2023-11-14T14:58:08+00:00 2022-12-31 350921680 CROWE LLP 135 N Pennsylvania Street Suite 200 Indianapolis IN 462042407 990 2022-01-01 351786005 Rehabilitation Hospital of Indiana Inc REHA 3173292000 4141 Shore Drive Indianapolis IN 462542607 MARJORIE BASEY CFO 3173292195 2023-11-14 true Marjorie Basey 999009999 KIM SCIFRES P00319397 3176321100 2022 2023-04-26 12:10:37Z DANIEL B WOLOSZYN 4141 Shore Drive Indianapolis IN 462542607 45456008 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. 5 5 487 7 0 0 170370 417305 46813756 44611877 24271 33470 725028 371534 47733425 45434186 9599 14665 0 33447361 32430341 0 84154 13548124 13754080 47005084 46199086 728341 -764900 33903801 32308766 16436055 15605920 17467746 16702846 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 15285991 16723870 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. 10736545 14665 9350655 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. 8658686 18729541 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. 34681222 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 54 0 true 487 true false false false false false false false false false false false false X 5 5 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 JOHN LAYTON BOARD MEMBER (UNTIL 6/1/22) 1.0 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 TERRY METZGER BOARD MEMBER 1.0 0 X 0 0 0 DANIEL B WOLOSZYN CEO 40.0 1.0 X 454307 0 33963 MARJORIE R BASEY CFO 40.0 0 X 200919 0 18601 MONTE M SPENCE COO 40.0 0 X 241703 0 41932 CHRISTINA BAUMGARTNER EXECUTIVE DIRECTOR OF THERAPY 40.0 0 X 169576 0 31704 JEAN BARSKE Chief Strategy & Business Development Officer 40.0 0 X 173592 0 40105 JOSHUA M HALON CHIEF NURSING OFFICER 40.0 0 X 192725 0 31207 Alice Ngorima Shawarira Clinical Charge Nurse 40.0 0 X 209682 0 316 GARY SKINNER DIRECTOR OF IT 40.0 0 X 175313 0 18517 MARY C ESCALANTE EXECUTIVE PHARMACY DIRECTOR 40.0 0 X 195464 0 27538 PAULETTE TANIS Clinical Charge Nurse 40.0 0 X 203848 0 37861 PETER A BISBECOS Chief Legal Officer 40.0 0 X 177450 0 13458 2394579 0 295202 48 false true false Summit Construction Co Inc 1107 Burdsal Parkway Indianapolis IN 46208 Construction 3937385 Cardinal Health 2840 Elm Point Industrial Dr ST CHARLES MO 63301 MEDICAL SUPPLIES & PHARMACEUTICAL SERVICES 1629125 SODEXO INC & AFFILIATES PO BOX 360170 PITTSBURGH PA 152516170 DIETARY SERVICES 1173226 ALLERGAN 5 Giralda Farms MADISON NJ 07940 Medical Supplies & Pharmaceutical Services 921426 CERNER CORPORATION 8779 HILLCREST ROAD KANSAS CITY MO 64138 HEALTHCARE INFORMATION TECHNOLOGY 810620 25 15880 301240 100185 15880 417305 NET PATIENT SERVICE REVENUE 622310 43156601 43156601 PHARMACY REVENUE 446110 1399895 1399895 MANAGEMENT FEE 900099 55381 55381 0 0 0 0 44611877 25970 25970 2500 2082 418 0 418 418 27240 19740 0 7500 7500 7500 REBATE REVENUE 900099 184590 184590 CAFETERIA REVENUE 722514 178927 178927 MISCELLANEOUS INCOME 900099 7599 7599 0 0 0 0 371116 45434186 44804066 0 212815 X 14665 14665 1630333 1396380 233953 0 24924801 21348092 3576709 0 640308 476261 155018 9029 3321378 2470441 804106 46831 1913521 1423277 463263 26981 33898 20915 12983 133150 82154 50996 6190682 3819124 2371031 527 103318 5579 97739 118311 6389 111922 1310565 69984 1239795 786 115011 6211 108800 12470 673 11797 239607 623 238984 1425141 1425141 MEDICAL SUPPLIES/EQUIPMENT 3820700 3526888 293812 LICENSES AND FEES 137274 7413 129861 DUES AND SUBSCRIPTIONS 113953 6153 107800 0 0 0 0 46199086 34681222 11433710 84154 3164 3239 5377403 236633 5899355 5479051 0 0 0 0 385443 314436 571441 906765 56451059 32682361 20360592 23768698 281 0 0 1306122 1599944 33903801 32308766 5674795 5221115 9700405 0 0 1060855 10384805 16436055 15605920 X 17467746 16702846 17467746 16702846 33903801 32308766 -764900 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 40192 40192 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 33498105 15832762 17665343 962060 365933 596127 19314060 16483666 2830394 170196 170196 23768698 Estimated Third-party settlements 911102 Lease Liability 633703 Related party note payable 8840000 10384805 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 2017 and for all state income taxes through 2018. 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, 2022 and 2021. true true X true X true X true true false true true 167016 0 167016 0.0036 9641368 5363460 4277908 0.0926 0 0 0 0.0 0 0 9808384 5363460 4444924 0.0962 0 0 0 0.0 1 13 222403 0 222403 0.0048 0 0 0 0.0 1 31885 0 31885 0.0007 5 10496 15260 0 15260 0.0003 7 10509 269548 0 269548 0.0058 7 10509 10077932 5363460 4714472 0.1020 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 0 11228463 12166871 -938408 X 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: During 2022, RHI impacted Obesity and Diabetes with the below initiative. Many of our initiatives from prior years were shut down do to COVID 19. As 2022 was a year to rebuild our Community Benefit programs, the below initiatives were one of the first outreach activities. RHI continued during the year of 2022 to re-build other prior initiatives to continue to impact this need more in 2023. IPS Sports Physicals - To impact obesity and diabetes in our local community, RHI participated in an effort to keep our local youth physically active by helping Indianapolis Public School students receive the required physical in order for them to participate in school sports. RHI's community benefit program is focused on carrying our mission outside the walls of our hospital to serve and impact the top health needs identified in our community. The prevalence of obesity and diabetes was one specific health need identified as significant in our community. In America's Health Rankings, Indiana ranks 41st for diabetes and 40th for obesity. Both are known risk factors for stroke and contribute to risks associated with falls and other injuries. RHI feels this is an important event which helps to promote access to physical activity for many high school students. RHI team members partnered with our colleagues at IU Health on Thursday, May 12th at Washington High School and Wednesday, May 18th at Crispus Attucks High School to provide free sports physical screens for IPS students from local schools. Volunteer roles included greeting, screening for vision and measuring the height, weight and blood pressure of student athletes. Because of these collaborative efforts, we have helped over 80 Marion County high school students stay active by passing the required physicals that will allow them to stay active and participate in sports activities. During 2022, RHI impacted Social Determinants of Health with a number of initiatives all described below. Junior Achievement JobSparks - On September 20th and 21st, RHI team members partnered with other local organizations and industry leaders to support the 2022 JA JobSparks event at the Indiana State Fairgrounds. This two-day career expo impacted over 10,000 Indianapolis eight graders by providing hands on learning experiences meant to "spark" an interest in students and provide a greater understanding of the coursework and skills required to be successful in a wide range of careers. Research shows that when students have an idea of what they might want to do after high school, they are more likely to stay in school and graduate. RHI therapists assisted with this year's event by providing interactive, job-specific experiences and sharing their clinical expertise on careers in occupational and speech therapy. Habitat for Humanity - On Friday, October 14th, 2022 Team RHI members partnered with Greater Indy Habitat for Humanity to support a build day on the West side of Indianapolis. Our volunteers shared their time and talents painting and putting on the finishing interior touches for the Tutt family's new house. RHI continues to welcome the opportunity to serve our community. In the most recent Community Health Needs Assessment, Marion County ranks poorly for severe housing problems and percent of households rent burdened. In addition to stable housing, research shows that homeownership leads to many additional benefits including improved mental health, decreased reliance on social services, and improved academic achievement of children. As a result of these collaborative efforts, a family will soon be owning their first Habitat home. RHI believes that carrying our mission outside the walls of our hospital to positively impact the health needs of our community is important. Student Book Gifting Program - As part of RHI's commitment to support educational achievement, RHI sponsored a Book Gifting Program for the students at Jonathan Jennings Elementary School 109. On Tuesday, December 20th, 2022 RHI employees distributed new, age-appropriate books to each of the 299 students at the school. Additional funding was provided to support the stocking of the school's new book vending machine, thus allowing selected students to be rewarded with a new book throughout the school year. This is the third year RHI has supported this initiative that focuses on providing students with high quality reading resources. Research suggests that 60% of students in the United States do not own a book at their reading level at home. This statistic is even higher for low income households. RHI looks forward to supporting future programs and initiatives that contribute to the educational successes of students in Marion County. 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 - CARMEL 12425 OLD MERIDIAN STREET SUITE B2 CARMEL IN 46032 OUTPATIENT FACILITY 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, 2022 and 2021, 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, 2022 and 2021 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 2022 Medicare cost report. 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 in 2019 was 951,869. 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 2019 was 6,665,703. 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 178959 0 17332 0 4628 0 8306 0 10295 0 219520 0 0 0 MONTE M SPENCE COO 209108 0 21937 0 10658 0 9068 0 32864 0 283635 0 0 0 DANIEL B WOLOSZYN CEO 386093 0 51661 0 16553 0 12200 0 21763 0 488270 0 0 0 JEAN BARSKE Chief Strategy & Business Development Officer 156936 0 16042 0 614 0 7341 0 32764 0 213697 0 0 0 CHRISTINA BAUMGARTNER EXECUTIVE DIRECTOR OF THERAPY 153342 0 15930 0 304 0 7161 0 24543 0 201280 0 0 0 JOSHUA M HALON CHIEF NURSING OFFICER 171278 0 17343 0 4104 0 6987 0 24220 0 223932 0 0 0 PETER A BISBECOS Chief Legal Officer 157954 0 15525 0 3971 0 7210 0 6248 0 190908 0 0 0 MARY C ESCALANTE EXECUTIVE PHARMACY DIRECTOR 169590 0 18201 0 7673 0 3318 0 24220 0 223002 0 0 0 GARY SKINNER DIRECTOR OF IT 162646 0 8550 0 4117 0 6606 0 11911 0 193830 0 0 0 Alice Ngorima Shawarira Clinical Charge Nurse 209496 0 0 0 186 0 316 0 0 0 209998 0 0 0 PAULETTE TANIS Clinical Charge Nurse 201714 0 0 0 2134 0 7426 0 30435 0 241709 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 First, a detailed review of the 990 is performed by management and by IU Health. Then, 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: 747301, Program Service Expense: 461085, Management and General Expenses: 286216, Fundraising Expenses: ; PHYSICIAN FEES - Total Expense: 587132, Program Service Expense: 362260, Management and General Expenses: 224872, Fundraising Expenses: ; CONSULTING - Total Expense: 114642, Program Service Expense: 70207, Management and General Expenses: 43908, Fundraising Expenses: 527; SERVICE CONTRACTS - Total Expense: 4496377, Program Service Expense: 2774265, Management and General Expenses: 1722112, Fundraising Expenses: ; COLLECTION/PT TRANSPORT - Total Expense: 245230, Program Service Expense: 151307, Management and General Expenses: 93923, 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 284054 ALLOCATION RHI FOUNDATION INC O 143514 ALLOCATION