2013-11-14T09:02:19-06:00 2012-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 2600 INDIANAPOLIS IN 46204 990 2012-01-01 237042323 INDIANA UNIVERSITY HEALTH BEDFORD INC % ANITA HAMILTON INDI 8122751200 2900 WEST 16TH STREET Suite BEDFORD IN 47421 Charles Shelter 2013-11-13 3176817000 2012 2016-02-24 21:20:13Z IU HEALTH BEDFORD HOSPITAL Bradford Dykes 2900 West 16th Street Bedford IN 47421 61633757 false X iuhealthbedford.org X 1970 IN Improving Lives with High Quality Compassionate Care 12 7 573 46 0 0 80619 76822 52205071 60965926 25431 157326 187454 368126 52498575 61568200 1796 6029 0 0 31652423 32441130 0 0 0 18786683 22443804 50440902 54890963 2057673 6677237 34329615 38991803 13007526 10992477 21322089 27999326 As an Indiana University Health Partner, our mission is to improve the health of our patients and community by providing high quality, compassionate, customer focused healthcare services, and to support the education and research initiatives of the Indiana University Health System. false false 7791042 0 12303936 Inpatient Care We had 1,262 admissions resulting in 4,893 patient days in 2012. We also had 601 swing bed days. 27200119 6029 42872771 Outpatient Care IU Health Bedford had 87,382 Outpatient Registrations resulting in 836 Observation Days, 765 Outpatient surgeries, 175,691 Outpatient Laboratory tests, 21,203 Radiology tests, 4,581 Cat Scans, 14,452 Emergency Room visits, 21,927 Outpatient Physical Therapies and 4,479 Respiratory Therapy visits. We also had 2,905 Ambulance Runs. 8408225 0 5942104 Physician Group The IU Health Bedford Physician Group consists of approximately 18 Physicians and 5 Nurse Practitioners. It is designed to have a service area that covers Lawrence, Monroe, Martin, Greene, Jackson, Washington and Orange Counties. The Physicians and Nurse Practitioners had 54,630 Office visits in 2012. 43399386 true true false false false false false false false true true false false false true false false true false false false false false false false false true true false true true false false false false false false false false false false false false true true true true false false true X 96 0 true 573 true false false false false false false false false false false X 12 7 false false false false true true true true true false false false true true true true true false true false IN X ANITA HAMILTON 8122785281 2900 West 16th Street Bedford IN 47421 Harley Brown 3.0 0.0 X X 6600 0 0 Helen Nash 3.0 0.0 X X 3300 0 0 Randy Hawkins 3.0 0.0 X X 3210 0 0 James T Oswalt 3.0 0.0 X X 2940 0 0 Jack Kenworthy 3.0 0.0 X X 2670 0 0 James T Bellush 3.0 0.0 X X 2940 0 0 Jamie Blackwell 3.0 0.0 X 2490 0 0 Neil C Pickett 3.0 55.0 X 0 251127 50801 Gene Robbins 3.0 0.0 X 0 14190 0 Dan Dusleag 40.0 0.0 X 179441 0 9620 Hojjatt Shamloo 40.0 0.0 X 394329 0 10557 Bradford W Dykes 40.0 0.0 X X 283558 0 40056 Charles Shetler 40.0 0.0 X 165577 0 10516 Brenda Davis 40.0 0.0 X 135172 0 4024 Cindy Smale 40.0 0.0 X 117011 0 6241 Rafi Siddiqi MD 40.0 0.0 X 350182 0 8836 Tassawar Hussain MD 40.0 0.0 X 329420 0 0 Eung Jun Cha MD 40.0 0.0 X 290172 0 8412 Christopher Bennett MD 40.0 0.0 X 258816 0 7649 Alan Smith 40.0 0.0 X 267429 0 11247 2795257 265317 167959 28 false true false ALLIANCE HEALTHCARE SERVICES PO Box 96485 Chicago IL 606936485 MRI Testing 662640 HMS MONITOR 2739 Momentum Place Chicago IL 60689 Computer System 572039 MAYO MEDICAL LABS PO Box 9146 Minneapolis MN 554809146 Lab Testing 361658 IU HEALTH SOUTHERN INDIANA PHYSICIA PO Box 1329 Bloomington IN 47402 Physicians 329997 INTEGRA IMAGING PARTNERS PO Box 86 Bedford IN 47421 Radiologist 226845 8 31371 41451 4000 17232 76822 Net Patient Revenue 622110 59627929 59627929 ELECTRONIC HEALTH RECORD 900099 1212826 1212826 Counseling Contract Revenue 900099 57637 57637 Physician Medicare Incentive 900099 45718 45718 Nurse Practitioner Services 900099 20100 20100 1716 1716 60965926 222208 222208 0 0 141977 141977 0 141977 141977 675 65557 -64882 -64882 -64882 0 0 0 SHARED EMPLOYEES 900099 102982 102982 CAFETERIA SALES 722320 73264 73264 REIMB FOR EXP (SPECIALTY CLINICS) 900099 23344 23344 26559 26559 226149 61568200 61118811 372567 0 6029 6029 0 0 1380252 1380252 0 24410582 19209797 5200785 1548667 1191445 357222 3374483 2409585 964898 1727146 1312630 414516 3256265 1685773 1570492 15923 15923 51328 51328 0 0 0 1590339 1590339 172773 172773 1530466 1195327 335139 1064437 863448 200989 0 772838 626909 145929 35200 35200 0 177102 98171 78931 256025 207682 48343 0 2065918 1675828 390090 618643 530477 88166 Med/Surg and Other Supplies 5505109 5417066 88043 BAD DEBT EXPENSE 2216584 2216584 Medicaid Assessment Fee 2195423 2195423 Misc General 919431 758900 160531 54890963 43399386 11491577 0 7247564 13110998 3756944 3214641 0 0 7285299 6983985 0 0 0 0 384764 1468491 803205 616168 662792 548776 42467335 29438591 14169047 13028744 0 0 0 0 0 0 0 0 20000 20000 34329615 38991803 3850246 3740595 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9157280 7251882 13007526 10992477 X 21222480 27901746 0 0 99609 97580 21322089 27999326 34329615 38991803 X 6677237 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 99609 2029 97580 79703 20000 94 99609 80832 1129 79703 76206 4626 80832 78190 1984 76206 0.00000 1.00000 0.00000 false false 912711 912711 15811775 8078363 7733412 24645116 20622884 4022232 1097733 737344 360389 13028744 0 Due to Medicare/Medicaid 4240445 Professional Liability/Tail Coverage 104675 Indiana University Health 2906762 7251882 Restricted Funds Schedule D, Part V Hospice Donations are used for the needs of our cancer patients. Money is donated by the Medical Group to pay for Patient's prescriptions who cannot afford them. These are donations on the Hospital's books that are earmarked for the Foundation. Radiology Incentive money is money donated for seminars etc for Radiology employees. Restricted donations are monies that are donated to the Hospital for specific use only. FIN 48 (ASC 740) Footnote from Financial Statements Schedule D, Part X, Line 2 Indiana University Health Bedford Hospital is a subsidiary in the consolidated financial statements of Indiana University Health. Indiana University Health adopted FIN 48 (ASC 740) in 2007. No disclosures were required under GAAP as Indiana University Health does not have any material tax contingencies that required disclosures in the footnotes. true true X true X true X true true false true true 1683 1619839 0 1619839 0.03080 3113 7967146 4819665 3147481 0.05980 4796 9586985 4819665 4767320 0.09060 16 5355 244461 2815 241646 0.00460 2 185 9687 0 9687 0.00020 2 336506 0 336506 0.00190 4 108 6717 0 6717 0.00010 24 5648 597371 2815 594556 0.00680 24 10444 10184356 4822480 5361876 0.09740 1 105 24397 24397 0.00050 1 19 14216 14216 0.00030 1 6 1565 1565 3 130 40178 40178 0.00080 true 751201 16918317 16144497 773820 X true true 1 1 IU Health Bedford Inc

2900 West 16th Street Bedford IN 47421

iuhealthbedford.org X X IU Health Bedford Inc 1 true true 100 true 200. true X X X X X X true true X X X X X X true false X X X X true X false false Part I, Line 6a IU Health Bedford's Community Benefit information is included in IU Health's (Parent Company) Community Benefit Report. Part I, Line 7, column (f) Bad Debt expense of $2,216,584 was excluded from total expenses in the calculation of the percent of total expense. Part I, Line 7 We used the Cost to Charge Ratio as our costing methodology. Part II - Community Building Activities We support Community Building Activities by involvement with the Economic Development Committee, the Local Chamber of Commerce and the Indiana State Department of Health Licensure Council. We also offer career education and job shadowing for local students. Part III, Line 4 Historically, we book a reserve for Bad Debt based on a matrix of our accounts receivable; when an account is written off as Bad Debt it is booked against that reserve. We used the Cost to Charge ratio as our costing methodology. Part III, Line 8 Medicare Shortfalls and Surplus Many of our Medicare beneficiaries are poor and would have qualified for the Hospital's Charity Care Program in addition to Medicare. If these patients had been treated as Charity Care, the cost of medical care would have been a Community Benefit. Our Medicare Cost report is used to determine Medicare surplus or shortfall. We had a small surplus this year. Part III, Line 9b Debt Collection Policy The first statement lists detail by revenue code, the total balance due and the discounted amount due if paid within 30 days of statement date. The first statement for uninsured patients will also reflect the uninsured discount, according to policy. Statements will be aged by the last payment date on the account. Patients with Medicare will receive 3 statements after the initial detail statement. Non-Medicare patients will receive 2 additional statements after the initial detail statement. Accounts not paid in full that receive the 4th statement for Medicare Patients, 3rd statement Non-Medicare will be referred to a Collection Agency. When a patient establishes a payment plan, the statement process is changed to a monthly reminder of payment now due. A 10 day extension from the due date will be granted to allow for mailing and processing time, before a payment is considered delinquent. Multiple missed payments will result in the account being referred to a Collection Agency. We have a separate Financial Assistance Policy. Part V, Section B, Line 12h Credit Scoring Part VI, Line 2 - Needs Assessment Our needs assessment covering 2011-2012 was done by Corporate. They collaborated with the following Organizations and Agencies: Bedford Parks Department, Bedford Public Library, DWA Healthcare Communications Group, Girls Club of Bedford, IU Health Bedford Hospital, Keach and Grove Insurance Agency, Office of the Mayor-Mitchell, Indiana, Parkview Intermediate School, Verite Healthcare Consulting, LLC and the General Public through an online survey. The Key conclusions were that Lawrence County has experienced no measurable population growth since 2000. Projections indicating a population that will be both decreasing and aging are troubling if accurate. Between 2000 and 2007 Lawrence County's median household income declined. Employment decreased 3.8% between 2001-2007. The percent of children in poverty increased from 13.3% in 2002 to 18.0% in 2007. Housing costs also presented a challenge for many in the community. Renters must work 77 hours per week in Lawrence County to afford a two-bedroom unit at the fair market rent. English remains the primary language spoken by residents in Lawrence County. The child abuse and neglect rate for children under 17 increased form 8.2% in 2002 to 9.6% in 2007. Part VI, Line 3 - Patient Education of Eligibility for Assistance Patients are educated and informed of the Financial Assistance Policy at time of service, through phone calls from the Patient Financial Staff, pamphlets and Community Outreach Events. We give the Patient a Financial Assistance application to fill out which contains demographic and financial information. If the application is not returned, we do a credit scoring and if their credit is 600 or below, the account is written off. We have a separate policy for Bad Debt collection that is followed once the determination is made that the Patient is not eligible for Financial Assistance. Part VI, Line 4 - Community Information IU Health Bedford serves Lawrence, Orange, Martin, Greene and Jackson counties. All counties represent 97% Caucasian individuals. The average median household income was $43,195. Part VI, Line 5 - Promotion of Community Health We have Community Health Fairs where we do diabetic and cholesterol screenings at a reduced cost. We also have pap and mammogram clinics. Part VI, Line 6 - Affiliated Health Care System Roles IU Health Bedford, Inc. is an affiliate of Indiana University Health, which includes Methodist Hospital, Indiana University Hospital and Riley Hospital for Children. Other Indiana University Health affiliates include: IU Heath La Porte Hospital, Inc. IU Health Starke Hospital IU Health Arnett, Inc. Rehabilitation Hospital of Indiana IU Health West Hospital Goshen Health System IU Health Blackford Hospital IU Health Tipton Hospital IU Health Ball Memorial Hospital IU Health North Hospital IU Health Methodist Hospital, Riley IU Health Bloomington, Inc. Midwest Proton Radiotherapy Institute IU Health Paoli, Inc. The immediate advantages of being an affiliate of Indiana University Health include centralized services which results in a reduction of duplicated services and lowers health care costs for our patients. Part VI, Line 7 - State filing of community benefit report Indiana true ASSISTANCE TO INDIVIDUALS 73 6029 MEDICINES & SUPPLIES Form 990, Schedule I, Part I, Line 2 Description of Organization's Procedures for Monitoring the Use of Grants Medicines and supplies are purchased for the indigent. Invoices are paid directly by IU Health Bedford, Inc., therefore monitoring is not required. Form 990, Schedule I, Part III, column (b) Actual invoices paid were examined and the number of individuals were counted to determine the number of recipients reported in column (b). false false false false false false false true false Neil C Pickett 0 250469 0 400 0 258 0 19434 0 31367 0 301928 0 0 Dan Dusleag 179441 0 0 0 0 0 0 0 9620 0 189061 0 0 0 Hojjatt Shamloo 394329 0 0 0 0 0 0 0 10557 0 404886 0 0 0 Bradford W Dykes 242071 0 39681 0 1806 0 19024 0 21032 0 323614 0 0 0 Charles Shetler 155285 0 10292 0 0 0 0 0 10516 0 176093 0 0 0 Rafi Siddiqi MD 350182 0 0 0 0 0 0 0 8836 0 359018 0 0 0 Tassawar Hussain MD 329420 0 0 0 0 0 0 0 0 0 329420 0 0 0 Eung Jun Cha MD 290172 0 0 0 0 0 0 0 8412 0 298584 0 0 0 Christopher Bennett MD 258816 0 0 0 0 0 0 0 7649 0 266465 0 0 0 Alan Smith 267429 0 0 0 0 0 0 0 11247 0 278676 0 0 0 Schedule J, Part I, Line 3 Compensation of the organization's CEO/Executive Director Bradford W. Dykes, the CEO of Indiana University Health Bedford, Inc. ("IU Health Bedford"), is compensated as an employee of Indiana University Health, Inc. ("IU Health") for his services performed at IU Health Bedford. IU Health has a process in place to determine the compensation of IU Health Bedford'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 7 Criteria for Incentive Pay Effective 6/07 Incentive goals will be developed and reviewed annually for IU Health Bedford, Inc Executives. The percentage of pay-out is based on a set of goals to be accomplished during a budget year. The goals will be established by the Executive and his or her direct supervisor. The goals will be identified in written format. Predetermined financial criteria (operating margin and days cash on hand) will be met before any percent of the incentive compensation will be paid out. Pay-out will be distributed after the final audit of the financial statements. Pay-out will be in compliance with any legal or regulatory guidelines. The Executive Committee of the Board meets early spring each year to review Executive Compensation. The status of the VP's meeting their goals is discussed at that time and whether they will receive their incentive pay. Description of Classes of Members or Stockholders Form 990, Part VI, Line 6 Indiana University Health Bedford has one member which is Indiana University Health, Inc. Description of Classes of Persons and the Nature of Their Rights Form 990, Part VI, Line 7a The Directors serving on the Board of Directors have the right to nominate prospective directors for six positions. The Physicians constituting the Corporation's Clinic Physician Group have the right to nominate the two Director positions. The Member shall nominate the three remaining prospective Directors of the Board. After viewing the nominations of the prospective Directors as set forth above, the Member shall elect the Board of Directors. The President and CEO is also appointed by the Member. Descr Classes of Persons, Decisions Requiring Appr & Type of Voting Rights Form 990, Part VI, Line 7b A) Adoption and amendment of the Articles and Bylaws of the Corporation B) Adoption, Interpretation and change of any statement of the Mission or Purposes of the Corporation, C) Adoption of any material changes in the services provided by the corporation; D) The appointment or removal of the Chief Executive Officer of the Corporation; E) Adoption, interpretation or change of the Strategic Plan of the corporation; F) Incurrence of debt or execution of any debt instrument that is not approved in the annual or operating budgets; G) Adoption and Change of the annual Operating and Capital Budgets; H) Acquisition, sale, lease, transfer or alienation of any corporation assets other than in the usual and regular course of the Corporation's business when such acquisition, sale, lease, transfer or alienation is outside the terms of the annual operating or capital budget previously approved by the Member. I) Participation of the Corporation in Healthcare Networks, Alliances or other Healthcare Delivery Systems; and (J) Adoption and change of any Managed Care or Third Party Payor contracts, whether new or renewal. Describe the Process used by Management &/or Governing Body to Review 990 Form 990, Part VI, Line 11b Management will provide a copy of the return to the members of the Finance Committee of the Board and review the return with the Committee before the 990 is filed with the IRS. Description of Process to Monitor Transactions for Conflicts of Interest Form 990, Part VI, Line 12c The IU Health Bedford, Inc. Bylaws requires each Director and Officer of the corporation to refrain from participation in any discussion, evaluation, or approval of a transaction involving the corporation in which the Director or Officer (or immediate family member) has a financial interest or professional interest which impairs the good faith discharge of his or her duty of loyalty. Annually each Director or Officer is required to execute a Standard of Conduct and Conflict of interest statement and certify to the Corporation that no conflict of interest exists which would substantially impair that Person's overall ability to fulfill his or her duty of loyalty to the Corporation. In addition to the annual Conflict of Interest Statement, each Director and Officer has a duty to disclose any potential conflict of interests arising from a transaction arrangement to be considered by the Board of Directors at any meeting where the transaction is discussed or voted upon. Disclosure of the material facts underlying the potential conflict of interest shall be submitted in writing to the Chairman and included in the minutes of the meeting. The Director or Officer submitting such a disclosure is required to leave the meeting while his or her disclosure is discussed. The remaining Directors must make a determination by a majority vote as to whether the material facts constitute a conflict of interest. Any Director or Officer who is determined to have a conflict of interest with regard to any transaction or arrangement shall not be entitled to attend any portion of a meeting in which the matter is discussed or voted upon. The Board may take disciplinary action with regard to a violation of the conflict of interest policy, including the removal of the Director or Officer. Senior Management and Department Directors are also required to sign an annual conflict of interest statement, disclosing any potential conflicts of interest. Process for Determining Compensation for CEO Form 990, Part VI, Line 15a Our CEO is an Employee of Indiana University Health. We are billed monthly for his services. Process for Determining Compensation for Other Officers or Key Employees Form 990, Part VI, Line 15b The evaluation of salaries for Executives and key employees occurs annually. Data is submitted to the Indiana Hospital Association Salary Survey in April and a comparison survey of other Indiana Hospitals is returned. CEO approves the salary amount. Information on compensation for the CEO is provided to the Board Executive Committee. Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public Form 990, Part VI, Line 19 The organizing documents, financial statements and conflict of interest policy are made available to the public upon written request or by a requesting person. 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