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INDIANA UNIVERSITY HEALTH BEDFORD INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
INDIANA UNIVERSITY HEALTH BEDFORD INC (EIN 23-7042323)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-16
IRS object ID
201203219349300215
Schema version
2011v1.3
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-16T08:40:25-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 2600AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN237042323EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1INDIANA UNIVERSITY HEALTH BEDFORD INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% ANITA HAMILTONInCareOfName
Name ControlINDINameControl
Phone8122751200Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12900 WEST 16TH STREETAddressLine1
CityBEDFORDCity
StateINState
ZIP Code47421ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCharles L ShetlerName
TitleCFOTitle
Date Signed2012-10-08DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1IU HEALTH BEDFORD HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonBradford DykesNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12900 West 16th StreetAddressLine1
CityBedfordCity
StateINState
ZIP Code47421ZIPCode
FieldValueIRS element (for citing)
Gross Receipts52550901GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteIUHEALTHBEDFORD.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1970YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionImproving Lives with High Quality Compassionate Care.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees508TotalNbrEmployees
Total Nbr Volunteers28TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year141727ContributionsGrantsPriorYear
Contributions Grants Current Year80619ContributionsGrantsCurrentYear
Program Service Revenue Prior Year50520096ProgramServiceRevenuePriorYear
Program Service Revenue CY52205071ProgramServiceRevenueCY
Investment Income Prior Year55284InvestmentIncomePriorYear
Investment Income Current Year25431InvestmentIncomeCurrentYear
Other Revenue Prior Year175355OtherRevenuePriorYear
Other Revenue Current Year187454OtherRevenueCurrentYear
Total Revenue Prior Year50892462TotalRevenuePriorYear
Total Revenue Current Year52498575TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1380GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1796GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year30610747SalariesEtcPriorYear
Salaries Etc Current Year31652423SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year16940894OtherExpensePriorYear
Other Expenses Current Year18786683OtherExpensesCurrentYear
Total Expenses Prior Year47553021TotalExpensesPriorYear
Total Expenses Current Year50440902TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3339441RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2057673RevenuesLessExpensesCY
Total Assets BOY33577272TotalAssetsBOY
Total Assets EOY34329615TotalAssetsEOY
Total Liabilities BOY14332762TotalLiabilitiesBOY
Total Liabilities EOY13007526TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY19244510NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY21322089NetAssetsOrFundBalancesEOY
Mission DescriptionAs an Indiana University Health Partner, our mission is to improve the health of our patients and community by providing high quality, compassionate, customer focused healthcare services, and to support the education and research initiatives of the Indiana University Health System.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense7313260Expense
Grants1000Grants
Revenue10679319Revenue
DescriptionInpatient Care We had 1,312 admissions resulting in 5,104 patient days in 2011. We, also, had 621 swing bed days.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense23852289Expense
Grants0Grants
Revenue34647156Revenue
DescriptionOutpatient Care IU Health Bedford had 88,519 outpatient registrations resulting in 804 Observation Days, 808 Outpatient Surgeries, 172,490 outpatient Laboratory tests, 22,243 outpatient Radiology tests, 4,081 outpatient CT Scans, 14,464 Emergency Room visits, 18,997 outpatient Physical Therapy Visits, and 4,050 outpatient Respiratory Therapy visits. We also had 2,470 ambulance runs in 2011.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense8788177Expense
Grants0Grants
Revenue6889923Revenue
DescriptionPhysician Group The IU Health Bedford Physician Group consists of approximately 17 Physicians and 5 Nurse Practitioners. It is designed to have a service area that covers Lawrence, Monroe, Martin, Greene, Jackson, Washington and Orange Counties. The Physicians and Nurse Practitioners had 61,007 office visits and 4,935 Nursing Home visits in 2011.Description
FieldValueIRS element (for citing)
Total Program Service Expense39953726TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109695NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees508NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonANITA HAMILTONNamePerson
Telephone Number8122785281TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12900 West 16th StreetAddressLine1
CityBedfordCity
StateINState
ZIP Code47421ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
Harley Brown
Director & Chairman3.0XX680000
Mary Lu Hanson
Director3.0X102000
Helen Nash
Director & Vice Chairman3.0XX376000
Randy Hawkins
Director & Secretary3.0XX339000
James T Oswalt
Director3.0X358000
Jack Kenworthy
Director & Treasurer3.0XX321000
James T Bellush
Director3.0X303000
Neil C Pickett
Director3.0X027304613534
Gene Robbins
Director3.0X000
Dan Dusleag
Pediatrician & Director40.0X151957036193
Hojjatt Shamloo
Internist & Director40.0X389013046890
Bradford W Dykes
CEO40.0XX29621807075
Charles Shetler
CFO40.0X162015029130
Brenda Davis
VP Patient Services40.0X13269609137
Cindy Smale
VP HR & Development40.0X114943023820
Rafi Siddiqi MD
Surgeon40.0408076045002X
Randall Martin MD
Anesthesiologist40.0321087044049X
Eung Jun Cha MD
Orthopedic Surgeon40.0324664038747X
Stephen Schultz MD
Internist40.0265344036043X
Alan Smith MD
Pathologist40.0267158038945X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2857961TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs273046TotalReportableCompFrmRltdOrgs
Total Other Compensation368565TotalOtherCompensation
Number Individuals GT100 K28NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Alliance Healthcare Services
PO Box 96485ChicagoIL60693MRI Testing662697
HMS Monitor
2739 Momentium PlaceChicagoIL60689Computer System403441
Unity Physician Group
1144 West Third StBloomingtonIN47404Physicians369452
Mayo Medical Labs
2001 1st StreetRochesterMN55905Lab Testing315471
Integra Imaging Partners
PO Box 86BedfordIN47421Contractor292329
FieldValueIRS element (for citing)
Number Of Contractors GT100 K9NumberOfContractorsGT100K
Related Organizations14716RelatedOrganizations
Government Grants65903GovernmentGrants
Noncash Contributions11992NoncashContributions
Total Contributions80619TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net Patient Revenue6221105198781151987811
Counseling Contract Revenue900099148875148875
Physician Medicare Incentive9000994850948509
Doyle Nursing Home Visits9000991231612316
Dewitte Disability Exams90009975607560
FieldValueIRS element (for citing)
Total Program Service Revenue52205071TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column25047TotalRevenueColumn
Exclusion$25,047ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real97202Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real52326Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real44876Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column44876TotalRevenueColumn
Exclusion$44,876ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other384Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other384Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column384TotalRevenueColumn
Exclusion$384ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Cafeteria Sales72232078751$78,751
Purch Discount Late Fees9000991132711327
CREDIT CARD REWARDS90009914405$14,405

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column38095TotalRevenueColumn
Exclusion$38,095ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue142578TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column52498575TotalRevenueColumn
Related Or Exempt Function Income52216398RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$201,558ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1796Total
Program Services1796ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1423877Total
Management And General1423877ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total24347783Total
Program Services19305384ProgramServices
Management And General5042399ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1216674Total
Program Services924672ProgramServices
Management And General292002ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2954676Total
Program Services2184502ProgramServices
Management And General770174ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1709413Total
Program Services1299154ProgramServices
Management And General410259ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total3656033Total
Program Services3008641ProgramServices
Management And General647392ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total18566Total
Management And General18566ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total46366Total
Management And General46366ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total850952Total
Program Services850952ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total154235Total
Program Services154235ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2184358Total
Program Services1759676ProgramServices
Management And General424682ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total935215Total
Program Services645298ProgramServices
Management And General289917ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1009092Total
Program Services836007ProgramServices
Management And General173085ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total29872Total
Program Services29872ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total210552Total
Program Services118018ProgramServices
Management And General92534ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total553178Total
Program Services435701ProgramServices
Management And General117477ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2096650Total
Program Services1651388ProgramServices
Management And General445262ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total333736Total
Program Services251293ProgramServices
Management And General82443ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES57669805766980
Bad Debt Expense151214151214
Repairs52144142647194970
MISCELLANEOUS EXPENSES268243152472115771

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total50440902Total
Program Services39953726ProgramServices
Management And General10487176ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY6452369BOY
EOY7247564EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY6059324BOY
EOY3756944EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5682302BOY
EOY7285299EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY32683BOY
EOY384764EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY805233BOY
EOY803205EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY465416BOY
EOY662792EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis41555425LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec27386378LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY14079945BOY
EOY14169047EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY20000EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY33577272BOY
EOY34329615EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3753506BOY
EOY3850246EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY10579256BOY
EOY9157280EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY14332762BOY
EOY13007526EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY19164807BOY
EOY21222480EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY79703BOY
EOY99609EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY19244510BOY
EOY21322089EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY33577272BOY
EOY34329615EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2057673ReconcilationRevenueExpenses
Reconcilation Other Changes19906ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance79703BeginningOfYearBalance
Contributions20000Contributions
Other Expenditures94OtherExpenditures
End Of Year Balance99609EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance80832BeginningOfYearBalance
Other Expenditures1129OtherExpenditures
End Of Year Balance79703EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance76206BeginningOfYearBalance
Contributions4626Contributions
End Of Year Balance80832EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance78190BeginningOfYearBalance
Other Expenditures1984OtherExpenditures
End Of Year Balance76206EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis912711OtherCostOrOtherBasis
Book Value912711BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis15857654OtherCostOrOtherBasis
Depreciation7463380Depreciation
Book Value8394274BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis23708802OtherCostOrOtherBasis
Depreciation19256893Depreciation
Book Value4451909BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1076258OtherCostOrOtherBasis
Depreciation666105Depreciation
Book Value410153BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings14169047TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Due to Medicare/Medicaid$1,981,559
Professional Liability/Tail Coverage$94,122
Indiana University Health$7,081,599
FieldValueIRS element (for citing)
Total Of Amounts9157280TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Restricted FundsSchedule D, Part VHospice Donations are used for the needs our cancer patients. Money is donated by the Medical Group to pay for Patient's prescriptions who cannot afford them. These are donations on the Hospital's books that are earmarked for the Foundation. Radiology incentive is money donated for seminars etc for Radiology employees. Restricted donations are monies that are donated to the Hospital for specific use only.
FIN 48 Footnote from Financial StatementsSchedule D, Part X, Line 2Indiana University Health Bedford Hospital is a subsidiary in the consolidated financial statements of Indiana University Health. Indiana University Health adopted FIN 48 in 2007. No disclosures were required under GAAP as Indiana University Health does not have any material tax contingencies that required disclosures in the footnotes.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served2651PersonsServed
Total Community Benefit Expense2673831TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2673831NetCommunityBenefitExpense
Percent Of Total Expense0.05320PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served3053PersonsServed
Total Community Benefit Expense5769749TotalCommunityBenefitExpense
Direct Offsetting Revenue950470DirectOffsettingRevenue
Net Community Benefit Expense4819279NetCommunityBenefitExpense
Percent Of Total Expense0.09580PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served5704PersonsServed
Total Community Benefit Expense8443580TotalCommunityBenefitExpense
Direct Offsetting Revenue950470DirectOffsettingRevenue
Net Community Benefit Expense7493110NetCommunityBenefitExpense
Percent Of Total Expense0.14900PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs15NumberOfActivitiesOrPrograms
Persons Served5417PersonsServed
Total Community Benefit Expense597355TotalCommunityBenefitExpense
Direct Offsetting Revenue2425DirectOffsettingRevenue
Net Community Benefit Expense594930NetCommunityBenefitExpense
Percent Of Total Expense0.01180PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served5PersonsServed
Total Community Benefit Expense98302TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense98302NetCommunityBenefitExpense
Percent Of Total Expense0.00200PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Total Community Benefit Expense747598TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense747598NetCommunityBenefitExpense
Percent Of Total Expense0.01490PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense1870TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1870NetCommunityBenefitExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs20NumberOfActivitiesOrPrograms
Persons Served5422PersonsServed
Total Community Benefit Expense1445125TotalCommunityBenefitExpense
Direct Offsetting Revenue2425DirectOffsettingRevenue
Net Community Benefit Expense1442700NetCommunityBenefitExpense
Percent Of Total Expense0.02870PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs20NumberOfActivitiesOrPrograms
Persons Served11126PersonsServed
Total Community Benefit Expense9888705TotalCommunityBenefitExpense
Direct Offsetting Revenue952895DirectOffsettingRevenue
Net Community Benefit Expense8935810NetCommunityBenefitExpense
Percent Of Total Expense0.17770PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense4834TotalCommunityBuildingExpense
Net Community Building Expense4834NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense27811TotalCommunityBuildingExpense
Net Community Building Expense27811NetCommunityBuildingExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served15PersonsServed
Total Community Building Expense4699TotalCommunityBuildingExpense
Net Community Building Expense4699NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served15PersonsServed
Total Community Building Expense37344TotalCommunityBuildingExpense
Net Community Building Expense37344NetCommunityBuildingExpense
Percent Of Total Expense0.00080PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$151,214BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare17571762AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare15802581CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall1769181MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1IU HEALTH BEDFORD INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12900 WEST 16TH STREETAddressLine1
CityBEDFORDCity
StateINState
ZIP Code47421ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
Critical Access HospitalXCriticalAccessHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1IU HEALTH BEDFORD INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent200.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Medical IndigencyXMedicalIndigency
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Other FactorsXOtherFactors
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicyfalseNondiscrimEmergencyCarePolicy
Other ReasonXOtherReason
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

IdentifierIdentifierExplanationExplanation
Part I, Line 6aIU Health Bedford's Community Benefit information is included in IU Health's (Parent Company) Community Benefit Report.e.
Part I, Line 7, column (f)Bad Debt expense of $151,214 was excluded from total expenses in the calculation of the percent of total expense.
Part I, Line 7We used the Cost to Charge Ratio as our costing methodology.
Part II - Community Building ActivitiesWe support Community Building Activities by involvement with the Economic Development Committee, the Local Chamber of Commerce and the Indiana State Department of Health Licensure Council. We also offer career education and job shadowing for local students.
Part III, Line 4Historically, we book a reserve for Bad Debt based on a matrix of our Accounts Receivable; when an account is written off as Bad Debt it is booked against that reserve. We used the Cost to Charge ratio as our costing methodology.
Part III, Line 8Medicare Shortfalls and Surplus Many of our Medicare beneficiaries are poor and would have qualified for the Hospital's Charity Care Program in addition to Medicare. If these patients had been treated as Charity Care, the cost of medical care would have been a Community Benefit. Our Medicare Cost Report is used to determine our Medicare Surplus or Shortfall. In 2011, we had a surplus.
Part III, Line 9bDebt Collection Policy The first statement lists detail by revenue code, the total balance due and the discounted amount due if paid within 30 days of statement date. The first statement for uninsured patients will also reflect the uninsured discount, according to policy. Statements will be aged by the last payment date on the account. Patients with Medicare will receive 3 statements after the initial detail statement. Non-Medicare patients will receive 2 additional statements after the initial detail statement. Accounts not paid in full that receive the 4th statement for Medicare patients, 3rd statement for non-Medicare will be referred to a Collection Agency. When a patient establishes a payment plan, the statement process is changed to a monthly reminder of payment amount now due. A 10 day extension from the due date will be granted to allow for mailing and processing time, before a payment is considered delinquent. Multiple missed payments will result in the account being referred to a collection agency. We have a separate Financial Assistance Policy.
Part V, Section B, Line 11hCredit scoring
Part V, Section B, Line 15eNone of the above actions are taken until after the patient's eligibility for our FAP is determined.
Part V, Section B, Line 18dIU Health's Financial Assistance Program does not differentiate between Emergent and Non-Emergent Care.
Part VI, Line 2 - Needs AssessmentA needs assessment is underway with our parent company and will be complete in the fall 2012.
Part VI, Line 3 - Patient Education of Eligibility for AssistancePatients are educated and informed of the Financial Assistance Policy at time of service, through phone calls from the Patient Financial Staff, pamphlets and Community Outreach Events. We give the patient a Financial Assistance application to fill out which contains demographic and financial information. If the application is not returned, we do a credit scoring and if their credit score is 600 or below the account is written off. We have a separate policy for debt collection that is followed once the determination is made that the patient is not eligible for Financial Assistance.
Part VI, Line 4 - Community InformationIU Health Bedford serves Lawrence, Orange, Martin, Greene and Jackson Counties. All counties represent more than 97% Caucasian individuals. The average median household income of the 5 counties is $43,062.
Part VI, Line 5 - Promotion of Community HealthWe have Community Health Fairs where we do diabetic and cholesterol screenings at a reduced cost. We also have pap and mammogram clinics.
Part VI, Line 6 - Affiliated Health Care System RolesIU Health Bedford, Inc. is an affiliate of Indiana University Health, which includes Methodist Hospital, Indiana University Hospital and Riley Hospital for Children. Other Indiana University Health affiliates include: IU Heath La Porte Hospital, Inc. IU Health Starke Hospital IU Health Arnett, Inc. Rehabilitation Hospital of Indiana IU Health West Hospital Goshen Health System IU Health Blackford Hospital IU Health Tipton Hospital IU Health Ball Memorial Hospital IU Health North Hospital IU Health Methodist Hospital, Riley IU Health Bloomington, Inc. Midwest Proton Radiotherapy Institute IU Health Paoli, Inc. The immediate advantages of being an affiliate of Indiana University Health include centralized services which results in a reduction of duplicated services and lowers health care costs for our patients.
Part VI, Line 7 - State filing of community benefit reportIndiana

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Neil C Pickett
02456770257520161700013534028658000
Dan Dusleag
1515970003600108860253070188150000
Hojjatt Shamloo
3885350004780206520262380435903000
Bradford W Dykes
2463110470000290700070750303293000
Charles Shetler
14445201544302120096100195200191145000
Rafi Siddiqi MD
4074460006300206520243500453078000
Randall Martin MD
31928100018060206520233970365136000
Eung Jun Cha MD
32189200027720206520180950363411000
Stephen Schultz MD
26335700019870206520153910301387000
Alan Smith MD
26182400053340206520182930306103000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierExplanationExplanation
Schedule J, Part I, Line 3IU Health Bedford Hospital, Inc. relied on a related party, IU Health, Inc. to determine CEO compensation.
Schedule J, Part I, Line 7Criteria for Incentive Pay Effective: 6/07 Incentive goals will be developed and reviewed annually for IU Health Bedford, Inc. Executives. The percentage of pay-out is based on a set of goals to be accomplished during a budget year. The goals will be established by the Executive and his or her direct supervisor. The goals will be identified in written format. Predetermined financial criteria (operating margin and days cash on hand) will be met before any percent of the incentive compensation will be paid out. Pay-out will be distributed after the final audit of the financial statements and the financial criteria has been met. Pay-out will be in compliance with any legal or regulatory guidelines.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Name ChangeForm 990, Part VI, Line 4The legal name of the organization changed from Bedford Regional Medical Center to Indiana University Health Bedford, Inc. Articles of Amendment were previously filed.
Description of Classes of Members or StockholdersForm 990, Part VI, Line 6Indiana University Health Bedford has one member which is Indiana University Health.
Description of Classes of Persons and the Nature of Their RightsForm 990, Part VI, Line 7aThe Directors serving on the Board of Directors have the right to nominate prospective Directors for six positions. The Physicians constituting the Corporation's Clinic Physician Group have the right to nominate the two Director positions. The member shall nominate the three remaining prospective Directors of the Board. After viewing the nominations of the prospective Directors as set forth above, the member shall elect the Board of Directors. The President and CEO is also appointed by the member.
Descr Classes of Persons, Decisions Requiring Appr & Type of Voting RightsForm 990, Part VI, Line 7bA) Adoption and amendment of the Articles and Bylaws of the Corporation B) Adoption, Interpretation and change of any statement of the Mission or Purposes of the Corporation, C) Adoption of any material changes in the services provided by the corporation; D) The appointment or removal of the Chief Executive Officer of the Corporation; E) Adoption, interpretation or change of the Strategic Plan of the corporation; F) Incurrence of debt or execution of any debt instrument that is not approved in the annual or operating budgets; G) Adoption and Change of the annual Operating and Capital Budgets; H) Acquisition, sale, lease, transfer or alienation of any corporation assets other than in the usual and regular course of the Corporation's business when such acquisition, sale, lease, transfer or alienation is outside the terms of the annual operating or capital budget previously approved by the Member. I) Participation of the Corporation in Healthcare Networks, Alliances or other Healthcare Delivery Systems; and (J) Adoption and change of any Managed Care or Third Party Payor contracts, whether new or renewal.
Describe the Process used by Management &/or Governing Body to Review 990Form 990, Part VI, Line 11bManagement will provide a copy of the return to the members of the Finance Committee of the Board and review the return with the Committee before the 990 is filed with the IRS.
Description of Process to Monitor Transactions for Conflicts of InterestForm 990, Part VI, Line 12cThe IU Health Bedford, Inc. Bylaws requires each Director and Officer of the corporation to refrain from participation in any discussion, evaluation, or approval of a transaction involving the corporation in which the Director or Officer (or immediate family member) has a financial interest or professional interest which impairs the good faith discharge of his or her duty of loyalty. Annually each Director or Officer is required to execute a Standard of Conduct and Conflict of interest statement and certify to the Corporation that no conflict of interest exists which would substantially impair that Person's overall ability to fulfill his or her duty of loyalty to the Corporation. In addition to the annual Conflict of Interest Statement, each Director and Officer has a duty to disclose any potential conflict of interests arising from a transaction arrangement to be considered by the Board of Directors at any meeting where the transaction is discussed or voted upon. Disclosure of the material facts underlying the potential conflict of interest shall be submitted in writing to the Chairman and included in the minutes of the meeting. The Director or Officer submitting such a disclosure is required to leave the meeting while his or her disclosure is discussed. The remaining Directors must make a determination by a majority vote as to whether the material facts constitute a conflict of interest. Any Director or Officer who is determined to have a conflict of interest with regard to any transaction or arrangement shall not be entitled to attend any portion of a meeting in which the matter is discussed or voted upon. The Board may take disciplinary action with regard to a violation of the conflict of interest policy, including the removal of the Director or Officer. Senior Management and Department Directors are also required to sign an annual conflict of interest statement, disclosing any potential conflicts of interest.
Process for Determining Compensation for CEOForm 990, Part VI, Line 15aOur CEO is an Employee of Indiana University Health. We are billed monthly for his services.
Process for Determining Compensation for Other Officers or Key EmployeesForm 990, Part VI, Line 15bThe evaluation of salaries for Executives and key employees occurs annually. Data is submitted to the Indiana Hospital Association Salary Survey in April and a comparison survey of other Indiana Hospitals is returned. CEO approves the salary amount. Information on compensation for the CEO is provided to the Board Executive Committee.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen PublicForm 990, Part VI, Line 19The organizing documents, financial statements and Conflict of Interest Policy are made available to the Public upon written request or by a request in person.
Hours devoted to related organizationsForm 990, Part VII, Section A, Line 1a, column (B)Neil Pickett devotes 45 hours per week to a related organization, Indiana University Health.
Other changes in net assets or fund balancesForm 990, Part XI, Line 5Change in interest in Foundation $19,906
Form 5471 DisclosureIndiana University Health Bedford, Inc. (FEIN: 23-7042323) constructively owned a controlled foreign corporation in 2011 through its affiliate, Indiana University Health (FEIN: 35-1955875). Pursuant to IRC Section 6038, the 2011 controlled foreign corporation filing requirement of Indiana University Health Bedford, Inc. was fulfilled on the 2011 Form 5471 filed on its behalf by: Indiana University Health FEIN: 35-1955872 950 N. Meridian Street, Suite 800 Indianapolis, IN 46204 The 2011 Form 5471 for Indiana University Health was filed at the following IRS processing center: Ogden, UT 84201-0012

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (37 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
IU Health LaPorte Hospital Inc
1007 LincolnwayLa PorteIN46350351125434HealthcareIN501(c)(3)3IU Healthtrue
IU Health LaPorte Physicians Inc
1007 LincolnwayLaPorteIN46350311070868HealthcareIN501(c)(3)3IUHLHtrue
Indiana University Health Inc
950 N Meridian St Ste 800IndianapolisIN46204351955872HealthcareIN501(c)(3)3NAfalse
IU Health Arnett Inc
950 N Meridian St Ste 800IndianapolisIN46204263162145healthcareIN501(c)(3)3IU Healthtrue
Clarian Transplant Institute Inc
950 N Meridian St Ste 800IndianapolisIN46204134350599healthcareIN501(c)(3)9IU Healthtrue
IU Health North Hospital Inc
950 N Meridian St Ste 800IndianapolisIN46204351932442healthcareIN501(c)(3)3IU Healthtrue
Methodist Health Foundation Inc
1800 North Capitol AvenueIndianapolisIN46202356043086fundraisingIN501(c)(3)11, TYPE 1IU Healthtrue
Methodist Health Group Inc
950 N Meridian St Ste 800IndianapolisIN46204350876390healthcareIN501(c)(3)11, III-FINAfalse
Methodist Medical Group Inc
950 N Meridian St Ste 800IndianapolisIN46204351945384healthcareIN501(c)(3)3IU Healthtrue
IU Health West Hospital Inc
950 N Meridian St Ste 800IndianapolisIN46204351814660healthcareIN501(c)(3)3IU Healthtrue
Methodist Occupational Health Ctrs Inc
950 N Meridian St Ste 800IndianapolisIN46204351844176healthcareIN501(c)(3)3IU Healthtrue
Methodist Research Institute Inc
950 N Meridian St Ste 800IndianapolisIN46204352023710healthcareIN501(c)(3)11, TYPE IIU Healthtrue
MH Healthcare Inc
950 N Meridian St Ste 800IndianapolisIN46204351766531healthcareIN501(c)(3)3Meth Med Grptrue
Goshen Health System Inc
200 High Park AvenueGoshenIN46527351974765healthcareIN501(c)(3)11, TYPE IIU Healthtrue
Goshen Hospital Association Inc
200 High Park AvenueGoshenIN46527356001540healthcareIN501(c)(3)3Gosh Hlh Systrue
IU Health Tipton Hospital Inc
950 N Meridian St Ste 800IndianapolisIN46204262772226healthcareIN501(c)(3)3IU Healthtrue
IU Health Ball Memorial Hospital Inc
2401 West University AvenueMuncieIN47303350867958healthcareIN501(c)(3)3IU Healthtrue
IU Health Blackford Hospital Inc
410 Pilgrim BoulevardHartford CityIN47348010646166healthcareIN501(c)(3)3IUH Balltrue
IU Health Paoli Inc
PO Box 499PaoliIN47454352090919healthcareIN501(c)(3)3IUH Bloomingtrue
IU Health Bloomington Inc
PO Box 1149BloomingtonIN47402351720796healthcareIN501(c)(3)3IU Healthtrue
IU Health Ball Memorial Hosp Auxiliary
2401 West University AvenueMuncieIN47303356025400healthcareIN501(c)(3)11, III-FIIUH Balltrue
IU Health Ball Memorial Physicians Inc
2401 West University AvenueMuncieIN47303351925641healthcareIN501(c)(3)9IUH Balltrue
Indiana University Healthcare Associates
950 N Meridian St Ste 800IndianapolisIN46204351747218healthcareIN501(c)(3)9IU Healthtrue
IU Health Ball Memorial Hosp Foundation
2401 West University AvenueMuncieIN47303311111784fundraisingIN501(c)(3)11, TYPE IIUH Balltrue
Indiana Radiology Partners Inc
950 N Meridian St Suite 800IndianapolisIN46204201017034HealthcareIN501(c)(3)3IU Healthtrue
IU Health Bedford Foundation
2900 West 16th StreetBedfordIN47421351615521SupportIN501(c)(3)7IUH Bedfordtrue
IU Health Bedford Auxiliary
2900 West 16th StreetBedfordIN47421237140460SupportIN501(c)(3)11, III-FIIUH Bedfordtrue
HealthLinc Inc
200 High Park AvenueGoshenIN46527263571507HealthcareIN501(c)(3)3Gosh Hlh Systrue
IU Health Morgan Hospital Inc
2209 John R Wooden DriveMartinsvilleIN46151273533027HealthcareIN501(c)(3)3IU Healthtrue
IU Health White Memorial Hospital Inc
720 South Sixth StreetMonticelloIN47960273532963HealthcareIN501(c)(3)3IU Healthtrue
IU Health Arnett Foundation
2600 Greenbush StreetLafayetteIN47904356079797HealthcareIN501(c)(3)11, TYPE 1IUH Arnetttrue
Morgan County Memorial Foundation Inc
2209 John R Wooden DriveMartinsvilleIN46151352035162healthcareIN501(c)(3)11, TYPE IIIUH Morgantrue
Morgan Health Services Inc
1949 Hospital DriveMartinsvilleIN46151351968564healthcareIN501(c)(3)3IUH Morgantrue
White County Memorial Hospital Fdn Inc
PO Box 952MonticelloIN47960351671806healthcareIN501(c)(3)11, III-OIUH Whitetrue
IU Health Paoli Hospital Foundation Inc
PO Box 499PaoliIN47454310992486FundraisingIN501(c)(3)11, III-OIUH Paolitrue
IU Medical Group Foundation Inc
340 W 10th St No FS5100IndianapolisIN46202201093251FundraisingIN501(c)(3)11, IINAfalse
Morgan County Memorial Hosp Guild Inc
2209 John R Wooden DrMartinsvilleIN46151310886844FundraisingIN501(c)(3)11, III-FIIUH Morgantrue

Form990 Schedule R Part III Form990ScheduleRPartIII (25 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsCode VCodeVAmountPercentage OwnershipPercentageOwnership
Clarian Health Network LLC
950 N Meridian Street Suite 800IndianapolisIN46204352055030healthcareINNAN/A00$00.00000
Clarian Health North LLC
11700 North Meridian STreetCarmelIN46032431980602healthcareINNAN/A00$00.00000
Clarian Hlth Vent Fund I LLC
950 N Meridian Street Suite 800IndianapolisIN46204262523206venture capitINNAN/A00$00.00000
Clarian Health West LLC
1111 North Ronald Reagan ParkwayAvonIN46123431980611healthcareINNAN/A00$00.00000
Health Venture Management LLC
950 N Meridian Street Suite 800IndianapolisIN46204205740218managementINNAN/A00$00.00000
Indiana Endoscopy Centers LLC
3000 Riverchase Galleria Suite 500BirminghamAL35244208398421healthcareINNAN/A00$00.00000
IN Lakes Managed Care Org LLC
310 S Main StreetGoshenIN46526351946663healthcareINNAN/A00$00.00000
Senate St Surgery Center
3000 Riverchase Galleria Suite 500BirminghamAL35244421709357healthcareINNAN/A00$00.00000
The Healthcare Group LLC
8802 N Meridian Street Suite 100IndianapolisIN46260352067373managed careINNAN/A00$00.00000
Ball Outpatient Surgery Center
3000 Riverchase Galleria Suite 500BirminghamAL35244270275794healthcareINNAN/A00$00.00000
Cardinal Health Initiatives
2401 West University AvenueMuncieIN47303300102702purchasingINNAN/A00$00.00000
Mid-America Surgery Center
2401 West University AvenueMuncieIN47303352002953healthcareINNAN/A00$00.00000
BMH Outpatient Surg Svcs
2401 West University AvenueMuncieIN47303204567998healthcareINNAN/A00$00.00000
CHV Fund Management LLC
950 North Meridian Street Suite 80IndianapolisIN46204262523151venture capitINNAN/A00$00.00000
ROC Surgery LLC
3000 Riverchase Galleria Suite 500BirminghamAL35244271497960HEALTHCAREINNAN/A00$00.00000
IUH Surgery Centers LLC
3000 Riverchase Galleria Suite 500BirminghamAL35244452314634healthcareINNAN/A00$00.00000
EHSC Holdings LLC
3000 Riverchase Galleria Suite 500BirminghamAL35244454147879healthcareINNAN/A00$00.00000
SSSC Holdings LLC
3000 Riverchase Galleria Suite 500BirminghamAL35244454148167healthcareINNAN/A00$00.00000
IEC Holdings LLC
3000 Riverchase Galleria Suite 500BirminghamAL35244454148032healthcareINNAN/A00$00.00000
ROCS Holdings LLC
3000 Riverchase Galleria Suite 500BirminghamAL35244454148369healthcareINNAN/A00$00.00000
BOSC Holdings LLC
3000 Riverchase Galleria Suite 500BirminghamAL35244454147343healthcareINNAN/A00$00.00000
Bloomington Endoscopy Centers LLC
PO Box 1149BloomingtonIN47402352117943healthcareINNAN/A00$00.00000
Beltway Surgery Centers LLC
3000 Riverchase Galleria Ste 500BirminghamAL35244352072586HealthcareINNAN/A00$00.00000
CTF International Growth Portfolio
280 Congress St Ste 500BostonMA02210200231923InvestmentsMANAN/A00$00.00000
Eagle Highlands Surgery Center LLC
3000 Riverchase Galleria Ste 500BirminghamAL35244352259204HealthcareINNAN/A00$00.00000

Form990 Schedule R Part IV Form990ScheduleRPartIV (18 entries)

Address Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryEINEINPrimary ActivityPrimaryActivityLegal Domicile Foreign CountryLegalDomicileForeignCountryBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeLegal Domicile StateLegalDomicileState
IUH Assurance Ltd
720 West Bay Road PO Box 69Grand CaymanCJ980396429InsuranceCJNAC000.00000
IU Health Plans Inc
262127080HMONAC000.000001776 Meridian Street Suite 300INDIANAPOLISIN46202IN
CHV Capital Inc
260752507VENTURE CAPITALNAC000.00000950 N Meridian Street Suite 800INDIANAPOLISIN46204IN
IU Health Risk Purchasing Group Inc
260202446InsuranceNAC000.00000151 Meeting Street Suite 301CHARLESTONSC29401IN
Occ-Health Revenue Systems Inc
203308057WORK COMP PPONAC000.00000950 N Meridian Street Suite 800INDIANAPOLISIN46204IN
Parkmor Drug Inc
131394980PHARMACY SALESNAC000.000001501 South Main StreetGOSHENIN46526IN
BMH Medical Pavilion Association Inc
351858408CONDO MANAGEMENTNAC000.000002525 West University AvenueMUNCIEIN47303IN
Cardinal Health Ventures Inc
351611424ManagementNAC000.000002401 West University AvenueMUNCIEIN47303IN
PILR Inc
204294750DEVELOPMENTNAC000.00000200 High Park AvenueGOSHENIN46526IN
IU Health Southern Indiana Phys Inc
351913875HEALTHCARENAC000.00000PO Box 1149BLOOMINGTONIN47402IN
IU Health Risk Retention Group Inc
201107674InsuranceNAC000.00000151 Meeting Street Suite 301CharlestonSC29401SC
Radiation Oncology Resources Inc
262008424HealthcareNAC000.00000200 High Park AvenueGoshenIN46527IN
University Health Management Inc
272891143ManagementNAC000.00000950 N Meridian Street Suite 800IndianapolisIN46204IN
University Health Mgmt (China) Inc
273891311ManagementNAC000.00000950 N Meridian Street Suite 800IndianapolisIN46204IN
Indiana University Health ACO Inc
454421020healthcareNAC950 N Meridian Street Suite 800IndianapolisIN46204IN
SCANS Inc
453080392healthcareNAC950 N Meridian Street Suite 800IndianapolisIN46204IN
IU Health Board Designated Trust
306309021InvestmentsNAT000.00000400 Howard StSan FranciscoCA94105IN
IU Health NTGI S&P500 Fund CF
306298263InvestmentsNAT000.00000PO Box 804358ChicagoIL60680IN
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg