INDIANA UNIVERSITY HEALTH WHITE MEMORIAL HOSPITAL INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- INDIANA UNIVERSITY HEALTH WHITE MEMORIAL HOSPITAL INC (EIN 27-3532963)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-12
- IRS object ID
- 201503169349301780
- Schema version
- 2014v5.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-12T09:51:37-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE SUITE 4000 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 273532963 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA UNIVERSITY HEALTH WHITE MEMORIAL | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % BROC L BUDDE | InCareOfNm |
| Business Name Control | INDI | BusinessNameControlTxt |
| Phone | 3179624575 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 950 N MERIDIAN STREET SUITE 800 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Cara L Breidster | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2015-11-11 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JENNIFER D RHODERICK | PreparerPersonNm |
| PTIN | P00395735 | PTIN |
| Phone | 3176817000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JEFFREY C ZEH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 950 N MERIDIAN ST STE 800 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $30,739,487 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://IUHEALTH.ORG/WHITE-MEMORIAL/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | Improve the health of our patients and community through innovation and excellence in care, education, research, and service. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 231 | TotalEmployeeCnt |
| Total Volunteers | 28 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $47,351 | PYContributionsGrantsAmt |
| CY Contributions Grants | $179,997 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $30,146,551 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $30,034,155 | CYProgramServiceRevenueAmt |
| PY Investment Income | $44,772 | PYInvestmentIncomeAmt |
| CY Investment Income | -$5,995 | CYInvestmentIncomeAmt |
| PY Other Revenue | $949,441 | PYOtherRevenueAmt |
| CY Other Revenue | -$63,618 | CYOtherRevenueAmt |
| PY Total Revenue | $31,188,115 | PYTotalRevenueAmt |
| CY Total Revenue | $30,144,539 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $31,541 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $25,792 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,032,544 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,443,532 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $18,442,469 | PYOtherExpensesAmt |
| CY Other Expenses | $16,158,452 | CYOtherExpensesAmt |
| PY Total Expenses | $29,506,554 | PYTotalExpensesAmt |
| CY Total Expenses | $25,627,776 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,681,561 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,516,763 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $38,269,358 | TotalAssetsBOYAmt |
| Total Assets EOY | $46,430,226 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $26,843,947 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $30,485,496 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,425,411 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $15,944,730 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Improve the health of our patients and community through innovation and excellence in care, education, research, and service. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $22,388,248 | ExpenseAmt |
| Grant | $25,792 | GrantAmt |
| Revenue | $30,034,155 | RevenueAmt |
| Desc | Indiana University Health White Memorial Hospital, Inc. ("IU Health White Memorial Hospital") 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 White Memorial Hospital offers a comprehensive range of services that includes general medical/surgical services, a 24-hour emergency department, sophisticated diagnostic imaging services, laboratory, chemotherapy, home health and therapy services, as well as labor and delivery suites that provide a home-like setting yet contain all of the equipment needed to assist with labor, delivery and recovery. All patient rooms are private and boast warm colors and natural light to enhance comfort and health in a family-friendly environment that offers pullout beds for overnight stays and wireless internet access. | Desc |
| Total Program Service Expenses | $22,388,248 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 53 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 231 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | false | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BROC L BUDDE | PersonNm |
| Phone | 3179624575 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 950 N MERIDIAN ST STE 800 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| LARRY W PAMPEL DDS | |||||||||
| CHAIR | 2.0 | 5.0 | Yes (X) | Yes (X) | $3,600 | $8,250 | $0 | ||
| KATHLEEN M ALTMAN | |||||||||
| VICE CHAIR | 2.0 | 0.0 | Yes (X) | Yes (X) | $3,600 | $0 | $0 | ||
| JANET J FAKER | |||||||||
| DIRECTOR/SECRETARY | 2.0 | 0.0 | Yes (X) | Yes (X) | $3,600 | $0 | $0 | ||
| JAMES P BIEN MD | |||||||||
| DIRECTOR | 2.0 | 55.0 | Yes (X) | $0 | $269,004 | $59,707 | |||
| GARY C COOLEY | |||||||||
| DIRECTOR | 2.0 | 0.0 | Yes (X) | $3,600 | $0 | $0 | |||
| ALFONSO W GATMAITAN | |||||||||
| DIRECTOR | 2.0 | 55.0 | Yes (X) | $0 | $530,167 | $113,574 | |||
| RICHARD G HORTON | |||||||||
| DIRECTOR | 2.0 | 0.0 | Yes (X) | $3,600 | $0 | $0 | |||
| RANDALL R MITCHELL | |||||||||
| DIRECTOR | 2.0 | 5.0 | Yes (X) | $3,600 | $9,000 | $0 | |||
| REGINALD L SHIREMAN | |||||||||
| DIRECTOR (PARTIAL YEAR) | 2.0 | 0.0 | Yes (X) | $2,700 | $0 | $0 | |||
| STEPHANIE J LONG RN | |||||||||
| CEO (PARTIAL YEAR) | 50.0 | 0.0 | Yes (X) | $181,854 | $0 | $25,700 | |||
| BRIAN T SHOCKNEY | |||||||||
| INTERIM CEO (PARTIAL YEAR) | 0.0 | 55.0 | Yes (X) | $0 | $212,964 | $56,756 | |||
| CARA L BREIDSTER | |||||||||
| CFO | 0.0 | 55.0 | Yes (X) | $0 | $247,859 | $53,881 | |||
| ADEL M KHDOUR MD | |||||||||
| CMO | 0.0 | 50.0 | $0 | $239,971 | $58,555 | Yes (X) | |||
| ROBERT B BONNER | |||||||||
| COORDINATOR, PHARMACY | 50.0 | 0.0 | $113,904 | $0 | $22,969 | Yes (X) | |||
| JULIA M BUNNELL | |||||||||
| CLINICAL PHARMACIST | 50.0 | 0.0 | $106,617 | $0 | $28,235 | Yes (X) | |||
| MARY E MINIER | |||||||||
| COO | 50.0 | 0.0 | $103,252 | $0 | $14,270 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $529,927 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,517,215 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $433,647 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MONTICELLO EMERGENCY CARE LLC | |||||
| 720 S SIXTH STREET | MONTICELLO | IN | 46960 | MEDICAL | $528,632 |
| INDIANA UNIVERISTY HEALTH ARNETT I | |||||
| 950 N MERIDIAN STREET SUITE 800 | INDIANAPOLIS | IN | 46204 | MEDICAL | $378,002 |
| FREDERIC A HENNEY MD | |||||
| 720 S 6TH STREET SUITE J | MONTICELLO | IN | 47960 | MEDICAL | $257,237 |
| MONTICELLO MED CENTER LLC | |||||
| 826 NORTH 6TH STREET | MONTICELLO | IN | 47960 | MEDICAL | $251,559 |
| FISHER SCIENTIFIC LLC | |||||
| 13551 COLLECTIONS CTR DR | CHICAGO | IL | 60693 | MEDICAL | $108,139 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $6,458 | RelatedOrganizationsAmt |
| Government Grants | $172,099 | GovernmentGrantsAmt |
| All Other Contributions | $1,440 | AllOtherContributionsAmt |
| Total Contributions | $179,997 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $29,552,788 | $29,552,788 |
| RENT FROM RELATED 501(C)(3) ORGS. | 532000 | $233,529 | $233,529 |
| SHARED SERVICES | 541900 | $14,334 | $14,334 |
| EHRC INCENTIVE | 900099 | $233,504 | $233,504 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $30,034,155 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,447 | TotalRevenueColumnAmt |
| Exclusion | $31,447 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $240,058 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $557,506 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$317,448 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$317,448 | TotalRevenueColumnAmt |
| Exclusion | -$317,448 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,767 | SecuritiesAmt |
| Other | $33,675 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$3,767 | SecuritiesAmt |
| Other | -$33,675 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$37,442 | TotalRevenueColumnAmt |
| Exclusion | -$37,442 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA/FOOD SERVICE | 721210 | $79,511 | $79,511 |
| EDUCATION | 900099 | $57,360 | $57,360 |
| ALL OTHER REVENUE | 900099 | $116,959 | $116,959 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $253,830 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,144,539 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $30,034,155 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | -$69,613 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,792 | TotalAmt |
| Program Services | $25,792 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $231,854 | TotalAmt |
| Program Services | $188,764 | ProgramServicesAmt |
| Management And General | $43,090 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,954 | TotalAmt |
| Program Services | $53,696 | ProgramServicesAmt |
| Management And General | $12,258 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,330,320 | TotalAmt |
| Program Services | $5,967,973 | ProgramServicesAmt |
| Management And General | $1,362,347 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $269,472 | TotalAmt |
| Program Services | $223,210 | ProgramServicesAmt |
| Management And General | $46,262 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,017,011 | TotalAmt |
| Program Services | $788,538 | ProgramServicesAmt |
| Management And General | $228,473 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $528,921 | TotalAmt |
| Program Services | $429,740 | ProgramServicesAmt |
| Management And General | $99,181 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,790 | TotalAmt |
| Management And General | $75,790 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,942 | TotalAmt |
| Management And General | $5,942 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,244 | TotalAmt |
| Management And General | $2,244 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,644 | TotalAmt |
| Management And General | $1,644 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,644,101 | TotalAmt |
| Program Services | $4,161,885 | ProgramServicesAmt |
| Management And General | $482,216 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $917 | TotalAmt |
| Program Services | $917 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,486 | TotalAmt |
| Program Services | $145,551 | ProgramServicesAmt |
| Management And General | $3,935 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,578 | TotalAmt |
| Program Services | $18,578 | ProgramServicesAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $603,166 | TotalAmt |
| Program Services | $32,005 | ProgramServicesAmt |
| Management And General | $571,161 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,313 | TotalAmt |
| Program Services | $9,892 | ProgramServicesAmt |
| Management And General | $3,421 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,738 | TotalAmt |
| Program Services | $8,523 | ProgramServicesAmt |
| Management And General | $1,215 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,199,417 | TotalAmt |
| Program Services | $1,170,005 | ProgramServicesAmt |
| Management And General | $29,412 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,632,276 | TotalAmt |
| Program Services | $1,491,288 | ProgramServicesAmt |
| Management And General | $140,988 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,344 | TotalAmt |
| Program Services | $132,734 | ProgramServicesAmt |
| Management And General | $36,610 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| DRUGS AND MEDICAL SUPPLIES | $2,813,942 | $2,813,942 |
| BAD DEBT | $2,451,979 | $2,451,979 |
| INSTITUTIONAL DUES/LICENSES | $63,281 | $63,281 |
| HOSPITAL ASSESSMENT FEE | $385,407 | $385,407 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,917,887 | TotalAmt |
| Program Services | $1,824,548 | ProgramServicesAmt |
| Management And General | $93,339 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,627,776 | TotalAmt |
| Program Services | $22,388,248 | ProgramServicesAmt |
| Management And General | $3,239,528 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $930 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $168,380 | BOYAmt |
| EOY | $7,444,514 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,774,279 | BOYAmt |
| EOY | $4,460,000 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $363,781 | BOYAmt |
| EOY | $320,725 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,350 | BOYAmt |
| EOY | $101,905 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $37,815,687 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,071,339 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,534,027 | BOYAmt |
| EOY | $32,744,348 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,056,669 | BOYAmt |
| EOY | $1,061,650 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $277,872 | BOYAmt |
| EOY | $296,154 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,269,358 | BOYAmt |
| EOY | $46,430,226 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,069,173 | BOYAmt |
| EOY | $3,060,663 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $229,415 | BOYAmt |
| EOY | $2,242 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,545,359 | BOYAmt |
| EOY | $27,422,591 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,843,947 | BOYAmt |
| EOY | $30,485,496 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,195,020 | BOYAmt |
| EOY | $15,704,160 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,745 | BOYAmt |
| EOY | $52,745 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $177,646 | BOYAmt |
| EOY | $187,825 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,425,411 | BOYAmt |
| EOY | $15,944,730 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,269,358 | BOYAmt |
| EOY | $46,430,226 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,516,763 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$7,622 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $10,178 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $2,244 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,244 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1i - Other Activities | FormAndLineReferenceDesc |
| Explanation | IU Health White Memorial Hospital paid institutional membership dues to the American Hospital Association ("AHA") and Indiana Hospital Association ("IHA") during 2014 in the amount of $9,212 and $2,673, respectively. Each membership organization notified IU Health White Memorial Hospital that a portion of the dues it paid were used for lobbying purposes. The AHA used 22.80%, or $2,100 of 2014 membership dues paid by IU Health White Memorial Hospital, for lobbying expenditures. The IHA used 5.38%, or $144 of the 2014 membership dues paid by IU Health White Memorial Hospital, for lobbying expenditures. The total membership dues paid to these organizations by IU Health White Memorial Hospital during 2014 that were attributable to lobbying expenditures was $2,244. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $277,877 | BeginningYearBalanceAmt |
| Contributions | $15,176 | ContributionsAmt |
| End Year Balance | $293,053 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $143,329 | BeginningYearBalanceAmt |
| Contributions | $134,496 | ContributionsAmt |
| Investment Earnings Or Losses | $52 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $277,877 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $133,831 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $15,823 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $6,325 | GrantsOrScholarshipsAmt |
| End Year Balance | $143,329 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $152,745 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$12,566 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $6,348 | GrantsOrScholarshipsAmt |
| End Year Balance | $133,831 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.82002 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.17998 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $972,779 | OtherCostOrOtherBasisAmt |
| Book Value | $972,779 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $30,187,561 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,417,674 | DepreciationAmt |
| Book Value | $27,769,887 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Depreciation | $0 | DepreciationAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $6,506,097 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,587,892 | DepreciationAmt |
| Book Value | $3,918,205 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $149,250 | OtherCostOrOtherBasisAmt |
| Depreciation | $65,773 | DepreciationAmt |
| Book Value | $83,477 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $32,744,348 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERCOMPANY PAYABLES (NET) | $23,520,398 |
| DUE TO THIRD-PARTY PAYORS | $3,843,197 |
| SELF-INSURANCE LIABILITIES | $58,996 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $27,422,591 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part V, Line 4 - Intended Use of the Org.'s Endowment Funds | The net income from restricted net assets is generally used for equipment, improvements, and maintenance of the hospital's facilities. |
| Schedule D, Part X, Line 2 - FIN 48 (ASC 740) Footnote | IU Health White Memorial Hospital is a subsidiary in the consolidated financial statements of IU Health. IU Health adopted FIN 48 in 2007. No disclosures were required in 2014 under GAAP as IU Health does not have any material tax contingencies that required disclosures in the footnotes. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1725 | PersonsServedCnt |
| Total Community Benefit Expns | $1,368,210 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,368,210 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05900 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2290 | PersonsServedCnt |
| Total Community Benefit Expns | $4,160,230 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,969,217 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $191,013 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00820 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4015 | PersonsServedCnt |
| Total Community Benefit Expns | $5,528,440 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,969,217 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,559,223 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06720 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 18 | ActivitiesOrProgramsCnt |
| Persons Served | 1455 | PersonsServedCnt |
| Total Community Benefit Expns | $40,325 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,500 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $37,825 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 223 | PersonsServedCnt |
| Total Community Benefit Expns | $126,051 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $126,051 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00540 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 31 | PersonsServedCnt |
| Total Community Benefit Expns | $1,614 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,614 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 23 | ActivitiesOrProgramsCnt |
| Persons Served | 1709 | PersonsServedCnt |
| Total Community Benefit Expns | $167,990 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,500 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $165,490 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00710 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 23 | ActivitiesOrProgramsCnt |
| Persons Served | 5724 | PersonsServedCnt |
| Total Community Benefit Expns | $5,696,430 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,971,717 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,724,713 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07430 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $7,449 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,449 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 14500 | PersonsServedCnt |
| Total Community Benefit Expns | $5,100 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,100 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 5522 | PersonsServedCnt |
| Total Community Benefit Expns | $31,462 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $31,462 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 20 | PersonsServedCnt |
| Total Community Benefit Expns | $121 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $121 | NetCommunityBenefitExpnsAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 20042 | PersonsServedCnt |
| Total Community Benefit Expns | $44,132 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $44,132 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $611,712 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $12,382,943 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,820,303 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $562,640 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IU HEALTH WHITE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 720 SOUTH SIXTH STREET | AddressLine1Txt |
| City | MONTICELLO | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47960 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://IUHEALTH.ORG/WHITE-MEMORIAL/ | WebsiteAddressTxt |
| State License | 14-005034-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IU HEALTH WHITE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400. | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | X | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | X | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 - Input from Community | In conducting each of its most recent CHNA, IU Health White Memorial Hospital took into account input from persons who represent the broad interests of the community it serves by hosting several community conversation focus groups. These focus groups included public health officials and community leaders to discuss the healthcare needs of the service area and what role IU Health could play in addressing the identified needs. To obtain a more complete picture of the factors that play into IU Health White Memorial Hospital's community's health, input from public health officials and community leaders in White County was gathered through two separate focus group sessions. The first was a two hour live group session at IU Health White Memorial Hospital, and the second was held via a phone conference call for those who were not able to meet in person. IU Health White Memorial Hospital 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. Attendees who participated in the focus group included: Melinda Molter - Customer Service Representative (CSR), White Oaks Health Campus - Ms. Molter is representative of a community perspective regarding senior health. As a CSR at White Oaks Health Campus, she works to provide access to various services for seniors within the community. Jerry Horner - Former President of the NCNC, Inc. Board of Directors Jim Annis - Town Council member, White County - Mr. Annis is representative of a community perspective regarding healthy living. As a member of the White County Town Council, he is knowledgeable in the community's needs and resources available to address those needs. Leslie Goss - Executive Director, White County Community Foundation - Ms. Goss is representative of a community perspective regarding economic development. As Executive Director of the Community Foundation in White County, she is knowledgeable on the financial stability of the community and the resources available to it. Tom Fletcher - Superintendent, Twin Lakes Schools, Monticello - Mr. Fletcher is representative of a community perspective regarding children's health and education. As the Superintendent of Twin Lakes Schools, he is familiar with the health issues and needs of children within the community. Don Koleszar - Vice President, White County Economic Development Organization - Mr. Koleszar is representative of a community perspective towards healthy living. As a board member of the White County Economic Development Organization, he is familiar with the general market and income of the community, as well as the obstacles low-income individuals in the area face. Nan Albright - Administrator, Monticello Assisted Living Health Care - Ms. Albright is representative of a community perspective regarding access to healthcare and healthy living. As an employee of Monticello Assisted Living Health Care, she is knowledgeable within the areas of patient care, needs, and access to services. Ken Houston - Mayor, City of Monticello - Mayor Houston is representative of a community perspective regarding healthy living. As mayor of Monticello, he is knowledgeable of the Monticello community's needs and the resources available to address those needs. Cindy Hicks - Manager, White County WorkOne Agency - Ms. Hicks is representative of a community perspective regarding employment in White County. As manager at the White County WorkOne Agency, she understands the issue of unemployment, lack of income, and the needs of the underserved populations, as well as ways to address those needs. Butch Kramer - Town Council member, White County Town Council - Mr. Kramer is representative of a community perspective regarding healthy living. As a member of the White County Town Council, he is knowledgeable on the community's needs and resources available to address those needs. James Mann - City Council member, Monticello City Council - Mr. Mann is representative of a community perspective regarding healthy living. As a member of the Monticello City Council, he is knowledgeable on the community's needs and resources available to address those needs. Randy Price - President and CEO, White County REMC - As the President and CEO of White County REMC, Mr. Price understands that the mission of the organization is to provide superior energy services and meaningful contributions to the community. Upon arrival to the focus group, participants were asked to list five health needs, which should be prioritized in their opinion, for the White County community served by IU Health White Memorial Hospital. These responses were collected and aggregated into a comprehensive list of identified needs to be further discussed later in the session and ranked for severity of need within the community. IU Health White Memorial Hospital facilitators then provided participants with a presentation featuring the mission of IU Health White Memorial Hospital, current outreach priorities, and local health data, including demographics, insurance information, poverty rates, county health rankings, causes of death, physical activity, chronic conditions, preventive behaviors, and community needs index. Upon completion of the data presentation, IU Health White Memorial Hospital facilitated a discussion on the comprehensive list of identified needs from earlier in the session. The objective of this method was intended to inspire candid discussions prior to a second identification of five prioritized health needs by each participant. The votes on the five prioritized health needs were tallied and final input from the group was encouraged during this process in order to validate the previously identified needs. Following additional discussion, participants were also asked to address what they thought the role of the IU Health White Memorial Hospital could be in meeting the local health needs. |
| Schedule H, Part V, Section B, Line 7a - CHNA Website | A copy of IU Health White Memorial Hospital's 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 Website | A copy of IU Health White Memorial Hospital's 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 Needs | IU Health White Memorial 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 White Memorial Hospital selected the following four needs to be addressed: - Obesity Prevention - Access to Healthcare - PreK-12 Education - Health Education and Literacy Obesity Prevention To improve the lifestyle of Indiana residents, IU Health has utilized 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 prevent chronic diseases such as obesity and diabetes and increase the awareness of the importance of making healthy choices, since Thirty-six percent of Hoosier adults are overweight and 29.5% are obese, costing the nations billions of dollars each year to treat these chronic health conditions. As part of the overall IU Health Day of Service, IU Health White Memorial Hospital collaborated with the Monticello Parks & Recreation office and had 25 volunteers work through two shifts at Altherr Nature Park. The volunteers removed ivy from the trees and trails, and moved a large amount of stone to cover multiple walking paths in the park. Others enjoyed pruning and raking debris from the flower gardens. Efforts were made with the park system as a way to encourage local residents to get out and get more physical activity by utilizing local parks. In order to provide educational information and promote health and safety to the Monticello community, IU Health White Memorial Hospital hosted its fifth annual Health & Safety Fair on May 3, 2014. More than 400 attendees received education about healthy eating, how to finance medical expenses and participated in BMI and blood pressure screenings. The hospital hosted a Teddy Bear Clinic where kids brought in their stuffed animals for a check-up and kids practiced putting out fires with the fire department and learned about water safety from the Indiana Department of Natural Resources. Access to Affordable 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 White Memorial Hospital treats all patients regardless of their ability to pay. IU Health White Memorial Hospital is also working to raise awareness and work 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. In addition, IU Health White Memorial Hospital opened a Walk-In clinic in September of 2013. While not a full-service replacement for primary care, patients experiencing healthcare conditions from cold and flu to minor burns can be seen without an appointment. Before the clinic, patients had to utilize the hospital's emergency department or drive 35 miles to an urgent care facility. In 2014, the Walk-In Clinic served 6,128 patients. Level I emergency department visits have decreased greatly since the clinic opened. K-12 Education Education plays a crucial role in health outcomes. Level of education has an impact not only on personal health, but it has multigenerational implications as well. Children with a solid educational foundation and parents who are involved in their education are more likely to embrace healthy lifestyles and habits and succeed generally in life. Additionally, research from The National Center for Public Policy and Higher Education shows that greater educational attainment is associated with health-promoting behaviors, such as increased consumption of fruits and vegetables and other aspects of healthy eating; engaging in physical activity and refraining from smoking. Realizing that educational disparities appear early, IU Health is committed to enhancing childhood education to improve health and lifelong quality of life. Kindergarten Countdown Kindergarten Countdown is a free, four-week summer camp, sponsored by IU Health White Memorial Hospital in partnership with the United Way of White County. This program completed its third year and is held at North White Elementary School in White County. This program is designed to prepare children with little to no preschool experience for their new roles as kindergarten students. The camp is taught by licensed, experienced teachers and takes place in a school setting. Students attend school for half a day to adjust to the routines and procedures of kindergarten to help them transition into school. IU Health White Memorial Hospital supports Kindergarten Countdown as a community initiative to strengthen K-12 education. Since launching the program, IU Health White Memorial Hospital has provided volunteers, school supplies, books and healthy snacks from its cafeteria to the children who participate in the program each year. As part of its commitment to education and the community, IU Health White Memorial Hospital offers a job shadow class to Twin Lakes High School students. Each year, roughly 20 high school students learn about the various departments in the hospital and spend 15 hours a week during the spring semester shadowing IU Health White Memorial employees. The hospital is dedicated to helping local high school students expand their career options through shadowing and learning about careers in the medical field. 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: - Community collaboration and partnership - Senior health - Tobacco use and substance abuse After completing a gap analysis, IU Health White Memorial 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 four needs not chosen. |
| Schedule H, Part V, Section B, Line 13b - Income Level Other than FPG | In addition to FPG, IU Health White Memorial Hospital may take into consideration a patient's income and/or ability to pay in calculation of a financial assistance award. |
| Schedule H, Part V, Section B, Line 13h - Other FAP Factors | IU Health White Memorial 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 White Memorial Hospital's Financial Assistance Program. Patients who may be eligible for coverage under an applicable insurance policy, including, but not limited to, health, automobile, and homeowner's, must exhaust all insurance benefits prior to receiving an award from IU Health White Memorial Hospital's 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 White Memorial Hospital. Eligible patients who receive medical care from an IU Health White Memorial 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 White Memorial 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 patient's 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 Children's 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 patient's account if said patient is found to have no estate. Additionally, IU Health White Memorial 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 Website | A copy of IU Health White Memorial Hospital's FAP is available on the following website: http://iuhealth.org/patients/my-iu-health/billing-services/financial-assis tance/ |
| Schedule H, Part V, Section B, Line 16b - FAP Application Website | A copy of IU Health White Memorial Hospital's FAP Application is available on the following website: http://iuhealth.org/patients/my-iu-health/billing-services/financial-assis tance/ |
| Schedule H, Part V, Section B, Line 16i - Other Measures to Publicize | IU Health White Memorial Hospital goes to great lengths to ensure patients know that it treats all patients regardless of their ability to pay. Although a complete copy of the financial assistance policy is not attached to each patient statement, a plain language summary is included instead. Additionally, on the back of each patient statement is a telephone number that allows patients to ask any questions about the policy and request financial assistance. |
| Schedule H, Part V, Section B, Line 22d - Other Determination of Charges | IU Health White Memorial 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 White Memorial Hospital's FAP are applied to the chargemaster or physician fee schedule calculated amount. IU Health White Memorial Hospital does not use gross charges in the calculation of the amount to charge a Financial Assistance eligible patient. |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 3c - Other Factors Used in Determining Elig. | Eligibility for financial assistance is determined based upon a patient's household income and number of members in the household. A patient is eligible for financial assistance, when the patient's: - Household income is equal to or less than 200% of the Federal Poverty Guidelines ("FPG"); or - Household income is greater than 400% of the FPG, the patient is an uninsured patient, and qualifies based on an established sliding scale. Additional financial assistance is available for patients whose health insurance does not provide full coverage for all of their medical expenses and whose medical expenses would make them indigent if they were forced to pay full charges. |
| Schedule H, Part I, Line 6a - C.B. Report Prepared by a Related Org. | IU Health White Memorial Hospital's community benefit and other investments, encompassing its total community investment, are included in the IU Health Community Benefit Report which is prepared on behalf of and includes IU Health and its related hospital entities in the State of Indiana ("IU Health Statewide System"). The IU Health Community Benefit Report is made available to the public on IU Health's 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 System's community benefit efforts. It is also available by request through the Indiana State Department of Health or IU Health. |
| Schedule H, Part I, Line 7, Column (f) - Bad Debt Expense | The amount of bad debt expense included on Form 990, Part IX, Line 25, column (A), but subtracted for purposes of calculating the percentage of total expense is $2,451,979 |
| Schedule H, Part I, Line 7 - Total Community Benefit Expense | Schedule H, Part I, Line 7, Column (f), Percent of Total Expense, is based on column (e) Net Community Benefit Expense. The percent of total expense based on column (c) Total Community Benefit Expense, which includes direct offsetting revenue, is 19.89%. |
| Schedule H, Part I, Line 7g - Subsidized Health Services | IU Health White Memorial Hospital does not include any costs associated with physician clinics as subsidized health services. |
| Schedule H, Part II - Promotion of Health in Communities Served | IU Health White Memorial Hospital participates in a variety of community-building activities that address the underlying quality of life in the communities it serves. IU Health White Memorial Hospital invested over $44,000 in community-building activities by providing investments and resources to local community initiatives that addressed economic development, community health improvement, and workforce development. A few examples of outreach activities include participating in the local United Way's Kindergarten Countdown Camp and CPR training for Twin Lakes School Corporation bus drivers. Additionally, through IU Health White Memorial Hospital's team member community benefit service program, Strength that Cares, team members made a difference in the lives of Hoosiers. In 2014, IU Health White Memorial Hospital contributed to the community in a variety of ways including having team members volunteering their time with the White County Parks and Recreation Department to improve walking trails, landscape, prune and provide general cleanup at Altherr Nature Park in White County during the annual IU Health Day of Service. In addition, team members volunteered with the local United Way's Kindergarten Countdown Camp as a community initiative to strengthen K-12 education. Since launching the program, IU Health White Memorial Hospital has provided volunteers, school supplies, books and healthy snacks to the children who participate in the program. |
| Schedule H, Part III, Line 2 - Methodology Used to Est. Bad Debt Exp. | The bad debt expense of $611,712 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 Expense | The provision for uncollected patient accounts, for all payors, is recognized when services are provided based upon management's 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 the review are then used to make any modifications to the provision for uncollected patient accounts and the allowance for uncollectible accounts. In addition, IU Health White Memorial Hospital 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 IU Health White Memorial Hospital and, in certain cases, are reclassified to charity care if deemed to otherwise meet financial assistance policies of IU Health White Memorial Hospital. |
| Schedule H, Part III, Line 8 - Medicare Shortfall | Although IU Health White Memorial did not have a Medicare shortfall for 2014, the Medicare surplus reported on Schedule H, Part III, Line 7 is calculated, in accordance with the Form 990 instructions, using "allowable costs" from IU Health White Memorial Hospital's Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes are not reflective of all costs associated with IU Health White Memorial Hospital's participation in Medicare programs. For example, the Medicare Cost Report excludes certain costs such as billed physician services, the costs of Medicare Parts C and D, fee schedule reimbursed services, and durable medical equipment services. Inclusion of all costs associated with IU Health White Memorial Hospital's participation in Medicare programs would switch this surplus to a shortfall. IU Health White Memorial Hospital's Medicare shortfall per the Medicare cost report is attributable to reimbursements that are less than the cost of providing patient care and services to Medicare beneficiaries and does not include any amounts that result from inefficiencies or poor management. IU Health White Memorial 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 Policy | If a patient cannot satisfy standard payment expectations, a financial assistance screening process for alternative sources of balance resolution is completed. Those resolutions may include a discount on charges, Medicaid enrollment, interest-free loan or application for charity care. If a patient does not apply for charity care but otherwise meets the charity care guidelines established by IU Health White Memorial, the charges will be waived and the cost of services would be treated as charity care. |
| Schedule H, Part VI, Line 2 - Needs Assessment | Communities are multifaceted and so are their health needs. IU Health White Memorial 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 White Memorial Hospital assesses the health care needs of the communities it serves by utilizing the detailed community needs assessment undertaken by organizations such as the White 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 White Memorial 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 Health's ability to impact positive change was evaluated. |
| Schedule H, Part VI, Line 3 - Patient Education of Eligibility for Assist. | IU Health White Memorial Hospital goes to great lengths to ensure patients know that it treats all patients regardless of their ability to pay. IU Health White Memorial Hospital shares financial assistance information with patients during the admission process, billing process, and online. Helping patients understand that financial support for their care is available is a part of IU Health White Memorial Hospital's commitment to its mission. IU Health White Memorial Hospital's financial assistance policy exists to serve those in need by providing financial relief to patients who ask for assistance after care has been provided. 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 White Memorial Hospital's financial assistance program. Financial counselors are onsite to assist with financial concerns or questions during the patient's stay. Patient Financial Services Customer Service representatives are also available after the patient's 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. A plain language summary of the financial assistance policy is printed on the back of each patient statement, while the financial assistance application is mailed to all IU Health White Memorial Hospital patients with a patient balance due after insurance. Additionally, on the back of each patient statement is a telephone number that allows patients the ability to request financial assistance. Uninsured patients are also made aware of this process at the time of registration. IU Health White Memorial Hospital's financial assistance policy utilizes the federal poverty guidelines to determine eligibility. The goal is to make access to quality care within a patient's reach. The IU Health White Memorial Hospital Financial Assistance policy provides the following support to patients that qualify: - Free care for those earning up to 200 percent of federal poverty guidelines; - Discounted care on a sliding scale for families earning from 200 to 400 percent of federal poverty guidelines; and - Financial assistance to patients whose health insurance coverage, if any, does not provide full coverage for all of their medical expenses and whose medical expenses would make them indigent if they were forced to pay full charges. Patients are guided through their course of care with particular sensitivity, reviewing changing circumstances and allowing for financial assistance at any point during the relationship and billing process. For those inpatients that may qualify for the Medicaid program and have not applied, IU Health White Memorial Hospital financial counselors will assist patients with the Medicaid application. If a patient does not apply for financial assistance, but meets the financial assistance guidelines established by IU Health White Memorial Hospital, IU Health White Memorial Hospital will waive charges and treat the cost of services as financial assistance. |
| Schedule H, Part VI, Line 4 - Community Information | IU Health White Memorial Hospital is located in White County, Indiana, a county located in central northwest Indiana. White County includes ZIP codes within the towns of Brookston, Burnettsville, Chalmers, Monon, Monticello, Reynolds, and Wolcott. Based on the most recent Census Bureau (2012) statistics, White County's population is 24,466. The county's population estimates by race are 90.2% white, 6.8% Hispanic, 0.4% Asian, 0.8% Black, 0.6% American Indian or Alaska Native, 0.1% Native Hawaiian/Pacific Islander and 1.1% persons reporting two or more races. White county has modest levels of educational attainment. The level of education most of the population has achieved is a high school degree (88.8%). As of 2014, 14.7% of the population had a bachelor's degree or higher. IU Health White Memorial Hospital has a varied payor mix for inpatient services with 56.99% Medicare, 15.97% commercial, 22.97% Medicaid, and 4.07% self-pay. Outpatient services follow a similar pattern with 36.22% commercial, 35.13% Medicare, 16.12% Medicaid, and 12.53% self-pay. Discharge information for the hospital shows the majority of patients are from White County (77.37%), Carroll County (4.62%), Other Indiana Counties (3.87%), and Out-of-State (14.14%). |
| Schedule H, Part VI, Line 5 - Promotion of Community Health | IU Health White Memorial Hospital is a subsidiary of IU Health, a tax-exempt healthcare organization, whose Board of Directors is composed of members, of which substantially all are independent community members. IU Health White Memorial Hospital invests in its community to improve the quality of life of its community members. Several community benefit highlights are described below. IU Health White Memorial Hospital hosted its fifth annual Health and Safety Fair at the hospital during 2014. Over 400 people attended and received education about healthy eating habits, bike safety, fall prevention and car seat safety. In addition, an IU Health LifeLine helicopter, along with local police, conservation and fire trucks were on display to tour. The Monticello Fire Department provided their smoke house on site, allowing children to learn how to safely exit a smoky building. IU Health White Memorial Hospital is one of the few locations in the state that underwent Safe Haven training. The hospital provided Shaken Infant Syndrome/Safe Haven training to 32 nursing students and 45 students enrolled in the Twin Lakes School Corporation Medical Terminology Class. The hospital also has two Shaken Infant simulators and its staff works closely with the county prosecutor's office on cases where Shaken Infant Syndrome is suspected. |
| Schedule H, Part VI, Line 6 - Affiliated Health Care System | IU Health White Memorial Hospital is a part of the IU Health statewide healthcare system which continues to broaden its reach and positive impact throughout the state of Indiana. IU Health is Indiana's most comprehensive academic medical 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 entities within the IU Health system are IU Health West Hospital, IU Health North Hospital, IU Health Ball Memorial, IU Health Blackford Hospital, IU Health Bloomington Hospital, IU Health Paoli Hospital, IU Health Bedford Hospital, IU Health Tipton Hospital, IU Health La Porte Hospital, IU Health Starke Hospital, IU Health Morgan and IU Health Goshen Hospital. Although each IU Health hospital prepares and submits its own community benefits plan relative to the local community, IU Health considers its community benefit plan as part of an overall vision for strengthening Indiana's overall health. A comprehensive community outreach strategy and community benefit plan is in place that encompasses the academic medical center downtown Indianapolis, suburban Indianapolis and statewide entities around priority areas that focus on health improvement efforts statewide. IU Health is keenly aware of the positive impact it can have on the communities of need in the state of Indiana by focusing on the most pressing needs in a systematic and strategic way. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES P BIEN MD | ||||||||||||||
| DIRECTOR | $0 | $248,513 | $0 | $0 | $0 | $20,491 | $0 | $34,500 | $0 | $25,207 | $0 | $328,711 | $0 | $0 |
| ALFONSO W GATMAITAN | ||||||||||||||
| DIRECTOR | $0 | $409,910 | $0 | $111,219 | $0 | $9,038 | $0 | $88,931 | $0 | $24,643 | $0 | $643,741 | $0 | $0 |
| STEPHANIE J LONG RN | ||||||||||||||
| CEO (PARTIAL YEAR) | $181,231 | $0 | $0 | $0 | $623 | $0 | $7,000 | $0 | $18,700 | $0 | $207,554 | $0 | $0 | $0 |
| BRIAN T SHOCKNEY | ||||||||||||||
| INTERIM CEO (PARTIAL YEAR) | $0 | $211,122 | $0 | $0 | $0 | $1,842 | $0 | $27,253 | $0 | $29,503 | $0 | $269,720 | $0 | $0 |
| CARA L BREIDSTER | ||||||||||||||
| CFO | $0 | $245,741 | $0 | $0 | $0 | $2,118 | $0 | $33,671 | $0 | $20,210 | $0 | $301,740 | $0 | $0 |
| ADEL M KHDOUR MD | ||||||||||||||
| CMO | $0 | $239,453 | $0 | $0 | $0 | $518 | $0 | $32,244 | $0 | $26,311 | $0 | $298,526 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 4b - Supplemental Nonqualified Retirement Plan | FormAndLineReferenceDesc |
| Explanation | Alfonso W. Gatmaitan 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 and other key dates. If the executive leaves prior to retirement or other key dates, the benefit may be forfeited or reduced. Alfonso W. Gatmaitan 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. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PHILIP E PRESCOTT | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SEE PART V | RelationshipDescriptionTxt |
| Transaction | $65,954 | TransactionAmt |
| Transaction | SEE PART V | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule L, Part IV, Line 1, Columns(b)(d) - Relationship and Description | FormAndLineReferenceDesc |
| Explanation | Philip E. Prescott, a family member of Kathleen Altman, Vice-Chair of IU Health White Memorial Hospital board of directors, served and was compensated as an employee of IU Health White Memorial Hospital. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part VI, Section A, Lines 6, 7a and 7b - Members or Stockholders | Line 6: The sole member of IU Health White Memorial Hospital, Inc. is Indiana University Health, Inc. ("IU Health"), a 501(c)(3) tax-exempt organization. Line 7a: The Board of Directors of the IU Health White Memorial Hospital shall consist of up to nine (9) voting members appointed by IU Health, provided that without the consent of the Board of Directors, IU Health may not alter the requirement that at least seventy-five (75%) of the Directors must reside in White County. Line 7b: The following are subject to IU Health's approval: - Any proposed amendment to the Corporation's Articles of Incorporation of Bylaws; - Approval of the Corporation's annual capital and operating budgets; - Approval of any unbudgeted operating or capital budget items or deviations, including any issuance or guarantee of any unbudgeted debt, greater than the budgeted amount by (i) $250,000 per fiscal year per budget line item and (ii) $750,000 per fiscal year in the aggregate; provided, however, the foregoing limit shall be subject to change in the event certain performance standards are not met; - Approval of any strategic plan for the Corporation, including any amendments to a strategic plan; - Approval of any encumbrance, sale or conveyance of assets in excess of five percent (5%), on a cumulative basis, of the Corporation's Net Book Value, during any fiscal year; - Any merger, consolidation, joint venture or affiliation involving the Corporation or any of its affiliates and any other entity; - Appointment and removal of the Corporation's Chief Executive Officer, upon a recommendation of the Board; and - The dissolution of the Corporation or any of its affiliates. |
| Part VI, Section A, Line 8b - Documentation of Meetings | IU Health White Memorial Hospital, Inc.'s Board of Directors does not have any committees with the authority to act on behalf of the Board of Directors. |
| Part VI, Section B, Line 11b - Review of Form 990 | The CFO and IU Health Arnett's Audit Committee reviewed and approved the Form 990. Following their 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 Health's Tax Department to answer any questions. |
| Part VI, Section B - Lines 12, 13, and 14 | IU Health White Memorial Hospital is part of the IU Health system. As the sole member and controlling parent of IU Health White Memorial 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 White Memorial Hospital's Board of Directors was not required to separately adopt a conflict of interest, whistleblower, document retention and destruction and joint venture policies because IU Health's Board of Directors had already adopted and required these policies to be followed by its subsidiaries. |
| Part VI, Section B, Line 12c - Conflict of Interest Policy | IU Health White Memorial Hospital follows IU Health's Conflict of Interest Policy. IU Health's 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 Representative's 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 supervisor's 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 Compensation | IU Health White Memorial Hospital has the following process for determining the compensation of its CEO: Periodically, and additionally as needed, IU Health White Memorial Hospital engages an outside compensation consulting firm to conduct a compensation and benefits study for its CEO and other senior executives. The resulting report prepared by the outside compensation consulting firm is provided to IU Health White Memorial Hospital's Human Resources Department for its review in determining compensation. The Board of Directors then reviews the report prepared by the outside compensation consulting firm and the Human Resources Department's recommendations regarding any changes in executive compensation and benefits. Additionally, the CEO has a written contract that is subject to approval by the Board of Directors. |
| Part VI, Section C, Line 19 - Public Disclosure | IU Health White Memorial Hospital, Inc.'s Articles of Incorporation are available to the public through the Indiana Secretary of State's web-site. IU Health White Memorial Hospital's conflict of interest policy is described on Form 990, Schedule O. IU Health White Memorial Hospital is a consolidated subsidiary in the consolidated financial statements for Indiana University Health, Inc. ("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 Balances | During 2014, IU Health White Memorial Hospital, Inc. recorded the following changes in interest in net assets or fund balances: Change in Interest in Restricted Net Assets of Foundations: 10,178 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:SHARED SERVICES/PROF. FEES TOTAL FEES:4644101 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (44 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Clarian Transplant Institute Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 134350599 | Healthcare | IN | 501(c)(3) | 9 | IUH | Yes (true) |
| Goshen Health System Inc | ||||||||||
| 200 High Park Ave | Goshen | IN | 46527 | 351974765 | Healthcare | IN | 501(c)(3) | 11 I | IUH | Yes (true) |
| Goshen Hospital Association Inc | ||||||||||
| 200 High Park Ave | Goshen | IN | 46527 | 356001540 | Healthcare | IN | 501(c)(3) | 3 | GHS | Yes (true) |
| HealthLINC Incorporated | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 263571507 | Healthcare | IN | 501(c)(3) | 9 | IUHB | Yes (true) |
| Indiana Health Info Exchange Inc | ||||||||||
| 846 N Senate Ave | Indianapolis | IN | 46202 | 364550324 | Healthcare | IN | 501(c)(3) | 11 I | NA | false |
| Indiana Radiology Partners Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 201017034 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| Indiana University Health Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351955872 | Healthcare | IN | 501(c)(3) | 3 | NA | false |
| IU Health Arnett Foundation Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 356079797 | Fundraising | IN | 501(c)(3) | 11 I | IUHA | Yes (true) |
| IU Health Arnett Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 263162145 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health Ball Memorial Hospital Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 350867958 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health Ball Memorial Physicians Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351925641 | Healthcare | IN | 501(c)(3) | 9 | IUHBMH | Yes (true) |
| IU Health Bedford Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 237042323 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health Blackford Hospital Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 010646166 | Healthcare | IN | 501(c)(3) | 3 | IUHBMH | Yes (true) |
| IU Health Bloomington Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351720796 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health BMH Foundation Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 311111784 | Fundraising | IN | 501(c)(3) | 11 I | IUHBMH | Yes (true) |
| IU Health Care Associates Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351747218 | Healthcare | IN | 501(c)(3) | 9 | IUH | Yes (true) |
| IU Health Goshen Foundation Inc | ||||||||||
| 200 High Park Ave | Goshen | IN | 46527 | 462565300 | Fundraising | IN | 501(c)(3) | 11 I | GHS | Yes (true) |
| IU Health LaPorte Hospital Inc | ||||||||||
| PO Box 250 | LaPorte | IN | 46352 | 351125434 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health LaPorte Physicians Inc | ||||||||||
| PO Box 250 | LaPorte | IN | 46352 | 311070868 | Healthcare | IN | 501(c)(3) | 3 | IUHLH | Yes (true) |
| IU Health Morgan Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 273533027 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health North Hospital Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351932442 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health Paoli Hosp Foundation Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 310992486 | Fundraising | IN | 501(c)(3) | 9 | IUHP | Yes (true) |
| IU Health Paoli Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 352090919 | Healthcare | IN | 501(c)(3) | 3 | IUHB | Yes (true) |
| IU Health Tipton Hospital Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 262772226 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health West Hospital Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351814660 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| IU Health White Mem Hosp Fndtn Inc | ||||||||||
| PO Box 952 | Monticello | IN | 47960 | 351671806 | Fundraising | IN | 501(c)(3) | 11 III-FI | IUHWMH | Yes (true) |
| IU Medical Group Foundation Inc | ||||||||||
| 340 W 10th St No FS5100 | Indianapolis | IN | 46202 | 201093251 | Fundraising | IN | 501(c)(3) | 11 II | NA | false |
| LaPorte Hospital Foundation Inc | ||||||||||
| PO Box 250 | LaPorte | IN | 46352 | 310952775 | Fundraising | IN | 501(c)(3) | 11 I | NA | false |
| Methodist Health Foundation Inc | ||||||||||
| 1800 N Capitol Ave | Indianapolis | IN | 46202 | 356043086 | Fundraising | IN | 501(c)(3) | 11 I | IUH | Yes (true) |
| Methodist Health Group Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 350876390 | Healthcare | IN | 501(c)(3) | 11 III-FI | NA | false |
| Methodist Medical Group Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351945384 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| Methodist Occup Health Centers Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351844176 | Healthcare | IN | 501(c)(3) | 3 | IUH | Yes (true) |
| Methodist Research Institute Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 352023710 | Healthcare | IN | 501(c)(3) | 11 I | IUH | Yes (true) |
| MH Healthcare Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351766531 | Healthcare | IN | 501(c)(3) | 3 | MMG | Yes (true) |
| Morgan Co Mem Hosp Foundation Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 352035162 | Fundraising | IN | 501(c)(3) | 11 II | IUHMH | Yes (true) |
| Morgan Co Mem Hosp Guild Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 310886844 | Fundraising | IN | 501(c)(3) | 11 III-FI | IUHMH | Yes (true) |
| Morgan Health Services Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351968564 | Healthcare | IN | 501(c)(3) | 3 | IUHMH | Yes (true) |
| Rehabilitation Hospital of Indiana Inc | ||||||||||
| 4141 Shore Dr | Indianapolis | IN | 46254 | 351786005 | Healthcare | IN | 501(c)(3) | 3 | MHH | Yes (true) |
| RHI Foundation Inc | ||||||||||
| 4141 Shore Dr | Indianapolis | IN | 46254 | 351932349 | Fundraising | IN | 501(c)(3) | 11 I | RHI | Yes (true) |
| The Cheer Guild of Riley Hos for Child | ||||||||||
| 705 Riley Hospital Dr | Indianapolis | IN | 46202 | 356018517 | Fundraising | IN | 501(c)(3) | 11 III-FI | NA | false |
| University Family Physicians Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 237427350 | Healthcare | IN | 501(c)(3) | 9 | IUHCA | Yes (true) |
| MDwise Marketplace Inc | ||||||||||
| 1200 Madison Ave | Indianapolis | IN | 46225 | 465270582 | Insurance | IN | 501(c)(4) | N/A | IUH | Yes (true) |
| MDwise Network Inc | ||||||||||
| 1200 Madison Ave | Indianapolis | IN | 46225 | 472619552 | Insurance | IN | 501(c)(4) | N/A | IUH | Yes (true) |
| Tipton Co Health Care Foundation Inc | ||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 311231905 | Fundraising | IN | 501(c)(3) | 11 I | IUHTH | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | UBI Code VUBICodeVAmt | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Ball Outpatient Sur Ctr LLC | ||||||||||||||
| 569 Brookwood Village Ste 901 | Birmingham | AL | 35209 | 270275794 | Healthcare | IN | BOSCH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| Beltway Surgery Centers LLC | ||||||||||||||
| 569 Brookwood Village Ste 901 | Birmingham | AL | 35209 | 352072586 | Healthcare | IN | BSCH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| Bloomington Endo Centers LLC | ||||||||||||||
| PO Box 1149 | Bloomington | IN | 47402 | 352117943 | Healthcare | IN | IUHB | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| BOSC Holdings LLC | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 454147343 | Healthcare | IN | IUH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| BSC Holdings LLC | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 452314634 | Healthcare | IN | IUH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| Cardinal Health Init LLC | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 300102702 | Purchasing | IN | IUHBMH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| CHV Fund I LLC | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 262523206 | Venture Capital | IN | IUH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| CHV Fund II Management LLC | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 371717823 | Venture Capital | IN | CHV | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| CHV Fund II LLC | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 800902337 | Venture Capital | IN | IUH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| CHV Fund Management LLC | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 262523151 | Venture Capital | IN | CHV | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| Clarian Health Network LLC | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 352055030 | Healthcare | IN | IUH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| Eagle High Surg Center LLC | ||||||||||||||
| 569 Brookwood Village Ste 901 | Birmingham | AL | 35209 | 352259204 | Healthcare | IN | EHSCH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| EHSC Holdings LLC | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 454147879 | Healthcare | IN | IUH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| Health Venture Management LLC | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 205740218 | Management | IN | IUH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| IEC Holdings LLC | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 454148032 | Healthcare | IN | IUH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| Indiana Endoscopy Centers LLC | ||||||||||||||
| 569 Brookwood Village Ste 901 | Birmingham | AL | 35209 | 208398421 | Healthcare | IN | IECH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| IUH Saxony Surgery Ctr LLC | ||||||||||||||
| 569 Brookwood Village Ste 901 | Birmingham | AL | 35209 | 275271091 | Healthcare | IN | SSCH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| ROC Surgery LLC | ||||||||||||||
| 569 Brookwood Village Ste 901 | Birmingham | AL | 35209 | 271497960 | Healthcare | IN | ROCSH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| ROCS Holdings LLC | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 454148369 | Healthcare | IN | IUH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| Senate St Surgery Center LLC | ||||||||||||||
| 569 Brookwood Village Ste 901 | Birmingham | AL | 35209 | 421709357 | Healthcare | IN | SSSCH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| SSC Holdings LLC | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 464472887 | Healthcare | IN | IUH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
| SSSC Holdings LLC | ||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 454148167 | Healthcare | IN | IUH | N/A | $0 | $0 | false | $0 | false | 0.00000 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (23 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BMH Medical Pavilion Association Inc | |||||||||||||||||
| 2525 W University Ave | Muncie | IN | 47303 | 351858408 | Condo Management | IN | IUHBMH | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| Cardinal Health Ventures Inc | |||||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 351611424 | Management | IN | IUHBMH | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| CHV Capital Inc | |||||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 260752507 | Venture Capital | IN | IUH | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| IU Health 457(B) Plan | |||||||||||||||||
| 1100 N Market St | Wilmington | DE | 19890 | 476948347 | Investments | IN | IUH | T | $0 | $0 | 0.00000 | Yes (true) | |||||
| IU Health ACO Inc | |||||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 454421020 | Healthcare | IN | IUH | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| IU Health Board Designated Trust | |||||||||||||||||
| 400 Howard St | San Francisco | CA | 94105 | 306309021 | Investments | IN | IUH | T | $0 | $0 | 0.00000 | Yes (true) | |||||
| IU Health NTGI S&P500 Fund CF | |||||||||||||||||
| PO Box 804358 | Chicago | IL | 60680 | 306298263 | Investments | IN | IUH | T | $0 | $0 | 0.00000 | Yes (true) | |||||
| IU Health Plans Holding Company Inc | |||||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 463794815 | Insurance | IN | IUH | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| IU Health Plans NFP Inc | |||||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 463803873 | Insurance | IN | IUHPHC | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| IU Health Plans Inc | |||||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 262127080 | HMO | IN | IUH | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| IU Health Risk Purchasing Group Inc | |||||||||||||||||
| 151 Meeting St Ste 301 | Charleston | SC | 29401 | 260202446 | Insurance | IN | IUH | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| IU Health Risk Retention Group Inc | |||||||||||||||||
| 151 Meeting St Ste 301 | Charleston | SC | 29401 | 201107674 | Insurance | SC | IUH | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| IU Health Southern IN Physicians Inc | |||||||||||||||||
| PO Box 1149 | Bloomington | IN | 47402 | 351913875 | Healthcare | IN | IUHB | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| IUH Assurance SPC Ltd | |||||||||||||||||
| 980395429 | Insurance | IUH | C | $0 | $0 | 0.00000 | Yes (true) | PO BOX 69 94 SOLARIS AVE | CAMANA BAY | GRAND CAYMAN | CJ | CJ | |||||
| Occ-Health Revenue Systems Inc | |||||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 203308057 | Work Comp PPO | IN | MOHC | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| Parkmor Drug Inc | |||||||||||||||||
| 1501 S Main St | Goshen | IN | 46526 | 131394980 | Pharmacy Sales | IN | GHS | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| PILR Inc | |||||||||||||||||
| 200 High Park Ave | Goshen | IN | 46526 | 204294750 | Development | IN | GHS | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| Proteuo Fund LP | |||||||||||||||||
| 981075227 | Investments | IUH | C | $0 | $0 | 0.00000 | Yes (true) | PO BOX 31106 89 NEXUS WAY | CAMANA BAY | GRAND CAYMAN | CJ | CJ | |||||
| Radiation Oncology Resources Inc | |||||||||||||||||
| 200 High Park Ave | Goshen | IN | 46526 | 262008424 | Healthcare | IN | GHS | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| SCANS Inc | |||||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 453080392 | Healthcare | IN | CHVF1 | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| Univ Hlth (Shanghai) Mgt Con Co Ltd | |||||||||||||||||
| Management | UHMC | C | $0 | $0 | 0.00000 | Yes (true) | 88 CENTURY AVE | SHANGHAI | CH | CH | |||||||
| University Health Management Inc | |||||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 272891143 | Management | IN | CHV | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| University Health Mgmt (China) Inc | |||||||||||||||||
| 950 N Meridian St Ste 800 | Indianapolis | IN | 46204 | 273891311 | Management | IN | CHV | C | $0 | $0 | 0.00000 | Yes (true) | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| IU HEALTH ARNETT INC | ||
| J | $233,529 | FMV |
| IU HEALTH ARNETT INC | ||
| M | $298,076 | FMV |
| IU HEALTH ARNETT INC | ||
| O | $79,926 | FMV |
| IU HEALTH RISK RETENTION GROUP INC | ||
| R | $93,032 | FMV |
| IUH ASSURANCE SPC LTD | ||
| R | $57,560 | FMV |
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