INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC (EIN 26-2772226)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-10
- IRS object ID
- 202143149349304954
- Schema version
- 2020v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-10T13:30:50-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 262772226 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Indiana University Health Tipton Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | INDI | BusinessNameControlTxt |
| Phone | 3179634842 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 950 N MERIDIAN STREET 300 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CARA L BREIDSTER | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2021-11-10 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | CARA L | PersonFirstNm |
| Person Last | BREIDSTER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KENNETH D PUCKETT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 950 N MERIDIAN STREET 300 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $53,294,016 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-TIPTON-HOSPITAL | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2008 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 266 | TotalEmployeeCnt |
| Total Volunteers | 58 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $29,954 | PYContributionsGrantsAmt |
| CY Contributions Grants | $123,738 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $43,544,115 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $48,677,246 | CYProgramServiceRevenueAmt |
| PY Investment Income | $891,959 | PYInvestmentIncomeAmt |
| CY Investment Income | $908,025 | CYInvestmentIncomeAmt |
| PY Other Revenue | $237,559 | PYOtherRevenueAmt |
| CY Other Revenue | $205,094 | CYOtherRevenueAmt |
| PY Total Revenue | $44,703,587 | PYTotalRevenueAmt |
| CY Total Revenue | $49,914,103 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $7,050 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,496,246 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,906,662 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $28,521,231 | PYOtherExpensesAmt |
| CY Other Expenses | $29,594,488 | CYOtherExpensesAmt |
| PY Total Expenses | $41,017,477 | PYTotalExpensesAmt |
| CY Total Expenses | $43,508,200 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,686,110 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,405,903 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $60,620,574 | TotalAssetsBOYAmt |
| Total Assets EOY | $77,875,892 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $20,933,693 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $30,110,265 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $39,686,881 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $47,765,627 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $34,650,319 | ExpenseAmt |
| Grant | $7,050 | GrantAmt |
| Revenue | $47,512,647 | RevenueAmt |
| Desc | IU HEALTH TIPTON HOSPITAL IS A 25-BED ACUTE-CARE AND CRITICAL ACCESS HOSPITAL THAT OFFERS A BROAD RANGE OF SERVICES TO CARE FOR ITS PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. IU HEALTH TIPTON HOSPITAL PROVIDES LEADING-EDGE, PATIENT-CENTERED CARE, AS WELL AS PERSONALIZED NURSING CARE, IN A WIDE RANGE OF MEDICAL SPECIALTIES TO RESIDENTS OF TIPTON COUNTY AND ITS SURROUNDING COMMUNITIES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $0 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $660,721 | RevenueAmt |
| Desc | As of December 31, 2020, Indiana University Health Tipton Hospital, 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 Tipton Hospital recognized $660,721 as other program service revenue. Indiana University Health Tipton Hospital, Inc. will continue to monitor compliance with the terms and conditions of the Provider Relief Fund. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $285,473 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $391,442 | RevenueAmt |
| Desc | IU HEALTH TIPTON HOSPITAL RECEIVES REVENUE THROUGH INPATIENT AND OUTPATIENT PHARMACY SERVICES, AS WELL AS THE ON-SITE RETAIL PHARMACY. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (2 entries)
| ExpenseExpenseAmt | GrantGrantAmt | RevenueRevenueAmt | DescDesc |
|---|---|---|---|
| $44,637 | $0 | $61,206 | IU HEALTH TIPTON HOSPITAL, INC. RECEIVES "SHARED SERVICES" REVENUE BY SHARING/PROVIDING SERVICES WITH INDIANA UNIVERSITY HEALTH CARE ASSOCIATES, INC. AND INDIANA UNIVERSITY HEALTH, INC. (SAXONY). |
| $37,361 | $0 | $51,230 | IU HEALTH TIPTON HOSPITAL, INC. RECEIVES RENTAL REVENUE FROM A RELATED EXEMPT ORGANIZATION, IU HEALTH CARE ASSOCIATES, INC. FOR VARIOUS OFFICES AND CLINICS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $81,998 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $112,436 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $35,017,790 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 28 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 266 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRAIG J JONES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3179634842 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 950 N MERIDIAN ST SUITE 300 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| LINDA G JOINES | |||||||||
| DIRECTOR / SECRETARY | 1.0 | 0 | Yes (X) | Yes (X) | $3,600 | $0 | $0 | ||
| STEVEN A WERTZ | |||||||||
| DIRECTOR / CHAIR | 1.0 | 0 | Yes (X) | Yes (X) | $3,600 | $0 | $0 | ||
| BEN B HOBBS | |||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $3,600 | $0 | $0 | |||
| DAVID L VORIS | |||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $3,600 | $0 | $0 | |||
| DESTRY W LAMBERT MD | |||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $3,600 | $0 | $0 | |||
| TAMERA N BROWN | |||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $3,600 | $0 | $0 | |||
| CARA L BREIDSTER | |||||||||
| REGIONAL CFO (ISR) | 10.0 | 45.0 | Yes (X) | $0 | $367,659 | $44,376 | |||
| KENNETH D PUCKETT | |||||||||
| REGIONAL PRESIDENT (ISR) | 10.0 | 45.0 | Yes (X) | $0 | $818,678 | $142,031 | |||
| MICHAEL L HARLOWE | |||||||||
| PRESIDENT | 55.0 | 0.0 | Yes (X) | $325,544 | $9,979 | $35,217 | |||
| ARTHUR VASQUEZ | |||||||||
| REGIONAL COO (ISR) | 10.0 | 45.0 | $0 | $397,727 | $50,567 | Yes (X) | |||
| HARPREETINDER SINGH MD | |||||||||
| REGIONAL CMO (ISR) | 10.0 | 45.0 | $0 | $463,852 | $40,484 | Yes (X) | |||
| LISA A SPARKS RN | |||||||||
| REGIONAL CNO (ISR) | 10.0 | 45.0 | $0 | $291,471 | $48,004 | Yes (X) | |||
| TAMARAH D BROWNLEE | |||||||||
| REGIONAL VP-HR (ISR) | 10.0 | 45.0 | $0 | $209,222 | $48,321 | Yes (X) | |||
| ANGELA K MORGAN | |||||||||
| MANAGER - PHARMACY DEPT. | 50.0 | 0 | $146,273 | $0 | $44,634 | Yes (X) | |||
| JEFFREY W MOORE RN | |||||||||
| ANESTHETIST | 50.0 | 0 | $180,126 | $0 | $11,654 | Yes (X) | |||
| MELISSA R HICKS | |||||||||
| CNO - VP PT CARE SVCS | 50.0 | 0 | $172,936 | $0 | $30,148 | Yes (X) | |||
| SARAH BURKS | |||||||||
| Manager-Rehabilitation Services | 50.0 | 0 | $119,094 | $0 | $7,884 | Yes (X) | |||
| STEVEN SNELL | |||||||||
| PHARMACIST | 50.0 | 0 | $122,460 | $0 | $2,659 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,088,034 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,558,588 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $505,977 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 11 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| TRIMEDX LLC | |||||
| 5451 LAKEVIEW PKWY S DR | INDIANAPOLIS | IN | 46268 | CLINICAL ENGINEERING | $1,037,774 |
| ANESTHESIA CONSULTANTS OF INDIANAPOLIS | |||||
| 3815 RIVER CROSSING PKWY | INDIANAPOLIS | IN | 46240 | MEDICAL STAFFING | $395,167 |
| PEPPER CONSTRUCTION COMPANY OF INDIANA | |||||
| 1850 W 15TH STREET | INDIANAPOLIS | IN | 46202 | CONSTRUCTION | $234,229 |
| OTIS ELEVATOR CO | |||||
| PO BOX 73579 | CHICAGO | IL | 606737579 | FACILITIES MGMT. | $154,729 |
| SODEXO INC AND AFFILIATES | |||||
| PO BOX 360170 | PITTSBURGH | PA | 152516170 | Facilities | $118,992 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $123,738 | RelatedOrganizationsAmt |
| Total Contributions | $123,738 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 622100 | $47,512,647 | $47,512,647 |
| FEDERAL RECOVERY REVENUE | 541900 | $660,721 | $660,721 |
| PHARMACY | 446110 | $391,442 | $391,442 |
| SHARED SERVICES | 532000 | $61,206 | $61,206 |
| RENT FROM RELATED 501(C)(3) ORGS. | 900099 | $51,230 | $51,230 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $48,677,246 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $454,967 | TotalRevenueColumnAmt |
| Exclusion | $454,967 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,832,971 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,379,913 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $453,058 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $453,058 | TotalRevenueColumnAmt |
| Exclusion | $453,058 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA/FOOD SERVICE | Desc |
| Business | 722320 | BusinessCd |
| Total Revenue Column | $136,636 | TotalRevenueColumnAmt |
| Exclusion | $136,636 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $68,458 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $68,458 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $205,094 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,914,103 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $48,677,246 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,113,119 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,050 | TotalAmt |
| Program Services | $7,050 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $381,313 | TotalAmt |
| Program Services | $350,836 | ProgramServicesAmt |
| Management And General | $30,477 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,647,790 | TotalAmt |
| Program Services | $9,816,301 | ProgramServicesAmt |
| Management And General | $831,489 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $402,174 | TotalAmt |
| Program Services | $370,768 | ProgramServicesAmt |
| Management And General | $31,406 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,686,124 | TotalAmt |
| Program Services | $1,554,454 | ProgramServicesAmt |
| Management And General | $131,670 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $789,261 | TotalAmt |
| Program Services | $727,627 | ProgramServicesAmt |
| Management And General | $61,634 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,612 | TotalAmt |
| Management And General | $2,612 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,394,050 | TotalAmt |
| Program Services | $5,962,736 | ProgramServicesAmt |
| Management And General | $6,431,314 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,571 | TotalAmt |
| Management And General | $18,571 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,827 | TotalAmt |
| Program Services | $73,576 | ProgramServicesAmt |
| Management And General | $51,251 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,320 | TotalAmt |
| Program Services | $38,157 | ProgramServicesAmt |
| Management And General | $14,163 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,527,476 | TotalAmt |
| Program Services | $2,527,476 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,955 | TotalAmt |
| Program Services | $6,096 | ProgramServicesAmt |
| Management And General | $1,859 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,867 | TotalAmt |
| Program Services | $3,867 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $658,849 | TotalAmt |
| Program Services | $1,541 | ProgramServicesAmt |
| Management And General | $657,308 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,486,505 | TotalAmt |
| Program Services | $1,486,505 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $222,955 | TotalAmt |
| Management And General | $222,955 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| DRUGS AND MEDICAL SUPPLIES | $9,151,696 | $9,151,696 |
| BAD DEBT | $1,617,420 | $1,617,420 |
| HOSPITAL ASSESSMENT FEE | $1,161,849 | $1,161,849 |
| EQUIPMENT - REPAIRS & MAINTENACE | $100,659 | $100,659 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,877 | TotalAmt |
| Program Services | $59,176 | ProgramServicesAmt |
| Management And General | $3,701 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,508,200 | TotalAmt |
| Program Services | $35,017,790 | ProgramServicesAmt |
| Management And General | $8,490,410 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,110,122 | BOYAmt |
| EOY | $41,706,629 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,888 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,947,670 | BOYAmt |
| EOY | $5,971,878 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $720,147 | BOYAmt |
| EOY | $1,015,955 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $211,789 | BOYAmt |
| EOY | $141,328 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,182,226 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,244,421 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,216,314 | BOYAmt |
| EOY | $4,937,805 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,224,969 | BOYAmt |
| EOY | $5,708,678 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,471,959 | BOYAmt |
| EOY | $9,077,294 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,712,716 | BOYAmt |
| EOY | $9,316,325 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,620,574 | BOYAmt |
| EOY | $77,875,892 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,610,940 | BOYAmt |
| EOY | $10,496,698 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,322,753 | BOYAmt |
| EOY | $19,613,567 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,933,693 | BOYAmt |
| EOY | $30,110,265 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,974,165 | BOYAmt |
| EOY | $38,449,302 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,712,716 | BOYAmt |
| EOY | $9,316,325 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,686,881 | BOYAmt |
| EOY | $47,765,627 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,620,574 | BOYAmt |
| EOY | $77,875,892 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $6,405,903 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $69,235 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $1,603,608 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $2,612 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,612 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | FormAndLineReferenceDesc |
| Explanation | IU Health Tipton Hospital paid institutional membership dues to the American Hospital Association ("AHA") and Indiana Hospital Association ("IHA") during 2020 in the amount of $10,131 and $3,463 respectively. Each membership organization notified IU Health Tipton Hospital that a portion of the dues it paid were used for lobbying purposes. The AHA used 23.32%, or $2,363 of the 2020 membership dues paid by IU Health Tipton Hospital, for lobbying expenditures. The IHA used 7.18%, or $249 of the 2020 membership dues paid by IU Health Tipton Hospital, for lobbying expenditures. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,712,716 | BeginningYearBalanceAmt |
| Contributions | $1,800 | ContributionsAmt |
| Investment Earnings Or Losses | $2,107,729 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $406,456 | GrantsOrScholarshipsAmt |
| Other Expenditures | $99,465 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $9,316,324 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,019,574 | BeginningYearBalanceAmt |
| Contributions | $24,796 | ContributionsAmt |
| Investment Earnings Or Losses | -$857,577 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $228,218 | GrantsOrScholarshipsAmt |
| Other Expenditures | $159,671 | OtherExpendituresAmt |
| Administrative Expenses | $86,188 | AdministrativeExpensesAmt |
| End Year Balance | $7,712,716 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,318,829 | BeginningYearBalanceAmt |
| Contributions | $14,939 | ContributionsAmt |
| Investment Earnings Or Losses | $808,027 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $37,773 | GrantsOrScholarshipsAmt |
| Other Expenditures | $967 | OtherExpendituresAmt |
| Administrative Expenses | $83,481 | AdministrativeExpensesAmt |
| End Year Balance | $9,019,574 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,384,234 | BeginningYearBalanceAmt |
| Contributions | $28,793 | ContributionsAmt |
| Investment Earnings Or Losses | $289,716 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $220,452 | GrantsOrScholarshipsAmt |
| Other Expenditures | $79,078 | OtherExpendituresAmt |
| Administrative Expenses | $84,384 | AdministrativeExpensesAmt |
| End Year Balance | $8,318,829 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,669,107 | BeginningYearBalanceAmt |
| Contributions | $134,061 | ContributionsAmt |
| Investment Earnings Or Losses | -$114,159 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $218,496 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $86,279 | AdministrativeExpensesAmt |
| End Year Balance | $8,384,234 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.0 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.64 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.36 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,734,185 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,796,634 | DepreciationAmt |
| Book Value | $2,937,551 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,872,457 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,433,128 | DepreciationAmt |
| Book Value | $1,439,329 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $575,584 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,659 | DepreciationAmt |
| Book Value | $560,925 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,937,805 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INT. IN NET ASSETS OF FNDTN. | Desc |
| Book Value | $9,316,325 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $9,316,325 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERCOMPANY PAYABLES (NET) | $16,177,664 |
| DUE TO THIRD-PARTY PAYERS | $3,006,591 |
| SELF INSURANCE LIABILITIES | $26,497 |
| OPERATING LEASE LIABILITIES | $402,815 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $19,613,567 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part V, Line 4 Intended uses of endowment funds | TEMPORARILY AND PERMANENTLY RESTRICTED NET ASSETS REPRESENT ENDOWMENTS HELD BY TIPTON COUNTY FOUNDATION, INC., AN UNRELATED 501(C)(3) TAX EXEMPT ORGANIZATION, OF WHICH INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL, INC. IS THE BENEFICIARY. THE USES OF THE FUNDS ARE IN ACCORDANCE WITH THE DONOR-RESTRICTIONS OF EACH ENDOWMENT. |
| Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | IU Health Tipton Hospital is a subsidiary in IU Health's 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. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 599 | PersonsServedCnt |
| Total Community Benefit Expns | $341,475 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $341,475 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0082 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1899 | PersonsServedCnt |
| Total Community Benefit Expns | $7,440,907 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,272,288 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,168,619 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0756 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 2498 | PersonsServedCnt |
| Total Community Benefit Expns | $7,782,382 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,272,288 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,510,094 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0838 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 207 | PersonsServedCnt |
| Total Community Benefit Expns | $209,535 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $209,535 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0050 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 15 | PersonsServedCnt |
| Total Community Benefit Expns | $78,878 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $78,878 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0019 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 2564 | PersonsServedCnt |
| Total Community Benefit Expns | $176,869 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $176,869 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0042 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 2786 | PersonsServedCnt |
| Total Community Benefit Expns | $465,282 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $465,282 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0111 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 5284 | PersonsServedCnt |
| Total Community Benefit Expns | $8,247,664 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,272,288 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,975,376 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0949 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $551,378 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $15,603,086 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $15,256,009 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $347,077 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IU HEALTH TIPTON HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 S MAIN ST | AddressLine1Txt |
| City | TIPTON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46072 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-TIPTON-HOSPITAL | WebsiteAddressTxt |
| State License | 22-005049-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IU HEALTH TIPTON HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://iuhealth.org/in-the-community/community-benefit | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://iuhealth.org/in-the-community/community-benefit | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0.0 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://iuhealth.org/pay-a-bill/financial-assistance | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://iuhealth.org/pay-a-bill/financial-assistance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://iuhealth.org/pay-a-bill/financial-assistance | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 3E | IU Health Tipton Hospital'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 needs as priorities for IU Health Tipton Hospital: - Access to Healthcare Services - Aging Population and Needs of Seniors - Chronic Disease Management - Drug and Substance Abuse (including Opioids and Alcohol)* - Mental Health* - Transportation IU HEALTH USES THE TERM BEHAVIORAL HEALTH TO REFER MENTAL HEALTH AND DRUG AND SUBSTANCE ABUSE (INCLUDING OPIOIDS AND ALCOHOL). |
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - IU HEALTH TIPTON HOSPITAL. IU HEALTH TIPTON HOSPITAL'S APPROACH TO GATHERING QUALITATIVE DATA FOR ITS 2018 CHNA CONSISTED OF A MULTI-COMPONENT APPROACH TO IDENTIFY AND VERIFY COMMUNITY HEALTH NEEDS FOR THE IU HEALTH TIPTON HOSPITAL SERVICE AREA. THIS INCLUDED THE FOLLOWING COMPONENTS: 1. COMMUNITY MEETINGS 2. KEY STAKEHOLDER INTERVIEWS 3. COMMUNITY SURVEY COMMUNITY MEETINGS: TO OBTAIN A MORE COMPLETE UNDERSTANDING OF THE COMMUNITY HEALTH NEEDS IT SERVES, IU HEALTH TIPTON HELD TWO COMMUNITY MEETINGS WITH PUBLIC HEALTH OFFICIALS AND COMMUNITY LEADERS. THE COMMUNITY MEETINGS WERE HELD ON APRIL 17, 2018 AT THE HAMILTON COUNTY 4H FAIRGROUNDS IN NOBLESVILLE AND ON MAY 2, 2018 AT THE IU HEALTH TIPTON HOSPITAL IN TIPTON. THE GOAL OF SOLICITING THESE LEADERS' FEEDBACK WAS TO GATHER INSIGHTS INTO THE QUANTITATIVE DATA THAT MAY NOT BE EASILY IDENTIFIED FROM THE SECONDARY STATISTICAL DATA ALONE. ORGANIZATIONS WHO PARTICIPATED IN THE FOCUS GROUPS IN TIPTON COUNTY INCLUDED: -TIPTON COUNTY FIRE DEPARTMENT -ALTERNATIVES, INC. -TIPTON SCHOOLS -TIPTON EMERGENCY DEPARTMENT -TIPTON COUNTY FOUNDATION -TIPTON COUNTY SCHOOL NURSE -FOUR COUNTY COUNSELING CENTER -PURDUE EXTENSION -TIPTON CHAMBER OF COMMERCE -TIPTON COUNTY HEALTH DEPARTMENT -ASPIRE INDIANA -CENTRAL INDIANA COUNCIL ON AGING (CICOA) -CHAUCIE'S PLACE -DEPARTMENT OF CHILD SERVICES -FISHERS CITY COUNCIL -GOOD SAMARITAN NETWORK -HAND, INC. -HOPE FAMILY CARE CENTER -HAMILTON COUNTY COUNCIL ON ALCOHOL AND OTHER DRUGS -HAMILTON COUNTY HEALTH DEPARTMENT -HAMILTON COUNTY HARVEST FOOD BANK -NOBLESVILLE CHAMBER OF COMMERCE -NOBLESVILLE SCHOOLS -PARTNERSHIP FOR A HEALTHY HAMILTON COUNTY -PREVAIL, INC. -PRIMELIFE ENRICHMENT, INC. -SHEPARD'S CENTER OF HAMILTON COUNTY -STONES 3 RESOURCES -TRINITY FREE CLINIC -WESTFIELD WASHINGTON SCHOOLS AT EACH OF THE COMMUNITY MEETINGS, IU HEALTH FACILITATORS PRESENTED THE GOALS AND REQUIREMENTS OF THE CHNA, REVIEWED SECONDARY HEALTH DATA INCLUDING DEMOGRAPHICS, INSURANCE INFORMATION, POVERTY RATES AND COUNTY HEALTH RANKINGS, CAUSES OF DEATH, PHYSICAL ACTIVITY, CHRONIC CONDITIONS AND PAST NEEDS IDENTIFIED DURING THE PREVIOUS CHNA CYCLE. AT THE TIPTON COUNTY MEETING, EACH PARTICIPANT WAS ASKED TO SELECT THE TOP FIVE HEALTH NEEDS. AFTER THE RESULTS WERE TALLIED, A DISCUSSION TO GAIN CONSENSUS OF THE TOP FIVE HEALTH NEEDS OF THE COMMUNITY WAS CONDUCTED, ALONG WITH CURRENT RESOURCES AND GAPS FOR EACH NEED WAS DISCUSSED. THIS WAS INTENDED TO INSPIRE CANDID DISCUSSIONS AND GIVE LEADERS ANOTHER CHANCE TO VOTE FOR THEIR TOP FIVE NEEDS FROM THE LIST. THE FOCUS GROUP CONCLUDED BY SHARING A TIMELINE OF NEXT STEPS AND ACCOMPLISHMENTS SINCE THE LAST CHNA. DUE TO THE SIZE OF THE GROUP AT THE HAMILTON COUNTY MEETING, PARTICIPANTS WERE SPLIT INTO THREE GROUPS. THE SAME LIST WAS PROVIDED TO EACH GROUP OF POTENTIAL UNMET HEALTH NEEDS FOR THE INDIVIDUALS TO DISCUSS AND VOTE ON TO INDICATE WHAT THEY CONSIDERED TO BE THE MOST SIGNIFICANT HEALTH NEEDS FOR HAMILTON COUNTY. KEY STAKEHOLDER INTERVIEWS: IU HEALTH TIPTON ALSO CONDUCTED AN INTERVIEW WITH A REPRESENTATIVE OF THE HAMILTON COUNTY PUBLIC HEALTH DEPARTMENT WHO ALSO ATTENDED THE NOBLESVILLE COMMUNITY MEETING. THE INTERVIEW WAS CONDUCTED TO ASSURE THAT APPROPRIATE AND ADDITIONAL INPUT WAS RECEIVED FROM A GOVERNMENT PUBLIC HEALTH OFFICIAL. ACCORDINGLY, THE RESULTS OF THE COMMUNITY MEETINGS WERE DISCUSSED AND INSIGHTS WERE SOUGHT OUT REGARDING SIGNIFICANT COMMUNITY HEALTH NEEDS, WHY SUCH NEEDS ARE PRESENT, AND HOW THESE NEEDS CAN BE ADDRESSED. COMMUNITY SURVEY: IU HEALTH TIPTON ALSO SOLICITED RESPONSES FROM THE GENERAL PUBLIC REGARDING THE HEALTH OF THE IU HEALTH TIPTON COMMUNITY THROUGH A COMMUNITY SURVEY CONDUCTED BY THE INDIANA HOSPITAL COLLABORATIVE. A QUESTIONNAIRE WAS DEVELOPED, WITH INPUT PROVIDED BY THE INDIANA HOSPITAL SYSTEMS, AND INCLUDED A NUMBER OF QUESTIONS ABOUT THE GENERAL HEALTH STATUS, ACCESS AND UTILIZATION OF SERVICES, PERSONAL BEHAVIORS, SOCIAL DETERMINANTS OF HEALTH, AND ALSO RESPONDENT DEMOGRAPHIC INFORMATION. THE SURVEYS WERE MAILED TO APPROXIMATELY 82,000 HOUSEHOLDS BETWEEN APRIL 2, 2018 AND JUNE 29, 2018 ACROSS THE STATE OF INDIANA. OVERALL, 9,161 COMPLETED THE QUESTIONNAIRES WERE RECEIVED BY ALL OF THE PARTICIPATING HOSPITALS, FOR AN OVERALL RESPONSE RATE OF 11.6%, 5,030 QUESTIONNAIRES WERE RECEIVED FROM THE 17 INDIANA COUNTIES SERVED BY ONE OR MORE OF THE IU HEALTH HOSPITALS. A DATASET WAS THEN CREATED FROM THE IU HEALTH SURVEY RESPONSES, AND THE RESPONSES WERE ADJUSTED FOR TWO FACTORS; THE NUMBER OF ADULTS IN EACH HOUSEHOLD AND A POST-STRATIFICATION ADJUSTMENT DESIGNED TO MAKE THE RESULTS MORE REPRESENTATIVE OF THE POPULATION IN EACH COMMUNITY. FOR IU HEALTH TIPTON HOSPITAL, SURVEYS WERE RECEIVED FROM 620 COMMUNITY HOUSEHOLDS. BELOW IS THE ASSESSMENT OF SECONDARY DATA REGARDING THE HEALTH NEEDS OF THE COMMUNITY, WHICH IU HEALTH TIPTON HOSPITAL SERVES. THE HOSPITAL'S COMMUNITY IS COMPRISED OF TIPTON AND HAMILTON COUNTIES IN INDIANA. THE SURVEY SAMPLE WAS 92.1% CAUCASIAN (WHITE) AND 50.7% WERE FEMALE. THE EDUCATIONAL ATTAINMENT OF THE COMMUNITY WAS VERY HIGH AS 92.6% REPORTED COMPLETING HIGH SCHOOL OR GED, 39.4% REPORTED COMPLETING A BACHELOR'S DEGREE OR HIGHER. SURVEY RESPONDENTS ALSO WERE ASKED TO REPORT THEIR INSURANCE STATUS. A MAJORITY OF RESPONDENTS HAD COMMERCIAL/PRIVATE INSURANCE (93.8%), FOLLOWED BY A SMALL PERCENTAGE REPORTING TO BE UNINSURED/SELF-PAY (6.2%). SUBSEQUENT TO THE ACA'S PASSAGE, A JUNE 2012 SUPREME COURT RULING PROVIDED STATES WITH THE DISCRETION REGARDING WHETHER OR NOT TO EXPAND MEDICAID ELIGIBILITY. INDIANA WAS ONE OF THOSE STATES THAT EXPANDED MEDICAID. ACROSS THE UNITED STATES, UNINSURED RATES HAVE FALLEN MOST IN STATES THAT DECIDED TO EXPAND MEDICAID. |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - IU HEALTH TIPTON HOSPITAL. In conjunction with the community health needs assessment (CHNA), IU Health Tipton's Board adopted an implementation strategy in April 2019 related to the 2018 CHNA. IU Health Tipton 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 Tipton will address the following community health needs between 2019 and 2021: - Access to Healthcare - Aging Population and Needs of Seniors - Chronic Disease Management - Drug and Substance Abuse (including Opioids and Alcohol)* - Mental Health* - Transportation - IU Health uses the term behavioral health to refer to mental health and drug and substance abuse (including opioids and alcohol). Behavioral Health IU Health Tipton Hospital's implementation strategy to address the identified need of behavioral health includes the following: - Provide access to meeting spaces and supplies (through grant funds) for the local smoking cessation program - Partnered with the local smoking cessation coordinator and the Tipton County Health Department on the Smoking Cessation program for the community. IU Health Tipton Hospital sponsored the program by providing a $3,000 grant to help cover costs to facilitate the program as well as providing the meeting space. The program is offered on a one-on-one basis so the member feels more comfortable sharing information. Meetings were held within the hospital to help provide a safe and neutral space. The goal for the program is to decrease the number of community members who use tobacco by providing them tools to quit smoking. Overall meeting numbers for 2020 were down due to COVID-19 and the federal, state and hospital coronavirus requirements. Remaining funds from the hospital grant will be carried over to the 2021 calendar year to help continue support for the program. - Provide 24/7 peer counseling via telemedicine for patients who present in the emergency department with substance abuse issues - The virtual peer recovery program at IU Health Tipton saw 66 patients in 2020. Alcohol was documented as the cause in 40 of the 66 patients seen. After initial evaluation in the emergency department, if a physician recommends the peer recovery program, the patient is connected to a coach. The patient is connected to the coach on average within 10 minutes (average among all participating Emergency Departments in the system). A total of 75% of the patients referred accepted peer recovery care. In 2020 there were a total of 175 total peer recovery sessions, and 77.69% of the peer recovery program encounters had successful follow-ups. - Provide trained behavioral health clinicians to telemedicine visits for patients who present in the emergency department with behavioral health issues - The telemedicine program in the IU Health Tipton emergency department provides trained behavioral health clinicians to patients who present in the ED with behavioral health needs. The program saw 42 patients in 2020. The top needs of the patients seen were major depressive disorder, anxiety disorders and suicidal ideations. Aging Population and Needs of Seniors and Transportation IU Health Tipton Hospital's implementation strategy to address the identified need of aging population and needs of seniors includes the following: - Provide access to free screenings, general health education and activities to promote active and healthy lifestyles for seniors - Team members assembled a total of 100 hygiene and cleaning kits for members of the local senior center. Many seniors remained at home during the COVID-19 pandemic with limited opportunities to get out and access necessary supplies. The kits included items like toilet paper, soap, shampoo, laundry detergent, dish soap and body wipes. These kits were provided to members of the senior center in partnership with the Encore Lifestyle and Enrichment Center. - Provide transportation to seniors utilizing community organizations' buses - IU Health Tipton partnered with the Encore Lifestyle and Enrichment Center (Senior Center) to provide a $4,000 grant for the 2020 transportation program. The program provided a total of 3,392 rides in 2020. This number was down from 2019 due to the program being shut down for 11 weeks because of the pandemic. There are equally high needs for transportation to pharmacy, physician, grocery, banking, etc. In total, 304 rides were provided to IU Health Tipton Hospital for appointments. The vehicles were also able to be used to deliver meals to those seniors' homes who otherwise were having difficulty securing meals during the stay-at-home order. Access to Healthcare IU Health Tipton Hospital's implementation strategy to address the identified need of access to healthcare includes the following: - Work with the Tipton County Foundation, Women's Fund, to establish a mammography screening program for underserved community members (same as Chronic Disease strategy) - The hospital will work with the Tipton County Foundation to research the possibility of establishing a program for underserved community members to have access to mammogram screenings. There have been discussions around this program, however no formal program or policies have been created. The hospital will continue to partner with the county foundation on the research for the program. Chronic Disease IU Health Tipton Hospital's implementation strategy to address the identified need of chronic disease includes the following: - Promote health, wellness and good nutrition and active living through our annual Days of Service by making improvements to local parks, thus encouraging greater physical activity in the parks by community members - The annual Day of Service event was with the local Tipton City Park. The entire community has access to the park and all of the activities, the county population is approximately 15,000. Team member volunteers worked remotely in 2020 to complete projects for local organizations. Projects included a HOPE tree full of wooden ornaments with hand painted encouraging messages for the community; painted fence panels for the local park, hand painted fun designs to create fun backgrounds for photos, learning opportunities and conversation starters; hand written note cards for educators in the community, cards were delivered to both school systems in the community. IU Health Tipton Hospital will address all the community health needs based on their 2018 Community Health Needs Assessment. |
| Schedule H, Part V, Section B, Line 13 Facility , 1 | Facility , 1 - IU HEALTH TIPTON HOSPITAL. IN ADDITION TO FPG, IU HEALTH TIPTON HOSPITAL 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 TIPTON HOSPITAL. IU Health Tipton Hospital 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 will treat the adult as a dependent for purposes of the FPL calculation. IU Health 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, 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 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 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 V, Section B, Line 16 Facility , 1 | Facility , 1 - IU HEALTH TIPTON HOSPITAL. IU Health Tipton Hospital 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 0 | FacilityNum |
Supplemental Information Detail SupplementalInformationDetail (21 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 6a C.B. REPORT PREPARED BY A RELATED ORG. | IU HEALTH TIPTON HOSPITAL'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 BAD DEBT EXPENSE | Bad debt expense is reported on a cost based on the cost-to-charge ratio derived from Worksheet 2, ratio of patient care-cost-to charges. 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 $1,617,420. |
| Schedule H, Part I, Line 7 TOTAL COMMUNITY BENEFIT EXPENSE | SCHEDULE H, PART I, LINE 7, COLUMN (F), PERCENT OF TOTAL EXPENSE, IS BASED ON COLUMN (E) NET COMMUNITY BENEFIT EXPENSE. THE PERCENT OF TOTAL EXPENSE BASED ON COLUMN (C) TOTAL COMMUNITY BENEFIT EXPENSE, WHICH DOES NOT INCLUDE DIRECT OFFSETTING REVENUE, IS 19.69%. |
| Schedule H, Part II PROMOTION OF HEALTH IN COMMUNITIES SERVED | IU Health Tipton Hospital participates in a variety of community-building activities that address the social determinants of health in the communities it serves. IU Health Tipton 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 Tipton'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: - Encore Lifestyle and Enrichment Center - Tipton City Park - Tipton County Health Department 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 Tipton Hospital 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 will treat the adult as a dependent for purposes of the FPL calculation. IU Health 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, 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 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 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 6a Community benefit report prepared by related organization | Indiana University Health, Inc. |
| Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation | 1617420 |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | THE BAD DEBT EXPENSE REPORTED ON SCHEDULE H, PART III, LINE 2 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 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 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 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 Tipton Hospital is a subsidiary in the consolidated financial statements of IU Health. IU Health's consolidated financial statements, footnote 4, addresses bad debt expense 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 | IU HEALTH TIPTON HOSPITAL DID NOT HAVE A MEDICARE SHORTFALL FOR 2020. IU HEALTH TIPTON HOSPITAL'S MEDICARE REIMBURSEMENTS, HOWEVER, ARE NORMALLY LESS THAN THE COST OF PROVIDING PATIENT CARE AND SERVICES TO MEDICARE BENEFICIARIES AND DO NOT INCLUDE ANY AMOUNTS THAT RESULT FROM INEFFICIENCIES OR POOR MANAGEMENT. IU Health Tipton Hospital 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. 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 Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health'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 Tipton Hospital's participation in Medicare programs would significantly reduce the Medicare surplus reported on Schedule H, Part III, Line 7. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | IU Health Tipton Hospital'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 TIPTON 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 TIPTON 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 TIPTON 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 TIPTON HOSPITAL 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 TIPTON HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES BY CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR EACH OF ITS HOSPITAL LOCATIONS. FOR THE 2018 CHNAS, INDIANA UNIVERSITY HEALTH 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 TIPTON HOSPITAL 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 COMMUNITIES 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 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 Tipton Hospital is committed to serving the healthcare needs of all of its patients regardless of their ability to pay for such services. To assist in meeting those needs, IU Health Tipton Hospital has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health Tipton Hospital is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health Tipton Hospital will make a good faith effort to locate and obtain health insurance coverage for patients prior to considering patients for coverage under the FAP. IU Health Tipton Hospital 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 Tipton Hospital is located in Tipton County, Indiana, a county located in central Indiana. Tipton County includes ZIP codes within the towns of Tipton, Elwood, Windfall City, Kempton, and Sharpsville. Based on the most recent Census Bureau (2020) statistics, Tipton County's population is 15,359, with approximately 50.2% being female and 49.8% male. The county's population estimates by race are 94.6% white, 2.9% Hispanic, 0.7% Black, 0.6% Asian, 0.4% American Indian or Alaska Native, and 1.1% persons reporting two or more races. Tipton County has relatively Moderate levels of educational attainment. Among residents ages 25 and up, 89.3% completed their education with a high school diploma or equivalent. 24.7% had a bachelor's degree or higher. About 10.7% ended their formal education before finishing high school. |
| Schedule H, Part VI, Line 5 Promotion of community health | IU Health Tipton Hospital is committed to improving the future of our community members by offering programs and grants that lead to improved health. Community benefit highlights are focused on Access to Healthcare, Aging Population and Needs of Seniors, Chronic Disease Management, Behavioral Health and Transportation. In 2020, IU Health Tipton Hospital continued our support of the transportation program operated by our local senior center through grant funding. The transportation program provides necessary rides to healthcare appointments, pharmacy, grocery store, banking, and other destinations for basic living needs. Hospital team members also assembled 100 hygiene kits that were donated to senior citizens in the community. During the COVID-19 pandemic many seniors remained at home with limited opportunities to get out and access necessary supplies. Our kits provided them items like toilet paper, soap, shampoo, laundry detergent, dish soap and body wipes. These kits were provided to members of the senior center in partnership with the Encore Lifestyle and Enrichment Center. The hospital partnered with the IU Health Foundation to provide two Community Impact Grants to local organizations to help with needs brought on by the coronavirus pandemic. The Boys and Girls Club of Tipton County utilized the funding to purchase and install two water fountains with the water bottle filling station and a four-person hand washing station. The local Good Shepherd Food Pantry sought additional funding to provide hygiene and household cleaning supply kits to over 80 families monthly for the reminder of 2020. IU Health Tipton Hospital is a subsidiary of IU Health. IU Health extends 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. |
| Schedule H, Part VI, Line 6 Affiliated health care system | IU Health Tipton Hospital 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 Tipton Hospital 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 Tipton Hospital 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 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENNETH D PUCKETT | ||||||||||||||
| REGIONAL PRESIDENT (ISR) | $0 | $530,772 | $0 | $264,649 | $0 | $23,256 | $0 | $110,203 | $0 | $31,828 | $0 | $960,708 | $0 | $0 |
| MICHAEL L HARLOWE | ||||||||||||||
| PRESIDENT | $251,509 | $7,709 | $41,084 | $1,259 | $32,951 | $1,010 | $6,792 | $208 | $27,377 | $839 | $359,713 | $11,026 | $0 | $0 |
| CARA L BREIDSTER | ||||||||||||||
| REGIONAL CFO (ISR) | $0 | $264,625 | $0 | $46,094 | $0 | $56,940 | $0 | $18,631 | $0 | $25,745 | $0 | $412,036 | $0 | $0 |
| HARPREETINDER SINGH MD | ||||||||||||||
| REGIONAL CMO (ISR) | $0 | $348,976 | $0 | $59,386 | $0 | $55,490 | $0 | $17,044 | $0 | $23,440 | $0 | $504,335 | $0 | $0 |
| ARTHUR VASQUEZ | ||||||||||||||
| REGIONAL COO (ISR) | $0 | $312,385 | $0 | $50,036 | $0 | $35,305 | $0 | $18,400 | $0 | $32,167 | $0 | $448,294 | $0 | $0 |
| LISA A SPARKS RN | ||||||||||||||
| REGIONAL CNO (ISR) | $0 | $225,418 | $0 | $37,088 | $0 | $28,966 | $0 | $16,988 | $0 | $31,016 | $0 | $339,475 | $0 | $0 |
| TAMARAH D BROWNLEE | ||||||||||||||
| REGIONAL VP-HR (ISR) | $0 | $167,995 | $0 | $28,939 | $0 | $12,288 | $0 | $13,635 | $0 | $34,685 | $0 | $257,543 | $0 | $0 |
| MELISSA R HICKS | ||||||||||||||
| CNO - VP PT CARE SVCS | $137,068 | $0 | $19,040 | $0 | $16,828 | $0 | $10,689 | $0 | $19,458 | $0 | $203,084 | $0 | $0 | $0 |
| JEFFREY W MOORE RN | ||||||||||||||
| ANESTHETIST | $178,734 | $0 | $600 | $0 | $792 | $0 | $11,654 | $0 | $0 | $0 | $191,781 | $0 | $0 | $0 |
| ANGELA K MORGAN | ||||||||||||||
| MANAGER - PHARMACY DEPT. | $133,769 | $0 | $7,758 | $0 | $4,746 | $0 | $9,757 | $0 | $34,877 | $0 | $190,907 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | IU HEALTH TIPTON HOSPITAL'S REGIONAL PRESIDENT IS EMPLOYED BY IU HEALTH. IU HEALTH TIPTON HOSPITAL'S PRESIDENT WAS EMPLOYED PART YEAR BY IU HEALTH NORTH AND PART YEAR BY IU HEALTH TIPTON DURING 2020. IU HEALTH, IU HEALTH NORTH, IU HEALTH TIPTON, 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 | Kenneth D. Puckett participates in an IU Health supplemental executive retirement plan, provisions of which are designed to retain this critical employee. The plan provides for an additional retirement benefit for service through normal retirement or other key dates. If this executive leaves prior to retirement or other key dates, that benefit may be forfeited or reduced. The executive listed above has an amount included in column c, deferred compensation, representing the current year unvested contributions made under the supplemental retirement plan. These amounts were not 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. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 4d Description of other program services | (Expenses $ 44,637 including grants of $ 0)(Revenue $ 61,206) IU HEALTH TIPTON HOSPITAL, INC. RECEIVES "SHARED SERVICES" REVENUE BY SHARING/PROVIDING SERVICES WITH INDIANA UNIVERSITY HEALTH CARE ASSOCIATES, INC. AND INDIANA UNIVERSITY HEALTH, INC. (SAXONY). |
| Form 990, Part III, Line 4d Description of other program services | (Expenses $ 37,361 including grants of $ 0)(Revenue $ 51,230) IU HEALTH TIPTON HOSPITAL, INC. RECEIVES RENTAL REVENUE FROM A RELATED EXEMPT ORGANIZATION, IU HEALTH CARE ASSOCIATES, INC. FOR VARIOUS OFFICES AND CLINICS. |
| Form 990, Part VI, Line 13 PART VI, LINES 12, 13, AND 14 - POLICIES | IU HEALTH TIPTON HOSPITAL IS PART OF THE IU HEALTH SYSTEM. AS THE SOLE MEMBER AND CONTROLLING PARENT OF IU HEALTH TIPTON HOSPITAL, IU HEALTH AND ITS BOARD OF DIRECTORS HAVE MANDATED THAT CERTAIN POLICIES BE FOLLOWED TO ENSURE GREATER STANDARDIZATION THROUGHOUT THE SYSTEM. THUS, IU HEALTH TIPTON HOSPITAL'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 TIPTON HOSPITAL IS IU HEALTH, A 501(C)(3) TAX-EXEMPT ORGANIZATION. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | THE BOARD OF DIRECTORS OF THE IU HEALTH TIPTON HOSPITAL SHALL RANGE FROM THREE (3) TO SEVEN (7), WITH IU HEALTH HAVING THE RIGHT TO APPOINT ONE (1) MORE THAN ONE-HALF (1/2) OF THE DIRECTORS. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | THE FOLLOWING ACTIONS REQUIRE IU HEALTH'S PRIOR APPROVAL: -THE APPOINTMENT OR REMOVAL OF ANY DIRECTOR; -THE AMENDMENT OF THE ARTICLES OF INCORPORATION; -THE AMENDMENT OF THE BYLAWS; -THE APPROVAL OF IU HEALTH TIPTON HOSPITAL'S ANNUAL CAPITAL AND OPERATING BUDGETS; -THE INCURRENCE OF EXPENSES FOR ANY UNBUDGETED OPERATING OR CAPITAL BUDGET ITEMS OR DEVIATIONS, INCLUDING ANY ISSUANCE OR GUARANTEE OF DEBT NOT INCLUDED IN IU HEALTH TIPTON HOSPITAL'S APPROVED BUDGET FOR THE CURRENT FISCAL YEAR, BUT ONLY TO THE EXTENT THAT SUCH EXPENSES EXCEED BUDGETED AMOUNTS BY (A) $100,000 PER FISCAL YEAR PER BUDGET LINE ITEM OR (B) $500,000 PER FISCAL YEAR IN THE AGGREGATE; -THE ADOPTION OF ANY STRATEGIC PLAN FOR IU HEALTH TIPTON HOSPITAL, INCLUDING ANY AMENDMENTS THERETO; -THE ENCUMBRANCE, SALE, LEASE, TRANSFER OR OTHER ALIENATION OF MORE THAN 5% OF THE NET BOOK VALUE OF IU HEALTH TIPTON HOSPITAL'S ASSETS, MEASURED ON A CONSOLIDATED BASIS DURING ANY FISCAL YEAR; -THE ADDITION OF ANY MEMBERS OF IU HEALTH TIPTON HOSPITAL; -THE CREATION OF ANY NEW AFFILIATES OF IU HEALTH TIPTON HOSPITAL; -THE APPROVAL OF ANY MERGER, CONSOLIDATION, JOINT VENTURE OR AFFILIATION INVOLVING IU HEALTH TIPTON HOSPITAL OR ANY OF ITS AFFILIATES; AND -THE DISSOLUTION OF IU HEALTH TIPTON HOSPITAL OR ANY OF ITS AFFILIATES. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The Indianapolis Suburban Chief Financial Officer and Finance Committee reviewed and approved the Form 990. Following their 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 Tipton Hospital 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 TIPTON HOSPITAL'S REGIONAL PRESIDENT IS EMPLOYED BY IU HEALTH, INC. 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 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 SULLIVANCOTTER. 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 SULLIVANCOTTER'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 SULLIVANCOTTER. 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 SULLIVANCOTTER 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 TIPTON HOSPITAL'S PRESIDENT WAS EMPLOYED BY IU HEALTH NORTH HOSPITAL PART YEAR AND IU HEALTH TIPTON HOSPITAL PART YEAR. IU HEALTH TIPTON HOSPITAL, IU HEALTH NORTH HOSPITAL, 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 TIPTON HOSPITAL'S ARTICLES OF INCORPORATION ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH THE INDIANA SECRETARY OF STATE'S WEBSITE. IU HEALTH TIPTON HOSPITAL'S CONFLICT OF INTEREST PROCEDURES DESCRIBED ON FORM 990, SCHEDULE O. IU HEALTH TIPTON HOSPITAL 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 TIPTON HOSPITAL'S FORM 990. |
| Form 990, Part VII, Section A, Line 1a, Column (A) Comp. of the Five Highest Paid Ind. Contractors | The amounts paid to Pepper Construction Company totaling $234,229 include both goods and services associated with the construction of IUH Tipton Endoscopy processing renovation. 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 11d Other Miscellaneous Revenue | OTHER - Total Revenue: 68458, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 68458; |
| Form 990, Part IX, Line 11g Other Fees | SHARED SERVICE/PROFESSIONAL FEES - Total Expense: 12394050, Program Service Expense: 5962736, Management and General Expenses: 6431314, Fundraising Expenses: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | CHANGE IN INTEREST IN RESTRICTED NET ASSETS OF FOUNDATIONS - 1603608; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (29 entries)
| Address Line1USAddress/AddressLine1Txt | Address Line2USAddress/AddressLine2Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CLARIAN TRANSPLANT INSTITUTE INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 800 | INDIANAPOLIS | IN | 46204 | 134350599 | HEALTHCARE | IN | 501(c)(3) | 10 | IUH | Yes (true) |
| INDIANA UNIVERSITY HEALTH INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 351955872 | HEALTHCARE | IN | 501(c)(3) | 3 | NA | false |
| IU HEALTH ARNETT INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 263162145 | HEALTHCARE | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU HEALTH BALL MEMORIAL HOSPITAL INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 350867958 | HEALTHCARE | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU HEALTH BALL MEMORIAL PHYSICIANS INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 351925641 | HEALTHCARE | IN | 501(c)(3) | 10 | IUHBMH | Yes (true) |
| IU HEALTH BEDFORD INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 237042323 | HEALTHCARE | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU HEALTH BLACKFORD HOSPITAL INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 010646166 | HEALTHCARE | IN | 501(c)(3) | 3 | IUHBMH | Yes (true) |
| IU HEALTH BLOOMINGTON INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 351720796 | HEALTHCARE | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU HEALTH BMH FOUNDATION INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 800 | INDIANAPOLIS | IN | 46204 | 311111784 | FUNDRAISING | IN | 501(c)(3) | Type I | IUHBMH | Yes (true) |
| IU HEALTH CARE ASSOCIATES INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 351747218 | HEALTHCARE | IN | 501(c)(3) | 10 | IUH | Yes (true) |
| IUHLP LIQUIDATION INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 800 | INDIANAPOLIS | IN | 46204 | 351125434 | HEALTHCARE | IN | 501(c)(3) | 10 | IUH | Yes (true) |
| IU HEALTH MORGAN INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 800 | INDIANAPOLIS | IN | 46204 | 273533027 | HEALTHCARE | IN | 501(c)(3) | 10 | IUH | Yes (true) |
| IU HEALTH NORTH HOSPITAL INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 351932442 | HEALTHCARE | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU HEALTH PAOLI INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 352090919 | HEALTHCARE | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU HEALTH PLANS NFP INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 800 | INDIANAPOLIS | IN | 46204 | 463803873 | INSURANCE | IN | 501(c)(4) | IUH | Yes (true) | |
| IU HEALTH WEST HOSPITAL INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 351814660 | HEALTHCARE | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU HEALTH WHITE MEMORIAL HOSPITAL INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 273532963 | HEALTHCARE | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| MDWISE MARKETPLACE INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 800 | INDIANAPOLIS | IN | 46204 | 465270582 | INSURANCE | IN | 501(c)(4) | IUH | Yes (true) | |
| MDWISE NETWORK INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 800 | INDIANAPOLIS | IN | 46204 | 472619552 | INSURANCE | IN | 501(c)(4) | IUH | Yes (true) | |
| INDIANA UNIVERSITY HEALTH FOUNDATION INC | |||||||||||
| 1633 N CAPITOL AVE | SUITE 1200 | INDIANAPOLIS | IN | 46202 | 356043086 | FUNDRAISING | IN | 501(c)(3) | Type I | IUH | Yes (true) |
| METHODIST HEALTH GROUP INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 800 | INDIANAPOLIS | IN | 46204 | 350876390 | HEALTHCARE | IN | 501(c)(3) | Type III-FI | NA | false |
| METHODIST OCCUP HEALTH CENTERS INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 351844176 | HEALTHCARE | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| RILEY CHEER GUILD INC | |||||||||||
| 705 RILEY HOSPITAL DR | INDIANAPOLIS | IN | 46202 | 356018517 | FUNDRAISING | IN | 501(c)(3) | Type III-FI | NA | false | |
| UNIVERSITY FAMILY PHYSICIANS INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 800 | INDIANAPOLIS | IN | 46204 | 237427350 | HEALTHCARE | IN | 501(c)(3) | 10 | IUHCA | Yes (true) |
| IU HEALTH FRANKFORT INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 815174295 | HEALTHCARE | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU HEALTH JAY INC | |||||||||||
| 950 N MERIDIAN STREET | Suite 300 | INDIANAPOLIS | IN | 46204 | 822736786 | HEALTHCARE | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| INDIANA HEALTH INFO EXCHANGE INC | |||||||||||
| 846 N SENATE AVE | INDIANAPOLIS | IN | 46202 | 364550324 | HEALTHCARE | IN | 501(c)(3) | Type I | NA | false | |
| IU MEDICAL GROUP FOUNDATION INC | |||||||||||
| 340 W 10TH ST NO FS5100 | INDIANAPOLIS | IN | 46202 | 201093251 | FUNDRAISING | IN | 501(c)(3) | Type I | NA | false | |
| 16 Tech Community Corporation | |||||||||||
| 1220 Waterway Blvd | Indianapolis | IN | 46202 | 810853467 | Economic Development | IN | 501(c)(3) | Type I | NA | false | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|
| BALL OUTPATIENT SUR CTR LLC | |||||||
| 569 Brookwood Village Ste 901 | BIRMINGHAM | AL | 35244 | 270275794 | HEALTHCARE | IN | NA |
| BELTWAY SURGERY CENTERS LLC | |||||||
| 569 Brookwood Village Ste 901 | BIRMINGHAM | AL | 35244 | 352072586 | HEALTHCARE | IN | NA |
| BOSC HOLDINGS LLC | |||||||
| 950 N Meridian St Ste 800 | INDIANAPOLIS | IN | 46204 | 454147343 | HEALTHCARE | IN | NA |
| BSC HOLDINGS LLC | |||||||
| 950 N Meridian St Ste 800 | INDIANAPOLIS | IN | 46204 | 452314634 | HEALTHCARE | IN | NA |
| CHV FUND I LLC | |||||||
| 950 N Meridian St Ste 800 | INDIANAPOLIS | IN | 46204 | 262523206 | VENTURE CAPITAL | IN | NA |
| CHV FUND II MANAGEMENT LLC | |||||||
| 950 N Meridian St Ste 800 | INDIANAPOLIS | IN | 46204 | 371717823 | VENTURE CAPITAL | IN | NA |
| CHV FUND II LLC | |||||||
| 950 N Meridian St Ste 800 | INDIANAPOLIS | IN | 46204 | 800902337 | VENTURE CAPITAL | IN | NA |
| CHV FUND MANAGEMENT LLC | |||||||
| 950 N Meridian St Ste 800 | INDIANAPOLIS | IN | 46204 | 262523151 | VENTURE CAPITAL | IN | NA |
| IEC HOLDINGS LLC | |||||||
| 950 N Meridian St Ste 800 | INDIANAPOLIS | IN | 46204 | 454148032 | HEALTHCARE | IN | NA |
| INDIANA ENDOSCOPY CENTERS LLC | |||||||
| 569 Brookwood Village Ste 901 | BIRMINGHAM | AL | 35244 | 208398421 | HEALTHCARE | IN | NA |
| ROC SURGERY LLC | |||||||
| 569 Brookwood Village Ste 901 | BIRMINGHAM | AL | 35244 | 271497960 | HEALTHCARE | IN | NA |
| ROCS HOLDINGS LLC | |||||||
| 950 N Meridian St Ste 800 | INDIANAPOLIS | IN | 46204 | 454148369 | HEALTHCARE | IN | NA |
| SENATE ST SURGERY CENTER LLC | |||||||
| 569 Brookwood Village Ste 901 | BIRMINGHAM | AL | 35244 | 421709357 | HEALTHCARE | IN | NA |
| SSSC HOLDINGS LLC | |||||||
| 950 N Meridian St Ste 800 | INDIANAPOLIS | IN | 46204 | 454148167 | HEALTHCARE | IN | NA |
| HEALTH VENTURE MANAGEMENT LLC | |||||||
| 950 N Meridian St Ste 800 | INDIANAPOLIS | IN | 46204 | 205740218 | MANAGEMENT | IN | NA |
| SSC HOLDINGS LLC | |||||||
| 950 N Meridian St Ste 800 | INDIANAPOLIS | IN | 46204 | 464472887 | HEALTHCARE | IN | NA |
| EAGLE HIGH SURG CENTER LLC | |||||||
| 569 Brookwood Village Ste 901 | BIRMINGHAM | AL | 35244 | 352259204 | HEALTHCARE | IN | NA |
| EHSC HOLDINGS LLC | |||||||
| 950 N Meridian St Ste 800 | INDIANAPOLIS | IN | 46204 | 454147879 | HEALTHCARE | IN | NA |
| EWASC HOLDINGS LLC | |||||||
| 950 N Meridian St Ste 800 | INDIANAPOLIS | IN | 46204 | 473087761 | HEALTHCARE | IN | NA |
| IUH EWA SURGERY CTR LLC | |||||||
| 569 Brookwood Village Ste 901 | BIRMINGHAM | AL | 35244 | 473102482 | HEALTHCARE | IN | NA |
| IUH SAXONY SURGERY CTR LLC | |||||||
| 569 Brookwood Village Ste 901 | BIRMINGHAM | AL | 35244 | 275271091 | HEALTHCARE | IN | NA |
| IU HEALTH FORT WAYNE LLC | |||||||
| 950 N Meridian St Ste 800 | INDIANAPOLIS | IN | 46204 | 831224627 | HEALTHCARE | IN | NA |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (18 entries)
| Address Line1USAddress/AddressLine1Txt | Address Line2USAddress/AddressLine2Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | Address Line2ForeignAddress/AddressLine2Txt | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | CityForeignAddress/CityNm |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHV CAPITAL INC | ||||||||||||||||
| 950 N MERIDIAN ST | SUITE 800 | INDIANAPOLIS | IN | 46204 | 260752507 | VENTURE CAPITAL | IN | NA | C Corporation | Yes (true) | ||||||
| IU HEALTH 457(B) PLAN | ||||||||||||||||
| 1100 N MARKET ST | WILMINGTON | DE | 19890 | 476948347 | INVESTMENTS | IN | NA | Trust | Yes (true) | |||||||
| IU HEALTH ACO INC | ||||||||||||||||
| 950 N MERIDIAN ST | SUITE 800 | INDIANAPOLIS | IN | 46204 | 454421020 | HEALTHCARE | IN | NA | C Corporation | Yes (true) | ||||||
| IU HEALTH BOARD DESIGNATED TRUST | ||||||||||||||||
| 400 HOWARD ST | SAN FRANCISCO | CA | 94105 | 306309021 | INVESTMENTS | IN | NA | Trust | Yes (true) | |||||||
| IU HEALTH NTGI S&P500 FUND CF | ||||||||||||||||
| PO BOX 804358 | CHICAGO | IL | 60680 | 306298263 | INVESTMENTS | IN | NA | Trust | Yes (true) | |||||||
| IU HEALTH PLANS HOLDING COMPANY INC | ||||||||||||||||
| 950 N MERIDIAN ST | SUITE 800 | INDIANAPOLIS | IN | 46204 | 463794815 | INSURANCE | IN | NA | C Corporation | Yes (true) | ||||||
| IU HEALTH PLANS INC | ||||||||||||||||
| 950 N MERIDIAN ST | SUITE 800 | INDIANAPOLIS | IN | 46204 | 262127080 | HMO | IN | NA | C Corporation | Yes (true) | ||||||
| IU HEALTH RISK PURCHASING GROUP INC | ||||||||||||||||
| 151 MEETING ST | SUITE 301 | CHARLESTON | SC | 29401 | 260202446 | INSURANCE | IN | NA | C Corporation | Yes (true) | ||||||
| IU HEALTH RISK RETENTION GROUP INC | ||||||||||||||||
| 151 MEETING ST | SUITE 301 | CHARLESTON | SC | 29401 | 201107674 | INSURANCE | SC | NA | C Corporation | Yes (true) | ||||||
| IUH ASSURANCE SPC LTD | ||||||||||||||||
| 980395429 | INSURANCE | NA | C Corporation | Yes (true) | PO BOX 69 94 SOLARIS AVE | CAMANA BAY | GRAND CAYMAN | CJ | CJ | |||||||
| PROTEUO FUND LP | ||||||||||||||||
| 981075227 | INVESTMENTS | NA | C Corporation | Yes (true) | PO BOX 69 94 SOLARIS AVE | GRAND CAYMAN | CJ | CJ | CAMANA BAY | |||||||
| IU HEALTH PLANS INSURANCE COMPANY | ||||||||||||||||
| 950 N MERIDIAN ST | SUITE 800 | INDIANAPOLIS | IN | 46204 | 811097215 | INSURANCE | IN | NA | C Corporation | Yes (true) | ||||||
| BMH MEDICAL PAVILION ASSOCIATION INC | ||||||||||||||||
| 2525 W UNIVERSITY AVE | MUNCIE | IN | 47303 | 351858408 | CONDO MANAGEMENT | IN | NA | C Corporation | Yes (true) | |||||||
| CERBERUS RESIDENTIAL OPPORT INST LTD | ||||||||||||||||
| INVESTMENTS | NA | C Corporation | Yes (true) | 190 ELGIN AVENUE | GRAND CAYMAN | CJ | CJ | GEORGE TOWN | ||||||||
| University Surgeons Inc | ||||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 202981280 | Physician Services | IN | NA | C Corporation | Yes (true) | |||||||
| Pediatric Surgical Associates Inc | ||||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 352122922 | Physician Services | IN | NA | C Corporation | Yes (true) | |||||||
| Cardiothoracic Surgeons Inc | ||||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351416173 | Physician Services | IN | NA | C Corporation | Yes (true) | |||||||
| University Vascular Surgery Inc | ||||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351832370 | Physician Services | IN | NA | C Corporation | Yes (true) | |||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| IU HEALTH CARE ASSOCIATES INC | ||
| J | $51,230 | FMV |
| IU HEALTH CARE ASSOCIATES INC | ||
| M | $2,711,339 | FMV |
| IU HEALTH NORTH HOSPITAL INC | ||
| O | $760,371 | FMV |
| IU HEALTH RISK RETENTION GROUP INC | ||
| R | $97,974 | FMV |
| IUH ASSURANCE LTD | ||
| R | $60,781 | FMV |
| IU HEALTH FOUNDATION INC | ||
| C | $123,738 | FMV |