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Nonprofiteer
← INDIANA AMBULATORY SURGICAL ASSOCIATES INC

Form 990 for tax year 2022

Filed by INDIANA AMBULATORY SURGICAL ASSOCIATES INC.

Totals

Total revenue
$2,584,076
Total expenses
$3,359,442
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$2,558,354
Investment income
$0
Other revenue
$25,722
Total assets, end of year
$2,256,841
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$2,256,841
Program services expenses (Part IX)
$3,357,602
Management and general expenses
$1,840
Fundraising expenses
$0
Program service expenses (Part III)
$3,357,602

Program services were 99.9% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • RICHARD NEFF MD

    CHAIRMAN/CMO

    Total calculated
    $426,217
    From this org
    $0
    From related orgs
    $397,918
    Other
    $28,299
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $359,873 related
    Bonus
    $0 + $38,045 related
    Other
    $0
    Deferred
    $0 + $9,150 related
    Nontaxable benefits
    $0 + $19,149 related
    Filer's total
    $0 + $426,217 related

  • SANDRA J LUTTNER

    VICE CHAIR/SECRETARY

    Total calculated
    $184,992
    From this org
    $0
    From related orgs
    $167,028
    Other
    $17,964
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $167,028 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $10,176 related
    Nontaxable benefits
    $0 + $7,788 related
    Filer's total
    $0 + $184,992 related

  • JAMES KINNEER

    DIRECTOR/VP, ORG. DEVELOPMENT

    Total calculated
    $261,866
    From this org
    $0
    From related orgs
    $227,352
    Other
    $34,514
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $206,778 related
    Bonus
    $0 + $20,574 related
    Other
    $0
    Deferred
    $0 + $15,365 related
    Nontaxable benefits
    $0 + $19,149 related
    Filer's total
    $0 + $261,866 related

  • GREGG W WILSON DMD

    DIRECTOR/MEDICAL DIRECTOR

    Total calculated
    $40,437
    From this org
    $40,437
    From related orgs
    $0
    Other
    $0
    Hours/week
    6

  • THOMAS TREVORROW MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • STEPHEN A WOLFE

    PRESIDENT & CEO

    Total calculated
    $844,704
    From this org
    $0
    From related orgs
    $802,111
    Other
    $42,593
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $607,396 related
    Bonus
    $0 + $93,339 related
    Other
    $0 + $101,376 related
    Deferred
    $0 + $23,994 related
    Nontaxable benefits
    $0 + $18,599 related
    Filer's total
    $0 + $844,704 related

  • ROBERT GONGAWARE

    CHIEF FINANCIAL OFFICER

    Total calculated
    $358,146
    From this org
    $0
    From related orgs
    $323,825
    Other
    $34,321
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $297,705 related
    Bonus
    $0 + $26,120 related
    Other
    $0
    Deferred
    $0 + $21,386 related
    Nontaxable benefits
    $0 + $12,935 related
    Filer's total
    $0 + $358,146 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
THE CEO'S COMPENSATION IS PAID BY INDIANA REGIONAL MEDICAL CENTER. INDIANA REGIONAL MEDICAL CENTER USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B
INDIANA REGIONAL MEDICAL CENTER HAS A SUPPLEMENTAL, NONQUALIFIED RETIREMENT PLAN UNDER IRC SECTION 457(F) FOR PRESIDENT & CEO, STEPHEN A. WOLFE. NO AMOUNTS WERE PAID TO HIM, AND CONTRIBUTIONS TO THE PLAN WERE $90,000 DURING CALENDAR YEAR 2022.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2022
Filed
10 May 2024
IRS schema version
2022v5.0
Source object
202411349349305796

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