2024-11-15T06:41:43+00:00 2023-12-31 350921680 CROWE LLP 135 N Pennsylvania Street Suite 200 Indianapolis IN 462042407 990 2023-01-01 351786005 Rehabilitation Hospital of Indiana Inc REHA 3173292000 4141 Shore Drive Indianapolis IN 462542607 MARJORIE BASEY CFO 3173292195 2024-11-15 true KIM SCIFRES P00319397 3176321100 2024-11-15 2023 2024-10-15 13:58:12Z DANIEL B WOLOSZYN 4141 Shore Drive Indianapolis IN 462542607 46796375 false X WWW.RHIREHAB.COM X 1989 IN The primary focus of the Rehabilitation Hospital of Indiana is to deliver acute inpatient and outpatient rehabilitation services to the residents of Central Indiana regardless of their ability to pay. 6 6 452 7 0 0 417305 356811 44611877 46134936 33470 3136 371534 301492 45434186 46796375 14665 8545 0 32430341 30473828 0 0 13754080 15053598 46199086 45535971 -764900 1260404 32308766 33788941 15605920 15825691 16702846 17963250 Rehabilitation Hospital of Indiana (RHI) is an acute care rehabilitation hospital for inpatient and outpatient rehabilitation. RHI specializes in brain injury, spinal cord injury, stroke, and comprehensive medical rehabilitation for injuries or illnesses resulting in loss of function. (CONTINUED ON SCHEDULE O) false false 15862096 17699805 REHABILITATION NURSING: REHABILITATION NURSES WORK TO REINFORCE HEALING TECHNIQUES BY ENCOURAGING PATIENTS TO PRACTICE WHAT THEY LEARN IN THERAPY. THE NURSES AT REHABILITATION HOSPITAL, INC. HAVE A STRONG BACKGROUND IN MEDICAL-SURGICAL NURSING AND MANY HAVE HAD EXTENSIVE EXPERIENCE IN THE CRITICAL CARE AND ACUTE REHAB SETTING. 8965093 18941553 THERAPY SERVICES: THERAPY IS A KEY COMPONENT OF A PATIENT'S RECOVERY AND INCLUDES PHYSICAL, OCCUPATIONAL, SPEECH, AND RECREATIONAL THERAPY. THE THERAPY PROGRAM'S PURPOSE IS TO DEVELOP A COMPREHENSIVE PLAN TO HELP PATIENTS BECOME INDEPENDENTLY CAPABLE IN THEIR EVERYDAY LIVES TO THE EXTENT POSSIBLE BASED ON THEIR INDIVIDUAL CIRCUMSTANCES. ADDITIONALLY, THE OVERALL GOAL IS TO HELP BUILD STRENGTH AND ENDURANCE BY USING VARIOUS TECHNIQUES AND SPECIALIZED EQUIPMENT. 8582967 8545 9598599 OTHER PROGRAMS INCLUDE: CLINICAL RESOURCE FACILITATION, RESEARCH GRANTS, ANCILLARY SERVICES WHICH CONSISTS OF ,LAB, EKG, RADIOLOGY, PHARMACY, CENTRAL SUPPLIES, NEUROPSYCHOLOGY, NUTRITION, RESPIRATORY THERAPY, MEDICAL SERVICES (CLINICS), AND DIETARY SERVICES. OUR INTERNS & MEDICAL RESIDENTS PROGRAM REPRESENTS AN EDUCATIONAL PROGRAM TO TRAIN MEDICAL RESIDENTS IN THE ACUTE REHAB SETTING. THE SERVICES PROVIDED WITH CARE COLLABRATION HELPS THE PATIENT AND FAMILY THROUGH THERAPY, COUNSELING, AND EDUCATION. 33410156 true true false true false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true false false false true 56 0 true 452 true false false false false false false false false false false false false X 6 6 false false false false true true true true true false false true true true true true true true true false IN X Marjorie Basey 3173292195 4141 SHORE DRIVE Indianapolis IN 462542607 HAROLD BERFIEND BOARD CHAIR 1.0 0 X X 0 0 0 DAWN ROPP BOARD MEMBER 1.0 0 X 0 0 0 DOUG BROWN Board Member (from 11/15/2023) 1.0 1.0 X 0 0 0 RYAN NAGY BOARD MEMBER 1.0 0 X 0 0 0 SCOTT WEAVER BOARD MEMBER 1.0 1.0 X 0 0 0 Stephan masoncup board member (from 11/15/2023) 1.0 0 X 0 0 0 TERRY METZGER BOARD MEMBER (until 5/5/2023) 1.0 0 X 0 0 0 DANIEL B WOLOSZYN CEO 40.0 1.0 X 404123 0 46851 MARJORIE R BASEY CFO 40.0 0 X 197397 0 20750 MONTE M SPENCE COO 40.0 0 X 220126 0 59641 CHRISTINA BAUMGARTNER EXECUTIVE DIRECTOR OF THERAPY 40.0 0 X 167836 0 43272 GARY SKINNER DIRECTOR OF IT 40.0 0 X 176106 0 23240 JEAN BARSKE Chief Strategy & Business Development Officer 40.0 0 X 162220 0 57882 JOSHUA M HALON CHIEF NURSING OFFICER 40.0 0 X 184049 0 39713 MARY C ESCALANTE EXECUTIVE PHARMACY DIRECTOR 40.0 0 X 178996 0 23752 PETER A BISBECOS Chief Legal Officer 40.0 0 X 185334 0 19058 Alice Ngorima Shawarira Clinical Charge Nurse 40.0 0 X 194166 0 26195 Brian obert Inpatient Pharmacy Director 40.0 0 X 153626 0 38803 Hong yang Clinical Charge Nurse 40.0 0 X 185307 0 3745 PAULETTE TANIS Clinical Charge Nurse 40.0 0 X 169302 0 54383 Robin shrader Clinical Charge Nurse 40.0 0 X 158860 0 38757 2737448 0 496042 53 false true false Cardinal Health 2840 Elm Point Industrial Dr ST CHARLES MO 63301 MEDICAL SUPPLIES & PHARMACEUTICAL SERVICES 1772121 SODEXO INC & AFFILIATES PO BOX 360170 PITTSBURGH PA 152516170 DIETARY SERVICES 1227890 CERNER CORPORATION 8779 HILLCREST ROAD KANSAS CITY MO 64138 HEALTHCARE INFORMATION TECHNOLOGY 1130659 Maxim Healthcare Services Inc 12558 Collections Center Drive Chicago IL 60693 Nursing Staffing Agency 1050855 Merz Pharmaceuticals LLC 6601 Six Forks Road Suite 430 Raleigh NC 27615 Medical Supplies & Pharmaceutical Services 462232 30 7062 278969 70780 356811 NET PATIENT SERVICE REVENUE 622310 44513408 44513408 PHARMACY REVENUE 446110 1567637 1567637 MANAGEMENT FEE 900099 53891 53891 0 0 0 0 46134936 3136 3136 2500 0 2500 0 2500 2500 0 0 REBATE REVENUE 900099 104836 104836 CAFETERIA REVENUE 722514 193971 193971 MISCELLANEOUS INCOME 900099 185 185 0 0 0 0 298992 46796375 46239957 0 199607 X 8545 8545 2210347 1796001 414346 20741825 16853613 3888212 554640 415646 138994 5182579 3883816 1298763 1784437 1449931 334506 8025 5323 2702 104724 69462 35262 7360621 4882203 2478418 0 28453 14226 14227 25865 9790 16075 1212850 41588 1171262 31332 31332 23391 23391 156481 447 156034 1881744 1881744 Medical Supplies/Equipment 3924842 3924842 Licences and Fees 226149 226149 Dues and Subscriptions 69121 69121 0 0 0 0 45535971 33410156 12125815 0 3239 3239 236633 2799198 5479051 5985828 0 0 0 0 314436 516751 906765 913734 57023993 34554492 23768698 22469501 0 0 1599944 1100690 32308766 33788941 5221115 6940538 0 0 10384805 8885153 15605920 15825691 X 16702846 17963250 16702846 17963250 32308766 33788941 1260404 0 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 7000 7000 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY RHI IS A MEMBER OF THE AMERICAN MEDICAL REHABILITATION PROVIDERS ASSOCIATION (AMRPA). THROUGH THE MEMBERSHIP, LOBBYING ACTIVITIES ARE INCLUDED. RHI ALSO UTILIZES ICE MILLER TO ASSIST WITH RATE AND PAYMENT ISSUES WITH THE STATE OF INDIANA. 2506638 2506638 33621764 17030086 16591678 962060 427471 534589 19893751 17096935 2796816 39780 39780 22469501 Estimated Third-party settlements 829606 Lease Liability 135547 Related party note payable 7920000 8885153 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The Hospital is a not-for-profit corporation pursuant to Section 501(c)(3) of the Internal Revenue Code and is exempt from income taxes on related income pursuant to Section 501(a). Accordingly, no provision for income taxes is required for the Hospital in the consolidated financial statements. A tax position is recognized as a benefit only if it is "more likely than not" that the tax position would be sustained in a tax examination, with a tax examination being presumed to occur. The amount recognized is the largest amount of tax benefit that is greater than 50% likely of being realized on examination. For tax positions not meeting the "more likely than not" test, no tax benefit is recorded. The Hospital is no longer subject to examination by U.S. federal taxing authorities for years before 2018 and for all state income taxes through 2019. The Hospital does not expect the total amount of unrecognized tax positions to significantly change in the next 12 months. The Hospital would recognize interest and/or penalties related to income tax matters in income tax expense. The Hospital has no amounts accrued for interest or penalties as of December 31, 2023 and 2022. true true X true X true X true true false true true 138260 0 138260 0.0030 8404620 4998861 3405759 0.0748 0 0 0 0.0 0 0 8542880 4998861 3544019 0.0778 0 0 0 0.0 1 13 243374 0 243374 0.0053 0 0 0 0.0 0 0 0 0.0 11 13712 18779 0 18779 0.0004 12 13725 262153 0 262153 0.0058 12 13725 8805033 4998861 3806172 0.0836 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 10761329 11960479 -1199150 X true true 1 1 REHABILITATION HOSPITAL OF INDIANA 4141 Shore Drive Indianapolis IN 46254 www.rhirehab.com 22-005971-1 X X Acute Rehabilitation REHABILITATION HOSPITAL OF INDIANA 1 false false true X X X X X X X X X 21 true true false true X https://www.rhirehab.com/media/2110/rhi-2021-chna-draft-v31.pdf X true 22 true https://www.rhirehab.com/media/2167/2022_2024-implementation-strategy-rhi-draft-mb-dk-edits-59.pdf false true X 200.0 400.0 X X true true X X X true X https://www.rhirehab.com/media/1911/financial-assistance-policy.pdf X https://www.rhirehab.com/media/1457/financial-assistance-application-english.pdf X https://www.rhirehab.com/media/1956/financial-assistance-summary-pls-2020-final-version.pdf X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E Based on the 2021 CHNA, the following community health needs have been identified (in alphabetical order) as significant in the community served by RHI. -COVID-19 Pandemic -Mental Health Status -Obesity and Diabetes -Smoking -Social Determinants of Health -Substance Use Disorder -Violence and Injuries Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - REHABILITATION HOSPITAL OF INDIANA, INC.. 2021 CHNA. Primary data were gathered through online meetings with hospital staff and administration, and key stakeholder interviews. Two internal meetings were conducted - one comprised of hospital front-line staff, and another comprised of leadership and administration. Key stakeholder interviews were conducted by phone or online video conferences, and meetings were conducted by online video conferences. Representatives from the following organizations provided input through key stakeholder interviews: -CICOA Aging and In-Home Solutions -Easterseals Crossroads -Indiana Minority Health Coalition -Indiana Supreme Court - Family Violence -Indianapolis Public Schools 109 - Marion County Public Health Department -RHI Board of Directors Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - REHABILITATION HOSPITAL OF INDIANA, INC.. The 2021 Community Health Needs Assessment (CHNA) was conducted as a collaborative effort involving RHI, IU Health, Community Health Network, and St. Vincent Health. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - REHABILITATION HOSPITAL OF INDIANA. The 2021 CHNA identified the following needs as significant in the community served by RHI (IN ALPHABETICAL ORDER). THE TWO NEEDS THAT RHI FELT THE MOST CAPABLE OF IMPACTING DURING 2022-2024 ARE 1) OBESITY AND DIABETES AND 2) SOCIAL DETERMINATES OF HEALTH. COVID-19 Pandemic Mental Health Status Obesity and Diabetes Smoking Social Determinants of Health Substance Use Disorder Violence and Injuries NEEDS ADDRESSED TOWARDS OBESTITY AND DIABETES IN 2023 -IN ORDER TO EDUCATE STUDENTS IN THE COMMUNITY ON THE IMPORTANCE OF HEALTHY LIFESTYLE CHOICES, RHI SPONSERED A HEALTH AND WELLNESS PROGRAM AT JONATHAN JENNINGS ELEMENTARY SCHOOL 109. THE PROGRAM WAS GEARED TOWARDS 4TH-6TH GRADERS. THE FOCUS WAS ON PREVENTION OF TYPE 2 DIABETES AND OBESITY. THERE WERE 150 STUDENTS IN ATTENDANCE. Students learned how to prepare simple and cost-effective healthy snacks from foods available in local stores, including Dollar General and Meijer. Students were also able to sample some of these snack items as they learned how to prepare them. Students were provided with goodie bags including recipes and educational materials (in English and Spanish) to take home for their families. RHI provided 150 pedometers and engaged students in a step challenge in PE classes to promote physical activity. -RHI partnered with IU Health to promote physical activity amongst high schoolers by providing free sports physicals to students at various IPS schools including Shortridge, Crispus Attucks, and George Washington High Schools. Students received the vison, height, weight, and blood pressure screenings that are required to participate in sports activities. NEEDS ADDRESSED TOWARDS SOCIAL DETERMINANTS OF HEALTH IN 2023 -In 2023, RHI provided 100 backpacks of ready to eat and easy to prepare food to students at Jonathan Jennings Elementary School 109. "Blessings in Backpacks" provided critical nutrition for food insecure children during extended breaks from school over the extended Spring, Fall, and Holiday breaks. -RHI employees have demonstrated commitment to education while participating in the Fall and Winter Volunteer Reading Program sessions at Jonathan Jennings Elementary School 109. The volunteers spent an hour each Thursday afternoon assisting teachers and students with reading, journaling, and other lesson planning activities. Among the 4 classrooms, RHI served a total of 102, 2nd and 3rd grade students. -RHI sponsored an annual Book Gifting Program, providing books to over 300 students. -RHI partnered with Junior Achievement of Central Indiana, a coalition of educators, organizations, and representatives of over 120 companies to support the JA JobSparks event at the Indiana State Fairgrounds. RHI collaborated with other local hospitals supporting the Health and Life Sciences cluster, informing students on healthcare career paths. This multi-day career expo impacted over 11,000 Indianapolis eight graders annually by providing hands on learning experiences meant to "spark" an interest in students and provide them with a greater understanding of the coursework and skills required to be successful in a wide range of careers. -RHI partnered with Greater Indy Habitat for Humanity on the West side of Indianapolis to support build day by landscaping two new homes for local families. -RHI volunteers collaborated with Servants at Work (SAW) to improve in-home safety, accessibility, and mobility by sponsoring and building ramps for local, low-income residents. NEEDS NOT ADDRESSED: RHI is unable to address all of the significant health needs identified in the local community. This is not meant to minimize the importance of any health need or the integrity of the community health needs assessment (CHNA) process. RHI is a mission and values driven hospital; therefore, addressing significant community health needs that align with the hospital's mission will have the greatest opportunity to activate and leverage hospital resources as well as maximize current strategic collaborations with community-based partners. RHI is unable to address the following community health needs identified in the 2021 Community Health Needs Assessment. Covid-19 Pandemic : RHI has constraints in the necessary resources to effectively address this need. Other community hospitals and organizations including IU Health and Ascension St. Vincent are currently addressing this need with COVID testing and vaccination clinics. Mental Health Status: RHI has constraints in the necessary resources to effectively address this need. Smoking: RHI is unable to address the high smoking rates in Marion County and Indiana as a whole. Other community organizations are currently addressing this need. Additionally, there are resource constraints and a lack of expertise to effectively address the need. Substance Use Disorders: RHI is unable to address this need. Other community organizations are currently addressing this need. Additionally, there are resource constraints and a lack of expertise to effectively address the need. Violence and Injuries: RHI does not have the expertise and resources to impact violence and crime rates in Marion County. Additionally, this need is being addressed by others including Indiana Coalition Against Domestic Violence. Schedule H, Part V, Section B, Line 21 Facility , 1 Facility , 1 - REHABILITATION HOSPITAL OF INDIANA, INC.. RHI is not a general acute care hospital/facility nor is RHI equipped to provide care to patients with urgent care needs. RHI is a specialty provider of rehabilitation services such as Physical, Occupational and Speech Therapy. 2 RHI NEUROREHABILITATION CENTER (NBIC) 9531 VALPARAISO COURT INDIANAPOLIS IN 46268 OUTPATIENT REHABILITATION FACILITY Schedule H, Part I Line 7 Table Cost-to-charge ratios were used for charity care costs, patient care costs, unreimbursed Medicaid and other means tested government programs. RHI used the worksheets provided in the IRS instructions. All other costs are direct costs (community health improvement services, health professions education, research, cash contributions). Schedule H, Part III, Line 3 Bad Debt Expense Methodology The organization does not report any portion of bad debt as community benefit and chooses not to estimate for purposes of Part III, Section A, Line 3 the amount of bad debt attributable to patients that may be eligible under the organization's financial assistance policy. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Footnote to the Audited Financial Statement. Generally, patients who are covered by third-party payors are responsible for related deductibles and coinsurance, which vary in amount. The Hospital also provides services to uninsured patients, and offers those uninsured patients a discount, either by policy or law, from standard charges. The Hospital estimates the transaction price for patients with deductibles and coinsurance, and from those who are uninsured, based on historical experience and current market conditions. The initial estimate of the transaction price is determined by reducing the standard charge by any contractual adjustments, discounts, and implicit price concessions. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to patient service revenue in the period of the change. For the years ending December 31, 2023 and 2022, no significant adjustments to revenue were recognized due to changes in the estimates of implicit price concessions for performance obligations satisfied in prior years. Subsequent changes that are determined to be the result of an adverse change in the patient's ability to pay are recorded as bad debt expense. Bad debt expense for the years ending December 31, 2023 and 2022 was not significant. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Any cost incurred for treatment of a patient in which the total amount of revenue was not collected, is reported as a shortfall. By continuing to treat patient eligible for Medicare, hospitals alleviate the federal government's burden for directly providing medical services. The shortfall is due to continued cuts in Medicare reimbursement while RHI continues to invest in state-of the-art equipment and facilities to meet the challenging healthcare needs of the community. Medicare allowable costs were determined based on the cost to charge ratio from the FY 2023 Medicare cost report. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance The Hospital's collection policy contains provisions on practices to be followed for patients who are known to qualify for financial assistance. The collection policy states that RHI will not engage in extraordinary collection actions before making reasonable efforts to determine whether a patient is eligible for assistance under RHI's Financial Assistance Policy. Schedule H, Part V, Section B, Line 16a FAP website - REHABILITATION HOSPITAL OF INDIANA: Line 16a URL: https://www.rhirehab.com/media/1911/financial-assistance-policy.pdf; Schedule H, Part V, Section B, Line 16b FAP Application website - REHABILITATION HOSPITAL OF INDIANA: Line 16b URL: https://www.rhirehab.com/media/1457/financial-assistance-application-english.pdf; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - REHABILITATION HOSPITAL OF INDIANA: Line 16c URL: https://www.rhirehab.com/media/1956/financial-assistance-summary-pls-2020-final-version.pdf; Schedule H, Part VI, Line 2 Needs assessment Federal regulations allow hospital facilities to define the community they serve based on "all of the relevant facts and circumstances," including the "geographic location" served by the hospital facility, "target populations served" (e.g., children, women, or the aged), and/or the hospital facility's principal functions (e.g., focus on a particular specialty area or targeted disease). Accordingly, this CHNA focuses on community health issues relevant to rehabilitation services. In assessing community health needs relevant to RHI, the following statistics are important to understand: * Patients most often are admitted to RHI as a result of stroke, Traumatic Brain Injury (TBI), Spinal Cord Injury (SCI), major trauma, cardiac events, amputations, other orthopedic conditions, and other issues for which rehabilitation services are medically necessary. * About 94 percent of admissions to RHI are for patients transferred from an acute medical/surgical hospital. Many patients first are seen in hospital emergency rooms and trauma centers, then are admitted to acute medical/surgical hospitals, and then are transferred to RHI to receive intensive rehabilitation services. * RHI provides both inpatient and outpatient services. Outpatient care is provided at the main hospital site and at two other locations (Indianapolis and Carmel, Indiana). Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Patients are informed about financial assistance before admissions by the clinical liaison. This occurs when the patient is at the general acute care hospital before transferring to RHI. Patients are also informed of financial assistance with signage that is located throughout hospital. The patient is informed during registration by the admissions representative and a summary of the financial assistance policy is included in each admission packet. During the patient's stay, the Care Coordinator will work with the patient in completing the financial assistance application. The Care Coordinator will continue to work with the patients after discharge, if the situation requires. Patients receive a summary of the FAP with all statements. RHI also mails a summary of the policy along with a financial assistance application to any uninsured patient that has a balance on his/her account. RHI also publicizes its FAP on the hospital web site. RHI provides representatives to assist patients with the financial assistance process Monday through Friday from 8am to 5pm. Schedule H, Part VI, Line 4 Community information RHI provides a range of services for patients from central Indiana and across the State of Indiana. For purposes of this CHNA, RHI's "local community" is defined as Marion County, Indiana. The total population of Marion County as of 7/1/2023 is 968,460. RHI also serves the State of Indiana as a whole. Accordingly, this CHNA also considers relevant community health needs across the entire state. The total population of Indiana in 2023 was 6.862 million people. As permitted by federal regulations, this CHNA also focuses on community health issues relevant to rehabilitation services. Demographic characteristics and trends directly influence community health needs. The total population in Marion County is expected to grow by 5.5 percent between 2019 and 2025 (approximately 55,000 people). While the total community is expected to grow modestly, the population age 65 years and older is expected to increase by 12.8 percent over the same time period. This change should contribute to greater demand for health services, including rehabilitation services, as older individuals typically need and use more services than younger persons. Marion County has substantial variation in demographic characteristics across community ZIP codes. Four ZIP codes (46218, 46235, 46254, and 46226) all had a proportion of the population that was Black above 50 percent. ZIP codes 46222 (28.5 percent) and 46224 (27.6 percent) had the highest proportion of Hispanic (or Latino) residents. Residents without a high school diploma and experiencing linguistic isolation are more prevalent in the county than in Indiana as a whole. The proportion of the population disabled is above the national average, but below the Indiana average. Schedule H, Part VI, Line 5 Promotion of community health A majority of the organization's governing body is comprised of persons who reside in the Organization's primary service area who are neither employees nor independent Contractors of the organization, nor family members thereof. The organization extends medical staff privileges to all qualified physicians in its community for some or all of its departments or specialties. Our hospital applies surplus funds to fund improvements in patient care, medical education and research, rhi partners with indiana university, iu health, and iupui in various research activities to advance the research efforts and to provide evidence-based medicine for those in need. Rhi also devotes time, efforts, resources and financial support to a resident program in collaboration with indiana university physical medicine and rehabilitation. Rhi offers free monthly support groups related to stroke, brain injury, and spinal cord Injury providing education, training and coping skills to both survivors and their Caregivers. Additionally, these programs help to decrease social isolation and increase Support in the community Schedule H, Part VI, Line 6 Affiliated health care system RHI is owned by two major health systems; 1) IU Health, Inc. and 2) St. Vincent Health. IU Health, Inc. is the majority owner of RHI. RHI works primarily with the IU Health system on various activities to address the community needs. Schedule H, Part VI, Line 7 State filing of community benefit report IN X X X false false false false false false false false false MARJORIE R BASEY CFO 192354 0 0 0 5043 0 8197 0 12553 0 218147 0 0 0 MONTE M SPENCE COO 209468 0 0 0 10658 0 8823 0 50818 0 279767 0 0 0 DANIEL B WOLOSZYN CEO 387570 0 0 0 16553 0 13200 0 33651 0 450974 0 0 0 JEAN BARSKE Chief Strategy & Business Development Officer 161565 0 0 0 655 0 6814 0 51068 0 220102 0 0 0 CHRISTINA BAUMGARTNER EXECUTIVE DIRECTOR OF THERAPY 167181 0 0 0 655 0 7083 0 36189 0 211108 0 0 0 PETER A BISBECOS Chief Legal Officer 184455 0 0 0 879 0 6505 0 12553 0 204392 0 0 0 MARY C ESCALANTE EXECUTIVE PHARMACY DIRECTOR 178323 0 0 0 673 0 0 0 23752 0 202748 0 0 0 JOSHUA M HALON CHIEF NURSING OFFICER 179698 0 0 0 4351 0 7568 0 32145 0 223762 0 0 0 GARY SKINNER DIRECTOR OF IT 172402 0 0 0 3704 0 7178 0 16062 0 199346 0 0 0 Alice Ngorima Shawarira Clinical Charge Nurse 192689 0 150 0 1327 0 8019 0 18176 0 220361 0 0 0 PAULETTE TANIS Clinical Charge Nurse 167238 0 220 0 1844 0 6110 0 48273 0 223685 0 0 0 Hong yang Clinical Charge Nurse 184671 0 450 0 186 0 3745 0 0 0 189052 0 0 0 Robin shrader Clinical Charge Nurse 158632 0 200 0 28 0 6867 0 31890 0 197617 0 0 0 Brian obert Inpatient Pharmacy Director 146930 0 0 0 6696 0 6658 0 32145 0 192429 0 0 0 Form 990, Part III, Line 1 MISSION RHI's individualized approach to each patient is the results of a collective effort of trained and compassionate team members who value the quality of life. It is the right kind of treatment- inpatient, outpatient and follow up services- provided under the same roof. Form 990, Part VI, Line 6 Classes of members or stockholders The Not-for-profit corporations St. Vincent Health, Inc. and Indiana University Health, Inc. are the corporate members of RHI. There are 2 classes of membership: Class A and Class B. The class A member is St. Vincent Health and the class B member is Indiana University Health, Inc. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Each of the corporate members has the right to appoint 50% of the members of the RHI board of Directors. The class A member, St. Vincent Health, has the right to appoint all class A directors; the class B member, Indiana University Health, Inc. has the right to appoint all class B directors. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The following matters require the joint approval of the two corporate members of the Hospital: 1. Approve, interpret and change any statement of mission, philosophy, role and purpose of RHI. 2. Approve and amend bylaws and articles of incorporation. 3. Fix the number of Directors of RHI. The appointment, election or removal of any class A director shall require the approval of the class A member and the appointment, election or removal of any class B director shall require the approval of the class B member. 4. Approve the merger, dissolution, consolidation or reorganization of RHI. 5. Approve the formation of other entities by RHI. 6. Approve the acquisition, sale, lease, transfer or other alienation of property of RHI, other than in the usual and regular course of RHI's business, when such acquisition, sale, lease, transfer or other alienation meets specified financial levels set in accordance with policies established from time to time by the class A and class B members. 7. Approve capital and operating budgets of RHI. 8. Approve debt incurred by RHI which is in excess of such limits as are established by the Class A and Class B Corporate Members. 9. Approve the disposition of the assets of RHI at the time of its dissolution. 10. Establish (i) policy concerning quality of care and services or (ii) policy and procedures concerning finance and resources for RHI, which are inconsistent with policies established by the Class A and Class B Corporate Members. 11. Approve the long-range financial and strategic plans for RHI. 12. Approve an internal auditing program for RHI, which is inconsistent with the internal auditing program established by the Class A and Class B Corporate Members. 13. Appoint or remove the Chief Executive Officer of RHI provided, however, that the Class A and Class B Corporate Members shall confer with the Board of Directors concerning the appointment or removal of the Chief Executive Officer. 14. Approve the policy pertaining to the evaluation of the Chief Executive Officer of RHI. 15. Appoint or remove the Medical Director. 16. Take any action which would be inconsistent with the governing documents or policies of the Class A or Class B Corporate Members. Form 990, Part VI, Line 11b Review of form 990 by governing body A detailed review of the 990 is performed by management . The final Form 990 is sent to the entire board prior to filing the return with the IRS. Form 990, Part VI, Line 12c Conflict of interest policy Annually, all employees and board members are required to complete a conflict of interest form. The CEO and Chairman of the board review the conflict of interest forms completed by the board members and the Director of Human Resources reviews conflict of interest forms completed by employees. If, during a board meeting, there is an action item that presents a formal conflict, the interested person would be asked to recuse himself/herself from the vote. This recusal would be documented in the minutes. If a key employee discloses a potential conflict, that person is removed from the decision-making process for transactions related to that conflict. Form 990, Part VI, Line 15a Process to establish compensation of top management official The salary for the CEO is defined in the written hiring agreement which is approved by the Board of Directors. Annual performance goals are determined and set by the chairman of the board. Salary increases and performance bonuses are determined based upon performance and the attainment of these goals. The tool used to evaluate the CEO's annual performance and pay is based on the accomplishment of these approved goals and objectives. The evaluation of performance and goals is completed by the Chair and Vice Chair of the Board annually and is performed in the Executive Session of the annual board meeting. The combination of CEO goal reviews, hospital average merit increases projected, and the yearly governing body evaluation are used in executive session that will align with 1. CEO merit increase and 2. Bonus approval. The evaluation/approvals are documented by the Chairman of the Board. In addition, RHI Human Resources obtains a Compensation survey/study annually which is used to evaluate the compensation of RHI staff including the CEO. Form 990, Part VI, Line 15b Process to establish compensation of other employees The administrative officers' compensation is evaluated annually based on the Hospital's standard performance review system and based on the performance of annual goals. Annual goals for each officer are recommended by the CEO and approved by the Board of Directors. Salary increases and performance bonuses are determined based upon performance and goals. The CEO reviews and evaluates the annual performance of each administrative officer and recommends a performance rating based on the Hospital's standard performance review system. This is documented in the HR/personnel files. The CEO also reviews and evaluates the performance of each officer as it relates to the assigned annual goals. The annual evaluation of performance goals is taken to the Chair of the Board to review and approve in an executive session of the annual board meeting. This is documented by the Chairman of the Board. In addition, RHI Human Resources obtains a Compensation survey/study annually which is used to evaluate the compensation of RHI staff including the administrative officers. Form 990, Part VI, Line 19 Required documents available to the public Financial statements, governing documents, and conflict of interest policies are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104; these documents are not available to the public at this time. Form 990, Part IX, Line 11g Other Fees CONTRACT LABOR - Total Expense: 1633830, Program Service Expense: 1083698, Management and General Expenses: 550132, Fundraising Expenses: ; PHYSICIAN FEES - Total Expense: 516831, Program Service Expense: 342807, Management and General Expenses: 174024, Fundraising Expenses: ; CONSULTING FEES - Total Expense: 15911, Program Service Expense: 10554, Management and General Expenses: 5357, Fundraising Expenses: ; COLLECTION/PT TRANSPORT - Total Expense: 256080, Program Service Expense: 169854, Management and General Expenses: 86226, Fundraising Expenses: ; SERVICE CONTRACTS - Total Expense: 4937969, Program Service Expense: 3275290, Management and General Expenses: 1662679, Fundraising Expenses: ; RHI FOUNDATION INC 4141 SHORE DRIVE INDIANAPOLIS IN 46254 351932349 TO SUPPORT REHABILITATION HOSPITAL OF INDIANA IN 501(c)(3) Type I REHABILITATION HOSPITAL OF INDIANA INC true false false true false false false false false false false false false false true true false false false false RHI FOUNDATION INC N 286074 ALLOCATION RHI FOUNDATION INC O 151251 ALLOCATION