INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC (EIN 26-2772226)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-13
- IRS object ID
- 202013189349303486
- Schema version
- 2019v5.1
- 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 | 2020-11-13T09:40:34-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | 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 | BusinessNameLine1Txt |
| Business Name Line2 | INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % CRAIG J JONES | InCareOfNm |
| Business Name Control | INDI | BusinessNameControlTxt |
| Phone | 3179634842 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 950 N MERIDIAN STREET Suite 300 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CARA BREIDSTER | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3179634842 | PhoneNum |
| Signature | 2020-11-08 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JENNIFER D RHODERICK | PreparerPersonNm |
| PTIN | P00395735 | PTIN |
| Phone | 3176817000 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 162.1.179.250 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 35198520203185000014 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2020-11-13 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | EC0F867CDA2A68A93B900C7968EA20F6D551AC78 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 6C5B360722C3FFAFCFE5827037413334CAD8ED04 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Kenneth Puckett | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 950 N MERIDIAN ST STE 300 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $45,547,818 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | SEE SCHEDULE O | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2008 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | Improve the health of our patients and community through innovation and excellence in care, education, research and service. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 281 | TotalEmployeeCnt |
| Total Volunteers | 70 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $221,529 | PYContributionsGrantsAmt |
| CY Contributions Grants | $29,954 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $40,438,903 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $43,544,115 | CYProgramServiceRevenueAmt |
| PY Investment Income | $573,846 | PYInvestmentIncomeAmt |
| CY Investment Income | $891,959 | CYInvestmentIncomeAmt |
| PY Other Revenue | $215,366 | PYOtherRevenueAmt |
| CY Other Revenue | $237,559 | CYOtherRevenueAmt |
| PY Total Revenue | $41,449,644 | PYTotalRevenueAmt |
| CY Total Revenue | $44,703,587 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,506,037 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,496,246 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $25,303,420 | PYOtherExpensesAmt |
| CY Other Expenses | $28,521,231 | CYOtherExpensesAmt |
| PY Total Expenses | $37,809,457 | PYTotalExpensesAmt |
| CY Total Expenses | $41,017,477 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,640,187 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,686,110 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $60,114,064 | TotalAssetsBOYAmt |
| Total Assets EOY | $60,620,574 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $23,265,360 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $20,933,693 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $36,848,704 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $39,686,881 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | IMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITY THROUGH INNOVATION AND EXCELLENCE IN CARE, EDUCATION, RESEARCH AND SERVICE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $32,703,882 | ExpenseAmt |
| Revenue | $42,752,412 | RevenueAmt |
| Desc | Indiana University Health Tipton Hospital, Inc. ("IU Health Tipton Hospital"), located in Tipton, Indiana, 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. IU Health Tipton Hospital receives "Shared Services" revenue by sharing/providing services with Methodist Occupational Health Centers, Inc. ("Methodist Occupational Health Centers"), Indiana University Health Care Associates, Inc. ("IU Health Physicians"), Indiana University Health North Hospital, Inc. ("IU Health North Hospital"), and Indiana University Health, Inc. ("IU Health"). | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $519,612 | ExpenseAmt |
| Revenue | $679,267 | RevenueAmt |
| Desc | IU Health Tipton Hospital receives revenue through pharmacy services as well as their retail pharmacy. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $39,189 | ExpenseAmt |
| Revenue | $51,230 | RevenueAmt |
| Desc | IU Health Tipton Hospital receives rental revenue from a related exempt organization, IU Health Physicians for various offices and clinics. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $46,820 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $61,206 | RevenueAmt |
| Desc | Shared Services | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $46,820 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $61,206 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $33,309,503 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| 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 | 30 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 281 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CRAIG J JONES | PersonNm |
| Phone | 3179634842 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 950 N MERIDIAN STREET SUITE 300 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Kenneth D Puckett | ||||||||||
| President-Indy Suburban Region | 10.0 | 45.0 | Yes (X) | $0 | $749,896 | $145,910 | ||||
| ARTHUR VASQUEZ | ||||||||||
| COO - Indy Suburban Region | 10.0 | 45.0 | $0 | $316,788 | $48,361 | Yes (X) | ||||
| Cara L Breidster | ||||||||||
| CFO - Indy Suburban Region | 10.0 | 45.0 | Yes (X) | $0 | $321,380 | $41,748 | ||||
| MICHAEL L HARLOWE | ||||||||||
| PRESIDENT - TIPTON | 55.0 | 0.0 | Yes (X) | $0 | $291,075 | $35,860 | ||||
| RUTH A KAIN RN | ||||||||||
| Former Key Employee | 0.0 | 55.0 | $0 | $264,913 | $41,126 | Yes (X) | ||||
| LISA A SPARKS RN | ||||||||||
| CNO - Indy Suburban Region | 10.0 | 45.0 | $0 | $231,548 | $43,717 | Yes (X) | ||||
| RANDALL C YUST | ||||||||||
| Former Officer | 0.0 | 55.0 | $0 | $227,727 | $29,249 | Yes (X) | ||||
| TAMARAH D BROWNLEE | ||||||||||
| VP-HR - Indy Suburban Region | 10.0 | 45.0 | $0 | $192,896 | $40,664 | Yes (X) | ||||
| JONATHAN R GOBLE | ||||||||||
| Former Director | 0.0 | 0.0 | $0 | $208,726 | $0 | Yes (X) | ||||
| MELISSA R HICKS | ||||||||||
| CNO- VP Pt Care Svcs (PART YR) | 40.0 | 0.0 | $74,331 | $88,778 | $35,738 | Yes (X) | ||||
| JEFFERY W MOORE RN | ||||||||||
| Anesthetist | 40.0 | 0.0 | $180,026 | $0 | $11,638 | Yes (X) | ||||
| ANGELA K MORGAN | ||||||||||
| MANAGER - PHARMACY DEPT. | 40.0 | 0.0 | $127,789 | $0 | $41,451 | Yes (X) | ||||
| EMILY A SNELL | ||||||||||
| PHARMACIST | 40.0 | 0.0 | $112,929 | $0 | $40,607 | Yes (X) | ||||
| LEZLIE V WOODS | ||||||||||
| Director - Operations | 40.0 | 0.0 | $112,053 | $0 | $31,169 | Yes (X) | ||||
| CATHERINE L WHITE | ||||||||||
| PHARMACIST | 40.0 | 0.0 | $113,898 | $0 | $26,893 | Yes (X) | ||||
| STEVEN A WERTZ | ||||||||||
| CHAIRMAN | 1.0 | 0.0 | Yes (X) | $3,600 | $0 | $0 | Yes (X) | |||
| LINDA G JOINES | ||||||||||
| DIRECTOR/SECRETARY | 1.0 | 0.0 | Yes (X) | $3,600 | $0 | $0 | Yes (X) | |||
| TAMERA N BROWN RN | ||||||||||
| DIRECTOR | 1.0 | 0.0 | $3,600 | $0 | $0 | Yes (X) | ||||
| BEN B HOBBS | ||||||||||
| DIRECTOR | 1.0 | 0.0 | $3,600 | $0 | $0 | Yes (X) | ||||
| DESTRY W LAMBERT MD | ||||||||||
| DIRECTOR | 1.0 | 0.0 | $3,600 | $0 | $0 | Yes (X) | ||||
| DAVID L VORIS | ||||||||||
| DIRECTOR | 1.0 | 0.0 | $3,600 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $742,626 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,893,727 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $614,131 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | 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 |
|---|---|---|---|---|---|
| ARAMARK | |||||
| 10510 TWIN LAKES PARKWAY | CHARLOTTE | NC | 28269 | FACILITIES MGMT. | $494,221 |
| ANESTHESIA CONSULTANTS OF INDIANAPO | |||||
| 3815 RIVER CROSSING PKWY | INDIANAPOLIS | IN | 46240 | MEDICAL | $400,000 |
| TRIMEDX LLC | |||||
| 5451 LAKEVIEW PKWY S DR | INDIANAPOLIS | IN | 46268 | CLINICAL ENGINEERING | $367,463 |
| OTIS ELEVATOR CO | |||||
| PO Box 73579 | CHICAGO | IL | 606737579 | FACILITIES MGMT. | $150,046 |
| HENRY C SMITHER ROOFING | |||||
| 6850 East 32nd Street | INDIANAPOLIS | IN | 46226 | Facilities Mgmt | $199,300 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,578 | RelatedOrganizationsAmt |
| Government Grants | $28,376 | GovernmentGrantsAmt |
| All Other Contributions | $0 | AllOtherContributionsAmt |
| Total Contributions | $29,954 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 622100 | $42,752,412 | $42,752,412 |
| SHARED SERVICES | 541900 | $61,206 | $61,206 |
| PHARMACY | 446110 | $679,267 | $679,267 |
| RENT FROM RELATED 501(C)(3) ORGS. | 532000 | $51,230 | $51,230 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $43,544,115 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $826,551 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $826,551 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $908,140 | SecuritiesAmt |
| Other | $1,499 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $844,231 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $63,909 | SecuritiesAmt |
| Other | $1,499 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $65,408 | TotalRevenueColumnAmt |
| Exclusion | $65,408 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA/FOOD SERVICE | 722320 | $219,040 | $219,040 |
| MISCELLANEOUS REVENUE | 900099 | $18,519 | $18,519 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $237,559 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,703,587 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $43,544,115 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,129,518 | 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 | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,219 | TotalAmt |
| Program Services | $109,003 | ProgramServicesAmt |
| Management And General | $3,216 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,765,392 | TotalAmt |
| Program Services | $9,485,554 | ProgramServicesAmt |
| Management And General | $279,838 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $372,441 | TotalAmt |
| Program Services | $361,768 | ProgramServicesAmt |
| Management And General | $10,673 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,524,662 | TotalAmt |
| Program Services | $1,480,971 | ProgramServicesAmt |
| Management And General | $43,691 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $721,532 | TotalAmt |
| Program Services | $700,856 | ProgramServicesAmt |
| Management And General | $20,676 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,482 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $8,482 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $230 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,008 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $7,008 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,960,644 | TotalAmt |
| Program Services | $5,712,024 | ProgramServicesAmt |
| Management And General | $6,248,620 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,920 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $24,920 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,746 | TotalAmt |
| Program Services | $97,178 | ProgramServicesAmt |
| Management And General | $39,568 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,826 | TotalAmt |
| Program Services | $30,826 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,980,214 | TotalAmt |
| Program Services | $1,980,214 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,227 | TotalAmt |
| Program Services | $13,582 | ProgramServicesAmt |
| Management And General | $645 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,832 | TotalAmt |
| Program Services | $6,832 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $702,804 | TotalAmt |
| Program Services | $478 | ProgramServicesAmt |
| Management And General | $702,326 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,750,258 | TotalAmt |
| Program Services | $1,750,258 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $266,934 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $266,934 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DRUGS AND MEDICAL SUPPLIES | $8,104,347 | $8,104,347 | $0 |
| BAD DEBT | $1,982,525 | $1,982,525 | $0 |
| INSTITUTIONAL DUES/LICENSES | $25,307 | $25,307 | $0 |
| HOSPITAL ASSESSMENT FEE | $1,126,331 | $1,126,331 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $392,596 | TotalAmt |
| Program Services | $341,449 | ProgramServicesAmt |
| Management And General | $51,147 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,017,477 | TotalAmt |
| Program Services | $33,309,503 | ProgramServicesAmt |
| Management And General | $7,707,974 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,456 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,313,182 | BOYAmt |
| EOY | $29,110,122 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $4,888 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,357,852 | BOYAmt |
| EOY | $2,947,670 | 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 |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| 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 | $617,266 | BOYAmt |
| EOY | $720,147 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $178,412 | BOYAmt |
| EOY | $211,789 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,879,523 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,663,209 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,047,135 | BOYAmt |
| EOY | $5,216,314 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,630,023 | BOYAmt |
| EOY | $5,224,969 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,866,624 | BOYAmt |
| EOY | $9,471,959 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,020,114 | BOYAmt |
| EOY | $7,712,716 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,114,064 | BOYAmt |
| EOY | $60,620,574 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,544,627 | BOYAmt |
| EOY | $2,610,940 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,720,733 | BOYAmt |
| EOY | $18,322,753 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,265,360 | BOYAmt |
| EOY | $20,933,693 | 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 | $27,829,130 | BOYAmt |
| EOY | $31,974,165 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,019,574 | BOYAmt |
| EOY | $7,712,716 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,848,704 | BOYAmt |
| EOY | $39,686,881 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,114,064 | BOYAmt |
| EOY | $60,620,574 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,686,110 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $461,116 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,309,049 | 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) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| 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 | $230 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $230 | 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 1i - Other Activities | FormAndLineReferenceDesc |
| Explanation | IU Health Tipton Hospital paid institutional membership dues to the Indiana Hospital Association ("IHA") during 2019 in the amount of $3,515 respectively. Each membership organization notified IU Health Tipton Hospital that a portion of the dues it paid were used for lobbying purposes. The IHA used 6.53%, or $230 of the 2019 membership dues paid by IU Health Tipton Hospital, for lobbying expenditures. The total membership dues paid to these organizations by IU Health Tipton Hospital during 2019 that were attributable to lobbying expenditures was $230. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| 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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| 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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| 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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| 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 |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,752,980 | BeginningYearBalanceAmt |
| Contributions | $25,533 | ContributionsAmt |
| Investment Earnings Or Losses | $196,490 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $220,413 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $85,483 | AdministrativeExpensesAmt |
| End Year Balance | $8,669,107 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.77280 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.22720 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Land | LandGrp |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $2,872,457 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,274,331 | DepreciationAmt |
| Book Value | $1,598,126 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $13,767,330 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,379,306 | DepreciationAmt |
| Book Value | $3,388,024 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $239,736 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,572 | DepreciationAmt |
| Book Value | $230,164 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,216,314 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INT. IN NET ASSETS OF FNDTN. | Desc |
| Book Value | $7,712,716 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $7,712,716 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERCOMPANY PAYABLES (NET) | $16,462,488 |
| DUE TO THIRD-PARTY PAYERS | $1,241,479 |
| SELF INSURANCE LIABILITIES | $49,322 |
| OPERATING LEASE LIABILITIES | $569,464 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $18,322,753 | 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 Org.'s 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. The Tax Cuts and Jobs Act (TCJA) was enacted on December 22, 2017. For tax-exempt entities, TCJA requires organizations to pay an excise tax on compensation above certain thresholds and record income or losses for tax determination purposes from unrelated business activities on an activity-by-activity basis, among other provisions. Proposed regulations and interim guidance, necessary for implementation, have been issued on most aspects of TCJA. It is expected that proposed regulations will be issued as final regulations by the IRS in 2020. As of and for the year ended December 31, 2019, Indiana University Health has made reasonable estimates of the provision for income taxes, the compensation excise tax, and the effects, if any, on existing deferred tax balances. Indiana University Health will continue to refine its calculations in future periods, as additional regulations and guidance are issued by the IRS. Deferred income taxes that, as of December 31, 2019 and 2018, 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, 2019 and 2018, the Indiana University Health System had gross deferred tax assets of $143,157,000 and $119,965,000 respectively, primarily relating to net operating loss carryovers. Management determined that a full valuation allowance at December 31, 2019 and 2018, 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 change in the valuation allowance for the current year is $23,192,000. At December 31, 2019, the Indiana University Health System has available net operating loss carryforwards of $575,596,000. Net operating losses generated from 1999 through 2017 will expire between 2020 and 2037. Net operating losses generated after 2017 do not expire. Certain subsidiaries of Indiana University Health are taxable entities. The tax expense and liabilities of these subsidiaries are not material to the consolidated financial statements. |
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 |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| 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 | 535 | PersonsServedCnt |
| Total Community Benefit Expns | $496,189 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $496,189 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01270 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 893 | PersonsServedCnt |
| Total Community Benefit Expns | $4,881,629 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,605,180 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,276,449 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08390 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1428 | PersonsServedCnt |
| Total Community Benefit Expns | $5,377,818 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,605,180 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,772,638 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09660 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 2780 | PersonsServedCnt |
| Total Community Benefit Expns | $187,049 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $187,049 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00480 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 128 | PersonsServedCnt |
| Total Community Benefit Expns | $108,525 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $108,525 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00280 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 2641 | PersonsServedCnt |
| Total Community Benefit Expns | $209,860 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $209,860 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01300 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 5549 | PersonsServedCnt |
| Total Community Benefit Expns | $505,434 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $505,434 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02060 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 6977 | PersonsServedCnt |
| Total Community Benefit Expns | $5,883,252 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,605,180 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,278,072 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11720 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 142 | PersonsServedCnt |
| Total Community Benefit Expns | $103 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $103 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $208 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $208 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 142 | PersonsServedCnt |
| Total Community Benefit Expns | $311 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $311 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $723,423 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $14,854,844 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $14,760,124 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $94,720 | 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 | SEE PART V, SECTION C | WebsiteAddressTxt |
| State License | 20-005049-1 | 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 | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | 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 | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 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 |
| 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 | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | 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 (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 - Input from Community | 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 7a - CHNA Website | A copy of IU Health Tipton Hospital's CHNA is available on its website at the following URL: https://iuhealth.org/in-the-community/community-benefit |
| Schedule H, Part V, Section B, Line 10a - Implementation Strategy Website | A copy of IU Health Tipton Hospital's CHNA implementation strategy is available on its website at the following URL: https://iuhealth.org/in-the-community/community-benefit |
| Schedule H, Part V, Section B, Line 11 - Addressing Identified Needs | IU Health Tipton prioritized and determined which of the community health needs identified in its most recently conducted Community Health Needs Assessment ("CHNA") were most critical for it to address. 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 were reviewed to identify and analyze the needs identified by each source. 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: - Partner with local subject matter experts to provide programs in schools and clubs to help educate youth on the risks of using drugs and alcohol leading to abuse - Our Athletic Trainers and the Tipton County Health Department partnered to provide an Anti-Vaping talk to approximately 100 students at Tri-Central High School. One program was offered in 2019 on two different nights for the anti-vaping discussion. - Provide access to meeting spaces and supplies for the local smoking cessation program - Our local smoking cessation coordinator partnered with the Tipton County Health Department on the program. In total she was able to meet with 18 community members throughout the year. Her meetings with them were on an individual basis and held here at the hospital in a common area. At the end of the year 33% of the participants had successfully quit smoking. - 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 Tipton saw 16 patients in 2019. Alcohol was documented as the cause in 12 out of the 16 patients seen. After initial evaluation in the emergency department, if a physician recommends the peer recovery program the patient is connected to a coach in 5m 28s (average among all participating EDs in the system). Currently there are not any methods in place to consistently track successful referrals. This is something that is being worked on to put in place in the future. We do know that 68% 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 Tipton emergency department saw 37 patients in 2019. The top needs of the patients seen were major depressive disorder and suicidal ideations. Currently the psychiatric program is not able to follow-up with patients, however there is a goal to establish a follow-up and or bridge pilot in 2020. 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 - We partnered with the local Encore Lifestyle and Enrichment Center for 4 different educational programs in 2019. There were about 15 community members present at each program. Each member learned what they need to watch for to help prevent the flu during the peak season, they also learned what signs to watch for and when they need to see a physician. During the Pelvic Floor, Parkinsons and Diabetes talk participants learned the general information, how to prevent and managing daily activities with the diseases. Interactive games were played during the discussions to keep the learning fun for the seniors. The overall impact was great in providing the seniors this important information. Presenters had copies of our local health director that lists all of the physicians on staff in the community as well as their contact information. Note: Screening events to be added in 2020. - Provide transportation to seniors utilizing community organizations' buses - We partnered with the Encore Lifestyle and Enrichment Center (Senior Center) to provide a grant for the 2019 transportation program. The program provided a total of 5,947 rides in 2019. There is a high equal need of transportation to pharmacy, physician, grocery, banking, etc. In total 622 rides were provided to IU Health Tipton Hospital for appointments. The transportation program not only provides services to the above errands and appointments, they also offer excursions to the senior population. These excursions are to different destinations in Indiana and provide great social time for this populations, as well as the opportunity for short travel trips that otherwise wouldn't be possible for the members. - Collaborate with community organizations to implement a modified Fresh & Fit program to serve the senior population in the community. - We were not able to roll out the Fresh & Fit program for seniors in 2019. We will plan to discuss the program with both internal partners and external partners for 2020. Access to Healthcare IU Health Tipton Hospital's implementation strategy to address the identified need of access to healthcare includes the following: - Provide free diabetic screenings and education on proper disease management to the community (same as Chronic Disease strategy) - We held one screening event and one educational event in the community in 2019, for a total of 157 community members screened and/or educated. A1C screenings were part of the main blood draw at our annual health fair. We also had a Diabetic Education booth at the fair so that attendees could get the education on managing diabetes. Our diabetic educator and dietitian hosted an educational discussion at our local senior center (Encore Lifestyle and Enrichment Center). They provided general information that was focused on the senior population on living with diabetes or preventing the disease. Note: The screening results from the health fair were sent directly to the patient in the mail. All patients participating were encouraged to follow-up with their physician to discuss their results. Participants were also reminded to visit the diabetic education booth at the event to learn more about diabetes and how to read their results, they also had access to a health directory if they needed a primary care physician in the area. - Work with the Tipton County Foundation, Women's Fund, to establish a mammography screening program for underserved community members (same as Chronic Disease strategy) - Will partner with the local Tipton County Foundation to create a program that will help community members. There were discussions around this program held in 2019, however no formal program has been created. Another meeting will take place 1st quarter 2020. Radiology staff will be our internal partners and the local Tipton County Foundation/Women's Fund will be our external partner. 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 - Our annual Day of Service event was with the local Tipton City Park. The entire community of all ages have access to the park and all of the activities, the county population is approximately 15,000. Team member volunteers repainted the lines and arrows for the walking lane that is around the perimeter of the park as well as the speedbumps throughout the park. 7 new mature trees were planted within the park, 5 truckloads of mulch were placed around the play equipment in the park, 14 new wooden pickets were added to the decorated picket fence around the toddler play area, 2 new metal parent bench swings. - Provide free diabetic screenings and education on proper disease management to the community (same as Access to Healthcare strategy) - We held one screening event and one educational event in the community in 2019, for a total of 157 community members screened and/or educated. A1C screenings were part of the main blood draw at our annual health fair. We also had a Diabetic Education booth at the fair so that attendees could get the education on managing diabetes. Our diabetic educator and dietitian hosted an educational discussion at our local senior center (Encore Lifestyle and Enrichment Center). They provided general information that was focused on the senior population on liv |
| Schedule H, Part V, Section B, Line 13b - Income Level Other than FPG | 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 13h - Other FAP Factors | IU Health Tipton Hospital takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. IU Health Tipton Hospital's Individual Solutions Department Prior to seeking Financial Assistance under the FAP, all patients or their guarantors must consult with a member of IU Health Tipton Hospital's Individual Solutions department to determine if healthcare coverage may be obtained from a government insurance/assistance product or from the Health Insurance Exchange Marketplace. 2. Alternate Sources of Assistance When technically feasible, a patient will exhaust all other state and federal assistance programs prior to receiving an award from IU Health Tipton Hospital's Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowner's, must exhaust all insurance benefits prior to receiving an award from IU Health Tipton Hospital's Financial Assistance Program. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. Patients may be asked to show proof that such a claim was properly submitted to the proper insurance provider at the request of IU Health Tipton Hospital. Eligible patients who receive medical care from IU Health Tipton Hospital 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 to which IU Health Tipton Hospital is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health Tipton Hospital reserves the right to reverse the award in an amount equal to the amount IU Health Tipton Hospital would be entitled to receive had no Financial Assistance been awarded. 3. Alternate Methods of Eligibility Determination IU Health Tipton Hospital will conduct a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an ECA. Said accounts may be eligible for assistance under the FAP based on the patient's individual scoring criteria. To ensure all patients potentially eligible for Financial Assistance under the FAP may receive Financial Assistance, IU Health Tipton Hospital will deem patients/guarantors to be presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied his/her required co-pay/deductible: -Indiana Children's Special Health Care Services -Medicaid -Healthy Indiana Plan -Patients who are awarded Hospital Presumptive Eligibility (HPE) -Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level 4. Additional Considerations Financial Assistance may be granted to a deceased patient's account if said patient is found to have no estate. Additionally, IU Health Tipton Hospital will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance application. 5. Non-Emergent Services Down Payment Uninsured Patients presenting for scheduled or other non-emergent services will not be charged more than the Amounts Generally Billed ("AGB") for their services. Patients will receive an estimated AGB cost of their care prior to IU Health Tipton Hospital rendering the services and will be asked to pay a down-payment percentage of the AGB adjusted cost prior to receiving services. In the event a patient is unable to fulfill the down-payment, their service may be rescheduled for a later date as medically prudent and in accordance with all applicable federal and state laws and/or regulations. 6. Emergency Services Non-Refundable Deposit This section will be implemented with a strict adherence to EMTALA and IU Health Policy ADM 1.32, Screening and Transfer of Emergency or Unstable Patients. Amount of Non-Refundable Deposit All Uninsured Patients presenting for services at one of IU Health Tipton Hospital's Emergency Departments, via transfer from another hospital facility, or direct admission, will be responsible for a one-hundred dollar ($100.00) non-refundable deposit for services rendered. Patients/guarantors will be responsible for any copays and/or deductibles required by their plan prior to full Financial Assistance being applied. Uninsured Patients wishing to make an application for Financial Assistance greater than the AGB must fulfill their non-refundable deposit prior to IU Health Tipton Hospital processing said application. Uninsured Patients making payments toward their outstanding non-refundable deposit balance will have said payments applied to their oldest application on file, if applicable. |
| Schedule H, Part V, Section B, Line 16a - FAP Website | A copy of IU Health Tipton Hospital's FAP is available at the following URL: https://iuhealth.org/pay-a-bill/financial-assistance/ |
| Schedule H, Part V, Section B, Line 16b - FAP Application Website | A copy of IU Health Tipton Hospital's FAP Application is available at the following URL: https://iuhealth.org/pay-a-bill/financial-assistance/ |
| Schedule H, Part V, Section B, Line 16c - FAP PLS Website | A copy of IU Health's FAP Plain Language Summary is available on its website at the following URL: https://iuhealth.org/pay-a-bill/financial-assistance/ |
| Schedule H, Part V, Section B, Line 16j - Other Measures to Publicize | IU Health Tipton Hospital takes several other measures to broadly publicize its FAP within the community. These measures include the following: 1. Conspicuous public displays will be posted in appropriate acute care settings such as the emergency department and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 2. IU Health Tipton Hospital will include a conspicuous written notice on all patient billing statements that notifies the patient about the availability of this Policy, and the telephone number of its Customer Service Department which can assist patients with any questions they may have regarding this Policy. 3. IU Health Tipton Hospital Customer Service representatives will be available via telephone Monday through Friday, excluding major holidays, from 8:00 a.m. to 7:00 p.m. Eastern Time to address questions related to this Policy. 4. IU Health Tipton Hospital will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health Tipton Hospital will educate its patient facing team members of the FAP and the process for referring patients to the Program. |
| Schedule H, Part V, Section B, Line 3e Prioritized Health Needs | 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 A, Line 1 Primary Website Address | https://iuhealth.org/find-locations/iu-health-tipton-hospital |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
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| Schedule H, Part I, Line 3c - Other Factors Used in Determining Elig. | 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. Indiana Residency Requirement Financial Assistance will only be made available to residents of the State of Indiana and those eligible for assistance under 42 U.S.C.A. 1396b(v). IU Health Tipton Hospital will employ the same residency test as set forth in Indiana Code 6-3-1-12 to define an Indiana resident. The term Resident includes any individual who was domiciled in Indiana during the taxable year, or any individual who maintains a permanent place of residence in Indiana and spends more than one hundred eight-three (183) days of the taxable year in Indiana. Patients residing in the state of Indiana while attending an institution of higher education may be eligible for assistance under the FAP if they meet the aforementioned residency test and are not claimed as a dependent on a parent's or guardian's federal income tax statement. 2. IU Health Tipton Hospital's Individual Solutions Department Prior to seeking Financial Assistance under the FAP, all patients or their guarantors must consult with a member of IU Health Tipton Hospital's Individual Solutions department to determine if healthcare coverage may be obtained from a government insurance/assistance product or from the Health Insurance Exchange Marketplace. 3. Uninsured Patients All Uninsured Patients presenting for services at IU Health Tipton Hospital eligible under the FAP will not be charged more than the AGB as described in the FAP. 4. Services Rendered by Individual Providers The FAP does not cover services rendered by individual providers. A full listing of providers and services not covered by the FAP is available at https://iuhealth.org/pay-a-bill/financial-assistance and is updated on a quarterly basis. 5. Alternate Sources of Assistance When technically feasible, a patient will exhaust all other state and federal assistance programs prior to receiving an award from IU Health Tipton Hospital's Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowner's, must exhaust all insurance benefits prior to receiving an award from IU Health Tipton Hospital's Financial Assistance Program. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. Patients may be asked to show proof that such a claim was properly submitted to the proper insurance provider at the request of IU Health Tipton Hospital. Eligible patients who receive medical care from IU Health Tipton Hospital 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 to which IU Health Tipton Hospital is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health Tipton Hospital reserves the right to reverse the award in an amount equal to the amount IU Health Tipton Hospital would be entitled to receive had no Financial Assistance been awarded. 6. Alternate Methods of Eligibility Determination IU Health Tipton Hospital will conduct a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an ECA. Said accounts may be eligible for assistance under the FAP based on the patient's individual scoring criteria. To ensure all patients potentially eligible for Financial Assistance under the FAP may receive Financial Assistance, IU Health Tipton Hospital will deem patients/guarantors to be presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied his/her required co-pay/deductible: -Indiana Children's Special Health Care Services -Medicaid -Healthy Indiana Plan -Patients who are awarded Hospital Presumptive Eligibility (HPE) -Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level 7. Additional Considerations Financial Assistance may be granted to a deceased patient's account if said patient is found to have no estate. Additionally, IU Health Tipton Hospital will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance application. 8. Patient Assets IU Health Tipton Hospital may consider patient/guarantor Assets in the calculation of a patient's true financial burden. A patient's/guarantor's primary residence and one (1) motor vehicle will be exempted from consideration in most cases. A patient's primary residence is defined as the patient's principal place of residence and will be excluded from a patient's extraordinary asset calculation so long as the patient's equity is less than five-hundred thousand dollars ($500,000) and the home is occupied by the patient/guarantor, patient's/guarantor's spouse or child under twenty-one (21) years of age. One (1) motor vehicle may be excluded as long as the patient's equity in the vehicle is less than fifty-thousand dollars ($50,000). IU Health Tipton Hospital reserves the right to request a list of all property owned by the patient/guarantor and adjust a patient's award of Financial Assistance if the patient demonstrates a claim or clear title to any extraordinary Asset not excluded from consideration under the above guidance. 9. Non-Emergent Services Down Payment Uninsured Patients presenting for scheduled or other non-emergent services will not be charged more than the AGB for their services. Patients will receive an estimated AGB cost of their care prior to IU Health Tipton Hospital rendering the services and will be asked to pay a down-payment percentage of the AGB adjusted cost prior to receiving services. In the event a patient is unable to fulfill the down-payment, their service may be rescheduled for a later date as medically prudent and in accordance with all applicable federal and state laws and/or regulations. 10. Emergency Services Non-Refundable Deposit This section will be implemented with a strict adherence to EMTALA and IU Health Tipton Hospital Policy ADM 1.32, Screening and Transfer of Emergency or Unstable Patients. Amount of Non-Refundable Deposit All Uninsured Patients presenting for services at IU Health Tipton Hospital's Emergency Department, via transfer from another hospital facility, or direct admission, will be responsible for a one-hundred dollar ($100.00) non-refundable deposit for services rendered. Patients/guarantors will be responsible for any copays and/or deductibles required by their plan prior to full Financial Assistance being applied. Uninsured Patients wishing to make an application for Financial Assistance greater than the AGB must fulfill their non-refundable deposit prior to IU Health Tipton Hospital processing said application. Uninsured Patients making payments toward their outstanding non-refundable deposit balance will have said payments applied to their oldest application on file, if applicable. 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 7, Column (f) - 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 $1,982,525. |
| 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 15.07%. |
| 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 Hospital is a subsidiary of IU Health. IU Health 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 that addressed economic development, community support and workforce development. Several examples include IU Health's support of the following organizations and initiatives that focus on some of the root causes of health issues, such as transportation, chronic disease and access to healthcare: - Encore Lifestyle and Enrichment Center - Boys and Girls Club of Tipton County - Tipton Community School Corporation - Tri-Central School Corporation - Tipton City Park - Tipton County Health Department Additionally, through the IU Health Statewide System's team member community benefit service program, "IU Health Serves", team members across the state make a difference in the lives of thousands of Hoosiers every year. |
| Schedule H, Part III, Line 2 - Methodology Used to Est. Bad Debt Exp. | The bad debt expense of $723,423 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 - Est. Bad Debt Attr. to Patients Under FAP An uninsured patient and/or guarantor who was admitted through an eligible facility's emergency department via a direct admission from a physician's office, or transfer from another hospital facility, and whose household income is less than or equal to 200% of the Federal Poverty Level may be eligible for full charity assistance after the successful completion of the Financial Assistance Application and satisfaction of his/her non-refundable deposit. To capture all patients who are potentially eligible for Financial Assistance under the IU Health Financial Assistance Policy, IU Health will deem patients/guarantors to be presumptively eligible for financial assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied the required co-pay/deductible: 1. Indiana Children's Special Health Care Services 2. Medicaid 3. Healthy Indiana Plan 4. Patients who are awarded Hospital Presumptive Eligibility 5. Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level (FPL). IU Health also conducts a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an extraordinary collection actions. Said accounts may be eligible for assistance under the financial assistance policy based on the patient's individual scoring criteria and are not included in bad debt. 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 | 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. Under its financial assistance policy, the Indiana University Health System provides medically necessary care to uninsured patients with inadequate financial resources at charitable discounts equivalent to the amounts generally billed, and it provides eligibility for full charity for emergent encounters for uninsured patients who earn less than 200% of the federal poverty level and who meet application criteria. Patients whose liability is deemed catastrophic relative to their annual household income are also eligible for reduced charges. 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 free care 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 $96,693,000 and $94,886,000 in 2019 and 2018, respectively. |
| Schedule H, Part III, Line 8 - Medicare Shortfall | IU HEALTH TIPTON HOSPITAL DID NOT HAVE A MEDICARE SHORTFALL FOR 2019. 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 - Written Debt Collection Policy | 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 Patients or their guarantors wishing to apply for Financial Assistance are encouraged to submit a Financial Assistance Application within ninety (90) days of their discharge. Patients or their guarantors may submit an application up to two-hundred and forty (240) days from the date of their first billing statement from IU Health Tipton Hospital, however, accounts may be subject to ECA as soon as one hundred and twenty (120) days after having received their first billing statement. Patients or their guarantors submitting an incomplete application will receive written notification of the application's deficiency upon discovery by IU Health Tipton Hospital. The application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health Tipton Hospital will suspend any ECA until the application is complete, or the patient fails to cure any deficiencies in their application in the allotted period. Patients will limited English proficiency may request to have a copy of the FAP, a FAP Application, and FAP Plain Language Summary in one of the below languages: -Arabic -Burmese -Burmese-Falam -Burmese-Hakha Chin -Mandarin/Chinese -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 FAP Application to be mailed to a patient's primary mailing address free of charge. IU Health Tipton Hospital keeps all applications and supporting documentation confidential. Patients applying for assistance under the FAP will be required to complete a Financial Assistance Application. Patients must include the following documentation with their Financial Assistance Application: -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 a patient's and/or guarantor's income does not warrant the filing of a federal tax statement, the patient 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; and -If applicable, divorce/dissolution decrees and child custody order 2. Eligibility Determination IU Health Tipton Hospital 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. If a patient or guarantor is granted less than full charity assistance and the patient or guarantor provides additional information for reconsideration, IU Health Tipton Hospital Revenue Cycle Services may amend a prior Financial Assistance Determination. If a patient or guarantor seeks to appeal the Financial Assistance Determination further, a written request must be submitted, along with the supporting documentation, to the Financial Assistance Committee for additional review/reconsideration. All decisions of the Financial Assistance Committee are final. A patient's Financial Assistance Application and eligibility determination are specific to each individual date(s) of service and related encounters. 3. Extraordinary Collection Actions IU Health Tipton Hospital may refer delinquent patient accounts to a third-party collection agency after utilizing reasonable efforts to determine a patient's eligibility for assistance under the FAP. IU Health Tipton Hospital and its third-party collection agencies may initiate ECA against a patient or their guarantor in accordance with this Policy and 26 C.F.R. 1.501(r). Said ECA may include the following: -Selling a patient's 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's or their guarantor's nonpayment of one or more bills for previously provided care covered under the FAP. -Actions requiring a legal or judicial process, including but not limited to placing a lien on 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 Tipton Hospital and its third party collection agencies, will engage in fair, respectful and transparent collections activities. Patients or guarantors currently subject to an ECA who have not previously applied for Financial Assistance may apply for assistance up to two-hundred and forty (240) days of the date of their first billing statement from IU Health Tipton Hospital. IU Health Tipton Hospital and their third-party collection agencies will suspend any ECA engaged on a patient or their guarantor while an Application is being processed and considered. 4. Refunds Patients eligible for assistance under the FAP who remitted payment to IU Health Tipton Hospital 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 on a separate account not eligible for assistance under the FAP 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 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 Assist. | 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. Conspicuous public displays will be posted in appropriate acute care settings such as the emergency department and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 2. IU Health Tipton Hospital will include a conspicuous written notice on all patient billing statements that notifies the patient about the availability of this Policy, and the telephone number of its Customer Service Department which can assist patients with any questions they may have regarding this Policy. 3. IU Health Tipton Hospital Customer Service representatives will be available via telephone Monday through Friday, excluding major holidays, from 8:00 a.m. to 7:00 p.m. Eastern Time to address questions related to this Policy. 4. IU Health Tipton Hospital will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health Tipton Hospital will educate its patient facing team members of the FAP 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 (2019) statistics, Tipton County's population is 15,148, with approximately 50% being female and 50% male. The county's population estimates by race are 97.1% 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, 88.4% completed their education with a high school diploma or equivalent. 21.3% had a Bachelor's degree or higher. About 11.6% 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 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 2019, IU Health Tipton Hospital hosted an annual health fair that offered a variety of free and low-cost screenings, blood draws, including glucose, A1C and cholesterol; blood pressure checks, foot screenings, sleep disorder screenings, and bone density screenings. These evaluations were offered at no cost to about 185 community members. Participants also had the opportunity to bring any unwanted medications to our collection site so they could be disposed of properly. In support of transportation and aging population and needs of our senior community members, IU Health Tipton Hospital also provides a grant annually to help support the transportation program operated by our local senior center. The transportation program provides necessary rides to healthcare appointments, pharmacy, grocery store, banking, and other destinations for basic living needs. IU Health Tipton Hospital also supports our community through additional outreach activities and grants given to organizations to support the health of the community. 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 IU Health Statewide system 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. IU Health 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. - IU Health Medical Center is honored to be nationally ranked by U.S. News & World Report for the 22nd year in a row. According to the U.S. News rankings, IU Health Medical Center is the No. 1 ranked hospital in Indiana and Indianapolis and the only nationally ranked adult hospital in the state. For 2019-2020, IU Health Medical Center was rated as high performing nationally in five specialties, with a sixth specialty achieving a top 50 national ranking: - Cancer - high performing - Gastroenterology - high performing - Geriatrics - ranked 45th in nation - Nephrology - high performing - Neurology & Neurosurgery - high performing - Urology - high performing Besides IU Health Medical Center, IU Health has three other hospitals among the 10 top ranked hospitals in Indiana: IU Health Ball Memorial (#5), IU Health Arnett (#8) and IU Health Bloomington (#8) hospitals. The annual rankings, now in their 30th year, are designed to assist patients and their doctors in making informed decisions about where to receive care for challenging health conditions or for common elective procedures. Education and Research As an academic health center, IU Health 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, 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: - Cancer: One of the initiative's primary goals is to enable the IU Health Melvin and Bren Simon Cancer Center to attain the National Cancer Institute's (NCI) top status of "comprehensive," which would recognize it as one of the top-tier cancer centers in the nation. 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. - Neuroscience: The neurosciences research program tackles a broad range of brain injuries, neurodegenerative disorders and neurodevelopmental disorders. - Cardiovascular: The cardiovascular research initiative develops a comprehensive program for the study and treatment of heart failure, from newborns to older adults. A top priority is developing a cardiovascular genetics program. The Strategic Research Initiative provides patients with access to internationally renowned physicians and to new therapies developed through translational research and clinical trials, and will make use of the latest genetic tools to develop personalized therapies that are more effective for individuals and efficient for healthcare providers. IU Health Statewide System IU Health is a part of the IU Health Statewide System which continues to broaden its reach and positive impact throughout the state of Indiana. IU Health is Indiana's most comprehensive academic health center and consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health, and IU Health Saxony Hospital. Other hospitals in the IU Health Statewide System include the following: - IU Health Arnett Hospital - IU Health Ball Memorial Hospital - IU Health Bedford Hospital - IU Health Blackford Hospital - IU Health Bloomington Hospital - IU Health Frankfort Hospital - IU Health Jay Hospital - IU Health North Hospital - IU Health Paoli Hospital - IU Health Tipton Hospital - IU Health West Hospital - IU Health White Memorial Hospital Although each hospital in the IU Health Statewide System prepares and submits its own community benefit plan relative to the local community, the IU Health Statewide System considers the sum of these plans part of a statewide vision for strengthening Indiana's overall health. A comprehensive community outreach strategy and community benefit plan is in place that encompasses the academic medical center downtown Indianapolis, suburban Indianapolis and statewide entities around priority areas that focus on health improvement efforts statewide. IU Health is keenly aware of the positive impact it can have on the communities of need in the state of Indiana by focusing on the most pressing needs in a systematic and strategic way. In 2019, IU Health provided more than $738 million in total community benefit and served more than one million individuals. Some ways we address our community health priorities as a system include: IU Health Day of Service The annual IU Health Days of Service is a high-impact event aimed at engaging IU Health team members in activities that address an identified community priority health need. Each year, more than 2,000 IU Health team members volunteer during the Days of Service. Community Health Initiatives With investments in high-quality and impactful initiatives to address community health needs statewide, IU Health is helping Indiana residents improve their health and their quality of life. In 2019, IU Health impacted many people statewide through educational presentations, health risk screenings, health education programs, and additional health educational opportunities made available to the community, especially to our community members in the greatest need of such services. Twenty-four local organizations are benefitting from grants awarded by IU Health. In 2019, IU Health Community Outreach and Engagement awarded more than $900,000 to community organizations and institutions which - like IU Health - are addressing the health needs of the community. These needs include access to affordable healthcare, behavioral health and substance abuse, healthy weight and nutrition and social determinants of health. The grants, administered by the Indiana University Health Foundation, were awarded to the following: Behavioral Health and Substance Abuse - Volunteers of America Ohio & Indiana's (https://www.voaohin.org/) (VOAOHIN) Fresh Start Recovery Center received a $75,000 grant to provide residential addiction treatment to pregnant women and mothers. It also allows up to two children ages 5 and under to live with their mother while they receive services. - Goodwill Foundation of Central and Southern Indiana(https://www.goodwillindy.org/foundation/) received $75,000 to help Goodwill Education Initiatives (GEI) Resilience Initiative support resilience work across 15 Excel Center locations by leveraging groundbreaking research on neuroplasticity - the ability of the brain to reorganize itself - and to train staff and students on enhancing their resilience and mitigating the effects of trauma. - Additional grant winners: - Reach for Youth (https://www.reachforyouth.org/) - Lutheran Foundation (https://thelutheranfoundation) - Indy Public Safety Foundation (https://indypsf.org/) Healthy Weight and Nutrition - United Way of Central Indiana, Inc.'s (https://uwci.org/) initiative Jump IN for Healthy Kids received a $50,000 grant to address the epidemic of childhood obesity with a specific focus on implementing strategies that create healthy places, healthy neighborhoods, and healthy communities in Marion County. - Playworks (https://www.playworks.org/indiana/), a national non-profit organization that partners with Indianapolis schools and youth organizations to help them leverage play for positive outcomes, received a $23,000 grant. - Additional grant winners: - Indianapolis Parks Foundation (https://www.indyparksfoundation.org/) Social Determinants of Health - A $100,250 grant was awarded to Gleaners Food Bank's (https://www.gleaners.org/) H |
| Schedule H, Part VI, Line 7 - State Filing of Community Benefit Report | IN |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | 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 (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JONATHAN R GOBLE | ||||||||||||||
| Former Director | $0 | $0 | $0 | $0 | $0 | $208,726 | $0 | $0 | $0 | $0 | $0 | $208,726 | $0 | $208,726 |
| MICHAEL L HARLOWE | ||||||||||||||
| PRESIDENT - TIPTON | $0 | $256,500 | $0 | $32,253 | $0 | $2,322 | $0 | $11,657 | $0 | $24,203 | $0 | $326,935 | $0 | $0 |
| RANDALL C YUST | ||||||||||||||
| Former Officer | $0 | $107,866 | $0 | $62,817 | $0 | $57,044 | $0 | $14,926 | $0 | $14,323 | $0 | $256,976 | $0 | $0 |
| RUTH A KAIN RN | ||||||||||||||
| Former Key Employee | $0 | $196,146 | $0 | $37,691 | $0 | $31,076 | $0 | $15,998 | $0 | $25,128 | $0 | $306,039 | $0 | $0 |
| JEFFERY W MOORE RN | ||||||||||||||
| Anesthetist | $178,734 | $0 | $500 | $0 | $792 | $0 | $11,638 | $0 | $0 | $0 | $191,664 | $0 | $0 | $0 |
| ANGELA K MORGAN | ||||||||||||||
| MANAGER - PHARMACY DEPT. | $118,230 | $0 | $5,462 | $0 | $4,097 | $0 | $8,944 | $0 | $32,507 | $0 | $169,240 | $0 | $0 | $0 |
| EMILY A SNELL | ||||||||||||||
| PHARMACIST | $109,449 | $0 | $3,300 | $0 | $180 | $0 | $7,981 | $0 | $32,626 | $0 | $153,536 | $0 | $0 | $0 |
| Cara L Breidster | ||||||||||||||
| CFO - Indy Suburban Region | $0 | $268,019 | $0 | $40,264 | $0 | $13,097 | $0 | $18,008 | $0 | $23,740 | $0 | $363,128 | $0 | $0 |
| Kenneth D Puckett | ||||||||||||||
| President-Indy Suburban Region | $0 | $462,981 | $0 | $211,080 | $0 | $75,835 | $0 | $116,713 | $0 | $29,197 | $0 | $895,806 | $0 | $0 |
| LISA A SPARKS RN | ||||||||||||||
| CNO - Indy Suburban Region | $0 | $195,530 | $0 | $35,029 | $0 | $989 | $0 | $14,942 | $0 | $28,775 | $0 | $275,265 | $0 | $0 |
| ARTHUR VASQUEZ | ||||||||||||||
| COO - Indy Suburban Region | $0 | $269,606 | $0 | $46,696 | $0 | $486 | $0 | $18,075 | $0 | $30,286 | $0 | $365,149 | $0 | $0 |
| TAMARAH D BROWNLEE | ||||||||||||||
| VP-HR - Indy Suburban Region | $0 | $163,933 | $0 | $28,597 | $0 | $366 | $0 | $8,259 | $0 | $32,405 | $0 | $233,560 | $0 | $0 |
| MELISSA R HICKS | ||||||||||||||
| CNO- VP Pt Care Svcs (PART YR) | $55,310 | $66,059 | $18,932 | $22,612 | $89 | $107 | $4,434 | $5,296 | $11,852 | $14,156 | $90,617 | $108,230 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 - Comp. of the Org.'s CEO/Executive Director | IU Health Tipton Hospital's Regional President is employed by IU Health. IU Health Tipton Hospital's President is employed by IU Health North Hospital. IU Health, IU Health North Hospital, IU Health Tipton 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. Please see schedule O for additional details.. Schedule J, Part I, Line 4a - Severance Payments Jonathan R. Goble entered into a severance agreement with IU Health during 2018. Severance of $208,726 that was received during 2019 is included in column B(III), other reportable compensation. Deferred severance of $231,294 was disclosed in 2018 in column C, retirement and other deferred compensation. |
| 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 the executive leaves prior to retirement or other key dates, that benefit may be forfeited or reduced. Kenneth D. Puckett 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 (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part VI, Section A, Lines 6, 7a and 7b - Members or Stockholders | Line 6: The sole member of IU Health Tipton Hospital is IU Health, a 501(c)(3) tax-exempt organization. Line 7A: 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. Line 7B: 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. |
| Part VI, Section B, Line 11b - Review of Form 990 | The following process was used by IU Health Tipton Hospital to review the Form 990 prior to its filing: The Indianapolis Regional Chief Financial Officer (CFO) reviewed and approved the Form 990. Following the CFO's review and approval, a complete copy of the Form 990 was made available to each board member prior to its filing. Each member was also informed of the availability of IU Health's Tax Department to answer any questions. |
| Part VI, Section B, 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. |
| Part VI, Section B, 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. |
| Part VI, Section B, Line 15a & 15b - Process for Determining Compen. | IU Health Tipton Hospital's Regional President is employed by IU Health, Inc. IU Health Tipton Hospital's President is employed by IU Health North Hospital. IU Health's process for determining compensation is as follows: (1) The Board of Directors ("Board") has established a Talent Management and Executive Compensation Committee ("TMECC"), the purpose of which includes reviewing and making recommendations regarding executive (Senior Vice Presidents and above) pay and benefits (collectively referred to as "compensation") on an annual basis. The TMECC is made up of members of the Board that are neither physicians nor employees and do not otherwise have a conflict of interest regarding any of IU Health's compensation arrangements. The TMECC reviews an executive's entire compensation package including base salary, short-term and long-term incentives, health and welfare benefits, qualified and nonqualified retirement plans, as well as any additional fringe benefits. As deemed appropriate, the Committee on Finance, which is also made up of members of the Board, may also review executive compensation and benefits. (2) The TMECC engages an independent compensation consulting firm on an annual basis to conduct a compensation analysis for its executive group, which consists of employees at the level of senior vice president and above. The current compensation advisor is 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 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. |
| Part VI, Section C, Line 19 - Public Disclosure | 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. |
| Part XI, Line 9 - Other Changes in Net Assets or Fund Balances | During 2018, IU Health Tipton Hospital recorded the following other changes in net assets or fund balances: Change in Interest in Restricted Net Assets of Foundations: ($1,306,858) Equity Transfer (Settlement of Debt): $(2,191) Total Other Changes: ($1,309,049) |
| Page 1, Line J Web Site: | https://iuhealth.org/find-locations/iu-health-tipton-hospital |
| FORM 990 PART IX LINE 11G | DESCRIPTION:SHARED SERVICE/PROFESSIONAL FE TOTAL FEES:11960644 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (29 entries)
| Address Line1USAddress/AddressLine1Txt | 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 St Ste 800 | Indianapolis | IN | 46204 | 134350599 | Healthcare | IN | 501(c)(3) | 10 | IUH | Yes (true) |
| Indiana University Health Inc | ||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46204 | 351955872 | Healthcare | IN | 501(c)(3) | 3 | NA | false |
| IU Health Arnett Inc | ||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46204 | 263162145 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health Ball Memorial Hospital Inc | ||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46204 | 350867958 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health Ball Memorial Physicians Inc | ||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46204 | 351925641 | Healthcare | IN | 501(c)(3) | 10 | IUHBMH | Yes (true) |
| IU Health Bedford Inc | ||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46204 | 237042323 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health Blackford Hospital Inc | ||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46204 | 010646166 | Healthcare | IN | 501(c)(3) | 3 | IUHBMH | Yes (true) |
| IU Health Bloomington Inc | ||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46204 | 351720796 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health BMH Foundation Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 311111784 | Fundraising | IN | 501(c)(3) | 12 I | IUHBMH | Yes (true) |
| IU Health Care Associates Inc | ||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46204 | 351747218 | Healthcare | IN | 501(c)(3) | 10 | IUH | Yes (true) |
| IUHLP Liquidation Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351125434 | Healthcare | IN | 501(c)(3) | 10 | IUH | Yes (true) |
| IUHLP-P Liquidation Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 311070868 | Healthcare | IN | 501(c)(3) | 10 | IUHLP | Yes (true) |
| IU Health Morgan Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 273533027 | Healthcare | IN | 501(c)(3) | 10 | IUH | Yes (true) |
| IU Health North Hospital Inc | ||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46204 | 351932442 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health Paoli Inc | ||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46204 | 352090919 | Healthcare | IN | 501(c)(3) | 3 | IUHB | Yes (true) |
| IU Health Plans NFP Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 463803873 | Insurance | IN | 501(c)(4) | N/A | IUH | Yes (true) |
| IU Health West Hospital Inc | ||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46204 | 351814660 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health White Memorial Hospital Inc | ||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46204 | 273532963 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| MDwise Marketplace Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 465270582 | Insurance | IN | 501(c)(4) | N/A | IUH | Yes (true) |
| MDwise Network Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 472619552 | Insurance | IN | 501(c)(4) | N/A | IUH | Yes (true) |
| Indiana University Health Foundation Inc | ||||||||||
| 1633 N Capitol Ave Ste 1200 | Indianapolis | IN | 46202 | 356043086 | Fundraising | IN | 501(c)(3) | 12 I | IUH | Yes (true) |
| Methodist Health Group Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 350876390 | Healthcare | IN | 501(c)(3) | 12 III-FI | NA | false |
| Methodist Occup Health Centers Inc | ||||||||||
| 950 N Meridian St Ste 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) | 12 III-FI | NA | false |
| University Family Physicians Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 237427350 | Healthcare | IN | 501(c)(3) | 10 | IUHCA | Yes (true) |
| IU Health Frankfort Inc | ||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46204 | 815174295 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health Jay Inc | ||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46220 | 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) | 12 I | NA | false |
| IU Medical Group Foundation Inc | ||||||||||
| 340 W 10th St No FS5100 | Indianapolis | IN | 46202 | 201093251 | Fundraising | IN | 501(c)(3) | 12 II | 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 | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|
| 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 Capit | IN | NA | |
| CHV Fund II Management LLC | ||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 371717823 | Venture Capit | IN | NA | |
| CHV Fund II LLC | ||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 800902337 | Venture Capit | IN | NA | |
| CHV Fund Management LLC | ||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 262523151 | Venture Capit | 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 | N/A | |
| SSC Holdings LLC | ||||||||
| 950 N Meridian St Ste 800 | INDIANPAOLIS | 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 (17 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHV Capital Inc | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 260752507 | Venture Capit | IN | NA | C | Yes (true) | |||||
| IU Health 457(B) Plan | ||||||||||||||
| 1100 N Market St | Wilmington | DE | 19890 | 476948347 | Investments | IN | NA | T | Yes (true) | |||||
| IU Health ACO Inc | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 454421020 | Healthcare | IN | NA | C | Yes (true) | |||||
| IU Health Board Designated Trust | ||||||||||||||
| 400 Howard St | San Francisco | CA | 94105 | 306309021 | Investments | IN | NA | T | Yes (true) | |||||
| IU Health NTGI S&P500 Fund CF | ||||||||||||||
| PO Box 804358 | Chicago | IL | 60680 | 306298263 | Investments | IN | NA | T | Yes (true) | |||||
| IU Health Plans Holding Company Inc | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 463794815 | Insurance | IN | NA | C | Yes (true) | |||||
| IU Health Plans Inc | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 262127080 | HMO | IN | NA | C | Yes (true) | |||||
| IU Health Risk Purchasing Group Inc | ||||||||||||||
| 151 Meeting St Ste 301 | Charleston | SC | 29401 | 260202446 | Insurance | IN | NA | C | Yes (true) | |||||
| IU Health Risk Retention Group Inc | ||||||||||||||
| 151 Meeting St Ste 301 | Charleston | SC | 29401 | 201107674 | Insurance | SC | NA | C | Yes (true) | |||||
| IUH Assurance SPC Ltd | ||||||||||||||
| 980395429 | Insurance | NA | C | Yes (true) | PO BOX 69 94 SOLARIS AVE | CAMANA BAY | GRAND CAYMAN | CJ | CJ | |||||
| Proteuo Fund LP | ||||||||||||||
| 981075227 | Investments | NA | C | Yes (true) | PO BOX 31106 89 NEXUS WAY | CAMANA BAY | GRAND CAYMAN | CJ | CJ | |||||
| SCANS Inc | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 453080392 | Healthcare | IN | NA | C | Yes (true) | |||||
| IU Health Plans Insurance Company | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 811097215 | Insurance | IN | NA | C | Yes (true) | |||||
| BMH Medical Pavilion Association Inc | ||||||||||||||
| 2525 W University Ave | Muncie | IN | 47303 | 351858408 | Condo Management | IN | NA | C | Yes (true) | |||||
| Cardinal Health Ventures Inc | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351611424 | Management | IN | NA | C | Yes (true) | |||||
| IU Health Southern IN Physicians Inc | ||||||||||||||
| 950 N Meridian St Ste 300 | Indianapolis | IN | 46204 | 351913875 | Healthcare | IN | NA | C | Yes (true) | |||||
| Cerberus Residential Opport Inst Ltd | ||||||||||||||
| 000000000 | Investments | NA | C | Yes (true) | 190 Elgin Avenue George Town | George Town | Grand Cayman | CJ | CJ | |||||
| 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 (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| IU HEALTH CARE ASSOCIATES INC | ||
| J | $51,230 | FMV |
| IU HEALTH CARE ASSOCIATES INC | ||
| M | $2,538,000 | FMV |
| IU HEALTH NORTH HOSPITAL INC | ||
| O | $1,137,449 | FMV |
| IU HEALTH RISK RETENTION GROUP INC | ||
| R | $100,684 | FMV |
| IUH ASSURANCE LTD | ||
| R | $95,238 | FMV |