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INDIANA REGIONAL MEDICAL CENTER: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
INDIANA REGIONAL MEDICAL CENTER (EIN 25-0965404)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201241369349300029
Schema version
2010v3.4
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)
Timestamp2012-05-15T07:19:05-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PARENTEBEARD LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11650 MARKET STREET SUITE 4500AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN250965404EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1INDIANA REGIONAL MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlINDINameControl
Phone7243577008Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1835 HOSPITAL ROADAddressLine1
CityINDIANACity
StatePAState
ZIP Code15701ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROBERT GONGAWAREName
TitleSENIOR VP FINANCETitle
Phone7243577008Phone
Date Signed2012-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJULIUS GREEN CPAName
Phone2159720701Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSTEPHEN WOLFENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1835 HOSPITAL ROADAddressLine1
CityINDIANACity
StatePAState
ZIP Code15701ZIPCode
FieldValueIRS element (for citing)
Gross Receipts158462347GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.INDIANARMC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1944YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTO SERVE THE HEALTHCARE NEEDS OF EVERY LIFE WE TOUCH WITH COMPASSION, RESPECT, AND DIGNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees1469TotalNbrEmployees
Total Nbr Volunteers150TotalNbrVolunteers
Total Gross UBI1943347TotalGrossUBI
Net Unrelated Business Txbl Income791829NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1660228ContributionsGrantsPriorYear
Contributions Grants Current Year871225ContributionsGrantsCurrentYear
Program Service Revenue Prior Year126023102ProgramServiceRevenuePriorYear
Program Service Revenue CY129136107ProgramServiceRevenueCY
Investment Income Prior Year5576442InvestmentIncomePriorYear
Investment Income Current Year5077771InvestmentIncomeCurrentYear
Other Revenue Prior Year3084921OtherRevenuePriorYear
Other Revenue Current Year4947068OtherRevenueCurrentYear
Total Revenue Prior Year136344693TotalRevenuePriorYear
Total Revenue Current Year140032171TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year75923738SalariesEtcPriorYear
Salaries Etc Current Year76965871SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year55139782OtherExpensePriorYear
Other Expenses Current Year58719631OtherExpensesCurrentYear
Total Expenses Prior Year131063520TotalExpensesPriorYear
Total Expenses Current Year135685502TotalExpensesCurrentYear
Revenues Less Expenses Prior Year5281173RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4346669RevenuesLessExpensesCY
Total Assets BOY175520117TotalAssetsBOY
Total Assets EOY189712799TotalAssetsEOY
Total Liabilities BOY72970602TotalLiabilitiesBOY
Total Liabilities EOY70005602TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY102549515NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY119707197NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE MISSION OF INDIANA REGIONAL MEDICAL CENTER IS TO SERVE THE HEALTHCARE NEEDS OF EVERY LIFE WE TOUCH WITH COMPASSION, RESPECT, AND DIGNITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense110075798Expense
Revenue129136107Revenue
DescriptionHEALTH DIAGNOSTIC, INTERVENTION & TREATMENT SERVICE:INDIANA REGIONAL MEDICAL CENTER ("IRMC") IS A NON-PROFIT, COMMUNITY BASED HEALTH SYSTEM THAT OFFERS A WIDE RANGE OF SERVICES INCLUDING DIAGNOSTICS, MEDICINE, SURGERY, PEDIATRICS, OBSTETRICS, GERIATRIC BEHAVIORAL HEALTHCARE AND REHABILITATIVE NURSING. IRMC DEMONSTRATES AN ONGOING COMMITMENT TO THE COMMUNITY BY CONTINUALLY REVIEWING AND IMPROVING ITS SERVICES TO ENSURE THAT THE COMMUNITY RECEIVES TOP-QUALITY, EFFICIENT, ACCESSIBLE, COST-EFFECTIVE HEALTHCARE AND QUALITY OUTREACH AND HEALTH PROMOTION SERVICES. IRMC CONTINUES TO PROVIDE MOBILE HEALTH SERVICES TO RURAL AREAS OF THE COUNTY. IN ADDITION TO PRIMARY CARE PHYSICIANS, IRMC WAS SUCCESSFUL IN RECRUITING TWO PAIN MANAGEMENT PHYSICIANS, EMERGENCY DEPARTMENT PHYSICIANS AND A CLINICAL PSYCHOLOGIST.MASS HEALTH SCREENING: IRMC'S MOBILE MEDICAL SERVICES CONTINUES TO PROVIDE FREE BLOOD PRESSURE SCREENINGS IN 19 LOCATIONS IN INDIANA COUNTY. WE ALSO CONTINUE TO PARTICIPATE IN NUMEROUS FREE COMMUNITY EVENTS PROVIDING EDUCATION, SCREENINGS PROGRAMS AND FIRST AID SERVICES.HEALTH FAIRS: THE PROVISION OF HEALTH SERVICES AND INFORMATION THROUGH HEALTH FAIRS, CLASSES AND PROGRAMS - THE INSTITUTE FOR HEALTHY LIVING AT IRMC OFFERS HEALTH SERVICES AND EDUCATION PROGRAMS TO THE COMMUNITY AT NO CHARGE.HEALTH CARE DELIVERY & MANAGEMENT: THE COMMUNITY HEALTH ADVISORY COUNCIL OF INDIANA COUNTY, WHICH WAS FORMED IN 1996, SERVES AS A STATE HEALTH IMPROVEMENT PARTNERSHIP. THE GOAL OF THE COUNCIL IS TO IDENTIFY OR DEVELOP RESOURCES TO ADDRESS TOP HEALTH PRIORITIES IN THE COUNTY. THE COUNCIL CONTINUES TO PROMOTE AN ANNUAL INFLUENZA CAMPAIGN. THE COUNCIL IMPLEMENTED A COUNTY PRESCRIPTION ASSISTANCE PROGRAM TO ASSIST RESIDENTS WITH ACCESSING PHARMACEUTICALS FREE OR AT A REDUCED COST BASED ON INCOME.HEALTH CARE PROGRAMS, GENERAL/OTHER: THE CENTER FOR DIABETES CARE CONTINUES TO OFFER FREE EDUCATION SERVICES AT VARIOUS LOCATIONS THROUGHOUT THE COUNTY. IN ADDITION, THEY CONTINUE TO BE THE PRIMARY SPONSOR OF THE COUNTY'S DIABETES WALK. EACH MONTH STAFF AND MANAGEMENT AT IRMC PROVIDE SUPPORT TO A LOCAL FOOD BANK. FOR THE THIRD YEAR, IRMC WAS NAMED ONE OF THE BEST PLACES TO WORK IN PA. PREVENTIVE HEALTH SERVICES, GENERAL/OTHER: M. DORCAS CLARK WOMEN'S IMAGING CENTER: THE WOMEN'S IMAGING CENTER AND THEIR STAFF HAVE PARTICIPATED IN NUMEROUS COMMUNITY EVENTS PROVIDING INFORMATION ABOUT THE IMPORTANCE OF BREAST HEALTH. BIRDIE'S CLOSET, A PROJECT DESIGNED TO HELP WOMEN COPE WITH APPEARANCE-RELATED SIDE-EFFECTS OF CANCER TREATMENT WAS OPENED IN THE WOMEN'S IMAGING CENTER.Description
Total Program Service Expense110075798TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096207NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1469NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ROBERT GONGAWAREBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7243577008TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1835 HOSPITAL ROADAddressLine1
CityINDIANACity
StatePAState
ZIP Code15701ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
JOHN DOLAN
CHAIRMAN1.00XX000
TODD BRICE
VICE CHAIRMAN1.00XX000
BEVERLY GAZZA
SECRETARY1.00XX000
JOSEPH GEARY
TREASURER1.00XX000
MARK BOYKIW
BOARD MEMBER1.00X000
NATHAN KOVALCHICK
BOARD MEMBER1.00X000
THOMAS MCCOY
BOARD MEMBER1.00X000
ROBERT ROUT
BOARD MEMBER1.00X000
EDWARD MCDOWELL
BOARD MEMBER1.00X000
MARK MCGOWAN
BOARD MEMBER1.00X000
ANN WHITE
BOARD MEMBER1.00X000
STEPHEN A WOLFE
PRESIDENT & CEO36.00XX373839059857
ROBERT GONGAWARE
SR VP FISCAL SERVICES38.00X207824012097
BRUCE A BUSH MD
SR VP MEDICAL DIRECTOR37.00300838010037X
DOMINIC PACCAPANICCIA
CHIEF OPERATING OFFICER39.00220023030471X
CINDY VIRGIL
SR VP PATIENT SERVICES39.00190339018954X
WADE PATRICK
SR VP INFORMATION SERVICES40.00188072018654X
LARRY SEDLEMEYER
SR VP BUS. DEVELOPMENT & P40.00156437010679X
LUIS P TOMACRUZ
PHYSICIAN40.00450820019986X
DONNA BALEWICK
PHYSICIAN40.0039830207042X
VINEET GOEL
PHYSICIAN40.00390754020247X
ANTHONY SICO
PHYSICIAN40.00385740020477X
JOHN PATRICK CAWLEY
PHYSICIAN40.0032261907116X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3585607TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation235617TotalOtherCompensation
Number Individuals GT100 K57NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LIGHTHOUSE ELECTRIC
1957 RT 519 SOUTHCANNONSBURGPA15317CONSTRUCTION CONTRACTOR1388074
MAYO COLLABORATIVE SERVICES INC
PO BOX 1450MINNEAPOLISMN55485OUTSIDE LAB SERVICE936027
STRAW CONSTRUCTION
PO BOX 9429 FETTEROLF ROADBOSWELLPA15531CONSTRUCTION CONTRACTOR745895
DERRY CONSTRUCTION
527 RT 217LATROBEPA15650CONSTRUCTION CONTRACTOR734586
INDIANA OPEN MRI LLC
PO BOX 450NEW STANTONPA15672WOUND CARE SERVICES525084
FieldValueIRS element (for citing)
Number Of Contractors GT100 K101NumberOfContractorsGT100K
Government Grants484759GovernmentGrants
All Other Contributions386466AllOtherContributions
Total Contributions871225TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SCV REV621990128442829128442829
RENTAL REVENUE-AFFILIA531120325494325494
LIFELINE REVENUE900099189945189945
HEALTH CLASSES/COUNSEL624100128650128650
HOSPICE PRESCRIPTIONS6219904918949189
FieldValueIRS element (for citing)
Total Program Service Revenue129136107TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3381652TotalRevenueColumn
Unrelated Business Revenue38827UnrelatedBusinessRevenue
Exclusion$3,342,825ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1186892Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real890929Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real295963Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column295963TotalRevenueColumn
Exclusion$295,963ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities19059176Securities
Other176190Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities17445431Securities
Other93816Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1613745Securities
Other82374Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1696119TotalRevenueColumn
Exclusion$1,696,119ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
LABORATORY REVENUE62150018754451875445
LEASED EMPLOYEES9000991743302$1,743,302
CAFETERIA REV722210585390$585,390

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column446968TotalRevenueColumn
Unrelated Business Revenue29075UnrelatedBusinessRevenue
Exclusion$417,893ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue4651105TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column140032171TotalRevenueColumn
Related Or Exempt Function Income129136107RelatedOrExemptFunctionIncome
Unrelated Business Revenue1943347UnrelatedBusinessRevenue
Exclusion$8,081,492ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1798121Total
Program Services770662ProgramServices
Management And General1027459ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total53980529Total
Program Services42898102ProgramServices
Management And General11082427ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total5096302Total
Program Services4074182ProgramServices
Management And General1022120ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total12229603Total
Program Services9776822ProgramServices
Management And General2452781ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3861316Total
Program Services3086887ProgramServices
Management And General774429ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total339162Total
Management And General339162ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total113320Total
Management And General113320ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total71979Total
Program Services71979ProgramServices

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total150000Total
Management And General150000ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total10333907Total
Program Services8315736ProgramServices
Management And General2018171ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total823690Total
Program Services32027ProgramServices
Management And General791663ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total20380804Total
Program Services19985585ProgramServices
Management And General395219ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1783296Total
Program Services642613ProgramServices
Management And General1140683ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1843458Total
Program Services1354249ProgramServices
Management And General489209ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total251661Total
Program Services139408ProgramServices
Management And General112253ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1408342Total
Management And General1408342ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total8487284Total
Program Services7377067ProgramServices
Management And General1110217ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1225248Total
Program Services979511ProgramServices
Management And General245737ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
UBI TAXES111228111228
BAD DEBT EXPENSE59672045967204
MAINTENANCE & REPAIRS27048545424882162366
MA ASSESSMENT12034151203415
FOOD735701147553588148

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total785078Total
Program Services649835ProgramServices
Management And General135243ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total135685502Total
Program Services110075798ProgramServices
Management And General25609704ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY6191BOY
EOY6380EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY877376BOY
EOY5192292EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11147274BOY
EOY11333418EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1263535BOY
EOY1444833EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3938710BOY
EOY3431021EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis147875461LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec89918406LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY56399040BOY
EOY57957055EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY95973044BOY
EOY97109706EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY5185940BOY
EOY5403288EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY541213BOY
EOY7656912EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY187794BOY
EOY177894EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY175520117BOY
EOY189712799EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY13207854BOY
EOY13698550EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY29521511BOY
EOY26163770EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY173321BOY
EOY2449826EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY2000000BOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY28067916BOY
EOY27693456EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY72970602BOY
EOY70005602EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY99296133BOY
EOY116637715EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3253382BOY
EOY3069482EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY102549515BOY
EOY119707197EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY175520117BOY
EOY189712799EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses4346669ReconcilationRevenueExpenses
Reconcilation Other Changes12811013ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$71,979OtherActivitiesAmount
Total Lobbying Expenditures IIB71979TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF OTHER LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1I:ReturnReference
ExplanationPAID PART-TIME STAFF MEMBER OCCASIONALLY LOBBIES LOCAL AND FEDERAL GOVERNMENTS SPECIFICALLY ON HEALTHCARE REFORM TOPICS. THE MEDICAL CENTER IS ALSO A MEMBER OF NATIONAL AND STATE HOSPITAL AND HEALTHCARE ASSOCIATIONS THAT PERFORM LOBBYING ACTIVITIES. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS IS LISTED AS LOBBYING EXPENDITURES.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance3253000BeginningOfYearBalance
Contributions872000Contributions
Other Expenditures1055000OtherExpenditures
End Of Year Balance3070000EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2376000BeginningOfYearBalance
Contributions1812000Contributions
Other Expenditures935000OtherExpenditures
End Of Year Balance3253000EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3262000BeginningOfYearBalance
Contributions680036Contributions
Other Expenditures1566036OtherExpenditures
End Of Year Balance2376000EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance1.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis227375InvestmentCostOrOtherBasis
Other Cost Or Other Basis2997091OtherCostOrOtherBasis
Book Value3224466BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis44038455OtherCostOrOtherBasis
Depreciation24700264Depreciation
Book Value19338191BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis96346949OtherCostOrOtherBasis
Depreciation63863231Depreciation
Book Value32483718BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4265591OtherCostOrOtherBasis
Depreciation1354911Depreciation
Book Value2910680BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings57957055TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
POST-RETIREMENT LIABILITY$1,746,309
PENSION LIABILITY$23,513,439
ESTIMATED THIRD PARTY PAYOR SETTLEMENTS$1,002,034
DUE TO AFFILIATES$1,431,674
FieldValueIRS element (for citing)
Total Of Amounts27693456TotalOfAmounts
Total Revenue140032171TotalRevenue
Total Expenses135685502TotalExpenses
Excess Or Deficit For Year4346669ExcessOrDeficitForYear
Net Unrealized GL On Investments11316280NetUnrealizedGLOnInvestments
Other$1,494,733OtherAmount
Total Adjustments12811013TotalAdjustments
Excess Or Deficit Per FS17157682ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt153584113TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments11316280NetUnrealizedGainsInvestments
Other Revenues1344733OtherRevenues
Revenue Not Rptd F99012661013RevenueNotRptdF990
Revenue Subtotal140923100RevenueSubtotal
Other Revenues Not Included-890929OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-890929RevenueNotRptdOnFinStmt
Total Revenue Per Form990140032171TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt136426431TotExpensesEtcAuditedFinclStmt
Other Expenses Included890929OtherExpensesIncluded
Expenses Not Rptd F990890929ExpensesNotRptdF990
Expenses Subtotal135535502ExpensesSubtotal
Investment Expenses Not Included2150000InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt150000ExpensesNotRptdOnFinStmt
Total Expenses Per Form990135685502TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:ENDOWMENT FUNDS ARE USED PRIMARILY TO PURCHASE CAPITAL EQUIPMENT.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE HOSPITAL ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2011 AND 2010. THE HOSPITAL'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES.
PART XI, LINE 8 - OTHER ADJUSTMENTS:PENSION AND POST-RETIREMENT LIABILITIES ADJUSTMENT 5,146,008. IMPAIRMENT LOSS ON GOODWILL -3,443,000. GAIN ATTRIBUTABLE TO ACQUISITION OF INDIANA AMBULATORY SURGICAL ASSOC. 3,791,728. TRANSFER TO AFFILIATE -1,794,003. RESTRUCTURING COSTS RELATED TO EARLY RETIREMENT PROGRAM -2,206,000.
PART XII, LINE 2D - OTHER ADJUSTMENTS:PENSION AND POST-RETIREMENT LIABILITIES ADJUSTMENT 5,146,008. INVESTMENT FEES -150,000. RESTRUCTURING COSTS RELATED TO EARLY RETIREMENT PROGRAM -2,206,000. IMPAIRMENT LOSS ON GOODWILL -3,443,000. GAIN ATTRIBUTABLE TO ACQUISITION OF INDIANA AMBULATORY SURGICAL ASSOC. 3,791,728. TRANSFER TO AFFILIATE -1,794,003.
PART XII, LINE 4B - OTHER ADJUSTMENTS:RENTAL EXPENSES -890,929.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES 890,929.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1675520TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1675520NetCommunityBenefitExpense
Percent Of Total Expense0.01290PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense15379746TotalCommunityBenefitExpense
Direct Offsetting Revenue9646568DirectOffsettingRevenue
Net Community Benefit Expense5733178NetCommunityBenefitExpense
Percent Of Total Expense0.04420PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense17055266TotalCommunityBenefitExpense
Direct Offsetting Revenue9646568DirectOffsettingRevenue
Net Community Benefit Expense7408698NetCommunityBenefitExpense
Percent Of Total Expense0.05710PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense386966TotalCommunityBenefitExpense
Direct Offsetting Revenue51551DirectOffsettingRevenue
Net Community Benefit Expense335415NetCommunityBenefitExpense
Percent Of Total Expense0.00260PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2590529TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2590529NetCommunityBenefitExpense
Percent Of Total Expense0.02000PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2977495TotalCommunityBenefitExpense
Direct Offsetting Revenue51551DirectOffsettingRevenue
Net Community Benefit Expense2925944NetCommunityBenefitExpense
Percent Of Total Expense0.02260PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense20032761TotalCommunityBenefitExpense
Direct Offsetting Revenue9698119DirectOffsettingRevenue
Net Community Benefit Expense10334642NetCommunityBenefitExpense
Percent Of Total Expense0.07970PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense447800TotalCommunityBuildingExpense
Direct Offsetting Revenue69800DirectOffsettingRevenue
Net Community Building Expense378000NetCommunityBuildingExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense447800TotalCommunityBuildingExpense
Direct Offsetting Revenue69800DirectOffsettingRevenue
Net Community Building Expense378000NetCommunityBuildingExpense
Percent Of Total Expense0.00290PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$2,100,000BadDebtExpenseAmount
Amount Attributable To525000AmountAttributableTo
Amount Reimbursed By Medicare29173846AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare28393795CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall780051MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
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 Line1INDIANA REGIONAL MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1835 HOSPITAL ROADAddressLine1
CityINDIANACity
StatePAState
ZIP Code15701ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
OtherURGENT CARE FACILITYOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanationReturn ReferenceReturnReference
PART I, LINE 7: THE HOSPITAL USED A COST-TO-CHARGE RATIO IN DETERMINING THE FIGURES REPORTED IN THIS TABLE. THIS COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 RATIO OF PATIENT CARE COST TO CHARGES.
PART I, LINE 7G: NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC WERE INCLUDED IN THE AMOUNT ON PART I, LINE 7G.
PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $5,967,204.
PART II: OUR MISSION IS TO SERVE THE HEALTHCARE NEEDS OF EVERY LIFE WE TOUCH WITH COMPASSION, RESPECT AND DIGNITY. ALL OF THE PROGRAMS OFFERED MEET COMMUNITY BENEFIT OBJECTIVES AND ARE RELATED TO OUR MISSION. IRMC OFFERS PROGRAMS THAT IMPROVE ACCESS TO HEALTH CARE SERVICES, ENHANCES HEALTH OF THE COMMUNITY WE SERVE, PROVIDES ADVANCED MEDICAL OR HEALTHCARE KNOWLEDGE AND RELIEVES SOME OF THE FINANCIAL OR PROGRAMMATIC BURDEN OF GOVERNMENT OR OUR COMMUNITY. INDIANA REGIONAL MEDICAL CENTER PROVIDES NUMEROUS COMMUNITY PROGRAMS AND ACTIVITIES THAT PROVIDE TREATMENT OR PROMOTE HEALTH AND HEALING TO OUR COMMUNITIES. OUR MOBILE MEDICAL SERVICES CONTINUES TO PROVIDE FREE BLOOD PRESSURE SCREENINGS IN 19 LOCATIONS IN INDIANA COUNTY. WE ALSO CONTINUE TO PARTICIPATE IN NUMEROUS FREE COMMUNITY EVENTS PROVIDING EDUCATION, SCREENING PROGRAMS AND FIRST AID SERVICES. OVER THE PAST YEAR, THE MOBILE MEDICAL HEALTH LOGGED OVER 3,300 PARTICIPANTS. WE ALSO PROVIDE NUMEROUS HEALTH FAIRS REACHING ALMOST 400 PARTICIPANTS, AND CLASSES AND EDUCATION PROGRAMS WITH OVER 5,000 PARTICIPANTS. THE INSTITUTE FOR HEALTHY LIVING AT INDIANA REGIONAL MEDICAL CENTER OFFERS HEALTH SERVICES AND EDUCATION PROGRAMS TO THE COMMUNITY AT NO CHARGE.THE CENTER FOR DIABETES CARE CONTINUES TO OFFER FREE EDUCATION SERVICES AT VARIOUS LOCATIONS THROUGHOUT THE COUNTY. IN ADDITION, THEY CONTINUE TO BE THE PRIMARY SPONSOR OF THE COUNTY'S DIABETES WALK. EACH MONTH STAFF AND MANAGEMENT AT IRMC PROVIDE SUPPORT TO A LOCAL FOOD BANK. PREVENTIVE HEALTH SERVICES - M. DORCAS CLARK WOMEN'S IMAGING CENTER AND THEIR STAFF HAVE PARTICIPATED IN NUMEROUS COMMUNITY EVENTS PROVIDING INFORMATION ABOUT THE IMPORTANCE OF BREAST HEALTH. BIRDIE'S CLOSET, A PROJECT DESIGNED TO HELP WOMEN COPE WITH APPEARANCE RELATED SIDE-EFFECTS OF CANCER TREATMENT WAS OPENED IN THE WOMEN'S IMAGING CENTER. SUPPORT HEALTH GROUPSFAMILY PROGRAMS - EARLY PREGNANCY, MATERNITY TOUR, DOCTOR DAD, BOF SERIES, BREASTFEEDING, ALL ABOUT BABY, LAMAZE, HOME ALONE, BABYSITTING, LET'S TALK GIRLS, BIG BROTHER, CPR, HEARTSAVER. 432 CONTACTS FOR THE YEAR.COMMUNITY CLASSES - PACE, TAI CHI, YOGA, CANCER, STRONG WOMEN, DROP WEIGHT, ORNISH, DIABETES, DROP 10. 5,030 CLASS HOURS.IN 2009, INDIANA REGIONAL MEDICAL CENTER OPENED A NEW FACILITY OFFERING URGENT CARE SERVICES IN THE BLAIRSVILLE COMMUNITY AS A RESPONSE TO MEDICAL SERVICES NEEDED IN THAT AREA. THIS FACILITY IS 12 MILES FROM THE HOSPITAL CAMPUS.
PART III, LINE 4: THE FOLLOWING IS THE TEXT OF THE FOOTNOTE FROM THE AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: ACCOUNTS RECEIVABLE, PATIENTS, ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS ESTIMATED BASED ON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES.THE BAD DEBT EXPENSE IS RECORDED AT 75% OF GROSS CHARGES FOR THOSE ACCOUNTS THAT ARE NOT PARTICIPATING IN ANY INSURANCE COVERAGE. THESE PATIENT INVOICED AMOUNTS ARE REDUCED BY 25%. FOR THOSE BALANCES THAT ARE THE DEDUCTIBLES OR CO-PAYMENTS, AFTER THE INSURANCE PAYS, THOSE ARE RECORDED AT THAT AMOUNT. A PORTION OF THE BAD DEBT SHOULD BE INCLUDED AS COMMUNITY BENEFIT AS THE HOSPITAL IS NOT ABLE TO DENY SERVICES TO ANY PATIENT PRESENTING TO THE EMERGENCY DEPARTMENT, REGARDLESS IF THE PATIENTS HAVE THE MEANS TO PAY. THE DEDUCTIBLE AND CO-INSURANCE BALANCES THAT ARE NOT PAID REDUCE THE NET REVENUES DUE TO THE HOSPITAL AS PART OF THE RESPECTIVE PATIENT'S INSURANCE COVERAGE. IN ADDITION, THERE IS A "COST" TO THE HOSPITAL FOR TREATING ALL PATIENTS. AS WITH THE UNREIMBURSED AMOUNTS OF THE MEDICAID PATIENT SERVICES, THE HOSPITAL SHOULD BE ABLE TO INCLUDE THE UNREIMBURSED COSTS OF THE SERVICES THAT RESULTED IN NO PAYMENT.
PART III, LINE 8: THE MEDICARE COST REPORT WAS USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6.
PART III, LINE 9B: PATIENTS ARE EXPECTED TO PAY ALL BALANCES IN FULL WITHIN FIFTEEN DAYS OF A FINAL BILLING. IF THIS IS NOT POSSIBLE, PATIENTS WILL BE COUNSELED ON THE USE OF MEDICAL ASSISTANCE OR THE INDIANA CHARITY CARE PROGRAM, I-CARE.ON A MONTHLY BASIS, THE CREDIT SUPERVISOR WILL COMPILE A REPORT LISTING ALL ACCOUNTS, WHICH HAVE BEEN BILLED TO MEDICARE, AND ANY SECONDARY INSURANCE CARRIER WHERE APPLICABLE. A LISTING OF ACCOUNTS WHICH HAVE BEEN BILLED TO MEDICAL ASSISTANCE AS A SECONDARY PAYOR ARE REVIEWED BY THE CREDIT SUPERVISOR FOR AN AUTOMATIC WRITE OFF AFTER MEDICAL ASSISTANCE HAS PROCESSED THE ACCOUNT. ACCOUNTS WHICH HAVE BALANCES AFTER MEDICARE AND ALL SECONDARY PAYORS HAVE BEEN BILLED WILL BE PLACED WITH AN OUTSIDE COLLECTION AGENCY AFTER TWO UNANSWERED STATEMENTS. AN EXCEPTION WILL BE MADE IN THE EVENT A PATIENT/GUARANTOR DOES NOT FOLLOW THROUGH WITH THE MEDICAL ASSISTANCE APPLICATION PROCESS, WHEN REQUESTED TO DO SO. THE AGENCY WILL ATTEMPT TO COLLECT THE ACCOUNT FOR SIX MONTHS. AFTER THAT TIME THE ACCOUNT WILL BE WRITTEN OFF AS MEDICARE BAD DEBT.THE IRMC COLLECTION POLICY CONTAINS PROVISIONS TO PROVIDE A SOFTER APPROACH FOR THOSE THAT IRMC HAS LEARNED WOULD QUALIFY FOR FINANCIAL ASSISTANCE. UPON RECEIPT OF THE CALL FROM THE PATIENT THAT THERE IS HARDSHIP IN PAYING THE BILL, THE IRMC COLLECTION REPRESENTATIVE SHARES THE INFORMATION FOR APPLICATION FOR BOTH MEDICAL ASSISTANCE AND CHARITY CARE. WHILE THE PATIENT'S ACCOUNT IS IN THIS PROCESS, THEIR ACCOUNT WILL NOT BE PROVIDED TO THE COLLECTION AGENCY.
PART VI, LINE 2: DURING THE PAST YEAR, IRMC HAS BEEN REVIEWING INFORMATION AND DATA ABOUT THE HEALTH OF OUR COUNTY. INFORMATION WAS COLLECTED FROM THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM SURVEY, COUNTY HEALTH PROFILE, COUNTY HEALTH RANKINGS, COMMUNITY MEMBERS, MEDICAL STAFF AND HOSPITAL LEADERSHIP. OVERALL, THE HEALTH OF INDIANA COUNTY RESIDENTS IS BETTER OR EQUAL TO THOSE IN THE SURROUNDING COUNTIES. HOWEVER, SEVERAL AREAS WERE IDENTIFIED AS AREAS FOR IMPROVEMENT.OUR REPORT OUTLINES THE 19 COMMUNITY NEEDS ORIGINALLY IDENTIFIED THROUGH THE SURVEY AND DATA SOURCES. THE TOP SEVEN PRIORITIES THAT IRMC WILL BE FOCUSING ON IN THE NEXT THREE YEARS ARE: EARLY PRENATAL CARECHOLESTEROL TESTINGINFLUENZA/PNEUMONIA DEATHSNUMBER OF PRIMARY CARE PHYSICIANSOVERWEIGHT/OBESITY RATESDRUG ABUSEPREVENTABLE HOSPITALIZATIONS
PART VI, LINE 3: IRMC WILL POST AT ALL POINTS OF REGISTRATION, A NOTICE OF THE CHARITY CARE POLICY. THE MEDICAL CENTER WILL ALSO PROVIDE NOTICE OF THE CHARITY CARE POLICY IN PATIENTS' BILLS AND TO LOCAL SOCIAL SERVICE AGENCIES. THE MEDICAL CENTER ALSO PROVIDES THIS INFORMATION ON THE INDIANA REGIONAL MEDICAL CENTER'S INTERNET HOME PAGE. AT THE EARLIEST FEASIBLE TIME, THE MEDICAL CENTER PERSONNEL WILL ATTEMPT TO DETERMINE PATIENT ELIGIBILITY FOR COVERAGE OF PART OR ALL OF THEIR PATIENT BILL.ALL PRE-REGISTRATION, REGISTRATION, BUSINESS OFFICE, AND PATIENT FINANCIAL SERVICES STAFF RECEIVE TRAINING AS TO THE CHARITY CARE POLICY AND ARE TO BE FAMILIAR WITH THE AVAILABILITY OF CHARITABLE ASSISTANCE AND THE CRITERIA FOR SUCH ASSISTANCE.
PART VI, LINE 4: SINCE OPENING ITS DOORS IN 1914, INDIANA REGIONAL MEDICAL CENTER (IRMC) HAS MAINTAINED A GOAL OF SERVING THE COMMUNITY WITH QUALITY, PROGRESSIVE, COMPASSIONATE PATIENT CARE. AS THE COUNTY'S SOLE, FULL-SERVICE HEALTHCARE PROVIDER, IRMC HAS CONTINUALLY RISEN TO THE CHALLENGE OF MEETING THE NEEDS OF ITS COMMUNITY. IRMC RESIDES IN INDIANA, PENNSYLVANIA IN THE HEART OF THE COUNTY. THE HOSPITAL SITS ON A 75-ACRE CAMPUS AND ADMITS OVER 7,700 PATIENTS, DELIVERS MORE THAN 600 BABIES, AND ACCOMMODATES ANOTHER QUARTER-MILLION OUTPATIENT ENCOUNTERS EACH YEAR. AS AN ACUTE CARE FACILITY, IRMC IS LICENSED FOR 164 BEDS AND PROVIDES A BROAD RANGE OF MEDICAL AND EDUCATIONAL SERVICES AT ITS MAIN CAMPUS AND SATELLITE LOCATIONS ACROSS INDIANA COUNTY. AS THE ONLY HOSPITAL LOCATED IN THIS RURAL COUNTY, IRMC PROVIDES SERVICES TO A DIVERSE POPULATION OF 89,000 RESIDENTS SPREAD OVER 830 SQUARE MILES.OVER THE YEARS, IRMC HAS DEVELOPED PROGRAMS AND SERVICES THAT ADDRESS IMPROVING ACCESS TO CARE, PREVENTIVE SERVICES, AND COMMUNITY HEALTH EDUCATION. IRMC HAS FOUND A WAY TO NOT ONLY SUCCEED WHEN OTHER RURAL HOSPITALS ARE CLOSING THEIR DOORS, BUT ALSO EXPAND AND PROVIDE CARE TO THE RESIDENTS OF FIVE SURROUNDING COUNTIES. IRMC IS THE NUMBER TWO EMPLOYER IN THE COUNTY WITH 1,300 EMPLOYEES AND CONTINUES TO ATTRACT AND RETAIN A QUALITY WORKFORCE THROUGH THE ACHIEVEMENT OF NUMEROUS RECOGNITIONS, SUCH AS THE #1 BEST PLACE TO WORK IN PA, THE #2 BEST PLACE TO WORK IN THE NATION ACCORDING TO MODERN HEALTHCARE MAGAZINE, ACHIEVED NOTABLE STATUS BY SCORING AT THE MASTERY LEVEL IN PENNSYLVANIA'S KAPE PROGRAM, AND NAMED TO FORTUNE'S 100 BEST COMPANIES TO WORK FOR. FURTHER, IRMC IS CURRENTLY PURSUING THE MALCOLM BALDRIGE NATIONAL QUALITY AWARD - A PRESTIGIOUS HONOR ACHIEVED BY FEW.
PART VI, LINE 6: IN THE MID-NINETIES, HOSPITALS AND HEALTHCARE FACILITIES BEGAN TO SHIFT THEIR ATTENTION FROM JUST SICK OR HOSPITAL BASED CARE TO INCLUDE ADDRESSING COMMUNITY HEALTH AND DISEASE PREVENTION. AS A FIRST STEP IN THAT DIRECTION, IRMC FORMED A COMMUNITY SERVICE DEPARTMENT WHOSE PURPOSE WAS TO DELIVER EDUCATION AND PREVENTATIVE SCREENINGS TO THE COMMUNITY-AT-LARGE. IN 2005, REALIZING THAT ALMOST EVERY DEPARTMENT IN THE HOSPITAL HAD OPPORTUNITIES TO PROMOTE HEALTH AND WELLNESS, IRMC CREATED THE INSTITUTE FOR HEALTHY LIVING, A VIRTUAL ORGANIZATION COORDINATING ALL ASPECTS OF COMMUNITY OUTREACH AND HEALTH IMPROVEMENT. IMPROVING AND SUSTAINING COMMUNITY HEALTH, HOWEVER, IS A COLLABORATIVE ENDEAVOR THAT INTEGRATES AS MANY KEY STAKEHOLDERS AS POSSIBLE. IN THAT REGARD, IRMC SPEARHEADED THE FORMATION OF THE INDIANA COUNTY COMMUNITY HEALTH ADVISORY COUNCIL (CHAC), AN ENTERPRISE REPRESENTING MEMBERS FROM VARIOUS COMMUNITY AGENCIES, ORGANIZATIONS AND SCHOOLS WHOSE PURPOSE IT IS TO IDENTIFY HEALTH NEEDS IN OUR COUNTY AND TO FIND WAYS TO MEET THEM. THE CHAC HAS BEEN ACTIVE SINCE 1996 AND IRMC SERVES AS ITS BASE AND CHAIRMANSHIP. THE IRMC / INSTITUTE FOR HEALTHY LIVING 2011 COMMUNITY HEALTH NEEDS ASSESSMENT AND REPORT IS THE PRODUCT OF AN 18-MONTH PROCESS THAT SOUGHT COMMUNITY INPUT, MEDICAL STAFF INPUT, INVOLVED KEY INTEREST GROUPSSUCH AS THE CHAC, AND SELECTED PRIMARY AND SECONDARY SOURCES OF SURVEY INPUT TO IDENTIFY TARGET AREAS FOR IMPROVEMENT WITH SPECIFIC ACTION PLANS.USING THE THREE SURVEY INPUTS OF THE PA BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (BRFSS), THE ROBERT WOOD JOHNSON COUNTY HEALTH RANKINGS, AND THE PA DEPARTMENT OF HEALTH ANNUAL COUNTY HEALTH PROFILES, IRMC WAS ABLE TO IDENTIFY AND SET PRIORITIES AMONG 19 AREAS FOR COMMUNITY HEALTH IMPROVEMENT THAT DIFFERED SIGNIFICANTLY FROM STATE OR NATIONAL BENCHMARKS. IRMC THEN TARGETED SEVEN OF THOSE NEED AREAS FOR SPECIFIC INTERVENTION AND ACTION. INDIANA REGIONAL MEDICAL CENTER USES ITS OWN FUNDS TO ENHANCE BOTH THE CLINICAL STRATEGIES AND THE COMMUNITY STRATEGIES.CLINICAL STRATEGIES (A FEW EXAMPLES): RECRUITING ADDITIONAL PHYSICIANS FOR IDENTIFIED COMMUNITY NEEDS, EXPLORE DEVELOPMENT OF A FAMILY PRACTICE RESIDENCY PROGRAM TO FACILITATE RECRUITMENT AND RETENTION, ENLARGE THE MEDICAL FITNESS CENTER, ESTABLISH A WEIGHT LOSS TASK FORCE, DEVELOP A MEDICAL WEIGHT MANAGEMENT CENTER, PROVIDE FLU SHOTS TO ALL INPATIENTS DURING FLU SEASON, PROVIDE PNEUMONIA VACCINE TO ALL NON-VACCINATED INPATIENTS, ETC. COMMUNITY STRATEGIES (A FEW EXAMPLES): PARTNER WITH AGENCIES PROVIDING SERVICES AND EDUCATION TO YOUNG TEENS AND WOMEN, EVALUATE A PARTNERSHIP WITH EARLY HEAD START, IMPROVE VISIBILITY AND INFORMATION AVAILABLE ABOUT THE OB/GYN CLINIC, WORKED TO ESTABLISH PRACTICES IN THE MORE RURAL AREAS OF THE COUNTY THAT REQUIRE THE MEDICAL CENTER TO SUBSIDIZE DELIVERING CARE THERE, ESTABLISHED THE INDIANA AT CHESTNUT RIDGE FACILITY THAT OFFERS PRIMARY CARE AND URGENT-CARE AND WAS A SIGNIFICANT CAPITAL INVESTMENT, IMPLEMENT A PATIENT PORTAL TO IMPROVE PATIENT ACCESS TO MEDICAL RECORDS, BECAME A PROVIDER OF THE WE CAN! (WAYS TO ENHANCE CHILDREN'S ACTIVITY AND NUTRITION), PARTNERED WITH 7 ELEMENTARY SCHOOLS TO INSTALL PROJECT FIT AMERICA, IMPLEMENTED GROCERY STORE TOURS TO ASSIST PEOPLE WITH SEEKING HEALTHY CHOICES, PARTNER WITH 4 GROCERY STORES TO HAVE A DIETICIAN AVAILABLE TO HELP SHOPPERS MAKE HEALTHY CHOICES, CONDUCT THE ANNUAL "VACCINE FOR VETERANS" PROGRAM ON VETERANS DAY, EVALUATE THE POTENTIAL FOR PUBLIC PNEUMONIA VACCINE CLINICS, CONTINUE TO PROVIDE FREE FLU AND PNEUMONIA VACCINE TO HIGH-RISK, LOW INCOME RESIDENTS, ETC.
PART VI, LINE 7: INDIANA REGIONAL MEDICAL CENTER HAS THE FOLLOWING AFFILIATED ENTITIES:INDIANA HEALTHCARE FOUNDATION CONDUCTS FUNDRAISING ACTIVITIES, SUCH AS THE COLUMBUS DAY GOLF OUTING AND LOVE OF LIFE GALA, IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTER. INDIANA REGIONAL MEDICAL CENTER AND PUNXSUTAWNEY AREA HOSPITAL JOINTLY FORMED INDIANA JEFFERSON RADIATION ONCOLOGY, INC. FOR THE PURPOSE OF ENHANCING THE QUALITY AND AVAILABILITY OF RADIATION ONCOLOGY SERVICES OFFERED TO PATIENTS IN INDIANA AND JEFFERSON COUNTIES, PA AND SURROUNDING AREAS.INDIANA HEALTHCARE PHYSICIAN SERVICES, INC. IS A NON-PROFIT HOSPITAL OWNED GROUP OF PRACTICES OWNED AND OPERATED TO SERVE THE RURAL AREAS OF INDIANA AND SURROUNDING COMMUNITIES. WE PROVIDE ACCESSIBLE, COST EFFECTIVE QUALITY HEALTHCARE WITHIN THE RURAL COMMUNITIES OF INDIANA AND SURROUNDING COUNTIES. WE SUPPORT AND WORK COLLABORATIVELY WITH OTHER NON-PROFIT AGENCIES WITHIN OUR SITES.INDIANA HEALTHCARE PROPERTIES HOLDS AND MANAGES PROPERTY IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTER.
N/APART VI, LINE 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 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
STEPHEN A WOLFE
36532300085160444900153670433696000
ROBERT GONGAWARE
19614501167900010903011940219921000
BRUCE A BUSH MD
2838680169700002907071300310875000
DOMINIC PACCAPANICCIA
21503204991000119290185420250494000
CINDY VIRGIL
17751901282000059330130210209293000
WADE PATRICK
17681901125300018130168410206726000
LARRY SEDLEMEYER
153521029160003178075010167116000
LUIS P TOMACRUZ
41608503473500000199860470806000
DONNA BALEWICK
3831570151450000070420405344000
VINEET GOEL
37706701368700000202470411001000
ANTHONY SICO
34287004287000000204770406217000
JOHN PATRICK CAWLEY
32236202570000071160329735000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1AINDIANA REGIONAL MEDICAL CENTER PAYS COUNTRY CLUB MEMBERSHIP DUES FOR PRESIDENT & CEO, STEPHEN WOLFE, WHICH IS NOT INCLUDED IN HIS COMPENSATION. THE MEMBERSHIP IS A CORPORATE MEMBERSHIP USED FOR BUSINESS PURPOSES ONLY.
PART I, LINE 4BINDIANA REGIONAL MEDICAL CENTER HAS A SUPPLEMENTAL, NONQUALIFIED RETIREMENT PLAN UNDER IRC SECTION 457(F) FOR PRESIDENT & CEO STEPHEN WOLFE. NO AMOUNTS WERE PAID TO HIM FROM THIS PLAN DURING 2010.
PART I, LINE 7BONUSES MAY BE GRANTED AT THE DISCRETION OF THE BOARD AND ARE BASED ON FACTORS SUCH AS PERFORMANCE AND MEETING GOALS AND OBJECTIVES.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
INDIANA COUNTY HOSPITAL AUTHORITY
2516973192003-01-1510000000ADVANCE REFUND 1992 BONDS AND FINANCE CAPITAL IMPROVEMENTS000
INDIANA COUNTY HOSPITAL AUTHORITY
2516973192004-12-0810000000FINANCE CAPITAL IMPROVEMENTS000
INDIANA COUNTY HOSPITAL AUTHORITY
2516973192009-02-1210000000FINANCE CAPITAL PROJECTS000

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
1000000050000995000020030011
1000000091500990850020060011
1000000061000993900020100011

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
000010.000000.000000.000001
000010.000000.000000.000001
000010.000000.000000.000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
000001
010001
010001

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 6INDIANA HEALTHCARE CORPORATION ("IHC") IS THE SOLE CORPORATE MEMBER OF INDIANA REGIONAL MEDICAL CENTER ("IRMC").
FORM 990, PART VI, SECTION A, LINE 7AIHC HAS THE POWER TO FILL VACANCIES, NOMINATE AND APPROVE THE ELECTION OF, AND APPROVE REMOVAL OF THE BOARD OF DIRECTORS OF IRMC.
FORM 990, PART VI, SECTION A, LINE 7BIRMC SHALL OBTAIN THE APPROVAL OF IHC BEFORE ACTION ON ANY OF THE FOLLOWING MATTERS BECOMES FINAL AND EFFECTIVE FOR IRMC: (1) AMENDMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS; (2) THE SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS OF IRMC; (3) MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION; (4) DISSOLUTION OF IRMC; (5) APPROVAL OF AN ANNUAL OPERATING AND CAPITAL BUDGET FOR IRMC; (6) ANY OTHER MATTER THAT BY LAW WOULD REQUIRE THE APPROVAL OF MEMBERS OF A NONPROFIT CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11EACH BOARD MEMBER WILL BE CONTACTED INDIVIDUALLY AND GIVEN THE OPPORTUNITY TO RECEIVE A COPY OF THE COMPLETE RETURN BY E-MAIL, POSTAL SERVICE, OR PICKED UP AT 835 HOSPITAL ROAD IN THE CHIEF FINANCIAL OFFICER'S OFFICE. THE RETURN IS ALSO PRESENTED AT A BOARD MEETING BEFORE FILING WITH THE INTERNAL REVENUE SERVICE.
EVERY MEMBER OF THE BOARD, AND EVERY INDIVIDUAL APPOINTED TO THE BOARD OR BOARD COMMITTEES, AS WELL AS ALL KEY MANAGEMENT PERSONNEL AND PHYSICIAN LEADERS, ARE REQUIRED TO EXECUTE A CONFLICT OF INTEREST DISCLOSURE STATEMENT, WHICH WILL BE UPDATED AT LEAST ON AN ANNUAL BASIS OR AS ADDITIONAL CONFLICTING INTERESTS ARISE. IN ADDITION, EVERY MEMBER OF THE BOARD WILL SPECIFICALLY ACKNOWLEDGE THE CONFLICT OF INTEREST POLICY AND HIS/HER ATTEMPT TO ABIDE BY IT BY SIGNING THE ACKNOWLEDGEMENT FORM. EVERY BOARD COMMITTEE MEMBER, OFFICER, KEY MANAGEMENT EMPLOYEE, AND PHYSICIAN LEADER IS REQUIRED TO SIGN THIS ACKNOWLEDGEMENT AS WELL. THE ACKNOWLEDGEMENT AND DISCLOSURE FORMS WILL BE KEPT ON FILE BY THE CHIEF EXECUTIVE OFFICER, AND THE CHAIRMAN AND VICE-CHAIRMAN WILL BE FAMILIAR WITH THE STATEMENTS THAT ARE FILED BY BOARD MEMBERS IN ORDER TO GUIDE THEIR CONDUCT IN THE EVENT A CONFLICT ARISES. EVERY PERSON COVERED BY THIS POLICY SHALL SUBMIT IN WRITING TO THE CHIEF EXECUTIVE OFFICER A CONFLICT OF INTEREST DISCLOSURE STATEMENT LISTING ALL FINANCIAL AND CONFLICTING INTERESTS. EACH STATEMENT WILL BE RESUBMITTED WITH ANY NECESSARY CHANGES EACH YEAR OR AS ANY ADDITIONAL CONFLICTING OR FINANCIAL INTERESTS ARISE. THE CHAIRMAN OF THE BOARD SHALL BECOME FAMILIAR WITH ALL SUCH DISCLOSURE STATEMENTS IN CASE A CONFLICT ARISES. THE VICE CHAIRMAN OF THE BOARD SHALL BE FAMILIAR WITH THE DISCLOSURE STATEMENT FILED BY THE CHAIRMAN. PENALTIES FOR NON-COMPLIANCE: FAILURE TO COMPLY WITH THIS POLICY SHALL CONSTITUTE GROUNDS FOR REMOVAL FROM OFFICE AND, IN THE CASE OF KEY MANAGEMENT PERSONNEL, TERMINATION OF EMPLOYMENT.FORM 990, PART VI, SECTION B, LINE 12C
POSITIONS FOR OFFICERS AND KEY EMPLOYEES ARE REVIEWED ON AN ANNUAL BASIS. APPROPRIATE COMPARISONS ARE MADE ON A REGIONAL AND NATIONAL LEVEL IN ORDER TO MAINTAIN A FAIR AND EQUITABLE COMPENSATION STRUCTURE. ALL RECOMMENDATIONS ARE APPROVED BY THE BOARD OF DIRECTORS AND DOCUMENTED IN THE BOARD MINUTES.FORM 990, PART VI, SECTION B, LINE 15
GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON A REQUEST BASIS.FORM 990, PART VI, SECTION C, LINE 19
AVERAGE HOURS WORKEDTHE FOLLOWING OFFICERS AND DIRECTORS WORK AN AVERAGE OF 40 HOURS PER WEEK BETWEEN INDIANA REGIONAL MEDICAL CENTER AND ALL RELATED TAX-EXEMPT ORGANIZATIONS: STEPHEN A. WOLFE DOMINIC PACCAPANICCIA CINDY VIRGIL BRUCE A. BUSH, MD ROBERT GONGAWARE THE FOLLOWING BOARD MEMBERS ARE ALSO BOARD MEMBERS OF INDIANA HEALTHCARE PHYSICIAN SERVICES, INC.: JOHN DOLAN TODD BRICE BEVERLY GAZZA JOSEPH GEARY THOMAS MCCOY ROBERT ROUTFORM 990, PART VII, SECTION A
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 11,316,280. PENSION AND POST-RETIREMENT LIABILITIES ADJUSTMENT 5,146,008. IMPAIRMENT LOSS ON GOODWILL -3,443,000. GAIN ATTRIBUTABLE TO ACQUISITION OF INDIANA AMBULATORY SURGICAL ASSOC. 3,791,728. TRANSFER TO AFFILIATE -1,794,003. RESTRUCTURING COSTS RELATED TO EARLY RETIREMENT PROGRAM -2,206,000. TOTAL TO FORM 990, PART XI, LINE 5: 12,811,013.FORM 990, PART XI, LINE 5:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1INDIANA AMBULATORY SURGICAL ASSOCIATES LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1835 HOSPITAL ROADAddressLine1
CityINDIANACity
StatePAState
ZIP Code15701ZIPCode
FieldValueIRS element (for citing)
EIN232923182EIN
Primary ActivitiesAMBULATORY SURGERYPrimaryActivities
Legal Domicile StatePALegalDomicileState
Total Income2522674TotalIncome
EOY Assets13085383EOYAssets
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
INDIANA HEALTHCARE FOUNDATION
835 HOSPITAL ROADINDIANAPA15701251574302FUNDRAISING IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTERPA501(C)(3)LINE 11A, IINDIANA HEALTHCARE CORPORATION0
INDIANA HEALTHCARE CORPORATION
835 HOSPITAL ROADINDIANAPA15701251547379PARENT CORPORATIONPA501(C)(3)LINE 70N/A
INDIANA JEFFERSON RADIATION ONCOLOGY INC
835 HOSPITAL ROADINDIANAPA15701900406301RADIATION ONCOLOGY SERVICESPA501(C)(3)LINE 11A, IINDIANA REGIONAL MEDICAL CENTER1
INDIANA HEALTHCARE PHYSICIAN SERVICES INC
835 HOSPITAL ROADINDIANAPA15701251842046PROVIDE HEALTH CAREPA501(C)(3)LINE 3INDIANA HEALTHCARE CORPORATION0
INDIANA HEALTHCARE PROPERTIES
835 HOSPITAL ROADINDIANAPA15701251524635HOLD & MANAGE PROPERTY IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTERPA501(C)(3)LINE 11A, IINDIANA HEALTHCARE CORPORATION0

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1INDIANA REHABILITATION SERVICES LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1855 SPRINGDALE DR STE 200AddressLine1
CityEXTONCity
StatePAState
ZIP Code19341ZIPCode
FieldValueIRS element (for citing)
EIN202214391EIN
Primary ActivityREHABILITATION SERVICESPrimaryActivity
Legal Domicile StatePALegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Predominant Income TypeUNRELATEDPredominantIncomeType
Share Of Total Income86376ShareOfTotalIncome
Share Of EOY Assets246322ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner1GeneralOrManagingPartner
Percentage Ownership0.51000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
INDIANA JEFFERSON RADIATION ONCOLOGY INC
I208595COST
INDIANA JEFFERSON RADIATION ONCOLOGY INC
O2033108COST
INDIANA JEFFERSON RADIATION ONCOLOGY INC
P960035COST