1,624 PRESCHOOL CHILDREN AGES 0 TO 4, 4,400 SCHOOL CHILDREN AGES 5 TO17, 1,947 COLLEGE AGES 18 TO 24, 6,339 YOUNG ADULTS AGES 25 TO 44, 7,185 OLDER ADULTS AGES 45 TO 64, AND 4,675 SENIORS AGES 65 AND OLDER.THE MEDIAN AGE OF PEOPLE IN CLAY COUNTY IS 41.1 YEARS OLD. IN CLAY COUNTY THERE ARE 25,467 WHITES, 373 HISPANICS, 189 BLACKS, 96 ASIANS, 75 AMERICAN INDIAN AND ALASKA NATIVE, 12 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 331 WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN 2017 WAS $50,746, WHICH RANKED 56TH IN THE STATE. THE POVERTY RATE IS 11.2%, WHICH RANKS 51ST IN THE STATE. THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 18.1%, WHICH RANKS 38TH IN THE STATE. THERE WERE 2,684 PEOPLE HAD FOOD STAMPS IN 2018, WHICH RANKS 44TH IN THE STATE. THERE WERE 2,274 CHILDREN ON FREE AND REDUCED LUNCHES IN 2018, WHICH RANKS 44TH IN THE STATE. IN CLAY COUNTY, 11,850 PEOPLE ARE EMPLOYED, WHICH RANKS 62ND IN THE STATE AND 482 PEOPLE ARE UNEMPLOYED, WHICH RANKS 56TH IN THE STATE.GREENE COUNTY - THE POPULATION IN GREENE COUNTY IS 32,006, WHICH RANKS THEM AS 53RD IN INDIANA. THE LARGEST CITY IN GREENE COUNTY IS LINTON, WITH A POPULATION OF 5,210. THE COUNTY IS 542.50 SQUARE MILES, WHICH MAKES THE POPULATION PER SQUARE MILE 60.32. THERE ARE 1,659 PRESCHOOL CHILDREN AGES 0 TO 4; 5,360 SCHOOL CHILDREN AGES 5 TO 17; 2,299 COLLEGE AGES 18 TO 24; 7,215 YOUNG ADULTS AGES 25 TO 44; 9,225 OLDER ADULTS AGES 45 TO 64; AND, 6,248 SENIORS AGES 65 AND OLDER. THE MEDIAN AGE IN GREENE COUNTY IS 43.7 YEARS OLD. IN GREENE COUNTY THERE ARE 31,327 WHITES, 476 HISPANICS, 90 BLACKS, 120 ASIANS, 124 AMERICAN INDIAN OR ALASKA NATIVE, 8 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 337 WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN 2017 WAS $59,347, WHICH IS RANKED 19TH IN THE STATE. THE POVERTY RATE IS 11.6%, WHICH RANKS 49TH IN INDIANA. THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 18.8%, WHICH RANKS 34TH IN THE STATE. IN 2013 THERE WAS AN AVERAGE OF 47 FAMILIES ON WELFARE EACH MONTH, WHICH IS 46TH IN THE STATE. IN 2018 THERE WAS AN AVERAGE OF 22 FAMILIES ON WELFARE, RANKING 61ST IN THE STATE. IN 2018 THERE WERE 3,075 PEOPLE RECEIVING FOOD STAMPS, WHICH RANKS 35TH IN THE STATE. THERE WERE 2,366 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN 2018; THIS IS 35TH IN THE STATE. IN GREENE COUNTY 13,145 PEOPLE ARE EMPLOYED, WHICH RANKS 60TH IN THE STATE. 609 PEOPLE ARE UNEMPLOYED, WHICH RANKS 43RD IN INDIANA. SULLIVAN COUNTY - SULLIVAN COUNTY HAS A POPULATION OF 20,690, WHICH RANKS SULLIVAN 70TH IN INDIANA. THE LARGEST CITY IS SULLIVAN, WITH A POPULATION OF 4,097. THE COUNTY IS 447.10 SQUARE MILES, WHICH MAKES THE POPULATION PER SQUARE MILE 47.08. THERE ARE 1,043 PRESCHOOL CHILDREN AGES 0 TO 4; 2,936 SCHOOL CHILDREN AGES 5 TO 17; 1,709 COLLEGE AGES 18 TO 24; 5,691 YOUNG ADULTS AGES 25 TO 44; 5,593 OLDER ADULTS AGES 45 TO 64; AND, 3,718 SENIORS AGES 65 AND OLDER. THE MEDIAN AGE OF PEOPLE IN SULLIVAN COUNTY IS 41.3 YEARS OLD. IN SULLIVAN COUNTY THERE ARE 19,273 WHITES, 371 HISPANICS, 989 BLACKS, 56 ASIANS, 71 AMERICAN INDIAN AND ALASKA NATIVE, 2 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 299 WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN 2017 WAS $46,810, WHICH RANKED 78TH IN THE STATE. THE POVERTY RATE IS 14.6%, WHICH RANKS 21ST IN THE STATE. THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 19%, WHICH RANKS 31ST IN THE STATE. IN 2018, THERE WAS AN AVERAGE OF 18 FAMILIES ON WELFARE EACH MONTH, WHICH IS 67TH IN THE STATE. THERE WERE 2,047 PEOPLE RECEIVING FOOD STAMPS IN 2018, WHICH RANKS 58TH IN THE STATE. THERE WERE 1,669 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN 2018/19, WHICH RANKS 65TH IN THE STATE. IN SULLIVAN COUNTY 8,214 PEOPLE ARE EMPLOYED, WHICH RANKS 77TH IN THE STATE. 402 PEOPLE ARE UNEMPLOYED, WHICH RANKS 68TH IN THE STATE.PARKE/VERMILLION COUNTY - THE POPULATION IN PARKE COUNTY IS 16,927, WHICH RANKS 76TH IN THE STATE OF INDIANA. THE LARGEST CITY IS ROCKVILLE WITH A POPULATION OF 2,499 PEOPLE. PARKE COUNTY HAS 444.70 SQUARE MILES WITH 38.75 PEOPLE PER SQUARE MILE. THERE ARE 1,020 PRESCHOOL AGES 0 TO 4; 2,627 SCHOOL CHILDREN AGES 5 TO 17; 1,302 COLLEGE AGES 18 TO 24; 4,100 YOUNG ADULTS AGES 25 TO 44; 4,597 OLDER ADULTS AGES 45 TO 64; AND, 3,281 SENIORS AGES 65 AND OLDER. THE MEDIAN AGE IN PARKE COUNTY IS 42.1 YEARS OLD. THERE ARE 16,218 WHITES, 444 BLACKS, 278 HISPANICS, 81 AMERICAN INDIAN OR ALASKA NATIVE, 35 ASIAN, 5 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 144 PEOPLE WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN PARKE COUNTY IS $48,537, WHICH RANKS 69TH IN THE STATE. THE POVERTY RATE IS 14.3%, WHICH RANKS 25TH IN THE STATE, AND THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 19.5%, WHICH RANKS 27TH IN THE STATE. IN 2018, AN AVERAGE OF 26 FAMILIES EACH MONTH WAS ON WELFARE. THIS RANKS AS 27TH IN THE STATE OF INDIANA. THERE WERE 1,583 PEOPLE ON FOOD STAMPS IN 2018, WHICH IS 68TH IN THE STATE. THERE WERE 1,230 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN 2018/19, WHICH IS 75TH IN THE STATE OF INDIANA. THERE ARE 6,883 EMPLOYED PEOPLE IN PARKE COUNTY, WHICH RANKS 80TH IN THE STATE. THERE ARE 286 UNEMPLOYED PEOPLE, WHICH RANKS 79TH IN THE STATE. VERMILLION COUNTY - THE POPULATION IN VERMILLION COUNTY IS 15,479, WHICH RANKS 79TH IN THE STATE. THE LARGEST CITY IN VERMILLION COUNTY IS CLINTON WITH A POPULATION OF 4,717 PEOPLE. VERMILLION COUNTY HAS 256.90 SQUARE MILES AND A POPULATION PER SQUARE MILE OF 61.09. THERE ARE 845 PRESCHOOL AGES 0 TO 4; 2,534 SCHOOL CHILDREN AGES 5 TO 17; 1,190 COLLEGE AGES 18 TO 24; 3,526 YOUNG ADULTS AGES 25 TO 44; 4,282 OLDER ADULTS AGES 45 TO 64; AND, 3,102 SENIORS AGES 65 AND OLDER. THE MEDIAN AGE IN VERMILLION COUNTY IS 43 YEARS OLD. IN VERMILLION COUNTY THERE ARE 15,092 WHITES, 201 HISPANICS, 75 BLACKS, 59 AMERICAN INDIAN OR ALASKA NATIVE, 40 ASIANS, 8 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 205 WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN 2017 IS $46,330, WHICH RANKS 80TH IN INDIANA. THE POVERTY RATE IN 2017 WAS 13.3%, WHICH RANKS 34TH IN THE STATE. THE POVERTY RATE AMONG CHILDREN FEWER THAN 18 IS 17.9%, WHICH RANKS 39TH IN INDIANA. IN 2018, THE AVERAGE NUMBER OF FAMILIES ON WELFARE EACH MONTH WAS 29, THIS IS 46TH IN THE STATE. THERE WERE 1,774 PEOPLE ON FOOD STAMPS IN 2018, WHICH RANKS 64TH IN INDIANA. THERE WERE 1,321 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN 2018/19. IN VERMILLION COUNTY, THERE ARE 6,774 PEOPLE EMPLOYED, WHICH RANKS 82ND IN THE STATE OF INDIANA AND THERE ARE 395 PEOPLE UNEMPLOYED, WHO RANKS 69TH IN THE STATE.VIGO COUNTY THE TOTAL POPULATION IN VIGO COUNTY WAS 107,386 IN 2018. VIGO COUNTY IS RANKED 17TH IN THE STATE OF INDIANA. THE LARGEST CITY IN VIGO COUNTY IS TERRE HAUTE WITH A POPULATION OF 60,753 PEOPLE. THERE ARE 6,190 PRESCHOOL AGE 0 TO 4; 15,775 SCHOOL AGE CHILDREN AGES 5 TO 17; 15,917 COLLEGE AGE ADULTS AGED 18 TO 24; 26,368 YOUNG ADULTS AGED 25 TO 44; 25,619 OLDER ADULTS AGED 45 TO 46; AND 17,517 SENIORS AGED 65 AND OVER. THE MEDIAN AGE FOR VIGO COUNTY IS 36.3 YEARS OLD. THE COUNTY'S POPULATION MAJORITY IS WHITE WITH 94,359 PEOPLE. THERE ARE 7,837 BLACKS, 2,171 ASIANS, 2,922 HISPANICS, 417 AMERICAN INDIAN OR ALASKAN NATIVE, 43 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 2,559 WITH TWO OR MORE RACIAL GROUPS. THE AVERAGE HOUSEHOLD INCOME FOR VIGO COUNTY IS $42,497, WHICH RANKS 91ST IN THE STATE OF INDIANA. THE POVERTY RATE IS 19.4%, WHICH IS 4TH IN INDIANA AND THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 25%, 4TH IN INDIANA. IN 2018, THERE WERE 13,211 PEOPLE WHO RECEIVED FOOD STAMPS, WHICH IS 10TH IN THE STATE OF INDIANA. THERE WERE 7,696 CHILDREN IN VIGO COUNTY ON FREE AND REDUCED FOOD STAMPS, WHICH IS 16TH IN INDIANA. IN 2018 THERE WAS 133 FAMILIES ON WELFARE EACH MONTH, WHICH IS 8TH IN THE STATE OF INDIANA. THERE ARE 46,989 PEOPLE EMPLOYED IN VIGO COUNTY, WHICH RANKS 16TH IN THE STATE AND 2,153 PEOPLE UNEMPLOYED, WHICH RANKS 15TH IN THE STATE.
PART VI, LINE 5: UNION HOSPITAL, ALONG WITH TERRE HAUTE REGIONAL HOSPITAL ARE FOUNDING MEMBERS OF THE TERRE HAUTE CHAMBER OF COMMERCE BETTER HEALTH WABASH VALLEY INITIATIVE (BHWV). THE ORIGINAL COMMITMENT WAS TO ASSIST IN THE PURCHASE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT DATA AND TO MAKE THAT DATA WIDELY AVAILABLE TO THE PUBLIC. BETTER HEALTH WABASH VALLEY NOW HAS ADDITIONAL SUPPORTING MEMBERS INCLUDING SULLIVAN COUNTY COMMUNITY HOSPITAL, HAMILTON CENTER AND UNITED WAY OF THE WABASH VALLEY. THESE ORGANIZATIONS HAVE MADE A FINANCIAL CONTRIBUTION TO BETTER HEALTH WABASH VALLEY. ALL MONIES CONTRIBUTED TO BETTER HEALTH WABASH VALLEY GO THROUGH THE TERRE HAUTE CHAMBER OF COMMERCE FOUNDATION WHICH IS A 501(C)(3) ORGANIZATION. BETTER HEALTH WABASH VALLEY'S MISSION IS TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY WHILE MAKING THE WABASH VALLEY A HEALTHIER COMMUNITY TO LIVE, WORK AND PLAY. BETTER HEALTH WABASH VALLEY IS REPRESENTED BY SEVERAL DIFFERENT ORGANIZATIONS IN THE COMMUNITY INCLUDING, HEALTHCARE AND MENTAL HEALTH ORGANIZATIONS, SCHOOL CORPORATIONS, UNIVERSITIES, NOT-FOR-PROFITS AND BUSINESSES. UNION HOSPITAL WILL REMAIN HEAVILY INVOLVED AND COMMITTED TO THE BETTER HEALTH WABASH VALLEY INITIATIVE OVER THE NEXT SEVERAL YEARS. AS EMPLOYERS IN THE WABASH VALLEY LOOK FOR WAYS TO KEEP HEALTH INSURANCE CLAIMS AT A MINIMUM WE WILL WORK WITH THEM ON EMPLOYEE WELLNESS STRATEGIES, ADDITIONALLY WE WILL ASSIST IN PROGRAM DEVELOPMENT THAT COULD BE IMPLEMENTED ON AN ORGANIZATIONAL LEVEL AT LITTLE TO NO COST TO THE EMPLOYER. AN EXAMPLE OF THIS MIGHT BE PROVIDING MATERIALS OR ONLINE RESOURCES FOR A WALKING PROGRAM. BETTER HEALTH WABASH VALLEY AND ITS MEMBERS HAVE DECIDED TO FOCUS ON CARDIOVASCULAR DISEASE, OBESITY AND CHILDHOOD OBESITY AS TOP ISSUES THAT THEY WILL FOCUS ON OVER THE NEXT THREE YEARS.
PART VI, LINE 6: THE ORGANIZATION IS PART OF AN AFFILATED HEALTH CARE SYSTEM TO PROVIDE VISION AND STRATEGIC DIRECTION IN THE FORMATION OF A REGIONAL HEALTH CARE SYSTEM TO EXPAND AND IMPROVE THE DELIVERY OF HEALTH CARE SERVCIES IN ORDER TO MEET THE HEALTH CARE NEEDS OF RESIDENTS IN THE SYSTEM'S SERVICE AREA.
PART VI, LINE 7, REPORTS FILED WITH STATES IN
Schedule H (Form 990) 2023
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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2023
Open to Public
Inspection
Name of the organization
UNION HOSPITAL INC
 
Employer identification number
35-0876396
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) CATHOLIC CHARITIES OF TERRE HAUTE
1801 POPLAR ST
TERRE HAUTE,IN47803
35-1577679 501C3 6,800 0     CHARITABLE CONTRIBUTION
(2) CHANCES FOR INDIANA YOUTH
1101 S 13TH ST
TERRE HAUTE,IN47802
31-0931817 501C3 12,500 0     CHARITABLE CONTRIBUTION
(3) INDIANA HOSPITAL ASSOCIATION
500 N MERIDIAN ST STE 250
INDIANAPOLIS,IN46204
35-0988753 501C6 185,681 0     CHARITABLE CONTRIBUTION
(4) ROSE-HULMAN INSTITUTE OF TECHNOLOGY
5500 WABASH AVE
TERRE HAUTE,IN47803
35-0868149 501C3 5,550 0     CHARITABLE CONTRIBUTION
(5) RUTH HOUSE
128 S CROWDER ST
SULLIVAN,IN47882
83-4469170 501C3 50,000 0     CHARITABLE CONTRIBUTION
(6) SIDE EFFECTS INC
259 INDUSTRIAL DR
FRANKLIN,OH45005
31-1580777 N/A 5,500 0     CHARITABLE CONTRIBUTION
(7) TERRE HAUTE AIR SHOW
581 SOUTH AIRPORT ST
TERRE HAUTE,IN47803
87-4833049 501C3 15,000 0     CHARITABLE CONTRIBUTION
(8) TERRE HAUTE BOYS & GIRLS CLUB
924 N 13 ST
TERRE HAUTE,IN47807
35-0868182 501C3 50,000 0     CHARITABLE CONTRIBUTION
(9) TERRE HAUTE CHAMBER OF COMMERCE
630 WABASH AVE
TERRE HAUTE,IN47807
35-0704800 501C6 38,650 0     CHARITABLE CONTRIBUTION
(10) TERRE HAUTE SYMPHONY ASSOCIATION INC
25 NORTH 6TH ST
TERRE HAUTE,IN47807
35-1120529 501C3 10,000 0     CHARITABLE CONTRIBUTION
(11) UNION HOSPITAL FOUNDATION
1606 N 7TH ST
TERRE HAUTE,IN47804
35-1642823 501C3 200,000 0     CHARITABLE CONTRIBUTION
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
8
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
3
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2023

Schedule I (Form 990) 2023
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: GRANTS TO ENTITIES IN THE UNITED STATES AND SCHOLARSHIPS PROVIDED: GRANTS AND ASSISTANCE ARE PROVIDED TO ELIGIBLE 501(C)(3) PULIC CHARITIES, LOCAL SCHOOL CORPORATION FOR GENERAL SUPPORT, AND SCHOLARSHIPS FOR ELIGIBLE INDIVIDUALS. UNION HOSPITAL DOES NOT MONITOR THE USE OF THESE FUNDS BY THE ORGANIZATIONS OR INDIVIDUALS.
Schedule I (Form 990) 2023



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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic Attach to Form 990.
medium right arrow graphic Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
Name of the organization
UNION HOSPITAL INC
 
Employer identification number

35-0876396
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2023

Schedule J (Form 990) 2023
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1STEVEN HOLMAN
PRESIDENT & CEO
(i)

(ii)
1,039,237
-------------
0
374,344
-------------
0
233,897
-------------
0
15,898
-------------
0
24,435
-------------
0
1,687,811
-------------
0
0
-------------
0
2NABIL MNAYARJI
PHYSICIAN
(i)

(ii)
925,198
-------------
0
382,862
-------------
0
0
-------------
0
16,250
-------------
0
23,852
-------------
0
1,348,162
-------------
0
0
-------------
0
3VANNARA SAKBUN
PHYSICIAN
(i)

(ii)
692,908
-------------
0
266,981
-------------
0
0
-------------
0
11,573
-------------
0
27,429
-------------
0
998,891
-------------
0
0
-------------
0
4MATTHEW NEALON
SR VP FINANCE/CFO/ASST TREASURER
(i)

(ii)
528,287
-------------
0
124,710
-------------
0
87,224
-------------
0
16,250
-------------
0
28,518
-------------
0
784,989
-------------
0
0
-------------
0
5VUPPAA REDDY
PHYSICIAN
(i)

(ii)
323,030
-------------
0
409,120
-------------
0
0
-------------
0
15,068
-------------
0
458
-------------
0
747,676
-------------
0
0
-------------
0
6MARY ABERNATHY
PHYSICIAN
(i)

(ii)
647,625
-------------
0
12,525
-------------
0
0
-------------
0
13,993
-------------
0
23,852
-------------
0
697,995
-------------
0
0
-------------
0
7FRANCES MADDEN
PHYSICIAN
(i)

(ii)
260,311
-------------
0
349,452
-------------
0
0
-------------
0
16,250
-------------
0
28,421
-------------
0
654,434
-------------
0
0
-------------
0
8JACK HILL
VICE PRES./COO
(i)

(ii)
406,610
-------------
0
102,617
-------------
0
72,669
-------------
0
10,858
-------------
0
28,672
-------------
0
621,426
-------------
0
0
-------------
0
9VIJAY KUMAR
VICE PRESIDENT/CIO
(i)

(ii)
401,877
-------------
0
81,273
-------------
0
63,508
-------------
0
9,005
-------------
0
9,013
-------------
0
564,676
-------------
0
0
-------------
0
10JAMES SCHRADER
CHIEF STRATEGY/BUSINESS DEV.
(i)

(ii)
346,790
-------------
0
68,702
-------------
0
61,261
-------------
0
12,154
-------------
0
26,872
-------------
0
515,779
-------------
0
0
-------------
0
11RHONDA SMITH
VICE PRESIDENT
(i)

(ii)
359,933
-------------
0
70,813
-------------
0
57,856
-------------
0
16,250
-------------
0
10,451
-------------
0
515,303
-------------
0
0
-------------
0
12AMY HOCK
CHIEF LEGAL OFFICER
(i)

(ii)
372,536
-------------
0
76,232
-------------
0
22,380
-------------
0
12,114
-------------
0
27,872
-------------
0
511,134
-------------
0
0
-------------
0
13KATHLEEN COUTINHO MD
MEMBER
(i)

(ii)
378,547
-------------
0
21,167
-------------
0
0
-------------
0
15,118
-------------
0
8,635
-------------
0
423,467
-------------
0
0
-------------
0
14REBECCA LYNCH
VICE PRESIDENT/CMO
(i)

(ii)
321,840
-------------
0
62,603
-------------
0
6,622
-------------
0
12,072
-------------
0
0
-------------
0
403,137
-------------
0
0
-------------
0
15LAURA STARKS
VICE PRESIDENT
(i)

(ii)
319,686
-------------
0
35,000
-------------
0
22,807
-------------
0
0
-------------
0
20,910
-------------
0
398,403
-------------
0
0
-------------
0
16STEPHANIE LAWS
VICE PRESIDENT
(i)

(ii)
245,087
-------------
0
46,355
-------------
0
46,268
-------------
0
13,826
-------------
0
18,948
-------------
0
370,484
-------------
0
0
-------------
0
17KENNETH KIGORWE MD
MEMBER
(i)

(ii)
239,482
-------------
0
32,800
-------------
0
0
-------------
0
14,019
-------------
0
27,429
-------------
0
313,730
-------------
0
0
-------------
0
Schedule J (Form 990) 2023

Schedule J (Form 990) 2023
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 7 THE ORGANIZATION PROVIDES NON-FIXED PAYMENTS TO SEVERAL INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A. THESE NON-FIXED PAYMENTS ARE BASED ON THE ORGANIZATION'S ABILITY TO PAY AND ARE NOT CONSTRUED AS A CONTRACT BETWEEN UNION AND ITS EXECUTIVES. THE EXECUTIVE BONUS PLAN IS A MIXTURE OF OBJECTIVES, STANDARDS AND SUBJECTIVE STANDARDS THAT BOTH THE POLICY AND THE IMPLEMENTATION OF THE POLICY BY THE PERSONNEL COMMITTEE AND THE BOARD OF DIRECTORS APPROVES AND AWARDS DEPENDING ON UNION'S ABILITY TO PAY. THERE IS NO AUTOMATIC RIGHT TO A BONUS OR A SPECIFIC BONUS AMOUNT EVEN IF ALL CRITERIA ARE MET. THE PERFORMANCE MEASURE PLAN IS LINKED TO THE UNION STRATEGIC AND FISCAL-YEAR BUSINESS PLANNING PROCESS. THE PLAN IS INTENDED TO FOCUS PARTICIPANTS' ATTENTION ON MISSION-CRITICAL GOALS AND KEY STRATEGIC PRIORITIES. THE PLAN IS ALSO INTENDED TO ENHANCE THE PERFORMANCE OF UNION EXECUTIVES AND THE ORGANIZATION. PRIOR TO THE START OF THE FISCAL YEAR AND AS PART OF THE BUSINESS PLANNING PROCESS, THE UNION PRESIDENT AND CEO WILL FINALIZE A LIST OF GOALS, WEIGHTS AND MEASURES TO BE USED TO ASSESS PERFORMANCE DURING THE FISCAL YEAR. THE LIST IS PRESENTED TO AND DISCUSSED WITH THE COMMITTEE. THE COMMITTEE REVIEWS AND APPROVES THE BONUS PLAN GOALS, WEIGHTS, AND MEASURES. ORGANIZATION GOALS WILL BE ASSIGNED TO EACH PARTICIPANT HOSPITAL-WIDE. IN ADDITION TO HOSPITAL-WIDE GOALS INDIVIDUAL AND/OR FUNCTIONAL/DEPARTMENT GOALS MAY OR MAY NOT BE INCLUDED. AFTER THE CONCLUSION OF EACH FISCAL YEAR, THE PRESIDENT AND CEO WILL PREPARE AN ANNUAL BONUS PLAN REPORT FOR THE COMMITTEE. THE REPORT CONTAINS: AN APPRAISAL OF UNION AND HOSPITAL/OPERATING UNIT PERFORMANCE DURING THE RECENTLY-COMPLETED FISCAL YEAR; AND THE PRESIDENT AND CEO'S RECOMMENDED PAYOUT FOR EACH PLAN PARTICIPANT. THE BONUS RECOMMENDATIONS FOR ALL SR. MANAGEMENT ARE RECEIVED AND REVIEWED FIRST BY THE PERSONNEL COMMITTEE WHO THEN MAKE DECISIONS AND SUBMITS TO THE BOARD TO VOTE. THE COMMITTEE WILL DETERMINE AND SUBMIT THE PAYOUT FOR THE PRESIDENT AND CEO TO THE BOARD OF DIRECTORS WHO, ABSENT THE PRESIDENT AND CEO, WILL VOTE ON APPROVAL. AWARD DETERMINATIONS ARE CALCULATED AS PERCENTAGES OF PARTICIPANT'S SALARIES PAID FOR TIME WORKED DURING THE FISCAL YEAR. PAYOUT FOR THE PRESIDENT IS 0% TO 30%; CFO AND COO ARE 0% TO 25%; AND OTHER EXECUTIVES ARE 0% TO 20%. THE EXECUTIVE BONUS PLAN PAYOUTS ARE TO BE PAID WHEN DETERMINED BY THE PERSONNEL COMMITTEE, SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS.
Schedule J (Form 990) 2023

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
Name of the organization
UNION HOSPITAL INC
 
Employer identification number

35-0876396
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... $
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ $
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ............... $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990) 2023
Schedule L (Form 990) 2023
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) SYCAMORE INSURANCE ASSOCIATION
 
BOARD MEMBER OF UHI, DON SCOTT, IS AN OFFICER AND OWNER 1,801,570 SYCAMORE INSURANCE PROVIDES INSURANCE PRODUCTS TO THE ORGANIZATION.   No
(2) SYCAMORE ENGINEERING
 
BOARD MEMBER OF UHI, SARA SMITH, IS A FAMILY MEMBER OF >35% OWNER 1,420,877 SYCAMORE ENGINEERING PROVIDES SERVICES TO THE ORGANIZATION   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990) 2023


Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990)

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 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2023
Open to Public
Inspection
Name of the organization
UNION HOSPITAL INC
 
Employer identification number

35-0876396
Return Reference Explanation
FORM 990, PART I, DOING BUSINESS AS: CARDIAC REHAB GROUP OF UNION HOSPITAL CLARA FAIRBANKS CENTER FOR WOMEN CLAY CITY CENTER FOR FAMILY MEDICINE HEARTLAND MIDWIVES HUX CANCER CENTER RICHARD G. LUGAR CENTER FOR RURAL HEALTH UH REGISTERED DIETITIAN GROUP UNION CENTER FOR JOINT REPLACEMENT UNION CENTER FOR SPORTS MEDICINE UNION HOSPITAL CLINTON UNION HOSPITAL CLINTON WESTERN INDIANA RURAL MEDICINE UNION HOSPITAL CVT/NEURO GROUP UNION HOSPITAL FAMILY MEDICINE CENTER UNION HOSPITAL HEALTH GROUP UNION HOSPITAL HUX HEART CENTER UNION HOSPITAL MEDICAL GROUP UNION HOSPITAL NEUROSCIENCE UNION HOSPITAL TERRE HAUTE UNION HOSPITALISTS GROUP WABASH VALLEY SURGERY CENTER WEST CENTRAL COMMUNITY HOSPITAL
FORM 990, PART VI, SECTION A, LINE 6 UNION HOSPITAL HAS ONE MEMBER, UNION HEALTH SYSTEM, INC., AN INDIANA NONPROFIT, TAX EXEMPT CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S MEMBER MAY APPOINT THE HOSPITAL BOARD DIRECTORS WITH THE RECOMMENDATION OF THE HOSPITAL'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B GOVERNING BODY DECISIONS SUBJECT TO APPROVAL BY THE MEMBER INCLUDE: 1. MISSION AND VISION STATEMENT CHANGES; 2. CHANGES TO THE GOVERNING DOCUMENT; 3. APPROVAL AND REMOVAL OF BOARD DIRECTORS; 4. INCURRING DEBT; 5. APPROVAL, SALE, TRANSFER OR SUBSTANTIAL CHANGE IN USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS; 6. FORMATION OF A SUBSIDIARY; 7. TRANSFER OR ENCUMBRANCE OF THE ASSETS; 8. APPROVAL OF ANNUAL OPERATING BUDGET, CAPITAL PLAN, STRATEGIC PLAN, AND BUSINESS PLAN; 9. APPOINTMENT OF THE CEO; 10. TRANSACTIONS OVER $250,000; AND 11. APPROVAL OF ANY MANAGEMENT AGREEMENTS.
FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW OF THE FORM 990 BY THE ORGANIZATION'S MANAGEMENT. THE GOVERNING BODY REVIEWS AND APPROVES THE FORM 990 AND THE FINAL FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, ARE PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 12C THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY THE CORPORATE COMPLIANCE OFFICER. THE SCOPE OF THIS POLICY INCLUDES DIRECTORS, OFFICERS, MANAGEMENT, AND EMPLOYEES. THE POLICY IS IN PLACE TO AVOID PERSONAL INTERESTS THAT CONFLICT, OR MAY APPEAR TO CONFLICT, WITH THE BEST INTERESTS OF UNION AND ITS AFFILIATES AND THE COMMUNITIES THEY SERVE. THE COVERED PERSONS ARE TO REFRAIN FROM PERSONAL INTERESTS, DIRECT OR INDIRECT WITH ANY THIRD PARTIES. IT IS THE RESPONSIBILITY OF OFFICERS, MANAGEMENT, AND EMPLOYEES TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES AND ACT ACCORDINGLY. A SELF-DISCLOSURE FROM COVERED PERSONS TO THE CORPORATE COMPLIANCE OFFICER IS REQUIRED ON ANY POTENTIAL CONFLICTS OF INTEREST. THE COVERED PERSONS ARE TO REFRAIN FROM PARTICIPATING IN ANY DELIBERATION OR DECISIONS ON SUCH TRANSACTIONS. THE CONFLICTS DISCLOSED ARE REVIEWED AND RESOLVED BY THE CORPORATE COMPLIANCE OFFICER.
FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION OF SR. EXECUTIVE OR SR. ADMINISTRATIVE POSITIONS INCLUDES A SUBCOMMITTEE OF THE BOARD OF DIRECTORS' EXECUTIVE COMMITTEE CONSISTING OF INDEPENDENT BOARD MEMBERS WHOSE RESPONSIBILITY INCLUDES SUCH REVIEW, INCLUDING REVIEW OF THE CEO'S COMPENSATION. THEY GATHER INFORMATION AND FOLLOW THE STEPS SET FORTH BELOW AND IN TURN SUBMIT TO THE FULL BOARD OF DIRECTORS THE RECOMMENDATIONS IN TERMS OF COMPENSATION AND BENEFITS FOR THE CEO AND SR. MANAGEMENT. A SUBCOMMITTEE OF THE BOARD OF DIRECTORS' EXECUTIVE COMMITTEE CONSISTS OF INDIVIDUALS WHO ARE INDEPENDENT AND DISINTERESTED BOARD MEMBERS. THE CEO IS EXCUSED FROM THE MEETING WHEN HIS/HER COMPENSATION/BENEFITS ARE REVIEWED BOTH AT THE COMMITTEE LEVEL AND THE BOARD LEVEL. THE STEPS INCLUDE: 1. THE EXECUTIVE/COMPENSATION SUBCOMMITTEE INSTRUCTS THE VP OF HUMAN RESOURCES TO RETAIN AN OUTSIDE INDEPENDENT CONSULTANT TO (1) PROVIDE THE COMMITTEE WITH INFORMATION, AND (2) TO REVIEW THE ACTIONS AND COMPENSATION/BENEFITS TO BE SURE THAT THERE IS NOT EXCESSIVE COMPENSATION. THE CONSULTANT THAT HAS BEEN USED THE PAST SEVERAL YEARS IS SULLIVAN COTTER & ASSOCIATES, INC. UNDER THE PROCESS, SULLIVAN COTTER FIRST IS PROVIDED WITH THE NAMES AND JOB DESCRIPTIONS FOR THE SR. MANAGEMENT TEAM THAT IS BEING EVALUATED. THE INDEPENDENT ADVISOR THEN SUBMITS TO THE EXECUTIVE/COMPENSATION SUBCOMMITTEE COMPARABLE INFORMATION, SPECIFICALLY: > FOUR (4) COMMERCIALLY AVAILABLE EXECUTIVE HEALTH CARE COMPENSATION SURVEYS PREPARED BY INDEPENDENT FIRMS, WERE REFERENCED TO OBTAIN MARKET DATA FOR THIS REVIEW: - INTEGRATED HEALTHCARE STRATEGIES: 2020 HEALTHCARE EXECUTIVE COMPENSATION SURVEY - ADVISORY BOARD BENCHMARK DATA 2020 SURVEY - INDIANA HOSPITAL & HEALTH ASSOCIATION: 2020 COMPENSATION SURVEY REPORT - SULLIVAN COTTER & ASSOCIATES: 2020 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS > MARKET DATA REFLECTING FUNCTIONALLY-COMPARABLE POSITIONS WERE OBTAINED FOR ALL TEN EXECUTIVE POSITIONS > DATA WERE ABSTRACTED FOR COMPARABLY-SIZED ORGANIZATIONS AS MEASURED BY NET REVENUE > THE DATA REPORTED REPRESENTED THE 50TH, 75TH, AND 90TH PERCENTILES OF BASE SALARY AND TOTAL CASH COMPENSATION (BASE SALARY PLUS ACTUAL ANNUAL INCENTIVE - ABBREVIATED TCC) > REGIONAL MARKET DATA WERE ALSO COLLECTED FROM THE PUBLISHED COMPENSATION SURVEYS AS WELL AS A SPECIAL CUT OF THE FOLLOWING INDIANA HOSPITALS FROM SULLIVAN COTTER'S 2020 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS: - BALL MEMORIAL HOSPITAL - REID HOSPITAL & HEALTH CARE SERVICES - BLOOMINGTON HOSPITAL - RILEY HOSPITAL FOR CHILDREN - ELKHART GENERAL HOSPITAL - SAINT JOHN'S HEALTH SYSTEM - GOOD SAMARITAN HOSPITAL - SAINT JOSEPH REGIONAL MEDICAL CENTER - MEMORIAL HOSPITAL OF SOUTH BEND - SAINT MARY'S MEDICAL CENTER - METHODIST HOSPITALS - TERRE HAUTE REGIONAL HOSPITAL - PARKVIEW HOSPITAL > THAT DATA WAS ALSO REPORTED WITH NATIONAL AVERAGE, REGIONAL AVERAGE AND INDIANA AVERAGE. 2. THE EXECUTIVE/COMPENSATION SUBCOMMITTEE OF UNION HOSPITAL'S BOARD OF DIRECTORS TAKES THE DATA PROVIDED BY THE INDEPENDENT CONSULTANTS AND FOLLOWING A REVIEW OF THE PERFORMANCE OF EACH INDIVIDUAL SUBMITS TO THE FULL BOARD FOR APPROVAL RECOMMENDATIONS IN TERMS OF SALARIES, BENEFITS, AND BONUSES. FINAL APPROVAL IS BY THE BOARD OF DIRECTORS. THE CEO DOES NOT TAKE PART IN THE DISCUSSION OR ACTION ON HIS/HER SALARY, BENEFITS AND BONUS. 3. MINUTES OF THE EXECUTIVE/COMPENSATION SUBCOMMITTEE AND THE BOARD MEETINGS ARE CONTEMPORANEOUSLY KEPT AND MAINTAIN WITH THE CORPORATE MINUTE BOOKS.
FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11G MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 34,241,594. MANAGEMENT AND GENERAL EXPENSES 6,197,174. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,438,768. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 64,558,133. MANAGEMENT AND GENERAL EXPENSES 11,683,976. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 76,242,109.
FORM 990, PART XI, LINE 9: EQUITY TRANSFER TO UAPC -57,858,541.
FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT: THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2023


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2023
Open to Public Inspection
Name of the organization
UNION HOSPITAL INC
 
Employer identification number

35-0876396
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity











Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)CENTER FOR OCCUPATIONAL HEALTH
4001 WABASH AVE

TERRE HAUTE,IN47803
35-2118417
OCCUPATIONAL HEALTH SERVICES IN 501(C)(3) LINE 3 UNION HOSPITAL
 
Yes
 
(2)UNION ASSOCIATED PHYSICIAN CLINIC INC
1606 N SEVENTH ST

TERRE HAUTE,IN47804
27-0581401
PHYSICIAN GROUP IN 501(C)(3) LINE 10 UNION HEALTH SYSTEMS
 
 
No
(3)UNION HEALTH SYSTEMS
1606 N SEVENTH ST

TERRE HAUTE,IN47804
27-0581133
MANAGEMENT ORGANIZATION IN 501(C)(3) LINE 12B, II N/A
 
No
(4)UNION HOSPITAL FOUNDATION INC
1606 N SEVENTH ST

TERRE HAUTE,IN47804
35-1642823
FUNDRAISING IN 501(C)(3) LINE 12C, III-FI N/A
 
No
(5)VISITING NURSE ASSOCIATION OF THE WABASH VALLEY
400 8TH AVENUE

TERRE HAUTE,IN47804
35-0869064
HOME HEALTH AND HOSPICE CARE IN 501(C)(3) LINE 10 UNION HOSPITAL FOUNDATION INC
 
 
No




For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2023
Schedule R (Form 990) 2023
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) UNION HOSPITAL THERAPY LLC

150 N ROSENBERGER
EVANSVILLE,IN47712
46-4357168
REHABILITATION AND THERAPY SERVICES IN UNION HOSPITAL INC
 
INVESTMENT 995,037 896,534   No     No 51.960 %
(2) ONCOLOGY SERVICES GROUP LLC

6100 W 96TH STREET SUITE 125
INDIANAPOLIS,IN46278
20-8567643
MEDICAL SERVICES IN N/A
        No     No  










Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No












Schedule R (Form 990) 2023
Schedule R (Form 990) 2023
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) CENTER FOR OCCUPATIONAL HEALTH

S 1,288,338 BOOK VALUE





Schedule R (Form 990) 2023
Schedule R (Form 990) 2023
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2023
Schedule R (Form 990) 2023
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2023

Additional Data


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