2025-11-06T09:43:16-06:00 2024-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2024-01-01 350868178 SOUTH BEND MEDICAL FOUNDATION SOUT 5742045233 3355 DOUGLAS ROAD SOUTH BEND IN 46635 ADAM ALLSOP CHIEF FINANCIAL OFFICER 5742045233 2025-11-06 1 1 TYLER K GREENE CPA P00057872 3176334705 2025-11-06 2024 2025-03-06 01:10:19Z TIM TRAVIS 3355 DOUGLAS ROAD SOUTH BEND IN 46635 36314109 0 X WWW.SBMF.ORG X 1946 IN TO PROVIDE HIGH-QUALITY PATHOLOGY AND BLOOD SERVICES TO THOSE WE SERVE, KEEPING IN MIND THERE IS A LIFE BEHIND EVERYTHING WE DO. 10 8 176 8 21419 1768 2946 3727 16655340 17438932 -205731 1576394 1991387 2344566 18443942 21363619 14290 5875 0 0 12130242 12417499 0 0 0 10946833 10275660 23091365 22699034 -4647423 -1335415 49222710 45280911 13912492 10152921 35310218 35127990 X MISSION - TO PROVIDE HIGH-QUALITY PATHOLOGY AND BLOOD SERVICES TO THOSE WE SERVE, KEEPING IN MIND THERE IS A LIFE BEHIND EVERYTHING WE DO.VISION - A COMMITMENT TO BECOMING A NATIONALLY RECOGNIZED NOT-FOR-PROFIT ORGANIZATION THROUGH INVESTMENT IN QUALITY, TECHNOLOGY, COMMUNITY AND OUR PEOPLE.VALUES - RESPECT: VALUE AND RESPECT OTHERS, THEIR PERSPECTIVE AND EMBRACE OUR DIFFERENCES. INNOVATION: LEAN INTO CHANGE, RECOGNIZING HEALTHCARE IS EVERCHANGING; CREATIVITY IS KEY. STEWARDSHIP: BE SOCIALLY AND FISCALLY RESPONSIBLE IN ALL WE DO. EXCELLENCE: PROVIDE ACCURATE, TIMELY SERVICE AND COMMUNICATION TO OUR CLIENTS, COMMUNITY AND ONE ANOTHER. 0 0 21297436 5875 19608487 SOUTH BEND MEDICAL FOUNDATION, INC. (THE FOUNDATION), PROVIDES PATHOLOGY SERVICES FOR PATIENTS AND DOCTORS THROUGHOUT NORTHERN AND CENTRAL INDIANA AND SOUTHWESTERN MICHIGAN WITH A CONCENTRATION OF REVENUES FROM HOSPITALS LOCATED IN THE SURROUNDING AREAS. THE FOUNDATION ALSO HAS A BLOOD BANK LINE OF BUSINESS WHERE BLOOD IS DONATED BY VOLUNTEERS AND SUBSEQUENTLY PROCESSED AND SOLD TO LOCAL HOSPITALS IN THE SURROUNDING AREAS. THE FOUNDATION PROVIDES ASSISTANCE TO INDIVIDUALS IN THE FORM OF FREE OR REDUCED FEE MEDICAL CARE AT VARIOUS LOCATIONS THROUGHOUT THE COMMUNITIES SERVED. THESE INDIVIDUALS MEET SBMF'S CHARITY CARE ELIGIBILITY REQUIREMENTS, OR THE REQUIREMENTS OF THE REFERRING HEALTH CARE PROVIDER. DURING 2024, THE FOUNDATION PROVIDED $68,628 IN PATIENT MEDICAL ASSISTANCE.THE FOUNDATION ALSO PROVIDES DISCOUNTS FOR PAYMENT AT TIME OF SERVICE TO PATIENTS WHO DO NOT HAVE GOVERNMENT PROVIDED INSURANCE COVERAGE OR DO NOT WISH TO HAVE A CLAIM FILLED WITH THEIR COMMERCIAL INSURANCE CARRIER. DURING 2024, THE FOUNDATION PROVIDED $80,622 IN TIME OF SERVICE DISCOUNTS. 21297436 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 30 0 1 176 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 IN X BARB RESNIK 5742045233 3355 DOUGLAS ROAD SOUTH BEND IN 46635 NITA GERIG MD CMO/SECRETARY 32.00 0.00 X X 331462 0 56314 AL HARDING MD CHAIRMAN 1.00 0.00 X X 0 0 0 JAMES KELLY MD MBA VICE CHAIRMAN 1.00 0.00 X X 0 0 0 SHERY ROUSSAIRE TREASURER 1.00 0.00 X X 0 0 0 MICHAEL BLAKESLEY MD BOARD MEMBER 1.00 0.00 X 0 0 0 JANILYN DAUB BOARD MEMBER 1.00 0.00 X 0 0 0 LAURIE GRIESINGER MD BOARD MEMBER 40.00 0.00 X 270892 0 29769 JOHN GRIFFITH BOARD MEMBER 1.00 0.00 X 0 0 0 CARLTON LYONS MD BOARD MEMBER 1.00 0.00 X 0 0 0 SHARON STACK PHD BOARD MEMBER 1.00 0.00 X 0 0 0 TIMOTHY TRAVIS PRESIDENT/CEO 40.00 0.00 X 350901 0 63691 TERRY PIPP CFO (TERMED 4/2025) 40.00 0.00 X 220168 0 46810 TIMOTHY STOLT COO 40.00 0.00 X 158137 0 30311 DERRICK FORCHETTI PATHOLOGIST 40.00 0.00 X 344845 0 44791 ERICA MARTIN PATHOLOGIST 40.00 0.00 X 328821 0 37160 JAMES DYER PATHOLOGIST 40.00 0.00 X 319813 0 41489 ODETA LAPKUS PATHOLOGIST 40.00 0.00 X 313723 0 29844 NICHOLE ANEST PATHOLOGIST 40.00 0.00 X 295345 0 26370 2934107 0 406549 22 0 1 0 VERSITI BLOOD CENTER OF INDIANA 638 N 18TH STREET MILWAUKEE WI 53233 BLOOD TESTING & MEDICAL DIRECTOR 1328115 US PACK MED LLC 2251 LYNXX LN SUITE 5 ORLANDO FL 32804 COURIER SERVICES 767526 NOVOPATH LLC PO BOX 248819 OKLAHOMA CITY OK 731248819 PATHOLOGY LIS 254467 ELLKAY LLC 200 RIVERFRONT BLVD 3RD FLOOR ELMWOOD PARK NJ 07407 IT SERVICES 124663 4 3727 3727 NET OPERATING REVENUE 621500 17438932 17438932 17438932 670973 981 669992 154573 0 154573 154573 154573 15855911 14950490 905421 905421 905421 SB CLINIC STAFFING 900099 860824 860824 BLOOD RESEARCH 541900 728151 728151 PATH-AI, DIGITAL PATHO 541900 19603 19603 581415 580580 835 2189993 21363619 19608487 21419 1729986 X 5875 5875 1556420 1494976 61444 8721303 8413344 307959 57696 54044 3652 1447103 1355509 91594 634977 594786 40191 20055 20055 78900 78900 60529 60529 2878466 2715954 162512 21615 21615 622753 488109 134644 456775 430987 25788 1098374 923617 174757 121067 111015 10052 29734 27265 2469 496135 488268 7867 726820 564289 162531 335416 262896 72520 MEDICAL SUPPLIES 3092475 3092475 RECRUITMENT 131591 106745 24846 DONOR INCENTIVES 72733 59000 13733 32222 26138 6084 22699034 21297436 1401598 0 824022 523352 452321 332632 2495008 2170975 12050 0 389899 368349 353544 355331 28172576 11128945 17645984 17043631 25379175 22473412 1670707 2013229 49222710 45280911 1804149 1613959 0 61218 10785862 6963620 1322481 1514124 13912492 10152921 X 35310218 35127990 35310218 35127990 49222710 45280911 X -1335415 1136687 16500 X X 0 1 X 1 0 X 272104 2543 8375 2946 3727 289695 19436130 18346550 15172749 16655340 17438932 87049701 225868 1035971 1304826 1836926 2169555 6573146 19934102 19385064 16485950 18495212 19612214 93912542 0 0 0 93912542 176435 864279 724481 797777 825546 3388518 176435 864279 724481 797777 825546 3388518 1359 1135 1393 1816 5703 20111896 20250478 17210431 19294382 20439576 97306763 0.96510 0.97860 0.03480 0.02140 X 1357180 1357180 15062068 787984 14274084 178863 294 178569 11503697 10340667 1163030 70768 70768 17043631 RIGHT OF USE LIABILITIES 1514124 1514124 X 22456277 1136687 16500 1153187 21303090 60529 60529 21363619 22638505 0 22638505 60529 60529 22699034 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION AND RECOGNIZE A TAX LIABILITY IF THE FOUNDATION HAS 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 THE FOUNDATION, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2024 AND 2023 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. THE FOUNDATION HAS FILED ITS FEDERAL AND STATE INCOME TAX RETURNS FOR PERIODS THROUGH DECEMBER 31, 2023. THESE INCOME TAX RETURNS ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS). THE FOUNDATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: (GAIN)/LOSS ON JOINT VENTURE 16,500. X X X 0 0 0 0 0 0 0 0 0 TIMOTHY TRAVIS PRESIDENT/CEO 315600 0 34701 0 600 0 18900 0 44791 0 414592 0 0 0 DERRICK FORCHETTI PATHOLOGIST 320350 0 23115 0 1380 0 0 0 44791 0 389636 0 0 0 NITA GERIG MD CMO/SECRETARY 310764 0 16738 0 3960 0 30942 0 25372 0 387776 0 0 0 ERICA MARTIN PATHOLOGIST 291600 0 36621 0 600 0 24040 0 13120 0 365981 0 0 0 JAMES DYER PATHOLOGIST 285830 0 30023 0 3960 0 29440 0 12049 0 361302 0 0 0 ODETA LAPKUS PATHOLOGIST 296378 0 13385 0 3960 0 0 0 29844 0 343567 0 0 0 NICHOLE ANEST PATHOLOGIST 285830 0 8135 0 1380 0 0 0 26370 0 321715 0 0 0 LAURIE GRIESINGER MD BOARD MEMBER 248812 0 21540 0 540 0 0 0 29769 0 300661 0 0 0 TERRY PIPP CFO (TERMED 4/2025) 216157 0 51 0 3960 0 32626 0 14184 0 266978 0 0 0 TIMOTHY STOLT COO 149621 0 54 0 8462 0 0 0 30311 0 188448 0 0 0 FORM 990, PART VI, SECTION A, LINE 1A THE ADMINISTRATIVE COMMITTEE SHALL CONSIST OF THE OFFICERS OF THE CORPORATION. SUBJECT TO THE CONTROL OF THE BOARD OF DIRECTORS, THE ADMINISTRATIVE COMMITTEE SHALL HAVE FULL AUTHORITY TO ACT FOR AND ON BEHALF OF THE CORPORATION AND EXERCISE ALL OF THE POWERS OF THE BOARD OF DIRECTORS THAT MAY BE LAWFULLY DELEGATED BY SUCH BOARD TO SUCH COMMITTEE EXCEPT, HOWEVER, THE ADMINISTRATIVE COMMITTEE SHALL HAVE NO POWER TO DONATE ANY PART OF THE ASSETS OF THE CORPORATION. THE ADMINISTRATIVE COMMITTEE SHALL RECEIVE STATUS REPORTS ON OTHER COMMITTEE ACTIVITIES AND DISCUSS ITEMS OF INTEREST TO THE GROUP AS A WHOLE OR TO INDIVIDUAL OFFICERS FOR THE PERFORMANCE OF THEIR DUTIES. THE ADMINISTRATIVE COMMITTEE SHALL KEEP MINUTES OF ITS MEETINGS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS INITIALLY REVIEWED BY THE FINANCE DEPARTMENT AND FINANCE COMMITTEE. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES ARE COMPLETED BY SUBSTANTIALLY ALL BOARD MEMBERS, OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES. THE ORGANIZATION'S CFO REVIEWS ALL RESPONSES TO DETERMINE WHETHER OR NOT A POTENTIAL OR ACTUAL CONFLICT OF INTEREST EXISTS. IF AN ACTUAL CONFLICT OF INTEREST IS DETERMINED TO EXIST, PERSONS WITH A CONFLICT ARE RECUSED FROM VOTING ON THE CONFLICTING ISSUE. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT WILL PRESENT AN ANNUAL REPORT TO THE EXECUTIVE COMMITTEE (OR FULL BOARD OF DIRECTORS IF NO EXECUTIVE COMMITTEE HAS BEEN FORMED) TO REVIEW THE CURRENT SALARIES OF THE EMPLOYED PATHOLOGISTS COMPARED TO BENCHMARK DATA OF CURRENT MARKET RATES, AND TO REVIEW THE SALARIES OF HIGHLY COMPENSATED EMPLOYEES OF THE CORPORATION. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICIES, AND GOVERNING DOCUMENTS ARE NOT REQUIRED DISCLOSURES PURSUANT TO IRC SECTION 6104. THESE DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G REFERENCE LAB SERVICES: PROGRAM SERVICE EXPENSES 1,043,969. MANAGEMENT AND GENERAL EXPENSES 62,467. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,106,436. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 940,622. MANAGEMENT AND GENERAL EXPENSES 56,283. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 996,905. TEMPORARY LABOR: PROGRAM SERVICE EXPENSES 35,161. MANAGEMENT AND GENERAL EXPENSES 2,104. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,265. COURIER SERVICES: PROGRAM SERVICE EXPENSES 696,202. MANAGEMENT AND GENERAL EXPENSES 41,658. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 737,860. FORM 990, PART XI, LINE 9: GAIN ON JOINT VENTURE 16,500. FORM 990, PART XII, LINE 2C ANNUALLY, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS (CHAIRMAN, VICE CHAIRMAN, TREASURER, SECRETARY, AND MANAGEMENT) AS WELL AS THE FULL BOARD OF DIRECTORS MEET TO REVIEW THE AUDIT. LEGACY PATH LLC 3355 DOUGLAS RD SOUTH BEND IN 46635 933956221 HEALTHCARE IN 0 0 SOUTH BEND MEDICAL FOUNDATION CHARTPRO LLC 3355 DOUGLAS RD SOUTH BEND IN 46635 HEALTHCARE IN 0 0 SOUTH BEND MEDICAL FOUNDATION