INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC (EIN 26-2772226)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-15
IRS object ID
201613209349305236
Schema version
2015v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-11-15T10:41:38-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 4000AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN262772226EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1INDIANA UNIVERSITY HEALTH TIPTON HOSPITALBusinessNameLine1Txt
Business Name Line2INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
In Care Of% BROC L BUDDEInCareOfNm
Business Name ControlINDIBusinessNameControlTxt
Phone3179624575PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1950 N MERIDIAN STREET SUITE 800AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL L HARLOWEPersonNm
Person TitlePRESIDENT & CEOPersonTitleTxt
Phone3179624575PhoneNum
Signature2016-11-14SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJENNIFER D RHODERICKPreparerPersonNm
PTINP00395735PTIN
Phone3176817000PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMICHAEL L HARLOWEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1950 N MERIDIAN ST STE 800AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$42,837,297GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressHTTP://IUHEALTH.ORG/TIPTON/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2008FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionImprove the health of our patients and community through innovation and excellence in care, education, research and service.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee283TotalEmployeeCnt
Total Volunteers30TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$47,547PYContributionsGrantsAmt
CY Contributions Grants$273,496CYContributionsGrantsAmt
PY Program Service Revenue$40,331,212PYProgramServiceRevenueAmt
CY Program Service Revenue$40,917,614CYProgramServiceRevenueAmt
PY Investment Income$15,691PYInvestmentIncomeAmt
CY Investment Income$26,549CYInvestmentIncomeAmt
PY Other Revenue$335,063PYOtherRevenueAmt
CY Other Revenue$298,267CYOtherRevenueAmt
PY Total Revenue$40,729,513PYTotalRevenueAmt
CY Total Revenue$41,515,926CYTotalRevenueAmt
PY Grants And Similar Paid$9,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$13,879,076PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$11,869,174CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$28,662,104PYOtherExpensesAmt
CY Other Expenses$24,188,001CYOtherExpensesAmt
PY Total Expenses$42,550,180PYTotalExpensesAmt
CY Total Expenses$36,057,175CYTotalExpensesAmt
PY Revenues Less Expenses-$1,820,667PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,458,751CYRevenuesLessExpensesAmt
Total Assets BOY$39,998,033TotalAssetsBOYAmt
Total Assets EOY$46,260,557TotalAssetsEOYAmt
Total Liabilities BOY$26,033,565TotalLiabilitiesBOYAmt
Total Liabilities EOY$26,774,029TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$13,964,468NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$19,486,528NetAssetsOrFundBalancesEOYAmt
MissionImprove the health of our patients and community through innovation and excellence in care, education, research and service.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$29,384,322ExpenseAmt
Grant$0GrantAmt
Revenue$40,917,614RevenueAmt
DescIndiana University Health Tipton Hospital, Inc. ("IU Health Tipton Hospital"), located in Tipton, Indiana, is a 25-bed acute-care and critical access hospital that offers a broad range of services to care for its patients without regard to their ability to pay. IU Health Tipton Hospital provides leading-edge, patient-centered care, as well as personalized nursing care, in a wide range of medical specialties to residents of Tipton County and its surrounding communities.Desc
Total Program Service Expenses$29,384,322TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document41IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee283EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBROC L BUDDEPersonNm
Phone3179624575PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1950 N MERIDIAN ST STE 800AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
STEVEN A WERTZ
CHAIRMAN1.00.0Yes (X)Yes (X)$3,600$0$0
LINDA G JOINES
DIRECTOR/SECRETARY1.00.0Yes (X)Yes (X)$3,600$0$0
TAMERA N BROWN
DIRECTOR1.00.0Yes (X)$3,600$0$0
JONATHAN R GOBLE
DIRECTOR1.055.0Yes (X)$0$564,643$117,314
BEN B HOBBS
DIRECTOR1.00.0Yes (X)$3,600$0$0
DESTRY W LAMBERT MD
DIRECTOR1.00.0Yes (X)$3,600$0$0
DAVID L VORIS
DIRECTOR1.00.0Yes (X)$3,600$0$0
MICHAEL L HARLOWE
PRESIDENT & CEO0.055.0Yes (X)$0$242,686$31,685
RANDALL C YUST
CFO0.055.0Yes (X)$0$285,458$30,797
GUARAV ARORA MD
CMO0.055.0$0$592,476$33,263Yes (X)
JEFFERY W MOORE RN
C.R.N.A.40.00.0$203,166$0$8,096Yes (X)
JENNIFER L HARRISON
DIRECTOR, CLINICAL OPERATIONS40.00.0$144,045$0$29,103Yes (X)
JOELLEN SCOTT RN
SVP & CNO40.00.0$143,069$0$15,064Yes (X)
ANGELA K MORGAN
MANAGER, PHARMACY DEPT.40.00.0$112,386$0$34,058Yes (X)
CATHERINE L WHITE
PHARMACIST40.00.0$104,099$0$22,249Yes (X)
ANGELA S THOMPSON
VP, HR & SUPPORT SERVICES0.055.0$0$193,816$60,171Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$728,365TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,879,079TotReportableCompRltdOrgAmt
Total Other Compensation$381,800TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ARAMARK
10510 TWIN LAKES PARKWAYCHARLOTTENC28269FACILITIES MGMT.$612,808
MESSER CONSTRUCTION CO INC
5158 FISHWICK DRIVECINCINNATIOH45216CONSTRUCTION$341,231
ANESTHESIA CONSULTANTS OF INDIANAPO
3815 RIVER CROSSING PKWYINDIANAPOLISIN46240MEDICAL$333,333
IRRIGATION PLUS INC
22918 MULE BARN RDSHERIDANIN46069LANDSCAPING$210,196
MEYER NAJEM CONSTRUCTION LLC
10399 PARKSIDE DRIVEFISHERSIN46038CONSTRUCTION$192,762
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt
Related Organizations$244,837RelatedOrganizationsAmt
Government Grants$28,659GovernmentGrantsAmt
Total Contributions$273,496TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621110$40,076,893$40,076,893
SHARED SERVICES541900$76,074$76,074
PHARMACY621500$222,455$222,455
RENT FROM RELATED 501(C)(3) ORGS.532000$250,443$250,443
ELECTRONIC HEALTH RECORDS INCENTIVE900099$291,749$291,749
FieldValueIRS element (for citing)
Total Program Service Revenue$40,917,614TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$65,825TotalRevenueColumnAmt
Exclusion$65,825ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$95,446RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$95,446RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$95,446TotalRevenueColumnAmt
Exclusion$95,446ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,282,095SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,321,365SecuritiesAmt
Other$6OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$39,270SecuritiesAmt
Other-$6OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$39,276TotalRevenueColumnAmt
Exclusion-$39,276ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA/FOOD SERVICE722320$87,536$87,536
EDUCATION900099$351$351
FITNESS CENTER900099$32,347$32,347

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$82,587TotalRevenueColumnAmt
Exclusion$82,587ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$202,821OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$41,515,926TotalRevenueColumnAmt
Related Or Exempt Func Income$40,917,614RelatedOrExemptFuncIncomeAmt
Exclusion$324,816ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$21,600TotalAmt
Program Services$17,912ProgramServicesAmt
Management And General$3,688ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$9,303,252TotalAmt
Program Services$7,714,619ProgramServicesAmt
Management And General$1,588,633ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$410,834TotalAmt
Program Services$340,680ProgramServicesAmt
Management And General$70,154ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,452,194TotalAmt
Program Services$1,204,216ProgramServicesAmt
Management And General$247,978ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$681,294TotalAmt
Program Services$564,956ProgramServicesAmt
Management And General$116,338ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$29,922TotalAmt
Management And General$29,922ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$2,635TotalAmt
Management And General$2,635ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$9,893TotalAmt
Management And General$9,893ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$9,822,682TotalAmt
Program Services$8,634,340ProgramServicesAmt
Management And General$1,188,342ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$10,223TotalAmt
Program Services$203ProgramServicesAmt
Management And General$10,020ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$111,429TotalAmt
Program Services$56,813ProgramServicesAmt
Management And General$54,616ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$60,485TotalAmt
Program Services$10,530ProgramServicesAmt
Management And General$49,955ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,299,234TotalAmt
Program Services$2,045,701ProgramServicesAmt
Management And General$253,533ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$10,151TotalAmt
Program Services$5,511ProgramServicesAmt
Management And General$4,640ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,512TotalAmt
Program Services$1,117ProgramServicesAmt
Management And General$395ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$878,345TotalAmt
Program Services$17,847ProgramServicesAmt
Management And General$860,498ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,859,931TotalAmt
Program Services$125,887ProgramServicesAmt
Management And General$1,734,044ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$279,402TotalAmt
Program Services$1,641ProgramServicesAmt
Management And General$277,761ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
DRUGS AND MEDICAL SUPPLIES$4,790,066$4,790,066
BAD DEBT$3,090,175$3,090,175
INSTITUTIONAL DUES/LICENSES$37,017$37,017
HOSPITAL ASSESSMENT FEE$673,750$673,750

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$221,149TotalAmt
Program Services$51,341ProgramServicesAmt
Management And General$169,808ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$36,057,175TotalAmt
Program Services$29,384,322ProgramServicesAmt
Management And General$6,672,853ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,000BOYAmt
EOY$40EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,186,964BOYAmt
EOY$11,412,734EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,988,662BOYAmt
EOY$4,309,644EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$751,819BOYAmt
EOY$731,298EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$203,364BOYAmt
EOY$147,254EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$13,538,822LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$8,698,907LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,099,167BOYAmt
EOY$4,839,915EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$5,169,740BOYAmt
EOY$5,099,947EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$11,445,283BOYAmt
EOY$11,050,618EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$9,151,034BOYAmt
EOY$8,669,107EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$39,998,033BOYAmt
EOY$46,260,557EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,779,022BOYAmt
EOY$2,821,512EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,172BOYAmt
EOY$1,172EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$23,676BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$22,229,695BOYAmt
EOY$23,951,345EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$26,033,565BOYAmt
EOY$26,774,029EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,211,488BOYAmt
EOY$10,817,421EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,794,979BOYAmt
EOY$2,697,415EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,958,001BOYAmt
EOY$5,971,692EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,964,468BOYAmt
EOY$19,486,528EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$39,998,033BOYAmt
EOY$46,260,557EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,458,751ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$77,152NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$140,461OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$2,635OtherActivitiesAmt
Total Lobbying Expenditures$2,635TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule C, Part II-B, Line 1i - Other ActivitiesFormAndLineReferenceDesc
ExplanationIU Health Tipton Hospital paid institutional membership dues to the American Hospital Association ("AHA") and Indiana Hospital Association ("IHA") during 2015 in the amount of $10,671 and $4,009, respectively. Each membership organization notified IU Health Tipton Hospital that a portion of the dues it paid were used for lobbying purposes. The AHA used 22.80%, or $2,433 of 2015 membership dues paid by IU Health Tipton Hospital, for lobbying expenditures. The IHA used 5.05%, or $202 of the 2015 membership dues paid by IU Health Tipton Hospital, for lobbying expenditures. The total membership dues paid to these organizations by IU Health Tipton Hospital during 2015 that were attributable to lobbying expenditures was $2,635.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$8,752,980BeginningYearBalanceAmt
Contributions$25,533ContributionsAmt
Investment Earnings Or Losses$196,490InvestmentEarningsOrLossesAmt
Grants Or Scholarships$220,413GrantsOrScholarshipsAmt
Administrative Expenses$85,483AdministrativeExpensesAmt
End Year Balance$8,669,107EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$8,463,912BeginningYearBalanceAmt
Contributions$25,739ContributionsAmt
Investment Earnings Or Losses$583,156InvestmentEarningsOrLossesAmt
Grants Or Scholarships$235,348GrantsOrScholarshipsAmt
Administrative Expenses$84,479AdministrativeExpensesAmt
End Year Balance$8,752,980EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$8,504,412BeginningYearBalanceAmt
Contributions$31,259ContributionsAmt
Investment Earnings Or Losses$291,508InvestmentEarningsOrLossesAmt
Grants Or Scholarships$321,643GrantsOrScholarshipsAmt
Administrative Expenses$41,624AdministrativeExpensesAmt
End Year Balance$8,463,912EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$8,387,765BeginningYearBalanceAmt
Contributions$69,674ContributionsAmt
Investment Earnings Or Losses$475,455InvestmentEarningsOrLossesAmt
Grants Or Scholarships$401,734GrantsOrScholarshipsAmt
Administrative Expenses$26,748AdministrativeExpensesAmt
End Year Balance$8,504,412EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$8,356,870BeginningYearBalanceAmt
Contributions$21,461ContributionsAmt
Investment Earnings Or Losses$459,775InvestmentEarningsOrLossesAmt
Grants Or Scholarships$421,350GrantsOrScholarshipsAmt
Administrative Expenses$28,991AdministrativeExpensesAmt
End Year Balance$8,387,765EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.68880PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.31120TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd
LandLandGrp
BuildingsBuildingsGrp

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,098,520OtherCostOrOtherBasisAmt
Depreciation$754,697DepreciationAmt
Book Value$1,343,823BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,434,465OtherCostOrOtherBasisAmt
Depreciation$7,938,373DepreciationAmt
Book Value$3,496,092BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,837OtherCostOrOtherBasisAmt
Depreciation$5,837DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,839,915TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescINT. IN NET ASSETS OF FNDTN.Desc
Book Value$8,669,107BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$8,669,107TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
INTERCOMPANY PAYABLES (NET)$19,423,326
DUE TO THIRD-PARTY PAYORS$4,480,718
SELF INSURANCE LIABILITIES$47,301
FieldValueIRS element (for citing)
Total Liability$23,951,345TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part V, Line 4 - Intended Uses of Org.'s Endowment FundsTemporarily and permanently restricted net assets represent endowments held by Tipton County Foundation, Inc., an unrelated 501(c)(3) tax-exempt organization, of which Indiana University Health Tipton Hospital, Inc. is the beneficiary. The uses of the funds are accordance with the donor-restrictions of each endowment.
Schedule D, Part X, Line 2 - FIN 48 (ASC 740) FootnoteIU Health Tipton Hospital is a subsidiary in the consolidated financial statements of Indiana University Health, Inc. ("IU Health"). IU Health adopted FIN 48 in 2007. No disclosures were required in 2015 under GAAP as IU Health does not have any material tax contingencies that required disclosures in the footnotes.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served1096PersonsServedCnt
Total Community Benefit Expns$1,246,232TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,246,232NetCommunityBenefitExpnsAmt
Total Expense0.03780TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served1797PersonsServedCnt
Total Community Benefit Expns$4,558,956TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,821,623DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,737,333NetCommunityBenefitExpnsAmt
Total Expense0.08300TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served2893PersonsServedCnt
Total Community Benefit Expns$5,805,188TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,821,623DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,983,565NetCommunityBenefitExpnsAmt
Total Expense0.12080TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs16ActivitiesOrProgramsCnt
Persons Served8943PersonsServedCnt
Total Community Benefit Expns$139,872TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$139,872NetCommunityBenefitExpnsAmt
Total Expense0.00420TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served143PersonsServedCnt
Total Community Benefit Expns$270,872TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$270,872NetCommunityBenefitExpnsAmt
Total Expense0.00820TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served94PersonsServedCnt
Total Community Benefit Expns$5,829TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,829NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs21ActivitiesOrProgramsCnt
Persons Served9180PersonsServedCnt
Total Community Benefit Expns$416,573TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$416,573NetCommunityBenefitExpnsAmt
Total Expense0.01260TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs21ActivitiesOrProgramsCnt
Persons Served12073PersonsServedCnt
Total Community Benefit Expns$6,221,761TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,821,623DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,400,138NetCommunityBenefitExpnsAmt
Total Expense0.13340TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served28PersonsServedCnt
Total Community Benefit Expns$5,074TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,074NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$573TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$573NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Persons Served28PersonsServedCnt
Total Community Benefit Expns$5,647TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,647NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$1,033,012BadDebtExpenseAmt
Reimbursed By Medicare$14,378,041ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$13,366,080CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$1,011,961MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1IU HEALTH TIPTON HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 S MAIN STAddressLine1Txt
CityTIPTONCityNm
State AbbreviationINStateAbbreviationCd
ZIP46072ZIPCd
FieldValueIRS element (for citing)
Website AddressHTTP://IUHEALTH.ORG/TIPTON/WebsiteAddressTxt
State License15-005049-1StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1IU HEALTH TIPTON HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 - Input from CommunityIn conjunction with other area hospitals, IU Health Tipton Hospital's approach to gathering qualitative data for its CHNA consisted of a multi-component approach to identify and verify community health needs for the IU Health Tipton Hospital service area. This included the following components: 1. Hosting multiple one and a half to two hour community conversation focus groups with public health officials and community leaders in attendance to discuss the healthcare needs of the service area and what role IU Health Tipton Hospital could play in addressing the identified need. 2. Surveying the community at large through the hospital's website, with special emphasis to garner input from low income, uninsured, or minority groups. To obtain a more complete picture of the factors that play into IU Health Tipton Hospitals communitys health, input from public health officials and community leaders in Tipton County were gathered through multiple one and half to two hour community and audience-specific focus groups/town halls. In addition, the community at large was surveyed, with special attention to gathering input from low income, uninsured, or minority groups. The goal of soliciting these leaders feedback was to gather insights into the quantitative data that may not be easily identified from the secondary statistical data alone. Attendees who participated in the focus group included: Thomas Clark - Chief of Police, Tipton County Police Department Kristina Craig - Program Coordinator, Chrysler Kevin Emsweller - Superintendent, Tipton County School Corporation Tony Frawley - Sheriff, Tipton County Sheriff Department Frank Giammarino - President, Tipton County Foundation Melinda Goodnight - Director, Encore Hope Lashlee - Case Manager, Area 5 Terri Newcom - Extension Educator, Purdue Extension Cindy Wagoner - Supervisor, Area 5 Hannah Woods - ATL, Chrysler To obtain a more complete picture of the factors that play into the Tipton County communitys health, input from local health leaders was gathered through a focus group session lasting three hours. IU Health facilitators mailed letters and made follow-up telephone calls inviting public health officials and community leaders to attend the focus group discussion, paying special attention to including organizations that represent the interest of low-income, minority and uninsured individuals. The goal of soliciting these leaders feedback was to gather insights into the quantitative data that may not be easily identified from the secondary statistical data alone. IU Health facilitators presented the goals and requirements of the CHNA, reviewed secondary health data including demographics, insurance information, poverty rates and county health rankings, causes of death, physical activity, chronic conditions and past needs identified during the previous CHNA cycle. Each participant was asked to select the top five health needs. After the results were tallied, a discussion to gain consensus of the top five health needs of the community was conducted, along with current resources and gaps for each need was discussed. This was intended to inspire candid discussions and give leaders another chance to vote for their top five needs from the list. The focus group concluded by sharing a timeline of next steps and accomplishments since the last CHNA. IU Health Tipton Hospital also solicited responses from the general public regarding the health of IU Health Tipton Hospital's community through an online survey as well as paper versions of the survey. The survey consisted of approximately 20 multiple choice and open-ended questions that assessed the community members feedback regarding healthcare issues and barriers to access. A link was made available on the hospitals website via an electronic survey tool from December 2014 through June 2015. A paper version was distributed to local community businesses, local chamber members, community health fairs and events, as well as within some hospital patient waiting areas. In addition to disseminating directly to the general public of the community, the survey was also sent via e-mail to participants in the needs assessment focus groups to provide an opportunity for these community leaders to pass on to their local community members.
Schedule H, Part V, Section B, Line 7a - CHNA WebsiteA copy of IU Health Tipton Hospitals CHNA is available on its website at the following URL: http://iuhealth.org/about-iu-health/in-the-community/
Schedule H, Part V, Section B, Line 10a - Implementation Strategy WebsiteA copy of IU Health Tipton Hospitals CHNA implementation strategy is available on its website at the following URL: http://iuhealth.org/about-iu-health/in-the-community/
Schedule H, Part V, Section B, Line 11 - Addressing Identified NeedsIU Health Tipton Hospital prioritized and determined which of the community health needs identified in its most recently conducted CHNA were most critical for it to address by using the Hanlon Method of prioritization. This method prioritizes identified needs based upon the prevalence and severity of the need and the effectiveness of interventions available to address the needs. Based upon the Hanlon Method of prioritization, IU Health Tipton Hospital selected the following four needs to be addressed: - Behavioral Health (includes Mental Health/Substance Abuse) - Nutrition and Active Living - Access to Healthcare - Chronic Disease Behavioral Health (includes Mental Health/Substance Abuse) IU Health Tipton Hospital's implementation strategy to address the identified need of behavioral health includes the following: - Inpatient referrals to 1-800-QUIT-NOW - School based and worksite educational programs - Grants and Partnerships (Drug Prevention) - When appropriate, financial donations will also be considered to local organizations addressing behavioral health in Tipton County Nutrition and Active Living IU Health Tipton Hospital's implementation strategy to address the identified need of nutrition and active living includes the following: - Continue partnership option with local farmers market, offer health screening when appropriate. Offer physical activity ideas for the family - Explore partnerships with integrating nutrition and active living in Tipton County school systems - Have IU Health Tipton Hospital as one of the sites for the IU Health Market, an onsite fresh produce market - Participate in the statewide campaigns (potentially: Wellness Competitions/Fitbits/Ways of Wellness; Strong Schools; Famers Markets, etc. Access to Healthcare IU Health Tipton Hospital's implementation strategy to address the identified need of access to healthcare includes the following: - Help the Tipton County residents locate a primary care physician by promoting IU Health Find a Doc Resource - Continue to provide health screenings at off-site community events - Increase service line participation and attendance at the annual community health fair - Increase education about available healthcare options and educate residents on when it's appropriate to use the ED - Increase availability of Community Health Workers - Increase availability of walk-in clinics and physicians Chronic Disease IU Health Tipton Hospital's implementation strategy to address the identified need of chronic disease includes the following: - Educational resources to local businesses on service lines (Cancer, Cardiology, Cardiac Rehab, etc.), attend established meetings to share education and offer screenings - When appropriate, financial donations will also be considered to local organizations addressing chronic disease in Tipton County Also, based upon the Hanlon Method of prioritization, the following identified community health needs were not chosen as one of the needs to be addressed: - Injury Prevention - Prenatal Health - Infant Mortality After completing a gap analysis, IU Health Tipton Hospital determined that the severity of and lack of resources available to address the four needs chosen to be addressed outweighed the severity of and resources available to address the three needs not chosen.
Schedule H, Part V, Section B, Line 13b - Income Level Other than FPGIn addition to FPG, IU Health Tipton 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 FactorsIU Health Tipton Hospital takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. Alternate Sources of Assistance When technically feasible, a patient will be required to exhaust all other state and federal assistance programs prior to receiving an award from IU Health Tipton 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 Tipton 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 their insurance provider at the request of IU Health Tipton Hospital. Eligible patients who receive medical care from an IU Health Tipton Hospital facility 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 Tipton Hospital is entitled. Said patients may be asked to complete a financial assistance application. 2. Presumptive Financial Assistance Eligibility Patients who are deemed to be presumptively eligible for Financial Assistance will receive a Financial Adjustment to their final statement balance based on the patients individual scoring criteria. Patients are considered to be presumptively eligible for Financial Assistance if the financial need has been determined by the following third parties: Eskenazi Health, formerly Wishard Memorial Hospital, Project Health, Indiana Childrens Special Health Care Services, Medicaid, Out-of-State Medicaid, Healthy Indiana Plan, or Volunteers in Medicine. Patients are also considered to be presumptively eligible if they are pending Medicaid approval or have a hospital bill with a maximum balance to be determined by the Financial Assistance Committee and who meet certain risk segmentation scoring criteria. 3. Additional Considerations Financial Assistance may be granted to a deceased patients account if said patient is found to have no estate. Additionally, IU Health Tipton Hospital will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance application.
Schedule H, Part V, Section B, Line 16a - FAP WebsiteA copy of IU Health Tipton Hospitals FAP is available at the following URL: http://iuhealth.org/patients/my-iu-health/billing-services/financial-assis tance/
Schedule H, Part V, Section B, Line 16b - FAP Application WebsiteA copy of IU Health Tipton Hospitals FAP Application is available at the following URL: http://iuhealth.org/patients/my-iu-health/billing-services/financial-assis tance/
Schedule H, Part V, Section B, Line 16i - Other Measures to PublicizeIU Health Tipton Hospital takes several other measures to publicize its FAP within the community. These measures include the following: 1. Signs are posted in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 2. IU Health Tipton Hospital includes a plain language description of its FAP with all patient bills and statements of services. 3. IU Health Revenue Cycle Services representatives are available via telephone Monday through Friday, excluding major holidays, from 8 a.m. to 7 p.m. (Eastern Time) to address questions related to Financial Assistance. 4. IU Health Revenue Cycle Services educates its patient facing team members of its FAP and the process for referring patients to the Program.
Schedule H, Part V, Section B, Line 22d - Other Determination of ChargesIU Health Tipton Hospital limits the amounts charged for Emergency or other Medically Necessary Services provided to individuals eligible for assistance under its FAP to not more than amounts generally billed to individuals who have insurance coverage for such care. The basis for calculating the amount charged to all patients, including those who are eligible for Financial Assistance, is derived through the use of a chargemaster or physician fee schedule and are uniformly applied. All additional discounts required by insurance contract or IU Health Tipton Hospitals FAP are applied to the chargemaster or physician fee schedule calculated amount. IU Health Tipton Hospital does not use gross charges in the calculation of the amount to charge a Financial Assistance eligible patient.

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 3c - Other Factors Used in Determining Elig.IU Health Tipton Hospital uses several factors other than Federal Poverty Guidelines ("FPGs") in determining eligibility for free or discounted care under its FAP. These factors include the following: 1. Indiana Residency Requirement IU Health Tipton Hospital only makes Financial Assistance available to residents of the State of Indiana. IU Health Tipton Hospital employs the same residency test as set forth in Indiana Code 6-3-1-12 to define as resident any individual who was domiciled in Indiana during the taxable year, or any individual who maintains a permanent place of residence in this state and spends more than one hundred eighty-three (183) days of the taxable year in Indiana. 2. Alternate Sources of Assistance When technically feasible, patients must exhaust all other state and federal assistance programs prior to receiving an award from IU Health Tipton 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 form IU Health Tipton 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 their insurance provider at the request of IU Health Tipton Hospital. Eligible patients who receive medical care from an IU Health Tipton Hospital facility 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 Tipton Hospital is entitled. Said patients may be asked to complete a financial assistance application. 3. Presumptive Financial Assistance Eligibility Patients who are deemed to be presumptively eligible for Financial Assistance will receive a Financial Adjustment to their final statement balance based on the patients individual scoring criteria. Patients are considered to be presumptively eligible if the financial need has been determined by the following third parties: Eskenazi Health, formerly Wishard Memorial Hospital, Project Health, Indiana Childrens Special Health Care Services, Medicaid, Out-of-State Medicaid, Healthy Indiana Plan, or Volunteers in Medicine. Patients may also be considered presumptively eligible if they are pending Medicaid approval or have a hospital bill with a maximum balance to be determined by the Financial Assistance Committee and who meet certain risk segmentation scoring criteria. 4. Additional Considerations Financial Assistance may be granted to a deceased patients account if said patient is found to have no estate. IU Health Tipton Hospital will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance Application. A patients income and/or ability to pay may be taken into consideration in the calculation of a financial assistance award. 5. Patient Assets IU Health Tipton Hospital will consider patient Assets in the calculation of a patients true financial burden. A patients primary residence and one (1) motor vehicle will be exempted from consideration in most cases. IU Health Tipton Hospital will apply the definitions set for in Indiana Administrative Code 405 IAC 2-3-15 to define a patients primary residence and motor vehicle. A patients primary residence is defined as the patients principal place of residence. The patients primary residence will be excluded from a patients extraordinary asset calculation so long as the patients equity is less than five-hundred thousand dollars ($500,000) and the home is not occupied by the patients spouse or child under twenty-one (21) years of age. One (1) motor vehicle, regardless of its fair market value, may be excluded in limited circumstances defined in Indiana Administrative Code 405 IAC 2-3-15(d)(6). IU Health Tipton Hospital reserves the right to adjust a patients Federal Poverty Level ("FPL") if the patient demonstrates a claim or clear title to any extraordinary Asset not excluded from consideration under the above guidance. IU Health Tipton Hospital will not seek the title to discovered Assets without the express authorization of the Financial Assistance Committee.
Schedule H, Part I, Line 6a - C.B. Report Prepared by a Related Org.IU Health Tipton Hospital 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 ("IU Health Statewide System"). The IU Health Community Benefit Report is made available to the public on IU Healths website at http://iuhealth.org/communitybenefit/. 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 Systems community benefit efforts. It is also available by request through the Indiana State Department of Health or IU Health. IU Health Tipton Hospital also makes printed copies of the IU Health Community Benefit Report available to all executives at the hospital as well as organizations within the community. It is also e-mailed to all Tipton County Chamber of Commerce members along with a link to find the report online.
Schedule H, Part I, Line 7, Column (f) - Bad Debt ExpenseThe 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 $3,090,175.
Schedule H, Part I, Line 7 - Total Community Benefit ExpenseSchedule 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 18.87%.
Schedule H, Part II - Promotion of Health in Communities ServedIU Health Tipton Hospital participates in a variety of community-building activities that address the social determinants of health in the communities it serves. IU Health Tipton Hospital is a subsidiary of IU Health. IU Health 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 addressed economic development, community support and workforce development. Several examples include IU Healths support of the following organizations and initiatives that focus on some of the root causes of health issues, such as lack of education, employment and poverty: - College Mentors for Kids - Starfish Initiative - Teach for America - United Way Additionally, through the IU Health Statewide Systems team member community benefit service program, "Strength That Cares", 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 bad debt expense of $1,033,012 reported on Schedule H, Part III, Line 2 is reported at cost, as calculated using the cost to charge ratio methodology.
Schedule H, Part III, Line 4 - Bad Debt ExpenseIU Health Tipton Hospital is a subsidiary in the consolidated financial statements of IU Health. IU Health's bad debt expense footnote is as follows: The provision for uncollectible accounts, for all payors, is recognized when services are provided based upon managements assessment of historical and expected net collections, taking into consideration business and economic conditions, changes and trends in health care coverage, and other collection indicators. Periodically, management assesses the adequacy of the allowance for uncollectible accounts based upon accounts receivable payor composition and aging, the significance of individual payors to outstanding accounts receivable balances, and historical write-off experience by payor category, as adjusted for collection indicators. The results of this review are then used to make any modifications to the provision for uncollectible accounts and the allowance for uncollectible accounts. In addition, the Indiana University Health System follows established guidelines for placing certain past due patient balances with collection agencies. Patient accounts that are uncollected, including those placed with collection agencies, are initially charged against the allowance for uncollectible accounts in accordance with collection policies of the Indiana University Health System and, in certain cases, are reclassified to charity care if deemed to otherwise meet financial assistance policies of the Indiana University Health System.
Schedule H, Part III, Line 8 - Medicare ShortfallAlthough IU Health Tipton Hospital is not showing a Medicare Shortfall for 2015, this is calculated in accordance with the Form 990 instructions, using "allowable costs" from IU Health Tipton Hospitals Medicare cost report. "Allowable Costs" for Medicare cost report purposes are not reflective of all costs associated with IU Health Tipton Hospitals participation in Medicare programs. For example, the Medicare cost report excludes certain costs such as billed physicians services, the costs of Medicare Parts C and D, Fee Schedule reimbursed services, and durable medical equipment services. Inclusions of all costs associated with IU Health Tipton Hospitals participations in Medicare Programs would flip the shown Medicare surplus reported on Schedule H, Part III, Line 7 to a shortfall. IU Health Tipton Hospital accepts all Medicare patients knowing that there may be shortfalls; therefore it has taken the position that the 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 PolicyIU Health Tipton's FAP and Bad Debt Referral 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 must submit a Financial Assistance Application within twenty-one (21) days of receiving their first billing statement from IU Health Tipton Hospital. Individuals other than the patient, such as the patients physician, family members, community or religious groups, social services or hospital personnel may request a Financial Assistance Application to be mailed to a patients primary mailing address free of charge. IU Health Tipton Hospital keeps all applications and supporting documentation confidential. 2. Eligibility Determination IU Health Tipton Hospital informs 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 assistance and the patient or guarantor provides additional information for reconsideration, 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 may 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 will remain in effect for three-hundred-sixty-five (365) days from the date of receipt of a completed application. 3. Extraordinary Collection Actions IU Health Tipton Hospital only implements its "Bad Debt Referral Policyother Extraordinary Collection Action after it has made reasonable efforts to determine whether the patient account is eligible for assistance under its FAP. When it is necessary to engage in such action, IU Health Tipton Hospital, and its contracted third parties, will engage in fair, respectful and transparent collections activities. Patients or guarantors who have not applied for Financial Assistance and whose accounts have been engaged in Extraordinary Collection Actions may request Financial Assistance, complete an Application with requested documentation, and be considered for a reduction in their bill if it is within the two-hundred-forty (240) days of receiving their first billing statement. IU Health Tipton Hospital may also suspend collection activity on an account while an Application is being processed and considered. IU Health Tipton Hospital and its collection agencies will not provide assistance after an account has entered into legal proceedings without first obtaining written consent from its Financial Assistance Committee. The award of Financial Assistance may be subject to successful completion of a payment plan. In the event a patient or guarantor who is receiving Financial Assistance fails to complete the terms of their payment plan, IU Health Tipton Hospital reserves the right to submit the unadjusted account balance, less any amount previously paid by the patient, to an Extraordinary Collection Action.
Schedule H, Part VI, Line 2 - Needs AssessmentCommunities are multifaceted and so are their health needs. IU Health Tipton 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 Tipton Hospital assesses the health care needs of the communities by utilizing the detailed community needs undertaken by organizations such as the Tipton County Health Department, the Indiana State Department of Health, the Centers for Disease Control and Prevention and the United Way of Central Indiana. After completion of the CHNA, IU Health Tipton Hospital reviewed the information gathered from community leader focus groups, community input surveys and statistical data. The needs identified were analyzed and ranked using the Hanlon method of prioritization to determine the prevalence and severity of community health needs and which ones were most critical. Additionally, the effectiveness of an intervention for each need and IU Healths ability to impact positive change was evaluated.
Schedule H, Part VI, Line 3 - Patient Education of Eligibility for Assist.IU Health Tipton 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 Tipton Hospital has adopted a Financial Assistance Policy that provides Financial Assistance to eligible patients receiving Emergency or Medically-Necessary Services. This policy was developed and is utilized to determine a patients financial ability to pay for services. IU Health Tipton Hospital goes to great lengths to publicize its financial assistance policy and ensure that patients know they will be treated regardless of their ability to pay. IU Health Tipton Hospital shares financial assistance information with patients throughout their entire episode of care and beyond including the admissions process, billing process, and online. 1. Admissions Process IU Health Tipton Hospital educates all patient facing team members on its Financial Assistance Policy and the process for referring patients to the program. During the admissions process, opportunities for financial assistance are discussed with patients who are identified as self-pay (uninsured) or if they request assistance information. The patient is also provided with an Admissions Packet that outlines information regarding IU Health Tipton Hospitals financial assistance program. Financial counselors are onsite to assist with financial concerns or questions during the patients stay. Patient Financial Services Customer Service representatives are also available after the patients stay to help patients apply for financial assistance, understand their bills, explain what they can expect during the billing process, accept payment (if needed), update their insurance or payor information, and update their address or other demographic information. 2. Billing Process IU Health Tipton Hospital includes a plain language summary of its Financial Assistance Policy with all patient bills and statements of services. The plain language summary includes contact information allowing patients the ability to request financial assistance. Additionally, a Financial Assistance Application is mailed to all IU Health Tipton Hospital patients with a patient balance due after insurance. IU Health Revenue Cycle Services representatives are available via telephone Monday through Friday, excluding major holidays, from 8 a.m. to 7 p.m. (Eastern Time) to address questions related to Financial Assistance. Customer Service team members will also mail paper applications to a patient at their request. 3. Online IU Health Tipton Hospitals Financial Assistance Policy and Financial Assistance Application are available on its website at http://iuhealth.org/patients/my-iu-health/billing-services/financial-assis tance/. The website also includes contact information for customer service representatives to assist with the application process.
Schedule H, Part VI, Line 4 - Community InformationIU Health Tipton Hospital is located in Tipton County, Indiana, a county located in central Indiana. Tipton County includes ZIP codes within the towns of Tipton, Elwood, Windfall City, Kempton, and Sharpsville. Based on the most recent Census Bureau (2014) statistics, Tipton Countys population is 15,415, with approximately 50% being female and 50% male. The countys population estimates by race are 95.3% white, 2.6% Hispanic, 0.5% Black, 0.5% Asian, 0.3% American Indiana or Alaska Native, and 0.8% persons reporting two or more races. Tipton County has relatively low levels of educational attainment. In the county, 10.8% did not complete high school and 41.3% stopped their education after high school or a GED; about a third (31%) have some college, which includes an associates degree. Just 16.4% have a bachelors degree or higher, which is far below the national level of more than 29% and below the state level of nearly 23%.
Schedule H, Part VI, Line 5 - Promotion of Community HealthIU Health Tipton Hospital invests in its community to improve the quality of life of its community members. Several community benefit highlights are described below. IU Health Tipton Hospital hosts an annual health fair every spring for the residents of Tipton and surrounding counties. It offers a variety of free and low-cost screenings, activities, service line information and door prizes. IU Health Tipton Hospital invites community organizations to participate to help bring awareness to their services. In 2015, the health fair provided a blood draw, including glucose and cholesterol; sleep disorders screening; blood pressure screening; cardiac ultrasound screening; pulmonary function testing; DEXA/bone density screening; diabetes risk assessments/screenings (A1C); oxygen saturation levels screening, and low-cost ($49) computed tomography (CT) heart scan calcium scoring. IU Health Tipton Hospital also offered information on upcoming screenings such as skin cancer and prostate cancer. Before the physicians presentations, participants had access to booths and activities to learn more about breast health awareness. Among the booths, participants were able to schedule a mammogram, take tours of the IU Health Tipton Hospital Womens Center, learn more about free wellness screenings at IU Health Tipton Hospital and get information on massage therapy, yoga and Pilates. Participants were also able to receive A1C (diabetes) screenings, bone density screenings and a free breast health risk screening. The 2015 IU Health Day of Service was a way for the healthcare system to partner with parks and encourage the public to get active and use the trails in their communities. Among the ways the IU Health system encourages use of the trails is by making modifications and beautifying the trails, installing fitness stations and more. Each IU Health hospital was tasked with making improvements to a trail in its community or working with staff members at a local park on a project at that park. IU Health Tipton Hospital engaged 41 volunteers to help complete a project at Tipton City Park, which is used by local community members and their families, as well as families from surrounding communities.
Schedule H, Part VI, Line 6 - Affiliated Health Care SystemIU Health Tipton Hospital is part of the IU Health Statewide System. The IU Health Statewide system is Indianas most comprehensive healthcare system. A unique partnership with the Indiana University School of Medicine ("IU School of Medicine"), one of the nations leading medical schools, gives patients access to innovative treatments and therapies. IU Health is comprised of hospitals, physicians and allied services dedicated to providing preeminent care throughout Indiana and beyond. National Recognition - Six hospitals designated as Magnet by the American Nurses Credentialing Center recognizing excellence in nursing care. - Ten clinical programs ranked among the top 50 national programs in U.S. News & World Reports 2015-16 edition of Americas Best Hospitals. - Ten out of ten specialty programs at Riley Hospital for Children at IU Health ranked among the top 50 childrens hospitals in the nation. 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. Research conducted by IU School of Medicine faculty gives IU Health physicians and patients access to the most leading-edge and comprehensive treatment options. Collaborative Strategic Research Initiative Conceived by IU Health and the IU School of Medicine in 2012, the Strategic Research Initiative aims to enhance the institutions joint capabilities in fundamental scientific investigation, translational research and clinical trials targeting innovative treatments for disease. The two organizations committed to invest $150 million over five years to this new research collaboration. Established in 2013, the Center for Innovation and Implementation Science is partially supported by the Strategic Research Initiative. The new center, launched by the IU School of Medicine and the Indiana Clinical and Translational Sciences Institute, focuses on increasing efficacy and reducing costs at IU Health. With oversight of four specialized research and discovery units managed by IU School of Medicine researchers, the center will address problems with the potential to reduce costs or generate new revenue estimated at $5 million per year or more. 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 Indianas 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 Goshen Hospital - IUHLP Liquidation, Inc. f/k/a IU Health La Porte Hospital - IU Health Morgan Hospital - IU Health North Hospital - IU Health Paoli Hospital - IU Health Starke 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 benefits plan relative to the local community, the IU Health Statewide System considers its community benefit plan as part of an overall vision for strengthening Indianas 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. Some ways we address our community health priorities as a system include: IU Health Day of Service The annual IU Health Day of Service is a high-impact, one-day event aimed at engaging IU Health team members in activities that address an identified community need. Tackling the issue of obesity in the communities IU Health serves, the seventh annual Day of Service in 2015 focused on leaving behind key physical assets to help meet a statewide need for more venues for physical activity and recreation. During the 2015 Day of Service: - More than 2,200 team members and 6,000 volunteer hours were dedicated by IU Health team members - Created 3 miles of walking trails - Revitalized 18 parks and trailheads - Mounted 7 swing sets - Distributed hundreds of bicycles and bicycle helmets to elementary schools Kindergarten Countdown As one of IU Healths signature programs and collaboration with United Way, Kindergarten Countdown helps hundreds of soon-to-be kindergartners improve their readiness for school. In addition to providing health screenings and vaccinations to students, the program offers assistance to parents in registering their kindergartners for school. Kindergarten Countdown summer camps are designed to provide at-risk youngsters the basic skills they need to succeed in their first year of school. From "Get Ready to Read" pre- and post-tests, campers in the IU Health camps achieved a 21 percent average increase in scores from the beginning of the four-week camp to the end. The program also creates positive impact by increasing awareness of kindergarten readiness, improving parent engagement and strengthening relationships between volunteers and team members at hospitals, schools and community organizations. IU Health recognizes that in some cases we dont have all the expertise or resources to address the needs of the community and other organizations are better suited to tackle some of the specific needs of the community. IU Health, therefore, provided financial support to like-minded non-profit organizations that are working to improve the health of the community in our identified priorities of need. Clinical Research Clinical trials are conducted at the following IU Health partners: - Methodist Cancer Center Research Group - IU Simon Cancer Center - Methodist Research Institute - Indiana Clinical and Translational Sciences Institute (Indiana CTSI) - IU Health Arnett Clinical Research - IU Health Arnett Cancer Care - IU Health Goshen Center for Cancer Care - IU Health Ball Memorial Cancer Center - IU Health Ball Memorial Hospital - IU Health Bloomington Hospital - Riley Hospital for Children at IU Health Methodist Research Institute ("MRI") The Biorepository at MRI, under IRB approval, collects human biological materials (blood, bone, tissue, urine) vital for medical research to provide the best way to study a variety of diseases and their potential treatments. Basic science researchers at MRI publish the results of their innovative grant-supported research in prestigious peer-reviewed journals. Their work has been recognized both nationally and internationally as they participate in system-wide collaborative efforts within IU Health as well as with the IU School of Medicine. 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 2015, IU Health impacted many people statewide through 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. Examples of the types of programming and investment we make in community outreach areas include: Access to Healthcare One of the first steps to improved health outcomes is having access to healthcare resources. To show its commitment to providing affordable healthcare access, IU Health treats all patients regardless of their ability to pay. IU Health is also working to raise awareness and works to identify individuals within our communities that have barriers to care and connect these individuals with better access and consistency of healthcare resources to meet their needs. Some ways that these IU Health hospitals address Access to Healthcare include: - Public Assistance Enrollment - Veggies and Vaccines - Indiana University Student Outreach Clinic - Indianapolis Public Schools Student Athlete Physicals - Fishers Fire Department QR Code Magnet Program for Immediate Access to Patient Medical Records - Partnership for a Healthy Hamilton County Nutrition and Healthy Weight To improve the lifestyle of Indiana residents, IU Health has utilized innovative and best practice methods to attack obesity in our communities. IU Health is working to improve access to nutritious foods and physical activity in low-income neighborhoods, in addition to providing traditional health education and public advocacy efforts. With these initiatives, IU Health strives to

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Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JONATHAN R GOBLE
DIRECTOR$0$472,004$0$84,386$0$8,253$0$93,623$0$23,691$0$681,957$0$0
MICHAEL L HARLOWE
PRESIDENT & CEO$0$228,525$0$13,039$0$1,122$0$10,098$0$21,587$0$274,371$0$0
RANDALL C YUST
CFO$0$268,743$0$3,591$0$13,124$0$10,882$0$19,915$0$316,255$0$0
GUARAV ARORA MD
CMO$0$568,711$0$5,225$0$18,540$0$10,470$0$22,793$0$625,739$0$0
JEFFERY W MOORE RN
C.R.N.A.$202,400$0$250$0$516$0$8,096$0$0$0$211,262$0$0$0
JENNIFER L HARRISON
DIRECTOR, CLINICAL OPERATIONS$89,439$0$53,618$0$988$0$6,118$0$22,985$0$173,148$0$0$0
JOELLEN SCOTT RN
SVP & CNO$121,400$0$1,239$0$20,430$0$5,511$0$9,553$0$158,133$0$0$0
ANGELA S THOMPSON
VP, HR & SUPPORT SERVICES$0$117,367$0$2,535$0$73,914$0$35,799$0$24,372$0$253,987$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 - Comp. of the Org.'s CEO/Executive DirectorIU Health Tipton Hospitals President & CEO is employed by IU Health. IU Healths process for determining compensation includes the use of a compensation survey/study conducted by an independent compensation consultant with review and approval by the Committee on Personnel and Compensation and the Board of Directors. Please see Schedule O for additional details.
Schedule J, Part I, Line 4a - Severance PaymentsAngela S. Thompson received severance of $67,034 from IU Health during 2015. These amounts are included in column b (iii), other reportable compensation. In addition, Angela S. Thompson has a severance accrual of $31,365 included in column c, retirement and other deferred compensation.
Schedule J, Part I, Line 4b - Supplemental Nonqualified Retirement PlanJonathan R. Goble participates 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. Jonathan R. Goble has an amount included in column c, deferred compensation, representing the current year unvested contributions made under the supplemental executive retirement plan. No amounts were actually paid to this executive during the year.
Schedule J, Part I, Line 7 - Non-Fixed PaymentsAmounts 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.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part VI, Section A, Lines 6, 7a and 7b - Members or StockholdersLine 6: The sole member of IU Health Tipton Hospital is IU Health, a 501(c)(3) tax-exempt organization. Line 7A: The Board of Directors of the IU Health Tipton Hospital shall range from three (3) to seven (7), with IU Health having the right to appoint one (1) more than one-half (1/2) of the directors. Line 7B: The following actions require IU Healths prior approval: - The appointment or removal of any director; - The amendment of the Articles of Incorporation; - The amendment of the Bylaws; - The approval of IU Health Tipton Hospitals annual capital and operating budgets; - The incurrence of expenses for any unbudgeted operating or capital budget items or deviations, including any issuance or guarantee of debt not included in IU Health Tipton Hospitals approved budget for the current fiscal year, but only to the extent that such expenses exceed budgeted amounts by (a) $100,000 per fiscal year per budget line item or (b) $500,000 per fiscal year in the aggregate; - The adoption of any strategic plan for IU Health Tipton Hospital, including any amendments thereto; - The encumbrance, sale, lease, transfer or other alienation of more than 5% of the net book value of IU Health Tipton Hospitals assets, measured on a consolidated basis during any fiscal year; - The addition of any members of IU Health Tipton Hospital; - The creation of any new affiliates of IU Health Tipton Hospital; - The approval of any merger, consolidation, joint venture or affiliation involving IU Health Tipton Hospital or any of its affiliates; and - The dissolution of IU Health Tipton Hospital or any of its affiliates.
Part VI, Section B, Line 11b - Review of Form 990The following process was used by IU Health Tipton Hospital to review the Form 990 prior to its filing: The President & CEO reviewed and approved the Form 990. Following the President & CEOs 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 IU Healths Tax Department to answer any questions.
Part VI, Section B, Lines 12, 13, and 14 - PoliciesIU Health Tipton Hospital is part of the IU Health system. As the sole member and controlling parent of IU Health Tipton 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 Tipton 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 PolicyIU Health Tipton 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: (a) 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. (b) 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. (c) 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. (d) 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. (e) 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. (f) 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 15 - Process for Determining CompensationIU Health Tipton Hospitals President & CEO is employed by IU Health. IU Healths process for determining compensation is as follows: (1) The Board of Directors has established a Committee on Personnel and Compensation. The individuals on this Committee are made up of individuals who are on the Board and who do not have a conflict of interest with IU Health. There are no physicians or employees on this Committee. This Committee develops and reviews annually the executive compensation philosophy, market analysis as to comparability and reasonableness. One of the purposes of this Committee is to review, approve and make recommendations regarding executive compensation and benefits to the IU Health Board. As deemed appropriate, this Committee also reviews the same detail with the Committee on Finance. The Committee on Finance is represented by certain members of the Board as well. (2) Each year the Committee on Personnel and Compensation engages an outside compensation consulting firm to conduct a compensation and benefits study for all senior vice presidents and above. The current compensation advisor is the Hay Group. Hay Group performs an independent compensation survey. The relevant comparability data includes: compensation and benefit 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. The Committee reviews the entire compensation package including: base compensation, short term and long term incentive plans, basic health and welfare benefits, qualified and nonqualified plans as well as any additional fringe benefits. Further, Hay Group will provide recommendations based upon the reasonable compensation information as it relates to salary increases, bonuses and benefits that are consistent with the compensation philosophy of the Committee. A separate analysis using the same methodology is done for the Chief Executive Officer. (3) The Committee reviews the salary survey and, if appropriate, makes recommendations on increases in salary and any changes in bonuses or benefits. The Committee's goal is to ensure that the total compensation and benefits package is reasonable based upon the independent data provided by Hay Group. The Committee votes on any changes in compensation or benefits. This review, discussion and vote are documented in the minutes for the meeting. There are no executives present during the final discussion and approval of compensation. (4) The Board reviews the report prepared by the Hay Group as well as the recommendations of the Committee on Personnel and Compensation as to changes in compensation approved by the Committee. As requested, the Committee on Finance also provides its review of recommendations on changes in executive compensation and benefits. This review, discussion and vote are documented in the minutes. (5) The Board then reviews the recommendations provided by the Committee on Personnel and Compensation and votes on the changes as well. No additional compensation or benefits are paid to the executives until the changes have been approved by the Committee and the Board. The discussion and approval are documented in the minutes of the meeting. There are no executives present during the final discussion and approval of compensation. The General Counsel prepares a formal written opinion reviewing the compensation and benefits approval process, comparing that process to the Intermediate Sanctions Test of IRC Section 4958 and, if the facts warrant, provides comments regarding the compensation and benefits approval process as this 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 Committee and Board also reviews the achievements of the executive group as it relates to the long-term and short-term shared and individual goals developed by the executive 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 and the compensation survey. The discussion and vote of the Committee 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 Committee on Personnel and Compensation and Audit Committee also review the required Form 990 disclosures related to executive compensation and benefits as well as compensation practices and approval processes prior to the filing of the Form 990 return with the Internal Revenue Service. IU Health Tipton Hospital has a process in place to determine the compensation for the other officers and key employees. IU Health Tipton Hospital uses an independent compensation consultant who utilizes a variety of methods and procedures to obtain compensation ranges for comparable officer and employee positions. The independent compensation consultant provides IU Health Tipton Hospital with recommended compensation ranges for its officers and other employees, which are then used as a guide for setting reasonable compensation by management. Management decisions with regard to determining compensation are subject to the review and approval of the Compensation Committee and Board of Directors.
Part VI, Section C, Line 19 - Public DisclosureIU Health Tipton Hospital Articles of Incorporation are available to the public through the Indiana Secretary of State's web-site. IU Health Tipton Hospitals conflict of interest policy is described on Form 990, Schedule O. IU Health Tipton 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.
Part XI, Line 9 - Other Changes in Net Assets or Fund BalancesDuring 2015, IU Health Tipton Hospital recorded the following other changes in net assets or fund balances: Change in Interest in Restricted Net Assets of Foundations: $-83,873 Change in Interest in Unrestricted Net Assets of Foundations: $224,334 Total Change: $140,461
FORM 990 PART IX LINE 11GDESCRIPTION:SHARED SERVICES/PROF. FEES TOTAL FEES:9822682

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (45 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Clarian Transplant Institute Inc
950 N Meridian St Ste 800IndianapolisIN46204134350599HealthcareIN501(c)(3)9IUHYes (true)
Goshen Health System Inc
200 High Park AveGoshenIN46527351974765HealthcareIN501(c)(3)11 IIUHYes (true)
Goshen Hospital Association Inc
200 High Park AveGoshenIN46527356001540HealthcareIN501(c)(3)3GHSYes (true)
HealthLINC Incorporated
950 N Meridian St Ste 800IndianapolisIN46204263571507HealthcareIN501(c)(3)9IUHBYes (true)
Indiana Health Info Exchange Inc
846 N Senate AveIndianapolisIN46202364550324HealthcareIN501(c)(3)11 INAfalse
Indiana Radiology Partners Inc
950 N Meridian St Ste 800IndianapolisIN46204201017034HealthcareIN501(c)(3)3IUHYes (true)
Indiana University Health Inc
950 N Meridian St Ste 800IndianapolisIN46204351955872HealthcareIN501(c)(3)3NAfalse
IU Health Arnett Foundation Inc
950 N Meridian St Ste 800IndianapolisIN46204356079797FundraisingIN501(c)(3)11 IIUHAYes (true)
IU Health Arnett Inc
950 N Meridian St Ste 800IndianapolisIN46204263162145HealthcareIN501(c)(3)3IUHYes (true)
IU Health Ball Memorial Hospital Inc
950 N Meridian St Ste 800IndianapolisIN46204350867958HealthcareIN501(c)(3)3IUHYes (true)
IU Health Ball Memorial Physicians Inc
950 N Meridian St Ste 800IndianapolisIN46204351925641HealthcareIN501(c)(3)9IUHBMHYes (true)
IU Health Bedford Inc
950 N Meridian St Ste 800IndianapolisIN46204237042323HealthcareIN501(c)(3)3IUHYes (true)
IU Health Blackford Hospital Inc
950 N Meridian St Ste 800IndianapolisIN46204010646166HealthcareIN501(c)(3)3IUHBMHYes (true)
IU Health Bloomington Inc
950 N Meridian St Ste 800IndianapolisIN46204351720796HealthcareIN501(c)(3)3IUHYes (true)
IU Health BMH Foundation Inc
950 N Meridian St Ste 800IndianapolisIN46204311111784FundraisingIN501(c)(3)11 IIUHBMHYes (true)
IU Health Care Associates Inc
950 N Meridian St Ste 800IndianapolisIN46204351747218HealthcareIN501(c)(3)9IUHYes (true)
IU Health Goshen Foundation Inc
200 High Park AveGoshenIN46527462565300FundraisingIN501(c)(3)11 IGHSYes (true)
IUHLP Liquidation Inc
PO Box 250LaPorteIN46352351125434HealthcareIN501(c)(3)3IUHYes (true)
IUHLP-P Liquidation Inc
PO Box 250LaPorteIN46352311070868HealthcareIN501(c)(3)3IUHLHYes (true)
IU Health Morgan Inc
950 N Meridian St Ste 800IndianapolisIN46204273533027HealthcareIN501(c)(3)3IUHYes (true)
IU Health North Hospital Inc
950 N Meridian St Ste 800IndianapolisIN46204351932442HealthcareIN501(c)(3)3IUHYes (true)
IU Health Paoli Hosp Foundation Inc
950 N Meridian St Ste 800IndianapolisIN46204310992486FundraisingIN501(c)(3)9IUHPYes (true)
IU Health Paoli Inc
950 N Meridian St Ste 800IndianapolisIN46204352090919HealthcareIN501(c)(3)3IUHBYes (true)
IU Health Plans NFP Inc
950 N Meridian St Ste 800IndianapolisIN46204463803873InsuranceIN501(c)(4)N/AIUHYes (true)
IU Health West Hospital Inc
950 N Meridian St Ste 800IndianapolisIN46204351814660HealthcareIN501(c)(3)3IUHYes (true)
IU Health White Mem Hosp Fndtn Inc
PO Box 952MonticelloIN47960351671806FundraisingIN501(c)(3)11 III-FIIUHWMHYes (true)
IU Health White Memorial Hospital Inc
950 N Meridian St Ste 800IndianapolisIN46204273532963HealthcareIN501(c)(3)3IUHYes (true)
IU Medical Group Foundation Inc
340 W 10th St No FS5100IndianapolisIN46202201093251FundraisingIN501(c)(3)11 IINAfalse
LaPorte Hospital Foundation Inc
PO Box 250LaPorteIN46352310952775FundraisingIN501(c)(3)11 INAfalse
MDwise Marketplace Inc
1200 Madison AveIndianapolisIN46225465270582InsuranceIN501(c)(4)N/AIUHYes (true)
MDwise Network Inc
1200 Madison AveIndianapolisIN46225472619552InsuranceIN501(c)(4)N/AIUHYes (true)
Methodist Health Foundation Inc
1800 N Capitol AveIndianapolisIN46202356043086FundraisingIN501(c)(3)11 IIUHYes (true)
Methodist Health Group Inc
950 N Meridian St Ste 800IndianapolisIN46204350876390HealthcareIN501(c)(3)11 III-FINAfalse
Methodist Medical Group Inc
950 N Meridian St Ste 800IndianapolisIN46204351945384HealthcareIN501(c)(3)3IUHYes (true)
Methodist Occup Health Centers Inc
950 N Meridian St Ste 800IndianapolisIN46204351844176HealthcareIN501(c)(3)3IUHYes (true)
Methodist Research Institute Inc
950 N Meridian St Ste 800IndianapolisIN46204352023710HealthcareIN501(c)(3)11 IIUHYes (true)
MH Healthcare Inc
950 N Meridian St Ste 800IndianapolisIN46204351766531HealthcareIN501(c)(3)3MMGYes (true)
Morgan Co Mem Hosp Foundation Inc
950 N Meridian St Ste 800IndianapolisIN46204352035162FundraisingIN501(c)(3)11 IIIUHMHYes (true)
Morgan Co Mem Hosp Guild Inc
950 N Meridian St Ste 800IndianapolisIN46204310886844FundraisingIN501(c)(3)11 III-FIIUHMHYes (true)
Morgan Health Services Inc
950 N Meridian St Ste 800IndianapolisIN46204351968564HealthcareIN501(c)(3)3IUHMHYes (true)
Rehabilitation Hospital of Indiana Inc
4141 Shore DrIndianapolisIN46254351786005HealthcareIN501(c)(3)3MHHYes (true)
RHI Foundation Inc
4141 Shore DrIndianapolisIN46254351932349FundraisingIN501(c)(3)11 IRHIYes (true)
The Cheer Guild of Riley Hos for Child
705 Riley Hospital DrIndianapolisIN46202356018517FundraisingIN501(c)(3)11 III-FINAfalse
Tipton Co Health Care Foundation Inc
950 N Meridian St Ste 800IndianapolisIN46204311231905FundraisingIN501(c)(3)11 IIUHTHYes (true)
University Family Physicians Inc
950 N Meridian St Ste 800IndianapolisIN46204237427350HealthcareIN501(c)(3)9IUHCAYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (23 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Ball Outpatient Sur Ctr LLC
569 Brookwood Village Ste 901BirminghamAL35244270275794HealthcareINNA
Beltway Surgery Centers LLC
569 Brookwood Village Ste 901BirminghamAL35244352072586HealthcareINNA
Bloomington Endo Center LLC
PO Box 550BloomingtonIN47402352117943HealthcareINNA
BOSC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454147343HealthcareINNA
BSC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204452314634HealthcareINNA
CHV Fund I LLC
950 N Meridian St Ste 800IndianapolisIN46204262523206Venture CapitalINNA
CHV Fund II Management LLC
950 N Meridian St Ste 800IndianapolisIN46204371717823Venture CapitalINNA
CHV Fund II LLC
950 N Meridian St Ste 800IndianapolisIN46204800902337Venture CapitalINNA
CHV Fund Management LLC
950 N Meridian St Ste 800IndianapolisIN46204262523151Venture CapitalINNA
Clarian Health Network LLC
950 N Meridian St Ste 800IndianapolisIN46204352055030HealthcareINNA
Eagle High Surg Center LLC
569 Brookwood Village Ste 901BirminghamAL35244352259204HealthcareINNA
EHSC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454147879HealthcareINNA
EWASC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204473087761HealthcareINNA
Health Venture Management LLC
950 N Meridian St Ste 800IndianapolisIN46204205740218ManagementINNA
IEC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454148032HealthcareINNA
Indiana Endoscopy Centers LLC
569 Brookwood Village Ste 901BirminghamAL35244208398421HealthcareINNA
IUH EWA Surgery Ctr LLC
569 Brookwood Village Ste 901BirminghamAL35244473102482HealthcareINNA
IUH Saxony Surgery Ctr LLC
569 Brookwood Village Ste 901BirminghamAL35244275271091HealthcareINNA
ROC Surgery LLC
569 Brookwood Village Ste 901BirminghamAL35244271497960HealthcareINNA
ROCS Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454148369HealthcareINNA
Senate St Surgery Center LLC
569 Brookwood Village Ste 901BirminghamAL35244421709357HealthcareINNA
SSC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204464472887HealthcareINNA
SSSC Holdings LLC
950 N Meridian St Ste 800IndianapolisIN46204454148167HealthcareINNA

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (23 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
BMH Medical Pavilion Association Inc
2525 W University AveMuncieIN47303351858408Condo ManagementINNACYes (true)
Cardinal Health Ventures Inc
950 N Meridian St Ste 800IndianapolisIN46204351611424ManagementINNACYes (true)
CHV Capital Inc
950 N Meridian St Ste 800IndianapolisIN46204260752507Venture CapitalINNACYes (true)
IU Health 457(B) Plan
1100 N Market StWilmingtonDE19890476948347InvestmentsINNATYes (true)
IU Health ACO Inc
950 N Meridian St Ste 800IndianapolisIN46204454421020HealthcareINNACYes (true)
IU Health Board Designated Trust
400 Howard StSan FranciscoCA94105306309021InvestmentsINNATYes (true)
IU Health NTGI S&P500 Fund CF
PO Box 804358ChicagoIL60680306298263InvestmentsINNATYes (true)
IU Health Plans Holding Company Inc
950 N Meridian St Ste 800IndianapolisIN46204463794815InsuranceINNACYes (true)
IU Health Plans NFP Inc
950 N Meridian St Ste 800IndianapolisIN46204463803873InsuranceINNACYes (true)
IU Health Plans Inc
950 N Meridian St Ste 800IndianapolisIN46204262127080HMOINNACYes (true)
IU Health Risk Purchasing Group Inc
151 Meeting St Ste 301CharlestonSC29401260202446InsuranceINNACYes (true)
IU Health Risk Retention Group Inc
151 Meeting St Ste 301CharlestonSC29401201107674InsuranceSCNACYes (true)
IU Health Southern IN Physicians Inc
PO Box 1149BloomingtonIN47402351913875HealthcareINNACYes (true)
IUH Assurance SPC Ltd
980395429InsuranceNACYes (true)PO BOX 69 94 SOLARIS AVECAMANA BAYGRAND CAYMANCJCJ
Occ-Health Revenue Systems Inc
950 N Meridian St Ste 800IndianapolisIN46204203308057Work Comp PPOINNACYes (true)
Parkmor Drug Inc
1501 S Main StGoshenIN46526131394980Pharmacy SalesINNACYes (true)
PILR Inc
200 High Park AveGoshenIN46526204294750DevelopmentINNACYes (true)
Proteuo Fund LP
981075227InvestmentsNACYes (true)PO BOX 31106 89 NEXUS WAYCAMANA BAYGRAND CAYMANCJCJ
Radiation Oncology Resources Inc
200 High Park AveGoshenIN46526262008424HealthcareINNACYes (true)
SCANS Inc
950 N Meridian St Ste 800IndianapolisIN46204453080392HealthcareINNACYes (true)
Univ Hlth (Shanghai) Mgt Con Co Ltd
ManagementNACYes (true)88 CENTURY AVESHANGHAICHCH
University Health Management Inc
950 N Meridian St Ste 800IndianapolisIN46204272891143ManagementINNACYes (true)
University Health Mgmt (China) Inc
950 N Meridian St Ste 800IndianapolisIN46204273891311ManagementINNACYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
IU HEALTH CARE ASSOCIATES INC
J$250,443FMV
IU HEALTH CARE ASSOCIATES INC
M$1,639,258FMV
IU HEALTH NORTH HOSPITAL INC
O$502,064FMV
IU HEALTH RISK RETENTION GROUP INC
R$130,083FMV
IUH ASSURANCE LTD
R$104,339FMV

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