STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

INDIANA UNIVERSITY HEALTH NORTH HOSPITAL INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
INDIANA UNIVERSITY HEALTH NORTH HOSPITAL INC (EIN 35-1932442)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-13
IRS object ID
202023189349303287
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)
Return2020-11-13T09:40:34-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIR STE 4000AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN351932442EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1INDIANA UNIVERSITY HEALTH NORTH HOSPITALBusinessNameLine1Txt
Business Name Line2INCBusinessNameLine2Txt
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)
PersonCARA L BREIDSTERPersonNm
Person TitleCFOPersonTitleTxt
Phone3179634842PhoneNum
Signature2020-11-08SignatureDt

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 Address162.1.179.250IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id35198520203185000013FederalOriginalSubmissionId
Federal Original Submission Id2020-11-13FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdEC0F867CDA2A68A93B900C7968EA20F6D551AC78AtSubmissionCreationDeviceId
At Submission Filing Device Id6C5B360722C3FFAFCFE5827037413334CAD8ED04AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKENNETH D PUCKETTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1950 N MERIDIAN ST STE 300AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$293,117,483GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressSEE SCHEDULE OWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionImprove the health of our communities, support the educational commitment of Indiana University Health, Inc., nurture the individual spirit, and celebrate the experiences of life.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee1418TotalEmployeeCnt
Total Volunteers149TotalVolunteersCnt
Total Gross UBI$31,105TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$840PYContributionsGrantsAmt
CY Contributions Grants$87,079CYContributionsGrantsAmt
PY Program Service Revenue$265,380,249PYProgramServiceRevenueAmt
CY Program Service Revenue$279,590,809CYProgramServiceRevenueAmt
PY Investment Income$6,268,908PYInvestmentIncomeAmt
CY Investment Income$10,608,057CYInvestmentIncomeAmt
PY Other Revenue$3,468,255PYOtherRevenueAmt
CY Other Revenue$2,812,234CYOtherRevenueAmt
PY Total Revenue$275,118,252PYTotalRevenueAmt
CY Total Revenue$293,098,179CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$920CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$74,079,791PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$74,854,375CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$9,898CYTotalFundraisingExpenseAmt
PY Other Expenses$137,002,362PYOtherExpensesAmt
CY Other Expenses$146,306,981CYOtherExpensesAmt
PY Total Expenses$211,082,153PYTotalExpensesAmt
CY Total Expenses$221,162,276CYTotalExpensesAmt
PY Revenues Less Expenses$64,036,099PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$71,935,903CYRevenuesLessExpensesAmt
Total Assets BOY$539,270,716TotalAssetsBOYAmt
Total Assets EOY$612,988,321TotalAssetsEOYAmt
Total Liabilities BOY$231,715,962TotalLiabilitiesBOYAmt
Total Liabilities EOY$233,518,606TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$307,554,754NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$379,469,715NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionIMPROVE THE HEALTH OF OUR COMMUNITIES, SUPPORT THE EDUCATIONAL COMMITMENT/EFFORTS OF INDIANA UNIVERSITY HEALTH, INC. ("IU HEALTH"), NURTURE THE INDIVIDUAL SPIRIT, AND CELEBRATE THE EXPERIENCES OF LIFE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$179,316,733ExpenseAmt
Grant$920GrantAmt
Revenue$274,782,012RevenueAmt
DescIndiana University Health North Hospital, Inc. ("IU Health North Hospital") has provided leading family-centered care to Carmel and Hamilton County residents since 2005. As a full-service hospital for adults and children with an attached medical office building, IU Health North Hospital brings together physician offices, 149 inpatient beds, and operating rooms in a state-of-the-art facility where compassionate caregivers provide superior patient treatment without regard to a patient's ability to pay.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$2,604,941ExpenseAmt
Grant$0GrantAmt
Revenue$3,991,769RevenueAmt
DescIU Health North Hospital provides services to related tax-exempt organizations.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$521,754ExpenseAmt
Grant$0GrantAmt
Revenue$799,528RevenueAmt
DescIU Health North Hospital leases physician office and clinic space to related tax-exempt organizations.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$11,420ExpenseAmt
Revenue$17,500RevenueAmt
DescPharmacyDesc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$11,420TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$17,500TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$182,454,848TotalProgramServiceExpensesAmt
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 Document58IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1418EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
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 Members12GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
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 OtherYes (true)CompensationProcessOtherInd
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
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Kristy A Schulhof
DIRECTOR/PRESIDENT (PART YEAR)53.02.0Yes (X)Yes (X)$0$1,022,070$423,160
MATTHEW R COOK
DIRECTOR2.053.0Yes (X)$0$884,838$150,078
Kenneth D Puckett
President - Indy Suburban Reg.35.020.0Yes (X)Yes (X)$0$749,896$145,910
PAUL M CALKINS MD
VP & CMO55.00.0$602,605$0$31,892Yes (X)
KEVIN L SMITH MD
DIRECTOR2.053.0Yes (X)$0$520,724$12,547
MEGAN CRITTENDON MD
DIRECTOR2.053.0Yes (X)$0$374,099$11,362
ARTHUR VASQUEZ
COO - Indy Suburban Region35.020.0$0$316,788$48,361Yes (X)
Cara L Breidster
CFO - Indy Suburban Region35.020.0Yes (X)$0$321,380$41,748
MICHAEL L HARLOWE
PRESIDENT - TIPTON0.055.0$291,075$0$35,860Yes (X)
DEREK E EMPIE
SECRETARY5.050.0Yes (X)$0$268,310$45,345
RUTH A KAIN RN
Former Key Employee0.055.0$0$264,913$41,126Yes (X)
LISA A SPARKS RN
CNO - Indy Suburban Region35.020.0$0$231,548$43,717Yes (X)
RANDALL C YUST
Former Officer55.00.0$0$227,727$29,249Yes (X)
DIANE L HESSON
Interim CNO (PART YEAR)35.020.0$141,699$65,495$36,484Yes (X)
MARK A MCLEAN
DIR OPERATIONS (PART YEAR)35.020.0$88,973$115,837$32,933Yes (X)
TAMARAH D BROWNLEE
VP-HR - Indy Suburban Region35.020.0$0$192,896$40,664Yes (X)
ATHANASIA S BANICH
PRES. North/Coo Saxony (Pt Yr)55.00.0Yes (X)$8,391$166,818$34,137
JONATHAN R GOBLE
Former Officer0.00.0$0$208,726$0Yes (X)
JANICE M VADAS
Director Allied Services40.00.0$182,794$0$15,145Yes (X)
CHAD A DILLEY
ADMIN DIR-CV(PT YR)/COO-SAXONY40.00.0$159,296$14,813$7,156Yes (X)
ROBERT E EVARD MD
DIRECTOR12.02.0Yes (X)$0$79,612$0
JAY L HESS MD
DIRECTOR1.07.0Yes (X)$6,500$37,500$0
CHARLES E SCHALLIOL
CHAIRMAN2.02.0Yes (X)Yes (X)$18,750$0$0
CLAUDIA J SOMES MD
DIRECTOR2.02.0Yes (X)$14,375$0$0
MARSHA A STONE
DIRECTOR2.02.0Yes (X)$0$8,000$0
MARK R BENSON DO
DIRECTOR2.02.0Yes (X)$0$7,000$0
MICHELE M KAWIECKI
DIRECTOR2.02.0Yes (X)$6,500$0$0
REV KAREN E DEVAISHE
DIRECTOR (Part Year)2.02.0Yes (X)$0$3,500$0
JOHN D GOLDENBERG M
DIRECTOR2.02.0Yes (X)$3,000$0$0
MICHAEL L KUBACKI
DIRECTOR (Part Year)2.00.0Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,514,458TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$6,071,990TotReportableCompRltdOrgAmt
Total Other Compensation$1,226,874TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K54IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (true)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ARAMARK HEALTHCARE TECHNOLOGIES
10510 TWIN LAKES PARKWAYCHARLOTTENC28269CLINICAL ENGINEERING$1,079,911
MESSER CONSTRUCTION CO
2445 N MERIDIAN STINDIANAPOLISIN46208CONSTRUCTION$27,965,031
SODEXO INC AFFILIATES
4880 PAYSPHERE CIRCLECHICAGOIL60674FACILITIES$775,719
TRIMEDX LLC
5451 LAKEVIEW PKWY S DRINDIANAPOLISIN46268CLINICAL ENGINEERING$1,422,412
SOUTH WESTERN COMMUNICATIONS INC
7031 Mayflower Park DriveZIONSVILLEIN46077CONSULTING$679,241
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K29CntrctRcvdGreaterThan100KCnt
Related Organizations$87,058RelatedOrganizationsAmt
All Other Contributions$21AllOtherContributionsAmt
Total Contributions$87,079TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE622110$274,782,012$274,782,012
SHARED SERVICES541990$3,991,769$3,991,769
RENT FROM RELATED 501(C)(3) ORGS.532000$799,528$799,528
PHARMACY446110$17,500$17,500
FieldValueIRS element (for citing)
Total Program Service Revenue$279,590,809TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,038,200TotalRevenueColumnAmt
Exclusion$10,038,200ExclusionAmt

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$102,099RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$18,042RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$84,057RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$84,057TotalRevenueColumnAmt
Exclusion$84,057ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$571,119OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$1,262OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$569,857OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$569,857TotalRevenueColumnAmt
Exclusion$569,857ExclusionAmt
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 (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
CAFETERIA/FOOD SERVICE721110$2,565,319$31,105$2,534,214
EDUCATION900099$23,359$23,359
GIFT SHOP453220$78,822$78,822

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$60,677TotalRevenueColumnAmt
Exclusion$60,677ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,728,177OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$293,098,179TotalRevenueColumnAmt
Related Or Exempt Func Income$279,590,809RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$31,105UnrelatedBusinessRevenueAmt
Exclusion$13,389,186ExclusionAmt
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$920TotalAmt
Program Services$920ProgramServicesAmt

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$507,364TotalAmt
Program Services$445,154ProgramServicesAmt
Management And General$62,210ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$59,484,412TotalAmt
Program Services$52,191,690ProgramServicesAmt
Management And General$7,292,722ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,176,686TotalAmt
Program Services$1,909,827ProgramServicesAmt
Management And General$266,859ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$8,416,884TotalAmt
Program Services$7,384,983ProgramServicesAmt
Management And General$1,031,901ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,269,029TotalAmt
Program Services$3,745,651ProgramServicesAmt
Management And General$523,378ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$5,889TotalAmt
Management And General$5,889ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$3,750TotalAmt
Management And General$3,750ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$1,257TotalAmt
Management And General$1,257ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$49,124,273TotalAmt
Program Services$47,252,638ProgramServicesAmt
Management And General$1,871,635ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$218,808TotalAmt
Program Services$217,692ProgramServicesAmt
Management And General$1,116ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$951,853TotalAmt
Program Services$721,972ProgramServicesAmt
Management And General$229,881ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$455,429TotalAmt
Program Services$240,459ProgramServicesAmt
Management And General$214,970ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$9,326,082TotalAmt
Program Services$3,296,723ProgramServicesAmt
Management And General$6,029,359ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$68,036TotalAmt
Program Services$31,418ProgramServicesAmt
Management And General$36,618ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$29,774TotalAmt
Program Services$18,976ProgramServicesAmt
Management And General$10,798ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$12,816,024TotalAmt
Management And General$12,816,024ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$10,615,380TotalAmt
Program Services$5,693,660ProgramServicesAmt
Management And General$4,921,720ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,658,646TotalAmt
Program Services$364,592ProgramServicesAmt
Management And General$1,294,054ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
DRUGS AND MEDICAL SUPPLIES$32,875,589$32,875,589
BAD DEBT$9,855,480$9,855,480
HOSPITAL ASSESSMENT FEE$12,130,306$12,130,306
INSTITUTIONAL DUES/LICENSES$136,399$136,399

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$6,034,006TotalAmt
Program Services$3,940,719ProgramServicesAmt
Management And General$2,083,389ManagementAndGeneralAmt
Fundraising$9,898FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$221,162,276TotalAmt
Program Services$182,454,848ProgramServicesAmt
Management And General$38,697,530ManagementAndGeneralAmt
Fundraising$9,898FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

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

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$357,360,930BOYAmt
EOY$375,510,963EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$37,241,837BOYAmt
EOY$36,603,411EOYAmt

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$188,412BOYAmt
EOY$171,399EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,332,371BOYAmt
EOY$2,597,290EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,144,255BOYAmt
EOY$1,524,064EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$331,901,870LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$135,320,676LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$140,844,785BOYAmt
EOY$196,581,194EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$158,126BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$539,270,716BOYAmt
EOY$612,988,321EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$20,914,414BOYAmt
EOY$31,338,641EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$473,581BOYAmt
EOY$265,779EOYAmt

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$210,327,967BOYAmt
EOY$201,914,186EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$231,715,962BOYAmt
EOY$233,518,606EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$307,554,754BOYAmt
EOY$379,469,715EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$307,554,754BOYAmt
EOY$379,469,715EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$539,270,716BOYAmt
EOY$612,988,321EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$71,935,903ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$20,942OtherChangesInNetAssetsAmt
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$1,257OtherActivitiesAmt
Total Lobbying Expenditures$1,257TotalLobbyingExpendituresAmt
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 North Hospital paid institutional membership dues to the Indiana Hospital Association ("IHA") during 2019 in the amount of $19,247. Each membership organization notified IU Health North Hospital that a portion of the dues it paid were used for lobbying purposes. The IHA used 6.53%, or $1,257 of the 2019 membership dues paid by IU Health North Hospital, for lobbying expenditures. The total membership dues paid to this organization by IU Health North Hospital during 2019 that were attributable to lobbying expenditures was $1,257.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
LandLandGrp

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$166,811,493OtherCostOrOtherBasisAmt
Depreciation$57,914,732DepreciationAmt
Book Value$108,896,761BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,086,838OtherCostOrOtherBasisAmt
Depreciation$384,649DepreciationAmt
Book Value$702,189BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$84,918,580OtherCostOrOtherBasisAmt
Depreciation$65,471,849DepreciationAmt
Book Value$19,446,731BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$79,084,959OtherCostOrOtherBasisAmt
Depreciation$11,549,446DepreciationAmt
Book Value$67,535,513BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$196,581,194TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
INTERCOMPANY PAYABLES (NET)$198,371,042
DUE TO THIRD-PARTY PAYERS$1,838,884
SELF-INSURANCE LIABILITIES$363,253
OPERATING LEASE LIABILITIES$1,341,007
FieldValueIRS element (for citing)
Total Liability$201,914,186TotalLiabilityAmt
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 North Hospital is a subsidiary in Indiana University Health, Inc.'s ("IU Health") Consolidated Audited Financial Statements. The Internal Revenue Service (IRS) has determined that Indiana University Health and certain of its affiliated entities are tax-exempt organizations as defined in Section 501(c)(3) of the Internal Revenue Code (IRC). Indiana University Health and its tax-exempt affiliates are, however, subject to federal and state income taxes on unrelated business income under the provisions of IRC Section 511. The Tax Cuts and Jobs Act (TCJA) was enacted on December 22, 2017. For tax-exempt entities, TCJA requires organizations to pay an excise tax on compensation above certain thresholds and record income or losses for tax determination purposes from unrelated business activities on an activity-by-activity basis, among other provisions. Proposed regulations and interim guidance, necessary for implementation, have been issued on most aspects of TCJA. It is expected that proposed regulations will be issued as final regulations by the IRS in 2020. As of and for the year ended December 31, 2019, Indiana University Health has made reasonable estimates of the provision for income taxes, the compensation excise tax, and the effects, if any, on existing deferred tax balances. Indiana University Health will continue to refine its calculations in future periods, as additional regulations and guidance are issued by the IRS. Deferred income taxes that, as of December 31, 2019 and 2018, have no net carrying value reflect the net tax effect of temporary differences between the carrying amounts of assets and liabilities for financial reporting and the amounts used for income tax purposes. As of December 31, 2019 and 2018, the Indiana University Health System had gross deferred tax assets of $143,157,000 and $119,965,000 respectively, primarily relating to net operating loss carryovers. Management determined that a full valuation allowance at December 31, 2019 and 2018, was necessary to reduce the deferred tax assets to the amount that would more likely than not be realized. Based on the weight of the evidence, if it is more likely than not that some portion or all of the deferred tax assets will not be realized, a valuation allowance to reduce the deferred tax assets is recorded. The change in the valuation allowance for the current year is $23,192,000. At December 31, 2019, the Indiana University Health System has available net operating loss carryforwards of $575,596,000. Net operating losses generated from 1999 through 2017 will expire between 2020 and 2037. Net operating losses generated after 2017 do not expire. Certain subsidiaries of Indiana University Health are taxable entities. The tax expense and liabilities of these subsidiaries are not material to the consolidated financial statements.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 BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served1630PersonsServedCnt
Total Community Benefit Expns$1,884,697TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,884,697NetCommunityBenefitExpnsAmt
Total Expense0.00890TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served4406PersonsServedCnt
Total Community Benefit Expns$33,534,638TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$19,330,103DirectOffsettingRevenueAmt
Net Community Benefit Expns$14,204,535NetCommunityBenefitExpnsAmt
Total Expense0.06720TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served6036PersonsServedCnt
Total Community Benefit Expns$35,419,335TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$19,330,103DirectOffsettingRevenueAmt
Net Community Benefit Expns$16,089,232NetCommunityBenefitExpnsAmt
Total Expense0.07610TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs8ActivitiesOrProgramsCnt
Persons Served9430PersonsServedCnt
Total Community Benefit Expns$986,162TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$25,366DirectOffsettingRevenueAmt
Net Community Benefit Expns$960,796NetCommunityBenefitExpnsAmt
Total Expense0.00450TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served217PersonsServedCnt
Total Community Benefit Expns$537,965TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$537,965NetCommunityBenefitExpnsAmt
Total Expense0.00250TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served9082PersonsServedCnt
Total Community Benefit Expns$98,335TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$98,335NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs12ActivitiesOrProgramsCnt
Persons Served18729PersonsServedCnt
Total Community Benefit Expns$1,622,462TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$25,366DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,597,096NetCommunityBenefitExpnsAmt
Total Expense0.00750TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs12ActivitiesOrProgramsCnt
Persons Served24765PersonsServedCnt
Total Community Benefit Expns$37,041,797TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$19,355,469DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,686,328NetCommunityBenefitExpnsAmt
Total Expense0.08360TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$359TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$359NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$359TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$359NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$2,431,347BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$31,754,867ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$41,638,200CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$9,883,333MedicareSurplusOrShortfallAmt

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 Line1IU HEALTH NORTH HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line111700 N MERIDIAN STAddressLine1Txt
CityCARMELCityNm
State AbbreviationINStateAbbreviationCd
ZIP46032ZIPCd
FieldValueIRS element (for citing)
Website AddressSEE PART V, SECTION CWebsiteAddressTxt
State License20-004171-1StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Childrens HospitalYes (X)ChildrensHospitalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1IU HEALTH NORTH HOSPITALBusinessNameLine1Txt
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 A, Line 1 Primary Website Addresshttps://iuhealth.org/find-locations/iu-health-north-hospital
Schedule H, Part V, Section B, Line 3e Prioritized Health NeedsIU Health North Hospitals 2018 Community Health Needs Assessment (CHNA) Report includes a prioritized description of significant health needs in the community. The CHNA report identified the following seven needs as priorities for IU Health North: - ACCESS TO HEALTH CARE SERVICES - DRUG AND SUBSTANCE ABUSE - Food Insecurity - HEALTH CARE AND SOCIAL SERVICES FOR SENIORS - MENTAL HEALTH - OBESITY AND DIABETES - SOCIAL DETERMINANTS OF HEALTH
Schedule H, Part V, Section B, Line 5 Input from CommunityIn conducting its most recent Community Health Needs Assessment ("CHNA") IU Health North Hospital took into account input from persons who represent the broad interests of the communities it serves. Primary data were gathered in three different methodologies for this assessment: Community Meetings, Key Stakeholder Interviews, and a Community Survey. For purposes of this CHNA, IU Health North Hospitals community is defined as Hamilton and Marion Counties, Indiana. These two counties accounted for 68 percent of the hospitals inpatient cases in 2016. Community Meetings Hamilton County On April 17, 2018, a meeting of community representatives was held at the Hamilton County 4H Fairgrounds in Noblesville, the county seat of Hamilton County. The meeting was attended by 38 community members invited by IU Health because they represent important community organizations and sectors such as: local health departments, police/fire departments, non-profit organizations, local business, health care providers, mayors/local policymakers, faith-based organizations, parks and recreation departments, and schools. Through this meeting, IU Health sought a breadth of perspectives on the communitys health needs. The specific organizations represented at the meeting are listed below. - Aspire Indiana - Central Indiana Council on Aging (CICOA) - Chaucies Place - Community Health Network North - Department of Child Services - Fishers City Council - Fishers Fire & Emergency Services - Good Samaritan Network - HAND, Inc. - HOPE Family Care Center - Hamilton County Council on Alcohol and other Drugs - Hamilton County Health Department - Hamilton County Harvest Food Bank - Hamilton County Youth Assistance Program - Hamilton Heights School Corporation - Hamilton Southeastern Schools - IU Health - IU Health Indy Suburban Region/IU Health North Hospital and IU Health Saxony Hospital - Noblesville Chamber of Commerce - Noblesville Town Council - Noblesville Schools - Partnership for a Healthy Hamilton County - Prevail, Inc. - PrimeLife Enrichment, Inc. - Riverview Health - Riverview Health Physicians - Shepherds Center of Hamilton County - St. Francis - St. Vincent Carmel/Fishers - Stones 3 Resources - Trinity Free Clinic - Westfield Washington School 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. Due to the size of the group, participants were then split into three groups. The same list was provided to each group of potential unmet health needs for the individuals to discuss and vote on to indicate what they considered to be the most significant health needs for Hamilton County. Those health needs were: - Transportation - Housing - Employment - Job training - Food insecurity - Nutritional education - Social support - Access to health services - Cost of medication - Insurance coverage/enrollment - Violence/crime - Chronic disease management During the meeting, a range of other topics was discussed, including: - Individuals with a mental health diagnosis - Individuals with a history of substance abuse/misuse - Individuals with chronic conditions - Children and seniors as priority populations - Nutritional education - Employment - Limited supply of health care professionals After discussing the needs identified, each participant was asked through a voting process to identify the two they consider to be most significant. From this process, the groups identified the following needs as most significant for Hamilton County: - Transportation - Housing - Access to health services - Chronic disease management - Cost of medication - Insurance coverage/enrollment - Social support Interviews Hamilton County An interview also was conducted with a representative of the Hamilton County Health Department. The interview was conducted to assure that appropriate and additional input was received from a governmental public health official. The individual that was interviewed participated in the community meeting. Accordingly, the results of the community meeting were discussed and insights were sought regarding significant community health needs, why such needs are present, and how they can be addressed. The interview was guided by a structured protocol that focused on opinions regarding significant community health needs, describing why such needs are present, and seeking ideas for how to address them. According to the interviewee, many in Indiana incorrectly believe that since Hamilton County is affluent, there is little need to focus on improving community health. The county does have needs and has pockets of vulnerable populations that need continued attention. The county also needs more public health funding to provide adequate programs and services. The interviewee confirmed that the three top needs identified by community meeting participants were significant, adding that all three have been chronic issues in the county. These three needs were: - Transportation - Access to Health Services - Housing Mental health and substance abuse services are particularly difficult to access in the county. Only one real treatment center and no inpatient facilities exist, requiring residents to travel long distances to services outside of the county. Primary care also is difficult to access for patients with certain types of insurance coverage. Many providers are not accepting new patients with Medicare or Medicaid. This issue became more problematic a few years ago after a community clinic closed. Regarding populations at risk, individuals with a mental health diagnosis, the uninsured or underinsured, children, and seniors are most at risk. Seniors face issues including a lack of transportation, difficulties accessing mental health services, and isolation. A lack of specialized providers for pain management, physical therapy, and related pain management services is contributing to an over-prescribing of opiates. The need for health education in the community is significant. Health department and other community resources are limited. Education is needed particularly regarding risks associated with substance abuse and sexually-transmitted diseases. Many uninsured are using emergency rooms for primary care since they do not know where else to go. A service that could connect these residents to providers accepting low income and Medicaid patients is needed. Medication assistance for seniors also is an issue. Many seniors are confused by the array of medications they have been prescribed, leading to a lack of medication adherence and compliance. Community Meetings Marion County Between May 7 and 9, 2018, three meetings of community representatives were held in Indianapolis, the county seat of Marion County. In total, the meetings were attended by 42 community members invited by IU Health in partnership with Community Health Network because they represent important community organizations and sectors such as: local health departments, police/fire departments, non-profit organizations, local business, health care providers, mayors/local policymakers, faith-based organizations, parks and recreation departments, and schools. Through these meetings, IU Health sought a breadth of perspectives on the communitys health needs. The specific organizations represented at the meetings are listed below. - Adult and Child Health - All Senior Citizens Connect - Central Indiana Council on Aging (CICOA) - City of Indianapolis - Coburn Place - Community Health Network - Gennesaret Free Clinics - Gleaners Food Bank - Health by Design - IU Health Methodist Hospital - IU Health University Hospital - Indiana Youth Institute - Indianapolis Fire Department - Indianapolis Metropolitan Police Department - Indy Hunger Network - Indianapolis Parks and Recreation - Irvington Development Organization - Jump IN for Healthy Kids - Lawrence Community Gardens - Marion County Public Health Department - New Beginnings Church - Paramount Schools of Excellence - Progress House - Purdue Extension - The Polis Center - University of Indianapolis The meeting began with a presentation that discussed the goals and status of the CHNA process and the purpose of the community meetings. Then, secondary data were presented, along with a summary of the most unfavorable community health indicators. For Marion County, those indicators were (in alphabetical order): - Air pollution - Communicable diseases and STDs - Crime - Mental health and supply of mental health providers - Obesity and lack of physical activity - Poverty and high 'Community Need Index' - Smoking and tobacco use 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 by each group, such as: - High school graduation rates - Built environment - Access to prim
Schedule H, Part V, Section B, Line 7a CHNA WebsiteA copy of IU Health North Hospital's CHNA is available on its website at the following URL: https://iuhealth.org/in-the-community/community-benefit
Schedule H, Part V, Section B, Line 10a Implementation Strategy WebsiteA copy of IU Health North Hospital's CHNA implementation strategy is available on its website at the following URL: HTTPS://IUHEALTH.ORG/IN-THE-COMMUNITY/COMMUNITY-BENEFIT
Schedule H, Part V, Section B, Line 11 Addressing Identified NeedsIn conjunction with the CHNA, IU Health North Hospital's Board adopted an implementation strategy in April 2019 related to the 2018 CHNA. IU Health North Hospital prioritized and determined which of the community health needs identified in its most recently conducted CHNA were most critical for it to address. IU Health North Hospital will address the following community health needs between 2019 and 2021: - Access to Healthcare Services - Drug and Substance Abuse (including Opioids and Alcohol) - Food Insecurity - Healthcare and Social Services for Seniors - Mental Health - Obesity and Diabetes - 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 North Hospital's implementation strategy to address the identified need of Access to Healthcare includes the following: - Provide funding for Trinity Free Clinic to support the medical and dental needs of Hamilton County residents who are uninsured and underinsured. - In 2019, IU Health North provided support to Trinity, which allowed the clinic to expand its mental health screening program, increase hours of acute medical and dental care, expand well-child visits to include fluoride varnish, and provide continued care for hypertension patients who have difficulty accessing primary care. - Encourage IU Health team members to assist in staffing the medical clinic. - Provide funding for the Heart & Soul Clinic's operations in Westfield to support medical and dental needs of Hamilton County residents who are uninsured and underinsured. - In 2019, IU Health North provided support to Heart & Soul, which was used in providing medical and dental care for the 567 patients they served, an increase of 32 percent over 2018. Of the 567 patients, 90 percent were classified as low or very-low income. - Invest in the Partnership for a Healthy Hamilton County (PHHC) to encourage collaboration among area health agencies and organizations. - IU Health North provided support to PHHC in 2019, which was used to assist the Fishers Youth Assistance Summer Meals Program and PHHC's overall operations during its transition to become its own 501c3 organization. - Develop programs and strategies to improve the overall health of Hamilton County residents and employees. - Participate in PHHC committees related to pertinent Community Health Needs Assessment (CHNA) priorities. - Support the Fishers Youth Assistance Summer Meals Program. - Provide an Individual Solutions coordinator to help patients register for health insurance through Healthy Indiana Plan (HIP) 2.0 or other Marketplace insurance. - Create a pilot program that provides in-home visits by a licensed social worker for seniors who need behavioral health services. - Provide physician-led health seminars to seniors at PrimeLife Enrichment, Inc. - Provide free finger-stick health screenings for seniors at PrimeLife Enrichment, Inc. to measure cholesterol, triglycerides, glucose, A1C and blood pressure. - Provide education to encourage positive changes to impact future screening results. - Provide in-hospital training for team members so the hospital is able to create an environment that is welcoming and conducive for those living with dementia. - Provide funding to the Shepherd's Center of Hamilton County in support of its Reaching Resources program, which allows seniors to age as independently and gracefully as possible. - Provide 24/7 peer counseling via telemedicine for patients who present in the emergency department (ED) with substance abuse issues. - Provide telemedicine visits with trained behavioral health clinicians to patients who present in the emergency department (ED) with behavioral health needs. - Provide funding for a Fishers EMS Duty Officer (EDO) to provide follow-up home visits for patients who have been discharged from the hospital with behavioral health-related issues. - Provide funding for Aspire Indiana to address specific behavioral health needs in Hamilton County. - In 2019, IU Health North provided support to Aspire to purchase two new pediatric exam tables for the Noblesville clinic and one for the Carmel clinic, and to provide employment assistance for Aspire clients. - Collaborate with the Max Challenge of Fishers to provide 100 Hamilton County residents with a free 10-week program to improve their overall health through fitness and nutrition. - Provide three health screenings during the 10-week period to measure changes in cholesterol, triglycerides, glucose, A1C, blood pressure, weight and Body Mass Index (BMI). Behavioral Health (includes Drug & Substance Abuse and Mental Health) IU Health North Hospital's implementation strategy to address the identified need of Behavioral Health includes the following: - Invest in the Partnership for a Healthy Hamilton County (PHHC) to encourage collaboration among area health agencies and organizations. - Develop programs and strategies to improve the overall health of Hamilton County residents and employees. - Participate in PHHC committees related to pertinent Community Health Needs Assessment (CHNA) priorities. - Support the Fishers Youth Assistance Summer Meals Program. - Create a pilot program that provides in-home visits by a licensed social worker for seniors who need behavioral health services. - Provide in-hospital training for team members so the hospital is able to create an environment that is welcoming and conducive for those living with dementia. - Provide funding to the Shepherd's Center of Hamilton County in support of its Reaching Resources program, which allows seniors to age as independently and gracefully as possible. - Provide 24/7 peer counseling via telemedicine for patients who present in the emergency department (ED) with substance abuse issues. - In 2019, 91 percent of patients who were offered peer recovery counseling accepted the service and were open to discussing ways to treat their substance abuse disorder. The peer recovery counselors spent 2,004 total minutes coaching patients with substance abuse disorders. - Provide telemedicine visits with trained behavioral health clinicians to patients who present in the emergency department (ED) with behavioral health needs. - In 2019, approximately 60 patients were transferred from the ED to behavioral health services for follow-up services or referral to an inpatient facility. - Provide funding for a Fishers EMS Duty Officer (EDO) to provide follow-up home visits for patients who have been discharged from the hospital with behavioral health-related issues. - In 2019, 366 Hamilton County resident patients and 44 non-Hamilton County resident patients received a follow-up call via the program. 122 total individuals did not answer or respond to the follow-up call but there were 237 referrals to services in the community. There were 53 home visit referrals, 17 referrals to financial assistance for medication and other needs, five referrals to transportation services, 55 referrals to social services and 15 referrals to a primary care provider or contact. - Provide annual funding to the Indiana Center for Prevention of Youth Abuse & Suicide. - In 2019, IU Health North provided support to ICPYAS, and approximately 70 schools hosted the Smart Steps program in 2019. - Collaborate with the Indiana Center for Prevention of Youth Abuse & Suicide to provide training for community and IU Health team members on the recognition and prevention of child sexual abuse. - In 2019, 525 adults completed the Stewards of Children training. - Provide funding for Breathe Easy Hamilton County efforts. - Provide senior executive support for the Breathe Easy Hamilton County initiative. - Attend and financially support the annual Breathe Easy Hamilton County luncheon. - Provide funding for Aspire Indiana to address specific behavioral health needs in Hamilton County. Food Insecurity IU Health North Hospital's implementation strategy to address the identified need of Food Insecurity includes the following: - Invest in the Partnership for a Healthy Hamilton County (PHHC) to encourage collaboration among area health agencies and organizations. - Develop programs and strategies to improve the overall health of Hamilton County residents and employees. - Participate in PHHC committees related to pertinent Community Health Needs Assessment (CHNA) priorities. - Support the Fishers Youth Assistance Summer Meals program through investment in the Partnership for a Healthy Hamilton County (PHHC). - With PHHC's assistance, the program increased access to healthy food by providing a total of 46,220 meals in 2019, an average of 514 students served each week. - Collaborate with the Fishers Parks & Recreation to provide 20 garden boxes measuring 10'x10' on the campus. - Provide funding to the Fishers Parks & Recreation to cover the cost of garden plot rental for community members who rent one of the Fishers Parks garden plots
Schedule H, Part V, Section B, Line 13b Income Level Other than FPGIn addition to FPG, IU Health North Hospital may take into consideration a patients 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 North Hospital takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. IU Healths Individual Solutions Department Prior to seeking Financial Assistance under the FAP, all patients or their guarantors must consult with a member of IU Healths 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 North Hospitals Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowners, must exhaust all insurance benefits prior to receiving an award from IU Health North Hospitals 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 North Hospital. Eligible patients who receive medical care from IU Health North Hospital as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award to which IU Health North Hospital is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health North Hospital reserves the right to reverse the award in an amount equal to the amount IU Health North Hospital would be entitled to receive had no Financial Assistance been awarded. 3. Alternate Methods of Eligibility Determination IU Health North Hospital will conduct a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an Extraordinary Collection Action ("ECA"). Said accounts may be eligible for assistance under the FAP based on the patients individual scoring criteria. To ensure all patients potentially eligible for Financial Assistance under the FAP may receive Financial Assistance, IU Health North Hospital will deem patients/guarantors to be presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied his/her required co-pay/deductible: - Indiana Childrens 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 patients account if said patient is found to have no estate. Additionally, IU Health North Hospital will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance application. 5. Non-Emergent Services Down Payment Uninsured Patients presenting for scheduled or other non-emergent services will not be charged more than the Amounts Generally Billed ("AGB") for their services. Patients will receive an estimated AGB cost of their care prior to IU Health North Hospital rendering the services and will be asked to pay a down-payment percentage of the AGB adjusted cost prior to receiving services. In the event a patient is unable to fulfill the down-payment, their service may be rescheduled for a later date as medically prudent and in accordance with all applicable federal and state laws and/or regulations. 6. Emergency Services Non-Refundable Deposit This section will be implemented with a strict adherence to EMTALA and IU Health Policy ADM 1.32, Screening and Transfer of Emergency or Unstable Patients. 7. Amount of Non-Refundable Deposit All Uninsured Patients presenting for services at IU Health North Hospitals 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 North Hospital processing said application. Uninsured Patients making payments toward their outstanding non-refundable deposit balance will have said payments applied to their oldest application on file, if applicable.
Schedule H, Part V, Section B, Line 16a FAP WebsiteA copy of IU Health North Hospitals 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 North Hospitals 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 North Hospital 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 North Hospital will include a conspicuous written notice on all patient billing statements that notifies the patient about the availability of this Policy, and the telephone number of its Customer Service Department which can assist patients with any questions they may have regarding this Policy. 3. IU Health 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 North Hospital will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health North Hospital will educate its patient facing team members of the FAP and the process for referring patients to the Program.
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Schedule H, Part I, Line 3c - Other Factors Used in Determining Elig.IU Health North Hospital 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 North Hospital will employ the same residency test as set forth in Indiana Code 6-3-1-12 to define an Indiana resident. The term Resident includes any individual who was domiciled in Indiana during the taxable year, or any individual who maintains a permanent place of residence in Indiana and spends more than one hundred eight-three (183) days of the taxable year in Indiana. Patients residing in the state of Indiana while attending an institution of higher education may be eligible for assistance under the FAP if they meet the aforementioned residency test and are not claimed as a dependent on a parents or guardians federal income tax return. 2. IU Healths Individual Solutions Department Prior to seeking Financial Assistance under the FAP, all patients or their guarantors must consult with a member of IU Healths 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 North Hospital eligible under the FAP will not be charged more than the AGB as described in the FAP. 4. Services Rendered by Individual Providers The FAP does not cover services rendered by individual providers. A full listing of providers and services not covered by the FAP is available at https://iuhealth.org/pay-a-bill/financial-assistance and is updated on a quarterly basis. 5. Alternate Sources of Assistance When technically feasible, a patient will exhaust all other state and federal assistance programs prior to receiving an award from IU Health North Hospitals Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowners, must exhaust all insurance benefits prior to receiving an award from IU Health North Hospitals 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 North Hospital. Eligible patients who receive medical care from IU Health North Hospital as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award to which IU Health North Hospital is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health North Hospital reserves the right to reverse the award in an amount equal to the amount IU Health North Hospital would be entitled to receive had no Financial Assistance been awarded. 6. Alternate Methods of Eligibility Determination IU Health North Hospital will conduct a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an ECA. Said accounts may be eligible for assistance under the FAP based on the patients individual scoring criteria. To ensure all patients potentially eligible for Financial Assistance under the FAP may receive Financial Assistance, IU Health North Hospital will deem patients/guarantors to be presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied his/her required co-pay/deductible: - Indiana Childrens 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 patients account if said patient is found to have no estate. Additionally, IU Health North Hospital will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance application. 8. Patient Assets IU Health North Hospital may consider patient/guarantor Assets in the calculation of a patient's true financial burden. A patient's/guarantor's primary residence and one (1) motor vehicle will be exempted from consideration in most cases. A patient's primary residence is defined as the patient's principal place of residence and will be excluded from a patient's extraordinary asset calculation so long as the patient's equity is less than five-hundred thousand dollars ($500,000) and the home is occupied by the patient/guarantor, patient's/guarantor's spouse or child under twenty-one (21) years of age. One (1) motor vehicle may be excluded as long as the patient's equity in the vehicle is less than fifty-thousand dollars ($50,000). IU Health North Hospital reserves the right to request a list of all property owned by the patient/guarantor and adjust a patient's award of Financial Assistance if the patient demonstrates a claim or clear title to any extraordinary Asset not excluded from consideration under the above guidance. 9. Non-Emergent Services Down Payment Uninsured Patients presenting for scheduled or other non-emergent services will not be charged more than the AGB for their services. Patients will receive an estimated AGB cost of their care prior to IU Health North Hospital rendering the services and will be asked to pay a down-payment percentage of the AGB adjusted cost prior to receiving services. In the event a patient is unable to fulfill the down-payment, their service may be rescheduled for a later date as medically prudent and in accordance with all applicable federal and state laws and/or regulations. 10. Emergency Services Non-Refundable Deposit This section will be implemented with a strict adherence to EMTALA and IU Health 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 North Hospitals 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 North Hospital processing said application. Uninsured Patients making payments toward their outstanding non-refundable deposit balance will have said payments applied to their oldest application on file, if applicable.
Schedule H, Part I, Line 6a - C.B. Report Prepared by a Related Org.IU Health North Hospital's community benefit and other investments, encompassing its total community investment, are included in the IU Health Community Benefit Report which is prepared on behalf of and includes IU Health and its related hospital entities in the State of Indiana. The IU Health Community Benefit Report is made available to the public on IU Health's website at https://iuhealth.org/in-the-community/Community-Benefit. The IU Health Community Benefit Report is also distributed to numerous key organizations throughout the State of Indiana in order to broadly share the IU Health Statewide System's community benefit efforts. It is also available by request through the Indiana State Department of Health or IU Health.
Schedule H, Part I, Line 7, Column (c) - 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 excludes direct offsetting revenue, is 17.53%.
Schedule H, Part I, Line 7, Column (f) - Percent of Total ExpenseThe amount of bad debt expense subtracted for purposes of calculating the percentage of total expense on Line 7, column (f) is $9,855,480. 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 II - Promotion of Health in Communities ServedIU Health North Hospital is part of the IU Health Statewide System. The IU Health Statewide System participates in a variety of community-building activities that address the social determinants of health in the communities it serves through investments in economic 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. This includes making contributions to community-building activities by providing investments and resources to local community initiatives that address issues, such as access to healthcare, community support and economic development. Several examples include IU Health North Hospital's support of the following organizations and initiatives that focus on some of the root causes of health issues, such as lack of education, insufficient access to resources, employment and poverty: - Partnership for a Healthy Hamilton County - Aspire Indiana, Inc. - Trinity Free Clinic - Indiana Center for the Prevention of Youth Abuse and Suicide - Shepherd's Center of Hamilton County Additionally, through the IU Health Statewide System's team member community benefit service program, "IU Health Serves," team members across the state make a difference in the lives of thousands of Hoosiers every year.
Schedule H, Part III, Line 2 - Bad Debt Expense MethodologyThe amount reported on line 2 as bad debt is reported at cost, as calculated using the cost to charge ratio methodology. SCHEDULE H, PART III, LINE 3 - EST. BAD DEBT ATTR. TO PATIENTS UNDER FAP AN UNINSURED PATIENT AND/OR GUARANTOR WHO WAS ADMITTED THROUGH AN ELIGIBLE FACILITY'S EMERGENCY DEPARTMENT VIA A DIRECT ADMISSION FROM A PHYSICIAN'S OFFICE, OR TRANSFER FROM ANOTHER HOSPITAL FACILITY, AND WHOSE HOUSEHOLD INCOME IS LESS THAN OR EQUAL TO 200% OF THE FEDERAL POVERTY LEVEL MAY BE ELIGIBLE FOR FULL CHARITY ASSISTANCE AFTER THE SUCCESSFUL COMPLETION OF THE FINANCIAL ASSISTANCE APPLICATION AND SATISFACTION OF HIS/HER NON-REFUNDABLE DEPOSIT. TO CAPTURE ALL PATIENTS WHO ARE POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE IU HEALTH FINANCIAL ASSISTANCE POLICY, IU HEALTH WILL DEEM PATIENTS/GUARANTORS TO BE PRESUMPTIVELY ELIGIBLE FOR FINANCIAL ASSISTANCE IF THEY ARE FOUND TO BE ELIGIBLE FOR ONE OF THE FOLLOWING PROGRAMS, RECEIVED EMERGENCY OR DIRECT ADMIT CARE, AND SATISFIED THE REQUIRED CO-PAY/DEDUCTIBLE: 1. INDIANA CHILDREN'S SPECIAL HEALTH CARE SERVICES 2. MEDICAID 3. HEALTHY INDIANA PLAN 4. PATIENTS WHO ARE AWARDED HOSPITAL PRESUMPTIVE ELIGIBILITY 5. ENROLLED IN A STATE AND/OR FEDERAL PROGRAM THAT VERIFIES THE PATIENT'S GROSS HOUSEHOLD INCOME IS LESS THAN OR EQUAL TO 200% OF THE FEDERAL POVERTY LEVEL (FPL). IU HEALTH ALSO CONDUCTS A QUARTERLY REVIEW OF ALL ACCOUNTS PLACED WITH A COLLECTION AGENCY PARTNER FOR A PERIOD OF NO LESS THAN ONE HUNDRED AND TWENTY (120) DAYS AFTER THE ACCOUNT IS ELIGIBLE FOR AN EXTRAORDINARY COLLECTION ACTIONS. SAID ACCOUNTS MAY BE ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY BASED ON THE PATIENT'S INDIVIDUAL SCORING CRITERIA AND ARE NOT INCLUDED IN BAD DEBT. DUE TO THIS COMPREHENSIVE METHODOLOGY, IU HEALTH DOES NOT BELIEVE ANY AMOUNT OF BAD DEBT IS ATTRIBUTABLE TO PATIENTS WHO MAY BE ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY AND NO PORTION OF BAD DEBT IS INCLUDED AS COMMUNITY BENEFIT.
Schedule H, Part III, Line 4 - Bad Debt ExpenseIU Health North Hospital is a subsidiary in the consolidated financial statements of IU Health. IU Health's bad debt expense footnote is as follows: The Indiana University Health System does not require collateral or other security from its patients, substantially all of whom are residents of the State, for the delivery of health care services. However, consistent with industry practice, the Indiana University Health System routinely obtains assignment of (or is otherwise entitled to receive) patients' benefits payable under their health insurance programs, plans or policies (e.g., Medicare, Medicaid, managed care payers, and commercial insurance policies. The Indiana University Health System uses a portfolio approach to account for categories of patient contracts as a collective group, rather than recognizing revenue on an individual contract basis. The portfolios consist of major payer classes for inpatient revenue and outpatient revenue. Based on the historical collection trends and other analysis, the Indiana University Health System believes that revenue recognized by utilizing the portfolio approach approximates the revenue that would have been recognized if an individual contract approach were used. In support of its mission, the Indiana University Health System provides care to uninsured and underinsured patients. The Indiana University Health System provides charity care to patients who lack financial resources and are deemed to be medically indigent. 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 IU Health North Hospitals Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health North Hospitals 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 North Hospitals participation in Medicare programs would significantly increase the Medicare shortfall reported on Schedule H, Part III, Line 7. IU Health North Hospital'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 North Hospital accepts all Medicare patients knowing that there may be shortfalls; therefore it has taken the position that any shortfall should be counted as part of its community benefit. Additionally, it is implied in Internal Revenue Service Revenue Ruling 69-545 that treating Medicare patients is a community benefit. Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with governmental health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community.
Schedule H, Part III, Line 9b - Written Debt Collection PolicyIU Health North Hospitals 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, 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 applications deficiency upon discovery by IU health. The application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health will suspend any ECA until the application is complete, or the 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 patients physician, family members, legal counsel, community or religious groups, social services or hospital personnel may request a FAP Application to be mailed to a patients primary mailing address free of charge. IU Health 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 patients and/or guarantors 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 North Hospital will inform patients or guarantors of the results of their application by providing the patient or guarantor with a Financial Assistance Determination within ninety (90) days of receiving a completed Application and all requested documentation. If a patient or guarantor is granted less than full charity assistance and the patient or guarantor provides additional information for reconsideration, IU Health 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 patients Financial Assistance Application and eligibility determination are specific to each individual date(s) of service and related encounters. 3. Extraordinary Collection Actions IU Health North Hospital may refer delinquent patient accounts to a third-party collection agency after utilizing reasonable efforts to determine a patients eligibility for assistance under the FAP. IU Health 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 patients or their guarantors 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 patients or their guarantors 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 patients or their guarantors property, foreclosing on a patients or their guarantors real property attaching or seizing a patients or their guarantors bank account or other personal property, commencing a civil action against a patient or their guarantor, causing a patient or guarantors arrest, causing a patient and/or guarantor to be subject to a writ of body attachment, and garnishing a patient or guarantors wages. When it is necessary to engage in such action, IU Health North Hospital and its third party collection agencies, will engage in fair, respectful and transparent collections activities. Patients or guarantors currently subject to an ECA who have not previously applied for Financial Assistance may apply for assistance up to two-hundred and forty (240) days of the date of their first billing statement from IU Health. IU Health 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 North Hospital in excess of their patient responsibility will be alerted to the overpayment as promptly after discovery as is reasonable given the nature of the overpayment. Patients with an outstanding account balance on a separate account not eligible for assistance under the FAP will have their refund applied to the outstanding balance. Patients without an outstanding account balance described above will be issued a refund check for their overpayment as soon as technically feasible.
Schedule H, Part VI, Line 2 - Needs AssessmentCommunities are multifaceted and so are their health needs. IU Health North Hospital understands that the health of individuals and communities are shaped by various social and environmental factors, along with health behaviors and additional influences. IU Health North Hospital assesses the health care needs of the communities it serves by conducting a Community Health Needs Assessment (CHNA) for each of its hospital locations. For the 2018 CHNAs, Indiana University Health conducted the community survey data collection in collaboration with Indiana University, University of Evansville and an Indiana Hospital Collaborative, including Community Health Network, Franciscan Alliance, St. Vincent Health and other hospital partners. After completion of the CHNA, IU Health North Hospital reviewed secondary data, findings from other community health assessments of areas served by the hospital, input obtained from individuals who participated in community meetings, input obtained from key stakeholders, and a community survey to identify and analyze the needs identified by each source. The top health needs of the IU Health communities are those that are supported by multiple data sources. Additionally, the effectiveness of an intervention for each need and IU Health's ability to impact positive change was evaluated. IU Health believes its CHNA process is comprehensive and additional assessments are not required.
Schedule H, Part VI, Line 3 - Patient Education of Eligibility for Assist.IU Health North Hospital is committed to serving the healthcare needs of all of its patients regardless of their ability to pay for such services. To assist in meeting those needs, IU Health North Hospital has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health North Hospital is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health North Hospital will make a good faith effort to locate and obtain health insurance coverage for patients prior to considering patients for coverage under the FAP. IU Health North Hospital takes several measures to inform its patients of the FAP and FAP-eligibility. These measures include the following: 1. Conspicuous public displays will be posted in appropriate acute care settings such as the emergency department and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 2. IU Health North Hospital will include a conspicuous written notice on all patient billing statements that notifies the patient about the availability of this Policy, and the telephone number of its Customer Service Department which can assist patients with any questions they may have regarding this Policy. 3. IU Health 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 North Hospital will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health North Hospital will educate its patient facing team members of the FAP and the process for referring patients to the Program.
Schedule H, Part VI, Line 4 - Community InformationIU Health North Hospital is located in Hamilton County, Indiana, a county located in central Indiana. Its service area counties include Marion, Hamilton, Boone, Hendricks, Hancock, Madison and Tipton counties. Hamilton County includes ZIP codes within the towns of Arcadia, Atlanta, Carmel, Cicero, Fishers, Noblesville, Sheridan, and Westfield. Based on the most recent Census Bureau (2019) statistics, Hamilton County's population is 338,011 persons with approximately 51% being female and 49% male. The county's population estimates by race are 82.8% White, 4.5% Black, 4.3% Hispanic or Latino, 6.5%% Asian, 0.2% American Indian or Alaska Native, and 2.1% persons reporting two or more races. Hamilton County has relatively high levels of educational attainment. Among residents ages 25 and up, 96.4% completed their education with a high school diploma or equivalent. Among resident ages 25 and up, 57.8% earned a bachelor's degree or higher.
Schedule H, Part VI, Line 5 - Promotion of Community HealthIU Health North Hospital is a subsidiary of Indiana University Health, Inc., a tax-exempt healthcare organization, whose Board of Directors is composed of members of which substantially all are independent community members. During 2019, IU Health North Hospital's promotion of community health included the following highlights: In 2019, IU Health North Hospital maintained a strong presence across the northern Indianapolis suburbs in Hamilton County and supported numerous not-for-profit agencies including local parks departments, medical and dental clinics that provide care to the un- and under-insured, behavioral health agencies, and organizations that provide health and social services to seniors who are in need. As part of these efforts, IU Health North Hospital also continued its participation in the Partnership for a Healthy Hamilton County in conjunction with Community Health Network, Riverview Health, Ascension St. Vincent Carmel and several other health-related agencies in the county. This group seeks to transform communities by influencing and leading health innovation through community collaborations. IU Health North Hospital provided a 10-week fitness and nutrition program, Fresh & Fit, to 100 Hamilton County residents helping them to improve their overall health by lowering cholesterol, blood pressure, blood sugar, A1C and weight. Participants in Fresh & Fit also report additional benefits of the program including increased energy, improved mental well-being, reduced pain and a reduction in medications. IU Health North Hospital is a subsidiary of IU Health. IU Health and its related hospital entities across the state of Indiana extend medical privileges to all physicians who meet the credentialing qualifications necessary for appointment to its medical staff. IU Health does not deny appointment on the basis of gender, race, creed or national origin. IU Health, in conjunction with the IU School of Medicine, trains the next generation of physicians in an exceptional environment. Blending breakthrough research and treatments with the highest quality of patient care.
Schedule H, Part VI, Line 6 - Affiliated Health Care SystemIU Health North Hospital is part of the IU Health Statewide System. The IU Health Statewide system is Indiana's most comprehensive healthcare system. A unique partnership with the Indiana University School of Medicine ("IU School of Medicine"), one of the nation's leading medical schools, gives patients access to innovative treatments and therapies. IU Health is comprised of hospitals, physicians and allied services dedicated to providing preeminent care throughout Indiana and beyond. National Recognition - Eight hospitals designated as Magnet by the American Nurses Credentialing Center recognizing excellence in nursing care. - IU Health Medical Center is honored to be nationally ranked by U.S. News & World Report for the 22nd year in a row. According to the U.S. News rankings, IU Health Medical Center is the No. 1 ranked hospital in Indiana and Indianapolis and the only nationally ranked adult hospital in the state. For 2019-2020, IU Health Medical Center was rated as high performing nationally in five specialties, with a sixth specialty achieving a top 50 national ranking: - Cancer - high performing - Gastroenterology - high performing - Geriatrics - ranked 45th in nation - Nephrology - high performing - Neurology & Neurosurgery - high performing - Urology - high performing Besides IU Health Medical Center, IU Health has three other hospitals among the 10 top ranked hospitals in Indiana: IU Health Ball Memorial (#5), IU Health Arnett (#8) and IU Health Bloomington (#8) hospitals. The annual rankings, now in their 30th year, are designed to assist patients and their doctors in making informed decisions about where to receive care for challenging health conditions or for common elective procedures. Education and Research As an academic health center, IU Health works in partnership with the IU School of Medicine to train physicians, blending breakthrough research and treatments with the highest quality of patient care. Each year, more than 1,000 residents and fellows receive training in IU Health hospitals. Research conducted by IU School of Medicine faculty gives IU Health physicians and patients access to the most leading-edge and comprehensive treatment options. In 2017, IU Health and the IU School of Medicine announced that they would invest $50 million over six years in the Strategic Research Initiative, a new research collaboration that has enhanced the institutions' joint capabilities in fundamental scientific investigation, translational research and clinical trials. The initial focus is on projects in the fields of neuroscience, cancer and cardiovascular disease with the goal to fund transformative proposals that will fundamentally change the understanding of these diseases and lead to important new therapies for patients. The three target research areas represent research strengths at IU School of Medicine, key strategic service lines for IU Health, and important medical needs in a time of an aging population and rising healthcare costs: - Cancer: One of the initiative's primary goals is to enable the IU Health Melvin and Bren Simon Cancer Center to attain the National Cancer Institute's (NCI) top status of "comprehensive," which would recognize it as one of the top-tier cancer centers in the nation. This designation was achieved in August 2019 making the center the only NCI-designated Comprehensive Cancer Center in Indiana and one of just 51 in the nation. - Neuroscience: The neurosciences research program tackles a broad range of brain injuries, neurodegenerative disorders and neurodevelopmental disorders. - Cardiovascular: The cardiovascular research initiative develops a comprehensive program for the study and treatment of heart failure, from newborns to older adults. A top priority is developing a cardiovascular genetics program. The Strategic Research Initiative provides patients with access to internationally renowned physicians and to new therapies developed through translational research and clinical trials, and will make use of the latest genetic tools to develop personalized therapies that are more effective for individuals and efficient for healthcare providers. IU Health Statewide System IU Health is a part of the IU Health Statewide System which continues to broaden its reach and positive impact throughout the state of Indiana. IU Health is Indiana's most comprehensive academic health center and consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health, and IU Health Saxony Hospital. Other hospitals in the IU Health Statewide System include the following: - IU Health Arnett Hospital - IU Health Ball Memorial Hospital - IU Health Bedford Hospital - IU Health Blackford Hospital - IU Health Bloomington Hospital - IU Health Frankfort Hospital - IU Health Jay Hospital - IU Health North Hospital - IU Health Paoli Hospital - IU Health Tipton Hospital - IU Health West Hospital - IU Health White Memorial Hospital Although each hospital in the IU Health Statewide System prepares and submits its own community benefit plan relative to the local community, the IU Health Statewide System considers the sum of these plans part of a statewide vision for strengthening Indiana's overall health. A comprehensive community outreach strategy and community benefit plan is in place that encompasses the academic medical center downtown Indianapolis, suburban Indianapolis and statewide entities around priority areas that focus on health improvement efforts statewide. IU Health is keenly aware of the positive impact it can have on the communities of need in the state of Indiana by focusing on the most pressing needs in a systematic and strategic way. In 2019, IU Health provided more than $738 million in total community benefit and served more than one million individuals. Some ways we address our community health priorities as a system include: IU Health Day of Service The annual IU Health Days of Service is a high-impact event aimed at engaging IU Health team members in activities that address an identified community priority health need. Each year, more than 2,000 IU Health team members volunteer during the Days of Service. Community Health Initiatives With investments in high-quality and impactful initiatives to address community health needs statewide, IU Health is helping Indiana residents improve their health and their quality of life. In 2019, IU Health impacted many people statewide through educational presentations, health risk screenings, health education programs, and additional health educational opportunities made available to the community, especially to our community members in the greatest need of such services. Twenty-four local organizations are benefitting from grants awarded by IU Health. In 2019, IU Health Community Outreach and Engagement awarded more than $900,000 to community organizations and institutions which - like IU Health - are addressing the health needs of the community. These needs include access to affordable healthcare, behavioral health and substance abuse, healthy weight and nutrition and social determinants of health. The grants, administered by the Indiana University Health Foundation, were awarded to the following: Behavioral Health and Substance Abuse - Volunteers of America Ohio & Indiana's (https://www.voaohin.org/) (VOAOHIN) Fresh Start Recovery Center received a $75,000 grant to provide residential addiction treatment to pregnant women and mothers. It also allows up to two children ages 5 and under to live with their mother while they receive services. - Goodwill Foundation of Central and Southern Indiana(https://www.goodwillindy.org/foundation/) received $75,000 to help Goodwill Education Initiatives (GEI) Resilience Initiative support resilience work across 15 Excel Center locations by leveraging groundbreaking research on neuroplasticity - the ability of the brain to reorganize itself - and to train staff and students on enhancing their resilience and mitigating the effects of trauma. - Additional grant winners: - Reach for Youth (https://www.reachforyouth.org/) - Lutheran Foundation (https://thelutheranfoundation) - Indy Public Safety Foundation (https://indypsf.org/) Healthy Weight and Nutrition - United Way of Central Indiana, Inc.'s (https://uwci.org/) initiative Jump IN for Healthy Kids received a $50,000 grant to address the epidemic of childhood obesity with a specific focus on implementing strategies that create healthy places, healthy neighborhoods, and healthy communities in Marion County. - Playworks (https://www.playworks.org/indiana/), a national non-profit organization that partners with Indianapolis schools and youth organizations to help them leverage play for positive outcomes, received a $23,000 grant. - Additional grant winners: - Indianapolis Parks Foundation (https://www.indyparksfoundation.org/) Social Determinants of Health - A $100,250 grant was awarded to Gleaners Food Bank's (https://www.gleaners.org/) Ho
Schedule H, Part VI, Line 7 - State Filing of Community Benefit ReportIN

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 (20 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
JONATHAN R GOBLE
Former Officer$0$0$0$0$0$208,726$0$0$0$0$0$208,726$0$208,726
MATTHEW R COOK
DIRECTOR$0$581,502$0$248,092$0$55,244$0$126,007$0$24,071$0$1,034,916$0$0
KEVIN L SMITH MD
DIRECTOR$0$426,132$0$94,052$0$540$0$11,200$0$1,347$0$533,271$0$0
DEREK E EMPIE
SECRETARY$0$231,195$0$36,357$0$758$0$14,966$0$30,379$0$313,655$0$0
RANDALL C YUST
Former Officer$0$107,866$0$62,817$0$57,044$0$14,926$0$14,323$0$256,976$0$0
PAUL M CALKINS MD
VP & CMO$483,673$0$55,818$0$63,114$0$15,337$0$16,555$0$634,497$0$0$0
RUTH A KAIN RN
Former Key Employee$0$196,146$0$37,691$0$31,076$0$15,998$0$25,128$0$306,039$0$0
MARK A MCLEAN
DIR OPERATIONS (PART YEAR)$77,359$100,716$8,992$11,708$2,622$3,413$5,723$7,450$8,584$11,176$103,280$134,463$0$0
DIANE L HESSON
Interim CNO (PART YEAR)$101,023$46,694$36,512$16,876$4,164$1,925$7,559$3,494$17,392$8,039$166,650$77,028$0$0
MICHAEL L HARLOWE
PRESIDENT - TIPTON$256,500$0$32,253$0$2,322$0$11,657$0$24,203$0$326,935$0$0$0
JANICE M VADAS
Director Allied Services$173,502$0$8,740$0$552$0$11,523$0$3,622$0$197,939$0$0$0
Kristy A Schulhof
DIRECTOR/PRESIDENT (PART YEAR)$0$302,984$0$148,510$0$570,576$0$392,112$0$31,048$0$1,445,230$0$60,777
Cara L Breidster
CFO - Indy Suburban Region$0$268,019$0$40,264$0$13,097$0$18,008$0$23,740$0$363,128$0$0
Kenneth D Puckett
President - Indy Suburban Reg.$0$462,981$0$211,080$0$75,835$0$116,713$0$29,197$0$895,806$0$0
MEGAN CRITTENDON MD
DIRECTOR$0$365,105$0$6,684$0$2,310$0$11,362$0$0$0$385,461$0$0
ATHANASIA S BANICH
PRES. North/Coo Saxony (Pt Yr)$7,801$155,087$575$11,429$15$302$245$4,871$1,390$27,631$10,026$199,320$0$0
LISA A SPARKS RN
CNO - Indy Suburban Region$0$195,530$0$35,029$0$989$0$14,942$0$28,775$0$275,265$0$0
ARTHUR VASQUEZ
COO - Indy Suburban Region$0$269,606$0$46,696$0$486$0$18,075$0$30,286$0$365,149$0$0
TAMARAH D BROWNLEE
VP-HR - Indy Suburban Region$0$163,933$0$28,597$0$366$0$8,259$0$32,405$0$233,560$0$0
CHAD A DILLEY
ADMIN DIR-CV(PT YR)/COO-SAXONY$131,520$12,230$23,762$2,210$4,014$373$6,348$590$199$19$165,843$15,422$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 - Comp. of the Org.'s CEO/Executive DirectorIU Health North Hospital's Regional President is employed by IU Health. IU Health North Hospital's President is also employed by IU Health, Inc. IU Health, IU Health North Hospital, and other related entities have a process in place to determine the compensation for the other officers and key employees. IU Health Human Resources uses market data from multiple compensation experts/vendors who utilize a variety of methods and procedures to obtain compensation ranges for comparable officer and employee positions. This market data and multiple other factors (including market pay benchmarks, internal equity, candidate/employee qualifications & performance, and business needs) are used to recommend compensation ranges for its officers and other employees, which are then used as a guide for setting reasonable compensation by management. Please see schedule O for additional details..
SCHEDULE J, PART I, LINE 4A - SEVERANCEJonathan R. Goble entered into a severance agreement with IU Health during 2018. Severance of $208,726 that was received during 2019 is included in column B(III), other reportable compensation. Deferred severance of $231,294 was disclosed in 2018 in column C, retirement and other deferred compensation. Kristy A. Schulhof entered into a severance agreement with IU Health during 2019. Severance of $55,348 that was received during 2019 is included in column B(III), other reportable compensation. Deferred severance of $374,645 is included in column C, retirement and other deferred compensation.
Schedule J, Part I, Line 4b - Supplemental Nonqualified Retirement PlanMatthew R. Cook, Kristy A. Schulhof, and Kenneth D. Puckett participate in an IU Health supplemental executive retirement plan, provisions of which are designed to retain these 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, that benefit may be forfeited or reduced. Each of these executives listed above, with the exception of Kristy A. Schulhof have an amount included in column c, deferred compensation, representing the current year unvested contributions made under the supplemental retirement plan. These amounts were not paid to these executives during the year. The following executives have an amount included in column B (III), other reportable compensation, representing the current year vested amounts received under the supplemental executive retirement plan: - Kristy A. Schulhof ($461,442)
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. Form 990, Part VII, Section A, Line 5 / Schedule J, Part II -- Compensation paid for services rendered by Paul Calkins Paul Calkins was employed as the VP & Chief Medical Officer, by IU Health North Hospital from January 2019 through August 2019. Paul Calkins ceased employment with IU Health North effective 8/16/2019. After this date, IU Health North contracted and paid Anesthesia Consultants, Inc. for Paul Calkins' services as the VP & Chief Medical Officer of IU Health North. During 2019, compensation paid by IU Health North to Anesthesia Consultants, Inc. for his services to IU Health North was $186,285. This amount is reflected in compensation paid by IU Health North on Schedule J, Part II, in column (B)(i), base compensation paid by IU Health North.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Page 1, Line J Web Site:https://iuhealth.org/find-locations/iu-health-north-hospital Part VI, Section A - Governing Body and Management Line 4 - Significant Changes to Organizational Documents Indiana University Health North Hospital, Inc. ("IU Health North Hospital") filed Amended Articles of Incorporation with the Indiana Secretary of State's Office effective March 1, 2019. IU Health North Hospital also executed amended and restated bylaws effective March 1, 2019 in order to reflect its change in operation following the boards merger with IU Health West Hospital. A summary of the updated bylaws are shown on Schedule O, lines 7a and 7b. A summary of the Amended Articles of Incorporation are included below. Article II, Which defines the purposes of the legal entity was amended to specifically address: - Increasing community access to quality health care services to the indigent, poor, and underserved; - Providing health services to the community through ownership and operation of a hospital in Hendricks County, Indiana; - Engaging in and supporting health education, training and research activities, including programs for nurses, health professionals and clergy; - Engaging in any lawful activities within the purposes for which a corporation may be organized under the Act, which are in furtherance of, supportive of, allied with or incidental to the purposes of the corporation; - Engage in all of the above mentioned activities on an interdenominational, public benefit basis while adhering to and assuring the preservation of the corporations values.
Part VI, Section A, Line 1b Independent Voting MembersIU Health North Hospital is part of a multi-entity hospital system controlled by IU Health, a 501(c)(3) tax-exempt organization whose board is comprised of voting members, of which substantially all are independent community members.
Part VI, Section A, Lines 6, 7a and 7b Members or StockholdersLine 6: The sole member of IU Health North Hospital is IU Health, a 501(c)(3) tax-exempt organization. Line 7A: The Board of Directors of the IU Health North Hospital shall consist of up to fifteen (15) voting members all appointed by IU Health, who shall include representatives from the Medical staffs of IU Health North Hospital and IU Health West Hospital, and the President of the Indianapolis Suburban Region, who shall be an ex-officio, voting director of the Board. At all times, the IU Health North Hospital directors shall consist of the same individuals appointed by IU Health to serve as directors of IU Health West Hospital. Line 7B: The Board of Directors shall not, without the prior approval of the IU Health: - Any proposed amendment to the Corporation's Articles of Incorporation or these Bylaws; - Adoption of the Corporation's annual capital and operating budgets; - Approval of any unbudgeted operating or capital budget items or deviations, including any issuance or guarantee of any unbudgeted debt; - Approval of any strategic plan for the Corporation, including any amendments to a strategic plan; - Approval of any encumbrance, sale or conveyance of assets; - Any merger, consolidation, joint venture or affiliation involving the Corporation or any of its affiliates and any other entity; - Appointment and removal of the Corporation's President and other officers; - Construction, acquisition or lease of Hospital buildings; - Approve any management agreement for the management of all or substantial part of IU Health West Hospital's operations; - Projects or contracts that require Member approval in accordance with the Member's resolution and policy governing system-wide Contract Execution Authority and Payment Approval Limits; and - The dissolution of the Corporation or any of its affiliates.
Part VI, Section A, Line 11b Review of Form 990The Indianapolis Suburban Chief Financial Officer and Finance Committee reviewed and approved the Form 990. Following their review and approval, a complete copy of the Form 990 was made available to each board member prior to its filing. Each member was also informed of the availability of IU Health's Tax Department to answer any questions.
Part VI, Section B, Lines 12, 13, 14, and 16b PoliciesIU Health North Hospital is part of the IU Health system. As the sole member and controlling parent of IU Health North Hospital, IU Health and its Board of Directors have mandated that certain policies be followed to ensure greater standardization throughout the system. Thus, IU Health North Hospital's Board of Directors was not required to separately adopt a conflict of interest, whistleblower, document retention and destruction and joint venture policies because IU Health's Board of Directors had already adopted and required these policies to be followed by its subsidiaries.
Part VI, Section B, Line 12c Conflict of Interest PolicyIU Health North Hospital follows IU Health's Conflict of Interest Policy. IU Health's Conflict of Interest Policy includes the following provisions: All IU Health employees, associates, colleagues and contracted personnel, including employed physicians and paid medical directors ("IU Health Representatives") are covered by and subject to its Conflict of Interest Policy. IU Health regularly and consistently monitors and enforces compliance with the policy through the following procedures: (a) On an annual basis, each IU Health Representative at the level of Manager or above, together with every other person designated by the Corporate Compliance Department ("Department"), must complete, sign and submit a Conflict of Interest Questionnaire ("Questionnaire") to the Department. Governing board members, committee members, corporate officers, medical staff and researchers must comply with the administrative requirements noted in the respective policies and procedures relative to those areas. (b) An IU Health Representative must supplement a Questionnaire in writing, if after completion of the original Questionnaire, a situation arises, or may reasonably be expected to arise, that would change any answer or information on the original Questionnaire if the situation had existed or been anticipated at the time of completion of the original Questionnaire. (c) If a fully and properly completed Questionnaire reveals facts or other information that might reasonably indicate a Conflict of Interest or violation of the policy, the IU Health Representative completing the questionnaire must secure approval by his/her supervisor, evidenced in writing. (d) The Department will review each Questionnaire and determine whether a Conflict of Interest exists and, if so, whether and how it should or may be eliminated, avoided or managed in order to comply with the spirit of the policy and with the best interests of IU Health and its patients. In making the determination, the Corporate Compliance Department may consult with the IU Health Representative's supervisor and other appropriate individuals and groups. (e) The scope of the policy is not limited to those who are required to complete Questionnaires. If an IU Health Representative is involved in a situation or relationship that would constitute a violation of the policy in the absence of disclosure and approval as described above, then the IU Health Representative must disclose the matter to his/her supervisor, secure his/her supervisor's approval in writing, and disclose the matter to the Department. Otherwise, the IU Health Representative is in violation of the policy and subject to corrective action, up to and including termination. (f) The Chief Compliance Officer, in consultation with onsite Compliance personnel, may from time to time appoint standing or ad hoc committees to assist in resolving issues that arise under provisions of the policy.
Part VI, Section B, Line 15a & 15b - Process for Determining Compen.IU Health North Hospital's Regional President is employed by IU Health, Inc. IU Health North Hospital's President is also employed by IU Health, Inc. IU Health's process for determining compensation is as follows: (1) The Board of Directors ("Board") has established a Talent Management and Executive Compensation Committee ("TMECC"), the purpose of which includes reviewing and making recommendations regarding executive (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 North Hospital and other related entities have a process in place to determine the compensation for the other officers and key employees. IU Health Human Resources uses market data from multiple compensation experts/vendors who utilize a variety of methods and procedures to obtain compensation ranges for comparable officer and employee positions. This market data and multiple other factors (including market pay benchmarks, internal equity, candidate/employee qualifications & performance, and business needs) are used to recommend compensation ranges for its officers and other employees, which are then used as a guide for setting reasonable compensation by management.
Part VI, Section C, Line 19 Public DisclosureIU Health North Hospital's Articles of Incorporation are available to the public through the Indiana Secretary of State's web-site. IU Health North Hospital's conflict of interest policy is described on Form 990, Schedule O. IU Health North Hospital is a subsidiary in IU Health's Consolidated Audited Financial Statements. IU Health's Consolidated Audited Financial Statements are available for public inspection through its bond filings and as an attachment to IU Health's Form 990 as well as IU Health North's Form 990.
Part VII, Section B, Attach 2 Comp of the Five Highest Pd Ind. ContractorsThe amounts paid to Messer Construction Co. totaling $27,965,031 include both goods and services associated with the construction of IU Health Joe & Shelly Schwarz Cancer Center located on the IU Health North Hospital campus. The amounts for goods vs. services were not easily separated for reporting on the 990, Part VII, Section B, Independent contractors.
Part XI, Line 9 Other Changes in Net Assets or Fund BalancesIU Health North Hospital recorded the following other changes in net assets or fund balances in 2019: EQUITY TRANSFER (SETTLEMENT OF DEBT): (20,942)
FORM 990 PART IX LINE 11GDESCRIPTION:SHARED SERVICES/PROF. FEES TOTAL FEES:49124273

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 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 BMH Foundation Inc
950 N Meridian St Ste 800IndianapolisIN46204311111784FundraisingIN501(c)(3)12 IIUHBMHYes (true)
IU Health Care Associates Inc
950 N Meridian St Ste 300IndianapolisIN46204351747218HealthcareIN501(c)(3)10IUHYes (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 Morgan Inc
950 N Meridian St Ste 800IndianapolisIN46204273533027HealthcareIN501(c)(3)10IUHYes (true)
IU Health Paoli Inc
950 N Meridian St Ste 300IndianapolisIN46204352090919HealthcareIN501(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)
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)
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)
IU 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)
Indiana Health Info Exchange Inc
846 N Senate AveIndianapolisIN46202364550324HealthcareIN501(c)(3)12 INAfalse
IU Medical Group Foundation Inc
340 W 10th St No FS5100IndianapolisIN46202201093251FundraisingIN501(c)(3)12 IINAfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (22 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Ball Outpatient Sur Ctr LLC
569 Brookwood Village Ste 901BirminghamAL35244270275794HealthcareINNA
Beltway Surgery Centers 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 CapitINNA
CHV Fund II Management LLC
950 N Meridian St Ste 800IndianapolisIN46204371717823Venture CapitINNA
CHV Fund II LLC
950 N Meridian St Ste 800IndianapolisIN46204800902337Venture CapitINNA
CHV Fund Management LLC
950 N Meridian St Ste 800IndianapolisIN46204262523151Venture CapitINNA
Health Venture Management LLC
950 N Meridian St Ste 800IndianapolisIN46204205740218ManagementINNA
IEC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454148032HealthcareINNA
Indiana Endoscopy Centers LLC
569 Brookwood Village Ste 901BirminghamAL35244208398421HealthcareINNA
ROC Surgery LLC
569 Brookwood Village Ste 901BirminghamAL35244271497960HealthcareINNA
ROCS Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454148369HealthcareINNA
Senate St Surgery Center LLC
569 Brookwood Village Ste 901BirminghamAL35244421709357HealthcareINNA
SSSC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454148167HealthcareINNA
SSC Holdings LLC
950 N Meridian St Ste 800INDIANPAOLISIN46204464472887HealthcareINNA
Eagle High Surg Center 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 Surgery Ctr LLC
569 Brookwood Village Ste 901BirminghamAL35244473102482HealthcareINNA
IUH Saxony Surgery Ctr LLC
569 Brookwood Village Ste 901BirminghamAL35244275271091HealthcareINNA
IU HEALTH 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 CountryLegalDomicileForeignCountryCd
CHV Capital Inc
950 N Meridian St Ste 800IndianapolisIN46204260752507Venture CapitINNACYes (true)
IU Health 457(B) Plan
1100 N Market StWilmingtonDE19890476948347InvestmentsDENATYes (true)
IU Health ACO Inc
950 N Meridian St Ste 800IndianapolisIN46204454421020HealthcareINNACYes (true)
IU Health Board Designated Trust
400 Howard StSan FranciscoCA94105306309021InvestmentsCANATYes (true)
IU Health NTGI S&P500 Fund CF
PO Box 804358ChicagoIL60680306298263InvestmentsILNATYes (true)
IU Health Plans Holding Company Inc
950 N Meridian St Ste 800IndianapolisIN46204463794815InsuranceINNACYes (true)
IU Health Plans Insurance Company
950 N Meridian St Ste 800IndianapolisIN46204811097215InsuranceINNACYes (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)
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)
BMH Medical Pavilion Association Inc
2525 W University AveMuncieIN47303351858408Condo ManagementINNACYes (true)
Cardinal Health Ventures Inc
950 N Meridian St Ste 800IndianapolisIN46204351611424ManagementINNACYes (true)
IU Health Southern IN Physicians Inc
950 N Meridian St Ste 300IndianapolisIN46204351913875HealthcareINNACYes (true)
Cerberus Residential Opport Inst Ltd
000000000InvestmentsNACYes (true)190 Elgin Avenue George TownGeorge TownGrand CaymanCJCJ
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 OrgYes (true)LoansOrGuaranteesFromOthOrgInd
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 OrgYes (true)RentalOfFcltsFromOthOrgInd
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 (12 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
IU Health Care Associates Inc
J$427,555FMV
IU Health Care Asscociates Inc
L$362,225FMV
IU Health Care Asscociates Inc
M$11,019,468FMV
Methodist Occupational Health Centers Inc
M$133,680FMV
IU Health Care Asscociates Inc
O$100,953FMV
IU Health Tipton Hospital Inc
O$1,137,449FMV
IU HEALTH WEST HOSPITAL INC
O$101,743FMV
IUH ASSURANCE SPC LTD
R$513,079FMV
IU Health Risk Retention Group Inc
R$797,135FMV
IU HEALTH FOUNDATION INC
C$87,058FMV
IU HEALTH WHITE MEMORIAL HOSPITAL INC
E$1,712,285FMV
IU HEALTH ARNETT INC
E$1,546,637FMV