2021-11-09T12:00:41-06:00 2020-12-31 990 2020-01-01 263162145 Indiana University Health Arnett Inc INDI 3179634842 950 N MERIDIAN STREET 300 INDIANAPOLIS IN 46204 Todd A Williams CFO 2021-11-09 Todd A Williams 999009999 2020 2022-09-23 18:48:47Z Arthur Vasquez 950 N MERIDIAN STREET 300 INDIANAPOLIS IN 46204 504155610 false X SEE SCHEDULE O X 2008 IN lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. 13 8 2626 47 888770 451350 1296595 236993 511000319 498955355 4872296 2011996 2291936 2843944 519461146 504048288 478793 507440 0 228781611 234760349 0 0 260006119 254110160 489266523 489377949 30194623 14670339 475189520 319820511 254113168 84073820 221076352 235746691 X lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. false false 465231262 507440 474532037 Indiana University Health Arnett in Lafayette, Indiana is a full-service, 191-bed hospital that includes more than 40 specialties and 23 outpatient clinics. The hospital features an adjacent outpatient surgery center, cancer center and several medical offices serving Lafayette and the surrounding counties. IU Health Arnett is a Magnet-designated hospital recognized by the American Nurses Credentialing Center for demonstrating excellence in nursing services and high-quality clinical outcomes for patients. 5626379 5902359 OUR NETWORK OF PHARMACIES OFFERS THE CONVENIENCE OF ONE-STOP SHOPPING. WE PROVIDE EXPERT CARE AND HELP PATIENTS MAKE THE BEST USE OF THEIR MEDICATIONS. 0 13519300 As of December 31, 2020, Indiana University Health Arnett, Inc. had received stimulus funds from the Provider Relief Fund under the provisions of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) and Paycheck Protection Program and Health Care Enhancement Act. Indiana University Health Arnett recognized $13,519,300 as other program service revenue. Indiana University Health Arnett, Inc. will continue to monitor compliance with the terms and conditions of the Provider Relief Fund. 4161142 4365250 IU HEALTH ARNETT PROVIDES SERVICES TO RELATED TAX-EXEMPT ORGANIZATIONS. 579040 607443 INCOME (LOSS) FROM PASS-THROUGH ENTITIES 27612 28966 RENT FROM RELATED 501(C)(3) ORGANIZATIONS 4767794 5001659 475625435 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 true false true false false false false false false false false false false false false true true true true false false true 75 0 true 2626 true true true false false false false false false false false false false false X 13 8 false false false false true true true true true false false true true true true true true false true true true IN X CRAIG J JONES 3179634842 950 N MERIDIAN STREET SUITE 300 INDIANAPOLIS IN 46204 CHRISTOPHER A MANSFIELD MD DIRECTOR/VICE CHAIR 53.0 2.0 X X 447698 0 50570 DAVID HUMMELS DIRECTOR/CHAIR (PART YEAR) 2.0 2.0 X X 4500 0 0 VICTOR L LECHTENBERG DIRECTOR/CHAIR (PART YEAR) 2.0 2.0 X X 4500 0 0 AMANDA WHITLOCK DIRECTOR 2.0 2.0 X 4500 0 0 GARY D HENRIOTT DIRECTOR 2.0 3.0 X 9000 0 0 MICHELE S SAYSANA MD DIRECTOR 2.0 53.0 X 0 439143 16802 RANDALL R MITCHELL DIRECTOR 2.0 2.0 X 13500 0 0 RANDY W PRICE DIRECTOR 2.0 2.0 X 4500 0 0 REV KATE L WALKER DIRECTOR 2.0 2.0 X 6750 0 0 ROGER G BANGS MD DIRECTOR 53.0 2.0 X 676500 0 30974 RUBAN NIRMALAN MD DIRECTOR 53.0 2.0 X 743654 0 45461 SHAN SHERIDAN DIRECTOR 2.0 2.0 X 9000 0 0 WILLIAM Y LI MD DIRECTOR 53.0 2.0 X 448109 0 49906 DANIEL E NEUFELDER REGIONAL PRESIDENT (WCR) 35.0 20.0 X 0 779105 144072 PHILIP LIST SECRETARY (WCR) 35.0 20.0 X 0 153459 15864 TODD A WILLIAMS CFO/TREASURER (WCR) 35.0 20.0 X 0 359481 51693 ALLISON SHUTTZ CNO (WCR) (PART YEAR) 35.0 20.0 X 170267 0 40730 BRIAN M WEIRICH CNO(WCR) (PART YEAR) 35.0 20.0 X 193331 0 33544 JAMES H PARSONS CHIEF PRACTICE OFFICER 55.0 0.0 X 213981 0 48261 JAMES P BIEN MD CMO (WCR) - VP QUALITY & SAFETY 35.0 20.0 X 466113 0 50679 JEFFREY C ZEH COO (WCR) 35.0 20.0 X 374172 0 18627 KOREEN C KYHNELL VP - HUMAN RESOURCES (WCR) 35.0 20.0 X 0 227983 39821 CHENG DU MD PHYSICIAN 50.0 0 X 818450 0 51227 GARRETT JACKSON MD PHYSICIAN 45.0 5.0 X 1082414 122167 26670 JOSEPH E HUBBARD MD PHY. 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CHAIRPERSON 50.0 0 X 835366 0 49899 STANTON M REGAN MD PHYSICIAN 50.0 0 X 994475 0 52459 ANDREW K EDWARDS MD FORMER OFFICER 50.0 0.0 X 412308 0 45006 BRIAN T SHOCKNEY FORMER KEY EMPLOYEE 0.0 55.0 X 0 849268 141492 CARA L BREIDSTER FORMER OFFICER 0.0 55.0 X 0 367659 44376 DEREK E EMPIE FORMER OFFICER 0.0 50.0 X 0 329087 50270 DONALD E CLAYTON MD FORMER OFFICER 50.0 0.0 X 123447 0 19966 9111940 3627353 1168484 355 true true false TRIMEDX LLC 5451 LAKEVIEW PKWY S DR INDIANAPOLIS IN 46268 CLINICAL ENGINEERING 4259041 KETTELHUT CONSTRUCTION 740 SAGAMORE PARKWAY SOUTH LAFAYETTE IN 47905 CONSTRUCTION 2432625 Hagerman Construction Corp 10315 Allisonville Road FISHERS IN 46038 Construction 1997740 BARTON ASSOCIATES INC 1029 S SOMERSET AVE INDIANAPOLIS IN 46241 CONSULTING 1449143 MEDEFIS 2121 N 117th Ave OMAHA NE 68164 VENDOR MANAGEMENT 1437383 49 0 0 0 219410 17332 251 0 236993 NET PATIENT SERVICE REVENUE 622110 474532037 474532037 0 0 SHARED SERVICES 541900 4365250 4365250 0 0 PHARMACY 446110 5902359 5516200 386159 0 INCOME (LOSS) FROM PASS-THROUGH ENTITIES 900099 607443 104832 502611 0 FEDERAL RECOVERY REVENUE 900099 13519300 13519300 0 0 28966 28966 0 0 498955355 197564 0 0 197564 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1921754 0 107322 0 1814432 1814432 0 0 1814432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CAFETERIA/FOOD SERVICE 722320 435227 0 0 435227 GIFT SHOP 453220 127278 0 0 127278 MEDICAL STAFF DUES 900099 63615 0 0 63615 2217824 0 0 2217824 2843944 504048288 498066585 888770 4855940 X 507440 507440 4158827 4037660 121167 600727 583225 17502 193146700 187518648 5628052 5765603 5597601 168002 20110595 19524597 585998 10977897 10658015 319882 38926 38926 1500 1500 14026 14026 90611781 88906824 1704957 0 26445 18581 7864 1349981 1185267 164714 1485637 1290660 194977 10912976 10910332 2644 178737 124405 54332 20143 19334 809 1328 1328 14752051 12795028 1957023 4973882 2439116 2534766 DRUGS AND MEDICAL SUPPLIES 77101649 77101649 BAD DEBT 33416211 33416211 HOSPITAL ASSESSMENT FEE 17406229 17406229 INSTITUTIONAL DUES/LICENSES 75500 75500 1743158 1506285 236873 0 489377949 475625435 13752514 0 0 0 197094235 39659283 112737 49564 62353959 58427785 0 0 0 0 985413 498092 5245655 9978597 2734835 3017867 331948978 127491178 203202719 204457800 0 3459967 3731523 0 0 475189520 319820511 45072808 65682310 0 0 209040360 18391510 254113168 84073820 X 221076352 235746691 221076352 235746691 475189520 319820511 14670339 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 14026 14026 false Schedule C, Part II-B, Line 1i OTHER ACTIVITIES IU HEALTH ARNETT PAID INSTITUTIONAL MEMBERSHIP DUES TO THE INDIANA HOSPITAL ASSOCIATION ("IHA") AND AMERICAN HOSPITAL ASSOCIATION DURING 2020 IN THE AMOUNT OF $40,434 AND $47,699 RESPECTIVELY. EACH MEMBERSHIP ORGANIZATION NOTIFIED IU HEALTH ARNETT THAT A PORTION OF THE DUES IT PAID WERE USED FOR LOBBYING PURPOSES. THE IHA USED 7.18%, OR $2,903 OF THE 2020 MEMBERSHIP DUES PAID BY IU HEALTH ARNETT, FOR LOBBYING EXPENDITURES. AMERICAN HOSPITAL ASSOCIATION USED 23.32% OR $11,123 OF 2020 MEMBERSHIP DUES PAID BY IU HEALTH ARNETT, FOR LOBBYING EXPENDITURES. 3859567 3859567 222244847 59844157 162400690 7213 7213 0 97605594 67197156 30408438 8231757 442652 7789105 204457800 INTERCOMPANY PAYABLES (NET) 14391321 DUE TO THIRD-PARTY PAYERS 2813690 SELF-INSURANCE LIABILITIES 916525 OPERATING LEASE LIABILITIES 269974 18391510 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote IU HEALTH ARNETT IS A SUBSIDIARY IN INDIANA UNIVERSITY HEALTH, INC.'S ("IU HEALTH") CONSOLIDATED AUDITED FINANCIAL STATEMENTS. The Internal Revenue Service (IRS) has determined that Indiana University Health and certain of its affiliated entities are tax-exempt organizations as defined in Section 501(c)(3) of the Internal Revenue Code (IRC). Indiana University Health and its tax-exempt affiliates are, however, subject to federal and state income taxes on unrelated business income under the provisions of IRC Section 511. Deferred income taxes that, as of December 31, 2020 and 2019, have no net carrying value reflect the net tax effect of temporary differences between the carrying amounts of assets and liabilities for financial reporting and the amounts used for income tax purposes. As of December 31, 2020 and 2019, the Indiana University Health System had gross deferred tax assets of $135,889,000 and $143,157,000 respectively, primarily relating to net operating loss carryovers. Management determined that a full valuation allowance at December 31, 2020 and 2019, was necessary to reduce the deferred tax assets to the amount that would more likely than not be realized. Based on the weight of the evidence, if it is more likely than not that some portion or all of the deferred tax assets will not be realized, a valuation allowance to reduce the deferred tax assets is recorded. The decrease in the valuation allowance for the current year was $7,264,000. At December 31, 2020, the Indiana University Health System has available net operating loss carryforwards of $546,376,000. Net operating losses generated from 2000 through 2017 will expire between 2021 and 2037. Net operating losses generated after 2017 do not expire. true true X true X 300 false true true false true true 0 18800 7573234 0 7573234 0.0166 0 34476 75713324 53935781 21777543 0.0478 0 0 0 0 0 0.0 0 53276 83286558 53935781 29350777 0.0644 7 6797 1724201 1700 1722501 0.0038 1 0 2685701 817790 1867911 0.0041 1 207421 95584782 82553426 13031356 0.0286 1 33 219589 0 219589 0.0005 2 300 528164 72459 455705 0.0010 12 214551 100742437 83445375 17297062 0.0379 12 267827 184028995 137381156 46647839 0.1023 0 0.0 0 0.0 1 10069 10069 0.0000 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0 10069 0 10069 0.0000 false 8828563 69447818 82824551 -13376733 X true true 1 1 IU HEALTH ARNETT HOSPITAL 5165 MCCARTY LANE LAFAYETTE IN 47905 HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-ARNETT-HOSPITAL 22-011506-1 X X X X X IU HEALTH ARNETT HOSPITAL 1 false false true X X X X X X X X X 18 true false false true X HTTPS://IUHEALTH.ORG/IN-THE-COMMUNITY/COMMUNITY-BENEFIT true 19 true HTTPS://IUHEALTH.ORG/IN-THE-COMMUNITY/COMMUNITY-BENEFIT false true X 300.0 0.0 X X X X X X X true true X X X true X HTTPS://IUHEALTH.ORG/PAY-A-BILL/FINANCIAL-ASSISTANCE X HTTPS://IUHEALTH.ORG/PAY-A-BILL/FINANCIAL-ASSISTANCE X HTTPS://IUHEALTH.ORG/PAY-A-BILL/FINANCIAL-ASSISTANCE X 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 IU HEALTH ARNETT'S 2018 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT INCLUDES A PRIORITIZED DESCRIPTION OF SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY. THE CHNA REPORT IDENTIFIED THE FOLLOWING SEVEN NEEDS AS PRIORITIES FOR IU HEALTH ARNETT - ACCESS TO HEALTH CARE SERVICES - DRUG AND SUBSTANCE ABUSE - HEALTH CARE AND SOCIAL SERVICES FOR SENIORS - MENTAL HEALTH - OBESITY AND DIABETES - SMOKING - SOCIAL DETERMINANTS OF HEALTH Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - IU HEALTH ARNETT HOSPITAL. IN CONDUCTING ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") IU HEALTH ARNETT HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITIES IT SERVES. PRIMARY DATA WERE GATHERED IN THREE WAYS: COMMUNITY MEETINGS, KEY STAKEHOLDER INTERVIEWS, AND A COMMUNITY SURVEY. FOR PURPOSES OF THIS CHNA, IU HEALTH ARNETT HOSPITAL'S COMMUNITY IS DEFINED AS BENTON, CARROLL, AND TIPPECANOE COUNTIES, INDIANA. THESE THREE COUNTIES ACCOUNTED FOR OVER 67 PERCENT OF THE HOSPITAL'S INPATIENT CASES IN 2016. COMMUNITY MEETINGS - TIPPECANOE COUNTY ON MAY 8, 2018, A MEETING OF COMMUNITY REPRESENTATIVES WAS HELD AT IU HEALTH ARNETT HOSPITAL IN LAFAYETTE, THE COUNTY SEAT OF TIPPECANOE COUNTY. THE MEETING WAS ATTENDED BY 22 COMMUNITY MEMBERS INVITED BY IU HEALTH BECAUSE THEY REPRESENT IMPORTANT COMMUNITY ORGANIZATIONS AND SECTORS SUCH AS: LOCAL HEALTH DEPARTMENTS, NON-PROFIT ORGANIZATIONS, LOCAL BUSINESSES, HEALTH CARE PROVIDERS, LOCAL POLICYMAKERS, PARKS AND RECREATION DEPARTMENTS, AND SCHOOLS. THROUGH THIS MEETING, IU HEALTH SOUGHT A BREADTH OF PERSPECTIVES ON THE COMMUNITY'S HEALTH NEEDS. THE SPECIFIC ORGANIZATIONS REPRESENTED AT THE MEETING ARE LISTED BELOW. - CITY OF LAFAYETTE - FOOD FINDERS FOOD BANK - HANNA COMMUNITY CENTER - HEARTFORD HOUSE CHILD ADVOCACY CENTER - HENRIOTT GROUP, INC. - IU HEALTH - IU HEALTH ARNETT HOSPITAL - IU HEALTH WEST CENTRAL REGION - LTHC HOMELESS SERVICES - LAFAYETTE FAMILY YMCA - NORTH CENTRAL HEALTH SERVICES - PURDUE EXTENSION - RIGGS COMMUNITY HEALTH CENTER - SYCAMORE SPRINGS - TIPPECANOE ARTS FEDERATION - TIPPECANOE COUNTY CASA - TIPPECANOE COUNTY - TIPPECANOE HEALTH DEPARTMENT - UNITED WAY OF GREATER LAFAYETTE - YWCA GREATER LAFAYETTE - YWCA FOUNDATION THE MEETING BEGAN WITH A PRESENTATION THAT DISCUSSED THE GOALS AND STATUS OF THE CHNA PROCESS AND THE PURPOSE OF THE COMMUNITY MEETING. THEN, SECONDARY DATA WERE PRESENTED, ALONG WITH A SUMMARY OF THE MOST UNFAVORABLE COMMUNITY HEALTH INDICATORS. FOR TIPPECANOE COUNTY, THOSE INDICATORS WERE (IN ALPHABETICAL ORDER): - CANCER INCIDENCE AND MORTALITY - DIABETES - PHYSICAL INACTIVITY AND ACCESS TO EXERCISE OPPORTUNITIES - PHYSICALLY AND MENTALLY UNHEALTHY DAYS - PREVENTABLE HOSPITAL STAYS - SEXUALLY TRANSMITTED DISEASES - SMOKING, INCLUDING DURING PREGNANCY - SUPPLY OF PRIMARY CARE PHYSICIANS AND MENTAL HEALTH PROVIDERS PARTICIPANTS THEN WERE ASKED TO DISCUSS WHETHER THE IDENTIFIED, UNFAVORABLE INDICATORS ACCURATELY IDENTIFIED THE MOST SIGNIFICANT COMMUNITY HEALTH ISSUES AND WERE ENCOURAGED TO ADD ISSUES THAT THEY BELIEVED WERE SIGNIFICANT. SEVERAL ISSUES WERE ADDED, SUCH AS: OPIOID ABUSE, THE NUMBER OF UNINSURED, CHILDHOOD TRAUMA, AND SUICIDE. OBESITY WAS ADDED AS A FACTOR THAT CONTRIBUTES TO DIABETES. DURING THE MEETING, A RANGE OF OTHER TOPICS WAS DISCUSSED, INCLUDING: - ACCESS TO HEALTHY FOOD - SUICIDE (NOT RELATED TO OVERDOSES) AMONG THE YOUNGER POPULATION - TEEN PREGNANCY - SCREEN TIME - PURDUE UNIVERSITY STUDENTS CONTRIBUTING TO THE POVERTY RATE AFTER DISCUSSING THE NEEDS IDENTIFIED THROUGH SECONDARY DATA AND ADDING OTHERS TO THE LIST, EACH PARTICIPANT WAS ASKED THROUGH A VOTING PROCESS TO IDENTIFY "THREE TO FIVE" THEY CONSIDER TO BE MOST SIGNIFICANT. FROM THIS PROCESS, THE GROUP IDENTIFIED THE FOLLOWING NEEDS AS MOST SIGNIFICANT IN TIPPECANOE COUNTY: - DIABETES AND OBESITY - OPIOID ABUSE - SUPPLY OF PRIMARY CARE PHYSICIANS - SUPPLY OF MENTAL HEALTH PROVIDERS THE GROUP DECIDED IT WOULD BE BEST TO SPLIT THE SUPPLY OF PRIMARY CARE PHYSICIANS AND THE SUPPLY OF MENTAL HEALTH PROVIDERS INTO TWO DISTINCT NEEDS. COMMUNITY MEETINGS - CARROLL COUNTY ON APRIL 16, 2018, A MEETING OF COMMUNITY REPRESENTATIVES WAS HELD AT WABASH & ERIE CANAL CONFERENCE CENTER IN DELPHI, THE COUNTY SEAT OF CARROLL COUNTY. THE MEETING WAS ATTENDED BY 12 COMMUNITY MEMBERS INVITED BY IU HEALTH BECAUSE THEY REPRESENT IMPORTANT COMMUNITY ORGANIZATIONS AND SECTORS SUCH AS: NON-PROFIT ORGANIZATIONS, LOCAL BUSINESS, HEALTH CARE PROVIDERS, LOCAL POLICYMAKERS, AND SCHOOLS. THROUGH THIS MEETING, IU HEALTH SOUGHT A BREADTH OF PERSPECTIVES ON THE COMMUNITY'S HEALTH NEEDS. THE SPECIFIC ORGANIZATIONS REPRESENTED AT THE MEETING ARE LISTED BELOW. - CARROLL COUNTY CHAMBER OF COMMERCE - CARROLL COUNTY COUNCIL - CARROLL WHITE RURAL ELECTRIC MEMBERSHIP CORPORATION (REMC) - DELPHI COMMUNITY ELEMENTARY SCHOOL - FAMILY HEALTH CLINICS (NORTH CENTRAL NURSING CLINICS) - IU HEALTH ARNETT HOSPITAL - IU HEALTH WEST CENTRAL REGION - NORTH CENTRAL HEALTH SERVICES THE MEETING BEGAN WITH A PRESENTATION THAT DISCUSSED THE GOALS AND STATUS OF THE CHNA PROCESS AND THE PURPOSE OF THE COMMUNITY MEETING. THEN, SECONDARY DATA WERE PRESENTED, ALONG WITH A SUMMARY OF THE MOST UNFAVORABLE COMMUNITY HEALTH INDICATORS. FOR CARROLL COUNTY, THOSE INDICATORS WERE (IN ALPHABETICAL ORDER): - CANCER INCIDENCE AND MORTALITY - DIABETES - PHYSICAL INACTIVITY AND ACCESS TO EXERCISE OPPORTUNITIES - PHYSICALLY AND MENTALLY UNHEALTHY DAYS - PREVENTABLE HOSPITAL STAYS - SEXUALLY TRANSMITTED DISEASES - SMOKING, INCLUDING DURING PREGNANCY - SUPPLY OF PRIMARY CARE PHYSICIANS AND MENTAL HEALTH PROVIDERS PARTICIPANTS THEN WERE ASKED TO DISCUSS WHETHER THE IDENTIFIED, UNFAVORABLE INDICATORS ACCURATELY IDENTIFIED THE MOST SIGNIFICANT COMMUNITY HEALTH ISSUES AND WERE ENCOURAGED TO ADD ISSUES THAT THEY BELIEVED WERE SIGNIFICANT. SEVERAL ISSUES WERE ADDED, SUCH AS: OPIOID USE, PHARMACY CARE, AND URGENT/EMERGENCY CARE. DURING THE MEETING, A RANGE OF OTHER TOPICS WAS DISCUSSED, INCLUDING: - CHILDREN/YOUTH - FOLLOW UP CARE - PHARMACY ACCESS - TRANSPORTATION AFTER DISCUSSING THE NEEDS IDENTIFIED THROUGH SECONDARY DATA AND ADDING OTHERS TO THE LIST, EACH PARTICIPANT WAS ASKED THROUGH A VOTING PROCESS TO IDENTIFY "THREE TO FIVE" THEY CONSIDER TO BE MOST SIGNIFICANT. FROM THIS PROCESS, THE GROUP IDENTIFIED THE FOLLOWING NEEDS AS MOST SIGNIFICANT FOR CARROLL COUNTY: - SUPPLY OF PRIMARY CARE PHYSICIANS AND MENTAL HEALTH PROVIDERS - PHYSICAL INACTIVITY AND ACCESS TO EXERCISE OPPORTUNITIES - OPIOID USE - URGENT/EMERGENCY CARE - PHYSICALLY AND MENTALLY UNHEALTHY DAYS - PHARMACY CARE - CANCER INCIDENCE AND MORTALITY - DIABETES KEY STAKEHOLDER INTERVIEWS: AN INTERVIEW WAS CONDUCTED WITH A REPRESENTATIVE FROM THE BENTON COUNTY HEALTH DEPARTMENT, AND THE FEEDBACK WAS CONSISTENT WITH THE INPUT RECEIVED DURING THE COMMUNITY MEETINGS. AN INTERVIEW WAS CONDUCTED WITH A REPRESENTATIVE OF THE TIPPECANOE COUNTY HEALTH DEPARTMENT. THE INTERVIEW WAS CONDUCTED TO ASSURE THAT APPROPRIATE AND ADDITIONAL INPUT WAS RECEIVED FROM A GOVERNMENTAL PUBLIC HEALTH OFFICIAL. THE INDIVIDUAL THAT WAS INTERVIEWED FOR TIPPECANOE COUNTY PARTICIPATED IN THE COMMUNITY MEETING. ACCORDINGLY, THE RESULTS OF THE COMMUNITY MEETING WERE DISCUSSED AND INSIGHTS WERE SOUGHT REGARDING SIGNIFICANT COMMUNITY HEALTH NEEDS, WHY SUCH NEEDS ARE PRESENT, AND HOW THEY CAN BE ADDRESSED. THE INTERVIEW WAS GUIDED BY A STRUCTURED PROTOCOL THAT FOCUSED ON OPINIONS REGARDING SIGNIFICANT COMMUNITY HEALTH NEEDS, DESCRIBING WHY SUCH NEEDS ARE PRESENT, AND SEEKING IDEAS FOR HOW TO ADDRESS THEM. THE INTERVIEWEE CONFIRMED THAT THE FOUR NEEDS IDENTIFIED BY THE COMMUNITY MEETING PARTICIPANTS WERE SIGNIFICANT, ADDING THAT ALL FOUR RANK FAIRLY EVENLY IN TERMS OF THEIR PREVALENCE AND SIGNIFICANCE. THESE FOUR NEEDS WERE: - DIABETES AND OBESITY - OPIOID ABUSE - SUPPLY OF PRIMARY CARE PHYSICIANS - SUPPLY OF MENTAL HEALTH PROVIDERS "DIABETES AND OBESITY" WAS IDENTIFIED AS PARTICULARLY PREVALENT IN LOW INCOME POPULATIONS WHO STRUGGLE TO AFFORD AND ACCESS HEALTHY FOODS. THE SHORTAGE OF PRIMARY CARE AND MENTAL HEALTH PROVIDERS IS "REAL" AND IS MADE MORE CHALLENGING BECAUSE EXISTING PROFESSIONALS TYPICALLY ONLY ARE AVAILABLE TO PATIENTS DURING BUSINESS HOURS. THE SUPPLY OF MENTAL HEALTH PROVIDERS CONTRIBUTES TO OPIOID ABUSE, BECAUSE THOSE UNABLE TO ACCESS MENTAL HEALTH SERVICES MAY BE SELF-MEDICATING. HOMELESSNESS ALSO WAS DESCRIBED AS A CONTRIBUTING FACTOR TO SUBSTANCE ABUSE. MANY RECOVERING OR SUFFERING FROM ADDICTION HAVE TROUBLE FINDING STABLE HOUSING, LEADING TO CONTINUED DRUG ABUSE. AFFORDABLE HOUSING FOR LOW INCOME AND SECTION 8 RESIDENTS IS NEEDED. MANY RESIDENTS ARE UNINSURED OR UNDERINSURED, LEADING TO INADEQUATE ACCESS TO CARE. FOR UNDERINSURED INDIVIDUALS, MANY PROVIDERS ARE OUT OF NETWORK, PRESENTING SIGNIFICANT ACCESS BARRIERS. MANY COMMUNITY RESIDENTS DO NOT OWN CARS. A LACK OF TRANSPORTATION OPTIONS PRESENTS ANOTHER BARRIER TO ACCESSING CARE. BRINGING HEALTH SERVICES TO PEOPLE IN THEIR HOMES WOULD BE HELPFUL. DUE TO INADEQUATE ACCESS TO PRIMARY CARE, MANY USE EMERGENCY DEPARTMENTS FOR BASIC HEALTH CARE SERVICE. THIS IS PARTICULARLY TRUE FOR LOW INCOME RESIDENTS WHO, AT THE END OF THE MONTH, EXHAUST THEIR FOOD, MEDICATION, AND OTHER BASIC-NEEDS ASSISTANCE. Schedule H, Part V, Section B, Line 5 Facility , 2 Facility , 2 - IU HEALTH ARNETT HOSPITAL (CONT). PROGRAMS THAT SEEK TO IMPROVE THE HEALTH OF LOW INCOME POPULATIONS WOULD ENHANCE JOB RETENTION, EDUCATION LEVELS, AND HOUSING STABILITY. MATERNAL AND CHILD HEALTH SERVICES ALSO ARE NEEDED. PREGNANT WOMEN IN TIPPECANOE COUNTY (AND INDIANA IN GENERAL) LACK ACCESS TO PRENATAL SERVICES. BIRTH CONTROL ALSO IS DIFFICULT TO ACCESS FOR MANY RESIDENTS. COMMUNITY SURVEY TO INFORM THE CHNA, A COMMUNITY SURVEY WAS CONDUCTED BY THE INDIANA HOSPITAL COLLABORATIVE. ACROSS INDIANA, 9,161 COMPLETED QUESTIONNAIRES WERE RECEIVED BY ALL PARTICIPATING HOSPITALS IN THE INDIANA HOSPITAL COLLABORATIVE, FOR AN OVERALL RESPONSE RATE OF 11.6 PERCENT; 5,030 QUESTIONNAIRES WERE RECEIVED FROM THE 17 INDIANA COUNTIES SERVED BY ONE OR MORE IU HEALTH HOSPITALS. FOR IU HEALTH ARNETT HOSPITAL, SURVEYS WERE RECEIVED FROM 861 COMMUNITY HOUSEHOLDS. ACCORDING TO THE RESPONSES, THESE HOUSEHOLDS INCLUDED 1,595 ADULTS. THE COMMUNITY SURVEY INDICATES THAT SUBSTANCE ABUSE, OBESITY, MENTAL HEALTH, CHRONIC DISEASES, AND POVERTY REPRESENT TOP CONCERNS IN THE COMMUNITY SERVED BY IU HEALTH ARNETT HOSPITAL. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - IU HEALTH ARNETT HOSPITAL. In conjunction with the CHNA, IU Health Arnett's Board adopted an implementation strategy in April 2019 related to the 2018 CHNA. IU Health Arnett prioritized and determined which of the community health needs identified in its most recently conducted CHNA were most critical for it to address. IU Health Arnett will address the following community health needs between 2019 and 2021: - Access to Healthcare Services - Behavioral Health - Drug and Substance Abuse (including Opioids, Alcohol and Tobacco) - Healthcare and Social Services for Seniors - Behavioral Health - Mental Health IU Health uses the term "Behavioral Health" to refer to Mental Health and Drug and Substance Abuse (including Opioids and Alcohol). Access to Healthcare IU Health Arnett's implementation strategy to address the identified need of Access to Healthcare includes the following: - Provide scholarships for the Purdue University behavioral health nurse practitioner program. - IU Health funding supported 4 scholarships to the BHNPP at Purdue University - Support telemedicine virtual visits with primary care physicians and behavioral health specialists. - Expand virtual peer recovery coaches - Continue/expand quick response team (QRT)/paramedicine model. - Provide funding to support recovery coach and certified recovery specialist training. - Support youth career events and organizations. - IU Health is the healthcare sponsor for Junior Achievement's BizTown - Execute IU Health's five-year recruitment plan. - Explore the option to become a National Health Service Corps Site - IU Health Arnett is not eligible. - Provide windshield tours for physician recruits. -None needed - Provide internships and onsite/offsite learning opportunities for future professionals. - IU Health Arnett Family Medicine Residency Program consists of annual cohorts of 5 residents. Pharmacy provided over 300 student contact hours along with more than $2 million in overall health professional education investment Behavioral Health (includes Drug & Substance Abuse and Mental Health) IU Health Arnett's implementation strategy to address the identified need of Behavioral Health includes the following: - Create support groups for parents, families and those struggling with behavioral health issues. - Support the Mental Health America Crisis Center. - IU Health partnered with Mental Health America on numerous initiatives, including the Crisis Center, by providing $40,000 in funding during 2020. - Support local schools on North Central Health Services Youth Resilience grant project. - IU Health provided $2,500 in grants to 2 local school corporations to provide additional professional development to staff, students and parents to increase resiliency. - Support integrated care programs. - Support Willowstone Active Parenting classes. - Willowstone Family Services received $4,500 to support Active Parenting classes, in which 27 families consisting of 35 parents of 63 children enrolled in programming. - Provide health insurance navigation. - Provide behavioral health navigation services. - Provide trainings to hospital staff and community members (Question, Persuade, Refer (QPR) training, Mental Health First Aid, Applied Suicide Intervention Skills Training (ASIST), etc.). - Create/support awareness campaigns or events. - Increase youth education programs to prevent substance use. - Encourage proper storage and safe disposal of prescription medication through participation in drug take-back activities. - IU Health Arnett Retail Pharmacy partnered with Purdue University's BoilerWoRx program to distribute Deterra medication disposal packets to patients. Hundreds of the packets were distributed in 2020. The pharmacy also has a medication disposal box for community members to drop off unwanted medications for safe disposal. - Support opportunities for physician training and continuing education on substance use disorders (SUD). - Support community naloxone training. - Increase the number of trained peer recovery coaches and certified recovery specialists. - Support existing and research expansion of Quick Response Team (QRT)/community paramedicine programs. - IU Health referred fewer than 10 patients to the QRT during 2020. - Refer patients to local treatment facilities. - Accept primary care provider patients from local treatment facilities. - Create/support local support groups. - Support tobacco cessation program. - IU Health Arnett hosted limited tobacco cessation programs in 2020.COVID-19 impacted the in-person classes and virtual classes were not very well attended. - Support recovery housing options. - Support Recovery Cafe model. - Recovery Cafe Lafayette opened in 2019. - IU Health COE provided $4,650 in funding to support peer recovery coach training. - Collaborate with local initiatives. - IU Health team members participate in the Tippecanoe Resilience and Recovery Network, formerly the Tippecanoe Opioid Task Force, with representation on the prevention workgroup. Healthcare and Social Services for Seniors IU Health Arnett's implementation strategy to address the identified need of Healthcare and Social Services for Seniors include the following: - Provide insurance navigation for seniors. - Support Food Finders Senior Shopping Day. - Continue Meals on Wheels program. - IU Health Arnett Hospital prepares and packages meals for the Lafayette Meals on Wheels program. In June 2020, the program left the IU Health Arnett facility and went to a different location. In 2020, IU Health Arnett prepared 300 meals each day. - Support organizations that provide programming or services to seniors. - Participate in senior outreach activities (Senior Games, Lafayette Senior Expo, and Area IV walking groups).All of the outreach activities were canceled in 2020 due to COVID-19. - Support Senior Wellness Center Activities (Tai Chi, etc.) - Support the "Stepping On" classes (fall prevention). - IU Health Arnett Trauma Services canceled the Stepping on Classes due to COVID-19 restrictions. Smoking IU Health Arnett's implementation strategy to address the identified need of Smoking includes the following: - To help address needs associated with smoking and tobacco use, IU Health Arnett partnered with the Lafayette School Corporation DARE, granting them $2,000 to purchase the workbooks for the 1,500 middle schoolers going through the program. IU Health Arnett is unable to address those community health needs that do not relate directly to the Hospital's mission to deliver healthcare. These are needs that other governmental agencies and/or community organizations have the most appropriate expertise and resources to address. IU Health Arnett is unable to address the following community health needs identified in the 2018 Community Health Needs Assessment: Maternal and Child Health The Nurse Family Partnership provides in-home services to qualifying families. Healthy Communities of Clinton County Coalition offers numerous health services to new and expecting mothers. IU Health Arnett provides maternity services in the region, as well as post-partum and breastfeeding support groups for new mothers. As a system, IU Health is addressing maternal and child health by focusing on infant mortality, creating a system-wide collaborative to focus on this issue. Obesity and Diabetes IU Health Arnett focused on obesity prevention as one of the priority health needs from 2015-2018. The hospital supported many activities in the community. However, during the 2018 community health needs assessment, other needs arose as more necessary to address. There are other community resources that continue to address obesity and diabetes, including Healthy Active Tippecanoe. The hospital provides diabetes education programs. The local YMCA provides a Diabetes Prevention Program. Purdue Extension is another community resource that addresses obesity and diabetes. IU Health team members will continue to participate in the Healthy Active Tippecanoe, which addresses healthy eating and active living. Social Determinants of Health Many of the strategies will indirectly address various social determinants of health. IU Health team members often serve on agency boards or participate in local coalitions addressing the social determinants of health. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - IU HEALTH ARNETT HOSPITAL. IN ADDITION TO FPG, IU HEALTH ARNETT MAY TAKE INTO CONSIDERATION A PATIENT'S INCOME AND/OR ABILITY TO PAY IN CALCULATION OF A FINANCIAL ASSISTANCE AWARD. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - IU HEALTH ARNETT HOSPITAL. IU Health Arnett takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. Eligibility for Financial Assistance due to Financial or Personal Hardship In order to be eligible for Financial Assistance due to Financial or Personal Hardship under this Policy, a patient or guarantor must: - Submit a completed Financial Assistance Application with all supporting documentation and be approved in accordance with this Policy; - Be an Indiana Resident as defined in this Policy; and - If Uninsured, consult with a member of IU Health's Individual Solutions department to determine if health care coverage may be obtained from a government insurance or assistance product, the Health Insurance Marketplace, or from any other source of coverage. Financial Assistance due to Financial Hardship is only available for encounters where care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility. 2. Financial Assistance due to Financial Hardship The FPL income threshold under this section is as follows: - If one or more adults and zero dependents are in the household, the FPL Income Threshold is 200%. - If two or more adults and one or more dependents are in the household, the FPL Income Threshold is 250%. - If one adult and one or more dependents are in the household, the FPL Income Threshold is 300%. In some instances, an adult will also qualify as a dependent. When this occurs, IU Health Arnett will treat the adult as a dependent for purposes of the FPL calculation. IU Health Arnett will utilize the most recent FPL data available and will apply the FPL data to a patient or guarantor's account balance based upon the calendar date a completed Financial Assistance Application was received, not a patient's date of service. An Uninsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Gross Charges if approved. An Underinsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Patient Responsibility if approved. 3. Financial Assistance due to Personal Hardship An Uninsured or Underinsured patient or their guarantor whose household income is above the FPL income threshold may be eligible for Financial Assistance if the patient's outstanding Patient Responsibility exceeds 20% of the patient's or their guarantor's annual household income. - If approved, the patient's balance will be reduced to 20% of the patient or guarantor's annual household income or the Amounts Generally Billed, whichever is less. - IU Health will work with the patient or guarantor to identify a reasonable payment plan on the remainder of the balance. 4. Eligibility Period If approved for financial assistance by IU Health Arnett, the patient will be guaranteed financial assistance for treatment related to the underlying condition, for which the patient was originally screened and approved, through the remainder of the calendar year. As a condition of extending the on-going Financial Assistance, the patient must comply with requests from IU Health to verify that the patient continues to meet the conditions for qualification. 5. Appeals and Assistance Granted By the Financial Assistance Committee The Financial Assistance Committee will review and make determinations on all requests for appeals related to Financial Assistance. If a patient or guarantor seeks to appeal a Financial Assistance Determination, a written request must be submitted, along with the supporting documentation. The Financial Assistance Committee will review requests for and may grant additional Financial Assistance, including but not limited to, the following: - Assistance to patients who are seeking treatment that can only be provided in Indiana by IU Health or who would benefit from continued medical services from IU Health for continuity of care; - Care approved by the IU Health Chief Medical Officer (CMO) or the Chief Executive Officer (CEO) or CMO of an IU Health facility or region, including medically necessary non-elective services for which no payment source can be identified; - Care provided when it is known no payment source exists; - International humanitarian aid; and - Other care identified by the Financial Assistance Committee that fulfills the IU Health Mission. All decisions of the Financial Assistance Committee are final. 6. Presumptive Eligibility No Financial Assistance Application is required to receive Financial Assistance under this Presumptive Eligibility section. IU Health Arnett will deem patients or their guarantors presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs and care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility: - Medicaid (any state) - Indiana Children's Special Health Care Services - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. IU Health Arnett will conduct a quarterly review of all accounts placed with a collection agency partner for at least one hundred and twenty (120) days after the account is eligible for an ECA as set forth in this Policy. If the patient or guarantor's individual scoring criteria demonstrates the patient has a low likelihood and/or propensity to pay or no credit, the patient or guarantor may be deemed presumptively eligible for Financial Assistance. Financial Assistance may additionally be granted in the following circumstances: - If the patient or their guarantor is found to have filed a petition for bankruptcy. - If the patient is deceased and found to have no estate. - If the patient is deceased and was under 21 years of age at the time of death. 7. Exhaustion of Alternate Sources of Assistance Patients must exhaust all other state and federal assistance programs prior to receiving Financial Assistance due to Financial or Personal Hardship under this Policy including, but not limited to, Medicaid. Patients who may be eligible for coverage under an applicable health insurance policy must exhaust all insurance benefits. - This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. - IU Health may request patients show proof that such a claim was properly submitted to the appropriate insurance provider before awarding Financial Assistance. Eligible patients who receive medical care from an IU Health facility as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award. In the event Financial Assistance has already been granted in the above circumstances, IU Health reserves the right to reverse the Financial Assistance Determination in an amount equal to the amount IU Health would be entitled to receive had no Financial Assistance been awarded. 8. Patient Assets There are situations where a patient or their guarantor may have significant income or assets available to pay for healthcare services such as a legal settlement. The Financial Assistance Committee may evaluate the income or assets in determining Financial Hardship. IU Health Arnett may require a list of all property owned by the patient or guarantor and adjust a Financial Assistance Determination as a result. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - IU HEALTH ARNETT HOSPITAL. IU Health Arnett takes several other measures to broadly publicize its FAP within the community. These measures include the following: 1. Post this Policy, a Plain Language Summary of this Policy, and the Financial Assistance Application on its website. 2. Provide patients with a Plain Language Summary of this Policy during registration and/or discharge. 3. Post conspicuous displays in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 4. Include a conspicuous written notice on all patient post-discharge billing statements notifying the patient about this Policy and the telephone number of the Customer Service Department which can assist patients with questions regarding this Policy. 5. Make available Customer Service representatives via telephone during normal business hours. 6. Mail copies of this Policy, a Plain Language Summary of this Policy, and a Financial Assistance Application to patients or their guarantor free of charge upon request. 7. Broadly communicate this Policy as a part of its general outreach efforts. 8. Educate patient-facing team members on this Policy and the process for referring patients to the program. 45 IU HEALTH ARNETT HOSP OUTPAT SURG CTR 1327 S 500 E LAFAYETTE IN 47905 DIAGNOSTIC AND OTHER OUTPATIENT IUH ARNETT MOB - ONSITE 5177 MCCARTY LANE LAFAYETTE IN 47905 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH ARNETT CARDIOLOGY 5175 McCarty Lane LAFAYETTE IN 47905 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH ARNETT HOSPITAL SLEEP CENTER 3900 MCCARTY LANE STE 101 LAFAYETTE IN 47905 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH ARNETT MED OFFICES -FERRY ST 2600 FERRY ST LAFAYETTE IN 47904 DIAGNOSTIC AND OTHER OUTPATIENT ARNETT RETAIL PHARMACY 2600 GREENBUSH ST LAFAYETTE IN 47904 PHARMACY IUH ARNETT MED OFFICES - GREENBUSH ST 2600 GREENBUSH ST LAFAYETTE IN 47905 DIAGNOSTIC AND OTHER OUTPATIENT DSI LAFAYETTE DIALYSIS 915 MEZZANINE DR LAFAYETTE IN 47905 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH ARNETT NEPHROLOGY 915 MEZZANINE DR LAFAYETTE IN 47905 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH ARNETT MED OFFICE - OTTERBEIN 407 N MEADOW ST OTTERBEIN IN 47970 DIAGNOSTIC AND OTHER OUTPATIENT IUH ARNETT MED OFFICES - W LAFAYETTE 253 SAGAMORE PKWY W WEST LAFAYETTE IN 47906 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH ARNETT FAMILY MEDICINE 2800 FERRY ST LAFAYETTE IN 47904 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH ARNETT PHYSICIANS CANCER SERV 720 S 6TH ST MONTICELLO IN 47960 SPECIALTY CARE IU HEALTH ARNETT PHYSICIANS CANCER SERV 420 N 26TH ST LAFAYETTE IN 47904 SPECIALTY CARE IU HEALTH ARNETT RETAIL PHARMACY 5165 MCCARTY LN ENTRANCE 4 LAFAYETTE IN 47905 PHARMACY IU HEALTH ARNETT MEDICAL OFFICE - DELPHI 651 ARMORY ROAD DELPHI IN 46923 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH ARNETT MED OFF - LAFAYETTE 1 WALTER SCHOLER DR LAFAYETTE IN 47909 DIAGNOSTIC AND OTHER OUTPATIENT IUH ARNETT OCCUPATIONAL HEALTH SERVICES 2600 GREENBUSH ST LAFAYETTE IN 47905 DIAGNOSTIC AND OTHER OUTPATIENT IUH ARNETT OUTPATIENT SURGERY CENTER 1327 VETERANS MEMORIAL PKWY E LAFAYETTE IN 47905 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH ARNETT PAIN MEDICINE 415 N 26TH ST STE 202 LAFAYETTE IN 47904 DIAGNOSTIC AND OTHER OUTPATIENT IUH ARNETT URGENT CARE - W LAFAYETTE 253 SAGAMORE PKWY W WEST LAFAYETTE IN 47906 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH ARNETT MCCARTY PHARMACY 5165 MCCARTY LN RM AG320 LAFAYETTE IN 47905 PHARMACY IU HEALTH ARNETT PHYSICIANS FAMILY MED 810 S SIXTH ST MONTICELLO IN 47960 PRIMARY CARE IU HEALTH ARNETT PHYSICIANS GEN SURGERY 810 S SIXTH ST MONTICELLO IN 47960 SPECIALTY CARE IU HEALTH ARNETT PHYSICIANS CARDIOLOGY 810 S SIXTH ST MONTICELLO IN 47960 SPECIALTY CARE IU HEALTH ARNETT PHYSICIANS NEPHROLOGY 810 S SIXTH ST MONTICELLO IN 47960 SPECIALTY CARE IUH ARNETT PHYS ORTHO & SPORTS MED 810 S SIXTH ST MONTICELLO IN 47960 SPECIALTY CARE IUH ARNETT PHYS PRIMARY CARE WALK-IN 810 S SIXTH ST MONTICELLO IN 47960 PRIMARY CARE IUH ARNETT PHYSICIANS WOMEN'S HEALTH 810 S SIXTH ST MONTICELLO IN 47960 SPECIALTY CARE RILEY PHYSICIANS AT IU HEALTH ARNETT 810 S SIXTH ST MONTICELLO IN 47960 SPECIALTY CARE IU HEALTH ARNETT PHYSICIANS GEN SURGERY 1458 S JACKSON ST SUITE A FRANKFORT IN 46041 SPECIALTY CARE IU HEALTH ARNETT OBGYN 550 S HOKE AVE FRANKFORT IN 46041 SPECIALTY CARE IU HEALTH ARNETT PHYSICIANS CANCER SERV 550 S HOKE AVE FRANKFORT IN 46041 SPECIALTY CARE IU HEALTH ARNETT PHYSICIANS FAMILY MED 550 S HOKE AVE FRANKFORT IN 46041 PRIMARY CARE IUH ARNETT PHYSICIANS INTERNAL MED & PED 550 S HOKE AVE FRANKFORT IN 46041 PRIMARY CARE IU HEALTH ARNETT PHYSICIANS NEPHROLOGY 550 S HOKE AVE FRANKFORT IN 46041 SPECIALTY CARE IUH ARNETT PHYS ORTHO & SPORTS MED 550 S HOKE AVE FRANKFORT IN 46041 SPECIALTY CARE IUH ARNETT PHYSICIANS ANESTHESIOLOGY 1300 S JACKSON ST FRANKFORT IN 46041 SPECIALTY CARE IUH ARNETT PHYSICIANS GASTROENTEROLOGY 1300 S JACKSON ST FRANKFORT IN 46041 SPECIALTY CARE IU HEALTH ARNETT PHYSICIANS RADIOLOGY 1300 S JACKSON ST FRANKFORT IN 46041 RADIOLOGY IU HEALTH ARNETT PAIN MGMT-FRANKFORT 1458 S JACKSON ST FRANKFORT IN 46041 SPECIALTY CARE IU HEALTH ARNETT CARDIOLOGY 1458 S JACKSON ST FRANKFORT IN 46041 SPECIALTY CARE IUH ARNETT PHYSICIAN MEDICAL WEIGHT LOSS 1458 S JACKSON ST FRANKFORT IN 46041 SPECIALTY CARE IUH ARNETT PHYSICIANS ALLERGY & ASTHMA 1458 S JACKSON ST FRANKFORT IN 46041 SPECIALTY CARE Schedule H, Part I, Line 6a C.B. REPORT PREPARED BY A RELATED ORG. IU HEALTH ARNETT'S COMMUNITY BENEFIT AND OTHER INVESTMENTS, ENCOMPASSING ITS TOTAL COMMUNITY INVESTMENT, ARE INCLUDED IN THE IU HEALTH COMMUNITY BENEFIT REPORT WHICH IS PREPARED ON BEHALF OF AND INCLUDES IU HEALTH AND ITS RELATED HOSPITAL ENTITIES IN THE STATE OF INDIANA. THE IU HEALTH COMMUNITY BENEFIT REPORT IS MADE AVAILABLE TO THE PUBLIC ON IU HEALTH'S WEBSITE AT HTTPS://IUHEALTH.ORG/IN-THE-COMMUNITY/COMMUNITY-BENEFIT. THE IU HEALTH COMMUNITY BENEFIT REPORT IS ALSO DISTRIBUTED TO NUMEROUS KEY ORGANIZATIONS THROUGHOUT THE STATE OF INDIANA IN ORDER TO BROADLY SHARE THE IU HEALTH STATEWIDE SYSTEM'S COMMUNITY BENEFIT EFFORTS. IT IS ALSO AVAILABLE BY REQUEST THROUGH THE INDIANA STATE DEPARTMENT OF HEALTH OR IU HEALTH. Schedule H, Part I, Line 7f PERCENT OF TOTAL EXPENSE THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSE ON LINE 7, COLUMN (F) IS $33,416,211. Schedule H, Part I, Line 7c TOTAL COMMUNITY BENEFIT EXPENSE PERCENTAGE OF TOTAL EXPENSES LISTED ON SCHEDULE H, PART I, LINE 7, COLUMN (F) IS CALCULATED BASED ON NET COMMUNITY BENEFIT EXPENSE. THE PERCENTAGE OF TOTAL EXPENSES CALCULATED BASED ON TOTAL COMMUNITY BENEFIT EXPENSE IS 40.36%. Schedule H, Part II PROMOTION OF HEALTH IN COMMUNITIES SERVED IU Health Arnett participates in a variety of community-building activities that address the social determinants of health in the communities it serves. IU Health Arnett and its related hospital entities across the state of Indiana ("IU Health Statewide System") invest in economic development efforts across the state, collaborate with like-minded organizations through coalitions that address key issues, and advocate for improvements in the health status of vulnerable populations. This includes making contributions to community-building activities by providing investments and resources to local community initiatives. Several examples include IU Health Arnett's support of the following organizations' efforts that focus on some of the root causes of health issues, such as access to healthcare, lack of education, insufficient access to resources, employment and poverty: -Riggs Community Health Center -Starfish Initiative -Teach for America -United Way Additionally, through the IU Health Statewide System's team member volunteer program, IU Health Serves, team members across the state positively impact the health of the community and foster a culture of engagement and social responsibility. In 2020, more than 1,400 team members throughout the statewide system dedicated time to support over 49 projects to positively impact the community. Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care IU Health Arnett uses several factors other than federal poverty guidelines ("FPG") in determining eligibility for free care under its FAP. These factors include the following: 1. Eligibility for Financial Assistance due to Financial or Personal Hardship In order to be eligible for Financial Assistance due to Financial or Personal Hardship under this Policy, a patient or guarantor must: - Submit a completed Financial Assistance Application with all supporting documentation and be approved in accordance with this Policy; - Be an Indiana Resident as defined in this Policy; and - If Uninsured, consult with a member of IU Health's Individual Solutions department to determine if health care coverage may be obtained from a government insurance or assistance product, the Health Insurance Marketplace, or from any other source of coverage. Financial Assistance due to Financial Hardship is only available for encounters where care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility. 2. Financial Assistance due to Financial Hardship The FPL income threshold under this section is as follows: - If one or more adults and zero dependents are in the household, the FPL Income Threshold is 200%. - If two or more adults and one or more dependents are in the household, the FPL Income Threshold is 250%. - If one adult and one or more dependents are in the household, the FPL Income Threshold is 300%. In some instances, an adult will also qualify as a dependent. When this occurs, IU Health Arnett will treat the adult as a dependent for purposes of the FPL calculation. IU Health Arnett will utilize the most recent FPL data available and will apply the FPL data to a patient or guarantor's account balance based upon the calendar date a completed Financial Assistance Application was received, not a patient's date of service. An Uninsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Gross Charges if approved. An Underinsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Patient Responsibility if approved. 3. Financial Assistance due to Personal Hardship An Uninsured or Underinsured patient or their guarantor whose household income is above the FPL income threshold may be eligible for Financial Assistance if the patient's outstanding Patient Responsibility exceeds 20% of the patient's or their guarantor's annual household income. - If approved, the patient's balance will be reduced to 20% of the patient or guarantor's annual household income or the Amounts Generally Billed, whichever is less. - IU Health Arnett will work with the patient or guarantor to identify a reasonable payment plan on the remainder of the balance. 4. Eligibility Period If approved for financial assistance by IU Health Arnett, the patient will be guaranteed financial assistance for treatment related to the underlying condition, for which the patient was originally screened and approved, through the remainder of the calendar year. As a condition of extending the on-going Financial Assistance, the patient must comply with requests from IU Health Arnett to verify that the patient continues to meet the conditions for qualification. 5. Appeals and Assistance Granted By the Financial Assistance Committee The Financial Assistance Committee will review and make determinations on all requests for appeals related to Financial Assistance. If a patient or guarantor seeks to appeal a Financial Assistance Determination, a written request must be submitted, along with the supporting documentation. The Financial Assistance Committee will review requests for and may grant additional Financial Assistance, including but not limited to, the following: - Assistance to patients who are seeking treatment that can only be provided in Indiana by IU Health or who would benefit from continued medical services from IU Health for continuity of care; - Care approved by the IU Health Chief Medical Officer (CMO) or the Chief Executive Officer (CEO) or CMO of an IU Health facility or region, including medically necessary non-elective services for which no payment source can be identified; - Care provided when it is known no payment source exists; - International humanitarian aid; and - Other care identified by the Financial Assistance Committee that fulfills the IU Health Mission. All decisions of the Financial Assistance Committee are final. 6. Presumptive Eligibility No Financial Assistance Application is required to receive Financial Assistance under this Presumptive Eligibility section. IU Health Arnett will deem patients or their guarantors presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs and care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility: - Medicaid (any state) - Indiana Children's Special Health Care Services - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. IU Health Arnett will conduct a quarterly review of all accounts placed with a collection agency partner for at least one hundred and twenty (120) days after the account is eligible for an ECA as set forth in this Policy. If the patient or guarantor's individual scoring criteria demonstrates the patient has a low likelihood and/or propensity to pay or no credit, the patient or guarantor may be deemed presumptively eligible for Financial Assistance. Financial Assistance may additionally be granted in the following circumstances: - If the patient or their guarantor is found to have filed a petition for bankruptcy. - If the patient is deceased and found to have no estate. - If the patient is deceased and was under 21 years of age at the time of death. 7. Exhaustion of Alternate Sources of Assistance Patients must exhaust all other state and federal assistance programs prior to receiving Financial Assistance due to Financial or Personal Hardship under this Policy including, but not limited to, Medicaid. Patients who may be eligible for coverage under an applicable health insurance policy must exhaust all insurance benefits. - This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. - IU Health may request patients show proof that such a claim was properly submitted to the appropriate insurance provider before awarding Financial Assistance. Eligible patients who receive medical care from an IU Health facility as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award. In the event Financial Assistance has already been granted in the above circumstances, IU Health reserves the right to reverse the Financial Assistance Determination in an amount equal to the amount IU Health would be entitled to receive had no Financial Assistance been awarded. 8. Patient Assets There are situations where a patient or their guarantor may have significant income or assets available to pay for healthcare services such as a legal settlement. The Financial Assistance Committee may evaluate the income or assets in determining Financial Hardship. IU Health may require a list of all property owned by the patient or guarantor and adjust a Financial Assistance Determination as a result. Schedule H, Part I, Line 7g Subsidized Health Services IU HEALTH Arnett HOSPITAL DOES NOT INCLUDE ANY COSTS ASSOCIATED WITH PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 33416211 Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE AMOUNT REPORTED ON LINE 2 AS BAD DEBT IS REPORTED AT COST, AS CALCULATED USING THE COST TO CHARGE RATIO METHODOLOGY. Schedule H, Part III, Line 3 Bad Debt Expense Methodology IU Health Arnett will deem patients or their guarantors presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs and care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility: 1. Medicaid (any state) 2. Indiana Children's Special Health Care Services 3. Healthy Indiana Plan 4. Patients who are awarded Hospital Presumptive Eligibility (HPE) 5. A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. No Financial Assistance Application is required to receive Financial Assistance under this Presumptive Eligibility section. IU Health Arnett will conduct a quarterly review of all accounts placed with a collection agency partner for at least one hundred and twenty (120) days after the account is eligible for an ECA as set forth in this Policy. If the patient or guarantor's individual scoring criteria demonstrates the patient has a low likelihood and/or propensity to pay or no credit, the patient or guarantor may be deemed presumptively eligible for Financial Assistance. Financial Assistance may additionally be granted in the following circumstances: a) If the patient or their guarantor is found to have filed a petition for bankruptcy. b) If the patient is deceased and found to have no estate. c) If the patient is deceased and was under 21 years of age at the time of death. Due to this comprehensive methodology, IU Health Arnett does not believe any amount of bad debt is attributable to patients who may be eligible under the financial assistance policy and no portion of bad debt is included as community benefit. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote IU Health Arnett IS A SUBSIDIARY IN THE CONSOLIDATED FINANCIAL STATEMENTS OF IU HEALTH. IU HEALTH'S BAD DEBT EXPENSE FOOTNOTE IS AS FOLLOWS: The Indiana University Health System does not require collateral or other security from its patients, substantially all of whom are residents of the State, for the delivery of health care services. However, consistent with industry practice, the Indiana University Health System routinely obtains assignment of (or is otherwise entitled to receive) patients' benefits payable under their health insurance programs, plans, or policies (e.g., Medicare, Medicaid, managed care payers, and commercial insurance policies). The Indiana University Health System uses a portfolio approach to account for categories of patient contracts as a collective group, rather than recognizing revenue on an individual contract basis. The portfolios consist of major payer classes for inpatient revenue and outpatient revenue. Based on the historical collection trends and other analysis, the Indiana University Health System believes that revenue recognized by utilizing the portfolio approach approximates the revenue that would have been recognized if an individual contract approach were used. In support of its mission, the Indiana University Health System provides care to uninsured and underinsured patients. The Indiana University Health System provides charity care to patients who lack financial resources and are deemed to be medically indigent. Financial assistance is available to qualifying uninsured and underinsured patients receiving care at an Indiana University Health System hospital location. Under its financial assistance policy, the Indiana University Health System provides medically necessary care to uninsured patients. Financial assistance up to the full amount of patient financial responsibility is available for uninsured and underinsured patients receiving care via the emergency department, direct admission from a physician's office, or transfer from another hospital. The federal poverty level (FPL) thresholds for this type of financial assistance are based on household makeup. Households without dependents are eligible for assistance if household income is less than or equal to 200% FPL, two adults and at least one dependent are eligible if household income is less than or equal to 250% FPL, and households with one adult and at least one dependent are eligible if household income is less than or equal to 300% FPL. Individuals with medical bills totaling more than 20% of annual household income, regardless of FPL, qualify for catastrophic assistance and are eligible for a reduction in patient financial responsibility to 20% of annual household income. Since the Indiana University Health System does not pursue collection of these amounts, the discounted amounts are not reported as patient service revenue. The Indiana University Health System uses presumptive eligibility screening procedures for some forms of financial assistance and recognizes net patient service revenue on services provided to self-pay patients at the discounted rate at the time services are rendered. The estimated cost of charity care, using the consolidated cost to charge ratio, was $90,358,000 and $96,693,000 in 2020 and 2019, respectively. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 6 IS CALCULATED, IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS, USING "ALLOWABLE COSTS" FROM THE IU HEALTH ARNETT MEDICARE COST REPORT. "ALLOWABLE COSTS" FOR MEDICARE COST REPORT PURPOSES, HOWEVER, ARE NOT REFLECTIVE OF ALL COSTS ASSOCIATED WITH IU HEALTH ARNETT'S PARTICIPATION IN MEDICARE PROGRAMS. FOR EXAMPLE, THE MEDICARE COST REPORT EXCLUDES CERTAIN COSTS SUCH AS BILLED PHYSICIAN SERVICES, THE COSTS OF MEDICARE PARTS C AND D, FEE SCHEDULE REIMBURSED SERVICES, AND DURABLE MEDICAL EQUIPMENT SERVICES. INCLUSION OF ALL COSTS ASSOCIATED WITH IU HEALTH ARNETT'S PARTICIPATION IN MEDICARE PROGRAMS WOULD SIGNIFICANTLY INCREASE THE MEDICARE SHORTFALL REPORTED ON SCHEDULE H, PART III, LINE 7. IU HEALTH ARNETT'S MEDICARE SHORTFALL IS ATTRIBUTABLE TO REIMBURSEMENTS THAT ARE LESS THAN THE COST OF PROVIDING PATIENT CARE AND SERVICES TO MEDICARE BENEFICIARIES AND DOES NOT INCLUDE ANY AMOUNTS THAT RESULT FROM INEFFICIENCIES OR POOR MANAGEMENT. IU ARNETT ACCEPTS ALL MEDICARE PATIENTS KNOWING THAT THERE MAY BE SHORTFALLS; THEREFORE IT HAS TAKEN THE POSITION THAT ANY SHORTFALL SHOULD BE COUNTED AS PART OF ITS COMMUNITY BENEFIT. ADDITIONALLY, IT IS IMPLIED IN INTERNAL REVENUE SERVICE REVENUE RULING 69-545 THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance IU Health Arnett follows IU Health's FAP and written debt collection policy describe the collection practices applicable to patients, including those who may qualify for financial assistance. 1. Financial Assistance Application Financial Assistance Applications must include the following documentation: - All sources of Income for the last three (3) months. - Most recent three (3) months of pay stubs or Supplemental Security Income via Social Security. - Most recent three (3) statements from checking and savings accounts, certificates of deposit, stocks, bonds and money market accounts. - Most recent state and Federal Income Tax forms including Schedules C, D, E, and F. In the event the patient or guarantor's income does not warrant the filing of a federal tax statement, the individual may submit a notarized affidavit attesting to the foregoing. - Most recent W-2 statement. - For patients or members of the Household who are currently unemployed, Wage Inquiry from WorkOne. - If applicable, divorce/dissolution decrees and child custody order. Patients or their guarantors wishing to apply for Financial Assistance due to Financial Hardship are encouraged to submit an Application within ninety (90) days of discharge. Patients or their guarantors may submit an Application up to two-hundred and forty (240) days from the date of their initial post-discharge billing statement from IU Health, however, accounts may be subject to Extraordinary Collection Actions (ECA) as soon as one-hundred and twenty (120) days after receipt of the initial post-discharge billing statement. Patients or their guarantors submitting an incomplete Financial Assistance Application will receive written notification of the Application's deficiency upon discovery by IU Health. The Application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health will suspend any ECA until the Application is complete or the expiration of the forty-five (45) day period. Patients with limited English proficiency may request a copy of this Policy, a Financial Assistance Application, and a Plain Language Summary in one of the below languages: - Arabic; - Burmese; - Burmese - Falam; - Burmese - Hakha Chin; - Mandarin/Chinese; or - Spanish The patient, and/or their representative, such as the patient's physician, family members, legal counsel, community or religious groups, social services or hospital personnel may request a Financial Assistance Application be mailed to a patient's primary mailing address free of charge. IU Health maintains the confidentiality of all Financial Assistance Applications and supporting documentation. IU Health will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance Application. 2. Financial Assistance Determinations IU Health will inform patients or guarantors of the results of their Application by providing the patient or guarantor with a Financial Assistance Determination within ninety (90) days of receiving a completed Application and all requested documentation. A patient's Financial Assistance Application and Financial Assistance Determination are specific to each date(s) of service and approved related encounters. If a patient or guarantor is granted less than full charity assistance and the patient or guarantor provides additional information for reconsideration, Revenue Cycle Services may amend a prior Financial Assistance Determination. 3. Extraordinary Collection Actions IU Health may refer delinquent patient accounts to a third-party collection agency after utilizing reasonable efforts to determine a patient's eligibility for assistance under this Policy. Reasonable efforts include the following: - IU Health will notify the patient of this Policy at least thirty (30) days prior to initiating an ECA. - IU Health will not initiate an ECA for at least one-hundred and twenty (120) days after the patient's initial post-discharge billing statement. - IU Health will review all Financial Assistance Applications received up to and including two-hundred and forty (240) days after the patient's initial post-discharge billing statement. IU Health will cease any ECAs it has initiated upon receipt of a Financial Assistance Application until a Financial Assistance Determination is made under this policy. - If an Application is Approved, IU Health will issue a revised statement, issue refunds, and make reasonable efforts to reverse ECAs as necessary. IU Health and its third-party collection agencies may initiate an ECA against a patient or their guarantor in accordance with this Policy and 26 C.F.R. § 1.501(r). ECAs may include the following: - Selling a patient or their guarantor's outstanding financial responsibility to a third party. - Reporting adverse information about the patient or their guarantor to consumer credit reporting agencies or credit bureaus. - Deferring or denying, or requiring a payment before providing, medically necessary care because of a patient or their guarantor's nonpayment of one or more bills for previously provided care covered under this Policy. - Actions requiring a legal or judicial process, including but not limited to placing a lien on a patient's or their guarantor's property, foreclosing on a patient's or their guarantor's real property, attaching or seizing a patient's or their guarantor's bank account or other personal property, commencing a civil action against a patient or their guarantor, causing a patient or guarantor's arrest, causing a patient and/or guarantor to be subject to a writ of body attachment, and garnishing a patient or guarantor's wages When it is necessary to engage in such action, IU Health and its third party collection agencies, will engage in fair, respectful and transparent collections activities. 4. Refunds Patients eligible for Financial Assistance under this Policy who remitted payment to IU Health in excess of their Patient Responsibility will be alerted to the overpayment as promptly after discovery as is reasonable given the nature of the overpayment. Patients with an outstanding account balance due on a separate account will have their refund applied to the outstanding balance. Patients without an outstanding account balance described above will be issued a refund check for their overpayment as soon as technically feasible. Schedule H, Part V, Section B, Line 16a FAP website - IU HEALTH ARNETT HOSPITAL: Line 16a URL: HTTPS://IUHEALTH.ORG/PAY-A-BILL/FINANCIAL-ASSISTANCE; Schedule H, Part V, Section B, Line 16b FAP Application website - IU HEALTH ARNETT HOSPITAL: Line 16b URL: HTTPS://IUHEALTH.ORG/PAY-A-BILL/FINANCIAL-ASSISTANCE; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - IU HEALTH ARNETT HOSPITAL: Line 16c URL: HTTPS://IUHEALTH.ORG/PAY-A-BILL/FINANCIAL-ASSISTANCE; Schedule H, Part VI, Line 2 Needs assessment COMMUNITIES ARE MULTIFACETED AND SO ARE THEIR HEALTH NEEDS. IU HEALTH Arnett UNDERSTANDS THAT THE HEALTH OF INDIVIDUALS AND COMMUNITIES ARE SHAPED BY VARIOUS SOCIAL AND ENVIRONMENTAL FACTORS, ALONG WITH HEALTH BEHAVIORS AND ADDITIONAL INFLUENCES. IU HEALTH Arnett ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES BY CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). FOR THE 2018 CHNA, IU HEALTH Arnett CONDUCTED THE COMMUNITY SURVEY DATA COLLECTION IN COLLABORATION WITH INDIANA UNIVERSITY, UNIVERSITY OF EVANSVILLE AND AN INDIANA HOSPITAL COLLABORATIVE, INCLUDING COMMUNITY HEALTH NETWORK, FRANCISCAN ALLIANCE, ST. VINCENT HEALTH AND OTHER HOSPITAL PARTNERS. AFTER COMPLETION OF THE CHNA, IU HEALTH Arnett REVIEWED SECONDARY DATA, FINDINGS FROM OTHER COMMUNITY HEALTH ASSESSMENTS OF AREAS SERVED BY THE HOSPITAL, INPUT OBTAINED FROM INDIVIDUALS WHO PARTICIPATED IN COMMUNITY MEETINGS, INPUT OBTAINED FROM KEY STAKEHOLDERS, AND A COMMUNITY SURVEY TO IDENTIFY AND ANALYZE THE NEEDS IDENTIFIED BY EACH SOURCE. THE TOP HEALTH NEEDS OF THE IU HEALTH Arnett COMMUNITY ARE THOSE THAT ARE SUPPORTED BY MULTIPLE DATA SOURCES. ADDITIONALLY, THE EFFECTIVENESS OF AN INTERVENTION FOR EACH NEED AND IU HEALTH'S ABILITY TO IMPACT POSITIVE CHANGE WAS EVALUATED. IU Health Arnett believes its CHNA process is comprehensive and additional assessments are not required. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance IU Health Arnett takes several measures to inform its patients of the FAP and FAP-eligibility. These measures include the following: 1. Post this Policy, a Plain Language Summary of this Policy, and the Financial Assistance Application on its website. 2. Provide patients with a Plain Language Summary of this Policy during registration and/or discharge. 3. Post conspicuous displays in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 4. Include a conspicuous written notice on all patient post-discharge billing statements notifying the patient about this Policy and the telephone number of the Customer Service Department which can assist patients with questions regarding this Policy. 5. Make available Customer Service representatives via telephone during normal business hours. 6. Mail copies of this Policy, a Plain Language Summary of this Policy, and a Financial Assistance Application to patients or their guarantor free of charge upon request. 7. Broadly communicate this Policy as a part of its general outreach efforts. 8. Educate patient-facing team members on this Policy and the process for referring patients to the program. Schedule H, Part VI, Line 4 Community information IU HEALTH ARNETT IS PRIMARILY LOCATED IN TIPPECANOE COUNTY BUT ALSO HAS MEDICAL OFFICES AND SERVES PATIENTS IN BENTON, CARROLL, CLINTON, AND WHITE COUNTIES. TIPPECANOE COUNTY INCLUDES ZIP CODES WITHIN THE TOWNS OF BATTLE GROUND, CLARKS HILL, DAYTON, LAFAYETTE, ROMNEY, WEST LAFAYETTE AND WEST POINT. BASED ON THE MOST RECENT CENSUS BUREAU (2020 ESTIMATE) STATISTICS, TIPPECANOE COUNTY'S POPULATION IS 186,251 PERSONS WITH APPROXIMATELY 49% BEING FEMALE AND 51% MALE. THE COUNTY'S POPULATION ESTIMATES BY RACE ARE 74.8% WHITE, 8.7% HISPANIC OR LATINO, 8.8% ASIAN, 5.9% BLACK, 0.4% AMERICAN INDIAN OR ALASKA NATIVE, AND 2.2% PERSONS REPORTING TWO OR MORE RACES. TIPPECANOE COUNTY HAS RELATIVELY MODERATE LEVELS OF EDUCATIONAL ATTAINMENT. AMONG RESIDENTS AGES 25 AND UP, 91.6% ENDED THEIR FORMAL EDUCATION WITH A HIGH SCHOOL DIPLOMA OR EQUIVALENT. AMONG RESIDENTS AGES 25 AND UP, 38.7% EARNED A BACHELOR'S DEGREE OR HIGHER. Schedule H, Part VI, Line 5 Promotion of community health IU Health Arnett is a subsidiary of Indiana University Health, Inc., a tax-exempt healthcare organization, whose Board of Directors is composed of members, of which substantially all are independent community members. In 2018, IU Health Arnett completed a community health needs assessment which identified 4 priority health needs: Access to Healthcare, Health and Social Services for Seniors, Mental Health and Substance Use. The Community Outreach and Engagement Committee worked to identify major community partners to assist with education, outreach, programs and services to address these priority needs. IU Health committed $387,000 to 17 major partners, including local school corporations, community YMCAs and Purdue University, among others. Additionally, to assist with accessing healthcare, IU Health Arnett team members participated in a community initiative, Workforce 2030 Council, in order to build more interest and capacity in healthcare careers. IU Health provided $10,000 in scholarships to Purdue University's Mental Health Nurse Practitioner Program. For mental health, IU Health supported evidence-based parenting classes through Willowstone Family Services. IU Health also partnered with Mental Health America Wabash Valley Region to fund different programs and services, including the Crisis Center and community education sessions. In 2020, MHA utilized funds from IU Health to purchase equipment that made it possible to continue their services during a statewide lockdown order. IU HEALTH ARNETT HOSPITAL IS A SUBSIDIARY OF IU HEALTH. IU HEALTH AND ITS RELATED HOSPITAL ENTITIES ACROSS THE STATE OF INDIANA EXTEND MEDICAL PRIVILEGES TO ALL PHYSICIANS WHO MEET THE CREDENTIALING QUALIFICATIONS NECESSARY FOR APPOINTMENT TO ITS MEDICAL STAFF. IU HEALTH DOES NOT DENY APPOINTMENT ON THE BASIS OF GENDER, RACE, CREED, OR NATIONAL ORIGIN. IU HEALTH, IN CONJUNCTION WITH THE IU SCHOOL OF MEDICINE, TRAINS THE NEXT GENERATION OF PHYSICIANS IN AN EXCEPTIONAL ENVIRONMENT, BLENDING BREAKTHROUGH RESEARCH AND TREATMENTS WITH THE HIGHEST QUALITY OF PATIENT CARE. Schedule H, Part VI, Line 6 Affiliated health care system IU Health Arnett is part of the IU Health Statewide System ("the system"), which is Indiana's most comprehensive healthcare system. A unique partnership with the Indiana University School of Medicine ("IU School of Medicine"), one of the nation's leading medical schools, gives patients access to innovative treatments and therapies. The system is comprised of hospitals, physicians and allied services dedicated to providing preeminent care throughout Indiana and beyond. National Recognition -Eight hospitals designated as Magnet by the American Nurses Credentialing Center recognizing excellence in nursing care. -U.S. News & World Report - Annual Rankings -IU Health Medical Center is nationally ranked for the 23rd year in a row. IU Health Medical Center is nationally ranked in 3 adult specialties and 10 pediatric specialties and rated high performing in 5 adult specialties and 6 procedures and conditions. -IU Health has five hospitals that are considered high performing in certain procedures and conditions: IU Health Ball, IU Health Arnett, IU Health North, IU Health West, and IU Health Bloomington hospitals. -Riley Hospital for Children at IU Health is nationally ranked in 10 pediatric specialties. IU Health Statewide System Hospitals in the system include the following: -IU Health Inc. (i.e., the IU Health Academic Health Center consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health, and IU Health Saxony Hospital) -IU Health Arnett -IU Health Ball -IU Health Bedford Hospital -IU Health Blackford -IU Health Bloomington Hospital -IU Health Frankfort -IU Health Jay -IU Health North Hospital -IU Health Paoli Hospital -IU Health Tipton Hospital -IU Health West Hospital -IU Health White Memorial Hospital The system is divided into five regions that serve communities in Northwest, Northeast, Central, and Southern Indiana. IU Health Inc. has significant statewide reach as a: 1) teaching hospital, 2) research activities with the IU School of Medicine and other national collaborations, 3) Riley's network of locations throughout the state due to its pediatric expertise, and 4) Riley's trauma department is the only Level I Pediatric Trauma Center in Indiana. Although each hospital in the system conducts and adopts its own CHNA and implementation strategy, the system considers the sum of these plans part of a system wide goal of making Indiana one of the healthiest states in the nation. The hospitals are guided by a system wide mission to improve the health of our patients and community through innovation, and excellence in care, education, research, and service. The system is keenly aware of the positive impact it can have on improving the health of communities throughout the state of Indiana by aligning resources in a system-level and strategic way. Education and Research The system includes the Academic Health Center that works in partnership with the IU School of Medicine to train physicians, blending breakthrough research and treatments with the highest quality of patient care. Each year, more than 1,000 residents and fellows receive training in IU Health hospitals. Research conducted by IU School of Medicine faculty gives IU Health physicians and patients access to the most leading-edge and comprehensive treatment options. In 2017, IU Health and the IU School of Medicine announced that they would invest $50 million over six years in the Strategic Research Initiative (SRI), a new research collaboration that has enhanced the institutions' joint capabilities in fundamental scientific investigation, translational research and clinical trials. The initial focus is on projects in the fields of neuroscience, cancer and cardiovascular disease with the goal to fund transformative proposals that will fundamentally change the understanding of these diseases and lead to important new therapies for patients. The three target research areas represent research strengths at IU School of Medicine, key strategic service lines for IU Health, and important medical needs in a time of an aging population and rising healthcare costs. One of the most significant outcomes of this initiative includes the Indiana University Melvin and Bren Simon Cancer Center receiving the National Cancer Institute's (NCI)-designated status of "comprehensive." This designation was achieved in August 2019 making the center the only NCI-designated Comprehensive Cancer Center in Indiana and one of just 51 in the nation. Community Health To further promote the health of the communities served by the system, the system-level Community Health team builds the capabilities and competencies to impact team members, risk lives, and patients throughout the system. Additionally, the team partners with state and local community-based organizations, community coalitions, and governmental agencies to pursue a system-level advocacy/collaboration strategy that seeks to improve the health of communities. All hospitals in the system identify and address significant health needs unique to the community it serves. However, because some of these health needs are common in communities served by multiple hospitals in the system, they warrant a system level strategy. Community Health plans and provides technical assistance for system-level strategies that address these common health needs including health equity, tobacco treatment, behavioral health access, and social needs. Each hospital works collaboratively with the Community Health team to operationalize system-level strategies through the implementation of specific activities that align and activate local resources. This benefits the community each hospital serves and works towards a statewide impact (system-level) on health outcomes. IU Health Serves IU Health Serves, a system-level team member volunteer program, seeks to positively impact the health of communities the IU Health Statewide System serves and fosters a culture of engagement and social responsibility. IU Health Arnett coordinates the different initiatives of the program, including Days of Service. This is the largest volunteer event of the year, consisting of projects designed to engage IU Health Arnett team members in activities that address local, identified community health priorities. Community Impact Investment (CII) Fund The CII Fund is a $100 million board designated fund to be managed and overseen by the IU Health Foundation to financially support high impact community investing designed to address social determinants of health in communities IU Health serves. Each IU Health hospital has a significant impact on and are deeply invested in their local communities. Through the grants provided by this CII Fund, IU Health can strategically and intentionally address the social, economic and environmental factors that impact the health of our surrounding communities. Each IU Health hospital and its team members are eligible for this grant opportunity Schedule H, Part VI, Line 7 State filing of community benefit report IN true INDIANA UNIVERSITY HEALTH FOUNDATION INC 1800 NORTH CAPITOL AVENUE INDIANAPOLIS IN 46202 356043086 501(C)(3) 41000 EDUCATION FUND YMCA of Lafayette 1950 South 18th Street Lafayette IN 47905 350868213 501(c)(3) 118800 community campaign United Way of Greater Lafayette 1114 State Street Lafayette IN 47905 350891621 501(c)(3) 25000 GENERAL SUPPORT Healthy Communities of Clinton County 1458 OAK ST STE B Frankfort IN 46041 462835793 501(c)(3) 87417 GENERAL SUPPORT MENTAL HEALTH AMERICA OF TIPPECANOE COUNTY INC 914 South St Lafayette IN 47901 383653969 501(c)(3) 45000 GENERAL SUPPORT Food Finders 1204 greenbush street Lafayette IN 47904 311020198 501(c)(3) 41400 GENERAL SUPPORT White County United Way PO Box 580 Monticello IN 47960 351137113 501(c)(3) 13500 GENERAL SUPPORT TIPPECANOE SCHOOL CORPORATION 21 Elston Road Lafayette IN 47909 000000000 GOVT 12500 SCHOOL SUPPLIES PURDUE UNIVERSITY 475 STADIUM MALL DRIVE WEST LAFAYETTE IN 47907 356002041 GOVT 10000 EDUCATION LAFAYETTE SCHOOL CORPORATION 2300 CASON STREET LAFAYETTE IN 47904 000000000 GOVT 8100 WATER BOTTLE FILLERS TWIN LAKES SCHOOL CORPORATION 565 SOUTH MAIN STREET MONTICELLO IN 47960 000000000 GOVT 6500 SCHOOL SAFETY 7 4 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. ORG.'S PROC. FOR MON. THE USE OF GRANT FUNDS ALTHOUGH IU HEALTH ARNETT DOES NOT MONITOR THE USE OF GRANT FUNDS ONCE DISTRIBUTED, THROUGH DUE DILIGENCE THE ORGANIZATION HAS REASONABLY CONFIRMED THAT THE ENTITIES TO WHICH THE CONTRIBUTIONS ARE MADE ARE HIGHLY REPUTABLE IN THE COMMUNITY AND USE THE FUNDS FOR THE PURPOSES INTENDED. false true false false false false false true false CHRISTOPHER A MANSFIELD MD DIRECTOR/VICE CHAIR 421448 0 7710 0 18540 0 18400 0 32170 0 498267 0 0 0 RUBAN NIRMALAN MD DIRECTOR 724244 0 600 0 18810 0 18638 0 26824 0 789116 0 0 0 ROGER G BANGS MD DIRECTOR 628465 0 6971 0 41064 0 18400 0 12574 0 707473 0 0 0 WILLIAM Y LI MD DIRECTOR 428267 0 600 0 19242 0 18400 0 31506 0 498015 0 0 0 MICHELE S SAYSANA MD DIRECTOR 0 374063 0 64366 0 713 0 16802 0 0 0 455945 0 0 CARA L BREIDSTER FORMER OFFICER 0 264625 0 46094 0 56940 0 18631 0 25745 0 412036 0 0 DEREK E EMPIE FORMER OFFICER 0 253961 0 43264 0 31861 0 18354 0 31916 0 379357 0 0 ANDREW K EDWARDS MD FORMER OFFICER 392898 0 600 0 18810 0 19268 0 25738 0 457314 0 0 0 DONALD E CLAYTON MD FORMER OFFICER 106548 0 600 0 16299 0 9507 0 10459 0 143413 0 0 0 DANIEL E NEUFELDER REGIONAL PRESIDENT (WCR) 0 524378 0 228363 0 26364 0 117624 0 26448 0 923177 0 0 TODD A WILLIAMS CFO/TREASURER (WCR) 0 268233 0 35958 0 55290 0 18400 0 33293 0 411174 0 0 PHILIP LIST SECRETARY (WCR) 0 136827 0 16500 0 132 0 9775 0 6089 0 169324 0 0 BRIAN T SHOCKNEY FORMER KEY EMPLOYEE 0 555231 0 263743 0 30294 0 112183 0 29309 0 990760 0 0 JAMES P BIEN MD CMO (WCR) - VP QUALITY & SAFETY 351676 0 44720 0 69717 0 18400 0 32279 0 516792 0 0 0 JEFFREY C ZEH COO (WCR) 295087 0 43364 0 35720 0 18400 0 227 0 392798 0 0 0 BRIAN M WEIRICH CNO(WCR) (PART YEAR) 140737 0 13296 0 39298 0 12752 0 20792 0 226876 0 0 0 KOREEN C KYHNELL VP - HUMAN RESOURCES (WCR) 0 177513 0 24119 0 26350 0 13086 0 26735 0 267804 0 0 JAMES H PARSONS CHIEF PRACTICE OFFICER 168046 0 23055 0 22880 0 13437 0 34825 0 262242 0 0 0 ALLISON SHUTTZ CNO (WCR) (PART YEAR) 125252 0 20554 0 24460 0 9845 0 30885 0 210997 0 0 0 JOSEPH E HUBBARD MD PHY. DEPT. CHAIRPERSON 1034766 0 600 0 20040 0 18400 0 31714 0 1105520 0 0 0 CHENG DU MD PHYSICIAN 796822 0 0 0 21629 0 20734 0 30493 0 869677 0 0 0 STANTON M REGAN MD PHYSICIAN 973239 0 1250 0 19986 0 18400 0 34059 0 1046934 0 0 0 NAVEED AHMAD MD PHY. DEPT. CHAIRPERSON 815956 0 600 0 18810 0 18400 0 31499 0 885265 0 0 0 GARRETT JACKSON MD PHYSICIAN 1063915 120079 539 61 17959 2027 1355 153 22610 2552 1106378 124872 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation IU HEALTH ARNETT'S REGIONAL PRESIDENT IS EMPLOYED BY IU HEALTH, INC. IU HEALTH, INC., IU HEALTH ARNETT, AND OTHER RELATED ENTITIES HAVE A PROCESS IN PLACE TO DETERMINE THE COMPENSATION FOR THE OTHER OFFICERS AND KEY EMPLOYEES. IU HEALTH HUMAN RESOURCES USES MARKET DATA FROM MULTIPLE COMPENSATION EXPERTS/VENDORS WHO UTILIZE A VARIETY OF METHODS AND PROCEDURES TO OBTAIN COMPENSATION RANGES FOR COMPARABLE OFFICER AND EMPLOYEE POSITIONS. THIS MARKET DATA AND MULTIPLE OTHER FACTORS (INCLUDING MARKET PAY BENCHMARKS, INTERNAL EQUITY, CANDIDATE/EMPLOYEE QUALIFICATIONS & PERFORMANCE, AND BUSINESS NEEDS) ARE USED TO RECOMMEND COMPENSATION RANGES FOR ITS OFFICERS AND OTHER EMPLOYEES, WHICH ARE THEN USED AS A GUIDE FOR SETTING REASONABLE COMPENSATION BY MANAGEMENT. PLEASE SEE SCHEDULE O FOR ADDITIONAL DETAILS. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan DANIEL E. NEUFELDER AND BRIAN T. SHOCKNEY PARTICIPATE IN AN IU HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, PROVISIONS OF WHICH ARE DESIGNED TO RETAIN ITS CRITICAL EMPLOYEES. THE PLAN PROVIDES FOR AN ADDITIONAL RETIREMENT BENEFIT FOR SERVICE THROUGH NORMAL RETIREMENT OR OTHER KEY DATES. IF THE EXECUTIVE LEAVES PRIOR TO RETIREMENT OR OTHER KEY DATES, THE BENEFIT MAY BE FORFEITED OR REDUCED. DANIEL E. NEUFELDER AND BRIAN T. SHOCKNEY HAVE AN AMOUNT INCLUDED IN COLUMN C, DEFERRED COMPENSATION, REPRESENTING THE CURRENT YEAR UNVESTED CONTRIBUTIONS MADE UNDER THE SUPPLEMENTAL RETIREMENT PLAN. NO AMOUNTS WERE ACTUALLY PAID TO THESE EXECUTIVES DURING THE YEAR. Schedule J, Part I, Line 7 Non-fixed payments AMOUNTS DISCLOSED IN COLUMN B(II) INCLUDE A LONG-TERM AND SHORT-TERM INCENTIVE FOR CERTAIN EXECUTIVES AND SHORT-TERM INCENTIVE FOR OTHER EMPLOYEES. ALTHOUGH THESE PLANS ARE BASED ON A FIXED FORMULA THAT HAS BEEN APPROVED BY THE BOARD OF DIRECTORS BASED UPON CERTAIN QUALITATIVE AND QUANTITATIVE FACTORS AND GOALS, ALL DISCRETIONARY INCENTIVE PLANS MUST BE APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT. LINE J - WEB SITE HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-ARNETT-HOSPITAL Form 990, Part III, Line 4d Description of other program services (Expenses $ 4,161,142 including grants of $)(Revenue $ 4,365,250) IU HEALTH ARNETT PROVIDES SERVICES TO RELATED TAX-EXEMPT ORGANIZATIONS. Form 990, Part III, Line 4d Description of other program services (Expenses $ 579,040 including grants of $)(Revenue $ 607,443) INCOME (LOSS) FROM PASS-THROUGH ENTITIES Form 990, Part III, Line 4d Description of other program services (Expenses $ 27,612 including grants of $)(Revenue $ 28,966) RENT FROM RELATED 501(C)(3) ORGANIZATIONS Form 990, Part IV, Line 13 SECTION B, LINES 12, 13, 14, AND 16B - POLICIES IU HEALTH ARNETT IS PART OF THE IU HEALTH SYSTEM. AS THE SOLE MEMBER AND CONTROLLING PARENT OF IU HEALTH ARNETT, IU HEALTH AND ITS BOARD OF DIRECTORS HAVE MANDATED THAT CERTAIN POLICIES BE FOLLOWED TO ENSURE GREATER STANDARDIZATION THROUGHOUT THE SYSTEM. THUS, IU HEALTH ARNETT'S BOARD OF DIRECTORS WAS NOT REQUIRED TO SEPARATELY ADOPT A CONFLICT OF INTEREST, WHISTLEBLOWER, DOCUMENT RETENTION AND DESTRUCTION AND JOINT VENTURE POLICIES BECAUSE IU HEALTH'S BOARD OF DIRECTORS HAD ALREADY ADOPTED AND REQUIRED THESE POLICIES TO BE FOLLOWED BY ITS SUBSIDIARIES. Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE MEMBER OF IU HEALTH ARNETT IS IU HEALTH, A 501(C)(3) TAX-EXEMPT HOSPITAL. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE CONTROL AND MANAGEMENT OF THE AFFAIRS OF IU HEALTH ARNETT IS VESTED IN A BOARD OF UP TO FOURTEEN (14) VOTING DIRECTORS WHOM ARE APPOINTED BY IU HEALTH, AS THE SOLE MEMBER OF THE ORGANIZATION. FOUR (4) OF THE VOTING DIRECTORS WILL BE PHYSICIAN REPRESENTATIVES FROM THE WEST CENTRAL REGION. THE PHYSICIAN DIRECTORS WILL BE IDENTIFIED THROUGH A NOMINATION PROCESS DEVELOPED BY THE WEST CENTRAL REGION AND SUBMITTED TO IU HEALTH FOR CONSIDERATION AND APPROVAL. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE BOARD OF DIRECTORS MAY NOT UNDERTAKE CERTAIN ACTIONS WITHOUT THE PRIOR APPROVAL OF IU HEALTH, AS THE SOLE MEMBER. ACTIONS THAT REQUIRE PRIOR APPROVAL INCLUDE THE FOLLOWING: -ANY PROPOSED AMENDMENT TO THE CORPORATION'S ARTICLES OF INCORPORATION OR THESE BYLAWS; -ADOPTION OF THE CORPORATION'S ANNUAL CAPITAL AND OPERATING BUDGETS; -APPROVAL OF ANY UNBUDGETED OPERATING OR CAPITAL BUDGET ITEMS OR DEVIATIONS, INCLUDING ANY ISSUANCE OR GUARANTEE OF ANY UNBUDGETED DEBT; -APPROVAL OF ANY STRATEGIC PLAN FOR THE CORPORATION, INCLUDING ANY AMENDMENTS TO A STRATEGIC PLAN; -APPROVAL OF ANY ENCUMBRANCE, SALE OR CONVEYANCE OF ASSETS; -ANY MERGER, CONSOLIDATION, JOINT VENTURE OR AFFILIATION INVOLVING THE CORPORATION OR ANY OF ITS AFFILIATES AND ANY OTHER ENTITY; -APPOINTMENT AND REMOVAL OF THE CORPORATION'S PRESIDENT AND OTHER OFFICERS; -CONSTRUCTION, ACQUISITION OR LEASE OF HOSPITAL BUILDINGS; -PROJECTS OR CONTRACTS THAT REQUIRE MEMBER APPROVAL IN ACCORDANCE WITH THE MEMBER'S RESOLUTION AND POLICY GOVERNING SYSTEM-WIDE CONTRACT EXECUTION AUTHORITY AND PAYMENT APPROVAL LIMITS; AND -THE DISSOLUTION OF THE CORPORATION OR ANY OF ITS AFFILIATES. Form 990, Part VI, Line 11b Review of form 990 by governing body THE CFO REVIEWED AND APPROVED THE FORM 990. FOLLOWING THE CFO'S REVIEW AND APPROVAL, A COMPLETE COPY OF THE FORM 990 WAS MADE AVAILABLE TO EACH BOARD MEMBER PRIOR TO ITS FILING. EACH MEMBER WAS ALSO INFORMED OF THE AVAILABILITY OF IU HEALTH'S TAX DEPARTMENT TO ANSWER ANY QUESTIONS. Form 990, Part VI, Line 12c Conflict of interest policy IU HEALTH Arnett FOLLOWS IU HEALTH'S CONFLICT OF INTEREST POLICY. IU HEALTH'S CONFLICT OF INTEREST POLICY INCLUDES THE FOLLOWING PROVISIONS: ALL IU HEALTH EMPLOYEES, ASSOCIATES, COLLEAGUES AND CONTRACTED PERSONNEL, INCLUDING EMPLOYED PHYSICIANS AND PAID MEDICAL DIRECTORS ("IU HEALTH REPRESENTATIVES") ARE COVERED BY AND SUBJECT TO ITS CONFLICT OF INTEREST POLICY. IU HEALTH REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY THROUGH THE FOLLOWING PROCEDURES: (A) ON AN ANNUAL BASIS, EACH IU HEALTH REPRESENTATIVE AT THE LEVEL OF MANAGER OR ABOVE, TOGETHER WITH EVERY OTHER PERSON DESIGNATED BY THE CORPORATE COMPLIANCE DEPARTMENT ("DEPARTMENT"), MUST COMPLETE, SIGN AND SUBMIT A CONFLICT OF INTEREST QUESTIONNAIRE ("QUESTIONNAIRE") TO THE DEPARTMENT. GOVERNING BOARD MEMBERS, COMMITTEE MEMBERS, CORPORATE OFFICERS, MEDICAL STAFF AND RESEARCHERS MUST COMPLY WITH THE ADMINISTRATIVE REQUIREMENTS NOTED IN THE RESPECTIVE POLICIES AND PROCEDURES RELATIVE TO THOSE AREAS. (B) AN IU HEALTH REPRESENTATIVE MUST SUPPLEMENT A QUESTIONNAIRE IN WRITING, IF AFTER COMPLETION OF THE ORIGINAL QUESTIONNAIRE, A SITUATION ARISES, OR MAY REASONABLY BE EXPECTED TO ARISE, THAT WOULD CHANGE ANY ANSWER OR INFORMATION ON THE ORIGINAL QUESTIONNAIRE IF THE SITUATION HAD EXISTED OR BEEN ANTICIPATED AT THE TIME OF COMPLETION OF THE ORIGINAL QUESTIONNAIRE. (C) IF A FULLY AND PROPERLY COMPLETED QUESTIONNAIRE REVEALS FACTS OR OTHER INFORMATION THAT MIGHT REASONABLY INDICATE A CONFLICT OF INTEREST OR VIOLATION OF THE POLICY, THE IU HEALTH REPRESENTATIVE COMPLETING THE QUESTIONNAIRE MUST SECURE APPROVAL BY HIS/HER SUPERVISOR, EVIDENCED IN WRITING. (D) THE DEPARTMENT WILL REVIEW EACH QUESTIONNAIRE AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS AND, IF SO, WHETHER AND HOW IT SHOULD OR MAY BE ELIMINATED, AVOIDED OR MANAGED IN ORDER TO COMPLY WITH THE SPIRIT OF THE POLICY AND WITH THE BEST INTERESTS OF IU HEALTH AND ITS PATIENTS. IN MAKING THE DETERMINATION, THE CORPORATE COMPLIANCE DEPARTMENT MAY CONSULT WITH THE IU HEALTH REPRESENTATIVE'S SUPERVISOR AND OTHER APPROPRIATE INDIVIDUALS AND GROUPS. (E) THE SCOPE OF THE POLICY IS NOT LIMITED TO THOSE WHO ARE REQUIRED TO COMPLETE QUESTIONNAIRES. IF AN IU HEALTH REPRESENTATIVE IS INVOLVED IN A SITUATION OR RELATIONSHIP THAT WOULD CONSTITUTE A VIOLATION OF THE POLICY IN THE ABSENCE OF DISCLOSURE AND APPROVAL AS DESCRIBED ABOVE, THEN THE IU HEALTH REPRESENTATIVE MUST DISCLOSE THE MATTER TO HIS/HER SUPERVISOR, SECURE HIS/HER SUPERVISOR'S APPROVAL IN WRITING, AND DISCLOSE THE MATTER TO THE DEPARTMENT. OTHERWISE, THE IU HEALTH REPRESENTATIVE IS IN VIOLATION OF THE POLICY AND SUBJECT TO CORRECTIVE ACTION, UP TO AND INCLUDING TERMINATION. (F) THE CHIEF COMPLIANCE OFFICER, IN CONSULTATION WITH ONSITE COMPLIANCE PERSONNEL, MAY FROM TIME TO TIME APPOINT STANDING OR AD HOC COMMITTEES TO ASSIST IN RESOLVING ISSUES THAT ARISE UNDER PROVISIONS OF THE POLICY. Form 990, Part VI, Line 15b Process to establish compensation of other employees IU HEALTH ARNETT'S REGIONAL PRESIDENT IS EMPLOYED BY IU HEALTH. IU HEALTH'S PROCESS FOR DETERMINING COMPENSATION IS AS FOLLOWS: (1) THE BOARD OF DIRECTORS ("BOARD") HAS ESTABLISHED A TALENT MANAGEMENT AND EXECUTIVE COMPENSATION COMMITTEE ("TMECC"), THE PURPOSE OF WHICH INCLUDES REVIEWING AND MAKING RECOMMENDATIONS REGARDING EXECUTIVE (SENIOR VICE PRESIDENTS AND ABOVE) PAY AND BENEFITS (COLLECTIVELY REFERRED TO AS "COMPENSATION") ON AN ANNUAL BASIS. THE TMECC IS MADE UP OF MEMBERS OF THE BOARD THAT ARE NEITHER PHYSICIANS NOR EMPLOYEES AND DO NOT OTHERWISE HAVE A CONFLICT OF INTEREST REGARDING ANY OF IU HEALTH'S COMPENSATION ARRANGEMENTS. THE TMECC REVIEWS AN EXECUTIVE'S ENTIRE COMPENSATION PACKAGE INCLUDING BASE SALARY, SHORT-TERM AND LONG-TERM INCENTIVES, HEALTH AND WELFARE BENEFITS, QUALIFIED AND NONQUALIFIED RETIREMENT PLANS, AS WELL AS ANY ADDITIONAL FRINGE BENEFITS. AS DEEMED APPROPRIATE, THE COMMITTEE ON FINANCE, WHICH IS ALSO MADE UP OF MEMBERS OF THE BOARD, MAY ALSO REVIEW EXECUTIVE COMPENSATION AND BENEFITS. (2) THE TMECC ENGAGES AN INDEPENDENT COMPENSATION CONSULTING FIRM ON AN ANNUAL BASIS TO CONDUCT A COMPENSATION ANALYSIS FOR ITS EXECUTIVE GROUP, WHICH CONSISTS OF EMPLOYEES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. THE CURRENT COMPENSATION ADVISOR IS SULLIVAN COTTER. SULLIVANCOTTER PERFORMS ITS ANALYSIS IN THE FORM OF A COMPENSATION SURVEY ("SURVEY") THAT INCLUDES RELEVANT COMPARABILITY DATA FOR COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS (BOTH GOVERNMENTAL AND TAX EXEMPT) FOR FUNCTIONALLY COMPARABLE POSITIONS AS WELL AS THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA. SULLIVANCOTTER THEN PREPARES A SURVEY REPORT AND PROVIDES RECOMMENDATIONS TO THE TMECC, IF DEEMED APPROPRIATE, ON CHANGES IN EXECUTIVE COMPENSATION. A SEPARATE ANALYSIS USING THE SAME METHODOLOGY IS DONE FOR THE PRESIDENT AND CHIEF EXECUTIVE OFFICER. (3) THE TMECC THEN REVIEWS SULLIVAN COTTER'S REPORT AND RECOMMENDATIONS AND, IF APPROPRIATE, VOTES ON WHETHER TO RECOMMEND ANY CHANGES IN EXECUTIVE COMPENSATION TO THE BOARD. THE TMECC WILL ONLY RECOMMEND CHANGES TO THE BOARD IF THEY ARE CONSISTENT WITH THE BOARD'S PHILOSOPHY ON COMPENSATION MATTERS AND ARE DEEMED REASONABLE BASED UPON THE INDEPENDENT ANALYSIS PROVIDED BY SULLIVAN COTTER. THE TMECC'S REVIEW, DISCUSSION AND VOTE ARE DOCUMENTED IN THE MINUTES FOR THE MEETING. THERE ARE NO EXECUTIVES PRESENT DURING THE FINAL DISCUSSION AND APPROVAL. (4) THE BOARD THEN REVIEWS THE REPORT PREPARED BY SULLIVAN COTTER AS WELL AS THE RECOMMENDATIONS OF THE TMECC AS TO ANY CHANGES IN EXECUTIVE COMPENSATION. AS DEEMED APPROPRIATE, THE COMMITTEE ON FINANCE MAY ALSO PROVIDE ITS REVIEW OF THE TMECC'S RECOMMENDATIONS ON ANY CHANGES IN EXECUTIVE COMPENSATION. THIS REVIEW AND DISCUSSION ARE DOCUMENTED IN THE MINUTES. (5) THE BOARD THEN VOTES ON WHETHER TO ACCEPT THE TMECC'S RECOMMENDATIONS ON ANY CHANGES IN EXECUTIVE COMPENSATION. CHANGES IN EXECUTIVE COMPENSATION ARE MADE IF APPROVED BY THE TMECC AND BOARD ON AN ANNUAL BASIS, OR AS NECESSARY THROUGHOUT THE YEAR. THE DISCUSSION AND APPROVAL ARE DOCUMENTED IN THE MINUTES OF THE MEETING. THERE ARE NO EXECUTIVES PRESENT DURING THE FINAL DISCUSSION AND APPROVAL. IU HEALTH'S GENERAL COUNSEL ALSO PREPARES A FORMAL WRITTEN OPINION REVIEWING THE EXECUTIVE COMPENSATION APPROVAL PROCESS, COMPARING IT TO THE INTERMEDIATE SANCTIONS TEST OF IRC SECTION 4958. IF WARRANTED, IU HEALTH'S GENERAL COUNSEL MAY ALSO PROVIDE COMMENTS REGARDING THE EXECUTIVE COMPENSATION APPROVAL PROCESS AS IT RELATES TO MEETING THE REQUIREMENTS FOR A REBUTTABLE PRESUMPTION OF REASONABLENESS AS PROVIDED IN THE INTERMEDIATE SANCTIONS TEST. (6) AFTER THE END OF EACH YEAR, THE TMECC AND BOARD ALSO REVIEW THE ACHIEVEMENTS OF THE EXECUTIVE GROUP AS IT RELATES TO THE LONG-TERM AND SHORT-TERM SHARED AND INDIVIDUAL GOALS DEVELOPED BY THE EXECUTIVES AND THE BOARD. THESE ACHIEVEMENTS MAY ALSO BE REVIEWED WITH THE COMMITTEE ON FINANCE. THE BOARD, AT ITS DISCRETION, MAY APPROVE BONUS PAYMENTS BASED UPON THE ACHIEVEMENT OF THE GOALS. THE DISCUSSION AND VOTE OF THE TMECC AND BOARD IS DOCUMENTED IN THE MINUTES FOR EACH SUCH MEETING. THE BONUSES ARE NOT PAID UNTIL APPROVAL IS MADE BY THE BOARD. (7) THE TMECC AND AUDIT COMMITTEE ALSO REVIEW FORM 990 DISCLOSURES RELATED TO EXECUTIVE COMPENSATION AS WELL AS THE ORGANIZATION'S PRACTICES AND APPROVAL PROCESSES PRIOR TO THE FILING OF THE FORM 990 RETURN WITH THE INTERNAL REVENUE SERVICE. IU HEALTH ARNETT AND OTHER RELATED ENTITIES HAVE A PROCESS IN PLACE TO DETERMINE THE COMPENSATION FOR THE OTHER OFFICERS AND KEY EMPLOYEES. IU HEALTH HUMAN RESOURCES USES MARKET DATA FROM MULTIPLE COMPENSATION EXPERTS/VENDORS WHO UTILIZE A VARIETY OF METHODS AND PROCEDURES TO OBTAIN COMPENSATION RANGES FOR COMPARABLE OFFICER AND EMPLOYEE POSITIONS. THIS MARKET DATA AND MULTIPLE OTHER FACTORS (INCLUDING MARKET PAY BENCHMARKS, INTERNAL EQUITY, CANDIDATE/EMPLOYEE QUALIFICATIONS & PERFORMANCE, AND BUSINESS NEEDS) ARE USED TO RECOMMEND COMPENSATION RANGES FOR ITS OFFICERS AND OTHER EMPLOYEES, WHICH ARE THEN USED AS A GUIDE FOR SETTING REASONABLE COMPENSATION BY MANAGEMENT. Form 990, Part VI, Line 19 Required documents available to the public IU HEALTH ARNETT'S ARTICLES OF INCORPORATION ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH THE INDIANA SECRETARY OF STATE'S WEBSITE. IU HEALTH ARNETT'S CONFLICT OF INTEREST PROCEDURES ARE DISCLOSED ON THE FORM 990, SCHEDULE O. IU HEALTH ARNETT IS A SUBSIDIARY IN IU HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS. IU HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH ITS BOND FILINGS AND AS AN ATTACHMENT TO IU HEALTH'S FORM 990 AS WELL AS IU HEALTH ARNETT'S FORM 990. Form 990, Part VII, Section B, Line 1 COMP OF THE FIVE HIGHEST PD IND. CONTRACTORS THE AMOUNTS PAID TO Kettelhut CONSTRUCTION TOTALING $2,432,625 INCLUDE BOTH GOODS AND SERVICES ASSOCIATED WITH THE CONSTRUCTION OF IU Health Arnett CARDIOLOGY RELOCATION. THE AMOUNTS FOR GOODS VS. SERVICES WERE NOT EASILY SEPARATED FOR REPORTING ON THE 990, PART VII, SECTION B, INDEPENDENT CONTRACTORS. THE AMOUNTS PAID TO Hagerman CONSTRUCTION Corp TOTALING $1,997,740 INCLUDE BOTH GOODS AND SERVICES ASSOCIATED WITH THE CONSTRUCTION OF IU Health ARNETT WOUND CARE. THE AMOUNTS FOR GOODS VS. SERVICES WERE NOT EASILY SEPARATED FOR REPORTING ON THE 990, PART VII, SECTION B,INDEPENDENT CONTRACTORS. Form 990, Part VIII, Line 2f Other Program Service Revenue RENT FROM RELATED 501(C)(3) ORGS - Total Revenue: 28966, Related or Exempt Function Revenue: 28966, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue ALL OTHER REVENUE - Total Revenue: 2217824, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 2217824; Form 990, Part IX, Line 11g Other Fees SHARED SERVICES/PROF FEES - Total Expense: 90611781, Program Service Expense: 88906824, Management and General Expenses: 1704957, Fundraising Expenses: ; ARNETT CLINIC LLC 950 N MERIDIAN ST STE 800 INDIANAPOLIS IN 46204 352030653 HEALTHCARE IN 3791031 61568331 IUHA CAH PHYSICIANS LLC 950 N MERIDIAN ST STE 800 INDIANAPOLIS IN 46204 262769447 HEALTHCARE IN 0 0 IUHA CLARIAN-ARNETT OCCUP HEALTH CTRS LLC 950 N MERIDIAN ST STE 800 INDIANAPOLIS IN 46204 271973115 HEALTHCARE 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