GOSHEN HOSPITAL ASSOCIATION INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: GOSHEN HOSPITAL ASSOCIATION INC (EIN 35-6001540)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-08
IRS object ID: 201343129349301484
Schema version: 2012v2.1
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)
Timestamp	2013-11-08T13:35:01-06:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	861065772	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	DELOITTE TAX LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	111 MONUMENT CIRCLE SUITE 2000	AddressLine1
City	INDIANAPOLIS	City
State	IN	State
ZIP Code	462045108	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	356001540	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	GOSHEN HOSPITAL ASSOCIATION INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	GOSH	NameControl
Phone	5745742665	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	200 HIGH PARK AVENUE	AddressLine1
City	GOSHEN	City
State	IN	State
ZIP Code	46526	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	AMY FLORIA	Name
Title	CFO	Title
Phone	5745352661	Phone
Date Signed	2013-11-08	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	SHAWNA M JIMENEZ	Name
PTIN	P01222873	PTIN
Phone	3174648600	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

Field	Value	IRS element (for citing)
Business Name Line1	IU HEALTH GOSHEN HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	RANDAL CHRISTOPHEL	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	200 HIGH PARK AVENUE	AddressLine1
City	GOSHEN	City
State	IN	State
ZIP Code	46526	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	229625584	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.IUHEALTH.ORG/GOSHEN	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1946	YearFormation
State Legal Domicile	IN	StateLegalDomicile
Activity Or Mission Description	TO IMPROVE THE HEALTH OF OUR COMMUNITIES BY PROVIDING INNOVATIVE, OUTSTANDING CARE AND SERVICES.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	12	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	8	NbrIndependentVotingMembers
Total Nbr Employees	1440	TotalNbrEmployees
Total Nbr Volunteers	355	TotalNbrVolunteers
Total Gross UBI	-185089	TotalGrossUBI
Net Unrelated Business Txbl Income	-185089	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	158830	ContributionsGrantsPriorYear
Contributions Grants Current Year	126834	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	200406955	ProgramServiceRevenuePriorYear
Program Service Revenue CY	219847588	ProgramServiceRevenueCY
Investment Income Prior Year	5421558	InvestmentIncomePriorYear
Investment Income Current Year	2802296	InvestmentIncomeCurrentYear
Other Revenue Prior Year	3656377	OtherRevenuePriorYear
Other Revenue Current Year	6848866	OtherRevenueCurrentYear
Total Revenue Prior Year	209643720	TotalRevenuePriorYear
Total Revenue Current Year	229625584	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	260500	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	208000	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	76970083	SalariesEtcPriorYear
Salaries Etc Current Year	79425542	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	117865606	OtherExpensePriorYear
Other Expenses Current Year	107837862	OtherExpensesCurrentYear
Total Expenses Prior Year	195096189	TotalExpensesPriorYear
Total Expenses Current Year	187471404	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	14547531	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	42154180	RevenuesLessExpensesCY
Total Assets BOY	207700119	TotalAssetsBOY
Total Assets EOY	253624903	TotalAssetsEOY
Total Liabilities BOY	69536171	TotalLiabilitiesBOY
Total Liabilities EOY	68217308	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	138163948	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	185407595	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	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.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	156003187	Expense
Grants	208000	Grants
Revenue	224732005	Revenue
Description	IU HEALTH GOSHEN HOSPITAL IS A NON-DENOMINATIONAL NON-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 HERITAGE AND VALUES, IU HEALTH GOSHEN HOSPITAL WILL DELIVER EXCEPTIONAL HEALTHCARE IN AN INTEGRATED MODEL TO THE COMMUNITIES WE SERVE, ACHIEVING PREEMINENCE WITH COMMITMENT TO QUALITY, LEADERSHIP, AND INNOVATION. BY 2015, WE WILL ACHIEVE ALL ELEMENTS OF THIS VISION BY FOCUSING ON THE FOLLOWING KEY AREAS:- PROVIDING HIGH-QUALITY CARE WITH COMPASSION, VALUE AND STATE-OF-THE-ART TECHNOLOGY;- CREATING AN ENVIRONMENT THAT FOSTERS THE HIGHEST LEVEL OF ENTHUSIASM, COMMITMENT, COLLABORATION AND SATISFACTION;- STRATEGICALLY RESPONDING TO OUR DIVERSE COMMUNITY'S CHANGING HEALTHCARE NEEDS, WITH INCREASING EMPHASIS ON WELLNESS; AND- HELPING OUR COMMUNITIES TO BE THE "BEST PLACES" TO LIVE AND WORK.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 142 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 2012. IN ADDITION, HEALTHCARE EXCEL (QUALITY IMPROVEMENT ORGANIZATION FOR INDIANA) REPORTED THAT THE HOSPITAL WAS ABOVE OUR PEER GROUP AND OVERALL STATE PERFORMANCE IN ALL AREAS OF OUR PUBLICLY REPORTED MEASURES FOR THE 4 QUARTERS ENDING MARCH 31, 2012.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 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. ANNUALLY, IU HEALTH GOSHEN HOSPITAL MAKES CONTRIBUTIONS TO WELL-DESERVING ORGANIZATIONS FROM GOSHEN AND THE SURROUNDING COMMUNITIES. THE HOSPITAL SUPPORTS AREA NON-PROFIT AGENCIES THAT SHARES ITS MISSION, VISION AND VALUES THROUGH THE COMMUNITY BENEFIT FUND. THE PROGRAM IS AN EFFORT TO FURTHER THE IMPACT THESE ORGANIZATIONS CAN MAKE AND INCREASE THE NUMBER OF BENEFICIAL PROGRAMS AVAILABLE TO THE COMMUNITY. IN 2012, THE HOSPITAL PROVIDED OVER $208,000 TO 57 ORGANIZATIONS. SINCE ITS INCEPTION IN 1998, THE COMMUNITY BENEFIT FUND HAS GIVEN OVER $1.9 MILLION IN GRANT MONEY. 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. IN 2012, THE HOSPITAL EXTENDED CHARITY CARE TO OVER 3,955 PATIENTS TOTALING $9.3 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 HOSPITAL RECEIVED THE GOLD PERFORMANCE ACHIEVEMENT AWARD BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION'S NCDR ACTION REGISTRY (2011) - ONE OF ONLY 167 HOSPITALS NATIONWIDE TO EARN THE DISTINCTION. IU HEALTH GOSHEN HOSPITAL WAS NAMED AMONG "100 BEST PLACES TO WORK IN HEALTHCARE" BY HOSPITAL REVIEW MAGAZINE IN 2012.IU HEALTH GOSHEN HOSPITAL WAS RECOGNIZED IN 2011 BY THE AMERICAN COLLEGE OF SURGEONS THROUGH THEIR NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM AS ONE OF 26 HOSPITALS ACHIEVING EXEMPLARY PERFORMANCE FOR SURGICAL PATIENT CARE.IU HEALTH GOSHEN HOSPITAL HAS BEEN NAMED AN ACCREDITED HEART FAILURE INSTITUTE BY THE NATIONAL HEALTHCARE ACCREDITATION COLLOQUIUM.	Description
Total Program Service Expense	156003187	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	1	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	0	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	1	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	131	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	1440	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	12	NbrVotingGoverningBodyMembers
Number Independent Voting Members	8	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	IN	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	DIRECTOR OF FINANCE	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	5745352665	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	200 HIGH PARK AVENUE	AddressLine1
City	GOSHEN	City
State	IN	State
ZIP Code	46526	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Highest Compensated EmployeeHighestCompensatedEmployee
JAMES DAGUE
PRESIDENT & CEO (RETIRED 02/2012)	40.00	1.00	X	X	1301376	0	909574
RANDY CHRISTOPHEL
PRESIDENT & CEO	40.00	1.00	X	X	531555	0	108161
LINDA BAXLEY
VICE CHAIR	1.00	0.00	X	X	0	0	0
DERALD BONTRAGER
CHAIR	1.00	1.00	X	X	0	0	0
RANDY CRIPE
DIRECTOR	1.00	0.00	X		0	0	0
KEVIN DEARY
DIRECTOR - PARTIAL YEAR	1.00	0.00	X		0	0	0
DON OGLE
DIRECTOR	1.00	0.00	X		0	0	0
MARTHA SUZIE YEAGER
DIRECTOR	1.00	0.00	X		0	0	0
KAREN PLETCHER
DIRECTOR	1.00	0.00	X		0	0	0
DAN NAFZIGER MD
DIRECTOR	1.00	40.00	X		0	157948	15616
DANIEL BERGER MD
DIRECTOR	1.00	40.00	X		0	204518	21697
KAREN SMITH
DIRECTOR	1.00	0.00	X		0	0	0
JODY NEER MD
DIRECTOR	1.00	40.00	X		0	375228	32561
SUSAN STIFFNEY
DIRECTOR	1.00	0.00	X		0	0	0
RAO BETINA MD
DIRECTOR - PARTIAL YEAR	1.00	0.00	X		0	0	0
JESSE BERGER
DIRECTOR - PARTIAL YEAR	1.00	0.00	X		0	0	0
EDWARD BOYTS MD
DIRECTOR - PARTIAL YEAR	1.00	40.00	X		0	206096	27926
CHRISTOPHER GRAFF
DIRECTOR - PARTIAL YEAR	1.00	0.00	X		0	0	0
AMY FLORIA
CFO	40.00	1.00		X	346891	0	33436
RANDALL CAMMENGA MD
COO	40.00	1.00		X	422534	0	32731
ALAN WELDY
V/P LEGAL	40.00	1.00		X	432856	0	30311
POOPALASINGHAM POOVENDRAN
PHYSICIAN	40.00	0.00			583979	0	33301	X
MIN YAN
PHYSICIAN	40.00	0.00			369015	0	31395	X
MARIA GARCIA
PHYSICIAN	40.00	0.00			293989	0	29342	X
PAMELA KARSEN
VICE PRESIDENT OF NURSING	40.00	0.00			290908	0	27543	X
XI ZEE WANG
PHYSICIAN	40.00	0.00			253968	0	30924	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	4827071	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	943790	TotalReportableCompFrmRltdOrgs
Total Other Compensation	1364518	TotalOtherCompensation
Number Individuals GT100 K	40	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
HEALTHTRAN LLC
PO BOX 712460	CINCINNATI	OH	452712460	COLLEAGUE DRUG BENEFIT	1242673
GERIG SURGICAL ASSOCIATES PC
2006 SOUTH MAIN STREET STE A	GOSHEN	IN	46526	ON CALL SERVICES	948795
QUEST DIAGNOSTICS
PO BOX 12989	CHICAGO	IL	60693	LAB SERVICES	663456
LANDAUER MEDICAL PHYSICS
PO BOX 809153	CHICAGO	IL	606809153	CONSULTING SERVICES	396200
VENTURE INTERNATIONAL LLC
PO BOX 461	HUDSONVILLE	MI	49426	CONSULTING SERVICES	208505

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	14	NumberOfContractorsGT100K
All Other Contributions	126834	AllOtherContributions
Total Contributions	126834	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	PATIENT CARE	Description
Business Code	621110	BusinessCode
Total Revenue Column	219847588	TotalRevenueColumn
Related Or Exempt Function Income	219847588	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	219847588	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	2802296	TotalRevenueColumn
Unrelated Business Revenue	-185089	UnrelatedBusinessRevenue
Exclusion	$2,987,385	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	1028204	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	0	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	1028204	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	1028204	TotalRevenueColumn
Exclusion	$1,028,204	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
FOOD SERVICE REVENUE	721000	936245	$936,245
FINANCE CHARGES	561000	232643		232643
OTHER ONCOLOGY REV MIS	621500	189173		189173

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	4462601	TotalRevenueColumn
Related Or Exempt Function Income	4462601	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	5820662	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	229625584	TotalRevenueColumn
Related Or Exempt Function Income	224732005	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	-185089	UnrelatedBusinessRevenue
Exclusion	$4,951,834	ExclusionAmount

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	X	InfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	208000	Total
Program Services	208000	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	3035212	Total
Management And General	3035212	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	57697999	Total
Program Services	39476587	ProgramServices
Management And General	18221412	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	2111223	Total
Program Services	1372295	ProgramServices
Management And General	738928	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	12608042	Total
Program Services	8201830	ProgramServices
Management And General	4406212	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	3973066	Total
Program Services	2582493	ProgramServices
Management And General	1390573	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	1410147	Total
Program Services	3443	ProgramServices
Management And General	1406704	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	302426	Total
Program Services	2862	ProgramServices
Management And General	299564	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	5229	Total
Management And General	5229	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	61262	Total
Program Services	61262	ProgramServices

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	26095617	Total
Program Services	26095617	ProgramServices

Advertising Advertising

Field	Value	IRS element (for citing)
Total	4172083	Total
Program Services	4172083	ProgramServices

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	884549	Total
Program Services	884549	ProgramServices

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	1343674	Total
Program Services	1343674	ProgramServices

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	968526	Total
Program Services	968526	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	713648	Total
Program Services	713648	ProgramServices

Interest Interest

Field	Value	IRS element (for citing)
Total	1964383	Total
Management And General	1964383	ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	9661063	Total
Program Services	9661063	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	10533210	Total
Program Services	10533210	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	1510444	Total
Program Services	1510444	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
DRUGS AND MED. SUPPLIES	38801228	38801228
REPAIRS & MAINTENANCE	5567396	5567396
EQUIPMENT RENTAL	1899106	1899106
UTILITIES	1792826	1792826

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	151045	Total
Program Services	151045	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	187471404	Total
Program Services	156003187	ProgramServices
Management And General	31468217	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	12472332	BOY
EOY	24428555	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	11282149	BOY
EOY	12511479	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	27017971	BOY
EOY	29335784	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	860326	BOY
EOY	1292423	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	4577268	BOY
EOY	6005926	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2555123	BOY
EOY	4232372	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	209175133	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	106626380	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	100484922	BOY
EOY	102548753	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	47774955	BOY
EOY	71931547	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	675073	BOY
EOY	1338064	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	207700119	BOY
EOY	253624903	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	22615615	BOY
EOY	22783313	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	44970675	BOY
EOY	43481171	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	1949881	BOY
EOY	1952824	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	69536171	BOY
EOY	68217308	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	137554991	BOY
EOY	184767777	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	608957	BOY
EOY	639818	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	138163948	BOY
EOY	185407595	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	207700119	BOY
EOY	253624903	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	42154180	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	4467998	ReconciliationUnrealizedInvest
Reconcilation Prior Adjustment	301733	ReconcilationPriorAdjustment
Reconcilation Other Changes	319736	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	1	FederalGrantAuditRequired
Federal Grant Audit Performed	1	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$5,229	OtherActivitiesAmount
Total Lobbying Expenditures IIB	5229	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING.	Explanation

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	2988795	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	3883888	OtherCostOrOtherBasis
Book Value	6872683	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	95917748	OtherCostOrOtherBasis
Depreciation	30608078	Depreciation
Book Value	65309670	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	377004	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	113748	OtherCostOrOtherBasis
Depreciation	169703	Depreciation
Book Value	321049	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	102771345	OtherCostOrOtherBasis
Depreciation	75848599	Depreciation
Book Value	26922746	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	3122605	OtherCostOrOtherBasis
Book Value	3122605	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	102548753	TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
BOARD DESIGNATED FUNDS	70390365	F
CANCER CENTER INVESTMENT	1541182	F

Field	Value	IRS element (for citing)
Total Of Book Value Securities	71931547	TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
ASSET RETIREMENT OBLIGATION	$202,334
DEFERRED COMPENSATION	$482,650
DEFERRED MALPRACTICE CLAIMS	$292,977
INTEREST RATE SWAP	$974,863

Field	Value	IRS element (for citing)
Total Of Amounts	1952824	TotalOfAmounts

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3878331	TotalCommunityBenefitExpense
Net Community Benefit Expense	3878331	NetCommunityBenefitExpense
Percent Of Total Expense	0.02070	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	22895509	TotalCommunityBenefitExpense
Direct Offsetting Revenue	22944254	DirectOffsettingRevenue
Net Community Benefit Expense	-48745	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	26773840	TotalCommunityBenefitExpense
Direct Offsetting Revenue	22944254	DirectOffsettingRevenue
Net Community Benefit Expense	3829586	NetCommunityBenefitExpense
Percent Of Total Expense	0.02070	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	937064	TotalCommunityBenefitExpense
Direct Offsetting Revenue	66866	DirectOffsettingRevenue
Net Community Benefit Expense	870198	NetCommunityBenefitExpense
Percent Of Total Expense	0.00460	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	226231	TotalCommunityBenefitExpense
Direct Offsetting Revenue	35649	DirectOffsettingRevenue
Net Community Benefit Expense	190582	NetCommunityBenefitExpense
Percent Of Total Expense	0.00100	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	665950	TotalCommunityBenefitExpense
Net Community Benefit Expense	665950	NetCommunityBenefitExpense
Percent Of Total Expense	0.00360	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1829245	TotalCommunityBenefitExpense
Direct Offsetting Revenue	102515	DirectOffsettingRevenue
Net Community Benefit Expense	1726730	NetCommunityBenefitExpense
Percent Of Total Expense	0.00920	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	28603085	TotalCommunityBenefitExpense
Direct Offsetting Revenue	23046769	DirectOffsettingRevenue
Net Community Benefit Expense	5556316	NetCommunityBenefitExpense
Percent Of Total Expense	0.02990	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Total Community Building Expense	6613	TotalCommunityBuildingExpense
Net Community Building Expense	6613	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	51079	TotalCommunityBuildingExpense
Net Community Building Expense	51079	NetCommunityBuildingExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	75	NumberOfActivitiesOrPrograms
Persons Served	102	PersonsServed
Total Community Building Expense	7105	TotalCommunityBuildingExpense
Net Community Building Expense	7105	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Total Community Building Expense	15533	TotalCommunityBuildingExpense
Net Community Building Expense	15533	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	75	NumberOfActivitiesOrPrograms
Persons Served	102	PersonsServed
Total Community Building Expense	80330	TotalCommunityBuildingExpense
Net Community Building Expense	80330	NetCommunityBuildingExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$8,439,410	BadDebtExpenseAmount
Amount Attributable To	994631	AmountAttributableTo
Amount Reimbursed By Medicare	39166512	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	45206412	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-6039900	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	IU HEALTH GOSHEN HOSPITAL	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	200 HIGH PARK AVENUE	AddressLine1
City	GOSHEN	City
State	IN	State
ZIP Code	46526	ZIPCode

Field	Value	IRS element (for citing)
Website Address	WWW.IUHEALTH.ORG/GOSHEN	WebsiteAddress
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	IU HEALTH GOSHEN HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	200.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	400.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Other Factors	X	OtherFactors
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Lowest Negotiated Rates	X	LowestNegotiatedRates
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	4	NumberOfOtherFacilities

Other Facilities OtherFacilities (4 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
IU HEALTH GOSHEN
200 HIGH PARK AVENUE	GOSHEN	IN	46526	CLINIC
THE RETREAT WOMEN'S HEALTH CENTER
1135 PROFESSIONAL DRIVE	GOSHEN	IN	46526	CLINIC
INDIANA LAKES MANAGED CARE
2018 SOUTH MAIN STREET	GOSHEN	IN	46526	HEALTH CARE MANAGEMENT
NEW PARIS MEDICAL CLINIC
2018 SOUTH MAIN STREET	GOSHEN	IN	46526	CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 7: IN 2012, GOSHEN HOSPITAL ASSOCIATION, INC. RECEIVED RETROACTIVE MEDICAID PAYMENTS FROM THE HOSPITAL ASSESSMENT FEE ("HAF") PROGRAM. THIS RETROACTIVE PAYMENT REPRESENTED TWELVE MONTHS OF MEDICAID REIMBURSEMENT FOR 2012 ALONG WITH SIX ADDITIONAL MONTHS OF REIMBURSEMENT RELATED TO TAX YEAR 2011 CLAIMS. AS A RESULT OF THE RETROACTIVE MEDICAID PAYMENTS RECEIVED FROM THE HAF PROGRAM, GOSHEN HOSPITAL ASSOCIATION, INC.'S COMMUNITY BENEFIT PERCENTAGE IS 2.99% IN 2012 COMPARED TO 7.65% IN 2011.
PART III, LINE 2: GOSHEN HOSPITAL ASSOCATION, 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 ASSOCATION, 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: 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, THE INDIANA UNIVERSITY HEALTH SYSTEM 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 THE INDIANA UNIVERSITY HEALTH SYSTEM AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CARE IF DEEMED TO OTHERWISE MEET FINANCIAL ASSISTANCE POLICIES OF THE INDIANA UNIVERSITY HEALTH SYSTEM.
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 DEPARTMENT HEADS 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 A MINIMUM OF THREE TIMES THROUGHOUT THE YEAR 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 V, SECTION B, LINE 12H: FAMILY SIZE IS ANOTHER FACTOR IN DETERMINING DISCOUNTS GRANTED TO PATIENTS.	IU HEALTH GOSHEN HOSPITAL
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 142 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 2012 CENSUS, THE POPULATION OF ELKHART COUNTY IS 199,619. THE MEDIAN INCOME FOR A HOUSEHOLD IN ELKHART COUNTY BASED ON THE 2012 CENSUS IS $47,308 AND THE MEDIAN INCOME FOR A FAMILY IS $54,285. APPROXIMATELY 10.1% OF FAMILIES AND 15.7% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 24.0% OF THOSE UNDER THE AGE 18 AND 7.8% OF THOSE AGE 65 AND OVER. THE RACIAL MAKEUP OF THE COUNTY WAS ABOUT 76.7% WHITE, 6.0% AFRICAN AMERICAN, AND 18.7% OTHER RACES. 4.0% OF THE POPULATION IS HISPANIC OR LATINO.
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.
IN	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (17 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
BASHOR CHILDREN'S HOME
62226 COUNTY ROAD 15	GOSHEN	IN	46526	350933555	501(C)(3)	7500	OPERATING SUPPORT
BOYS & GIRLS CLUB OF GREATER GOSHEN INC
102 WEST LINCOLN SUITE 240	GOSHEN	IN	46526	351033735	501(C)(3)	15000	OPERATING SUPPORT
CENTER FOR HEALING & HOPE
423 E JEFFERSON STREET	GOSHEN	IN	46528	020560511	501(C)(3)	5000	OPERATING SUPPORT
COUNCIL ON AGING OF ELKHART COUNTY INC
230 E JACKSON BLVD	ELKHART	IN	46516	510178910	501(C)(3)	5000	OPERATING SUPPORT
ELKHART COUNTY HEALTH DEPARTMENT-HEALTHY BEGINNINGS
1400 HUDSON STREET	ELKHART	IN	46516	350909968	GOV'T ENTITY	5000	OPERATING SUPPORT
ELKHART COUNTY PROSECUTOR'S OFFICE
301 SOUTH MAIN STREET SUITE 100	ELKHART	IN	46516	356000142	GOV'T ENTITY	5000	OPERATING SUPPORT
FAMILY CHRISTIAN DEVELOPMENT CENTER
151 S LOCKE STREET	NAPPANEE	IN	46550	351979463	501(C)(3)	5000	OPERATING SUPPORT
FAMILY SERVICES OF ELKHART COUNTY INC
101 EAST HIVELY AVE	ELKHART	IN	46517	350868079	501(C)(3)	5000	OPERATING SUPPORT
LACASA INC
202 N COTTAGE AVE	GOSHEN	IN	46528	351554538	501(C)(3)	5000	OPERATING SUPPORT
LAGRANGE COUNTY COUNCIL ON AGING
PO BOX 107	LAGRANGE	IN	46761	237455893	501(C)(3)	5000	OPERATING SUPPORT
MAPLE CITY HEALTH CARE CENTER
213 MIDDLEBURY STREET	GOSHEN	IN	46528	351749398	501(C)(3)	20000	OPERATING SUPPORT
NORTHERN INDIANA HISPANIC HEALTH COALITION NIHHC
444 N NAPPANEE ST	ELKHART	IN	46514	320039221	501(C)(3)	7500	OPERATING SUPPORT
OAKLAWN PSYCHIATRIC CENTER
330 LAKEVIEW DRIVE	GOSHEN	IN	46527	351070041	501(C)(3)	10000	OPERATING SUPPORT
UNITED CANCER SERVICES OF ELKHART COUNTY INC
23971 US HIGHWAY 33	ELKHART	IN	46530	351091429	501(C)(3)	15000	OPERATING SUPPORT
GOSHEN COLLEGE
1700 S MAIN	GOSHEN	IN	46526	352158366	501(C)(3)	10000	OPERATING SUPPORT
GOSHEN HIGH SCHOOL
401 LINCOLNWAY EAST	GOSHEN	IN	46526	356002423	GOV'T ENTITY	5000	OPERATING SUPPORT
THE WINDOW INC
223 S MAIN ST	GOSHEN	IN	46526	351427937	501(C)(3)	5000	OPERATING SUPPORT

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	17	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	SCHEDULE I, PART I, LINE 2: 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.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Payments	X	IdemnificationGrossUpPayments
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	1	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JAMES DAGUE
PRESIDENT & CEO (RETIRED 02/2012)	110908	0	314750	0	875718	0	908208	0	1366	0	2210950	0	0	0
RANDY CHRISTOPHEL
PRESIDENT & CEO	332857	0	99225	0	99473	0	99561	0	8600	0	639716	0	0	0
DAN NAFZIGER MD
DIRECTOR	0	51751	0	100652	0	5545	0	15319	0	297	0	173564	0	0
DANIEL BERGER MD
DIRECTOR	0	107120	0	86148	0	11250	0	19322	0	2375	0	226215	0	0
JODY NEER MD
DIRECTOR	0	303933	0	41555	0	29740	0	24495	0	8066	0	407789	0	0
EDWARD BOYTS MD
DIRECTOR - PARTIAL YEAR	0	141097	0	64199	0	800	0	20158	0	7768	0	234022	0	0
AMY FLORIA
CFO	237438	0	80112	0	29341	0	24495	0	8941	0	380327	0	0	0
RANDALL CAMMENGA MD
COO	299166	0	89412	0	33956	0	24495	0	8236	0	455265	0	0	0
ALAN WELDY
V/P LEGAL	316800	0	102343	0	13713	0	24495	0	5816	0	463167	0	0	0
POOPALASINGHAM POOVENDRAN
PHYSICIAN	563498	0	0	0	20481	0	24495	0	8806	0	617280	0	0	0
MIN YAN
PHYSICIAN	300786	0	25800	0	42429	0	24495	0	6900	0	400410	0	0	0
MARIA GARCIA
PHYSICIAN	282151	0	800	0	11038	0	24495	0	4847	0	323331	0	0	0
PAMELA KARSEN
VICE PRESIDENT OF NURSING	215414	0	67437	0	8057	0	24495	0	3048	0	318451	0	0	0
XI ZEE WANG
PHYSICIAN	212568	0	800	0	40600	0	24495	0	6429	0	284892	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
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 III	PART I, LINE 4A: AS PER OUR EMPLOYMENT AGREEMENT, UPON A 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. JAMES DAGUE $475,821	SUPPLEMENTAL INFORMATION
PART III	PART I, LINE 4B: ALL EMPLOYEES AND AMOUNTS LISTED ARE VOLUNTARY DEFERRALS OR COMPANY CONTRIBUTIONS TO 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. RANDY CHRISTOPHEL $27,838 JAMES DAGUE $103,389	SUPPLEMENTAL INFORMATION

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
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: JAMES DAGUE RANDY 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 OCTOBER 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 IX, LINE 11G	MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 314,447. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 314,447. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,315,341. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,315,341. OUTSIDE PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 23,465,829. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,465,829.	OTHER FEES
FORM 990, PART XI, LINE 9:	EQUITY TRANSFERS 308,190. INTEREST RATE SWAP 11,546.	CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Total IncomeTotalIncome	EOY AssetsEOYAssets	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Direct Controlling Entity NADirectControllingEntityNA
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	-266451	365203		N/A
PILR INC
200 HIGH PARK AVE	GOSHEN	IN	46526	204294750	DEVELOPMENT	IN	0	0	GHS

Form990 Schedule R Part II Form990ScheduleRPartII (37 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
CLARIAN TRANSPLANT INSTITUTE INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	134350599	HEALTHCARE	IN	501(C)(3)	9	IUH	1
GOSHEN HEALTH SYSTEM INC
200 HIGH PARK AVE	GOSHEN	IN	46526	351974765	HEALTHCARE	IN	501(C)(3)	11 I	IUH	1
HEALTHLINC INC
714 S ROGERS ST	BLOOMINGTON	IN	47402	263571507	HEALTHCARE	IN	501(C)(3)	9	IUHB	1
INDIANA RADIOLOGY PARTNERS INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	201017034	HEALTHCARE	IN	501(C)(3)	3	IUH	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
2600 GREENBUSH ST	LAFAYETTE	IN	47904	356079797	FUNDRAISING	IN	501(C)(3)	11 I	IUHA	1
IU HEALTH ARNETT INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	263162145	HEALTHCARE	IN	501(C)(3)	3	IUH	1
IU HEALTH BALL MEMORIAL HOSPITAL INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	350867958	HEALTHCARE	IN	501(C)(3)	3	IUH	1
IU HEALTH BALL MEMORIAL PHYSICIANS INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	351925641	HEALTHCARE	IN	501(C)(3)	9	IUHBMH	1
IU HEALTH BEDFORD INC
2900 W 16TH ST	BEDFORD	IN	47421	237042323	HEALTHCARE	IN	501(C)(3)	3	IUH	1
IU HEALTH BLACKFORD HOSPITAL INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	010646166	HEALTHCARE	IN	501(C)(3)	3	IUHBMH	1
IU HEALTH BLOOMINGTON INC
PO BOX 1149	BLOOMINGTON	IN	47403	351720796	HEALTHCARE	IN	501(C)(3)	3	IUH	1
IU HEALTH BMH FOUNDATION INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	311111784	FUNDRAISING	IN	501(C)(3)	11 I	IUHBMH	1
IU HEALTH CARE ASSOCIATES INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	351747218	HEALTHCARE	IN	501(C)(3)	9	IUH	1
IU HEALTH LAPORTE HOSPITAL INC
PO BOX 250	LAPORTE	IN	46352	351125434	HEALTHCARE	IN	501(C)(3)	3	IUH	1
IU HEALTH LAPORTE PHYSICIANS INC
PO BOX 250	LAPORTE	IN	46352	311070868	HEALTHCARE	IN	501(C)(3)	3	IUHLH	1
IU HEALTH MORGAN HOSPITAL INC
2209 JOHN R WOODEN DR	MARTINSVILLE	IN	46151	273533027	HEALTHCARE	IN	501(C)(3)	3	IUH	1
IU HEALTH NORTH HOSPITAL INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	351932442	HEALTHCARE	IN	501(C)(3)	3	IUH	1
IU HEALTH PAOLI HOSP FOUNDATION INC
PO BOX 499	PAOLI	IN	47454	310992486	FUNDRAISING	IN	501(C)(3)	11 III-O	IUHP	1
IU HEALTH PAOLI INC
PO BOX 499	PAOLI	IN	47454	352090919	HEALTHCARE	IN	501(C)(3)	3	IUHB	1
IU HEALTH TIPTON HOSPITAL INC
1000 S MAIN ST	TIPTON	IN	46072	262772226	HEALTHCARE	IN	501(C)(3)	3	IUH	1
IU HEALTH WEST HOSPITAL INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	351814660	HEALTHCARE	IN	501(C)(3)	3	IUH	1
IU HEALTH WHITE MEMORIAL HOSPITAL INC
720 S SIXTH ST	MONTICELLO	IN	47960	273532963	HEALTHCARE	IN	501(C)(3)	3	IUH	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
METHODIST HEALTH FOUNDATION INC
1800 N CAPITOL AVE	INDIANAPOLIS	IN	46202	356043086	FUNDRAISING	IN	501(C)(3)	11 I	IUH	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	1
METHODIST OCCUP HEALTH CENTERS INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	351844176	HEALTHCARE	IN	501(C)(3)	3	IUH	1
METHODIST RESEARCH INSTITUTE INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	352023710	HEALTHCARE	IN	501(C)(3)	11 I	IUH	1
MH HEALTHCARE INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	351766531	HEALTHCARE	IN	501(C)(3)	3	MMG	1
MORGAN CO MEM HOSP FOUNDATION INC
2209 JOHN R WOODEN DR	MARTINSVILLE	IN	46151	352035162	FUNDRAISING	IN	501(C)(3)	11 II	IUHMH	1
MORGAN CO MEM HOSP GUILD INC
2209 JOHN R WOODEN DR	MARTINSVILLE	IN	46151	310886844	FUNDRAISING	IN	501(C)(3)	11 III-FI	IUHMH	1
MORGAN HEALTH SERVICES INC
1949 HOSPITAL DR	MARTINSVILLE	IN	46151	351968564	HEALTHCARE	IN	501(C)(3)	3	IUHMH	1
WHITE CO MEM HOSP FOUNDATION INC
PO BOX 952	MONTICELLO	IN	47960	351671806	FUNDRAISING	IN	501(C)(3)	11 III-O	IUHWMH	1
UNIVERSITY FAMILY PHYSICIANS INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	237427350	HEALTHCARE	IN	501(C)(3)	9	IUHCA	1
REHABILITATION HOSPITAL OF INDIANA INC
4141 SHORE DRIVE	INDIANAPOLIS	IN	46254	351786005	HEALTHCARE	IN	501(C)(3)	3	IUH	1
RHI FOUNDATION INC
4141 SHORE DRIVE	INDIANAPOLIS	IN	46254	351932349	FUNDRAISING	IN	501(C)(3)	11 I	RHI	1

Form990 Schedule R Part III Form990ScheduleRPartIII (22 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA
BALL OUTPATIENT SURGERY CENTER LLC
3000 RIVERCHASE GALLERIA STE 500	BIRMINGHAM	AL	35244	270275794	HEALTHCARE	IN	N/A
BELTWAY SURGERY CENTERS LLC
3000 RIVERCHASE GALLERIA STE 500	BIRMINGHAM	AL	35244	352072586	HEALTHCARE	IN	N/A
BLOOMINGTON ENDOSCOPY CENTERS LLC
PO BOX 1149	BLOOMINGTON	IN	47402	352117943	HEALTHCARE	IN	N/A
BMH OUTPATIENT SURGERY SERVICES LLC
2401 W UNIVERSITY AVE	MUNCIE	IN	47303	204567998	HEALTHCARE	IN	N/A
BOSC HOLDINGS LLC
3000 RIVERCHASE GALLERIA STE 500	BIRMINGHAM	AL	35244	454147343	HEALTHCARE	IN	N/A
CARDINAL HEALTH INITIATIVES LLC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	300102702	PURCHASING	IN	N/A
CHV FUND I LLC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	262523206	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
CTF INTERNATIONAL GROWTH PORTFOLIO
280 CONGRESS ST STE 500	BOSTON	MA	02210	200231923	INVESTMENTS	MA	N/A
EAGLE HIGHLANDS SURGERY CENTER LLC
3000 RIVERCHASE GALLERIA STE 500	BIRMINGHAM	AL	35244	352259204	HEALTHCARE	IN	N/A
EHSC HOLDINGS LLC
3000 RIVERCHASE GALLERIA STE 500	BIRMINGHAM	AL	35244	454147879	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
3000 RIVERCHASE GALLERIA STE 500	BIRMINGHAM	AL	35244	454148032	HEALTHCARE	IN	N/A
INDIANA ENDOSCOPY CENTERS LLC
3000 RIVERCHASE GALLERIA STE 500	BIRMINGHAM	AL	35244	208398421	HEALTHCARE	IN	N/A
BSC HOLDINGS LLC
3000 RIVERCHASE GALLERIA STE 500	BIRMINGHAM	AL	35244	452314634	HEALTHCARE	IN	N/A
MID-AMERICA SURGERY CENTER LLC
2401 W UNIVERSITY AVE	MUNCIE	IN	47303	352002953	HEALTHCARE	IN	N/A
ROC SURGERY LLC
3000 RIVERCHASE GALLERIA STE 500	BIRMINGHAM	AL	35244	271497960	HEALTHCARE	IN	N/A
ROCS HOLDINGS LLC
3000 RIVERCHASE GALLERIA STE 500	BIRMINGHAM	AL	35244	454148369	HEALTHCARE	IN	N/A
SENATE STREET SURGERY CENTER LLC
3000 RIVERCHASE GALLERIA STE 500	BIRMINGHAM	AL	35244	421709357	HEALTHCARE	IN	N/A
SSSC HOLDINGS LLC
3000 RIVERCHASE GALLERIA STE 500	BIRMINGHAM	AL	35244	454148167	HEALTHCARE	IN	N/A
CARDINAL HEALTH ALLIANCE LLC
2401 W UNIVERSITY AVE	MUNCIE	IN	47303	351966281	MANAGED CARE	IN	N/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (17 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Type Of EntityTypeOfEntity	Controlled OrgControlledOrg	Address Line1AddressForeign/AddressLine1	CityAddressForeign/City	CountryAddressForeign/Country	Legal Domicile Foreign CountryLegalDomicileForeignCountry	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership
BMH MEDICAL PAVILION ASSOCIATION INC
2525 W UNIVERSITY AVE	MUNCIE	IN	47303	351858408	CONDO MANAGEMENT	IN	N/A	C	0
CARDINAL HEALTH VENTURES INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	351611424	MANAGEMENT	IN	N/A	C	0
CHV CAPITAL INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	260752507	VENTURE CAPITAL	IN	N/A	C	0
IU HEALTH ACO INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	454421020	HEALTHCARE	IN	N/A	C	0
IU HEALTH BOARD DESIGNATED TRUST
400 HOWARD ST	SAN FRANCISCO	CA	94105	306309021	INVESTMENTS	IN	N/A	T	0
IU HEALTH NTGI S&P500 FUND CF
PO BOX 804358	CHICAGO	IL	60680	306298263	INVESTMENTS	IN	N/A	T	0
IU HEALTH PLANS INC
1776 MERIDIAN ST STE 300	INDIANAPOLIS	IN	46202	262127080	HMO	IN	N/A	C	0
IU HEALTH RISK PURCHASING GROUP INC
151 MEETING ST STE 301	CHARLESTON	SC	29401	260202446	INSURANCE	IN	N/A	C	0
IU HEALTH RISK RETENTION GROUP INC
151 MEETING ST STE 301	CHARLESTON	SC	29401	201107674	INSURANCE	SC	N/A	C	0
IU HEALTH SOUTHERN IN PHYSICIANS INC
PO BOX 1149	BLOOMINGTON	IN	47402	351913875	HEALTHCARE	IN	N/A	C	0
IUH ASSURANCE LTD
				980395429	INSURANCE		N/A	C	0	720 W BAY RD PO BOX 69	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	0
PARKMOR DRUG INC
200 HIGH PARK AVE	GOSHEN	IN	46526	351394980	PHARMACY SALES	IN		C	1					GHS	490662	3184510	1.00000
RADIATION ONCOLOGY RESOURCES INC
200 HIGH PARK AVE	GOSHEN	IN	46526	262008424	HEALTHCARE	IN		C	1					GHS	-763735	308944	1.00000
SCANS INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	453080392	HEALTHCARE	IN	N/A	C	0
UNIVERSITY HEALTH MANAGEMENT INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	272891143	MANAGEMENT	IN	N/A	C	0
UNIVERSITY HEALTH MGMT (CHINA) INC
950 N MERIDIAN ST STE 800	INDIANAPOLIS	IN	46204	273891311	MANAGEMENT	IN	N/A	C	0

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	0	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
GOSHEN HEALTH SYSTEM INC
O	11108698	FMV
GOSHEN HEALTH SYSTEM INC
R	9661063	FMV
GOSHEN HEALTH SYSTEM INC
S	10223739	FMV