2011-11-14T15:41:35-05:00 2010-12-31 ERNST & YOUNG US LLP 1100 HUNTINGTON CTR 41 S HIGH ST COLUMBUS OH 43215 990 2010-01-01 351720796 INDIANA UNIVERSITY HEALTH BLOOMINGTON INC INDI 8123539551 PO BOX 1149 BLOOMINGTON IN 47403 James Myers 2011-11-14 6142245678 2010 2016-02-24 21:20:13Z MARK E MOORE CEO PO BOX 1149 BLOOMINGTON IN 474021149 333469422 false X WWW.IUHEALTHBLOOMINGTON.ORG X 1988 IN indiana 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. 19 14 3169 450 5663285 1599834 2033914 314008300 325151744 -6999800 5996039 64888 54752 308673222 333236449 94954 57500 0 0 151700057 164731426 0 0 0 145491108 144435964 297286119 309224890 11387103 24011559 307022525 331749624 108713175 104731787 198309350 227017837 X INDIANA 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. false false 177940065 217041001 INPATIENT 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. 51633550 62979618 INPATIENT 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. 26102072 31837798 ACUTE 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. 5190477 57500 6237597 260866164 true true false false false false false false false true false false false true false false true false false true false false false false false true false true false true true false false false false false false false false true true false false false false false true true true false false false X 278 0 true 3169 true true true false false false false false false false false false X 19 14 false false false false true true true true true false true true true true true true true true true true true true IN X JAMES J MYERS CFO 8123539551 BLOOMINGTON HOSP PO BOX 1149 BLOOMINGTON IN 474021149 MOYA ANDREWS 2.0 X 0 0 0 BRAD BOMBA JR MD 2.0 X 0 0 0 MARK BRADFORD 2.0 X 0 0 0 SANDY DEWEESE 2.0 X 0 0 0 DANIEL EVANS JR 2.0 X 0 1252646 828133 JIM FARIS MD 2.0 X 0 0 0 KAREN HANSON 2.0 X 0 0 0 WILLIAM HUNT 2.0 X 0 0 0 CHRIS KROLL 2.0 X 0 0 0 LEE MARCHANT 2.0 X 0 0 0 CHARLES MCKEEN MD 2.0 X 0 0 0 BRUCE MONSON 2.0 X 0 0 0 JIM PERIN 2.0 X 0 0 0 DANIEL PETERSON 2.0 X 0 0 0 JOYCE POLING 2.0 X 0 0 0 ELLIE ROGERS 2.0 X 0 0 0 SUSAN WIER 2.0 X 0 0 0 LINDA WILLIAMSON 2.0 X 0 0 0 ANN WRENN 2.0 X 0 0 0 MARK MOORE 50.0 X 568387 0 162455 JAMES MYERS 50.0 X 307555 0 88860 RUTH ANN MORRIS 50.0 X 257010 0 78145 L GENE PERRY 8.0 X 247553 0 11303 LARRY BAILEY 10.0 X 253911 0 50492 MARK MCMATH 50.0 X 208553 0 50522 MARK CRAIN 50.0 X 189983 0 46506 STEVEN DECKARD 50.0 X 206899 0 47121 KENNETH MARSHALL MD 50.0 X 268908 0 54888 F BRIAN WHITMAN 50.0 X 160513 0 28392 AMARTYADEB GOSWAMI MD 40.0 X 298216 0 29453 LEE MCKINLEY MD 40.0 X 265935 0 48088 JOHN STEARLEY MD 40.0 X 259494 0 38547 CHARLES MCCALLA MD 40.0 X 241849 0 39358 A PERRY GRIFFITH MD 40.0 X 235216 0 28709 3969982 1252646 1630972 107 false true false INTERNAL MEDICINE ASSOCIATES 550 LANDMARK AVENUE BLOOMINGTON IN 474020550 MEDICAL SERVICES 1764264 MAYO MEDICAL LABORATORIES P O BOX 9146 MINNEAPOLIS MN 554809146 MEDICAL LABORATORY 898763 BLOOMINGTON ANESTHESIOLOGISTS P O BOX 2121 DEPT 1438 Memphis TN 381590001 ANESTHESIOLOGY 818735 SOUTHEASTERN IN HEALTH ORGANIZATON 417 WASHINGTON ST P O BOX 1787 Columbus IN 472021787 INS CLAIM PROCESSING 790193 BLOOMINGTON OPERATING ROOM MGMT ASS P O BOX 1149 BLOOMINGTON IN 474021149 MEDICAL SERVICES 774583 31 273612 1760302 2033914 NET PATIENT SERVICE REVENUE 900099 288384525 288384525 NET LABORATORY PATIENT REVENUE 621500 29047665 23473892 5573773 CAFETERIA REVENUE 722210 1447197 1447197 JOINT VENTURE INCOME 900099 1838060 1838060 RELATED RENTAL REVENUE 531120 538250 538250 3896047 3861287 34760 325151744 49161 49161 0 0 270527 215775 54752 54752 54752 5922676 41400 17198 5922676 24202 5946878 5946878 0 0 0 0 333236449 318096014 5663285 7443236 57500 57500 0 0 0 3287956 1922507 1365449 0 79430 58125 21305 120942738 104448354 16494384 7984245 6835767 1148478 23659330 20256102 3403228 8777727 7515113 1262614 1879977 929843 950134 311347 311347 340446 340446 0 0 430572 430572 9709604 7578086 2131518 1842594 1842594 60948341 52420600 8527741 2980517 2384414 596103 0 5710503 4374748 1335755 398813 246189 152624 0 0 2915922 2538160 377762 0 17275480 12517439 4758041 2071880 1657504 414376 BAD DEBTS 23587273 23587273 MAINTENANCE AGREEMENTS 5829197 5040486 788711 UNRELATED BUSINESS INCOME TAX 493998 493998 PURCHASED REPAIR SERVICES 1525798 1137623 388175 PURCHASED LABORATORY SERVICES 1499529 1499529 4684173 3860802 823371 309224890 260866164 48358726 0 65414 55578 31797823 41323166 1421229 1726640 35891772 39116988 5140284 4942153 4083108 4474441 347188704 223652396 132115369 123536308 84821945 101783826 2137514 2485222 9548067 12305302 307022525 331749624 27549514 33415710 60778 91378 52555434 48213743 12051389 7295548 16496060 15715408 108713175 104731787 X 194200605 222704136 3474314 3679220 634431 634481 198309350 227017837 307022525 331749624 X 24011559 4696928 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 14453926 14453926 146116881 84995974 61120907 5823362 3891380 1931982 176722451 133532629 43189822 4072084 1232413 2839671 123536308 0 ACCRUED DEFINED BENEFIT PENSION LIABILITY 10339177 ESTIMATED MEDICARE/MEDICAID SETTLEMENT 3831556 ACCRUED MALPRACTICE LIABILITY 1544675 15715408 ASC 740 Disclosure Sch D, Pt X, Line 2 INDIANA 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. 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X X X Indiana university Health Bloomington 1 27 IU HEALTH CANCER RADIATION CENTER

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OUTPATIENT FACILITY SOUTHERN INDIANA SURGERY CENTER LLC

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BEHAVIORAL HEALTH CENTER IU HEALTH WOUND CENTER

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WOUND CARE CENTER IU HEALTH CHILDREN'S THERAPY CENTER

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RADIOLOGICAL services CHARITY CARE ParT I, LINE 3C The 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 reporting part I, line 6a The 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 cost Part I, Line 7 7g. 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 activities part ii The 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 practices part iii, line 4 The 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 practices part iii, line 8 Department-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 practices part iii, line 9 Accounts that are approved for charity care assistance are immediately written-off and all collection efforts are ceased. community needs health assessment Pt VI, Line 2 The 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 assistance part vi, line 3 The 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 information part vi, line 4 The 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 health part vi, line 5 The 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 system part vi, line 6 Indiana 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 REPORT 990 SCHEDULE H, PART VI IN, true AMERICAN HEART ASSOCIATION 460 N LINDBERGH BLVD ST LOUIS MO 63141 135613797 501(c)(3) 7500 TO ASSIST IN AHA FUND RAISING EFFORTS IN THE BLOOMINGTON COMMUNITY CITY OF BLOOMINGTON PARKS & RECREATION PO BOX 848 BLOOMINGTON IN 47402 356000954 501(c)(6) 25000 TO UNDERWRITE HEALTH AND FITNESS PROGRAMS FOR THE BENEFIT OF BLOOMINGTON YOUTH INDIANA AIDS FUND 429 E VERMONT ST SUITE 300 INDIANAPOLIS IN 46202 356203550 501(c)(3) 11000 TO UNDERWRITE THE DIAGNOSTIC AND HEALTH INITIATIVES OF THE INDIANA AIDS FUND. MONROE COUNTY YMCA 2125 S HIGHLAND AVE BLOOMINGTON IN 47401 351384859 501(c)(3) 9000 TO 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. 4 0 Form 990, Schedule I Description of Organization's Procedures for Monitoring the Use of Grants THROUGH 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. X X X X false true false false false false false true false DANIEL EVANS JR 0 981359 0 215358 0 55929 0 804785 0 23348 0 2080779 0 0 MARK MOORE 456779 0 80491 0 31117 0 148641 0 13814 0 730842 0 0 0 JAMES MYERS 240703 0 44747 0 22105 0 76301 0 12559 0 396415 0 0 0 RUTH ANN MORRIS 220520 0 34906 0 1584 0 65536 0 12609 0 335155 0 0 0 L GENE PERRY 82033 0 28418 0 137102 0 7895 0 3408 0 258856 0 83352 0 LARRY BAILEY 209073 0 32123 0 12715 0 32666 0 17826 0 304403 0 0 0 MARK MCMATH 178108 0 29893 0 552 0 32805 0 17717 0 259075 0 0 0 MARK CRAIN 143797 0 20912 0 25274 0 33961 0 12545 0 236489 0 0 0 STEVEN DECKARD 172292 0 26115 0 8492 0 34522 0 12599 0 254020 0 0 0 KENNETH MARSHALL MD 260658 0 0 0 8250 0 39688 0 15200 0 323796 0 0 0 F BRIAN WHITMAN 135386 0 20212 0 4915 0 16097 0 12295 0 188905 0 0 0 AMARTYADEB GOSWAMI MD 297856 0 0 0 360 0 11250 0 18203 0 327669 0 0 0 LEE MCKINLEY MD 264903 0 0 0 1032 0 35365 0 12723 0 314023 0 0 0 JOHN STEARLEY MD 210588 0 47322 0 1584 0 25781 0 12766 0 298041 0 0 0 CHARLES MCCALLA MD 216609 0 0 0 25240 0 27109 0 12249 0 281207 0 0 0 A PERRY GRIFFITH MD 234664 0 0 0 552 0 10796 0 17913 0 263925 0 0 0 Supplemental Nonqualified Retirement Plan Schedule J, Part I, Line 4b AS 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 EMPLOYEES SCHEDULE J, PART I, LINE 7 ACCORDING 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. hospital authority of monroe county 000000000 000000000 2006-02-16 19962132 TAX-EXEMPT EQUIPMENT LOANS false false false 0 0 19962132 0 0 0 0 0 0 19962132 0 0 2006 false false true true false false false false false 0.00000 0.00000 0.00000 true false true false false false TAX-EXEMPT EQUIPMENT LOANS (MASTER LEASE AND SUBLEASE AGREEMENT) Sch K, Part V SEE SCHEDULE O. MONROE BANK see part v 212671 GEN. BANKING TRANSACTIONS false BORMA see part v 774583 MEDICAL SERV PROVIDER false BELINDA CRAIN see part v 58125 RELATIVE IS BH EMPL false internal medical associates see part v 2369635 medical services false matthew crain see part v 21305 RELATIVE IS BH EMPL false BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS FORM 990, SCHEDULE L, PART IV CHARLES 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. dESCRIPTION OF OTHER PROGRAM SERVICES fORM 990, PART III, LINE 4D INDIANA 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 Stockholders Form 990, Part VI, Question 6 AS 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 Rights Form 990, Part VI, Question 7a ANY 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 Rights Form 990, Part VI, Question 7b NO 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 990 Form 990, Part VI, Question 11 BEGINNING 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 Interest Form 990, Part VI, Question 12c FOLLOWING 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 Begun Form 990, Part VI, Question 15a INDIANA 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 Begun FORM 990, Part VI, LINE 15B THE 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 Public Form 990, Part VI, Question 19 INDIANA 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 ASSETS PART XI, LINE 5 UNREALIZED 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 V THESE 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 organizations Pt VII, Section A, Line 1a, Column B In additon to time spend for duties at Indiana University Health Bloomington, inc., the following individuals spent time attending to duties at related organizations. L. 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