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INDIANA UNIVERSITY HEALTH BLOOMINGON INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
INDIANA UNIVERSITY HEALTH BLOOMINGON INC (EIN 35-1720796)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-14
IRS object ID
201943189349312724
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)
Return2019-11-14T15:57:51-06:00ReturnTs
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)
EIN351720796EIN

Business Name BusinessName

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL L CRAIGPersonNm
Person TitleVP & CFOPersonTitleTxt
Phone3179634842PhoneNum
Signature2019-11-14SignatureDt

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 Id35198520193185000007FederalOriginalSubmissionId
Federal Original Submission Id2019-11-14FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdE86E71EDF6F7DFE9336F32ED7F8459C58967F52AAtSubmissionCreationDeviceId
At Submission Filing Device IdB94C62B5C6A0955190C280FDFCA25CEB3EEAF170AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBRIAN T SHOCKNEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1950 N MERIDIAN ST STE 300AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$510,461,341GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressSEE SCHEDULE OWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1988FormationYr
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 Body13VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee2735TotalEmployeeCnt
Total Volunteers238TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$61,581NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,426,000PYContributionsGrantsAmt
CY Contributions Grants$3,697,447CYContributionsGrantsAmt
PY Program Service Revenue$435,751,697PYProgramServiceRevenueAmt
CY Program Service Revenue$473,015,183CYProgramServiceRevenueAmt
PY Investment Income$5,283,975PYInvestmentIncomeAmt
CY Investment Income$8,355,418CYInvestmentIncomeAmt
PY Other Revenue$3,015,202PYOtherRevenueAmt
CY Other Revenue$2,234,114CYOtherRevenueAmt
PY Total Revenue$446,476,874PYTotalRevenueAmt
CY Total Revenue$487,302,162CYTotalRevenueAmt
PY Grants And Similar Paid$873,688PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$81,427CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$135,893,901PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$137,511,534CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$220,433,837PYOtherExpensesAmt
CY Other Expenses$228,483,342CYOtherExpensesAmt
PY Total Expenses$357,201,426PYTotalExpensesAmt
CY Total Expenses$366,076,303CYTotalExpensesAmt
PY Revenues Less Expenses$89,275,448PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$121,225,859CYRevenuesLessExpensesAmt
Total Assets BOY$578,845,857TotalAssetsBOYAmt
Total Assets EOY$644,933,798TotalAssetsEOYAmt
Total Liabilities BOY$67,772,712TotalLiabilitiesBOYAmt
Total Liabilities EOY$52,028,374TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$511,073,145NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$592,905,424NetAssetsOrFundBalancesEOYAmt
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$284,136,357ExpenseAmt
Grant$81,427GrantAmt
Revenue$464,745,577RevenueAmt
DescIndiana University Health Bloomington, Inc. ("IU Health Bloomington") is a 293-bed full service hospital that offers a broad range of services to care for its patients without regard to their ability to pay. Based upon the values of trust, excellence, accountability, and mutual respect, IU Health Bloomington enhances the health of its patients and community in south-central Indiana by advancing the art and science of medicine through the use of new technologies, procedures, and care.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$4,374,197ExpenseAmt
Grant$0GrantAmt
Revenue$7,154,623RevenueAmt
DescIU HEALTH BLOOMINGTON PROVIDES SERVICES TO RELATED TAX-EXEMPT ORGANIZATIONS.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$649,562ExpenseAmt
Grant$0GrantAmt
Revenue$1,062,451RevenueAmt
DescIU Health Bloomington receives revenue from the following pass-through entities: Brown County Medical Cooperative, LLC, SIHO Network, LLC, SIRA Imaging Center, LLC, Southern Indiana Surgery Center, LLC and PIMCO Bravo Fund.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (2 entries)

ExpenseExpenseAmtGrantGrantAmtRevenueRevenueAmtDescDesc
$29,148$0$4,856RENTAL INCOME FROM RELATED TAX-EXEMPT ENTITIES
$2,967$0$47,676Clinical Research
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$32,115TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$52,532TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$289,192,231TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
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 EntityYes (true)DisregardedEntityInd
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 Document264IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee2735EmployeeCnt
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 Members13GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCRAIG J JONESPersonNm
Phone3179634842PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (28 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
LYNN H COYNE
(SCR) DIRECTOR/BOARD CHAIR2.05.0Yes (X)Yes (X)$0$0$0
JOYCE B POLING
(SCR) DIRECTOR/Secretary2.05.0Yes (X)Yes (X)$0$0$0
JAMES J LAUGHLIN MD
(SCR) DIRECTOR2.053.0Yes (X)$0$456,043$13,700
MATTHEW D BAILEY
PRESIDENT (SCR) (Part Year)25.030.0Yes (X)Yes (X)$0$1,493,222$329,267
BRIAN T SHOCKNEY
President (SCR) (Part Year)25.030.0Yes (X)Yes (X)$274,723$222,658$80,275
Daniel J Peterson
Chairman (SCR)2.05.0Yes (X)Yes (X)$0$0$0
Jack A Kenworthy
Vice Chairman (SCR)2.05.0Yes (X)Yes (X)$0$0$0
Danny L Moore
Treasurer (SCR) (Part Year)2.05.0Yes (X)Yes (X)$0$0$0
Richard G Hendrickson
Dir/Treasur (SCR) (Part Year)2.05.0Yes (X)Yes (X)$0$3,600$0
David L Beachy DO
(SCR) Director2.053.0Yes (X)$0$287,229$37,429
Alfonso W Gatmaitan
(SCR) Director2.053.0Yes (X)$0$3,058,805$1,037,833
Julie Minton
(SCR) Director (Part Year)2.05.0Yes (X)$0$0$0
Janet Farlow Perry
(SCR) Director2.05.0Yes (X)$0$0$0
Hojjat M Shamloo MD
(SCR) Director2.053.0Yes (X)$0$484,042$44,168
John S Strobel MD
(SCR) Director2.053.0Yes (X)$0$721,056$38,285
MICHAEL L CRAIG
VP & CFO (SCR)25.030.0Yes (X)$0$279,207$29,312
KENNETH E MARSHALL MD
VP & CMO (SCR) (PARTIAL YEAR)25.030.0$180,306$150,755$33,144Yes (X)
LARRY BAILEY
PRESIDENT IUH PAOLI/IUH MORGAN10.045.0$489,304$0$34,909Yes (X)
WENDY HERNANDEZ
VP, PROF & SUPPORT SERVICES50.05.0$196,574$0$28,731Yes (X)
Daniel A Handel MD
VP & CMO (SCR)(PARTIAL YEAR)55.00.0$327,587$49,480$28,382Yes (X)
Cynthia Herrington
VP & CNO (SCR) (Part Year)50.05.0$179,318$0$18,897Yes (X)
Derek Fields
Dir-Pharmacy55.00.0$188,836$0$27,600Yes (X)
CAREY C MAYER MD
PSYCHIATRIST55.00.0$283,132$0$35,442Yes (X)
CHAD W SCHULTHEIS MD
PSYCHIATRIST55.00.0$281,833$0$36,843Yes (X)
Nida JSyed MD
Psychiatrist55.00.0$293,948$0$20,561Yes (X)
Greg SSidell MD
Psychiatrist55.00.0$292,463$0$41,458Yes (X)
Douglas M Frye
Physicist-Radiation Medicine55.00.0$241,615$0$40,853Yes (X)
LINDA LEWIS
VP & CNO0.00.0$124,205$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,353,844TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$7,206,097TotReportableCompRltdOrgAmt
Total Other Compensation$1,957,089TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K105IndivRcvdGreaterThan100KCnt
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
27310 NETWORK PLACECHICAGOIL60673FACILITIES$5,052,887
FA WILHELM CONSTRUCTION CO INC
3914 Prospect StreetINDIANAPOLISIN46203Construction$9,738,917
HELLMUTH OBATA KASSABAUM INC
10 S BROADWAY SUITE 200ST LOUISMO63102DESIGN/ENGINEERING$4,280,814
MEDEFIS
PO Box 5068NEW YORKNY100875068Staffing$3,278,909
CSO ARCHITECTS INC
PO BOX 6069 DEPT 94INDIANAPOLISIN462066069Architectural/Design$2,032,225
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K35CntrctRcvdGreaterThan100KCnt
Related Organizations$0RelatedOrganizationsAmt
Government Grants$3,055,939GovernmentGrantsAmt
All Other Contributions$641,508AllOtherContributionsAmt
Total Contributions$3,697,447TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE622110$464,745,577$464,745,577
SHARED SERVICES541900$7,154,623$7,154,623
RENT FROM RELATED 501(C)(3) ORGS.532000$4,856$4,856
CLINICAL RESEARCH541700$47,676$47,676
INCOME (LOSS) FROM PASS-THROUGH ENTITIES900099$1,062,451$1,062,451
FieldValueIRS element (for citing)
Total Program Service Revenue$473,015,183TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,011,393TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$8,011,393ExclusionAmt

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$611,982RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,045,328RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$433,346RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$433,346TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$433,346ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$22,453,176SecuritiesAmt
Other$4,700OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$22,045,620SecuritiesAmt
Other$68,231OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$407,556SecuritiesAmt
Other-$63,531OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$344,025TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$344,025ExclusionAmt
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$1,422,621$1,422,621
VENDING900099$43,549$43,549
EDUCATION900099$142,845$142,845

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,058,445TotalRevenueColumnAmt
Exclusion$1,058,445ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,667,460OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$487,302,162TotalRevenueColumnAmt
Related Or Exempt Func Income$473,015,183RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$10,589,532ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$81,427TotalAmt
Program Services$81,427ProgramServicesAmt

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$2,033,833TotalAmt
Program Services$1,809,114ProgramServicesAmt
Management And General$224,719ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$107,090,920TotalAmt
Program Services$95,258,401ProgramServicesAmt
Management And General$11,832,519ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$5,402,126TotalAmt
Program Services$4,805,243ProgramServicesAmt
Management And General$596,883ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$15,375,894TotalAmt
Program Services$13,677,005ProgramServicesAmt
Management And General$1,698,889ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$7,608,761TotalAmt
Program Services$6,768,066ProgramServicesAmt
Management And General$840,695ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$556,300TotalAmt
Program Services$70ProgramServicesAmt
Management And General$556,230ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$4,342TotalAmt
Management And General$4,342ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$12,959TotalAmt
Management And General$12,959ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$317,168TotalAmt
Management And General$317,168ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$88,600,376TotalAmt
Program Services$32,612,862ProgramServicesAmt
Management And General$55,987,514ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$102,162TotalAmt
Program Services$4,454ProgramServicesAmt
Management And General$97,708ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,387,093TotalAmt
Program Services$1,237,611ProgramServicesAmt
Management And General$149,482ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,612,691TotalAmt
Program Services$1,557,214ProgramServicesAmt
Management And General$55,477ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$6,272,962TotalAmt
Program Services$6,018,458ProgramServicesAmt
Management And General$254,504ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$233,119TotalAmt
Program Services$173,584ProgramServicesAmt
Management And General$59,535ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$60,527TotalAmt
Program Services$41,937ProgramServicesAmt
Management And General$18,590ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,159,393TotalAmt
Program Services$1,159,393ProgramServicesAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$13,840,395TotalAmt
Program Services$12,454,836ProgramServicesAmt
Management And General$1,385,559ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,342,667TotalAmt
Program Services$575,239ProgramServicesAmt
Management And General$1,767,428ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DRUGS AND MEDICAL SUPPLIES$64,152,396$64,152,396
BAD DEBT$25,764,281$25,764,281
HOSPITAL ASSESSMENT FEE$17,935,751$17,935,751
NONCAPITALIZED EQUIPMENT$1,046,507$525,174$521,333

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,082,253TotalAmt
Program Services$2,579,715ProgramServicesAmt
Management And General$502,538ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$366,076,303TotalAmt
Program Services$289,192,231ProgramServicesAmt
Management And General$76,884,072ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$13,827BOYAmt
EOY$1,637,134EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$236,390,720BOYAmt
EOY$286,220,442EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$60,009,757BOYAmt
EOY$60,897,331EOYAmt

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$403,541BOYAmt
EOY$193,452EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$5,212,018BOYAmt
EOY$5,515,391EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,065,400BOYAmt
EOY$3,960,418EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$357,966,593LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$257,454,418LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$81,689,161BOYAmt
EOY$100,512,175EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$172,677,658BOYAmt
EOY$166,745,390EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$3,438,376BOYAmt
EOY$2,306,666EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$3,610,563BOYAmt
EOY$3,610,563EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$13,334,836BOYAmt
EOY$13,334,836EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$578,845,857BOYAmt
EOY$644,933,798EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$25,033,065BOYAmt
EOY$28,954,953EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$31,166BOYAmt
EOY$1,114,136EOYAmt

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$216,497BOYAmt
EOY$216,497EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$42,491,984BOYAmt
EOY$21,742,788EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$67,772,712BOYAmt
EOY$52,028,374EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$497,738,309BOYAmt
EOY$579,570,588EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,774,144BOYAmt
EOY$7,774,144EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,560,692BOYAmt
EOY$5,560,692EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$511,073,145BOYAmt
EOY$592,905,424EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$578,845,857BOYAmt
EOY$644,933,798EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$121,225,859ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$9,059,217NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$30,334,363OtherChangesInNetAssetsAmt
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 RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$12,959OtherActivitiesAmt
Total Lobbying Expenditures$12,959TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind
Form4720 Filed4912 TaxfalseForm4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule C, Part II-B, Line 1i - Other ActivitiesFormAndLineReferenceDesc
ExplanationIU Health Bloomington paid institutional membership dues to the American Hospital Association ("AHA"), Indiana Hospital Association ("IHA") and The Greater Bloomington Chamber of Commerce during 2018 in the amount of $42,811, $34,425 and $13,400, respectively. Each membership organization notified IU Health Bloomington that a portion of the dues it paid were used for lobbying purposes. The AHA used 22.98%, or $9,838 of the 2018 membership dues paid by IU Health Bloomington, for lobbying expenditures. The IHA used 7.12%, or $2,451 of the 2018 membership dues paid by IU Health Bloomington, for lobbying expenditures. The Greater Bloomington Chamber of Commerce use $5.00%, or $670 of the 2018 membership dues paid by IU Health Bloomington, for lobbying expenditures. The total membership dues paid to these organizations by IU Health Bloomington during 2018 that were attributable to lobbying expenditures was $12,959.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$13,334,836BeginningYearBalanceAmt
End Year Balance$13,334,836EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,906,654BeginningYearBalanceAmt
Contributions$8,468,719ContributionsAmt
Investment Earnings Or Losses$16,073InvestmentEarningsOrLossesAmt
Grants Or Scholarships$49,762GrantsOrScholarshipsAmt
Other Expenditures$4,513OtherExpendituresAmt
Administrative Expenses$2,335AdministrativeExpensesAmt
End Year Balance$13,334,836EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,906,654BeginningYearBalanceAmt
End Year Balance$4,906,654EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,906,654BeginningYearBalanceAmt
End Year Balance$4,906,654EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,817,324BeginningYearBalanceAmt
Contributions$89,330ContributionsAmt
End Year Balance$4,906,654EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.41700PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.58300TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,741,447OtherCostOrOtherBasisAmt
Book Value$19,741,447BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$154,956,495OtherCostOrOtherBasisAmt
Depreciation$136,107,857DepreciationAmt
Book Value$18,848,638BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,487,767OtherCostOrOtherBasisAmt
Depreciation$5,800,732DepreciationAmt
Book Value$1,687,035BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$132,219,258OtherCostOrOtherBasisAmt
Depreciation$110,879,927DepreciationAmt
Book Value$21,339,331BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$43,561,626OtherCostOrOtherBasisAmt
Depreciation$4,665,902DepreciationAmt
Book Value$38,895,724BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$100,512,175TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
INTERCOMPANY PAYABLES (NET)$18,346,906
DUE TO THIRD-PARTY PAYERS$2,718,662
SELF-INSURANCE LIABILITIES$311,422
ENVIRONMENTAL OBLIGATIONS$412,602
ACCRUED LOAN GUARANTEES-$46,804
FieldValueIRS element (for citing)
Total Liability$21,742,788TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part V, Line 4 - Intended Uses of Org.'s Endowment FundsTemporarily and permanently restricted net assets are generally restricted for indigent and other patient care services, medical education and research programs, and medical supplies and equipment.
Schedule D, Part X, Line 2 - FIN 48 (ASC 740) FootnoteIU Health Bloomington is a subsidiary in IU Health's Consolidated Audited Financial Statements. The Internal Revenue Service (IRS) has determined that IU Health and certain of its affiliated entities are tax-exempt organizations as defined in Section 501(c)(3) of the Internal Revenue Code (IRC). IU Health and its tax-exempt affiliates are, however, subject to federal and state income taxes on unrelated business income under the provision of IRC Section 511. The Tax Cuts and Jobs Act (TCJA) was enacted on December 22, 2017. For tax-exempt entities, TCJA requires organizations to categorize certain fringe benefit expenses as a source of unrelated business income subject to tax, pay an excise tax on compensation above certain thresholds, and record income or losses for tax determination purposes from unrelated business activities on an activity-by-activity basis, among other provisions. Regulations necessary to implement certain aspects of TCJA are expected to be promulgated by the IRS in 2019. As of and for the year ended December 31, 2018, Indiana University Health has made reasonable estimates of the provision for income taxes, the compensation excise tax, and the effects, if any, on existing deferred tax balances based on accounting guidance included in Accounting Standards Codification (ASC) 740, Income Taxes. Indiana University Health will continue to refine its calculations in future periods, as additional regulations and guidance are issued by the IRS. Deferred income taxes which as of December 31, 2018 and 2017, have no net carrying value, reflect the net tax effect of temporary differences between the carrying amounts of assets and liabilities for financial reporting and the amounts used for income tax purposes. As of December 31, 2018 and 2017, the Indiana University Health System had gross deferred tax assets of $119,965 and $93,794, respectively, primarily relating to net operating loss carryovers. Management determined that a full valuation allowance at December 31, 2018 and 2017 was necessary to reduce the deferred tax assets to the amount that would more likely than not be realized. ASC Topic 740-10-50-3, Income Taxes: Disclosure, requires a valuation allowance to reduce the deferred tax assets reported if, based on the weight of the evidence, it is more likely than not that some portion or all of the deferred tax assets will not be realized. The change in the valuation allowance for the current year is $26,171. At December 31, 2018, the Indiana University Health System has available net operating loss carryforwards of $482,349. Net operating losses generated from 1999 through 2017 will expire between 2019 and 2037. Net operating losses generated during 2018 do not expire. Certain subsidiaries of Indiana University Health are taxable entities. The tax expense and liabilities of these subsidiaries are not material to the consolidated financial statements.

Schedule H IRS990ScheduleH

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served5430PersonsServedCnt
Total Community Benefit Expns$5,493,696TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,493,696NetCommunityBenefitExpnsAmt
Total Expense0.01610TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served7061PersonsServedCnt
Total Community Benefit Expns$70,860,670TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$54,072,427DirectOffsettingRevenueAmt
Net Community Benefit Expns$16,788,243NetCommunityBenefitExpnsAmt
Total Expense0.04930TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served12491PersonsServedCnt
Total Community Benefit Expns$76,354,366TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$54,072,427DirectOffsettingRevenueAmt
Net Community Benefit Expns$22,281,939NetCommunityBenefitExpnsAmt
Total Expense0.06540TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs18ActivitiesOrProgramsCnt
Persons Served42607PersonsServedCnt
Total Community Benefit Expns$3,746,620TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$186,625DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,559,995NetCommunityBenefitExpnsAmt
Total Expense0.01050TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Persons Served3146PersonsServedCnt
Total Community Benefit Expns$704,598TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$205,937DirectOffsettingRevenueAmt
Net Community Benefit Expns$498,661NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served982PersonsServedCnt
Total Community Benefit Expns$21,627,060TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,991,297DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,635,763NetCommunityBenefitExpnsAmt
Total Expense0.02240TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$8,165TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,165NetCommunityBenefitExpnsAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served483PersonsServedCnt
Total Community Benefit Expns$680,081TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$598,486DirectOffsettingRevenueAmt
Net Community Benefit Expns$81,595NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs29ActivitiesOrProgramsCnt
Persons Served47218PersonsServedCnt
Total Community Benefit Expns$26,766,524TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,982,345DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,784,179NetCommunityBenefitExpnsAmt
Total Expense0.03460TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs29ActivitiesOrProgramsCnt
Persons Served59709PersonsServedCnt
Total Community Benefit Expns$103,120,890TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$69,054,772DirectOffsettingRevenueAmt
Net Community Benefit Expns$34,066,118NetCommunityBenefitExpnsAmt
Total Expense0.10000TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served244PersonsServedCnt
Total Community Benefit Expns$3,062TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,062NetCommunityBenefitExpnsAmt

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served5075PersonsServedCnt
Total Community Benefit Expns$42,053TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$42,053NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served12PersonsServedCnt
Total Community Benefit Expns$5,139TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,139NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Persons Served5331PersonsServedCnt
Total Community Benefit Expns$50,254TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$50,254NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$5,493,696BadDebtExpenseAmt
Reimbursed By Medicare$94,251,135ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$103,427,287CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$9,176,152MedicareSurplusOrShortfallAmt

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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (3 entries)

Primary ActivitiesPrimaryActivitiesTxtOrg Profit Or OwnershipOrgProfitOrOwnershipPctPhysicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
SEE PART VI
AMBULATORY SURGERY CENTER0.50.5
SEE PART VI
DIAG. AND OTHER OUTPATIENT0.50.5
SEE PART VI
AMBULATORY SURGERY CENTER0.50.5
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

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

US Address USAddress

FieldValueIRS element (for citing)
Address Line1601 WEST SECOND STREETAddressLine1Txt
CityBLOOMINGTONCityNm
State AbbreviationINStateAbbreviationCd
ZIP47403ZIPCd
FieldValueIRS element (for citing)
Website AddressSEE PART V, SECTION CWebsiteAddressTxt
State License18-005047-1StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1IU HEALTH BLOOMINGTON 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
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Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care0.FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 - Input from CommunityIn conducting its most recent CHNA, IU Health Bloomington's approach to gathering qualitative data consisted of a multi-component approach to identify and verify community health needs for the IU Health Bloomington service area. This included the following components: 1. Community Meetings 2. Key Stakeholders Interviews 3. Community Survey Community Meetings (Monroe & Owen Counties) To obtain a more complete picture of the factors that play into the Monroe and Owen County community health, input from local leaders with a stake in the community's health were invited to attend a community health sub-committee meeting on May 8, 2018 held at IU Health Bloomington. Organizations who participated in the focus groups are as follows: - Bloomington Economic Development Center - Bloomington Health Foundation - Bloomington North High School - Monroe County Health Department - Local Council of Women - United Way of Monroe County - Slotegraff and Niehoff The meeting began with a presentation that discussed the goals and status of the CHNA process and the purpose of the community meeting. Then, secondary data were presented, along with a summary of the most unfavorable community health indicators. For the community served by IU Health Bloomington Hospital, those indicators were (in alphabetical order): - Cardiovascular diseases and related mortality - Drug and substance abuse - Motor vehicle accidents and drunk driving - Physically and mentally unhealthy days - Poverty and un-employment - Severe housing problems - Smoking, including during pregnancy - Supply of primary care physicians and mental health providers Meeting participants then were asked to discuss whether the identified, unfavorable indicators accurately identified the most significant community health issues and were encouraged to add issues that they believed were significant.Several issues were added, such as: childhood poverty, transportation needs, infant mortality, sexually transmitted diseases, obesity, patient compliance, and chronic disease. In addition, the group decided it would be best to split poverty and un-employment into two distinct needs. After discussing the needs identified through secondary data and adding others to the list, each participant was asked through a voting process to identify three to five needs they consider to be the most significant. From this process, the group identified these five needs as being the most significant in the community served by IU Health Bloomington Hospital: - Drug and substance abuse - Chronic disease - Smoking, including during pregnancy - Obesity - Physically and mentally unhealthy days In addition to the sub-committee meeting, two open focus groups were conducted at local schools in Monroe County and a third open focus group was conducted at the Owen County YMCA. A member of the Owen County Health Board attended the Owen County YMCA focus group. In total, 18 individuals participated in these focus groups. Individual interviews were conducted with people experiencing or recently experiencing homelessness and the Bloomington Commission on Aging. The top health issues identified were: - Homelessness - Lack of mental healthcare providers - Transportation to healthcare appointments for those without vehicles - Food Insecurities - Substance Abuse - Children and infants in need - Housing - Healthcare During the meetings, a range of other topics were discussed including: - Resource access - Substance use - Food insecurity - Importance of side-walks for community building, - transportation, and recreation - Healthcare - Basic needs - Homelessness - Childhood conditions - Understanding self - sense of belonging to community - Transportation - Social connections - Insurance - High cost of housing - Care of older adults in the community - Mental health After comparing, the data gathered from the meetings and interviews, the following five needs were noted as the most significant for the community served by IU Health Bloomington Hospital: - Drug and substance abuse - Chronic disease - Smoking, including during pregnancy - Obesity - Mental health Community Meeting (Lawrence County) To obtain a more complete picture of the factors that play into the Lawrence community health, input from local leaders with a stake in the community's health were invited to attend a community health sub-committee meeting on April 10, 2018 held at IU Health Bedford. Organizations who participated in the focus groups are as follows: - Bedford Public Library - Bedford Chamber of Commerce - City of Bedford - City of Bedford Parks and Recreation - Purdue Extension - Stone City Products The meeting began with a presentation that discussed the goals and status of the CHNA process and the purpose of the community meeting. Then, secondary data were presented, along with a summary of the most unfavorable community health indicators. For the community served by IU Health Bloomington Hospital, those indicators were (in alphabetical order): - Chronic Disease management and mortality - Low birthweight and teen birth rates - Mental illness and supply of mental health providers - Mortality from motor vehicle accidents and other injuries - Obesity and physical inactivity - Smoking and smoking during pregnancy - Unemployment and economic factors Meeting participants then were asked to discuss whether the identified, unfavorable indicators accurately identified the most significant community health issues and were encouraged to add issues that they believed were significant. Several issues were added, such as: substance abuse and treatment, access to and pricing of healthcare, collaboration in the community on health needs, and healthy food access and knowledge. During the meetings, a range of other topics were discussed including: - Hospital admission that are preventable - Skills gap in local area compared to job opportunities - Mental health stigma - Smoking policies - Limited resources in the community - Lack of awareness of existing programs/resources - Population patterns in the world and in rural communities After discussing the needs identified through secondary data and adding others to the list, each participant was asked through a voting process to identify three to five needs they consider the most significant. From this process, the group identified five needs as being the most significant in the Lawrence County community: - Substance abuse and treatment - Obesity and physical inactivity - Access to and pricing of healthcare - Unemployment and economic factors/workforce training and education - Mental illness and supply of mental health providers Key Stakeholder Interviews (Monroe and Lawrence Counties) IU Health Bloomington also conducted key stakeholder interviews with representatives of the Monroe and Lawrence County Health Departments. An interview was not conducted with the Owen County Health Department; however, a member of the Owen County Health Board attended the Owen county YMCA focus group. The interviews were conducted to assure that appropriate and additional input was received from the governmental public health officials. Accordingly, 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 interviews were guided by a structural protocol that focused on opinions regarding significant community health needs, describing why such needs are present, and seeking ideas for how to address them. Monroe County The interviewee confirmed that the needs identified through the community meetings were all issues, including: - Drug and substance abuse - Chronic disease - Smoking, including pregnancy - Obesity - Physical Inactivity Overall, services for mental health and substance abuse treatment were considered some of the most significant needs. Substance abuse continues to be a major issue and seems to have increased in recent years despite many efforts to curb the epidemic. While obesity has improved in recent times in Monroe County, it is still an issue and leading to chronic diseases such as heart disease and diabetes. Early childhood trauma and early adult trauma were identified as contributing factors for many of these issues as it was thought that many who experience traumatic events do not learn coping skills to carry on later into life. Access to health care and health services is a need. Although Monroe County has an abundance of resources, it is often difficult to get economically disadvantaged populations to affordable providers. Basic needs insecurity is an issue for certain residents, and affects many aspects of health. Encouraging vaccinations in the community is an important need, as conditions like mumps, measles and others seem to have been revitalized. Public health funding is a major need, as funding opportunities are typically for new programs while previously established programs have difficulty maintaining their
Schedule H, Part V, Section B, Line 7a - CHNA WebsiteA copy of IU Health Bloomington'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 Bloomington'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 Bloomington's Board adopted an implementation strategy in April 2019 relating to the 2018 CHNA. IU Health Bloomington prioritized and determined which of the community health needs identified in its most recently conducted CHNA was most critical for it to address. IU Health Bloomington will address the following community health needs between 2019 and 2021: -Access to Healthcare Services -Chronic Disease and Chronic Disease Management -Drug and Substance Abuse (including Opioids and Alcohol) -Obesity, Diabetes and Physical Inactivity -Mental Health -Senior Health -Social Determinants of Health IU Health uses the term Behavioral Health to refer to Mental Health and Drug and Substance Abuse (including Opioids and Alcohol). Access to Healthcare IU Health Bloomington's implementation strategy to address the identified need of Access to Healthcare includes the following: -Implement a medical neighborhood approach to increase delivery of coordinated healthcare to patients. -Community organizations and members will have access to information about services to support health and wellness. -Support development of a community portal with referral to services. -Develop congregational support through a community collaboration. -Conduct prediabetes screenings in the community to identify people at-risk for diabetes and chronic disease. -Support evidence-based obesity prevention programs: GOAL (Get Onboard Active Living); Moving Forward, and Goal University Chronic Disease and Chronic Disease Management -Implement a medical neighborhood approach to increase delivery of coordinated healthcare to patients. -Community organizations and members will have access to information about services to support health and wellness. -Support development of a community portal with referral to services. -Develop congregational support through a community collaboration. -Develop an integrated pathway for diabetes, hypertension, hyperlipidemia prevention and comprehensive education and care. -Conduct prediabetes screenings in the community to identify people at-risk for diabetes and chronic disease. -Support evidence-based obesity prevention programs: GOAL (Get Onboard Active Living); Moving Forward, and Goal University -Identify at-risk populations, such as pregnant moms, youth, and adults using tobacco products and refer to services. Obesity, Diabetes and Physical Inactivity IU Health Bloomington's implementation strategy to address the identified need of Obesity, Diabetes and Physical Inactivity includes the following: -Develop an integrated pathway for diabetes, hypertension, hyperlipidemia prevention and comprehensive education and care. -Conduct prediabetes screenings in the community to identify people at-risk for diabetes and chronic disease. -Support evidence-based obesity prevention programs: GOAL (Get Onboard Active Living); Moving Forward, and Goal University Behavioral Health (includes Drug & Substance Abuse and Mental Health) IU Health Bloomington's implementation strategy to address the identified need of Behavioral Health includes the following: -Women with children and pregnant women who have behavioral health and/or substance use issues will be identified early and receive care through IU Health Bloomington Women's Clinics. -Provide and promote drug take-back program in the hospital. -Develop behavioral health access and appointment system of support for Positive Link client's onsite. -Provide services and upgrade area for confidential support in collaboration with Volunteers of America. -Support caregivers caring for family or dependents with dementia. -Provide staff from Alzheimer's Resource Services to support the Memory Clinic. Senior Health IU Health Bloomington's implementation strategy to address the identified need of Senior Health includes the following: -Support caregivers caring for family or dependents with dementia. -Provide staff from Alzheimer's Resource Services to support the Memory Clinic. Also, IU Health Bloomington will address all community health needs based on their 2018 Community Health Needs Assessment.
Schedule H, Part V, Section B, Line 13b - Income Level Other than FPGIn addition to FPG, IU Health Bloomington 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 Bloomington takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. IU Health's Individual Solutions Department Prior to seeking Financial Assistance under the FAP, all patients or their guarantors must consult with a member of IU Health's Individual Solutions department to determine if healthcare coverage may be obtained from a government insurance/assistance product or from the Health Insurance Exchange Marketplace. 2. Alternate Sources of Assistance When technically feasible, a patient will exhaust all other state and federal assistance programs prior to receiving an award from IU Health Bloomington's Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowner's, must exhaust all insurance benefits prior to receiving an award from IU Health Bloomington's Financial Assistance Program. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. Patients may be asked to show proof that such a claim was properly submitted to the proper insurance provider at the request of IU Health Bloomington. Eligible patients who receive medical care from IU Health Bloomington 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 Bloomington is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health Bloomington reserves the right to reverse the award in an amount equal to the amount IU Health Bloomington would be entitled to receive had no Financial Assistance been awarded. 3. Alternate Methods of Eligibility Determination IU Health Bloomington will conduct a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an Extraordinary Collection Action ("ECA"). Said accounts may be eligible for assistance under the FAP based on the patient's individual scoring criteria. To ensure all patients potentially eligible for Financial Assistance under the FAP may receive Financial Assistance, IU Health Bloomington will deem patients/guarantors to be presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied his/her required co-pay/deductible: -Indiana Children's Special Health Care Services -Medicaid -Healthy Indiana Plan -Patients who are awarded Hospital Presumptive Eligibility (HPE) -Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level 4. Additional Considerations Financial Assistance may be granted to a deceased patient's account if said patient is found to have no estate. Additionally, IU Health Bloomington 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 Bloomington 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 Bloomington's Emergency Department, via transfer from another hospital facility, or direct admission, will be responsible for a one-hundred dollar ($100.00) non-refundable deposit for services rendered. Patients/guarantors will be responsible for any copays and/or deductibles required by their plan prior to full Financial Assistance being applied. Uninsured Patients wishing to make an application for Financial Assistance greater than the AGB must fulfill their non-refundable deposit prior to IU Health Bloomington 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 Bloomington's FAP is available on the following website: https://iuhealth.org/pay-a-bill/financial-assistance
Schedule H, Part V, Section B, Line 16b - FAP Application WebsiteA copy of IU Health Bloomington's FAP Application is available on the following website: https://iuhealth.org/pay-a-bill/financial-assistance
Schedule H, Part V, Section B, Line 16c - FAP PlS WebsiteA plain language summary of the FAP, including translated copies, is available on the following website: https://iuhealth.org/pay-a-bill/financial-assistance
Schedule H, Part V, Section B, Line 16j - Other Measures to PublicizeIU Health Bloomington 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 Bloomington 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 Bloomington 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 Bloomington will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health Bloomington will educate its patient facing team members of the FAP and the process for referring patients to the Program.
Schedule H, Part V, Section B, Line 3e Prioritized Health NeedsIU Health Bloomington'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 Bloomington: -Access to Healthcare Services -Chronic Disease and Chronic Disease Management -Drug and Substance Abuse (including Opioids and Alcohol) -Mental Health -Obesity, Diabetes, and Physical Inactivity -Senior Health -Social Determinants of Health IU Health uses the term behavioral health to refer to mental health and drug and substance abuse (including opioids and alcohol).
Schedule H, Part V, Section A, Line 1 Primary Website Addresshttps://iuhealth.org/find-locations/iu-health-bloomington-hospital
FieldValueIRS element (for citing)
Facility25FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (25 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
BLOOMINGTON ENDOSCOPY CENTER
550 LANDMARK AVEBLOOMINGTONIN47402AMBULATORY SURGERY
SOUTHERN INDIANA SURGERY CENTER
2800 REX GROSSMAN BLVDBLOOMINGTONIN47403AMBULATORY SURGERY
GREEN COUNTY WIC
200 E MAIN ST STE 1BLOOMFIELDIN47424DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH ADVANCED HEART CARE CENTER
714 S ROGERS STBLOOMINGTONIN47403DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH ANTICOAGULATOIN CLINIC
451 LANDMARK AVEBLOOMINGTONIN47403DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH BEHAVIORAL HEALTH
445 LANDMARK AVEBLOOMINGTONIN47404DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH BLOOMINGTON OCCUP SERVICES
326 S WOODCREST DRBLOOMINGTONIN47401DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH BLOOMINGTON URGENT CARE EAST
326 S WOODCRESTBLOOMINGTONIN47401DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH CANCER RADIATION CENTER
2620 COTA DRBLOOMINGTONIN47404DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH CANCER RADIATION CENTER
9149 SR 37 RR 11BEDFORDIN47421DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH CHILDREN'S THERAPY CENTER
4935 W ARLINGTON RD STE B CBLOOMINGTONIN47404DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH COMMUNITY HEALTH
333 E MILLER DRBLOOMINGTONIN47401DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH COMMUNITY HEALTH EDUC CENTER
431 S COLLEGEBLOOMINGTONIN47403DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH DIABETES CENTER
727 W 2ND STBLOOMINGTONIN47403DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH EMERGENCY MEDICAL TRANSPORT
601 W 1ST STBLOOMINGTONIN47403DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH OCCUPATIONAL HEALTH
3443 W 3RD STBLOOMINGTONIN47403DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH PAIN CENTER
888 AUTO MALL RDBLOOMINGTONIN47401DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH REHAB AND SPORTS MDEDICINE
5 CRANE AVESPENCERIN47460DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH REHAB AND SPORTS MEDICINE
326 S WOODCREST DRBLOOMINGTONIN47401DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH REHAB AND SPORTS MEDICINE
2499 W COTA DRBLOOMINGTONIN47403DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH WOUND CENTER
2920 MCINTIRE DRBLOOMINGTONIN47404DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH BLOOMINGTON HOSP HOME HEALTH
333 E MILLER DRBLOOMINGTONIN47402HOME HEALTH
IU HEALTH HOSPICE
619 W 1ST STBLOOMINGTONIN47403HOSPICE
SIRA IMAGING CENTER
500 S LANDMARK AVEBLOOMINGTONIN47403DIAGNOSTIC AND OTHER OUTPATIENT
IU HEALTH CANCER CENTER INFUSION THERAPY
508 W 2ND STBLOOMINGTONIN47403DIAGNOSTIC AND OTHER OUTPATIENT

Supplemental Information Detail SupplementalInformationDetail (19 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part IV, Line 1(a) - Name of EntitySIRA Imaging Center, LLC
Schedule H, Part IV, Line 2(a) - Name of EntitySouthern Indiana Surgery Center, LLC
Schedule H, Part IV, Line 3(a) - Name of EntityBrown County Medical Cooperative, LLC
Schedule H, Part I, Line 3c - Other Factors Used in Determining Elig.IU Health Bloomington 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 Bloomington will employ the same residency test as set forth in Indiana Code 6-3-1-12 to define an Indiana resident. The term Resident includes any individual who was domiciled in Indiana during the taxable year, or any individual who maintains a permanent place of residence in Indiana and spends more than one hundred eight-three (183) days of the taxable year in Indiana. Patients residing in the state of Indiana while attending an institution of higher education may be eligible for assistance under the FAP if they meet the aforementioned residency test and are not claimed as a dependent on a parent's or guardians' federal income tax return. 2. IU Health's Individual Solutions Department Prior to seeking Financial Assistance under the FAP, all patients or their guarantors must consult with a member of IU Health's Individual Solutions department to determine if healthcare coverage may be obtained from a government insurance/assistance product or from the Health Insurance Exchange Marketplace. 3. Uninsured Patients All Uninsured Patients presenting for services at IU health Bloomington 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 Bloomington's Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowner's, must exhaust all insurance benefits prior to receiving an award from IU Health Bloomington's Financial Assistance Program. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. Patients may be asked to show proof that such a claim was properly submitted to the proper insurance provider at the request of IU Health Bloomington. Eligible patients who receive medical care from IU Health Bloomington 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 Bloomington is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health Bloomington reserves the right to reverse the award in an amount equal to the amount IU Health Bloomington would be entitled to receive had no Financial Assistance been awarded. 6. Alternate Methods of Eligibility Determination IU Health Bloomington will conduct a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an ECA. Said accounts may be eligible for assistance under the FAP based on the patient's individual scoring criteria. To ensure all patients potentially eligible for Financial Assistance under the FAP may receive Financial Assistance, IU Health Bloomington will deem patients/guarantors to be presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied his/her required co-pay/deductible: - Indiana Children's Special Health Care Services - Medicaid - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level 7. Additional Considerations Financial Assistance may be granted to a deceased patient's account if said patient is found to have no estate. Additionally, IU Health Bloomington 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 Bloomington 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 Bloomington 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 Bloomington 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 Bloomington's Emergency Department, via transfer from another hospital facility, or direct admission, will be responsible for a one-hundred dollar ($100.00) non-refundable deposit for services rendered. Patients/guarantors will be responsible for any copays and/or deductibles required by their plan prior to full Financial Assistance being applied. Uninsured Patients wishing to make an application for Financial Assistance greater than the AGB must fulfill their non-refundable deposit prior to IU Health Bloomington 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 Bloomington's community benefit and other investments, encompassing its total community investment, are included in the IU Health Community Benefit Report which is prepared on behalf of and includes IU Health and its related hospital entities in the State of Indiana. The IU Health Community Benefit Report is made available to the public on IU Health's website at https://iuhealth.org/in-the-community. The IU Health Community Benefit Report is also distributed to numerous key organizations throughout the State of Indiana in order to broadly share the IU Health Statewide System's community benefit efforts. It is also available by request through the Indiana State Department of Health or IU Health.
Schedule H, Part I, Line 7, Column (c) - Total Community Benefit ExpenseSchedule H, Part I, Line 7, Column (f), Percent of Total Expense, is based on column (e) Net Community Benefit Expense. The percent of total expense based on column (c) Total Community Benefit Expense, which excludes direct offsetting revenue, is 30.30%.
Schedule H, Part I, Line 7, Column (f) - Percent of Total ExpenseThe amount of bad debt expense subtracted for purposes of calculating the percentage of total expense on Line 7, column (f) is $25,764,281. Bad debt expense is reported at cost based on the cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges.
Schedule H, Part I, Line 7g - Subsidized Health ServicesIU Health Bloomington does not include any costs associated with physician clinics as subsidized health services.
Schedule H, Part II - Promotion of Health in Communities ServedIU Health Bloomington is part of the IU Health Statewide System. The IU Health Statewide System participates in a variety of community-building activities that address the social determinants of health in the communities it serves through investments in economic development efforts across the state, collaboration with like-minded organizations through coalitions that address key issues, and advocacy for improvements in the health status of vulnerable populations. This includes making contributions to community-building activities by providing investments and resources to local community initiatives that 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: -Monroe County Public Health Clinic -Monroe County Community School System -Monroe County Opioid Commission -Early Learning Indiana -United Way Additionally, through the IU Health Statewide System's team member community benefit service program, "Strength That Cares", team members across the state make a difference in the lives of thousands of Hoosiers every year.
Schedule H, Part III, Line 2 - Bad Debt Expense MethodologyThe amount reported on line 2 as bad debt is reported at cost, as calculated using the cost to charge ratio methodology.
Schedule H, Part III, Line 4 - Bad Debt ExpenseIU Health Bloomington is a subsidiary in the consolidated financial statements of IU Health. IU Health's consolidated financial statements, Footnote 4, addresses bad debt expense as follows: The Indiana University Health System does not require collateral or other security from its patients, substantially all of whom are residents of the State, for the delivery of health care services. However, consistent with industry practice, the Indiana University Health System routinely obtains assignment of (or is otherwise entitled to receive) patients' benefits payable under their health insurance programs, plans or policies (e.g., Medicare, Medicaid, managed care payers, and commercial insurance policies. The Indiana University Health System uses a portfolio approach to account for categories of patient contracts as a collective group, rather than recognizing revenue on an individual contract basis. The portfolios consist of major payer classes for inpatient revenue and outpatient revenue. Based on the historical collection trends and other analysis, the Indiana University Health System believes that revenue recognized by utilizing the portfolio approach approximates the revenue that would have been recognized if an individual contract approach were used. In support of its mission, the Indiana University Health System provides care to uninsured and underinsured patients. The Indiana University Health System provides charity care to patients who lack financial resources and are deemed to be medically indigent. Under its financial assistance policy, the Indiana University Health System provides medically necessary care to uninsured patients with inadequate financial resources at charitable discounts equivalent to the amounts generally billed, and it provides eligibility for full charity for emergent encounters for uninsured patients who earn less than 200% of the federal poverty level and who meet application criteria. Patients whose liability is deemed catastrophic relative to their annual household income are also eligible for reduced charges. Since the Indiana University Health System does not pursue collection of these amounts, the discounted amounts are not reported as patient service revenue. The Indiana University Health System uses presumptive eligibility screening procedures for free care and recognizes net patient service revenue on services provided to self-pay patients at the discounted rate at the time services are rendered. The estimated cost of charity care, using the consolidated cost to charge ratio, was $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 Bloomington Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health Bloomington's participation in Medicare programs. For example, the Medicare Cost Report excludes certain costs such as billed physician services, the costs of Medicare Parts C and D, fee schedule reimbursed services, and durable medical equipment services. Inclusion of all costs associated with IU Health Bloomington's participation in Medicare programs would significantly increase the Medicare shortfall reported on Schedule H, Part III, Line 7. IU Health Bloomington'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 Bloomington 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 Bloomington's FAP and Written Debt Collection Policy describe the collection practices applicable to patients, including those who may qualify for financial assistance. 1. Financial Assistance Application Patients or their guarantors wishing to apply for Financial Assistance are encouraged to submit a Financial Assistance Application within ninety (90) days of their discharge. Patients or their guarantors may submit an application up to two-hundred and forty (240) days from the date of their first billing statement from IU Health, however, accounts may be subject to ECA as soon as one hundred and twenty (120) days after having received their first billing statement. Patients or their guarantors submitting an incomplete application will receive written notification of the application's deficiency upon discovery by IU health. The application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health will suspend any ECA until the application is complete, or the patient fails to cure any deficiencies in their application in the allotted period. Patients with limited English proficiency may request to have a copy of the FAP, a FAP Application, and FAP Plain Language Summary in one of the below languages: -Arabic -Burmese -Burmese-Falam -Burmese-Hakha Chin -Mandarin/Chinese -Spanish The patient, and/or their representative, such as the patient's physician, family members, legal counsel, community or religious groups, social services or hospital personnel may request a FAP Application to be mailed to a patient's primary mailing address free of charge. IU Health Bloomington keeps all applications and supporting documentation confidential. Patients applying for assistance under the FAP will be required to complete a Financial Assistance Application. Patients must include the following documentation with their Financial Assistance Application: -All sources of Income for the last three (3) months; -Most recent three (3) months of pay stubs or Supplemental Security Income via Social Security; -Most recent three (3) statements from checking and savings accounts, certificates of deposit, stocks, bonds and money market accounts; -Most recent state and Federal Income Tax forms including schedules C, D, E, and F. In the event a patient's and/or guarantor's income does not warrant the filing of a federal tax return, the patient may submit a notarized affidavit attesting to the foregoing; -Most recent W-2 statement; -For patients or members of the Household who are currently unemployed, Wage Inquiry from WorkOne; and -If applicable, divorce/dissolution decrees and child custody order 2. Eligibility Determination IU Health Bloomington will inform patients or guarantors of the results of their application by providing the patient or guarantor with a Financial Assistance Determination within ninety (90) days of receiving a completed Application and all requested documentation. If a patient or guarantor is granted less than full charity assistance and the patient or guarantor provides additional information for reconsideration, IU Health Revenue Cycle Services may amend a prior Financial Assistance Determination. If a patient or guarantor seeks to appeal the Financial Assistance Determination further, a written request must be submitted, along with the supporting documentation, to the Financial Assistance Committee for additional review/reconsideration. All decisions of the Financial Assistance Committee are final. A patient's Financial Assistance Application and eligibility determination are specific to each individual date(s) of service and related encounters. 3. Extraordinary Collection Actions IU Health Bloomington may refer delinquent patient accounts to a third-party collection agency after utilizing reasonable efforts to determine a patient's eligibility for assistance under the FAP. IU Health Bloomington and its third-party collection agencies may initiate ECA against a patient or their guarantor in accordance with this Policy and 26 C.F.R. 1.501(r). Said ECA may include the following: -Selling a patient's or their guarantor's outstanding financial responsibility to a third party. -Reporting adverse information about the patient or their guarantor to consumer credit reporting agencies or credit bureaus. -Deferring or denying, or requiring a payment before providing, medically necessary care because of a patient's or their guarantor's nonpayment of one or more bills for previously provided care covered under the FAP. -Actions requiring a legal or judicial process, including but not limited to placing a lien on patient's or their guarantor's property, foreclosing on a patient's or their guarantor's real property attaching or seizing a patient's or their guarantor's bank account or other personal property, commencing a civil action against a patient or their guarantor, causing a patient or guarantor's arrest, causing a patient and/or guarantor to be subject to a writ of body attachment, and garnishing a patient or guarantor's wages. When it is necessary to engage in such action, IU Health Bloomington 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 Bloomington. IU Health Bloomington 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 Bloomington 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 Bloomington 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 Bloomington assesses the health care needs of the communities it serves by conducting a CHNA. This assessment includes collaboration with other community organizations such as: -Bloomington Economic Development Center -Bloomington Health Foundation -Bloomington North High School -Local Council of Women -Monroe County Health Department -Slodagraff and Niehoff -United Way of Monroe County -Bedford Public Library -Bedford Chamber of Commerce -City of Bedford -City of Bedford Parks and Recreation -Purdue Extension -Stone City Products After completion of the CHNA, IU Health Bloomington reviewed the information gathered from community leader focus groups, community input surveys and statistical data. The needs identified were analyzed and ranked to determine the prevalence and severity of community health needs and which ones were most critical. Additionally, the effectiveness of an intervention for each need and IU Health Bloomington's ability to impact positive change was evaluated.
Schedule H, Part VI, Line 3 - Patient Education of Eligibility for Assist.IU Health Bloomington 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 Bloomington has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health Bloomington is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health Bloomington 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 Bloomington 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 Bloomington 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 Bloomington will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health Bloomington 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 Bloomington Hospital is located in Monroe County, a county located in south central Indiana. Monroe County includes ZIP codes within the towns of Bloomington, Ellettsville and Unionville. Based on the most recent Census Bureau (2018) statistics, Monroe County's population is 146,917 and approximately 50.3% were female and 49.7% male. The county's population estimates by race are 86.4% White, 3.6% Black, 7.0% Asian, 0.3% American Indian or Alaska Native and 2.6% persons reporting two or more races. In the county, in addition to the above categorizations, 3.5% reported Hispanic or Latino heritage. Monroe County has relatively high levels of educational attainment, as compared to other Indiana counties. Almost half (45.8%) of the population has a bachelor's degree or graduate/professional degree, while 91.9% of the population has obtained a high school degree.
Schedule H, Part VI, Line 5 - Promotion of Community HealthIU Health Bloomington 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. IU Health Bloomington Community Health offers a wide variety of programs and services to the community. From work with the local school systems, to programs that help those living with HIV/AIDS and Alzheimer's disease, our goal is to help our community live healthier.
Schedule H, Part VI, Line 6 - Affiliated Health Care SystemIU Health Bloomington is part of the IU Health Statewide System. The IU Health Statewide System is Indiana's most comprehensive healthcare system. A unique partnership with the IU School of Medicine, one of the nation's leading medical schools, gives patients access to innovative treatments and therapies. IU Health is comprised of hospitals, physicians and allied services dedicated to providing preeminent care throughout Indiana and beyond. National Recognition -Eight hospitals designated as Magnet by the American Nurses Credentialing Center recognizing excellence in nursing care. -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. -One adult and ten pediatric specialty programs ranked among the top 50 national programs in U.S. News & World Report's 2018-2019 edition of America's Best Hospitals. -Nine out of ten specialty programs at Riley Hospital for Children at IU Health ranked among the top 50 children's hospitals in the nation. Education and Research As an academic health center, IU Health works in partnership with the IU School of Medicine to train physicians, blending breakthrough research and treatments with the highest quality of patient care. Each year, more than 1,000 residents and fellows receive training in IU Health hospitals. Research conducted by IU School of Medicine faculty gives IU Health physicians and patients access to the most cutting-edge and comprehensive treatment options. In 2012, IU Health and the IU School of Medicine announced that they would invest $150 million in the Strategic Research Initiative, for a five year period ended December 31, 2016 for certain basic, clinical and translational research programs. 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. The initial focus is on projects in the fields of neuroscience, cancer and cardiovascular disease with the goal to fund transformative proposals that will fundamentally change our understanding of these diseases and lead to important new therapies for patients. The three target research areas represent research strengths at IU School of Medicine, key strategic service lines for IU Health, and important medical needs in a time of an aging population and rising healthcare costs: -Cancer: One of the initiative's primary goals is to enable the IU Health Melvin and Bren Simon Cancer Center to attain the National Cancer Institute's top status of "comprehensive," which would recognize it as one of the top-tier cancer centers in the nation. -Neuroscience: The neurosciences research program will tackle a broad range of brain injuries, neurodegenerative disorders and neurodevelopmental disorders. -Cardiovascular: The cardiovascular research initiative will develop a comprehensive program for the study and treatment of heart failure, from newborns to older adults. A top priority is developing a cardiovascular genetics program. The Strategic Research Initiative will provide patients with access to internationally renowned physicians and to new therapies developed through translational research and clinical trials, and will make use of the latest genetic tools to develop personalized therapies that are more effective for individuals and efficient for healthcare providers. IU Health Statewide System IU Health is a part of the IU Health Statewide System which continues to broaden its reach and positive impact throughout the state of Indiana. IU Health is Indiana's most comprehensive academic health center and consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health, and IU Health Saxony Hospital. Other hospitals in the IU Health Statewide System include the following: -IU Health Arnett Hospital -IU Health Ball Memorial Hospital -IU Health Bedford Hospital -IU Health Blackford Hospital -IU Health Bloomington Hospital -IU Health Frankfort Hospital -IU Health Jay Hospital -IU Health North Hospital -IU Health Paoli Hospital -IU Health Tipton Hospital -IU Health West Hospital -IU Health White Memorial Hospital Although each hospital in the IU Health Statewide System prepares and submits its own community benefits plan relative to the local community, the IU Health Statewide System considers its community benefit plan as part of an overall vision for strengthening Indiana's overall health. A comprehensive community outreach strategy and community benefit plan is in place that encompasses the academic medical center downtown Indianapolis, suburban Indianapolis and statewide entities around priority areas that focus on health improvement efforts statewide. IU Health is keenly aware of the positive impact it can have on the communities of need in the state of Indiana by focusing on the most pressing needs in a systematic and strategic way. In 2018, IU Health provided more than $711 million in total community benefit and served more than 1 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 during the Days of Service. Community Health Initiatives With investments in high-quality and impactful initiatives to address community health needs statewide, IU Health is helping Indiana residents improve their health and their quality of life. In 2018, IU Health impacted many people statewide through presentations, health risk screenings, health education programs, and additional health educational opportunities made available to the community, especially to our community members in the greatest need of such services. The Indiana University Health Board of Directors also approved Community Health Improvement Grants. With these grants, nearly $750,000 will fund projects that address IU Health priorities-behavioral health/substance abuse, obesity, tobacco use, and infant mortality-as well as community-specific needs. The grants, administered by the Indiana University Health Foundation, were awarded to the following in the South Central Region: Family Vitality Initiative development and implementation, IU Health South Central Region, $230,000 over two years. By bringing together existing healthcare providers, social workers and researchers, this integrated program will take a holistic approach to addressing substance-related healthcare issues, especially among the most vulnerable populations of women and children. The South Central Region has seen alarming increases in the numbers of infants who test positive for opiates at birth, opioid-related encounters in each emergency department, and mothers struggling with addiction including smoking. The IU Health Community Health Grants seek to improve community health by supporting collaboration among IU Health Regional Hospital Boards and Community Health Committees, and local resources and programs. The Community Health Grants are awarded to programs most likely to improve access to health services, enhance the health of the community, advance medical or healthcare knowledge, and relieve or reduce the burden of government or other community efforts. Grantees must also build capacity for addressing these community health issues going forward. Community Partnerships IU Health believes in the power of investing in community partnerships and what that means for the health of our residents and their communities. IU Health seeks to partner with local non-profits on initiatives that specifically aim to serve an identified community need, particularly in the areas of IU Health's five community outreach priorities: reducing health disparities or improving the quality of life for individuals living within IU Health communities, reaching largely underserved communities and supporting the strategic business goals for IU Health. Below are a few of the partners we worked with in 2018 to address priority health needs in Monroe County. -Monroe County Public Health Clinic -Monroe County Community School System -Monroe County Opioid Commission -Early Learning Indiana -United Way Access to Healthcare IU Health is committed to providing quality and complete healthcare for Hoosiers. Access to healthcare was a leading community health need identified in all communities served by IU Health across the state. IU Health is focusing on the needs
Schedule H, Part III, Line 3 - Bad Debt Att to Patients Eligible Under FAPAn 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 I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Bloomington Hospital Foundation IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1149AddressLine1Txt
CityBloomingtonCityNm
State AbbreviationINStateAbbreviationCd
ZIP47402ZIPCd
FieldValueIRS element (for citing)
Recipient EIN351720795RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$81,427CashGrantAmt
Purpose Of GrantGeneral SupportPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSch. I, Part I, Line 2 - Org.'s Proced. for Monit. the Use of Grant FundsFormAndLineReferenceDesc
ExplanationAlthough IU Health Bloomington 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

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (20 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JAMES J LAUGHLIN MD
(SCR) DIRECTOR$0$408,397$0$40,788$0$6,858$0$13,700$0$0$0$469,743$0$0
MATTHEW D BAILEY
PRESIDENT (SCR) (Part Year)$0$287,416$0$158,544$0$1,047,262$0$322,129$0$7,138$0$1,822,489$0$343,365
MICHAEL L CRAIG
VP & CFO (SCR)$0$234,635$0$42,348$0$2,224$0$12,590$0$16,722$0$308,519$0$0
KENNETH E MARSHALL MD
VP & CMO (SCR) (PARTIAL YEAR)$78,417$65,565$0$0$101,889$85,190$3,341$2,794$14,710$12,299$198,357$165,848$0$0
BRIAN T SHOCKNEY
President (SCR) (Part Year)$203,036$164,557$40,359$32,710$31,328$25,391$29,937$24,264$14,402$11,672$319,062$258,594$0$0
LARRY BAILEY
PRESIDENT IUH PAOLI/IUH MORGAN$257,796$0$95,359$0$136,149$0$13,700$0$21,209$0$524,213$0$115,340$0
LINDA LEWIS
VP & CNO$0$0$0$0$124,205$0$0$0$0$0$124,205$0$0$0
WENDY HERNANDEZ
VP, PROF & SUPPORT SERVICES$169,480$0$26,267$0$827$0$10,555$0$18,176$0$225,305$0$0$0
CAREY C MAYER MD
PSYCHIATRIST$281,608$0$0$0$1,524$0$13,512$0$21,930$0$318,574$0$0$0
CHAD W SCHULTHEIS MD
PSYCHIATRIST$265,957$0$0$0$15,876$0$13,642$0$23,201$0$318,676$0$0$0
David L Beachy DO
(SCR) Director$0$254,890$0$25,481$0$6,858$0$13,700$0$23,729$0$324,658$0$0
Alfonso W Gatmaitan
(SCR) Director$0$853,829$0$504,450$0$1,700,526$0$1,012,983$0$24,850$0$4,096,638$0$703,392
Hojjat M Shamloo MD
(SCR) Director$0$330,464$0$151,256$0$2,322$0$13,700$0$30,468$0$528,210$0$0
John S Strobel MD
(SCR) Director$0$601,964$0$58,845$0$60,247$0$13,700$0$24,585$0$759,341$0$0
Daniel A Handel MD
VP & CMO (SCR)(PARTIAL YEAR)$262,321$39,622$47,195$7,129$18,071$2,729$9,557$1,443$15,101$2,281$352,245$53,204$0$0
Cynthia Herrington
VP & CNO (SCR) (Part Year)$143,899$0$34,774$0$645$0$8,457$0$10,440$0$198,215$0$0$0
Nida JSyed MD
Psychiatrist$261,410$0$0$0$32,538$0$11,000$0$9,561$0$314,509$0$0$0
Greg SSidell MD
Psychiatrist$260,388$0$0$0$32,075$0$11,000$0$30,458$0$333,921$0$0$0
Douglas M Frye
Physicist-Radiation Medicine$234,717$0$6,183$0$715$0$10,621$0$30,232$0$282,468$0$0$0
Derek Fields
Dir-Pharmacy$166,067$0$17,205$0$5,564$0$9,497$0$18,103$0$216,436$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 4a - SeveranceMatthew D. Bailey entered into a severance agreement with IU Health during 2018. Severance of $198,986 that was received during 2018 is included in column B(III), other reportable compensation. Deferred severance of $308,429 is included in column c, retirement and other deferred compensation. Alfonso W. Gatmaitan entered into a severance agreement with IU Health during 2018. Severance of $17,530 that was received during 2018 is included in column B(III), other reportable compensation. Deferred severance of $999,283 is included in column c, retirement and other deferred compensation. Kenneth E. Marshall entered into a severance agreement with IU Health during 2018. Severance of $185,350 that was received during 2018 is included in column B(III), other reportable compensation. Linda Lewis entered into a severance agreement with IU Health during 2018. Severance of $124,205 that was received during 2018 is included in column B(III), other reportable compensation.
Schedule J, Part I, Line 4b - Supplemental Nonqualified Retirement PlanMatthew D. Bailey, Larry R. Bailey, Brian T. Shockney and Alfonso W. Gatmaitan participate in a supplemental executive retirement plan, provisions of which are designed to retain these critical employees. The plan provides for an additional retirement benefit for service through normal retirement or other key dates. If the executive leaves prior to retirement or other key dates, the benefit may be forfeited or reduced. Brian T. Shockney has an amount included in column c, deferred compensation, representing the current year unvested contributions made under the supplemental retirement plan. No amounts were actually paid to this executive during the year. Matthew D. Bailey, Larry R. Bailey and Alfonso W. Gatmaitan have amounts included in column B (iii), other reportable compensation, representing the vested amount paid out under IU Health's supplemental executive retirement plan. The amounts received are as follows: -Matthew D. Bailey ($ 789,115) -Larry R. Bailey ($132,573) -Alfonso W. Gatmaitan ($1,654,573)
Schedule J, Part I, Line 7 - Non-Fixed PaymentsAmounts disclosed in Column B(ii) include incentives for certain executives. As part of IU Health Bloomington's executive compensation plan, annual goals are set for each member of the senior leadership group with each members' annual incentive determined upon the degree of successful completion of his or her set goals. Any incentive payouts are made in the form of a lump sum payment and do not affect the executive's base pay. Alternatively, the executive may elect to defer any or all of the incentive compensation through IU Health Bloomington's 457(f) plan, subject to any plan restrictions. Any incentive amounts for the President must receive approval from the Compensation Committee. All other incentive amounts must receive approval from the President and the Compensation Committee.
Schedule J, Part I, Line 1a - Listed BenefitsTemporary housing allowance was provided to two key employees listed in IU Health Bloomington's Form 990, Part VII, Section A. The cost of the arrangement was treated as taxable compensation and was grossed-up for taxes.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part VI, Section A, Line 2 - Family or Business RelationshipsCertain officers, directors or key employees of Indiana University Health, Inc. (IU Health) may also serve on the boards or as officers of other related or unrelated organizations. As noted below, no additional compensation was provided to these individuals for their service to related organizations. Related for-profit organization: Indiana University Southern Indiana Physicians, Inc. Type of Relationship: Business Director or Officer: Brian T. Shockney, Joyce B. Poling and Michael L. Craig
Part VI, Section A, Lines 6, 7a and 7b - Members or StockholdersLine 6: The sole member of IU Health Bloomington is IU Health, a 501(c)(3) tax-exempt organization. Line 7A: The Board of Directors shall consist of thirteen (13) members. To be eligible for Board membership, a Director candidate shall satisfy the selection criteria and personal characteristics as may be established by IU Health from time to time. It is preferred that at least three (3) of the Directors are physician members, but it is not required. The composition of the Board of Directors shall be consistent with the following criteria: I. Two (2) members shall be representatives of Indiana University Health Bedford, Inc.; ii. Two (2) members shall be representatives of Indiana University Health Paoli, Inc.; iii. Two (2) members shall be representatives of Indiana University Health Morgan, Inc.; iv. Five (5) members shall be representatives of Indiana University Health Bloomington, Inc.; and v. Two (2) members shall be the President of the IU Health South Central Region and an IU Health executive leadership representative. Line 7B: The following matters require the approval of IU Health, as the Member, before becoming effective: (a) Authorize the establishment or acquisition of any subsidiaries, affiliates or joint venture arrangements or acquisitions of all or substantially all of the assets of any other business or entity; (b) Recommend and ratify or amend and operating and capital budgets of the Corporation; (c) Authorize any unbudgeted operating or capital budget items or deviations, including any issuance or guarantee of any unbudgeted debt, greater than the budgeted amount of $100,000 for any individual item or $300,000 per fiscal year in the aggregate; (d) Authorize the incurrence of debt by the Corporation in accordance with policies and procedures issued by IU Health, including to serve as a guarantor, surety or co-obligor; (e) Authorize any merger, consolidation, reorganization, sale or transfer of all or substantially all of the Corporation's assets or a subsidiary organization of the Corporation; (f) Authorize any voluntary declaration of bankruptcy, plan of dissolution, any liquidating distribution of assets or other action related to the dissolution or liquidation of the Corporation or a subsidiary organization of the Corporation; (g) Approve any management agreement for the management of all or a substantial part of the Corporation's operations; (h) Approve, upon recommendation of the Nominating Committee, the members of the Board of Directors of the Corporation; (i) Recommend and ratify any strategic plans and amendments thereto, which will be aligned with IU Health; (j) Approve any action to terminate acute care services or close the hospital operated by the Corporation (the "Hospital"); and (k) Approve any amendments to the Articles of Incorporation and Bylaws of the Corporation or a subsidiary organization of the Corporation.
Part VI, Section B, Line 11b - Review of Form 990The VP & CFO reviewed and approved the Form 990. Following the VP & CFO's review and approval, a complete copy of the Form 990 was made available to each board member prior to its filing. Each member was also informed of the availability of IU Health's Tax Department to answer any questions.
Part VI, Section B, Lines 12, 13, 14, and 16b - PoliciesIU Health Bloomington is part of the IU Health system. As the sole member and controlling parent of IU Health Bloomington, IU Health and its Board of Directors have mandated that certain policies be followed to ensure greater standardization throughout the system. Thus, IU Health Bloomington's Board of Directors was not required to separately adopt a conflict of interest, whistleblower, document retention and destruction and joint venture policies because IU Health's Board of Directors had already adopted and required these policies to be followed by its subsidiaries.
Part VI, Section B, Line 12c - Conflict of Interest PolicyIU Health Bloomington follows IU Health's Conflict of Interest Policy. IU Health's Conflict of Interest Policy includes the following provisions: All IU Health employees, associates, colleagues and contracted personnel, including employed physicians and paid medical directors ("IU Health Representatives") are covered by and subject to its Conflict of Interest Policy. IU Health regularly and consistently monitors and enforces compliance with the policy through the following procedures: (a) On an annual basis, each IU Health Representative at the level of Manager or above, together with every other person designated by the Corporate Compliance Department ("Department"), must complete, sign and submit a Conflict of Interest Questionnaire ("Questionnaire") to the Department. Governing board members, committee members, corporate officers, medical staff and researchers must comply with the administrative requirements noted in the respective policies and procedures relative to those areas. (b) An IU Health Representative must supplement a Questionnaire in writing, if after completion of the original Questionnaire, a situation arises, or may reasonably be expected to arise, that would change any answer or information on the original Questionnaire if the situation had existed or been anticipated at the time of completion of the original Questionnaire. (c) If a fully and properly completed Questionnaire reveals facts or other information that might reasonably indicate a Conflict of Interest or violation of the policy, the IU Health Representative completing the questionnaire must secure approval by his/her supervisor, evidenced in writing. (d) The Department will review each Questionnaire and determine whether a Conflict of Interest exists and, if so, whether and how it should or may be eliminated, avoided or managed in order to comply with the spirit of the policy and with the best interests of IU Health and its patients. In making the determination, the Corporate Compliance Department may consult with the IU Health Representative's supervisor and other appropriate individuals and groups. (e) The scope of the policy is not limited to those who are required to complete Questionnaires. If an IU Health Representative is involved in a situation or relationship that would constitute a violation of the policy in the absence of disclosure and approval as described above, then the IU Health Representative must disclose the matter to his/her supervisor, secure his/her supervisor's approval in writing, and disclose the matter to the Department. Otherwise, the IU Health Representative is in violation of the policy and subject to corrective action, up to and including termination. (f) The Chief Compliance Officer, in consultation with onsite Compliance personnel, may from time to time appoint standing or ad hoc committees to assist in resolving issues that arise under provisions of the policy.
Part VI, Section B, Line 15 - Process for Determining CompensationIU Health Bloomington has the following process for determining the compensation of its officers and key employees: IU Health Bloomington has a formal written policy governing the compensation for its President, VP & CFO, and all other members of its senior leadership group ("SLG"). The policy provides that the compensation and/or benefits for the SLG are to be reviewed on an annual basis, with any changes approved, by the Compensation Committee. The Compensation Committee is comprised of independent members and members of IU Health Bloomington's administrative staff shall not be present while discussions are being held. Any proposed changes in compensation and/or benefits for the SLG that come before the Compensation Committee are required to be reasonable and market competitive based upon market comparability data supplied by an independent compensation consulting firm directly hired by the Compensation Committee. Written minutes of the Compensation Committee's meetings shall be kept, containing a list of the members involved in the decision-making process, documentation of the independence of such members, and what decisions were made. Following approval by the Compensation Committee, any changes are then disclosed to the Board of Directors at its next regularly scheduled meeting.
Part VI, Section C, Line 19 - Public DisclosureIU Health Bloomington's Articles of Incorporation are available for public inspection through the Indiana Secretary of State's website. IU Health Bloomington's conflict of interest procedures are described on Form 990, Schedule O. IU Health Bloomington is a subsidiary in IU Health's Consolidated Audited Financial Statements. IU Health's Consolidated Audited Financial Statements are available for public inspection through its bond filings and as an attachment to IU Health's Form 990 as well as IU Health Bloomington's Form 990.
Part XI, Line 9 - Other Changes in Net Assets or Fund BalancesDuring 2018, IU Health Bloomington recorded the following other changes in net assets or fund balances: Net Asset Transfer - $ (53,964,481) Change in Pension Obligation - $ 23,630,118 Total: $ (30,334,363)
Page 1, Line J Web Site:https://iuhealth.org/find-locations/iu-health-bloomington-hospital
Part VI, Section A, Line 4 - Sig. Changes to Gov. DocumentsDuring 2018, IU Health Bloomington amended and restated its Bylaws to change the composition, terms, and powers of its board of directors.
FORM 990 PART IX LINE 11GDESCRIPTION:SHARED SERVICES/PROF FEES TOTAL FEES:88600376

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Bloomington Endoscopy Center LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1950 N Meridian St Ste 800AddressLine1Txt
CityIndianapolisCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
EIN352117943EIN
Primary ActivitiesHealthcarePrimaryActivitiesTxt
Legal Domicile StateINLegalDomicileStateCd
Total Income$4,126,933TotalIncomeAmt
End Of Year Assets$4,317,546EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1IUHBBusinessNameLine1Txt

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 BMH Foundation Inc
950 N Meridian St Ste 800IndianapolisIN46204311111784FundraisingIN501(c)(3)12 IIUHBMHYes (true)
IU Health Care Associates Inc
950 N Meridian St Ste 300IndianapolisIN46204351747218HealthcareIN501(c)(3)10IUHYes (true)
IU Health Frankfort Inc
950 N Meridian St Ste 300IndianapolisIN46204815174295HealthcareIN501(c)(3)3IUHYes (true)
IU Health Jay 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)
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)3IUHBYes (true)
IU Health Plans NFP Inc
950 N Meridian St Ste 800IndianapolisIN46204463803873InsuranceIN501(c)(4)N/AIUHYes (true)
IU Health Tipton Hospital Inc
950 N Meridian St Ste 300IndianapolisIN46204262772226HealthcareIN501(c)(3)3IUHYes (true)
IU Health West Hospital Inc
950 N Meridian St Ste 300IndianapolisIN46204351814660HealthcareIN501(c)(3)3IUHYes (true)
IU Health White Memorial Hospital Inc
950 N Meridian St Ste 300IndianapolisIN46204273532963HealthcareIN501(c)(3)3IUHYes (true)
IU Medical Group Foundation Inc
340 W 10th St No FS5100IndianapolisIN46202201093251FundraisingIN501(c)(3)12 IINAfalse
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)
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)
Indiana University 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)3MHHYes (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)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDirect Controlling NADirectControllingNACd
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
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 800IndianapolisIN46204831224627HealthcareINN/A
HEALTH VENTURE MANAGEMENT LLC
950 N MERIDIAN ST STE 800IndianapolisIN46204205740218ManagementINNA

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
BMH Medical Pavilion Association Inc
2525 W University AveMuncieIN47303351858408Condo MgmtINNACYes (true)
Cardinal Health Ventures Inc
950 N Meridian St Ste 800IndianapolisIN46204351611424ManagementINNACYes (true)
CHV Capital Inc
950 N Meridian St Ste 800IndianapolisIN46204260752507Venture CapitalINNACYes (true)
IU Health 457(B) Plan
1100 N Market StWilmingtonDE19890476948347InvestmentsINNATYes (true)
IU Health ACO Inc
950 N Meridian St Ste 800IndianapolisIN46204454421020HealthcareINNACYes (true)
IU Health Board Designated Trust
400 Howard StSan FranciscoCA94105306309021InvestmentsINNATYes (true)
IU Health NTGI S&P500 Fund CF
PO Box 804358ChicagoIL60680306298263InvestmentsINNATYes (true)
IU Health Plans Holding Company Inc
950 N Meridian St Ste 800IndianapolisIN46204463794815InsuranceINNACYes (true)
IU Health Plans Inc
950 N Meridian St Ste 800IndianapolisIN46204262127080HMOINNACYes (true)
IU Health Risk Purchasing Group Inc
151 Meeting St Ste 301CharlestonSC29401260202446InsuranceINNACYes (true)
IU Health Risk Retention Group Inc
151 Meeting St Ste 301CharlestonSC29401201107674InsuranceSCNACYes (true)
IU Health Southern IN Physicians Inc
950 N Meridian St Ste 300IndianapolisIN46204351913875HealthcareINIUHBCYes (true)$107,163,516$26,505,8820.76920
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)
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Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (11 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
IU HEALTH SOUTHERN INDIANA PHYSICIANS INC
J$533,380FMV
IU HEALTH BEDFORD INC
K$118,907FMV
IU HEALTH BEDFORD INC
L$4,147,969FMV
IU HEALTH PAOLI INC
L$1,984,854FMV
IU HEALTH SOUTHERN INDIANA PHYSICIANS INC
L$344,046FMV
IU HEALTH CARE ASSOCIATES INC
M$66,686FMV
IU HEALTH SOUTHERN INDIANA PHYSICIANS INC
M$12,143,337FMV
IU HEALTH PAOLI INC
O$198,799FMV
IU HEALTH SOUTHERN INDIANA PHYSICIANS INC
O$169,234FMV
IU HEATLH RISK RETENTION GROUP INC
R$966,740FMV
IUH ASSURANCE SPC LTD
R$823,306FMV