2020-11-13T09:40:34-06:00 2019-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 4000 INDIANAPOLIS IN 46204 990 2019-01-01 351814660 INDIANA UNIVERSITY HEALTH WEST HOSPITAL INC % CRAIG J JONES INDI 3179634842 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS IN 46204 CARA L BREIDSTER CFO 3179634842 2020-11-08 JENNIFER D RHODERICK P00395735 3176817000 2019 2022-09-23 18:48:47Z KENNETH D PUCKETT 950 N MERIDIAN ST STE 300 INDIANAPOLIS IN 46204 263141497 false X SEE SCHEDULE O X 1990 IN Improve the health of our patients and community through innovation and excellence in care, education, research and service. 12 7 1314 159 0 0 259 98500 239113407 249530253 6843697 11131716 1727372 2155905 247684735 262916374 20000 30000 0 0 61297448 64539644 0 0 0 127925448 135406926 189242896 199976570 58441839 62939804 521438931 589101817 120515303 125263338 400923628 463838479 X IMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITY THROUGH INNOVATION AND EXCELLENCE IN CARE, EDUCATION, RESEARCH AND SERVICE. false false 163693033 30000 248438240 Indiana University Health West Hospital, Inc. ("IU Health West Hospital") is a 127-bed multidisciplinary healthcare facility located in Avon, IN. The hospital offers a full range of services, including maternity, orthopedics and cancer care. Built with a specific goal to meet the needs of our patients, families and visitors, IU Health West Hospital includes features designed to ensure privacy and create a quiet, soothing atmosphere in patient spaces. From all-private rooms and intimate, comfortable family waiting areas to separate corridors and elevators away from public spaces for staff and supply movement, IU Health West Hospital delivers on our goals to create a healing sanctuary for patients. 247145 375243 IU Health West Hospital provides services to related tax-exempt organizations. 472084 716770 IU Health West Hospital receives rent from a related exempt organization, Indiana University Health Care Associates ("IU Health Physicians"), for space in their Medical Office Building that's connected to the Hospital and the Ortho, Sport & Spine Center. 164412262 true true false true false false false false false false true false false false true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true 62 0 true 1314 true false false false false false false false false false false false false X 12 7 false false true false true true true true true false false true true true true true true true true false IN X CRAIG J JONES 3179634842 950 N MERIDIAN ST STE 300 INDIANAPOLIS IN 46204 X Michelle A Janney RN Director (Part Year) 2.0 53.0 X 0 1285983 23935 MATTHEW R COOK DIRECTOR 2.0 53.0 X 0 884838 150078 Elizabeth Dunlap Director (Part Year) 2.0 53.0 X 0 817175 139814 KENNETH D PUCKETT Dir/PRES. - Indy Suburban Reg 10.0 45.0 X X 0 749896 145910 David A Ingram MD Director (Part Year) 2.0 53.0 X 0 780543 107628 KEVIN L SMITH MD DIRECTOR 2.0 53.0 X 0 520724 12547 Harpreetinder Singh M VP & CMO West Hospital 45.0 10.0 X 400241 35030 43378 MEGAN CRITTENDON MD DIRECTOR 2.0 53.0 X 0 374099 11362 ARTHUR VASQUEZ Pres West (Part Year)/ COO ISR 10.0 45.0 X 316788 0 48361 CARA L BREIDSTER CFO - Indy Suburban Region 10.0 45.0 X 0 321380 41748 DEREK E EMPIE SECRETARY 5.0 50.0 X 0 268310 45345 MATTHEW D BAILEY FORMER Officer 0.0 0.0 X 0 290903 0 LISA A SPARKS RN CNO - Indy Suburban Region 10.0 45.0 X 231548 0 43717 TAMARAH D BROWNLEE VP-HR - Indy Suburban Region 10.0 45.0 X 0 192896 40664 JAMES R BILLMAN PHARMACIST 40.0 0.0 X 192203 0 29642 PAMELA CHAPMAN Former Key Employee 0.0 55.0 X 0 171551 42426 ANNE K STEGEMOLLER DIRECTOR - PHARMACY 40.0 0.0 X 168159 0 40335 Anne Fara-Erny ACNO-IUH West/DIR-CE (PART YR) 40.0 0.0 X 48064 110790 34401 KAPRI D AMES ASSOC CNO (PART YEAR) 40.0 0.0 X 149567 0 30115 Eric D Peak Senior Pharmacist 40.0 0.0 X 155864 0 17632 ROBERT E EVARD MD DIRECTOR 2.0 12.0 X 0 79612 0 JAY L HESS MD DIRECTOR 1.0 7.0 X 0 44000 0 CHARLES E SCHALLIOL Director 2.0 2.0 X 0 18750 0 CLAUDIA J SOMES MD DIRECTOR 2.0 2.0 X 0 14375 0 PAUL IVKOVICH President - IUH West (PART YR) 55.0 0.0 X 0 8078 0 MARSHA A STONE DIRECTOR/CHAIRMAN 2.0 2.0 X X 8000 0 0 MARK R BENSON DO DIRECTOR 2.0 2.0 X 7000 0 0 MICHELE M KAWIECKI DIRECTOR 2.0 2.0 X 0 6500 0 REV KAREN E DEVAISHE DIRECTOR (Part Year) 2.0 2.0 X 3500 0 0 JOHN D GOLDENBERG M DIRECTOR 2.0 2.0 X 0 3000 0 CINDA L KELLEY DIRECTOR (Part Year) 2.0 0.0 X 750 0 0 Jill McCrory Director (Part Year) 2.0 0.0 X 750 0 0 1662434 6968933 1049038 48 true true false ARAMARK HEALTHCARE MANAGEMENT SERVI 2300 WARRENVILLE RD DOWNERS GROVE IL 60515 FACILITIES 3291571 Ermco Inc 1625 Thompson Rd INDIANAPOLIS IN 46217 Maintenance 532428 TRIMEDX LLC 5451 LAKEVIEW PKWY S DR INDIANAPOLIS IN 46268 CLINICAL ENGINEERING 1308432 Turner Construction Company 55 E Monroe Suite 1430 CHICAGO IL 60603 Construction 25590241 United Hospital Services LLC 9948 PARK DAVIS DR INDIANAPOLIS IN 462352394 Laundry 447174 19 98500 0 98500 NET PATIENT SERVICE REVENUE 622110 248438240 248438240 SHARED SERVICES 541900 375243 375243 RENT FROM RELATED 501(C)(3) ORGS. 532000 716770 716770 249530253 11004098 11004098 0 0 302414 225123 77291 0 77291 77291 127618 127618 127618 127618 0 0 0 0 0 0 0 0 0 CAFETERIA/FOOD SERVICE 721110 1065866 1065866 GIFT SHOP 453220 332855 332855 TELEPHONE 517000 99486 99486 580407 580407 2078614 262916374 249530253 13287621 X 30000 30000 0 0 0 1100541 1000658 99883 0 0 50851987 46236742 4615245 0 1824024 1658479 165545 0 7072210 6430348 641862 0 3690882 3355903 334979 0 0 0 2518 0 2518 0 1018 0 1018 0 0 0 54313242 27668158 26645084 324894 312566 12328 0 566855 458577 108278 0 156313 113885 42428 0 0 3583407 3196662 386745 0 53693 23896 29797 0 0 28804 5975 22829 0 5334634 5334634 0 0 0 8511745 7341775 1169970 0 1328059 315259 1012800 0 DRUGS AND MEDICAL SUPPLIES 27626196 27626196 BAD DEBT 17815476 17815476 HOSPITAL ASSESSMENT FEE 13206414 13206414 INSTITUTIONAL DUES/LICENSES 113570 113570 2440088 2167089 272999 199976570 164412262 35564308 0 0 0 391044274 424586518 0 0 30077475 26180609 0 0 0 0 792506 0 1420805 1330092 761440 897837 238751533 102644772 97342431 136106761 0 0 0 0 0 0 0 0 0 0 521438931 589101817 15072181 24135388 0 0 131478 7290 0 0 0 0 0 0 0 0 0 0 105311644 101120660 120515303 125263338 X 400923628 463838479 0 0 400923628 463838479 521438931 589101817 X 62939804 -24953 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1018 1018 false Schedule C, Part II-B, Lines 1i - Other Activities IU Health West Hospital paid institutional membership dues to the Indiana Hospital Association ("IHA") during 2019 in the amount of $15,589. Each membership organization notified IU Health West Hospital that a portion of the dues it paid were used for lobbying purposes. The IHA used 6.53%, or $1,018 of the 2019 membership dues paid by IU Health West Hospital, for lobbying expenditures. The total membership dues paid to this organization by IU Health West Hospital during 2019 that were attributable to lobbying expenditures was $1,018. 107710384 41449596 66260788 1188608 823720 364888 71252565 54704069 16548496 58599976 5667387 52932589 136106761 0 INTERCOMPANY PAYABLES (NET) 99173892 DUE TO THIRD-PARTY PAYERS 1720868 SELF-INSURANCE LIABILITIES 225900 101120660 X Schedule D, Part X, Line 2 - FIN 48 (ASC 740) Footnote IU Health West Hospital is a subsidiary in Indiana University Health, Inc.'s ("IU Health") Consolidated Audited Financial Statements. The Internal Revenue Service (IRS) has determined that Indiana University Health and certain of its affiliated entities are tax-exempt organizations as defined in Section 501(c)(3) of the Internal Revenue Code (IRC). Indiana University Health and its tax-exempt affiliates are, however, subject to federal and state income taxes on unrelated business income under the provisions of IRC Section 511. The Tax Cuts and Jobs Act (TCJA) was enacted on December 22, 2017. For tax-exempt entities, TCJA requires organizations to pay an excise tax on compensation above certain thresholds and record income or losses for tax determination purposes from unrelated business activities on an activity-by-activity basis, among other provisions. Proposed regulations and interim guidance, necessary for implementation, have been issued on most aspects of TCJA. It is expected that proposed regulations will be issued as final regulations by the IRS in 2020. As of and for the year ended December 31, 2019, Indiana University Health has made reasonable estimates of the provision for income taxes, the compensation excise tax, and the effects, if any, on existing deferred tax balances. Indiana University Health will continue to refine its calculations in future periods, as additional regulations and guidance are issued by the IRS. Deferred income taxes that, as of December 31, 2019 and 2018, have no net carrying value reflect the net tax effect of temporary differences between the carrying amounts of assets and liabilities for financial reporting and the amounts used for income tax purposes. As of December 31, 2019 and 2018, the Indiana University Health System had gross deferred tax assets of $143,157,000 and $119,965,000 respectively, primarily relating to net operating loss carryovers. Management determined that a full valuation allowance at December 31, 2019 and 2018, was necessary to reduce the deferred tax assets to the amount that would more likely than not be realized. Based on the weight of the evidence, if it is more likely than not that some portion or all of the deferred tax assets will not be realized, a valuation allowance to reduce the deferred tax assets is recorded. The change in the valuation allowance for the current year is $23,192,000. At December 31, 2019, the Indiana University Health System has available net operating loss carryforwards of $575,596,000. Net operating losses generated from 1999 through 2017 will expire between 2020 and 2037. Net operating losses generated after 2017 do not expire. Certain subsidiaries of Indiana University Health are taxable entities. The tax expense and liabilities of these subsidiaries are not material to the consolidated financial statements. true true X true X false true true false true true 4127 3612522 0 3612522 0.01980 6574 35459025 20908144 14550881 0.07990 0 0 0 0 0.00000 10701 39071547 20908144 18163403 0.09970 7 3156 1460879 0 1460879 0.00800 2 219 156033 0 156033 0.00090 1 0 323009 91346 231663 0.00130 0 0 0 0 0.00000 2 9162 126861 0 126861 0.00070 12 12537 2066782 91346 1975436 0.01090 12 23238 41138329 20999490 20138839 0.11060 0 0 0 0 0.00000 0 0 0 0 0.00000 2 61 16000 0 16000 0.00010 0 0 0 0 0.00000 0 0 0 0 0.00000 0 0 0 0 0.00000 1 51 192 0 192 0.00000 0 0 0 0 0.00000 0 0 0 0 0.00000 3 112 16192 0 16192 0.00010 false 3352873 0 38334546 42641302 -4306756 X true true 1 1 IU HEALTH WEST HOSPITAL 1111 N RONALD REAGAN PKWY AVON IN 46123 SEE PART V, SECTION C 20-003776-1 X X X X IU HEALTH WEST HOSPITAL 1 false false true X X X X X X X X X 18 true false false true X SEE PART V, SECTION C true 19 true SEE PART V, SECTION C false true X 200. 0. X X X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section A, Line 1 Primary Website Address https://iuhealth.org/find-locations/iu-health-west-hospital Schedule H, Part V, Section B, Line 3e Prioritized Health Needs IU HEALTH WEST HOSPITAL'S 2018 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT INCLUDES A PRIORITIZED DESCRIPTION OF SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY. THE CHNA REPORT IDENTIFIED THE FOLLOWING SEVEN NEEDS AS PRIORITIES FOR IU HEALTH WEST HOSPITAL: - Access to Health Care Services - Drug and Substance Abuse - Food Insecurity - Mental Health - Obesity and Diabetes - Smoking and Tobacco Usage - Social Determinants of Health Schedule H, Part V, Section B, Line 5 Input from Community In conducting its most recent Community Health Needs Assessment ("CHNA") IU Health West Hospital took into account input from persons who represent the broad interests of the communities it serves. Primary data were gathered in three different methodologies for this assessment: Community Meetings, Key Stakeholder Interviews, and a Community Survey. For purposes of this CHNA, IU Health West Hospital's community is defined as Hendricks and Marion Counties, Indiana. These two counties accounted for 87.8 percent of the hospital's inpatient cases in 2016. Community Meetings - Hendricks County On July 24, 2018, a meeting of community representatives was held at the IU Health West Hospital in Avon, which is part of Hendricks County. The meeting was attended by 15 community members invited by IU Health because they represent important community organizations and sectors such as: local health departments, police/fire departments, non-profit organizations, business community, health care providers, local policymakers, faith-based organizations, and schools. Through this meeting, IU Health sought a breadth of perspectives on the community's health needs. The specific organizations represented at the meeting are listed below. - American Lung Association - Avon Community School Corporation - Avon Washington Township Fire Department - Franciscan Alliance - HOPE Healthcare Services - Hendricks County Health Department - Hendricks County Senior Services - Hendricks County Substance Abuse Task Force - Hendricks County Tobacco Coalition - Hendricks Regional Health - IU Health West Hospital - Kids Count - Mental Health American Hendricks County - Susie's Place The meeting was requested by IU Health to obtain community input into the community's health needs. The session began with a presentation that discussed the goals and status of the CHNA process and the purpose of the community meeting. Then, secondary data were presented, along with a summary of the most "unfavorable" community health indicators. For Hendricks County those indicators were (in alphabetical order): - Access to healthy food - Air pollution - Crime (violent crime) - Excessive drinking - Mental health and supply of mental health providers - Obesity and lack of physical activity Participants then were asked to discuss whether the identified, unfavorable indicators accurately identified the most significant community health issues and were encouraged to add issues that they believed were significant. Several issues were added, such as: tobacco use, low income housing, access to affordable healthcare, adverse childhood events, and aging population. Air pollution was removed from the list, and the excessive drinking line item was amended to include substance abuse. During the meeting, a range of other topics was discussed, including: - Poverty rate numbers and relationship to 'ALICE' data - Immigrants in the community and representation in data - Western part of Hendricks County where food deserts are a bigger issue that didn't seem to come through in secondary data - Social associations data compared to abundance of churches and civic clubs in Hendricks County - Mental health services issues facing the sheriff's department/jail population - Low numbers of providers compared to the population and low number of providers who have spots available for Medicaid patients - Vaping - Trauma in childhood as a leading indicator of many of the adult issues discussed - Challenge of finding affordable housing After discussing the needs identified through secondary data and adding others to the list, each participant was asked to identify "three" that are most significant. From this process, the group identified the following needs as most significant in Hendricks County: - Mental health and supply of mental health providers - Access to affordable healthcare - Adverse childhood events - Tobacco use - Tied for fifth: Access to healthy food, excessive drinking & substance abuse, and aging population Interviews - Hendricks County An interview was also conducted with a representative of the Hendricks county health department. The interview was conducted to assure that appropriate and additional input was received from governmental public health officials. The results of the community meetings were discussed and insights were sought regarding significant community health needs, why such needs are present, and how they can be addressed. The interview was guided by a structured protocol. The interview was guided by a structured protocol that focused on opinions regarding significant community health needs, describing why such needs are present, and seeking ideas for how to address them. The interviewee confirmed that the needs identified by the community meeting participants were significant. These needs were: - Mental health and supply of mental health providers - Access to affordable healthcare - Adverse childhood events There is a lack of mental and behavioral health providers, including psychiatrists, substance abuse specialists, inpatient care, and others. It is often difficult to locate resources for those with substance abuse issues or suicidal ideations. In general, there is an undersupply of providers in the county, and more programs may be needed to incentivize providers to practice locally. Access to affordable care is an issue, especially with a recent closure of a facility that provided services for lower-income residents. Low income populations and those that do not receive healthcare benefits through their employers are disproportionately affected. The need for affordable primary care also generates a need for more preventive health care and screenings, as many residents do not go to a provider unless an emergency situation occurs. Substance abuse and drug addiction is a major concern, particularly around opioids. Availability of opioids is high and the cost of these drugs has decreased, leading to increased usage. Additionally, pill abuse is also rising as it is often easy to get a prescription for an opioid. Pain management treatment in general is difficult to access in the county. Obesity and physical inactivity are concerns in the community. Certain areas of the county do not live close to stores selling healthy foods, so often go to fast food instead. Additionally, sidewalks and other healthy-living infrastructure are in short supply. Obesity is also leading to chronic issues as the population ages, including bad knees, bad backs, diabetes, hypertension, and other conditions. Housing is a concern in the community, particularly affordable housing for low income residents. Current rental units can be unclean, and environmental health issues are common. More resources are needed for public health programming, as there are fewer low income clinics, staffing issues exist, and programs are not as widely disseminated as possible. Community Meetings - Marion County Between May 7 and 9, 2018, three meetings of community representatives were held in Indianapolis, the county seat of Marion County. In total, the meetings were attended by 42 community members invited by IU Health because they represent important community organizations and sectors such as: local health departments, police/fire departments, non-profit organizations, local business, health care providers, mayors/local policymakers, faith-based organizations, parks and recreation departments, and schools. Through the meetings, IU Health sought a breadth of perspectives on the community's health needs. The specific organizations represented at the meetings are listed below. - Adult and Child Health - All Senior Citizens Connect - Central Indiana Council on Aging (CICOA) - City of Indianapolis - Coburn Place - Community Health Network - Gennesaret Free Clinics - Gleaners Food Bank - Health by Design - IU Health Methodist Hospital - IU Health University Hospital - Indiana Youth Institute - Indianapolis Fire Department - Indianapolis Metropolitan Police Department - Indy Hunger Network - Indianapolis Parks and Recreation - Irvington Development Organization - Jump IN for Healthy Kids - Lawrence Community Gardens - Marion County Public Health Department - New Beginnings Church - Paramount Schools of Excellence - Progress House - Purdue Extension - The Polis Center - University of Indianapolis The meeting began with a presentation that discussed the goals and status of the CHNA process and the purpose of the community meetings. Then, secondary data were presented, along with a summary of the most unfavorable community health indicators. For Marion County, those indicators were (in alphabetical order): - Air pollution - Communicable diseases and STDs - Crime - Mental health and supply of mental health providers - Obesity and lack of physical activity - Poverty and high 'Community Need Index' - Smoking and tobacco use Meeting participants then were asked to discuss whether the identified, unfavorable indicators accurately identified the mos Schedule H, Part V, Section B, Line 7a CHNA Website A COPY OF IU HEALTH WEST HOSPITAL'S CHNA IS AVAILABLE ON ITS WEBSITE AT THE FOLLOWING URL: https://iuhealth.org/in-the-community/community-benefit Schedule H, Part V, Section B, Line 10a Implementation Strategy Website A COPY OF IU HEALTH WEST HOSPITAL'S CHNA IMPLEMENTATION STRATEGY IS AVAILABLE ON ITS WEBSITE AT THE FOLLOWING URL: https://iuhealth.org/in-the-community/community-benefit Schedule H, Part V, Section B, Line 11 Addressing Identified Needs In conjunction with the CHNA, IU Health West Hospital's Board adopted an implementation strategy in April 2019 related to the 2018 CHNA. IU Health West Hospital prioritized and determined which of the community health needs identified in its most recently conducted CHNA were most critical for it to address. IU Health West Hospital will address the following community health needs between 2019 and 2021: - Access to Healthcare Services - Drug and Substance Abuse (including Opioids and Alcohol) - Food Insecurity - Mental Health - Obesity and Diabetes - Smoking and Tobacco Usage - Social Determinants of Health IU Health uses the term "Behavioral Health" to refer to Mental Health and Drug and Substance Abuse (including Opioids and Alcohol). Access to Healthcare IU Health West Hospital's implementation strategy to address the identified need of Access to Healthcare includes the following: - Provide operational funding to support HOPE Healthcare Services. - In 2019, IU Health West provided assistance to HOPE Healthcare Services to support healthcare services for UN- and under - insured patients in Hendricks County and the surrounding areas. - Participate in or support 4-6 Healthy Indiana Plan (HIP)/Medicaid/Medicare registration events with the Hendricks County Health Partnership. - In 2019, a coalition within the Hendricks County Health Partnership organized and hosted a live Q&A session for insurance providers related to helping patients navigate the insurance system. Attendance was light, so the strategy is being reviewed. Behavioral Health (includes Drug & Substance Abuse and Mental Health) IU Health West Hospital's implementation strategy to address the identified need of Behavioral Health includes the following: - Partner with the Hendricks County Health Partnership to create a three-minute education video for student athletes. - In 2019, the student video was viewed online by a 506 people. The parent/coach/athletic trainer video was viewed online by all 50 Hendricks County school athletic trainers and by an additional 211 community members. - Partner with the Hendricks County Health Partnership to create a three-minute education video for providers and parents. - Partner with the Hendricks County Health Partnership to host public forums about the stigma of substance use disorders. Include live testimonials from individuals with substance use disorders (SUD). - Provide funding to support safe shelter for and evaluation of Sheltering Wings residents. - In 2019, IU Health West provided support to Sheltering Wings. With this support, Sheltering Wings was able to provide safe housing for 296 residents, answer 1,499 help line calls, and educate 16,398 victims. - Support Sheltering Wings educational outreach efforts. - Provide funding to support counseling for Susie's Place clients. - IU Health West provided support to Susie's Place, which saw 486 total cases (spanning the counties of Hendricks, Morgan, Putnam, and Shelby), up slightly from 2018's 477 cases. During 2019 the Family Advocate made 248 counseling/therapy referrals in Hendricks County as compared to 231 referrals made in 2018. - Replicate the Academic Health Center's successful Addictions and Pain Management Program in the IU Health West service area. - In 2019, an addictions center was opened at IU Health West, and 24/7 peer counseling via telemedicine was made available for patients who present in the emergency department (ED) with substance use disorders (SUD). - Provide 24/7 peer counseling via telemedicine for patients who present in the emergency department (ED) with substance use disorders (SUD). Food Insecurity IU Health West Hospital's implementation strategy to address the identified need of Food Insecurity includes the following: - Make fresh produce affordable and accessible to low-income residents. - In 2019, the Brownsburg Farmer's Market saw attendance of 500 people per market, a significant increase over 2018 attendance. - Support Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP) acceptance at all county farmers' markets. - Fund Double Up Bucks program to increase value of vouchers for participants. - IU Health West funded the Double Up Bucks program in 2019 to provide more farmers market spendable dollars to those in need. Obesity and Diabetes IU Health West Hospital's implementation strategy to address the identified need of Obesity and Diabetes include the following: - Continue current partnership with Brownsburg Farmers' Market. - Utilize bushel builders cards to encourage regular attendance. - In 2019, 580 bushel-builders cards were distributed to market attendees during the month of June, and 76 were completed and returned at the close of the market in September. - Provide 50 Hendricks County residents with a free 10-week program to improve their overall health through fitness and nutrition. - In, 2019, 30 of the 50 participants completed the 10-week program and reported a variety of successes from weight loss to improved cholesterol and A1C levels as well as reduced joint pain and a reduction in necessary medications. - Provide three health screenings during the 10-week period to measure changes in cholesterol, triglycerides, glucose, A1C, blood pressure, weight and Body Mass Index (BMI). - Support state grant to fund ten mile section of trail expansion. - Fund a 5K event and offer prep/training tips to encourage new walkers and runners. - Partner with the Brownsburg Parks & Recreation to make improvements to local parks, thus encouraging greater physical activity in the parks by Hendricks County residents and visitors. - In 2019 during the IU Health annual Days of Service, 77 IU Health West team members participated in projects at Arbuckle Park and the Green Street pathway and shelter. Smoking and Tobacco Usage IU Health West Hospital's implementation strategy to address the identified need of Smoking and Tobacco Usage include the following: - Collaborate with the Hendricks County Health Partnership to present a template of a comprehensive smoke-free workplace policy to the Town of Brownsburg. - Collaborate with the Hendricks County Health Partnership to reinitiate contact with school administrators and guidance counselors to ensure educational posters are displayed in schools. - In 2019, IU Health West provided assistance to the Hendricks County Health Partnership to support its work, including efforts to decrease smoking and tobacco usage. - Write and distribute press release about student outreach program. - Encourage school administrators to send educational material to all parents. Social Determinants of Health IU Health West Hospital's implementation strategy to address the identified need of Social Determinants of Health include the following: - Provide operational funding to support HOPE Healthcare Services. - In 2019, IU Health West provided assistance to HOPE Healthcare Services to support healthcare services for UN- and under - insured patients in Hendricks County and the surrounding areas. - Make fresh produce affordable and accessible to low-income residents. - Support Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP) acceptance at all county farmers' markets. - In 2019, the Brownsburg Farmer's Market saw attendance of 500 people per market, a significant increase over 2018 attendance. IU Health West also funded the Double Up Bucks program in 2019 to provide more farmers market spendable dollars to those in need. - Fund Double Up Bucks program to increase value of vouchers for participants. - Support state grant to fund ten mile section of trail expansion. - Fund a 5K event and offer prep/training tips to encourage new walkers and runners. - Partner with the Brownsburg Parks & Recreation to make improvements to local parks, thus encouraging greater physical activity in the parks by Hendricks County residents and visitors. IU West Hospital will address all community health needs based on their 2018 Community Health Needs Assessment. There were no identified needs that will not be addressed. Schedule H, Part V, Section B, Line 13b Income Level Other than FPG IN ADDITION TO FPG, IU HEALTH WEST HOSPITAL MAY TAKE INTO CONSIDERATION A PATIENT'S INCOME AND/OR ABILITY TO PAY IN CALCULATION OF A FINANCIAL ASSISTANCE AWARD. Schedule H, Part V, Section B, Line 13h Other FAP Factors IU Health West Hospital takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. IU Healths Individual Solutions Department Prior to seeking Financial Assistance under the FAP, all patients or their guarantors must consult with a member of IU Healths Individual Solutions department to determine if healthcare coverage may be obtained from a government insurance/assistance product or from the Health Insurance Exchange Marketplace. 2. Alternate Sources of Assistance When technically feasible, a patient will exhaust all other state and federal assistance programs prior to receiving an award from IU Health West Hospitals Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowners, must exhaust all insurance benefits prior to receiving an award from IU Health West Hospitals Financial Assistance Program. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. Patients may be asked to show proof that such a claim was properly submitted to the proper insurance provider at the request of IU Health West Hospital. Eligible patients who receive medical care from IU Health West Hospital as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award to which IU Health West Hospital is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health West Hospital reserves the right to reverse the award in an amount equal to the amount IU Health West Hospital would be entitled to receive had no Financial Assistance been awarded. 3. Alternate Methods of Eligibility Determination IU Health West Hospital will conduct a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an Extraordinary Collection Action ("ECA"). Said accounts may be eligible for assistance under the FAP based on the patients individual scoring criteria. To ensure all patients potentially eligible for Financial Assistance under the FAP may receive Financial Assistance, IU Health West Hospital will deem patients/guarantors to be presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied his/her required co-pay/deductible: - Indiana Childrens Special Health Care Services - Medicaid - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level 4. Additional Considerations Financial Assistance may be granted to a deceased patients account if said patient is found to have no estate. Additionally, IU Health West Hospital will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance application. 5. Non-Emergent Services Down Payment Uninsured Patients presenting for scheduled or other non-emergent services will not be charged more than the Amounts Generally Billed ("AGB") AGB for their services. Patients will receive an estimated AGB cost of their care prior to IU Health West Hospital rendering the services and will be asked to pay a down-payment percentage of the AGB adjusted cost prior to receiving services. In the event a patient is unable to fulfill the down-payment, their service may be rescheduled for a later date as medically prudent and in accordance with all applicable federal and state laws and/or regulations. 6. Emergency Services Non-Refundable Deposit This section will be implemented with a strict adherence to EMTALA and IU Health Policy ADM 1.32, Screening and Transfer of Emergency or Unstable Patients. Amount of Non-Refundable Deposit All Uninsured Patients presenting for services at IU Health West Hospitals Emergency Department, via transfer from another hospital facility, or direct admission, will be responsible for a one-hundred dollar ($100.00) non-refundable deposit for services rendered. Patients/guarantors will be responsible for any copays and/or deductibles required by their plan prior to full Financial Assistance being applied. Uninsured Patients wishing to make an application for Financial Assistance greater than the AGB must fulfill their non-refundable deposit prior to IU Health West Hospital processing said application. Uninsured Patients making payments toward their outstanding non-refundable deposit balance will have said payments applied to their oldest application on file, if applicable. Schedule H, Part V, Section B, Line 16a FAP Website A copy of IU Health West Hospital's FAP is available on the following website: https://iuhealth.org/pay-a-bill/financial-assistance Schedule H, Part V, Section B, Line 16b FAP Application Website A copy of IU Health West Hospital's FAP Application is available on the following website: https://iuhealth.org/pay-a-bill/financial-assistance Schedule H, Part V, Section B, Line 16c FAP PLS Website A plain language summary of the FAP, including translated copies, is available on the following website: https://iuhealth.org/pay-a-bill/financial-assistance Schedule H, Part V, Section B, Line 16j Other Measures to Publicize IU Health West Hospital takes several other measures to publicize its FAP within the community. These measures include the following: 1. Conspicuous public displays will be posted in appropriate acute care settings such as the emergency department and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 2. IU Health West Hospital will include a conspicuous written notice on all patient billing statements that notifies the patient about the availability of this Policy, and the telephone number of its Customer Service Department which can assist patients with any questions they may have regarding this Policy. 3. IU Health Customer Service representatives will be available via telephone Monday through Friday, excluding major holidays, from 8:00 a.m. to 7:00 p.m. Eastern Time to address questions related to this Policy. 4. IU Health West Hospital will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health West Hospital will educate its patient facing team members of the FAP and the process for referring patients to the Program. Schedule H, Part I, Line 3c - Other Factors Used in Determining Elig. IU Health West Hospital uses several factors other than Federal Poverty Guidelines ("FPGs") in determining eligibility for free care under its FAP. These factors include the following: 1. Indiana Residency Requirement Financial Assistance will only be made available to residents of the State of Indiana and those eligible for assistance under 42 U.S.C.A. 1396b(v). IU Health West Hospital will employ the same residency test as set forth in Indiana Code 6-3-1-12 to define an Indiana resident. The term Resident includes any individual who was domiciled in Indiana during the taxable year, or any individual who maintains a permanent place of residence in Indiana and spends more than one hundred eight-three (183) days of the taxable year in Indiana. Patients residing in the state of Indiana while attending an institution of higher education may be eligible for assistance under the FAP if they meet the aforementioned residency test and are not claimed as a dependent on a parents or guardians federal income tax return. 2. IU Healths Individual Solutions Department Prior to seeking Financial Assistance under the FAP, all patients or their guarantors must consult with a member of IU Healths Individual Solutions department to determine if healthcare coverage may be obtained from a government insurance/assistance product or from the Health Insurance Exchange Marketplace. 3. Uninsured Patients All Uninsured Patients presenting for services at IU health West Hospital eligible under the FAP will not be charged more than the AGB as described in the FAP. 4. Services Rendered by Individual Providers The FAP does not cover services rendered by individual providers. A full listing of providers and services not covered by the FAP is available at https://iuhealth.org/pay-a-bill/financial-assistance and is updated on a quarterly basis. 5. Alternate Sources of Assistance When technically feasible, a patient will exhaust all other state and federal assistance programs prior to receiving an award from IU Health West Hospitals Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowners, must exhaust all insurance benefits prior to receiving an award from IU Health West Hospitals Financial Assistance Program. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. Patients may be asked to show proof that such a claim was properly submitted to the proper insurance provider at the request of IU Health West Hospital. Eligible patients who receive medical care from IU Health West Hospital as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award to which IU Health West Hospital is entitled. In the event a Financial Assistance Award has already been granted in such circumstances, IU Health West Hospital reserves the right to reverse the award in an amount equal to the amount IU Health West Hospital would be entitled to receive had no Financial Assistance been awarded. 6. Alternate Methods of Eligibility Determination IU Health West Hospital will conduct a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an ECA. Said accounts may be eligible for assistance under the FAP based on the patients individual scoring criteria. To ensure all patients potentially eligible for Financial Assistance under the FAP may receive Financial Assistance, IU Health West Hospital will deem patients/guarantors to be presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied his/her required co-pay/deductible: - Indiana Childrens Special Health Care Services - Medicaid - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level 7. Additional Considerations Financial Assistance may be granted to a deceased patients account if said patient is found to have no estate. Additionally, IU Health West Hospital will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance application. 8. Patient Assets IU Health West Hospital may consider patient/guarantor Assets in the calculation of a patient's true financial burden. A patient's/guarantor's primary residence and one (1) motor vehicle will be exempted from consideration in most cases. A patient's primary residence is defined as the patient's principal place of residence and will be excluded from a patient's extraordinary asset calculation so long as the patient's equity is less than five-hundred thousand dollars ($500,000) and the home is occupied by the patient/guarantor, patient's/guarantor's spouse or child under twenty-one (21) years of age. One (1) motor vehicle may be excluded as long as the patient's equity in the vehicle is less than fifty-thousand dollars ($50,000). IU Health West Hospital reserves the right to request a list of all property owned by the patient/guarantor and adjust a patient's award of Financial Assistance if the patient demonstrates a claim or clear title to any extraordinary Asset not excluded from consideration under the above guidance. 9. Non-Emergent Services Down Payment Uninsured Patients presenting for scheduled or other non-emergent services will not be charged more than the AGB for their services. Patients will receive an estimated AGB cost of their care prior to IU Health West Hospital rendering the services and will be asked to pay a down-payment percentage of the AGB adjusted cost prior to receiving services. In the event a patient is unable to fulfill the down-payment, their service may be rescheduled for a later date as medically prudent and in accordance with all applicable federal and state laws and/or regulations. 10. Emergency Services Non-Refundable Deposit This section will be implemented with a strict adherence to EMTALA and IU Health Policy ADM 1.32, Screening and Transfer of Emergency or Unstable Patients. Amount of Non-Refundable Deposit All Uninsured Patients presenting for services at IU Health West Hospitals Emergency Department, via transfer from another hospital facility, or direct admission, will be responsible for a one-hundred dollar ($100.00) non-refundable deposit for services rendered. Patients/guarantors will be responsible for any copays and/or deductibles required by their plan prior to full Financial Assistance being applied. Uninsured Patients wishing to make an application for Financial Assistance greater than the AGB must fulfill their non-refundable deposit prior to IU Health West Hospital processing said application. Uninsured Patients making payments toward their outstanding non-refundable deposit balance will have said payments applied to their oldest application on file, if applicable. Schedule H, Part I, Line 6a - C.B. Report Prepared by a Related Org. IU Health West Hospital's community benefit and other investments, encompassing its total community investment, are included in the IU Health Community Benefit Report which is prepared on behalf of and includes IU Health and its related hospital entities in the State of Indiana. The IU Health Community Benefit Report is made available to the public on IU Health's website at https://iuhealth.org/in-the-community/community-benefit. The IU Health Community Benefit Report is also distributed to numerous key organizations throughout the State of Indiana in order to broadly share the IU Health Statewide System's community benefit efforts. It is also available by request through the Indiana State Department of Health or IU Health. Schedule H, Part I, Line 7, Column (f) - Bad Debt Expense The amount of bad debt expense included on Form 990, Part IX, Line 25, column (A), but subtracted for purposes of calculating the percentage of total expense on Line 7, column (f) is $17,815,476. Bad debt expense is reported at cost based on the cost-to-charge ratio derived from worksheet 2, ratio of patient care cost-to-charges. Schedule H, Part I, Line 7 - Total Community Benefit Expense Schedule H, Part I, Line 7, Column (f), Percent of Total Expense, is based on column (e) Net Community Benefit Expense. The percent of total expense based on column (c) Total Community Benefit Expense, which does not include direct offsetting revenue, is 22.58%. Schedule H, Part I, Line 7G - Subsidized Health Services IU Health West does not include any costs associated with physician clinics as subsidized health services. Schedule H, Part II - Promotion of Health in Communities Served IU Health West participates in a variety of community-building activities that address the social determinants of health in the communities it serves. IU Health West and its related hospital entities across the state of Indiana ("IU Health statewide system") invest in economic development efforts across the state, collaborate with like-minded organizations through coalitions that address key issues, and advocate for improvements in the health status of vulnerable populations. This includes making contributions to community-building activities by providing investments and resources to local community initiatives that address issues, such as access to healthcare, community support and economic development. Several examples include IU Health West's support of the following organizations and initiatives that focus on some of the root causes of health issues, such as lack of education, insufficient access to resources, employment and poverty: - Hope Healthcare Services - Sheltering Wings - Avon and Brownsburg Education Foundations - Hendricks County Health Partnership - Susie's Place Additionally, through the IU Health statewide system's team member community benefit service program, "IU Health serves", team members across the state make a difference in the lives of thousands of Hoosiers every year. Schedule H, Part III, Line 2 - Methodology Used to Est. Bad Debt Exp. The amount reported on line 2 as bad debt is reported at cost, as calculated using the cost to charge ratio methodology. Schedule H, Part III, Line 3 - Bad Debt Attributable to Patients Eligible Under the Financial Assistance Policy An uninsured patient and/or guarantor who was admitted through an eligible facility's emergency department via a direct admission from a physician's office, or transfer from another hospital facility, and whose household income is less than or equal to 200% of the Federal Poverty Level may be eligible for full charity assistance after the successful completion of the Financial Assistance Application and satisfaction of his/her non-refundable deposit. To capture all patients who are potentially eligible for Financial Assistance under the IU Health Financial Assistance Policy, IU Health will deem patients/guarantors to be presumptively eligible for financial assistance if they are found to be eligible for one of the following programs, received emergency or direct admit care, and satisfied the required co-pay/deductible: 1. Indiana Children's Special Health Care Services 2. Medicaid 3. Healthy Indiana Plan 4. Patients who are awarded Hospital Presumptive Eligibility 5. Enrolled in a state and/or federal program that verifies the patient's gross household income is less than or equal to 200% of the Federal Poverty Level (FPL). IU Health also conducts a quarterly review of all accounts placed with a collection agency partner for a period of no less than one hundred and twenty (120) days after the account is eligible for an extraordinary collection actions. Said accounts may be eligible for assistance under the financial assistance policy based on the patient's individual scoring criteria and are not included in bad debt. Due to this comprehensive methodology, IU Health does not believe any amount of bad debt is attributable to patients who may be eligible under the Financial Assistance Policy and no portion of bad debt is included as community benefit. Schedule H, Part III, Line 4 - Bad Debt Expense IU Health's consolidated financial statements, Footnote 4, addresses bad debt expense as follows: The Indiana University Health System does not require collateral or other security from its patients, substantially all of whom are residents of the State, for the delivery of health care services. However, consistent with industry practice, the Indiana University Health System routinely obtains assignment of (or is otherwise entitled to receive) patients' benefits payable under their health insurance programs, plans, or policies (e.g., Medicare, Medicaid, managed care payers, and commercial insurance policies). The Indiana University Health System uses a portfolio approach to account for categories of patient contracts as a collective group, rather than recognizing revenue on an individual contract basis. The portfolios consist of major payer classes for inpatient revenue and outpatient revenue. Based on the historical collection trends and other analysis, the Indiana University Health System believes that revenue recognized by utilizing the portfolio approach approximates the revenue that would have been recognized if an individual contract approach were used. In support of its mission, the Indiana University Health System provides care to uninsured and underinsured patients. The Indiana University Health System provides charity care to patients who lack financial resources and are deemed to be medically indigent. Under its financial assistance policy, the Indiana University Health System provides medically necessary care to uninsured patients with inadequate financial resources at charitable discounts equivalent to the amounts generally billed, and it provides eligibility for full charity for emergent encounters for uninsured patients who earn less than 200% of the federal poverty level and who meet application criteria. Patients whose liability is deemed catastrophic relative to their annual household income are also eligible for reduced charges. Since the Indiana University Health System does not pursue collection of these amounts, the discounted amounts are not reported as patient service revenue. The Indiana University Health System uses presumptive eligibility screening procedures for free care and recognizes net patient service revenue on services provided to self-pay patients at the discounted rate at the time services are rendered. The estimated cost of charity care, using the consolidated cost to charge ratio, was $96,693,000 and $94,886,000 in 2019 and 2018, respectively. Schedule H, Part III, Line 8 - Medicare Shortfall The amount reported on Schedule H, Part III, Line 6 is calculated, in accordance with the Form 990 instructions, using "allowable costs" from the IU Health West Hospital Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health West Hospital's participation in Medicare programs. For example, the Medicare Cost Report excludes certain costs such as billed physician services, the costs of Medicare Parts C and D, fee schedule reimbursed services, and durable medical equipment services. Inclusion of all costs associated with IU Health West's participation in Medicare programs would significantly increase the Medicare shortfall reported on Schedule H, Part III, Line 7. IU Health West Hospital's Medicare shortfall is attributable to reimbursements that are less than the cost of providing patient care and services to Medicare beneficiaries and does not include any amounts that result from inefficiencies or poor management. IU Health West Hospital accepts all Medicare patients knowing that there may be shortfalls; therefore it has taken the position that any shortfall should be counted as part of its community benefit. Additionally, it is implied in Internal Revenue Service Revenue Ruling 69-545 that treating Medicare patients is a community benefit. Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with governmental health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. Schedule H, Part III, Line 9b - Written Debt Collection Policy IU Health West Hospitals FAP and Written Debt Collection Policy describe the collection practices applicable to patients, including those who may qualify for financial assistance. 1. Financial Assistance Application Patients or their guarantors wishing to apply for Financial Assistance are encouraged to submit a Financial Assistance Application within ninety (90) days of their discharge. Patients or their guarantors may submit an application up to two-hundred and forty (240) days from the date of their first billing statement from IU Health, however, accounts may be subject to ECA as soon as one hundred and twenty (120) days after having received their first billing statement. Patients or their guarantors submitting an incomplete application will receive written notification of the applications deficiency upon discovery by IU health. The application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health will suspend any ECA until the application is complete, or the patient fails to cure any deficiencies in their application in the allotted period. Patients with limited English proficiency may request to have a copy of the FAP, a FAP Application, and FAP Plain Language Summary in one of the below languages: - Arabic - Burmese - Burmese-Falam - Burmese-Hakha Chin - Mandarin/Chinese - Spanish The patient, and/or their representative, such as the patients physician, family members, legal counsel, community or religious groups, social services or hospital personnel may request a FAP Application to be mailed to a patients primary mailing address free of charge. IU Health West Hospital keeps all applications and supporting documentation confidential. Patients applying for assistance under the FAP will be required to complete a Financial Assistance Application. Patients must include the following documentation with their Financial Assistance Application: - All sources of Income for the last three (3) months; - Most recent three (3) months of pay stubs or Supplemental Security Income via Social Security; - Most recent three (3) statements from checking and savings accounts, certificates of deposit, stocks, bonds and money market accounts; - Most recent state and Federal Income Tax forms including schedules C, D, E, and F. In the event a patients and/or guarantors income does not warrant the filing of a federal tax return, the patient may submit a notarized affidavit attesting to the foregoing; - Most recent W-2 statement; - For patients or members of the Household who are currently unemployed, Wage Inquiry from WorkOne; and - If applicable, divorce/dissolution decrees and child custody order 2. Eligibility Determination IU Health West Hospital will inform patients or guarantors of the results of their application by providing the patient or guarantor with a Financial Assistance Determination within ninety (90) days of receiving a completed Application and all requested documentation. If a patient or guarantor is granted less than full charity assistance and the patient or guarantor provides additional information for reconsideration, IU Health Revenue Cycle Services may amend a prior Financial Assistance Determination. If a patient or guarantor seeks to appeal the Financial Assistance Determination further, a written request must be submitted, along with the supporting documentation, to the Financial Assistance Committee for additional review/reconsideration. All decisions of the Financial Assistance Committee are final. A patients Financial Assistance Application and eligibility determination are specific to each individual date(s) of service and related encounters. 3. Extraordinary Collection Actions IU Health West Hospital may refer delinquent patient accounts to a third-party collection agency after utilizing reasonable efforts to determine a patients eligibility for assistance under the FAP. IU Health West Hospital and its third-party collection agencies may initiate ECA against a patient or their guarantor in accordance with this Policy and 26 C.F.R. 1.501(r). Said ECA may include the following: - Selling a patients or their guarantors outstanding financial responsibility to a third party. - Reporting adverse information about the patient or their guarantor to consumer credit reporting agencies or credit bureaus. - Deferring or denying, or requiring a payment before providing, medically necessary care because of a patients or their guarantors nonpayment of one or more bills for previously provided care covered under the FAP. - Actions requiring a legal or judicial process, including but not limited to placing a lien on patients or their guarantors property, foreclosing on a patients or their guarantors real property attaching or seizing a patients or their guarantors bank account or other personal property, commencing a civil action against a patient or their guarantor, causing a patient or guarantors arrest, causing a patient and/or guarantor to be subject to a writ of body attachment, and garnishing a patient or guarantors wages. When it is necessary to engage in such action, IU Health West Hospital and its third party collection agencies, will engage in fair, respectful and transparent collections activities. Patients or guarantors currently subject to an ECA who have not previously applied for Financial Assistance may apply for assistance up to two-hundred and forty (240) days of the date of their first billing statement from IU Health West Hospital. IU Health West Hospital and their third-party collection agencies will suspend any ECA engaged on a patient or their guarantor while an Application is being processed and considered. 4. Refunds Patients eligible for assistance under the FAP who remitted payment to IU Health West Hospital in excess of their patient responsibility will be alerted to the overpayment as promptly after discovery as is reasonable given the nature of the overpayment. Patients with an outstanding account balance on a separate account not eligible for assistance under the FAP will have their refund applied to the outstanding balance. Patients without an outstanding account balance described above will be issued a refund check for their overpayment as soon as technically feasible. Schedule H, Part VI, Line 2 - Needs Assessment Communities are multifaceted and so are their health needs. IU Health West Hospital understands that the health of individuals and communities are shaped by various social and environmental factors, along with health behaviors and additional influences. IU Health West Hospital assesses the health care needs of the communities it serves by conducting a Community Health Needs Assessment (CHNA). For the 2018 CHNA, IU Health West Hospital conducted the community survey data collection in collaboration with Indiana University, University of Evansville and an Indiana Hospital Collaborative, including Community Health Network, Franciscan Alliance, St. Vincent Health and other hospital partners. After completion of the CHNA, IU Health West Hospital reviewed secondary data, findings from other community health assessments of areas served by the hospital, input obtained from individuals who participated in community meetings, input obtained from key stakeholders, and a community survey to identify and analyze the needs identified by each source. The top health needs of the IU Health West Hospital community are those that are supported by multiple data sources. Additionally, the effectiveness of an intervention for each need and IU Health's ability to impact positive change was evaluated. IU Health West Hospital believes its CHNA process is comprehensive and additional assessments are not required. Schedule H, Part VI, Line 3 - Patient Education of Eligibility for Assist. IU Health West Hospital is committed to serving the healthcare needs of all of its patients regardless of their ability to pay for such services. To assist in meeting those needs, IU Health West Hospital has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health West Hospital is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health West Hospital will make a good faith effort to locate and obtain health insurance coverage for patients prior to considering patients for coverage under the FAP. IU Health West Hospital takes several measures to inform its patients of the FAP and FAP-eligibility. These measures include the following: 1. Conspicuous public displays will be posted in appropriate acute care settings such as the emergency department and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 2. IU Health West Hospital will include a conspicuous written notice on all patient billing statements that notifies the patient about the availability of this Policy, and the telephone number of its Customer Service Department which can assist patients with any questions they may have regarding this Policy. 3. IU Health Customer Service representatives will be available via telephone Monday through Friday, excluding major holidays, from 8:00 a.m. to 7:00 p.m. Eastern Time to address questions related to this Policy. 4. IU Health West Hospital will broadly communicate this Policy as part of its general outreach efforts. 5. IU Health West Hospital will educate its patient facing team members of the FAP and the process for referring patients to the Program. Schedule H, Part VI, Line 4 - Community Information IU Health West Hospital is located in Hendricks County, Indiana, a county located in central Indiana. Based on the most recent Census Bureau (2019) statistics, Hendricks County's population is 170,311 persons with approximately 50% being female and 50% male. The county's population estimates by race are 82.9% White, 7.8% Black, 4.3% Hispanic or Latino, 3.1% Asian, 0.3% American Indian or Alaska Native, 0.1% Native Hawaiian or Other Pacific Islander and 2.1% persons reporting two or more races. Hendricks County has relatively moderate levels of educational attainment. Among adults 25 and above, 93.4% completed their education with a high school diploma or equivalent. 36.3% had a bachelor's degree or higher. About 7% ended their formal education before finishing high school. Schedule H, Part VI, Line 5 - Promotion of Community Health IU Health West Hospital is a subsidiary of Indiana University Health, Inc., a tax-exempt healthcare organization, whose Board of Directors is composed of members, of which substantially all are independent community members. In order to help the community in accessing healthcare, IU Health West Hospital partners with Hope Healthcare Services in Avon, Indiana, to help meet the needs of Hendricks County residents who continue to be un- or under-insured. Hope Healthcare Services serves more than 800 people each year with primary medical and dental care, chronic disease management, and medication management. Multiple IU Health West physicians volunteer at the clinic, where medical and dental care is supported entirely by volunteer healthcare providers. Additionally to assist with obesity prevention, IU Health West Hospital and the Town of Brownsburg, IN partner to present the town's farmers market from May-September on the Town Hall Green. In addition to creating a venue for residents to access locally grown fresh produce, the hospital and town are committed to supporting at risk individuals and families, by accepting WIC and SNAP payments for produce, and by providing a collection location for produce donations to Brownsburg area food pantries. To improve the overall health of the community, IU Health West Hospital provided a 10-week fitness and nutrition program, Fresh & Fit, to 50 Hendricks County residents helping them to reduce their cholesterol, blood pressure, A1C and body mass index. Participants in Fresh & Fit also report additional benefits of the program including increased energy, improved mental well-being, reduced pain and a reduction in medications. Schedule H, Part VI, Line 6 - Affiliated Health Care System IU Health West Hospital is part of the IU Health Statewide System. The IU Health Statewide system is Indiana's most comprehensive healthcare system. With hospitals, physician offices and allied services, IU Health provides access to a full range of specialty and primary care services for adults and children. A unique partnership with Indiana University (IU) School of Medicine - one of the nation's leading medical schools - gives patients access to groundbreaking research and innovative treatments to complement high-quality care. National Recognition - Eight hospitals designated as Magnet by the American Nurses Credentialing Center recognizing excellence in nursing care. - IU Health Medical Center is honored to be nationally ranked by U.S. News & World Report for the 22nd year in a row. According to the U.S. News rankings, IU Health Medical Center is the No. 1 ranked hospital in Indiana and Indianapolis and the only nationally ranked adult hospital in the state. For 2019-2020, IU Health Medical Center was rated as high performing nationally in five specialties, with a sixth specialty achieving a top 50 national ranking: - Cancer - high performing - Gastroenterology - high performing - Geriatrics - ranked 45th in nation - Nephrology - high performing - Neurology & Neurosurgery - high performing - Urology - high performing Besides IU Health Medical Center, IU Health has three other hospitals among the 10 top ranked hospitals in Indiana: IU Health Ball Memorial (#5), IU Health Arnett (#8) and IU Health Bloomington (#8) hospitals. The annual rankings, now in their 30th year, are designed to assist patients and their doctors in making informed decisions about where to receive care for challenging health conditions or for common elective procedures. Education and Research As an academic health center, IU Health works in partnership with the IU School of Medicine to train physicians, blending breakthrough research and treatments with the highest quality of patient care. Each year, more than 1,000 residents and fellows receive training in IU Health hospitals. Research conducted by IU School of Medicine faculty gives IU Health physicians and patients access to the most leading-edge and comprehensive treatment options. In 2017, IU Health and the IU School of Medicine announced that they would invest $50 million over six years in the Strategic Research Initiative, a new research collaboration that has enhanced the institutions' joint capabilities in fundamental scientific investigation, translational research and clinical trials. The initial focus is on projects in the fields of neuroscience, cancer and cardiovascular disease with the goal to fund transformative proposals that will fundamentally change the understanding of these diseases and lead to important new therapies for patients. The three target research areas represent research strengths at IU School of Medicine, key strategic service lines for IU Health, and important medical needs in a time of an aging population and rising healthcare costs: - Cancer: One of the initiative's primary goals is to enable the IU Health Melvin and Bren Simon Cancer Center to attain the National Cancer Institute's (NCI) top status of "comprehensive," which would recognize it as one of the top-tier cancer centers in the nation. This designation was achieved in August 2019 making the center the only NCI-designated Comprehensive Cancer Center in Indiana and one of just 51 in the nation. - Neuroscience: The neurosciences research program tackles a broad range of brain injuries, neurodegenerative disorders and neurodevelopmental disorders. - Cardiovascular: The cardiovascular research initiative develops a comprehensive program for the study and treatment of heart failure, from newborns to older adults. A top priority is developing a cardiovascular genetics program. The Strategic Research Initiative provides patients with access to internationally renowned physicians and to new therapies developed through translational research and clinical trials, and will make use of the latest genetic tools to develop personalized therapies that are more effective for individuals and efficient for healthcare providers. IU Health Statewide System IU Health is a part of the IU Health Statewide System which continues to broaden its reach and positive impact throughout the state of Indiana. IU Health is Indiana's most comprehensive academic health center and consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health, and IU Health Saxony Hospital. Other hospitals in the IU Health Statewide System include the following: - IU Health Arnett Hospital - IU Health Ball Memorial Hospital - IU Health Bedford Hospital - IU Health Blackford Hospital - IU Health Bloomington Hospital - IU Health Frankfort Hospital - IU Health Jay Hospital - IU Health North Hospital - IU Health Paoli Hospital - IU Health Tipton Hospital - IU Health West Hospital - IU Health White Memorial Hospital Although each hospital in the IU Health Statewide System prepares and submits its own community benefit plan relative to the local community, the IU Health Statewide System considers the sum of these plans part of a statewide vision for strengthening Indiana's overall health. A comprehensive community outreach strategy and community benefit plan is in place that encompasses the academic medical center downtown Indianapolis, suburban Indianapolis and statewide entities around priority areas that focus on health improvement efforts statewide. IU Health is keenly aware of the positive impact it can have on the communities of need in the state of Indiana by focusing on the most pressing needs in a systematic and strategic way. In 2019, IU Health provided more than $738 million in total community benefit and served more than one million individuals. Some ways we address our community health priorities as a system include: IU Health Day of Service The annual IU Health Days of Service is a high-impact event aimed at engaging IU Health team members in activities that address an identified community priority health need. Each year, more than 2,000 IU Health team members volunteer during the Days of Service. Community Health Initiatives With investments in high-quality and impactful initiatives to address community health needs statewide, IU Health is helping Indiana residents improve their health and their quality of life. In 2019, IU Health impacted many people statewide through educational presentations, health risk screenings, health education programs, and additional health educational opportunities made available to the community, especially to our community members in the greatest need of such services. Twenty-four local organizations are benefitting from grants awarded by IU Health. In 2019, IU Health Community Outreach and Engagement awarded more than $900,000 to community organizations and institutions which - like IU Health - are addressing the health needs of the community. These needs include access to affordable healthcare, behavioral health and substance abuse, healthy weight and nutrition and social determinants of health. The grants, administered by the Indiana University Health Foundation, were awarded to the following: Behavioral Health and Substance Abuse - Volunteers of America Ohio & Indiana's (https://www.voaohin.org/) (VOAOHIN) Fresh Start Recovery Center received a $75,000 grant to provide residential addiction treatment to pregnant women and mothers. It also allows up to two children ages 5 and under to live with their mother while they receive services. - Goodwill Foundation of Central and Southern Indiana(https://www.goodwillindy.org/foundation/) received $75,000 to help Goodwill Education Initiatives (GEI) Resilience Initiative support resilience work across 15 Excel Center locations by leveraging groundbreaking research on neuroplasticity - the ability of the brain to reorganize itself - and to train staff and students on enhancing their resilience and mitigating the effects of trauma. - Additional grant winners: - Reach for Youth (https://www.reachforyouth.org/) - Lutheran Foundation (https://thelutheranfoundation) - Indy Public Safety Foundation (https://indypsf.org/) Healthy Weight and Nutrition - United Way of Central Indiana, Inc.'s (https://uwci.org/) initiative Jump IN for Healthy Kids received a $50,000 grant to address the epidemic of childhood obesity with a specific focus on implementing strategies that create healthy places, healthy neighborhoods, and healthy communities in Marion County. - Playworks (https://www.playworks.org/indiana/), a national non-profit organization that partners with Indianapolis schools and youth organizations to help them leverage play for positive outcomes, received a $23,000 grant. - Additional grant winners: - Indianapolis Parks Foundation (https://www.indyparksfoundation.org/) Social Determinants of Health - A $100,250 grant was awarded to Gleane Schedule H, Part VI, Line 7 - State Filing of Community Benefit Report IN true HENDRICKS COUNTY ECONOMIC DEVELOPMENT PARTNERSHIP 5250 E US HIGHWAY 36 AVON IN 46123 351817139 501(C)(6) 20000 COMMUNITY ECONOMIC DEV United Way of Central Indiana 3901 N Meridian St INDIANAPOLIS IN 46208 351007590 501(c)(3) 10000 Commitment to Community 1 1 Schedule I, Part I, Line 2 - Org.'s Proc. for Mon. the Use of Grant Funds Although IU Health West Hospital does not monitor the use of grant funds once distributed, through due diligence the organization has reasonably confirmed that the entities to which the contributions are made are highly reputable in the community and use the funds for the purposes intended. true true false false false false false true false KENNETH D PUCKETT Dir/PRES. - Indy Suburban Reg 0 462981 0 211080 0 75835 0 116713 0 29197 0 895806 0 0 DEREK E EMPIE SECRETARY 0 231195 0 36357 0 758 0 14966 0 30379 0 313655 0 0 ARTHUR VASQUEZ Pres West (Part Year)/ COO ISR 269606 0 46696 0 486 0 18075 0 30286 0 365149 0 0 0 Harpreetinder Singh MD VP & CMO West Hospital 336812 29479 45213 3957 18216 1594 16354 1431 23533 2060 440128 38521 0 0 MEGAN CRITTENDON MD DIRECTOR 0 365105 0 6684 0 2310 0 11362 0 0 0 385461 0 0 LISA A SPARKS RN CNO - Indy Suburban Region 195530 0 35029 0 989 0 14942 0 28775 0 275265 0 0 0 PAMELA CHAPMAN Former Key Employee 0 150860 0 15509 0 5182 0 11608 0 30818 0 213977 0 0 JAMES R BILLMAN PHARMACIST 186353 0 500 0 5350 0 4209 0 25433 0 221845 0 0 0 ANNE K STEGEMOLLER DIRECTOR - PHARMACY 150328 0 17531 0 300 0 11502 0 28833 0 208494 0 0 0 MATTHEW D BAILEY FORMER Officer 0 0 0 0 0 290903 0 0 0 0 0 290903 0 290903 Elizabeth Dunlap Director (Part Year) 0 542355 0 247707 0 27113 0 114940 0 24874 0 956989 0 0 Michelle A Janney RN Director (Part Year) 0 686415 0 358023 0 241545 0 18075 0 5860 0 1309918 0 0 David A Ingram MD Director (Part Year) 0 506994 0 260879 0 12670 0 107628 0 0 0 888171 0 0 CARA L BREIDSTER CFO - Indy Suburban Region 0 268019 0 40264 0 13097 0 18008 0 23740 0 363128 0 0 Eric D Peak Senior Pharmacist 155174 0 510 0 180 0 10149 0 7483 0 173496 0 0 0 MATTHEW R COOK DIRECTOR 0 581502 0 248092 0 55244 0 126007 0 24071 0 1034916 0 0 KEVIN L SMITH MD DIRECTOR 0 426132 0 94052 0 540 0 11200 0 1347 0 533271 0 0 TAMARAH D BROWNLEE VP-HR - Indy Suburban Region 0 163933 0 28597 0 366 0 8259 0 32405 0 233560 0 0 Anne Fara-Erny ACNO-IUH West/DIR-CE (PART YR) 42190 97250 3974 9160 1900 4380 2931 6757 7477 17236 58472 134783 0 0 KAPRI D AMES ASSOC CNO (PART YEAR) 132246 0 17074 0 247 0 9571 0 20544 0 179682 0 0 0 Schedule J, Part I, Line 3 - Comp. of the Org.'s CEO/Executive Director IU Health West Hospital's Regional President is employed by IU Health. IU Health West Hospital's President is employed by IU Health West Hospital, Inc. IU Health, IU Health West Hospital, and other related entities have a process in place to determine the compensation for the other officers and key employees. IU Health Human Resources uses market data from multiple compensation experts/vendors who utilize a variety of methods and procedures to obtain compensation ranges for comparable officer and employee positions. This market data and multiple other factors (including market pay benchmarks, internal equity, candidate/employee qualifications & performance, and business needs) are used to recommend compensation ranges for its officers and other employees, which are then used as a guide for setting reasonable compensation by management. Please see schedule O for additional details.. Schedule J, Part I, Line 4a Severance Matthew D. Bailey entered into a severance agreement with IU Health during 2018. Severance of $290,903 that was received during 2019 is included in column b(iii), other reportable compensation. Deferred severance of $290,903 was disclosed in 2018 in column C, retirement and other deferred compensation. Schedule J, Part I, Line 4b - Supplemental Nonqualified Retirement Plan Michelle A. Janney, R.N., Matthew R. Cook, Elizabeth Dunlap, David A. Ingram, and Kenneth D. Puckett participate in an IU Health supplemental executive retirement plan, provisions of which are designed to retain its critical employees. The plan provides for an additional retirement benefit for service through normal retirement or other key dates. If the executive leaves prior to retirement or other key dates, the benefit may be forfeited or reduced. Each of the executives listed above, with the exception of Michelle A. Janney, R.N. has an amount included in column c, deferred compensation, representing the current year unvested contributions made under the supplemental executive retirement plan. These amounts were not paid to the executives during the year. The following executives have an amount included in column B (iii), other reportable compensation, representing the current year vested amounts received under the supplemental executive retirement plan: - Michelle A. Janney, R.N. ($146,318) Schedule J, Part I, Line 7 - Non-Fixed Payments AMOUNTS DISCLOSED IN COLUMN B(II) INCLUDE A LONG-TERM AND SHORT-TERM INCENTIVE FOR CERTAIN EXECUTIVES AND SHORT-TERM INCENTIVE FOR OTHER EMPLOYEES. ALTHOUGH THESE PLANS ARE BASED ON A FIXED FORMULA THAT HAS BEEN APPROVED BY THE BOARD OF DIRECTORS BASED UPON CERTAIN QUALITATIVE AND QUANTITATIVE FACTORS AND GOALS, ALL DISCRETIONARY INCENTIVE PLANS MUST BE APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT. Page 1, Line J Web Site: https://iuhealth.org/find-locations/iu-health-west-hospital Part VI, Section A - Governing Body and Management Line 4 - Significant Changes to Organizational Documents Indiana University Health West Hospital, Inc. ("IU Health West Hospital") filed Amended Articles of Incorporation with the Indiana Secretary of State's Office effective March 1, 2019. IU Health West Hospital also executed amended and restated bylaws effective March 1, 2019 in order to reflect its change in operation following the boards merger with IU Health North Hospital. A summary of the updated bylaws are shown on Schedule O, lines 7a and 7b. A summary of the Amended Articles of Incorporation are included below. Article II, Which defines the purposes of the legal entity was amended to specifically address: - Increasing community access to quality health care services to the indigent, poor, and underserved; - Providing health services to the community through ownership and operation of a hospital in Hendricks County, Indiana; - Engaging in and supporting health education, training and research activities, including programs for nurses, health professionals and clergy; - Engaging in any lawful activities within the purposes for which a corporation may be organized under the Act, which are in furtherance of, supportive of, allied with or incidental to the purposes of the corporation; and - Engage in all of the above mentioned activities on an interdenominational, public benefit basis while adhering to and assuring the preservation of the corporations values. Part VI, Section A, Lines 6, 7a and 7b Members or Stockholders Line 6: The sole member of IU Health West Hospital is IU Health, a 501(c)(3) tax-exempt organization. Line 7A: The Board of Directors of IU Health West Hospital shall consist of up to fifteen (15) voting members all appointed by IU Health, who shall include representatives from the Medical staffs of IU Health West Hospital and IU Health North Hospital, and the President of the Indianapolis Suburban Region, who shall be an ex-officio, voting director of the Board. At all times, the IU Health West Hospital directors shall consist of the same individuals appointed by IU Health to serve as directors of IU Health North Hospital. Line 7B: The Board of Directors shall not, without the prior approval of the IU Health: - Any proposed amendment to the Corporation's Articles of Incorporation or these Bylaws; - Adoption of the Corporation's annual capital and operating budgets; - Approval of any unbudgeted operating or capital budget items or deviations, including any issuance or guarantee of any unbudgeted debt; - Approval of any strategic plan for the Corporation, including any amendments to a strategic plan; - Approval of any encumbrance, sale or conveyance of assets; - Any merger, consolidation, joint venture or affiliation involving the Corporation or any of its affiliates and any other entity; - Appointment and removal of the Corporation's President and other officers; - Construction, acquisition or lease of Hospital buildings; - Approve any management agreement for the management of all or substantial part of IU Health West Hospital's operations; - Projects or contracts that require Member approval in accordance with the Member's resolution and policy governing system-wide Contract Execution Authority and Payment Approval Limits; and - The dissolution of the Corporation or any of its affiliates. Part VI, Section A, Line 11b Review of Form 990 The Indianapolis Suburban Region Chief Financial Officer reviewed and approved the Form 990. Following the CFO's review and approval, a complete copy of the Form 990 was made available to each board member prior to its filing. Each member was also informed of the availability of the IU Health Tax Department to answer any questions. Part VI, Section B, Lines 12, 13, and 14 Policies IU Health West Hospital is part of the IU Health system. As the sole member and controlling parent of IU Health West Hospital, IU Health and its board of directors have mandated that certain policies be followed to ensure greater standardization throughout the system. Thus, IU Health West Hospital's Board of Directors was not required to separately adopt a conflict of interest, whistleblower, document retention and destruction and joint venture policies because IU Health's Board of Directors had already adopted and required these policies to be followed by its subsidiaries. Part VI, Section B, Line 12c Conflict of Interest Policy IU Health West Hospital follows IU Healths Conflict of Interest Policy. IU Healths Conflict of Interest Policy includes the following provisions: All IU Health employees, associates, colleagues and contracted personnel, including employed physicians and paid medical directors ("IU Health Representatives") are covered by and subject to its Conflict of Interest Policy. IU Health regularly and consistently monitors and enforces compliance with the policy through the following procedures: (1) On an annual basis, each IU Health Representative at the level of Manager or above, together with every other person designated by the Corporate Compliance Department ("Department"), must complete, sign and submit a Conflict of Interest Questionnaire ("Questionnaire") to the Department. Governing board members, committee members, corporate officers, medical staff and researchers must comply with the administrative requirements noted in the respective policies and procedures relative to those areas. (2) An IU Health Representative must supplement a Questionnaire in writing, if after completion of the original Questionnaire, a situation arises, or may reasonably be expected to arise, that would change any answer or information on the original Questionnaire if the situation had existed or been anticipated at the time of completion of the original Questionnaire. (3) If a fully and properly completed Questionnaire reveals facts or other information that might reasonably indicate a Conflict of Interest or violation of the policy, the IU Health Representative completing the questionnaire must secure approval by his/her supervisor, evidenced in writing. (4) The Department will review each Questionnaire and determine whether a Conflict of Interest exists and, if so, whether and how it should or may be eliminated, avoided or managed in order to comply with the spirit of the policy and with the best interests of IU Health and its patients. In making the determination, the Corporate Compliance Department may consult with the IU Health Representatives supervisor and other appropriate individuals and groups. (5) The scope of the policy is not limited to those who are required to complete Questionnaires. If an IU Health Representative is involved in a situation or relationship that would constitute a violation of the policy in the absence of disclosure and approval as described above, then the IU Health Representative must disclose the matter to his/her supervisor, secure his/her supervisors approval in writing, and disclose the matter to the Department. Otherwise, the IU Health Representative is in violation of the policy and subject to corrective action, up to and including termination. (6) The Chief Compliance Officer, in consultation with onsite Compliance personnel, may from time to time appoint standing or ad hoc committees to assist in resolving issues that arise under provisions of the policy. Part VI, Section B, Line 15a & 15b - Process for Determining Compen. IU Health West Hospital's Regional President is employed by IU Health, Inc. IU Health West Hospital's President is employed by IU Health West Hospital. IU Health's process for determining compensation is as follows: (1) The Board of Directors ("Board") has established a Talent Management and Executive Compensation Committee ("TMECC"), the purpose of which includes reviewing and making recommendations regarding executive (Senior Vice Presidents and above) pay and benefits (collectively referred to as "compensation") on an annual basis. The TMECC is made up of members of the Board that are neither physicians nor employees and do not otherwise have a conflict of interest regarding any of IU Health's compensation arrangements. The TMECC reviews an executive's entire compensation package including base salary, short-term and long-term incentives, health and welfare benefits, qualified and nonqualified retirement plans, as well as any additional fringe benefits. As deemed appropriate, the Committee on Finance, which is also made up of members of the Board, may also review executive compensation and benefits. (2) The TMECC engages an independent compensation consulting firm on an annual basis to conduct a compensation analysis for its executive group, which consists of employees at the level of senior vice president and above. The current compensation advisor is SullivanCotter. SullivanCotter performs its analysis in the form of a compensation survey ("survey") that includes relevant comparability data for compensation levels paid by similarly situated organizations (both governmental and tax exempt) for functionally comparable positions as well as the availability of similar services in the geographic area. SullivanCotter then prepares a survey report and provides recommendations to the TMECC, if deemed appropriate, on changes in executive compensation. A separate analysis using the same methodology is done for the President and Chief Executive Officer. (3) The TMECC then reviews SullivanCotter's report and recommendations and, if appropriate, votes on whether to recommend any changes in executive compensation to the Board. The TMECC will only recommend changes to the Board if they are consistent with the Board's philosophy on compensation matters and are deemed reasonable based upon the independent analysis provided by SullivanCotter. The TMECC's review, discussion and vote are documented in the minutes for the meeting. There are no executives present during the final discussion and approval. (4) The Board then reviews the report prepared by SullivanCotter as well as the recommendations of the TMECC as to any changes in executive compensation. As deemed appropriate, the Committee on Finance may also provide its review of the TMECC's recommendations on any changes in executive compensation. This review and discussion are documented in the minutes. (5) The Board then votes on whether to accept the TMECC's recommendations on any changes in executive compensation. Changes in executive compensation are made if approved by the TMECC and Board on an annual basis, or as necessary throughout the year. The discussion and approval are documented in the minutes of the meeting. There are no executives present during the final discussion and approval. IU Health's General Counsel also prepares a formal written opinion reviewing the executive compensation approval process, comparing it to the Intermediate Sanctions Test of IRC Section 4958. If warranted, IU Health's General Counsel may also provide comments regarding the executive compensation approval process as it relates to meeting the requirements for a rebuttable presumption of reasonableness as provided in the Intermediate Sanctions Test. (6) After the end of each year, the TMECC and Board also review the achievements of the executive group as it relates to the long-term and short-term shared and individual goals developed by the executives and the Board. These achievements may also be reviewed with the Committee on Finance. The Board, at its discretion, may approve bonus payments based upon the achievement of the goals. The discussion and vote of the TMECC and Board is documented in the minutes for each such meeting. The bonuses are not paid until approval is made by the Board. (7) The TMECC and Audit Committee also review Form 990 disclosures related to executive compensation as well as the organization's practices and approval processes prior to the filing of the Form 990 return with the Internal Revenue Service. IU Health West Hospital and other related entities have a process in place to determine the compensation for the other officers and key employees. IU Health Human Resources uses market data from multiple compensation experts/vendors who utilize a variety of methods and procedures to obtain compensation ranges for comparable officer and employee positions. This market data and multiple other factors (including market pay benchmarks, internal equity, candidate/employee qualifications & performance, and business needs) are used to recommend compensation ranges for its officers and other employees, which are then used as a guide for setting reasonable compensation by management. Part VI, Section C, Line 19 Public Disclosure IU Health West Hospital's Articles of Incorporation are available to the public through the Indiana Secretary of State's web-site. IU Health West Hospital's conflict of interest policy is described on Form 990, Schedule O. IU Health West Hospital is a consolidated subsidiary in the consolidated financial statements for IU Health. The consolidated financial statements for IU Health are available to the public through its bond filings and as an attachment to the form 990 as well as IU Health West's Form 990. Part VII, Section B, Attach 2 Comp of the Five Highest Pd Ind. Contractors The amounts paid to Messer Construction Co. totaling $25,590,241 include both goods and services associated with the construction of IU Health West expansion project. This project will add three floors to two of its three-story towers, allowing it to increase its inpatient capacity. The amounts for goods vs. services were not readily available for reporting on the 990, Part VII, Section B, Independent contractors. PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS OR FUND BALANCES IU Health West Hospital recorded the following other changes in net assets or fund balances in 2019: EQUITY TRANSFER (SETTLEMENT OF DEBT): (24,953) FORM 990 PART IX LINE 11G DESCRIPTION:SHARED SERVICES/PROF. 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