2020-11-04T16:40:37-06:00 2019-12-31 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2019-01-01 350868133 THE METHODIST HOSPITALS INC METH 2198864402 600 GRANT STREET GARY IN 46402 MATTHEW DOYLE CHIEF EXECUTIVE OFFICER 2198864549 2020-11-02 1 DAVID LOWENTHAL P00378651 3122071040 2020-11-02 73.8.87.142 2020-11-02 17:33:59 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 23D9C3BAD3C11415BCA5E3AEE50D281DF37E870F 2019 2021-01-29 14:40:06Z MATTHEW DOYLE 600 GRANT STREET GARY IN 46402 416702529 0 X WWW.METHODISTHOSPITALS.ORG X 1941 IN THE METHODIST HOSPITALS, INC. (METHODIST) IS AN INDIANA NONPROFIT CORPORATION OPERATING TWO GENERAL ACUTE CARE HOSPITALS IN NORTHWEST INDIANA. AS GENERAL ACUTE CARE FACILITIES, METHODIST PROVIDES A BROAD RANGE OF DIAGNOSTIC, THERAPEUTIC, EMERGENCY, REHABILITATION, INPATIENT, OUTPATIENT, AND ANCILLARY SERVICES. METHODIST'S MISSION IS TO PROVIDE HIGH QUALITY HEALTHCARE TO ALL PERSONS REGARDLESS OF THEIR RACE, RELIGION, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. METHODIST STRIVES TO PROVIDE APPROPRIATE HEALTH EDUCATION, WELLNESS, AND PREVENTATIVE SERVICES. IN ADDITION, METHODIST IS COMMITTED TO BEING A RESPONSIBLE MEMBER OF THE COMMUNITY, OFFERING ITS RESOURCES TO ASSIST IN THE ACCOMPLISHMENT OF COMMUNITY OBJECTIVES. 13 12 2948 69 22338 0 422260 522636 384379338 378660323 17452216 3691297 433766 440518 402687580 383314774 202384 188843 0 0 188455049 186532432 0 0 0 202100504 202604425 390757937 389325700 11929643 -6010926 360852303 368092378 114049521 125194798 246802782 242897580 X THE METHODIST HOSPITALS, INC'S MISSION IS TO PROVIDE COMPASSIONATE, QUALITY HEALTH CARE SERVICES TO ALL THOSE IN NEED. 0 0 338253431 188843 378637985 THE METHODIST HOSPITALS, INC. HAS A COMMITMENT TO RESPOND TO THE NEEDS OF ITS DIVERSE COMMUNITIES THROUGH QUALITY SERVICES. ITS REGIONAL REPUTATION FOR EXCELLENCE SINCE 1923 CONTINUES TO SUPPORT THE MARKET POSITION. METHODIST HOSPITALS IS AN INDIANA NOT-FOR-PROFIT CORPORATION, 616 BED COMMUNITY-BASED HEALTHCARE SYSTEMS GOVERNED BY A BOARD OF DIRECTORS. AS STEWARDS OF THE MISSION, REINVESTMENT IN THE COMMUNITIES IS CARRIED OUT THROUGH CHARITABLE GIVING, COMMUNITY EDUCATION PROGRAMS, ECONOMIC DEVELOPMENT FORUMS, SUPPORT SERVICES, SCREENINGS, AND ADVOCATING QUALITY CARE FOR THE MOST VULNERABLE AND UNDERSERVED. METHODIST HOSPITALS CONTINUES TO BE A FRONTRUNNER IN PROMOTING COMMUNITY HEALTH INITIATIVES AND SERVING POPULATIONS WITH HIGH INCIDENTS OF ACUTE ILLNESSES. METHODIST HOSPITALS HAS TWO FULL SERVICE ACUTE CARE CAMPUSES, 14 MILES APART. NORTHLAKE IS THE URBAN CAMPUS IN GARY, WHILE SOUTHLAKE CAMPUS IN MERRILLVILLE IS LOCATED NEAR ONE OF THE MIDWEST'S BUSIEST RETAIL AREAS. COMBINED CAMPUS BED CAPACITY IS 616 INCLUDING NURSERIES. METHODIST PROVIDES A BROAD RANGE OF DIAGNOSTIC, THERAPEUTIC, EMERGENCY, REHABILITATION, INPATIENT, OUTPATIENT AND ANCILLARY SERVICES. MIDLAKE CAMPUS IS AN OUTPATIENT FACILITY IN GARY CONVENIENTLY LOCATED BETWEEN NORTHLAKE AND SOUTHLAKE CAMPUSES, PARALLEL TO INTERSTATE 80/94. THE REHAB CENTERS, PROVIDING OUTPATIENT REHABILITATION SERVICES AT MIDLAKE, OPENED IN 2003. LOCATED ADJACENT TO THE MAIN ENTRANCE OF THE SOUTHLAKE CAMPUS IN MERRILLVILLE, IS THE DIAGNOSTIC OUTPATIENT CENTER AND MEDICAL OFFICE BUILDING. THIS FACILITY PROVIDES ADVANCED DIAGNOSTIC, IMAGING SERVICES, AND LABORATORY SERVICES AS WELL AS PROFESSIONAL OFFICES FOR MANY OF THE MEDICAL STAFF. THE MEDICAL STAFF OF MORE THAN 500 PHYSICIANS REPRESENTS NEARLY 40 MEDICAL SPECIALTIES. METHODIST HOSPITALS IS ONE OF THE TOP EMPLOYERS IN NORTHWEST INDIANA WITH OVER 2,100 EMPLOYEES. MISSIONTHE MISSION IS TO PROVIDE COMPASSIONATE, QUALITY HEALTH CARE SERVICES TO ALL THOSE IN NEED. VISIONTHE VISION IS TO BE THE BEST PLACE FOR EMPLOYEES TO WORK. THE BEST PLACE FOR PATIENTS TO RECEIVE CARE AND THE BEST PLACE FOR PHYSICIANS TO PRACTICE MEDICINE. 338253431 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 229 0 1 2948 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 IN X MATTHEW DOYLE 2198864000 600 GRANT STREET GARY IN 46402 VINEET SHAH PHYSICIAN 40.00 0.00 X 691354 0 29354 MIHAS KODENCHERY PHYSICIAN 40.00 0.00 X 696695 0 21537 ANDRE ARTIS PHYSICIAN 40.00 0.00 X 684484 0 15706 RAYMOND GRADY CHIEF EXECUTIVE OFFICER 40.00 0.30 X 617256 0 74944 ADOLPHUS ANEKWE PHYSICIAN 40.00 0.00 X 615224 0 29248 THACH NGUYEN PHYSICIAN 40.00 0.00 X 540507 0 17229 VINCENT SEVIER CHIEF QUALITY OFFICER 40.00 0.00 X 358790 0 30905 JAMES RENNEKER CHIEF NURSING OFFICER 40.00 0.00 X 320106 0 18453 TRACEY CRANDALL VP OF HUMAN RESOURCES 40.00 0.00 X 276320 0 22046 WRIGHT ALCORN VP OF OPERATIONS 40.00 0.00 X 277844 0 18242 ED ROMERO PART YR JAN-JUN CHIEF FINANCIAL OFFICER 40.00 0.00 X 235398 0 11332 MATTHEW DOYLE PART YR OCT-CUR CHIEF FINANCIAL OFFICER 40.00 0.00 X 92138 0 3221 BHARAT H BARAI MD BOARD MEMBER 2.00 0.00 X 76050 0 0 SCOTT T RIBORDY BOARD CHAIRMAN 2.20 0.20 X X 6000 0 0 ROBERT E JOHNSON III BOARD VICE-CHAIRMAN 2.20 0.00 X X 6000 0 0 GLENN S VICIAN BOARD SECRETARY 2.20 0.20 X X 6000 0 0 JOHN A LOWENSTINE CPA BOARD TREASURER 2.20 0.00 X X 6000 0 0 CHARLES D BROOKS JR BOARD MEMBER 2.00 0.00 X 6000 0 0 MATTISON A DILTS BOARD MEMBER 2.00 0.10 X 6000 0 0 RITA R JACKSON BOARD MEMBER 2.00 0.00 X 4000 0 0 SANETA MAIKO PHD BOARD MEMBER 2.00 0.00 X 2500 0 0 SCOTT J MAY CPA BOARD MEMBER 2.00 0.00 X 6000 0 0 CHERYL L PRUITT PHD BOARD MEMBER 2.00 0.00 X 6000 0 0 KATRINA WRIGHT MD BOARD MEMBER 2.00 0.00 X 6000 0 0 REV LARRY WHITEHEAD BOARD MEMBER (PART YEAR) 2.00 0.00 X 1000 0 0 MAMON POWERS JR BOARD MEMBER 2.00 0.00 X 0 0 0 5543666 0 292217 170 0 1 0 CROTHALL SERVICES GROUP 13028 COLLECTION CENTER DR CHICAGO IL 60693 BIOMEDICAL SERVICES 5540833 AMERICAN ANESTHESIOLOGY ASSOCIATES OF IL PO BOX 281034 ATLANTA GA 30384 ANESTHESIOLOGY SERVICES 4923180 EPIC SYSTEMS CORPORATION BOX 88314 MILWAUKEE WI 53288 COMPUTER SOFTWARE SERVICES 2438013 FRESENIUS MEDICAL CARE 16343 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 DIALYSIS SERVICES 2103532 NORTHWEST EMERGENCY ASSOCIATES LLC 900 ALDERBROOK CT CROWN POINT IN 46307 EMERGENCY ROOM PROVIDERS 1728173 90 59269 25511 437856 522636 HEALTHCARE AND SOCIAL ASSISTANCE 621500 306458380 306458380 DISPROPORTIONATE SHARE 621500 68044191 68044191 OTHER PATIENT SERVICES 621500 4114997 4114997 PARTNERSHIP INCOME 621500 22338 22338 EMR INCENTIVE PAYMENTS 900099 20417 20417 378660323 3360506 3360506 1062039 621521 440518 440518 440518 33078825 18200 32534740 231494 544085 -213294 330791 330791 383314774 378637985 22338 4131815 X 188843 188843 2438672 670488 1768184 147233359 127234413 19998946 3388361 2887738 500623 23203433 19498432 3705001 10268607 8705025 1563582 1846882 1314147 532735 822922 674784 148138 191275 3288 187987 124217 124217 44193688 35958977 8234711 735789 625910 109879 68588601 63092112 5496489 6179780 4995427 1184353 10979629 6869578 4110051 310557 284620 25937 48986 44601 4385 3157300 2723236 434064 18016450 15686220 2330230 3531657 3170140 361517 BAD DEBT EXPENSE 25621302 25621302 MEDICAID ASSESSMENT FEE 17509084 17509084 DUES & SUBSCRIPTIONS 746306 495066 251240 389325700 338253431 51072269 0 26992372 23491118 24068405 8822929 58495138 65511578 12468563 13016086 4997130 5320361 508401619 364879654 138651937 143521965 85146763 102053375 10031995 6354966 360852303 368092378 32894572 32802806 42302740 52226704 18938701 18800001 19913508 21365287 114049521 125194798 X 246561059 242645213 241723 252367 246802782 242897580 360852303 368092378 X -6010926 8461712 -6355988 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 126720 0 1 26076 152796 0 PART II-B, LINE 1: THE CHIEF CONSULTANT OF GOVERNMENTAL AFFAIRS MEETS WITH STATE AND LOCAL LEGISLATORS ON ISSUES AFFECTING THE ORGANIZATION. A PORTION OF MEMBERSHIP DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION, AMERICAN MEDICAL REHABILITATION PROVIDERS ASSOCIATION, AND INDIANA HOSPITAL ASSOCIATION (IHA) IS ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE RESPECTIVE PERCENTAGES HAVE BEEN APPLIED, AS PROVIDED BY THE RESPECTIVE ORGANIZATIONS. PART II-B, LINE 1(G): THE CHIEF CONSULTANT OF GOVERNMENTAL AFFAIRS MEETS WITH STATE AND LOCAL LEGISLATORS ON ISSUES AFFECTING THE ORGANIZATION. 5373674 5373674 274498345 212259634 62238711 2775265 887474 1887791 220531386 151732546 68798840 5222949 5222949 143521965 THIRD PARTY PAYOR SETTLEMENT 6222642 ESTIMATED SELF INSURANCE LIABILITY 6909107 ASBESTOS MITIGATION LIABILITY 664943 PENSION & POST RETIREMENT OBLIGATIONS 6979088 OTHER LIABILITIES 216095 GUARANTEES TO PHYSICIANS 373412 21365287 359465263 8461712 -32808527 -24346815 383812078 124217 -621521 -497304 383314774 363305269 818176 818176 362487093 124217 26714390 26838607 389325700 PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE FROM FOUNDATION 261,851. BAD DEBT EXPENSE -25,621,302. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC COST -3,855,988. GOODWILL IMPAIRMENT -2,500,000. PENSION-RELATED CHARGES NETTED WITH REVENUE -1,093,088. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSE -621,521. PART XII, LINE 2D - OTHER ADJUSTMENTS: FOUNDATION EXPENSES 196,655. RENTAL EXPENSE 621,521. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 25,621,302. PENSION RELATED CHARGES NETTED WITH REVENUE 1,093,088. 1 1 X 1 X 1 X 1 1 1 0 1 1 11116322 11116322 0.03070 108652310 100775183 7877127 0.02170 119768632 100775183 18993449 0.05240 22 3167 332975 332975 0.00090 1 24 591591 185256 406335 0.00110 287709 287709 0.00080 23 3191 1212275 185256 1027019 0.00280 23 3191 120980907 100960439 20020468 0.05520 1 25621302 2793689 81355371 88634866 -7279495 X 1 1 2 1 THE METHODIST HOSPITALS INC 600 GRANT STREET GARY IN 46402 WWW.METHODISTHOSPITALS.ORG 18-005002-1 X X X 2 THE METHODIST HOSPITALS INC 8701 BROADWAY MERRILLVILLE IN 46410 WWW.METHODISTHOSPITALS.ORG 18-005002-1 X X X THE METHODIST HOSPITALS INC (NORTHLAKE 1 0 0 1 X X X X X X X X X X 19 1 1 0 1 X SEE PART V, PAGE 8 X 1 19 0 1 0 1 X 200.000000000000 400.000000000000 X X X X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X X 1 X 0 X X X X 1 X 0 0 THE METHODIST HOSPITALS INC (SOUTHLAKE 2 0 0 1 X X X X X X X X X X 19 1 1 0 1 X SEE PART V, PAGE 8 X 1 19 0 1 0 1 X 200.000000000000 400.000000000000 X X X X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X X 1 X 0 X X X X 1 X 0 0 THE METHODIST HOSPITALS, INC (NORTHLAKE CAMPUS) PART V, SECTION B, LINE 3J: THE CHNA THAT WAS CONDUCTED CONTAINED: THE TOP COMMUNITY HEALTH AND SOCIAL PROBLEMS; BARRIERS TO GOOD HEALTH; DEMOGRAPHICS OF THE PRIMARY SERVICE AREAS AS COMPARED TO THE STATE AND COUNTY THE HOSPITAL IS LOCATED IN; DEATH, DISEASE, AND CHRONIC CONDITIONS THAT ARE PREVALENT IN THE PRIMARY SERVICE AREA. THE SURVEY ALSO DEFINES THE SAMPLE AND DATA COLLECTION METHODOLOGY USED ALONG WITH A COPY OF THE SURVEY. THE METHODIST HOSPITALS, INC (SOUTHLAKE CAMPUS) PART V, SECTION B, LINE 3J: THE CHNA THAT WAS CONDUCTED CONTAINED: THE TOP COMMUNITY HEALTH AND SOCIAL PROBLEMS; BARRIERS TO GOOD HEALTH; DEMOGRAPHICS OF THE PRIMARY SERVICE AREAS AS COMPARED TO THE STATE AND COUNTY THE HOSPITAL IS LOCATED IN; DEATH, DISEASE, AND CHRONIC CONDITIONS THAT ARE PREVALENT IN THE PRIMARY SERVICE AREA. THE SURVEY ALSO DEFINES THE SAMPLE AND DATA COLLECTION METHODOLOGY USED ALONG WITH A COPY OF THE SURVEY. THE METHODIST HOSPITALS, INC (NORTHLAKE CAMPUS) PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPRISED OF A SERIES OF ONLINE INTERVIEWS WITH COMMUNITY AND HEALTH CARE LEADERS, SECONDARY ANALYSIS OF THE REGIONAL DEMOGRAPHICS AND HEALTH TRENDS, AND A QUANTITATIVE SURVEY OF RESIDENTS OF THE REGION USING BOTH AN ONLINE AND PAPER-BASED SURVEY THAT WAS DISTRIBUTED AT LOCATIONS AND EVENTS SUCH AS: SENIOR CENTERS, FQHCS, LOCAL COLLEGES, HEALTH FAIRS, PHYSICIAN SEMINARS, AND CHURCHES. OUTREACH TO DISTRIBUTE PAPER SURVEYS WAS USED SO AS TO IMPROVE THE SURVEY SCOPE TO THOSE THAT MAY BE UNDER-REPRESENTED IN A TRADITIONAL SURVEY RESEARCH PROJECT. THE METHODIST HOSPITALS, INC (SOUTHLAKE CAMPUS) PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPRISED OF A SERIES OF ONLINE INTERVIEWS WITH COMMUNITY AND HEALTH CARE LEADERS, SECONDARY ANALYSIS OF THE REGIONAL DEMOGRAPHICS AND HEALTH TRENDS, AND A QUANTITATIVE SURVEY OF RESIDENTS OF THE REGION USING BOTH AN ONLINE AND PAPER-BASED SURVEY THAT WAS DISTRIBUTED AT LOCATIONS AND EVENTS SUCH AS: SENIOR CENTERS, FQHCS, LOCAL COLLEGES, HEALTH FAIRS, PHYSICIAN SEMINARS, AND CHURCHES. OUTREACH TO DISTRIBUTE PAPER SURVEYS WAS USED SO AS TO IMPROVE THE SURVEY SCOPE TO THOSE THAT MAY BE UNDER-REPRESENTED IN A TRADITIONAL SURVEY RESEARCH PROJECT. THE METHODIST HOSPITALS, INC (NORTHLAKE CAMPUS) PART V, SECTION B, LINE 6A: THE METHODIST HOSPITALS, INC'S CHNA WAS CONDUCTED JOINTLY WITH THE FOLLOWING OTHER HOSPITAL ORGANIZATIONS: COMMUNITY HEALTHCARE SYSTEMS AND FRANCISCAN ALLIANCE OF NORTHWEST INDIANA. THE METHODIST HOSPITALS, INC (SOUTHLAKE CAMPUS) PART V, SECTION B, LINE 6A: THE METHODIST HOSPITALS, INC'S CHNA WAS CONDUCTED JOINTLY WITH THE FOLLOWING OTHER HOSPITAL ORGANIZATIONS: COMMUNITY HEALTHCARE SYSTEMS AND FRANCISCAN ALLIANCE OF NORTHWEST INDIANA. THE METHODIST HOSPITALS, INC (NORTHLAKE CAMPUS) PART V, SECTION B, LINE 11: METHODIST HOSPITALS USED THE CHNA TO IDENTIFY ISSUES OF GREATEST CONCERN, THAT ARE ALIGNED WITH STATE HEALTH DEPARTMENT PRIORITIES AND DEVELOPED ACTION PLANS ON KEY FOCUS AREAS IN WHICH METHODIST HAS BOTH EXPERTISE AND RESOURCES TO COMMIT IN ORDER TO IMPROVE RESIDENT'S HEALTH , IMPROVE QUALITY OF LIFE, REDUCE HEALTH DISPARITIES AND TO INCREASE ACCESSIBILITY TO PREVENTATIVE SERVICES. THE HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA INCLUDED THE FOLLOWING PRIORITY FOCUS AREAS: CHILD HEALTH AND WELLBEING WITH FOCUSES ON REDUCING INFANT MORTALITY, ENCOURAGING BREASTFEEDING, AND DEVELOPING DAY CARE SERVICES; FOOD AND NUTRITION - WITH FOCUS ON IMPROVING ACCESS TO HEALTHY FOODS; AND CHRONIC DISEASE WITH A FOCUS ON HEART DISEASE PREVENTION AND SMOKING CESSATION. DURING 2019, METHODIST MAINTAINED ITS ONGOING INITIATIVES IN THE ARES OF: CANCER, HEART DISEASE AND STROKE, AND ACCESS TO CARE PROGRAMS. METHODIST HOSPITALS DOES NOT CURRENTLY HAVE PROGRAMS THAT SPECIFICALLY ADDRESS THE REGION'S DISABILITY CARE, UNEMPLOYMENT/JOB TRAINING, POVERTY AND HOMELESSNESS, AND VIOLENCE, VIOLENT CRIME AND DOMESTIC ABUSE. THE METHODIST HOSPITALS, INC (SOUTHLAKE CAMPUS) PART V, SECTION B, LINE 11: METHODIST HOSPITALS USED THE CHNA TO IDENTIFY ISSUES OF GREATEST CONCERN, THAT ARE ALIGNED WITH STATE HEALTH DEPARTMENT PRIORITIES AND DEVELOPED ACTION PLANS ON KEY FOCUS AREAS IN WHICH METHODIST HAS BOTH EXPERTISE AND RESOURCES TO COMMIT IN ORDER TO IMPROVE RESIDENT'S HEALTH , IMPROVE QUALITY OF LIFE, REDUCE HEALTH DISPARITIES AND TO INCREASE ACCESSIBILITY TO PREVENTATIVE SERVICES. THE HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA INCLUDED THE FOLLOWING PRIORITY FOCUS AREAS: CHILD HEALTH AND WELLBEING WITH FOCUSES ON REDUCING INFANT MORTALITY, ENCOURAGING BREASTFEEDING, AND DEVELOPING DAY CARE SERVICES; FOOD AND NUTRITION - WITH FOCUS ON IMPROVING ACCESS TO HEALTHY FOODS; AND CHRONIC DISEASE WITH A FOCUS ON HEART DISEASE PREVENTION AND SMOKING CESSATION. DURING 2019, METHODIST MAINTAINED ITS ONGOING INITIATIVES IN THE ARES OF: CANCER, HEART DISEASE AND STROKE, AND ACCESS TO CARE PROGRAMS. METHODIST HOSPITALS DOES NOT CURRENTLY HAVE PROGRAMS THAT SPECIFICALLY ADDRESS THE REGION'S DISABILITY CARE, UNEMPLOYMENT/JOB TRAINING, POVERTY AND HOMELESSNESS, AND VIOLENCE, VIOLENT CRIME AND DOMESTIC ABUSE. THE METHODIST HOSPITALS, INC (NORTHLAKE CAMPUS) PART V, SECTION B, LINE 13B: METHODIST HOSPITALS PROVIDES EMERGENCY AND OTHER MEDICALLY NECESSARY SERVICES AT NO CHARGE TO THE PATIENT IF THE FAMILY INCOME IS AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG). PATIENTS WHOSE FAMILY INCOME IS BETWEEN 200 - 400% OF FPG ARE ELIGIBLE FOR SLIDING-SCALE FINANCIAL RELIEF. ALL OTHER APPLICANTS WILL BE SCREENED FOR OTHER SOURCES OF PAYMENT TO DETERMINE WHAT LEVEL OF FINANCIAL ASSISTANCE MAY BE GRANTED. THE METHODIST HOSPITALS, INC (SOUTHLAKE CAMPUS) PART V, SECTION B, LINE 13B: METHODIST HOSPITALS PROVIDES EMERGENCY AND OTHER MEDICALLY NECESSARY SERVICES AT NO CHARGE TO THE PATIENT IF THE FAMILY INCOME IS AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG). PATIENTS WHOSE FAMILY INCOME IS BETWEEN 200 - 400% OF FPG ARE ELIGIBLE FOR SLIDING-SCALE FINANCIAL RELIEF. ALL OTHER APPLICANTS WILL BE SCREENED FOR OTHER SOURCES OF PAYMENT TO DETERMINE WHAT LEVEL OF FINANCIAL ASSISTANCE MAY BE GRANTED. THE METHODIST HOSPITALS, INC (NORTHLAKE CAMPUS) PART V, SECTION B, LINE 13H: FAMILY SIZE AND COMPOSITION. THE METHODIST HOSPITALS, INC (SOUTHLAKE CAMPUS) PART V, SECTION B, LINE 13H: FAMILY SIZE AND COMPOSITION THE METHODIST HOSPITALS, INC (NORTHLAKE CAMPUS) PART V, SECTION B, LINE 15E: METHODIST HOSPITALS MAY UTILIZE OTHER SOURCES OF INFORMATION TO MAKE INDIVIDUAL ASSESSMENTS OF FINANCIAL NEED. METHODIST MAY UTILIZE A THIRD-PARTY TO CONDUCT AN ELECTRONIC REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED USING A HEALTHCARE INDUSTRY-RECOGNIZED MODEL BASED ON PUBLIC RECORD DATABASES. IN ADDITION, METHODIST HOSPITALS PROVIDES WEB LINKS TO STATE AND FEDERAL INSURANCE PROGRAMS GEARED TOWARDS THE UNINSURED. THE METHODIST HOSPITALS, INC (SOUTHLAKE CAMPUS) PART V, SECTION B, LINE 15E: METHODIST HOSPITALS MAY UTILIZE OTHER SOURCES OF INFORMATION TO MAKE INDIVIDUAL ASSESSMENTS OF FINANCIAL NEED. METHODIST MAY UTILIZE A THIRD-PARTY TO CONDUCT AN ELECTRONIC REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED USING A HEALTHCARE INDUSTRY-RECOGNIZED MODEL BASED ON PUBLIC RECORD DATABASES. IN ADDITION, METHODIST HOSPITALS PROVIDES WEB LINKS TO STATE AND FEDERAL INSURANCE PROGRAMS GEARED TOWARDS THE UNINSURED. THE METHODIST HOSPITALS, INC (NORTHLAKE CAMPUS) PART V, SECTION B, LINE 16J: METHODIST HOSPITALS' FINANCIAL ASSISTANCE POLICY AND INSTRUCTIONS ON HOW TO CONTACT METHODIST FOR ASSISTANCE AND FURTHER INFORMATION IS POSTED IN THE HOSPITAL AND CLINIC REGISTRATION AND ADMITTING LOCATIONS, AND IN THE EMERGENCY DEPARTMENT AND ON THE HOSPITAL'S WEBSITE. INFORMATION MAY ALSO BE OBTAINED FROM FINANCIAL COUNSELORS. IN ADDITION, METHODIST HOSPITALS INCLUDES A REFERENCE TO THE PAYMENT POLICIES AND FINANCIAL ASSISTANCE ON ALL PRINTED MONTHLY STATEMENTS AND COLLECTION LETTERS. THE METHODIST HOSPITALS, INC (SOUTHLAKE CAMPUS) PART V, SECTION B, LINE 16J: METHODIST HOSPITALS' FINANCIAL ASSISTANCE POLICY AND INSTRUCTIONS ON HOW TO CONTACT METHODIST FOR ASSISTANCE AND FURTHER INFORMATION IS POSTED IN THE HOSPITAL AND CLINIC REGISTRATION AND ADMITTING LOCATIONS, AND IN THE EMERGENCY DEPARTMENT AND ON THE HOSPITAL'S WEBSITE. INFORMATION MAY ALSO BE OBTAINED FROM FINANCIAL COUNSELORS. IN ADDITION, METHODIST HOSPITALS INCLUDES A REFERENCE TO THE PAYMENT POLICIES AND FINANCIAL ASSISTANCE ON ALL PRINTED MONTHLY STATEMENTS AND COLLECTION LETTERS. THE METHODIST HOSPITALS, INC (NORTHLAKE CAMPUS) PART V, LINE 7: THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT CAN BE LOCATED AT THE FOLLOWING WEB ADDRESS -HTTP://WWW.METHODISTHOSPITALS.ORG/ABOUT_METHODIST/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ THE METHODIST HOSPITALS, INC (SOUTHLAKE CAMPUS) PART V, LINE 7: THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT CAN BE LOCATED AT THE FOLLOWING WEB ADDRESS -HTTP://WWW.METHODISTHOSPITALS.ORG/ABOUT_METHODIST/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ THE METHODIST HOSPITALS, INC (NORTHLAKE CAMPUS) PART V, LINES 16A, 16B, AND 16C:THE FAP, FAP APPLICATION, AND FAP PLAIN LANGUAGE SUMMARY CAN BE LOCATED AT THE FOLLOWING WEB ADDRESS - HTTP://WWW.METHODISTHOSPITALS.ORG/BILLING_INFO/OBTAINING-FINANCIAL-ASSISTANCE/ THE METHODIST HOSPITALS, INC (SOUTHLAKE CAMPUS) PART V, LINES 16A, 16B, AND 16C:THE FAP, FAP APPLICATION, AND FAP PLAIN LANGUAGE SUMMARY CAN BE LOCATED AT THE FOLLOWING WEB ADDRESS -HTTP://WWW.METHODISTHOSPITALS.ORG/BILLING_INFO/OBTAINING-FINANCIAL-ASSISTANCE/ 26 1 - METHODIST HOSPITALS MEDICAL OFFICE BUILDIN 101 E 87TH AVE MERRILLVILLE IN 46410 IMAGING AND LAB SERVICES; OUTPATIENT SURGERY CENTER; BREAST CENTER; PHYSICIA 2 - METHODIST HOSPITALS ENDOSCOPY CENTER 8895 BROADWAY MERRILLVILLE IN 46410 OUTPATIENT ENDOSCOPY CENTER 3 - METHODIST HOSPITALS INC 2269 WEST 25TH STREET GARY IN 46404 OUTPATIENT REHAB/PHYSICIAN OFFICES 4 - METHODIST HOSPITALS PHYSICIAN GROUP 5800 BROADWAY MERRILLVILLE IN 46410 PHYSICIAN OFFICES-CARDIOLOGY 5 - METHODIST HOSPITALS NORTHLAKE PHYSICIANS C 650 GRANT ST GARY IN 46408 PHYSICIAN OFFICES-FAMILY MEDICINE, SURGERY, UROLOGY 6 - METHODIST HOSPITALS PHYSICIAN GROUP 202 E 86TH BROADWAY STES 200 201 202-B MERRILLVILLE IN 46410 PHYSICIAN OFFICES-CARDIOLOGY 7 - METHODIST HOSPITALS REHAB CENTER 303 E 89TH AVE MERRILLVILLE IN 46410 OUTPATIENT REHAB, HOME HEALTH SERVICES 8 - METHODIST HOSPITAL CARDIOGRAPHICS LLC 600 GRANT STREET GARY IN 46402 EKG READING 9 - METHODIST HOSPITALS CARE FIRSTCARDIAC REH 751-761 EAST 81ST AVE MERRILLVILLE IN 46410 OUTPATIENT CARDIAC REHAB, IMMEDIATE CARE CLINIC, AND PHYSICIAN OFFICES-FAMIL 10 - METHODIST HOSPITALS PHYSICIAN GROUP 3195 BROADWAY GARY IN 46403 PHYSICIAN OFFICE-INTERNAL MEDICINE 11 - METHODIST HOSPITALS CENTER FOR ADVANCED CL 200 E 89TH AVE MERRILLVILLE IN 46410 PHYSICIAN OFFICES-NEUROSCIENCES 12 - SCHERERVILLE IMAGING CENTER 7860 BURR STREET SCHERERVILLE IN 46375 IMAGING CENTER 13 - METHODIST HOSPITALS PHYSICIAN GROUP 244 E 90TH DRIVE MERRILLVILLE IN 46410 PHYSICIAN OFFICE-PODIATRY 14 - METHODIST HOSPITALS PHYSICIAN GROUP 9105-A INDIANAPOLIS BLVD HIGHLAND IN 46322 PHYSICIAN OFFICE-PODIATRY 15 - METHODIST HOSPITALS PHYSICIAN GROUP 1275 E NORTH STREET CROWN POINT IN 46307 IMMEDIATE CARE CLINIC AND PHYSICIAN OFFICES 16 - METHODIST HOSPITALS PHYSICIAN GROUP 6101 MILLER AVE GARY IN 46403 PHYSICIAN OFFICE-INTERNAL MEDICINE 17 - METHODIST HOSPITALS PHYSICIAN GROUP 2200 GRANT ST GARY IN 46404 PHYSICIAN OFFICE-OB/GYN 18 - METHODIST HOSPITALS PHYSICIAN GROUP 502 EAST CULVER RD KNOX IN 46534 PHYSICIAN OFFICE-CARDIOLOGY AND PODIATRY 19 - METHODIST HOSPITALS PHYSICIAN GROUP 10 N MICHIGAN HOBART IN 46342 PHYSICIAN OFFICE-INTERNAL MEDICINE 20 - METHODIST HOSPITALS PHYSICIAN GROUP 255 EAST 90TH DR - SUITE W1 MERRILLVILLE IN 46410 PHYSICIAN OFFICE-OTOLARYNGOLOGY 21 - METHODIST HOSPITALS PHYSICIAN GROUP 206 E 86TH ST MERRILLVILLE IN 46410 PHYSICIAN OFFICE-GENERAL SURGERY 22 - METHODIST HOSPITALS PHYSICIAN GROUP 3229 BROADWAY - STE 104 GARY IN 46409 PHYSICIAN OFFICES-CARDIOLOGY 23 - METHODIST HOSPITALS PHYSICIAN GROUP 801 WEST GLEN PARK AVE GRIFFITH IN 46319 PHYSICIAN OFFICE-GENERAL SURGERY 24 - METHODIST HOSPITALS PHYSICIAN GROUP 704 SOUTH STATE ROAD 2 HEBRON IN 46341 PHYSICIAN OFFICE-FAMILY MEDICINE 25 - METHODIST HOSPITALS PHYSICIAN GROUP 1212 BROAD ST GRIFFITH IN 46319 PHYSICIAN OFFICES-CARDIOLOGY 26 - METHODIST HOSPITALS PHYSICIAN GROUP 8733 W 400 N MICHIGAN CITY IN 46360 PHYSICIAN OFFICES-BARIATRIC PART I, LINE 3C: METHODIST HOSPITALS USES PUBLISHED FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR CHARITY OR MAY BE ELIGIBLE FOR SLIDING-SCALE FINANCIAL RELIEF. IF A PATIENT IS DEEMED TO HAVE A CATASTROPHIC BALANCE WHICH IS A BALANCE DUE TO METHODIST HOSPITALS THAT IS GREATER THAN 25% OF THE PATIENT'S ANNUAL FAMILY INCOME AS DETERMINED OVER A 12-MONTH PERIOD, THE PATIENT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. PART I, LINE 7: THE METHODOLOGY USED IS A COST-TO-CHARGE RATIO. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 25,621,302. PART II, COMMUNITY BUILDING ACTIVITIES: METHODIST HOSPITALS' COMMUNITY ENGAGEMENT INCLUDES A BROAD RANGE OF AFFILIATIONS AND PARTNERSHIPS INCLUDING THE CITY OF GARY, GARY LITERACY COALITION, YWCA OF GARY, LOCAL CHAMBERS OF COMMERCE, COMMUNITY ORGANIZATIONS FOR FAMILIES AND YOUTH, AND THE MERRILLVILLE HIGH SCHOOL INTERNSHIP PROGRAM. THE HOSPITAL IS ALSO A LEADER IN THE SUPPORT OF A NUMBER OF HEALTH ADVOCACY ORGANIZATION INCLUDING THE AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, PINK RIBBON SOCIETY, NATIONAL MULTIPLE SCLEROSIS SOCIETY, PARKINSON'S FOUNDATION, AND THE MARCH OF DIMES. METHODIST ALSO DEMONSTRATES ITS COMMITMENT TO THE HEALTH OF ITS SURROUNDING COMMUNITIES THROUGH A WIDE ARRAY OF COMMUNITY OUTREACH PROGRAMS INCLUDING: VARIOUS SCREENING PROGRAMS, SUPPORT GROUPS, FREE HEALTH FAIRS, AND EDUCATION SEMINARS. PART III, LINE 2: A SIGNIFICANT PORTION OF UNINSURED PATIENTS ARE UNABLE OR UNWILLING TO PAY FOR SERVICES RENDERED BY THE HOSPITAL. FOR THOSE PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, BASED ON HISTORICAL EXPERIENCE, A PROVISION FOR BAD DEBTS IS RECORDED RELATED TO THESE PARTICULAR PATIENTS. PART III, LINE 3: FOR UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE DUE TO INCOMPLETE APPLICATIONS, A PROVISON FOR BAD DEBT IS RECORDED BASED UPON HISTORICAL EXPERIENCE. PART III, LINE 4: GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE HOSPITAL ALSO PROVIDES SERVICES TO UNINSURED PATIENTS, AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. FOR THE YEARS ENDED DECEMBER 31, 2019 AND 2018, CHANGES IN ITS ESTIMATES OF IMPLICIT PRICE CONCESSIONS, DISCOUNTS, AND CONTRACTUAL ADJUSTMENTS FOR PERFORMANCE OBLIGATIONS SATISFIED IN PRIOR YEARS WERE NOT SIGNIFICANT. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. PART III, LINE 8: THE HOSPITAL DOES NOT REPORT ANY SHORTFALL WITH MEDICARE AS A COMMUNITY BENEFIT. PART III, LINE 9B: LIABILITIES FOR NON-COVERED SERVICES, INSURANCE RESIDUALS AND PURE SELF PAY LIABILITIES ARE DUE WITHIN 30 DAYS OF DISCHARGE. ATTEMPTS ARE MADE TO COLLECT DEDUCTIBLES PRE-SERVICE AND DEPOSITS OR PAYMENT IN-FULL PRE-SERVICE FOR SELF-PAY PATIENTS. IF A PATIENT CANNOT PAY THE ENTIRE BALANCE WITHIN 30 DAYS, PAYMENT PLANS ARE AVAILABLE. IF THE PATIENT CANNOT PAY AT ALL, THE HOSPITAL OFFERS NEED-BASED FINANCIAL ASSISTANCE BASED ON HOUSEHOLD INCOME AS A PERCENT OF THE FPL. PATIENTS WHO HAVE THE ABILITY TO PAY, YET DEFAULT ON PAYMENT PLANS ARE SENT TO COLLECTIONS (BAD DEBT). ACCOUNTS EVALUATED FOR BAD DEBT ARE PERIODICALLY RE-SCREENED FOR PRESUMPTIVE CHARITY QUALIFICATION AND IF QUALIFIED, ARE REMOVED FROM THE COLLECTION PROCESS. MEDICARE RESIDUALS ARE INVOICED TO THE PATIENT AND SENT THROUGH A BAD DEBT COLLECTION CYCLE. IF COLLECTION ATTEMPTS ARE UNSUCCESSFUL, THE MEDICARE ACCOUNT IS REMOVED FROM COLLECTIONS AND IS REPORTED AS MEDICARE BAD DEBT. PART VI, LINE 2: METHODIST HOSPITALS, INC. ASSESSES THE SERVICES NEEDED BASED UPON A REVIEW OF DEMOGRAPHIC AND CLINICAL FACTORS. BASED UPON THE DATA, THE HEALTHCARE NEEDS ARE THEN COMPARED TO THE SERVICES CURRENTLY PROVIDED OR AVAILABLE IN THE IMMEDIATE AREA AND SURROUNDING COMMUNITIES. METHODIST HOSPITAL ALSO HAD AN INDEPENDENT COMMUNITY HEALTH NEEDS ASSESSMENT PERFORMED TO DETERMINE THE HEALTH STATUS, BEHAVIORS, AND NEEDS FOR RESIDENTS IN THE HOSPITAL'S SERVICE AREAS. PART VI, LINE 3: METHODIST PROVIDES PATIENTS WITH A PAYMENT OPTIONS BROCHURE AND "FINANCIALLY CLEARS" PATIENTS PRIOR TO SERVICE DELIVERY. FINANCIAL CLEARANCE INVOLVES ESTIMATING THE PATIENT LIABILITY, EDUCATING THE PATIENT ABOUT INSURANCE BENEFITS AND OUT-OF-POCKET EXPENSES AND AGREEING TO A PLAN WITH THE PATIENT FOR HOW THAT LIABILITY WILL BE COVERED. SELF PAY PATIENTS ARE SCREENED FOR ELIGIBILITY FOR FEDERAL, STATE AND LOCAL PAYMENT SOURCES. IN ADDITION, METHODIST PUBLICIZES ON ITS WEBSITE INFORMATION ABOUT THE VARIOUS FINANCIAL ASSISTANCE PLANS THAT A PATIENT MAY BE ELIGIBLE FOR ALONG WITH THE NECESSARY APPLICATIONS. PART VI, LINE 4: METHODIST HOSPITALS SERVES NORTHWEST INDIANA WITH THE PRIMARY GEOGRAPHIC AREA BEING SERVED AS LAKE COUNTY, INDIANA. PORTER COUNTY, INDIANA COMPRISES MOST OF THE SECONDARY SERVICE AREA. THE DEMOGRAPHIC AREA OF THE REGION IS VERY DIVERSE, RANGING FROM THE VERY AFFLUENT TO A SIGNIFICANT INDIGENT POPULATION. PART VI, LINE 5: METHODIST HOSPITALS, INC. PROVIDES MONTHLY STROKE AND CANCER SCREENINGS, AND THROUGHOUT THE YEAR OFFERS: PREVENTATIVE HEALTHCARE SCREENINGS, WORKSHOPS, INTERNSHIPS FOR HIGH SCHOOL STUDENTS, EDUCATIONAL SEMINARS, AND HOSTS VARIOUS SUPPORT GROUPS THAT COMMUNITY MEMBERS CAN ATTEND. THE MAJORITY OF THE GOVERNING BODY MEMBERS LIVE AND/OR WORK WITHIN METHODIST HOSPITALS' SERVICE AREAS. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES IN 0 AMERICAN HEART ASSOCIATION 405 BOARDWALK HEBRON IN 46341 135613797 501(C)(3) 25000 HEART DISEASE AWARENESS/PREVENTION PROGRAMS GARY LITERACY COALITION 650 GRANT ST - SUITE 5 GARY IN 46402 201323689 501(C)(3) 99084 SUPPORT LOCAL LITERACY PROGRAMS INDIAN AMERICAN CULTURAL CENTER 8605 MERRILLVILLE RD MERRILLVILLE IN 46410 351981658 501(C)(3) 11000 SUPPORT CULTURAL ARTS PROGRAMS INDIAN MEDICAL ASSOCIATION OF NW INDIANA 8605 MERRILLVILLE RD MERRILLVILLE IN 46410 314130002 501(C)(3) 11000 SUPPORT LOCAL HEALTH FAIRS AND SCHOLARSHIP SUPPORT 4 0 PART I, LINE 2: THE ORGANIZATION DOES NOT MONITOR HOW THE GRANTS ARE USED BY THE ORGANIZATION RECEIVING THE FUNDS. X X X 0 1 0 0 0 0 0 1 0 VINEET SHAH PHYSICIAN 691354 0 0 0 0 0 8400 0 20954 0 720708 0 0 0 MIHAS KODENCHERY PHYSICIAN 521547 0 175148 0 0 0 4200 0 17337 0 718232 0 0 0 ANDRE ARTIS PHYSICIAN 684484 0 0 0 0 0 5600 0 10106 0 700190 0 0 0 RAYMOND GRADY CHIEF EXECUTIVE OFFICER 580743 0 36513 0 0 0 64274 0 10670 0 692200 0 0 0 ADOLPHUS ANEKWE PHYSICIAN 372034 0 243190 0 0 0 8143 0 21105 0 644472 0 0 0 THACH NGUYEN PHYSICIAN 529157 0 11350 0 0 0 0 0 17229 0 557736 0 0 0 VINCENT SEVIER CHIEF QUALITY OFFICER 347480 0 11310 0 0 0 8400 0 22505 0 389695 0 0 0 JAMES RENNEKER CHIEF NURSING OFFICER 303281 0 16825 0 0 0 8333 0 10120 0 338559 0 0 0 TRACEY CRANDALL VP OF HUMAN RESOURCES 261405 0 14915 0 0 0 0 0 22046 0 298366 0 0 0 WRIGHT ALCORN VP OF OPERATIONS 269040 0 8804 0 0 0 2407 0 15835 0 296086 0 0 0 ED ROMERO PART YR JAN-JUN CHIEF FINANCIAL OFFICER 230691 0 4707 0 0 0 0 0 11332 0 246730 0 0 0 PART I, LINE 4B RAYMOND GRADY PARTICIPATES IN A 457(F) PLAN. THE PURPOSE OF THE PLAN IS TO PROVIDE DEFERRED COMPENSATION PRIMARILY FOR THE PARTICIPANT. THE 457(F) PLAN IS AVAILABLE TO A SELECT GROUP OF MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES. RAYMOND GRADY DID NOT RECEIVE ANY DISTRIBUTIONS FROM THE PLAN DURING THE CALENDAR YEAR 2019. PART I, LINE 7 AS INDICATED IN SCHEDULE J, PART II, OFFICERS AND OTHER KEY EMPLOYEES RECEIVED A BONUS BASED ON PERFORMANCE AND THE FINANCIAL RESULTS OF THE ORGANIZATION. THIS BONUS WAS APPROVED BY THE EXECUTIVE STAFF FOR DIRECTOR-LEVEL BONUSES AND BY THE BOARD FOR EXECUTIVE STAFF BONUSES. A INDIANA FINANCE AUTHORITY 351602316 45471AMK5 2014-08-27 52517507 REFUND PRIOR ISSUE DATED 8/15/2001 0 0 0 A 2350000 52517507 4632368 425250 2005 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 0 0 0 1 1 A 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: INDIANA FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 09/19/2019 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CONTROLLER AND CFO OF THE ORGANIZATION AND THEN SENT TO MEMBERS OF THE GOVERNING BODY FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD PASSED A RESOLUTION IN 1994 WHICH REQUIRES EACH BOARD MEMBER TO ANNUALLY DISCLOSE ALL SITUATIONS WHERE A POTENTIAL CONFLICT OF INTEREST MAY EXIST. THE CONFLICT OF INTEREST/RELATED PARTY QUESTIONNAIRES ARE COMPLETED AND REVIEWED ON AN ANNUAL BASIS. ANY POTENTIALLY CONFLICTED DIRECTORS ARE PROHIBITED FROM PARTICIPATING IN THE DISCUSSION ABOUT OR VOTING ON ANY CONFLICTED ISSUE. FORM 990, PART VI, SECTION B, LINE 15 THE HR AND GOVERNANCE COMMITTEE USES INDEPENDENT AND EXTERNAL RESOURCES FOR THE ESTABLISHMENT OF COMPENSATION FOR OFFICERS AND OTHER KEY EMPLOYEES. THE COMMITTEE USES COMPARABILITY DATA AND MARKET COMPARISONS INCLUDING COMPENSATION SURVEYS AND FORM 990 INFORMATION FROM OTHER ORGANIZATIONS AS PART OF THE COMPENSATION DETERMINATION PROCESS. THE COMPENSATION APPROACH, PROCESS, AND DATA ARE THOROUGHLY DISCUSSED IN THE COMMITTEE MEETINGS AND THE REVIEW AND APPROVALS ARE DOCUMENTED THROUGHOUT THE PROCESS. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS 2019. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 2,147,554. MANAGEMENT AND GENERAL EXPENSES 74,150. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,221,704. CONSULTING: PROGRAM SERVICE EXPENSES 1,049,238. MANAGEMENT AND GENERAL EXPENSES 197,651. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,246,889. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 9,644,355. MANAGEMENT AND GENERAL EXPENSES 55,895. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,700,250. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 21,251,077. MANAGEMENT AND GENERAL EXPENSES 6,817,408. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,068,485. BILLING: PROGRAM SERVICE EXPENSES 44,787. MANAGEMENT AND GENERAL EXPENSES 29,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,787. MARKETING: PROGRAM SERVICE EXPENSES 101,955. MANAGEMENT AND GENERAL EXPENSES 18,184. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 120,139. TRANSCRIPTION SERVICES: PROGRAM SERVICE EXPENSES 115,387. MANAGEMENT AND GENERAL EXPENSES 20,435. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 135,822. REFERENCE LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 1,357,080. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,357,080. TRANSPORTATION SERVICES: PROGRAM SERVICE EXPENSES 247,544. MANAGEMENT AND GENERAL EXPENSES 68,002. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 315,546. COLLECTION FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 953,986. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 953,986. FORM 990, PART XI, LINE 9: PENSION RELATED CHANGES OTHER THAN NET PERIODIC COST -3,855,988. GOODWILL IMPAIRMENT -2,500,000. PART XII, LINE 2C THERE HAS BEEN NO CHANGE IN PROCESS FROM PRIOR YEAR. 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