2012-11-16T08:40:25-06:00 2011-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 2600 INDIANAPOLIS IN 46204 990 2011-01-01 237042323 INDIANA UNIVERSITY HEALTH BEDFORD INC % ANITA HAMILTON INDI 8122751200 2900 WEST 16TH STREET BEDFORD IN 47421 Charles L Shetler 2012-10-08 3176817000 2011 2016-02-24 21:20:13Z IU HEALTH BEDFORD HOSPITAL Bradford Dykes 2900 West 16th Street Bedford IN 47421 52550901 false X IUHEALTHBEDFORD.ORG X 1970 IN Improving Lives with High Quality Compassionate Care. 12 8 508 28 0 0 141727 80619 50520096 52205071 55284 25431 175355 187454 50892462 52498575 1380 1796 0 0 30610747 31652423 0 0 0 16940894 18786683 47553021 50440902 3339441 2057673 33577272 34329615 14332762 13007526 19244510 21322089 As 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. false false 7313260 1000 10679319 Inpatient Care We had 1,312 admissions resulting in 5,104 patient days in 2011. We, also, had 621 swing bed days. 23852289 0 34647156 Outpatient 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. 8788177 0 6889923 Physician 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. 39953726 true true false false false false false false true true false false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 95 0 true 508 true false false false false false false false false false false X 12 8 false false true false true true true true true false false false true true true true true true true false IN X ANITA HAMILTON 8122785281 2900 West 16th Street Bedford IN 47421 X Harley Brown 3.0 X X 6800 0 0 Mary Lu Hanson 3.0 X 1020 0 0 Helen Nash 3.0 X X 3760 0 0 Randy Hawkins 3.0 X X 3390 0 0 James T Oswalt 3.0 X 3580 0 0 Jack Kenworthy 3.0 X X 3210 0 0 James T Bellush 3.0 X 3030 0 0 Neil C Pickett 3.0 X 0 273046 13534 Gene Robbins 3.0 X 0 0 0 Dan Dusleag 40.0 X 151957 0 36193 Hojjatt Shamloo 40.0 X 389013 0 46890 Bradford W Dykes 40.0 X X 296218 0 7075 Charles Shetler 40.0 X 162015 0 29130 Brenda Davis 40.0 X 132696 0 9137 Cindy Smale 40.0 X 114943 0 23820 Rafi Siddiqi MD 40.0 X 408076 0 45002 Randall Martin MD 40.0 X 321087 0 44049 Eung Jun Cha MD 40.0 X 324664 0 38747 Stephen Schultz MD 40.0 X 265344 0 36043 Alan Smith MD 40.0 X 267158 0 38945 2857961 273046 368565 28 false true false Alliance Healthcare Services PO Box 96485 Chicago IL 60693 MRI Testing 662697 HMS Monitor 2739 Momentium Place Chicago IL 60689 Computer System 403441 Unity Physician Group 1144 West Third St Bloomington IN 47404 Physicians 369452 Mayo Medical Labs 2001 1st Street Rochester MN 55905 Lab Testing 315471 Integra Imaging Partners PO Box 86 Bedford IN 47421 Contractor 292329 9 14716 65903 11992 80619 Net Patient Revenue 622110 51987811 51987811 Counseling Contract Revenue 900099 148875 148875 Physician Medicare Incentive 900099 48509 48509 Doyle Nursing Home Visits 900099 12316 12316 Dewitte Disability Exams 900099 7560 7560 52205071 25047 25047 0 0 97202 52326 44876 44876 44876 384 0 384 384 384 0 0 0 Cafeteria Sales 722320 78751 78751 Purch Discount Late Fees 900099 11327 11327 CREDIT CARD REWARDS 900099 14405 14405 38095 38095 142578 52498575 52216398 0 201558 1796 1796 0 0 0 1423877 1423877 0 24347783 19305384 5042399 1216674 924672 292002 2954676 2184502 770174 1709413 1299154 410259 3656033 3008641 647392 18566 18566 46366 46366 0 0 0 850952 850952 154235 154235 2184358 1759676 424682 935215 645298 289917 0 1009092 836007 173085 29872 29872 0 210552 118018 92534 553178 435701 117477 0 2096650 1651388 445262 333736 251293 82443 MEDICAL SUPPLIES 5766980 5766980 Bad Debt Expense 151214 151214 Repairs 521441 426471 94970 MISCELLANEOUS EXPENSES 268243 152472 115771 50440902 39953726 10487176 0 6452369 7247564 6059324 3756944 0 0 5682302 7285299 0 0 0 0 32683 384764 805233 803205 465416 662792 41555425 27386378 14079945 14169047 0 0 0 0 0 0 0 0 0 20000 33577272 34329615 3753506 3850246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10579256 9157280 14332762 13007526 X 19164807 21222480 0 0 79703 99609 19244510 21322089 33577272 34329615 X 2057673 19906 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 79703 20000 94 99609 80832 1129 79703 76206 4626 80832 78190 1984 76206 0.00000 1.00000 0.00000 false false 912711 912711 15857654 7463380 8394274 23708802 19256893 4451909 1076258 666105 410153 14169047 0 Due to Medicare/Medicaid 1981559 Professional Liability/Tail Coverage 94122 Indiana University Health 7081599 9157280 Restricted Funds Schedule D, Part V Hospice 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 Statements Schedule D, Part X, Line 2 Indiana 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. true true X true X true X true true true false true true 2651 2673831 0 2673831 0.05320 3053 5769749 950470 4819279 0.09580 5704 8443580 950470 7493110 0.14900 15 5417 597355 2425 594930 0.01180 2 5 98302 0 98302 0.00200 2 747598 0 747598 0.01490 1 1870 0 1870 20 5422 1445125 2425 1442700 0.02870 20 11126 9888705 952895 8935810 0.17770 1 4834 4834 0.00010 1 27811 27811 0.00060 1 15 4699 4699 0.00010 3 15 37344 37344 0.00080 true 151214 0 17571762 15802581 1769181 X true true 1 1 IU HEALTH BEDFORD INC

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X X IU HEALTH BEDFORD INC 1 true true 100 true 200. true X X X X X X true true X X X true false false X X false false Part I, Line 6a IU 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 7 We used the Cost to Charge Ratio as our costing methodology. Part II - Community Building Activities We 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 4 Historically, 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 8 Medicare 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 9b Debt 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 11h Credit scoring Part V, Section B, Line 15e None of the above actions are taken until after the patient's eligibility for our FAP is determined. Part V, Section B, Line 18d IU Health's Financial Assistance Program does not differentiate between Emergent and Non-Emergent Care. Part VI, Line 2 - Needs Assessment A 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 Assistance Patients 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 Information IU 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 Health We 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 Roles IU 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 report Indiana false false false false false false false true false Neil C Pickett 0 245677 0 25752 0 1617 0 0 0 13534 0 286580 0 0 Dan Dusleag 151597 0 0 0 360 0 10886 0 25307 0 188150 0 0 0 Hojjatt Shamloo 388535 0 0 0 478 0 20652 0 26238 0 435903 0 0 0 Bradford W Dykes 246311 0 47000 0 2907 0 0 0 7075 0 303293 0 0 0 Charles Shetler 144452 0 15443 0 2120 0 9610 0 19520 0 191145 0 0 0 Rafi Siddiqi MD 407446 0 0 0 630 0 20652 0 24350 0 453078 0 0 0 Randall Martin MD 319281 0 0 0 1806 0 20652 0 23397 0 365136 0 0 0 Eung Jun Cha MD 321892 0 0 0 2772 0 20652 0 18095 0 363411 0 0 0 Stephen Schultz MD 263357 0 0 0 1987 0 20652 0 15391 0 301387 0 0 0 Alan Smith MD 261824 0 0 0 5334 0 20652 0 18293 0 306103 0 0 0 Schedule J, Part I, Line 3 IU Health Bedford Hospital, Inc. relied on a related party, IU Health, Inc. to determine CEO compensation. Schedule J, Part I, Line 7 Criteria 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. Name Change Form 990, Part VI, Line 4 The 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 Stockholders Form 990, Part VI, Line 6 Indiana University Health Bedford has one member which is Indiana University Health. Description of Classes of Persons and the Nature of Their Rights Form 990, Part VI, Line 7a The 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 Rights Form 990, Part VI, Line 7b A) 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 990 Form 990, Part VI, Line 11b Management 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 Interest Form 990, Part VI, Line 12c The 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 CEO Form 990, Part VI, Line 15a Our CEO is an Employee of Indiana University Health. We are billed monthly for his services. Process for Determining Compensation for Other Officers or Key Employees Form 990, Part VI, Line 15b The 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 Public Form 990, Part VI, Line 19 The 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 organizations Form 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 balances Form 990, Part XI, Line 5 Change in interest in Foundation $19,906 Form 5471 Disclosure Indiana 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 IU Health LaPorte Hospital Inc 1007 Lincolnway La Porte IN 46350 351125434 Healthcare IN 501(c)(3) 3 IU Health true IU Health LaPorte Physicians Inc 1007 Lincolnway LaPorte IN 46350 311070868 Healthcare IN 501(c)(3) 3 IUHLH true Indiana University Health Inc 950 N Meridian St Ste 800 Indianapolis IN 46204 351955872 Healthcare IN 501(c)(3) 3 NA false IU Health Arnett Inc 950 N Meridian St Ste 800 Indianapolis IN 46204 263162145 healthcare IN 501(c)(3) 3 IU Health true Clarian Transplant Institute Inc 950 N Meridian St Ste 800 Indianapolis IN 46204 134350599 healthcare IN 501(c)(3) 9 IU Health true IU Health North Hospital Inc 950 N Meridian St Ste 800 Indianapolis IN 46204 351932442 healthcare IN 501(c)(3) 3 IU Health true Methodist Health Foundation Inc 1800 North Capitol Avenue Indianapolis IN 46202 356043086 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