GOSHEN HOSPITAL ASSOCIATION INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- GOSHEN HOSPITAL ASSOCIATION INC (EIN 35-6001540)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-15
- IRS object ID
- 201613209349309711
- Schema version
- 2015v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-15T13:50:31-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE SUITE 4200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 462045108 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 356001540 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOSHEN HOSPITAL ASSOCIATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GOSH | BusinessNameControlTxt |
| Phone | 5743642665 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HIGH PARK AVENUE | AddressLine1Txt |
| City | GOSHEN | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46526 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AMY FLORIA | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5743642665 | PhoneNum |
| Signature | 2016-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SHAWNA M JIMENEZ | PreparerPersonNm |
| PTIN | P01222873 | PTIN |
| Phone | 3174648600 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IU HEALTH GOSHEN HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | AMY FLORIA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HIGH PARK AVENUE | AddressLine1Txt |
| City | GOSHEN | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46526 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $228,300,859 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.IUHEALTH.ORG/GOSHEN | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1946 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH OF OUR COMMUNITIES BY PROVIDING INNOVATIVE, OUTSTANDING CARE AND SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 1553 | TotalEmployeeCnt |
| Total Volunteers | 370 | TotalVolunteersCnt |
| Total Gross UBI | -$38,560 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$38,560 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $972,913 | PYContributionsGrantsAmt |
| CY Contributions Grants | $483,910 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $214,342,899 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $215,474,240 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,361,131 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,471,536 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,869,727 | PYOtherRevenueAmt |
| CY Other Revenue | $7,871,173 | CYOtherRevenueAmt |
| PY Total Revenue | $228,546,670 | PYTotalRevenueAmt |
| CY Total Revenue | $228,300,859 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $269,870 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $699,113 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $80,717,595 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $90,139,382 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $110,933,350 | PYOtherExpensesAmt |
| CY Other Expenses | $107,134,955 | CYOtherExpensesAmt |
| PY Total Expenses | $191,920,815 | PYTotalExpensesAmt |
| CY Total Expenses | $197,973,450 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $36,625,855 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $30,327,409 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $318,785,001 | TotalAssetsBOYAmt |
| Total Assets EOY | $334,905,201 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $53,785,347 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $49,391,038 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $264,999,654 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $285,514,163 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF IU HEALTH GOSHEN HOSPITAL IS TO IMPROVE THE HEALTH OF OUR COMMUNITIES BY PROVIDING INNOVATIVE, OUTSTANDING CARE AND SERVICES, THROUGH EXCEPTIONAL PEOPLE DOING EXCEPTIONAL WORK. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $163,531,710 | ExpenseAmt |
| Grant | $699,113 | GrantAmt |
| Revenue | $222,249,945 | RevenueAmt |
| Desc | IU HEALTH GOSHEN HOSPITAL IS A NON-DENOMINATIONAL NOT-FOR-PROFIT ORGANIZATION PROVIDING HEALTH CARE SERVICES FOR THE GENERAL PUBLIC AS WELL AS CHARITY WITHIN THE COMMUNITY. SEE SCHEDULE O FOR ADDITIONAL DETAIL.THE MISSION OF IU HEALTH GOSHEN HOSPITAL IS TO IMPROVE THE HEALTH OF OUR COMMUNITIES BY PROVIDING INNOVATIVE, OUTSTANDING CARE AND SERVICE, THROUGH EXCEPTIONAL PEOPLE DOING EXCEPTIONAL WORK. THE HOSPITAL'S VALUES INCLUDE: COMPASSION - AND COMMITMENT TO SERVICE WITH EMPATHY. ACCOUNTABILITY - WITH INTEGRITY AND ACTION. RESPECT - THROUGH TREATING OTHERS AS YOU WISH TO BE TREATED. EXCELLENCE - IN ALL WE DO.BUILDING UPON OUR MISSION AND VALUES, IU HEALTH GOSHEN HOSPITAL WILL DELIVER EXCEPTIONAL HEALTHCARE TO THE COMMUNITIES WE SERVE USING AN INTEGRATED MODEL OF CARE AND ACHIEVING EXCELLENCE THROUGH A COMMITMENT TO QUALITY, LEADERSHIP, AND INNOVATION. BY 2020, WE WILL ACHIEVE THIS VISION BY FOCUSING ON THE FOLLOWING STRATEGIC PRIORITIES: - LEAD THE REGION IN CLINICAL INTEGRATION AND MANAGEMENT OF POPULATION HEALTH.- DELIVER HIGH VALUE TO OUR PATIENTS, PROVIDERS, PAYERS AND COLLEAGUES.- GOSHEN'S ONCOLOGY AND HEART & VASCULAR SERVICE LINES BECOME THE DESTINATION OF CHOICE IN OUR BROADER REGION.- CULTIVATE A CULTURE FOR COLLEAGUES WHERE PERSONAL AND PROFESSIONAL MISSIONS ARE ALIGNED.- INSPIRE A SPIRIT OF PARTNERSHIP AND GENEROSITY BY ENGAGING OUR COMMUNITY WITH OPPORTUNITIES THAT MEET REGIONAL HEALTH NEEDS.AS A COMMUNITY HOSPITAL, IU HEALTH GOSHEN HOSPITAL IS DEDICATED TO MEETING THE SPECIFIC HEALTH CARE NEEDS OF OUR COMMUNITIES. AS A COMMUNITY LEADER, THE HOSPITAL IS COMMITTED TO PROVIDING CARE IN AN INNOVATIVE AND DYNAMIC ENVIRONMENT. THE HOSPITAL HAS 123 PATIENT BEDS AND OVER 137 PHYSICIANS ON ITS MEDICAL STAFF IN NEARLY 25 SPECIALTIES. THESE PHYSICIANS, TOGETHER WITH OTHER DEDICATED PROFESSIONALS, PROVIDE A WIDE RANGE OF SERVICES INCLUDING THE FOLLOWING: ACUTE MEDICAL & SURGICAL, EMERGENCY, HOME HEALTH, RADIOLOGY, LABORATORY, CANCER CARE, BARIATRICS, WOMEN'S HEALTH, PAIN MANAGEMENT, SLEEP STUDIES, REHABILITATION, PATIENT AND COMMUNITY HEALTH EDUCATION AND PROFESSIONAL EDUCATION.IU HEALTH GOSHEN HOSPITAL HAS CONSISTENTLY MET NATIONAL QUALITY STANDARDS. THE HOSPITAL COMPOSITE SCORES FOR PUBLICLY REPORTED QUALITY MEASURES IN THE AREAS OF ACUTE MYOCARDIAL INFARCTION, PNEUMONIA, HEART FAILURE, SURGICAL CARE IMPROVEMENT PROJECT, AND HOSPITAL OUTPATIENT EXCEED 95% IN 2013. IN ADDITION, HEALTHCARE EXCEL (QUALITY IMPROVEMENT ORGANIZATION FOR INDIANA) REPORTED THAT THE HOSPITAL WAS ABOVE OUR PEER GROUP AND OVERALL STATE PERFORMANCE IN 17 OUT OF 19 AREAS OF OUR PUBLICLY REPORTED MEASURES FOR CY 2013.THE AMERICAN NURSES CREDENTIALING CENTER'S (ANCC) MAGNET RECOGNITION PROGRAM FOR EXCELLENCE IN NURSING SERVICES HAS DESIGNATED IU HEALTH GOSHEN HOSPITAL AS A MAGNET HOSPITAL. DESIGNATED HOSPITALS HAVE SUCCESSFULLY CREATED A WORK ENVIRONMENT THAT NURSES FIND BOTH PERSONALLY AND PROFESSIONALLY REWARDING, ADVANCING THE PRACTICE OF NURSING AND IMPROVING PATIENT OUTCOMES. RESEARCH SHOWS THAT MAGNET HOSPITALS ARE MORE EFFECTIVE AT ATTRACTING AND KEEPING QUALITY NURSES. IU HEALTH GOSHEN HOSPITAL IS AMONG AN ELITE GROUP OF ONLY 7% OF HOSPITALS IN THE NATION TO BE RE-DESIGNATED AS A MAGNET FACILITY AND THE ONLY FACILITY IN THE REGION.THE GOSHEN CENTER FOR CANCER CARE IS ACCREDITED BY THE COMMISSION ON CANCER OF THE AMERICAN COLLEGE OF SURGEONS (COC). RECEIVING CARE AT A COC-APPROVED CENTER FOR CANCER CARE ASSURES THAT PATIENTS WILL HAVE ACCESS TO:- QUALITY CARE CLOSE TO HOME.- COMPREHENSIVE CARE OFFERING A RANGE OF STATE-OF-THE ART SERVICES AND EQUIPMENT.- A MULTIDISCIPLINARY TEAM APPROACH TO COORDINATE THE BEST TREATMENT OPTIONS AVAILABLE TO CANCER PATIENTS.- PARTICIPATION IN CANCER CLINICAL TRIALS, EDUCATION AND SUPPORT.- LIFELONG PATIENT FOLLOW-UP THROUGH A CANCER REGISTRY THAT COLLECTS DATA ON TYPE AND STAGE OF CANCERS AND TREATMENT RESULTS.- ONGOING MONITORING AND IMPROVEMENT IN CARE.THE CENTER FOR CANCER CARE IS A LEADER IN INNOVATIVE CANCER TREATMENT. WE WERE AMONG THE FIRST TO ADOPT A COMPREHENSIVE, MULTIDISCIPLINARY APPROACH TO CANCER TREATMENT. WE OFFER HOLISTIC PROGRAMS FOR STRENGTHENING MINDS AS WELL AS BODIES, PLACE A PREMIUM ON FAMILY INVOLVEMENT AND SPIRITUAL NEEDS, AND ENCOURAGE PATIENTS TO PLAY A DECISION-MAKING ROLE IN TREATMENT SELECTION. THE CENTER FOR CANCER CARE HAS SPECIALLY TRAINED SURGICAL ONCOLOGISTS, A BREAST SURGEON, MEDICAL ONCOLOGIST, A RADIATION ONCOLOGIST, NATUROPATHIC PRACTITIONERS AND HIGHLY DISTINGUISHED MAGNET DESIGNATED NURSES.IU HEALTH GOSHEN HOSPITAL IMPROVES THE HEALTH AND WELL-BEING OF ITS COMMUNITIES BY PROVIDING COMMUNITY WELLNESS AND EDUCATION PROGRAMS. THROUGH LOCAL PARTNERSHIPS, THE HOSPITAL IDENTIFIES HEALTH ISSUES AND CREATES PROGRAMS TO ENSURE OUR COMMUNITY IS THE HEALTHIEST PLACE TO LIVE, WORK AND RAISE A FAMILY. THE FIRST OF THESE PROGRAMS COVER CPR, EMS, DIABETES, CHILDBIRTH, FITNESS, NUTRITION, COMMUNITY EDUCATION AND HEALTH SCREENINGS AND ELKHART COUNTY CHILDHOOD OBESITY INITIATIVE. THE CPR CLASS IS FOR ANYONE - PROFESSIONALS OR PRIVATE CITIZENS - WHO WANT TO KNOW HOW TO PERFORM LIFE-SAVING CARDIOPULMONARY RESUSCITATION; FIRST AID CLASSES ARE ALSO OFFERED. EMS TRAINING IS AVAILABLE FOR PERSONS INTERESTED IN BECOMING EMERGENCY MEDICAL TECHNICIANS OR FIREFIGHTERS. THE DIABETES EDUCATION HELPS PEOPLE DELAY THE ONSET AND SLOW THE PROGRESSION OF COMPLICATIONS FROM THIS DISEASE. IT INCLUDES SEMINARS, SUPPORT GROUPS, CONSULTATIONS AND SCREENINGS. CHILDBIRTH EDUCATION PREPARES EXPECTANT MOTHERS AND THEIR FAMILIES DURING THIS SIGNIFICANT TIME IN THEIR LIFE. CLASSES REVIEW MANY ASPECTS OF CHILDBIRTH INCLUDING LABOR REHEARSAL, CESAREAN DELIVERIES, SINGLE-TEEN ISSUES, BREAST FEEDING AND A CLASS JUST FOR SIBLINGS. IN ADDITION TO VARIOUS COMMUNITY WELLNESS AND EDUCATION PROGRAMS, IU HEALTH GOSHEN HOSPITAL PROVIDES A FULL-SERVICE RESOURCE FOR COMPREHENSIVE HEALTH INFORMATION AND ASSISTANCE. NURSE ON CALL (NOC) IS A FULL-SERVICE, MULTI-LINGUAL HEALTH INFORMATION, REFERRAL AND NURSE TRIAGE TELEPHONE SERVICE AVAILABLE 24 HOURS A DAY, 7 DAYS WEEK. NOC IS STAFFED BY SPECIALLY TRAINED, KNOWLEDGEABLE AND EXPERIENCED REGISTERED NURSES. THIS FREE SERVICE PROVIDES MEDICAL GUIDANCE WHEN SICK OR INJURED, INFORMATION ON PHYSICIANS IN THE AREA, REFERRALS TO COMMUNITY RESOURCES AND REGISTRATION FOR CLASSES AND EVENTS. THE IU HEALTH GOSHEN COMMUNITY BENEFIT FUND IS ONE EXAMPLE OF HOW IU HEALTH GOSHEN RE-INVESTS MONEY INTO THE COMMUNITIES WE SERVE. 2016 MARKS THE 18TH ANNIVERSARY OF THE HEALTH SYSTEM'S COMMITMENT. ANY NONPROFIT ORGANIZATION WITH A MISSION CONSISTENT WITH THAT OF IU HEALTH GOSHEN AND WORKS TOWARD MEETING THE NEEDS OF THE COMMUNITY ARE ENCOURAGED TO APPLY. SINCE ITS INCEPTION IN 1998, THE CHARITABLE GIVING COMMITTEE OF THE BOARD OF DIRECTORS HAS AWARDED MORE THAN $4.25 MILLION IN GRANTS TO COMMUNITY ORGANIZATIONS AND PROJECTS THAT MEET THE HEALTH NEEDS OF OUR COMMUNITY. IN 2015, THE COMMUNITY BENEFIT FUND GRANT COMMITTEE AWARDED $300,600 TO MORE THAN 58 DIFFERENT ORGANIZATIONS IN GOSHEN AND SURROUNDING COMMUNITIES. ALSO, $19,343 IN MATCHING GIFTS WAS DISTRIBUTED TO THE 2014 GRANT RECIPIENTS.ADDITIONALLY, FUNDS WERE DESIGNATED TO HELP CREATE THE NEW SITE FOR MAPLE CITY HEALTH CARE CENTER AS WELL AS TO FUND PILOT PROGRAMS LOCALLY IN TELEHEALTH. EVERY YEAR THE BOARD OF DIRECTORS OF IU HEALTH GOSHEN DESIGNATES A PERCENTAGE OF THE PREVIOUS YEAR'S OPERATIONAL BUDGET FOR THE HOSPITAL'S COMMUNITY BENEFIT FUND, THROUGH WHICH GRANTS ARE AWARDED EACH SPRING.IU HEALTH GOSHEN HOSPITAL PROVIDES HEALTH CARE SERVICES TO ALL MEMBERS OF THE COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS FINANCIAL ASSISTANCE TO THOSE PATIENTS UNABLE TO PAY ALL OR A PORTION OF THEIR BILL AND WHO ARE UNABLE TO QUALIFY FOR ASSISTANCE THROUGH FEDERAL AND STATE GOVERNMENT ASSISTANCE PROGRAMS. PATIENTS ARE ASKED TO COMPLETE A FINANCIAL AID APPLICATION TO DETERMINE THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. THE HOSPITAL PROVIDES THE ASSISTANCE OF A FINANCIAL ADVOCATE TO HELP PATIENTS COMPLETE THIS APPLICATION AND TO INVESTIGATE OTHER FORMS OF AVAILABLE ASSISTANCE INCLUDING ENROLLMENT IN MARKETPLACE PLANS. IN 2015, THE HOSPITAL EXTENDED CHARITY CARE TO 7,848 ACCOUNTS TOTALING $8.9 MILLION. IU HEALTH GOSHEN HOSPITAL ALSO PARTNERS WITH A LOCAL FINANCIAL INSTITUTION TO PROVIDE A FLEXIBLE AND AFFORDABLE FINANCING SOLUTION FOR A PATIENT'S MEDICAL CARE.IU HEALTH GOSHEN RECEIVED THE BEACON AWARD FOR EXCELLENCE FROM THE AMERICAN ASSOCIATION OF CRITICAL CARE NURSES. THIS IS THE SECOND TIME IU HEALTH GOSHEN HAS WON THE AWARD AND IS ONLY ONE OF TWO IN THE STATE TO BE A RECIPIENT.IU HEALTH GOSHEN HOSPITAL HAS BEEN NAMED AN ACCREDITED HEART FAILURE INSTITUTE BY THE NATIONAL HEALTHCARE ACCREDITATION COLLOQUIUM.THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS (NAPBC) HAS AWARDED THREE-YEAR, FULL ACCREDITATION TO IU HEALTH GOSHEN RETREAT WOMEN'S HEALTH CENTER.PRESS GANEY HAS AWARDED IU HEALTH GOSHEN WITH 7 SUMMIT AWARDS.THE FOLLOWING ACHIEVEMENTS W | Desc |
| Total Program Service Expenses | $163,531,710 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 152 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1553 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIRECTOR OF FINANCE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5743642665 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HIGH PARK AVE | AddressLine1Txt |
| City | GOSHEN | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46526 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| GEORGE KIM MD | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MARTHA SUZIE YEAGER | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| VERNITA TODD | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| RANDY CRIPE | ||||||||
| TREASURER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| BRENDA SROF | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KAREN SMITH | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KAREN PLETCHER | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| LINDA BAXLEY | ||||||||
| CHAIR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| SUSAN STIFFNEY RN | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JODY NEER MD | ||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $402,256 | $31,732 | ||
| DANIEL NAFZIGER MD | ||||||||
| VICE CHAIR | 1.00 | 40.00 | Yes (X) | $0 | $152,724 | $13,461 | Yes (X) | |
| RANDAL CHRISTOPHEL | ||||||||
| PRESIDENT AND CEO | 40.00 | 2.00 | Yes (X) | $733,020 | $0 | $123,565 | Yes (X) | |
| MARGARET S FRANGER | ||||||||
| VP OF CANCER SERVICES | 40.00 | 1.00 | $292,140 | $0 | $47,260 | Yes (X) | ||
| RICK TARSKE | ||||||||
| VP OF GOSHEN PHYSICIANS | 40.00 | 1.00 | $186,008 | $0 | $30,345 | Yes (X) | ||
| ALAN WELDY | ||||||||
| VP OF HR AND COMPLIANCE | 40.00 | 1.00 | $456,271 | $0 | $54,704 | Yes (X) | ||
| VLADIMIR RADIVOJEVIC | ||||||||
| VP OF SURGICAL SERVICES | 40.00 | 1.00 | $211,480 | $0 | $37,128 | Yes (X) | ||
| MARK PODGORSKI | ||||||||
| VP OF HOSPITAL OPERATIONS | 40.00 | 1.00 | $276,565 | $0 | $43,373 | Yes (X) | ||
| PAM KARSEN | ||||||||
| VP OF NURSING | 40.00 | 1.00 | $328,138 | $0 | $23,538 | Yes (X) | ||
| STEVE GARBODEN | ||||||||
| VP PLANNING AND MANAGED CARE | 40.00 | 1.00 | $256,680 | $0 | $30,005 | Yes (X) | ||
| AMY FLORIA | ||||||||
| CFO | 40.00 | 1.00 | $409,953 | $0 | $49,311 | Yes (X) | ||
| RANDALL CAMMENGA MD | ||||||||
| COO | 40.00 | 1.00 | $620,599 | $0 | $17,174 | Yes (X) | ||
| LARRY ALLEN MD | ||||||||
| CMO | 40.00 | 1.00 | $377,752 | $0 | $51,381 | Yes (X) | ||
| JOHN LOWDEN | ||||||||
| SENIOR MEDICAL PHYSICIST | 40.00 | 0.00 | $207,864 | $0 | $22,136 | Yes (X) | ||
| VICTORIA OWENS | ||||||||
| ASSOCIATE PATHOLOGIST | 40.00 | 0.00 | $242,105 | $0 | $24,924 | Yes (X) | ||
| XI ZEE WANG | ||||||||
| ASSOCIATE PATHOLOGIST | 40.00 | 0.00 | $284,474 | $0 | $26,706 | Yes (X) | ||
| MIN YAN | ||||||||
| CHIEF PATHOLOGIST | 40.00 | 0.00 | $387,244 | $0 | $27,092 | Yes (X) | ||
| POOPALASINGHAM POOVENDRAN MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $523,556 | $0 | $33,280 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,793,849 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $554,980 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $687,115 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 33 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GERIG SURGICAL ASSOCIATES PC | |||||
| 2006 SOUTH MAIN ST | GOSHEN | IN | 46526 | ON CALL SERVICES | $1,077,049 |
| PERA MEDIA STRATEGIES | |||||
| 10512 REDMOND RD | AUSTIN | TX | 78739 | MARKETING CONSULTING/ADVERTISING | $1,060,382 |
| ADVISORY BOARD | |||||
| PO BOX 79461 | BALTIMORE | MD | 212790461 | CONSULTING SERVICES | $957,134 |
| VARIAN MEDICAL SYSTEMS | |||||
| 70140 NETWORK PLACE | CHICAGO | IL | 606731701 | MEDICAL SOFTWARE/EQUIPMENT | $852,049 |
| ERNST & YOUNG | |||||
| PNC BANK 3712 SOLUTIONS CENTER | CHICAGO | IL | 606773007 | AUDITING SERVICES | $559,322 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $483,910 | RelatedOrganizationsAmt |
| Total Contributions | $483,910 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT CARE | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $215,474,240 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $215,474,240 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $215,474,240 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,471,536 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$38,560 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,510,096 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $215,297 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $215,297 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $215,297 | TotalRevenueColumnAmt |
| Exclusion | $215,297 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| FOOD SERVICE REVENUE | 722514 | $880,171 | $880,171 | |
| FINANCE CHARGES | 561000 | $257,622 | $257,622 | |
| OTHER ONCOLOGY REV MIS | 621500 | $187,985 | $187,985 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,330,098 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,330,098 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $7,655,876 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $228,300,859 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $222,249,945 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$38,560 | UnrelatedBusinessRevenueAmt |
| Exclusion | $5,605,564 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $699,113 | TotalAmt |
| Program Services | $699,113 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,683,177 | TotalAmt |
| Management And General | $4,683,177 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,700,797 | TotalAmt |
| Program Services | $42,499,584 | ProgramServicesAmt |
| Management And General | $18,201,213 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,791,457 | TotalAmt |
| Program Services | $2,464,447 | ProgramServicesAmt |
| Management And General | $1,327,010 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,656,254 | TotalAmt |
| Program Services | $10,826,566 | ProgramServicesAmt |
| Management And General | $5,829,688 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,307,697 | TotalAmt |
| Program Services | $2,800,004 | ProgramServicesAmt |
| Management And General | $1,507,693 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,550,282 | TotalAmt |
| Management And General | $1,550,282 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,705 | TotalAmt |
| Management And General | $121,705 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,577 | TotalAmt |
| Management And General | $5,577 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,966,344 | TotalAmt |
| Program Services | $1,966,344 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,012,505 | TotalAmt |
| Program Services | $3,012,505 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,008,740 | TotalAmt |
| Program Services | $4,008,740 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,732,832 | TotalAmt |
| Program Services | $1,732,832 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $396,555 | TotalAmt |
| Program Services | $396,555 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $473,971 | TotalAmt |
| Program Services | $473,971 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,215,395 | TotalAmt |
| Management And General | $1,215,395 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,161,089 | TotalAmt |
| Program Services | $14,161,089 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,510,368 | TotalAmt |
| Program Services | $10,510,368 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,814,754 | TotalAmt |
| Program Services | $1,814,754 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| DRUGS & MED. SUPPLIES | $39,237,986 | $39,237,986 | $0 | $0 |
| REPAIRS & MAINTENANCE | $6,784,923 | $6,784,923 | $0 | $0 |
| HOSPITAL ASSESSMENT FEE | $3,915,231 | $3,915,231 | $0 | $0 |
| UTILITIES | $1,681,213 | $1,681,213 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,545,485 | TotalAmt |
| Program Services | $14,545,485 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,973,450 | TotalAmt |
| Program Services | $163,531,710 | ProgramServicesAmt |
| Management And General | $34,441,740 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,010,170 | BOYAmt |
| EOY | $14,701,061 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,939 | BOYAmt |
| EOY | $105,033 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,404,884 | BOYAmt |
| EOY | $28,697,333 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,349,390 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,829,951 | BOYAmt |
| EOY | $5,144,095 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,082,000 | BOYAmt |
| EOY | $4,234,630 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $236,243,435 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $129,361,222 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,386,767 | BOYAmt |
| EOY | $106,882,213 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $163,184,513 | BOYAmt |
| EOY | $174,017,852 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,432,387 | BOYAmt |
| EOY | $1,122,984 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $318,785,001 | BOYAmt |
| EOY | $334,905,201 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,754,005 | BOYAmt |
| EOY | $17,057,640 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,709,995 | BOYAmt |
| EOY | $31,267,109 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,321,347 | BOYAmt |
| EOY | $1,066,289 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,785,347 | BOYAmt |
| EOY | $49,391,038 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $263,946,742 | BOYAmt |
| EOY | $284,714,852 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,052,912 | BOYAmt |
| EOY | $799,311 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $264,999,654 | BOYAmt |
| EOY | $285,514,163 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $318,785,001 | BOYAmt |
| EOY | $334,905,201 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $30,327,409 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$8,515,630 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$730,651 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$566,619 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $5,577 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $5,577 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $2,988,795 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $3,884,037 | OtherCostOrOtherBasisAmt |
| Book Value | $6,872,832 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $99,626,893 | OtherCostOrOtherBasisAmt |
| Depreciation | $39,906,898 | DepreciationAmt |
| Book Value | $59,719,995 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $377,005 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $113,748 | OtherCostOrOtherBasisAmt |
| Depreciation | $222,334 | DepreciationAmt |
| Book Value | $268,419 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $117,574,089 | OtherCostOrOtherBasisAmt |
| Depreciation | $89,231,990 | DepreciationAmt |
| Book Value | $28,342,099 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,678,868 | OtherCostOrOtherBasisAmt |
| Book Value | $11,678,868 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $106,882,213 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| BOARD DESIGNATED FUNDS | $168,669,726 | F |
| CANCER CENTER INVESTMENT | $1,858,055 | F |
| LONG TERM INVESTMENTS | $3,490,071 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $174,017,852 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT OBLIGATION | $121,103 |
| DEFERRED COMPENSATION | $469,869 |
| DEFERRED MALPRACTICE | $223,379 |
| INTEREST RATE SWAP | $251,938 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,066,289 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7848 | PersonsServedCnt |
| Total Community Benefit Expns | $4,089,295 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,089,295 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02070 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7791 | PersonsServedCnt |
| Total Community Benefit Expns | $24,781,951 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,053,003 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $728,948 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00370 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 15639 | PersonsServedCnt |
| Total Community Benefit Expns | $28,871,246 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,053,003 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,818,243 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02440 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 33051 | PersonsServedCnt |
| Total Community Benefit Expns | $834,978 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $66,692 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $768,286 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 379 | PersonsServedCnt |
| Total Community Benefit Expns | $689,102 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,547 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $684,555 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00350 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 32 | PersonsServedCnt |
| Total Community Benefit Expns | $848,206 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $848,206 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00430 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 33462 | PersonsServedCnt |
| Total Community Benefit Expns | $2,372,286 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $71,239 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,301,047 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01170 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 49101 | PersonsServedCnt |
| Total Community Benefit Expns | $31,243,532 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,124,242 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,119,290 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03610 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $510,923 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $510,923 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00260 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $35,795 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $35,795 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $566,718 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $566,718 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00290 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $7,955,604 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,131,889 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $38,319,512 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $47,991,711 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$9,672,199 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IU HEALTH GOSHEN HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HIGH PARK AVENUE | AddressLine1Txt |
| City | GOSHEN | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46526 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.IUHEALTH.ORG/GOSHEN | WebsiteAddressTxt |
| State License | 100270430 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IU HEALTH GOSHEN HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://GOSHENHEALTH.COM/PROMO-PAGES/COMMUNITY-NEEDS | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://GOSHENHEALTH.COM/PROMO-PAGES/COMMUNITY-NEEDS | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| IU HEALTH GOSHEN HOSPITAL | PART V, SECTION B, LINE 5: THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. THE HEALTH NEEDS OF ELKHART COUNTY WERE IDENTIFIED AND PRIORITIZED THROUGH A SYSTEMATIC DATA INFORMED PROCESS AND WITH THE INPUT OF INDIVIDUALS THROUGHOUT ELKHART COUNTY AND IN THE ELKHART COUNTY HEALTH DEPARTMENT.MORE THAN 23,000 SURVEYS, AVAILABLE IN BOTH ENGLISH AND SPANISH, WERE SENT TO COMMUNITY MEMBERS, INCLUDING THE MINORITY POPULATIONS OF AMISH, HISPANIC AND AFRICAN-AMERICAN. PERSONS RECEIVING THE COMMUNITY SURVEY COULD RESPOND VIA A WEB LINK, THROUGH THE POST, OR BY PHONE (AVAILABLE 24/7) FROM THE LAST WEEK OF MAY 2015 THROUGH THE SECOND WEEK OF JUNE 2015. OVER 600 SURVEYS WERE RETURNED, 599 (93.2%) OF THESE FROM ELKHART COUNTY.BESIDES PROVIDING RESIDENTIAL AND DEMOGRAPHIC INFORMATION, RECIPIENTS WERE ALSO ASKED TO RATE THEIR OWN HEALTH, THE COMMUNITY'S HEALTH, THE TOP HEALTH NEEDS IN THE COMMUNITY, WHETHER OR NOT THERE WERE ENOUGH PROGRAMS TO MEET THESE NEEDS, AND HOW IU HEALTH GOSHEN HOSPITAL COULD IMPROVE. ELKHART COUNTY HEALTH DEPARTMENT OFFICIALS WERE ALSO CONSULTED. NO COMMENTS WERE RECEIVED FROM THE PUBLIC REGARDING THE LAST CHNA REPORT AND IMPLEMENTATION PLAN.IU HEALTH GOSHEN HOSPITAL CONTRACTED WITH THE BOWEN RESEARCH CENTER, DEPARTMENT OF FAMILY MEDICINE, INDIANA UNIVERSITY SCHOOL OF MEDICINE, TO ANALYZE PRIMARY DATA COLLECTED FROM THE SURVEYS. THE BOWEN CENTER ALSO ANALYZED VARIOUS EXISTING HEALTH, SOCIAL, AND ECONOMIC SECONDARY DATA SETS. FOR CONTEXTUAL COMPARISONS, ELKHART COUNTY DATA WERE COMPARED WITH KOSCIUSKO, LAGRANGE, MARSHALL, NOBLE AND ST. JOSEPH COUNTIES, AS WELL AS THE STATE OF INDIANA. |
| IU HEALTH GOSHEN HOSPITAL | PART V, SECTION B, LINE 11: THE HEALTH NEEDS LISTED BELOW ACCOUNT FOR 96.6% OF THE HEALTH NEEDS IDENTIFIED BY COMMUNITY RESIDENTS AND SUPPORTED BY SECONDARY DATA FROM ELKHART COUNTY.- OBESITY/EXERCISE/HEALTHY EATING- ACCESS TO HEALTH SERVICES- TREATMENT OF CHRONIC DISEASES- MENTAL HEALTH/ADDICTION/DEPRESSION- POVERTY- HEALTH LITERACY- TOBACCO USE/SMOKINGIU HEALTH GOSHEN HOSPITAL CONSIDERED THE FOLLOWING SOURCES OF INFORMATION IN PRIORITIZING THE HEALTH NEEDS THAT IT WOULD ADDRESS: - COMMUNITY PERCEPTIONS - THESE WERE OBTAINED THROUGH THE COMMUNITY SURVEY- STATISTICAL HEALTH INFORMATION - SECONDARY DATA FOR ELKHART COUNTY WAS COMPARED TO ITS BENCHMARKS- EXPERTISE OF HEALTH LEADERS - THE ELKHART COUNTY HEALTH DEPARTMENT ON THE MOST SIGNIFICANT HEALTH NEEDSAFTER CAREFUL CONSIDERATION, IU HEALTH GOSHEN HAS IDENTIFIED THE FOLLOWING HEALTH NEEDS IN RANK ORDER THAT IT IS BEST EQUIPPED TO ADDRESS:- OBESITY- ACCESS TO HEALTH SERVICES- MENTAL HEALTH ISSUES- TREATMENT OF CHRONIC DISEASES - FOCUSING SPECIFICALLY ON DIABETES AND HYPERTENSION, POTENTIALLY CANCER RELATED HEALTH ISSUES- TOBACCOS USE/SMOKINGNO ACTIONS WERE TAKEN DURING TAX YEAR 2015 TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH IU HEALTH GOSHEN HOSPITAL'S MOST RECENTLY CONDUCTED CHNA. THE SECOND CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2015; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE NEXT 3 YEARS. THE HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT. THE HEALTH NEEDS SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS PLAN ARE POVERTY, HEALTH LITERACY, AND INJURY/SAFETY. THE HOSPITAL DID NOT TAKE ACTION TO ADDRESS THESE NEEDS AS IT HAS LIMITED FINANCIAL AND OTHER RESOURCES, AND WITH THE COMMUNITY'S INPUT USED ITS RESOURCES TO ADDRESS THE TOP FIVE PRIORITIES.IU HEALTH GOSHEN HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2015 WITH RESPECT TO ITS PREVIOUSLY CONDUCTED CHNA:HEALTH NEED IDENTIFIED: OBESITY PREVENTION- HELD MONTHLY FITNESS CLASSES (ZUMBA/BOOTCAMPS/EXERCISE CLASSES, WALKING CLUBS). THE NUMBER OF PARTICIPANTS FOR 2015 IS 937.- PROVIDED OBESITY PREVENTION, NUTRITION, AND WEIGHT MANAGEMENT PROGRAMS (HEALTHY STEPS PROGRAM, PREVENTION EDUCATION, NUTRITION EDUCATION CLASSES, STUDENT ATHLETE CONFERENCE, NUTRITION NEWSLETTERS, COOKING PRESENTATIONS). THE NUMBER OF PARTICIPANTS FOR 2015 IS 4,949.- PROVIDED SUPPORT GROUP NUTRITION AND WEIGHT MANAGEMENT PROGRAMS (TEAM BARIATRICS SUPPORT GROUPS, DISORDERED EATING SUPPORT GROUPS). THE NUMBER OF PARTICIPANTS FOR 2015 IS 438.- HELD NUMEROUS OBESITY SCREENINGS (BMI SCREENINGS, HIGH SCHOOL HEALTH SCREENINGS, 4-H FAIR OBESITY SCREENINGS, BODY COMPOSITION SCREENINGS). THE NUMBER OF PARTICIPANTS FOR 2015 IS 330.HEALTH NEED IDENTIFIED: TOBACCO CESSATION- HELD CANCER EDUCATION PROGRAMS (SURVIVOR SPEAKER LUNCHEON, NOONTIME NOSH-COOKING PRESENTATIONS, RELAY FOR LIFE, NEWSLETTERS). THE NUMBER OF PARTICIPANTS FOR 2015 IS 3,945.- PROVIDED SUPPORT GROUPS FOR CANCER AND SMOKING CESSATION. THE NUMBER OF PARTICIPANTS FOR 2015 IS 490.HEALTH NEED IDENTIFIED: DIABETES- PROVIDED DIABETES EDUCATION (EDUCATIONAL CLASSES, DIABETIC FITNESS WORKSHOPS, ADULT DIABETES PREVENTION PROGRAM). THE NUMBER OF PARTICIPANTS FOR 2015 IS 69.- PROVIDED SUPPORT GROUPS FOR DIABETES (DIABETES SUPPORT GROUP, INSULIN RESISTANCE SEMINAR AND SUPPORT GROUPS). THE NUMBER OF PARTICIPANTS FOR 2015 IS 272.- HELD SCREENINGS FOR DIABETES (HUBBARD HILL HEALTH FAIR, ELKHART COUNTY FAIR, VALLEY HEALTH FAIR, WOMEN'S EXPOS, RISK ASSESSMENTS FOR CHILDREN). THE NUMBER OF PARTICIPANTS FOR 2015 IS 359.HEALTH NEED IDENTIFIED: ACCESS TO HEALTHCARE- PROVIDED HEALTH FAIRS ON ACCESS TO HEALTHCARE (HEALTH FAIRS AT HUBBARD HILL, IVY TECH, 4-H ELKHART COUNTY FAIR, CONCORD MALL, WOMEN'S EXPO, AND WORKSITE WELLNESS FAIRS AT LOCAL BUSINESSES, LAGRANGE COUNTY SENIOR EXPO). THE NUMBER OF PARTICIPANTS FOR 2015 IS 528.HEALTH NEED IDENTIFIED: BEHAVIORAL HEALTH- HELD HEALTH FAIRS ON BEHAVIORAL HEALTH (HEALTHY, HAPPY HOLIDAY'S PRESENTATION). NO SPECIFIC ACTIONS WERE TAKEN IN 2015. |
| IU HEALTH GOSHEN HOSPITAL | PART V, SECTION B, LINE 13H: FAMILY SIZE IS ANOTHER FACTOR IN DETERMINING DISCOUNTS GRANTED TO PATIENTS. |
| IU HEALTH GOSHEN HOSPITAL: | PART V, SECTION B, LINE 16A: THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL: HTTPS://GOSHENHEALTH.COM/GOSHENHOSPITAL/MEDIA/FORMS-AND-APPLICATIONS/FINAL-POLICY-FINANCIAL-ASSISTANCE-CHARITY-CARE-REVISED-07-28-2015-ENGLISH.PDFIU HEALTH GOSHEN HOSPITAL:PART V, SECTION B, LINE 16B: THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL: HTTPS://GOSHENHEALTH.COM/PATIENT-TOOLS/PAY-ONLINE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - IU HEALTH GOSHEN | ||||
| 200 HIGH PARK AVE | GOSHEN | IN | 46526 | CLINIC |
| 2 - THE RETREAT WOMEN'S HEALTH CENTER | ||||
| 1135 PROFESSIONAL DRIVE | GOSHEN | IN | 46526 | CLINIC |
| 3 - INDIANA LAKES ACCOUNTABLE CARE | ||||
| 2018 SOUTH MAIN STREET | GOSHEN | IN | 46526 | ACO |
| 4 - INDIANA LAKES MANAGED CARE | ||||
| 2018 SOUTH MAIN STREET | GOSHEN | IN | 46526 | HEALTH CARE MANAGEMENT |
| 5 - NEW PARIS MEDICAL CLINIC | ||||
| 2018 SOUTH MAIN STREET | GOSHEN | IN | 46526 | CLINIC |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | GOSHEN HOSPITAL ASSOCIATION, INC. REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE INDIANA UNIVERSITY HEALTH, INC. ANNUAL COMMUNITY BENEFIT REPORT (EIN: 35-1955872). |
| PART I, LINE 7: | GOSHEN HOSPITAL ASSOCIATION, INC. CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | GOSHEN HOSPITAL ASSOCIATION, INC. PROMOTED THE HEALTH OF ITS COMMUNITY BY SUPPORTING VARIOUS LOCAL ORGANIZATIONS THAT ENGAGE IN COMMUNITY BUILDING ACTIVITIES. |
| PART III, LINE 2: | GOSHEN HOSPITAL ASSOCIATION, INC.'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS "LOOK-BACK" METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS CO-PAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY. |
| PART III, LINE 3: | GOSHEN HOSPITAL ASSOCIATION, INC. ESTIMATED THE POSSIBLE AMOUNT OF CHARITY CARE WITHIN BAD DEBT EXPENSE BY REVIEWING ACCOUNTS THAT WERE INTERNALLY CODED AS HAVING BEEN PROVIDED A FINANCIAL ASSISTANCE APPLICATION, BUT THAT WAS NOT COMPLETED BY THE PATIENT OR GUARANTOR, IN WHICH THE ACCOUNT WAS SUBSEQUENTLY WRITTEN OFF TO BAD DEBT. |
| PART III, LINE 4: | THE FOLLOWING NARRATIVE ADDRESSES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHICH IS INCLUDED IN THE FOOTNOTES IN THE FINANCIAL STATEMENTS FOR IU HEALTH GOSHEN: THE PROVISION FOR UNCOLLECTED PATIENT ACCOUNTS, FOR ALL PAYORS, IS RECOGNIZED WHEN SERVICES ARE PROVIDED BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION BUSINESS AND ECONOMIC CONDITIONS, CHANGES AND TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND AGING, THE SIGNIFICANCE OF INDIVIDUAL PAYORS TO OUTSTANDING ACCOUNTS RECEIVABLE BALANCES, AND HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, AS ADJUSTED FOR COLLECTION INDICATORS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTED PATIENT ACCOUNTS AND THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN ADDITION, INDIANA UNIVERSITY HEALTH GOSHEN FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES. PATIENT ACCOUNTS THAT ARE UNCOLLECTED, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTION POLICIES OF INDIANA UNIVERSITY HEALTH GOSHEN AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CARE IF DEEMED TO OTHERWISE MEET FINANCIAL ASSISTANCE POLICIES OF INDIANA UNIVERSITY HEALTH GOSHEN. |
| PART III, LINE 8: | ACTUAL MONTH TO DATE AND YEAR TO DATE REVENUES, CONTRACTUALS, REVENUE AND ACCOUNTS RECEIVABLE RELATED RATIOS, AND REVENUE RELATED STATISTICS (DAYS, DISCHARGES, ETC.) ARE COMPARED TO BUDGET AND PRIOR YEAR AMOUNTS ON A MONTHLY BASIS BY THE CFO OF GOSHEN HOSPITAL'S DIRECTORS AND FINANCIAL REPRESENTATIVES. ADDITIONALLY, ACTUAL CONTRACTUAL ALLOWANCE AS A PERCENTAGE OF GROSS ACCOUNTS RECEIVABLE AND CONTRACTUAL PROVISION AS A PERCENTAGE OF GROSS PATIENT CHARGES COMPARED TO BUDGETED AND PRIOR YEAR AMOUNTS ARE MONITORED. THIS IS DONE AS PART OF THE HOSPITAL'S MONTHLY CLOSE PROCESS. EXPLANATIONS TO VARIANCES (OR NON-VARIANCES WHEN EXPECTED) ARE RESEARCHED AND PROVIDED BY THE APPROPRIATE PERSONNEL AND REVIEWED WITH MANAGEMENT OF THE HOSPITAL. THE FINANCE DEPARTMENT ALSO CONSIDERS THESE KEY PERFORMANCE INDICATORS WHEN DEVELOPING THEIR ESTIMATES OF CONTRACTUAL ALLOWANCES TO ENSURE RECORDED AMOUNTS APPEAR REASONABLE BASED ON ACTUAL DATA AVAILABLE.FINANCIAL REPRESENTATIVES PREPARE AND UPDATE THE CONTRACTUAL ALLOWANCE MODEL AS A BASIS FOR ALL THIRD PARTY PAYORS BASED ON ACTUAL STATISTICS (E.G. DISCHARGES, DAYS, ETC.) AND ON CURRENT REIMBURSEMENT RATES. THE MODEL ANALYZES PATIENT RECEIVABLES AND CONTRACTUAL ALLOWANCE BY PAYOR AND BY PATIENT STATUS. THE MODEL ESTIMATES THE COLLECTABILITY OF PATIENT ACCOUNTS BASED ON HISTORICAL COLLECTION RATES. FINANCE COLLEAGUES ALSO UPDATE THE MODEL TO ACCOUNT FOR CHANGES IN REIMBURSEMENT RULES. AFTER THE MODEL IS PREPARED, IT IS REVIEWED BY THE CHIEF FINANCIAL OFFICER FOR APPROPRIATENESS AND REASONABLENESS.CONTRACTUAL ALLOWANCE CALCULATIONS ARE RECONCILED TO THE GENERAL LEDGER ON A MONTHLY BASIS. ONCE THE CALCULATION IS PREPARED, THE FINANCE DEPARTMENT ADJUSTS THE GENERAL LEDGER ACCOUNTS. |
| PART III, LINE 9B: | FINANCIAL ASSISTANCE IS GRANTED TO THOSE PATIENTS UNABLE TO PAY ALL OR A PORTION OF THEIR BILL AND WHO ARE UNABLE TO QUALIFY FOR ASSISTANCE THROUGH FEDERAL AND STATE GOVERNMENT ASSISTANCE PROGRAMS. IF AFTER INSURANCE REIMBURSEMENT ADDITIONAL ASSISTANCE IS NEEDED, ALL PATIENTS MAY OBTAIN FINANCIAL ASSISTANCE IF THE INCOME CRITERIA ARE MET. ALL FINANCIAL ASSISTANCE APPLICATIONS ARE BASED ON POLICY GUIDELINES. UNINSURED PATIENTS ARE REQUIRED TO PROVIDE DOCUMENTATION AND AN APPLICATION. WHEN APPROVED, THE ADJUSTMENT IS APPLIED TO THE PATIENT'S ACCOUNT. FOR PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE OF FINANCIAL ASSISTANCE, PAYMENT PLANS AND LUMP SUM SETTLEMENTS ARE AVAILABLE. IU HEALTH GOSHEN HOSPITAL ALSO PARTNERS WITH A LOCAL FINANCING INSTITUTION TO PROVIDE A FLEXIBLE AND AFFORDING FINANCING SOLUTION. |
| PART VI, LINE 2: | AS A COMMUNITY HOSPITAL, IU HEALTH GOSHEN HOSPITAL IS DEDICATED TO MEETING THE SPECIFIC HEALTH CARE NEEDS OF OUR COMMUNITY. THE HOSPITAL HAS 123 PATIENT BEDS AND OVER 137 PHYSICIANS ON ITS MEDICAL STAFF IN NEARLY 25 SPECIALTIES. THESE PHYSICIANS, TOGETHER WITH OTHER DEDICATED PROFESSIONALS, PROVIDE A WIDE RANGE OF SERVICES INCLUDING THE FOLLOWING: ACUTE MEDICAL & SURGICAL, EMERGENCY, HOME HEALTH, RADIOLOGY, LABORATORY, CANCER CARE, BARIATRICS, WOMEN'S HEALTH, PAIN MANAGEMENT, SLEEP STUDIES, REHABILITATION, PATIENT AND COMMUNITY HEALTH EDUCATION AND PROFESSIONAL EDUCATION.THE CENTER FOR CANCER CARE IS A LEADER IN INNOVATIVE CANCER TREATMENT. WE WERE AMONG THE FIRST TO ADOPT A COMPREHENSIVE, MULTIDISCIPLINARY APPROACH TO CANCER TREATMENT. WE OFFER HOLISTIC PROGRAMS FOR STRENGTHENING MINDS AS WELL AS BODIES, PLACE A PREMIUM ON FAMILY INVOLVEMENT AND SPIRITUAL NEEDS, AND ENCOURAGE PATIENTS TO PLAY A DECISION-MAKING ROLE IN TREATMENT SELECTION. THE CENTER FOR CANCER CARE HAS SPECIALLY TRAINED SURGICAL ONCOLOGISTS, A BREAST SURGEON, MEDICAL ONCOLOGISTS, A RADIATION ONCOLOGIST, NATUROPATHIC PRACTITIONERS AND HIGHLY DISTINGUISHED MAGNET DESIGNATED NURSES.IU HEALTH GOSHEN HOSPITAL IMPROVES THE HEALTH AND WELL-BEING OF ITS COMMUNITIES BY PROVIDING COMMUNITY WELLNESS AND EDUCATION PROGRAMS. THROUGH LOCAL PARTNERSHIPS, THE HOSPITAL IDENTIFIES HEALTH ISSUES AND CREATES PROGRAMS TO ENSURE OUR COMMUNITY IS THE HEALTHIEST PLACE TO LIVE, WORK AND RAISE A FAMILY. THE FIRST OF THESE PROGRAMS COVER CPR, EMS, DIABETES, CHILDBIRTH, FITNESS, NUTRITION, COMMUNITY EDUCATION AND HEALTH SCREENINGS AND ELKHART COUNTY CHILDHOOD OBESITY INITIATIVE. THE CPR CLASS IS FOR ANYONE - PROFESSIONALS OR PRIVATE CITIZENS - WHO WANT TO KNOW HOW TO PERFORM LIFE-SAVING CARDIOPULMONARY RESUSCITATION; FIRST AID CLASSES ARE ALSO OFFERED. EMS TRAINING IS AVAILABLE FOR PERSONS INTERESTED IN BECOMING EMERGENCY MEDICAL TECHNICIANS OR FIREFIGHTERS. THE DIABETES EDUCATION HELPS PEOPLE DELAY THE ONSET AND SLOW THE PROGRESSION OF COMPLICATIONS FROM THIS DISEASE. IT INCLUDES SEMINARS, SUPPORT GROUPS, CONSULTATIONS AND SCREENINGS. CHILDBIRTH EDUCATION PREPARES EXPECTANT MOTHERS AND THEIR FAMILIES DURING THIS SIGNIFICANT TIME IN THEIR LIFE. CLASSES REVIEW MANY ASPECTS OF CHILDBIRTH INCLUDING LABOR REHEARSAL, CESAREAN DELIVERIES, SINGLE-TEEN ISSUES, BREAST FEEDING AND A CLASS JUST FOR SIBLINGS. IN ADDITION TO VARIOUS COMMUNITY WELLNESS AND EDUCATION PROGRAMS, IU HEALTH GOSHEN HOSPITAL PROVIDES A FULL-SERVICE RESOURCE FOR COMPREHENSIVE HEALTH INFORMATION AND ASSISTANCE. NURSE ON CALL (NOC) IS FULL-SERVICE, MULTI-LINGUAL HEALTH INFORMATION, REFERRAL AND NURSE TRIAGE TELEPHONE SERVICE AVAILABLE 24 HOURS A DAY, 7 DAYS WEEK. NOC IS STAFFED BY SPECIALLY TRAINED, KNOWLEDGEABLE AND EXPERIENCED REGISTERED NURSES. THIS FREE SERVICE PROVIDES MEDICAL GUIDANCE WHEN SICK OR INJURED, INFORMATION ON PHYSICIANS IN THE AREA, REFERRALS TO COMMUNITY RESOURCES AND REGISTRATION FOR CLASSES AND EVENTS. |
| PART VI, LINE 3: | UNINSURED PATIENTS ARE SCREENED DURING THE PRE-REGISTRATION PROCESS FOR ELIGIBILITY IN THE HEALTHY INDIANA PLAN AND FOR ANY OTHER KNOWN SOURCES OF FINANCIAL ASSISTANCE. ALL REGISTRATION LOCATIONS HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE AND WILL HAVE INFORMATION ON THE CRITERIA AND PROCESS FOR APPLYING FOR FINANCIAL ASSISTANCE. APPLICATIONS ARE ALSO PROVIDED TO ANY PATIENTS WITH A BALANCE DUE WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE. COUNSELORS ARE AVAILABLE TO PATIENTS TO AID IN THE APPLICATION PROCESS INCLUDING THE COLLECTION OF INFORMATION TO COMPLETE THE APPLICATION. PAYMENT OPTIONS AND INFORMATION ON FINANCIAL ASSISTANCE IS AVAILABLE ON THE HOSPITAL'S WEBSITE. PATIENTS MAY DOWNLOAD A PRELIMINARY APPLICATION, AND THE PATIENT AGREEMENT ASSOCIATED WITH FINANCIAL ASSISTANCE FROM THE WEBSITE. THIS INFORMATION IS AVAILABLE IN ENGLISH AND SPANISH. |
| PART VI, LINE 4: | IU HEALTH GOSHEN HOSPITAL SERVES THE NORTHERN INDIANA AREA IN ELKHART COUNTY. ACCORDING TO THE 2015 CENSUS, THE POPULATION OF ELKHART COUNTY IS 203,474. THE MEDIAN INCOME FOR A HOUSEHOLD IN ELKHART COUNTY BASED ON THE 2015 CENSUS IS $46,983. APPROXIMATELY 12.6% OF FAMILIES AND 13.9% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 24.3% OF THOSE UNDER THE AGE 18 AND 6.2% OF THOSE AGE 65 AND OVER. THE RACIAL MAKEUP OF THE COUNTY WAS ABOUT 89.5% WHITE, 6.3% AFRICAN AMERICAN, AND 15.3% HISPANIC OR LATINO. THE REMAINING 4.2% OF THE POPULATION IS A MAKEUP OF ALL OTHER RACES. |
| PART VI, LINE 5: | ALL OF THE HOSPITAL'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. A MAJORITY OF THE BOARD MEMBERS ARE INDEPENDENT OF THE ORGANIZATION. THE GOVERNING BODY APPROVES MEDICAL STAFF PRIVILEGES AS INDICATED IN THE ORGANIZATION'S CREDENTIALING AND PRIVILEGING POLICIES AND AS RECOMMENDED BY THE MEDICAL EXECUTIVE COMMITTEE OF THE HOSPITAL. THE HOSPITAL'S GOVERNING BODY APPROVES THE ANNUAL OPERATING BUDGET FOR THE HOSPITAL AND THE EXPENDITURE OF CAPITAL FUNDS ABOVE CERTAIN DOLLAR AMOUNTS. THE GOVERNING BODY ALSO PARTICIPATES IN STRATEGIC PLANNING INITIATIVES TO DETERMINE GOALS OBJECTIVES FOCUSED ON PATIENT CARE FOR THE COMMUNITY. |
| PART VI, LINE 6: | HOSPITAL MANAGEMENT PROVIDES IU HEALTH WITH THE HOSPITAL'S ANNUAL OPERATING BUDGET AND KEY STRATEGIC OBJECTIVES. IN ADDITION, THE HOSPITAL MANAGEMENT PROVIDES IU HEALTH WITH VARIOUS KEY METRICS INVOLVING PATIENT SATISFACTION, PATIENT QUALITY AND COLLEAGUE SATISFACTION. IU HEALTH REVIEWS THE DATA TO ENSURE KEY INITIATIVES ARE FOCUSED TOWARDS THE PROMOTING AND MEETING THE HEALTHCARE NEEDS OF THE COMMUNITIES. IN ADDITION, THE HOSPITAL COLLABORATES WITH IU HEALTH TO PROVIDE NECESSARY NURSING EDUCATION AND PHYSICIAN RECRUITMENT TO ASSIST IN MEETING THE HEALTH NEEDS OF THE COMMUNITY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IN |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (24 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| MAPLE CITY HEALTH CARE CENTER | |||||||
| 213 MIDDLEBURY STREET | GOSHEN | IN | 46528 | 351749398 | 501(C)(3) | $395,000 | OPERATING SUPPORT |
| THE HORIZON EDUCATION ALLIANCE | |||||||
| 124 E WASHINGTON STREET | GOSHEN | IN | 46528 | 460803293 | 501(C)(3) | $30,000 | OPERATING SUPPORT |
| UNITED CANCER SERVICES ELKHART COUNTY | |||||||
| 23971 US HIGHWAY 33 | ELKHART | IN | 46530 | 351091429 | 501(C)(3) | $20,407 | OPERATING SUPPORT |
| BOYS & GIRLS CLUBS ELKHART COUNTY | |||||||
| 102 WEST LINCOLN SUITE 240 | GOSHEN | IN | 46526 | 351033735 | 501(C)(3) | $20,000 | OPERATING SUPPORT |
| CARE FOUNDATION INC | |||||||
| 64468 MEADOW RIDGE DRIVE | GOSHEN | IN | 46526 | 352111562 | 501(C)(3) | $16,000 | OPERATING SUPPORT |
| NORTHERN INDIANA HISPANIC HEALTH COALITION | |||||||
| 444 N NAPPANEE STREET | ELKHART | IN | 46514 | 320039221 | 501(C)(3) | $15,000 | OPERATING SUPPORT |
| CENTER FOR HEALING AND HOPE | |||||||
| 423 E JEFFERSON STREET | GOSHEN | IN | 46528 | 020560511 | 501(C)(3) | $13,102 | OPERATING SUPPORT |
| LACASA INC | |||||||
| 202 N COTTAGE AVE | GOSHEN | IN | 46528 | 351554538 | 501(C)(3) | $12,850 | OPERATING SUPPORT |
| BASHOR HOME OF THE UMC INC | |||||||
| 62226 COUNTY ROAD 15 | GOSHEN | IN | 46526 | 350933555 | 501(C)(3) | $11,100 | OPERATING SUPPORT |
| OAKLAWN PSYCHIATRIC CENTER | |||||||
| 330 LAKEVIEW DRIVE | GOSHEN | IN | 46527 | 351070041 | 501(C)(3) | $11,000 | OPERATING SUPPORT |
| COUNCIL ON AGING OF ELKHART COUNTY INC | |||||||
| 230 E JACKSON BLVD | ELKHART | IN | 46516 | 510178910 | 501(C)(3) | $10,000 | OPERATING SUPPORT |
| CHILD AND PARENT SERVICES | |||||||
| 100 W HIVELY AVENUE | ELKHART | IN | 46517 | 350888765 | 501(C)(3) | $10,000 | OPERATING SUPPORT |
| ELKHART COUNTY CLUBHOUSE | |||||||
| 114 S 5TH STREET | GOSHEN | IN | 46528 | 271151738 | 501(C)(3) | $10,000 | OPERATING SUPPORT |
| MDC GOLDENROD | |||||||
| 1514 COLLEGE AVENUE | GOSHEN | IN | 46526 | 311205424 | 501(C)(3) | $8,200 | OPERATING SUPPORT |
| ELKHART COUNTY HEALTH DEPARTMENT | |||||||
| 1400 HUDSON STREET | ELKHART | IN | 46516 | 356000142 | STATE OF INDIANA | $8,000 | OPERATING SUPPORT |
| GOSHEN COMMUNITY SCHOOLS | |||||||
| 613 PURL STREET | GOSHEN | IN | 46526 | 351099157 | STATE OF INDIANA | $8,000 | OPERATING SUPPORT |
| FIRST MENNONITE CHURCH OF MIDDLEBURY FOOD PANTRY | |||||||
| 201 E LAWRENCE ST | MIDDLEBURY | IN | 46540 | 452475878 | 501(C)(3) | $6,794 | OPERATING SUPPORT |
| SPA WOMENS MINISTRY | |||||||
| 23221 US 20 EAST | ELKHART | IN | 46516 | 431998891 | 501(C)(3) | $5,340 | OPERATING SUPPORT |
| CHURCH COMMUNITY SERVICES | |||||||
| PO BOX 2346 | ELKHART | IN | 46515 | 351155054 | 501(C)(3) | $5,300 | OPERATING SUPPORT |
| FAMILY CHRISTIAN DEVELOPMENT CENTER | |||||||
| 151 S LOCKE STREET | NAPPANEE | IN | 46550 | 351979463 | 501(C)(3) | $5,000 | OPERATING SUPPORT |
| ELKHART COUNTY SUICIDE PREVENTION | |||||||
| 608 OAKLAND AVE | ELKHART | IN | 46516 | 320167537 | 501(C)(3) | $5,000 | OPERATING SUPPORT |
| COMMUNITY DENTAL CLINIC INC | |||||||
| 7750 W 200 SOUTH | TOPEKA | IN | 46571 | 352068053 | 501(C)(3) | $5,000 | OPERATING SUPPORT |
| THE WINDOW INC | |||||||
| 223 S MAIN STREET | GOSHEN | IN | 46526 | 351427937 | 501(C)(3) | $5,000 | OPERATING SUPPORT |
| UNITED HEALTH SERVICES ST JOSEPH | |||||||
| 711 E COLFAX AVE | SOUTH BEND | IN | 46617 | 351118647 | 501(C)(3) | $5,000 | OPERATING SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 24 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S. CONSISTS OF REQUIRING THE COMPLETION OF A FOLLOW-UP REPORT FORM WITH SUBSEQUENT GRANT FUND APPLICATIONS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JODY NEER MD | ||||||||||||||
| DIRECTOR | $0 | $341,328 | $0 | $55,841 | $0 | $5,087 | $0 | $24,097 | $0 | $7,635 | $0 | $433,988 | $0 | $0 |
| DANIEL NAFZIGER MD | ||||||||||||||
| VICE CHAIR | $0 | $56,383 | $0 | $91,234 | $0 | $5,107 | $0 | $13,163 | $0 | $298 | $0 | $166,185 | $0 | $0 |
| RANDAL CHRISTOPHEL | ||||||||||||||
| PRESIDENT AND CEO | $457,011 | $0 | $239,300 | $0 | $36,709 | $0 | $116,140 | $0 | $7,425 | $0 | $856,585 | $0 | $0 | $0 |
| MARGARET S FRANGER | ||||||||||||||
| VP OF CANCER SERVICES | $227,971 | $0 | $62,974 | $0 | $1,195 | $0 | $37,269 | $0 | $9,991 | $0 | $339,400 | $0 | $0 | $0 |
| RICK TARSKE | ||||||||||||||
| VP OF GOSHEN PHYSICIANS | $167,575 | $0 | $11,773 | $0 | $6,660 | $0 | $28,246 | $0 | $2,099 | $0 | $216,353 | $0 | $0 | $0 |
| ALAN WELDY | ||||||||||||||
| VP OF HR AND COMPLIANCE | $341,903 | $0 | $100,946 | $0 | $13,422 | $0 | $49,709 | $0 | $4,995 | $0 | $510,975 | $0 | $0 | $0 |
| VLADIMIR RADIVOJEVIC | ||||||||||||||
| VP OF SURGICAL SERVICES | $163,302 | $0 | $42,990 | $0 | $5,188 | $0 | $30,753 | $0 | $6,375 | $0 | $248,608 | $0 | $0 | $0 |
| MARK PODGORSKI | ||||||||||||||
| VP OF HOSPITAL OPERATIONS | $215,549 | $0 | $56,890 | $0 | $4,126 | $0 | $40,323 | $0 | $3,050 | $0 | $319,938 | $0 | $0 | $0 |
| PAM KARSEN | ||||||||||||||
| VP OF NURSING | $249,555 | $0 | $69,747 | $0 | $8,836 | $0 | $21,439 | $0 | $2,099 | $0 | $351,676 | $0 | $0 | $0 |
| STEVE GARBODEN | ||||||||||||||
| VP PLANNING AND MANAGED CARE | $168,036 | $0 | $51,716 | $0 | $36,928 | $0 | $23,828 | $0 | $6,177 | $0 | $286,685 | $0 | $0 | $0 |
| AMY FLORIA | ||||||||||||||
| CFO | $308,793 | $0 | $88,003 | $0 | $13,157 | $0 | $43,582 | $0 | $5,729 | $0 | $459,264 | $0 | $0 | $0 |
| RANDALL CAMMENGA MD | ||||||||||||||
| COO | $256,742 | $0 | $213,802 | $0 | $150,055 | $0 | $10,600 | $0 | $6,574 | $0 | $637,773 | $0 | $0 | $0 |
| LARRY ALLEN MD | ||||||||||||||
| CMO | $294,131 | $0 | $75,353 | $0 | $8,268 | $0 | $46,885 | $0 | $4,496 | $0 | $429,133 | $0 | $0 | $0 |
| JOHN LOWDEN | ||||||||||||||
| SENIOR MEDICAL PHYSICIST | $194,544 | $0 | $13,320 | $0 | $0 | $0 | $20,700 | $0 | $1,436 | $0 | $230,000 | $0 | $0 | $0 |
| VICTORIA OWENS | ||||||||||||||
| ASSOCIATE PATHOLOGIST | $195,000 | $0 | $11,250 | $0 | $35,855 | $0 | $24,924 | $0 | $0 | $0 | $267,029 | $0 | $0 | $0 |
| XI ZEE WANG | ||||||||||||||
| ASSOCIATE PATHOLOGIST | $244,908 | $0 | $0 | $0 | $39,566 | $0 | $18,240 | $0 | $8,466 | $0 | $311,180 | $0 | $0 | $0 |
| MIN YAN | ||||||||||||||
| CHIEF PATHOLOGIST | $323,369 | $0 | $25,000 | $0 | $38,875 | $0 | $18,259 | $0 | $8,833 | $0 | $414,336 | $0 | $0 | $0 |
| POOPALASINGHAM POOVENDRAN MD | ||||||||||||||
| PHYSICIAN | $505,505 | $0 | $0 | $0 | $18,051 | $0 | $28,840 | $0 | $4,440 | $0 | $556,836 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | TAX INDEMNIFICATION AND GROSS-UP PAYMENTS IU HEALTH GOSHEN HOSPITAL GROSSED UP THE TAXABLE VALUE OF AUTOMOBILES FOR 3 OF THE OFFICERS LISTED IN FORM 990, PART VII AND INCLUDED THE AMOUNT IN THE EMPLOYEES' W-2 AS ADDITIONAL COMPENSATION. HEALTH OR SOCIAL CLUB DUES IU HEALTH GOSHEN HOSPITAL PAID FOR COUNTRY CLUB DUES FOR 4 OF THE OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES LISTED IN FORM 990, PART VII. ALL REIMBURSEMENTS ARE CONSIDERED TAXABLE INCOME TO THE EMPLOYEES. |
| PART I, LINE 4A: | AS PER OUR EMPLOYMENT AGREEMENT, UPON QUALIFYING TERMINATION DEFINED AS AN INVOLUNTARY SEPARATION FROM SERVICE OTHER THAN FOR CAUSE, THE EMPLOYEE IS ENTITLED TO SEVERANCE PAY BASED UPON YEARS OF SERVICE. THE TERMS AND CONDITIONS TO RECEIVE SEVERANCE PAYMENTS REQUIRE THE EMPLOYEE TO SIGN A RELEASE OF CLAIMS FORM THAT COVERS ALL SITUATIONS SURROUNDING THE EMPLOYEE'S EMPLOYMENT AND SEPARATION FROM IU HEALTH GOSHEN. RANDALL CAMMENGA $108,570 |
| PART I, LINE 4B: | ELIGIBLE EXECUTIVES PARTICIPATE IN VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO NON-QUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO ANY LISTED PERSONS IN PART VII. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | THE FOLLOWING OFFICERS, BOARD MEMBERS, AND KEY EMPLOYEES ARE EMPLOYEES OF IU HEALTH GOSHEN HOSPITAL OR ITS RELATED ORGANIZATIONS, AND SERVE ON OTHER RELATED TAXABLE BOARDS: RANDAL CHRISTOPHEL AMY FLORIA ALAN WELDY |
| FORM 990, PART VI, SECTION A, LINE 6 | IU HEALTH GOSHEN IS THE SOLE MEMBER OF IU HEALTH GOSHEN HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | IU HEALTH GOSHEN AS THE SOLE MEMBER OF IU HEALTH GOSHEN HOSPITAL HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF THE HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7B | ITEMS THAT REQUIRE APPROVAL OF IU HEALTH GOSHEN INCLUDE ANY AMENDMENT OF THE OPERATING AGREEMENT, DISSOLUTION OF THE ORGANIZATION OR THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11 | A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AND THE AUDIT COMMITTEE IN NOVEMBER FOR REVIEW AND QUESTIONS BEFORE THE RETURN IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH BOARD MEMBER COMPLETES AN ANNUAL DISCLOSURE OF KNOWN OR POTENTIAL CONFLICTS. EACH DISCLOSURE IS REVIEWED BY THE VP-LEGAL. ADDITIONALLY WHEN AGENDA ITEMS ARE DISCUSSED AT MEETINGS IT IS ASKED IF THERE ARE ANY KNOWN OR POTENTIAL CONFLICTS OF INTEREST, AND CONFLICTED PARTIES MUST RECUSE THEMSELVES. |
| FORM 990, PART VI, SECTION B, LINE 15 | AN INDEPENDENT COMMITTEE APPROVES THE COMPENSATION WHICH IS DETERMINED TO BE REASONABLE BASED UPON INDEPENDENT COMPARABILITY DATA PROVIDED BY AN INDEPENDENT CONSULTANT. APPROVAL OF AMOUNTS ARE DOCUMENTED IN THE MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | IU HEALTH GOSHEN HOSPITAL WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | EQUITY TRANSFER -537,697. INTEREST RATE SWAP -28,922. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|
| NAPPANEE CLINIC LLC | ||||||||||
| 200 HIGH PARK AVENUE | GOSHEN | IN | 46526 | 201068334 | HEALTHCARE | IN | $0 | $0 | GHS | |
| INDIANA LAKES MANAGED CARE ORG LLC | ||||||||||
| 200 HIGH PARK AVENUE | GOSHEN | IN | 46526 | 351946663 | HEALTHCARE | IN | -$72,730 | $287,663 | N/A | |
| INDIANA LAKES ACCOUNTABLE CARE ORG LLC | ||||||||||
| 200 HIGH PARK AVENUE | GOSHEN | IN | 46526 | 455450141 | HEALTHCARE | IN | -$158,377 | $0 | N/A | |
| PILR INC | ||||||||||
| 200 HIGH PARK AVENUE | GOSHEN | IN | 46526 | 204294750 | DEVELOPMENT | IN | $0 | $0 | GHS | |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (46 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CLARIAN TRANSPLANT INSTITUTE INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 134350599 | HEALTHCARE | IN | 501(C)(3) | 9 | IUH | Yes (1) | |
| GOSHEN HEALTH SYSTEM INC | |||||||||||
| 200 HIGH PARK AVE | GOSHEN | IN | 46526 | 351974765 | HEALTHCARE | IN | 501(C)(3) | 11 III-FI | IUH | Yes (1) | |
| HEALTHLINC INCORPORATED | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 263571507 | HEALTHCARE | IN | 501(C)(3) | 9 | IUHB | Yes (1) | |
| INDIANA HEALTH INFO EXCHANGE INC | |||||||||||
| 846 N SENATE AVE | INDIANAPOLIS | IN | 46202 | 364550324 | HEALTHCARE | IN | 501(C)(3) | 11 I | 0 | N/A | |
| INDIANA RADIOLOGY PARTNERS INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 201017034 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| INDIANA UNIVERSITY HEALTH INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351955872 | HEALTHCARE | IN | 501(C)(3) | 3 | 0 | N/A | |
| IU HEALTH ARNETT FOUNDATION INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 356079797 | FUNDRAISING | IN | 501(C)(3) | 11 I | IUHA | Yes (1) | |
| IU HEALTH ARNETT INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 263162145 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH BALL MEMORIAL HOSPITAL INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 350867958 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH BALL MEMORIAL PHYSICIANS INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351925641 | HEALTHCARE | IN | 501(C)(3) | 9 | IUHBMH | Yes (1) | |
| IU HEALTH BEDFORD INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 237042323 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH BLACKFORD HOSPITAL INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 010646166 | HEALTHCARE | IN | 501(C)(3) | 3 | IUHBMH | Yes (1) | |
| IU HEALTH BLOOMINGTON INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351720796 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH BMH FOUNDATION INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 311111784 | FUNDRAISING | IN | 501(C)(3) | 11 I | IUHBMH | Yes (1) | |
| IU HEALTH CARE ASSOCIATES INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351747218 | HEALTHCARE | IN | 501(C)(3) | 9 | IUH | Yes (1) | |
| IU HEALTH GOSHEN FOUNDATION INC | |||||||||||
| 200 HIGH PARK AVE | GOSHEN | IN | 46526 | 462565300 | FUNDRAISING | IN | 501(C)(3) | 7 | GHS | Yes (1) | |
| IU HEALTH LAPORTE HOSPITAL INC | |||||||||||
| PO BOX 250 | LAPORTE | IN | 46352 | 351125434 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH LAPORTE PHYSICIANS INC | |||||||||||
| PO BOX 250 | LAPORTE | IN | 46352 | 311070868 | HEALTHCARE | IN | 501(C)(3) | 3 | IUHLH | Yes (1) | |
| IU HEALTH MORGAN INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 273533027 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH NORTH HOSPITAL INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351932442 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH PAOLI HOSP FOUNDATION INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 310992486 | FUNDRAISING | IN | 501(C)(3) | 9 | IUHP | Yes (1) | |
| IU HEALTH PAOLI INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 352090919 | HEALTHCARE | IN | 501(C)(3) | 3 | IUHB | Yes (1) | |
| IU HEALTH PLANS NFP INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 463803873 | INSURANCE | IN | 501(C)(4) | N/A | IUH | Yes (1) | |
| IU HEALTH TIPTON HOSPITAL INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 262772226 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH WEST HOSPITAL INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351814660 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU HEALTH WHITE MEM HOSP FNDTN INC | |||||||||||
| PO BOX 952 | MONTICELLO | IN | 47960 | 351671806 | FUNDRAISING | IN | 501(C)(3) | 11 III-FI | IUHWMH | Yes (1) | |
| IU HEALTH WHITE MEMORIAL HOSPITAL INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 273532963 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| IU MEDICAL GROUP FOUNDATION INC | |||||||||||
| 340 W 10TH ST NO FS5100 | INDIANAPOLIS | IN | 46202 | 201093251 | FUNDRAISING | IN | 501(C)(3) | 11 II | 0 | N/A | |
| LAPORTE HOSPITAL FOUNDATION INC | |||||||||||
| PO BOX 250 | LAPORTE | IN | 46352 | 310952775 | FUNDRAISING | IN | 501(C)(3) | 11 I | 0 | N/A | |
| MDWISE MARKETPLACE INC | |||||||||||
| 1200 MADISON AVE | INDIANAPOLIS | IN | 46225 | 465270582 | INSURANCE | IN | 501(C)(4) | N/A | IUH | Yes (1) | |
| MDWISE NETWORK INC | |||||||||||
| 1200 MADISON AVE | INDIANAPOLIS | IN | 46225 | 472619552 | INSURANCE | IN | 501(C)(4) | N/A | IUH | Yes (1) | |
| METHODIST HEALTH FOUNDATION INC | |||||||||||
| 1800 N CAPITOL AVE | INDIANAPOLIS | IN | 46202 | 356043086 | FUNDRAISING | IN | 501(C)(3) | 11 I | IUH | Yes (1) | |
| METHODIST HEALTH GROUP INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 350876390 | HEALTHCARE | IN | 501(C)(3) | 11 III-FI | 0 | N/A | |
| METHODIST MEDICAL GROUP INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351945384 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| METHODIST OCCUP HEALTH CENTERS INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351844176 | HEALTHCARE | IN | 501(C)(3) | 3 | IUH | Yes (1) | |
| METHODIST RESEARCH INSTITUTE INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 352023710 | HEALTHCARE | IN | 501(C)(3) | 11 I | IUH | Yes (1) | |
| MH HEALTHCARE INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351766531 | HEALTHCARE | IN | 501(C)(3) | 3 | MMG | Yes (1) | |
| MORGAN CO MEM HOSP FOUNDATION INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 352035162 | FUNDRAISING | IN | 501(C)(3) | 11 II | IUHMH | Yes (1) | |
| MORGAN CO MEM HOSP GUILD INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 310886844 | FUNDRAISING | IN | 501(C)(3) | 11 III-FI | IUHMH | Yes (1) | |
| MORGAN HEALTH SERVICES INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351968564 | HEALTHCARE | IN | 501(C)(3) | 3 | IUHMH | Yes (1) | |
| REHABILITATION HOSPITAL OF INDIANA INC | |||||||||||
| 4141 SHORE DR | INDIANAPOLIS | IN | 46254 | 351786005 | HEALTHCARE | IN | 501(C)(3) | 3 | MHH | Yes (1) | |
| RHI FOUNDATION INC | |||||||||||
| 4141 SHORE DR | INDIANAPOLIS | IN | 46254 | 351932349 | FUNDRAISING | IN | 501(C)(3) | 11 I | RHI | Yes (1) | |
| THE CHEER GUILD OF RILEY HOS FOR CHILD | |||||||||||
| 705 RILEY HOSPITAL DR | INDIANAPOLIS | IN | 46202 | 356018517 | FUNDRAISING | IN | 501(C)(3) | 11 III-FI | 0 | N/A | |
| TIPTON CO HEALTH CARE FOUNDATION INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 311231905 | FUNDRAISING | IN | 501(C)(3) | 11 I | IUHTH | Yes (1) | |
| UNIVERSITY FAMILY PHYSICIANS INC | |||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 237427350 | HEALTHCARE | IN | 501(C)(3) | 9 | IUHCA | Yes (1) | |
| GOSHEN HOSPITAL WOMENS AUXILIARY | |||||||||||
| 200 HIGH PARK AVE | GOSHEN | IN | 46526 | 237017521 | HEALTHCARE | IN | 501(C)(3) | 11 III-O | 0 | N/A | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (23 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| BALL OUTPATIENT SURGERY CENTER LLC | |||||||
| 569 BROOKWOOD VILLAGE STE 901 | BIRMINGHAM | AL | 35209 | 270275794 | HEALTHCARE | IN | N/A |
| BELTWAY SURGERY CENTERS LLC | |||||||
| 569 BROOKWOOD VILLAGE STE 901 | BIRMINGHAM | AL | 35209 | 352072586 | HEALTHCARE | IN | N/A |
| BLOOMINGTON ENDOSCOPY CENTER LLC | |||||||
| PO BOX 550 | BLOOMINGTON | IN | 47402 | 352117943 | HEALTHCARE | IN | N/A |
| BOSC HOLDINGS LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 454147343 | HEALTHCARE | IN | N/A |
| BSC HOLDINGS LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 452314634 | HEALTHCARE | IN | N/A |
| CHV FUND I LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 262523206 | VENTURE CAPITAL | IN | N/A |
| CHV FUND II MANAGEMENT LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 371717823 | VENTURE CAPITAL | IN | N/A |
| CHV FUND II LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 800902337 | VENTURE CAPITAL | IN | N/A |
| CHV FUND MANAGEMENT LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 262523151 | VENTURE CAPITAL | IN | N/A |
| CLARIAN HEALTH NETWORK LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 352055030 | HEALTHCARE | IN | N/A |
| EAGLE HIGHLANDS SURGERY CENTER LLC | |||||||
| 569 BROOKWOOD VILLAGE STE 901 | BIRMINGHAM | AL | 35209 | 352259204 | HEALTHCARE | IN | N/A |
| EHSC HOLDINGS LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 454147879 | HEALTHCARE | IN | N/A |
| EWASC HOLDINGS LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 473087761 | HEALTHCARE | IN | N/A |
| HEALTH VENTURE MANAGEMENT LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 205740218 | MANAGEMENT | IN | N/A |
| IEC HOLDINGS LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 454148032 | HEALTHCARE | IN | N/A |
| INDIANA ENDOSCOPY CENTERS LLC | |||||||
| 569 BROOKWOOD VILLAGE STE 901 | BIRMINGHAM | AL | 35209 | 208398421 | HEALTHCARE | IN | N/A |
| IU HEALTH EWA SURGERY CENTER LLC | |||||||
| 569 BROOKWOOD VILLAGE STE 901 | BIRMINGHAM | AL | 35209 | 473102482 | HEALTHCARE | IN | N/A |
| IU HEALTH SAXONY SURGERY CENTER LLC | |||||||
| 569 BROOKWOOD VILLAGE STE 901 | BIRMINGHAM | AL | 35209 | 275271091 | HEALTHCARE | IN | N/A |
| ROC SURGERY LLC | |||||||
| 569 BROOKWOOD VILLAGE STE 901 | BIRMINGHAM | AL | 35209 | 271497960 | HEALTHCARE | IN | N/A |
| ROCS HOLDINGS LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 454148369 | HEALTHCARE | IN | N/A |
| SENATE STREET SURGERY CENTER LLC | |||||||
| 569 BROOKWOOD VILLAGE STE 901 | BIRMINGHAM | AL | 35209 | 421709357 | HEALTHCARE | IN | N/A |
| SSC HOLDINGS LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 464472887 | HEALTHCARE | IN | N/A |
| SSSC HOLDINGS LLC | |||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 454148167 | HEALTHCARE | IN | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BMH MEDICAL PAVILION ASSOCIATION INC | |||||||||||||||||
| 2525 W UNIVERSITY AVE | MUNCIE | IN | 47303 | 351858408 | CONDO MANAGEMENT | IN | N/A | C | Yes (1) | ||||||||
| CARDINAL HEALTH VENTURES INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 351611424 | MANAGEMENT | IN | N/A | C | Yes (1) | ||||||||
| CHV CAPITAL INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 260752507 | VENTURE CAPITAL | IN | N/A | C | Yes (1) | ||||||||
| IU HEALTH 457(B) PLAN | |||||||||||||||||
| 1100 N MARKET ST | WILMINGTON | DE | 19890 | 476948347 | INVESTMENTS | IN | N/A | T | Yes (1) | ||||||||
| IU HEALTH ACO INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 454421020 | HEALTHCARE | IN | N/A | C | Yes (1) | ||||||||
| IU HEALTH BOARD DESIGNATED TRUST | |||||||||||||||||
| 400 HOWARD ST | SAN FRANCISCO | CA | 94105 | 306309021 | INVESTMENTS | IN | N/A | T | Yes (1) | ||||||||
| IU HEALTH NTGI S&P500 FUND CF | |||||||||||||||||
| PO BOX 804358 | CHICAGO | IL | 60680 | 306298263 | INVESTMENTS | IN | N/A | T | Yes (1) | ||||||||
| IU HEALTH PLANS HOLDING COMPANY INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 463794815 | INSURANCE | IN | N/A | C | Yes (1) | ||||||||
| IU HEALTH PLANS NFP INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 463803873 | INSURANCE | IN | N/A | C | Yes (1) | ||||||||
| IU HEALTH PLANS INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 262127080 | HMO | IN | N/A | C | Yes (1) | ||||||||
| IU HEALTH RISK PURCHASING GROUP INC | |||||||||||||||||
| 151 MEETING ST STE 301 | CHARLESTON | SC | 29401 | 260202446 | INSURANCE | IN | N/A | C | Yes (1) | ||||||||
| IU HEALTH RISK RETENTION GROUP INC | |||||||||||||||||
| 151 MEETING ST STE 301 | CHARLESTON | SC | 29401 | 201107674 | INSURANCE | SC | N/A | C | Yes (1) | ||||||||
| IU HEALTH SOUTHERN IN PHYSICIANS INC | |||||||||||||||||
| PO BOX 1149 | BLOOMINGTON | IN | 47402 | 351913875 | HEALTHCARE | IN | N/A | C | Yes (1) | ||||||||
| IUH ASSURANCE SPC LTD | |||||||||||||||||
| 980395429 | INSURANCE | N/A | C | Yes (1) | PO BOX 69 94 SOLARIS AVE | GRAND CAYMAN | CJ | CJ | |||||||||
| OCC-HEALTH REVENUE SYSTEMS INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 203308057 | WORK COMP PPO | IN | N/A | C | Yes (1) | ||||||||
| PARKMOR DRUG INC AND SUBSIDIARIES | |||||||||||||||||
| 1501 S MAIN ST | GOSHEN | IN | 46526 | 131394980 | PHARMACY SALES | IN | C | Yes (1) | GHS | $465,688 | $3,979,020 | 1.00000 | |||||
| PROTEUO FUND LP | |||||||||||||||||
| 981075227 | INVESTMENTS | N/A | C | Yes (1) | PO BOX 31106 89 NEXUS WAY | GRAND CAYMAN | CJ | CJ | |||||||||
| RADIATION ONCOLOGY RESOURCES INC | |||||||||||||||||
| 200 HIGH PARK AVE | GOSHEN | IN | 46526 | 262008424 | HEALTHCARE | IN | C | Yes (1) | GHS | 1.00000 | |||||||
| SCANS INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 453080392 | HEALTHCARE | IN | N/A | C | Yes (1) | ||||||||
| UNIV HLTH (SHANGHAI) MGT CON CO LTD | |||||||||||||||||
| MANAGEMENT | N/A | C | Yes (1) | 88 CENTURY AVE | SHANGHAI | CH | CH | ||||||||||
| UNIVERSITY HEALTH MANAGEMENT INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 272891143 | MANAGEMENT | IN | N/A | C | Yes (1) | ||||||||
| UNIVERSITY HEALTH MGMT (CHINA) INC | |||||||||||||||||
| 950 N MERIDIAN ST STE 800 | INDIANAPOLIS | IN | 46204 | 273891311 | MANAGEMENT | IN | N/A | C | Yes (1) | ||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| IU HEALTH GOSHEN FOUNDATION INC | ||
| C | $483,910 | FMV |
| GOSHEN HEALTH SYSTEM INC | ||
| O | $2,277,095 | FMV |
| GOSHEN HEALTH SYSTEM INC | ||
| R | $13,765,920 | FMV |
| IU HEALTH GOSHEN FOUNDATION INC | ||
| R | $395,169 | FMV |