2014-11-17T10:27:23-06:00 2013-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 4000 INDIANAPOLIS IN 46204 990 2013-01-01 350867958 INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL INC % BROC BUDDE INDI 3179624575 950 N MERIDIAN STREET SUITE 800 Suite INDIANAPOLIS IN 46204 LORI A LUTHER COO/CFO 2014-11-14 JENNIFER D RHODERICK P00395735 2013 2015-11-30 17:44:51Z MICHAEL E HALEY 950 N MERIDIAN ST STE 800 INDIANAPOLIS IN 46204 375170511 false X HTTP://IUHEALTH.ORG/BALL-MEMORIAL/ X 1926 IN Improve the health of our patients and community through innovation and excellence in care, education, research, and service. 18 12 2916 605 13728392 3663000 2883309 395646439 360152851 444866 410103 7055213 7424501 406809518 370870764 1500 7500 0 0 134279407 138448444 0 0 0 232989247 190809747 367270154 329265691 39539364 41605073 305190165 289690398 215429722 138445748 89760443 151244650 X Improve the health of our patients and community through innovation and excellence in care, education, research, and service. false false 291197181 7500 360152851 Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") is a 370-bed full service hospital which serves as a destination health facility for the residents of East Central Indiana, and is home to medical specialties including oncology, cardiology, orthopedic and sports medicine, and specialized women and children's services. IU Health Ball Memorial Hospital's clinical staff of more than 400 physicians, representing more than 45 medical specialties, serves patients, without regard to their ability to pay, in a warm, healing environment designed to enhance the healing process. IU Health Ball Memorial Hospital is home to the largest graduate medical education teaching program in Indiana outside of Indianapolis offering family medicine, internal medicine and transitional residency programs as well as a medical research department. 291197181 true true false true false false false false false false true false false true true false false true false false false false false false false false true true true false true true false false false false false false false false true true false false false false false true true true false false false 151 0 true 2916 true true true false false false false false false false false false X 18 12 true false false false true true true true true false false true true true true true true false true true true IN X BROC BUDDE 3179624575 950 N MERIDIAN STREET SUITE 800 INDIANAPOLIS IN 46204 JAMES A FISHER CHAIRMAN 5.0 0.0 X X 0 0 0 DANIEL F EVANS JR VICE CHAIRMAN 5.0 55.0 X X 0 1468119 562967 PETER M VOSS MD VICE CHAIRMAN 5.0 55.0 X X 0 458746 35194 TERRY L WALKER VICE CHAIRMAN 5.0 0.0 X X 0 0 0 PATRICK A CLEARY MD PHD DIRECTOR 5.0 55.0 X 0 368211 32953 GORDON D COX DIRECTOR 5.0 0.0 X 0 0 0 MICHAEL L COX DIRECTOR/SECRETARY/TREASURER 5.0 0.0 X X 0 0 0 WILBUR R DAVIS DIRECTOR 5.0 0.0 X 0 0 0 CHRISTINA C DRUMMOND MD DIRECTOR 5.0 55.0 X 0 208787 45407 JO ANN M GORA PHD DIRECTOR 5.0 0.0 X 0 0 0 MICHAEL E HALEY DIRECTOR/PRESIDENT 55.0 0.0 X X 697569 0 51259 JEFFREY A HEAVILON MD DIRECTOR 5.0 0.0 X 0 0 0 JOHN K JACKSON DIRECTOR 5.0 0.0 X 0 0 0 JOHN D LITTLER DIRECTOR 5.0 0.0 X 0 0 0 TERRY E MATCHETT DIRECTOR 5.0 0.0 X 0 0 0 J STEVEN RHEA DIRECTOR 5.0 0.0 X 0 0 0 CHARLES R ROUTH MD DIRECTOR 5.0 55.0 X 500 285664 29548 D KAYE WHITEHEAD DIRECTOR 5.0 0.0 X 0 0 0 CAROL E SEALS CFO (PARTIAL YEAR) 55.0 0.0 X 157667 0 9536 LORI A LUTHER COO/CFO 55.0 0.0 X 239195 0 18139 JEFFREY C BIRD MD VP & CMO 55.0 0.0 X 279546 0 43243 DOREEN C JOHNSON RN VP & CNE 55.0 0.0 X 189627 0 33650 KAREN POPOVICH DIRECTOR, MGMT. SVCS. 55.0 0.0 X 229496 0 1467 ALVIS E FOSTER RADIATION PHYSICIST 55.0 0.0 X 204855 0 10269 BRANDON S DICKEY ASSOC. PROG. DIRECTOR 55.0 0.0 X 172600 0 32541 JOSEPH R BUTTS RADIATION PHYSICIST 55.0 0.0 X 167236 0 7569 SUSAN RALSTON DIRECTOR, PHARMACY 55.0 0.0 X 163090 0 6447 HAROLD L BERFIEND FORMER COO 0.0 55.0 X 0 330605 42416 TERRY A PENCE SLC 55.0 0.0 X 157346 0 34167 2658727 3120132 996772 69 true true false HAGERMAN INC 10315 ALLISONVILLE ROAD FISHERS IN 46038 CONSTRUCTION 6044525 MERIDIAN HEALTH SERVICES 240 N TILLOTSON AVENUE MUNCIE IN 47304 MGMT/LEASED EMP 2496708 UNITED HOSPITAL SERVICES LLC 9948 PARK DAVIS DR INDIANAPOLIS IN 46235 LAUNDRY SERVICES 1120863 FRESENIUS MANAGEMENT SERVICES 16343 COLLECTION CENTER DR CHICAGO IL 60693 MEDICAL SERVICES 1032663 MEDICAL CONSULTANTS PC 800 SOUTH TILLOTSON MUNCIE IN 47303 MEDICAL SERVICES 699048 29 2680813 194832 7664 2883309 NET PATIENT SERVICE REVENUE 621110 332390209 332390209 PHARMACY 446110 17228212 3658527 13569685 SHARED SERVICES 541900 6096184 5935598 160586 INCOME (LOSS) FROM PARTNERSHIPS 900099 534225 536104 -1879 RENT FROM RELATED 501(C)(3) ORGS. 532000 2082884 2082884 1821137 1821137 360152851 227980 227980 0 0 1880749 1880749 0 1880749 1880749 4481870 4046293 253454 435577 -253454 182123 182123 0 0 0 CAFETERIA/FOOD SERVICE 721110 1490294 1490294 GIFT SHOP 453220 418288 418288 VENDING 900099 89482 89482 3545688 3545688 5543752 370870764 346424459 13728392 7834604 X 7500 7500 0 0 0 1719931 1583209 136722 0 100457846 92472204 7985642 10302702 9483715 818987 17986145 16556382 1429763 7981820 7347325 634495 752627 752627 225860 225860 261485 261485 12601 12601 0 0 48524652 25481937 23042715 337195 3754 333441 1991295 1501171 490124 1971882 1822615 149267 0 8414457 7864160 550297 149662 122148 27514 0 5893 5113 780 5291095 5291095 0 17048014 17048014 2153864 2147131 6733 DRUGS AND MEDICAL SUPPLIES 74187821 74187821 BAD DEBT 16253501 16253501 UBI TAX -12500 -12500 RECRUITMENT 305674 40980 264694 12934669 11977406 957263 329265691 291197181 38068510 0 21347 27502 61074 0 0 0 43814380 45117941 0 0 0 0 376294 29179 6738864 5949792 1951724 2071638 444358013 271452518 171001488 172905495 26068136 23755642 0 0 7117560 6929507 7971 0 48031327 32903702 305190165 289690398 31473888 30015494 0 0 110969 48486 91119384 83184016 0 0 0 0 5533014 2978493 0 0 87192467 22219259 215429722 138445748 X 89760443 151244650 0 0 0 0 89760443 151244650 305190165 289690398 X 41605073 640472 19238662 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 12601 12601 false Schedule C, Part II-B, Lines 1i - Other Activities Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") paid institutional membership dues to the American Hospital Association ("AHA"), Indiana Hospital Association ("IHA"), and Safety Net Hospitals for Pharmaceutical Access ("SNHPA") during 2013 in the amount of $36,395, $61,222, and 4,350, respectively. Each membership organization notified IU Health Ball Memorial Hospital that a portion of the dues it paid were used for lobbying purposes. The AHA used 23.98%, or $8,728 of 2013 membership dues paid by IU Health Ball Memorial Hospital, for lobbying expenditures. The IHA used 5.26%, or $3,220 of the 2013 membership dues paid by IU Health Ball Memorial Hospital, for lobbying expenditures. The The SNHPA used 15.00%, or $653 of the 2013 membership dues paid by IU Health Ball Memorial Hospial, for lobbying expenditures, total membership dues paid to these organizations by IU Health Ball Memorial Hospital during 2012 that were attributable to lobbying expenditures was $12,601. 2924410 2924410 263030657 133888976 129141681 2773867 2093523 680344 154677253 131447726 23229527 20951826 4022293 16929533 172905495 INTERCOMPANY RECEIVABLES (NET) 32065084 UNAMORTIZED BOND ISSUANCE COST 764355 ALL OTHER ASSETS 74263 32903702 0 PENSION AND OTHER RETIREMENT LIAB. 14369621 DUE TO THIRD-PARTY PAYORS 4924224 INTEREST RATE SWAP LIABILITIES 595960 SELF-INSURANCE LIABILITIES 512399 ACCRUED INTEREST ON BONDS 1817055 22219259 Schedule D, Part X, Line 2 - FIN 48 (ASC 740) Footnote Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") is a parent in the consolidated financial statements of Indiana University Health Ball Memorial Hospital and Subsidiaries. IU Health Ball Memorial Hospital adopted FIN 48 in 2007. No disclosures were required in 2013 under GAAP as IU Health Ball Memorial Hospital does not have any material tax contingencies that required disclosures in the footnotes. true true X true X true X 650. true true true false true true 17200 16412791 16412791 0.05240 17350 65627893 55751700 9876193 0.03160 34550 82040684 55751700 26288984 0.08400 38 47895 599827 13299 586528 0.00190 7 2638 11204200 2705667 8498533 0.02720 1 434 726390 149858 576532 0.00180 4 24985 113666 800 112866 0.00040 50 75952 12644083 2869624 9774459 0.03130 50 110502 94684767 58621324 36063443 0.11530 1 14804 14804 2 892 89002 1050 87952 0.00030 1 903 16351 16351 0.00010 1 2619 18396 18396 0.00010 1 517 10251 10251 1 907 7677 7677 7 5838 156481 1050 155431 0.00050 false 3509131 0 113444737 117571926 -4127189 X true true 1 1 IU HEALTH BALL MEMORIAL HOSPITAL 2401 UNIVERSITY AVE MUNCIE IN 47303 HTTP://IUHEALTH.ORG/BALL-MEMORIAL/ 13-005079-1 X X X X X IU HEALTH BALL MEMORIAL HOSPITAL 1 true X X X X X X X X X 13 true false true X HTTP://IUHEALTH.ORG/GETSTRONG/ X X X X X X X false false true true 200. true 650. true X X X X X X X true true X X X X true false X X X X true X false false Schedule H, Part V, Section B, Line 3 - Input from Community In conducting each of its most recent CHNA, Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") took into account input from persons who represent the broad interests of the community it serves by hosting several community conversation focus groups. These focus groups included public health officials and community leaders to discuss the healthcare needs of the service area and what role IU Health could play in addressing the identified needs. To obtain a more complete picture of the factors that play into IU Health Ball Memorial Hospital's community's health, input from public health officials and community leaders in Delaware County was gathered through three separate focus group sessions. The first was a one and a half hour live group session at IU Health Ball Memorial Hospital, and the other two were held via a phone conference call for those who were not able to meet in person. IU Health Ball Memorial Hospital facilitators mailed letters and made follow-up telephone calls inviting public health officials and community leaders to attend the focus group discussion, paying special attention to including organizations that represent the interest of low-income, minority, and uninsured individuals. The goal of soliciting these leaders' feedback was to gather insights into the quantitative data that may not be easily identified from the secondary statistical data alone. Attendees who participated in the focus group included: Dr. Eric King - Superintendent, Muncie Community Schools - Dr. King is representative of a community perspective regarding children's health and education. As Superintendent, he is knowledgeable in children's health and well-being, as well as the community surrounding them. Cecilia Williams - Delaware County Coordinator, Tobacco Free Coalition of Delaware County - Ms. Williams is representative of a community perspective regarding tobacco education and prevention. As an employee of the Tobacco Free Coalition, she is knowledgeable in the effects of smoking and the ways to education the community of its consequences. Austin Gerber - Intern, Tobacco Free Coalition of Delaware County - Ms. Gerber is representative of a community perspective regarding tobacco education and prevention. As an employee of the Tobacco Free Coalition, she is knowledgeable in the effects of smoking and the ways to education the community of its consequences. John Disher - Administrator, Marketing, PR, and Community Benefit, IU Health Ball Memorial Hospital - Mr. Disher is representative of a community perspective regarding general community health. As a community benefit and education coordinator at IU Health Ball Memorial Hospital, he is well-versed in the community's needs and how they are being addressed. Scott Smalstig - Vice President, Meridian Services - Mr. Smalstig is representative of a community perspective regarding behavioral health. As a VP of Meridian Services, he is familiar with behavioral and mental health issues in both adolescents and adults, as well as the resources in the community to assist them. Molly Flodder - TEAMwork for Quality Living - Ms. Flodder is representative of a community perspective regarding underserved/low income populations. As an employee of TEAMwork, she understands the underserved community and their needs. TEAMwork's mission is to provide opportunities for impoverished populations to become self-sufficient. Kevin Woodget - Pastor, Church of the Living God; Member, Health Coalition of Delaware County - Pastor Woodget is representative of a community perspective towards minority health issues in Delaware County. As a church pastor and member of the Health Coalition of Delaware County, he is knowledgeable about the many factors affecting health in the local community. Julie Hankins - Executive Director, Cancer Services of East Central Indiana ("ECI") - Ms. Hankins is representative of a community perspective regarding health and financial issues related to cancer diagnosis and treatment. As Executive Director of Cancer Services of ECI, she is knowledgeable about the many support needs of persons with cancer. Cheryl Matthews - Director of Education and Client Services, Cancer Services of ECI - Ms. Matthews is representative of a community perspective towards health education for adults and children, as well as issues related to cancer diagnosis and treatment. As Director of Education and Client services, she is familiar with health education needs of patients and their families. Larry Strange - Coordinator, Muncie Action Plan - Mr. Strange is representative of a community coalition composed of concerned citizens actively seeking to improve Muncie through five key initiatives that include the linking of learning, health, and prosperity. Judy Mays - Program Coordinator, Minority Tobacco Free Coalition - Ms. Mays is representative of a community perspective towards tobacco use among minority populations. As Program Coordinator and a health educator for the Minority Tobacco Free Coalition, she is knowledgeable about the effects of tobacco use, prevention, and cessation in the community. Heidi Miller - Open Door Health Services - Ms. Miller is representative of a community perspective regarding the provision of health and dental services for the under and uninsured populations of the community. As an employee of Open Door Health Services, she is knowledgeable about the populations served by the Federally Qualified Health Center. Dr. Melanie Schreiner, M.D. - Medical Director, Gateway Health Clinic; Physician, IU Health Ball Memorial Hospital - Dr. Schriner is representative of a community perspective related to healthcare services for the uninsured. As a family medicine physician and Medical Director of the Gateway Clinic, she is well-versed on the healthcare needs of the uninsured. Andrea Bruno - Executive Director, Gateway Health Clinic - Ms. Bruno is representative of a community perspective regarding the provision of health and dental services for the uninsured populations of the community. As Executive Director of Gateway Health Clinic, she is knowledgeable about providing health care to the uninsured. Joshua Williams - Administrator, Delaware County Health Department - Mr. Williams is representative of a community perspective related to public health. As an administrator of the local county health department, he is knowledgeable about a broad range of public health needs, including wellness initiatives and disease prevention. Tamara White - Community Health Coordinator, Delaware County Health Department - Ms. White is representative of a community perspective regarding health promotion and disease prevention issues, including chronic disease, HIV/STI, other infectious diseases, injury, adolescent health, reproductive health, immunizations, tobacco use, primary care, and mental health. Christiana Mann - Environmental Coordinator, Delaware County Health Department - Ms. Mann is representative of a community perspective related to community health initiatives. As the Environmental Coordinator for the local county health department, she is well-versed in environmental factors that promote human health and well-being, as well as those factors that foster a safe and healthy environment. Maude Jennings - Volunteer, Whitely Community Council - Ms. Jennings is representative of a community perspective regarding the education and health initiatives within the minority community. As a member of the Whitely Community Council, she understands many of the education and health needs of the Whitely neighborhood. Mary Dollison - Volunteer, Roy C. Buley Center; Member, Whitely Community Council - Ms. Dollison is representative of a community perspective regarding the education and wellness initiatives within the minority community. As a volunteer at the Roy C. Buley Center and member of the Whitely Community Council, she is well-versed in education and development programs for youth, and provides leadership for Whitley neighborhood improvements. Rebecca Clock - Director, Christian Ministries of Delaware County - Ms. Clock is representative of a community perspective related to hunger issues within the area. As a ne employee of Christina Ministries of Delaware County, she is knowledgeable about resources in the community that assist persons in need of food and shelter. Gary Chenault - President/CEO, United Way of Delaware County - Mr. Chenault is representative of a community perspective related to numerous community social service programs focused on the areas of education, income, and health. As President and CEO of the United Way of Delaware County, he is familiar with many of the core health, education, and financial needs of at-risk populations in the area. Upon arrival to the focus group, participants were asked to list five health needs, which should be prioritized in their opinion, for the Delaware County community served by IU Health Ball Memorial Hospital. These respo Schedule H, Part V, Section B, Line 7 - Addressing Identified Needs Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") prioritized and determined which of the community health needs identified in its most recently conducted Community Health Needs Assessment ("CHNA") were most critical for it to address by using the Hanlon Method of prioritization. This method prioritizes identified needs based upon the prevalence and severity of the need and the effectiveness of interventions available to address the needs. Based upon the Hanlon Method of prioritization, IU Health Ball Memorial Hospital selected the following five needs to be addressed: - Obesity Prevention - Access to Healthcare - Infant Health Factors - Tobacco Use Prevention - Mental Health/Behavioral Health Also, based upon the Hanlon Method of prioritization, the following identified community health need was not chosen as one of the needs to be addressed: - Health Education and Literacy After completing a gap analysis, IU Health Ball Memorial Hospital determined that the severity of and lack of resources available to address the five needs chosen to be addressed outweighed the severity of and resources available to address the one need not chosen. Schedule H, Part V, Section B, Line 14g - Other Measures to Publicize Indiana University Health Ball Memorial Hospital, Inc. goes to great lengths to ensure patients know that it treats all patients regardless of their ability to pay. Although a complete copy of the financial assistance policy is not attached to each patient statement, a plain language summary is included instead. Additionally, on the back of each patient statement is a telephone number that allows patients to ask any questions about the policy and request financial assistance. 20 ALBANY HEALTHCARE PHARMACY 349 W FIRST ST ALBANY IN 47320 RETAIL PHARMACY BALL CANCER CENTER 200 FOREST RIDGE RD STE 120 NEW CASTLE IN 47362 CANCER CARE BALL MEMORIAL HOSPITAL REHAB SERVICES 3600 W BETHEL AVE MUNCIE IN 47303 REHABILITATION BALL MEMORIAL HOSPITAL SLEEP LAB 6000 W KILGORE AVE MUNCIE IN 47304 SLEEP DISORDERS BALL STATE HEALTHCENTER PHARMACY 1500 NEELEY AVE MUNCIE IN 47306 RETAIL PHARMACY BLACKFORD COMMUNITY HEALTHCARE PHARMACY 400 PILGRIM BLVD HARTFORD CITY IN 47348 RETAIL PHARMACY BMH OUTPATIENT CT SERVICES 800 S TILLOTSON AVE STE A MUNCIE IN 47304 IMAGING BMH PEDIATRIC REHABILITATION CENTER 205 N TILLOTSON AVE MUNCIE IN 47304 PEDIATRIC REHABILITATION BMH REHAB SERVICES AND YORKTOWN PHARMACY 1420 S PILGRIM BLVD YORKTOWN IN 47396 REHABILITATION AND RETAIL PHARMACY BMH REHABILITATION SERVICES 3300 W COMMUNITY DR MUNCIE IN 47304 REHABILITATION BREAST CENTER SERVICE 2598 W WHITE RIVER ANTHONY IN 47303 IMAGING FAMILY PRACTICE CLINIC 221 N CELIA MUNCIE IN 47303 FAMILY PRACTICE IU HEALTH BALL MEMORIAL HOSPITAL LAB 1809 S MAIN ST UPLAND IN 46989 LABORATORY IU HEALTH BALL MEMORIAL HOSPITAL RADIOL 1809 S MAIN ST UPLAND IN 46989 IMAGING IU HEALTH BALL MEMORIAL HOSPITAL RADIOL 1420 S PILGRIM BLVD YORKTOWN IN 47396 IMAGING KENMORE HEALTHCARE PHARMACY 205 N TILLOTSON AVE MUNCIE IN 47304 RETAIL PHARMACY PAIN MANAGEMENT CENTER & FAMILY PHARMACY 5501 W BETHEL AVE MUNCIE IN 47304 PAIN MANAGEMENT AND RETAIL PHARMACY SOUTHWAY HEATLHCARE PHARMACY 3715 S MADISON ST MUNCIE IN 47302 RETAIL PHARMACY UPLAND HEALTHCARE PHARMACY 1809 S MAIN ST UPLAND IN 46989 RETAIL PHARMACY WOUND HEALING CENTER & BARIATRIC CENTER 2901 W JACKSON ST MUNCIE IN 47303 WOUND HEALING AND BARIATRIC Schedule H, Part I, Line 3c - Other Factors Used in Determining Elig. Eligibility for financial assistance is determined based upon a patient's household income and number of members in the household. A patient is eligible for financial assistance, when the patient's: - Household income is equal to or less than 400% of the Federal Poverty Guidelines ("FPG"); or - Household income is greater than 400% of the FPG, the patient is an uninsured patient, and qualifies based on an established sliding scale. Patients in the following categories are presumed to be eligible for financial assistance, without a determination of household income: - Patients whose financial need has been determined by the following third parties: Wishard, Project Health, Children's Special Health Care Services, Medicaid, or Out-of-State Medicaid; - Patients who are pending Medicaid approval; - Homeless patients; and - Patients who have a hospital bill with a maximum balance to be determined by the Executive Director of Revenue Cycle Services and who meet credit scoring and asset determination criteria. Additional requirements for eligibility include: - For patients/guarantors who are otherwise eligible for Financial Assistance and whose hospital and/or physician liability is greater than $60,000, Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") may review available assets in determining eligibility and amount of Financial Assistance provided. This dollar threshold may be increased annually based on IU Health Ball Memorial Hospital price increases and at the discretion of Revenue Cycle Leadership. - Financial assistance may be granted to patients/guarantors who qualify for government programs when funding has been delayed. If later government assistance is approved, the financial assistance awarded will be reversed. This includes, but is not limited to, when a patient's account is pending Medicaid approval. - Financial Assistance may be granted to a deceased patient whose estate has been determined to be without valuable assets. - Financial assistance will not be granted to non-consolidated patient statements of patients that have a physician bill with a balance less than $240.00. - IU Health Ball Memorial Hospital will deny financial assistance for any patient/guarantor who falsifies any portion of an application. - All third party resources and non-hospital financial aid programs, including public assistance available through Medicaid, must be exhausted before financial assistance will be awarded. Schedule H, Part I, Line 6a - C.B. Report Prepared by a Related Org. Indiana University Health Ball Memorial Hospital, Inc.'s community benefit and other investments, encompassing its total community investment, are included in the IU Health Community Benefit Report which is prepared on behalf of and includes IU Health and its related hospital entities in the State of Indiana ("IU Health Statewide System"). The IU Health Community Benefit Report is made available to the public on IU Health's website at http://iuhealth.org/communitybenefit/. The IU Health Community Benefit Report is also distributed to numerous key organizations throughout the State of Indiana in order to broadly share the IU Health Statewide System's community benefit efforts. It is also available by request through the Indiana State Department of Health or IU Health. Schedule H, Part I, Line 7, Column (f) - Bad Debt Expense The amount of bad debt expense included on Form 990, Part IX, Line 25, column (A), but subtracted for purposes of calculating the percentage of total expense on Line 7, column (f) is $16,253,501. Schedule H, Part I, Line 7 - Total Community Benefit Expense Schedule H, Part I, Line 7, Column (f), Percent of Total Expense, is based on column (e) Net Community Benefit Expense. The percent of total expense based on column (c) Total Community Benefit Expense, which does not include direct offsetting revenue, is 30.25%. Schedule H, Part I, Line 7g - Subsidized Health Services Indiana University Health Ball Memorial Hospital, Inc. does not include any costs associated with physician clinics as subsidized health services. Schedule H, Part II - Promotion of Health in Communities Served Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") is a subsidiary of Indiana University Health, Inc. ("IU Health"). IU Health participates in a variety of community-building activities that address the social determinants of health in the communities it serves. IU Health and its related hospital entities across the State of Indiana ("IU Health Statewide System") invest in economic development efforts across the state, collaborate with like-minded organizations through coalitions that address key issues, and advocate for improvements in the health status of vulnerable populations. This includes making contributions to community-building activities by providing investments and resources to local community initiatives that addressed economic development, community support and workforce development. Several examples include IU Health's support of the following organizations and initiatives that focus on some of the root causes of health issues, such as lack of education, employment and poverty: - College Mentors for Kids - Starfish Initiative - Teach for America - United Way Additionally, through the IU Health Statewide System's team member community benefit service program, "Strength That Cares", team members across the state make a difference in the lives of thousands of Hoosiers every year. For example, in 2013, almost 80 team members from IU Health gathered to help build a new home for a family as part of a Habitat for Humanity build event. Schedule H, Part III, Line 2 - Methodology Used to Est. Bad Debt Exp. The bad debt expense of $3,509,131 reported on Schedule H, Part III, Line 2 is reported at cost, as calculated using the cost to charge ratio methodology. Schedule H, Part III, Line 4 - Bad Debt Expense The provision for uncollected patient accounts, for all payors, is recognized when services are provided based upon management's assessment of historical and expected net collections, taking into consideration business and economic conditions, changes and trends in health care coverage and other collection indicators. Periodically, management assesses the adequacy of the allowance for uncollectible accounts based upon accounts receivable payor composition and aging, the significance of individual payors to outstanding accounts receivable balances, and historical write-off experience by payor category, as adjusted for collection indicators. The results of the review are then used to make any modifications to the provision for uncollected patient accounts and the allowance for uncollectible accounts. In addition, Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") follows established guidelines for placing certain past due patient balances with collection agencies. Patient accounts that are uncollected, including those placed with collection agencies, are initially charged against the allowance for uncollectible accounts in accordance with collection policies of IU Health Ball Memorial Hospital and, in certain cases, are reclassified to charity care if deemed to otherwise meet financial assistance policies of IU Health Ball Memorial Hospital. Schedule H, Part III, Line 8 - Medicare Shortfall The Medicare shortfall reported on Schedule H, Part III, Line 7 is calculated, in accordance with the Form 990 instructions, using "allowable costs" from the Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes are not reflective of all costs associated with IU Health Ball Memorial Hospital's participation in Medicare programs. For example, the Medicare Cost Report excludes certain costs such as billed physician services, the costs of Medicare Parts C and D, fee schedule reimbursed services, and durable medical equipment services. Inclusion of all costs associated with IU Health Ball Memorial Hospital's participation in Medicare programs would significantly increase the Medicare shortfall reported on Schedule H, Part III, Line 7. IU Health Ball Memorial Hospital's Medicare shortfall is attributable to reimbursements that are less than the cost of providing patient care and services to Medicare beneficiaries and does not include any amounts that result from inefficiencies or poor management. IU Health Ball Memorial Hospital accepts all Medicare patients knowing that there may be shortfalls; therefore it has taken the position that the shortfall should be counted as part of its community benefit. Additionally, it is implied in Internal Revenue Service Revenue Ruling 69-545 that treating Medicare patients is a community benefit. Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with governmental health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. Schedule H, Part III, Line 9b - Written Debt Collection Policy If a patient cannot satisfy standard payment expectations, a financial assistance screening process for alternative sources of balance resolution is completed. Those resolutions may include a discount on charges, Medicaid enrollment, interest-free loan or application for financial assistance. If a patient does not apply for financial assistance but otherwise meets the financial assistance guidelines established by Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital"), IU Health Ball Memorial Hospital will waive charges and treat the cost of services as financial assistance. Schedule H, Part VI, Line 2 - Needs Assessment Communities are multifaceted and so are their health needs. Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") understands that the health of individuals and communities are shaped by various social and environmental factors, along with health behaviors and additional influences. IU Health Ball Memorial Hospital assesses the health care needs of the communities it serves by conducting a Community Health Needs Assessment ("CHNA"). This assessment includes collaboration with other community organizations such as the Delaware County Health Department, the Indiana State Department of Health, the Centers for Disease Control and Prevention and the United Way of Delaware County. Schedule H, Part VI, Line 3 - Patient Education of Eligibility for Assist. Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") goes to great lengths to ensure patients know that it treats all patients regardless of their ability to pay. IU Health Ball Memorial Hospital shares financial assistance information with patients during the admission process, billing process, and online. Helping patients understand that financial support for their care is available is a part of IU Health Ball Memorial Hospital's commitment to its mission. IU Health Ball Memorial Hospital's financial assistance policy exists to serve those in need by providing financial relief to patients who ask for assistance after care has been provided. During the admissions process, opportunities for financial assistance are discussed with patients who are identified as self-pay (uninsured) or if they request assistance information. The patient is also provided with an Admissions Packet that outlines information regarding IU Health Ball Memorial Hospital's financial assistance program. Financial counselors are onsite to assist with financial concerns or questions during the patient's stay. Patient Financial Services Customer Service representatives are also available after the patient's stay to help patients apply for financial assistance, understand their bills, explain what they can expect during the billing process, accept payment (if needed), update their insurance or payor information, and update their address or other demographic information. A plain language summary of the financial assistance policy is printed on the back of each patient statement, while the financial assistance application is mailed to all IU Health Ball Memorial Hospital patients with a patient balance due after insurance. Additionally, on the back of each patient statement is a telephone number that allows patients the ability to request financial assistance. Uninsured patients are also made aware of this process at the time of registration. The IU Health website has a page (http://iuhealth.org/helpwithbills) dedicated to financial assistance and offers an online application and telephone numbers for customer service representatives to assist with the application process. IU Health Ball Memorial Hospital has an expansive financial assistance policy which utilizes the federal poverty guidelines to determine eligibility. The goal is to make access to quality care within a patient's reach. The IU Health Ball Memorial Hospital Financial Assistance policy provides the following support to patients that qualify: - Free care for those earning up to 200 percent of federal poverty guidelines; - Discounted care on a sliding scale for families earning from 200 to 400 percent of federal poverty guidelines; and - Discounted care on a sliding scale for uninsured families earning from 400 to 650 percent of federal poverty guidelines, and - Financial assistance to patients whose health insurance coverage, if any, does not provide full coverage for all of their medical expenses and whose medical expenses would make them indigent if they were forced to pay full charges. Patients are guided through their course of care with particular sensitivity, reviewing changing circumstances and allowing for financial assistance at any point during the relationship and billing process. For those inpatients that may qualify for the Medicaid program and have not applied, IU Health Ball Memorial Hospital financial counselors will assist patients with the Medicaid application. If a patient does not apply for financial assistance, but meets the financial assistance guidelines established by IU Health Ball Memorial Hospital, IU Health Ball Memorial Hospital will waive charges and treat the cost of services as financial assistance. Schedule H, Part VI, Line 4 - Community Information Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") is located in Delaware County, Indiana, a county located in central Indiana. Its service area counties included Delaware, Randolph, Jay, Henry, Blackford, Grant, and Madison counties. Delaware County includes ZIP codes within the towns of Muncie, Eaton, Gaston, Selma, Albany, Daleville, and Yorktown. Based on the most recent Census Bureau (2010) statistics, Delaware County's population is 117,671 persons with approximately 52% being female and 48% male. The county's population estimates by race are 89.6% White, 1.8% Hispanic or Latino, 7.0% Black, 1.1% Asian, 0.3% American Indiana or Alaska Native, and 2.0% persons reporting two or more races. Delaware County has relatively low levels of educational attainment. A high school degree is the level of education most have achieved, and the percentage of those with a high school degree has dropped 1% from 2000 to 2010 (37% to 36%). An additional 20% had some college, but no degree. As of 2010, 19% of the population has an associate's or bachelor's degree, and only 10% hold a graduate or professional degree. 86.8% of the IU Health Ball Memorial Hospital inpatient discharge population resides in Delaware (68.5%), Randolph (6.5%), Jay (5.6%), and Henry (6.2%) counties. 49% of community discharges were for patients with Medicare, 23% were for patients with commercial insurance, 21% were for patients with Medicaid, and 7% were for uninsured/self-pay patients. Schedule H, Part VI, Line 5 - Promotion of Community Health Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") invests in its community to improve the quality of life of its community members. Several community benefit highlights are described below. IU Health Ball Memorial Hospital launched "Active After School", a pilot program aimed at teaching elementary school students lifelong behaviors for healthy living. Two elementary schools in Muncie participated in the spring, and in the fall, eight schools in Muncie and two in Hartford City took advantage of the program. Active After School helped more than 100 youngsters be engaged in physical activity every day after school. IU Health Ball Memorial Hospital also offered a community wide "Walk with a Doc" event in Muncie. The monthly walking program along the Cardinal Greenway was designed to motivate individuals to exercise. More than 50 people participated in the walks during 2013 with three IU Health Ball Memorial Hospital physicians. Also during 2013, IU Health Ball Memorial Hospital partnered with a local museum to offer "Eat Well, Play Well", an interactive exhibit focused on nutrition and fitness education for children ages 5 through 12. IU Health Ball Memorial Hospital employees participated in community days at the exhibit and developed companion education materials that were distributed to more than 1,500 exhibit visitors. Schedule H, Part VI, Line 6 - Affiliated Health Care System Indiana University Health Ball Memorial Hospital, Inc. is part of the IU Health Statewide System. The IU Health Statewide system is Indiana's most comprehensive healthcare system. A unique partnership with the Indiana University School of Medicine ("IU School of Medicine"), one of the nation's leading medical schools, gives patients access to innovative treatments and therapies. IU Health is comprised of hospitals, physicians and allied services dedicated to providing preeminent care throughout Indiana and beyond. National Recognition - Six hospitals designated as Magnet by the American Nurses Credentialing Center recognizing excellence in nursing care. - Named to the 2013-2014 U.S. News & World Report's Best Hospitals Honor Roll, their highest distinction. - Eleven adult clinical programs ranked among the top 50 national programs in U.S. News & World Report - Ten pediatric clinical programs ranked among the top 50 national programs in the U.S. News & World Report Education and Research As an academic health center, IU Health works in partnership with the IU School of Medicine to train physicians, blending breakthrough research and treatments with the highest quality of patient care. Research conducted by IU School of Medicine faculty gives IU Health physicians and patients access to the most leading-edge and comprehensive treatment options. Collaborative Strategic Research Initiative Conceived by IU Health and the IU School of Medicine in 2012, the Strategic Research Initiative aims to enhance the institutions' joint capabilities in fundamental scientific investigation, translational research and clinical trials targeting innovative treatments for disease. The two organizations committed to invest $150 million over five years to this new research collaboration. Established in 2013, the Center for Innovation and Implementation Science is partially supported by the Strategic Research Initiative. The new center, launched by the IU School of Medicine and the Indiana Clinical and Translational Sciences Institute, focuses on increasing efficacy and reducing costs at IU Health. With oversight of four specialized research and discovery units managed by IU School of Medicine researchers, the center will address problems with the potential to reduce costs or generate new revenue estimated at $5 million per year or more. IU Health Statewide System IU Health is a part of the IU Health Statewide System which continues to broaden its reach and positive impact throughout the state of Indiana. IU Health is Indiana's most comprehensive academic health center and consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health, and IU Health Saxony Hospital. Other hospitals in the IU Health Statewide System include the following: - IU Health Arnett Hospital - IU Health Ball Memorial Hospital - IU Health Bedford Hospital - IU Health Blackford Hospital - IU Health Bloomington Hospital - IU Health Goshen Hospital - IU Health La Porte Hospital - IU Health Morgan Hospital - IU Health North Hospital - IU Health Paoli Hospital - IU Health Starke Hospital - IU Health Tipton Hospital - IU Health West Hospital - IU Health White Memorial Hospital Although each hospital in the IU Health Statewide System prepares and submits its own community benefits plan relative to the local community, the IU Health Statewide System considers its community benefit plan as part of an overall vision for strengthening Indiana's overall health. A comprehensive community outreach strategy and community benefit plan is in place that encompasses the academic medical center downtown Indianapolis, suburban Indianapolis and statewide entities around priority areas that focus on health improvement efforts statewide. IU Health is keenly aware of the positive impact it can have on the communities of need in the state of Indiana by focusing on the most pressing needs in a systematic and strategic way. Some ways we address our community health priorities as a system include: IU Health Day of Service The annual IU Health Day of Service is a high-impact, one-day event aimed at engaging IU Health team members in activities that address an identified community outreach priority. Tackling the issue of obesity in the communities IU Health serves, the fifth annual Day of Service in 2013 focused on leaving behind key physical assets to help meet a statewide need for more venues for physical activity and recreation. During the 2013 Day of Service: - More than 1,500 IU Health team members gave their time to improve walking trails and park assets, which serve more than 63,000 residents across the state. - 19 community parks were enhanced; IU Health team members spread mulch around play equipment to help ensure safety; put fresh coats of paint on park structures; and improved landscaping to boost aesthetic appeal. - 40 fitness stations were installed to provide community members opportunities for fitness at parks. - 300 sports balls were inflated and donated to the Indiana Sports Corporation to give more children equipment to support play and physical activity. - IU Health Physicians also hosted a Day of Service called "Give Back Day," featuring 15 interactive stations located along a walking path that promoted fun, health-related family-friendly activities. Participants enjoyed "walk with a doc," yoga, volleyball, cardio drumming and Zumba. The event also featured a taste test of healthy snacks. Fifty-two team members from IU Health Physicians, including 27 physicians, volunteered their time to engage in healthy activities with fellow community members. Kindergarten Countdown As one of IU Health's signature programs and collaboration with United Way, Kindergarten Countdown helps hundreds of soon-to-be kindergartners improve their readiness for school. In addition to providing health screenings and vaccinations to students, the program offers assistance to parents in registering their kindergartners for school. Kindergarten Countdown summer camps are designed to provide at-risk youngsters the basic skills they need to succeed in their first year of school. From "Get Ready to Read" pre- and post-tests, campers in the IU Health camps achieved a 21 percent average increase in scores from the beginning of the four-week camp to the end. The program also creates positive impact by increasing awareness of kindergarten readiness, improving parent engagement and strengthening relationships between volunteers and team members at hospitals, schools and community organizations. Clinical Research Clinical trials are conducted at the following IU Health locations: Academic Health Center (IU Health Methodist Hospital, IU Health University Hospital, and Riley Hospital for Children at IU Health), IU Health Arnett Hospital, IU Health Bloomington Hospital, IU Health La Porte Hospital, IU Health Ball Memorial Hospital, IU Health Saxony Hospital and IU Health Ball Memorial Hospital. There were approximately 2,200 clinical trials conducted in 2013 at IU Health. Methodist Research Institute ("MRI") The Biorepository at MRI, under IRB approval, collects human biological materials (blood, bone, tissue, urine) vital for medical research to provide the best way to study a variety of diseases and their potential treatments. Basic science researchers at MRI publish the results of their innovative grant-supported research in prestigious peer-reviewed journals. Their work has been recognized both nationally and internationally as they participate in system-wide collaborative efforts within IU Health as well as with the IU School of Medicine Community Health Initiatives With investments in high-quality and impactful initiatives to address community health needs statewide; IU Health is helping Indiana residents improve their health and their quality of life. In 2013, IU Health impacted many people statewide through presentations, health risk screenings, health education programs, and additional health educational opportunities made available to the community, especially to our community members in the greatest need of such services. Examples of the types of programming and investment we make in the five community outreach areas include: Access to Healthcare One of the first steps to improved health outcomes is having access to healthcare resources. To show its commitment to providing affordable healthcare access, IU Health treats all patients regardless of their ability to pay. IU Health is also working to raise awareness and works to identify individuals within our communities that have barriers to care and connect these individuals with better access and consistency of healthcare resources to meet their needs. Some ways that these IU Health hospitals address Access to Healthcare include: Veggies and Vaccines Leveraging existing partnerships from the successful IU Health Garden on the Go program, IU Health conducted a seasonal flu campaign for two weeks in October and November 2013 false DELAWARE ADVANCEMENT CORPORATION 401 S HIGH ST MUNCIE IN 47305 311111841 501(C)(3) 7500 N/A N/A GENERAL FUNDING 1 Schedule I, Part I, Line 2 - Org.'s Procedures for Monit. the Use of Grant Although Indiana University Health Ball Memorial Hospital, Inc. does not monitor the use of grant funds once distributed, through due diligence the organization has reasonably confirmed that the entities to which the contributions are made are highly reputable in the community and use the funds for the purposes intended. X false false true true false false false false false true false DANIEL F EVANS JR VICE CHAIRMAN 0 1054492 0 301421 0 112206 0 533606 0 29361 0 2031086 0 0 PETER M VOSS MD VICE CHAIRMAN 0 322920 0 119860 0 15966 0 5939 0 29255 0 493940 0 0 PATRICK A CLEARY MD PHD DIRECTOR 0 345157 0 7856 0 15198 0 6375 0 26578 0 401164 0 0 CHRISTINA C DRUMMOND MD DIRECTOR 0 203248 0 4543 0 996 0 12851 0 32556 0 254194 0 0 MICHAEL E HALEY DIRECTOR/PRESIDENT 485608 0 105447 0 106514 0 21020 0 30239 0 748828 0 0 0 CHARLES R ROUTH MD DIRECTOR 500 214964 0 51417 0 19283 0 998 0 28550 500 315212 0 0 CAROL E SEALS CFO (PARTIAL YEAR) 82782 0 0 0 74885 0 3394 0 6142 0 167203 0 0 0 LORI A LUTHER COO/CFO 223515 0 12939 0 2741 0 6027 0 12112 0 257334 0 0 0 JEFFREY C BIRD MD VP & CMO 277740 0 0 0 1806 0 10200 0 33043 0 322789 0 0 0 DOREEN C JOHNSON RN VP & CNE 176907 0 0 0 12720 0 7675 0 25975 0 223277 0 0 0 KAREN POPOVICH DIRECTOR, MGMT. SVCS. 36496 0 0 0 193000 0 67 0 1400 0 230963 0 0 0 ALVIS E FOSTER RADIATION PHYSICIST 196881 0 0 0 7974 0 7946 0 2323 0 215124 0 0 0 BRANDON S DICKEY ASSOC. PROG. DIRECTOR 147333 0 25000 0 267 0 7227 0 25314 0 205141 0 0 0 JOSEPH R BUTTS RADIATION PHYSICIST 167176 0 0 0 60 0 1947 0 5622 0 174805 0 0 0 SUSAN RALSTON DIRECTOR, PHARMACY 126305 0 0 0 36785 0 5086 0 1361 0 169537 0 0 0 HAROLD L BERFIEND FORMER COO 0 257957 0 43342 0 29306 0 21374 0 21042 0 373021 0 0 TERRY A PENCE SLC 150874 0 0 0 6472 0 6399 0 27768 0 191513 0 0 0 Schedule J, Part I, Line 1b - Personal Services Executive physicals were provided for certain board members, including Lori A. Luther, free of charge. Schedule J, Part I, Line 3 - Comp. of the Org.'s CEO/Executive Director Michael E. Haley, the CEO of Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital"), is compensated as an employee of Indiana University Health, Inc. ("IU Health") for his services performed at IU Health Ball Memorial Hospital. IU Health has a process in place to determine the compensation of IU Health Ball Memorial Hospital's CEO. This process includes the use of a written employment contract, the terms of which are determined based upon a compensation survey/study conducted by an independent compensation consultant with review and approval by IU Health's compensation committee and board of directors. Schedule J, Part I, Line 4a - Severance or Change-of-Control Payments Carol E. Seals received 2013 severance of $74,574 from Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital"). Karen Popovich received 2013 severance of $192,150 from Indiana University Health Ball Memorial Hospital. Susan M. Ralston received 2013 severance of $32,357 from Indiana University Health Ball Memorial Hospital. Schedule J, Part I, Line 4b - Supplemental Nonqualified Retirement Plan Daniel F. Evans, Jr. and Michael E. Haley participate in a supplemental executive retirement plan of Indiana University Health, Inc., provisions of which are designed to retain its critical employees. The plan provides for an additional retirement benefit for service through normal retirement or other key dates. If the executive leaves prior to retirement or other key dates, the benefit may be forfeited or reduced. Daniel F. Evans, Jr. and Michael E. Haley have an amount included in column c, deferred compensation, representing the current year increase in the accrued benefit and/or current contributions. No amount was actually paid to these executives during the year. Michael E. Haley has an amount included in column c, deferred compensation, representing the current year increase in the accrued benefit and/or current contributions. No amount was actually paid to this executive during the year. Schedule J, Part I, Line 7 - Non-fixed payments Amounts disclosed in Column B(ii) include a long-term and short-term incentive for certain executives and short-term incentive for other employees. Although these plans are based on a fixed formula that has been approved by the Board of Directors based upon certain qualitative and quantitative factors and goals, all discretionary incentive plans must be approved by the Board of Directors prior to any incentive payout. Schedule J, Part III - Daniel F. Evans, Jr. - 2009 through 2013 Forms W-2c Indiana University Health, Inc. ("IU Health") issued 2009, 2010, 2011, 2012, and 2013 Forms W-2c to Daniel F. Evans, Jr. in order to include previously excluded premiums it paid on a life insurance policy, in which Daniel F. Evans, Jr. was the insured party and a family member was the beneficiary, as taxable compensation. Furthermore, IU Health is amending its 2010, 2011, and 2012 Forms 990 to reflect the changes in Daniel F. Evans, Jr.'s taxable compensation. A HOSPITAL AUTHORITY OF DELAWARE COUNTY INDIANA 351836279 245834CA2 2006-05-31 77763463 SERIES 2006 BONDS-SEE PART VI false false false B HOSPITAL AUTHORITY OF DELAWARE COUNTY INDIANA 351836279 245834CL8 2009-12-08 24257961 SERIES 2009A BONDS-SEE PART VI false false false A 0 0 82500798 6827691 0 0 937213 0 0 74735894 0 0 2009 false false true true B 4940000 0 25201974 3414013 0 0 456086 0 0 0 21331875 0 true false true true A false true true true true true 0 false false false true B 0 A false false false true false false 0 false 0 false true B false false false true false false 0 false 0 false true A true B true Shedule K, Part I - Bond Issues 2006 Series Bonds: The 2006 Series Bonds were issued in order to provide funding for new construction of buildings and structures and the purchase of equipment. Part IV, Line C - July 20, 2011 Shedule K, Part I - Bond Issues 2009A Series Bonds: The 2009A Series Bonds were issued in order to refund the 1998 Series Bonds. The 1998 Series Bonds were issued on March 11, 1998. Part IV, Line C - August 15, 2013 MATT S COX SEE PART V 59352 SEE PART V false Schedule L, Part II, Columns (b) and (d) - Relationship and Purpose Matt S. Cox, the son of Michael L. Cox, served and was compensated as an employee of IU Health Ball Memorial Hospital. Part VI, Section A, Line 2 - Family or Business Relationships James A. Fisher, Peter M. Voss, M.D., Terry L. Walker, Michael L. Cox, and Michael E. Haley served on the board of directors of Cardinal Health Ventures, Inc. Additionally, Michael E. Haley, and Lori A. Luther served as officers. No additional compensation was provided to these individuals for their service. Lori A. Luther, Jeffrey C. Bird, and Doreen C. Johnson served on the board of managers of Cardinal Health Initiatives, LLC. No additional compensation was provided to these individuals for their service. Michael E. Haley and Harold L. Berfiend served on the board of managers of Ball Outpatient Surgery Center, LLC. No additional compensation was provided to these individuals for their service. Part VI, Section A, Lines 6, 7a and 7b - Members or Stockholders Line 6: Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") has one class of membership and the sole member is Indiana University Health, Inc. ("IU Health"). Line 7a: IU Health elects one more than one-half of the total number of Directors. Immediately following such election the remainder are elected by the Directors, excluding those whose terms are set to expire. Line 7b: Notwithstanding any other provisions of the Articles of Incorporation, the following matters require the written approval of IU Health prior to implementation: - Authorization for the establishment or acquisition of any subsidiaries, affiliates or joint venture arrangements or acquisition of all or substantially all of the assets of any other business or entity; - Approval or amendment to any operating or capital budget; - Authorization of any unbudgeted operating or capital budget items or deviations, including any issuance or guarantee of any unbudgeted debt, greater than the budgeted amount by $1 million for any individual item or $3 million per fiscal year in the aggregate; - Authorization of any agreement to act as primary obligor, or to serve as a guarantor, surety or co-obligor with respect to the indebtedness of any other party, to borrow amounts from third-party lenders, or to loan money to any person or entity; - Approval of strategic plans and amendments, which will be integrated with IU Health's strategic plan; - Amendment or repeal of the Corporation's or an Affiliate's articles of incorporation or bylaws (or other corresponding organizational documents of an Affiliate that is not a corporation); - Authorization of any merger, consolidation, reorganization, sale or transfer of all or substantially all of the Corporation's assets; - Authorization of any voluntary declaration of bankruptcy, plan of dissolution, any liquidating distribution of assets or other action related to its dissolution or liquidation; - Authorization of any pledge of, or grant any security interest or mortgage in, or otherwise encumber, any tangible assets of the Corporation in excess of $2,000,000, other than in the ordinary course of business or pursuant to a budget or strategic plan approved by IU Health; - Approval of any management agreement for the management of all or a substantial part of the Corporation's operations; or - Appointment or removal of any of the Corporation's Directors with or without cause. Part VI, Section A, Line 11b - Form 990 Provided to Governing Body Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") has established the following process for the review of the Form 990 and related schedules before it is filed: The COO/CFO reviewed and approved the Form 990 and related schedules. After the review and approval from the COO/CFO, IU Health Ball Memorial Hospital Board Audit committee reviewed and approved the Form 990. After audit committee approval, a final complete copy, as filed with the Internal Revenue Service, of the Form 990 and related schedules was made available to each board member on a secure intranet site prior to filing. Each member was informed of the availability of the Tax Department to answer any questions. Part VI, Section B, Lines 12, 13, 14, and 16b - Policies Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") is part of the Indiana University Health, Inc. ("IU Health") system. As the sole member and controlling parent of IU Health Ball Memorial Hospital, IU Health and its Board of Directors have mandated that certain policies be followed to ensure greater standardization throughout the system. Thus, IU Health Ball Memorial Hospital's Board of Directors was not required to separately adopt a conflict of interest, whistleblower, document retention and destruction and joint venture policies because IU Health's Board of Directors had already adopted and required these policies to be followed by its subsidiaries. Part VI, Section B, Line 12c - Conflict of Interest Policy Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") has a Conflict of Interest Policy, the purpose of which is to protect IU Health Ball Memorial Hospital's interests when it is contemplating entering into a transaction or arrangement that might benefit the private interest of an officer, director, or employee. Each employee that is manager level or above, including officers and directors, is required to annually sign a statement which affirms that such person (1) has received a copy of the conflict of interest policy; (2) has read and understands the policy; (3) has agreed to comply with the policy; and (4) understands and acknowledges that the Corporation is a tax-exempt organization and that in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. If an interest is disclosed, the form requires that the discloser's supervisor sign the form to indicate his/her knowledge and approval of the interest. The form is then submitted to Corporate Compliance for review. If the disclosure is by the CEO/President, it is reviewed by the board chairman for approval. If the disclosure is by a member of the board of directors, the General Counsel/Chief Compliance Officer reviews the disclosures and determines whether to consent. Board members with a conflict of interest cannot participate in any decision related to that conflict. Breach of the conflict of interest policy, including failure to complete and update the questionnaire and failure to disclose an interest that should be disclosed, may subject an individual to disciplinary action, including dismissal. Part VI, Section B, Line 15 - Process for Determining Compensation The CEO/Top Management Official for Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital") is employed by Indiana University Health, Inc. ("IU Health"). IU Health has the following process for determining compensation: 1. The Board of Directors has established a Committee on Personnel and Compensation. The individuals on this Committee are made up of individuals who are on the Board and who do not have a conflict of interest with Indiana University Health, Inc. ("IU Health"). There are no physicians or employees on this Committee. This Committee develops and reviews annually the executive compensation philosophy, market analysis as to comparability and reasonableness. One of the purposes of this Committee is to review, approve and make recommendations regarding executive compensation and benefits to the IU Health Board. As deemed appropriate, this Committee also reviews the same detail with the Committee on Finance. The Committee on Finance is represented by certain members of the Board as well. 2. Each year the Committee on Personnel and Compensation engages an outside compensation consulting firm to conduct a compensation and benefits study for all senior vice presidents and above. The current compensation advisor is the Hay Group. Hay Group performs an independent compensation survey. The relevant comparability data includes: compensation and benefit levels paid by similarly situated organizations (both governmental and tax exempt) for functionally comparable positions as well as the availability of similar services in the geographic area. The Committee reviews the entire compensation package including: base compensation, short term and long term incentive plans, basic health and welfare benefits, qualified and nonqualified plans as well as any additional fringe benefits. Further, Hay Group will provide recommendations based upon the reasonable compensation information as it relates to salary increases, bonuses and benefits that are consistent with the compensation philosophy of the Committee. A separate analysis using the same methodology is done for the Chief Executive Officer. 3. The Committee reviews the salary survey and, if appropriate, makes recommendations on increases in salary and any changes in bonuses or benefits. The Committee's goal is to ensure that the total compensation and benefits package is reasonable based upon the independent data provided by Hay Group. The Committee votes on any changes in compensation or benefits. This review, discussion and vote are documented in the minutes for the meeting. There are no executives present during the final discussion and approval of compensation. 4. The Board reviews the report prepared by the Hay Group as well as the recommendations of the Committee on Personnel and Compensation as to changes in compensation approved by the Committee. As requested, the Committee on Finance also provides its review of recommendations on changes in executive compensation and benefits. This review, discussion and vote are documented in the minutes. 5. The Board then reviews the recommendations provided by the Committee on Personnel and Compensation and votes on the changes as well. No additional compensation or benefits are paid to the executives until the changes have been approved by the Committee and the Board. The discussion and approval are documented in the minutes of the meeting. There are no executives present during the final discussion and approval of compensation. The General Counsel prepares a formal written opinion reviewing the compensation and benefits approval process, comparing that process to the Intermediate Sanctions Test of IRC Section 4958 and, if the facts warrant, provides comments regarding the compensation and benefits approval process as this relates to meeting the requirements for a rebuttable presumption of reasonableness as provided in the Intermediate Sanctions Test. 6. After the end of each year, the Committee and Board also reviews the achievements of the executive group as it relates to the long-term and short-term shared and individual goals developed by the executive and the Board. These achievements may also be reviewed with the Committee on Finance. The Board, at its discretion, may approve bonus payments based upon the achievement of the goals and the compensation survey. The discussion and vote of the Committee and Board is documented in the minutes for each such meeting. The bonuses are not paid until approval is made by the Board. 7. The Committee on Personnel and Compensation and Audit Committee also review the required Form 990 disclosures related to executive compensation and benefits as well as compensation practices and approval processes prior to the filing of the Form 990 return with the Internal Revenue Service. IU Health Ball Memorial Hospital has a yearly process in place to determine the compensation for the other officers and key employees. IU Health Ball Memorial Hospital uses an independent compensation consultant who utilizes a variety of methods and procedures to obtain compensation ranges for comparable officer and employee positions. The independent compensation consultant provides IU Health Ball Memorial Hospital with recommended compensation ranges for its officers and other employees, which are then used as a guide for setting reasonable compensation by management. Management decisions with regard to determining compensation are subject to the review and approval of the Compensation Committee and Board of Directors. Part VI, Section C, Line 19 - Public Disclosure Indiana University Health Ball Memorial Hospital, Inc.'s ("IU Health Ball Memorial Hospital") Articles of Incorporation are available for public inspection through the Indiana Secretary of State's web-site. IU Health Ball Memorial Hospital's conflict of interest procedures are disclosed on the Form 990, Schedule O. IU Health Ball Memorial Hospital has consolidated financial statements. The consolidated financial statements for IU Health Ball Memorial Hospital are available to the public through its bond filings. Part IX, Line 11g - Other Fees for Services Line 11g includes amounts paid for the following: Shared Services/Professional Fees - $48,524,652 Part XI, Line 9 - Other Changes in Net Assets or Fund Balances During 2013, Indiana University Health Ball Memorial Hospital, Inc. ("IU Health Ball Memorial Hospital"), made an equity transfer to Indiana University Health Ball Memorial Physicians, Inc. ("IU Health Ball Memorial Physicians"), a subsidiary of IU Health Ball Memorial Hospital, in the amount of -$18,300,658. Throughout the existence of IU Health Ball Memorial Physicians, IU Health Ball Memorial Hospital has provided funds to support IU Health Ball Memorial Physicians' exempt purpose. Although there was never any intent for IU Health Ball Memorial Physicians to repay IU Health Ball Memorial Hospital, these amounts were recorded as intercompany balances rather than equity transfers. During 2013, IU Health Ball Memorial Hospital and IU Health Ball Memorial Physicians made adjustments to their books and records to reflect these intercompany balances as equity transfers for both book and tax purposes. Also, during 2013, Indiana University Health Ball Memorial Hospital recorded a change in pension obligation in the amount of $37,539,320. 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