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INDIANA REGIONAL MEDICAL CENTER: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
INDIANA REGIONAL MEDICAL CENTER (EIN 25-0965404)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-05-15
IRS object ID
201841359349311779
Schema version
2016v3.0
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)
Return2018-05-15T16:28:36-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Baker Tilly Virchow Krause LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11650 Market Street Suite 4500AddressLine1Txt
CityPhiladelphiaCityNm
State AbbreviationPAStateAbbreviationCd
ZIP191037341ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN250965404EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Indiana Regional Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlINDIBusinessNameControlTxt
Phone7243577008PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1835 Hospital RoadAddressLine1Txt
CityIndianaCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15701ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRobert A GongawarePersonNm
Person TitleSenior VP FinancePersonTitleTxt
Phone7243577008PhoneNum
Signature2018-05-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJulius C Green CPAPreparerPersonNm
PTINP00350393PTIN
Phone2159720701PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address96.89.178.154IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-05-15IPDt
IP Tm15:21:33IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id9D0D8DD59390B7764A3ECE0F40BBFE3618018605AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerStephen A WolfePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1835 Hospital RoadAddressLine1Txt
CityIndianaCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15701ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$202,505,300GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.indianarmc.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1944FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionTO SERVE THE HEALTHCARE NEEDS OF EVERY LIFE WE TOUCH WITH COMPASSION, RESPECT, AND DIGNITY.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee1389TotalEmployeeCnt
Total Volunteers130TotalVolunteersCnt
Total Gross UBI$8,419,555TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$445,417NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$359,324PYContributionsGrantsAmt
CY Contributions Grants$152,604CYContributionsGrantsAmt
PY Program Service Revenue$139,047,052PYProgramServiceRevenueAmt
CY Program Service Revenue$149,071,180CYProgramServiceRevenueAmt
PY Investment Income$4,476,522PYInvestmentIncomeAmt
CY Investment Income$5,124,698CYInvestmentIncomeAmt
PY Other Revenue$7,267,034PYOtherRevenueAmt
CY Other Revenue$12,508,230CYOtherRevenueAmt
PY Total Revenue$151,149,932PYTotalRevenueAmt
CY Total Revenue$166,856,712CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$80,063,247PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$83,592,608CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$64,170,000PYOtherExpensesAmt
CY Other Expenses$71,409,535CYOtherExpensesAmt
PY Total Expenses$144,233,247PYTotalExpensesAmt
CY Total Expenses$155,002,143CYTotalExpensesAmt
PY Revenues Less Expenses$6,916,685PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$11,854,569CYRevenuesLessExpensesAmt
Total Assets BOY$239,409,301TotalAssetsBOYAmt
Total Assets EOY$246,705,223TotalAssetsEOYAmt
Total Liabilities BOY$126,337,454TotalLiabilitiesBOYAmt
Total Liabilities EOY$110,960,191TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$113,071,847NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$135,745,032NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe mission of Indiana Regional Medical Center is to serve the healthcare needs of every life we touch with compassion, respect, and dignity.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$125,101,139ExpenseAmt
Revenue$149,071,180RevenueAmt
DescHealth Diagnostic, Intervention & Treatment Service:Indiana Regional Medical Center ("IRMC") is a non-profit, community based health system that offers a wide range of services including diagnostics, medicine, surgery, pediatrics, obstetrics, geriatric behavioral healthcare and rehabilitative nursing. IRMC demonstrates an ongoing commitment to the community by continually reviewing and improving its services to ensure that the community receives top-quality, efficient, accessible, cost-effective healthcare and quality outreach and health promotion services. IRMC continues to provide mobile health services to rural areas of the county. In addition to primary care physicians, IRMC was successful in recruiting an ENT (Ears, Nose and Throat) physician, a Podiatrist, 2 OB/GYN doctors, a Urologist, and a Cardiologist within the IPG Corporation to help continue to satisfy the needs of the community.Mass Health Screening: IRMC's Mobile Medical Services continues to provide free blood pressure screenings in 19 locations in Indiana County. We also continue to participate in numerous free community events providing education, screening programs and first aid services.Health Fairs:The provision of health services and information through health fairs, classes and programs - The Institute for Healthy Living at IRMC offers health services and educational programs to the community at no charge such as:Indiana Chamber of Commerce Business ExpoAgony of DeFeetBike to School DayStress to Clark MetalClymer Church Health FairCold Hands Warm HeartSpirit of Women Day of DanceDowntown Indiana ChristmasFamily Fun Fest Family Fun Day at Chestnut RidgeFitness Seminar to "B!Well"From Shoulders to FingertipsSpirit of Women - Girls Night OutSouth of the Border - Veins, Low Back Pain & Pelvic Health"B!Well" Farmers MarketIRMC "B!Well" Health FairKeystone Generating Station Health FairsLifeline program to Kiwanis and St. Andrew's VillageOlympic Day & Joint Center PicnicDOC - Pine Grove - healthy eating on a budget lunch seminarProstate Education SeminarExercise at Range ResourcesS&T Health FairSmall Change Big ChoicesSmall Choices Big ChangeTeen TalkTorrance State Hospital health FairHealth Care Delivery & Management:The Community Health Advisory Council of Indiana County, which was formed in 1996, serves as a State Health Improvement Partnership. The goal of the council is to identify or develop resources to address top health priorities in the county. The council continues to promote an annual influenza campaign. The Council implemented a county prescription assistance program to assist residents with accessing pharmaceuticals free or at a reduced cost based on income.Health Care Programs, General/Other: The Center for Diabetes Care continues to offer free education services at various locations throughout the county. In addition, they continue to be the primary sponsor of the county's diabetes walk. Each month staff and management at IRMC provide support to a local food bank. IRMC has been a previous multi-year recipient of the Best Places to Work in PA. Preventive Health Services, General/Other: M. Dorcas Clark Women's Imaging Center: The Women's Imaging Center and their staff have participated in numerous community events providing information about the importance of breast health. Birdie's Closet, a project designed to help women cope with appearance-related side-effects of cancer treatment, was opened in the Women's Imaging Center.Desc
Total Program Service Expenses$125,101,139TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document264IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1389EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Robert A Gongaware SVP FinanceBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7243577008PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1835 Hospital RoadAddressLine1Txt
CityIndianaCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15701ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Anne White
Chair1.002.00Yes (X)Yes (X)$0$0$0
Nathan Kovalchick
Vice Chair1.001.00Yes (X)Yes (X)$0$0$0
T Michael Price
Treasurer1.001.00Yes (X)Yes (X)$0$0$0
Mark R McGowan PHD
Secretary1.001.00Yes (X)Yes (X)$0$0$0
Stephen A Wolfe
President & CEO34.006.00Yes (X)Yes (X)$413,504$0$110,684
Todd Brice
Board Member1.002.00Yes (X)$0$0$0
Russell A Drozdiak MD
Board Member1.001.00Yes (X)$0$0$0
Mark E Boykiw MD
Board Member1.0040.00Yes (X)$0$291,750$18,409
Beverly Gazza Esq
Board Member1.001.00Yes (X)$0$0$0
James R Martin
Board Member1.001.00Yes (X)$0$0$0
Greg Sipos
Board Member1.00Yes (X)$0$0$0
David Bizousky MD
Board Member/MED STAFF President1.00Yes (X)$0$0$0
Dominic Paccapaniccia
Chief Operating Officer38.002.00Yes (X)$235,346$0$41,445
Brett Braun
COO, IPG40.00Yes (X)$168,314$0$29,311
Jim Kinneer
VP, Org Dev40.00Yes (X)$128,211$0$30,661
Mark Richards
VP, Marketing40.00Yes (X)$107,245$0$14,818
Robert A Gongaware
SR VP Finance36.004.00$217,381$0$23,658Yes (X)
Bruce A Bush MD
Sr VP Medical Director36.004.00$280,238$0$34,278Yes (X)
Cindy Virgil
Sr VP Patient Services39.001.00$183,165$0$19,255Yes (X)
Dr Anthony L Sico
Physician40.00$256,723$0$23,273Yes (X)
Dr Patrick Shannon
physician40.00$254,955$0$59,631Yes (X)
Dr Jason Rasefske
physician40.00$244,739$0$43,611Yes (X)
Gregory Hay
Physician40.00$207,740$0$29,557Yes (X)
Dr Wendy Angelo
physician40.00$203,542$0$29,691Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,901,103TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$291,750TotReportableCompRltdOrgAmt
Total Other Compensation$508,282TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K52IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
A MARTINI & COMPANY INC
320 GRANT STREETVERONAPA15147CONSTRUCTION services FOR NEW BUILDING$13,345,828
Cerner Corporation
PO Box 959156St LouisMO63195Software System Installation$2,654,696
CURA HOSPITALITY INC
PO BOX 743676ATLANTAGA30374OUTSIDE FOOD AND NUTRITION SERVICES$946,248
MAYO COLLABORATIVE SERVICS INC
PO BOX 9146MINNEAPOLISMN55480OUTSIDE LAB SERVICES$893,902
PMHA
150 McCracken Run RdDuboisPA15801Billing & Revenue Cycle Services$550,380
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K29CntrctRcvdGreaterThan100KCnt
All Other Contributions$152,604AllOtherContributionsAmt
Total Contributions$152,604TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Svc Rev621990$148,538,087$148,538,087
Rental Revenue-Affiliates531120$313,132$313,132
Health Classes/Counsel624100$127,342$127,342
Hospice Prescriptions621990$92,619$92,619
FieldValueIRS element (for citing)
Total Program Service Revenue$149,071,180TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,526,892TotalRevenueColumnAmt
Exclusion$2,526,892ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,924TotalRevenueColumnAmt
Exclusion$1,924ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,733,497RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,472,040RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$261,457RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$261,457TotalRevenueColumnAmt
Exclusion$261,457ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$36,654,354SecuritiesAmt
Other$120,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$33,589,938SecuritiesAmt
Other$586,610OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$3,064,416SecuritiesAmt
Other-$466,610OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,597,806TotalRevenueColumnAmt
Exclusion$2,597,806ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
LAB SERVICES621500$7,907,833$7,907,833
Leased Employees900099$1,348,341$1,348,341
Cafeteria Rev722210$982,908$982,908

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,005,767TotalRevenueColumnAmt
Unrelated Business Revenue$511,722UnrelatedBusinessRevenueAmt
Exclusion$1,494,045ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$12,244,849OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$166,856,712TotalRevenueColumnAmt
Related Or Exempt Func Income$149,071,180RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$8,419,555UnrelatedBusinessRevenueAmt
Exclusion$9,213,373ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$60,190,745TotalAmt
Program Services$48,116,482ProgramServicesAmt
Management And General$12,074,263ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$5,053,722TotalAmt
Program Services$4,039,945ProgramServicesAmt
Management And General$1,013,777ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$13,966,599TotalAmt
Program Services$11,164,899ProgramServicesAmt
Management And General$2,801,700ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,381,542TotalAmt
Program Services$3,502,605ProgramServicesAmt
Management And General$878,937ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$574,931TotalAmt
Management And General$574,931ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$119,504TotalAmt
Management And General$119,504ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$1,043TotalAmt
Management And General$1,043ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$270,085TotalAmt
Management And General$270,085ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$13,972,245TotalAmt
Program Services$11,243,466ProgramServicesAmt
Management And General$2,728,779ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$910,047TotalAmt
Program Services$35,401ProgramServicesAmt
Management And General$874,646ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,438,268TotalAmt
Program Services$1,410,366ProgramServicesAmt
Management And General$27,902ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,346,191TotalAmt
Program Services$1,205,967ProgramServicesAmt
Management And General$2,140,224ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,830,161TotalAmt
Program Services$2,079,036ProgramServicesAmt
Management And General$751,125ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$295,068TotalAmt
Program Services$163,468ProgramServicesAmt
Management And General$131,600ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$16,484TotalAmt
Program Services$16,484ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,950,811TotalAmt
Management And General$1,950,811ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$9,524,085TotalAmt
Program Services$8,278,335ProgramServicesAmt
Management And General$1,245,750ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,968,299TotalAmt
Program Services$1,573,458ProgramServicesAmt
Management And General$394,841ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies & Phar$23,600,024$23,142,184$457,840
Bad Debt Expense$3,172,787$3,172,787
Repairs & Maintenance$2,862,639$2,288,394$574,245
Cleaning Services & Sup$1,242,227$993,036$249,191

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,314,636TotalAmt
Program Services$2,674,826ProgramServicesAmt
Management And General$639,810ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$155,002,143TotalAmt
Program Services$125,101,139ProgramServicesAmt
Management And General$29,901,004ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$7,505BOYAmt
EOY$7,707EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,379,224BOYAmt
EOY$3,846,073EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$12,407,997BOYAmt
EOY$18,760,220EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$2,741,012BOYAmt
EOY$1,782,995EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,438,456BOYAmt
EOY$3,005,097EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$3,237,534BOYAmt
EOY$8,992,239EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$198,566,223LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$104,111,202LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$92,302,979BOYAmt
EOY$94,455,021EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$96,928,044BOYAmt
EOY$92,114,107EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$20,853,175BOYAmt
EOY$11,592,236EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$278,242BOYAmt
EOY$7,418,661EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$4,835,133BOYAmt
EOY$4,730,867EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$239,409,301BOYAmt
EOY$246,705,223EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$18,230,947BOYAmt
EOY$16,165,241EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$51,061,521BOYAmt
EOY$49,145,968EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,495,929BOYAmt
EOY$1,314,409EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$55,549,057BOYAmt
EOY$44,334,573EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$126,337,454BOYAmt
EOY$110,960,191EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$105,696,471BOYAmt
EOY$130,313,948EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,375,376BOYAmt
EOY$5,431,084EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$113,071,847BOYAmt
EOY$135,745,032EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$239,409,301BOYAmt
EOY$246,705,223EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$11,854,569ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$5,282,608NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$5,536,008OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

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)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$1,043OtherActivitiesAmt
Total Lobbying Expenditures$1,043TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationThe Medical Center is a member of national and state hospital and healthcare associations that perform lobbying activities. A portion of the dues paid to these organizations is listed as lobbying expenditures.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,375,000BeginningYearBalanceAmt
Contributions$795,000ContributionsAmt
Other Expenditures$2,738,000OtherExpendituresAmt
End Year Balance$5,432,000EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,085,000BeginningYearBalanceAmt
Contributions$850,000ContributionsAmt
Other Expenditures$560,000OtherExpendituresAmt
End Year Balance$7,375,000EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,057,000BeginningYearBalanceAmt
Contributions$1,351,000ContributionsAmt
Other Expenditures$323,000OtherExpendituresAmt
End Year Balance$7,085,000EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,973,000BeginningYearBalanceAmt
Contributions$3,099,000ContributionsAmt
Other Expenditures$15,000OtherExpendituresAmt
End Year Balance$6,057,000EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,188,000BeginningYearBalanceAmt
Contributions$337,000ContributionsAmt
Other Expenditures$552,000OtherExpendituresAmt
End Year Balance$2,973,000EndYearBalanceAmt
FieldValueIRS element (for citing)
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,700,339OtherCostOrOtherBasisAmt
Book Value$2,700,339BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$71,448,632OtherCostOrOtherBasisAmt
Depreciation$32,669,616DepreciationAmt
Book Value$38,779,016BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$118,263,127OtherCostOrOtherBasisAmt
Depreciation$68,892,403DepreciationAmt
Book Value$49,370,724BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,154,125OtherCostOrOtherBasisAmt
Depreciation$2,549,183DepreciationAmt
Book Value$3,604,942BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$94,455,021TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDescAmtAmt
Post-Retirement Liability$204,100
Pension Liability$33,630,966
Estimated Third Party Payor Settlements$1,281,990
Due to Affiliates$3,906,032
estimated medical malpractice claims liability$3,560,343
Deferred Compensation Liability$1,590,015
CAPITAL LEASE OBLIGATIONS$161,127
FieldValueIRS element (for citing)
Total Liability$44,334,573TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$178,604,289TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$5,282,608NetUnrealizedGainsInvstAmt
Other Revenue$4,992,929OtherRevenueAmt
Revenue Not Reported$10,275,537RevenueNotReportedAmt
Revenue Subtotal$168,328,752RevenueSubtotalAmt
Other Revenues Not Included-$1,472,040OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$1,472,040RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$166,856,712TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$153,031,311TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$1,472,040OtherExpensesIncludedAmt
Expenses Not Reported$1,472,040ExpensesNotReportedAmt
Expenses Subtotal$151,559,271ExpensesSubtotalAmt
Other Expenses Not Included$3,442,872OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$3,442,872ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$155,002,143TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:Endowment funds are used primarily to purchase capital equipment.
Part X, Line 2:The Hospital accounts for uncertainty in income taxes using a recognition threshold of more-likely-than not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold is met. Management determined there were no tax uncertainties that met the recognition threshold in 2017 and 2016. The Hospital's policy is to recognize interest related to unrecognized tax benefits in interest expense and penalties in operating expenses.
Part XI, Line 2d - Other Adjustments:Bad Debts netted on financial statements -3,172,787. investment management fees netted on financials -270,085. CHANGE IN INTEREST IN INDIANA HEALTHCARE FOUNDATION -1,633,627. Pension and post-retirement liabilities adjustment 10,336,112. noncontrolling intererst in affiliates -155,514. Equity Distributions to noncontrolling interest -111,170.
Part XI, Line 4b - Other Adjustments:RENTAL EXPENSES -1,472,040.
Part XII, Line 2d - Other Adjustments:rental expenses 1,472,040.
Part XII, Line 4b - Other Adjustments:bad debts netted on financial statements 3,172,787. investment management fees netted on financials 270,085.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served4550PersonsServedCnt
Total Community Benefit Expns$4,305,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,305,000NetCommunityBenefitExpnsAmt
Total Expense0.02840TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served43071PersonsServedCnt
Total Community Benefit Expns$21,416,754TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,331,909DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,084,845NetCommunityBenefitExpnsAmt
Total Expense0.06640TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Persons Served36571PersonsServedCnt
Total Community Benefit Expns$1,336,051TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,336,051NetCommunityBenefitExpnsAmt
Total Expense0.00880TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served84192PersonsServedCnt
Total Community Benefit Expns$27,057,805TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,331,909DirectOffsettingRevenueAmt
Net Community Benefit Expns$15,725,896NetCommunityBenefitExpnsAmt
Total Expense0.10360TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served14118PersonsServedCnt
Total Community Benefit Expns$1,655,996TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$236,488DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,419,508NetCommunityBenefitExpnsAmt
Total Expense0.00930TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Persons Served22500PersonsServedCnt
Total Community Benefit Expns$82,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$82,000NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served7895PersonsServedCnt
Total Community Benefit Expns$15,031,000TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,797,310DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,233,690NetCommunityBenefitExpnsAmt
Total Expense0.06080TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Persons Served44513PersonsServedCnt
Total Community Benefit Expns$16,768,996TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,033,798DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,735,198NetCommunityBenefitExpnsAmt
Total Expense0.07060TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Persons Served128705PersonsServedCnt
Total Community Benefit Expns$43,826,801TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,365,707DirectOffsettingRevenueAmt
Net Community Benefit Expns$26,461,094NetCommunityBenefitExpnsAmt
Total Expense0.17420TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,171,000BadDebtExpenseAmt
Bad Debt Expense Attributable$634,200BadDebtExpenseAttributableAmt
Reimbursed By Medicare$27,378,185ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$28,009,859CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$631,674MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (3 entries)

Primary ActivitiesPrimaryActivitiesTxtOrg Profit Or OwnershipOrgProfitOrOwnershipPctOfcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPctPhysicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 COSM Realty Group Ltd
Real Estate0.400000.000000.30000
2 Indiana Ambulatory Surgical Associates LLC
Ambulatory Surgery0.700000.000000.30000
3 Indiana Total Therapy LLC
Therapy Services0.500000.000000.50000
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Indiana Regional Medical CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1835 Hospital RoadAddressLine1Txt
CityIndianaCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15701ZIPCd
FieldValueIRS element (for citing)
State License090701StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherUrgent Care Facility; offsite testing centersOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Indiana Regional Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)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 Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://www.indianarmc.org/about-us/community-health-needs-assessment/OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLhttp://www.indianarmc.org/about-us/community-health-needs-assessment/StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttp://www.indianarmc.org/financial-services/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttp://www.indianarmc.org/financial-services/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttp://www.indianarmc.org/financial-services/FAPSummaryOnWebsiteURLTxt
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
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
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 (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Indiana Regional Medical CenterPart V, Section B, Line 5: A steering committee made up of senior representatives of each hospital, as well as Representatives from local health departments, leading health and social service organizations and county government provided input FOR THE NEED ASSESSMENT.During this CHNA project, two dozen individuals were interviewed by representatives from all three hospitals including administrative and clinical staff from the hospitals, representatives from health and social service agencies, public health officers, warden, school district personnel, veteran's affairs, clergy, and other public and elected officials. STRATEGY SOLUTIONS INC. ("SSI") also conducted a community survey with 1,144 completed surveys. Finally information was gathered by the project team through a series of focus groups. These information-gathering efforts allowed the project team and steering committees to gain a better understanding of the health status, health care needs, service gaps and barriers to care of those living in the counties of Armstrong, Butler, Clarion, Clearfield, Forest, Indiana, Jefferson and Venango.Secondary public health data on disease incidence and mortality, as well as behavioral risk factors, were gathered from numerous sources including the Pennsylvania Department of Health, the Centers for Disease Control, Healthy People 2020, County Health Rankings, as well as a number of other reports and publications. Data were collected primarily for Indiana County and outlying area, although some selected national data is included where local/regional data was not available. Demographic data were collected from the Nielsen/Claritas demographic database. Primary qualitative data collected specifically for this assessment included a total of 24 in-depth interviews with individuals from different consistencies and interest groups with eight stakeholders specifically representing the needs of the IRMC service area. A community survey was conducted with 1,144 responses received from the region, with 573 from Indiana County. Inaddition to gathering input from stakeholder interviews, input and guidance also came from hospital and community representatives who served on the IRMC Steering Committee.
Indiana Regional Medical CenterPart V, Section B, Line 6a: CLARION HOSPITAL AND PUNXSUTAWNEY AREA HOSPITAL
Indiana Regional Medical CenterPart V, Section B, Line 7d: made available through a community mailing
Indiana Regional Medical CenterPart V, Section B, Line 11: Each year the top priorities are identified and addressed.IRMC's CHNA looked at different issues of community health. All were ranked according to priority need--high, moderate and low. The assignment of each health concern to one of these priority states was based upon four essential criteria:1. Accountable role - the extent to which the issue is an important priority to address for the hospital or the community2. magnitude of the problem - degree to which the problem leads to death, disability, or impaired quality of life3. impact on other health outcomes - extent to which the issue impacts health outcomes and/or is a driver of other conditions4. capacity to implement evidence based solutions - include the capacity to and ease of implementing evidence based solutions.Teams are addressing the top priorities listed. Senior administration, along with the Board of Directors, oversee and support each strategy.Some of the low priority needs which were not addressed are lack of health insurance; food and water borne illness; access to healthy foods and recreational facilities; mental health and deaths due to motor vehicle crashes. These needs were not addressed as IRMC was focused on higher priority needs.
Indiana Regional Medical CenterPart V, Section B, Line 16j: A message is provided on invoices that the financial assistance policy is available.

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7:The Hospital used a cost-to-charge ratio in determining the figures reported in this table. This cost-to-charge ratio was derived from Worksheet 2 Ratio of Patient Care Cost to Charges and as calculated and reported on the 6/30/16 Medicare cost report.
Part I, Line 7g:No costs attributable to a physician clinic were included in the amount on Part I, line 7g.
Part I, Line 7, Column (f):The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 3,172,787.
Part II, Community Building Activities:Our mission is to serve the healthcare needs of every life we touch with compassion, respect and dignity. All of the programs offered meet Community Benefit Objectives and are related to our mission. IRMC offers programs that improve access to health care services, enhances health of the community we serve, provides advanced medical or healthcare knowledge and relieves some of the financial or programmatic burden of government or our community. Indiana Regional Medical Center provides numerous community programs and activities that provide treatment or promote health and healing to our communities. Our Mobile Medical Services continues to provide free blood pressure screenings in 19 locations in Indiana County. We also continue to participate in numerous free community events providing education, screening programs and first aid services. Over the past year, the Mobile Medical Health logged over 2,500 participants. We also provide numerous Health Fairs reaching almost 2,200 participants, and Classes and Education Programs with over 4,000 participants. A few of the fairs or services provided are: Arthritis, Knee Pain and osteoporosis sessions put on by the Orthopedic physicians and the IRMC support clinicians, "Bike to School" (safety for children), Chestnut Ridge Health Fair, Diabetes, Exercise for Senior Centers, First Commonwealth Bank Weight management, Fortify your spine, Healthy Kids day, routine Multiphasic Blood Draws for rural areas and community members that may not seek out health care, services provided to New Florence Senior Center and North Cambria Senior Center (rural facilities in our secondary market area and no hospital close to them), Prostate screenings, Vaccines for Vets (veterans), Skin screenings, as well as a number of others. The Institute for Healthy Living at Indiana Regional Medical Center offers health services and education programs to the community at no charge.The Center for Diabetes Care continues to offer free education services at various locations throughout the county. In addition, they continue to be the primary sponsor of the county's Diabetes Walk. Each month Staff and Management at IRMC provide support to a local Food Bank. Preventive Health Services - M. Dorcas Clark Women's Imaging Center and their staff have participated in numerous community events providing information about the importance of Breast Health. Birdie's Closet, a project designed to help women cope with appearance related side-effects of cancer treatment was opened in the Women's Imaging Center. Support Health GroupsFamily Programs - Early Pregnancy, Maternity Tour, Doctor Dad, BOF Series, Breastfeeding, All about Baby, Lamaze, Home Alone, Babysitting, Let's Talk Girls, Big Brother, CPR, Heartsaver. 1,164 contacts for the year.Community Classes - PACE, Tai Chi, Yoga, Cancer, Strong Women, Drop Weight, Ornish, Diabetes, Drop 10. 3,580 class hours.In 2009, Indiana Regional Medical Center opened a new facility offering Urgent Care Services in the Blairsville community as a response to medical services needed in that area. This facility is 12 miles from the hospital campus.In 2012, Indiana Regional Medical Center opened its second Urgent Care facility to service the primary market share where there was a noted demand for these services. The Urgent Care centers require additional staffing on behalf of the hospital as it is a new/added location; however, these facilities significantly improve the cycle time of the patient throughout and services for the non-emergent services needed.
Part III, Line 2:The amount reported in Part III, line 2 is actual bad debts (at net, not gross charges) for the year.
Part III, Line 3:The amount reported in Part III, line 3 IS derived by using the Medicare cost to charge ratio from the cost report.A portion of the Bad Debt should be included as Community Benefit as the hospital is not able to deny services to any patient presenting to the Emergency Department, regardless if the patients have the means to pay. The deductible and co-insurance balances that are not paid reduce the Net Revenues due to the hospital as part of the respective patient's insurance coverage. In addition, there is a "cost" to the hospital for treating all patients. As with the unreimbursed amounts of the Medicaid patient services, the hospital should be able to include the unreimbursed costs of the services that resulted in no payment.
Part III, Line 4:The following is the text of the footnote from the audited financial statements that describes bad debt expense: "Accounts receivable, patients, are reported at net realizable value. Accounts are written off when they are determined to be uncollectible based upon management's assessment of individual accounts. The allowance for doubtful collections is estimated based on a periodic review of the accounts receivable aging, payor classifications, and application of historical write-off percentages."
Part III, Line 8:The Medicare cost report was used to determine the amount reported on line 6. Any shortfall reported in line 7 should be treated as community benefit as the hospital is providing medical care to these patients, regardless of their ability to pay.
Part III, Line 9b:Patients are expected to pay all balances in full within fifteen days of a final billing. If this is not possible, patients will be counseled on the use of Medical Assistance or the Indiana Charity Care program, I-Care.On a monthly basis, the Credit Supervisor will compile a report listing all accounts, which have been billed to Medicare, and any secondary insurance carrier where applicable. A listing of accounts which have been billed to Medical Assistance as a secondary payor are reviewed by the Credit Supervisor for an automatic write off after Medical Assistance has processed the account. Accounts which have balances after Medicare and all secondary payors have been billed will be placed with an outside collection agency after two unanswered statements. An exception will be made in the event a patient/guarantor does not follow through with the Medical Assistance application process, when requested to do so. The agency will attempt to collect the account for six months. After that time the account will be written off as Medicare Bad Debt.The IRMC Collection Policy contains provisions to provide a softer approach for those that IRMC has learned would qualify for financial assistance. Upon receipt of the call from the patient that there is hardship in paying the bill, the IRMC collection representative shares the information for application for both Medical Assistance and Charity Care. While the patient's account is in this process, their account will not be provided to the collection agency.
Part VI, Line 2:THE hospital leadership team formed a Steering Committee in the local service area that consisted of hospital and community leaders who represented the broad interests of their local region. These included representatives who understood the needs and issues related to various underrepresented groups including medically underserved populations, low-income persons, minority groups, and those with chronic disease needs, individuals with expertise in public health, and internal program managers. The staff, Steering Committee members and consulting team made significant efforts to ensure that the entire regional service territory, all socio-demographic groups and all potential needs, issues and underrepresented populations were considered in the assessment.SEE PART V OF SCHEDULE H FOR FURTHER DISCUSSION ON NEEDS ASSESSMENT.
Part VI, Line 3:IRMC posts, at all points of registration, a notice of the charity care policy. The Medical Center also provides notice of the charity care policy in patients' bills and to local social service agencies. The Medical Center also provides this information on the Indiana Regional Medical Center's internet home page. At the earliest feasible time, the Medical Center personnel will attempt to determine patient eligibility for coverage of part or all of their patient bill.All pre-registration, registration, business office, and patient financial services staff receive training as to the charity care policy and are to be familiar with the availability of charitable assistance and the criteria for such assistance.
Part VI, Line 4:Since opening its doors in 1914, Indiana Regional Medical Center (IRMC) has maintained a goal of serving the community with quality, progressive, compassionate patient care. As the county's sole, full-service healthcare provider, IRMC has continually risen to the challenge of meeting the needs of its community. IRMC resides in Indiana, Pennsylvania in the heart of the county. The hospital sits on a 75-acre campus and admits over 7,200 inpatients and services over 2,500 outpatients observed in-house, delivers more than 600 babies, and provides services to over 260,000 outpatients each year. As an acute care facility, IRMC is licensed for 164 beds and provides a broad range of medical and educational services at its main campus and satellite locations across Indiana County. As the only hospital located in this rural county, IRMC provides services to a diverse population of 89,000 residents spread over 830 square miles.Over the years, IRMC has developed programs and services that address improving access to care, preventive services, and community health education. IRMC has found a way to not only succeed when other rural hospitals are closing their doors, but also expand and provide care to the residents of five surrounding counties. IRMC is the number two employer in the county with 1,300 employees and continues to attract and retain a quality workforce through the achievement of numerous recognitions, such as the #1 Best Place to Work in PA, the #2 Best Place to Work in the Nation according to Modern Healthcare Magazine, achieved notable status by scoring at the Mastery Level in Pennsylvania's KAPE program, and named to Fortune's 100 Best Companies to Work For. Further, IRMC continues to pursue the Malcolm Baldrige National Quality Award - a prestigious honor achieved by few.
Part VI, Line 5:In the mid-nineties, hospitals and healthcare facilities began to shift their attention from just sick or hospital based care to include addressing community health and disease prevention. As a first step in that direction, IRMC formed a community service department whose purpose was to deliver education and preventative screenings to the community-at-large. In 2005, realizing that almost every department in the hospital had opportunities to promote health and wellness, IRMC created the Institute for Healthy Living, a virtual organization coordinating all aspects of community outreach and health improvement. Improving and sustaining community health, however, is a collaborative endeavor that integrates as many key stakeholders as possible. In that regard, IRMC spearheaded the formation of the Indiana County Community Health Advisory Council (CHAC), an enterprise representing members from various community agencies, organizations and schools whose purpose it is to identify health needs in our county and to find ways to meet them. The CHAC has been active since 1996 and IRMC serves as its base and chairmanship. The IRMC / Institute for Healthy Living 2011 Community Health Needs Assessment and Report is the product of an 18-month process that sought community input, medical staff input, involved key interest groupssuch as the CHAC, and selected primary and secondary sources of survey input to identify target areas for improvement with specific action plans.Using the three survey inputs of the PA Behavioral Risk Factor Surveillance Survey (BRFSS), the Robert Wood Johnson County Health Rankings, and the PA Department of Health annual county health profiles, IRMC was able to identify and set priorities among THE areas for community health improvement that differed significantly from state or national benchmarks. IRMC then targeted seven of those need areas for specific intervention and action. Indiana Regional Medical Center uses its own funds to enhance both the Clinical Strategies and the Community Strategies.Clinical Strategies (a few examples): recruiting additional physicians for identified community needs, explore development of a Family Practice Residency program to facilitate recruitment and retention, enlarge the medical fitness center, establish a weight loss task force, develop a medical weight management center, provide flu shots to all inpatients during flu season, provide pneumonia vaccine to all non-vaccinated inpatients, etc. Community Strategies (a few examples): Partner with agencies providing services and education to young teens and women, evaluate a partnership with Early Head Start, improve visibility and information available about the OB/GYN Clinic, worked to establish practices in the more rural areas of the county that require the Medical Center to subsidize delivering care there, established the Indiana at Chestnut Ridge facility that offers primary care and urgent-care and was a significant capital investment, implement a patient portal to improve patient access to medical records, became a provider of the We Can! (ways to enhance children's activity and nutrition), partnered with 7 elementary schools to install Project Fit America, implemented grocery store tours to assist people with seeking healthy choices, partner with 4 grocery stores to have a dietician available to help shoppers make healthy choices, conduct the annual "Vaccine for Veterans" program on Veterans Day, evaluate the potential for public pneumonia vaccine clinics, continue to provide free flu and pneumonia vaccine to high-risk, low income residents, etc.
Part VI, Line 6:Indiana Regional Medical Center has the following affiliated entities:Indiana Healthcare Foundation conducts fundraising activities, such as the Columbus Day Golf Outing and Love of Life Gala, in support of Indiana Regional Medical Center. INDIANA REGIONAL MEDICAL CENTER AND PUNXSUTAWNEY AREA HOSPITAL JOINTLY FORMED INDIANA JEFFERSON RADIATION ONCOLOGY, INC. FOR THE PURPOSE OF ENHANCING THE QUALITY AND AVAILABILITY OF RADIATION ONCOLOGY SERVICES OFFERED TO PATIENTS IN INDIANA AND JEFFERSON COUNTIES, PA AND SURROUNDING AREAS.Indiana Healthcare Physician Services, Inc. is a non-profit hospital owned group of practices owned and operated to serve the rural areas of Indiana and surrounding communities. We provide accessible, cost effective quality healthcare within the rural communities of Indiana and surrounding counties. We support and work collaboratively with other non-profit agencies within our sites.Indiana Healthcare Properties holds and manages property in support of Indiana Regional Medical Center.
Part VI, line 7:N/A

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 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
Stephen A Wolfe
President & CEO$413,504$0$0$0$0$0$78,425$0$32,259$0$524,188$0$0$0
Mark E Boykiw MD
Board Member$0$291,750$0$0$0$0$0$0$0$18,409$0$310,159$0$0
Dominic Paccapaniccia
Chief Operating Officer$235,346$0$0$0$0$0$21,215$0$20,230$0$276,791$0$0$0
Brett Braun
COO, IPG$168,314$0$0$0$0$0$6,927$0$22,384$0$197,625$0$0$0
Jim Kinneer
VP, Org Dev$128,211$0$0$0$0$0$11,539$0$19,122$0$158,872$0$0$0
Robert A Gongaware
SR VP Finance$217,381$0$0$0$0$0$19,564$0$4,094$0$241,039$0$0$0
Bruce A Bush MD
Sr VP Medical Director$280,238$0$0$0$0$0$0$0$34,278$0$314,516$0$0$0
Cindy Virgil
Sr VP Patient Services$183,165$0$0$0$0$0$14,653$0$4,602$0$202,420$0$0$0
Dr Anthony L Sico
Physician$256,723$0$0$0$0$0$0$0$23,273$0$279,996$0$0$0
Dr Patrick Shannon
physician$254,955$0$0$0$0$0$40,000$0$19,631$0$314,586$0$0$0
Dr Jason Rasefske
physician$244,739$0$0$0$0$0$20,000$0$23,611$0$288,350$0$0$0
Gregory Hay
Physician$207,740$0$0$0$0$0$10,374$0$19,183$0$237,297$0$0$0
Dr Wendy Angelo
physician$203,542$0$0$0$0$0$0$0$29,691$0$233,233$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 1aIndiana Regional Medical Center pays country club membership dues for President & CEO, Stephen Wolfe, which is not included in his compensation. The membership is a corporate membership used for business purposes only.
Part I, Line 4bIndiana Regional Medical Center has a supplemental, nonqualified retirement plan under IRC Section 457(f) for President & CEO Stephen Wolfe. No amounts were paid to him from this plan during 2016, and contributions to the plan were $41,350. THE FOLLOWING ALSO HAD CONTRIBUTIONS TO A SECTION 457(F) PLAN FOR 2016: JASON P. RASEFSKE - $20,000 Patrick Shannon - $40,000
Part I, Line 7Bonuses may be granted at the discretion of the board and are based on factors such as performance and meeting goals and objectives.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
Indiana County Hospital Authority
A2516973192009-02-12$10,000,000FINANCE CAPITAL PROJECTS000
Indiana County Hospital Authority - SERIES 2014A
B2516973192014-01-01$25,455,000FINANCE CAPITAL PROJECTS, FUND RESERVES AND PAY ISSUANCE COSTS000
Indiana County Hospital Authority - SERIES 2014B
C2516973192014-01-01$10,200,000FINANCE CAPITAL PROJECTS, FUND RESERVES AND PAY ISSUANCE COSTS000
INdiana County Hospital Authority - SERIES 2014C
D2516973192014-01-01$12,715,000REFINANCING AND PAY ISSUANCE COSTS000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndOther Spent ProceedsOtherSpentProceedsAmt
A$4,892,588$10,000,000$61,000$9,939,000201000Yes (1)Yes (1)
B$1,990,000$25,455,000$342,791$25,112,209201500Yes (1)Yes (1)
C$10,200,000$169,750$10,030,2502015000Yes (1)
D$2,171,498$12,715,000$133,512201300Yes (1)Yes (1)$12,581,488

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A000000Yes (1)
B000000Yes (1)
C000000Yes (1)
D000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A00Yes (1)00000Yes (1)
B0Yes (1)000000Yes (1)
C0Yes (1)00Yes (1)000Yes (1)
D00Yes (1)00000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)
DYes (1)

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2The following board members have a business relationship: Todd Brice and Anne White.
Form 990, Part VI, Section A, line 6Indiana Healthcare Corporation ("IHC") is the sole corporate member of Indiana Regional Medical Center ("IRMC").
Form 990, Part VI, Section A, line 7aIHC has the power to fill vacancies, nominate and approve the election of, and approve removal of the Board of Directors of IRMC.
Form 990, Part VI, Section A, line 7bIRMC shall obtain the approval of IHC before action on any of the following matters becomes final and effective for IRMC: (1) amendment of the articles of incorporation and bylaws; (2) the sale, lease or exchange of all or substantially all of the property or assets of IRMC; (3) merger or consolidation with any other corporation; (4) dissolution of IRMC; (5) approval of an annual operating and capital budget for IRMC; (6) any other matter that by law would require the approval of members of a nonprofit corporation.
Form 990, Part VI, Section B, line 11bThe return was reviewed in detail by the Director of Finance/Controller and reviewed by the CFO. Each board member was notified that the return was available for review on the "board shared drive" before filing with the IRS.
Form 990, Part VI, Section B, line 12cEvery member of the Board, and every individual appointed to the Board or Board committees, as well as all key management personnel and physician leaders, are required to execute a conflict of interest disclosure statement, which will be updated at least on an annual basis or as additional conflicting interests arise. In addition, every member of the Board will specifically acknowledge the conflict of interest policy and his/her attempt to abide by it by signing the acknowledgement form. Every Board committee member, officer, key management employee, and physician leader is required to sign this acknowledgement as well. The acknowledgement and disclosure forms will be kept on file by the Chief Executive Officer, and the Chairman and Vice-Chairman will be familiar with the statements that are filed by Board members in order to guide their conduct in the event a conflict arises. Every person covered by this Policy shall submit in writing to the Chief Executive Officer a Conflict of Interest Disclosure Statement listing all financial and conflicting interests. Each statement will be resubmitted with any necessary changes each year or as any additional conflicting or financial interests arise. The Chairman of the Board shall become familiar with all such disclosure statements in case a conflict arises. The Vice Chairman of the Board shall be familiar with the Disclosure Statement filed by the Chairman. Penalties for non-compliance: Failure to comply with this policy shall constitute grounds for removal from office and, in the case of Key Management Personnel, termination of employment.
Form 990, Part VI, Section B, line 15Positions for Officers and Key Employees are reviewed on an annual basis. Appropriate comparisons are made on a regional and national level in order to maintain a fair and equitable compensation structure. All recommendations are approved by the Board of Directors and documented in the Board Minutes.
Form 990, Part VI, Section C, line 19Governing documents, conflict of interest policy, and financial statements are available to the public upon request.
Form 990, Part XI, line 9:CHANGE IN INTEREST IN INDIANA HEALTHCARE FOUNDATION -1,633,627. Pension and post-retirement liabilities adjustment 10,336,112. noncontrolling interest in affiliates -155,514. Equity Distributions to noncontrolling interest -111,170. net transfers to affiliates -2,356,880. other change in investment of affiliates -542,913.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Indiana Healthcare Foundation
835 Hospital RoadIndianaPA15701251574302Fundraising in Support of Indiana Regional Medical CenterPA501(c)(3)Line 12a, IIndiana Healthcare Corporation0
Indiana Healthcare Corporation
835 Hospital RoadIndianaPA15701251547379Parent CorporationPA501(c)(3)Line 70N/A
Indiana Jefferson Radiation Oncology Inc
835 Hospital RoadIndianaPA15701900406301Radiation Oncology servicesPA501(c)(3)Line 12a, IIndiana Regional Medical CenterYes (1)
Indiana Healthcare Physician Services Inc
835 Hospital RoadIndianaPA15701251842046Provide health carePA501(c)(3)Line 3Indiana Healthcare Corporation0
Indiana Healthcare Properties
835 Hospital RoadIndianaPA15701251524635Hold & Manage property in Support of Indiana Regional Medical CenterPA501(c)(3)Line 12a, IIndiana Healthcare Corporation0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPctBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Indiana Rehabilitation Services LLC
855 Springdale Dr Ste 200ExtonPA19341202214391Rehabilitation ServicesPAN/AUNRELATED$30,244$142,619000.51000
Indiana Ambulatory Surgical Associates LLC
841 Hospital RoadIndianaPA15701232923182Ambulatory SurgeryPAUNRELATED$57,686$3,470,777000.70000Indiana Regional Medical Center
COSM REALTY GROUP LTD
1265 WAYNE AVENUE STE 307INdianaPA15701030439684REAL ESTATEPAUNRELATED000.40000INDIANA Regional Medical Center
PENNSYLVANIA MOUNTAINS HEALTHCARE ALLIANCE LLC
150 MCCRACKEN RUN ROADDUBOISPA15801251852975HEALTHCARE SERVICESPAUNRELATED$20,483$104,4640Yes (1)0.09310Indiana Regional Medical Center
INDIANA TOTAL THERAPY LLC
120 IRMC DRIVE STE 160INDIANAPA15701263843582THERAPY SERVICESPAN/AUNRELATED$229,424$147,371000.50000
MEDCARE EQUIPMENT COMPANY LLC
115 EQUITY DRIVEGREENSBURGPA15601261361520EQUIPMENTPAN/AUNRELATED$251,349$1,140,598000.01750

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1INDIANA HEALTHCARE ENTERPRISESBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1835 HOSPITAL ROADAddressLine1Txt
CityINDIANACityNm
State AbbreviationPAStateAbbreviationCd
ZIP15701ZIPCd
FieldValueIRS element (for citing)
EIN470973444EIN
Primary ActivitiesSALE OF HEALTHCARE RELATED ITEMS, GIFT SHOPPrimaryActivitiesTxt
Legal Domicile StatePALegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Indiana Jefferson Radiation Oncology IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypePTransactionTypeTxt
Involved$1,683,719InvolvedAmt
Method Of Amount DeterminationCOSTMethodOfAmountDeterminationTxt