STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

INDIANA UNIVERSITY HEALTH WEST HOSPITAL INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
INDIANA UNIVERSITY HEALTH WEST HOSPITAL INC (EIN 35-1814660)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-14
IRS object ID
201933189349314038
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-14T17:55:05-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 4000AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN351814660EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1INDIANA UNIVERSITY HEALTH WEST HOSPITALBusinessNameLine1Txt
Business Name Line2INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
In Care Of% CRAIG J JONESInCareOfNm
Business Name ControlINDIBusinessNameControlTxt
Phone3179634842PhoneNum

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCARA L BREIDSTERPersonNm
Person TitleCFOPersonTitleTxt
Phone3179634842PhoneNum
Signature2019-11-15SignatureDt

Preparer Person PreparerPersonGrp

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

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address162.1.129.128IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id35198520193185000022FederalOriginalSubmissionId
Federal Original Submission Id2019-11-14FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdE86E71EDF6F7DFE9336F32ED7F8459C58967F52AAtSubmissionCreationDeviceId
At Submission Filing Device IdEDBC7A9300E18FC3AE89303A319F5354A19FC7EFAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKENNETH D PUCKETTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1950 N MERIDIAN ST STE 300AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$248,086,495GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressSEE SCHEDULE OWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1990FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionImprove the health of our patients and community through innovation and excellence in care, education, research and service.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee1235TotalEmployeeCnt
Total Volunteers30TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$98,712NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$21,714PYContributionsGrantsAmt
CY Contributions Grants$259CYContributionsGrantsAmt
PY Program Service Revenue$223,750,030PYProgramServiceRevenueAmt
CY Program Service Revenue$239,113,407CYProgramServiceRevenueAmt
PY Investment Income$705,329PYInvestmentIncomeAmt
CY Investment Income$6,843,697CYInvestmentIncomeAmt
PY Other Revenue$1,690,889PYOtherRevenueAmt
CY Other Revenue$1,727,372CYOtherRevenueAmt
PY Total Revenue$226,167,962PYTotalRevenueAmt
CY Total Revenue$247,684,735CYTotalRevenueAmt
PY Grants And Similar Paid$22,500PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$20,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$58,695,019PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$61,297,448CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$116,255,481PYOtherExpensesAmt
CY Other Expenses$127,925,448CYOtherExpensesAmt
PY Total Expenses$174,973,000PYTotalExpensesAmt
CY Total Expenses$189,242,896CYTotalExpensesAmt
PY Revenues Less Expenses$51,194,962PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$58,441,839CYRevenuesLessExpensesAmt
Total Assets BOY$464,063,976TotalAssetsBOYAmt
Total Assets EOY$521,438,931TotalAssetsEOYAmt
Total Liabilities BOY$121,431,762TotalLiabilitiesBOYAmt
Total Liabilities EOY$120,515,303TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$342,632,214NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$400,923,628NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionIMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITY THROUGH INNOVATION AND EXCELLENCE IN CARE, EDUCATION, RESEARCH AND SERVICE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$155,483,010ExpenseAmt
Grant$20,000GrantAmt
Revenue$238,439,781RevenueAmt
DescIndiana University Health West Hospital, Inc. ("IU Health West Hospital") is 142-bed multidisciplinary healthcare facility located in Avon, IN. The hospital offers a full range of services, including maternity, orthopedics and cancer care. Built with a specific goal to meet the needs of our patients, families and visitors, IU Health West Hospital includes features designed to ensure privacy and create a quiet, soothing atmosphere in patient spaces. From all-private rooms and intimate, comfortable family waiting areas to separate corridors and elevators away from public spaces for staff and supply movement, IU Health West Hospital delivers on our goals to create a healing sanctuary for patients.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$291,419ExpenseAmt
Revenue$446,903RevenueAmt
DescIU Health West Hospital receives rent from a related exempt organization, Indiana University Health Care Associates ("IU Health Physicians"), for space in their Medical Office Building that's connected to the Hospital and the Ortho, Sport & Spine Center.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$147,842ExpenseAmt
Revenue$226,723RevenueAmt
DescIU Health West Hospital provides services to related tax-exempt organizations.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$155,922,271TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document70IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1235EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCRAIG J JONESPersonNm
Phone3179634842PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
MARSHA A STONE
CHAIRMAN5.00.0Yes (X)Yes (X)$4,500$0$0
MARK R BENSON DO
DIRECTOR5.00.0Yes (X)$4,500$0$0
REV KAREN E DEVAISHER
DIRECTOR5.00.0Yes (X)$4,500$0$0
CINDA L KELLEY
DIRECTOR5.00.0Yes (X)$3,750$0$0
MEGAN CRITTENDON MD
DIRECTOR5.050.0Yes (X)$0$358,965$24,636
Elizabeth Dunlap
Director5.050.0Yes (X)$0$767,220$34,402
Michelle A Janney
Director5.050.0Yes (X)$0$1,017,028$126,964
Jill McCrory
Director5.00.0Yes (X)$3,750$0$0
David A Ingram MD
Director5.050.0Yes (X)$0$539,320$111,083
KENNETH D PUCKETT
PRESIDENT - ISR10.045.0Yes (X)$0$525,684$97,308
DEREK E EMPIE
SECRETARY5.050.0Yes (X)$0$226,820$40,289
ARTHUR VASQUEZ
President/Treasurer55.00.0Yes (X)$0$268,019$41,667
CARA L BREIDSTER
CFO - ISR (PARTIAL YEAR)10.045.0Yes (X)$0$313,895$36,365
Harpreetinder Singh MD
VP & CMO (Partial Year)25.030.0$228,539$233,217$37,087Yes (X)
LISA A SPARKS RN
VP & CNO55.00.0$202,295$0$38,589Yes (X)
PAMELA CHAPMAN
DIRECTOR, OR SERVICES(Part Yr)55.00.0$15,830$143,812$38,588Yes (X)
JAMES R BILLMAN
PHARMACIST55.00.0$158,109$0$27,281Yes (X)
ANNE K STEGEMOLLER
DIRECTOR, PHARMACY55.00.0$165,473$0$36,471Yes (X)
LAURA A ROGGY
PHARMACIST55.00.0$154,699$0$25,963Yes (X)
Eric D Peak
Pharmacist, Senior55.00.0$153,744$0$14,921Yes (X)
Jamie L Conley-Lebeter
Mgr, Pharmacy Oprs55.00.0$143,536$0$30,052Yes (X)
JUDITH L COLEMAN
FORMER TREASURER0.055.0$0$297,648$33,403Yes (X)
MATTHEW D BAILEY
FORMER PRESIDENT0.055.0$0$1,493,222$329,267Yes (X)
GREGORY A SPURGIN MD
FOMER CMO0.055.0$0$301,623$21,425Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,243,225TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$6,486,473TotReportableCompRltdOrgAmt
Total Other Compensation$1,145,761TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K38IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ARAMARK HEALTHCARE MANAGEMENT SERVI
2300 WARRENVILLE RDDOWNERS GROVEIL60515FACILITIES$4,800,480
Cornerstone Medical Construction L
8902 N Meridian St Ste 205INDIANAPOLISIN46260Construction$1,398,748
MESSER CONSTRUCTION COMPANY
2445 N MERIDIAN STREETINDIANAPOLISIN46208CONSTRUCTION$815,775
Ermco Inc
1625 Thompson RdINDIANAPOLISIN46217Maintenance$973,199
MEDEFIS CONSOLIDATED
PO BOX 5068NEW YORKNY10087Staffing$802,141
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K17CntrctRcvdGreaterThan100KCnt
All Other Contributions$259AllOtherContributionsAmt
Total Contributions$259TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE622110$238,439,781$238,439,781
SHARED SERVICES541900$226,723$226,723
RENT FROM RELATED 501(C)(3) ORGS.532000$446,903$446,903
FieldValueIRS element (for citing)
Total Program Service Revenue$239,113,407TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,689,781TotalRevenueColumnAmt
Exclusion$6,689,781ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$377,705RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$401,760RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$24,055RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$24,055TotalRevenueColumnAmt
Exclusion-$24,055ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$153,916OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$153,916OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$153,916TotalRevenueColumnAmt
Exclusion$153,916ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Net Income From Gaming NetIncomeFromGamingGrp

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA/FOOD SERVICE721110$884,996$884,996
GIFT SHOP453220$304,750$304,750
TELEPHONE517000$102,785$102,785

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$458,896TotalRevenueColumnAmt
Exclusion$458,896ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,751,427OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$247,684,735TotalRevenueColumnAmt
Related Or Exempt Func Income$239,113,407RelatedOrExemptFuncIncomeAmt
Exclusion$8,571,069ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$20,000TotalAmt
Program Services$20,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$528,435TotalAmt
Program Services$491,638ProgramServicesAmt
Management And General$36,797ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$48,819,467TotalAmt
Program Services$45,419,985ProgramServicesAmt
Management And General$3,399,482ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,669,440TotalAmt
Program Services$1,553,191ProgramServicesAmt
Management And General$116,249ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,767,516TotalAmt
Program Services$6,296,269ProgramServicesAmt
Management And General$471,247ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,512,590TotalAmt
Program Services$3,267,995ProgramServicesAmt
Management And General$244,595ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$125,275TotalAmt
Management And General$125,275ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$10,230TotalAmt
Management And General$10,230ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$6,298TotalAmt
Management And General$6,298ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$50,211,885TotalAmt
Program Services$24,225,072ProgramServicesAmt
Management And General$25,986,813ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$400,936TotalAmt
Program Services$400,936ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$548,763TotalAmt
Program Services$427,294ProgramServicesAmt
Management And General$121,469ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$194,057TotalAmt
Program Services$186,217ProgramServicesAmt
Management And General$7,840ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,630,812TotalAmt
Program Services$3,329,319ProgramServicesAmt
Management And General$301,493ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$27,849TotalAmt
Program Services$18,299ProgramServicesAmt
Management And General$9,550ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$42,025TotalAmt
Program Services$4,783ProgramServicesAmt
Management And General$37,242ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$5,539,546TotalAmt
Program Services$5,539,546ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$7,869,586TotalAmt
Program Services$6,484,201ProgramServicesAmt
Management And General$1,385,385ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,244,835TotalAmt
Program Services$296,992ProgramServicesAmt
Management And General$947,843ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
DRUGS AND MEDICAL SUPPLIES$26,907,166$26,907,166
BAD DEBT$19,200,087$19,200,087
HOSPITAL ASSESSMENT FEE$10,863,905$10,863,905
INSTITUTIONAL DUES/LICENSES$90,703$90,703

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,011,490TotalAmt
Program Services$898,673ProgramServicesAmt
Management And General$112,817ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$189,242,896TotalAmt
Program Services$155,922,271ProgramServicesAmt
Management And General$33,320,625ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,750BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$338,891,877BOYAmt
EOY$391,044,274EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$31,939,139BOYAmt
EOY$30,077,475EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$781,984BOYAmt
EOY$792,506EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,521,470BOYAmt
EOY$1,420,805EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$832,880BOYAmt
EOY$761,440EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$195,362,763LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$98,020,332LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$90,091,876BOYAmt
EOY$97,342,431EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

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

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$464,063,976BOYAmt
EOY$521,438,931EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$14,509,341BOYAmt
EOY$15,072,181EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$255,666BOYAmt
EOY$131,478EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$106,666,755BOYAmt
EOY$105,311,644EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$121,431,762BOYAmt
EOY$120,515,303EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$342,612,401BOYAmt
EOY$400,923,628EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$19,813BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$342,632,214BOYAmt
EOY$400,923,628EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$464,063,976BOYAmt
EOY$521,438,931EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$58,441,839ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$150,425OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$6,298OtherActivitiesAmt
Total Lobbying Expenditures$6,298TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule C, Part II-B, Lines 1i - Other ActivitiesFormAndLineReferenceDesc
ExplanationIU Health West Hospital paid institutional membership dues to the American Hospital Association ("AHA") and Indiana Hospital Association ("IHA") during 2018 in the amount of $22,761 and $14,999, respectively. Each membership organization notified IU Health West Hospital that a portion of the dues it paid were used for lobbying purposes. The AHA used 22.98%, or $5,230 of 2018 membership dues paid by IU Health West Hospital, for lobbying expenditures. The IHA used 7.12%, or $1,068 of the 2018 membership dues paid by IU Health West Hospital, for lobbying expenditures. The total membership dues paid to these organizations by IU Health West Hospital during 2018 that were attributable to lobbying expenditures was $6,298.ExplanationTxt

Schedule D IRS990ScheduleD

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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$103,892,736OtherCostOrOtherBasisAmt
Depreciation$37,793,927DepreciationAmt
Book Value$66,098,809BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,188,609OtherCostOrOtherBasisAmt
Depreciation$626,525DepreciationAmt
Book Value$562,084BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$69,906,308OtherCostOrOtherBasisAmt
Depreciation$54,278,868DepreciationAmt
Book Value$15,627,440BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,375,110OtherCostOrOtherBasisAmt
Depreciation$5,321,012DepreciationAmt
Book Value$15,054,098BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$97,342,431TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
INTERCOMPANY PAYABLES (NET)$103,379,800
DUE TO THIRD-PARTY PAYERS$1,723,938
SELF-INSURANCE LIABILITIES$207,906
FieldValueIRS element (for citing)
Total Liability$105,311,644TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 - FIN 48 (ASC 740) FootnoteFormAndLineReferenceDesc
ExplanationIU Health West Hospital is a subsidiary in Indiana University Health, Inc.'s ("IU Health") Consolidated Audited Financial Statements. The Internal Revenue Service (IRS) has determined that IU Health and certain of its affiliated entities are tax-exempt organizations as defined in Section 501(c)(3) of the Internal Revenue Code (IRC). IU Health and its tax-exempt affiliates are, however, subject to federal and state income taxes on unrelated business income under the provision of IRC Section 511. THE TAX CUTS AND JOBS ACT (TCJA) WAS ENACTED ON DECEMBER 22, 2017. FOR TAX-EXEMPT ENTITIES, TCJA REQUIRES ORGANIZATIONS TO 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 AMOUNT 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 BOTH DECEMBER 31, 2018 AND 2017 WAS NECESSARY TO REDUCE THE DEFERRED TAX ASSETS TO THE AMOUNT THAT WOULD MORE LIKELY THAN NOT BE REALIZED. ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, 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 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 IU HEALTH ARE TAXABLE ENTITIES. THE TAX EXPENSE AND LIABILITIES OF THESE SUBSIDIARIES ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS.ExplanationTxt

Schedule H IRS990ScheduleH

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served4132PersonsServedCnt
Total Community Benefit Expns$3,749,657TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,749,657NetCommunityBenefitExpnsAmt
Total Expense0.02210TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served5819PersonsServedCnt
Total Community Benefit Expns$31,683,936TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$18,890,058DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,793,878NetCommunityBenefitExpnsAmt
Total Expense0.07520TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served9951PersonsServedCnt
Total Community Benefit Expns$35,433,593TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$18,890,058DirectOffsettingRevenueAmt
Net Community Benefit Expns$16,543,535NetCommunityBenefitExpnsAmt
Total Expense0.09730TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs6ActivitiesOrProgramsCnt
Persons Served4387PersonsServedCnt
Total Community Benefit Expns$1,541,330TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,541,330NetCommunityBenefitExpnsAmt
Total Expense0.00910TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served494PersonsServedCnt
Total Community Benefit Expns$234,043TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$234,043NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served5480PersonsServedCnt
Total Community Benefit Expns$133,887TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$133,887NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs10ActivitiesOrProgramsCnt
Persons Served10361PersonsServedCnt
Total Community Benefit Expns$1,909,260TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,909,260NetCommunityBenefitExpnsAmt
Total Expense0.01130TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs10ActivitiesOrProgramsCnt
Persons Served20312PersonsServedCnt
Total Community Benefit Expns$37,342,853TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$18,890,058DirectOffsettingRevenueAmt
Net Community Benefit Expns$18,452,795NetCommunityBenefitExpnsAmt
Total Expense0.10860TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served25PersonsServedCnt
Total Community Benefit Expns$15,500TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$15,500NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served25PersonsServedCnt
Total Community Benefit Expns$15,500TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$15,500NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$3,523,216BadDebtExpenseAmt
Reimbursed By Medicare$39,499,942ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$42,601,997CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$3,102,055MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1IU HEALTH WEST HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11111 N RONALD REAGAN PKWYAddressLine1Txt
CityAVONCityNm
State AbbreviationINStateAbbreviationCd
ZIP46123ZIPCd
FieldValueIRS element (for citing)
Website AddressSEE PART V, SECTION CWebsiteAddressTxt
State License19-003776-1StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1IU HEALTH WEST HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care0.FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section A, Line 1 Primary Website Addresshttps://iuhealth.org/find-locations/iu-health-west-hospital
Schedule H, Part V, Section B, Line 3e Prioritized Health NeedsIU HEALTH WEST HOSPITAL'S 2018 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT INCLUDES A PRIORITIZED DESCRIPTION OF SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY. THE CHNA REPORT IDENTIFIED THE FOLLOWING SEVEN NEEDS AS PRIORITIES FOR IU HEALTH WEST HOSPITAL: - Access to Health Care Services - Drug and Substance Abuse - Food Insecurity - Mental Health - Obesity and Diabetes - Smoking and Tobacco Usage - Social Determinants of Health
Schedule H, Part V, Section B, Line 5 Input from CommunityIn conducting its most recent Community Health Needs Assessment ("CHNA") IU Health West Hospital took into account input from persons who represent the broad interests of the communities it serves. Primary data were gathered in three different methodologies for this assessment: Community Meetings, Key Stakeholder Interviews, and a Community Survey. For purposes of this CHNA, IU Health West Hospitals community is defined as Hendricks and Marion Counties, Indiana. These two counties accounted for 87.8 percent of the hospitals inpatient cases in 2016. Community Meetings Hendricks County On July 24, 2018, a meeting of community representatives was held at the IU Health West Hospital in Avon, which is part of Hendricks County. The meeting was attended by 15 community members invited by IU Health because they represent important community organizations and sectors such as: local health departments, police/fire departments, non-profit organizations, business community, health care providers, local policymakers, faith-based organizations, and schools. Through this meeting, IU Health sought a breadth of perspectives on the communitys health needs. The specific organizations represented at the meeting are listed below. - American Lung Association - Avon Community School Corporation - Avon Washington Township Fire Department - Franciscan Alliance - HOPE Healthcare Services - Hendricks County Health Department - Hendricks County Senior Services - Hendricks County Substance Abuse Task Force - Hendricks County Tobacco Coalition - Hendricks Regional Health - IU Health West Hospital - Kids Count - Mental Health American Hendricks County - Susies Place The meeting was requested by IU Health to obtain community input into the communitys health needs. The session began with a presentation that discussed the goals and status of the CHNA process and the purpose of the community meeting. Then, secondary data were presented, along with a summary of the most "unfavorable" community health indicators. For Hendricks County those indicators were (in alphabetical order): - Access to healthy food - Air pollution - Crime (violent crime) - Excessive drinking - Mental health and supply of mental health providers - Obesity and lack of physical activity Participants then were asked to discuss whether the identified, unfavorable indicators accurately identified the most significant community health issues and were encouraged to add issues that they believed were significant. Several issues were added, such as: tobacco use, low income housing, access to affordable healthcare, adverse childhood events, and aging population. Air pollution was removed from the list, and the excessive drinking line item was amended to include substance abuse. During the meeting, a range of other topics was discussed, including: - Poverty rate numbers and relationship to 'ALICE' data - Immigrants in the community and representation in data - Western part of Hendricks County where food deserts are a bigger issue that didnt seem to come through in secondary data - Social associations data compared to abundance of churches and civic clubs in Hendricks County - Mental health services issues facing the sheriffs department/jail population - Low numbers of providers compared to the population and low number of providers who have spots available for Medicaid patients - Vaping - Trauma in childhood as a leading indicator of many of the adult issues discussed - Challenge of finding affordable housing After discussing the needs identified through secondary data and adding others to the list, each participant was asked to identify "three" that are most significant. From this process, the group identified the following needs as most significant in Hendricks County: - Mental health and supply of mental health providers - Access to affordable healthcare - Adverse childhood events - Tobacco use - Tied for fifth: Access to healthy food, excessive drinking & substance abuse, and aging population Interviews Hendricks County An interview was also conducted with a representative of the Hendricks county health department. The interview was 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, why such needs are present, and how they can be addressed. The interview was guided by a structured protocol. The interview was guided by a structured protocol that focused on opinions regarding significant community health needs, describing why such needs are present, and seeking ideas for how to address them. The interviewee confirmed that the needs identified by the community meeting participants were significant. These needs were: - Mental health and supply of mental health providers - Access to affordable healthcare - Adverse childhood events There is a lack of mental and behavioral health providers, including psychiatrists, substance abuse specialists, inpatient care, and others. It is often difficult to locate resources for those with substance abuse issues or suicidal ideations. In general, there is an undersupply of providers in the county, and more programs may be needed to incentivize providers to practice locally. Access to affordable care is an issue, especially with a recent closure of a facility that provided services for lower-income residents. Low income populations and those that do not receive healthcare benefits through their employers are disproportionately affected. The need for affordable primary care also generates a need for more preventive health care and screenings, as many residents do not go to a provider unless an emergency situation occurs. Substance abuse and drug addiction is a major concern, particularly around opioids. Availability of opioids is high and the cost of these drugs has decreased, leading to increased usage. Additionally, pill abuse is also rising as it is often easy to get a prescription for an opioid. Pain management treatment in general is difficult to access in the county. Obesity and physical inactivity are concerns in the community. Certain areas of the county do not live close to stores selling healthy foods, so often go to fast food instead. Additionally, sidewalks and other healthy-living infrastructure are in short supply. Obesity is also leading to chronic issues as the population ages, including bad knees, bad backs, diabetes, hypertension, and other conditions. Housing is a concern in the community, particularly affordable housing for low income residents. Current rental units can be unclean, and environmental health issues are common. More resources are needed for public health programming, as there are fewer low income clinics, staffing issues exist, and programs are not as widely disseminated as possible. 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 because they represent important community organizations and sectors such as: local health departments, police/fire departments, non-profit organizations, local business, health care providers, mayors/local policymakers, faith-based organizations, parks and recreation departments, and schools. Through the meetings, IU Health sought a breadth of perspectives on the communitys health needs. The specific organizations represented at the meetings are listed below. - Adult and Child Health - All Senior Citizens Connect - Central Indiana Council on Aging (CICOA) - City of Indianapolis - Coburn Place - Community Health Network - Gennesaret Free Clinics - Gleaners Food Bank - Health by Design - IU Health Methodist Hospital - IU Health University Hospital - Indiana Youth Institute - Indianapolis Fire Department - Indianapolis Metropolitan Police Department - Indy Hunger Network - Indianapolis Parks and Recreation - Irvington Development Organization - Jump IN for Healthy Kids - Lawrence Community Gardens - Marion County Public Health Department - New Beginnings Church - Paramount Schools of Excellence - Progress House - Purdue Extension - The Polis Center - University of Indianapolis The meeting began with a presentation that discussed the goals and status of the CHNA process and the purpose of the community meetings. Then, secondary data were presented, along with a summary of the most unfavorable community health indicators. For Marion County, those indicators were (in alphabetical order): - Air pollution - Communicable diseases and STDs - Crime - Mental health and supply of mental health providers - Obesity and lack of physical activity - Poverty and high 'Community Need Index' - Smoking and tobacco use Meeting participants then were asked to discuss whether the identified, unfavorable indicators accurately identified the most significant
Schedule H, Part V, Section B, Line 7a CHNA WebsiteA COPY OF IU HEALTH WEST HOSPITAL'S CHNA IS AVAILABLE ON ITS WEBSITE AT THE FOLLOWING URL: https://iuhealth.org/in-the-community
Schedule H, Part V, Section B, Line 10a Implementation Strategy WebsiteA COPY OF IU HEALTH WEST HOSPITAL'S CHNA IMPLEMENTATION STRATEGY IS AVAILABLE ON ITS WEBSITE AT THE FOLLOWING URL: https://iuhealth.org/in-the-community
Schedule H, Part V, Section B, Line 11 Addressing Identified NeedsIn conjunction with the CHNA, IU Health West Hospitals Board adopted an implementation strategy in April 2019 related to the 2018 CHNA. IU Health West Hospital prioritized and determined which of the community health needs identified in its most recently conducted CHNA were most critical for it to address. IU Health West Hospital will address the following community health needs between 2019 and 2021: - Access to Healthcare Services - Drug and Substance Abuse (including Opioids and Alcohol) - Food Insecurity - Mental Health - Obesity and Diabetes - Smoking and Tobacco Usage - Social Determinants of Health IU Health uses the term "Behavioral Health" to refer to Mental Health and Drug and Substance Abuse (including Opioids and Alcohol). Access to Healthcare IU Health West Hospitals implementation strategy to address the identified need of Access to Healthcare includes the following: - Provide operational funding to support HOPE Healthcare Services. - Participate in or support 4-6 Healthy Indiana Plan (HIP)/Medicaid/Medicare registration events with the Hendricks County Health Partnership. Behavioral Health (includes Drug & Substance Abuse and Mental Health) IU Health West Hospitals implementation strategy to address the identified need of Behavioral Health includes the following: - Partner with the Hendricks County Health Partnership to create a three-minute education video for student athletes. - Partner with the Hendricks County Health Partnership to create a three-minute education video for providers and parents. - Partner with the Hendricks County Health Partnership to host public forums about the stigma of substance use disorders. Include live testimonials from individuals with substance use disorders (SUD). - Provide funding to support safe shelter for and evaluation of Sheltering Wings residents. - Support Sheltering Wings educational outreach efforts. - Provide funding to support counseling for Susies Place clients. - Replicate the Academic Health Centers successful Addictions and Pain Management Program in the IU Health West service area. Provide 24/7 peer counseling via telemedicine for patients who present in the emergency department (ED) with substance use disorders (SUD). Food Insecurity IU Health West Hospitals implementation strategy to address the identified need of Food Insecurity includes the following: - Make fresh produce affordable and accessible to low-income residents. - Support Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP) acceptance at all county farmers markets. - Fund Double Up Bucks program to increase value of vouchers for participants. Obesity and Diabetes IU Health West Hospitals implementation strategy to address the identified need of Obesity and Diabetes include the following: - Continue current partnership with Brownsburg Farmers Market. - Utilize bushel builders cards to encourage regular attendance. - Provide 50 Hendricks County residents with a free 10-week program to improve their overall health through fitness and nutrition. - Provide three health screenings during the 10-week period to measure changes in cholesterol, triglycerides, glucose, A1C, blood pressure, weight and Body Mass Index (BMI). - Support state grant to fund ten mile section of trail expansion. - Fund a 5K event and offer prep/training tips to encourage new walkers and runners. - Partner with the Brownsburg Parks & Recreation to make improvements to local parks, thus encouraging greater physical activity in the parks by Hendricks County residents and visitors. Smoking and Tobacco Usage IU Health West Hospitals implementation strategy to address the identified need of Smoking and Tobacco Usage include the following: - Collaborate with the Hendricks County Health Partnership to present a template of a comprehensive smoke-free workplace policy to the Town of Brownsburg. - Collaborate with the Hendricks County Health Partnership to reinitiate contact with school administrators and guidance counselors to ensure educational posters are displayed in schools. - Write and distribute press release about student outreach program. - Encourage school administrators to send educational material to all parents. Social Determinants of Health IU Health West Hospitals implementation strategy to address the identified need of Social Determinants of Health include the following: - Provide operational funding to support HOPE Healthcare Services. - Make fresh produce affordable and accessible to low-income residents. - Support Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP) acceptance at all county farmers markets. - Fund Double Up Bucks program to increase value of vouchers for participants. - Support state grant to fund ten mile section of trail expansion. - Fund a 5K event and offer prep/training tips to encourage new walkers and runners. - Partner with the Brownsburg Parks & Recreation to make improvements to local parks, thus encouraging greater physical activity in the parks by Hendricks County residents and visitors. IU West Hospital will address all community health needs based on their 2018 Community Health Needs Assessment. There were no identified needs that will not be addressed.
Schedule H, Part V, Section B, Line 13b Income Level Other than FPGIN ADDITION TO FPG, IU HEALTH WEST HOSPITAL MAY TAKE INTO CONSIDERATION A PATIENT'S INCOME AND/OR ABILITY TO PAY IN CALCULATION OF A FINANCIAL ASSISTANCE AWARD.
Schedule H, Part V, Section B, Line 13h Other FAP FactorsIU Health West Hospital takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. IU Healths Individual Solutions Department Prior to seeking Financial Assistance under the FAP, all patients or their guarantors must consult with a member of IU Healths Individual Solutions department to determine if healthcare coverage may be obtained from a government insurance/assistance product or from the Health Insurance Exchange Marketplace. 2. Alternate Sources of Assistance When technically feasible, a patient will exhaust all other state and federal assistance programs prior to receiving an award from IU Health West Hospitals Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowners, must exhaust all insurance benefits prior to receiving an award from IU Health West Hospitals Financial Assistance Program. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. Patients may be asked to show proof that such a claim was properly submitted to the proper insurance provider at the request of IU Health West Hospital. Eligible patients who receive medical care from IU Health West Hospital as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award to which IU Health West Hospital is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health West Hospital reserves the right to reverse the award in an amount equal to the amount IU Health West Hospital would be entitled to receive had no Financial Assistance been awarded. 3. Alternate Methods of Eligibility Determination IU Health West Hospital will conduct a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an Extraordinary Collection Action ("ECA"). Said accounts may be eligible for assistance under the FAP based on the patients individual scoring criteria. To ensure all patients potentially eligible for Financial Assistance under the FAP may receive Financial Assistance, IU Health West Hospital will deem patients/guarantors to be presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied his/her required co-pay/deductible: - Indiana Childrens Special Health Care Services - Medicaid - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level 4. Additional Considerations Financial Assistance may be granted to a deceased patients account if said patient is found to have no estate. Additionally, IU Health West Hospital will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance application. 5. Non-Emergent Services Down Payment Uninsured Patients presenting for scheduled or other non-emergent services will not be charged more than the Amounts Generally Billed ("AGB") AGB for their services. Patients will receive an estimated AGB cost of their care prior to IU Health West Hospital rendering the services and will be asked to pay a down-payment percentage of the AGB adjusted cost prior to receiving services. In the event a patient is unable to fulfill the down-payment, their service may be rescheduled for a later date as medically prudent and in accordance with all applicable federal and state laws and/or regulations. 6. Emergency Services Non-Refundable Deposit This section will be implemented with a strict adherence to EMTALA and IU Health Policy ADM 1.32, Screening and Transfer of Emergency or Unstable Patients. Amount of Non-Refundable Deposit All Uninsured Patients presenting for services at IU Health West Hospitals Emergency Department, via transfer from another hospital facility, or direct admission, will be responsible for a one-hundred dollar ($100.00) non-refundable deposit for services rendered. Patients/guarantors will be responsible for any copays and/or deductibles required by their plan prior to full Financial Assistance being applied. Uninsured Patients wishing to make an application for Financial Assistance greater than the AGB must fulfill their non-refundable deposit prior to IU Health West Hospital processing said application. Uninsured Patients making payments toward their outstanding non-refundable deposit balance will have said payments applied to their oldest application on file, if applicable.
Schedule H, Part V, Section B, Line 16a FAP WebsiteA copy of IU Health West Hospitals FAP is available on the following website: https://iuhealth.org/pay-a-bill/financial-assistance
Schedule H, Part V, Section B, Line 16b FAP Application WebsiteA copy of IU Health West Hospitals FAP Application is available on the following website: https://iuhealth.org/pay-a-bill/financial-assistance
Schedule H, Part V, Section B, Line 16c FAP PLS WebsiteA plain language summary of the FAP, including translated copies, is available on the following website: https://iuhealth.org/pay-a-bill/financial-assistance
Schedule H, Part V, Section B, Line 16j Other Measures to PublicizeIU Health West Hospital takes several other measures to publicize its FAP within the community. These measures include the following: 1. Conspicuous public displays will be posted in appropriate acute care settings such as the emergency department and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 2. IU Health West Hospital will include a conspicuous written notice on all patient billing statements that notifies the patient about the availability of this Policy, and the telephone number of its Customer Service Department which can assist patients with any questions they may have regarding this Policy. 3. IU Health Customer Service representatives will be available via telephone Monday through Friday, excluding major holidays, from 8:00 a.m. to 7:00 p.m. Eastern Time to address questions related to this Policy. 4. IU Health West Hospital will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health West Hospital will educate its patient facing team members of the FAP and the process for referring patients to the Program.
FieldValueIRS element (for citing)
Facility4FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
IU HEALTH WEST CARDIACPULMONARY REHAB
1115 N RONALD REAGAN PKWY STE MAVONIN46123DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH WEST ORTHO SPORT & SPINE CTR
1115 N RONALD REAGAN PKWYAVONIN46123DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH WEST REHABILITATION SERVICES
1115 N RONALD REAGAN PKWY STE GAVONIN46123DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH WEST SLEEP DISORDERS CENTER
1115 N RONALD REAGAN PKWY STE 3AVONIN46123DIAGNOSTIC AND OTHER OUTPATIENT

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 3c - Other Factors Used in Determining Elig.IU Health West Hospital uses several factors other than Federal Poverty Guidelines ("FPGs") in determining eligibility for free care under its FAP. These factors include the following: 1. Indiana Residency Requirement Financial Assistance will only be made available to residents of the State of Indiana and those eligible for assistance under 42 U.S.C.A. 1396b(v). IU Health West Hospital will employ the same residency test as set forth in Indiana Code 6-3-1-12 to define an Indiana resident. The term Resident includes any individual who was domiciled in Indiana during the taxable year, or any individual who maintains a permanent place of residence in Indiana and spends more than one hundred eight-three (183) days of the taxable year in Indiana. Patients residing in the state of Indiana while attending an institution of higher education may be eligible for assistance under the FAP if they meet the aforementioned residency test and are not claimed as a dependent on a parents or guardians federal income tax return. 2. IU Healths Individual Solutions Department Prior to seeking Financial Assistance under the FAP, all patients or their guarantors must consult with a member of IU Healths Individual Solutions department to determine if healthcare coverage may be obtained from a government insurance/assistance product or from the Health Insurance Exchange Marketplace. 3. Uninsured Patients All Uninsured Patients presenting for services at IU health West Hospital eligible under the FAP will not be charged more than the AGB as described in the FAP. 4. Services Rendered by Individual Providers The FAP does not cover services rendered by individual providers. A full listing of providers and services not covered by the FAP is available at https://iuhealth.org/pay-a-bill/financial-assistance and is updated on a quarterly basis. 5. Alternate Sources of Assistance When technically feasible, a patient will exhaust all other state and federal assistance programs prior to receiving an award from IU Health West Hospitals Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowners, must exhaust all insurance benefits prior to receiving an award from IU Health West Hospitals Financial Assistance Program. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. Patients may be asked to show proof that such a claim was properly submitted to the proper insurance provider at the request of IU Health West Hospital. Eligible patients who receive medical care from IU Health West Hospital as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award to which IU Health West Hospital is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health West Hospital reserves the right to reverse the award in an amount equal to the amount IU Health West Hospital would be entitled to receive had no Financial Assistance been awarded. 6. Alternate Methods of Eligibility Determination IU Health West Hospital will conduct a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an ECA. Said accounts may be eligible for assistance under the FAP based on the patients individual scoring criteria. To ensure all patients potentially eligible for Financial Assistance under the FAP may receive Financial Assistance, IU Health West Hospital will deem patients/guarantors to be presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied his/her required co-pay/deductible: - Indiana Childrens Special Health Care Services - Medicaid - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level 7. Additional Considerations Financial Assistance may be granted to a deceased patients account if said patient is found to have no estate. Additionally, IU Health West Hospital will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance application. 8. Patient Assets IU Health West Hospital may consider patient/guarantor Assets in the calculation of a patient's true financial burden. A patient's/guarantor's primary residence and one (1) motor vehicle will be exempted from consideration in most cases. A patient's primary residence is defined as the patient's principal place of residence and will be excluded from a patient's extraordinary asset calculation so long as the patient's equity is less than five-hundred thousand dollars ($500,000) and the home is occupied by the patient/guarantor, patient's/guarantor's spouse or child under twenty-one (21) years of age. One (1) motor vehicle may be excluded as long as the patient's equity in the vehicle is less than fifty-thousand dollars ($50,000). IU Health West Hospital reserves the right to request a list of all property owned by the patient/guarantor and adjust a patient's award of Financial Assistance if the patient demonstrates a claim or clear title to any extraordinary Asset not excluded from consideration under the above guidance. 9. Non-Emergent Services Down Payment Uninsured Patients presenting for scheduled or other non-emergent services will not be charged more than the AGB for their services. Patients will receive an estimated AGB cost of their care prior to IU Health West Hospital rendering the services and will be asked to pay a down-payment percentage of the AGB adjusted cost prior to receiving services. In the event a patient is unable to fulfill the down-payment, their service may be rescheduled for a later date as medically prudent and in accordance with all applicable federal and state laws and/or regulations. 10. Emergency Services Non-Refundable Deposit This section will be implemented with a strict adherence to EMTALA and IU Health Policy ADM 1.32, Screening and Transfer of Emergency or Unstable Patients. Amount of Non-Refundable Deposit All Uninsured Patients presenting for services at IU Health West Hospitals Emergency Department, via transfer from another hospital facility, or direct admission, will be responsible for a one-hundred dollar ($100.00) non-refundable deposit for services rendered. Patients/guarantors will be responsible for any copays and/or deductibles required by their plan prior to full Financial Assistance being applied. Uninsured Patients wishing to make an application for Financial Assistance greater than the AGB must fulfill their non-refundable deposit prior to IU Health West Hospital processing said application. Uninsured Patients making payments toward their outstanding non-refundable deposit balance will have said payments applied to their oldest application on file, if applicable.
Schedule H, Part I, Line 6a - C.B. Report Prepared by a Related Org.IU Health West Hospital's community benefit and other investments, encompassing its total community investment, are included in the IU Health Community Benefit Report which is prepared on behalf of and includes IU Health and its related hospital entities in the State of Indiana. The IU Health Community Benefit Report is made available to the public on IU Healths website at https://iuhealth.org/in-the-community. The IU Health Community Benefit Report is also distributed to numerous key organizations throughout the State of Indiana in order to broadly share the IU Health Statewide Systems community benefit efforts. It is also available by request through the Indiana State Department of Health or IU Health.
Schedule H, Part I, Line 7, Column (f) - Bad Debt ExpenseThe amount of bad debt expense included on Form 990, Part IX, Line 25, column (A), but subtracted for purposes of calculating the percentage of total expense on Line 7, column (f) is $19,200,087. BAD DEBT EXPENSE IS REPORTED AT COST BASED ON THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.
Schedule H, Part I, Line 7 - Total Community Benefit ExpenseSchedule H, Part I, Line 7, Column (f), Percent of Total Expense, is based on column (e) Net Community Benefit Expense. The percent of total expense based on column (c) Total Community Benefit Expense, which does not include direct offsetting revenue, is 21.96%.
Schedule H, Part II - Promotion of Health in Communities ServedIU HEALTH PARTICIPATES IN A VARIETY OF COMMUNITY-BUILDING ACTIVITIES THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH IN THE COMMUNITIES IT SERVES. IU HEALTH AND ITS RELATED HOSPITAL ENTITIES ACROSS THE STATE OF INDIANA ("IU HEALTH STATEWIDE SYSTEM") INVEST IN ECONOMIC DEVELOPMENT EFFORTS ACROSS THE STATE, COLLABORATE WITH LIKE-MINDED ORGANIZATIONS THROUGH COALITIONS THAT ADDRESS KEY ISSUES, AND ADVOCATE FOR IMPROVEMENTS IN THE HEALTH STATUS OF VULNERABLE POPULATIONS. THIS INCLUDES MAKING CONTRIBUTIONS TO COMMUNITY-BUILDING ACTIVITIES BY PROVIDING INVESTMENTS AND RESOURCES TO LOCAL COMMUNITY INITIATIVES THAT ADDRESSED ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT AND WORKFORCE DEVELOPMENT. SEVERAL EXAMPLES INCLUDE IU HEALTH'S SUPPORT OF THE FOLLOWING ORGANIZATIONS AND INITIATIVES THAT FOCUS ON SOME OF THE ROOT CAUSES OF HEALTH ISSUES, SUCH AS LACK OF EDUCATION, EMPLOYMENT AND POVERTY: - Hope HEALTHCARE SERVICES - SHELTERING WINGS - AVON AND BROWNSBURG EDUCATION FOUNDATIONS - United Way ADDITIONALLY, THROUGH THE IU HEALTH STATEWIDE SYSTEM'S TEAM MEMBER COMMUNITY BENEFIT SERVICE PROGRAM, "IU HEALTH SERVES", TEAM MEMBERS ACROSS THE STATE MAKE A DIFFERENCE IN THE LIVES OF THOUSANDS OF HOOSIERS EVERY YEAR.
Schedule H, Part III, Line 2 - Methodology Used to Est. Bad Debt Exp.The bad debt expense of $3,523,216 reported on Schedule H, Part III, Line 2 is reported at cost, as calculated using the cost to charge ratio methodology. SCHEDULE H, PART III, LINE 3 - EST. BAD DEBT ATTR. TO PATIENTS UNDER FAP AN UNINSURED PATIENT AND/OR GUARANTOR WHO WAS ADMITTED THROUGH AN ELIGIBLE FACILITY'S EMERGENCY DEPARTMENT VIA A DIRECT ADMISSION FROM A PHYSICIAN'S OFFICE, OR TRANSFER FROM ANOTHER HOSPITAL FACILITY, AND WHOSE HOUSEHOLD INCOME IS LESS THAN OR EQUAL TO 200% OF THE FEDERAL POVERTY LEVEL MAY BE ELIGIBLE FOR FULL CHARITY ASSISTANCE AFTER THE SUCCESSFUL COMPLETION OF THE FINANCIAL ASSISTANCE APPLICATION AND SATISFACTION OF HIS/HER NON-REFUNDABLE DEPOSIT. TO CAPTURE ALL PATIENTS WHO ARE POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE IU HEALTH FINANCIAL ASSISTANCE POLICY, IU HEALTH WILL DEEM PATIENTS/GUARANTORS TO BE PRESUMPTIVELY ELIGIBLE FOR FINANCIAL ASSISTANCE IF THEY ARE FOUND TO BE ELIGIBLE FOR ONE OF THE FOLLOWING PROGRAMS, RECEIVED EMERGENCY OR DIRECT ADMIT CARE, AND SATISFIED THE REQUIRED CO-PAY/DEDUCTIBLE: 1. INDIANA CHILDREN'S SPECIAL HEALTH CARE SERVICES 2. MEDICAID 3. HEALTHY INDIANA PLAN 4. PATIENTS WHO ARE AWARDED HOSPITAL PRESUMPTIVE ELIGIBILITY 5. ENROLLED IN A STATE AND/OR FEDERAL PROGRAM THAT VERIFIES THE PATIENT'S GROSS HOUSEHOLD INCOME IS LESS THAN OR EQUAL TO 200% OF THE FEDERAL POVERTY LEVEL (FPL). IU HEALTH ALSO CONDUCTS A QUARTERLY REVIEW OF ALL ACCOUNTS PLACED WITH A COLLECTION AGENCY PARTNER FOR A PERIOD OF NO LESS THAN ONE HUNDRED AND TWENTY (120) DAYS AFTER THE ACCOUNT IS ELIGIBLE FOR AN EXTRAORDINARY COLLECTION ACTIONS. SAID ACCOUNTS MAY BE ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY BASED ON THE PATIENT'S INDIVIDUAL SCORING CRITERIA AND ARE NOT INCLUDED IN BAD DEBT. DUE TO THIS COMPREHENSIVE METHODOLOGY, IU HEALTH DOES NOT BELIEVE ANY AMOUNT OF BAD DEBT IS ATTRIBUTABLE TO PATIENTS WHO MAY BE ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY AND NO PORTION OF BAD DEBT IS INCLUDED AS COMMUNITY BENEFIT.
Schedule H, Part III, Line 4 - Bad Debt ExpenseIU 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 ShortfallThe amount reported on Schedule H, Part III, Line 6 is calculated, in accordance with the Form 990 instructions, using "allowable costs" from the IU Health West Hospital Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health West Hospitals participation in Medicare programs. For example, the Medicare Cost Report excludes certain costs such as billed physician services, the costs of Medicare Parts C and D, fee schedule reimbursed services, and durable medical equipment services. Inclusion of all costs associated with IU Health Wests participation in Medicare programs would significantly increase the Medicare shortfall reported on Schedule H, Part III, Line 7. IU Health West Hospital's Medicare shortfall is attributable to reimbursements that are less than the cost of providing patient care and services to Medicare beneficiaries and does not include any amounts that result from inefficiencies or poor management. IU Health West Hospital accepts all Medicare patients knowing that there may be shortfalls; therefore it has taken the position that any shortfall should be counted as part of its community benefit. Additionally, it is implied in Internal Revenue Service Revenue Ruling 69-545 that treating Medicare patients is a community benefit. Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with governmental health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community.
Schedule H, Part III, Line 9b - Written Debt Collection PolicyIU Health West Hospitals FAP and Written Debt Collection Policy describe the collection practices applicable to patients, including those who may qualify for financial assistance. 1. Financial Assistance Application Patients or their guarantors wishing to apply for Financial Assistance are encouraged to submit a Financial Assistance Application within ninety (90) days of their discharge. Patients or their guarantors may submit an application up to two-hundred and forty (240) days from the date of their first billing statement from IU Health, however, accounts may be subject to ECA as soon as one hundred and twenty (120) days after having received their first billing statement. Patients or their guarantors submitting an incomplete application will receive written notification of the applications deficiency upon discovery by IU health. The application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health will suspend any ECA until the application is complete, or the patient fails to cure any deficiencies in their application in the allotted period. Patients with limited English proficiency may request to have a copy of the FAP, a FAP Application, and FAP Plain Language Summary in one of the below languages: - Arabic - Burmese - Burmese-Falam - Burmese-Hakha Chin - Mandarin/Chinese - Spanish The patient, and/or their representative, such as the patients physician, family members, legal counsel, community or religious groups, social services or hospital personnel may request a FAP Application to be mailed to a patients primary mailing address free of charge. IU Health West Hospital keeps all applications and supporting documentation confidential. Patients applying for assistance under the FAP will be required to complete a Financial Assistance Application. Patients must include the following documentation with their Financial Assistance Application: - All sources of Income for the last three (3) months; - Most recent three (3) months of pay stubs or Supplemental Security Income via Social Security; - Most recent three (3) statements from checking and savings accounts, certificates of deposit, stocks, bonds and money market accounts; - Most recent state and Federal Income Tax forms including schedules C, D, E, and F. In the event a patients and/or guarantors income does not warrant the filing of a federal tax return, the patient may submit a notarized affidavit attesting to the foregoing; - Most recent W-2 statement; - For patients or members of the Household who are currently unemployed, Wage Inquiry from WorkOne; and - If applicable, divorce/dissolution decrees and child custody order 2. Eligibility Determination IU Health West Hospital will inform patients or guarantors of the results of their application by providing the patient or guarantor with a Financial Assistance Determination within ninety (90) days of receiving a completed Application and all requested documentation. If a patient or guarantor is granted less than full charity assistance and the patient or guarantor provides additional information for reconsideration, IU Health Revenue Cycle Services may amend a prior Financial Assistance Determination. If a patient or guarantor seeks to appeal the Financial Assistance Determination further, a written request must be submitted, along with the supporting documentation, to the Financial Assistance Committee for additional review/reconsideration. All decisions of the Financial Assistance Committee are final. A patients Financial Assistance Application and eligibility determination are specific to each individual date(s) of service and related encounters. 3. Extraordinary Collection Actions IU Health West Hospital may refer delinquent patient accounts to a third-party collection agency after utilizing reasonable efforts to determine a patients eligibility for assistance under the FAP. IU Health West Hospital and its third-party collection agencies may initiate ECA against a patient or their guarantor in accordance with this Policy and 26 C.F.R. 1.501(r). Said ECA may include the following: - Selling a patients or their guarantors outstanding financial responsibility to a third party. - Reporting adverse information about the patient or their guarantor to consumer credit reporting agencies or credit bureaus. - Deferring or denying, or requiring a payment before providing, medically necessary care because of a patients or their guarantors nonpayment of one or more bills for previously provided care covered under the FAP. - Actions requiring a legal or judicial process, including but not limited to placing a lien on patients or their guarantors property, foreclosing on a patients or their guarantors real property attaching or seizing a patients or their guarantors bank account or other personal property, commencing a civil action against a patient or their guarantor, causing a patient or guarantors arrest, causing a patient and/or guarantor to be subject to a writ of body attachment, and garnishing a patient or guarantors wages. When it is necessary to engage in such action, IU Health West Hospital and its third party collection agencies, will engage in fair, respectful and transparent collections activities. Patients or guarantors currently subject to an ECA who have not previously applied for Financial Assistance may apply for assistance up to two-hundred and forty (240) days of the date of their first billing statement from IU Health West Hospital. IU Health West Hospital and their third-party collection agencies will suspend any ECA engaged on a patient or their guarantor while an Application is being processed and considered. 4. Refunds Patients eligible for assistance under the FAP who remitted payment to IU Health West Hospital in excess of their patient responsibility will be alerted to the overpayment as promptly after discovery as is reasonable given the nature of the overpayment. Patients with an outstanding account balance on a separate account not eligible for assistance under the FAP will have their refund applied to the outstanding balance. Patients without an outstanding account balance described above will be issued a refund check for their overpayment as soon as technically feasible.
Schedule H, Part VI, Line 2 - Needs AssessmentCommunities are multifaceted and so are their health needs. IU Health West Hospital understands that the health of individuals and communities are shaped by various social and environmental factors, along with health behaviors and additional influences. IU Health West Hospital assesses the health care needs of the communities it serves by conducting a Community Health Needs Assessment (CHNA). For the 2018 CHNA, IU Health West Hospital 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 West Hospital reviewed secondary data, findings from other community health assessments of areas served by the hospital, input obtained from individuals who participated in community meetings, input obtained from key stakeholders, and a community survey to identify and analyze the needs identified by each source. The top health needs of the IU Health West Hospital community are those that are supported by multiple data sources. Additionally, the effectiveness of an intervention for each need and IU Healths ability to impact positive change was evaluated.
Schedule H, Part VI, Line 3 - Patient Education of Eligibility for Assist.IU Health West Hospital is committed to serving the healthcare needs of all of its patients regardless of their ability to pay for such services. To assist in meeting those needs, IU Health West Hospital has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health West Hospital is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health West Hospital will make a good faith effort to locate and obtain health insurance coverage for patients prior to considering patients for coverage under the FAP. IU Health West Hospital takes several measures to inform its patients of the FAP and FAP-eligibility. These measures include the following: 1. Conspicuous public displays will be posted in appropriate acute care settings such as the emergency department and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 2. IU Health West Hospital will include a conspicuous written notice on all patient billing statements that notifies the patient about the availability of this Policy, and the telephone number of its Customer Service Department which can assist patients with any questions they may have regarding this Policy. 3. IU Health Customer Service representatives will be available via telephone Monday through Friday, excluding major holidays, from 8:00 a.m. to 7:00 p.m. Eastern Time to address questions related to this Policy. 4. IU Health West Hospital will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health West Hospital will educate its patient facing team members of the FAP and the process for referring patients to the Program.
Schedule H, Part VI, Line 4 - Community InformationIU Health West Hospital is located in Hendricks County, Indiana, a county located in central Indiana. Based on the most recent Census Bureau (2018) statistics, Hendricks Countys population is 167,009 persons with approximately 50% being female and 50% male. The countys population estimates by race are 83.8% White, 7.4% Black, 4.0% Hispanic or Latino, 3.0% Asian, 0.3% American Indian or Alaska Native, 0.1% Native Hawaiian or Other Pacific Islander and 2.1% persons reporting two or more races. Hendricks County has relatively moderate levels of educational attainment. Among adults 25 and above, 94% completed their education with a high school diploma or equivalent. 35% had a bachelors degree or higher. About 6% ended their formal education before finishing high school.
Schedule H, Part VI, Line 5 - Promotion of Community HealthIU HEALTH WEST HOSPITAL IS A SUBSIDIARY OF INDIANA UNIVERSITY HEALTH, INC., A TAX-EXEMPT HEALTHCARE ORGANIZATION, WHOSE BOARD OF DIRECTORS IS COMPOSED OF MEMBERS, OF WHICH SUBSTANTIALLY ALL ARE INDEPENDENT COMMUNITY MEMBERS. IN ORDER TO HELP THE COMMUNITY IN ACCESSING HEALTHCARE, IU HEALTH WEST HOSPITAL PARTNERS WITH HOPE HEALTHCARE SERVICES IN AVON, INDIANA, TO HELP MEET THE NEEDS OF HENDRICKS COUNTY RESIDENTS WHO CONTINUE TO BE UN- OR UNDER-INSURED. HOPE HEALTHCARE SERVICES SERVES MORE THAN 800 PEOPLE EACH YEAR WITH PRIMARY MEDICAL AND DENTAL CARE, CHRONIC DISEASE MANAGEMENT, AND MEDICATION MANAGEMENT. MULTIPLE IU HEALTH WEST PHYSICIANS VOLUNTEER AT THE CLINIC, WHERE MEDICAL AND DENTAL CARE IS SUPPORTED ENTIRELY BY VOLUNTEER HEALTHCARE PROVIDERS. ADDITIONALLY TO ASSIST WITH OBESITY PREVENTION, IU HEALTH WEST HOSPITAL AND THE TOWN OF BROWNSBURG, IN PARTNER TO PRESENT THE TOWN'S FARMERS MARKET FROM MAY-SEPTEMBER ON THE TOWN HALL GREEN. IN ADDITION TO CREATING A VENUE FOR RESIDENTS TO ACCESS LOCALLY GROWN FRESH PRODUCE, THE HOSPITAL AND TOWN ARE COMMITTED TO SUPPORTING AT RISK INDIVIDUALS AND FAMILIES, BY ACCEPTING WIC AND SNAP PAYMENTS FOR PRODUCE, AND BY PROVIDING A COLLECTION LOCATION FOR PRODUCE DONATIONS TO BROWNSBURG AREA FOOD PANTRIES. TO IMPROVE THE PRE K-12TH EDUCATION, IU HEALTH WEST HOSPITAL AND THE AVON SCHOOL CORPORATION HOST A FREE, FOUR WEEK KINDERGARTEN PREPARATORY PROGRAM EVERY JUNE. THE CHILDREN INVITED TO PARTICIPATE HAVE BEEN IDENTIFIED THROUGH THE DISTRICT'S KINDERGARTEN ASSESSMENT AS NEEDING A BOOST IN ORDER TO BE READY TO SUCCEED IN THE CLASSROOM. KINDERGARTEN TEACHERS STAFF THE CLASSROOM, WITH THE HELP OF 40+ HOSPITAL VOLUNTEERS OVER THE COURSE OF FOUR WEEKS, ALL OF WHOM HELP CHILDREN LEARN THE CLASSROOM BASICS, SUCH AS RAISING HANDS AND WALKING IN LINES, AND HELP SET THE STAGE FOR READING, WRITING AND MATH SUCCESS IN THE YEARS AHEAD.
Schedule H, Part VI, Line 6 - Affiliated Health Care SystemIU Health West Hospital is part of the IU Health Statewide System. The IU Health Statewide system is Indianas most comprehensive healthcare 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 you confidence that you made the right choice in trusting IU Health with your 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 childrens 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, IU HEALTH COMMITTED TO A STRATEGIC RESEARCH INITIATIVE TO SUPPORT RATABLY FOR A FIVE-YEAR PERIOD ENDED DECEMBER 31, 2016, CERTAIN BASIC, CLINICAL, AND TRANSLATIONAL RESEARCH PROGRAMS OF THE IU SCHOOL OF MEDICINE. THE TOTAL COMMITMENT AGGREGATED $75,000,000. IN 2017, A NEW FIVE-YEAR TERM OF $55,000,000 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 $11,000,000 AND $5,000,000, 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 $25,652,000 AND $32,875,000 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 Indianas 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 Indianas 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 $711 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. IN 2018, MORE THAN 2,848 IU HEALTH TEAM MEMBERS DEDICATED MORE THAN 9,694 VOLUNTEER HOURS IN THEIR COMMUNITIES. 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 clinics 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 capaci

Schedule I IRS990ScheduleI

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Recipient EIN351817139RecipientEIN
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Cash Grant$20,000CashGrantAmt
Purpose Of GrantCOMMUNITY ECONOMIC DEVPurposeOfGrantTxt
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Total Other Org1TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2 - Org.'s Proc. for Mon. the Use of Grant FundsFormAndLineReferenceDesc
ExplanationAlthough IU Health West Hospital 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.ExplanationTxt

Schedule J IRS990ScheduleJ

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Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
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Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KENNETH D PUCKETT
PRESIDENT - ISR$0$371,435$0$134,940$0$19,309$0$69,054$0$28,254$0$622,992$0$0
DEREK E EMPIE
SECRETARY$0$193,647$0$32,625$0$548$0$11,674$0$28,615$0$267,109$0$0
ARTHUR VASQUEZ
President/Treasurer$0$228,525$0$39,050$0$444$0$13,147$0$28,520$0$309,686$0$0
Harpreetinder Singh MD
VP & CMO (Partial Year)$205,294$209,496$13,688$13,968$9,557$9,753$6,064$6,188$12,292$12,543$246,895$251,948$0$0
MEGAN CRITTENDON MD
DIRECTOR$0$329,163$0$29,262$0$540$0$17,463$0$7,173$0$383,601$0$0
LISA A SPARKS RN
VP & CNO$181,838$0$19,539$0$918$0$10,408$0$28,181$0$240,884$0$0$0
PAMELA CHAPMAN
DIRECTOR, OR SERVICES(Part Yr)$14,683$133,398$1,102$10,010$45$404$837$7,602$2,989$27,160$19,656$178,574$0$0
JAMES R BILLMAN
PHARMACIST$153,194$0$206$0$4,709$0$1,696$0$25,585$0$185,390$0$0$0
ANNE K STEGEMOLLER
DIRECTOR, PHARMACY$147,305$0$17,868$0$300$0$8,612$0$27,859$0$201,944$0$0$0
LAURA A ROGGY
PHARMACIST$149,748$0$0$0$4,951$0$7,976$0$17,987$0$180,662$0$0$0
JUDITH L COLEMAN
FORMER TREASURER$0$242,034$0$53,304$0$2,310$0$13,691$0$19,712$0$331,051$0$0
GREGORY A SPURGIN MD
FOMER CMO$0$227,977$0$62,522$0$11,124$0$17,875$0$3,550$0$323,048$0$0
MATTHEW D BAILEY
FORMER PRESIDENT$0$287,416$0$158,544$0$1,047,262$0$322,129$0$7,138$0$1,822,489$0$343,365
Elizabeth Dunlap
Director$0$500,462$0$242,162$0$24,596$0$11,000$0$23,402$0$801,622$0$0
Michelle A Janney
Director$0$502,367$0$371,179$0$143,482$0$121,065$0$5,899$0$1,143,992$0$0
David A Ingram MD
Director$0$457,117$0$79,034$0$3,169$0$111,083$0$0$0$650,403$0$0
CARA L BREIDSTER
CFO - ISR (PARTIAL YEAR)$0$272,747$0$37,215$0$3,933$0$13,532$0$22,833$0$350,260$0$0
Eric D Peak
Pharmacist, Senior$151,422$0$0$0$2,322$0$7,721$0$7,200$0$168,665$0$0$0
Jamie L Conley-Lebeter
Mgr, Pharmacy Oprs$130,907$0$12,509$0$120$0$5,928$0$24,124$0$173,588$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 - Comp. of the Org.'s CEO/Executive DirectorIU HEALTH WEST HOSPITAL'S PRESIDENT IS EMPLOYED BY IU HEALTH. IU HEALTH'S PROCESS FOR DETERMINING COMPENSATION INCLUDES THE USE OF A COMPENSATION SURVEY/STUDY CONDUCTED BY AN INDEPENDENT COMPENSATION CONSULTANT WITH REVIEW AND APPROVAL BY THE COMMITTEE ON PERSONNEL AND COMPENSATION AND THE BOARD OF DIRECTORS. PLEASE SEE SCHEDULE O FOR ADDITIONAL DETAILS. SCHEDULE J, PART I, LINE 4A - SEVERANCE MATTHEW D. BAILEY ENTERED INTO A SEVERANCE AGREEMENT WITH IU HEALTH DURING 2018. SEVERANCE OF $190,847 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.
Schedule J, Part I, Line 4b - Supplemental Nonqualified Retirement PlanKENNETH D. PUCKETT, MATTHEW D. BAILEY, MICHELLE A. JANNEY, AND DAVID A. INGRAM PARTICIPATE IN AN IU HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, PROVISIONS OF WHICH ARE DESIGNED TO RETAIN ITS 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 THESE EXECUTIVES HAS AMOUNTS INCLUDED IN COLUMN C, DEFERRED COMPENSATION, REPRESENTING THE CURRENT YEAR UNVESTED CONTRIBUTIONS MADE UNDER THE SUPPLEMENTAL RETIREMENT PLAN. NO AMOUNTS WERE ACTUALLY PAID TO THESE EXECUTIVES DURING THE YEAR.
Schedule J, Part I, Line 7 - Non-Fixed PaymentsAMOUNTS DISCLOSED IN COLUMN B(II) INCLUDE A LONG-TERM AND SHORT-TERM INCENTIVE FOR CERTAIN EXECUTIVES AND SHORT-TERM INCENTIVE FOR OTHER EMPLOYEES. ALTHOUGH THESE PLANS ARE BASED ON A FIXED FORMULA THAT HAS BEEN APPROVED BY THE BOARD OF DIRECTORS BASED UPON CERTAIN QUALITATIVE AND QUANTITATIVE FACTORS AND GOALS, ALL DISCRETIONARY INCENTIVE PLANS MUST BE APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Page 1, Line J Web Site:https://iuhealth.org/find-locations/iu-health-west-hospital
Part VI, Section A, Lines 6, 7a and 7b Members or StockholdersLine 6: The sole member of IU Health West Hospital is IU Health, a 501(c)(3) tax-exempt organization. Line 7A: The Board of Directors of IU Health West Hospital shall consist of from three (3) to twelve (12) voting members appointed by IU Health, including up to four (4) directors who are members of the Medical Staff in good standing or physicians employed by IU Health West Hospital or IU Health. Line 7B: The Board of Directors shall not, without the prior approval of the IU Health: - Authorize any merger, consolidation, reorganization, sale or transfer of all or substantially all of the assets of IU Health West Hospital; - Authorize any plan of dissolution of IU Health West Hospital, any liquidating distribution of the IU Health West Hospitals assets or other action related to the dissolution or liquidation of IU Health West Hospital; - Authorize any voluntary declaration of bankruptcy of IU Health West Hospital; - Amend, repeal, revise or adopt changes to the organizational documents of IU Health West Hospital; - Authorize the consolidation of any entity with, or acquisition of any entity by, IU Health West Hospital; - Authorize any agreement to act as primary obligor, or to serve as a guarantor, surety or co-obligor with respect to the indebtedness of any other party, to borrow amounts from third-party lenders or to loan money to any person or entity; - Authorize any pledge of, or grant any security interest or mortgage in, or otherwise encumber, any tangible assets in excess of an appropriate monetary threshold, other than in the ordinary course of business or pursuant to an approved budget or strategic plan; - Authorize any agreement to act as primary obligor, or to serve as a guarantor, surety or co-obligor with respect to the indebtedness of any other party, to borrow amounts from third-party lenders or to loan money to any person or entity; - Approve any management agreement for the management of all or substantial part of IU Health West Hospitals operations; - Authorize the establishment or acquisition by IU Health West Hospital of any subsidiaries, affiliates or joint venture arrangements or the acquisition by IU Health West Hospital of the stock or other equity interest or substantially all the assets of any other business or entity, or - Adopt or amend an operating budget, capital budget, strategic plan, or long-range plan, or significantly deviate therefrom.
Part VI, Section A, Line 11b Review of Form 990The Indianapolis Suburban Region Chief Financial Officer reviewed and approved the Form 990. Following the CFO's review and approval, a complete copy of the Form 990 was made available to each board member prior to its filing. Each member was also informed of the availability of the IU Health Tax Department to answer any questions.
Part VI, Section B, Lines 12, 13, and 14 PoliciesIU Health West Hospital is part of the IU Health system. As the sole member and controlling parent of IU Health West Hospital, IU Health and its board of directors have mandated that certain policies be followed to ensure greater standardization throughout the system. Thus, IU Health West Hospitals Board of Directors was not required to separately adopt a conflict of interest, whistleblower, document retention and destruction and joint venture policies because IU Healths Board of Directors had already adopted and required these policies to be followed by its subsidiaries.
Part VI, Section B, Line 12c Conflict of Interest PolicyIU Health West Hospital follows IU Healths Conflict of Interest Policy. IU Healths Conflict of Interest Policy includes the following provisions: All IU Health employees, associates, colleagues and contracted personnel, including employed physicians and paid medical directors ("IU Health Representatives") are covered by and subject to its Conflict of Interest Policy. IU Health regularly and consistently monitors and enforces compliance with the policy through the following procedures: (1) 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. (2) 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. (3) 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. (4) 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 Representatives supervisor and other appropriate individuals and groups. (5) 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 supervisors 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. (6) 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 West Hospitals President is employed by IU Health. IU Healths process for determining compensation is as follows: (1) The Board of Directors has established a Committee on Personnel and Compensation. The individuals on this Committee are made up of individuals who are on the Board and who do not have a conflict of interest with IU Health. There are no physicians or employees on this Committee. This Committee develops and reviews annually the executive compensation philosophy, market analysis as to comparability and reasonableness. One of the purposes of this Committee is to review, approve and make recommendations regarding executive compensation and benefits to the IU Health Board. As deemed appropriate, this Committee also reviews the same detail with the Committee on Finance. The Committee on Finance is represented by certain members of the Board as well. (2) Each year the Committee on Personnel and Compensation engages an outside compensation consulting firm to conduct a compensation and benefits study for all senior vice presidents and above. The current compensation advisor is SullivanCotter. SullivanCotter performs an independent compensation survey. The relevant comparability data includes: 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. The Committee reviews the entire compensation package including: base compensation, short term and long term incentive plans, basic health and welfare benefits, qualified and nonqualified plans as well as any additional fringe benefits. Further, SullivanCotter will provide recommendations based upon the reasonable compensation information as it relates to salary increases, bonuses and benefits that are consistent with the compensation philosophy of the Committee. A separate analysis using the same methodology is done for the Chief Executive Officer. (3) The Committee reviews the salary survey and, if appropriate, makes recommendations on increases in salary and any changes in bonuses or benefits. The Committee's goal is to ensure that the total compensation and benefits package is reasonable based upon the independent data provided by SullivanCotter. The Committee votes on any changes in compensation or benefits. This review, discussion and vote are documented in the minutes for the meeting. There are no executives present during the final discussion and approval of compensation. (4) The Board reviews the report prepared by SullivanCotter as well as the recommendations of the Committee on Personnel and Compensation as to changes in compensation approved by the Committee. As requested, the Committee on Finance also provides its review of recommendations on changes in executive compensation and benefits. This review, discussion and vote are documented in the minutes. (5) The Board then reviews the recommendations provided by the Committee on Personnel and Compensation and votes on the changes as well. No additional compensation or benefits are paid to the executives until the changes have been approved by the Committee and the Board. The discussion and approval are documented in the minutes of the meeting. There are no executives present during the final discussion and approval of compensation. The General Counsel prepares a formal written opinion reviewing the compensation and benefits approval process, comparing that process to the Intermediate Sanctions Test of IRC Section 4958 and, if the facts warrant, provides comments regarding the compensation and benefits approval process as this 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 Committee and Board also reviews the achievements of the executive group as it relates to the long-term and short-term shared and individual goals developed by the executive 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 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 Committee on Personnel and Compensation and Audit Committee also review the required Form 990 disclosures related to executive compensation and benefits as well as compensation practices and approval processes prior to the filing of the Form 990 return with the Internal Revenue Service. IU Health West Hospital has a process in place to determine the compensation for the other officers and key employees. IU Health West Hospital uses an independent compensation consultant who utilizes a variety of methods and procedures to obtain compensation ranges for comparable officer and employee positions. The independent compensation consultant provides IU Health West Hospital with recommended compensation ranges for its officers and other employees, which are then used as a guide for setting reasonable compensation by management. Management decisions with regard to determining compensation are subject to the review and approval of the Compensation Committee and Board of Directors.
Part VI, Section C, Line 19 Public DisclosureIU Health West Hospital's Articles of Incorporation are available to the public through the Indiana Secretary of State's web-site. IU Health West Hospitals conflict of interest policy is described on Form 990, Schedule O. IU Health West Hospital is a consolidated subsidiary in the consolidated financial statements for IU Health. The consolidated financial statements for IU Health are available to the public through its bond filings.
PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS OR FUND BALANCESDURING 2018, IU HEALTH WEST HOSPITAL RECORDED THE FOLLOWING OTHER CHANGES IN NET ASSETS OR FUND BALANCES: Equity Transfer (Settlement of Debt): (130,354) IU HEALTH FOUNDATION - RESTRICTED INVESTMENTS: (20,071) TOTAL OTHER CHANGES IN NET ASSETS: (150,425)
FORM 990 PART IX LINE 11GDESCRIPTION:SHARED SERVICES/PROF. FEES TOTAL FEES:50211885

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (34 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Clarian Transplant Institute Inc
950 N Meridian St Ste 800IndianapolisIN46204134350599HealthcareIN501(c)(3)10IUHYes (true)
HealthLINC Incorporated
950 N Meridian St Ste 800IndianapolisIN46204263571507HealthcareIN501(c)(3)10IUHBYes (true)
Indiana Health Info Exchange Inc
846 N Senate AveIndianapolisIN46202364550324HealthcareIN501(c)(3)12 INAfalse
Indiana University Health Inc
950 N Meridian St Ste 300IndianapolisIN46204351955872HealthcareIN501(c)(3)3NAfalse
IU Health Arnett Inc
950 N Meridian St Ste 300IndianapolisIN46204263162145HealthcareIN501(c)(3)3IUHYes (true)
IU Health Ball Memorial Hospital Inc
950 N Meridian St Ste 300IndianapolisIN46204350867958HealthcareIN501(c)(3)3IUHYes (true)
IU Health Ball Memorial Physicians Inc
950 N Meridian St Ste 300IndianapolisIN46204351925641HealthcareIN501(c)(3)10IUHBMHYes (true)
IU Health Bedford Inc
950 N Meridian St Ste 300IndianapolisIN46204237042323HealthcareIN501(c)(3)3IUHYes (true)
IU Health Blackford Hospital Inc
950 N Meridian St Ste 300IndianapolisIN46204010646166HealthcareIN501(c)(3)3IUHBMHYes (true)
IU Health Bloomington Inc
950 N Meridian St Ste 300IndianapolisIN46204351720796HealthcareIN501(c)(3)3IUHYes (true)
IU Health BMH Foundation Inc
950 N Meridian St Ste 800IndianapolisIN46204311111784FundraisingIN501(c)(3)12 IIUHBMHYes (true)
IU Health Care Associates Inc
950 N Meridian St Ste 300IndianapolisIN46204351747218HealthcareIN501(c)(3)10IUHYes (true)
IUHLP Liquidation Inc
950 N Meridian St Ste 800IndianapolisIN46204351125434HealthcareIN501(c)(3)10IUHYes (true)
IUHLP-P Liquidation Inc
950 N Meridian St Ste 800IndianapolisIN46204311070868HealthcareIN501(c)(3)10IUHLPYes (true)
IU Health Morgan Inc
950 N Meridian St Ste 800IndianapolisIN46204273533027HealthcareIN501(c)(3)10IUHYes (true)
IU Health North Hospital Inc
950 N Meridian St Ste 300IndianapolisIN46204351932442HealthcareIN501(c)(3)3IUHYes (true)
IU Health Paoli Inc
950 N Meridian St Ste 300IndianapolisIN46204352090919HealthcareIN501(c)(3)3IUHYes (true)
IU Health Plans NFP Inc
950 N Meridian St Ste 800IndianapolisIN46204463803873InsuranceIN501(c)(4)N/AIUHYes (true)
IU Health Tipton Hospital Inc
950 N Meridian St Ste 300IndianapolisIN46204262772226HealthcareIN501(c)(3)3IUHYes (true)
IU Health White Memorial Hospital Inc
950 N Meridian St Ste 300IndianapolisIN46204273532963HealthcareIN501(c)(3)3IUHYes (true)
IU Medical Group Foundation Inc
340 W 10th St No FS5100IndianapolisIN46202201093251FundraisingIN501(c)(3)12 IINAfalse
LaPorte Hospital Foundation Inc
PO Box 250LaPorteIN46352310952775FundraisingIN501(c)(3)12 INAfalse
MDwise Marketplace Inc
1200 Madison AveIndianapolisIN46225465270582InsuranceIN501(c)(4)N/AIUHYes (true)
MDwise Network Inc
1200 Madison AveIndianapolisIN46225472619552InsuranceIN501(c)(4)N/AIUHYes (true)
IU Health Foundation Inc
1800 N Capitol AveIndianapolisIN46202356043086FundraisingIN501(c)(3)12 IIUHYes (true)
Methodist Health Group Inc
950 N Meridian St Ste 800IndianapolisIN46204350876390HealthcareIN501(c)(3)12 III-FINAfalse
Methodist Occup Health Centers Inc
950 N Meridian St Ste 300IndianapolisIN46204351844176HealthcareIN501(c)(3)3IUHYes (true)
Rehabilitation Hospital of Indiana Inc
4141 Shore DrIndianapolisIN46254351786005HealthcareIN501(c)(3)3IUHYes (true)
RHI Foundation Inc
4141 Shore DrIndianapolisIN46254351932349FundraisingIN501(c)(3)12 IRHIYes (true)
The Cheer Guild of Riley Hos for Child
705 Riley Hospital DrIndianapolisIN46202356018517FundraisingIN501(c)(3)12 III-FINAfalse
University Family Physicians Inc
950 N Meridian St Ste 800IndianapolisIN46204237427350HealthcareIN501(c)(3)10IUHCAYes (true)
IU Health Frankfort Inc
950 N Meridian St Ste 300IndianapolisIN46204815174295HealthcareIN501(c)(3)3IUHYes (true)
IU Health Jay Foundation Inc
950 N Meridian St Ste 800IndianapolisIN46204351809127FUNDRAISINGIN501(c)(3)12 IIUHYes (true)
IU Health Jay Inc
950 N Meridian St Ste 300IndianapolisIN46204822736786HealthcareIN501(c)(3)3IUHYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Ball Outpatient Sur Ctr LLC
569 Brookwood Village Ste 901BirminghamAL35244270275794HealthcareINNA
Beltway Surgery Centers LLC
569 Brookwood Village Ste 901BirminghamAL35244352072586HealthcareINNA
BOSC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454147343HealthcareINNA
BSC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204452314634HealthcareINNA
CHV Fund I LLC
950 N Meridian St Ste 800IndianapolisIN46204262523206Venture CapitalINNA
CHV Fund II Management LLC
950 N Meridian St Ste 800IndianapolisIN46204371717823Venture CapitalINNA
CHV Fund II LLC
950 N Meridian St Ste 800IndianapolisIN46204800902337Venture CapitalINNA
CHV Fund Management LLC
950 N Meridian St Ste 800IndianapolisIN46204262523151Venture CapitalINNA
Health Venture Management LLC
950 N Meridian St Ste 300IndianapolisIN46204205740218ManagementINNA
IEC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454148032HealthcareINNA
Indiana Endoscopy Centers LLC
569 Brookwood Village Ste 901BirminghamAL35244208398421HealthcareINNA
ROC Surgery LLC
569 Brookwood Village Ste 901BirminghamAL35244271497960HealthcareINNA
ROCS Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454148369HealthcareINNA
Senate St Surgery Center LLC
569 Brookwood Village Ste 901BirminghamAL35244421709357HealthcareINNA
SSSC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454148167HealthcareINNA
IU HEALTH FORT WAYNE LLC
950 N Meridian St Ste 800INDIANAPOLISIN46204831224627HealthcareINNA

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
BMH Medical Pavilion Association Inc
2525 W University AveMuncieIN47303351858408Condo ManagementINNACYes (true)
Cardinal Health Ventures Inc
950 N Meridian St Ste 800IndianapolisIN46204351611424ManagementINNACYes (true)
CHV Capital Inc
950 N Meridian St Ste 800IndianapolisIN46204260752507Venture CapitalINNACYes (true)
IU Health 457(B) Plan
1100 N Market StWilmingtonDE19890476948347InvestmentsINNATYes (true)
IU Health ACO Inc
950 N Meridian St Ste 800IndianapolisIN46204454421020HealthcareINNACYes (true)
IU Health Board Designated Trust
400 Howard StSan FranciscoCA94105306309021InvestmentsINNATYes (true)
IU Health NTGI S&P500 Fund CF
PO Box 804358ChicagoIL60680306298263InvestmentsINNATYes (true)
IU Health Plans Holding Company Inc
950 N Meridian St Ste 800IndianapolisIN46204463794815InsuranceINNACYes (true)
IU Health Plans Inc
950 N Meridian St Ste 800IndianapolisIN46204262127080HMOINNACYes (true)
IU Health Risk Purchasing Group Inc
151 Meeting St Ste 301CharlestonSC29401260202446InsuranceINNACYes (true)
IU Health Risk Retention Group Inc
151 Meeting St Ste 301CharlestonSC29401201107674InsuranceSCNACYes (true)
IU Health Southern IN Physicians Inc
950 N Meridian St Ste 300IndianapolisIN46204351913875HealthcareINNACYes (true)
IUH Assurance SPC Ltd
980395429InsuranceNACYes (true)PO Box 69 94 Solaris AveCamana BayGrand CaymanCJCJ
Proteuo Fund LP
981075227InvestmentsNACYes (true)PO Box 31106 89 Nexus WayCamana BayGrand CaymanCJCJ
SCANS Inc
950 N Meridian St Ste 800IndianapolisIN46204453080392HealthcareINNACYes (true)
IU Health Plans Insurance Company
950 N Meridian St Ste 800IndianapolisIN46204811097215InsuranceINNACYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (8 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
IU Health Care Associates Inc
J$446,903FMV
IU Health Care Associates Inc
L$222,354FMV
IU Health Care Associates Inc
M$12,670,252FMV
Methodist Occupational Health Centers Inc
M$121,221FMV
IU Health Care Associates Inc
O$181,611FMV
IU Health North Hospital Inc
O$84,786FMV
IUH Assurance SPC Ltd
R$394,353FMV
IU Health Risk Retention Group Inc
R$682,787FMV