UNION HOSPITAL INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
UNION HOSPITAL INC (EIN 35-0876396)
Tax period
2013-09-01 to 2014-08-31
Filed
2015-07-21
IRS object ID
201542029349300304
Schema version
2013v4.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2015-07-21T08:00:26-05:00ReturnTs
Tax Period End2014-08-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN351178661PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1ONE AMERICAN SQUARE 2200AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46282ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-09-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN350876396EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UNION HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlUNIOBusinessNameControlTxt
Phone8122387000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11606 NORTH SEVENTH STREETAddressLine1
CityTERRE HAUTECity
StateINState
ZIP Code47804ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWAYNE HUTSONPersonNm
Person TitleCFOPersonTitleTxt
Phone8122387000PhoneNum
Signature2015-07-21SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMBER KOCHER CPAPreparerPersonNm
PTINP01286298PTIN
Phone3176334705PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1SEE SCHEDULE OBusinessNameLine1
FieldValueIRS element (for citing)
Principal OfficerWAYNE HUTSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11606 NORTH SEVENTH STREETAddressLine1
CityTERRE HAUTECity
StateINState
ZIP Code47804ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$416,537,000GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.UHHG.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1892FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionWE EXIST TO SERVE OUR PATIENTS WITH COMPASSIONATE HEALTH CARE OF THE HIGHEST QUALITY.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee2539TotalEmployeeCnt
Total Volunteers256TotalVolunteersCnt
Total Gross UBI$589,274TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$15,626NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,144,196PYContributionsGrantsAmt
CY Contributions Grants$1,031,914CYContributionsGrantsAmt
PY Program Service Revenue$402,198,279PYProgramServiceRevenueAmt
CY Program Service Revenue$403,040,851CYProgramServiceRevenueAmt
PY Investment Income$648,762PYInvestmentIncomeAmt
CY Investment Income$3,380,751CYInvestmentIncomeAmt
PY Other Revenue$5,416,313PYOtherRevenueAmt
CY Other Revenue$6,493,752CYOtherRevenueAmt
PY Total Revenue$409,407,550PYTotalRevenueAmt
CY Total Revenue$413,947,268CYTotalRevenueAmt
PY Grants And Similar Paid$355,520PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$309,566CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$154,205,283PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$152,555,825CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$258,432,173PYOtherExpensesAmt
CY Other Expenses$262,014,459CYOtherExpensesAmt
PY Total Expenses$412,992,976PYTotalExpensesAmt
CY Total Expenses$414,879,850CYTotalExpensesAmt
PY Revenues Less Expenses-$3,585,426PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$932,582CYRevenuesLessExpensesAmt
Total Assets BOY$467,417,016TotalAssetsBOYAmt
Total Assets EOY$449,570,555TotalAssetsEOYAmt
Total Liabilities BOY$340,745,314TotalLiabilitiesBOYAmt
Total Liabilities EOY$328,438,244TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$126,671,702NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$121,132,311NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWE EXIST TO SERVE OUR PATIENTS WITH COMPASSIONATE HEALTH CARE OF THE HIGHEST QUALITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$388,936,090ExpenseAmt
Grant$309,566GrantAmt
Revenue$403,135,052RevenueAmt
DescUNION HOSPITAL (UHI), UNION HOSPITAL CLINTON (UHC), AND OUR NETWORK OF PRIMARY CARE PHYSICIANS JOIN TOGETHER TO PROVIDE COMPREHENSIVE CARE TO RESIDENTS OF WEST CENTRAL INDIANA AND EASTERN ILLINOIS. OUR FACILITIES AT UNION HOSPITAL INCLUDE TWO HOSPITALS AND MORE THAN 40 PRIMARY AND SPECIALTY CARE PHYSICIANS AND MID-LEVEL PROVIDERS. WE ARE THE LARGEST PROVIDER OF NOT-FOR-PROFIT HEALTH CARE SERVICES BETWEEN INDIANAPOLIS AND ST. LOUIS ALONG THE I-70 CORRIDOR, SERVING VIGO, PARKE, VERMILLION, CLAY, SULLIVAN AND GREENE COUNTIES IN INDIANA, AND CLARK AND EDGAR COUNTIES IN ILLINOIS AS OUR PRIMARY SERVICE AREA. OUR SECONDARY SERVICE AREA INCLUDES CRAWFORD COUNTY IN ILLINOIS.CONTINUE TO SCHEDULE O: CLAY GREENE SULLIVAN PARKE VERMILLION VIGOPOPULATION 26,803 32,781 21,223 17,202 15,878 108,291RANK IN IND. 59TH 51ST 69TH 77TH 79TH 17TH SQ MILES 357.50 542.5 447.10 444.70 256.9 403.30POP/SQ MILE 74.97 60.43 47.47 38.68 63.81 268.51LARGEST CITY BRAZIL LINTON SULLIVAN ROCKVILLE CLINTON TERRE HAUTEPOPULATION 8,153 5,373 4,205 2,581 4,826 61,112MEDIAN AGE 40.5 42.1 40.1 41.7 42.1 35.9POVERTY RATE 12.4% 10.6% 13.3% 8.2% 11.8% 14.0%UNMPLYMNT RATE 6.6 8.2 7.6 7.2 8.8 7.8AVG HOUSEHOLD INCOME 46,430 43,980 43,510 43,870 42,524 40,692CHILDREN LIVING BELOW POVERTY 22.2% 16.5% 25.0% 20.2% 23.1% 28.4%UNION HOSPITAL HAS BEEN SERVING COMMUNITIES IN WEST CENTRAL INDIANA AND EAST CENTRAL ILLINOIS FOR THE PAST 120 YEARS. UNION HOSPITAL SERVES 275,000 PEOPLE IN BOTH URBAN AND RURAL AREAS; CLAY, GREENE, SULLIVAN, PARKE, VERMILLION AND VIGO COUNTIES IN INDIANA ALONG WITH CLARK AND CRAWFORD COUNTIES IN ILLINOIS MAKE UP OUR PRIMARY SERVICE AREA AS IT RELATES TO COMMUNITY BENEFIT. THE MAJORITY OF FAMILIES IN OUR SERVICE AREA FALL SIGNIFICANTLY BELOW THE NATIONAL AND STATE MEDIAN HOUSEHOLD INCOME. AS THE LARGEST NOT-FOR-PROFIT HEALTHCARE PROVIDER BETWEEN ST. LOUIS AND INDIANAPOLIS, WE ARE PROUD TO BE THE SAFETY NET HOSPITAL FOR OUR COMMUNITY PROVIDING OVER $75 MILLION IN TOTAL COMMUNITY BENEFITS, THAT INCLUDE $33 MILLION IN CHARITY CARE TO OUR COMMUNITY. THE PEOPLE WHO MAKE UP UHI ARE DEVOTED TO HELPING OTHERS. WHETHER THEY PROVIDE CARE TO PATIENTS IN OUR HOSPITALS AND CLINICS, VOLUNTEER FOR COMMUNITY SERVICE ORGANIZATIONS AND CAUSES, OR ORGANIZE BAKE SALES FOR FELLOW EMPLOYEES IN NEED, OUR EMPLOYEES EXEMPLIFY A SPIRIT OF CARING. THAT SPIRIT OF CARING IS HARDWIRED THROUGHOUT THE ORGANIZATION FROM OUR VOLUNTEER BOARD OF DIRECTORS TO OUR LEADERSHIP TEAM TO OUR STAFF, PHYSICIANS AND VOLUNTEERS. ALL AROUND THE COMMUNITIES WE SERVE, YOU WILL FIND OUR CARING PEOPLE SERVING AS LEADERS IN CHURCHES, SCHOOLS AND COMMUNITY ORGANIZATIONS. THAT WEB OF INVOLVEMENT PROVIDES A RICH CONNECTION TO THE NEEDS OF OUR COMMUNITY AND GUIDES OUR ACTIVITIES TO IMPROVE THE QUALITY OF LIFE FOR ALL THAT WE SERVE. OUR COMMUNITIES ARE BOTH URBAN AND RURAL BUT SHARE A COMMON TRAIT: HOUSEHOLD INCOMES THAT FALL FAR BELOW THE STATE AND NATIONAL AVERAGES. ACCESS TO CARE IS A CHALLENGE FOR THOSE LIVING IN URBAN POVERTY AND THOSE WHO LIVE IN THE RURAL COUNTRYSIDE. THE SERVICES AND PROGRAMS OUTLINED IN THIS COMMUNITY BENEFIT REPORT WERE DESIGNED TO MEET THE NEEDS OF THE POOR AND UNINSURED AND TO IMPROVE ACCESS TO HEALTH CARE IN OUR RURAL COMMUNITIES. THE RICHARD G. LUGAR CENTER FOR RURAL HEALTH IS AN INNOVATION CENTER DESIGNED TO GIVE PROVIDERS THE TOOLS AND TRAINING TO SUCCESSFULLY ESTABLISH MEDICAL PRACTICE IN RURAL AREAS. THE CLAY CITY CENTER FOR FAMILY MEDICINE IS A MODEL TRAINING SITE FOR FAMILY MEDICINE RESIDENTS AND A VITAL RURAL HEALTH CLINIC SERVING THE PEOPLE OF CLAY COUNTY, INDIANA. A MULTI-DISCIPLINARY TEAM APPROACH PROVIDES A HIGH LEVEL OF SERVICE TO THIS AREA AND HAS RESULTED IN IMPRESSIVE HEALTH IMPROVEMENTS FOR ITS PEOPLE. UHI ALSO PROVIDES PRE-NATAL CARE FOR INDIGENT POPULATIONS BY OFFERING THE FOLLOWING SERVICES ON A SLIDING PAY SCALE: PRENATAL CARE, SUPPORT AND DELIVERY ARE PROVIDED THROUGH A TEAM OF PHYSICIANS, NURSES, SOCIAL WORKERS, AND SUBSTANCE ABUSE COUNSELORS TO WOMEN. OUR SPIRIT OF CARING MAKES US NATURAL PARTNERS WITH PROVIDENCE SELF SUFFICIENCY MINISTRIES' ST. ANN CLINIC, A FREE PRIMARY CARE CLINIC SERVING THE CITY OF TERRE HAUTE'S POOREST POPULATION. UNION HOSPITAL AFFILIATED PHYSICIANS, NURSES AND OTHERS PROVIDE THOUSANDS OF VOLUNTEER HOURS EACH YEAR TO STAFF THE CLINIC. UPON SEEING THE GROWING NEED FOR CARE, UHI HAS PROVIDED FUNDING FOR A FULL-TIME NURSE PRACTITIONER TO SEE PATIENTS AT THE CLINIC. THE CLINIC HAS BEEN SUCCESSFUL IN HELPING PATIENTS WITH CHRONIC DISEASE MANAGEMENT. WE KNOW THAT MANY WOMEN WILL FOREGO BREAST HEALTH SCREENING TO PUT THE NEEDS OF THEIR FAMILIES FIRST. MANY MORE WOMEN ARE CONCERNED THAT IF A PROBLEM IS FOUND IT WILL PUT TERRIBLE FINANCIAL BURDENS ON THEIR FAMILIES. PARTNERSHIPS WITH THE STATE OF INDIANA AND THE SUSAN G. KOMEN FOUNDATION HAVE ALLOWED THE CLARA FAIRBANKS CENTER FOR WOMEN TO PROVIDE SCREENING AND DIAGNOSIS AS WELL AS FOLLOW-UP CARE TO AREA WOMEN IN NEED, PROVIDING PEACE OF MIND AND DETECTING BREAST CANCERS EARLY. A WOMAN RECENTLY SERVED EXCLAIMED, "YOU SAVED MY LIFE AND MY HOUSE!" ENCOURAGING ACTIVE, HEALTHY LIFESTYLES AND PROVIDING ROLE MODELS IS THE GOAL BEHIND THE PERFECT PARTNERS PROGRAM, A PARTNERSHIP BETWEEN UNION AND BENJAMIN FRANKLIN ELEMENTARY SCHOOL. THIS LOW-COST, HIGH-IMPACT PROGRAM SERVES THE AREA'S POOREST INNER-CITY SCHOOL WITH FITNESS AND NUTRITION PROGRAMS, HEALTH FAIRS AND CAREER DAYS.Desc
Total Program Service Expenses$388,936,090TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document157IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee2539EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WAYNE HUTSON CFOBusinessNameLine1
FieldValueIRS element (for citing)
Phone8122387000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11606 N SEVENTH STREETAddressLine1
CityTERRE HAUTECity
StateINState
ZIP Code47804ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
MOLLY CALLAHAN
CHAIRMAN2.003.00Yes (X)Yes (X)$0$0$0
CINDY MARTIN
VICE CHAIRMAN2.001.00Yes (X)Yes (X)$0$0$0
WILLIAM G GRIMES
SECRETARY2.003.00Yes (X)Yes (X)$0$0$0
DAN DEBARD
TREASURER2.000.00Yes (X)Yes (X)$0$0$0
FREDERICK BAUER
ASST. SECRETARY2.000.00Yes (X)$0$0$0
WARD HUBBARD
ASST. TREASURER2.001.00Yes (X)$0$0$0
CURTIS BRIGHTON
MEMBER2.002.00Yes (X)$0$0$0
ROBERT HAERR
MEMBER2.000.00Yes (X)$0$0$0
JACQUELINE HOLDER
MEMBER2.000.00Yes (X)$0$0$0
JOHN LUKENS
MEMBER2.000.00Yes (X)$0$0$0
MARK LYNCH
MEMBER2.000.00Yes (X)$0$0$0
DR DAVID SOUTHWICK
MEMBER2.000.00Yes (X)$0$0$0
ROBERT MCLAUGHLIN
MEMBER2.000.00Yes (X)$0$0$0
STEVEN HOLMAN
PRESIDENT & CEO 5.5.14 TO PRESENT40.004.00Yes (X)Yes (X)$0$0$0
WAYNE HUTSON
SR VP FINANCE/CFO40.005.00Yes (X)$382,527$0-$56,612
KYM PFRANK
VICE PRESIDENT/COO40.002.00Yes (X)$321,120$0$33,561
JOHN BOLINGER
VICE PRESIDENT MED AFFAIRS40.000.00Yes (X)$405,028$0$27,780
JEANNETTE SPRADLIN
VICE PRESIDENT40.000.00Yes (X)$144,928$0$17,934
RHONDA SMITH
VICE PRESIDENT40.000.00Yes (X)$243,271$0$28,081
SALLY ZUEL
VICE PRESIDENT40.000.00Yes (X)$201,437$0-$760
PAMELA DEETER
VICE PRESIDENT40.000.00Yes (X)$172,880$0$7,879
TERRI HILL
VICE PRESIDENT40.000.00Yes (X)$218,002$0$907
KRISTI WILLIAMS
SYSTEM DIRECTOR - PHARMACY40.000.00$190,051$0$32,227Yes (X)
PRADEEP NAROTAM
NEUROSURGEON40.000.00$945,608$0-$41,261Yes (X)
LINGAN SIDDA
RADIOLOGIST40.000.00$870,303$0$27,612Yes (X)
NABIL MNAYARJI
RADIOLOGIST40.000.00$801,723$0$34,739Yes (X)
RITA RATANI
RADIOLOGIST40.000.00$783,802$0$35,548Yes (X)
VIPUL SHAH
RADIOLOGIST40.000.00$777,448$0$23,378Yes (X)
DAVID DOEER
FORMER PRESIDENT & CEO0.000.00$415,898$0-$235,908Yes (X)
SCOTT TEFFETELLER
FORMER PRESIDENT & CEO0.000.00$794,406$0$29,443Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$7,668,432TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation-$35,452TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K130IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
PROVIDENCE MEDICAL GROUP
2723 S 7TH STTERRE HAUTEIN47802MEDICAL SERVICES AND RENT$18,195,369
CARDIOVASCULAR MANAGEMENT LLC
2723 S 7TH STTERRE HAUTEIN47802MEDICAL MANAGEMENT SERVICES$15,219,432
AMBULATORY SURGERY MANAGEMENT
221 S 6TH STTERRE HAUTEIN47802MEDICAL MANAGEMENT SERVICES$6,505,792
ONCOLOGY SERVICES GROUP LLC
6100 W 96TH STE 125INDIANAPOLISIN46278MEDICAL SERVICES$2,822,871
FRESENIUS MEDICAL
2723 S 7TH STTERRE HAUTEIN47802MEDICAL SERVICES$2,040,961
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K43CntrctRcvdGreaterThan100KCnt
Related Organizations$139,348RelatedOrganizationsAmt
Government Grants$892,566GovernmentGrantsAmt
Total Contributions$1,031,914TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT REVENUEDesc
Business900099BusinessCd
Total Revenue Column$403,040,851TotalRevenueColumnAmt
Related Or Exempt Func Income$403,040,851RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$403,040,851TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,009,615TotalRevenueColumnAmt
Exclusion$3,009,615ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,321,004RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$2,532,214RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$1,211,210RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,211,210TotalRevenueColumnAmt
Exclusion-$1,211,210ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$428,654OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$57,518OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$371,136OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$371,136TotalRevenueColumnAmt
Exclusion$371,136ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
CAFETERIA REVENUE900099$2,110,550$2,110,550
AP & S PURCHASE SERVICES900099$722,963$722,963
CHILD DEVELOPMENT REVENUE624410$617,913$364,383$253,530

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,253,536TotalRevenueColumnAmt
Unrelated Business Revenue$335,744UnrelatedBusinessRevenueAmt
Exclusion$3,917,792ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$7,704,962OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$413,947,268TotalRevenueColumnAmt
Related Or Exempt Func Income$403,040,851RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$589,274UnrelatedBusinessRevenueAmt
Exclusion$9,285,229ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$309,566TotalAmt
Program Services$309,566ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,111,694TotalAmt
Program Services$1,979,713ProgramServicesAmt
Management And General$131,981ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$134,216,081TotalAmt
Program Services$125,108,195ProgramServicesAmt
Management And General$9,107,886ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$5,511,863TotalAmt
Program Services$5,167,372ProgramServicesAmt
Management And General$344,491ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,875,492TotalAmt
Program Services$1,758,274ProgramServicesAmt
Management And General$117,218ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$8,840,695TotalAmt
Program Services$8,288,152ProgramServicesAmt
Management And General$552,543ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$24,000TotalAmt
Program Services$22,500ProgramServicesAmt
Management And General$1,500ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$217,940TotalAmt
Program Services$204,319ProgramServicesAmt
Management And General$13,621ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$2,892TotalAmt
Program Services$2,711ProgramServicesAmt
Management And General$181ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,444,825TotalAmt
Program Services$4,167,023ProgramServicesAmt
Management And General$277,802ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$442,533TotalAmt
Program Services$414,875ProgramServicesAmt
Management And General$27,658ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$13,200,857TotalAmt
Program Services$12,375,803ProgramServicesAmt
Management And General$825,054ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$13,137,964TotalAmt
Program Services$12,316,841ProgramServicesAmt
Management And General$821,123ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$442,924TotalAmt
Program Services$415,241ProgramServicesAmt
Management And General$27,683ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$16,036,044TotalAmt
Program Services$15,033,791ProgramServicesAmt
Management And General$1,002,253ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$11,074,819TotalAmt
Program Services$10,382,643ProgramServicesAmt
Management And General$692,176ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$24,986,018TotalAmt
Program Services$23,424,392ProgramServicesAmt
Management And General$1,561,626ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$14,939,810TotalAmt
Program Services$14,006,072ProgramServicesAmt
Management And General$933,738ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PURCHASED SERVICES$76,653,157$72,548,598$4,104,559
MEDICAL SUPPLIES$56,805,781$53,255,420$3,550,361
HAF FEE$19,287,012$18,081,574$1,205,438

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$10,317,883TotalAmt
Program Services$9,673,015ProgramServicesAmt
Management And General$644,868ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$414,879,850TotalAmt
Program Services$388,936,090ProgramServicesAmt
Management And General$25,943,760ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$20,779,789BOYAmt
EOY$14,382,764EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$54,591,782BOYAmt
EOY$53,971,729EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$4,393,058BOYAmt
EOY$4,278,475EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$5,871,523BOYAmt
EOY$5,544,062EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$510,316,552LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$233,820,931LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$286,118,342BOYAmt
EOY$276,495,621EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$82,729,377BOYAmt
EOY$84,651,359EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$5,699,744BOYAmt
EOY$5,858,039EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$4,338,399BOYAmt
EOY$1,461,027EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,895,002BOYAmt
EOY$2,927,479EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$467,417,016BOYAmt
EOY$449,570,555EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$52,391,537BOYAmt
EOY$50,064,674EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$210,418BOYAmt
EOY$100,474EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$253,064,786BOYAmt
EOY$250,880,000EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$21,915,755BOYAmt
EOY$20,847,183EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,162,818BOYAmt
EOY$6,545,913EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$340,745,314BOYAmt
EOY$328,438,244EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$122,155,732BOYAmt
EOY$116,748,593EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,112,147BOYAmt
EOY$2,825,369EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,403,823BOYAmt
EOY$1,558,349EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$126,671,702BOYAmt
EOY$121,132,311EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$467,417,016BOYAmt
EOY$449,570,555EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$932,582ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$554,634NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$4,052,175OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$13,374OtherActivitiesAmt
Total Lobbying Expenditures$13,374TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationPERCENTAGE OF INDIANA HOSPITAL ASSOCATION AND AMERICAN HOSPITAL ASSOCIATION DUES PAID ATTRIBUTABLE TO LOBBYING EXPENSES AS DEFINED IN FEDERAL LAW.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,403,823BeginningYearBalanceAmt
Investment Earnings Or Losses$154,526InvestmentEarningsOrLossesAmt
End Year Balance$1,558,349EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$976,358BeginningYearBalanceAmt
Investment Earnings Or Losses$427,465InvestmentEarningsOrLossesAmt
End Year Balance$1,403,823EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$958,444BeginningYearBalanceAmt
Investment Earnings Or Losses$17,914InvestmentEarningsOrLossesAmt
End Year Balance$976,358EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$946,496BeginningYearBalanceAmt
Investment Earnings Or Losses$44,026InvestmentEarningsOrLossesAmt
Grants Or Scholarships$20,970GrantsOrScholarshipsAmt
Administrative Expenses$11,108AdministrativeExpensesAmt
End Year Balance$958,444EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$969,067BeginningYearBalanceAmt
Investment Earnings Or Losses$17,441InvestmentEarningsOrLossesAmt
Grants Or Scholarships$27,706GrantsOrScholarshipsAmt
Administrative Expenses$12,306AdministrativeExpensesAmt
End Year Balance$946,496EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$17,701,471OtherCostOrOtherBasisAmt
Book Value$17,701,471BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$356,959,706OtherCostOrOtherBasisAmt
Depreciation$127,652,774DepreciationAmt
Book Value$229,306,932BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,179,332OtherCostOrOtherBasisAmt
Depreciation$2,206,985DepreciationAmt
Book Value$972,347BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$126,888,794OtherCostOrOtherBasisAmt
Depreciation$103,961,172DepreciationAmt
Book Value$22,927,622BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,587,249OtherCostOrOtherBasisAmt
Book Value$5,587,249BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$276,495,621TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
PENSION LIABILITY$3,414,705
ESTIMATED THIRD PARTY SETTLEMENTS$3,131,208
FieldValueIRS element (for citing)
Total Liability$6,545,913TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE CORPORATION'S ENDOWMENT CONSISTS OF INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES WHICH WERE DONOR-RESTRICTED. NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE CORPORATION TO FUNCTION AS ENDOWMENTS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS.
PART X, LINE 2:ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY IF THE CORPORATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CORPORATION, AND HAS CONCLUDED THAT AS OF AUGUST 31, 2014 AND 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE CORPORATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FILINGS ARE CURRENT THROUGH 2013. THE IMPACT OF THE SUBSIDIARIES TAX CONSEQUENCES IS IMMATERIAL TO THESE FINANCIAL STATEMENTS.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,850,544TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$10,850,544NetCommunityBenefitExpnsAmt
Total Expense0.02620TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$80,882,124TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$40,730,326DirectOffsettingRevenueAmt
Net Community Benefit Expns$40,151,798NetCommunityBenefitExpnsAmt
Total Expense0.09680TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$177,404,676TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$143,241,588DirectOffsettingRevenueAmt
Net Community Benefit Expns$34,163,088NetCommunityBenefitExpnsAmt
Total Expense0.08230TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$269,137,344TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$183,971,914DirectOffsettingRevenueAmt
Net Community Benefit Expns$85,165,430NetCommunityBenefitExpnsAmt
Total Expense0.20530TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,925,682TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,925,682NetCommunityBenefitExpnsAmt
Total Expense0.01190TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,136,208TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,614,924DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,521,284NetCommunityBenefitExpnsAmt
Total Expense0.01330TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,568,566TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,921,194DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,647,372NetCommunityBenefitExpnsAmt
Total Expense0.01840TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$214,721TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$214,721NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$310,060TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$310,060NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$25,155,237TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,536,118DirectOffsettingRevenueAmt
Net Community Benefit Expns$18,619,119NetCommunityBenefitExpnsAmt
Total Expense0.04480TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$294,292,581TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$190,508,032DirectOffsettingRevenueAmt
Net Community Benefit Expns$103,784,549NetCommunityBenefitExpnsAmt
Total Expense0.25010TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$37,344,559BadDebtExpenseAmt
Reimbursed By Medicare$120,348,639ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$127,880,111CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$7,531,472MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities2HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndTeaching HospitalTeachingHospitalIndEmergency Room24 HrsEmergencyRoom24HrsIndOtherOtherDescCritical Access HospitalCriticalAccessHospitalInd
UNION HOSPITAL INC
11606 NORTH SEVENTH STREETTERRE HAUTEIN47804HTTP://WWW.MYUNIONHOSPITAL.ORG/UNIONHO15-005022-1Yes (X)Yes (X)Yes (X)Yes (X)PHYSICIAN PRACTICES, OFF CAMPUS THERAPY, RADIOLOGY
UNION HOSPITAL CLINTON
2801 S MAIN STCLINTONIN47842HTTP://WWW.MYUNIONHOSPITAL.ORG/UNIONHO15-005055-1Yes (X)Yes (X)Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNumCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndExisting ResourcesExistingResourcesIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndOther Health IssuesOtherHealthIssuesIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndInformation GapsInformationGapsIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndOwn Website URLOwnWebsiteURLTxtRpt Available Upon RequestRptAvailableUponRequestIndRpt Available Thru Other MethodRptAvailableThruOtherMethodIndAdopt Implementation StrategyAdoptImplementationStrategyIndExec Implementation StrategyExecImplementationStrategyIndDevelop Community Wide PlanDevelopCommunityWidePlanIndExec Community Wide PlanExecCommunityWidePlanIndPrioritize Health NeedsPrioritizeHealthNeedsIndAll Needs AddressedAllNeedsAddressedIndOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Used Deter Elig Free CareFPGUsedDeterEligFreeCareIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctFPG Used Determ Elig Dscnt CareFPGUsedDetermEligDscntCareIndFPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePctExplained BasisExplainedBasisIndIncome LevelIncomeLevelIndAsset LevelAssetLevelIndMedical IndigencyMedicalIndigencyIndInsurance StatusInsuranceStatusIndUninsured DiscountUninsuredDiscountIndMedicaid MedicareMedicaidMedicareIndApp Financial Asst ExplnAppFinancialAsstExplnIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndAttached To InvoiceAttachedToInvoiceIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndCollection ActivitiesCollectionActivitiesIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesInd
UNION HOSPITAL
1Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)12Yes (1)Yes (1)Yes (1)Yes (X)SEE PART VI, SUPPLEMENTAL INFOYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)0Yes (1)Yes (1)150.000000000000Yes (1)250.000000000000Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (1)0Yes (1)00
UNION HOSPITAL CLINTON
2Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)12Yes (1)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)0Yes (1)Yes (1)150.000000000000Yes (1)250.000000000000Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (1)0Yes (1)00

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
UNION HOSPITALPART V, SECTION B, LINE 3: AN ONLINE SURVEY WAS DEVELOPED FOR THE COMMUNITY TO RANK NEEDS BASED ON THE AREA CODE IN WHICH THEY RESIDE. THIS DATA HAS BEEN TAKEN INTO CONSIDERATION AND WILL HELP US PLAN AND IMPLEMENT PROGRAMS FOR COMMUNITY HEALTH IMPROVEMENT. ALSO, PUBLIC INPUT WAS SEEKED IN VARIOUS STAKEHOLDER MEETINGS THAT TAKE PLACE AT THE HOSPITAL ON A BI-MONTHLY BASIS. THOSE STAKEHOLDER MEETINGS CONSIST OF; COMMUNITY IMPACT COMMITTEE, PATIENT FAMILY ADVISORY, BOARD OF DIRECTORS ADVISORY AND VENDOR ADVISORY. THESE ADVISORY COMMITTEES WERE FORMED TO HELP THE HOSPITAL PERFORM A SWOT ANALYSIS AND GAIN DIFFERENT PERSPECTIVE FROM DIFFERENT INDIVIDUALS THAT THE HOSPITALS COME IN CONTACT WITH ON A DAILY BASIS. THIS ANALYSIS HAS BEEN COMPILED TO HELP WITH OUR STRATEGIC PLANNING PROCESS.
UNION HOSPITAL CLINTONPART V, SECTION B, LINE 3: AN ONLINE SURVEY WAS DEVELOPED FOR THE COMMUNITY TO RANK NEEDS BASED ON THE AREA CODE IN WHICH THEY RESIDE. THIS DATA HAS BEEN TAKEN INTO CONSIDERATION AND WILL HELP US PLAN AND IMPLEMENT PROGRAMS FOR COMMUNITY HEALTH IMPROVEMENT. ALSO, PUBLIC INPUT WAS SEEKED IN VARIOUS STAKEHOLDER MEETINGS THAT TAKE PLACE AT THE HOSPITAL ON A BI-MONTHLY BASIS. THOSE STAKEHOLDER MEETINGS CONSIST OF; COMMUNITY IMPACT COMMITTEE, PATIENT FAMILY ADVISORY, BOARD OF DIRECTORS ADVISORY AND VENDOR ADVISORY. THESE ADVISORY COMMITTEES WERE FORMED TO HELP THE HOSPITAL PERFORM A SWOT ANALYSIS AND GAIN DIFFERENT PERSPECTIVE FROM DIFFERENT INDIVIDUALS THAT THE HOSPITALS COME IN CONTACT WITH ON A DAILY BASIS. THIS ANALYSIS HAS BEEN COMPILED TO HELP WITH OUR STRATEGIC PLANNING PROCESS.
UNION HOSPITALPART V, SECTION B, LINE 4: UNION HOSPITAL CLINTONTERRE HAUTE REGIONAL HOSPITALSULLIVAN COUNTY COMMUNITY HOSPITAL
UNION HOSPITAL CLINTONPART V, SECTION B, LINE 4: UNION HOSPITAL CLINTONTERRE HAUTE REGIONAL HOSPITALSULLIVAN COUNTY COMMUNITY HOSPITAL
UNION HOSPITALPART V, SECTION B, LINE 5D: LOCATION OF CHNA: HTTP://WWW.MYUNIONHOSPITAL.ORG/UNIONHOSPITAL/INDEX.PHP/HEALTH-NEEDS-ASSESSMENT-CB
UNION HOSPITAL CLINTONPART V, SECTION B, LINE 5D: HTTP://WWW.MYUNIONHOSPITAL.ORG/UNIONHOSPITAL/INDEX.PHP/HEALTH-NEEDS-ASSESSMENT-CB
FieldValueIRS element (for citing)
Facility14FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (14 entries)

Address Line1USAddress/AddressLine1Address Line2USAddress/AddressLine2CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
CLARA FAIRBANKS CENTER FOR WOMEN
1711 N 6 1/2 ST HUX CANCER CTR 3RDFLOORTERRE HAUTEIN47804MAMMOGRAPHY CENTER
CLAY CITY CENTER FOR FAMILY MEDICINE
315 LANKFORD ST PO BOX 96CLAY CITYIN47841FAMILY MEDICINE CENTER
IMAGING SERVICES - THOMAS PROF PLAZA
5500 S US HWY 41TERRE HAUTEIN47802OUTPATIENT THERAPY & IMAGING CENTER
PEDIATRIC THERAPY SERVICES
450 8TH AVETERRE HAUTEIN47804OUTPATIENT THERAPY CENTER
PROVIDENCE MEDICAL GROUP CATH LAB
2723 S 7TH STTERRE HAUTEIN47802OUTPATIENT CATH LAB
PROVIDENCE MEDICAL GROUP CHEMO THERAPY
2723 S 7TH STTERRE HAUTEIN47802CHEMO THERAPY/INFUSION CENTER
THERAPY SERVICES (UPA BONE & JOINT)
1725 N 5TH STTERRE HAUTEIN47804OUTPATIENT THERAPY CENTER
THERAPY SERVICES - PROFESSIONAL PLAZA
4001 E WABASH AVENUETERRE HAUTEIN47803OUTPATIENT THERAPY CENTER
THERAPY SERVICES - ST MARY OF THE WOODS
ONE SISTER OF PROVIDENCEST MARY OF THE WOODIN47876OUTPATIENT THERAPY CENTER
UNION FAMILY MEDICINE EAST
4001 E WABASH AVENUETERRE HAUTEIN47803FAMILY MEDICINE CENTER
UNION HOSPITAL FAMILY MEDICINE CENTER
1513 N 6 1/2 STTERRE HAUTEIN47807FAMILY MEDICINE CENTER
UNION HOSPTIAL HUX CANCER CENTER
1711 N 6 1/2 STTERRE HAUTEIN47804CANCER CARE CENTER
WABASH VALLEY SURGERY CENTER
1421 N 7TH STTERRE HAUTEIN47807SURGERY CENTER
PROFESSIONAL OFFICE BUILDING
1530 N 7TH STTERRE HAUTEIN47807P.E.T. SCANS

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:SCHEDULE H PART I LINE 3BDESCRIPTION OF FAMILY INCOME LIMIT FOR DISCOUNTED CARETHE ORGANIZATION PROVIDES PARTIAL ASSISTANCE FOR INCOME LEVELS BETWEEN 150% AND 200% OF FEDERAL POVERTY GUIDELINES, AND OFFERS DISCOUNTED CARE ON A SLIDING SCALE FOR INCOME LEVELS BETWEEN 250% AND 400% OF FEDERAL POVERTY GUIDELINES.
SCHEDULE H PART I LINE 3BDESCRIPTION OF FAMILY INCOME LIMIT FOR DISCOUNTED CARETHE ORGANIZATION PROVIDES PARTIAL ASSISTANCE FOR INCOME LEVELS BETWEEN 150% AND 200% OF FEDERAL POVERTY GUIDELINES, AND OFFERS DISCOUNTED CARE ON A SLIDING SCALE FOR INCOME LEVELS BETWEEN 250% AND 400% OF FEDERAL POVERTY GUIDELINES.
PART II, COMMUNITY BUILDING ACTIVITIES:TO BETTER MEET THE NEEDS OF OUR COMMUNITIES UNION HOSPITAL PARTICIPATES IN COMMUNITY BUILDING ACTIVITIES TO IMPROVE THE HEALTH IN THE COMMUNITY. PROGRAMS HAVE BEEN DEVELOPED TO SPECIFICALLY HELP MEET THE NEEDS AS DEFINED BY OUR COMMUNITY HEALTH NEEDS ASSESSMENT. MANY OF THE PROGRAMS OR SERVICES DEVELOPED MEET SEVERAL DEFINED NEEDS AND SOME OF THEM ARE MORE FOCUSED ON A CENTRAL IDEA. ACCESS TO HEALTH CARE HAS ALSO BEEN IDENTIFIED AS A NEED IN OUR COMMUNITY. IN 1993 THE RICHARD G. LUGAR CENTER FOR RURAL HEALTH WAS ESTABLISHED TO HELP RECRUIT AND EDUCATE PHYSICIANS TO PRACTICE HEALTH CARE IN OUR RURAL COMMUNITIES. SINCE ITS INCEPTION THE LUGAR CENTER HAS WORKED TO DEVELOP PROGRAMS AND SERVICES THAT MAKE HEALTHCARE MORE ACCESSIBLE TO THOSE INDIVIDUALS LIVING IN RURAL COMMUNITIES. THE ESTABLISHMENT OF CLINICS SUCH AS THE CLAY CITY CENTER FOR FAMILY MEDICINE THAT SERVES AS A MEDICAL HOME FOR APPROXIMATELY 3,500 AREA RESIDENTS, DELIVERING OVER 8,000 VISITS ANNUALLY, IN ADDITION TO HOUSE CALLS. IN 2001, THE LUGAR CENTER DEVELOPED AND IMPLEMENTED A CHRONIC DISEASE MANAGEMENT PROGRAM AT THE CLINIC THAT IS STILL BEING INTEGRATED INTO CARE PLANS FOR PATIENTS AS APPROPRIATE. THIS EVIDENCE-BASED PROGRAM INCLUDES FIVE CHRONIC DISEASES-HYPERTENSION, DIABETES MELLITUS, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, CONGESTIVE HEART FAILURE, AND ASTHMA. THE LUGAR CENTER IN COORDINATION WITH THE FAMILY MEDICINE RESIDENCY HAS EXPANDED TRAINING CAPACITY FOR FUTURE RURAL HEALTH CARE PROVIDERS THROUGH COLLABORATIVE EFFORTS WITH RURAL PARTNERS AROUND THE WABASH VALLEY. THE RURAL HEALTH INNOVATION COLLABORATIVE IS ANOTHER PROGRAM THAT HAS BEEN DEVELOPED TO HELP IMPROVE ACCESS TO HEALTHCARE AMONG OTHER COMMUNITY BUILDING ACTIVITIES. IN 2008 UNION HOSPITAL'S LUGAR CENTER HELPED LAUNCH A RURAL HEALTH COLLABORATIVE AIMED AT IMPROVING AND EXPANDING HEALTH CARE IN OUR COMMUNITY. WHAT BEGAN AS AN INFORMAL EXERCISE IN CREATIVE PROBLEM-SOLVING HAS BECOME THE RHIC. FOUNDING PARTNERS INCLUDE INDIANA STATE UNIVERSITY (ISU), INDIANA UNIVERSITY SCHOOL OF MEDICINE (IUSM), UNION HOSPITAL AND IT'S RICHARD G. LUGAR CENTER FOR RURAL HEALTH (UH), THE TERRE HAUTE ECONOMIC DEVELOPMENT CORPORATION (THEDC), THE CITY OF TERRE HAUTE (THE CITY), AND IVY TECH COMMUNITY COLLEGE WABASH VALLEY (IVY TECH). THE MISSION OF THE RURAL HEALTH INNOVATION COLLABORATIVE (RHIC) IS TO IMPROVE AND EXPAND EDUCATION AND TRAINING OF HEALTH CARE PROFESSIONALS AND FUTURE HEALTH CARE PROFESSIONALS, ESPECIALLY FOR THOSE COMMITTED TO SERVING RURAL AND UNDERSERVED POPULATIONS. KEY COMPONENTS OF THIS MISSION INCLUDE: TO PROMOTE THE RETENTION OF HEALTH CARE PROFESSIONALS TO SERVE RURAL AND UNDERSERVED POPULATIONS; TO INVITE COMMUNITY REVITALIZATION BY PROMOTING THE ENHANCEMENT OF OPPORTUNITIES FOR EDUCATION, TRAINING, AND EXPERIENCE IN HEALTH-RELATED PROFESSIONS AND FIELDS; TO PROMOTE SOCIAL WELFARE AND TO ENCOURAGE AND COORDINATE COMMUNITY INITIATIVES TO ADDRESS CHALLENGES AFFECTING HEALTH CARE DELIVERY; TO PROMOTE THE EFFICIENT USE OF PUBLIC AND PRIVATE RESOURCES AND COLLABORATE WITH OTHER ENTITIES WITH SIMILAR OR COMPLEMENTARY PURPOSES; TO DESIGN AND IMPLEMENT INNOVATIVE BEST PRACTICES AND STRATEGIES THAT ARE CAPABLE OF REPLICATION IN OTHER AREAS OF THE UNITED STATES; AND TO DISSEMINATE EDUCATIONAL INFORMATION, THEREBY POTENTIALLY OR ACTUALLY BENEFITING THOSE OTHER AREAS.
PART III, LINE 4:FOOTNOTE TO ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSES CAN BE FOUND ON PAGE 13 AND PAGE 14 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER THE FINANCIAL FOOTNOTE "PATIENT ACCOUNTS RECEIVABLE, ESTIMATED THIRD PARTY SETTLMENT, AND NET PATIENT SERVICE REVENUE".EXPLANATION FOR LINE 2 AND 3 OR RATIONAL FOR INCLUDING OTHER BAD DEBT AMOUNT IN COMMUNITY BENEFIT: THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN CHARITY CARE CANDIDATES MUST COOPERATE FULLY. IN ADDITION THE HOSPITAL EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THIS REASON THE ORGANIZATION BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE.
PART III, LINE 8:THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED AUGUST 31, 2013 REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST.
PART III, LINE 9B:IF THE PATIENT DOES NOT QUALIFY FOR CHARITY, BUT QUALIFIES FOR LIMITED MEANS ASSISTANCE, A REDUCTION IN CHARGES WILL BE MADE TO THE ACCOUNT AND THE PATIENT WILL BE NOTIFIED VIA MAIL. AT THE PATIENT'S REQUEST, PAYMENT ARRANGEMENTS WILL BE MADE FOR THE REMAINING BALANCE.
PART VI, LINE 2:AT UNION HOSPITAL, ASSESSING THE NEEDS OF OUR COMMUNITY IS AN ONGOING ACTIVITY. ON FEBRUARY 7, 2012, THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS OFFICIALLY LAUNCHED AND MADE AVAILABLE FOR PUBLIC USE. THE CHNA REPRESENTS A UNIQUE COLLABORATION BETWEEN THE TWO LARGEST HEALTHCARE PROVIDERS IN THE WABASH VALLEY (UNION HOSPITAL AND REGIONAL HOSPITAL), ALONG WITH THE TERRE HAUTE CHAMBER OF COMMERCE (THCC) AND ITS BETTER HEALTH WABASH VALLEY (BHWV) INITIATIVE. THE SIX COUNTIES ASSESSED INCLUDE CLAY, GREENE, PARKE, SULLIVAN, VERMILLION AND VIGO COUNTIES. HEALTHY COMMUNITY INSTITUTE (HCI) USES DATA FROM SECONDARY SOURCES BY COMPILING THE DATA INTO ONE CHNA REPORT PROVIDING NEARLY 100 INDICATORS MEASURING HEALTH AND WELLNESS, ECONOMIC FACTORS, EDUCATION, PUBLIC SAFETY AND SOCIAL ENVIRONMENT. THIS TOOL CAN BE USED BY MANY DIFFERENT SEGMENTS OF THE COMMUNITY. THE DATA IS AUTOMATICALLY UPDATED BY HCI REPRESENTATIVES AS NEW DATA IS MADE PUBLIC BY OTHER SECONDARY DATA SOURCES. THE CHNA INDICATORS EACH FEATURE A "DASHBOARD" REPRESENTING DATA THAT HAS BEEN COLLECTED FROM ROUGHLY 40 DIFFERENT SOURCES. EACH "DASHBOARD" HAS A NEEDLE POINTING TO ONE OF THREE COLORS REPRESENTING THE GOOD (GREEN), THE CAUTIONARY (YELLOW) AND THE SERIOUS CONDITION (RED) OF A PARTICULAR INDICATOR. SIDE-BY-SIDE COMPARISONS OF THE FIVE COUNTIES FEATURED ON THE WEBSITE, ALONG WITH STATEWIDE AND NATIONWIDE COMPARISONS ARE ALSO AVAILABLE. THE CHNA IS HOUSED ON THE THCC WEBSITE, TERREHAUTECHAMBER.COM AND CAN BE ACCESSED THROUGH BOTH THE TERRE HAUTE REGIONAL HOSPITAL AND UNION HOSPITAL WEBSITES. THE BHWV IMPLEMENTATION PLAN WAS DEVELOPED BY A SUB-COMMITTEE OF BHWV. MEMBERS OF THIS SUB-COMMITTEE HAVE KNOWLEDGE OF PUBLIC HEALTH AND REPRESENT THE COMMUNITY AS A WHOLE. THIS IMPLEMENTATION PLAN IS INTENDED TO BE A "COMMUNITY PLAN". NO SINGLE ORGANIZATION CAN IMPACT THE HEALTH OF THE COMMUNITY ALONE. IT IS BHWV VISION THAT EACH COMMUNITY INCLUDED IN THE CHNA SHOULD HAVE A SAY NOT ONLY IN WHAT NEEDS THEY WILL FOCUS ON BUT HOW THEY WILL GO ABOUT POSITIVELY IMPACTING THOSE NEEDS. THE EXPECTATION IS THAT MANY OF THE COUNTIES INCLUDED IN THE CHNA WILL HAVE SIMILAR NEEDS AND PROJECTS, PROGRAMS AND EDUCATION WILL BE DEVELOPED FOR IMPLEMENTATION ACROSS THE ENTIRE "REGION". THE IMPLEMENTATION PLAN WENT INTO EFFECT IN MAY 2013 AND WILL BE UPDATED/REVIEWED ON AN ANNUAL BASIS. THE PLAN IS A THREE YEAR PLAN WITH ANNUAL REVIEW OF EFFECTIVENESS, BENCHMARKS, PROGRAMS AND COMMUNITY HEALTH NEEDS. BHWV ORGANIZATIONS MAY FORMALLY CHOOSE TO ADOPT THE INITIATIVES OUTLINED IN THIS DOCUMENT. THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA) REQUIRES ALL NOT-FOR-PROFIT HOSPITALS TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT PRIOR TO MARCH 2012 AND ALSO COMPLETE AN IMPLEMENTATION PLAN, SEEKING INPUT FROM THE COMMUNITY AND BOARD APPROVAL OF THE PLAN IS REQUIRED. FAILURE TO COMPLY WITH THE PPACA COULD RESULT IN FORFEITURE OF TAX EXEMPT STATUS OR A $50,000 FINE UNTIL THE REQUIREMENTS ARE MET. UNION HOSPITAL, SULLIVAN COUNTY COMMUNITY HOSPITAL, GREENE COUNTY GENERAL HOSPITAL AND ST. VINCENT CLAY HOSPITAL ARE ALL PARTNERS IN THE BHWV INITIATIVE THAT HAVE REQUIREMENTS THEY HAVE TO FULFILL TO BE IN COMPLIANCE WITH THE PPACA. TO HELP SUPPLEMENT OUR INVOLVEMENT IN BHWV, UNION HOSPITAL OFFICIALS HAVE FORMED THE UNION HOSPITAL COMMUNITY HEALTH IMPROVEMENT IMPLEMENTATION PLAN WHICH INCORPORATES DATA FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT, INPUT FROM COMMUNITY LEADERS HAVING INTEREST AND KNOWLEDGE IN PUBLIC HEALTH THAT ARE MEMBERS OF BHWV, THE UNION HOSPITAL BOARD OF DIRECTORS AND THE COMMUNITY AS A WHOLE. ADDITIONALLY, TO HELP SUPPLEMENT OUR FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT, AN ONLINE SURVEY WAS DEVELOPED FOR THE COMMUNITY TO RANK NEEDS BASED ON THE AREA CODE IN WHICH THEY RESIDE. THIS DATA HAS BEEN TAKEN INTO CONSIDERATION AND WILL HELP US PLAN AND IMPLEMENT PROGRAMS FOR COMMUNITY HEALTH IMPROVEMENT. UNION HOSPITAL ALSO SEEKS PUBLIC INPUT IN VARIOUS STAKEHOLDER MEETINGS THAT TAKE PLACE AT THE HOSPITAL ON A BI-MONTHLY BASIS. THOSE STAKEHOLDER MEETINGS CONSIST OF; COMMUNITY IMPACT COMMITTEE, PATIENT FAMILY ADVISORY, BOARD OF DIRECTORS ADVISORY AND VENDOR ADVISORY. THESE ADVISORY COMMITTEES WERE FORMED TO HELP THE HOSPITAL PERFORM A SWOT ANALYSIS AND GAIN DIFFERENT PERSPECTIVE FROM DIFFERENT INDIVIDUALS THAT THE HOSPITALS COME IN CONTACT WITH ON A DAILY BASIS. THIS ANALYSIS HAS BEEN COMPILED TO HELP WITH OUR STRATEGIC PLANNING PROCESS. UNION EMPLOYS A FULL-TIME POSITION (COMMUNITY BENEFIT SPECIALIST) DEDICATED TO COMMUNITY BENEFIT ACTIVITIES FOR THE ORGANIZATION. THE COMMUNITY BENEFIT SPECIALIST TAKES ON THE LEAD ROLE IN COLLECTING DATA TO ASSIST IN ASSESSING THE NEEDS OF OUR COMMUNITY. THE WEB SITE STATSINDIANA.EDU HAS A WEALTH OF HEALTH, DEMOGRAPHIC AND INCOME DATA PROVIDING UNION WITH AN ASSESSMENT OF ALL INDIANA COUNTIES IN OUR SERVICE AREA. THE U.S. CENSUS BUREAU AND COUNTYHEALTHRANKINGS.ORG PROVIDED US MORE DATA THAT CAN BE DRILLED DOWN TO THE STATE, COUNTY AND CITY LEVELS TO HELP UNION OFFICIALS ACCURATELY ASSESS COMMUNITY HEALTH NEEDS. UNION ALSO WORKS CLOSELY WITH INDIANA STATE UNIVERSITY HEALTH AND HUMAN SERVICES AND THE VIGO COUNTY HEALTH DEPARTMENT. THE HOSPITAL UTILIZES NATIONAL RESEARCH CORPORATION (NRC) TO CONDUCT ITS PATIENT SATISFACTIONS SURVEY PROCESS, THE NRC PRODUCT PROVIDES UNION WITH COMMUNITY HEALTH NEEDS ASSESSMENT AND PROGRAM INDICATORS.
PART VI, LINE 3:UHI USES A VARIETY OF TOOLS TO EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. SIGNS ARE DISPLAYED IN THE ADMITTING AREAS, BROCHURES AND THE FINANCIAL ASSISTANCE POLICY IS ATTAINED ON OUR STATEMENTS. CLAIMAID IS AVAILABLE OF POINT OF SERVICE ONSITE MEDICAID ELIGIBILITY ADVISOR THAT ASSISTS OUR PATIENTS IN QUALIFYING FOR ANY MEDICAID PROGRAMS. ALL OF OUR FINANCIAL COUNSELORS ARE TRAINED AND SCRIPTED TO COMMUNICATE FINANCIAL ASSISTANCE PROGRAMS AND ASSIST IN SETTING UP MEETINGS FOR THE CLAIMAID STAFF. FINANCIAL COUNSELORS ARE LOCATED IN THE ADMITTING IN BOTH UNION HOSPITAL EAST AND WEST FACILITIES AND AT UNION CLINTON FACILITY TO ASSIST OUR PATIENTS. THIS INCLUDES STAFF THAT CAN SPEAK SPANISH TO ASSIST IN ANY INTERPRETATION FOR A SPANISH SPEAKING PATIENT.
PART VI, LINE 4:THE ORGANIZATION SERVES A SIX COUNTY "REGION" LOCATED IN WABASH VALLEY INCLUDING CLAY, GREEN, PARKE, SULLIVAN, VERMILLION, AND VIGO COUNTIES. FOLLOWING IS A DESCRIPTION OF THE COMMUNITY BY COUNTY.CLAY COUNTY - THE TOTAL POPULATION OF CLAY COUNTY IS 26,803, WHICH RANKS CLAY COUNTY AS 59TH IN INDIANA. THE LARGEST CITY IN CLAY COUNTY IS BRAZIL, WITH A POPULATION OF 8,073. THE COUNTY IS 357.54 SQUARE MILES, WHICH MAKES THE POPULATION PER SQUARE MILE 75.20. THERE ARE 1,558 PRESCHOOL CHILDREN AGES 0 TO 4; 4,698 SCHOOL CHILDREN AGES 5 TO 17; 2,236 COLLEGE AGES 18 TO 24; 6,508 YOUNG ADULTS AGES 25 TO 44; 7,605 OLDER ADULTS AGES 45 TO 64; AND 4,232 SENIORS AGES 65 AND OLDER. THE MEDIAN AGE OF PEOPLE IN CLAY COUNTY IS 40.5 YEARS OLD. IN CLAY COUNTY THERE ARE 26,296 WHITES, 312 HISPANICS, 127 BLACKS, 84 ASIANS, 71 AMERICAN INDIAN AND ALASKA NATIVE, 10 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 249 WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN 2012 WAS $44,230, WHICH RANKED 56TH IN THE STATE. THE POVERTY RATE IS 15.65%, WHICH RANKS 33TH IN THE STATE. THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 22.9%, WHICH RANKS 44TH IN THE STATE. IN 2013, THERE WAS AN AVERAGE OF 46 FAMILIES ON WELFARE EACH MONTH, WHICH IS 47ND IN THE STATE. THERE WERE 4,049 PEOPLE HAD FOOD STAMPS IN 2013, WHICH RANKS 50ND IN THE STATE. THERE WERE 2,288 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN 2013, WHICH RANKS 53TH IN THE STATE. IN CLAY COUNTY, 11,145 PEOPLE ARE EMPLOYED, WHICH RANKS 63ND IN THE STATE AND 1,060 PEOPLE ARE UNEMPLOYED, WHICH RANKS 56RD IN THE STATE. GREENE COUNTY - THE POPULATION IN GREENE COUNTY IS 32,781, WHICH RANKS THEM AS 51ST IN INDIANA. THE LARGEST CITY IN GREENE COUNTY IS LINTON, WITH A POPULATION OF 5,373. THE COUNTY IS 542.50 SQUARE MILES, WHICH MAKES THE POPULATION PER SQUARE MILE 60.43. THERE ARE 1,831 PRESCHOOL CHILDREN AGES 0 TO 4; 5,690 SCHOOL CHILDREN AGES 5 TO 17; 2,525 COLLEGE AGES 18 TO 24; 7,682 YOUNG ADULTS AGES 25 TO 44; 9,541 OLDER ADULTS AGES 45 TO 64; AND, 5,671 SENIORS AGES 65 AND OLDER. THE MEDIAN AGE IN GREENE COUNTY IS 42.1 YEARS OLD. IN GREENE COUNTY THERE ARE 32,346 WHITES, 351 HISPANICS, 82 BLACKS, 114 ASIANS, 106 AMERICAN INDIAN OR ALASKA NATIVE, 7 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 285 WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN 2010 WAS $42,684, WHICH IS RANKED 66TH IN THE STATE. THE POVERTY RATE IS 15.9%, WHICH RANKS 27ST IN INDIANA. THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 22.0%, WHICH RANKS 38TH IN THE STATE. IN 2013 THERE WAS AN AVERAGE OF 47 FAMILIES ON WELFARE EACH MONTH, WHICH IS 46TH IN THE STATE. THERE WERE 4,796 PEOPLE RECEIVING FOOD STAMPS IN 2013, WHICH RANKS 38TH IN THE STATE. THERE WERE 2,595 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN 2013; THIS IS 37TH IN THE STATE. IN GREENE COUNTY 13,652 PEOPLE ARE EMPLOYED, WHICH RANKS 53ND IN THE STATE. 1,261 PEOPLE ARE UNEMPLOYED, WHICH RANKS 44TH IN INDIANA. SULLIVAN COUNTY - THE TOTAL POPULATION IS JUST OVER 21,000, WHICH RANKS SULLIVAN 69TH IN INDIANA. THE LARGEST CITY IS SULLIVAN, WITH A POPULATION OF 4,205. THE COUNTY IS 447.10 SQUARE MILES, WHICH MAKES THE POPULATION PER SQUARE MILE 47.47. THERE ARE 1,105 PRESCHOOL CHILDREN AGES 0 TO 4; 3,374 SCHOOL CHILDREN AGES 5 TO 17; 1,882 COLLEGE AGES 18 TO 24; 5,660 YOUNG ADULTS AGES 25 TO 44; 6,870 OLDER ADULTS AGES 45 TO 64; AND, 3,297 SENIORS AGES 65 AND OLDER. THE MEDIAN AGE OF PEOPLE IN SULLIVAN COUNTY IS 40.1 YEARS OLD. IN SULLIVAN COUNTY THERE ARE 19,908 WHITES, 325 HISPANICS, 938 BLACKS, 52 ASIANS, 65 AMERICAN INDIAN AND ALASKA NATIVE, 1 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 224 WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN 2012 WAS $41,223, WHICH RANKED 78TH IN THE STATE. THE POVERTY RATE IS 18.20%, WHICH RANKS 12TH IN THE STATE. THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 23.6%, WHICH RANKS 17TH IN THE STATE. IN 2013, THERE WAS AN AVERAGE OF 31 FAMILIES ON WELFARE EACH MONTH, WHICH IS 60TH IN THE STATE. THERE WERE 3,060 PEOPLE RECEIVING FOOD STAMPS IN 2013, WHICH RANKS 66TH IN THE STATE. THERE WERE 1,613 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN 2013, WHICH RANKS 67TH IN THE STATE. IN SULLIVAN COUNTY 7,623 PEOPLE ARE EMPLOYED, WHICH RANKS 76TH IN THE STATE. 859 PEOPLE ARE UNEMPLOYED, WHICH RANKS 66TH IN THE STATE.PARKE/VERMILLION COUNTY - THE POPULATION IN PARKE COUNTY IS 17,202, WHICH RANKS 76TH IN THE STATE OF INDIANA. THE LARGEST CITY IS ROCKVILLE WITH A POPULATION OF 2,581 PEOPLE. PARKE COUNTY HAS 444.70 SQUARE MILES WITH 38.68 PEOPLE PER SQUARE MILE. THERE ARE 958 PRESCHOOL AGES 0 TO 4; 2,705 SCHOOL CHILDREN AGES 5 TO 17; 1,413 COLLEGE AGES 18 TO 24; 4,160 YOUNG ADULTS AGES 25 TO 44; 5,009 OLDER ADULTS AGES 45 TO 64; AND, 2,824 SENIORS AGES 65 AND OLDER. THE MEDIAN AGE IN PARKE COUNTY IS 41.7 YEARS OLD. THERE ARE 16,443 WHITES, 412 BLACKS, 214 HISPANICS, 74 AMERICAN INDIAN OR ALASKA NATIVE, 33 ASIAN, 4 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 103 PEOPLE WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN PARKE COUNTY IS $41,311, WHICH RANKS 77TH IN THE STATE. THE POVERTY RATE IS 18.2%, WHICH RANKS 12TH IN THE STATE, AND THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 28.7%, WHICH RANKS 8TH IN THE STATE. IN 2013, AN AVERAGE OF 35 FAMILIES EACH MONTH WAS ON WELFARE. THIS RANKS AS 56TH IN THE STATE OF INDIANA. THERE WERE 2,237 PEOPLE ON FOOD STAMPS IN 2013, WHICH IS 74TH IN THE STATE. THERE WERE 1,299 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN 2013, WHICH IS 74TH IN THE STATE OF INDIANA. THERE ARE 6,894 EMPLOYED PEOPLE IN PARKE COUNTY, WHICH RANKS 79TH IN THE STATE. THERE ARE 650 UNEMPLOYED PEOPLE, WHO RANKS 78TH IN THE STATE. THE POPULATION IN VERMILLION COUNTY IS 15,878, WHICH RANKS 79TH IN THE STATE. THE LARGEST CITY IN VERMILLION COUNTY IS CLINTON WITH A POPULATION OF 4,826 PEOPLE. VERMILLION COUNTY HAS 256.90 SQUARE MILES AND A POPULATION PER SQUARE MILE OF 61.81. THERE ARE 927 PRESCHOOL AGES 0 TO 4; 2,759 SCHOOL CHILDREN AGES 5 TO 17; 1,223 COLLEGE AGES 18 TO 24; 3,694 YOUNG ADULTS AGES 25 TO 44; 4,610 OLDER ADULTS AGES 45 TO 64; AND, 2,827 SENIORS AGES 65 AND OLDER. THE MEDIAN AGE IN VERMILLION COUNTY IS 42.1 YEARS OLD. IN VERMILLION COUNTY THERE ARE 15,777 WHITES, 160 HISPANICS, 44 BLACKS, 41 AMERICAN INDIAN OR ALASKA NATIVE, 34 ASIANS, 6 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 138 WITH TWO OR MORE RACIAL GROUPS. THE MEDIAN HOUSEHOLD INCOME IN 2010 IS $42,709, WHICH RANKS 64TH IN INDIANA. THE POVERTY RATE IN 2012 WAS 14.6%, WHICH RANKS 42ND IN THE STATE. THE POVERTY RATE AMONG CHILDREN FEWER THAN 18 IS 21.3%, WHICH RANKS 40TH IN INDIANA. IN 2013, THE AVERAGE NUMBER OF FAMILIES ON WELFARE EACH MONTH WAS 36, THIS IS 69TH IN THE STATE. THERE WERE 2,408 PEOPLE ON FOOD STAMPS IN 2013, WHICH RANKS 69TH IN INDIANA. THERE WERE 1,273 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN 2013. IN VERMILLION COUNTY, THERE ARE 6,638 PEOPLE EMPLOYED, WHICH RANKS 81ST IN THE STATE OF INDIANA AND THERE ARE 785 PEOPLE UNEMPLOYED, WHO RANKS 73RD IN THE STATE. VIGO COUNTY - THE TOTAL POPULATION OF VIGO COUNTY WAS 108,291 FOR 2013. VIGO COUNTY IS RANKED 17TH IN THE STATE OF INDIANA ACCORDING TO POPULATION. THERE ARE 6,263 PRESCHOOL AGES 0 TO 4; 16,485 SCHOOL AGE CHILDREN AGES 5 TO 17; 16,101 COLLEGE AGE ADULTS AGES 18 TO 24; 27,149 YOUNG ADULTS AGES 25 TO 44; 27,374 OLDER ADULTS AGES 45 TO 64; AND 15,056 SENIORS AGES 65 AND OVER. THE MEDIAN AGE FOR VIGO COUNTY IS 35.9 YEARS OLD. THE LARGEST CITY IN VIGO COUNTY IS TERRE HAUTE, WHICH HAS A POPULATION OF 61,112 PEOPLE. TERRE HAUTE IS THE HOME TO 56.4% OF THE COUNTYS POPULATION. THE COUNTYS POPULATION MAJORITY IS WHITE WITH 95,941 PEOPLE. THERE ARE 7,701 BLACKS, 2,004 ASIANS, 2,671 HISPANICS, 397 AMERICAN INDIAN OR ALASKA NATIVE, 41 NATIVE HAWAIIAN AND OTHER PACIFIC ISLAND, AND 2,344 PEOPLE WITH TWO OR MORE RACIAL GROUPS. THE AVERAGE HOUSEHOLD INCOME FOR VIGO COUNTY IS $40,091, WHICH RANKS 83RD IN THE STATE OF INDIANA. THE POVERTY RATE IS 20.3%, WHICH IS 6TH IN INDIANA AND THE POVERTY RATE AMONG CHILDREN UNDER 18 YEARS OLD IS 29.0%, WHICH IS 7TH IN INDIANA. IN 2013, THERE WERE 18,596 PEOPLE WHO RECEIVED FOOD STAMPS, WHICH IS 10TH IN THE STATE OF INDIANA. THERE ARE 8,451 CHILDREN ON FREE AND REDUCED FEE LUNCHES IN VIGO COUNTY, WHICH IS 14TH IN INDIANA. IN 2013, THERE WAS AN AVERAGE OF 217 FAMILIES ON WELFARE EACH MONTH, WHICH IS 10TH IN THE STATE OF INDIANA. THERE ARE 44,750 PEOPLE EMPLOYED IN VIGO COUNTY, WHICH RANKS 16TH IN THE STATE AND 4,694 PEOPLE UNEMPLOYED, WHICH RANKS 11TH IN THE STATE. THE ANNUAL UNEMPLOYMENT RATE FOR 2013 WAS 9.5, WHICH IS 22ND IN THE STATE OF INDIANA.
PART VI, LINE 5:UNION HOSPITAL, ALONG WITH TERRE HAUTE REGIONAL HOSPITAL ARE FOUNDING MEMBERS OF THE TERRE HAUTE CHAMBER OF COMMERCE BETTER HEALTH WABASH VALLEY INITIATIVE (BHWV). THE ORIGINAL COMMITMENT WAS TO ASSIST IN THE PURCHASE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT DATA AND TO MAKE THAT DATA WIDELY AVAILABLE TO THE PUBLIC. BETTER HEALTH WABASH VALLEY NOW HAS ADDITIONAL SUPPORTING MEMBERS INCLUDING SULLIVAN COUNTY COMMUNITY HOSPITAL, HAMILTON CENTER AND UNITED WAY OF THE WABASH VALLEY. THESE ORGANIZATIONS HAVE MADE A FINANCIAL CONTRIBUTION TO BETTER HEALTH WABASH VALLEY. ALL MONIES CONTRIBUTED TO BETTER HEALTH WABASH VALLEY GO THROUGH THE TERRE HAUTE CHAMBER OF COMMERCE FOUNDATION WHICH IS A 501(C)(3) ORGANIZATION. BETTER HEALTH WABASH VALLEY'S MISSION IS TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY WHILE MAKING THE WABASH VALLEY A HEALTHIER COMMUNITY TO LIVE, WORK AND PLAY. BETTER HEALTH WABASH VALLEY IS REPRESENTED BY SEVERAL DIFFERENT ORGANIZATIONS IN THE COMMUNITY INCLUDING, HEALTHCARE AND MENTAL HEALTH ORGANIZATIONS, SCHOOL CORPORATIONS, UNIVERSITIES, NOT-FOR-PROFITS AND BUSINESSES. UNION HOSPITAL WILL REMAIN HEAVILY INVOLVED AND COMMITTED TO THE BETTER HEALTH WABASH VALLEY INITIATIVE OVER THE NEXT SEVERAL YEARS. AS EMPLOYERS IN THE WABASH VALLEY LOOK FOR WAYS TO KEEP HEALTH INSURANCE CLAIMS AT A MINIMUM WE WILL WORK WITH THEM ON EMPLOYEE WELLNESS STRATEGIES, ADDITIONALLY WE WILL ASSIST IN PROGRAM DEVELOPMENT THAT COULD BE IMPLEMENTED ON AN ORGANIZATIONAL LEVEL AT LITTLE TO NO COST TO THE EMPLOYER. AN EXAMPLE OF THIS MIGHT BE PROVIDING MATERIALS OR ONLINE RESOURCES FOR A WALKING PROGRAM. BETTER HEALTH WABASH VALLEY AND ITS MEMBERS HAVE DECIDED TO FOCUS ON CARDIOVASCULAR DISEASE, OBESITY AND CHILDHOOD OBESITY AS TOP ISSUES THAT THEY WILL FOCUS ON OVER THE NEXT THREE YEARS.
PART VI, LINE 6:THE ORGANIZATION IS PART OF AN AFFILATED HEALTH CARE SYSTEM TO PROVIDE VISION AND STRATEGIC DIRECTION IN THE FORMATION OF A REGIONAL HEALTH CARE SYSTEM TO EXPAND AND IMPROVE THE DELIVERY OF HEALTH CARE SERVCIES IN ORDER TO MEET THE HEALTH CARE NEEDS OF RESIDENTS IN THE SYSTEM'S SERVICE AREA.
PART VI, LINE 7, REPORTS FILED WITH STATESIN

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (5 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
MARION UNIVERSITY
3200 COLD SPRING RDINDIANAPOLISIN46222350868175501C3$20,000MAKE HISTORY PLEDGE
IHA HOSPITAL ASSISTANCE FOUNDATION
1 AMERICAN SQINDIANAPOLISIN46282455573749501C3$23,161GENERAL CONTRIBUTION FOR ASSISTANCE
UNITED WAY OF THE WABASH VALLEY
2901 OHIO BLVD STE 215TERRE HAUTEIN47803351008531501C3$6,400GENERAL CONTRIBUTION
TERRE HAUTE BOYS & GIRLS CLUB
924 N 13TH STTERRE HAUTEIN47807350868182501C3$5,000GENERAL CONTRIBUTION
CHANCES AND SERVICES FOR YOUTH
1101 S 13TH STREETTERRE HAUTEIN47802310931817501C3$10,000SAFE KIDS DONATION
FieldValueIRS element (for citing)
Total501c3 Org5Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationGRANTS TO ENTITIES IN THE UNITED STATES AND SCHOLARSHIPS PROVIDED: GRANTS AND ASSISTANCE ARE PROVIDED TO ELIGIBLE 501(C)(3) PUBLIC CHARITIES, LOCAL SCHOOL CORPORATION FOR GENERAL SUPPORT, AND SCHOLARSHIPS FOR ELIGIBLE INDIVIDUALS. UNION HOSPITAL DOES NOT MONITOR THE USE OF THESE FUNDS BY THE ORGANIZATIONS OR INDIVIDUAL.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
WAYNE HUTSON
SR VP FINANCE/CFO$278,774$0$62,475$0$41,278$0-$68,600$0$11,988$0$325,915$0$0$0
KYM PFRANK
VICE PRESIDENT/COO$242,179$0$45,974$0$32,967$0$16,400$0$17,161$0$354,681$0$0$0
JOHN BOLINGER
VICE PRESIDENT MED AFFAIRS$344,142$0$52,526$0$8,360$0$11,825$0$15,955$0$432,808$0$0$0
JEANNETTE SPRADLIN
VICE PRESIDENT$120,762$0$18,480$0$5,686$0$9,457$0$8,477$0$162,862$0$0$0
RHONDA SMITH
VICE PRESIDENT$204,580$0$31,099$0$7,592$0$11,188$0$16,893$0$271,352$0$0$0
SALLY ZUEL
VICE PRESIDENT$172,198$0$0$0$29,239$0-$8,864$0$8,104$0$200,677$0$0$0
PAMELA DEETER
VICE PRESIDENT$168,889$0$0$0$3,991$0$0$0$7,879$0$180,759$0$0$0
TERRI HILL
VICE PRESIDENT$173,642$0$32,795$0$11,565$0-$15,048$0$15,955$0$218,909$0$0$0
KRISTI WILLIAMS
SYSTEM DIRECTOR - PHARMACY$150,446$0$30,081$0$9,524$0$8,962$0$23,265$0$222,278$0$0$0
PRADEEP NAROTAM
NEUROSURGEON$691,369$0$254,239$0$0$0-$63,175$0$21,914$0$904,347$0$0$0
LINGAN SIDDA
RADIOLOGIST$425,279$0$448,730$0-$3,706$0$11,825$0$15,787$0$897,915$0$0$0
NABIL MNAYARJI
RADIOLOGIST$690,369$0$135,850$0-$24,496$0$11,825$0$22,914$0$836,462$0$0$0
RITA RATANI
RADIOLOGIST$429,823$0$353,979$0$0$0$11,825$0$23,723$0$819,350$0$0$0
VIPUL SHAH
RADIOLOGIST$403,959$0$355,989$0$17,500$0$0$0$23,378$0$800,826$0$0$0
DAVID DOEER
FORMER PRESIDENT & CEO$415,570$0$0$0$328$0-$244,489$0$8,581$0$179,990$0$0$0
SCOTT TEFFETELLER
FORMER PRESIDENT & CEO$440,998$0$126,750$0$226,658$0$11,825$0$17,618$0$823,849$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4ASEVERANCE PAYMENTS WERE MADE TO THE CURRENT AND FORMER PRESIDENT/CEO DURING FISCAL YEAR 2013 THAT WILL BE INCLUDED IN THE 12/31/2013 FORM W-2 AND REPORTED ON THE 8/31/2014 TAX YEAR RETURN.
PART I, LINE 7THE ORGANIZATION PROVIDES NON-FIXED PAYMENTS TO SEVERAL INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A. THESE NON-FIXED PAYMENTS ARE BASED ON THE ORGANIZATION'S ABILITY TO PAY AND ARE NOT CONSTRUED AS A CONTRACT BETWEEN UNION AND ITS EXECUTIVES. THE EXECUTIVE BONUS PLAN IS A MIXTURE OF OBJECTIVES, STANDARDS AND SUBJECTIVE STANDARDS THAT BOTH THE POLICY AND THE IMPLEMENTATION OF THE POLICY BY THE PERSONNEL COMMITTEE AND THE BOARD OF DIRECTORS APPROVES AND AWARDS DEPENDING ON UNION'S ABILITY TO PAY. THERE IS NO AUTOMATIC RIGHT TO A BONUS OR A SPECIFIC BONUS AMOUNT EVEN IF ALL CRITERIA ARE MET. THE PERFORMANCE MEASURE PLAN IS LINKED TO THE UNION STRATEGIC AND FISCAL-YEAR BUSINESS PLANNING PROCESS. THE PLAN IS INTENDED TO FOCUS PARTICIPANTS' ATTENTION ON MISSION-CRITICAL GOALS AND KEY STRATEGIC PRIORITIES. THE PLAN IS ALSO INTENDED TO ENHANCE THE PERFORMANCE OF UNION EXECUTIVES AND THE ORGANIZATION. PRIOR TO THE START OF THE FISCAL YEAR AND AS PART OF THE BUSINESS PLANNING PROCESS, THE UNION PRESIDENT AND CEO WILL FINALIZE A LIST OF GOALS, WEIGHTS AND MEASURES TO BE USED TO ASSESS PERFORMANCE DURING THE FISCAL YEAR. THE LIST IS PRESENTED TO AND DISCUSSED WITH THE COMMITTEE. THE COMMITTEE REVIEWS AND APPROVES THE BONUS PLAN GOALS, WEIGHTS, AND MEASURES. ORGANIZATION GOALS WILL BE ASSIGNED TO EACH PARTICIPANT HOSPITAL-WIDE. IN ADDITION TO HOSPITAL-WIDE GOALS INDIVIDUAL AND/OR FUNCTIONAL/DEPARTMENT GOALS MAY OR MAY NOT BE INCLUDED. AFTER THE CONCLUSION OF EACH FISCAL YEAR, THE PRESIDENT AND CEO WILL PREPARE AN ANNUAL BONUS PLAN REPORT FOR THE COMMITTEE. THE REPORT CONTAINS: AN APPRAISAL OF UNION AND HOSPITAL/OPERATING UNIT PERFORMANCE DURING THE RECENTLY-COMPLETED FISCAL YEAR; AND THE PRESIDENT AND CEO'S RECOMMENDED PAYOUT FOR EACH PLAN PARTICIPANT. THE BONUS RECOMMENDATIONS FOR ALL SR. MANAGEMENT ARE RECEIVED AND REVIEWED FIRST BY THE PERSONNEL COMMITTEE WHO THEN MAKE DECISIONS AND SUBMITS TO THE BOARD TO VOTE. THE COMMITTEE WILL DETERMINE AND SUBMIT THE PAYOUT FOR THE PRESIDENT AND CEO TO THE BOARD OF DIRECTORS WHO, ABSENT THE PRESIDENT AND CEO, WILL VOTE ON APPROVAL. AWARD DETERMINATIONS ARE CALCULATED AS PERCENTAGES OF PARTICIPANT'S SALARIES PAID FOR TIME WORKED DURING THE FISCAL YEAR. PAYOUT FOR THE PRESIDENT IS 0% TO 30%; CFO AND COO ARE 0% TO 25%; AND OTHER EXECUTIVES ARE 0% TO 20%. THE EXECUTIVE BONUS PLAN PAYOUTS ARE TO BE PAID WHEN DETERMINED BY THE PERSONNEL COMMITTEE, SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS.
PART II, COLUMN (B)(III)THE HOSPITAL PROVIDES SPLIT DOLLAR LIFE INSURANCE POLICIES TO CERTAIN OFFICERS, DIRECTORS, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES. FOR THE TAX YEAR 2012 THE FOLLOWING PAYMENTS WERE MADE TO PARTICIPATE IN THE POLICY AND ARE RECORDED AS NEGATIVE AMOUNT IN THE OTHER REPORTABLE COMPENSATION COLUMN (III): (1) WAYNE HUTSON $85,000 (6) SALLY ZUEL $22,500 (8) TERRI HILL $26,250 (10) PRADEEP NAROTAM $75,000 (11) LINGAN SIDDA $13,693 (12) NABIL MNAYARJI $24,496 (15) DAVID DOEER $258,000
PART II, LINE IIKIM PFRANK SERVED AS INTERIM CEO DURING THE PERIOD 9/1/2013 TO 5/14/2014.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
HOSPITAL AUTHORITY OF VIGO COUNTY (REVENUE BONDS SERIES 2007)
A351656988926742BY22007-07-12$176,052,475CONSTRUCT NEW HOSPITAL BUILDING000
HOSPITAL AUTHORITY OF VIGO COUNTY (REVENUE BONDS SERIES 2011)
B351656988926742CF22011-03-02$53,989,054CAPITAL ASSET RENOVATION/CONSTRUCTION, REFUNDING OF BONDS000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndOther Spent ProceedsOtherSpentProceedsAmt
A$176,052,475$15,716,590$2,151,525$158,184,3602010Yes (1)Yes (1)Yes (1)0
B$53,989,054$5,504,000$1,078,426$17,009,3962014Yes (1)00Yes (1)$30,397,232

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndEngage Bond Counsel ContractsEngageBondCounselContractsIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0Yes (1)Yes (1)Yes (1)0000
B0Yes (1)Yes (1)Yes (1)0000

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000000000
B000000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSERIES 2011 BONDS PURPOSE DETAILFormAndLineReferenceDesc
ExplanationTHE PROCEEDS FROM THE SALE OF THE SERIES 2011 BONDS, TOGETHER WITH CERTAIN OTHER MONEIES, WILL BE USED TO (I) FINANCE THE COST OF CONSTRUCTING, ACQUIRING, EQUIPPING OR RENOVATING CERTAIN CAPITAL ASSETS OF THE CORPORATION,(II) REFUND THE INDIANA HEALTH FACILITY FINANCING AUTHORITY VARIABLE RATE DEMAND REVENUE BONDS, SERIES 2002 AND THE INDIANA HEALTH AND EDUCATIONAL FACILITY FINANCING AUTHORITY VARIABLE RATE DEMAND REVENUE BONDS, SERIES 2006A, (III) FUND A DEBT SERVICE RESERVE FUND FOR THE SERIES 2011 BONDS, AND (IV) PAY A PORTION OF THE COST OF ISSUANCE OF THE SERIES 2011 BONDS.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
FORREST SHERER INC
SEE PART V BELOW$932,634SEE PART V0
AP&S CLINIC NORTH SIDE
SEE PART V BELOW$3,700,986SEE PART V0
BUNCH NURSERIES INC
SEE PART V BELOW$103,661SEE PART V0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART IVFormAndLineReferenceDesc
Explanation(A) NAME OF PERSON: FORREST SHERER, INC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: JOHN LUKENS IS THE UNION HOSPITAL BOARD CHAIRMAN AND PRESIDENT OF FOREST SHERER, INC.(D) DESCRIPTION OF TRANSACTION: THE HOSPITAL PURCHASES INSURANCE FROM THE INDEPENDENT INSURANCE AGENCY ON AN ARMS LENGTH BASIS.(A) NAME OF PERSON: AP&S CLINIC NORTHSIDE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: JACQUELINE HOLDER IS A UNION HOSPITAL BOARD MEMBER AND MEDICAL DOCTOR FOR AP&S CLINIC NORTHSIDE(D) DESCRIPTION OF TRANSACTION: THE HOSPITAL HAS A CONTRACTUAL ARRANGEMENT FOR SERVICES WHICH ARE PROVIDED ON AN ARMS LENGTH BASIS.A) NAME OF PERSON: BUNCH NURSERIES, INC.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: ENTITY IS MORE THAN 35% OWNED BY HUSBAND OF CINDY MARTIN, UNION BOARD MEMBER(D) DESCRIPTION OF TRANSACTION: ENTITY PROVIDED SERVICES TO THE HOSPITAL.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, DOING BUSINESS AS:CARDIAC REHAB GROUP OF UNION HOSPITAL CLARA FAIRBANKS CENTER FOR WOMEN CLAY CITY CENTER FOR FAMILY MEDICINE HEARTLAND MIDWIVES HUX CANCER CENTER RICHARD G. LUGAR CENTER FOR RURAL HEALTH UH REGISTERED DIETITIAN GROUP UNION CENTER FOR JOINT REPLACEMENT UNION CENTER FOR SPORTS MEDICINE UNION HOSPITAL CLINTON UNION HOSPITAL CLINTON WESTERN INDIANA RURAL MEDICINE UNION HOSPITAL CVT/NEURO GROUP UNION HOSPITAL FAMILY MEDICINE CENTER UNION HOSPITAL HEALTH GROUP UNION HOSPITAL HUX HEART CENTER UNION HOSPITAL MEDICAL GROUP UNION HOSPITAL NEUROSCIENCE UNION HOSPITAL TERRE HAUTE UNION HOSPITALISTS GROUP WABASH VALLEY SURGERY CENTER WEST CENTRAL COMMUNITY HOSPITAL
FORM 990, PART VI, SECTION A, LINE 6UNION HOSPITAL HAS ONE MEMBER, UNION HEALTH SYSTEM, INC., AN INDIANA NONPROFIT, TAX EXEMPT CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE ORGANIZATION'S MEMBER MAY APPOINT THE HOSPITAL BOARD DIRECTORS WITH THE RECOMMENDATION OF THE HOSPITAL'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BGOVERNING BODY DECISIONS SUBJECT TO APPROVAL BY THE MEMBER INCLUDE: 1. MISSION AND VISION STATEMENT CHANGES; 2. CHANGES TO THE GOVERNING DOCUMENT; 3. APPROVAL AND REMOVAL OF BOARD DIRECTORS; 4. INCURRING DEBT; 5. APPROVAL, SALE, TRANSFER OR SUBSTANTIAL CHANGE IN USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS; 6. FORMATION OF A SUBSIDIARY; 7. TRANSFER OR ENCUMBRANCE OF THE ASSETS; 8. APPROVAL OF ANNUAL OPERATING BUDGET, CAPITAL PLAN, STRATEGIC PLAN, AND BUSINESS PLAN; 9. APPOINTMENT OF THE CEO; 10. TRANSACTIONS OVER $250,000; AND 11. APPROVAL OF ANY MANAGEMENT AGREEMENTS.
FORM 990, PART VI, SECTION B, LINE 11THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW OF THE FORM 990 BY THE ORGANIZATION'S MANAGEMENT. THE GOVERNING BODY REVIEWS AND APPROVES THE FORM 990 AND THE FINAL FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, ARE PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 12CTHE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY THE CORPORATE COMPLIANCE OFFICER. THE SCOPE OF THIS POLICY INCLUDES DIRECTORS, OFFICERS, MANAGEMENT, AND EMPLOYEES. THE POLICY IS IN PLACE TO AVOID PERSONAL INTERESTS THAT CONFLICT, OR MAY APPEAR TO CONFLICT, WITH THE BEST INTERESTS OF UNION AND ITS AFFILIATES AND THE COMMUNITIES THEY SERVE. THE COVERED PERSONS ARE TO REFRAIN FROM PERSONAL INTERESTS, DIRECT OR INDIRECT WITH ANY THIRD PARTIES. IT IS THE RESPONSIBILITY OF OFFICERS, MANAGEMENT, AND EMPLOYEES TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES AND ACT ACCORDINGLY. A SELF-DISCLOSURE FROM COVERED PERSONS TO THE CORPORATE COMPLIANCE OFFICER IS REQUIRED ON ANY POTENTIAL CONFLICTS OF INTEREST. THE COVERED PERSONS ARE TO REFRAIN FROM PARTICIPATING IN ANY DELIBERATION OR DECISIONS ON SUCH TRANSACTIONS. THE CONFLICTS DISCLOSED ARE REVIEWED AND RESOLVED BY THE CORPORATE COMPLIANCE OFFICER.
FORM 990, PART VI, SECTION B, LINE 15THE PROCESS FOR DETERMINING COMPENSATION UNDER THE BY-LAWS OF UNION HOSPITAL INCLUDES A BOARD OF DIRECTORS PERSONNEL COMMITTEE WHOSE RESPONSIBILITIES INCLUDE IN CHARGE OF DOING THE APPROPRIATE REVIEW OF COMPENSATION FOR THE SR. MANAGEMENT TEAM, INCLUDING THE CEO. THEY GATHER INFORMATION AND FOLLOW THE STEPS SET FORTH BELOW AND IN TURN SUBMIT TO THE FULL BOARD OF DIRECTORS THE RECOMMENDATIONS IN TERMS OF COMPENSATION AND BENEFITS FOR THE CEO AND SR. MANAGEMENT. THE PERSONNEL COMMITTEE CONSISTS OF INDIVIDUALS WHO ARE DISINTERESTED. THE CEO IS EXCUSED FROM THE MEETING WHEN HIS COMPENSATION/BENEFITS ARE REVIEWED BOTH AT THE PERSONNEL COMMITTEE LEVEL AND THE BOARD LEVEL. NOTE: DURING THE CURRENT FISCAL YEAR, SALARY INCREASES WERE NOT GIVEN TO THE SR. MANAGEMENT TEAM INCLUDING THE CEO, AND THUS, AN ANALYSIS OF COMPENSATION WAS NOT COMPLETED. IN FUTURE PERIODS, THIS PROCEDURE WILL RESUME AS STATED IN THIS POLICY. THE STEPS INCLUDE: 1. THE PERSONNEL COMMITTEE RETAINS AN OUTSIDE INDEPENDENT CONSULTANT TO (1) PROVIDE THE COMMITTEE WITH INFORMATION, AND (2) TO REVIEW THE ACTIONS AND COMPENSATION/BENEFITS TO BE SURE THAT THERE IS NOT EXCESSIVE COMPENSATION. THE CONSULTANT THAT HAS BEEN USED THE PAST THREE (3) YEARS IS SULLIVAN COTTER & ASSOCIATES, INC. UNDER THE PROCESS, SULLIVAN COTTER FIRST IS PROVIDED WITH THE NAMES AND JOB DESCRIPTIONS FOR THE SR. MANAGEMENT TEAM THAT IS BEING EVALUATED. THE INDEPENDENT ADVISOR THEN SUBMITS TO THE PERSONNEL COMMITTEE COMPARABLE INFORMATION, SPECIFICALLY: > FIVE COMMERCIALLY AVAILABLE EXECUTIVE HEALTH CARE COMPENSATION SURVEYS PREPARED BY INDEPENDENT FIRMS, WERE REFERENCED TO OBTAIN MARKET DATA FOR THIS REVIEW - INTEGRATED HEALTHCARE STRATEGIES: 2009 HEALTHCARE EXECUTIVE COMPENSATION SURVEY - INDIANA HOSPITAL & HEALTH ASSOCIATION: 2009 COMPENSATION SURVEY REPORT - SULLIVAN, COTTER, AND ASSOCIATES: 2009 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS - WATSON WYATT DATA SERVICES: 2009/2010 HOSPITAL AND HEALTHCARE MANAGEMENT COMPENSATION REPORT - MERCER HUMAN RESOURCE CONSULTING: 2009 INTEGRATED HEALTH NETWORKS COMPENSATION SURVEY > MARKET DATA REFLECTING FUNCTIONALLY-COMPARABLE POSITIONS WERE OBTAINED FOR ALL SEVEN EXECUTIVE POSITIONS > DATA WERE ABSTRACTED FOR COMPARABLY-SIZED ORGANIZATIONS AS MEASURED BY NET REVENUE > THE DATA REPORTED REPRESENTED THE 50TH, 75TH, AND 90TH PERCENTILES OF BASE SALARY AND TOTAL CASH COMPENSATION (BASE SALARY PLUS ACTUAL ANNUAL INCENTIVE - ABBREVIATED TCC) > REGIONAL MARKET DATA WERE ALSO COLLECTED FROM THE PUBLISHED COMPENSATION SURVEYS AS WELL AS A SPECIAL CUT OF THE FOLLOWING INDIANA HOSPITALS FROM SULLIVAN COTTER'S 2009 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS - BALL MEMORIAL HOSPITAL - REID HOSPITAL & HEALTH CARE SERVICES - BLOOMINGTON HOSPITAL - RILEY HOSPITAL FOR CHILDREN - ELKHART GENERAL HOSPITAL - SAINT JOHN'S HEALTH SYSTEM - GOOD SAMARITAN HOSPITAL - SAINT JOSEPH REGIONAL MEDICAL CENTER - MEMORIAL HOSPITAL OF SOUTH BEND - SAINT MARY'S MEDICAL CENTER - METHODIST HOSPITALS - TERRE HAUTE REGIONAL HOSPITAL - PARKVIEW HOSPITAL > THAT DATA WAS ALSO REPORTED WITH NATIONAL AVERAGE, REGIONAL AVERAGE AND INDIANA AVERAGE. 2. THE PERSONNEL COMMITTEE OF UNION HOSPITAL'S BOARD OF DIRECTORS TAKES THE DATA PROVIDED BY THE INDEPENDENT CONSULTANTS AND FOLLOWING A REVIEW OF THE PERFORMANCE OF EACH INDIVIDUAL SUBMITS TO THE FULL BOARD FOR APPROVAL RECOMMENDATIONS IN TERMS OF SALARIES, BENEFITS, AND BONUSES. FINAL APPROVAL IS BY THE BOARD OF DIRECTORS. THE CEO DOES NOT TAKE PART IN THE DISCUSSION OR ACTION ON HIS SALARY, BENEFITS AND BONUS. 3. MINUTES OF THE PERSONNEL COMMITTEE AND THE BOARD MEETINGS ARE CONTEMPORANEOUSLY KEPT AND MAINTAIN WITH THE CORPORATE MINUTE BOOKS. 4. FOLLOWING THE ACTION OF THE BOARD OF DIRECTORS THE NEW PROPOSED SALARIES, BENEFITS AND BONUSES ARE SENT TO THE INDEPENDENT CONSULTANT (SULLIVAN COTTER) WHO SUBMITS BACK TO THE PERSONNEL COMMITTEE THEIR OPINION IN TERMS OF THE COMPENSATION BEING REASONABLE IN RELATION TO THE MARKET DATA AND MARKET PRACTICES. THIS REPORT IS ALSO RECEIVED AND REVIEWED BY THE BOARD PERSONNEL COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 9:UNREALIZED CHANGE IN IHRRRG - RISK RETENTION GROUP 208,568. UNREALIZED CHANGE IN COH INVESMENT 256,611. UNREALIZED CHANGE IN UAPC INVESTMENT -2,407,281. CHANGE IN PERMANETLY RESTRICTED NET ASSETS 154,526. OTHER CHANGE IN RECEIVABLE FROM UNION HOSPITAL FOUNDATION, INC -34,323. CHANGE IN PENSION LIABILITY -2,230,276.
PART XII, LINE 2C, OVERSIGHT OF AUDIT:THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1IPACS INCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11606 N SEVENTH STAddressLine1
CityTERRE HAUTECity
StateINState
ZIP Code47804ZIPCode
FieldValueIRS element (for citing)
EIN351720998EIN
Primary ActivitiesCOLLECTION AGENCYPrimaryActivitiesTxt
Legal Domicile StateINLegalDomicileStateCd
Total Income$87,572TotalIncomeAmt
End Of Year Assets$2,058,079EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1UNION HOSPITALBusinessNameLine1

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
UNION HEALTH SYSTEMS
1606 N SEVENTH STTERRE HAUTEIN47804270581133MANAGEMENT ORGANIZATIONIN501(C)(3)LINE 11B, IIN/A0
CENTER FOR OCCUPATIONAL HEALTH
4001 WABASH AVETERRE HAUTEIN47803352118417OCCUPATIONAL HEALTH SERVICESIN501(C)(3)LINE 7Yes (1)UNION HOSPITAL
UNION HOSPITAL HEALTH SERVICES INC
1606 N SEVENTH STTERRE HAUTEIN47804351642805HEALTH SERVICESIN501(C)(3)LINE 9Yes (1)UNION HOSPITAL
UNION HOSPITAL FOUNDATION
1659 N SEVENTH STTERRE HAUTEIN47804351642823FUNDRAISINGIN501(C)(3)LINE 11C, III-FI0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPct
UNION ASSOCIATED PHYSICIAN CLINIC INC
1606 N SEVENTH STTERRE HAUTEIN47804270581401PHYSICIAN GROUPINUNION HOSPITAL INCINVESTMENT-$6,404,425$16,331,3390Yes (1)0.50000
UNION HOSPITAL THERAPY LLC
150 N ROSENBERGEREVANSVILLEIN47712464357168REHABILITATION AND THERAPY SERVICESINUNION HOSPITAL INCINVESTMENT$787,045$451,533000.51000
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CENTER FOR OCCUPATIONAL HEALTHBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeOTransactionTypeTxt
Method Of Amount DeterminationFAIR MARKET VALUE OF SERVICESMethodOfAmountDeterminationTxt

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