2019-11-18T13:51:00-06:00 2018-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 4000 INDIANAPOLIS IN 46204 990 2018-01-01 351955872 INDIANA UNIVERSITY HEALTH INC % CRAIG J JONES INDI 3179634842 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS IN 46204 JENNIFER M ALVEY TREASURER/SVP & CFO 3179634842 2019-11-15 JENNIFER D RHODERICK P00395735 3176817000 162.1.129.128 35198520193185000018 2019-11-14 P E86E71EDF6F7DFE9336F32ED7F8459C58967F52A 0EC46664482BCB1EF10CC8721B0B9FE3BFD2352A 2018 2020-04-17 16:48:07Z DENNIS M MURPHY 950 N MERIDIAN ST STE 300 INDIANAPOLIS IN 46204 9781990336 false X https://iuhealth.org/ X 1995 IN Improve the health of our patients and community through innovation and excellence in care, education, research and service. 15 13 20616 1300 17734319 7542523 14626877 9094779 3598533649 3814410091 158185793 109423287 93569016 61078273 3864915335 3994006430 9312677 15222147 0 0 1103596765 1254297171 0 0 5064651 2079395776 2094008744 3192305218 3363528062 672610117 630478368 7854948856 8335546825 3278506324 3815421512 4576442532 4520125313 X IMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITY THROUGH INNOVATION AND EXCELLENCE IN CARE, EDUCATION, RESEARCH AND SERVICE. false false 1436994308 15285199 2226983069 Indiana University Health, Inc. ("IU Health") is an academic health center comprised of IU Health Methodist Hospital, IU Health University Hospital, and Riley Hospital for Children at IU Health (together referred to as "IU Health Academic Health Center"), IU Health Saxony Hospital, and IU Health Morgan. It also offers pharmacy, home care, outpatient, and emergency transport services throughout the central Indiana area. IU Health incorporates a unique partnership with Indiana University School of Medicine ("IU School of Medicine"), one of the nation's leading medical schools, to give patients access to innovative treatments and therapies, all without regard to their ability to pay. IU Health is also the parent organization of the IU Health System, Indiana's most comprehensive health care system. IU Health Methodist and IU Health University Hospitals IU Health Methodist and IU Health University Hospitals, located in Indianapolis, Indiana, are a 1,025-bed adult Academic Health Center in partnership with the IU School of Medicine. IU Health Methodist Hospital and IU Health University Hospital are designated as Magnet hospitals, recognized for excellence in nursing services and high-quality clinical outcomes for patients. IU Health University Hospital is a leading academic medical center with a commitment to disseminating research findings while improving the quality of life for people on a local, regional, national and international basis. IU Health Methodist Hospital and IU Health University Hospital both serve an adult population. These hospitals lead the way in community benefit initiatives. A substantial piece of community benefit is providing excellent care to patients, regardless of their ability to pay. Riley Hospital for Children at IU Health Riley Hospital for Children at IU Health, located in Indianapolis, Indiana, is 276-bed children's hospital that is Indiana's largest and most comprehensive pediatric hospital. It is regularly ranked among the top children's hospitals in the county by U.S. News & World Report's Best Children's Hospitals. In addition to clinical expertise, Riley Hospital for Children at IU Health's partnership with the IU School of Medicine ensures that patients have access to the most innovative treatments and the latest research and technology. Riley Hospital for Children at IU Health provides comprehensive, family-centered care to more than 300,000 children annually through its statewide primary and specialty care offices, and inpatient and outpatient services at its flagship hospital. Pediatric patients and their families travel from all 92 Indiana counties, the region and the world to access the nationally recognized clinical programs of Riley Hospital for Children at IU Health. Riley Hospital for Children at IU Health is also designated as a Magnet hospital, recognized for excellence in nursing services and high-quality clinical outcomes for patients. IU Health Saxony Hospital IU Health Saxony Hospital, located in Fishers, Indiana, is a 32-bed specialty care hospital primarily focusing on surgical services for cardiovascular and orthopedics. It opened in 2011 and includes six operating rooms, a full emergency department, a helipad for medical transport and a medical office complex. IU Health Saxony Hospital is also home to the Indiana University Health Hip and Knee Center. Here, the team of fellowship trained surgeons perform more hip and knee replacements than any other IU Health facility in the state. IU Health Morgan IU Health Morgan, an outpatient department of the IU Health Academic Health Center located in Martinsville, Indiana, offers coverage in adult and pediatric care; specialty care; emergency and urgent care; diagnostic imaging including 3D mammography; lab testing; outpatient surgical services; cancer care, including medical and radiation oncology; cardiac, physical, speech and occupational therapies; sleep lab; and community health and wellness, including medical nutrition therapy and diabetes care. 314336610 0 487143410 IU Health provides services to related tax-exempt organizations. 190360967 0 295012059 Member premium revenue 383636937 0 594541648 REFERENCE LABORATORY 98572685 0 152763097 PHARMACY 60548781 0 94980882 ALL OTHER PROGRAM SERVICE REVENUE 542758403 0 842285627 2484450288 true true false true false false false false false true true true false false true true false true false false true false false false false false true true true true true true false false false false false false false false true false false false false false true true true true true false true X 2993 0 true 20616 true true true true CJ UK CA KS MX false false false false false false false false true false X 15 13 true false false false true true true true true false false true true true true true true true true true true IN X CRAIG J JONES 3179634842 950 N MERIDIAN STREET SUITE 300 INDIANAPOLIS IN 46204 X ANNE NOBLES BOARD CHAIR / DIRECTOR 6.0 0.0 X X 42578 0 0 MICHAEL A MCROBBIE VICE-CHAIR 6.0 0.0 X X 22500 0 0 BISHOP JULIUS C TRIMBLE VICE-CHAIR 6.0 0.0 X X 22750 0 0 DENNIS M MURPHY DIRECTOR/PRESIDENT & CEO 60.0 0.0 X X 2337137 0 335025 HON SARAH EVANS BARKER DIRECTOR 6.0 0.0 X 0 0 0 MAUREEN BISOGNANO DIRECTOR 6.0 0.0 X 38750 0 0 J SCOTT DAVISON DIRECTOR / BOARD CHAIR 6.0 0.0 X X 41000 0 0 JAMES A DAVLIN V DIRECTOR 6.0 0.0 X 33000 0 0 THOMAS V EASTERDAY DIRECTOR 6.0 0.0 X 43750 0 0 KYLE L GRAZIER DIRECTOR 6.0 0.0 X 53750 0 0 JEFFREY A HARRISON DIRECTOR 6.0 0.0 X 38750 0 0 JAY L HESS MD DIRECTOR 6.0 2.0 X 39750 6750 0 MICHAEL J MIRRO MD DIRECTOR (PART YEAR) 6.0 0.0 X 5750 0 0 HARRY L GONSO DIRECTOR (PART YEAR) 6.0 0.0 X 28750 0 0 ROBERT A PALMER DIRECTOR 6.0 0.0 X 38750 0 0 LARRY H STEVENS MD DIRECTOR 6.0 55.0 X 46750 600762 18525 RYAN C KITCHELL TREASURER/EVP & CAO 55.0 0.0 X 1831685 0 237945 MARY BETH CLAUS SECRETARY/SVP & GEN. COUNSEL 55.0 0.0 X 799936 0 110309 JENNIFER M ALVEY TREASURER / SVP & CFO 55.0 0.0 X 872512 0 146707 ALFONSO W GATMAITAN EVP & COO (PART YEAR) 55.0 0.0 X 3058805 0 1037833 MICHELLE A JANNEY RN EVP & CNE 55.0 0.0 X 1017028 0 126964 JONATHAN E GOTTLIEB MD EVP & CME 55.0 0.0 X 1417127 0 21340 RYAN D NAGY MD PRESIDENT/CMO (AAHC) 25.0 30.0 X 0 858802 121247 MATTHEW R COOK PRESIDENT (RILEY) 55.0 0.0 X 707553 0 138083 RONALD L STIVER PRESIDENT (SCS) 55.0 0.0 X 806913 0 132690 MARK A LANTZY SVP & CIO/PRES. (HEALTH PLANS) 30.0 25.0 X 788940 0 130514 KEVIN R ARMSTRONG EVP & CHIEF OF STAFF 55.0 0.0 X 518021 0 105962 PARVEEN CHAND COO, AHC ADULT HOSPITALS 55.0 0.0 X 487837 0 36365 JONATHAN R GOBLE PRESIDENT (NCR)(PART YEAR) 15.0 40.0 X 1707608 0 255962 MATTHEW D BAILEY PRESIDENT (SCR)(PART YEAR) 0.0 55.0 X 1493222 0 329267 JAMES T PARKER SVP / PRES MDWISE (PART YEAR) 0.0 55.0 X 1284467 0 11768 JOHN F FITZGERALD MD SVP, POPULATION HEALTH 40.0 15.0 X 566521 254997 130522 ELIZABETH DUNLAP SVP, CHIEF HR OFFICER 55.0 0.0 X 767220 0 34402 ERIC S WILLIAMS MD FORMER EVP, ACAD. & MED. AFF. 0.0 55.0 X 0 226197 19179 PAUL R HAUT MD VP-COO/FMR INT. PRES. (RILEY) 55.0 0.0 X 0 423335 11918 MICHAEL L HARLOWE PRESIDENT (TIPTON) 25.0 30.0 X 0 267138 31996 DAWN M MOORE VP & CHIEF PHARMACY OFFICER 55.0 0.0 X 321527 0 34398 ELIZABETH L PAXTON RN FORMER VP & CNO (RILEY) 0.0 0.0 X 159798 0 7102 DANIEL F EVANS JR PRESIDENT EMERITUS 30.0 0.0 X 269476 0 27379 DONALD E CLAYTON MD FORMER PRESIDENT (WCR) 0.0 0.0 X 304574 136639 27856 RICHARD D CHADDERTON FORMER SVP, MKTG & STRATEGY 0.0 0.0 X 104170 0 8475 MICHAEL E HALEY VP, BEHAVIORAL HEALTH 55.0 0.0 X 695108 0 42848 22813763 2774620 3672581 1301 true true false IU HEALTH CARE ASSOCIATES INC 950 N MERIDIAN ST STE 300 INDIANAPOLIS IN 46204 MEDICAL 143280188 EVOLENT HEALTH LLC 800 N GLEBE RD STE 500 ARLINGTON VA 22203 POPULATION HEALTH 22056888 CERNER CORP 2800 ROCKCREEK PKWY KANSAS CITY MO 64117 HEALTH IT SOLUTIONS 35638779 TRIMEDX LLC 5451 LAKEVIEW PKWY S DR INDIANAPOLIS IN 46268 CLINICAL ENGINEERING 24086994 MEDEFIS 10826 OLD MILL RD STE 101 OMAHA NE 68154 TEMPORARY STAFFING 14580924 268 733550 6700865 1660364 9094779 NET PATIENT SERVICE REVENUE 622110 2226983069 2226983069 REFERENCE LABORATORY 621500 594541648 590598819 3942829 MEMBER PREMIUM REVENUE 541900 295012059 295012059 SHARED SERVICES 900099 487143410 476907234 10236176 PHARMACY 446110 152763097 138156316 14606781 57966808 67287054 -9320246 3814410091 101929487 35868713 66060774 0 0 14682142 5156648 9525494 0 9525484 139751 9385733 5788728191 1592867 5781713301 1113957 7014890 478910 7493800 1060747 6433053 0 0 0 0 0 0 0 0 0 CAFETERIA/FOOD SERVICE 721110 7424599 7424599 PARKING 812930 2675813 2675813 TELEPHONE 517000 1353866 1353866 40098511 -2931719 43030230 51552789 3994006430 3830813264 17734319 136364068 X 15122147 15122147 100000 100000 0 0 19213588 12944293 6269295 1431804 967355 464449 1012909429 681233437 328270571 3405421 87145261 58887759 28257502 61503112 41363989 19659034 480089 72093977 48486888 23388877 218212 1671721 1671721 5081821 5081821 2688465 2688465 723193 723193 0 9871519 9871519 337832975 220467471 116956028 409476 15230955 1494942 13460844 275169 29655090 15154787 14412896 87407 102836575 25511509 77281200 43866 0 80885381 7776574 73108697 110 3733722 1588185 2114992 30545 0 348240 145081 197142 6017 42252781 174188 42078593 0 144514878 101078085 43434466 2327 19464457 700297 18764160 DRUGS AND MEDICAL SUPPLIES 665352704 665352704 HEALTH CLAIMS TO PROVIDERS 315847055 315847055 BAD DEBT 111059795 111059795 UBI TAX 1747116 1747116 203210301 158993747 44110542 106012 3363528062 2484450288 874013123 5064651 404274 105418 323151725 370411669 742773 1166869 487920718 505620007 0 0 0 0 670709706 642250736 54141972 68739798 39599203 56347176 3642018549 2146939285 1491041286 1495079264 2614968878 2764003286 1786140221 2024026049 330407346 352987114 7836771 7586056 47883983 47223383 7854948856 8335546825 429948785 488713438 0 0 18755032 19920534 1279981535 1473351615 0 0 0 0 158155497 99720053 0 0 1391665475 1733715872 3278506324 3815421512 X 4571554251 4518269449 0 0 4888281 1855864 4576442532 4520125313 7854948856 8335546825 X 630478368 -274835808 -411959779 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false 0 false 0 false 0 false 0 true 616855 false 0 true 106338 723193 false Schedule C, Part II-B, Lines 1b and g - Paid staff and direct contact During 2018, IU Health spent a total of $616,855 in direct federal and state lobbying expenditures. During 2018, IU Health advocated before Congress on the following issues: - Healthcare Reform Legislation (in general) - Patient Protection and Affordable Care Act Matters - Changes to Medicare/Medicaid reimbursement - Graduate Medical Education - Medicaid/Medicare Managed Care - Changes to OPPS/IPPS reimbursement - NIH funding - Accountable Care Organizations - 340B program - Meaningful Use - Site-neutrality Payments - Critical Access and Rural Hospital Matters (Direct Supervision; Medicare Extenders) - Disproportionate Share Hospital Payments - Telemedicine/Telehealth - Electronic Health Records Interoperability - Organ Transplant Allocation - CMS Regulatory Requirements - Budget Matters During 2018, IU Health advocated at the State Level on the following issues: - Provider Reimbursements - Healthy Indiana Plan 2.0 - Medicaid Reimbursement Policies - Provider Licensure Matters - Workforce and Smoking Policies - Insurance Matters - Healthcare Reform - Hospital Licensure - Medicaid Managed Care - Telehealth/Telemedicine - Public Safety - Pricing Transparency/Surprise Bills - Regulation - Social Services - Patient Safety Matters - Access to Health Care - Opioids/Addictions Services - Upper Payment Limit Payments - Graduate Medical Education Schedule C, Part II-B, Lines 1j - Other Activities Several membership organizations notified IU Health during 2018 that a portion of the dues it paid would be used for lobbying purposes as follows: American Hospital Association: 22.98% or $19,713 Indiana Hospital Association: 7.12% or $21,188 Greater Indianapolis Chamber of Commerce: 5.0% / 10% or $28,750 Indiana Chamber of Commerce: 12% or $6,000 Children's Hospital Association: 21.23% or $30,210 Association of American Medical Colleges: 2.37% or $477 Total Portion of Dues Used for Lobbying Purposes: $106,338 4888281 3032417 1855864 4888281 4888281 4888281 4888281 4888281 4888281 4890781 2500 4888281 0.00000 1.00000 0.00000 false true true 147061560 147061560 1944047734 997026198 947021536 23752058 7608180 16143878 1411443590 1125523193 285920397 115713607 16781714 98931893 1495079264 ALTERNATIVE INVESTMENTS 2024026049 F 2024026049 0 INTERCOMPANY PAYABLES (NET) 1601472315 INTEREST RATE SWAP LIABILITIES 43695020 DUE TO THIRD-PARTY PAYERS 66929259 PENSION AND OTHER RET. LIAB. 7191197 ENVIRONMENTAL OBLIGATIONS 5463509 ACCRUED INTEREST ON BONDS 6391036 SELF-INSURANCE LIABILITIES 2573536 1733715872 X Schedule D, Part V, Line 4 - Intended Uses of Org.'s Endowment Funds Permanently restricted net assets are generally restricted for indigent and other patient care services, medical education and research programs, and medical supplies and equipment. Schedule D, Part X, Line 2 - FIN 48 (ASC 740) Footnote 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 categorize certain fringe benefit expenses as a source of unrelated business income subject to tax, 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. Regulations necessary to implement certain aspects of TCJA are expected to be promulgated by the IRS in 2019. As of and for the year ended December 31, 2018, 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 based on accounting guidance included in Accounting Standards Codification (ASC) 740, Income Taxes. 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 which, as of December 31, 2018 and 2017, 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, 2018 and 2017, the Indiana University Health System had gross deferred tax assets of $119,965,000 and $93,794,000, respectively, primarily relating to net operating loss carryovers. Management determined that a full valuation allowance at December 31, 2018 and 2017 was necessary to reduce the deferred tax assets to the amount that would more likely than not be realized. ASC Topic 740-10-50-3, Income Taxes: Disclosure, requires a valuation allowance to reduce the deferred tax assets reported if, based on the weight of the evidence, it is more likely than not that some portion or all of the deferred tax assets will not be realized. The change in the valuation allowance for the current year is $26,171,000. At December 31, 2018, the Indiana University Health System has available net operating loss carryforwards of $482,349,000. Net operating losses generated from 1999 through 2017 will expire between 2019 and 2037. Net operating losses generated during 2018 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. Central America and the Caribbean 0 0 Investments N/A 1432739035 Europe (Including Iceland and Greenland) 0 0 Investments N/A 22100404 North America 0 0 Investments N/A 670004 East Asia and the Pacific 0 0 Investments N/A 3463099 Central America and the Caribbean 0 0 Program Services SELF-INSURANCE 7060180 Central America and the Caribbean 0 0 Conduct board meetings N/A 33387 Central America and the Caribbean 0 0 Unrelated Trade or Business N/A 3260202 0 0 0 0 1469326311 1469326311 true false true true true false Schedule F, Part I, Line 3 - Activities per Region The amounts reported on Schedule F, Part I, Line 3 include the book values of foreign investments, insurance premiums paid directly to an off-shore captive, and travel and meeting expenses paid to attend off-shore captive meetings. true true X true X false true true false true true 26064 50963198 0 50963198 0.01550 83872 903311177 536367724 339943453 0.10330 0 0 0 0 0.00000 109936 954274375 536367724 390906651 0.11880 16 102779 17101380 362973 16738407 0.00510 4 25082 113645555 16667045 96978510 0.02950 1 7758 12489997 0 12489997 0.00380 1 0 10000000 0 10000000 0.00300 5 212728 13686783 150479 13536304 0.00410 27 348347 166923715 17180497 149743218 0.04550 27 458283 1121198090 553548221 540649869 0.16430 0 0 0 0 0.00000 0 0 0 0 0.00000 2 100 254182 0 254182 0.00010 0 0 0 0 0.00000 0 0 0 0 0.00000 1 0 3782 0 3782 0.00010 0 0 0 0 0.00000 0 0 0 0 0.00000 0 0 0 0 0.00000 3 100 257964 0 257964 0.00020 false 38504257 0 422490668 462397906 -39907238 X true true SEE PART VI AMBULATORY SURGERY CENTER 0.25743 0.0 0.74257 SEE PART VI AMBULATORY SURGERY CENTER 0.2587 0.0 0.7413 SEE PART VI AMBULATORY SURGERY CENTER 0.2601 0.0 0.7399 SEE PART VI AMBULATORY SURGERY CENTER 0.28963 0.0 0.71037 SEE PART VI AMBULATORY SURGERY CENTER 0.27114 0.0 0.72886 1 1 INDIANA UNIVERSITY HEALTH 1701 N SENATE BLVD INDIANAPOLIS IN 46202 https://iuhealth.org/ 17-005051-1 X X X X X X SEE PART V, SECTION C FOR ADDITIONAL INFORMATION INDIANA UNIVERSITY HEALTH 1 false false true X X X X X X X X X 18 true false false true X SEE PART V, SECTION C X true 19 true SEE PART V, SECTION C false true X 200. 0. X X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section A, Line 1 Name, Address, and Website IU Health operates several hospital locations under a single hospital license issued by the Indiana State Department of Health. The names, addresses, and primary website addresses for each of these locations are as follows: IU Health Methodist Hospital 1701 N. Senate Blvd. Indianapolis, IN 46202 https://iuhealth.org/find-locations/iu-health-methodist-hospital IU Health University Hospital 550 University Blvd. Indianapolis, IN 46202 https://iuhealth.org/find-locations/iu-health-university-hospital Riley Hospital for Children at IU Health 705 Riley Hospital Dr. Indianapolis, IN 46202 https://www.rileychildrens.org/ IU Health Methodist Hospital, IU Health University Hospital, and Riley Hospital for Children at IU Health are collectively referred to as the IU Health Academic Health Center. IU Health Saxony Hospital 13000 E. 136th St. Fishers, IN 46037 https://iuhealth.org/find-locations/iu-health-saxony-hospital Schedule H, Part V, Section B, Line 3e - Prioritized Health Needs IU Health's 2018 Community Health Needs Assessment (CHNA) Reports include prioritized descriptions of significant health needs in the community. The CHNA reports identified the following needs to be addressed: - Access to Health Care Services - Drug and Substance Abuse - Health Care and Social Services for Seniors - Mental Health - Obesity and Diabetes - Smoking - Social Determinants of Health - Food Insecurity - Maternal and Infant Health - Violence and Injuries Schedule H, Part V, Section B, Line 5 Input from Community IU Health operates four hospital locations that are licensed as a single hospital by the Indiana State Department of Health. These hospital locations are as follows: - IU Health Methodist Hospital - IU Health University Hospital - Riley Hospital for Children at IU Health - IU Health Saxony Hospital IU Health Methodist Hospital, IU Health University Hospital, and Riley Hospital for Children are located in Indianapolis, Marion County, Indiana and are referred to as the IU Health Academic Health Center. IU Health Saxony Hospital is located in Fishers, Hamilton County, Indiana. Although licensed as a single hospital, each of these facilities serve different, although sometimes overlapping, portions of the community which present their own unique health needs. In order to take into account all of these unique health needs, IU Health conducted separate Community Health Needs Assessments ("CHNAs") for each of its four hospital locations. For the 2018 Community Health Needs Assessment, 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. In conducting each of its most recent CHNAs, IU Health took into account input from persons who represent the broad interests of the communities it serves by hosting several community conversation focus groups. These focus groups included public health officials and community leaders to discuss the healthcare needs of the service area and what role IU Health could play in addressing the identified needs. IU Health Academic Health Center 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, nonprofit organizations, local businesses, 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 community's 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 primary care - Homelessness - Access to healthy food/food insecurity - Needs of the growing senior community - Substance abuse - Dental care - Disparities in access to basic, affordable needs - Education - Education on communicable diseases - Nutrition and cooking education - Teen pregnancy During the meetings, a range of other topics was discussed, including: - Ability to address topics such as crime, poverty, and air pollution - Aging population - Teen pregnancy - Water - Parks - Funding - Walkability - Social determinants of health - Disparities - Collaboration with community organizations - Government affairs department - Individuals with disabilities and their health needs - Effects of opioid abuse on children After discussing the needs identified through secondary data and adding others to the list, participants in each meeting were asked through a voting process to identify "three to five" they consider to be most significant. Food insecurity, substance abuse, mental health, social determinants of health, and obesity were frequently identified through the community meeting process for Marion County. Interviews - Marion County An interview was also conducted with two representatives of the Marion County Public Health Department. The interviews were conducted to assure that appropriate and additional input was received from governmental public health officials. The results of the community meetings were discussed and insights were sought regarding significant community health needs, reasons such needs are present, and how they can be addressed. The interviews were guided by a structured protocol that focused on opinions regarding significant community health needs, describing why such needs are present, and seeking ideas for how to address them. The interviewees confirmed that the needs identified by the community meeting participants were significant. These needs were: - Access to healthy food (food insecurity) and its relation to obesity - Poverty - Mental health - Disparities in access to basic needs (housing, transportation, etc.) - Substance abuse Poverty has increased significantly since 2005, from one out of every five households to one out of every three with children in poverty. This increased poverty level has created a large issue with food insecurity. While unemployment rates are low, wages are an issue for many in the community. The minimum wage is not a living wage and many people who have low paying jobs still struggle with food insecurity and other issues. Mental health status and access to mental health care is a significant issue, with a particular focus on the lack of providers, and issues surrounding suicide among children. Since many providers receive little in reimbursement from insurance for mental health treatment, finding providers and hospitals with a focus on mental health is difficult. There is a need for navigators that could help residents find needed services and sign up for state insurance plans. Substance abuse is a significant issue, as evidenced by drug overdose deaths. Additionally, while there were 500 ambulance trips for drug overdoses in 2013, this number is over 2,000 in recent years. Communicable diseases linked to substance abuse is also an issue, as rates of hepatitis C and HIV have increased in part due to intravenous drug use. Despite great progress and policy around the issue, smoking is still an issue that many are no longer paying attention to because of a misbelief that the issue is solved. The recent rise of e-cigarettes may contribute to increased smoking due to attracting teenagers. Transportation is a barrier to care. While the city has options, the bus system is inefficient and can take a long time. Cancer is also an issue, with large disparities in incidence rates among different demographic groups. In particular the incidence rates of lung, colon, and prostate cancers are significant needs in the community. The interviewees also identified several other significant issues in the community, including: - Dental care and access to dental care providers - Violence and homicide - Infant mortality, especially with the disparities present among different racial groups - Childhood obesity - Chronic diseases, particularly diabetes Community Survey - Marion County To inform the CHNA, a community survey was conducted. The survey was sponsored by a cooperative of Indiana hospital systems, under contract with the University of Evansville and the Indiana University School of Public Health-Bloomington. Researchers from Indiana University and University of Evansville contracted with the Center for Survey Research at Indiana University to administer the survey. The survey was conducted in two phases, with Phase 1 conducted as a paper survey mailed to an address-based sample, and Phase 2 administered by some of the hospitals to a convenience sample they selected. IU Health part Schedule H, Part V, Section B, Line 7a CHNA Website Copies of IU Health's CHNAs for its IU Health Academic Health Center and IU Health Saxony Hospital locations are available on its website at the following URL: https://iuhealth.org/in-the-community Schedule H, Part V, Section B, Line 10a Implementation Strategy Website Copies of IU Health's CHNA implementation strategies for its IU Health Academic Health Center and IU Health Saxony Hospital locations are available on its website at the following URL: https://iuhealth.org/in-the-community Schedule H, Part V, Section B, Line 11 Addressing Identified Needs IU Health prioritized and determined which of the community health needs identified in its most recently conducted CHNAs were most critical for it to address. Secondary data, findings from other community health assessments of areas served by the hospital, input obtained from individuals who participated in community meetings, input obtained from key stakeholders, and a community survey were reviewed to identify and analyze the needs identified by each source. IU Health Academic Health Center IU Health Methodist Hospital and IU Health University Hospital Community health needs listed by category will be addressed between 2019 and 2021 for the IU Health Methodist Hospital and IU Health University Hospital: 1. Access to Healthcare Services 2. Drug and Substance Abuse (including Opioids)* 3. Healthcare and Social Services for Seniors 4. Mental Health* 5. Obesity and Diabetes 6. Smoking, Tobacco Use and Exposure to Secondhand Smoke 7. Social Determinants of Health 8. Other statewide concerns: a. Public health funding b. Air pollution * IU Health uses the term Behavioral Health to refer to Mental Health and Drug and Substance Abuse (including Opioids). The implementation strategy to address the identified needs noted above includes the following: Behavioral Health - Implement substance abuse programming. - Work with community organizations to determine roles in programming. - Work with local police and fire departments for trainings and resources. Obesity and Diabetes - Perform cooking demonstrations, food preparation and tasting, nutrition education and planning, and tips for shopping economically for healthy foods. - Collaborate with low-income community housing projects, community organizations, and faith-based organizations to reach target population. - A nutritionist will educate the community. Smoking, Tobacco Use and Exposure to Secondhand Smoke - Collectively determine which screenings will be implemented. - Provide health screenings in the community. - Refer the community member to the appropriate care provider when abnormal screening results are found. Social Determinants of Health - Expand the Medical-Legal Partnership. - Help individuals and families in need of support connect to resources available in the Indianapolis community. - Ensure staff are fluent in English and Spanish. Translation services for other languages will be available as needed. - Work with community organizations to determine roles in programming. IU Health Methodist Hospital and IU Health University Hospital are unable to address those community health needs that do not relate directly to the hospitals' mission to deliver healthcare. These are needs that other governmental agencies and/or community organizations have the most appropriate expertise and resources to address. IU Health Methodist Hospital and IU Health University Hospital are unable to address the following community health needs identified in the 2018 Community Health Needs Assessment: - Healthcare and Social Services for Seniors - Funding for Public Health - Air Pollution Riley Hospital for Children at Indiana University Health Community health needs listed by category will be addressed between 2019 and 2021 for the Riley Hospital for Children at Indiana University Health: 1. Maternal and Infant Health 2. Mental Health** 3. Obesity and Access to Healthy Food 4. Poverty and Other Social Determinants of Health 5. Smoking, Tobacco Use and Exposure to Secondhand Smoke 6. Violence and Injuries 7. Other statewide concerns: a. Public health funding b. Air pollution ** IU Health uses the term Behavioral Health to refer to Mental Health. The implementation strategy to address the identified needs noted above includes the following: Maternal and Infant Health - Continue to collaborate with the Marion County Public Health Department in conducting the Fetal Infant Mortality Review. - Offer Safe Sleep parenting classes in the community. - Refer families, identified during wellness checks without a safe place for a baby to sleep, to Cribs for Kids or other local resource. - Provide continuing education to primary care providers in Indiana regarding safe sleep and available resources. - Provide lactation training, childcare education and well-baby checks for new mothers in the community. Obesity and Access to Healthy Food - Perform cooking demonstrations, food preparation and tasting, nutrition education and planning, and tips for shopping economically for healthy foods. - Collaborate with low-income community housing projects, community organizations, and faith-based organizations to reach target population. - A nutritionist will educate the community. - Implement 5-2-1-0 Program in collaboration with local organizations. - Identify community organizations that can assist with implementation of these programs. Smoking, Tobacco Use and Exposure to Secondhand Smoke; Behavioral Health - Patients, family members and caregivers of Riley patients will be screened for use of tobacco products, including vaping. Those who screen positive will be counseled regarding medical risks to self and/or patient and asked if they want to quit, or at least abstain while their child is in the hospital. If they agree, they will receive counseling from a core group of staff, also trained as certified tobacco treatment specialists. - Train staff to counsel and provide resources to tobacco users who wish to quit or abstain while their child is in the hospital. - Work with tobacco control coalition to add value and resources, as needed. Violence and Injuries - Provide free Safe Sitter classes to groups of low-income youth. Poverty and Other Social Determinants of Health - Expand the Medical-Legal Partnership. Riley at IU Health is unable to address those community health needs that do not relate directly to the hospital's mission to deliver healthcare. These are needs that other governmental agencies and/or community organizations have the most appropriate expertise and resources to address. Riley at IU Health is unable to address the following community health needs identified in the Community Health Needs Assessment: - Funding for Public Health - Air Pollution IU Health Saxony Hospital Community health needs listed by category will be addressed between 2019 and 2021 for the IU Health Saxony Hospital: 1. Access to Healthcare Services 2. Drug and Substance Abuse (including Opioids and Alcohol)* 3. Food Insecurity 4. Healthcare and Social Services for Seniors 5. Mental Health* 6. Obesity and Diabetes 7. Social Determinants of Health * IU Health uses the term Behavioral Health to refer to Mental Health and Drug and Substance Abuse (including Opioids). The implementation strategy to address the identified needs noted above includes the following: Access to Healthcare Services; Healthcare and Social Services for Seniors; Social Determinants of Health - Provide funding for Trinity Free Clinic to support the medical and dental needs of Hamilton County residents who are uninsured and underinsured. - Encourage IU Health team members to assist in staffing medical clinics. Access to Healthcare Services; Healthcare and Social Services for Seniors - 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. - Provide an Individual Solutions coordinator to help patients register for health insurance through Healthy Indiana Plan (HIP) 2.0 or other Marketplace insurance. - 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 physician-led health seminars to seniors at PrimeLife Enrichment, Inc. Access to Healthcare Services; Behavioral Health; Healthcare and Social Services for Seniors; Food Insecurity - 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. Access to Healthcare Services; Behavioral Health; Healthcare and Social Services for Seniors - 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. Access to Healthcare Services; Behavioral Health - Provide 24/7 peer c Schedule H, Part V, Section B, Line 13b Income Level Other than FPG In addition to FPG, IU Health may take into consideration a patient's income and/or ability to pay in the calculation of a financial assistance award. Schedule H, Part V, Section B, Line 13h Other FAP Eligibility Criteria IU Health takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. IU Health's Individual Solutions Department Prior to seeking Financial Assistance under the FAP, all patients or their guarantors must consult with a member of IU Health's Individual Solutions department to determine if healthcare coverage may be obtained from a government insurance/assistance product or from the Health Insurance Exchange Marketplace. 2. Alternate Sources of Assistance When technically feasible, a patient will exhaust all other state and federal assistance programs prior to receiving an award from IU Health's Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowner's, must exhaust all insurance benefits prior to receiving an award from IU Health's Financial Assistance Program. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. Patients may be asked to show proof that such a claim was properly submitted to the proper insurance provider at the request of IU Health. Eligible patients who receive medical care from IU Health 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 is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health reserves the right to reverse the award in an amount equal to the amount IU Health would be entitled to receive had no Financial Assistance been awarded. 3. Alternate Methods of Eligibility Determination IU Health will conduct a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an Extraordinary Collection Action ("ECA"). Said accounts may be eligible for assistance under the FAP based on the patient's individual scoring criteria. To ensure all patients potentially eligible for Financial Assistance under the FAP may receive Financial Assistance, IU Health will deem patients/guarantors to be presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied his/her required co-pay/deductible: - Indiana Children's Special Health Care Services - Medicaid - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level 4. Additional Considerations Financial Assistance may be granted to a deceased patient's account if said patient is found to have no estate. Additionally, IU Health 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 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 will all applicable federal and state laws and/or regulations. 6. Emergency Services Non-Refundable Deposit This section will be implemented with a strict adherence to EMTALA and IU Health Policy ADM 1.32, Screening and Transfer of Emergency or Unstable Patients. Amount of Non-Refundable Deposit All Uninsured Patients presenting for services at one of IU Health's Emergency Departments, via transfer from another hospital facility, or direct admission, will be responsible for a one-hundred dollar ($100.00) non-refundable deposit for services rendered. Patients/guarantors will be responsible for any copays and/or deductibles required by their plan prior to full Financial Assistance being applied. Uninsured Patients wishing to make an application for Financial Assistance greater than the AGB must fulfill their non-refundable deposit prior to IU Health processing said application. Uninsured Patients making payments toward their outstanding non-refundable deposit balance will have said payments applied to their oldest application on file, if applicable. Schedule H, Part V, Section B, Line 16a FAP Website A copy of IU Health's FAP is available on its website at the following URL: https://iuhealth.org/pay-a-bill/financial-assistance Schedule H, Part V, Section B, Line 16b FAP Application Website A copy of IU Health's FAP Application is available on its website at the following URL: https://iuhealth.org/pay-a-bill/financial-assistance Schedule H, Part V, Section B, Line 16c FAP PLS Website A copy of IU Health's FAP Plain Language Summary is available on its website at the following URL: https://iuhealth.org/pay-a-bill/financial-assistance Schedule H, Part V, Section B, Line 16J Other Measures to Publicize IU Health takes several other measures to broadly publicize its FAP within the community. These measures include the following: 1. Conspicuous public displays will be posted in appropriate acute care settings such as the emergency department and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 2. IU Health 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 will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health will educate its patient facing team members of the FAP and the process for referring patients to the Program. 105 IU HEALTH BALL MEM OUTPATIENT SURG CTR 2401 W UNIVERSITY AVE MUNCIE IN 47303 AMBULATORY SURGERY IU HEALTH BELTWAY SURGERY CENTER 151 PENNSYLVANIA PKWY INDIANAPOLIS IN 46280 AMBULATORY SURGERY BELTWAY SURGERY CENTER SPRING MILL 200 W 103RD ST STE 2400 INDIANAPOLIS IN 46290 AMBULATORY SURGERY IU HEALTH EAGLE HIGHLANDS SURGERY CENTER 6850 PARKDALE PL INDIANAPOLIS IN 46254 AMBULATORY SURGERY GLEN LEHMAN ENDOSCOPY SUITE 550 N UNIVERSITY BLVD STE 4100 INDIANAPOLIS IN 46202 AMBULATORY SURGERY INDIANA ENDOSCOPY CENTERS 10967 ALLISONVILLE RD STE 100 FISHERS IN 46038 AMBULATORY SURGERY INDIANA ENDOSCOPY CENTERS 1115 N RONALD REAGAN PKWY STE 3 AVON IN 46123 AMBULATORY SURGERY INDIANA ENDOSCOPY CENTERS 1801 N SENATE BLVD STE 710 INDIANAPOLIS IN 46202 AMBULATORY SURGERY INDIANA HEALTH BELTWAY SURGERY CENTER 8501 HARCOURT RD INDIANAPOLIS IN 46260 AMBULATORY SURGERY IU HEALTH MERIDIAN SOUTH SURGERY CENTER 8820 S MERIDIAN ST INDIANAPOLIS IN 46217 AMBULATORY SURGERY RILEY OUTPATIENT SURGERY CENTER 702 BARNHILL DR STE 0201 INDIANAPOLIS IN 46202 AMBULATORY SURGERY SAXONY SURGERY CENTER 13100 E 136TH ST STE 1100 FISHERS IN 46037 AMBULATORY SURGERY SENATE STREET SURGERY CENTER 1801 N SENATE BLVD INDIANAPOLIS IN 46202 AMBULATORY SURGERY CARDIO TESTING AT IU HEALTH METHODIST 1801 N SENATE BLVD STE 3100 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT CHARIS CENTER 6640 INTECH BLVD STE 195 INDIANAPOLIS IN 46278 DIAGNOSTIC AND OTHER OUTPATIENT INDIANA CANCER PAVILION 535 N BARNHILL DR INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH ADULT DIALYSIS CENTER 2140 N CAPITOL ST INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH ARNETT HOSPITAL LAB 5165 MCCARTY LN LAFAYETTE IN 47905 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH BALL MEMORIAL HOSPITAL LAB 2401 UNIVERSITY AVE MUNCIE IN 46037 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH BLACKFORD HOSPITAL LAB 410 PILGRIM BLVD HARTFORD CITY IN 47348 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH BLOOMINGTON HOSPITAL LAB 601 W 2ND ST BLOOMINGTON IN 47402 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH BRAIN TUMOR CLINIC 355 W 16TH ST STE 5400 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH BROWNSBURG 1375 N GREEN ST STE 200 BROWNSBURG IN 46112 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH CANCER CENTERS - SPRING MILL 200 W 103RD ST INDIANAPOLIS IN 46290 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH CICC EAST 6845 RAMA DR INDIANAPOLIS IN 46219 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH CICC NORTH 10202 LANTERN RD FISHERS IN 46038 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH CICC CARMEL 11725 ILLINOIS ST STE 565 CARMEL IN 46032 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH CICC METHODIST 1701 N SENATE BLVD C6 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH CICC WEST 1111 N RONALD REAGAN PKWY AVON IN 46123 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH HOME DIALYSIS 8802 N MERIDIAN ST STE 150 INDIANAPOLIS IN 46260 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH LAPORTE HOSPITAL LAB 1007 LINCOLNWAY LAPORTE IN 46350 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH MEDICAL DIAGNOSTIC CENTER 550 N UNIVERSITY BLVD INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH MELVIN & BREN SIMON CANCER CTR 1030 W MICHIGAN ST INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH METHODIST HOSPITAL OUTPT SVC 1701 N SENATE BLVD AG053 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH METHODIST LIFECARE PROGRAM 1633 N CAPITAL AVE STE 300 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH METHODIST MEDICAL PLAZA NORTH 151 PENNSYLVANIA PKWY INDIANAPOLIS IN 46280 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH METHODIST MEDICAL PLAZA 6850 PARKDALE PL INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH METHODIST MEDICAL PLAZA 9660 E WASHINGTON ST INDIANAPOLIS IN 46229 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH METHODIST MEDICAL PLAZA 8830 S MERIDIAN ST INDIANAPOLIS IN 46217 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH METHODIST PROFESSIONAL CENTER 1801 N SENATE BLVD INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH MOORESVILLE 820 SAMUEL MOORE PKWY MOORESVILLE IN 46158 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH NEUROSCIENCE CENTER 355 W 16TH ST INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH NEUROSCIENCE CTR NEUROPHYS 355 W 16TH ST STE 2100 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH NORTH HOSPITAL LAB 11700 N MICHIGAN ST CARMEL IN 46032 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH OPTHALMOLOGY CENTER 1160 W MICHIGAN AVE INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH ORTHO RADIOLOGY AND REHAB 1801 N SENATE AVE STE 510 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH PAOLI HOSPITAL LAB 642 W HOSPITAL RD PAOLI IN 47454 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH PATHOLOGY LAB 350 W 11TH ST INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH RADIOLOGY AT GEORGETOWN 4880 W CENTURY PLAZA RD STE 155 INDIANAPOLIS IN 46254 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH RADIOLOGY AT MOORESVILLE 820 SAMUEL MOORE PKWY MOORESVILLE IN 46158 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH RENAL SERVICES 550 N UNIVERSITY BLVD RM 1115 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH SAXONY HOSPITAL LAB 13000 E 136TH ST FISHERS IN 46037 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH SAXONY HOSPITAL OR 13100 E 136TH ST STE 2100 FISHERS IN 46037 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH SAXONY HOSPITAL SLEEP LAB 13100 E 136TH ST FISHERS IN 46037 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH SLEEP DISORDERS CENTER 1411 W COUNTY LINE RD STE C GREENWOOD IN 46142 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH SLEEP DISORDERS CENTER 714 N SENATE AVE INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH TIPTON HOSPITAL LAB 1000 S MAIN ST TIPTON IN 46072 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH TRANSPLANT 1701 N SENATE BLVD INDIANAPOLIS IN 46206 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH UNIV HOSP ADULT OUTP CENTER 550 UNIVERSITY BLVD RM 4175 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH WEST HOSPITAL LAB 1111 RONALD REAGAN PKWY AVON IN 46123 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH WHITE MEMORIAL HOSPITAL LAB 720 S 6TH ST MONTICELLO IN 47960 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH SAXONY HOSPITAL CARDIAC REHAB 13100 E 136TH ST FISHERS IN 46037 DIAGNOSTIC AND OTHER OUTPATIENT METHODIST MEDICAL PLAZA GEORGETOWN 4880 W CENTURY PLAZA RD INDIANAPOLIS IN 46254 DIAGNOSTIC AND OTHER OUTPATIENT METHODIST MEDICAL PLAZA GLENDALE 2620 KESSLER BLVD E DR INDIANAPOLIS IN 46220 DIAGNOSTIC AND OTHER OUTPATIENT METHODIST MEDICAL TOWER 1633 N CAPITAL AVE INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT NEUROREHABILITATION AND ROBOTICS 355 W 16TH ST STE 1078 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT NEUROSCIENCE RADIOLOGY 355 W 16TH ST STE 0400 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT PULMONARY REHABILITATION 1633 N CAPITAL AVE STE 103 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT RILEY REHABILITATION SERVICES 705 RILEY HOSPITAL DR INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT RILEY REHABILITATION SERVICES (EAST) 9650 E WASHINGTON ST STE 250 INDIANAPOLIS IN 46229 DIAGNOSTIC AND OTHER OUTPATIENT RILEY HOSPITAL HEMATOLOGYONCOLOGY 11725 ILLINOIS ST STE 01BD003-B6 CARMEL IN 46032 DIAGNOSTIC AND OTHER OUTPATIENT RILEY HOSPITAL RENAL SERVICES 705 RILEY HOSPITAL DR ROC STE 12 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT SPRING MILL OFFICE BUILDING LABORATORY 200 W 103RD ST INDIANAPOLIS IN 46290 DIAGNOSTIC AND OTHER OUTPATIENT THE SIMULATION CENTER AT FAIRBANKS HALL 340 W 10TH ST STE 4100 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH ADVANCED THERAPIES PHARMACY 355 W 16TH ST STE 1600 INDIANAPOLIS IN 46202 PHARMACY METHODIST RETAIL PHARMACY 1801 N SENATE BLVD STE 105 INDIANAPOLIS IN 46202 PHARMACY NORTH RETAIL PHARMACY 11700 N MERIDIAN ST STE B106 CARMEL IN 46032 PHARMACY RILEY RETAIL PHARMACY 705 RILEY HOSPITAL DR ROC 1201 INDIANAPOLIS IN 46202 PHARMACY SAXONY RETAIL PHARMACY 13100 E 136TH ST STE 1000 FISHERS IN 46037 PHARMACY UNIVERSITY RETAIL PHARMACY 550 N UNIVERSITY BLVD INDIANAPOLIS IN 46202 PHARMACY WEST RETAIL PHARMACY 1111 N RONALD REAGAN PKWY AVON IN 46123 PHARMACY IU HEALTH ARNETT HOME CARE 3900 MCCARTY LN STE 103 LAFAYETTE IN 47905 HOME HEALTH IU HEALTH ARNETT SLEEP APNEA EDUC CTR 3900 MCCARTY LN STE 102 LAFAYETTE IN 47905 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH BALL MEMORIAL HOME CARE 2300 W GILBERT ST MUNCIE IN 47303 HOME HEALTH IU HEALTH BEDFORD SLEEP APNEA EDUC CTR 1502 CLINIC DR BEDFORD IN 47421 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH HOME CARE 950 N MERIDIAN ST STE 700 INDIANAPOLIS IN 46204 HOME HEALTH IU HEALTH SLEEP APNEA EDUCATION CENTER 1411 W COUNTY LINE RD STE C GREENWOOD IN 46142 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH SLEEP APNEA EDUCATION CENTER 714 N SENATE AVE STE 110 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH TIPTON HOME CARE 202 S WEST ST TIPTON IN 46072 HOME HEALTH SLEEP APNEA EDUCATION CENTER AT SAXONY 13100 E 136TH ST STE 3200B FISHERS IN 46037 DIAGNOSTIC AND OTHER OUTPATIENT SLEEP APNEA EDUCATION CENTER AT WEST 1115 N RONALD REAGAN PKWY STE 3 AVON IN 46123 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH BALL MEMORIAL HOSPICE 2401 W UNIVERSITY BLVD MUNCIE IN 47303 HOSPICE IU HEALTH HOSPICE 1828 N ILLINOIS ST INDIANAPOLIS IN 46202 HOSPICE IU HEALTH HOSPICE 950 N MERIDIAN ST STE 700 INDIANAPOLIS IN 46204 HOSPICE IU HEALTH MORGAN 2209 JOHN R WOODEN DR MARTINSVILLE IN 46151 DIAGNOSTIC AND OTHER OUTPATIENT PULMONARY REHAB METHODIST MEDICAL TOWER 1633 N CAPITAL AVE STE 102 INDIANAPOLIS IN 46202 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH HOME DIALYSIS 83303 N MERIDIAN ST STE 150 INDIANAPOLIS IN 46260 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH PT & RADIOLOGY AT ARTISTRY 404 E WASHINGTON ST STE B INDIANAPOLIS IN 46204 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH EAST WASHINGTON AMBUL SURGERY 9660 E WASHINGTON ST STE 200 INDIANAPOLIS IN 46229 AMBULATORY SURGERY IU HEALTH MULTI-SPECIALITY SURGERY CTR 10601 N MERIDIAN ST SUITE 250 INDIANAPOLIS IN 46290 AMBULATORY SURGERY IU HEALTH SPRING MILL SURGERY CENTER 10300 N ILLINOIS ST SUITES 1300 INDIANAPOLIS IN 46290 AMBULATORY SURGERY IU HEALTH RADIOLOGY 151 Pennsylvania Pkwy Suite 160 INDIANAPOLIS IN 46280 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH HIP & KNEE CENTER 13000 E 136TH ST STE 2000 FISHERS IN 46037 AMBULATORY SURGERY AND DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH PHYSICIANS CARDIOVASCULAR SURG 1801 N SENATE BLVD STE 3300 INDIANAPOLIS IN 46202 AMBULATORY SURGERY IU HEALTH PHYSICIANS GENERAL SURGERY 1801 N SENATE BLVD STE 635 INDIANAPOLIS IN 46202 AMBULATORY SURGERY Schedule H, Part IV, Line 1(a) Name of Entity Beltway Surgery Centers, LLC Schedule H, Part IV, Line 2(a) Name of Entity SENATE STREET SURGERY CENTER, LLC Schedule H, Part IV, Line 3(a) Name of Entity INDIANA ENDOSCOPY CENTERS, LLC Schedule H, Part IV, Line 4(a) Name of Entity ROC SURGERY, LLC Schedule H, Part IV, Line 5(a) Name of Entity BALL OUTPATIENT SURGERY CENTER, LLC Schedule H, Part I, Line 3c Other Factors Used in Determining Elig. IU Health uses several factors other than Federal Poverty Guidelines ("FPG") in determining eligibility for free care under its FAP. These factors include the following: 1. Indiana Residency Requirement Financial Assistance will only be made available to residents of the State of Indiana and those eligible for assistance under 42 U.S.C.A. 1396b(v). IU Health will employ the same residency test as set forth in Indiana Code 6-3-1-12 to define an Indiana resident. The term Resident includes any individual who was domiciled in Indiana during the taxable year, or any individual who maintains a permanent place of residence in Indiana and spends more than one hundred eight-three (183) days of the taxable year in Indiana. Patients residing in the state of Indiana while attending an institution of higher education may be eligible for assistance under the FAP if they meet the aforementioned residency test and are not claimed as a dependent on a parent's or guardian's federal income tax statement. 2. IU Health's Individual Solutions Department Prior to seeking Financial Assistance under the FAP, all patients or their guarantors must consult with a member of IU Health's Individual Solutions department to determine if healthcare coverage may be obtained from a government insurance/assistance product or from the Health Insurance Exchange Marketplace. 3. Uninsured Patients All Uninsured Patients presenting for services at IU Health 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's Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowner's, must exhaust all insurance benefits prior to receiving an award from IU Health's Financial Assistance Program. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. Patients may be asked to show proof that such a claim was properly submitted to the proper insurance provider at the request of IU Health. Eligible patients who receive medical care from IU Health 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 is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health reserves the right to reverse the award in an amount equal to the amount IU Health would be entitled to receive had no Financial Assistance been awarded. 6. Alternate Methods of Eligibility Determination IU Health will conduct a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an ECA. Said accounts may be eligible for assistance under the FAP based on the patient's individual scoring criteria. To ensure all patients potentially eligible for Financial Assistance under the FAP may receive Financial Assistance, IU Health will deem patients/guarantors to be presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied his/her required co-pay/deductible: - Indiana Children's Special Health Care Services - Medicaid - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level 7. Additional Considerations Financial Assistance may be granted to a deceased patient's account if said patient is found to have no estate. Additionally, IU Health 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 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 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 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 will 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's Emergency Department, via transfer from another hospital facility, or direct admission, will be responsible for a one-hundred dollar ($100.00) non-refundable deposit for services rendered. Patients/guarantors will be responsible for any copays and/or deductibles required by their plan prior to full Financial Assistance being applied. Uninsured Patients wishing to make an application for Financial Assistance greater than the AGB must fulfill their non-refundable deposit prior to IU Health 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 7, Column (c) Total Community Benefit Expense Schedule H, Part I, Line 7, Column (f), Percent of Total Expense, is based on column (e) Net Community Benefit Expense. The percent of total expense based on column (c) Total Community Benefit Expense, which excludes direct offsetting revenue, is 34.07%. Schedule H, Part I, Line 7, Column (f) Percent of Total Expense The amount of bad debt expense subtracted for purposes of calculating the percentage of total expense on Line 7, column (f) is $114,075,911. This amount includes the bad debt expense reported on Form 990, Part IX, Line 25, column (A), and IU Health's portion of the bad debt attributable to the joint ventures reported on Schedule H, Part IV. Bad debt expense is reported at cost based on the cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. Schedule H, Part I, Line 7g Subsidized Health Services IU Health does not include any costs associated with physician clinics as subsidized health services. Schedule H, Part II - Promotion of Health in Communities Served IU Health and its related hospital entities across the State of Indiana ("IU Health Statewide System") participate in a variety of community-building activities that address the health and wellness of residents in the communities it serves through investments in 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. IU Health makes contributions to community-building activities by providing investments and resources to local partners in the community. Several examples include IU Health's support of the following organizations and initiatives that focus on community health needs, as well as the conditions and barriers that impact health, including access to healthcare, behavioral health and substance abuse, community revitalization and nutrition and healthy weight: . Connect2Help211 . Gennesaret Free Clinics . IU Student Outreach Clinic . Martin Center Sickle Cell Initiative . Raphael Health Center . Coburn Place Safe Haven II, Inc. . Family Promise . Goodwill Education Initiatives, Inc. . LifeSmart Youth, Inc. . NAMI Indiana, Inc. . Groundwork Indy . Habitat for Humanity . Kennedy King Memorial Initiative . Big Green Indianapolis . Brandywine Creek Farms . Gleaners Food Bank of Indiana . IPS Education Foundation, Inc. . Jump IN for Healthy Kids . Playworks Education Energized To take service outside the walls of our facilities, Indiana University Health created IU Health Serves, a team member volunteer program, to positively impact the health of the community and foster a culture of engagement and social responsibility. In 2018, more than 2,848 IU Health team members dedicated more than 9,694 volunteer hours in their communities. IU Health also sponsors and promotes IU Health Days of Service, which are high-impact events aimed at engaging IU Health team members in activities that address identified community outreach priorities. Each year, more than 2,000 IU Health team members volunteer during Days of Service. Schedule H, Part III, Line 2 Bad Debt Expense Methodology The amount reported on line 2 as bad debt is reported at cost, as calculated using the cost to charge ratio methodology. Schedule H, Part III, Line 3 - Bad Debt Attributable to Patients Eligible Under the Financial Assistance Policy An uninsured patient and/or guarantor who was admitted through an eligible facility's emergency department via a direct admission from a physician's office, or transfer from another hospital facility, and whose household income is less than or equal to 200% of the Federal Poverty Level may be eligible for full charity assistance after the successful completion of the Financial Assistance Application and satisfaction of his/her non-refundable deposit. To capture all patients who are potentially eligible for Financial Assistance under the IU Health Financial Assistance Policy, IU Health will deem patients/guarantors to be presumptively eligible for financial assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied the required co-pay/deductible: 1. Indiana Children's Special Health Care Services 2. Medicaid 3. Healthy Indiana Plan 4. Patients who are awarded Hospital Presumptive Eligibility 5. Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level (FPL). IU Health also conducts a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an extraordinary collection actions. Said accounts may be eligible for assistance under the financial assistance policy based on the patient's individual scoring criteria and are not included in bad debt. Due to this comprehensive methodology, IU Health does not believe any amount of bad debt is attributable to patients who may be eligible under the Financial Assistance Policy and no portion of bad debt is included as community benefit. Schedule H, Part III, Line 4 - Bad Debt Expense IU Health's consolidated financial statements, Footnote 4, addresses bad debt expense as follows: The Indiana University Health System does not require collateral or other security from its patients, substantially all of whom are residents of the State, for the delivery of health care services. However, consistent with industry practice, the Indiana University Health System routinely obtains assignment of (or is otherwise entitled to receive) patients' benefits payable under their health insurance programs, plans or policies (e.g., Medicare, Medicaid, managed care payers, and commercial insurance policies. The Indiana University Health System uses a portfolio approach to account for categories of patient contracts as a collective group, rather than recognizing revenue on an individual contract basis. The portfolios consist of major payer classes for inpatient revenue and outpatient revenue. Based on the historical collection trends and other analysis, the Indiana University Health System believes that revenue recognized by utilizing the portfolio approach approximates the revenue that would have been recognized if an individual contract approach were used. In support of its mission, the Indiana University Health System provides care to uninsured and underinsured patients. The Indiana University Health System provides charity care to patients who lack financial resources and are deemed to be medically indigent. Under its financial assistance policy, the Indiana University Health System provides medically necessary care to uninsured patients with inadequate financial resources at charitable discounts equivalent to the amounts generally billed, and it provides eligibility for full charity for emergent encounters for uninsured patients who earn less than 200% of the federal poverty level and who meet application criteria. Patients whose liability is deemed catastrophic relative to their annual household income are also eligible for reduced charges. Since the Indiana University Health System does not pursue collection of these amounts, the discounted amounts are not reported as patient service revenue. The Indiana University Health System uses presumptive eligibility screening procedures for free care and recognizes net patient service revenue on services provided to self-pay patients at the discounted rate at the time services are rendered. The estimated cost of charity care, using the consolidated cost to charge ratio, was $94,886,000 and $85,295,000 in 2018 and 2017, respectively. Schedule H, Part III, Line 8 Medicare Surplus or (Shortfall) The amount reported on Schedule H, Part III, Line 6 is calculated, in accordance with the Form 990 instructions, using "allowable costs" from the IU Health Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health's participation in Medicare programs. For example, the Medicare Cost Report excludes certain costs such as billed physician services, the costs of Medicare Parts C and D, fee schedule reimbursed services, and durable medical equipment services. Inclusion of all costs associated with IU Health's participation in Medicare programs would significantly increase the Medicare shortfall reported on Schedule H, Part III, Line 7. IU Health'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 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 Policy IU Health's FAP and Written Debt Collection Policy describe the collection practices applicable to patients, including those who may qualify for financial assistance. 1. Financial Assistance Application 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 application's deficiency upon discovery by IU health. The application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health will suspend any ECA until the application is complete, or the patient fails to cure any deficiencies in their application in the allotted period. Patients will limited English proficiency may request to have a copy of the FAP, a FAP Application, and FAP Plain Language Summary in one of the below languages: - Arabic - Burmese - Burmese-Falam - Burmese-Hakha Chin - Mandarin/Chinese - Spanish The patient, and/or their representative, such as the patient's physician, family members, legal counsel, community or religious groups, social services or hospital personnel may request a FAP Application to be mailed to a patient's primary mailing address free of charge. IU Health keeps all applications and supporting documentation confidential. Patients applying for assistance under the FAP will be required to complete a Financial Assistance Application. Patients must include the following documentation with their Financial Assistance Application: - All sources of Income for the last three (3) months; - Most recent three (3) months of pay stubs or Supplemental Security Income via Social Security; - Most recent three (3) statements from checking and savings accounts, certificates of deposit, stocks, bonds and money market accounts; - Most recent state and Federal Income Tax forms including schedules C, D, E, and F. In the event a patient's and/or guarantor's income does not warrant the filing of a federal tax statement, the patient may submit a notarized affidavit attesting to the foregoing; - Most recent W-2 statement; - For patients or members of the Household who are currently unemployed, Wage Inquiry from WorkOne; and - If applicable, divorce/dissolution decrees and child custody order 2. Eligibility Determination IU Health will inform patients or guarantors of the results of their application by providing the patient or guarantor with a Financial Assistance Determination within ninety (90) days of receiving a completed Application and all requested documentation. If a patient or guarantor is granted less than full charity assistance and the patient or guarantor provides additional information for reconsideration, IU Health Revenue Cycle Services may amend a prior Financial Assistance Determination. If a patient or guarantor seeks to appeal the Financial Assistance Determination further, a written request must be submitted, along with the supporting documentation, to the Financial Assistance Committee for additional review/reconsideration. All decisions of the Financial Assistance Committee are final. A patient's Financial Assistance Application and eligibility determination are specific to each individual date(s) of service and related encounters. 3. Extraordinary Collection Actions IU Health may refer delinquent patient accounts to a third-party collection agency after utilizing reasonable efforts to determine a patient's eligibility for assistance under the FAP. IU Health and its third-party collection agencies may initiate ECA against a patient or their guarantor in accordance with this Policy and 26 C.F.R. 1.501(r). Said ECA may include the following: - Selling a patient's or their guarantor's outstanding financial responsibility to a third party. - Reporting adverse information about the patient or their guarantor to consumer credit reporting agencies or credit bureaus. - Deferring or denying, or requiring a payment before providing, medically necessary care because of a patient's or their guarantor's nonpayment of one or more bills for previously provided care covered under the FAP. - Actions requiring a legal or judicial process, including but not limited to placing a lien on patient's or their guarantor's property, foreclosing on a patient's or their guarantor's real property attaching or seizing a patient's or their guarantor's bank account or other personal property, commencing a civil action against a patient or their guarantor, causing a patient or guarantor's arrest, causing a patient and/or guarantor to be subject to a writ of body attachment, and garnishing a patient or guarantor's wages. When it is necessary to engage in such action, IU Health 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 in excess of their patient responsibility will be alerted to the overpayment as promptly after discovery as is reasonable given the nature of the overpayment. Patients with an outstanding account balance on a separate account not eligible for assistance under the FAP will have their refund applied to the outstanding balance. Patients without an outstanding account balance described above will be issued a refund check for their overpayment as soon as technically feasible. Schedule H, Part VI, Line 2 Needs Assessment Communities are multifaceted and so are their health needs. IU Health 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 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 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. Schedule H, Part VI, Line 3 Patient Education of Eligibility for Assist. IU Health 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 has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health 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 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 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 will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health will educate its patient facing team members of the FAP and the process for referring patients to the Program. Schedule H, Part VI, Line 4 Community Information IU Health serves a large geographic area in Central Indiana. In completing CHNAs for its IU Health Academic Health Center and IU Health Saxony Hospital locations, IU Health defined "community" as the county of residence for each hospital location. Each individual hospital location serves a unique subsection of the community for which details are included below: IU Health Academic Health Center The community for IU Health Academic Health Center's primary service area is defined as Marion County, the community where IU Health Academic Health Center is located. The secondary service area is comprised of all other counties within the State of Indiana. Marion County includes zip codes within the towns of Beech Grove, Indianapolis, Lawrence, Southport, and Speedway, plus portions of Plainfield, which extends into Hendricks County. Based on the Census Bureau data estimates for 2018, Marion County's population was 954,670 and 51.8% were female. The county's population estimates by race are 54.8% White non-Hispanic, 28.9% Black non-Hispanic, 10.6% Hispanic or Latino, 3.6% Asian, 0.5% American Indian or Alaska native, and 2.9% persons reporting two or more races. A very small percentage of the population is ethnic groups other than those listed above. IU Health Saxony Hospital The community for IU Health Saxony Hospital's primary service area is defined as Hamilton County, the county where IU Health Saxony Hospital is located, plus Marion County. The secondary service area is comprised of nine contiguous counties consisting of Boone, Clinton, Hancock, Hendricks, Johnson, Madison, Morgan, Shelby and Tipton Counties. Approximately 51% of inpatient discharges originate from the primary service area. Hamilton County includes ZIP codes within the towns of Arcadia, Atlanta, Carmel, Cicero, Fishers, Noblesville, Sheridan, and Westfield. Based on Census Bureau estimates for 2018, Hamilton County's population was 330,086. Just over half (51.1%) were female and 48.9% were male. The county's population estimates by race are 83.4% White non-Hispanic, 4.4% Black, 4.1% Hispanic or Latino, 6.2% Asian, 0.2% American Indian or Alaska Native, and 2.1% two or more races. A very small percentage of the population is ethnic groups other than those listed above. Schedule H, Part VI, Line 5 Promotion of Community Health A majority of IU Health's board of directors is comprised of independent community members who reside in IU Health's primary service areas. IU Health extends medical privileges to all physicians who meet the credentialing qualifications necessary for appointment to its medical staff. IU Health does not deny appointment on the basis of gender, race, creed, or national origin. 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. IU Health's five year strategic planning process was renewed during 2014 resulting in mission-critical focusing and re-focusing of investments, both people and financial resources, to fund improvements in patient care, medical education, and research. One of the most crucial elements in that process was the statement of IU Health's Value Proposition: IU Health will be a leader in: - Managing the health of populations it serves, leveraging all aspects of its tripartite mission; - Providing care for patients with complex illnesses, while serving as a destination referral center in select areas. - IU Health will compete on excellence and innovation to drive outcomes and value. This proposition advances IU Health's Mission Statement and recognizes core values that are crucial to its historic and current identity. IU Health is already seeing new and sustained initiatives based upon this statement. Schedule H, Part VI, Line 6 Affiliated Health Care System Indiana University Health is Indiana's most comprehensive health system. With hospitals, physician offices and allied services, IU Health provides access to a full range of specialty and primary care services for adults and children. A unique partnership with Indiana University School of Medicine-one of the nation's leading medical schools-gives patients access to groundbreaking research and innovative treatments to complement high-quality care. National Recognition - Eight hospitals designated as Magnet by the American Nurses Credentialing Center recognizing excellence in nursing care. - Indiana University Health Medical Center is honored to be nationally ranked by U.S. News & World Report for the 21st year in a row. That means IU Health continues to be ranked among the best healthcare systems in the nation and the top healthcare system in Indiana. This ranking recognizes the exceptional care, unmatched expertise and continued excellence of our entire team of caregivers, while giving it patients confidence that they made the right choice in trusting IU Health with their care. - IU Health Medical Center was among the 4 percent of U.S. hospitals to earn a national ranking and has the most nationally ranked specialties in Indiana. - Nine out of ten specialty programs at Riley Hospital for Children at IU Health ranked among the top 50 children's hospitals in the nation. 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 2012, Indiana University Health committed to support ratably for a five-year period ended December 31, 2016, certain basic, clinical, and translational research programs (Strategic Research Initiative) of the School of Medicine. The total commitment aggregated $75,000. In 2017, a new five-year term of $55,000 was agreed upon effective July 1, 2017 through June 30, 2022. For the years ended December 31, 2018 and 2017, the Indiana University Health System expensed $11,000 and $5,000, respectively, under these agreements within supplies, drugs, purchased services, and other expenses in the accompanying consolidated statements of operations and changes in net assets, of which $25,652 and $32,875 was accrued related to these agreements within accounts payable and accrued expenses at December 31, 2018 and 2017, respectively. 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 top status of "comprehensive," which would recognize it as one of the top-tier cancer centers in the nation. - Neuroscience: The neurosciences research program will tackle a broad range of brain injuries, neurodegenerative disorders and neurodevelopmental disorders. - Cardiovascular: The cardiovascular research initiative will develop 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 will provide patients with access to internationally renowned physicians and to new therapies developed through translational research and clinical trials, and will make use of the latest genetic tools to develop personalized therapies that are more effective for individuals and efficient for healthcare providers. IU Health Statewide System IU Health is a part of the IU Health Statewide System which continues to broaden its reach and positive impact throughout the state of Indiana. IU Health is Indiana's most comprehensive academic health center and consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health, and IU Health Saxony Hospital. Other hospitals in the IU Health Statewide System include the following: - IU Health Arnett Hospital - IU Health Ball Memorial Hospital - IU Health Bedford Hospital - IU Health Blackford Hospital - IU Health Bloomington Hospital - IU Health Frankfort Hospital - IU Health Jay Hospital - IU Health North Hospital - IU Health Paoli Hospital - IU Health Tipton Hospital - IU Health West Hospital - IU Health White Memorial Hospital Although each hospital in the IU Health Statewide System prepares and submits its own community benefits plan relative to the local community, the IU Health Statewide System considers its community benefit plan as part of an overall vision for strengthening Indiana's overall health. A comprehensive community outreach strategy and community benefit plan is in place that encompasses the academic medical center downtown Indianapolis, suburban Indianapolis and statewide entities around priority areas that focus on health improvement efforts statewide. IU Health is keenly aware of the positive impact it can have on the communities of need in the state of Indiana by focusing on the most pressing needs in a systematic and strategic way. In 2018, IU Health provided more than $771 million in total community benefit and served more than one million individuals. Some ways we address our community health priorities as a system include: IU Health Day of Service The annual IU Health Days of Service is a high-impact event aimed at engaging IU Health team members in activities that address an identified community priority. Each year, more than 2,000 IU Health team members volunteer 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 2018, IU Health impacted many people statewide through 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. The Indiana University Health Board of Directors also approved Community Health Improvement Grants. With these grants, nearly $750,000 will fund projects that address IU Health priorities-behavioral health/substance abuse, obesity, tobacco use, and infant mortality-as well as community-specific needs. The grants, administered by the Indiana University Health Foundation, were awarded to the following: - Family Vitality Initiative development and implementation, IU Health South Central Region, $230,000 over two years. By bringing together existing healthcare providers, social workers and researchers, this integrated program will take a holistic approach to addressing substance-related healthcare issues, especially among the most vulnerable populations of women and children. The South Central Region has seen alarming increases in the numbers of infants who test positive for opiates at birth, opioid-related encounters in each emergency department, and mothers struggling with addiction including smoking. - Hope Healthcare Services Program, IU Health West, $203,000 over two years. Hope Healthcare Services in Avon is the only entity in Hendricks County that provides primary medical and dental care to uninsured patients. It is staffed entirely by volunteer clinicians, many of them IU Health team members, and helps more than 900 patients a year out of nearly 15,000 uninsured adults in Hendricks County. This grant will fund the clinic's first-ever employee, a nurse practitioner, allowing for consistent operating hours, and behavioral health services on-site and via tele-health. With this staffed clinic, they anticipate seeing more than 4,000 patients per year. - Perinatal Coordinator to address infant mortality, IU Health East Central Region, $124,000 over two years. This grant funds a new staff member who will focus on infants and children in Delaware, Blackford and Jay counties. This includes facilitating inter-professional collaboration, educating hospital staff, increasing collaboration with supporting agencies involved with bereavement, safe sleep, tobacco-free and addiction programs, and tracking outcomes in the areas of birthweight, birth defects and mortality. - Continuum of Mental Health Care Program, IU Health West Central Region, $85,247 for one year. In terms of mental illness and access to mental health care, Indiana ranks 48th out of 51 states. In its pilot year, this project will increase capacity to provide screening, support and counseling in Clinton, Tippecanoe and White counties by partnering w Schedule H, Part VI, Line 7 - State Filing of Community Benefit Report IN true INDIANA UNIVERSITY SCHOOL OF MEDICINE 714 N SENATE AVE INDIANAPOLIS IN 46202 356001673 GOV'T ENTITY 11000000 RESEARCH/TRAINING HEALTHNET INC 3401 RAYMOND ST INDIANAPOLIS IN 46203 351579827 501(C)(3) 2135828 GENERAL SUPPORT IU HEALTH FOUNDATION INC 1800 N CAPITOL AVE INDIANAPOLIS IN 46202 356043086 501(C)(3) 683554 SPIRITUAL VALUES FD. UNITED WAY OF CENTRAL INDIANA INC PO BOX 88409 INDIANAPOLIS IN 46208 351007590 501(C)(3) 50000 GENERAL SUPPORT PLAYWORKS EDUCATION ENERGIZED 380 WASHINGTON ST OAKLAND CA 94607 943251867 501(C)(3) 18500 COMMUNITY BENEFIT GLEANERS FOOD BANK OF INDIANA INC 3737 WALDEMERE AVE INDIANAPOLIS IN 46241 351483868 501(C)(3) 95000 COMMUNITY BENEFIT CICP FOUNDATION INC 111 MONUMENT CIRCLE INDIANAPOLIS IN 46204 352065457 501(C)(3) 35000 BIOCROSSROADS JUNIOR ACHIEVEMENT OF CENTRAL INDIANA INC 9449 PRIORITY WAY INDIANAPOLIS IN 46240 351003695 501(C)(3) 30000 COMMUNITY BENEFIT HABITAT FOR HUMANITY OF GREATER INDPLS 3135 N MERIDIAN ST INDIANAPOLIS IN 46208 351715910 501(C)(3) 116500 COMMUNITY BENEFIT INDIANAPOLIS PUBLIC SCHOOLS EDUCATION FND 120 E WALNUT ST INDIANAPOLIS IN 46204 311103966 501(C)(3) 35000 COMMUNITY BENEFIT CITY OF FISHERS 1 MUNICIPAL DR FISHERS IN 46038 000000000 GOV'T ENTITY 33036 EMS SERVICES SOCIAL HEALTH ASSOCIATION OF INDIANA INC 615 N Alabama St Indianapolis IN 46204 350869056 501(c)(3) 50000 Bullying Prevention GENNESARET FREE CLINIC INC 615 N Alabama St Indianapolis IN 46204 351776518 501(c)(3) 30000 Health Access GOODWILL OF CENTRAL AND SOUTHERN INDIANA 1635 W Michigan St Indianapolis IN 46222 350893506 501(c)(3) 98000 General Support INDIANA STATE DEPARTMENT OF HEALTH 2 N Meridian St Indianapolis IN 46204 000000000 GOV'T ENTITY 190179 Community Benefit STATE OF INDIANA 200 W Washington St Indianapolis IN 46204 000000000 GOV'T ENTITY 8000 Community Benefit INDIANA UNIVERSITY STUDENT OUTREACH CLINIC 714 N Senate Ave Indianapolis IN 46202 356001673 GOV'T ENTITY 30000 Health Access CENTER FOR AT-RISK ELDERS 120 E Market St 1190 Indianapolis IN 46204 452980122 501(c)(3) 101200 General Support CONNECT2HELP 3833 N Meridian St 302 Indianapolis IN 46208 311216792 501(c)(3) 125000 General Support RAPHAEL HEALTH CENTER INC 401 E 34th St Indianapolis IN 46205 351948768 501(c)(3) 50000 Community Benefit CENTRAL INDIANA COMMUNITY FOUNDATION 615 N Alabama St 119 Indianapolis IN 46204 351793680 501(c)(3) 55900 Community Benefit BRANDYWINE CREEK FARM 5332 N 400 E Greenfield IN 46140 000000000 501(c)(3) 30000 General Support NAMI INDIANA INC PO Box 22697 Indianapolis IN 46222 351640701 501(c)(3) 30000 Community Benefit FAMILY PROMISE OF GREATER INDIANAPOLIS INC PO Box 441367 Indianapolis IN 46244 351909912 501(c)(3) 25000 Community Benefit INDIANA PUBLIC HEALTH ASSOCIATION 615 N Alabama St 426 Indianapolis IN 46204 237092694 501(c)(3) 20000 Community Benefit KENNEDY KING MEMORIAL 850 Ft Wayne Ave Indianapolis IN 46204 465752825 501(c)(3) 15000 Community Benefit BIG GREEN 1637 Pearl St STE 201 Boulder CO 80302 275083595 501(c)(3) 10000 General Support BOYS AND GIRLS CLUBS OF INDIANPOLIS INC 3909 N Meridian St 100 Indianapolis IN 46208 350888754 501(c)(3) 6000 Community Benefit INNOVATIONS FOR LEARNING 649 Michigan Ave Evanston IL 60202 363873652 501(c)(3) 6000 General Support 29 0 SEE PART IV 1 100000 Schedule I, Part I, Line 2 - Org.'s Proc. for Mon. the Use of Grant Funds Although IU Health does not monitor the use of grant funds once distributed, through due diligence the organization has reasonably confirmed that the entities to which the contributions are made are highly reputable in the community and use the funds for the purposes intended. SCHEDULE I, PART III, LINE 1 - GRANTS AND OTHER ASSISTANCE TO INDIVIDUALS THE AMOUNT REPORTED ON SCHEDULE I, PART III, LINE 1 REPRESENTS FUNDS PROVIDED BY IU HEALTH TO IU SCHOOL OF MEDICINE TO SUPPORT A MANAGEMENT POSITION. X true true X X X X true true false false false false false true false DENNIS M MURPHY DIRECTOR/PRESIDENT & CEO 1466991 0 839573 0 30573 0 311270 0 23755 0 2672162 0 0 0 LARRY H STEVENS MD DIRECTOR 46750 529100 0 68098 0 3564 0 17125 0 1400 46750 619287 0 0 RYAN C KITCHELL TREASURER/EVP & CAO 958723 0 851710 0 21252 0 214270 0 23675 0 2069630 0 0 0 MARY BETH CLAUS SECRETARY/SVP & GEN. COUNSEL 530649 0 241932 0 27355 0 102435 0 7874 0 910245 0 0 0 ALFONSO W GATMAITAN EVP & COO (PART YEAR) 853829 0 504450 0 1700526 0 1012983 0 24850 0 4096638 0 703392 0 MICHELLE A JANNEY RN EVP & CNE 502367 0 371179 0 143482 0 121065 0 5899 0 1143992 0 99750 0 JONATHAN E GOTTLIEB MD EVP & CME 747392 0 472727 0 197008 0 13700 0 7640 0 1438467 0 0 0 RYAN D NAGY MD PRESIDENT/CMO (AAHC) 0 575786 0 281247 0 1769 0 120971 0 276 0 980049 0 0 MATTHEW R COOK PRESIDENT (RILEY) 552048 0 133189 0 22316 0 115178 0 22905 0 845636 0 0 0 JONATHAN R GOBLE PRESIDENT (NCR)(PART YEAR) 202192 0 123785 0 1381631 0 244995 0 10967 0 1963570 0 489016 0 RONALD L STIVER PRESIDENT (SCS) 477117 0 308392 0 21404 0 101812 0 30878 0 939603 0 0 0 JENNIFER M ALVEY TREASURER / SVP & CFO 582446 0 287162 0 2904 0 118123 0 28584 0 1019219 0 0 0 MARK A LANTZY SVP & CIO/PRES. (HEALTH PLANS) 516838 0 247506 0 24596 0 103702 0 26812 0 919454 0 0 0 DANIEL F EVANS JR PRESIDENT EMERITUS 232502 0 0 0 36974 0 12854 0 14525 0 296855 0 0 0 DONALD E CLAYTON MD FORMER PRESIDENT (WCR) 180015 80759 39387 17670 85172 38210 8016 3596 11213 5031 323803 145266 0 0 RICHARD D CHADDERTON FORMER SVP, MKTG & STRATEGY 0 0 0 0 104170 0 0 0 8475 0 112645 0 104170 0 MICHAEL E HALEY VP, BEHAVIORAL HEALTH 529660 0 41543 0 123905 0 13700 0 29148 0 737956 0 0 0 MATTHEW D BAILEY PRESIDENT (SCR)(PART YEAR) 287416 0 158544 0 1047262 0 322129 0 7138 0 1822489 0 343365 0 ERIC S WILLIAMS MD FORMER EVP, ACAD. & MED. AFF. 0 179635 0 37500 0 9062 0 5375 0 13804 0 245376 0 0 PAUL R HAUT MD VP-COO/FMR INT. PRES. (RILEY) 0 333856 0 87157 0 2322 0 11918 0 0 0 435253 0 0 MICHAEL L HARLOWE PRESIDENT (TIPTON) 0 252976 0 12920 0 1242 0 8447 0 23549 0 299134 0 0 DAWN M MOORE VP & CHIEF PHARMACY OFFICER 261540 0 59447 0 540 0 13834 0 20564 0 355925 0 0 0 ELIZABETH L PAXTON RN FORMER VP & CNO (RILEY) 11601 0 0 0 148197 0 3079 0 4023 0 166900 0 0 0 KEVIN R ARMSTRONG EVP & CHIEF OF STAFF 361432 0 150603 0 5986 0 89038 0 16924 0 623983 0 0 0 JAMES T PARKER SVP / PRES MDWISE (PART YEAR) 8717 0 305962 0 969788 0 11768 0 0 0 1296235 0 343012 0 PARVEEN CHAND COO, AHC ADULT HOSPITALS 401983 0 66112 0 19742 0 11000 0 25365 0 524202 0 0 0 JOHN F FITZGERALD MD SVP, POPULATION HEALTH 238975 107565 240975 108466 86571 38966 89536 40301 472 213 656529 295511 108662 0 ELIZABETH DUNLAP SVP, CHIEF HR OFFICER 500462 0 242162 0 24596 0 11000 0 23402 0 801622 0 0 0 Schedule J, Part I, Line 1a Listed Benefits Tax gross-ups were provided to certain individuals listed on IU Health's Form 990, Part VII, Section A. The tax gross-ups were treated as taxable compensation. Schedule J, Part I, Line 4a Severance Alfonso W. Gatmaitan entered into a severance agreement with IU Health during 2018. Severance of $17,530 that was received during 2018 is included in column b(iii), other reportable compensation. Deferred severance of $999,283 included in column C, retirement and other deferred compensation. James T. Parker entered into a severance agreement with IU Health during 2017. Severance of $472,318 that was received during 2018 is included in column b(iii), other reportable compensation. Deferred severance of $10,460 is included in column C, retirement and other deferred compensation. Jonathan R. Goble entered into a severance agreement with IU Health during 2018. Severance of $308,158 that was received during 2018 is included in column b(iii), other reportable compensation. Deferred severance of $231,294 is included in column C, retirement and other deferred compensation. Matthew D. Bailey entered into a severance agreement with IU Health during 2018. Severance of $198,986 that was received during 2018 is included in column b(iii), other reportable compensation. Deferred severance of $308,429 is included in column C, retirement and other deferred compensation. Richard D. Chadderton entered into a severance agreement with IU Health during 2017. Severance of $104,170 that was received during 2018 is included in column b(iii), other reportable compensation. Deferred severance of $104,618 was disclosed in 2017 in column C, retirement and other deferred compensation. Schedule J, Part I, Line 4b Supplemental Nonqualified Retirement Plan Dennis M. Murphy, Ryan C. Kitchell, Mary Beth Claus, Alfonso W. Gatmaitan, Michelle A. Janney, R.N., Jonathan E. Gottlieb, M.D., Matthew R. Cook, Jonathan E. Goble, Ronald L. Stiver, Jennifer M. Alvey, Mark A. Lantzy, Donald E. Clayton, M.D., Michael E. Haley, Matthew D. Bailey, Kevin R. Armstrong, Ryan D. Nagy, M.D., Elizabeth Dunlap and John F. Fitzgerald, M.D. participate in a 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, the benefit may be forfeited or reduced. Each of the executives listed above, with the exception of Matthew D. Bailey, Alfonso W. Gatmaitan, Michael E. Haley, James T. Parker, Donald E. Clayton, M.D., Jonathan E. Gottlieb, M.D., and Jonathan R. Goble have an amount included in column c, deferred compensation, representing the current year unvested contributions made under the supplemental executive retirement plan. These amounts were not paid to the 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: - Matthew D. Bailey ($789,115) - Alfonso W. Gatmaitan ($1,654,573) - Michael E. Haley ($96,662) - James T. Parker ($445,169) - Donald E. Clayton, M.D. ($34,539) - Jonathan E. Gottlieb, M.D. ($162,836) - John F. Fitzgerald, M.D. ($116,473) - Jonathan R. Goble ($1,009,769) - Michelle A. Janney, R.N. ($109,177) Schedule J, Part I, Line 7 Non-Fixed Payments Amounts disclosed in Column B(ii) include a long-term and short-term incentive for certain executives and short-term incentive for other employees. Although these plans are based on a fixed formula that has been approved by the Board of Directors based upon certain qualitative and quantitative factors and goals, all discretionary incentive plans must be approved by the Committee on Personnel and Compensation and Board of Directors prior to any incentive payout. A INDIANA FINANCE AUTHORITY 351602316 45471AEB4 2011-04-19 228195000 SERIES 2011A, B, C, D, AND E BONDS false false false B INDIANA FINANCE AUTHORITY 351602316 000000000 2017-10-12 125270000 SERIES 2011H AND I BONDS false false false C INDIANA FINANCE AUTHORITY 351602316 45471AEN8 2016-05-05 107790000 SERIES 2011L AND M BONDS false false false D INDIANA FINANCE AUTHORITY 351602316 45471AFX5 2011-12-07 221617127 SERIES 2011N BONDS true false false A 64150000 0 228203281 0 0 0 740000 0 0 70008281 157455000 0 2012 true false true true B 5810000 0 125270000 0 0 0 0 0 0 0 125270000 0 2017 true false true true C 0 0 107790000 0 0 0 0 0 0 0 107790000 0 2016 true false true true D 103770000 60500000 221624068 0 0 0 2148553 0 0 24728315 194747200 0 2013 true false true true A false true true true true true 0.00000 0.00000 0.00000 false false false true B false true true true true true 0.00000 0.00000 0.00000 false false false true C false true true true true true 0.00000 0.00000 0.00000 false false false true D false true true true true true 0.00000 0.00000 0.00000 false false false true A false false true false true false 0 false 0 false true B false false true false true false 0 false 0 false true C false false true false true false 0 false 0 false true D false false false true false false 0 false 0 false true A true B true C true D true Schedule K, Page 1a, Part I, Line A, Column (f) - Description of Purpose The Series 2011A, B, C, D, and E Bonds were issued to provide funding for the new construction of buildings and structures and the purchase of equipment. Additionally, the Bonds were issued in order to refund the Series 2008A, C, and D Bonds and pay off a taxable line of credit that refunded the Series 2008B Bonds. The Series 2008A, B, C, and D Bonds were issued on September 11, 2008. A portion of the proceeds of the Series 2011N Bonds was used to refund a portion of the Series 2011E Bonds in the amount of $21,500,000 on December 7, 2011. Schedule K, Page 1a, Part I, Line B, Column (f) - Description of Purpose The Series 2011H and I Bonds were issued in order to refund the Series 2005A, B, C, and D Bonds. The Series 2005A, B, C, and D Bonds were issued on November 15, 2005. On August 25, 2014, through the Indiana Finance Authority, IU Health reissued its Series 2011H and I bonds. The transaction was accounted for as a modification of debt. As part of the reissuance, the rate calculation methodology for each was amended resulting in a reduction to the rate applicable to each; the principal payment schedule was amended; and the bank purchase period was extended to November of 2017. As part of the reissuance, the Series 2011H and I Bonds were treated as being currently refunded on August 25, 2014. The original Series 2011H and I Bonds were issued on May 5, 2011. A 2017 reissuance of the Indiana Finance Authority Hospital Revenue Bonds, Series 2011H and 2011I occurred on October 12, 2017, and was treated as a current refunding of such bonds. Schedule K, Page 1a, Part I, Line C, Column (f) - Description of Purpose The Series 2011L and M Bonds were issued on May 25, 2011 in order to provide funding for the new construction of buildings and structures and the purchase of equipment. A 2016 reissuance of the Indiana Finance Authority Hospital Revenue Bonds, Series 2011L and 2011M occurred on May 5, 2016, and was treated as a current refunding of such bonds. Schedule K, Page 1a, Part I, Line D, Column (f) - Description of Purpose The Series 2011N Bonds were issued in order to refund the Series 2011E bonds issued on April 19, 2011, refund the 2011F and G Bonds issued on May 5, 2011, and to pay off a portion of a taxable line of credit, which was used to provide funding for the purchase of equipment. Additionally, the Series 2011N Bonds were used to pay down a taxable line of credit used to purchase the Series 2006 Bonds of Indiana University Health Ball Memorial Hospital, Inc., a related 501(c)(3) tax-exempt organization, which were issued on May 31, 2006; to refinance a taxable line of credit used to refund the Series 2006 Bonds of Indiana University Health White Memorial Hospital, Inc., a related 501(c)(3) tax-exempt organization, which were issued on October 26, 2006; and to refund the Series 1998B Bonds of Indiana University Health Bloomington Hospital, Inc., a related 501(c)(3) organization, which were issued on November 17, 1999. Schedule K, Page 2b, Part I, Line A, Column (f) - Description of Purpose The Series 2014A Bonds were issued in order to advance refund the Series 2006 and Series 2009A Bonds of Indiana University Health Ball Memorial Hospital, Inc., a related 501(c)(3) tax-exempt organization, and to pay certain expenses related to the issuance. The Series 2006 and Series 2009A Bonds were issued on May 31, 2006 and December 8, 2009, respectively. The total proceeds of the issue exceeds the issue price due to investment earnings. Schedule K, Page 2b, Part I, Line B, Column (f) - Description of Purpose The Series 2015A Bonds were issued in order to advance refund the Series 2006A Bonds as well as Taxable Bonds, Series 2011J and K, and a taxable bank loan. The Series 2006B Bonds were issued on January 24, 2006. The Series 2011J and K Bonds were issued on May 5, 2011. The total proceeds of the issue exceeds the issue price due to investment earnings. Schedule K, Page 2b, Part I, Line C, Column (f) - Description of Purpose The Series 2015B and C Bonds were issued in order to advance refund the Series 2006A Bonds. The Series 2006A Bonds were issued on January 24, 2006. The total proceeds of the issue exceeds the issue price due to investment earnings. The total proceeds of the issue exceeds the issue price due to investment earnings. Schedule K, Page 2b, Part I, Line D, Column (f) - Description of Purpose The Series 2016A, B, and C Bonds were issued in order to refund a portion of the Series 2006B Bonds. The Series 2006B Bonds were issued on September 14, 2006. Schedule K, Page 1a & 1b, Part II, Line 3 - Total Proceeds of Issue Total proceeds of issue disclosed on Part II, Line 3 are sometimes higher than the issue price disclosed in Part I due to the investment earnings on the bond proceeds: Schedule K, Page 1a, Column A, Series 2011A, B, C, D, and E Bonds: Issue Price: $228,195,000 Earnings: $8,281 Total Proceeds: $228,203,281 Schedule K, Page 1a, Column D, Series 2011N Bonds: Issue Price: $221,624,068 Earnings: $6,941 Total Proceeds: $221,624,068 Schedule K, Page 1B, Column A, Series 2014A Bonds: Issue Price: $80,777,895 Earnings: $1,566,784 Total Proceeds: $82,344,679 Schedule K, Page 1B, Column B, Series 2015A Bonds: Issue Price: $314,416,912 Earnings: $216,402 Total Proceeds: $314,633,314 Schedule K, Page 1B, Column C, Series 2015B and C Bonds: Issue Price: $193,675,000 Earnings: $271,909 Total Proceeds: $193,946,909 Issue Price: $193,675,000 Earnings: $271,909 Total Proceeds: $193,946,909 Schedule K, Page 2a & 2b, Part III, Lines 4, 5, and 6 - P.B.U. Percentages IU Health generally only finances a portion of each project with tax-exempt bonds. Funds other than tax-exempt bonds are sufficient to cover the amount of any private business use. Schedule K, Page 2a & 2b, Part IV, Line 2 - Date of Rebate Calculation Page 2a, Column D: Series 2011N Bonds: May 2016 Page 2b, Column A: Series 2104A Bonds: March 2016 Page 2b, Column B: Series 2015A Bonds: May 2016 Page 2b, Column C: Series 2015 B and C Bonds: July 2016 A INDIANA FINANCE AUTHORITY 351602316 45471ANR9 2014-10-14 80777895 SERIES 2014A BONDS false false false B INDIANA FINANCE AUTHORITY 351602316 45471ANY4 2015-05-07 314416912 SERIES 2015A BONDS false false false C INDIANA FINANCE AUTHORITY 351602316 000000000 2015-05-07 193675000 SERIES 2015B AND C BONDS false false false D INDIANA FINANCE AUTHORITY 351602316 45471APJ5 2016-02-18 290611029 SERIES 2016A, B, AND C BONDS false false false A 17760000 0 82344679 0 0 0 793499 0 0 0 81551179 0 2014 false true true true B 0 0 314633314 0 0 0 2122523 0 0 0 312510791 0 2015 false true true true C 50000000 0 193946909 0 0 0 171759 0 0 0 193775150 0 2015 false true true true D 16770000 0 290611029 0 0 0 1641061 0 0 0 288969968 0 2016 true false true true A false true true true true true 0.00000 0.00000 0.00000 false false false true B false true true true true true 0.00000 0.00000 0.00000 false false false true C false true true true true true 0.00000 0.00000 0.00000 false false false true D false true true true true true 0.00000 0.00000 0.00000 false false false true A false false false true false false 0 false 0 false true B false false false true false false 0 false 0 false true C false false false true true false 0 false 0 false true D false false true false true false 0 false 0 false true A true B true C true D true NANCY GATMAITAN SPOUSE OF IUH, INC. FORMER KEY EMPLOYEE, ALFONSO GATMAITAN 14917 COMPENSATION FOR SERVICES false JILAINE STEVENS SPOUSE OF IUH, INC. DIRECTOR, LARRY STEVENS 45760 COMPENSATION FOR SERVICES false VALERIE OMICIOLI SPOUSE OF IUH, INC. KEY EMPLOYEE JONATHAN GOTTLIEB 115000 COMPENSATION FOR SERVICES false Part VI, Section A, Line 2 Family or Business Relationships Certain officers, directors or key employees of Indiana University Health, Inc. (IU Health) also serve on the boards or as officers of related or unrelated for-profit organizations, as noted below. No additional compensation was provided to these individuals for their service to related organizations. Related for-profit organization: IUH Assurance SPC, Ltd. Type of relationship: Business Directors: Jennifer Alvey, Alfonso Gatmaitan, Michelle Janney, Mary Beth Claus, Ronald Stiver Related for-profit organization: IU Health Risk Retention Group, Inc. Type of relationship: Business Director or Officer: Jennifer Alvey, John Fitzgerald, M.D., Michelle Janney, Ronald Stiver Related for-profit organization: CHV Capital, Inc. and Subsidiaries Type of relationship: Business Director or Officer: Jennifer Alvey, Jonathan Gottlieb, M.D. Alfonso Gatmaitan Related for-profit organization: IU Health Plans, Inc. Type of relationship: Business Director or Officer: John Fitzgerald, M.D., Ryan Kitchell, Mark Lantzy, Alfonso Gatmaitan Related for-profit organization: IU Health ACO, Inc. Type of relationship: Business Director or Officer: Jennifer Alvey, John Fitzgerald, M.D., Ronald Stiver, Jonathan Gottlieb, M.D. Unrelated organization: American United Mutual Life Insurance Holding Company Type of relationship: Business Director or Officer: J. Scott Davison, Michael McRobbie Part VI, Section A, Line 6, 7a and 7b Members or Stockholders Line 6: There shall be two classes of members of the Corporation. One class, known as the University Class, shall consist of those persons serving from time to time as the Trustees of Indiana University. The other class, known as the Methodist Class, shall consist of the Members of the Methodist Health Group, Inc. Line 7a: Except as otherwise provided in the Articles or Bylaws, each class of Members shall be entitled to one (1) vote upon each question which properly comes before a meeting of the Members. Unless otherwise specified by law or the Trustees of Indiana University, the vote of the University Class shall be determined by a majority vote of the constituents of the University Class who are present at a meeting at which a quorum is present and a quorum shall consist of a majority of the constituents of the University Class. The vote of the Methodist Class shall be determined by a two-thirds (2/3) majority of the Members of the Methodist Health Group, Inc. or otherwise as set forth from time to time in the constituent instruments of the Methodist Health Group, Inc. Both member classes may take action without a meeting if a consent in writing setting forth the action so taken shall be approved by at least eighty (80) percent of the constituents of the respective member class or such greater percentage as that member class determines to be necessary for approval of an action without a meeting. With regard to the appointment of the Board of Directors of the Corporation, the directors, each of whom shall have one vote, will be selected as follows: (a) Eight (8) at-large directors shall be jointly elected by the affirmative vote of both member classes (the "At-Large Directors"). (b) Two (2) directors shall be appointed by the Methodist Class. (c) The President of Indiana University, the Dean of Indiana University School of Medicine (the "Dean"), and the Chair of the IU Board of Trustees or another IU Trustee designated by the Chair of the Board of Trustees, shall each be a standing director of the University Class, referred to collectively as "University Standing Directors". (d) The Bishop of the Indiana Area of the United Methodist Church (the "Bishop") shall be an ex officio director. If the Bishop determines that he/she is unable to serve as director for an upcoming year, the Bishop may name a designee to serve as a director by providing notification of such designee to the Corporation at or before the annual meeting of the Corporation. Directors named in (b) and (d) above are referred to collectively has "Methodist Standing Directors." (e) The President and Chief Executive Officer of the Corporation (the "President") shall be an ex officio director. No more than twenty percent (20%) of the directors shall be physicians who are providing professional services to the Corporation. Line 7b: Notwithstanding any other provisions of the Articles of Incorporation, the following matters require the approval of the University Class prior to implementation: (a) Any sale, lease, transfer or other alienation of the Indiana University Hospitals real property, as defined in the Definitive Agreement, including any assignment of the University Hospitals lease by and between the Trustees of Indiana University and the Corporation, except as otherwise authorized by resolution or agreement of the Trustees of Indiana University. (b) Any proposal by the Corporation which conflicts with the following principle: the Corporation will continue to make all patients available for medical education unless otherwise requested by the patient or his/her family, as the major clinical teaching resource for the Indiana University School of Medicine. (c) Any change in the formula used to calculate the amount of support provided to the Indiana University School of Medicine, as referenced in the Articles of Incorporation. (d) Any proposed action regarding the operation of Indiana University Hospitals, including the James Whitcomb Riley Hospital for Children, which would conflict with or be contrary to the requirements set forth in the Trustees Resolutions. (e) Any sale or other alienation of all or substantially all of the assets or operations of the Corporation, and any merger, consolidation, change of voting control or other reorganization of the Corporation. (f) Amendment, alteration or repeal of the Articles of Incorporation (g) Any dissolution of the Corporation, except as otherwise required by law. (h) Any revision to, or modification or revocation of the Core Values. (i) Any transfer of the membership of either of the member classes. (j) Any amendment to the Definitive Agreement. Notwithstanding any other provisions of the Articles of Incorporation, the following matters require the approval of the Methodist Class prior to implementation: (a) Any sale, lease, transfer or other alienation of the Methodist Hospital, Inc. ("MHI") Real Property, as defined in the Definitive Agreement, including any assignment of that certain MHI Lease by and between MHI and the Corporation, except as otherwise authorized by resolution or agreement of Methodist Health Group, Inc. (b) Any sale or other alienation of all or substantially all of the assets or operations of the Corporation, and any merger, consolidation, change of voting control, or other reorganization of the Corporation. (c) Amendment, alteration or repeal of the Articles of Incorporation. (d) Any dissolution of the Corporation, except as otherwise required by law. (e) Any revisions to, or modifications or revocation of the Core Values. (f) Any transfer of the membership of either of the member classes. (g) Any amendment to the Definitive Agreement. Part VI, Section A, Line 11b Review of Form 990 A thorough process was used by IU Health to review the Form 990 and related schedules prior to its filing. The Board of Directors' Committee on Values, Ethics, Social Responsibility, and Pastoral Services reviewed and approved the following section of the Form 990: 1. Schedule H - Hospitals The Board of Directors' Committee on Personnel and Compensation reviewed and approved the following sections of the Form 990: 1. Part VI - Governance, Management, and Disclosure 2. Part VII - Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors 3. Schedule J - Compensation Information The Board of Directors' Audit Committee was also provided with a complete copy of the Form 990 and related schedules to review. After the review and approval from the aforementioned individuals and committees, a complete copy of the Form 990 and related schedules was made available to each board member on a secure intranet site. Each member was also informed of the availability of the Tax Department to answer any questions. Part VI, Section B, Line 12c Conflict of Interest Policy 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 15 Process for Determining Compen. IU Health uses a thorough process to determine the compensation of its President and Chief Executive Officer, other officers, and key employees. The process includes the following: (1) The Board of Directors ("Board") has established a Committee on Personnel and Compensation ("Compensation Committee"), the purpose of which includes reviewing and making recommendations regarding executive compensation and benefits on an annual basis. The Compensation Committee 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 Compensation Committee reviews an executive's entire compensation package including base salary, short term and long term incentives, basic health and welfare benefits, qualified and nonqualified 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 Compensation Committee engages an independent compensation consulting firm on annual basis to conduct a compensation and benefits analysis for its executive group, which consists of employees at the level of senior vice president and above. The current compensation advisor is Sullivan Cotter & Associates, Inc. Sullivan Cotter & Associates, Inc. performs its analysis in the form of a compensation and benefits survey ("survey") that includes relevant comparability data for compensation and benefit 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. Sullivan Cotter & Associates, Inc. then prepares a survey report and provides recommendations to the Compensation Committee, if deemed appropriate, on changes in executive compensation and benefits. A separate analysis using the same methodology is done for the President and Chief Executive Officer. (3) The Compensation Committee then reviews Sullivan Cotter & Associates, Inc.'s report and recommendations and, if appropriate, votes on whether to recommend any changes in executive compensation and benefits to the Board. The Compensation Committee will only recommend changes to the Board if they are consistent with its philosophy on compensation matters and are deemed reasonable based upon the independent analysis provided by Sullivan Cotter & Associates, Inc. The Compensation Committee's review, discussion and vote are documented in the minutes for the meeting. There are no executives present during the final discussion and approval. (4) The Board then reviews the report prepared by Sullivan Cotter & Associates, Inc. as well as the recommendations of the Compensation Committee as to any changes in executive compensation and benefits. As deemed appropriate, the Committee on Finance may also provide its review of the Compensation Committee's recommendations on any changes in executive compensation and benefits. This review and discussion are documented in the minutes. (5) The Board then votes on whether to accept the Compensation Committee's recommendations on any changes in executive compensation and benefits. Changes in executive compensation and benefits are only made if approved by the Compensation Committee and Board on an annual basis. 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 and benefits 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 and benefits 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 Compensation Committee 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 and the compensation survey. The discussion and vote of the Compensation Committee 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 Compensation Committee and Audit Committee also review Form 990 disclosures related to executive compensation and benefits as well as the organization's practices and approval processes prior to the filing of the Form 990 return with the Internal Revenue Service. Part VI, Section C, Line 19 Public Disclosure IU Health's Articles of Incorporation are available for public inspection through the Indiana Secretary of State's website. IU Health's conflict of interest procedures are disclosed on Form 990, Schedule O. IU Health's Consolidated Audited Financial Statements are available for public inspection through its bond filings and as an attachment to the Form 990. PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS OR FUND BALANCES DURING 2018, IU HEALTH RECORDED THE FOLLOWING OTHER CHANGES IN NET ASSETS OR FUND BALANCES: EQUITY TRANSFER (SETTLEMENT OF DEBT/RESERVE): -298,368,628 EQUITY TRANSFERS (ADDITIONAL PAID-IN-CAPITAL): -5,359,611 INCOME/(LOSS) - RELATED 501(C)(3) ORGANIZATIONS: 4,548,186 MARK-TO-MARKET ON INTEREST RATE SWAPS: 1,315,340 CHANGE IN PENSION OBLIGATION: -111,087,386 IU HEALTH FOUNDATION - RESTRICTED INVESTMENTS: -3,032,417 OTHER: 24,737 TOTAL OTHER CHANGES IN NET ASSETS: -411,959,779 FORM 990 PART IX LINE 11G DESCRIPTION:SHARED SERVICES TOTAL FEES:XXX-XX-XXXX FORM 990 PART IX LINE 11G DESCRIPTION:INFORMATION SERVICES TOTAL FEES:28786763 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:43244078 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:12169447 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PROFESSIONAL FEES TOTAL FEES:15004564 FORM 990 PART IX LINE 11G DESCRIPTION:FEES - PHYSICIAN ADMIN TOTAL 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