2023-11-10T15:19:53-06:00 2022-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2022-01-01 351568853 HENDRICKS REGIONAL HEALTH FOUNDATION HEND 3177457376 1000 E MAIN ST DANVILLE IN 461220409 STAN RISSER TAX OFFICER 3177457376 2023-11-10 1 STAN RISSER 999009999 0 EMILIE M KNIERIEM CPA P01330194 3176334705 2023-11-10 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z STAN RISSER 1000 E MAIN ST DANVILLE IN 461220409 828783 0 X SUPPORTHENDRICKS.ORG X 1984 IN TO RAISE AWARENESS OF AND PROVIDE SUPPORT FOR INITIATIVES TO ENHANCE COMMUNITY HEALTH, PATIENT COMFORT, SAFETY, AND MEDICAL CARE AT HENDRICKS REGIONAL HEALTH. 12 12 0 75 0 0 667123 655982 0 0 36 0 -217502 -177030 449657 478952 440528 527666 0 0 113341 146689 0 0 82084 57637 46361 611506 720716 -161849 -241764 2432558 1931486 225854 244844 2206704 1686642 X THE MISSION OF HENDRICKS REGIONAL HEALTH FOUNDATION IS TO RAISE FUNDS FROM GRATEFUL PATIENTS AND THEIR FAMILIES, CORPORATE AND FOUNDATION CONTRIBUTORS, PHYSICIANS, NURSES AND STAFF, AND FROM THE COMMUNITY TO BENEFIT HENDRICKS REGIONAL HEALTH AND THOSE IT SERVES.WE SOLICIT AND MANAGE DONATIONS FOR A VARIETY OF PROJECTS AND PROGRAMS INCLUDING OUR PATIENT ASSISTANCE FUND, THE HENDRICKSGO! VAN AND THE CHILDBIRTH CENTER FUND.ADDITIONALLY, WE AWARD GRANTS FROM OUR UNRESTRICTED FUNDS TO VARIOUS HOSPITAL DEPARTMENTS TO HELP MAKE POSSIBLE IMPORTANT PROGRAMS, SERVICES AND CAPITAL PROJECTS THROUGHOUT THE HENDRICKS REGIONAL HEALTH ORGANIZATION. 0 0 629982 527666 INTERNAL DEPARTMENT GRANTS - HENDRICKS REGIONAL HEALTH FOUNDATION, INC. AWARDS GRANTS TO VARIOUS DEPARTMENTS AT HENDRICKS REGIONAL HEALTH. THESE GRANTS ARE USED BY THE DEPARTMENTS TO PURCHASE PREVIOUS UNBUDGETED ITEMS, PROVIDE MEDICAL SERVICES FOR PEOPLE IN NEED AND OTHER REQUESTS IDENTIFIED THROUGH AN INTERNAL GRANT PROGRAM. 629982 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 8 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X X THE ORGANIZATION 3177457376 1000 E MAIN STREET DANVILLE IN 46122 MARALEE EDMONDSON CHAIR 1.00 0.00 X X 0 0 0 SUSAN HOSTETTER VICE CHAIR 1.00 0.00 X X 0 0 0 AMBER LARUE SECRETARY 1.00 0.00 X X 0 0 0 CHAD FERMAN TREASURER 1.00 0.00 X X 0 0 0 MICHAEL BEATY DDS BOARD MEMBER 1.00 0.00 X 0 0 0 BETH BOLES BOARD MEMBER 1.00 0.00 X 0 0 0 AMY COMER-ELLIOTT BOARD MEMBER 1.00 0.00 X 0 0 0 ALLEN CULPEPPER BOARD MEMBER 1.00 0.00 X 0 0 0 CAROL GENTRY BOARD MEMBER 1.00 0.00 X 0 0 0 BEN MEYER BOARD MEMBER 1.00 0.00 X 0 0 0 JULIA MULHOLLAND BOARD MEMBER 1.00 0.00 X 0 0 0 SHERRI REAGIN BOARD MEMBER 1.00 0.00 X 0 0 0 ADAM SCOTT EXECUTIVE DIRECTOR - TERM ENDED JUNE '22 40.00 0.00 X 0 78585 20494 0 78585 20494 0 0 0 0 0 543175 112807 655982 172801 543175 349831 -177030 -177030 478952 0 0 -177030 527666 527666 136791 72499 5472 58820 9898 5246 396 4256 21351 11316 1281 8754 25010 13255 1501 10254 720716 629982 8650 82084 454654 102864 1924415 1788928 14250 3000 39239 36694 2432558 1931486 225804 244844 50 0 225854 244844 X 2059085 1570544 147619 116098 2206704 1686642 2432558 1931486 -241764 -278298 0 X X 0 1 X 1 0 X X 1 HENDRICKS REGIONAL HEALTH 351361243 6 1 527666 0 1 527666 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X PART X, LINE 2: THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAX STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE FOUNDATION'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. IN ADDITION, THE FOUNDATION QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION OTHER THAN A PRIVATE FOUNDATION UNDER SECTION (A)(2). GOLF OUTING 150825 120895 29930 4855 19700 9072 3686 GALA 502506 367000 135506 8000 75406 76681 131845 1 62645 55280 7365 3250 6676 10660 715976 543175 172801 4855 30950 91154 76681 146191 349831 -177030 1 HENDRICKS REGIONAL HEALTH 1000 E MAIN STREET DANVILLE IN 46122 351361243 GOV'T 527666 0 FMV PROGRAM SUPPORT 1 0 PART I, LINE 2: ALL GRANT RECIPIENTS MUST FIRST PURCHASE ANY ITEMS, OR PAY FOR PROGRAMS/SERVICES, AND SUBMIT RECEIPTS, OR PROOF OF PURCHASE, WITH A REIMBURSEMENT REQUEST TO ACCESS THEIR GRANT FUNDS FROM THE FOUNDATION. IF THE EXPENSE IS A PLANNED FUTURE EXPENSE, OR A DEPARTMENT CAN NOT PURCHASE THE ITEM ITSELF THE FOUNDATION REQUIRES USE OF THE HENDRICKS REGIONAL HEALTH PURCHASE ORDER SYSTEM TO REQUEST FUNDS. THE HRH PURCHASE ORDER SYSTEM REQUIRES DOCUMENTATION OF EXPENSE, PAYOR INFORMATION, AND SEVERAL LEVELS OF APPROVAL BEFORE FUNDS ARE RELEASED. 0 0 0 0 0 0 0 0 0 SCHEDULE J, LINE 3 COMPENSATION FOR THE EXECUTIVE DIRECTOR IS DETERMINED BY A RELATED ORGANIZATION. THAT ORGANIZATION UTILIZED COMPENSATION STUDIES IN DETERMINING THE EXECUTIVE DIRECTOR'S COMPENSATION. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY MANAGEMENT BEFORE BOARD MEMBERS ARE GIVEN A COPY TO REVIEW PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS RECEIVE A CONFLICT OF INTEREST STATEMENT AND FORM ANNUALLY AND MUST SIGN, DATE AND DISCLOSE ANY POTENTIAL CONFLICT. SIGNED FORMS REMAIN ON FILE IN THE FOUNDATION OFFICE. FORM 990, PART VI, SECTION B, LINE 15 THE HUMAN RESOURCE DEPARTMENT OF HENDRICKS REGIONAL HEALTH ANNUALLY MONITORS AND EVALUATES COMPENSATION LEVELS FOR ALL POSITIONS OF THE FOUNDATION. PERSONNEL COSTS AND BENEFITS ARE A GIFT IN KIND FROM HENDRICKS REGIONAL HEALTH TO THE FOUNDATION. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE MAINTAINED IN THE FOUNDATION OFFICE AS WELL AS THE FINANCE DEPARTMENT AT HENDRICKS REGIONAL HEALTH AND ARE AVAILABLE FOR REVIEW BY ANYONE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE REVIEW OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. HENDRICKS REGIONAL HEALTH 1000 E MAIN STREET DANVILLE IN 46122 351361243 HEALTH CARE/HOSPITAL IN 501(C)(3) LINE 6 0 HRH HEALTH SERVICES 1000 E MAIN STREET DANVILLE IN 46122 814766710 HOSPITAL SUPPORT IN 501(C)(3) LINE 12A, I HENDRICKS REGIONAL HEALTH 1 HRH REAL ESTATE HOLDING COMPANY INC 1000 E MAIN STREET DANVILLE IN 46122 474664298 TITLE HOLDING IN 501(C)(3) LINE 12A, I HENDRICKS REGIONAL HEALTH 1 HENDRICKS AMBULATORY MANAGEMENT 1000 E MAIN STREET DANVILLE IN 46122 208133722 AMBULANCE SERVICES IN N/A 0 0 0 1 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 HENDRICKS REGIONAL HEALTH B 527666 ACTUAL EXPENDITURES HENDRICKS REGIONAL HEALTH O 146689 ACTUAL EXPENDITURES