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INDIANA UNIVERSITY HEALTH PAOLI INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
INDIANA UNIVERSITY HEALTH PAOLI INC (EIN 35-2090919)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-13
IRS object ID
202013189349301526
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 ReturnHeader

FieldValueIRS element (for citing)
Return2020-11-13T07:36:23-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN352090919EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1INDIANA UNIVERSITY HEALTH PAOLI INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% CRAIG J JONESInCareOfNm
Business Name ControlINDIBusinessNameControlTxt
Phone3179634842PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1950 N MERIDIAN STREET Suite 300AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL L CRAIGPersonNm
Person TitleVP & CFOPersonTitleTxt
Phone3179634842PhoneNum
Signature2020-11-05SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJENNIFER D RHODERICKPreparerPersonNm
PTINP00395735PTIN
Phone3176817000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address162.1.179.251IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id35198520203185000004FederalOriginalSubmissionId
Federal Original Submission Id2020-11-13FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id4CFE63EA556978BED96946D2A2E6D5903275AA84AtSubmissionCreationDeviceId
At Submission Filing Device Id1FAF8F4A5CE5AF7D4EEB3F68F347C3134530D94AAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLARRY R BAILEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1950 N MERIDIAN ST STE 300AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$29,781,519GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressSee Schedule OWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1999FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionIMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITY THROUGH THE PROVISION OF COMPASSIONATE, HIGH-QUALITY AND CUSTOMER FOCUSED CARE.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee209TotalEmployeeCnt
Total Volunteers6TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$28,290PYContributionsGrantsAmt
CY Contributions Grants$39,588CYContributionsGrantsAmt
PY Program Service Revenue$23,746,871PYProgramServiceRevenueAmt
CY Program Service Revenue$27,530,611CYProgramServiceRevenueAmt
PY Investment Income$534,361PYInvestmentIncomeAmt
CY Investment Income$612,899CYInvestmentIncomeAmt
PY Other Revenue$162,234PYOtherRevenueAmt
CY Other Revenue$157,423CYOtherRevenueAmt
PY Total Revenue$24,471,756PYTotalRevenueAmt
CY Total Revenue$28,340,521CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$9,276,971PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,368,532CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$16,752,537PYOtherExpensesAmt
CY Other Expenses$18,744,355CYOtherExpensesAmt
PY Total Expenses$26,029,508PYTotalExpensesAmt
CY Total Expenses$28,112,887CYTotalExpensesAmt
PY Revenues Less Expenses-$1,557,752PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$227,634CYRevenuesLessExpensesAmt
Total Assets BOY$34,631,393TotalAssetsBOYAmt
Total Assets EOY$32,082,286TotalAssetsEOYAmt
Total Liabilities BOY$6,429,532TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,780,036TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$28,201,861NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$25,302,250NetAssetsOrFundBalancesEOYAmt
MissionIMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITY THROUGH THE PROVISION OF COMPASSIONATE, HIGH-QUALITY AND CUSTOMER FOCUSED CARE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$21,287,751ExpenseAmt
Grant$0GrantAmt
Revenue$27,471,641RevenueAmt
DescIndiana University Health Paoli, Inc. ("IU Health Paoli") is a 24-bed acute-care and critical access hospital that offers a broad range of medical specialties and services to care for its patients without regard to their ability to pay. IU Health Paoli specializes in rural, community-based services to serve south central Indiana through its 24-hour emergency room with air transport availability, OB services, community outreach programs and visiting specialist services.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$36,075ExpenseAmt
Grant$0GrantAmt
Revenue$46,555RevenueAmt
DescIU Health Paoli receives rent income from a related exempt organization, IU Health Bloomington, Inc. ("IU Health Bloomington") for various offices and clinics.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$9,620ExpenseAmt
Grant$0GrantAmt
Revenue$12,415RevenueAmt
DescIU Health Paoli receives "Shared Services" revenue by sharing/providing services with Indiana University Health Blackford, Inc. ("IU Health Blackford"), Indiana University Health Bedford, Inc. ("IU Health Bedford"), Indiana University Health Care Associates, Inc. ("IU Health Physicians"),Indiana University Health Southern Indiana Physicians, LLC. ("IU Health Southern Indiana Physicians"),and IU Health Bloomington. Physicians, LLC. ("IU Health Southern Indiana Physicians"),and IU Health Bloomington.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$21,333,446TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document19IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee209EmployeeCnt
Employment Tax Returns FiledfalseEmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCRAIG J JONESPersonNm
Phone3179634842PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1950 N MERIDIAN STREET SUITE 300AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
BRIAN T SHOCKNEY
Director/President (SCR)10.045.0Yes (X)Yes (X)$0$662,735$125,994
JOHN S STROBEL MD
DIRECTOR5.050.0Yes (X)$0$717,967$43,418
HOJATT M SHAMLOO MD
DIRECTOR5.050.0Yes (X)$0$651,159$49,480
Blake A Dye
Director5.050.0Yes (X)$0$534,852$32,758
Daniel A Handel MD
VP & CMO10.045.0$0$508,454$47,754Yes (X)
JAMES J LAUGHLIN MD
DIRECTOR5.050.0Yes (X)$0$422,607$18,075
MICHAEL L CRAIG
VP & CFO10.045.0Yes (X)$0$277,672$35,089
LARRY R BAILEY
PRESIDENT55.00.0Yes (X)$0$273,287$34,572
DAVID L BEACHY DO
DIRECTOR5.050.0Yes (X)$0$265,898$34,382
MATTHEW D BAILEY
FORMER OFFICER0.00.0$0$290,903$0Yes (X)
Alan W Biggs
COO10.045.0$0$251,587$31,382Yes (X)
Bruce R Wade
VP - Human Resources Regional10.045.0$0$219,967$37,638Yes (X)
Kenneth E Marshall M
Former Key Employee0.055.0$0$208,168$46,897Yes (X)
Cynthia R Herrington
VP & CNO10.045.0$0$219,586$29,406Yes (X)
Angela M Conklin
Anesthetist55.00.0$163,458$0$29,595Yes (X)
PAMELLA J BOND
VP, SUPPORT SERVICES55.00.0$164,515$0$22,421Yes (X)
FRANKLIN R FRAZIER R
C.R.N.A.55.00.0$169,067$0$12,308Yes (X)
Charlene L Clark
Mgr-Clinical Operations55.00.0$102,908$0$29,378Yes (X)
DANIEL J PETERSON
Director/CHAIR5.00.0Yes (X)Yes (X)$0$0$0
JACK A KENWORTHY
DIRECTOR/VICE CHAIR5.00.0Yes (X)Yes (X)$0$0$0
JOYCE B POLING
DIRECTOR/SECRETARY5.00.0Yes (X)Yes (X)$0$0$0
LYNN H COYNE
DIRECTOR5.00.0Yes (X)$0$0$0
RICHARD G HENDRICKSON
Director/Treasurer5.00.0Yes (X)Yes (X)$0$0$0
JANET FARLOW PERRY
DIRECTOR5.00.0Yes (X)$0$0$0
Julie Minton
Director5.00.0Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$599,948TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,504,842TotReportableCompRltdOrgAmt
Total Other Compensation$660,547TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K4IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
COMPHEALTH
PO BOX 972651DALLASTX753972651STAFFING$116,112
DWIGHT L STAUFFER
4883 E HERITAGE WOODS ROADBLOOMINGTONIN47401MEDICAL$135,058
JACKSON COKER
3000 Old Alabama Road Suite 119-60ALPHARETTAGA30022Staffing$105,858
JUDSON BREWER MD
3800 South Forrester StreetBLOOMINGTONIN47401
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Related Organizations$30,034RelatedOrganizationsAmt
Government Grants$799GovernmentGrantsAmt
All Other Contributions$8,755AllOtherContributionsAmt
Total Contributions$39,588TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
NET PATIENT SERVICE REVENUE622110$27,471,641$27,471,641$0$0
SHARED SERVICES541900$12,415$12,415$0$0
RENT FROM RELATED 501(C)(3) ORGS.532000$46,555$46,555$0$0
FieldValueIRS element (for citing)
Total Program Service Revenue$27,530,611TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$463,761TotalRevenueColumnAmt
Exclusion$463,761ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$2,448RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$2,448RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,448TotalRevenueColumnAmt
Exclusion$2,448ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,550,080SecuritiesAmt
Other$40,056OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,440,998SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$109,082SecuritiesAmt
Other$40,056OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$149,138TotalRevenueColumnAmt
Exclusion$149,138ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA/FOOD SERVICE722320$81,018$81,018
ALL OTHER REVENUE900099$73,957$73,957
FieldValueIRS element (for citing)
Other Revenue Total$154,975OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$28,340,521TotalRevenueColumnAmt
Related Or Exempt Func Income$27,530,611RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$770,322ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$557,364TotalAmt
Program Services$485,523ProgramServicesAmt
Management And General$71,841ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,870,397TotalAmt
Program Services$5,984,843ProgramServicesAmt
Management And General$885,554ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$273,404TotalAmt
Program Services$238,164ProgramServicesAmt
Management And General$35,240ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,120,801TotalAmt
Program Services$976,336ProgramServicesAmt
Management And General$144,465ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$546,566TotalAmt
Program Services$476,117ProgramServicesAmt
Management And General$70,449ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$7,874TotalAmt
Program Services$0ProgramServicesAmt
Management And General$7,874ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$230TotalAmt
Program Services$0ProgramServicesAmt
Management And General$230ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$11,961TotalAmt
Management And General$11,961ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$9,891,898TotalAmt
Program Services$4,875,098ProgramServicesAmt
Management And General$5,016,800ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$730TotalAmt
Program Services$730ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$41,060TotalAmt
Program Services$35,333ProgramServicesAmt
Management And General$5,727ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$42,346TotalAmt
Program Services$42,101ProgramServicesAmt
Management And General$245ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$787,240TotalAmt
Program Services$597,245ProgramServicesAmt
Management And General$189,995ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$26,394TotalAmt
Program Services$16,296ProgramServicesAmt
Management And General$10,098ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,116TotalAmt
Program Services$2,116ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,458,962TotalAmt
Program Services$1,307,890ProgramServicesAmt
Management And General$151,072ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$212,549TotalAmt
Program Services$48,194ProgramServicesAmt
Management And General$164,355ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
DRUGS AND MEDICAL SUPPLIES$2,384,387$2,384,387$0$0
BAD DEBT$2,672,050$2,672,050$0$0
INSTITUTIONAL DUES/LICENSES$586$586$0$0
ALL OTHER EXPENSES$330,758$317,223$13,535$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$873,214TotalAmt
Program Services$873,214ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$28,112,887TotalAmt
Program Services$21,333,446ProgramServicesAmt
Management And General$6,779,441ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$14,521,854BOYAmt
EOY$11,705,236EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,146,375BOYAmt
EOY$3,051,785EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$106,804BOYAmt
EOY$101,973EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$476,763BOYAmt
EOY$435,686EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$126,792BOYAmt
EOY$121,799EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$19,064,374LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$11,316,857LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$8,349,896BOYAmt
EOY$7,747,517EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$7,902,809BOYAmt
EOY$8,918,290EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$100BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$34,631,393BOYAmt
EOY$32,082,286EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,880,426BOYAmt
EOY$1,750,582EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,549,106BOYAmt
EOY$5,029,454EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,429,532BOYAmt
EOY$6,780,036EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$28,201,861BOYAmt
EOY$25,302,250EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$28,201,861BOYAmt
EOY$25,302,250EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$34,631,393BOYAmt
EOY$32,082,286EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$227,634ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$787,060NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$3,914,305OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$230OtherActivitiesAmt
Total Lobbying Expenditures$230TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule C, Part II-B, Line 1i - Other ActivitiesFormAndLineReferenceDesc
ExplanationIU Health Paoli paid institutional membership dues to the Indiana Hospital Association ("IHA") during 2019 in the amount of $3,515. Each membership organization notified IU Health Paoli 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 Paoli, for lobbying expenditures. The total membership dues paid to these organizations by IU Health Paoli during 2019 that were attributable to lobbying expenditures was $3,515.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$148,000OtherCostOrOtherBasisAmt
Book Value$148,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,889,859OtherCostOrOtherBasisAmt
Depreciation$3,544,505DepreciationAmt
Book Value$2,345,354BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$791,602OtherCostOrOtherBasisAmt
Depreciation$511,257DepreciationAmt
Book Value$280,345BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,293,717OtherCostOrOtherBasisAmt
Depreciation$6,828,691DepreciationAmt
Book Value$4,465,025BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$941,196OtherCostOrOtherBasisAmt
Depreciation$432,403DepreciationAmt
Book Value$508,793BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$7,747,517TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
DUE TO THIRD-PARTY PAYERS$3,688,866
INTERCOMPANY PAYABLES (NET)$1,202,343
SELF-INSURANCE LIABILITIES$28,877
PENSION AND OTHER LIABILITIES$0
FieldValueIRS element (for citing)
Total Liability$5,029,454TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 - FIN 48 (ASC 740) FootnoteFormAndLineReferenceDesc
ExplanationIU Health Paoli is a subsidiary in IU Health's Consolidated Audited Financial Statements. The Internal Revenue Service (IRS) has determined that IU Health and certain of its affiliated entities are tax-exempt organizations as defined in Section 501(c)(3) of the Internal Revenue Code (IRC). IU Health and its tax-exempt affiliates are, however, subject to federal and state income taxes on unrelated business income under the provision 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 same 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 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.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CarefalseFPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served1032PersonsServedCnt
Total Community Benefit Expns$764,424TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$764,424NetCommunityBenefitExpnsAmt
Total Expense0.03000TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served1903PersonsServedCnt
Total Community Benefit Expns$7,289,052TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,375,598DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,913,454NetCommunityBenefitExpnsAmt
Total Expense0.11450TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served2935PersonsServedCnt
Total Community Benefit Expns$8,053,476TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,375,598DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,677,878NetCommunityBenefitExpnsAmt
Total Expense0.14450TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs5ActivitiesOrProgramsCnt
Persons Served610PersonsServedCnt
Total Community Benefit Expns$498,885TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$498,885NetCommunityBenefitExpnsAmt
Total Expense0.01960TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served4PersonsServedCnt
Total Community Benefit Expns$65,395TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$65,395NetCommunityBenefitExpnsAmt
Total Expense0.00260TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$1,581,133TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,083,314DirectOffsettingRevenueAmt
Net Community Benefit Expns$497,819NetCommunityBenefitExpnsAmt
Total Expense0.01960TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served897PersonsServedCnt
Total Community Benefit Expns$5,924TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,924NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs8ActivitiesOrProgramsCnt
Persons Served1511PersonsServedCnt
Total Community Benefit Expns$2,151,337TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,083,314DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,068,023NetCommunityBenefitExpnsAmt
Total Expense0.04200TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs8ActivitiesOrProgramsCnt
Persons Served4446PersonsServedCnt
Total Community Benefit Expns$10,204,813TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,458,912DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,745,901NetCommunityBenefitExpnsAmt
Total Expense0.18650TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$1,032,213BadDebtExpenseAmt
Reimbursed By Medicare$8,843,050ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$9,142,423CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$299,373MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1INDIANA UNIVERSITY HEALTH PAOLI INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1642 W HOSPITAL RDAddressLine1Txt
CityPAOLICityNm
State AbbreviationINStateAbbreviationCd
ZIP47454ZIPCd
FieldValueIRS element (for citing)
Website AddressSEE PART V, SECTION CWebsiteAddressTxt
State License19-005065-1StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1INDIANA UNIVERSITY HEALTH PAOLI INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION COwnWebsiteURLTxt
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care0.FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 - Input from CommunityIn conducting its most recent CHNA, IU Health Paoli's approach to gathering qualitative data consisted of multiple components used to identify and verify community health needs for the IU Health Paoli service area. This included the following: 1. Community Meetings 2. Key Stakeholder Interviews 3. Community Survey Community Meetings To obtain a more complete picture of the factors that play into the Orange County community's health, input from local health and community leaders were gathered at a meeting on April 19, 2018 at the Orange County Community Center in Paoli. Organizations who participated in the focus group are as follows: -Backpacks of Blessings -Hoosier Hills PACT, Tobacco -Hoosier Uplands -Mid-Southern Bank -Orange County EMA -Orange County Government -Orange County Health Department -Orange County Publishing -Paoli Jr./Sr. High School -Pluto Corporation -Purdue Extension -Southern Indiana Community Healthcare -Women, Infants, and Children (WIC) The meeting began with a presentation that discussed the goals and status of the CHNA process and the purpose of the community meeting. Then, secondary data were presented, along with a summary of the most unfavorable community health indicators. For the community served by IU Health Paoli Hospital, those indicators were (in alphabetical order): - Educational attainment - Mental health and access to mental health services - Obesity and physical inactivity - Poverty and unemployment - Prevalence of chronic disease and associated mortality - Smoking, including during pregnancy - Substance abuse Meeting participants then were asked to discuss whether the identified, unfavorable indicators accurately identified the most significant community health issues and were encouraged to add issues that they believed were significant. Several issues were added, such as: access to healthcare, sexually transmitted diseases, and behavioral health. During the meeting, a range of other topics was discussed, including: - Disparities in education, transportation, knowledge of resources - Length of time for a new patient to get in to see a provider - Inability for some to afford employer's insurance and prescription costs - Lack of interest access - Lack of access to transportation - Individuals with sexually transmitted diseases are often under-diagnosed due to the lack of available services and treatment - Not enough fire and EMS trained personnel - Employee substance abuse - Possible solutions, such as access to technology, increased awareness of Alcoholics Anonymous and Narcotics Anonymous, telehealth for mental health services, education campaigns, additional support groups, additional local providers, low cost interventions, grant opportunities, and ride-sharing. After discussing the needs identified through secondary data and adding others to the list, each participant was asked through a voting process to identify three to five needs they consider to be the most significant. From this process, the group identified six needs as being the most significant in the community served by IU Health Paoli Hospital: - Behavioral health and substance abuse - Educational attainment - Poverty and unemployment - Mental health and access to mental health services - Obesity and physical inactivity - Access to healthcare Key Stakeholder Interviews IU Health Paoli also conducted an interview with a representative of the Orange County Health Department. The interview was conducted to assure that appropriate and additional input was received from a governmental public health official. Accordingly, the results of the community meeting were discussed and insights were sought regarding significant community health needs, why such needs are present, and how they can be addressed. The interview was guided by a structured protocol that focused on opinions regarding significant community health needs, describing why such needs are present, and seeking ideas for how to address them. The interviewee confirmed that the top needs identified by the community meeting group were some of the most significant. These needs were: - Behavioral health and substance abuse - Educational attainment - Poverty and unemployment - Mental health and access to mental health services - Obesity and physical inactivity - Access to healthcare Substance abuse is a significant issue in the community, and there are few treatment options for addiction. For treatment options that are available in and nearby the county, long waiting lists exist for care. Unemployment is also an issue, particularly because some residents cannot pass the required drug tests for employment. Chronic illness, disease, and issues with substance abuse all lead to people not working in the county. A lack of transportation options also contributes to poor health outcomes and to unemployment. While county transit exists, it is often limited. Additionally, Medicaid does not reimburse the same for transportation as before, so fewer residents are able to ensure travel to medical appointments. There is a lack of health services, particularly a lack of any urgent care facilities or low income clinics. Due to this shortage, many residents do not go to a medical professional except in emergency situations. Preventive healthcare is not common among residents, largely due to financial reasons and also education around proper preventive health behaviors. In order words, residents may not know preventive measures to take that contribute to better health - i.e. exercising, healthy eating, proper teeth care, etc. A lack of access to exercise opportunities exists, particularly because there are few walking or bicycle paths for activities. Several populations were identified as vulnerable: - Children, especially due to a number of households experiencing substance abuse and neglect issues. - Elderly populations need assistance with medication management. - There is a large Hispanic population that largely lacks health insurance and has limited English proficiency, making it difficult to get this group health services. More resources around education for tobacco cessation, chronic disease management, and other common health issues are needed. Youth education programs are also necessary to try to break the cycle of poor health and welfare that many families experience. More incentives are needed to ensure providers come to the region, especially for behavioral health care, dental care, and urgent care facilities. Obesity and diabetes continue to be issues in the community. Chronic obstructive pulmonary disease (COPD) is a concern due to a long history of tobacco use in the region, in addition to manufacturing jobs leading to poor conditions. There is an increase in Hepatitis C incidences due to IV drug use. Transitional housing programs are needed in the community, particularly for chronic homeless populations and those leaving incarceration. More work training programs are also needed for these groups. Community Survey To inform the CHNA, a community survey was conducted. The survey was sponsored by a cooperative of Indiana hospital systems, under contract with the University of Evansville and the Indiana University School of Public Health-Bloomington. Researchers from Indiana University and University of Evansville contracted with the Center for Survey Research at Indiana University to administer the survey. The survey was conducted in two phases, with Phase 1 conducted as a paper survey mailed to an address-based sample, and Phase 2 administered by some of the hospitals to a convenience sample they selected. IU Health participated in Phase 1. A questionnaire was developed, with input provided by the Indiana hospital systems, and included a number of questions about general health status, access and utilization of services, personal behaviors, social determinants of health, and also respondent demographic information (e.g., ZIP code, income level, employment status, race and ethnicity, household size, gender, and age). The survey was mailed to approximately 82,000 households, and the "field period" was April 2, 2018 through June 29, 2018. The process included two mailings to each address; a postcard mailing also took place to encourage responses. 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 of more IU Health hospital. 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 Paoli Hospital, 244 respondents participated in the survey. The community survey indicates that substance abuse, obesity, chronic diseases, poverty, and alcohol use or abuse represent top concerns in the community served by
Schedule H, Part V, Section B, Line 7a - CHNA WebsiteA copy of IU Health Paoli'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 WebsiteA copy of IU Health Paoli'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 NeedsIn conjunction with the CHNA, IU Health Paoli's Board adopted an implementation strategy in April 2019 related to the 2018 CHNA. IU Health Paoli prioritized and determined which of the community health need identified in its most recently conducted CHNA were most critical for it to address. IU Health Paoli will address the following community health needs between 2019 and 2021: - Access to Healthcare Services - Obesity, Diabetics and Physical Inactivity - Behavioral Health - Social Determinants of Health IU Health uses the term Behavioral Health to refer to Mental Health and Drug and Substance Abuse (including Opioids and Alcohol). Access to Healthcare IU Health Paoli's implementation strategy to address the identified need of Access to Healthcare includes the following: - Recruit providers by working with existing primary care providers on the recruitment efforts. - Recruited one provider, but lost one, so no gain in 2019. Actively recruiting for position. - Continue to provide Hospital Presumptive Eligibility (HPE) to self-pay patients and application assistance to patients and community members. - Paoli employs an insurance navigator that serves not only patients but allows for walk-in clients to come in during business hours to get assistance. - Maintain and recruit healthcare specialists to practice in hospital-based Visiting Specialist Clinics - Nine providers retained and three new providers recruited. Actively recruiting for additional positions. - Provide support in recruiting a Substance Abuse Medical Specialist to provide services to local community. - Participated in recruiting activities with SICHC to bring a provider to this area. - Provide behavioral health services and treatment to students. - Virtual Behavioral Health Hub set up in local Jr. & Sr. High school in Sept. 2019. Ten students utilized the service during 2019. Obesity Prevention IU Health Paoli's implementation strategy to address the identified need of Obesity Prevention includes the following: - Provide breastfeeding support group to nursing mothers. - Provide support group for community members with diabetes. - A support group met once a month and provided information, education & support with guest speakers, activities, and discussion. - Collaborate with the other Indiana University South Central Region hospitals and community organizations to host a Day of Service event focused on healthy weight, physical activity, good nutrition and promotion of positive behavioral health. - The 2019 day of service was held at the community parks and included repair and maintenance of trails, adding benches, distance markers, planting of flowers, playground maintenance, and cross-walk painting. Activities for the day of service were designed to improve parks and attract more community members to use the facilities. Behavioral Health (includes Drug & Substance Abuse and Mental Health) IU Health Paoli's implementation strategy to address the identified need of Behavioral Health includes the following: - Provide support in recruiting a Substance Abuse Medical Specialist to provide services to local community. - Participated in recruiting activities with SICHC to bring a provider to this area. - Provide a drug take-back bin for patients and community members to turn in unused or expired drugs. - A bin is located in hospital, collected 158 pounds of medications in 2019. - Pain Resource Nurse and committee address frequent and repeat patient emergency department (ED) visits and work to decrease unnecessary visits by assisting patients in finding needed resources. - During 2019, a nurse was active in this role. Continued to maintain the average decrease in ED visits that was achieved with the initiation of this program. - Provide peer recovery coaching via IU Health behavioral health virtual services to patients struggling with substance abuse issues. - 2019 was the first year for these services at IU Health Paoli, and the total number of sessions was 396, resulting in 97 episodes of treatment. - Screen perinatal patients and have trained PMAD Registered Nurses consult with patients and offer support group and warm-line services, if needed. - Of the 102 births in 2019, 100% of the mothers were screened and 7 individuals were further served via the support group meetings and the warm-line. - Provide behavioral health services and treatment to students. - Virtual Behavioral Health Hub set up in local Jr. & Sr. High school in Sept. 2019. Ten students utilized the service during 2019. - Provide patients with a behavioral health diagnosis with virtual psychiatric assessments by IU Health Virtual Visits care team. - New in 2019, this service provided 154 sessions and 21 repeat patients utilized additional sessions. Social Determinants of Health IU Health Paoli's implementation strategy to address the identified need of Social Determinants of Health include the following: - Provide opportunities for job shadowing in various areas of the hospital. - Only one job shadow occurred in 2019. This was due to an age restriction that kept many high school students from being able to participate. The age restriction was changed which will allow many more students to job shadow. - Provide internships to college students who are seeking designated healthcare degrees. - In 2019, IU Health Paoli averaged three interns per quarter and had almost 700 hours that employees had precepted a student in a clinical program. Also, IU Health Paoli will address all community health needs based on their 2018 Community Health Needs Assessment.
Schedule H, Part V, Section B, Line 13b - Income Level Other than FPGIn addition to FPG, IU Health Paoli 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 FactorsIU Health Paoli takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. IU Health Paoli'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 Paoli'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 Paoli'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 Paoli'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 Paoli. Eligible patients who receive medical care from IU Health Paoli 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 Paoli is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health Paoli reserves the right to reverse the award in an amount equal to the amount IU Health Paoli would be entitled to receive had no Financial Assistance been awarded. 3. Alternate Methods of Eligibility Determination IU Health Paoli 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 Extraordinary Collection Action ("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 Paoli 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 Paoli 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 AGB for their services. Patients will receive an estimated AGB cost of their care prior to IU Health Paoli 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 the Emergency Medical Treatment and Active Labor Act ("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 IU Health Paoli'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 Paoli 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 WebsiteA copy of IU Health Paoli's FAP is available on the following website: https://iuhealth.org/pay-a-bill/financial-assistance
Schedule H, Part V, Section B, Line 16b - FAP Application WebsiteA copy of IU Health Paoli's FAP Application is available on the following website: https://iuhealth.org/pay-a-bill/financial-assistance
Schedule H, Part V, Section B, Line 16c - FAP PLS WebsiteA plain language summary of the FAP, including translated copies, is available on the following website: https://iuhealth.org/pay-a-bill/financial-assistance
Schedule H, Part V, Section B, Line 16j - Other Measures to PublicizeIU Health Paoli takes several other measures to 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 Paoli 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 Paoli 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 Paoli will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health Paoli will educate its patient facing team members of the FAP and the process for referring patients to the Program.
Schedule H, Part V, Section A, Line 1 - Primary Website Addresshttps://iuhealth.org/find-locations/iu-health-paoli-hospital
Schedule H, Part V, Section B, Line 3e - Prioritized Health NeedsIU Health Paoli'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 five needs as priorities for IU Health Paoli Hospital: - Access to Healthcare - Obesity, Diabetes and Physical Inactivity - Mental Health* - Drug and Substance Abuse* - Social Determinants of Health *IU Health uses the term behavioral health to refer to mental health and drug and substance abuse (including opioids and alcohol).
FieldValueIRS element (for citing)
Facility4FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
IU HEALTH PAOLI HOSPITAL REHABILITATION
642 W Hospital RdPaoliIN47454REHABILITATION SERVICES
IUH PAOLI HOSPITAL OBGYN
642 W HOSPITAL RDPAOLIIN47454SPECIALTY CARE
IU HEALTH PAOLI HOSPITAL SURGERY DEPT
642 W HOSPITAL RDPAOLIIN47454SPECIALTY CARE
IU HEALTH PAOLI WALK-IN
642 W HOSPITAL RD 2ND FLOORPAOLIIN47454PRIMARY CARE

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 3c - Other Factors Used in Determining Elig.IU Health Paoli uses several factors other than Federal Poverty Guidelines ("FPGs") 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 Paoli 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 guardians' federal income tax return. 2. IU Health Paoli'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 Paoli'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 Paoli 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 Paoli'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 Paoli'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 Paoli. Eligible patients who receive medical care from IU Health Paoli 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 Paoli is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health Paoli reserves the right to reverse the award in an amount equal to the amount IU Health Paoli would be entitled to receive had no Financial Assistance been awarded. 6. Alternate Methods of Eligibility Determination IU Health Paoli 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 Paoli 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 Paoli 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 Paoli 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 Paoli 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 Paoli 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 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 Paoli'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 Paoli 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 Paoli'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. 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 ExpenseThe 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 $2,672,050. Bad debt expense is reported at cost based on the cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges.
Schedule H, Part I, Line 7 - Total Community Benefit ExpenseSchedule 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 40.11%.
Schedule H, Part I, Line 7g - Subsidized Health ServicesIU Health Paoli does not include any costs associated with physician clinics as subsidized health services.
Schedule H, Part II - Promotion of Health in Communities ServedIU Health Paoli participates in a variety of community-building activities that address the social determinants of health in the communities it serves. IU Health Paoli is a subsidiary of IU Health. IU HEALTH AND ITS RELATED HOSPITAL ENTITIES ACROSS THE STATE OF INDIANA ("IU HEALTH STATEWIDE SYSTEM") PARTICIPATE IN A VARIETY OF COMMUNITY-BUILDING ACTIVITIES THAT ADDRESS THE HEALTH AND WELLNESS OF RESIDENTS IN THE COMMUNITIES IT SERVES THROUGH INVESTMENTS IN WORKFORCE DEVELOPMENT EFFORTS ACROSS THE STATE, COLLABORATION WITH LIKE-MINDED ORGANIZATIONS THROUGH COALITIONS THAT ADDRESS KEY ISSUES, AND ADVOCACY FOR IMPROVEMENTS IN THE HEALTH STATUS OF VULNERABLE POPULATIONS.IU HEALTH MAKES CONTRIBUTIONS TO COMMUNITY-BUILDING ACTIVITIES BY PROVIDING INVESTMENTS AND RESOURCES TO LOCAL PARTNERS IN THE COMMUNITY. SEVERAL EXAMPLES INCLUDE IU HEALTH'S SUPPORT OF THE FOLLOWING ORGANIZATIONS AND INITIATIVES THAT FOCUS ON COMMUNITY HEALTH NEEDS, AS WELL AS THE CONDITIONS AND BARRIERS THAT IMPACT HEALTH, INCLUDING ACCESS TO HEALTHCARE, BEHAVIORAL HEALTH AND SUBSTANCE ABUSE, SOCIAL DETERMINANTS OF HEALTH AND NUTRITION AND HEALTHY WEIGHT: - COVERING KIDS AND FAMILIES - LIFESMART YOUTH - VOLUNTEERS OF AMERICA OHIO & INDIANA - GOODWILL FOUNDATION OF CENTRAL AND SOUTHERN INDIANA - REACH FOR YOUTH - LUTHERAN FOUNDATION - INDY PUBLIC SAFETY FOUNDATION - UNITED WAY OF CENTRAL INDIANA - PLAYWORKS - INDIANAPOLIS PARKS FOUNDATION - GLEANER'S FOOD BANK - INDIANA LEGAL SERVICES - BRANDYWINE CREEK FARMS - LAWRENCE COMMUNITY GARDEN - GREATER INDY HABITAT FOR HUMANITY - GROUNDWORK INDY - JUNIOR ACHIEVEMENT OF CENTRAL INDIANA - MARION COUNTY PUBLIC HEALTH DEPARTMENT TO TAKE VOLUNTEER SERVICE OUTSIDE THE WALLS OF OUR FACILITIES, INDIANA UNIVERSITY HEALTH CREATED IU HEALTH SERVES, A TEAM MEMBER VOLUNTEER PROGRAM, TO POSITIVELY IMPACT THE HEALTH OF THE COMMUNITY AND FOSTER A CULTURE OF ENGAGEMENT AND SOCIAL RESPONSIBILITY. IN 2019, MORE THAN 3,800 IU HEALTH TEAM MEMBERS DEDICATED MORE THAN 29,000 VOLUNTEER HOURS IN THEIR COMMUNITIES. IU HEALTH ALSO SPONSORS AND PROMOTES IU HEALTH DAYS OF SERVICE, WHICH ARE HIGH-IMPACT EVENTS AIMED AT ENGAGING IU HEALTH TEAM MEMBERS IN ACTIVITIES THAT ADDRESS IDENTIFIED COMMUNITY OUTREACH PRIORITIES. EACH YEAR, MORE THAN 2,000 IU HEALTH TEAM MEMBERS VOLUNTEER DURING DAYS OF SERVICE.
Schedule H, Part III, Line 2 - Methodology Used to Est. Bad Debt Exp.The bad debt expense of $1,032,213 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 4 - Bad Debt ExpenseIU Health Paoli 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 ShortfallThe 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 Paoli Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health Paoli'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 Paoli's participation in Medicare programs would significantly increase the Medicare shortfall reported on Schedule H, Part III, Line 7. IU Health Paoli's Medicare shortfall is attributable to reimbursements that are less than the cost of providing patient care and services to Medicare beneficiaries and does not include any amounts that result from inefficiencies or poor management. IU Health Paoli accepts all Medicare patients knowing that there may be shortfalls; therefore it has taken the position that any shortfall should be counted as part of its community benefit. Additionally, it is implied in Internal Revenue Service Revenue Ruling 69-545 that treating Medicare patients is a community benefit. Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with governmental health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community.
Schedule H, Part III, Line 9b - Written Debt Collection PolicyIU Health Paoli'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 Paoli, 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 Paoli. The application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health Paoli's 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 with 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 Paoli 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 return, 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 Paoli 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 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 Paoli 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 Paoli 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 Paoli 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 Paoli. IU Health Paoli 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 Paoli 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 AssessmentCommunities are multifaceted and so are their health needs. IU Health Paoli 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 Paoli assesses the health care needs of the communities it serves by conducting a CHNA. This assessment includes collaboration with other community organizations such: - Backpacks for Blessings - Hoosier Hills PACT, Tobacco - Hoosier Uplands - Mid-Southern Bank - Orange County EMS - Orange County Government - Orange County Health Department - Orange County Publishing - Paoli Jr./Sr. High School - Pluto Corporation - Purdue Extension - Southern Indiana Community Healthcare - Women, Infants and Children (WIC) After completion of the CHNA, IU Health Paoli reviewed the information gathered from community leader focus groups, community input surveys and statistical data. The needs identified were analyzed and ranked to determine the prevalence and severity of community health needs and which ones were most critical. Additionally, the effectiveness of an intervention for each need and IU Health Paoli's ability to impact positive change was evaluated.
Schedule H, Part VI, Line 3 - Patient Education of Eligibility for Assist.IU Health Paoli 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 Paoli has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health Paoli is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health Paoli 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 Paoli 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 Paoli 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 Paoli 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 Paoli will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health Paoli 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 InformationIU Health Paoli is located in Orange County, Indiana, a county located in south central Indiana. Orange County includes ZIP codes within the towns of French Lick, Orleans, Paoli, and West Baden Springs. Based on the most recent Census Bureau (2019) statistics, Orange County's population is 19,646 persons with approximately 50.1% being female and 49.9% male. The county's population estimates by race are 96.5% White, 1.5% Black, 1.8% Hispanic or Latino, 0.4% Asian, 0.4% American Indian or Alaska Native, and 1.5% persons reporting two or more races. Orange County has relatively low levels of educational attainment as compared to other Indiana counties. Roughly, 12.3% of the population has a bachelor's degree or graduate/professional degree, while 83.3% of the population has obtained a high school degree.
Schedule H, Part VI, Line 5 - Promotion of Community HealthIU Health Paoli participates in a variety of community-building activities that address the social determinants of health in the communities it serves. IU Health Paoli is a subsidiary of IU Health. IU HEALTH AND ITS RELATED HOSPITAL ENTITIES ACROSS THE STATE OF INDIANA ("IU HEALTH STATEWIDE SYSTEM") PARTICIPATE IN A VARIETY OF COMMUNITY-BUILDING ACTIVITIES THAT ADDRESS THE HEALTH AND WELLNESS OF RESIDENTS IN THE COMMUNITIES IT SERVES THROUGH INVESTMENTS IN WORKFORCE DEVELOPMENT EFFORTS ACROSS THE STATE, COLLABORATION WITH LIKE-MINDED ORGANIZATIONS THROUGH COALITIONS THAT ADDRESS KEY ISSUES, AND ADVOCACY FOR IMPROVEMENTS IN THE HEALTH STATUS OF VULNERABLE POPULATIONS. IU HEALTH MAKES CONTRIBUTIONS TO COMMUNITY-BUILDING ACTIVITIES BY PROVIDING INVESTMENTS AND RESOURCES TO LOCAL PARTNERS IN THE COMMUNITY. SEVERAL EXAMPLES INCLUDE IU HEALTH'S SUPPORT OF THE FOLLOWING ORGANIZATIONS AND INITIATIVES THAT FOCUS ON COMMUNITY HEALTH NEEDS, AS WELL AS THE CONDITIONS AND BARRIERS THAT IMPACT HEALTH, INCLUDING ACCESS TO HEALTHCARE, BEHAVIORAL HEALTH AND SUBSTANCE ABUSE, SOCIAL DETERMINANTS OF HEALTH AND NUTRITION AND HEALTHY WEIGHT: - College Mentors for Kids - Starfish Initiative - Teach for America - United Way TO TAKE VOLUNTEER SERVICE OUTSIDE THE WALLS OF OUR FACILITIES, INDIANA UNIVERSITY HEALTH CREATED IU HEALTH SERVES, A TEAM MEMBER VOLUNTEER PROGRAM, TO POSITIVELY IMPACT THE HEALTH OF THE COMMUNITY AND FOSTER A CULTURE OF ENGAGEMENT AND SOCIAL RESPONSIBILITY. IN 2019, MORE THAN 3,800 IU HEALTH TEAM MEMBERS DEDICATED MORE THAN 29,000 VOLUNTEER HOURS IN THEIR COMMUNITIES. IU HEALTH ALSO SPONSORS AND PROMOTES IU HEALTH DAYS OF SERVICE, WHICH ARE HIGH-IMPACT EVENTS AIMED AT ENGAGING IU HEALTH TEAM MEMBERS IN ACTIVITIES THAT ADDRESS IDENTIFIED COMMUNITY OUTREACH PRIORITIES. EACH YEAR, MORE THAN 2,000 IU HEALTH TEAM MEMBERS VOLUNTEER DURING DAYS OF SERVICE.
Schedule H, Part VI, Line 6 - Affiliated Health Care SystemIU Health Paoli 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, 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 are 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 benefits plan relative to the local community, the IU Health Statewide System considers its community benefit plan as part of an overall 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 $700 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. Each year more than 2,000 IU Health team members volunteer in their communities 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 in the South Central Region: Family Vitality Initiative development and implementation, IU Health South Central Region, $230,000 over two years. By bringing together existing healthcare providers, social workers and researchers, this integrated program will take a holistic approach to addressing substance-related healthcare issues, especially among the most vulnerable populations of women and children. The South Central Region has seen alarming increases in the numbers of infants who test positive for opiates at birth, opioid-related encounters in each emergency department, and mothers struggling with addiction including smoking. The IU Health Community Health Grants seek to improve community health by supporting collaboration among IU Health Regional Hospital Boards and Community Health Committees, and local resources and programs. The Community Health Grants are awarded to programs most likely to improve access to health services, enhance the health of the community, advance medical or healthcare knowledge, and relieve or reduce the burden of government or other community efforts. Grantees must also build capacity for addressing these community health issues going forward. Goodwill Foundation of Central and Southern Indiana 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. Community Partnerships IU Health believes in the power of investing in community partnerships and what that means for the health of our residents and their communities. IU Health seeks to partner with
Schedule H, Part III, Line 3 - Bad Debt Attributable to Patients EligibleAn 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 attributable to patients who are eligible under the Financial Assistance Policy and no portion of bad debt is included as community benefit.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MATTHEW D BAILEY
FORMER OFFICER$0$0$0$0$0$290,903$0$0$0$0$0$290,903$0$290,903
DAVID L BEACHY DO
DIRECTOR$0$232,102$0$26,938$0$6,858$0$17,422$0$16,960$0$300,280$0$0
JAMES J LAUGHLIN MD
DIRECTOR$0$359,608$0$56,141$0$6,858$0$18,075$0$0$0$440,682$0$0
HOJATT M SHAMLOO MD
DIRECTOR$0$425,705$0$204,132$0$21,322$0$18,075$0$31,405$0$700,639$0$0
JOHN S STROBEL MD
DIRECTOR$0$579,375$0$59,345$0$79,247$0$18,075$0$25,343$0$761,385$0$0
LARRY R BAILEY
PRESIDENT$0$237,104$0$31,407$0$4,776$0$17,845$0$16,727$0$307,859$0$0
MICHAEL L CRAIG
VP & CFO$0$239,653$0$35,745$0$2,274$0$18,084$0$17,005$0$312,761$0$0
BRIAN T SHOCKNEY
Director/President (SCR)$0$468,991$0$159,543$0$34,201$0$99,076$0$26,918$0$788,729$0$0
FRANKLIN R FRAZIER RN
C.R.N.A.$168,447$0$500$0$120$0$10,265$0$2,043$0$181,375$0$0$0
PAMELLA J BOND
VP, SUPPORT SERVICES$140,067$0$22,539$0$1,909$0$10,501$0$11,920$0$186,936$0$0$0
Angela M Conklin
Anesthetist$162,759$0$500$0$199$0$9,799$0$19,796$0$193,053$0$0$0
Daniel A Handel MD
VP & CMO$0$448,902$0$40,012$0$19,540$0$19,540$0$18,075$0$546,069$0$0
Kenneth E Marshall MD
Former Key Employee$0$199,232$0$5,586$0$3,350$0$12,658$0$34,239$0$255,065$0$0
Cynthia R Herrington
VP & CNO$0$183,513$0$23,552$0$12,521$0$10,519$0$18,887$0$248,992$0$0
Alan W Biggs
COO$0$250,466$0$500$0$621$0$10,287$0$21,095$0$282,969$0$0
Blake A Dye
Director$0$525,258$0$0$0$9,594$0$11,200$0$21,558$0$567,610$0$0
Bruce R Wade
VP - Human Resources Regional$0$175,440$0$24,161$0$20,366$0$8,403$0$29,235$0$257,605$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 - Comp. of the Org.'s President/Exec DirIU Health Paoli's Regional President is employed by Indiana University Health, Inc. IU Health Paoli's President is employed by IU Health Bloomington, Inc. IU Health, IU Health Bloomington, and other related organizations have a process in place to determine the compensation for its 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 officers 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 - SeveranceMatthew D. Bailey entered into a severance agreement with IU Health during 2018. Severance of $290,903 that was received during 2019 is included in column B(III), other reportable compensation. Deferred severance of $308,429 was disclosed in 2018 in column C, retirement and other deferred compensation.
Schedule J, Part I, Line 4b - Supplemental Nonqualified Retirement PlanBrian T. Shockney participates in a supplemental executive retirement plan, provisions of which are designed to retain critical employees. The plan provides for an additional retirement benefit for service through normal retirement or other key dates. If the executive leaves prior to retirement or other key dates, the benefit may be forfeited or reduced. Brian T. Shockney has an amount included in column c, deferred compensation, representing the current year unvested contributions made under the supplemental retirement plan. No amount was actually paid to this executive during the year.
Schedule J, Part I, Line 7 - Non-Fixed PaymentsAmounts 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 (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Page 1, Line J Web Site:https://iuhealth.org/find-locations/iu-health-paoli-hospital
Part VI, Section A, Line 2 - Family or Business RelationshipsCertain officers, directors or key employees of Indiana University Health, Inc. (IU Health) also serve on the boards or as officers of related or unrelated for-profit organizations, as noted below. No additional compensation was provided to these individuals for their service to related organizations. Related For-profit Organization: Indiana University Health Southern Indiana Physicians, Inc. (01/01/2019 - 03/07/2019) Type of Relationship: Business Directors or Officers: Larry R. Bailey, Brian T, Shockney, Joyce B. Poling and Michael L. Craig Part VI, Section A, Line 4 - Changes to the Governing Documents On June 28, 2019, Article I, Section 1.5, Sole Member was amended to name Indiana University Health, Inc. as Indiana University Health Paoli Hospital's sole member. Also, Article II, Section 2.1(b), Board Composition was amended decrease the number of board members representing Indiana University Health Bloomington, Inc. from five to four members and include one member directly appointed by the Local Council of Women, Inc.
Part VI, Section A, Lines 6, 7a and 7b - Members or StockholdersLine 6: The sole member of IU Health Paoli is IU Health, Inc., a 501(c)(3) tax-exempt organization. Line 7A: The Board of Directors shall consist from nine (9) to thirteen (13) members. To be eligible for Board Membership, a Director candidate shall satisfy the selection criteria and personal characteristics as may be established by the Member and IU Health from time to time. It is preferred that at least three (3) of the Directors are physician members, but is not required. The composition of the Board of Directors shall be consistent with the following criteria: i. Two (2) member shall be representatives of Indiana University Health Bedford, Inc.; ii. Two (2) members shall be representatives of Indiana University Health Paoli, Inc.; iii. Two (2) members shall be representatives of Indiana University Health Morgan, Inc.; iv. Four (4) members shall be representatives of Indiana University Health Bloomington, Inc.; and v. Two (2) members shall be the President of the IU Health South Central Region and an IU Health executive leadership representative. vi. One (1) member directly appointed by the Local Council of Women, Inc. ("Council Director") Line 7B: All action of the Corporation shall be by its Board of Directors, subject to the following matters which require the approval of the Member and IU Health: a) Authorize the establishment or acquisition of any subsidiaries, affiliates or joint venture arrangements or acquisition of all or substantially all of the assets of any other business or entity; b) Approve or amend any operating or capital budget (provided that the approval or amendment of any operating or capital budget, or any other action, that would eliminate a Core Service (as that term is defined in that certain Integration Definitive Agreement between IU Health Bloomington Hospital, Foundation and IU Health, dated March 5, 2009 (the "Definitive Agreement")). The elimination of a Core Service must also be approved by a majority vote of the Board; c) Authorize any unbudgeted operating or capital budget items or deviations, including any issuance or guarantee of any unbudgeted debt, greater than the budgeted amount by $100,000 for any individual item or $300,000 per fiscal year in the aggregate; d) Authorize the incurrence of debt by the Hospital in accordance with policies and procedures issued by IU Health (the "System Policies"), including to serve as a guarantor, surety or co-obliger; e) Approve any strategic plans and amendments thereto; f) Amend or repeal the Hospital's Articles of Incorporation or these By-Laws (or other corresponding organizational documents if an affiliate is not a corporation) in any manner, including without limitation any change relating to the nonprofit purposes of Hospital; g) Authorize any merger, consolidation, reorganization, sale or transfer of all or substantially all of the Hospital's assets or a subsidiary organization of the Hospital; h) Authorize any voluntary declaration of bankruptcy, plan of dissolution, liquidating distribution of assets or other action related to its dissolution or liquidation of the Hospital; i) Approve, upon recommendation of the Nominating Committee as provided in these Bylaws, the members of the Board of Directors of Hospital; j) Approve any management agreement for the management of all or a substantial part of Hospital's or any of its affiliate's operations; and k) Approve any action to terminate acute care services or to close the Hospital owned by the sole member.
Part VI, Section B, Line 11b - Review of Form 990The VP & CFO reviewed and approved the Form 990. Following the VP & 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, 14, and 16b - PoliciesIU Health Paoli is part of the IU Health system. As the sole member and controlling parent of IU Health Paoli, the sole member and controlling parent of IU Health Paoli, IU Health and its board of directors have mandated that certain policies be followed to ensure greater standardization throughout the system. Thus, IU Health Paoli'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 PolicyIU Health Paoli 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 compIU Health Paoli's Regional President is employed by IU Health. IU Health's process for determining compensation is as follows: (1) The Board of Directors ("Board") has established a Talent Management and Executive Compensation Committee ("TMECC"), the purpose of which includes reviewing and making recommendations regarding executive (Senior Vice Presidents and above) pay and benefits (collectively referred to as "compensation") on an annual basis. The TMECC is made up of members of the Board that are neither physicians nor employees and do not otherwise have a conflict of interest regarding any of IU Health's compensation arrangements. The TMECC reviews an executive's entire compensation package including base salary, short-term and long-term incentives, health and welfare benefits, qualified and nonqualified retirement plans, as well as any additional fringe benefits. As deemed appropriate, the Committee on Finance, which is also made up of members of the Board, may also review executive compensation and benefits. (2) The TMECC engages an independent compensation consulting firm on an annual basis to conduct a compensation analysis for its executive group, which consists of employees at the level of senior vice president and above. The current compensation advisor is 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 Paoli's President is employed by IU Health Bloomington, Inc. IU Health Bloomington and other related entities have a process in place to determine the compensation for the 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 DisclosureIU Health Paoli's Articles of Incorporation are available for public inspection through the Indiana Secretary of State's website. IU Health Paoli's conflict of interest procedures are described on Form 990, Schedule O. IU Health Paoli 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 Paoli's Form 990.
Part XI, Line 9 - Other Changes in Net Assets or Fund BalancesDuring 2019, IU Health Paoli recorded the following other changes in net assets or fund balances: Equity Transfers (Additional Paid-in-Capital): $ (3,914,305)
FORM 990 PART IX LINE 11GDESCRIPTION:PROF. FEES/SHARED SERVICES TOTAL FEES:9891898

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (29 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Clarian Transplant Institute Inc
950 N Meridian St Ste 800IndianapolisIN46204134350599HealthcareIN501(c)(3)10IUHYes (true)
Indiana Health Info Exchange Inc
846 N Senate AveIndianapolisIN46202364550324HealthcareIN501(c)(3)12 INAfalse
Indiana University Health Inc
950 N Meridian St Ste 300IndianapolisIN46204351955872HealthcareIN501(c)(3)3NAfalse
IU Health Arnett Inc
950 N Meridian St Ste 300IndianapolisIN46204263162145HealthcareIN501(c)(3)3IUHYes (true)
IU Health Ball Memorial Hospital Inc
950 N Meridian St Ste 300IndianapolisIN46204350867958HealthcareIN501(c)(3)3IUHYes (true)
IU Health Ball Memorial Physicians Inc
950 N Meridian St Ste 300IndianapolisIN46204351925641HealthcareIN501(c)(3)10IUHBMHYes (true)
IU Health Bedford Inc
950 N Meridian St Ste 300IndianapolisIN46204237042323HealthcareIN501(c)(3)3IUHYes (true)
IU Health Blackford Hospital Inc
950 N Meridian St Ste 300IndianapolisIN46204010646166HealthcareIN501(c)(3)3IUHBMHYes (true)
IU Health Bloomington Inc
950 N Meridian St Ste 300IndianapolisIN46204351720796HealthcareIN501(c)(3)3IUHYes (true)
IU Health Care Associates Inc
950 N Meridian St Ste 300IndianapolisIN46204351747218HealthcareIN501(c)(3)10IUHYes (true)
IUHLP Liquidation Inc
950 N Meridian St Ste 800IndianapolisIN46204351125434HealthcareIN501(c)(3)10IUHYes (true)
IUHLP-P Liquidation Inc
950 N Meridian St Ste 800IndianapolisIN46204311070868HealthcareIN501(c)(3)10IUHLPYes (true)
IU Health Morgan Inc
950 N Meridian St Ste 800IndianapolisIN46204273533027HealthcareIN501(c)(3)10IUHYes (true)
IU Health North Hospital Inc
950 N Meridian St Ste 300IndianapolisIN46204351932442HealthcareIN501(c)(3)3IUHYes (true)
IU Health Plans NFP Inc
950 N Meridian St Ste 800IndianapolisIN46204463803873InsuranceIN501(c)(4)N/AIUHYes (true)
IU Health Tipton Hospital Inc
950 N Meridian St Ste 300IndianapolisIN46204262772226HealthcareIN501(c)(3)3IUHYes (true)
IU Health West Hospital Inc
950 N Meridian St Ste 300IndianapolisIN46204351814660HealthcareIN501(c)(3)3IUHYes (true)
IU Health White Memorial Hospital Inc
950 N Meridian St Ste 300IndianapolisIN46204273532963HealthcareIN501(c)(3)3IUHYes (true)
IU Medical Group Foundation Inc
340 W 10th St No FS5100IndianapolisIN46202201093251FundraisingIN501(c)(3)12 IINAfalse
MDwise Marketplace Inc
950 N Meridian St Ste 800IndianapolisIN46204465270582InsuranceIN501(c)(4)N/AIUHYes (true)
MDwise Network Inc
950 N Meridian St Ste 800IndianapolisIN46204472619552InsuranceIN501(c)(4)N/AIUHYes (true)
Indiana University Health Foundation Inc
1633 N Capitol Ave Ste 1200IndianapolisIN46202356043086FundraisingIN501(c)(3)12 IIUHYes (true)
Methodist Health Group Inc
950 N Meridian St Ste 800IndianapolisIN46204350876390HealthcareIN501(c)(3)12 III-FINAfalse
Methodist Occup Health Centers Inc
950 N Meridian St Ste 300IndianapolisIN46204351844176HealthcareIN501(c)(3)3IUHYes (true)
Riley Cheer Guild Inc
705 Riley Hospital DrIndianapolisIN46202356018517FundraisingIN501(c)(3)12 III-FINAfalse
University Family Physicians Inc
950 N Meridian St Ste 800IndianapolisIN46204237427350HealthcareIN501(c)(3)10IUHCAYes (true)
IU Health Frankfort Inc
950 N Meridian St Ste 300IndianapolisIN46204815174295HealthcareIN501(c)(3)3IUHYes (true)
IU Health Jay Inc
950 N Meridian St Ste 300IndianapolisIN46204822736786HealthcareIN501(c)(3)3IUHYes (true)
IU Health Ball Memorial Hospital Foundat
950 N Meridian St Ste 800IndianapolisIN46204311111784FundraisingIN501(c)(3)12 IIUHBMHYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (22 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
BOSC LLC
569 Brookwood Village Ste 901BirminghamAL35244270275794HealthcareINNA
BSC LLC
569 Brookwood Village Ste 901BirminghamAL35244352072586HealthcareINNA
BOSC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454147343HealthcareINNA
BSC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204452314634HealthcareINNA
CHV Fund I LLC
950 N Meridian St Ste 800IndianapolisIN46204262523206Venture CapitalINNA
CHV Fund II Mgmt LLC
950 N Meridian St Ste 800IndianapolisIN46204371717823Venture CapitalINNA
CHV Fund II LLC
950 N Meridian St Ste 800IndianapolisIN46204800902337Venture CapitalINNA
CHV Fund Mgmt LLC
950 N Meridian St Ste 800IndianapolisIN46204262523151Venture CapitalINNA
IEC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454148032HealthcareINNA
IN Endo Centers LLC
569 Brookwood Village Ste 901BirminghamAL35244208398421HealthcareINNA
ROC Surgery LLC
569 Brookwood Village Ste 901BirminghamAL35244271497960HealthcareINNA
ROCS Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454148369HealthcareINNA
Sen St Surg CNTR LLC
569 Brookwood Village Ste 901BirminghamAL35244421709357HealthcareINNA
SSSC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454148167HealthcareINNA
HEALTH VENTURE MGMT LLC
950 N Meridian Street Suite 800IndianapolisIN46204205740218ManagementINNA
Egl Hilnd Surg Cntr LLC
569 Brookwood Village Ste 901BirminghamAL35244352259204HealthcareINNA
EHSC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454147879HealthcareINNA
EWASC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204473087761HealthcareINNA
IUH EWA Surg Cntr LLC
569 Brookwood Village Ste 901BirminghamAL35244473102482HealthcareINNA
IUH Sax Surgery Center LLC
569 Brookwood Village Ste 901BirminghamAL35244275271091HealthcareINNA
SSC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204464472887HealthcareINNA
IUH FORT WAYNE LLC
950 N MERIDIAN ST STE 800IndianapolisIN46204831224627HEALTHCAREINNA

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (17 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCdForeign PostalForeignAddress/ForeignPostalCd
BMH Medical Pavilion Association Inc
2525 W University AveMuncieIN47303351858408Condo MgmtINNACYes (true)
Cardinal Health Ventures Inc
950 N Meridian St Ste 800IndianapolisIN46204351611424ManagementINNACYes (true)
CHV Capital Inc
950 N Meridian St Ste 800IndianapolisIN46204260752507Venture CapitalINNACYes (true)
IU Health 457(B) Plan
1100 N Market StWilmingtonDE19890476948347InvestmentsINNATYes (true)
IU Health ACO Inc
950 N Meridian St Ste 800IndianapolisIN46204454421020HealthcareINNACYes (true)
IU Health Board Designated Trust
400 Howard StSan FranciscoCA94105306309021InvestmentsINNATYes (true)
IU Health NTGI S&P500 Fund CF
PO Box 804358ChicagoIL60680306298263InvestmentsINNATYes (true)
IU Health Plans Holding Company Inc
950 N Meridian St Ste 800IndianapolisIN46204463794815InsuranceINNACYes (true)
IU Health Plans Inc
950 N Meridian St Ste 800IndianapolisIN46204262127080HMOINNACYes (true)
IU Health Risk Purchasing Group Inc
151 Meeting St Ste 301CharlestonSC29401260202446InsuranceINNACYes (true)
IU Health Risk Retention Group Inc
151 Meeting St Ste 301CharlestonSC29401201107674InsuranceSCNACYes (true)
IU Health Southern IN Physicians Inc
950 N Meridian St Ste 300IndianapolisIN46204351913875HealthcareINIUHBCYes (true)
IUH Assurance SPC Ltd
980395429InsuranceNACYes (true)PO Box 69 94 Solaris AveCamana BayGrand CaymanCJCJ
Proteuo Fund LP
981075227InvestmentsNACYes (true)PO BOX 31106 89 NEXUS WAYCAMANA BAYGRAND CAYMANCJCJ
SCANS Inc
950 N Meridian St Ste 800IndianapolisIN46204453080392HealthcareINNACYes (true)
IU Health Plans Insurance Company
950 N Meridian St Ste 800IndianapolisIN46204811097215InsuranceINNACYes (true)
Cerberus Residential Opportunity Institu
999999999InvestmentsNACYes (true)190 Elgin Avenue George TownGrand CaymanCJCJN/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
IU HEALTH SOUTHERN INDIANA PHYSICIANS INC
M$1,284,616FMV
IUH ASSURANCE SPC LTD
R$61,973FMV
IU HEALTH RISK RETENTION GROUP INC
R$122,105FMV
IU HEALTH SOUTHERN INDIANA PHYSICIANS INC
R$3,914,304FMV