2015-11-05T01:00:23-06:00 2014-12-31 350921680 CROWE HORWATH LLP 3815 River Crossing Parkway Suite 300 Indianapolis IN 462400977 990 2014-01-01 351786005 Rehabilitation Hospital of Indiana Inc REHA 3173292000 4141 SHORE DRIVE Indianapolis IN 462542607 Marjorie Basey CFO 2015-11-04 true Rachel Spurlock P00520729 3175698989 2014 2016-03-07 17:11:31Z Marjorie Basey 4141 SHORE DRIVE Indianapolis IN 462542607 37152792 false X WWW.RHIN.COM X 1989 IN The primary focus of the Rehabilitation Hospital of Indiana is to deliver acute inpatient and outpatient rehabilitation services to the residents of Central Indiana regardless of their ability to pay. The cost of financial assistance and community benefit provided in 2014 = $2.2 million. 4 4 473 68 0 0 26779 50199 40059905 36957093 7555 10057 188398 135443 40282637 37152792 4975 0 0 26797203 24237481 0 0 0 12329969 11824878 39132147 36062359 1150490 1090433 31818920 30924254 25735996 23572649 6082924 7351605 Rehabilitation Hospital of Indiana's (RHI) mission is to provide personalized, compassionate care that enables individuals to regain hope and independence after life-changing injury or illness. RHI's vision is to lead the practice of rehabilitative medicine through internationally-recognized translational research, innovative and patient-centered care, and holistic training. false false 11498555 15022916 THERAPY SERVICES: THERAPY IS A KEY COMPONENT OF A PATIENT'S RECOVERY AND INCLUDES PHYSICAL, OCCUPATIONAL, SPEECH, AND RECREATIONAL THERAPY. THE THERAPY PROGRAM'S PURPOSE IS TO DEVELOP A COMPREHENSIVE PLAN TO HELP PATIENTS BECOME INDEPENDENTLY CAPABLE IN THEIR EVERYDAY LIVES. ADDITIONALLY, THE OVERALL GOAL IS TO HELP BUILD STRENGTH AND ENDURANCE BY USING VARIOUS TECHNIQUES AND SPECIALIZED EQUIPMENT. 10051798 13754064 REHABILITATION NURSING: REHABILITATION NURSES WORK TO REINFORCE HEALING TECHNIQUES BY ENCOURAGING PATIENTS TO PRACTICE WHAT THEY LEARN IN THERAPY. THE NURSES AT REHABILITATION HOSPITAL, INC. HAVE A STRONG BACKGROUND IN MEDICAL-SURGICAL NURSING AND MANY HAVE HAD EXTENSIVE EXPERIENCE IN THE CRITICAL CARE AND ACUTE REHAB SETTING. 7207088 7545347 OTHER PROGRAMS INCLUDE:ANCILLARY SERVICES WHICH CONSISTS OF LAB, EKG, RADIOLOGY, PHARMACY, CENTRAL SUPPLIES, NUTRITION, RESPIRATORY THERAPY, MEDICAL SERVICES (CLINICS), AND DIETARY SERVICES. OUR INTERNS & MEDICAL RESIDENTS PROGRAM REPRESENTS AN EDUCATIONAL PROGRAM TO TRAIN MEDICAL RESIDENTS IN THE ACUTE REHAB SETTING. 1856151 764487 NEUROPSYCHOLOGY: THE PSYCHOLOGICAL ASPECT OF A PATIENT'S REHABILITATION IS ALSO A VERY IMPORTANT PART OF A PATIENT'S RECOVERY. THE NEUROPSYCHOLOGIST WORKS IN COLLABORATION WITH THE REHABILITATION TEAM TO DESIGN THE APPROPRIATE PROGRAM FOR EACH INDIVIDUAL PATIENT. MOREOVER, THE REHABILITATION NEUROPSYCHOLOGIST HELPS THE PATIENT AND FAMILY COPE WITH THEIR ILLNESS AND DISABILITY THROUGH COUNSELING, THERAPY AND EDUCATION. 1856151 764487 30613592 true true false true false false false false false true false false false true true false true false false false false false false false false true true false false true true false false false false false false false false false false true false false false false true true true false false true 80 0 true 473 true false false false false false false false false false false X 4 4 false false false false true true true true true false false true true true true true true true true false IN X Marjorie Basey 3173292195 4141 SHORE DRIVE Indianapolis IN 462542607 MICHAEL NIEMEIER CHAIRMAN OF THE BOARD 1.00 X X 0 0 0 Ian Worden CHAIRMAN OF THE BOARD (TERM ENDED 6/2014) 1.00 X X 0 0 0 DAWN DAVIDSON VICE CHAIR (TERM STARTED 8/29/2014) 1.00 X X 0 0 0 JAMES TERWILLIGER VICE CHAIR/SECRETARY (TERM ENDED MARCH 2014) 1.00 X X 0 0 0 Marvin White Treasurer (TERM ENDED MARCH 2014) 1.00 X X 0 0 0 JONATHAN CURTRIGHT BOARD MEMBER (TERM STARTED 7/1/2014) 1.00 X 0 0 0 MIKE MULLINS BOARD MEMBER (TERM STARTED 8/28/2014) 1.00 X 0 0 0 JOHNATHAN NALLI BOARD MEMBER (6/1/2014-6/30/2014) 1.00 X 0 0 0 DANIEL WOLOSZYN CEO 40.00 X 348763 0 31043 Marjorie Basey CFO 40.00 X 132176 0 17345 MONTE M SPENCE COO 40.00 X 192712 0 28825 DEBRA CORDES CHIEF NURSING OFFICER 40.00 X 143777 0 5217 LANCE E TREXLER DIR OF NEUROREHAB PSYCHOLOGY 40.00 X 145685 0 30268 Gary Skinner Director 40.00 X 127692 0 11061 Joni Brown Exec Dir Human Resources 40.00 X 120763 0 18576 NEIL PATEL PHARMACIST 40.00 X 119867 0 29208 1331435 0 171543 22 false true true TREAT AMERICA FOOD SERVICES 8500 SHAWNEE MISSION PARKWAY MERRIAM KS 66202 DIETARY SERVICES 1110680 CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64117 COMPUTER SERVICES 896088 UNIVERSITY OF PHYSIATRIC ASSOCIATES 541 N CLINICAL DRIVE CL 626 INDIANAPOLIS IN 462025111 PHYSICIAN SERVICES 627903 INDIANA UNIVERSITY HEALTH INC 2201 RELIABLE PARKWAY CHICAGO IL 60685 LAB & BILLING SERVICES 454782 UNITED HOSPITAL SERVICES INC DEPT 78756 PO BOX 78000 DETROIT MI 482780756 LAUNDRY AND LINEN SERVICES 119077 6 X 30199 20000 30199 50199 Net Patient Service Revenue 621300 35720301 35720301 MANAGEMENT FEE 621110 1208147 1208147 Pharmacy Revenue 621300 5722 5722 RENT RELATED TO EXEMPT PURPOSE 531120 22923 22923 0 0 0 0 36957093 8525 8525 0 0 1532 0 0 1532 1532 1532 CAFETERIA & VENDING 722210 118488 118488 REBATE REVENUE 900099 7109 7109 PHYSICIAN SERVICES 900099 5550 5550 4296 4296 0 0 135443 37152792 37086814 0 15779 1164016 1164016 16480539 14657564 1822975 497684 390911 106773 4666447 3686493 979954 1428795 1208111 220684 1720 1540 180 133560 108184 25376 3244456 3066874 177582 0 65102 65102 1138632 1074545 64087 1019128 825494 193634 1088633 881793 206840 128203 103845 24358 27083 12507 14576 470879 423791 47088 1405181 1138197 266984 295060 238999 56061 NURSING SUPPLIES 2031618 2031618 BAD DEBT 763126 763126 MISC MEMBERSHIP DUES 12497 12497 0 0 0 0 36062359 30613592 5448767 0 2714 2714 7321403 7558144 5910575 6129559 0 0 201614 267660 1971300 991132 31520666 19766289 12494502 11754377 3002916 3004270 0 0 913896 1216398 31818920 30924254 5677246 4209693 15550000 14980000 0 3000000 3000000 1508750 1382956 25735996 23572649 X 6082924 7351605 6082924 7351605 31818920 30924254 X 1090433 590 177658 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4545 4545 false Schedule C, Part II-B, Line 1a Description of the Activities reported on lines 1A through 1I Line 1I Represents the portion of membership association dues allocated to lobbying activities by the respective association. 602474 1904165 2506639 14954248 10633883 4320365 401697 260090 141607 13551887 8872316 4679571 106195 106195 11754377 Estimated Third-party settlements 406964 Interest Rate Swap Liability 921976 Capital Lease Obligation 54016 1382956 X 37331040 590 177658 178248 37152792 0 0 37152792 36062359 0 0 36062359 0 0 36062359 Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A). ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REQUIRED FOR THE HOSPITAL IN THE CONSOLIDATED FINANCIAL STATEMENTS. A tax position is recognized as a benefit only if it is "more likely than not" that the tax position would be sustained in a tax examination, with a tax examination being presumed to occur. The amount recognized is the largest amount of tax benefit that is greater than 50% likely of being realized on examination. For tax positions not meeting the "more likely than not" test, no tax benefit is recorded. The Hospital is no longer subject to examination by U.S. federal taxing authorities for years before 2008 and for all state income taxes through 2009. The Hospital does not expect the total amount of unrecognized tax positions to significantly change in the next 12 months. The Hospital would recognize interest and/or penalties related to income tax matters in income tax expense. The Hospital has no amounts accrued for interest or penalties as of December 31, 2014 and 2013. Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 CHANGE IN INTEREST RATE SWAP - 177658 true true X true X true X true true false true true 525595 0 525595 0.0149 2110391 633252 1477139 0.0418 0 0 0 0.0 0 0 2635986 633252 2002734 0.0567 52417 11445 40972 0.0012 244506 133419 111087 0.0031 0 0 0 0.0 91128 0 91128 0.0026 2400 0 2400 0.0001 0 0 390451 144864 245587 0.0070 0 0 3026437 778116 2248321 0.0637 false 762450 0 10859842 11935601 -1075759 X true true 1 1 REHABILITATION HOSPITAL OF INDIANA www.rhin.com 13-005971-1 X X Acute Rehabiliation REHABILITATION HOSPITAL OF INDIANA 1 false false true X X X X X X X X X 12 true true false true X http://rhin.com/category/news/rhi-news-events/rhi-report-to-the-community/ X true 13 true http://rhin.com/wp-content/uploads/2014/01/2013-RHI-Benefit-to-the-Community-Implementation-Stategy- false false true X 2.0 4.0 X X X X true true X X X true X X X X X X true false X X X X false X X X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Rehabilitation Hospital of Indiana, Inc.. The approach to gathering qualitative data for the CHNA consisted of a multicomponent approach to identify and verify community health needs. This included hosting multiple one and a half hour to two hour community conversation focus groups with public health officials and community leaders to discuss the healthcare needs of the service area as well as surveying the community at large. Local leaders with a stake in the Marion County community's health were invited to attend focus group sessions held at IU Health affiliate hospitals to discuss the needs. Attendees who participated in the focus groups are listed below: Cynthia Stone, Associate Professor IU School of Public Health Orion Bell, President & CEO CICOA Aging and In-Home Solutions Paul Pfaff, Director IU Health Enrollment Center Molly Chavers, Executive Director, Indy Hub Chuck Brandenburg, Director of Special Projects and Grants, United Way Stacey Chappell, Health Promotions Coordinator, HealthNet Dr. Larry Reed, Director, IU Health Riley Hospital Trauma Katie Jones Director, Violence Prevention Program, Indiana State Department of Health Morgan McGill, Director, Office of Women's Health Dr. Jay Gladden, Dean, IUPUI School of Physical Education and Tourism Management Mary McKee, Director, Public Health Practice, Marion County Public Health Department Joanne Pope, Manager, After School and Summer Programs, Indy Parks Jenny Boyts, Community Coordinator, Challenge Foundation Academy Charlie Schlegal, Principal, Challenge Foundation Academy Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Rehabilitation Hospital of Indiana, Inc.. The CHNA was conducted with Indiana University Health. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Rehabilitation Hospital Of Indiana. RHI is a specialty provider of rehabilitation services such as physical, occupational and speech therapy. RHI Completed its community health needs assessment in conjunction with its majority owner/member hospital (Indiana university Health). Five needs were identified from the assessment including obesity, access to care, mental health, prenatal care and tobacco use. RHI determined three of the identified areas to address including access to care, obesity and mental health needs. Two needs identified in the CHNA, Tobacco use and prenatal care, are being undertaken by other Indiana University Health providers. ACCESS TO CARE has been addressed through several programs RHI sponsored or participated in with other organizations. RHI participated in a "Health and Wellness Fair - Stroke Awareness Month". The Health and Wellness Fair spotlighted National Stroke Awareness Month. The fair assisted individuals to better understand the signs and symptoms of stroke, prevention, and tools to assist individuals on stroke prevention, treatment and recovery. Individual screenings took place for use in follow-up with individual's health care provider. RHI has served as a host site for SRT Prosthetics & Orthotics Amputee Walking School. The Amputee Walking School is 100% FREE to any amputee (and their families), with or without a prosthesis. As a community service program, amputees are not required to be a patient of SRT. This program, presented by Dennis Oehler and Todd Schaffhauser, both are Paralympic champions in track and field events, enables individuals with disabilities to run, move from side-to-side, bend down, jump, climb stairs, and walk with confidence, by learning the dynamics of how the artificial devices work and how to use their muscles properly to control them. This leads to improve energy use and function. Collaboration between the presenters, and the physical therapist profession, is integral in this program. Connecting physical therapists from the Rehabilitation Hospital of Indiana and other facilities, including students, with Dennis and Todd provides a unique perspective of the capabilities of the prosthetic user. It also gives the therapists treatment ideas that can immediately be implemented with their patients. The therapists work with the participants on exercises for lower limb amputees of all ages and various levels of amputations. Treatment approaches for improved function and return to an active lifestyle are also presented. This includes instruction on advanced exercises and running techniques for above knee and below-knee amputees, with some participants actually running with their prosthesis for the first time. Staff from SRT, many are amputees themselves, also work with the participants. They provide guidance as well as first-hand experience with prostheses. RHI partnered with IUH in "IN-Shape Indiana Black and Minority Health Fair". The Theme for this year's Health Fair was "Be Active, Healthy and Happy!" It offered health screenings, education and resources that help community participants attain, maintain and live a healthy lifestyle and reduce their risk of chronic diseases. RHI clinicians performed 51 blood pressure screenings with education on normal values and the importance of maintaining a healthy lifestyle. Total community participants on 7/17/14 was 250 (and 1,300 for entire 4 day event). CONTINUED AT SCHEDULE H, PART VI. Schedule H, Part V, Section B, Line 21 Facility , 1 Facility , 1 - REHABILITATION HOSPITAL OF INDIANA. RHI is not a general acute care hospital/facility nor is RHI equipped to provide care to patients with urgent care needs. RHI is a specialty provider of rehabilitation services such as Physical, Occupational and Speech Therapy. Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - REHABILITATION HOSPITAL OF INDIANA, INC.. THE HOSPITAL LIMITS THE AMOUNTS CHARGED TO FAP ELIGIBLE INDIVIDUALS. FAP ELIGIBLE INDIVIDUALS WILL NOT BE CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) TO THOSE INDIVIDUALS WHO DO HAVE INSURANCE. THE AGB IS CALCULATED BASED ON THE LOOK-BACK METHOD FOR PAYERS INCLUDING MEDICARE FEE FOR SERVICES ALONG WITH ALL PRIVATE HEALTH INSURERS. 0 Schedule H, Part V, Section B, Line 11 HOW THE HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IN CHNA CONTINUED FROM SCHEDULE H, PART V, SECTION B, LINE 11: RHI partnered with Indiana Public Schools (IPS) for IPS School Physicals to provide free school physicals to low income students at Arsenal Tech High School. The goal of this program was to put together a team of physicians, nurses and advanced providers to help IPS student's access the physicals needed to safely participate in sports and encourage health activity. As a result of this collaboration, 421 students are now allowed to practice and stay active on their respective sports teams. RHI participated in "Indy Do Day" to help with "Operation Winter Ready". Operation Winter Ready is designed to provide much needed supplies to over 1,000 of our community's homeless individuals to help keep them warm, safe and healthier during the winter months. Volunteers assembled Winter Ready kits, which will include a blanket, gloves, socks, hat and hand warmers, as well as inspirational notes from neighborhood schools. The Indianapolis Metropolitan Police Department's Homeless Unit will then distribute the kits directly to the homeless camp locations, eliminating the challenges our homeless individuals face in accessing such critically needed items for winter survival. Veggies and Vaccines Partnered with IUH to administer free flu vaccinations at Churchman Woods Apartments on the Southside of Indianapolis. Through this partnership, RHI is able to deliver on its goal of improving access to healthcare services to vulnerable populations in underserved areas within Marion County. RHI is supporting programs and initiative specifically aimed to: serve an identified community need, particularly in the areas of RHI outreach priorities. To Reduce health disparities or improve the quality of life for individuals living in their communities. To reach largely underserved communities (minorities, low-income, homeless and at-risk populations). To improve access to healthcare RHI hosted flu shot clinics in October and November of 2014 at its main hospital in Marion County. To address the need of obesity, RHI partnered with IU Health on a Community Day of Service aimed at engaging RHI team members in activities that address identified community outreach priority. In response to the need for more physical activity assets to help combat obesity in the communities RHI serves, RHI staff volunteered at two community parks in Marion County to enhance park assets making recreation and exercise at the parks safer and more appealing for community recreation. "RHI Community Gym - RHI Sports Community Fitness Program occurs every Tuesday and Thursday at RHI. By making the therapy gym available at no cost to all members of the community that have a physical disability, RHI recognizes that an individual with a physical disability needs to continue a healthy lifestyle by exercising which may require the need of specialized equipment. Each session has a supervisor which consists of Sports program employees, sports program AmeriCorps members, or RHI therapists. To address preventing and reversing obesity, the hospital hosted nutrition education programs at its main campus for patients and their families. Diabetes education to educate at-risk or newly-diagnosed patients and their families on managing their diabetes. OBESITY PREVENTION Diabetes Prevention Program is supported by RHI by conducting research through the Indiana Spinal Cord and Brain Injury Research Fund. Rehabilitation Hospital of Indiana will examine the effects of a health and wellness program on the prevention of diabetes in community individuals with paraplegia. The implementation phase of this pilot study will be conducted over the course of 12 months. The content of this program will include interactive classes and information on nutrition and exercise. However, the critical piece of the program will be focused on health behavior change. RHI is purchasing (15) Fitbit Flexes that will facilitate the ability to track participants diet and exercise. Additionally, participation in this intensive group wellness intervention will allow individuals who have experienced a spinal cord injury control their weight and avoid developing diabetes. RHI Water Ski Clinic - RHI Sports' annual water ski clinic is a two-day program held at Morse Reservoir. This clinic provides individuals with physical disabilities the opportunity to participate in the thrilling sport of water skiing, helping to increase the participant's overall physical fitness and self-confidence while decreasing feelings of isolation and helplessness. The two-day event serves approximately 40 community individuals with physical disabilities. RHI assisted United Way, acting in capacity as a UW volunteer providing service and support as an agency evaluator of an existing UWCI agency. RHI assisted with the 2 year evaluation for Christamore House, a family and community center that provides early childhood education, after school programming, senior citizen services, preventative services and employment assistance to the residents of Haughville and the near Westside Indianapolis. To address mental health initiatives, RHI will partner with IU Health Academic Centers to provide Mental health Screenings to identified counties. Collaborate Behavioral Health on a community initiative, as well as partner with mental Health America of Greater Indianapolis for a mental health initiative for Marion County. Several of the previously listed programs support mental health. In addition, RHI provides free monthly support groups related to strokes and brain injury. TWO STROKE SUPPORT GROUPS OFFERED AT RHI. ONE GROUP IS TO TEACH INDIVIDUALS RECOVERING FROM A STROKE COPING SKILLS. THE SECOND STROKE SUPPORT GROUP IS TO PROVIDE TRAINING TO FAMILIES AND LOVED ONES OF THE RECOVERING STROKE PATIENT. The Brian Injury Support group teaches survivors of brain injury and their family and caregivers through pertinent situations, goal setting and providing information about return to work. These meetings help decrease social loneness and increase support in the community. RHI believes support groups provide its attendees with coping skills while promoting the health of the community it serves. The support groups encourage the communication among victims and/or family members with those who have sustained a similar injury and have returned to the community. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 762450 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The Cost to charge ratio based on worksheet 2 was used to calculate the amounts reported on lines a-d. Lines e-j are reported based on actual costs incurred. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount The provision for bad debts is based upon management's assessment of historical and expected collections of accounts receivable considering business and economic conditions, trends in health care coverage, and other collection indicators. Accounts receivable are written off and charged to the provision for bad debts after collection efforts have been made in accordance with the Hospital's policies. Recoveries are treated as a reduction to the provision for bad debts. Accounts receivable are reduced by an allowance for doubtful accounts. Periodically, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by major payor category. Data about the major payor sources of revenue is analyzed to establish an appropriate allowance for uncollectible receivables and provision for bad debts. For receivables associated with services provided to patients who have third-party coverage, contractually due amounts are analyzed and compared to actual cash collected over time to enhance the quality of the estimate of the allowance for doubtful accounts and the provision for bad debts (for example, for expected uncollectible deductibles and co-payments on accounts for which the third-party payor has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and co payment balances due for which third-party coverage exists for part of the bill), a significant allowance for doubtful accounts is recorded on the basis of historical experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. An estimate of the difference between contracted rates and amounts actually collected, after all reasonable collection efforts have been exhausted, is charged to the provision for bad debts and credited to the allowance for doubtful accounts. Schedule H, Part III, Line 3 Bad Debt Expense Methodology The organization does not report any portion of bad debt as community benefit and chooses not to estimate for purposes of Part III, Section A, Line 3 the amount of bad debt attributable to patients that may be eligible under the organization's financial assistance policy. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Footnote to the Audited Financial Statement. Allowances for Doubtful Accounts: The provision for bad debts is based upon management's assessment of historical and expected collections of accounts receivable considering business and economic conditions, trends in health care coverage, and other collection indicators. Accounts receivable are written off and charged to the provision for bad debts after collection efforts have been made in accordance with the Hospital's policies. Recoveries are treated as a reduction to the provision for bad debts. Accounts receivable are reduced by an allowance for doubtful accounts. Periodically, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by major payer category. Data about the major payer sources of revenue is analyzed to establish an appropriate allowance for uncollectible receivables and provision for bad debts. For receivables associated with services provided to patients who have third-party coverage, contractually due amounts are analyzed and compared to actual cash collected over time to enhance the quality of the estimate of the allowance for doubtful accounts provision for bad debts. For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and co payment balances due for which third-party coverage exists for part of the bill), a significant allowance for doubtful accounts is recorded on the basis of historical experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. An estimate of the difference between contracted rates and amounts actually collected, after all reasonable collection efforts have been exhausted, is charged to the provision for bad debts and credited to the allowance for doubtful accounts. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Any cost incurred for treatment of a patient in which the total amount of revenue was not collected, is reported as a shortfall. By continuing to treat patient eligible for Medicare, hospitals alleviate the federal government's burden for directly providing medical services. The shortfall is due to continued cuts in Medicare reimbursement while RHI continues to invest in state-of the-art equipment and facilities to meet the challenging healthcare needs of the community. Medicare allowable costs were determined based on the cost to charge ratio from the FY 2014 Medicare cost report. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance The Hospital's collection policy contains provisions on practices to be followed for patients who are known to qualify for financial assistance. The collection policy states that RHI will not engage in extraordinary collection actions before making reasonable efforts to determine whether a patient is eligible for assistance under RHI's Financial Assistance Policy. Schedule H, Part V, Section B, Line 16a FAP website - REHABILITATION HOSPITAL OF INDIANA: Line 16a URL: http://rhin.com/wp-content/uploads/2012/12/PFS-Financail-Assistance-Poliy-3-06.pdf; Schedule H, Part V, Section B, Line 16b FAP Application website - REHABILITATION HOSPITAL OF INDIANA: Line 16b URL: http://rhin.com/wp-content/uploads/2012/12/RHI-FINANCIAL-ASSISTANCE-APP-012312.pdf; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - REHABILITATION HOSPITAL OF INDIANA: Line 16c URL: http://rhin.com/billing-center/; Schedule H, Part VI, Line 2 Needs assessment Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B: RHI completed the Community Health Needs Assessment in conjunction with our majority owner/member hospital (Indiana University Health). RHI's Primary Service Area (PSA) is Marion County. The areas of need that were identified from this PSA by the Needs Assessment were : Obesity, Access to Care, Mental Health, Prenatal Care and Tobacco Use. RHI determined that we could impact 3 of these areas of need. The three areas chosen by RHI were: Obesity, Access to Care and Mental Health Needs. The implementation strategy is a plan which addresses how RHI will contribute to each of these three community health needs. RHI also evaluates the hospital's accessibility on an annual basis via an Annual Accessibility Study. This plan includes actions to further the intent of creating accessible facilities, programs and communities for persons with disabilities. In addition, RHI attempts to address the needs of people with disabilities through treatment programs and services, community programming and community awareness. The plan was developed with input from persons served, support group input, clinical outcomes data, satisfaction surveys, RHI personnel using suggestions and input from community involvement and other stakeholders. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization's financial assistance policy: Patients are informed about financial assistance before admissions by the clinical liaison. This occurs when the patient is at the general acute care hospital before transferring to RHI. Patients are also informed of financial assistance during registration by the admissions representative and a summary of the financial assistance policy is included in each admission packet. During the patient's stay, the discharge planner will work with the patient in completing the financial assistance application. Patients are informed again of financial assistance during the discharge process by the discharge planners. The discharge planners will continue to work with the patients after discharge, if the situation requires. Patients receive a summary of the FAP with all statements. RHI will also mail a summary of the policy along with a financial assistance application to any uninsured patient that has a balance on his/her account. RHI also publicizes its FAP on the hospital web site. RHI will provide representatives to assist patients with the financial assistance process Monday through Friday from 8am to 5pm. Schedule H, Part VI, Line 4 Community information Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves: RHI serves adolescents through adults with physical and cognitive disabilities primarily from 100-mile radius of RHI but catchment area normally includes all 92 Indiana counties and surrounding states. RHI offers services for inpatient for 91 beds and 3 outpatient locations. One location is located within the hospital and two offices conveniently located at separate locations. RHI's core services are structured through specialized units. By doing so, a rehabilitative environment is created that fosters progressive leadership, innovation and quality that will lead to preeminent patient care and outcomes. RHI's main services include but not limited to Stroke Rehabilitation, Brain and Spinal Cord injury, Multiple Trauma Rehabilitation and Orthopedic Rehabilitation. RHI is the largest freestanding acute rehabilitation hospital in Indiana coupled with being the only rehab hospital with CARF certification in spinal cord injury, general comprehensive rehab, brain injury and stroke rehabilitation. Rehabilitation Hospital of Indiana at IU Health Hospital is located in Marion County, a county in central Indiana. Based on the most recent Census Bureau (2010) statistics, Marion County's population is 903,393 persons with approximately 52% being female and 48% male. The county's population estimates by race are 59.6% White, 27.0% Black, 9.6% Hispanic or Latino, 2.1% Asian, 0.5%, American Indian or Alaska Native, and 2.5% persons reporting two or more races. Marion County has relatively moderate levels of educational attainment. A high school degree is the level of education 30% had achieved in 2010, and the percentage of those with a high school degree increased slightly from 2000 to 2010 (29.6% to 30.1%). An additional 20% of Marion County residents had some college, but no degree. As of 2010, 24% of the population has an associate's or bachelor's degree, and 9% hold a graduate or professional degree. Within the entire service area, the total population for the PSA is 903,393 and the total population for surrounding counties is 3,205,993. The Marion County population has increased 5% since 2000, when the population was estimated to be 860,440 persons. Comparatively, Marion County's population has increased more slowly than the average population across the total service area, which increased by approximately 8.46% from 2000 to 2010. Indiana's total 2010 population estimate of 6,483,802 was up by 6.6% from 2000, and population growth was up by 10% for the entire nation. The population for Marion County in 2011 and 2012 were 911,005 and 918,977 respectively. Between 2010 and 2011, the share of jobs was greatest in the entire state of Indiana in the areas of manufacturing, healthcare and social assistance, retail trade, and accommodation and food services. In Marion County, the share of jobs was greatest in the areas of healthcare and social assistance, manufacturing, retail trade, accommodation and food services, administrative support for waste management and remediation services, professional, scientific, and technical services, transportation and warehousing, and wholesale trade. Marion County has a diverse group of major employers reported by the Indiana Department of Workforce Development, including: Eli Lilly International Corporation/ Eli Lilly and Company, St. Vincent Hospital, Indiana University-Purdue, University Indianapolis, Indiana University Health System, Indiana University School of Medicine, St. Francis Hospital & Health Center and Allison Advanced Development Company (Liberty Works). Marion County reported a relatively similar unemployment rate to the state of Indiana, but had a slightly higher rate of unemployment than that for most surrounding counties and the entire US. State unemployment rates for 2012 and 2011, respectively were 8.4% and 9.0%. The unemployment rates for Marion County for the same periods were 8.7% and 9.4% respectively. Areas with higher poverty rates tend to have poorer access to healthcare, lower rates of preventive care, higher rates of preventable hospital admissions, and poorer health outcomes in general. According to the US Census, in 2009, the national poverty rate was at 14.3%, increasing from 13.2% in 2008. In Indiana, 14.4% of the state population lived in poverty, which was a 1.9% increase from the 2008 poverty rate (12.9%). For Marion County, a poverty rate of 19.7% was reported in 2009, rising from 16.5% in 2008 (3.2%). Comparatively for Indiana, Hendricks County has the lowest poverty rate at 5.1% and Monroe County has the highest poverty rate at 21.9%. Income level is an additional economic factor that has also been associated with the health status of a population. Based on US Census Bureau (2009) data, Marion County's per capita personal income was estimated to be $36,409, which is above the Indiana State average of $33,323; and a median household income around $41,201, which is below the Indiana state average of $45,427. However, Marion County's per capita personal income and median household income were both below the US national average of per capita income of $38,846 and median household income of $50,221. National statistics on health insurance indicate that 16% of the United States population is uninsured. Of the US Population that is insured, 49% are insured through an employer; 5% through individual providers, 16% through Medicaid, 12% through Medicare, and 1% through other public providers. In Indiana, it is estimated that 14% of the population are uninsured, 7% of which are children. Of the Indiana residents who are insured, 16% residents are insured through Medicaid, 14% through Medicare, 52% through their employer, 3% through individual providers, and 1% through other public providers. Based on inpatient discharge data from the Indiana Hospital Association (IHA), 31% of Marion County residents have commercial insurance, 22% are insured through Medicaid, 30% are insured through Medicare, 11% pay out-of-pocket (uninsured) and 6% have other government insurance or are unknown. At Rehabilitation Hospital of Indiana, it is estimated that 38% of discharged patients have commercial insurance, 10% are insured through Medicaid, 51% are insured through Medicare, 1% pay out-of-pocket (uninsured). Schedule H, Part VI, Line 5 Promotion of community health Provide any other information important to describing how the organization's hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.): RHI continues to forge positive relationships with all referral sources to identify access challenges and improvement. RHI also provides monthly support groups for patients and families including a Stroke Support Group held on the main campus; a Brain Injury Support Group on the main campus and at NRC; and a Stroke Care Givers Support Group on the main campus. RHI provides the support groups with a meeting room, one staff member's time and refreshments at no cost to the patients and families attending. There are two Stroke Support Groups offered at RHI. One group is to teach individuals recovering from a stroke coping skills. The second Stroke Support Group is to provide training to families and loved ones of the recovering stroke patient. The groups meet monthly on the main hospital campus. The Brain Injury Support Group teaches survivors of brain injury and their family and caregivers through pertinent situations, goal setting and providing information about return to work. Apart from the monthly meetings, social gatherings meet to decrease social loneliness and increase support in the community. RHI believes support groups provide its attendees with coping skills while promoting the health of the community it serves. The support groups encourage the communication among victims and/or family members with those who have sustained a similar injury and have returned to the community. RHI also provided an aquatics wellness program for individuals within the community. This program benefits members of the community such as individuals with arthritis and women during pregnancy. The water allows them to exercise under conditions that they normally would not be able to exercise. This program collects a small fee to offset a small portion of the cost of the program. Every Tuesday and Thursday evenings, RHI offers a Community Fitness Program by making the therapy gym available to all members of the community that have a physical disability. RHI recognizes that an individual with physical disability needs to continue a healthy life style by exercising which may require the need of specialized equipment. One or two RHI volunteers who are licensed therapists supervise the Community Fitness Program. RHI staff volunteers their time to provide supervision for the program, which is at no cost to the attendees. RHI recognizes that medical rehabilitation is a complex, interdisciplinary system of inpatient and outpatient therapies that is part of more complex system that includes emergent and acute care following catastrophic illness or injury as well as networks that provide long-term services and support. This system and its components provide opportunities for a broad diversity of applied research studies. The targets of current research at RHI range from interventions to reduce disability to a way to better measure rehabilitation effectiveness to leading edge methods to evaluate patients and maximize their outcomes. An Overview of the Research RHI conducts includes Identifying medications that enhance recovery following brain injury; Identifying commonly prescribed medications following brain injury that may have adverse effects on recovery; Evaluating the effectiveness of group therapy for patients and families to improve coping skills ; Improving return to work rates by developing networks of community services; Studying outcomes (community reintegration, well-being, and life satisfaction). RHI is Collaborating with the Mayo Clinic Traumatic Brain Injury System, Indiana University School of Medicine, Indiana University Health, St. Vincent and Purdue University to study patients after brain and spinal injuries. As we continue to grow as a rehabilitation hospital and leader in medicine and research development, RHI invites physicians to contact us about patients that could be eligible for rehabilitation and participation in our studies and medical advancement. The partnership between RHI and physicians is important in the continual effort to support and provide the best care for the patient. RHI has made various donations throughout the year to groups supporting the needs of the community. Schedule H, Part VI, Line 6 Affiliated health care system Describe the respective roles of the organization and its affiliates in promoting the health of the communities served by the system: RHI is owned by two major health systems, Indiana University Health (IUH) and St. Vincent Health. IUH is the majority owner of RHI. RHI works primarily with the IUH system on various activities to address the community needs. Schedule H, Part VI, Line 7 State filing of community benefit report IN X X X X false false false false false false false false false DANIEL WOLOSZYN CEO 273593 0 68125 0 7045 0 7558 0 23485 0 379806 0 0 0 MONTE M SPENCE COO 171290 0 17800 0 3622 0 5723 0 23102 0 221537 0 0 0 LANCE E TREXLER DIR OF NEUROREHAB PSYCHOLOGY 144575 0 0 0 1110 0 4575 0 25693 0 175953 0 0 0 A INDIANA FINANCE AUTHORITY 351602316 45471AEQ1 2011-11-10 16420000 SEE SCHEDULE K PART VI false false false A 570000 0 16420765 0 0 0 316503 0 0 3348026 11900000 856236 true false false true A false true true false false 0.0066 0.0066 true false true A false true true false 0.0 false false false true A true Schedule K, Part V Written Procedures The organization adopted written procedures in 2014. The organizatoin has processes that dertmine how management will timely identify and correct violations of federal tax requirements using the voluntary closing agreement program provided by the IRS when self-remediation is not available to the organization. The organization strives to stay abreast of federal regulations and considers the repercussions of all significant activities which could foreseeably have an impact on the organization's tax exempt bonds and the associated federal tax regulations. In the event a violation is identified the organization's policy is to correct the violation as soon as possible, while working with the federal authorities as necessary to ensure that sufficient controls are present which will guard against future violations. Schedule K, Part IV, Line 7 Written Procedures The organization adopted written procedures in 2014. The organization has processes to monitor it's ability to remain in compliance with the arbitrage requirements under Section 148 of the Internal Revenue Code. The organization strives to stay abreast of federal regulations and considers the repercussions of all significant activities which could foreseeably have an impact on the organization's tax exempt bonds and the associated federal tax regulations. Schedule K, Part III, Line 3a Private Business Use The organization has a management agreement for food & cafeteria services which does not violate the Safe Harbors of Rev Proc 97-13. Schedule K, Part III, Line 2 Private Business Use The organization leases space to contract physicians and this leased space is included in Part III, Line 4, Private Business Use. Schedule K, Part II, Line 3 Total proceeds of issue ISSUE PRICE: $16,420,000 EARNINGS: $765 TOTAL PROCEEDS: $16,420,765 $765 represents interest income Schedule K, Part III, Line 9 Written Procedures The organization adopted written procedures in 2014. The organizaiton ensures all nonqualified bonds (if any) of the issue are remediated in accordance with the associated regulations. The organization strives to stay abreast of federal regulations and considers the repercussions of all significant activities which could foreseeably have an impact on the organization's tax exempt bonds and the associated federal tax regulations. Schedule K, Part I, Column (f) DESCRIPTION OF PURPOSE THE SERIES 2011 BONDS WERE ISSUED IN ORDER TO PROVIDE FUNDING FOR THE CONSTRUCTION & RENOVATION OF BUILDINGS AND STRUCTURES AND THE PURCHASE OF NEW EQUIPMENT. ADDITIONALLY, THE SERIES 2011 BONDS WERE ISSUED IN ORDER TO REFUND THE SERIES 1990 BONDS. THE SERIES 1990 BONDS WERE ISSUED ON NOVEMBER 1, 1990. X TILT TABLE & COMPUTER 2 30198 Cost 0 false false false Schedule M, Part I Explanations of reporting method for number on contributions Other: NUMBER OF ITEMS RECEIVED IS BEING REPORTED. Schedule M, Part I Number of contributions or items contributed NUMBER OF ITEMS RECEIVED IS BEING REPORTED. Form 990, Part III, Line 1 ORGANIZATION'S MISSION (CONTINUED FROM PART III, LINE 1) RHI WILL ACHIEVE THIS VISION THROUGH THE FOLLOWING: ACHIEVING IN SUPERIOR PATIENT OUTCOMES; EMBRACING INNOVATIVE TREATMENT METHODS; RECRUITING OUTSTANDING CLINICAL EXPERTISE; TRAINING THE NEXT GENERATION OF REHABILITATION PROFESSIONALS; SEEKING PARTNERSHIPS WITH OTHER COMMUNITY MEMBERS WHO SERVE OUR PATIENT POPULATION; AND PROVIDING A LIFETIME CONTINUUM OF SERVICES FOR OUR PATIENTS. RHI'S VALUES INCLUDE: INTEGRITY: TREATING EACH INDIVIDUAL WITH DIGNITY AND RESPECT; INNOVATION: PIONEERING IN RESEARCH LEADING TO BETTER OUTCOMES; COMPASSION: PROVIDING AN EMPATHETIC AND HEALING ENVIRONMENT; TEAMWORK: EMPOWERING EMPLOYEES; AND SERVICE: PROVIDING COMMUNITY OUTREACH AND ADVOCACY FOR INDIVIDUALS WITH DISABILITIES THROUGH OUR STAFF, PHYSICIANS, AND THE RHI FOUNDATION. RHI OPERATES A 91 BED, FREESTANDING SPECIALTY MEDICAL REHABILITATION HOSPITAL LOCATED IN INDIANAPOLIS, INDIANA. THE HOSPITAL PROVIDES SHORT-TERM, COMPREHENSIVE REHABILITATION SERVICES TO PATIENTS, AND ITS PROGRAMS ARE DESIGNED TO RESTORE PHYSICAL, COGNITIVE AND PSYCHOSOCIAL FUNCTIONS FOLLOWING AN INCIDENT OF ACUTE ILLNESS OR TRAUMA. INPATIENT AND OUTPATIENT THERAPY AND SUPPORT SERVICES PROVIDED BY RHI INCLUDE PHYSICAL AND OCCUPATIONAL THERAPY, SPEECH THERAPY, RECREATIONAL THERAPY, ACTIVITIES OF DAILY LIVING, REHABILITATION NURSING, PSYCHOLOGY, SOCIAL SERVICES AND COGNITIVE RETRAINING, AND SUB ACUTE SERVICES REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY. THE HOSPITAL PROVIDES FREE AND/OR DISCOUNTED CARE TO THOSE WHO QUALIFY ACCORDING TO RHI'S POLICY. RHI VERIFIES AND COLLECTS FINANCIAL RESOURCE INFORMATION ON EACH PATIENT IN A MANNER THAT PROTECTS EACH PATIENT'S DIGNITY AND QUALITY OF LIFE. NO PATIENT'S ADMISSION IS DENIED DUE TO A PATIENT'S INABILITY TO SETTLE THEIR ACCOUNT. ANY PATIENT WHO WISHES TO BE CONSIDERED FOR CHARITY CARE FURNISHES THE HOSPITAL WITH THE REQUIRED FINANCIAL DOCUMENTATION WHICH THE HOSPITAL USES TO DETERMINE WHETHER HE/SHE QUALIFIED. PATIENTS WHO APPLY FOR AND ARE ELIGIBLE FOR CHARITY CARE GENERALLY ARE APPROVED DURING THE ADMISSION PROCESS, HOWEVER, A PATIENT CAN APPLY FOR CHARITY AT ANY TIME. MEDICAID ELIGIBILITY IS ALSO EVALUATED PRIOR TO THE ADMISSION PROCESS. IF A PATIENT APPEARS TO BE ELIGIBLE FOR ASSISTANCE UNDER A GOVERNMENTAL PROGRAM SUCH AS MEDICAID, RHI ASSISTS THE PATIENT WITH THIS PROCESS. THE HOSPITAL PROVIDES MANY SUPPORT GROUPS THAT BENEFIT AND PROMOTE THE HEALTH OF THE COMMUNITY IT SERVES. SOME OF THESE GROUPS INCLUDE THE STROKE SURVIVOR SUPPORT GROUP, THE STROKE CAREGIVER SUPPORT GROUP AND THE BRAIN INJURY SUPPORT GROUP, WHICH ALL ENCOURAGE COMMUNICATION BETWEEN PATIENTS AND/OR FAMILY MEMBERS WITH THOSE WHO HAVE SUSTAINED A SIMILAR INJURY AND HAVE RETURNED TO THE COMMUNITY. RHI ALSO OFFERS VOCATIONAL REHABILITATION SUPPORT WHICH PROVIDES SEVERAL SERVICES, AMONG THEM PRE-VOCATIONAL COUNSELING AND CONNECTIONS TO OTHER AGENCIES THAT PROVIDE ASSISTANCE IN RETURNING TO WORK OR SCHOOL. RHI PROVIDES TRANSPORTATION SERVICES TO THOSE RHI OUTPATIENTS THAT NEEDED ASSISTANCE IN GETTING TO AND FROM THEIR THERAPY APPOINTMENTS. RHI ALSO PROVIDES AN AQUATICS WELLNESS PROGRAM FOR INDIVIDUALS WITHIN THE COMMUNITY. RHI ENCOURAGES AND PROMOTES EDUCATION BY OFFERING INTERNS AND MEDICAL RESIDENTS THE OPPORTUNITY TO LEARN THEIR SPECIALIZED INTEREST OF STUDY. MEDICAL RESIDENTS ARE PLACED IN POSITIONS WHERE THEY CAN LEARN AND GROW AS THEY WORK TOWARD COMPLETING THEIR RESIDENCY PROGRAM. CoreFormPartIII_PartIIILine4d Description of other program services (Expenses $ 7,207,088 including grants of $)(Revenue $ 7,545,347) OTHER PROGRAMS INCLUDE:ANCILLARY SERVICES WHICH CONSISTS OF LAB, EKG, RADIOLOGY, PHARMACY, CENTRAL SUPPLIES, NUTRITION, RESPIRATORY THERAPY, MEDICAL SERVICES (CLINICS), AND DIETARY SERVICES. OUR INTERNS & MEDICAL RESIDENTS PROGRAM REPRESENTS AN EDUCATIONAL PROGRAM TO TRAIN MEDICAL RESIDENTS IN THE ACUTE REHAB SETTING. Form 990, Part VI, Line 1a Delegate broad authority to a committee The Executive Committee, if any, shall be comprised of the Officers of the Board of Directors, and the Chief Executive Officer, Ex-Officio. The Chairman of the Executive Committee shall be the Chairman of the Board of Directors. The Executive Committee, if any, shall meet at the times and places as shall be determined by the Chairman. When action is taken by the Executive Committee, the action will be reported to the Board of Directors at its next meeting. The Executive Committee, if any, shall have the power to transact all regular business of the Corporation during the period between meetings so the Board of Directors, subject to any prior limitation imposed by the Board of Directors, except that, in accordance with Indiana law, the Executive Committee, if any, may not authorize distributions or fill vacancies on the Board of Directors or on any committee of the Board of Directors. Form 990, Part VI, Line 6 Classes of members or stockholders The Not-for-profit corporations St. Vincent Health, Inc. and MH Healthcare are the corporate members of RHI. There are 2 classes of membership: Class A and Class B. The class A member is St. Vincent Health and the class B member is MH Healthcare. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Each of the corporate members has the right to appoint 50% of the members of the RHI board of Directors. The class A member, St. Vincent Health, has the right to appoint all class A directors; the class B member, MH Healthcare, has the right to appoint all class B directors. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The following matters require the joint approval of the two corporate members of the Hospital: 1. Approve, interpret and change any statement of mission, philosophy, role and purpose of RHI. 2. Approve and amend bylaws and articles of incorporation. 3. Fix the number of Directors of RHI. The appointment, election or removal of any class A director shall require the approval of the class A member and the appointment, election or removal of any class B director shall require the approval of the class B member. 4. Approve the merger, dissolution, consolidation or reorganization of RHI. 5. Approve the formation of other entities by RHI. 6. Approve the acquisition, sale, lease, transfer or other alienation of property of RHI, other than in the usual and regular course of RHI's business, when such acquisition, sale, lease, transfer or other alienation meets specified financial levels set in accordance with policies established from time to time by the class A and class B members. 7. Approve capital and operating budgets of RHI. 8. Approve debt incurred by RHI which is in excess of such limits as are established by the Class A and Class B Corporate Members. 9. Approve the disposition of the assets of RHI at the time of its dissolution. 10. Establish (i) policy concerning quality of care and services or (ii) policy and procedures concerning finance and resources for RHI, which are inconsistent with policies established by the Class A and Class B Corporate Members. 11. Approve the long-range financial and strategic plans for RHI. 12. Approve an internal auditing program for RHI, which is inconsistent with the internal auditing program established by the Class A and Class B Corporate Members. 13. Appoint or remove the Chief Executive Officer of RHI provided, however, that the Class A and Class B Corporate Members shall confer with the Board of Directors concerning the appointment or removal of the Chief Executive Officer. 14. Approve the policy pertaining to the evaluation of the Chief Executive Officer of RHI. 15. Appoint or remove the Medical Director. 16. Take any action which would be inconsistent with the governing documents or policies of the Class A or Class B Corporate Members. Form 990, Part VI, Line 11b Review of form 990 by governing body First, a detailed review of the 990 is performed by management and by the majority owner member organization. Then, the final Form 990 is sent to the entire board prior to filing the return with the IRS. Form 990, Part VI, Line 12c Conflict of interest policy Annually, all employees and board members are required to complete a conflict of interest form. The CEO and Chairman of the board review the conflict of interest forms completed by the board members and the Director of Human Resources reviews conflict of interest forms completed by employees. If, during a board meeting, there is an action item that presents a formal conflict, the interested person would be asked to recuse himself/herself from the vote. This recusal would be documented in the minutes. If a key employee discloses a potential conflict, that person is removed from the decision-making process for transactions related to that conflict. Form 990, Part VI, Line 15a Process to establish compensation of top management official The salary for the CEO is defined in the written hiring agreement which is approved by the Board of Directors. Annual performance goals are determined and set by the Chair and Vice Chair of the Board of Directors. Salary increases and performance bonuses are determined based upon performance and the attainment of these goals. The tool used to evaluate the CEO's annual performance and pay is based on the accomplishment of these approved goals and objectives. The evaluation of performance and goals is completed by the Chair and Vice Chair of the Board annually and is performed in the Executive Session of the annual board meeting. The Chair and Vice Chair represent both of the member owners of RHI. The evaluation is documented by the Chairman of the Board. In addition, RHI Human Resources obtains a Compensation survey/study annually which is used to evaluate the compensation of RHI staff including the CEO. This process was undertaken in 2012 with the hiring of the CEO was carried forward into 2014. Form 990, Part VI, Line 15b Process to establish compensation of other employees The administrative officers' compensation is evaluated annually based on the Hospital's standard performance review system and based on the performance of annual goals. Annual goals for each officer are recommended by the CEO and approved by the Board of Directors. Salary increases and performance bonuses are determined based upon performance and goals. The CEO reviews and evaluates the annual performance of each administrative officer and recommends a performance rating based on the Hospital's standard performance review system. This is documented in the HR/personnel files. The CEO also reviews and evaluates the performance of each officer as it relates to the assigned annual goals. The annual evaluation of performance goals is taken to the Chair and Vice Chair of the Board to review and approve in an executive session of the annual board meeting. This is documented by the Chairman of the Board. In addition, RHI Human Resources obtains a Compensation survey/study annually which is used to evaluate the compensation of RHI staff including the administrative officers. The survey was received in January, 2015, but the figures were for information effective October 1, 2014. Form 990, Part VI, Line 19 Required documents available to the public Financial statements, governing documents, and conflict of interest policies are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104; these documents are not available to the public at this time. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue MISCELLANEOUS REVENUE - Total Revenue: 2077, Related or Exempt Function Revenue: 2077, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; EMPLOYEE ACTIVITIES - Total Revenue: 2219, Related or Exempt Function Revenue: 2219, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN INTEREST RATE SWAP AGREEMENTS - 177658; RHI FOUNDATION INC 4141 SHORE DRIVE INDIANAPOLIS IN 46254 351932349 TO SUPPORT REHABILITATION HOSPITAL OF INDIANA IN 501(c)(3 Type I REHABILITATION HOSPITAL OF INDIANA INC true false false true false false false false false false false false false false true true false false false false RHI FOUNDATION INC O 171911 ALLOCATION RHI FOUNDATION INC N 254492 ALLOCATION