INDIANA UNIVERSITY HEALTH BLOOMINGON INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
INDIANA UNIVERSITY HEALTH BLOOMINGON INC (EIN 35-1720796)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201143189349305849
Schema version
2010v3.4
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)
Timestamp2011-11-14T15:41:35-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11100 HUNTINGTON CTR 41 S HIGH STAddressLine1
CityCOLUMBUSCity
StateOHState
ZIP Code43215ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN351720796EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1INDIANA UNIVERSITY HEALTH BLOOMINGTON INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlINDINameControl
Phone8123539551Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1149AddressLine1
CityBLOOMINGTONCity
StateINState
ZIP Code47403ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJames MyersName
TitleCFOTitle
Date Signed2011-11-14DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone6142245678Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARK E MOORE CEONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1149AddressLine1
CityBLOOMINGTONCity
StateINState
ZIP Code474021149ZIPCode
FieldValueIRS element (for citing)
Gross Receipts333469422GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.IUHEALTHBLOOMINGTON.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1988YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission Descriptionindiana university health bloomington's mission is to ImPROVE the health of our patients and community through innovation and excellence in care, education, research and service.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees3169TotalNbrEmployees
Total Nbr Volunteers450TotalNbrVolunteers
Total Gross UBI5663285TotalGrossUBI
Contributions Grants Prior Year1599834ContributionsGrantsPriorYear
Contributions Grants Current Year2033914ContributionsGrantsCurrentYear
Program Service Revenue Prior Year314008300ProgramServiceRevenuePriorYear
Program Service Revenue CY325151744ProgramServiceRevenueCY
Investment Income Prior Year-6999800InvestmentIncomePriorYear
Investment Income Current Year5996039InvestmentIncomeCurrentYear
Other Revenue Prior Year64888OtherRevenuePriorYear
Other Revenue Current Year54752OtherRevenueCurrentYear
Total Revenue Prior Year308673222TotalRevenuePriorYear
Total Revenue Current Year333236449TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year94954GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY57500GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year151700057SalariesEtcPriorYear
Salaries Etc Current Year164731426SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year145491108OtherExpensePriorYear
Other Expenses Current Year144435964OtherExpensesCurrentYear
Total Expenses Prior Year297286119TotalExpensesPriorYear
Total Expenses Current Year309224890TotalExpensesCurrentYear
Revenues Less Expenses Prior Year11387103RevenuesLessExpensesPriorYear
Revenues Less Expenses CY24011559RevenuesLessExpensesCY
Total Assets BOY307022525TotalAssetsBOY
Total Assets EOY331749624TotalAssetsEOY
Total Liabilities BOY108713175TotalLiabilitiesBOY
Total Liabilities EOY104731787TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY198309350NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY227017837NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionINDIANA UNIVERSITY HEALTH BLOOMINGTON'S MISSION IS TO IMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITY THROUGH INNOVATION AND EXCELLENCE IN CARE, EDUCATION, RESEARCH, AND SERVICE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense177940065Expense
Revenue217041001Revenue
DescriptionINPATIENT AND OUTPATIENT ANCILLARY MEDICAL SERVICES, INCLUDING LABORATORY, RADIOLOGY AND OTHER IMAGING SERVICES, PHARMACEUTICALS, RESPIRATORY AND REHABILITATION SERVICES, 24-HOUR EMERGENCY DEPARTMENT AND AMBULANCE SERVICES, AND A FULL RANGE OF CARDIAC SERVICES, AMONG OTHERS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense51633550Expense
Revenue62979618Revenue
DescriptionINPATIENT AND OUTPATIENT SURGICAL SERVICES: INDIANA UNIVERSITY Health BLOOMINGTON (IUHB)PERFORMED A TOTAL OF 4,269 INPATIENT AND 7,559 OUTPATIENT SURGICAL PROCEDURES DURING 2010. PLEASE SEE SCHEDULE O FOR ADDITIONAL INFORMATION CONCERNING IUHB'S PROGRAM SERVICES.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense26102072Expense
Revenue31837798Revenue
DescriptionACUTE INPATIENT MEDICAL CARE, REPRESENTING THE SERVICES PROVIDED TO TO A TOTAL OF 13,255 ADULT AND PEDIATRIC INPATIENTS AND 1,977 NEWBORN INFANTS DURING 2010. IUHB PROVIDES A RANGE OF COMPLEX MEDICAL CARE INCLUDING ORTHOPEDIC, POST-SURGICAL, CARDIAC, INTENSIVE CARE, AND PSYCHIATRIC SERVICES. PLEASE SEE SCHEDULE O FOR ADDITIONAL INFORMATION CONCERNING IUHB'S PROGRAM SERVICES.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp5190477TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt57500TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev6237597TotalOfOtherProgramServiceRev
Total Program Service Expense260866164TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiestrueForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedfalseFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredfalseScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With1096278NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees3169NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJAMES J MYERS CFONamePerson
Telephone Number8123539551TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1BLOOMINGTON HOSP PO BOX 1149AddressLine1
CityBLOOMINGTONCity
StateINState
ZIP Code474021149ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (34 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
MOYA ANDREWS
DIRECTOR2.0X000
BRAD BOMBA JR MD
DIRECTOR2.0X000
MARK BRADFORD
DIRECTOR2.0X000
SANDY DEWEESE
DIRECTOR2.0X000
DANIEL EVANS JR
DIRECTOR2.0X01252646828133
JIM FARIS MD
DIRECTOR2.0X000
KAREN HANSON
DIRECTOR2.0X000
WILLIAM HUNT
DIRECTOR2.0X000
CHRIS KROLL
DIRECTOR2.0X000
LEE MARCHANT
DIRECTOR2.0X000
CHARLES MCKEEN MD
DIRECTOR2.0X000
BRUCE MONSON
DIRECTOR2.0X000
JIM PERIN
DIRECTOR2.0X000
DANIEL PETERSON
DIRECTOR2.0X000
JOYCE POLING
DIRECTOR2.0X000
ELLIE ROGERS
DIRECTOR2.0X000
SUSAN WIER
DIRECTOR2.0X000
LINDA WILLIAMSON
DIRECTOR2.0X000
ANN WRENN
DIRECTOR2.0X000
MARK MOORE
CHIEF EXECUTIVE OFFICER50.05683870162455X
JAMES MYERS
CHIEF FINANCIAL OFFICER50.0307555088860X
RUTH ANN MORRIS
CHIEF NURSING OFFICER50.0257010078145X
L GENE PERRY
VP, RETIRED MAY 20108.0247553011303X
LARRY BAILEY
vice president10.0253911050492X
MARK MCMATH
CHIEF INFORMATION OFFICER50.0208553050522X
MARK CRAIN
VICE PRESIDENT50.0189983046506X
STEVEN DECKARD
VICE PRESIDENT50.0206899047121X
KENNETH MARSHALL MD
CHIEF MEDICAL OFFICER50.0268908054888X
F BRIAN WHITMAN
VICE PRESIDENT50.0160513028392X
AMARTYADEB GOSWAMI MD
HOSPITALIST PHYSICIAN40.0298216029453X
LEE MCKINLEY MD
PHYSICIAN40.0265935048088X
JOHN STEARLEY MD
PHYSICIAN40.0259494038547X
CHARLES MCCALLA MD
PHYSICIAN40.0241849039358X
A PERRY GRIFFITH MD
PSYCHIATRIST40.0235216028709X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3969982TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1252646TotalReportableCompFrmRltdOrgs
Total Other Compensation1630972TotalOtherCompensation
Number Individuals GT100 K107NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
INTERNAL MEDICINE ASSOCIATES
550 LANDMARK AVENUEBLOOMINGTONIN474020550MEDICAL SERVICES1764264
MAYO MEDICAL LABORATORIES
P O BOX 9146MINNEAPOLISMN554809146MEDICAL LABORATORY898763
BLOOMINGTON ANESTHESIOLOGISTS
P O BOX 2121 DEPT 1438MemphisTN381590001ANESTHESIOLOGY818735
SOUTHEASTERN IN HEALTH ORGANIZATON
417 WASHINGTON ST P O BOX 1787ColumbusIN472021787INS CLAIM PROCESSING790193
BLOOMINGTON OPERATING ROOM MGMT ASS
P O BOX 1149BLOOMINGTONIN474021149MEDICAL SERVICES774583
FieldValueIRS element (for citing)
Number Of Contractors GT100 K31NumberOfContractorsGT100K
Related Organizations273612RelatedOrganizations
Government Grants1760302GovernmentGrants
Total Contributions2033914TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
NET PATIENT SERVICE REVENUE900099288384525288384525
NET LABORATORY PATIENT REVENUE62150029047665234738925573773
CAFETERIA REVENUE7222101447197$1,447,197
JOINT VENTURE INCOME90009918380601838060
RELATED RENTAL REVENUE531120538250538250

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column3896047TotalRevenueColumn
Related Or Exempt Function Income3861287RelatedOrExemptFunctionIncome
Unrelated Business Revenue34760UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue325151744TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column49161TotalRevenueColumn
Exclusion$49,161ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real270527Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real215775Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real54752Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column54752TotalRevenueColumn
Unrelated Business Revenue54752UnrelatedBusinessRevenue

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities5922676Securities
Other41400Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other17198Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities5922676Securities
Other24202Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column5946878TotalRevenueColumn
Exclusion$5,946,878ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column333236449TotalRevenueColumn
Related Or Exempt Function Income318096014RelatedOrExemptFunctionIncome
Unrelated Business Revenue5663285UnrelatedBusinessRevenue
Exclusion$7,443,236ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total57500Total
Program Services57500ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3287956Total
Program Services1922507ProgramServices
Management And General1365449ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total79430Total
Program Services58125ProgramServices
Management And General21305ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total120942738Total
Program Services104448354ProgramServices
Management And General16494384ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total7984245Total
Program Services6835767ProgramServices
Management And General1148478ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total23659330Total
Program Services20256102ProgramServices
Management And General3403228ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total8777727Total
Program Services7515113ProgramServices
Management And General1262614ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1879977Total
Program Services929843ProgramServices
Management And General950134ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total311347Total
Management And General311347ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total340446Total
Management And General340446ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total430572Total
Management And General430572ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total9709604Total
Program Services7578086ProgramServices
Management And General2131518ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1842594Total
Management And General1842594ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total60948341Total
Program Services52420600ProgramServices
Management And General8527741ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2980517Total
Program Services2384414ProgramServices
Management And General596103ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5710503Total
Program Services4374748ProgramServices
Management And General1335755ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total398813Total
Program Services246189ProgramServices
Management And General152624ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total2915922Total
Program Services2538160ProgramServices
Management And General377762ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total17275480Total
Program Services12517439ProgramServices
Management And General4758041ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2071880Total
Program Services1657504ProgramServices
Management And General414376ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBTS2358727323587273
MAINTENANCE AGREEMENTS58291975040486788711
UNRELATED BUSINESS INCOME TAX493998493998
PURCHASED REPAIR SERVICES15257981137623388175
PURCHASED LABORATORY SERVICES14995291499529

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total4684173Total
Program Services3860802ProgramServices
Management And General823371ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total309224890Total
Program Services260866164ProgramServices
Management And General48358726ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

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BOY65414BOY
EOY55578EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

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BOY31797823BOY
EOY41323166EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1421229BOY
EOY1726640EOY

Accounts Receivable AccountsReceivable

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BOY35891772BOY
EOY39116988EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5140284BOY
EOY4942153EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4083108BOY
EOY4474441EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis347188704LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec223652396LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY132115369BOY
EOY123536308EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY84821945BOY
EOY101783826EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY2137514BOY
EOY2485222EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY9548067BOY
EOY12305302EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY307022525BOY
EOY331749624EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY27549514BOY
EOY33415710EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY60778BOY
EOY91378EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY52555434BOY
EOY48213743EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY12051389BOY
EOY7295548EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY16496060BOY
EOY15715408EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY108713175BOY
EOY104731787EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY194200605BOY
EOY222704136EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3474314BOY
EOY3679220EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY634431BOY
EOY634481EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY198309350BOY
EOY227017837EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY307022525BOY
EOY331749624EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses24011559ReconcilationRevenueExpenses
Reconcilation Other Changes4696928ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis14453926OtherCostOrOtherBasis
Book Value14453926BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis146116881OtherCostOrOtherBasis
Depreciation84995974Depreciation
Book Value61120907BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis5823362OtherCostOrOtherBasis
Depreciation3891380Depreciation
Book Value1931982BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis176722451OtherCostOrOtherBasis
Depreciation133532629Depreciation
Book Value43189822BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4072084OtherCostOrOtherBasis
Depreciation1232413Depreciation
Book Value2839671BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings123536308TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
ACCRUED DEFINED BENEFIT PENSION LIABILITY$10,339,177
ESTIMATED MEDICARE/MEDICAID SETTLEMENT$3,831,556
ACCRUED MALPRACTICE LIABILITY$1,544,675
FieldValueIRS element (for citing)
Total Of Amounts15715408TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierASC 740 DisclosureIdentifier
Return ReferenceSch D, Pt X, Line 2ReturnReference
ExplanationINDIANA UNIVERSITY HEALTH BLOOMINGTON, INC. is a subsidiary in the consolidated financial statements of Indiana University Health ,INC. (fka Clarian Health Partners, Inc.). Indiana University Health adopted asc 740 in 2007. No disclosures were required IN 2010 under GAAP as Indiana University Health, INC. does not have any material tax contingencies that required disclosures in the footnotes.Explanation

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCentral America and the CaribbeanRegion
Type Of Activities ConductedInvestmentsTypeOfActivitiesConducted
Total Expenditures3985006TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Amount Spent3985006SubtotalAmountSpent
Total Amount Spent3985006TotalAmountSpent
Transfer To Foreign CorpfalseTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorpfalseOwnForeignCorp
Passive Foreign Invest CofalsePassiveForeignInvestCo
Foreign PartnershipfalseForeignPartnership
Boycott CountriesfalseBoycottCountries

Form990 Schedule F Part V Form990ScheduleFPartV

FieldValueIRS element (for citing)
IdentifierOrganization's Procedures for Monitoring Use of Grant Funds Outside the USIdentifier
Return ReferenceSchedule F, Part VReturnReference

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served10180PersonsServed
Total Community Benefit Expense9713969TotalCommunityBenefitExpense
Net Community Benefit Expense9713969NetCommunityBenefitExpense
Percent Of Total Expense0.03400PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served33228PersonsServed
Total Community Benefit Expense29508996TotalCommunityBenefitExpense
Direct Offsetting Revenue13365299DirectOffsettingRevenue
Net Community Benefit Expense16143697NetCommunityBenefitExpense
Percent Of Total Expense0.05650PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Persons Served3327PersonsServed
Total Community Benefit Expense3123986TotalCommunityBenefitExpense
Direct Offsetting Revenue2351125DirectOffsettingRevenue
Net Community Benefit Expense772861NetCommunityBenefitExpense
Percent Of Total Expense0.00270PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served46735PersonsServed
Total Community Benefit Expense42346951TotalCommunityBenefitExpense
Direct Offsetting Revenue15716424DirectOffsettingRevenue
Net Community Benefit Expense26630527NetCommunityBenefitExpense
Percent Of Total Expense0.09320PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served54483PersonsServed
Total Community Benefit Expense1283931TotalCommunityBenefitExpense
Direct Offsetting Revenue15415DirectOffsettingRevenue
Net Community Benefit Expense1268516NetCommunityBenefitExpense
Percent Of Total Expense0.00440PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Persons Served3171PersonsServed
Total Community Benefit Expense463226TotalCommunityBenefitExpense
Direct Offsetting Revenue3200DirectOffsettingRevenue
Net Community Benefit Expense460026NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Persons Served16586PersonsServed
Total Community Benefit Expense21897098TotalCommunityBenefitExpense
Direct Offsetting Revenue15704431DirectOffsettingRevenue
Net Community Benefit Expense6192667NetCommunityBenefitExpense
Percent Of Total Expense0.02170PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Persons Served12602PersonsServed
Total Community Benefit Expense118163TotalCommunityBenefitExpense
Net Community Benefit Expense118163NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served86842PersonsServed
Total Community Benefit Expense23762418TotalCommunityBenefitExpense
Direct Offsetting Revenue15723046DirectOffsettingRevenue
Net Community Benefit Expense8039372NetCommunityBenefitExpense
Percent Of Total Expense0.02810PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served133577PersonsServed
Total Community Benefit Expense66109369TotalCommunityBenefitExpense
Direct Offsetting Revenue31439470DirectOffsettingRevenue
Net Community Benefit Expense34669899NetCommunityBenefitExpense
Percent Of Total Expense0.12130PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Persons Served25PersonsServed
Total Community Building Expense1778TotalCommunityBuildingExpense
Net Community Building Expense1778NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Persons Served4835PersonsServed
Total Community Building Expense46343TotalCommunityBuildingExpense
Net Community Building Expense46343NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Persons Served1985PersonsServed
Total Community Building Expense64680TotalCommunityBuildingExpense
Net Community Building Expense64680NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Persons Served6845PersonsServed
Total Community Building Expense112801TotalCommunityBuildingExpense
Net Community Building Expense112801NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$9,452,482BadDebtExpenseAmount
Amount Attributable To4500675AmountAttributableTo
Amount Reimbursed By Medicare70246284AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare86972318CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-16726034MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (3 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
S In Surgery cntr
outpatient surgery0.450000.55000
S In Radiology cntr
radiological0.500000.50000
Bloomington endo cnt
gastrointestional treatment0.510000.49000
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Indiana university Health BloomingtonBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1601 WEST SECOND STREETAddressLine1
CityBLOOMINGTONCity
StateINState
ZIP Code474032317ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Indiana university Health BloomingtonBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities27NumberOfOtherFacilities

Other Facilities OtherFacilities (27 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
IU HEALTH CANCER RADIATION CENTER
2620 COTA DRIVEBLOOMINGTONIN47403OUTPATIENT FACILITY
SOUTHERN INDIANA SURGERY CENTER LLC
2800 REX GROSSMAN BLVDBLOOMINGTONIN47403OUTPATIENT SURGERY CENTER
IU HEALTH EMERGENCY TRANSPORT SERVICES
601 WEST SECOND STREETBLOOMINGTONIN474032317AMBULANCE SERVICES
IU HEALTH HOME CARE
333 EAST MILLER DRBLOOMINGTONIN47401HOME HEALTH SERVICES
IU HEALTH HOSPICE
619 WEST FIRST STREETBLOOMINGTONIN47403HOSPICE SERVICES
IU HEALTH REHAB AND SPORTS MED CENTER
2499 WEST COTA DRIVEBLOOMINGTONIN474034217OUTPATIENT FACILITY
IU HEALTH PAIN CENTER
888 AUTO MALL ROADBLOOMINGTONIN47401OUTPATIENT FACILITY
IU HEALTH REHAB AND SPORTS MED CENTER
328 SOUTH WOODCREST DRBLOOMINGTONIN47401OUTPATIENT FACILITY
IU HEALTH URGENT CARE
326 SOUTH WOODCREST DRIVEBLOOMINGTONIN47401URGENT CARE CLINIC
IU HEALTH CANCER RADIATION CENTER
ROUTE 11 STATE RD 37 PO BOX 493BEDFORDIN47421RADIATION SERVICES
IU BEHAVIORAL HEALTH
445 S LANDMARK AVEBLOOMINGTONIN47403BEHAVIORAL HEALTH CENTER
IU HEALTH WOUND CENTER
2920 MCINTIRE DRIVEBLOOMINGTONIN47403WOUND CARE CENTER
IU HEALTH CHILDREN'S THERAPY CENTER
350 LANDMARK AVE SUITE BBLOOMINGTONIN47403OUTPATIENT FACILITY
IU HEALTH URGENT CARE
3443 WEST THIRD STREETBLOOMINGTONIN47404URGENT CARE CENTER
IU HEALTH HOME MEDICAL EQUIPMENT
1355 WEST BLOOMFIELD RD SUITE 4BLOOMINGTONIN47403DURABLE MEDICAL EQUIPMENT CNTR
IU HEALTH REHAB AND SPORTS MED CENTER
5 CRANE AVESPENCERIN47460OUTPATIENT FACILITY
IU HEALTH ANTICOAGULATION CENTER
451 LANDMARK AVEBLOOMINGTONIN47403LABORATORY CENTER
IU HEALTH REHAB AND SPORTS MED CENTER
2125 SOUTH HIGHLAND AVEBLOOMINGTONIN474016773OUTPATIENT FACILITY
IU HEALTH DIABETES CENTER
220 WEST ALLEN STBLOOMINGTONIN47403OUTPATIENT FACILITY
IU CHEST PAIN CENTER
714 SOUTH ROGERS STBLOOMINGTONIN47403OUTPATIENT FACILITY
IU HEALTH URGENT CARE
8695 WEST JACK CARNES WAYFRNECH LICKIN47432URGENT CARE CLINIC
IU HEALTH CARDIOPULMONARY REHAB
5 CRANE WAYSPENCERIN47460OUTPATIENT FACILITY
IU HEALTH CARDIOPULMONARY REHAB
103 WILLOW STNASHVILLEIN47448OUTPATIENT FACILITY
iu HEALTH BLOOMINGTON COMM HEALTH SVCS
333 EAST MILLER DRBLOOMINGTONIN47401COMMUNITY HEALTH SERVICES
IU HEALTH BLOOMINGTON OFFSITE LAB (MEDIC
2029 MCINTIRE DRIVEBLOOMINGTONIN47403OFF SITE LAB SERVICES
IU HEALTH BLOOMINGTON
2920 MCINTIRE DRIVEBLOOMINGTONIN47403outpatient facility
SOUTHERN INDIANA RADIOLOGICAL
500 LANDMARK DRIVEBLOOMINGTONIN47403RADIOLOGICAL services

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
CHARITY CAREParT I, LINE 3CThe Indiana University Health Bloomington Hospital makes charity care determinations based upon patients' liquid asset and income levels. The Hospital calculates a patient's total available funds by adding annual income and liquid assets, and then subtracting 200% of the Federal Poverty Guidelines for the family size. The difference between the billed charges and the total available funds to pay the hospital is adjusted off to charity.
community benefit reportingpart I, line 6aThe Indiana University Health Bloomington Hospital reports its community benefit investments and initiative highlights in two separate reports. First, the Hospital prepares a separate community benefit report that only reflects community benefit activities occurring under its tax identification number. In addition, the Indiana University Health statewide system publishes an annual Community Benefit Report that encompasses the community benefit activities of all of its statewide facilities.
financial assistance and certain other community benefits at costPart I, Line 77g. In accordance with the instructions, the Indiana University Health Bloomington Hospital identified subsidized health services as services that were provided at a financial loss and would no longer be offered in the community if the Hospital discontinued the service. The Hospital did not include any costs attributable to a physician clinic as subsidized health services. 7 col (f). When computing the denominator to use in the "Percent of total expense" calculation, the Indiana University Health Bloomington Hospital removed $23,587,273 of bad debt expense from the total expense reported on Form 990, Part IX, line 25, column (A). 7. The Indiana University Health Bloomington Hospital used a hospital-wide cost-to-charge ratio to calculate the cost of providing services to charity care patients. Department-specific cost-to-charge ratios from the Hospital's Medicare cost report were used to calculate the cost of Medicaid services, Healthy Indiana Plan services, and subsidized health services. Actual direct costs plus an indirect cost factor from the Medicare cost report was used to calculate the cost of community health improvement services, health professions education, and contributions to community groups.
community building activitiespart iiThe IU Health Bloomington Hospital provides financial and in-kind support to community agencies and programs that benefit the well-being of the community. This community support is provided to such programs as Leadership Bloomington. The IU Health Bloomington Hospital also improves the health of its community through collaborations and partnerships such as the Active Living Coalition and the Active Aging Coalition. The Active Living Coalition is comprised of individuals and organizations representing community sectors of health care, education, city government, county government, business, and service organizations who are addressing the public health issue of physical inactivity. The Coalition strives to increase the number of people who engage in a healthy, physically active lifestyle through collaborative efforts on community events, research, networking and programming that leads to increased physical activity opportunities for all who reside in Monroe County. This program is offered at no charge to the participants who are referred by their healthcare practitioner. The Active Aging Coalition is a grassroots networking organization consisting of seniors and the businesses and non-profit organizations who serve them. The goal of the Coalition is to identify specific areas of need impacting seniors and create focus groups to work on these areas. Finally, the IU Health Bloomington Hospital improves long-term access to healthcare in the community by working with educational institutions to host career days and place students in job shadowing opportunities in its facility.
bad debt, medicare & collection practicespart iii, line 4The Indiana University Health Bloomington Hospital applied a hospital-wide cost-to-charge ratio to the bad debt expense to calculate the cost of providing these services. Below is the footnote to the organization's financial statements that describes how the organization determines the provision for uncollectible patient accounts: "Summary of Significant Accounting Policies" Accounts Receivable and Allowance for Uncollectible Accounts IU Health Bloomington and its affiliates extend credit to patients, substantially all of whom are residents of the state of Indiana, and do not require collateral or other security for the delivery of healthcare services. However, assignment of benefit payments payable under patients' health insurance programs and plans (e.g., Medicare, Medicaid, health insurance organizations, and commercial insurance policies) is routinely obtained, consistent with industry practice. The provision for uncollectible patient accounts is based upon management's assessment of historical and expected net collections considering business and economic conditions, trends in healthcare coverage, and other collection indicators. Management routinely assesses the adequacy of the allowance for uncollectible accounts based upon accounts receivable payer composition and aging, and historical write-off experience by payer category as adjusted for collection indicators. In addition, IU Health Bloomington follows established guidelines for placing certain past due patient balances with collection agencies, which are charged against the allowance for uncollectible accounts in accordance with the collection policies of IU Health Bloomington." Methodology - Bad Debt Expense (at Cost) Likely Eligible for Charity Care The Hospital used 2000 and 2010 census data to estimate the percentage of its patient population whose household income was under its full charity care eligibility criteria of 200% of the Federal Poverty Guidelines (FPG). This percentage was applied to the Hospital's charges to estimate the amount of gross charges that met its financial assistance guidelines. The Hospital then subtracted the charges relating to patients that were eligible for governmental assistance programs such as Medicaid and the Healthy Indiana Plan. Hospital charity care adjustments were also removed because they too would not have resulted in bad debts. The remaining charges related to uninsured patients with household incomes below 200% of the FPG, and it is reasonable to assume that they resulted in Hospital bad debts. This total was then multiplied by the ratio of costs-to-charges from Worksheet 2 to calculate the cost of providing these services. The Hospital's methodology most likely resulted in a conservative estimate because it excluded the patients above 200% of the FPG that were eligible for partial charity assistance. Therefore, the figure reported on Part III, Line 3 likely understates the amount of bad debt expense could have qualified for charity assistance had the Hospital received a charity care application.
bad debt, medicare & collection practicespart iii, line 8Department-specific cost-to-charge ratios from the Hospital's Medicare cost report were used to calculate the cost of Medicare services. The Medicare costs of services included in Part I as "Subsidized Health Services" were then removed to ensure that costs were not double counted on Schedule H. In accordance with the Schedule H instructions, the IU Health Bloomington Hospital only included the allowable costs and net Medicare collections that were reported in the Hospital's Medicare cost report. Therefore, this figure excluded substantial Medicare shortfalls that resulted from providing ambulance, clinical laboratory, therapy, and Medicare Part C services. The Hospital believes that its entire Medicare shortfall should be considered a community benefit. In accordance with its mission, the hospital provides necessary healthcare services to all patients regardless of their insurance status or ability to pay. Services are provided to Medicare patients even though the Hospital understands that the resulting reimbursement will not be enough to cover the full cost of providing these services. Medicare beneficiaries benefit from the Hospital providing these services at a financial loss, and the Hospital feels that this benefit should be included in reports provided to the community.
bad debt, medicare & collection practicespart iii, line 9Accounts that are approved for charity care assistance are immediately written-off and all collection efforts are ceased.
community needs health assessmentPt VI, Line 2The IU Health Bloomington Hospital utilizes a variety of tools to assess the health care needs of its service area. These techniques include analyzing data from admission and diagnosis codes, reviewing emergency department statistics, and partnering with local agencies such as the Health Department, United Way, Indiana University, and City of Bloomington Parks and Recreation. The Hospital uses the results of its needs assessment to target its community benefit activities.
Patient education of eligibility for assistancepart vi, line 3The IU Health Bloomington Hospital employs a patient financial services (PFS) team of case workers and financial assistance representatives to educate patients about governmental assistance programs and the Hospitals internal financial assistance program. Uninsured patients are screened for eligibility for financial assistance, and, if eligible, the PFS team reaches out to the patients with education on the appropriate assistance program. This education takes place via room visits to uninsured inpatient patients and discussions in the emergency department with uninsured outpatient patients. The PFS team also screens Medicare patients for their ability to qualify for Medicaid or charity care assistance. The PFS team assists patients in completing the Medicaid, Healthy Indiana Plan, and charity application paperwork and serves as their advocates throughout the application process. This advocacy can extend as far as attending a courtroom hearing in support of a patients Medicaid eligibility appeal if his or her application is originally denied by the State. The Hospital also notifies patients of financial assistance programs at other points during the revenue cycle. For example, Hospital staff alert patients to financial assistance programs during pre-hospitalization charge estimate requests and post-hospitalization billing inquiries. The Hospital goes to extraordinary measures to educate and assist patients regarding the financial assistance programs that are potentially available to them. The IU Health Bloomington Hospital has also funded an extensive outreach program to raise awareness of and enrollment in Indianas state sponsored health insurance program (the Healthy Indiana Plan). The Hospital employs two Healthy Indiana Plan (HIP) Enrollment Coordinators whose primary responsibility is to promote the HIP program within its service area. The Hospital promotes this program through direct mailings, newspaper advertisements, HIP enrollment events, and other events within the community. The HIP Enrollment Coordinators meet with patients that need assistance completing Healthy Indiana Plan applications and are available to answer any questions that may arise during the application process. This tremendous outreach initiative demonstrates the Hospitals commitment to educating its patient base about the financial assistance programs that are available within the community.
community informationpart vi, line 4The IU Health Bloomington Hospital is located in Monroe County and serves as a regional referral center for its ten county service area. Monroe County is located in south central Indiana and has a population of 137,974. The other nine counties in the Hospitals service area are comprised of primarily rural communities. Bloomington is the largest town in Monroe County with a population of 69,247. The largest ethnic population in Monroe County is white (87.8%), followed by the Asian (5.2%), Black (3.3%), two or more race groups (2.5%) and American Indian/Alaska Native (0.3%). Hispanics make up 2.9% of the population, with Non-Hispanics equaling 97.1%. Monroe County has a lower-than-average median household income of $36,061 and a higher-than-average poverty rate of 21.9 percent. Lack of income serves as a barrier to accessing nutritious food, physical activities and transportation to such resources. This situation is exacerbated in the more rural areas of Monroe County where there are few public transportation options. However, the county is resource-rich with a vibrant health care and social assistance network, extensive parks and recreation programs and facilities and home to Indiana Universitys main campus.
Promotion of community healthpart vi, line 5The IU Health Bloomington Hospital is involved in several initiatives to increase access to care within its community. In 2010, the Hospital opened a new primary care clinic that will provide five new family care healthcare practitioners to the community. This clinic will help meet the primary care shortage and access to care issues present in the community. In 2010, the Hospital also began plans for a second primary care facility to provide for the healthcare needs of Monroe County. The Hospital also financially supports the local Volunteers in Medicine uninsured clinic by providing free testing services, staff support, and board leadership. Furthermore, the Hospital provides support to community members undergoing cancer treatment by providing an educational resource and support center (Olcott Center) that is free of charge to the community. Finally, the Hospital serves as the sponsoring agency for the WIC program of Monroe and Greene Counties, the Monroe County Public Health Clinic, and the Positive Link HIV and AIDS awareness and care coordination program.
Affiliated health care systempart vi, line 6Indiana University Health is a comprehensive healthcare system comprised of numerous hospitals, physicians practices, and other healthcare facilities across the State. By coordinating care across a full continuum of services, the system is able to provide preeminent care to the residents of Indiana. Although each hospital in the system prepares its own community benefit plan relative to its respective community, IU Health considers its community benefit plan as an important part of an overall vision for strengthening the state's healthcare safety net.
STATE FILING OF COMMUNITY BENEFIT REPORT990 SCHEDULE H, PART VIIN,

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAddress Line2AddressUS/AddressLine2
AMERICAN HEART ASSOCIATION
460 N LINDBERGH BLVDST LOUISMO63141135613797501(c)(3)7500TO ASSIST IN AHA FUND RAISING EFFORTS IN THE BLOOMINGTON COMMUNITY
CITY OF BLOOMINGTON PARKS & RECREATION
PO BOX 848BLOOMINGTONIN47402356000954501(c)(6)25000TO UNDERWRITE HEALTH AND FITNESS PROGRAMS FOR THE BENEFIT OF BLOOMINGTON YOUTH
INDIANA AIDS FUND
429 E VERMONT STINDIANAPOLISIN46202356203550501(c)(3)11000TO UNDERWRITE THE DIAGNOSTIC AND HEALTH INITIATIVES OF THE INDIANA AIDS FUND.SUITE 300
MONROE COUNTY YMCA
2125 S HIGHLAND AVEBLOOMINGTONIN47401351384859501(c)(3)9000TO PARTNER WITH THE MONROE COUNTY YMCA TO HELP SCHOOL AGED CHILDREN UNDERSTAND THE IMPORTANCE OF A HEALTHY AND ACTIVE LIFESTYLE THROUGH A PROGRAM KNOWN AS ENERGIZE.
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants4TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierForm 990, Schedule IIdentifier
Return ReferenceDescription of Organization's Procedures for Monitoring the Use of GrantsReturnReference
ExplanationTHROUGH ITS OWN ACTIVE INVOLVEMENT IN THE PROGRAMS IT HELPS TO SUPPORT OR UNDERWRITE, INDIANA UNIVERSITY HEALTH BLOOMINGTON IS AWARE AT ALL TIMES OF THE PROGRAMS' ACTIVITIES. NONE OF THE COST CLAIMED ON FORM 990, SECTION IX, LINE 1 IS PROVIDED TO THE RECIPIENT AS A GRANT, BUT RATHER AS SUPPORT FOR SPECIFIC PROGRAMS OF WHICH IUHB IS A PARTICIPANT.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DANIEL EVANS JR
0981359021535805592908047850233480208077900
MARK MOORE
45677908049103111701486410138140730842000
JAMES MYERS
2407030447470221050763010125590396415000
RUTH ANN MORRIS
220520034906015840655360126090335155000
L GENE PERRY
820330284180137102078950340802588560833520
LARRY BAILEY
2090730321230127150326660178260304403000
MARK MCMATH
17810802989305520328050177170259075000
MARK CRAIN
1437970209120252740339610125450236489000
STEVEN DECKARD
172292026115084920345220125990254020000
KENNETH MARSHALL MD
26065800082500396880152000323796000
F BRIAN WHITMAN
135386020212049150160970122950188905000
AMARTYADEB GOSWAMI MD
2978560003600112500182030327669000
LEE MCKINLEY MD
26490300010320353650127230314023000
JOHN STEARLEY MD
210588047322015840257810127660298041000
CHARLES MCCALLA MD
216609000252400271090122490281207000
A PERRY GRIFFITH MD
2346640005520107960179130263925000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Supplemental Nonqualified Retirement PlanSchedule J, Part I, Line 4bAS PART OF THE EXECUTIVE COMPENSATION PLAN RECOMMENDED TO INDIANA UNIVERSITY HEALTH BLOOMINGTON BY A PROFESSIONAL COMPENSATION CONSULTING FIRM, THE HOSPITAL OFFERS TO ELIGIBLE SENIOR EXECUTIVES THE OPPORTUNITY TO PARTICIPATE IN A NON-QUALIFIED 457(F) DEFERRED COMPENSATION PLAN. FOLLOWING ARE THE PARTICIPANTS IN THE PLAN AND THE AMOUNTS THAT WERE CONTRIBUTED BY BOTH EMPLOYER AND EMPLOYEE DURING 2010. KENNETH MARSHALL, M.D. 28,438 EMPLOYER-PAID CONTRIBUTION TO 457(F) PLAN F. BRIAN WHITMAN 8,724 EMPLOYER-PAID CONTRIBUTION TO 457(F) PLAN MARK MOORE 114,730 EMPLOYER-PAID CONTRIBUTION TO 457(F) PLAN JAMES MYERS 39,775 EMPLOYER-PAID CONTRIBUTION TO 457(F) PLAN AND 16,500 EMPLOYEE-PAID CONTRIBUTION TO 457(F) PLAN RUTH ANN MORRIS 22,774 EMPLOYER-PAID CONTRIBUTION TO 457(F) PLAN L. GENE PERRY 7,895 EMPLOYER-PAID CONTRIBUTION TO 457(F) PLAN. ALSO DURING 2010, L. GENE PERRY RECEIVED A 457(F) PLAN PAY-OUT OF 89,746; OF THIS AMOUNT 83,352 HAD BEEN REPORTED AS DEFERRED COMPENSATION DURING TAX YEARS 2005 THROUGH 2009. LARRY BAILEY 21,416 EMPLOYER-PAID CONTRIBUTION TO 457(F) PLAN MARK MCMATH 22,979 EMPLOYER-PAID CONTRIBUTION TO 457(F) PLAN STEVEN DECKARD 7,372 EMPLOYER-PAID CONTRIBUTION TO 457(F) PLAN DANIEL EVANS, JR PARTICIPATES IN An INDIANA UNIVERSITY HEALTH, INC. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, PROVISIONS OF WHICH ARE DESIGNED TO RETAIN CRITICAL EMPLOYEES. THE PLAN PROVIDES FOR ADDITIONAL BENEFITS 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.
NON-FIXED PAYMENTS TO OFFICERS AND KEY EMPLOYEESSCHEDULE J, PART I, LINE 7ACCORDING TO THE HOSPITAL'S EXECUTIVE COMPENSATION PLAN, ANNUAL GOALS WILL BE SET FOR EACH MEMBER OF THE SENIOR LEADERSHIP GROUP, AND THE DEGREE OF SUCCESSFUL COMPLETION DETERMINED FOLLOWING THE END OF THE YEAR WILL DETERMINE THAT LEADER'S ANNUAL BONUS, IF ANY. ANY PAYOUTS WILL BE IN THE FORM OF A LUMP SUM AND WILL NOT AFFECT THE LEADER'S BASE PAY. THE LEADER MAY ELECT TO DEFER ANY OR ALL OF THE BONUS COMPENSATION THROUGH THE BLOOMINGTON HOSPITAL 457(F) PLAN, SUBJECT TO ANY PLAN RESTRICTIONS OR REQUIREMENTS. THE AMOUNT OF MERIT PAYMENT FOR THE CEO SHALL BE DETERMINED BY THE COMPENSATION COMMITTEE; ALL OTHER SENIOR LEADERS' PAYMENTS SHALL BE RECOMMENDED BY THE CEO TO THE COMPENSATION COMMITTEE FOR APPROVAL PRIOR TO ANY AWARD.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1hospital authority of monroe countyBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN000000000IssuerEIN
CUSIP Number000000000CUSIPNumber
Date Issued2006-02-16DateIssued
Issue Price19962132IssuePrice
Description Of PurposeTAX-EXEMPT EQUIPMENT LOANSDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds19962132TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds0IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures19962132CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent0AmountUnspent
Year Of Subst Completion2006YearOfSubstCompletion
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedfalseBondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
IdentifierTAX-EXEMPT EQUIPMENT LOANS (MASTER LEASE AND SUBLEASE AGREEMENT)Identifier
Return ReferenceSch K, Part VReturnReference
ExplanationSEE SCHEDULE O.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
MONROE BANK
see part v212671GEN. BANKING TRANSACTIONSfalse
BORMA
see part v774583MEDICAL SERV PROVIDERfalse
BELINDA CRAIN
see part v58125RELATIVE IS BH EMPLfalse
internal medical associates
see part v2369635medical servicesfalse
matthew crain
see part v21305RELATIVE IS BH EMPLfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierBUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONSIdentifier
Return ReferenceFORM 990, SCHEDULE L, PART IVReturnReference
ExplanationCHARLES MCKEEN, M.D., AN IUHB DIRECTOR, IS ALSO A MEMBER OF A MEDICAL PRACTICE, BLOOMINGTON OPERATING ROOM MANAGEMENT ASSOCIATES (BORMA), WITH WHOM THE HOSPITAL CONTRACTS FOR SURGICAL MANAGEMENT AND MEDICAL SERVICES. IUHB PAID THE MEDICAL GROUP BORMA, BUT NOT DR. MCKEEN DIRECTLY, A TOTAL OF $774,583 DURING 2010. BRAD BOMBA, M.D., AND JAMES FARIS, M.D., BOTH IUHB DIRECTORS, ARE MEMBERS OF A LARGE BLOOMINGTON MEDICAL PRACTICE, INTERNAL MEDICINE ASSOCIATES (IMA), LATER REORGANIZED AND RENAMED PREMIER HEALTHCARE LLC, WITH WHOM THE HOSPITAL CONTRACTS FOR A WIDE VARIETY OF MEDICAL SERVICES, INCLUDING BUT NOT LIMITED TO CARDIOLOGY AND HOSPITALIST COVERAGE. IUHB PAID IMA AND PREMIER HEALTHCARE, BUT NOT DRS. BOMBA AND FARIS DIRECTLY, A COMBINED TOTAL OF $2,369,635 DURING 2010. MARK BRADFORD, A BH DIRECTOR, IS PRESIDENT OF THE MONROE BANK, IUHB'S PRIMARY BANK. MONROE BANK FINANCED APPROXIMATELY $1.4 MILLION OF IUHB PATIENT ACCOUNTS RECEIVABLE DURING 2010, IN ADDITION TO PROVIDING CUSTOMARY COMMERCIAL BANKING SERVICES. fees paid to monroe bank in 2010 were $212,671. MARK CRAIN, AN IUHB KEY EMPLOYEE, IS THE FATHER-IN-LAW OF ANOTHER HOSPITAL EMPLOYEE, PHARMACIST BELINDA CRAIN, AND THE FATHER OF ANOTHER EMPLOYEE, INFORMATION TECHNOLOGY SUPPORT SPECIALIST MATTHEW CRAIN. BELINDA CRAIN WAS PAID A TOTAL OF $58,125 FOR THE HOURS THAT SHE WORKED FOR IUHB AS A PHARMACIST DURING 2010, AND MATTHEW CRAIN WAS PAID A TOTAL OF $21,305 FOR HIS HOURS WORKED IN IUHB INFORMATION SERVICES.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
dESCRIPTION OF OTHER PROGRAM SERVICESfORM 990, PART III, LINE 4DINDIANA UNIVERSITY HEALTH BLOOMINGTON'S (IUHB) PRIMARY REASON FOR EXISTENCE IS TO PROVIDE HIGH-QUALITY MEDICAL CARE FOR ITS COMMUNITY. TO ACCOMPLISH THIS END, THE HOSPITAL HAS INCURRED SIGNIFICANT EXPENSE TO ACQUIRE THE BEST MEDICAL SUPPLIES AND EQUIPMENT AVAILABLE. MEDICAL SERVICES, BOTH INPATIENT AND OUTPATIENT, ARE SUBJECT TO ONGOING IMPROVEMENT AND EXPANSION IN RESPONSE TO THE CHANGING NEEDS OF THE COMMUNITY. AS THE ONLY FULL-SERVICE MEDICAL/SURGICAL HOSPITAL IN MONROE COUNTY, IUHB PROVIDES SERVICES TO A LARGE POPULATION. RESIDENTS OF OWEN, BROWN, GREENE, AND LAWRENCE COUNTIES ARE ALSO SIGNIFICANT USERS OF THE HOSPITAL'S SERVICES. DURING THE FISCAL YEAR ENDING DECEMBER 31, 2010, IUHB DISCHARGED A TOTAL OF 13,323 ADULT AND PEDIATRIC INPATIENTS, AS WELL AS 1,982 NEWBORN INFANTS. IN ADDITION, APPROXIMATELY 887,000 MEDICAL PROCEDURES WERE PERFORMED FOR HOSPITAL OUTPATIENTS. SINCE ITS INCEPTION, IUHB HAS PROVIDED MEDICAL CARE TO ANY AND ALL PATIENTS PRESENTING THEMSELVES FOR SERVICE, REGARDLESS OF THEIR ABILITY TO PAY. THE VALUE OF FREE CARE PROVIDED TO PATIENTS WHO QUALIFIED FOR HOSPITAL CHARITY DURING FISCAL YEAR 2010 WAS $24,239,000; THE HOSPITAL IS ALSO A FULL PARTICIPANT IN PROVIDING CARE TO MEDICARE AND MEDICAID PATIENTS, AT REIMBURSABLE AMOUNTS FAR LOWER THAN ITS NORMAL CHARGES. DURING 2010, THE HOSPITAL WAS EXTREMELY SUCCESSFUL IN ENROLLING MEMBERS OF ITS COMMUNITY BOTH IN THE MEDICAID PROGRAM AND IN THE MORE RECENTLY CREATED STATE HEALTH CARE PROGRAM KNOWN AS THE HEALTHY INDIANA PLAN (HIP). ALTHOUGH REIMBURSEMENT TO THE HOSPITAL UNDER THESE PROGRAMS IS EXTREMELY LOW IN COMPARISON TO GROSS PATIENT CHARGES, THE ENROLLMENT ASSISTANCE PROVIDED TO INDIVIDUALS SHOULD BE VIEWED AS A COMMUNITY BENEFIT SINCE SUCCESSFUL ENROLLEES ARE THEN COVERED FOR MOST OTHER ESSENTIAL MEDICAL SERVICES FROM OTHER PROVIDERS THAN JUST THE HOSPITAL ITSELF. THE HOSPITAL IS ALSO AN ACTIVE PARTICIPANT IN A LOCAL PROGRAM KNOWN AS VOLUNTEERS IN MEDICINE (VIM), THROUGH WHICH IT PROVIDED FREE MEDICAL SERVICES VALUED AT MORE THAN $5 MILLION DURING 2010. IN ORDER TO PROMOTE GOOD HEALTH CARE AND TO EMPHASIZE THE IMPORTANCE OF PREVENTIVE MEDICINE, THE HOSPITAL OFFERS FREE LECTURES PRESENTED BY KNOWLEDGEABLE PROFESSIONALS TO THE BLOOMINGTON COMMUNITY. HISTORICALLY, THESE LECTURES, WHICH ARE HELD BOTH AT THE HOSPITAL AND THROUGHOUT THE SERVICE AREA, HAVE BEEN WELL ATTENDED AND WELL RECEIVED BY THE RESIDENTS OF MONROE AND SURROUNDING COUNTIES. TOPICS COVERED BY THESE FREE SEMINARS INCLUDE NUTRITION, DIABETES, OBESITY, AND CANCER PREVENTION, TO NAME ONLY A FEW. IN ADDITION TO PROVIDING EDUCATIONAL SESSIONS FOR SENIORS, THE HOSPITAL HAS ALSO DEVELOPED ITS SENIORITY PLUS PLAN, DESIGNED TO PROVIDE A FULL RANGE OF FREE SERVICE AND ADVICE TO THIS GROUP IN ADDITION TO EXTENSIVE DISCOUNT PROGRAMS THAT HAVE BEEN ARRANGED BY HOSPITAL STAFF ON BEHALF OF SENIORITY PLUS MEMBERS. IUHB IS ACTIVELY INVOLVED IN EDUCATION FOR STUDENTS ENROLLED IN VARIOUS POST-SECONDARY VOCATIONAL AND ACADEMIC PROGRAMS, INCLUDING, BUT NOT LIMITED TO, NURSING, RESPIRATORY THERAPY, CLINICAL INFORMATICS, SURGICAL TECHNOLOGY, EMERGENCY MEDICAL RESPONSE, CLINICAL ENGINEERING, PHARMACY, LABORATORY, AND FOOD AND NUTRITION SERVICES. ALSO TO FURTHER ITS EDUCATIONAL GOALS, THE HOSPITAL OFFERS CAREER COUNSELING TO LOCAL HIGH SCHOOLS AND JUNIOR HIGH SCHOOLS, EVEN PROVIDING A HEALTH CARE CAREER CAMP FOR STUDENTS DURING THE SUMMER MONTHS. THROUGH THIS PROCESS, THE HOSPITAL HOPES TO INFORM YOUNG PEOPLE OF LITTLE KNOWN WAYS IN WHICH ONE MAY SERVE WITHIN THE MEDICAL COMMUNITY. THROUGHOUT THE YEAR, IUHB HAS PROVIDED THE COMFORT OF VARIOUS COUNSELING AND SUPPORT GROUPS AT NO CHARGE TO ALL THOSE WHO NEED AND DESIRE THIS SERVICE, ADDRESSING SUCH ISSUES AS SMOKING CESSATION, DIABETES MANAGEMENT, AND COPING WITH THE LOSS OF A LOVED ONE. THE HOSPITAL HAS ALSO CONTRIBUTED TO THE SAFETY AND WELL BEING OF THE CHILDREN IN ITS COMMUNITY BY PROVIDING CAR SEAT SAFETY CHECKS, BICYCLE HELMETS, SUNSCREEN, AND LEAD TESTING, ALL WITHOUT CHARGE TO THE BENEFICIARIES.
Description of Classes of Members or StockholdersForm 990, Part VI, Question 6AS OF DECEMBER 31, 2009, INDIANA UNIVERSITY HEALTH, INC. IS THE SOLE MEMBER OF INDIANA UNIVERSITY HEALTH BLOOMINGTON, INC.
Description of Classes of Persons and the Nature of Their RightsForm 990, Part VI, Question 7aANY AMENDMENT THAT WOULD IN ANY WAY RELATE TO THE NUMBER OF DIRECTORS OF HOSPITAL, THE SOURCE OF THEIR APPOINTMENTS, THE PROVISION WITH RESPECT TO SUPERMAJORITY VOTING, THE PROVISIONS REGARDING THE COUNCIL'S COMMITTEE INVOLVEMENT OR PROVISIONS WITH RESPECT TO THE REMOVAL OF SUCH DIRECTORS, SHALL REQUIRE THE PRIOR APPROVAL OF INDIANA UNIVERSITY HEALTH, INC.
Descr Classes of Persons, Decisions Requiring Appr & Type of Voting RightsForm 990, Part VI, Question 7bNO ACTION OF THE HOSPITAL'S BOARD OR OF ANY OFFICER OR AGENT OF THE HOSPITAL REGARDING ANY MATTERS THAT ARE SUBJECT TO INDIANA UNIVERSITY HEALTH, INC.'S RESERVED POWERS SHALL HAVE ANY FORCE OR EFFECT WITHOUT PRIOR NOTICE TO AND THE WRITTEN APPROVAL OF INDIANA UNIVERSITY HEALTH, INC.
Describe the Process used by Management &/or Governing Body to Review 990Form 990, Part VI, Question 11BEGINNING IN 2011, FOR THE TAX YEAR ENDED 12/31/2010, INDIANA UNIVERSITY HEALTH BLOOMINGTON PROVIDED A CONFIDENTIAL AND SECURE WEB SITE ACCESSIBLE TO MEMBERS OF ITS BOARD OF DIRECTORS, ON WHICH A COMPLETE COPY OF ITS IRS FORM 990 WAS POSTED FOR VIEWING prior to filng. DURING THE TAX RETURN POSTING PERIOD, DIRECTORS WERE ENCOURAGED TO SUBMIT QUESTIONS OR SUGGESTIONS TO THE HOSPITAL'S CFO.
Description of Process to Monitor Transactions for Conflicts of InterestForm 990, Part VI, Question 12cFOLLOWING THE ANNUAL SUBMISSION OF ALL RELEVANT PERSON'S CONFLICT OF INTEREST FORMS, THE HOSPITAL AUDIT AND COMPLIANCE COMMITTEE MEETS TO REVIEW ALL RESPONSES AND TO DETERMINE WHETHER ANY OF THE POTENTIAL CONFLICTS THAT HAVE BEEN DOCUMENTED WOULD PREVENT ANYONE'S SERVING ON THE BOARD OF DIRECTORS, OR CONTINUING AS A KEY EMPLOYEE. FOLLOWING ARE KEY EXCERPTS TAKEN FROM THE HOSPITAL'S 2010 CONFLICT OF INTEREST POLICY: 1) ALL BOARD MEMBERS, EX-OFFICIO BOARD MEMBERS, COMMITTEE MEMBERS OR SENIOR MANAGEMENT TEAM MEMBERS SHOULD ACT IN GOOD FAITH AND IN THE BEST INTERESTS OF INDIANA UNIVERSITY HEALTH BLOOMINGTON, INC. 2) ANY MEMBER HAVING AN EXISTING OR POTENTIAL INTEREST IN A CONTRACT OR OTHER TRANSACTION PRESENTED TO THE BOARD OF DIRECTORS OR A COMMITTEE THEREOF FOR DELIBERATION, AUTHORIZATION, APPROVAL, OR RATIFICATION, OR ANY PERSON WHO REASONABLY BELIEVES SUCH AN INTEREST EXISTS IN A MEMBER SHALL MAKE A PROMPT, FULL, AND FRANK DISCLOSURE OF THE INTEREST TO THE BOARD OR COMMITTEE AT THE EARLIEST POSSIBLE MEETING OF THE BOARD OR COMMITTEE 3) A CONFLICT OCCURS WHEN A MEMBER HAS A DIRECT OR INDIRECT PROFESSIONAL OR PERSONAL INTEREST THAT COMPETES WITH THE INTERESTS OF THE HOSPITAL. THE POLICY REQUIRES (A) REGULAR ANNUAL STATEMENTS FROM MEMBERS THAT DISCLOSE EXISTING AND POTENTIAL CONFLICTS OF INTEREST, AND (B) CORRECTIVE AND DISCIPLINARY ACTION WITH RESPECT TO THE TRANSGRESSIONS OF SUCH POLICIES.
Offices & Positions for Which Process was Used, & Year Process was BegunForm 990, Part VI, Question 15aINDIANA UNIVERSITY HEALTH BLOOMINGTON HAS A FORMAL WRITTEN POLICY DEFINING COMPENSATION TO ITS CEO, CFO, AND ALL OTHER KEY EXECUTIVE EMPLOYEES (THIS GROUP IS REFERRED TO INTERNALLY AS THE SLG.) THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT MEMBERS AND IS RESPONSIBLE FOR REVIEWING AND APPROVING ANY CHANGES TO EXECUTIVE COMPENSATION AND/OR BENEFITS OF AN ANNUAL BASIS. ANY CHANGES ARE TO BE REASONABLE, MARKET COMPETITIVE, AND BASED ON MARKET INFORMATION SUPPLIED BY INDEPENDENT CONSULTANTS EMPLOYED BY THE COMPENSATION COMMITTEE AND NOT BY THE ADMINISTRATIVE STAFF. CONSULTANTS SHALL REPORT THEIR FINDINGS DIRECTLY TO THE COMPENSATION COMMITTEE. MEMBERS OF THE ADMINISTRATIVE STAFF SHALL NOT BE PRESENT WHILE DISCUSSIONS ARE HELD TO DETERMINE THE LEVEL OF COMPENSATION AND BENEFITS FOR THE SLG. MINUTES OF COMPENSATION COMMITTEE PROCEEDINGS SHALL BE KEPT THAT REFLECT THE COMMITTEE'S INDEPENDENCE, ANY IDENTIFIED CONFLICTS OF INTEREST, WHAT DECISIONS WERE MADE AND WHAT INDIVIDUALS WERE PRESENT. SALARY ADJUSTMENTS AND/OR BENEFIT CHANGES FOR ANY SLG MEMBER MUST BE APPROVED BY THE COMMITTEE PRIOR TO IMPLEMENTATION. ALL SUCH APPROVED CHANGES WILL BE DISCLOSED TO THE FULL BOARD OF DIRECTORS AT THE NEXT REGULARLY SCHEDULED MEETING. The process described above was first implemented in 2003 and was used for the evaluation of all executives in 2010.
Offices & Positions for Which Process was Used, & Year Process was BegunFORM 990, Part VI, LINE 15BTHE COMPENSATION AND BENEFITS OF ALL KEY EXECUTIVE POSITIONS ARE SUBJECT TO THE SAME PROCESS AS DESCRIBED IN THE EXPLANATION FOR FORM 990, PART VI, QUESTION 15a. The process was most recently used in 2010 to evaluate the senior leadership group positions.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen PublicForm 990, Part VI, Question 19INDIANA UNIVERSITY HEALTH BLOOMINGTON, INC. ASKS THAT ANYONE REQUESTING A COPY OF ITS IRS FORM 990 COME TO ITS ADMINISTRATIVE OFFICE TO ACCESS THAT COPY. REQUESTS TO SEE THE RETURN CAN BE SUBMITTED VIA THE HOSPITAL'S INTERNET WEB SITE Or BY TELEPHONING THE GENERAL SWITCHBOARD NUMBER FOR THE HOSPITAL. STAFF ATTEMPTS ALWAYS TO RESPOND TO ALL REQUESTS WITHIN 24 HOURS, REGARDLESS OF THE MEANS OF TRANSMISSION. COMPLIANCE POLICIES, SUCH AS THOSE DEFINING CONFLICTS OF INTEREST ARE AVAILABLE TO HOSPITAL EMPLOYEES VIA AN EXTENSIVE INTRANET SITE. ANYONE OUTSIDE THE HOSPITAL MAY REQUEST A COPY VIA THE PUBLIC INTERNET SITE OR BY TELEPHONE. FINANCIAL STATEMENTS, TOO, ARE AVAILABLE FOR VIEWING UPON REQUEST, BUT MUST BE OBTAINED IN PERSON FROM THE HOSPITAL'S ADMINISTRATIVE OFFICES.
OTHER CHANGES IN NET ASSETSPART XI, LINE 5UNREALIZED INVESTMENT EARNINGS NOT RECOGNIZED ON FORM 990 5,916,698 UNREALIZED EARNINGS ON RELATED PARTIES NOT RECOGNIZED ON FORM 990 2,509 BOOK TO TAX DIFFERENCES IN UBI REPORTING 215,775 CHANGE IN PENSION OBLIGATION 1,203,558 CHANGE IN IUHB INTEREST IN THE ASSETS OF THE BH FOUNDATION 204,906 ASSETS TRANSFERRED TO AFFILIATES (2,846,518) -------------- TOTAL OTHER CHANGES IN NET ASSETS 4,696,928 ==============
TAX-EXEMPT EQUIPMENT LOANS (MASTER LEASE AND SUBLEASE AGREEMENT)Sch K, Part VTHESE FUNDS, WHICH WERE USED ENTIRELY FOR THE PURCHASE OF MEDICAL AND HOSPITAL IT EQUIPMENT, WERE ORIGINALLY RECEIVED IN THREE SEPARATE DRAWS: $14,252,734 ON 02/16/2006; $3,256,179 ON 06/07/2006; AND $2,453,219 ON 12/28/2006 (TOTAL = $19,962,132). THE EQUIPMENT FINANCED WITH THESE TAX-EXEMPT LOANS WAS SEPARATED INTO THREE CATEGORIES: $5,566,946 ASSETS WITH A 5-YEAR USEFUL LIFE; $2,403,488 ASSETS WITH AN 8-YEAR USEFUL LIFE; AND $11,991,698 ASSETS WITH A 10-YEAR USEFUL LIFE (TOTAL = $19,962,132). THE INTEREST RATE SPREAD TO THE BMA INDEX USED TO CALCULATE THE VARIABLE-RATE INTEREST COST IS 0.98% FOR THE 5-YEAR LOANS, 1.09% FOR THE 8-YEAR LOANS, AND 1.21% FOR THE 10-YEAR LOANS. AS OF 12/31/2010 THE UNPAID BALANCES ON THE THREE LOANS CATEGORIES IS AS FOLLOWS: $607,596 ON THE 5-YEAR LOANS; $1,148,222 ON THE 8-YEAR LOANS; AND $7,427,221 ON THE 10-YEAR LOANS (TOTAL = 9,183,039).
Hours spent on related organizationsPt VII, Section A, Line 1a, Column BIn additon to time spend for duties at Indiana University Health Bloomington, inc., the following individuals spent time attending to duties at related organizations. L. Gene Perry, 32 hours Mark Moore, 2 hours Larry Bailey, 32 hours Daniel Evans, Jr 53 hours

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (33 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
METHODIST HEALTH FOUNDATION INC
1800 NORTH CAPITAL AVENUEINDIANAPOLISIN46202356043086FUNDRAISINGIN501(C)(3)11aNA
METHODIST HEALTH GROUP INC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204350876390HEALTHCAREIN501(C)(3)11cNA
METHODIST MEDICAL GROUP INC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204351945384HEALTHCAREIN501(C)(3)3NA
METHODIST MEDICAL GROUP PHYSICIANS INC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204351814660HEALTHCAREIN501(C)(3)3NA
METHODIST OCCUPATIONAL HEALTH CTRS INC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204351844176HEALTHCAREIN501(C)(3)3NA
METHODIST RESEARCH INSTITUTE INC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204352023710HEALTHCAREIN501(C)(3)11aNA
MH HEALTHCARE INC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204351766531HEALTHCAREIN501(C)(3)3NA
BEDFORD REGIONAL MEDICAL CENTER INC
2900 WEST 16TH STREETBEDFORDIN47421237042323HEALTHCAREIN501(C)(3)3NA
GOSHEN HEALTH SYSTEM INC
200 HIGH PARK AVENUEGOSHENIN46527351974765HEALTHCAREIN501(C)(3)11aNA
GOSHEN HOSPITAL ASSOCIATION INC
200 HIGH PARK AVENUEGOSHENIN46527356001540HEALTHCAREIN501(C)(3)3NA
LAPORTE REGIONAL HEALTH SYSTEM INC
1007 LINCOLNWAYLAPORTEIN46350351125434HEALTHCAREIN501(C)(3)3NA
LAPORTE REGIONAL PHYSICIAN NETWORK INC
1007 LINCOLNWAYLAPORTEIN46350311070868HEALTHCAREIN501(C)(3)3NA
TIPTON HOSPITAL INC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204262772226HEALTHCAREIN501(C)(3)3NA
BALL MEMORIAL HOSPITAL INC
2401 WEST UNIVERSITY AVENUEMUNCIEIN47303350867958HEALTHCAREIN501(C)(3)3NA
BLACKFORD COMMUNITY HOSPITAL INC
410 PILGRIM BOULEVARDHARTFORD CITYIN47348010646166HEALTHCAREIN501(C)(3)3NA
HEALTHCARE CONNECTIONS INC
2410 WEST UNIVERSITY AVENUEMUNCIEIN47303351925641HEALTHCAREIN501(C)(3)9NA
INDIANA RADIOLOGY PARTNERS INC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204201017034HEALTHCAREIN501(C)(3)3NA
INDIANA UNIVERSITY HEALTHCARE ASSOCIATE
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204351747218HEALTHCAREIN501(C)(3)9NA
MIDWEST HEALTH STRATEGIES INC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204611415688HEALTHCAREIN501(C)(3)3NA
HEALTHLINC INC
200 HIGH PARK AVENUEGOSHENIN46527263571507HEALTHCAREIN501(C)(3)3NA
THE BMH FOUNDATION INC
2401 WEST UNIVERSITY AVENUEMUNCIEIN47303311111784FUNDRAISINGIN501(C)(3)11aNA
BMH AUXILIARY INC
2401 WEST UNIVERSITY AVENUEMUNCIEIN47303356025400HEALTHCAREIN501(C)(3)11cNA
IU HEALTH MORGAN HOSPITAL INC
2209 JOHN R WOODEN DRIVEMARTINSVILLEIN46151273533027HEALTHCAREIN501(C)(3)3NA
IU HEALTH WHITE MEMORIAL HOSPITAL INC
720 SOUTH SIXTH STREETMONTICELLOIN47960273532963HEALTHCAREIN501(C)(3)3NA
Indiana University Health Inc
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204351955872HEALTHCAREIN501(C)(3)3NA
CLARIAN ARNETT HEALTH SYSTEM INC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204263162145HEALTHCAREIN501(C)(3)3NA
CLARIAN TRANSPLANT INSTITUTE INC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204134350599HEALTHCAREIN501(C)(3)9NA
EMERGENCY MEDICAL GROUP INC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204351932442HEALTHCAREIN501(C)(3)3NA
LOCAL COUNCIL OF WOMEN OF BLOOMINGTON
PO BOX 1149BLOOMINGtonIN47402350992711NON-PROFITIN501(C)(3)7nA
indiana university HEALTH PAOLI
PO BOX 1149BLOOMINGTONIN47402352090919HEALTHCAREIN501(C)(3)3iuh BLOOM
BLOOMINGTON HOSPITAL AUXILLARY
PO BOX 1149BLOOMINGTONIN47402356041676VOLUNTEERSIN501(C)(4)IUH BLOOM
BLOOMINGTON HOSPITAL FOUNDATION INC
405 N ROGERS STREETBLOOMINGTONIN47404351720795FUNDRAISINGIN501(C)(3)11CIUH BLOOM
oRANGE COUNTY HOSPITAL FOUNDATION INC
PO BOX 499PAOLIIN47454310992486FUNDRAISINGIN501(C)(3)11DIUH BLOOM

Form990 Schedule R Part III Form990ScheduleRPartIII (16 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
CLARIAN HEALTH NETWORK LLC
950 n meridian st ste 800INDIANAPOLISIN46204352055030HEALTHCAREINNAN/A00false$0false0.00000
BALL OUTPATIENT SURGERY CENTER
2401 west university avenueMUNCIEIN47303270275794HEALTHCAREINNAN/A00false$0false0.00000
CARDINAL HEALTH INITIATIVES
2401 west university avenueMUNCIEIN47303300102702PURCHASINGINNAN/A00false$0false0.00000
MID AMERICA SURGERY CENTER
2401 west university avenueMUNCIEIN47303352002953HEALTHCAREINNAN/A00false$0false0.00000
BMH OUTPATIENT SURG SVCS
2401 WEST UNIVERSITY AVENUEMUNCIEIN47303204567998HEALTHCAREINNAN/A00false$0false0.00000
CHV FUND MANAGEMENT LLC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204262523151VENTURE CAPITALINNAN/A00false$0false0.00000
CLARIAN HEALTH NORTH LLC
11700 North Meridian StreetCARMELIN46032431980602HEALTHCAREINNAN/A00false$0false0.00000
CLARIAN HLTH VENT FUND I LLC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204262523206VENTURE CAPITALINNAN/A00false$0false0.00000
CLARIAN HEALTH WEST LLC
1111 NORtH RONALD REAGAN PKWYAVONIN46123431980611HEALTHCAREINNAN/A00false$0false0.00000
HEALTH VENTURE MANAGEMENT LLC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204205740218managementINNAN/A00false$0false0.00000
INDIANA ENDOSCOPY CENTERS LLC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204208398421HEALTHCAREINNAN/A00false$0false0.00000
IN LAKES MANAGED CARE ORG LLC
310 S MAIN STREETGOSHENIN46526351946663HEALTHCAREINNAN/A00false$0false0.00000
SENATE ST SURGERY CENTER LLC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204421709357HEALTHCAREINNAN/A00false$0false0.00000
THE HEALTHCARE GROUP LLC
8802 N MERIDIAN ST STE 100INDIANAPOLISIN46260352067373MANAGED CAREINNAN/A00false$0false0.00000
ROC SURGERY LLC
950 NORTH MERIDIAN STREET SUITE 80INDIANAPOLISIN271497960271497960HEALTH CAREINNAN/A00false$0false0.00000
bloomington endoscopy center llc
550 landmark avebloomingtonIN47403352117943surgery centerINIUH BLOOMENDOSCOPIC DIAG00false$0false0.51000

Form990 Schedule R Part IV Form990ScheduleRPartIV (15 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
SOUTHERN INDIANA MEDICAL GROUP
po Box 1149BloomingtonIN47402351913875HEALTHCAREINNAC CORP58984747550961.00000
BMH MEDICAL PAVilion ASSOCiation INC
2525 west university avenuemuncieIN47303351858408CONDO MGMTINNAC CORP000.00000
CARDINAL HEALTH VENTures INC
2525 WEST UNIVERSITY AVENUEMUNCIEIN47303351611424MANAGEMENTINNAC CORP000.00000
PILR INC
200 high park avenuegoshenIN46526204294750DEVELOPMENTINNAC CORP000.00000
clarian health risk retention grp inc
151 meeting street suite 301charlestonSC29401201107674HEALTHCARESCNAC CORP000.00000
IUH ASSURANCE LTD
980395429INSURANCENAC CORP000.00000720 WEST BAY ROAD PO BOX 69GRAND CAYMANcayman islandsCJCJ
CLARIAN HEALTH PLANS INC
1776 MERIDIAN STREET STE 300INDIANAPOLISIN46202262127080HMOINNAC CORP000.00000
CHV CAPITAL INC
950 N MERIDIAN STREET STE 800INDIANAPOLISIN46204260752507VENTURE CAPITALINNAC CORP000.00000
CLARIAN RISK PURCHASING GROUP INC
151 MEETING STREET SUITE 301CHARLESTONSC29401260202446INSURANCESCNAC CORP000.00000
M-PLAN INC
1776 n meridian street suite 300indianapolisIN46204351772506HMOINNAC CORP000.00000
OCC-HEALTH REVenue SYStems INC
950 N MERIDIAN STREET STE 800INDIANAPOLISIN46204203308057WORK COMP PPOINNAC CORP000.00000
PARKMOR DRUG INC
1501 south main streetgoshenIN46526131394980PHARMACY SALESINNAC CORP000.00000
RADIATION ONCOLOGY RESOURCES INC
200 HIGH PARK AVENUEGOSHENIN46526262008424HEALTH CAREINNONEC CORP000.00000
UNIVERSITY HEALTH MANAGEMENT INC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204272891143MANAGEMENTINNONEC CORP000.00000
UNIVERSITY HEALTH MGT (CHINA) INC
950 N MERIDIAN ST STE 800INDIANAPOLISIN46204273891311MANAGEMENTINNONEC CORP000.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
SOUTHERN INDIANA MEDICAL GROUP
B1770432
BLOOMINGTON HOSPITAL AUXILIARY
C76612
BLOOMINGTON HOSPITAL FOUNDATION
L316000
BLOOMINGTON HOSPITAL AUXILIARY
M83766
BLOOMINGTON HOSPITAL FOUNDATION
M604031
IU HEALTH PAOLI
N389727
bloomington hospital foundation
c197000
IU HEALTH PAOLI
P989880
SOUTHERN INDIANA MEDICAL GROUP
P218954

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