Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2011 and ending 12-31-2011
BCheck if applicable:
CName of organization
INDIANA UNIVERSITY HEALTH INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
950 N MERIDIAN STREET SUITE 800
 
Room/suite
City or town, state or country, and ZIP + 4
INDIANAPOLIS, IN46204
D Employer identification number

35-1955872
E Telephone number

G Gross receipts $ 3,105,284,108
F Name and address of principal officer:
DANIEL F EVANS JR
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.IUHEALTH.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1997
M State of legal domicile: IN
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: Improve the health of our patients and community through innovation and excellence in care, education, research and service.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 10
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 17,989
6 Total number of volunteers (estimate if necessary) .... 6 7,093
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 26,999,818
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 2,488,308
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 10,303,503 28,801,633
9 Program service revenue (Part VIII, line 2g) ......... 2,314,094,838 2,576,590,196
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 99,233,443 261,326,337
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 41,156,988 44,550,786
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 2,464,788,772 2,911,268,952
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 22,673,782 17,721,763
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 920,720,778 1,034,086,386
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 1,291,802,047 1,444,373,360
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,235,196,607 2,496,181,509
19 Revenue less expenses. Subtract line 18 from line 12....... 229,592,165 415,087,443
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 4,042,172,031 4,366,601,484
21 Total liabilities (Part X, line 26)............. 2,303,021,743 2,500,261,117
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,739,150,288 1,866,340,367
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III .........
1
Briefly describe the organization’s mission: Improve the health of our patients and community through innovation and excellence in care, education, research, and service.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 2,019,396,100 including grants of $ 17,721,763 ) (Revenue $ 2,610,642,907 )
Indiana University Health, Inc. ("IU Health") is Indiana's most comprehensive healthcare system. A unique partnership with Indiana University School of Medicine, one the nation's leading medical schools, gives patients access to innovative treatments and therapies, all without regard to their ability to pay. IU Health is comprised of hospitals, physicians and allied services dedicated to providing preeminent care through Indiana and beyond. See Schedule O for additional information on IU Health's 2011 program service accomplishments.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 2,019,396,100
Form 990 (2011)
Form 990 (2011)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment....................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II.. Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III.. Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements. Click to see list of attachments
20b
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II......................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V .........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
1,053
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
17,989
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ , CA , KS , UK , ID , EZ , DA , GR , HU , IS
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2011)
Form 990 (2011)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI .........
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
14
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
10
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IN
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
BROC BUDDE
950 N MERIDIAN STREET SUITE 800
INDIANAPOLIS,IN46204
(317) 962-4575
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) V WILLIAM HUNT
CHAIRMAN
 6.0 X           0 0 0
(2) D CRAIG BRATER MD
VICE CHAIRMAN
 6.0 X           23,326 0 0
(3) THOMAS W CHAPMAN PHD
VICE CHAIRMAN
 6.0 X           19,000 0 0
(4) DANIEL F EVANS JR
DIRECTOR/PRESIDENT & CEO
 55.0 X   X       1,449,996 0 839,848
(5) JAMES E LINGEMAN MD
DIRECTOR
 6.0 X           20,000 733,603 38,457
(6) THE HONORABLE SARAH EVANS BARKER
DIRECTOR
 6.0 X           0 0 0
(7) BISHOP MICHAEL J COYNER
DIRECTOR
 6.0 X           0 0 0
(8) CHARLES E GOLDEN
DIRECTOR
 6.0 X           41,750 0 0
(9) DAVID W GOODRICH
DIRECTOR
 6.0 X           43,750 0 0
(10) MICHAEL A MCROBBIE PHD
DIRECTOR
 6.0 X           13,250 0 0
(11) ANGELA BARRON MCBRIDE PHD
DIRECTOR
 6.0 X           22,250 0 0
(12) WILLIAM R CAST MD
DIRECTOR
 6.0 X           20,750 0 0
(13) J SCOTT DAVISON
DIRECTOR
 6.0 X           22,750 0 0
(14) ANNE NOBLES
DIRECTOR
 6.0 X           6,500 0 0
(15) MARVIN G PEMBER
EXECUTIVE VP & CFO (1/1-7/29)
 55.0     X       1,010,382 0 2,436,855
(16) ISADORE RIVAS
VP & INTERIM CFO (7/29-12/31)
 55.0     X       343,114 0 37,965
(17) RYAN C KITCHELL
VP & TREASURER (8/25-12/31)
 55.0     X       336,791 0 47,203
Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) NORMAN G TABLER JR
SVP GEN. COUNSEL & CCO/SECRET.
 55.0     X       616,835 0 36,471
(19) RICHARD F GRAFFIS MD
EVP & CMO
 55.0       X     842,964 0 38,489
(20) SAMUEL L ODLE
EVP & COO
 55.0       X     938,189 0 1,105,593
(21) LINDA Q EVERETT
EVP & CNE
 55.0       X     492,382 0 115,631
(22) DANIEL L FINK
PRES. & CEO (RILEY) (1/1-5/20)
 55.0       X     966,697 0 499,836
(23) JOHN C KOHNE MD
COO (IUH METHODIST)
 55.0       X     514,084 0 116,659
(24) DEBRA L UHL
COO (IUH UNIVERSITY)
 55.0       X     297,987 0 37,708
(25) JIM JORGENSON
VP & CPO
 55.0       X     264,475 0 36,517
(26) MARILYN COX
INTERIM CEO (RILEY)
 55.0       X     328,524 0 391,099
(27) LINDA CHASE
VP-NURSING/PCS&CNO(METHODIST)
 55.0       X     229,028 0 35,524
(28) TALAL S HAMDAN MD
PHYSICIAN
 55.0         X   776,538 0 22,739
(29) SAMI M AASAR MD
PHYSICIAN
 55.0         X   770,140 0 28,515
(30) LAWRENCE S KLEIN MD
PHYSICIAN
 55.0         X   778,847 0 17,072
(31) BLAIR S MACPHAIL MD
PHYSICIAN
 55.0         X   766,059 0 27,846
(32) EDWARD A HARLAMERT MD
PHYSICIAN
 55.0         X   769,999 0 22,448
(33) RICHARD S HELSPER
COO (IUH SAXONY)
 55.0           X 247,966 0 21,656
(34) DIANE J THOMPSON
VP-NURSING (IUH UNIVERSITY)
 55.0           X 254,978 0 208,260
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 13,229,301 733,603 6,162,391
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet604
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
IU HEALTH CARE ASSOCIATES INC
950 N MERIDIAN STREET SUITE 800
INDIANAPOLIS,IN46204 		MEDICAL 51,151,186
TURNER-HARMON A JOINT VENTURE
9190 PRIORITY WAY WEST SUITE 210
INDIANAPOLIS,IN46240 		CONSTRUCTION 32,692,865
PEPPER CONSTRUCTION
1850 WEST 15TH STREET
INDIANAPOLIS,IN46202 		CONSTRUCTION 21,467,917
CERNER CORPORATION
2800 ROCKCREEK PARKWAY
KANSAS CITY,MO64117 		CONSULTING 15,975,792
WURSTER CONSTRUCTION COMPANY
8463 CASTLEWOOD DRIVE
INDIANAPOLIS,IN46250 		CONSTRUCTION 9,077,963
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet440
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 448,754
e Government grants (contributions)1e 13,620,150
f All other contributions, gifts, grants, and
similar amounts not included above1f 		14,732,729
g Noncash contributions included in lines 1a-1f:$ 0
h Total. Add lines 1a-1f.......MediumBullet 28,801,633
Program Service Revenue Business Code
2a NET PATIENT SERVICE REVENUE 621,111 1,959,166,022 1,959,166,022 0 0
b REFERENCE LABORATORY 621,500 273,305,149 269,971,593 3,333,556 0
c MEMBER PREMIUM REVENUE 900,099 125,962,059 125,962,059 0 0
d SHARED SERVICES 541,900 117,387,310 106,590,598 10,796,712 0
e PHARMACY 446,110 59,867,635 51,552,280 8,315,355 0
f All other program service revenue . 40,902,021 40,730,335 171,686 0
g Total. Add lines 2a–2f........MediumBullet 2,576,590,196
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 52,082,680 34,052,711   18,029,969
4 Income from investment of tax-exempt bond proceeds..MediumBullet 9     9
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 12,367,914  
b Less: rental expenses 12,357,720  
c Rental income or (loss) 10,194  
d Net rental income or (loss).......MediumBullet 10,194   62,950 -52,756
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 390,901,084  
b Less: cost or other basis and sales expenses 181,657,436  
c Gain or (loss) 209,243,648  
d Net gain or (loss)..........MediumBullet 209,243,648     209,243,648
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a CAFETERIA/FOOD SERVICE 721,110 7,999,986 0 0 7,999,986
b PARKING 812,930 1,548,878 0 0 1,548,878
c TELEPHONE 517,000 1,370,020 0 0 1,370,020
d All other revenue .... 33,621,708 0 4,319,559 29,302,149
e Total. Add lines 11a–11d ......MediumBullet 44,540,592
12 Total revenue. See Instructions....MediumBullet 2,911,268,952 2,588,025,598 26,999,818 267,441,903
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 17,721,763 17,721,763
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 14,559,951 11,532,314 3,027,637  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 732,860 580,467 152,393  
7 Other salaries and wages 823,849,280 652,535,726 171,313,554  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 49,654,863 43,584,822 6,070,041  
9 Other employee benefits ....... 95,074,834 75,304,704 19,770,130  
10 Payroll taxes ........... 50,214,598 45,391,402 4,823,196  
11 Fees for services (non-employees):        
a Management ...... 2,803,712   2,803,712  
b Legal ......... 5,533,590   5,533,590  
c Accounting ........... 2,938,594   2,938,594  
d Lobbying ........... 636,719   636,719  
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 1,700,700   1,700,700  
g Other .......... 241,122,934 153,561,039 87,561,895  
12 Advertising and promotion .... 24,904,663 7,832,254 17,072,409  
13 Office expenses ....... 44,514,781 12,119,746 32,395,035  
14 Information technology ...... 45,218,392 35,815,551 9,402,841  
15 Royalties .. 0      
16 Occupancy ........... 67,871,659 26,389,112 41,482,547  
17 Travel ............ 2,765,465 1,611,689 1,153,776  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 220,351 88,654 131,697  
20 Interest ........... 39,856,955 31,568,987 8,287,968  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 148,827,267 105,706,680 43,120,587  
23 Insurance .............. 19,289,313 15,278,239 4,011,074  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a DRUGS AND MEDICAL SUPPLIES 433,311,976 433,311,976    
b HEALTH CLAIMS TO PROVIDERS 131,460,137 131,460,137    
c BAD DEBT 87,516,332 87,516,332    
d UBI TAX 1,148,040   1,148,040  
e
f All other expenses 142,731,780 130,484,506 12,247,274  
25 Total functional expenses. Add lines 1 through 24f 2,496,181,509 2,019,396,100 476,785,409 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 16,362 1 187,465
2 Savings and temporary cash investments ....... 419,885,647 2 260,656,360
3 Pledges and grants receivable, net ......... 0 3 0
4 Accounts receivable, net ......... 267,310,561 4 345,494,225
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 0 5 0
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L .......... 0 6 0
7 Notes and loans receivable, net ............. 761,304,821 7 419,455,511
8 Inventories for sale or use .............. 41,652,571 8 50,223,697
9 Prepaid expenses and deferred charges ............ 67,924,931 9 17,713,963
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 3,755,517,830
b Less: accumulated depreciation. ..... 10b 1,890,073,706 1,490,067,651 10c 1,865,444,124
11 Investments—publicly traded securities .......... 900,782,656 11 1,192,554,281
12 Investments—other securities. See Part IV, line 11 ...... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 76,333,741 13 192,050,855
14 Intangible assets ......... 3,898,864 14 11,983,073
15 Other assets. See Part IV, line 11 ........... 12,994,226 15 10,837,930
16 Total assets. Add lines 1 through 15 (must equal line 34)... 4,042,172,031 16 4,366,601,484
Liabilities 17 Accounts payable and accrued expenses . 295,564,132 17 323,624,865
18 Grants payable .......... 0 18 0
19 Deferred revenue .......... 142,473,611 19 44,763,657
20 Tax-exempt bond liabilities .......... 1,089,553,181 20 1,408,584,900
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 384,935,514 23 300,061,203
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 390,495,305 25 423,226,492
26 Total liabilities. Add lines 17 through 25..... 2,303,021,743 26 2,500,261,117
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 1,733,963,848 27 1,861,443,786
28 Temporarily restricted net assets ..... 288,359 28 0
29 Permanently restricted net assets ..... 4,898,081 29 4,896,581
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 1,739,150,288 33 1,866,340,367
34 Total liabilities and net assets/fund balances ..... 4,042,172,031 34 4,366,601,484
Form 990 (2011)
Form 990 (2011)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI .........
1
Total revenue (must equal Part VIII, column (A), line 12) ...
1
2,911,268,952
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
2,496,181,509
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
415,087,443
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
1,739,150,288
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-287,897,364
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
1,866,340,367
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2011)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH INC
 
Employer identification number

35-1955872
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2011
Name of organization
INDIANA UNIVERSITY HEALTH INC
 
Employer identification number

35-1955872
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
INDIANA UNIVERSITY HEALTH INC
  		Employer identification number

35-1955872
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
INDIANA UNIVERSITY HEALTH INC
  		Employer identification number

35-1955872
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
INDIANA UNIVERSITY HEALTH INC
  		Employer identification number

35-1955872
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
Use duplicate copies of Part III if additional space is needed
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
INDIANA UNIVERSITY HEALTH INC
 
Employer identification number

35-1955872
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2011

Schedule C (Form 990 or 990-EZ) 2011
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check expenses, and share of excess lobbying expenditures).
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2011


Schedule C (Form 990 or 990-EZ) 2011
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
60,000
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
478,707
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
98,012
j
Total. Add lines 1c through 1i ...............................
636,719
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
Schedule C, Part II-B Lines 1b and g - Paid staff and direct contact with legislators During 2011, Indiana University Health, Inc. ("IU Health") spent $478,707 in federal and state lobbying expenditures. During 2011, IU Health lobbied Congress on the following issues: - Healthcare reform legislation (in general) - Patient Protection and Affordable Care Act - Changes to Medicare/Medicaid reimbursement - Graduate medical education - Medicare Shared Savings Program - Value Based Purchasing - Changes to OPPS/IPPS reimbursement During 2011, IU Health lobbied at the state level on the following issues: - Statewide smoking ban - Medicaid reimbursement policies - Budget appropriations - Workers compensation - Provider licensure matters - Physician order for scope of treatment - Workforce and smoking policies
Schedule C, Part II-B Lines 1f - Grants to other organizations for lobbying purposes Indiana University Health, Inc. ("IU Health") made contributions to Safety Net Hospitals for Pharmaceutical Access ("SNHFPA") and Coalition to Protect America's Health Care ("CTPAHC") during 2011 in the amount of $10,000 and $50,000. Each organization notified IU Health that 100% of these contributions would be used for lobbying expenditures. The total contributions paid to these organizations by IU Health during 2011 that were attributable to lobbying expenditures were $60,000.
Schedule C, Part II-B Lines 1j - Other Activities Indiana University Health, Inc. ("IU Health") paid institutional membership dues to the American Hospital Association ("AHA"), Indiana Hospital Association ("IHA"), U.S. Chamber of Commerce ("USCOC"), Safety Net Hospitals for Pharmaceutical Access ("SNHFPA"), and National Association of Children's Hospitals & Related Institutions ("NACHRI") during 2011 in the amount of $127,494, $178,880, $100,000, $16,740, $10,000, and $68,866, respectively. Each membership organization notified IU Health that a portion of the dues it paid were used for lobbying purposes. The AHA used 24.42%, or $31,134 of 2011 membership dues paid by IU Health, for lobbying expenditures. The IHA used 5.29%, or $9,463 of the 2011 membership dues paid by IU Health, for lobbying expenditures. The USCOC used 50%, or $50,000 of the 2011 membership dues paid by IU Health, for lobbying expenditures. The SNHFPA used 22%, or $3,683 of the 2011 membership dues paid by IU Health, for lobbying expenditures. The NACHRI used 5.42%, or $3,732 of the 2011 membership dues paid by IU Health, for lobbying expenditures. The total membership dues paid to these organizations by IU Health during 2011 that were attributable to lobbying expenditures was $98,012.
Schedule C (Form 990 or 990EZ) 2011

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH INC
 
Employer identification number

35-1955872
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 5,186,440 5,220,052 82,476,620 72,300,805
b Contributions ........       10,329,033
c Net investment earnings, gains, and losses ...       90,972
d Grants or scholarships ..... 289,859 33,612 800,000  
e Other expenditures for facilities
and programs ........ 		    76,244,118  
f Administrative expenses ....     212,450 244,190
g End of year balance ...... 4,896,581 5,186,440 5,220,052 82,476,620
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet0 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   140,341,771 140,341,771
b Buildings ................   1,775,641,029 723,769,422 1,051,871,607
c Leasehold improvements ............   13,458,816 9,627,833 3,830,983
d Equipment ................   1,443,745,519 1,126,780,372 316,965,147
e Other .................   382,330,695 29,896,079 352,434,616
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 1,865,444,124
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes 0
INTEREST RATE SWAP LIABILITIES 195,625,691
INTERCOMPANY PAYABLES (NET) 120,039,320
DUE TO THIRD-PARTY PAYORS 60,943,863
PENSION AND OTHER RETIREMENT LIAB. 37,281,377
ENVIRONMENTAL OBLIGATIONS 4,420,811
SELF-INSURANCE LIABLITIES 4,334,624
ACCRUED INTEREST ON BONDS 228,064
ALL OTHER LIABILITIES 352,742

Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 423,226,492
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8  
9 Total adjustments (net). Add lines 4 through 8 ......................... 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Schedule D, Part V - Endowment Funds Line 4 - Intended Uses of Organization's Endowment Funds Temporarily and permanently restricted net assets are generally restricted for indigent and other patient care services, medical education and research programs, and medical supplies and equipment.
Schedule D, Part X - Other Liabilities Line 2 - FIN 48 (ASC 740) Footnote Indiana University Health, Inc. ("IU Health") adopted FIN 48 in 2007. No disclosures were required in 2011 under GAAP as IU Health does not have any material tax contingencies that required disclosures in the footnotes.
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH INC
 
Employer identification number

35-1955872
Part I
General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants
and other assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? ..............................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other
assistance outside the United States.
3
Activites per Region. (Use Part V if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees or agents in region or independent contractors (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total
expenditures for region/investments
in region
Central America and the Caribbean     Program Services SELF-INSURANCE 5,866,170
Central America and the Caribbean     Unrelated Trade or Business   4,319,559
Central America and the Caribbean     Conduct board meetings   81,363
Europe (Including Iceland and Greenland)     Investments   6,507,223
Central America and the Caribbean     Investments   430,163,153
North America     Investments   1,600,981
East Asia and the Pacific     Investments   530,785
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     449,069,234
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     449,069,234
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,
Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet
Use Part V if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .....MediumBullet
 
3
Enter total number of other organizations or entities ........................MediumBullet
 
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Use Part V if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................
2 Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 5
Part V
Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
Identifier ReturnReference Explanation
Schedule F, Part I - Activities Outside the United States Line 3 - Activities per Region The amounts reported on Schedule F, Part I, Line 3 represent expenditures made for insurance premiums paid directly to an off-shore captive and travel and meeting expenses paid to attend an off-shore captive meeting. Additionally, the book values of foreign investments are reported on a region-by-region aggregation basis. Indiana University Health, Inc. does not have any offices or employees in foreign countries.
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2011
Additional Data


Software ID:  
Software Version:  



SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH INC
 
Employer identification number

35-1955872
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the
following was the family income limit for eligibility for discounted care: ............
3b
Yes
 
c
If the organization did not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year?...........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ...............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance
and Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		  33,860 95,677,685 0 95,677,685 3.470 %
b Medicaid (from Worksheet 3, column a) .....   374,487 629,830,691 460,830,969 168,999,722 6.130 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .            
dTotal Financial Assistance and
Means-Tested Government Programs ..... 		  408,347 725,508,376 460,830,969 264,677,407 9.600 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		53 172,727 13,382,567 143,099 13,239,468 0.480 %
f Health professions education
(from Worksheet 5) .. 		8 8,178 67,934,155 14,103,919 53,830,236 1.950 %
g Subsidized health services
(from Worksheet 6) .. 		6 5 5,577,963 604 5,577,359 0.200 %
h Research (from Worksheet 7) 2 1,748 17,367,206 0 17,367,206 0.630 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) .... 16 100,623 3,547,996 50,157 3,497,839 0.130 %
jTotal Other Benefits ... 85 283,281 107,809,887 14,297,779 93,512,108 3.390 %
kTotal. Add lines 7d and 7j. .. 85 691,628 833,318,263 475,128,748 358,189,515 12.990 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing 2 4 58,500 0 58,500 0 %
2 Economic development 3 34,000 83,413 0 83,413 0 %
3 Community support 4 1,156 122,400 100 122,300 0 %
4 Environmental improvements 1 0 1,310 0 1,310 0 %
5 Leadership development and training for community members 1 0 8,253 0 8,253 0 %
6 Coalition building 4 23,162 495,268 13,813 481,455 0.020 %
7 Community health improvement advocacy 2 0 81,225 0 81,225 0 %
8 Workforce development   0 0 0 0 0 %
9 Other   0 0 0 0 0 %
10 Total 17 58,322 850,369 13,913 836,456 0.020 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense........
2
35,524,226
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....
3
0
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
421,768,465
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
473,139,556
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-51,371,091
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures
(see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1CHW LLC
  		ACUTE CARE HOSPITAL 76.884 % 0 % 23.116 %
2CHN LLC
  		ACUTE CARE HOSPITAL 63.810 % 0 % 36.190 %
3BSC LLC
  		AMBULATORY SURGERY CENTER 25.714 % 0 % 49.580 %
4EHSC LLC
  		AMBULATORY SURGERY CENTER 25.752 % 0 % 49.505 %
5SSSC LLC
  		AMBULATORY SURGERY CENTER 29.580 % 0 % 42.000 %
6IEC LLC
  		AMBULATORY SURGERY CENTER 26.010 % 0 % 49.000 %
7ROCS LLC
  		AMBULATORY SURGERY CENTER 30.077 % 0 % 41.026 %
8BOSC LLC
  		AMBULATORY SURGERY CENTER 27.817 % 0 % 45.456 %
9
10
11
12
13
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest)
How many hospital facilities did the organization operate during the tax year?6
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 IU HEALTH METHODIST HOSPITAL
1701 N SENATE BLVD
INDIANAPOLIS,IN46202 		X X X X   X X    
2 RILEY HOSP FOR CHILDREN AT IU HEALTH
705 RILEY HOSPITAL DRIVE
INDIANAPOLIS,IN46202 		X X X X   X X    
3 IU HEALTH UNIVERSITY HOSPITAL
550 NORTH UNIVERSITY BLVD
INDIANAPOLIS,IN46202 		X X   X   X X    
4 IU HEALTH SAXONY HOSPITAL
13000 E 136TH ST
FISHERS,IN46037 		X           X   CARDIOVASCULAR, ORTHOPEDIC, AND SPINE SPECIALITIES
5 IU HEALTH WEST HOSPITAL
1111 N RONALD REAGAN PKWY
AVON,IN46123 		X           X    
6 IU HEALTH NORTH HOSPITAL
11700 N MERIDIAN ST
CARMEL,IN46032 		X X X       X    
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
IU HEALTH METHODIST HOSPITAL
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 650.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
RILEY HOSP FOR CHILDREN AT IU HEALTH
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):2

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 650.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
IU HEALTH UNIVERSITY HOSPITAL
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):3

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 650.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
IU HEALTH SAXONY HOSPITAL
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):4

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 650.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
IU HEALTH WEST HOSPITAL
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):5

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 650.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
IU HEALTH NORTH HOSPITAL
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):6

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 650.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?63
Name and address Type of Facility (describe)
1 BALL OUTPATIENT SURGERY CENTER
2525 W UNIVERSITY STE 200
MUNCIE,IN47303 		AMBULATORY SURGERY
2 BELTWAY ENDOSCOPY CENTER - SPRINGMILL
200 W 103RD ST STE 2400
INDIANAPOLIS,IN46290 		AMBULATORY SURGERY
3 BELTWAY SURGERY CENTERS
151 N PENNSYLVANIA PKWY
INDIANAPOLIS,IN46280 		AMBULATORY SURGERY
4 BELTWAY SURGERY CENTERS - SPRINGMILL
200 W 103RD ST
INDIANAPOLIS,IN46280 		AMBULATORY SURGERY
5 EAGLE HIGHLANDS SURGERY CENTER
6850 PARKDALE PLACE
INDIANAPOLIS,IN46254 		AMBULATORY SURGERY
6 INDIANA ENDOSCOPY CENTERS
10967 ALLISONVILLE RD STE 100
FISHERS,IN46038 		AMBULATORY SURGERY
7 INDIANA ENDOSCOPY CENTERS
1115 RONALD REAGAN PKWY STE 347
AVON,IN46123 		AMBULATORY SURGERY
8 INDIANA ENDOSCOPY CENTERS
1801 N SENATE BLVD STE 401
INDIANAPOLIS,IN46202 		AMBULATORY SURGERY
9 RILEY OUTPATIENT SURGERY CENTER
702 BARNHILL DR STE 0201
INDIANAPOLIS,IN46202 		AMBULATORY SURGERY
10 SENATE STREET SURGERY CENTER
1801 N SENATE BLVD
INDIANAPOLIS,IN46202 		AMBULATORY SURGERY
11 IU HEALTH BARIATRIC & MED WEIGHT LOSS
6640 INTECH BLVD STE 300
INDIANAPOLIS,IN46278 		BARIATRIC AND MEDICAL WEIGHT LOSS
12 IU MEL & BREN SIMON CANCER CENTER
1030 W MICHIGAN ST
INDIANAPOLIS,IN46202 		CANCER CARE
13 HEART PARTNERS OF INDIANA
10967 ALLISONVILLE RD STE 240
FISHERS,IN46038 		CARDIOVASCULAR
14 HEART PARTNERS OF INDIANA
11725 ILLINOIS ST STE LL050
CARMEL,IN46032 		CARDIOVASCULAR
15 HEART PARTNERS OF INDIANA
1210B MEDICAL ARTS BLVD STE 144
ANDERSON,IN46011 		CARDIOVASCULAR
16 HEART PARTNERS OF INDIANA
13100 E 136TH ST STE 300
FISHERS,IN46037 		CARDIOVASCULAR
17 HEART PARTNERS OF INDIANA
1801 N SENATE BLVD STE 240
INDIANAPOLIS,IN46202 		CARDIOVASCULAR
18 HEART PARTNERS OF INDIANA
7231 SHADELAND STATION STE 100
INDIANAPOLIS,IN46250 		CARDIOVASCULAR
19 HEART PARTNERS OF INDIANA
8075 N SHADELAND AVE STE 350
INDIANAPOLIS,IN46250 		CARDIOVASCULAR
20 IU HEALTH CARDIOVASCULAR SURGEONS
1701 N SENATE BLVD STE 755
INDIANAPOLIS,IN46202 		CARDIOVASCULAR
21 IU HEALTH CARDIOVASCULAR SURGEONS
707 W 2ND ST
BLOOMINGTON,IN47401 		CARDIOVASCULAR
22 IU HEALTH CARDIOVASCULAR SURGEONS
637 S WALKER ST STE 2
BLOOMINGTON,IN47403 		CARDIOVASCULAR
23 METHODIST CARDIOLOGY PHYSICIANS
11725 N ILLINOIS ST STE 265
CARMEL,IN46032 		CARDIOVASCULAR
24 METHODIST CARDIOLOGY PHYSICIANS
1801 N SENATE BLVD STE 310
INDIANAPOLIS,IN46202 		CARDIOVASCULAR
25 METHODIST CARDIOLOGY PHYSICIANS
18077 RIVER RD STE 104
NOBLESVILLE,IN46060 		CARDIOVASCULAR
26 METHODIST CARDIOLOGY PHYSICIANS
6920 PARKDALE PL STE 107
INDIANAPOLIS,IN46254 		CARDIOVASCULAR
27 EAST WASHINGTON TIMESHARE
9670 E WASHINGTON ST STE 110
INDIANAPOLIS,IN46229 		DIAGNOSTIC AND OTHER MEDICAL
28 GEORGETOWN TIMESHARE
4880 CENTURY PLAZA RD STE 170
INDIANAPOLIS,IN46254 		DIAGNOSTIC AND OTHER MEDICAL
29 IU HEALTH GEORGETOWN MEDICAL PLAZA
4880 CENTURY PLAZA RD
INDIANAPOLIS,IN46254 		DIAGNOSTIC AND OTHER MEDICAL
30 IU HEALTH METHODIST MEDICAL PLAZA BBURG
1375 N GREEN ST STE 200
BROWNSBURGH,IN46207 		DIAGNOSTIC AND OTHER MEDICAL
31 IU HEALTH METHODIST MEDICAL PLAZA EHGH
6850 PARKDALE PL
INDIANAPOLIS,IN46254 		DIAGNOSTIC AND OTHER MEDICAL
32 IU HEALTH METHODIST MEDICAL PLAZA EAST
9660 E WASHINGTON ST
INDIANAPOLIS,IN46229 		DIAGNOSTIC AND OTHER MEDICAL
33 IU HEALTH METHODIST MEDICAL PLAZA NORTH
151 PENNSYLVANIA PKWY
CARMEL,IN46280 		DIAGNOSTIC AND OTHER MEDICAL
34 IU HEALTH METHODIST MEDICAL PLAZA SOUTH
8820 S MERIDIAN ST
INDIANAPOLIS,IN46217 		DIAGNOSTIC AND OTHER MEDICAL
35 IU HEALTH METHODIST MEDICAL TOWER
1633 N CAPITOL AVE
INDIANAPOLIS,IN46202 		DIAGNOSTIC AND OTHER MEDICAL
36 IU HEALTH SPRING MILL OUTPATIENT CENTER
200 W 103RD ST STE 1200
INDIANAPOLIS,IN46290 		DIAGNOSTIC AND OTHER MEDICAL
37 METHODIST MEDICAL PLAZA - GLENDALE
2620 KESSLER BLVD E
INDIANAPOLIS,IN46220 		DIAGNOSTIC AND OTHER MEDICAL
38 NORTH MERIDIAN TIMESHARE
201 PENNSYLVANIA PKWY STE 305
INDIANAPOLIS,IN46280 		DIAGNOSTIC AND OTHER MEDICAL
39 SOUTH 31 TIMESHARE
8820 S MERIDIAN ST STE 230
INDIANAPOLIS,IN46217 		DIAGNOSTIC AND OTHER MEDICAL
40 IU HEALTH DIALYSIS
2140 N CAPITOL AVE
INDIANAPOLIS,IN46202 		DIALYSIS
41 IU HEALTH HOME DIALYSIS CENTER
8830 N MERIDIAN ST
INDIANAPOLIS,IN46260 		DIALYSIS
42 IU HEALTH CHARIS EATING DISORDER CLINIC
6640 INTECH BLVD STE 195
INDIANAPOLIS,IN46278 		EATING DISORDERS
43 IU HEALTH HOME CARE
1411 W COUNTY LINE RD
GREENWOOD,IN46142 		HOME HEALTH CARE
44 IU HEALTH HOME CARE
1828 N ILLINOIS ST
INDIANAPOLIS,IN46202 		HOME HEALTH CARE
45 IU HEALTH HOME CARE
202 S WEST ST
TIPTON,IN46072 		HOME HEALTH CARE
46 IU HEALTH HOME CARE
702 N ILLINOIS ST
INDIANAPOLIS,IN46204 		HOME HEALTH CARE
47 CAPITAL NEUROLOGY
201 PENNSYLVANIA PKWY STE 300
INDIANAPOLIS,IN46280 		NEUROLOGY
48 EAST RETAIL PHARMACY
9650 E WASHINGTON ST
INDIANAPOLIS,IN46229 		PHARMACY
49 GEORGETOWN RETAIL PHARMACY
4880 CENTURY PLAZA RD STE 150
INDIANAPOLIS,IN46254 		PHARMACY
50 SOUTH RETAIL PHARMACY
8820 S MERIDIAN ST STE 105
INDIANAPOLIS,IN46217 		PHARMACY
51 IU HEALTH FISHERS RADIOLOGY
10995 ALLISONVILLE RD STE 100B
FISHERS,IN46038 		RADIOLOGY
52 IU HEALTH BALL MEMORIAL HOSPITAL LAB
2401 W UNIVERSITY AVE
MUNCIE,IN47303 		REFERENCE LABORATORY
53 IU HEALTH REHABILITATION
6820 PARKDALE PL STE 120
INDIANAPOLIS,IN46254 		REHABILITATION
54 IU HEALTH ARNETT SLEEP APNEA ED CENTER
3900 MCCARTY LN STE 102
LAFAYETTE,IN47909 		SLEEP DISORDERS
55 IU HEALTH BALL MEMORIAL SLEEP APNEA ED
6000 W KILGORE AVE STE A
MUNCIE,IN47304 		SLEEP DISORDERS
56 IU HEALTH BEDFORD SLEEP APNEA ED CENTER
1502 CLINIC DR
BEDFORD,IN47421 		SLEEP DISORDERS
57 IU HEALTH HOWARD SLEEP APNEA ED CENTER
829 N DIXON RD
KOKOMO,IN46901 		SLEEP DISORDERS
58 IU HEALTH SLEEP APNEA ED CTR AT INDPLS
714 N SENATE AVE STE 120
INDIANAPOLIS,IN46202 		SLEEP DISORDERS
59 IU HEALTH SLEEP LAB
714 N SENATE AVE STE 120
INDIANAPOLIS,IN46202 		SLEEP DISORDERS
60 SLEEP APNEA ED CTR AT IU HEALTH NORTH
11590 N MERIDIAN ST STE 410
CARMEL,IN46032 		SLEEP DISORDERS
61 SLEEP APNEA ED CTR AT IU HEALTH WEST
1111 N RONALD REAGAN PKWY 371
AVON,IN46123 		SLEEP DISORDERS
62 SLEEP DISORDERS CTR AT IU HEALTH NORTH
11590 N MERIDIAN ST STE 410
INDIANAPOLIS,IN46032 		SLEEP DISORDERS
63 IU HEALTH SPORTS PERFORMANCE
1402 CHASE CT
CARMEL,IN46032 		SPORTS PERFORMANCE
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
Schedule H, Part I - Financial Assistance Line 3c N/A
Schedule H, Part I - Financial Assistance Line 6a - Community Benefit Report Prepared by Related Organization Indiana University Health, Inc.'s ("IU Health") community benefits and investments are included in the IU Health Community Benefit Report which is made available to the public on its website at www.iuhealth.org. The Community Benefit report is also distributed to numerous key organizations throughout the State of Indiana to broadly share IU Health's community benefit efforts and investments statewide, and is available by request through the Indiana State Department of Health or IU Health.
Schedule H, Part I - Financial Assistance Line 7, Column (f) - Bad Debt Expense The amount of bad debt expense included on Form 990, Part IX, Line 25, column (A), but subtracted for purposes of calculating the percentage of total expense is $87,516,332. The bad debt expense of $35,524,226 on Schedule H, Part III, Line 2 is reported at cost.
Schedule H, Part I - Financial Assistance Line 7 - Total Community Benefit Expense Percentage of Total Expenses listed on Schedule H, Part I, Line 7, Column (f) is calculated based on Net Community Benefit Expense. The Percentage of Total Expenses calculated based on Total Community Benefit Expense is 30.24%.
Schedule H, Part I - Financial Assistance Line 7g - Subsidized Health Services Indiana University Health, Inc. does not include any costs associated with physician clinics as subsidized health services.
Schedule H, Part II - Community Building Activities Promotion of Health in Communities Served Indiana University Health, Inc. ("IU Health") leaders participate in a wide array of community-building activities that address the underlying quality of life in the communities IU Health serves. IU Health invests in economic development efforts across the state, collaborates with like-minded organizations through coalitions that address key issues, and advocates for improvements in the health status of vulnerable populations. In 2011, IU Health spent over 1.2 million dollars, serving more than 77,000 individuals as a statewide organization, and nearly 800,000 dollars locally at our six Indianapolis area and suburban hospitals on community-building activities. These investments and support provided resources to local community initiatives that addressed economic development, community health improvement, and workforce development. Outreach activities included job fairs and interview seminars; participation in an economic development council and chamber of commerce; and collaborative partnerships to improve community health. Coalition Building IU Health collaborates with organizations throughout Indiana to advance important causes connected to its mission. In 2011, it was involved in diverse coalitions, including Mid-North Quality of Life Plan coalition, Health by Design, United Way, and Near North Development Corporation. Additionally, IU Health supported several working groups committed to preventing domestic violence; joined forces with local partners to advance injury prevention activities; and supported agencies and community groups to fight obesity, as obesity's health effects include an increased risk for a range of problems, such as diabetes, heart disease, osteoarthritis, stroke, and high blood pressure. Habitat for Humanity Habitat for Humanity of Greater Indianapolis is committed to eliminating poverty by providing simple, decent housing and making home ownership available to low-income families, most of whom have children and live in unsafe, overcrowded or substandard conditions. IU Health supports Habitat for Humanity's efforts financially and by providing hundreds of volunteers to help build a home for a family in need, as IU Health recognizes that poverty is recognized as perhaps the single most important risk factor for premature death and disability. Additionally, IU Health West Hospital collaborated with Habitat in 2011 to conduct a "panel build" on the hospital campus. A panel build involves all of the materials needed to construct every wall, floor and ceiling panel for the home, which are built individually, loaded onto a truck, and taken to the home site where the pieces are put together like a puzzle. In addition to creating the building blocks of the home for a family in need, the project provided an excellent opportunity for hospital volunteers to collaborate with volunteers from community partner organizations to continue building valuable relationships. Volunteers from Day Nursery Association, Ben Davis High School and the Avon-Washington Township Fire Department all worked alongside volunteers and families from IU Health West Hospital to make the panel build a success. During IU Health's third annual Day of Service, 1,611 employees joined the fight against childhood obesity by increasing access to active places to play and fresh nutritious foods for low-income school children across Indiana. Community assets left behind as a result of the event included: 3 new school playgrounds, 12 improved school playgrounds, and 5 school gardens. Over 65,000 Hoosiers were positively impacted by the construction of new playgrounds and safety improvements made; creating secure & convenient places for community members to play and be active.
Schedule H, Part III - Bad Debt, Medicare, & Collection Practices Line 4 - Bad Debt Expense The provision for uncollected patient accounts is based upon management's assessment of historical and expected net collections considering business and economic conditions, changes and trends in health care coverage, and other collection indicators. Periodically, management assesses the adequacy of the allowance for uncollectible accounts based upon accounts receivable payor composition and aging, and historical write-off experience by payor category, as adjusted for collection indicators. The results of the review are then used to make any modifications to the provision for uncollected patient accounts and the allowance for uncollectible accounts. In addition, Indiana University Health, Inc. ("IU Health") follows established guidelines for placing certain past due patient balances with collection agencies. Patient accounts that are uncollected, including those placed with collection agencies, are initially charged against the allowance for uncollectible accounts in accordance with collection policies of IU Health and, in certain cases, are reclassified to charity care if deemed to otherwise meet charity care and financial assistance policies of IU Health. The bad debt expense reported on Line 2 is calculated under the cost to charge ratio methodology. IU Health provides health care services through various programs that are designed, among other matters, to enhance the health of the community and improve the health of low-income patients. In addition, IU Health provides services intended to benefit the poor and underserved, including those persons who cannot afford health insurance because of inadequate resources or are uninsured or underinsured.
Schedule H, Part III - Bad Debt, Medicare, & Collection Practices Line 8 - Medicare Shortfall The Medicare shortfall reported on Schedule H, Part III, Line 7 is calculated, in accordance with the Form 990 instructions, using "allowable costs" from Indiana University Health, Inc.'s ("IU Health") Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes are not reflective of all costs associated with IU Health's participation in Medicare programs. For example, the Medicare Cost Report excludes certain costs such as billed physician services, the costs of Medicare Parts C and D, fee schedule reimbursed services, and durable medical equipment services. Inclusion of all costs associated with IU Health's participation in Medicare programs would significantly increase the Medicare shortfall reported on Schedule H, Part III, Line 7. IU Health's Medicare shortfall is attributable to reimbursements that are less than the cost of providing patient care and services to Medicare beneficiaries and does not include any amounts that result from inefficiencies or poor management. IU Health accepts all Medicare patients knowing that there may be shortfalls; therefore it has taken the position that the shortfall should be counted as part of its community benefit. Additionally, it is implied in Internal Revenue Service Revenue Ruling 69-545 that treating Medicare patients is a community benefit. Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with governmental health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community.
Schedule H, Part III - Bad Debt, Medicare, & Collection Practices Line 9b - Written Debt Collection Policy and Financial Assistance If a patient cannot satisfy standard payment expectations, a financial assistance screening process for alternative sources of balance resolution is completed. Those resolutions may include: a discount on charges; Medicaid enrollment, interest-free loan or application for charity care. If a patient does not apply for charity care but meets the charity care guidelines established by Indiana University Health, Inc. ("IU Health"), IU Health will waive charges and treat the cost of services as charity care.
Schedule H, Part VI - Supplement Information Line 2 - Needs Assessment Communities are multifaceted and so are their health needs. Indiana University Health, Inc. ("IU Health") understands that the health of individuals and communities are shaped by various social and environmental factors, along with health behaviors and additional influences. IU Health assesses the health care needs of the communities it serves by utilizing the detailed community needs assessments undertaken by organizations such as the Marion County Health Department, the Indiana State Department of Health, the Centers for Disease Control and Prevention and the United Way of Central Indiana.
Schedule H, Part VI - Supplemental Information Line 3 - Patient Education of Eligibility for Assistance Indiana University Health, Inc. ("IU Health") goes to great lengths to ensure patients know that IU Health treats all patients regardless of their ability to pay. IU Health shares financial assistance information with patients during the admission process, billing process and online. Helping patients understand that financial support for their care is a part of IU Health's commitment to its mission. IU Health's financial assistance policy exists to serve those in need by providing financial relief to patients who ask for assistance after care has been provided. During the admissions process, opportunities for financial assistance are discussed with patients who are identified as a self-pay patient, or requests assistance information. The patient is also provided with an Admissions Packet that provides information regarding IU Health's financial assistance program. Financial counselors are onsite to assist financial concerns or questions during the patient's stay. Patient Financial Services - Customer Service representatives can help patients apply for financial assistance, understand their bills, explain what they can expect during the billing process, accept payment (if needed), update their insurance or payor information, and update their address or other demographics. A summary of the financial assistance policy is printed on the back of each patient statement, while the financial assistance application is mailed to all uninsured IU Health patients at the conclusion of their treatment along with a summary of the incurred charges. Additionally, on the back of each patient statement is a phone number that will allow patients the ability to request financial assistance. Uninsured patients are also made aware of this process at the time of registration. The IU Health website (iuhealth.org) has a page dedicated to financial assistance and offers an online application and phone numbers for customer service representatives to assist with the application process. IU Health has an expansive financial assistance program, which aligns with IU Health's policy and utilizes the federal poverty guidelines to determine eligibility, making access to quality care within a patient's reach. The IU Health Financial Assistance policy provides the following support to patients that qualify. - Free care for those earning up to 200 percent of federal poverty guidelines; - Discounted care on a sliding scale for families earning from 200 to 400 percent of federal poverty guidelines; and - Discounted care on a sliding scale for uninsured families earning from 400 to 650 percent of federal poverty guidelines, and - Financial assistance to patients whose health insurance coverage, if any, does not provide full coverage for all of their medical expenses and whose medical expenses would make them indigent if they were forced to pay full charges. Patients are guided through their course of care with particular sensitivity, reviewing changing circumstances and allowing for financial assistance at any point during the relationship and billing process with the patient. For those inpatients that may qualify for the Medicaid program and have not applied, IU Health financial counselors will assist patients with the Medicaid application. If a patient does not apply for financial assistance, but meets the financial assistance guidelines established by IU Health, IU Health will waive charges and treat the cost of services as financial assistance.
Schedule H, Part VI - Supplemental Information Line 4 - Community Information Indiana University Health, Inc. ("IU Health"), which includes IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health, IU Health West Hospital, IU Health North Hospital, and IU Health Saxony Hospital, serves a large geographic area in Central Indiana. Each individual hospital serves a unique subsection of the community and details for each are included below. IU Health Methodist Hospital - Service Area Counties: Marion, Hendricks, Johnson, Morgan, Hamilton, Madison, Hancock, Shelby, and Boone - 75% of the IU Health Methodist inpatient discharge population resides in Marion (66%), Hendricks (4%), Johnson (3%), and Morgan (2%) counties - 29% of community discharges were for patients with Medicaid, 25% were for patients with Medicare, and 17% were for uninsured/self-pay patients IU Health University Hospital - Service Area Counties: Marion, Hendricks, Hamilton, Johnson, Morgan, Delaware, Allen, Madison, Vigo, Tippecanoe, St. Joseph, Monroe, Bartholomew, Lake, Elkhart, Hancock, Grant, Howard, Vanderburgh, Wayne, Jackson, Henry, and Putnam - 32% of the IU Health University total inpatient discharge population resides in Marion County; the other 68% is distributed fairly evenly across 91 other counties in the state of Indiana - 44% of IU Health University community discharges were for patients with commercial insurance, 31% were for patients with Medicare, 14% were for patients with Medicaid, and 5% were for uninsured or self-pay patients Riley Hospital for Children at IU Health - Service Area Counties: Marion, Johnson, Lake, Hendricks, Hamilton, Morgan, Madison, Delaware, St. Joseph, Tippecanoe, Allen, Elkhart, Bartholomew, Vanderburgh, Vigo, Hancock, Wayne, Monroe, Jackson, Shelby, and La Porte - 33% of the Riley Hospital for Children at IU Health total inpatient discharge population resides in Marion County; the other 67% is distributed fairly evenly across 89 other counties in the state of Indiana. - 57% of IU Health Riley community discharges were for patients with Medicaid, 35% were for patients with commercial insurance, 1% were for patients with Medicare, and 4% were for self-pay patients IU Health West Hospital - Service Area Counties: Marion, Hendricks, Putnam, Morgan, Johnson, Boone, and Montgomery - Approximately 75% of the IU Health West inpatient discharge population resides in Marion (65%) and Hendricks (11%) counties - 12% of community discharges were for patients with Medicaid, 31% were for patients with Medicare, and 8% were for uninsured/self-pay patients IU Health North Hospital - Service Area Counties: Marion, Hamilton, Boone, Hendricks, Hancock, Madison, and Tipton - 78% of the IU Health North inpatient discharge population resides in Marion (35%), Hamilton (32%), Boone (6%), and Hendricks (5%) counties - 8% of community discharges were for patients with Medicaid, 15% were for patients with Medicare, and 4% were for uninsured/self-pay patients IU Health Saxony Hospital - Service Area Counties: Marion, Hamilton, Boone, Hendricks, Hancock, Madison, and Tipton - 78% of the IU Health North inpatient discharge population resides in Marion (35%), Hamilton (32%), Boone (6%), and Hendricks (5%) counties (IU Health Saxony inpatient discharge population data was not available at the time of this report) - 8% of community discharges were for patients with Medicaid, 15% were for patients with Medicare, and 4% were for uninsured/self-pay patients
Schedule H, Part VI - Supplemental Information Line 5 - Promotion of Community Health As an academic medical center, Indiana University Health, Inc. ("IU Health") and Indiana University School of Medicine work together to train physicians in an exceptional environment, blending breakthrough research and treatments with the highest quality of patient care. In 2011, more than 1,000 residents and fellows received training in IU Health hospitals. IU Health is committed to improving the health and safety of the communities it serves across Indiana. From bike helmet fittings to cancer support groups to diabetes management, we bring our unique and state-of-the-art resources beyond the hospital doors and onto the front steps of Indiana communities. With more than $17 million invested in high-quality and impactful initiatives to address community health needs; IU Health is helping Indiana residents improve their health and their quality of life. In 2011, IU Health impacted over 400,000 people statewide through presentations, health risk screenings, health education programs, and additional educational opportunities made available to the community, especially to our community members in the greatest need of such services.
Schedule H, Part VI - Supplemental Information Line 6 - Affiliated Health Care System Indiana University Health, Inc. ("IU Health") is Indiana's most comprehensive healthcare system. A unique partnership with Indiana University School of Medicine, one of the nation's leading medical schools, gives patients access to innovative treatments and therapies. IU Health is comprised of hospitals, physicians and allied services dedicated to providing preeminent care throughout Indiana and beyond. A collaborative partnership with IU Health and Indiana University School of Medicine, IU Health Physicians is comprised of more than 500 board-certified or board-eligible physicians, 70 locations statewide and more than 1,000 staff, including 170 advanced practice providers. National Recognition: - Eight clinical programs ranked among the top 50 national programs in U.S. News & World Report's 2010-11 Edition of America's Best Hospitals. - Ten specialty programs at Riley Hospital for Children at IU Health ranked among the top 30 children's hospitals in the nation. - Six hospitals designated as Magnet hospital systems by the American Nurses Credentialing Center recognizing excellence in nursing care. - Named to the 2012-2013 U.S. News & World Report's Best Hospitals Honor Roll, their highest distinction. Education and Research: As an academic health center, IU Health works in partnership with Indiana University School of Medicine to train physicians, blending breakthrough research and treatments with the highest quality of patient care. Research conducted by Indiana University School of Medicine faculty gives IU Health physicians and patients access to the most leading-edge and comprehensive treatment options. The IU Health statewide healthcare system consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health, IU Health West Hospital, IU Health North Hospital, IU Health Ball Memorial Hospital, IU Health Blackford Hospital, IU Health Bloomington Hospital, IU Health Paoli Hospital, IU Health Bedford Hospital, IU Health Tipton Hospital, IU Health La Porte Hospital, IU Health Starke Hospital, and IU Health Goshen Hospital. In July of 2011, IU Health Morgan Hospital and IU Health White Hospital also became a member of IU Health. In December of 2011, IU Health opened its newest location, IU Health Saxony Hospital in Fishers, Indiana. Although each IU Health healthcare system hospital prepares and submits its own community benefits plan relative to the local community, IU Health considers its community benefit plan as part of an overall vision for strengthening Indiana's overall health. A comprehensive community outreach strategy and community benefit plan is in place that encompasses the academic medical center downtown Indianapolis, suburban Indianapolis and statewide entities around priority areas that focus on health improvement efforts statewide. IU Health is keenly aware of the positive impact it can have on the communities of need in the state of Indiana by focusing on the most pressing needs in a systematic and strategic way. After taking a careful look into IU Health's communities we serve, and by utilizing the detailed community needs assessments undertaken by public health officials and community partners, IU Health identified the following community health needs. Obesity Prevention To improve the lifestyle of Indiana residents, IU Health has utilized best practice methods to attack obesity in our communities. IU Health is working to improve access to nutritious foods and physical activity in low-income neighborhoods, in addition to providing traditional health education and public advocacy efforts. With these initiatives, IU Health strives to prevent chronic diseases such as obesity and diabetes and increase the awareness of the importance of making healthy choices, since Thirty-six percent of Hoosier adults are overweight and 29.5% are obese, costing the nation billions of dollars each year to treat these chronic health conditions. Garden on the Go: Year-round mobile produce delivery program, that aims to increase access to affordable, fresh fruits & vegetables for the city's most disadvantaged neighbors. By the end of December 2011, Garden on the Go served thousands of Indianapolis community members, reaching a total of 8281 residents! Indy Urban Acres: 8-acre organic urban farm that supplies low-income Hoosiers with healthy fruits and vegetables. Produce grown at this site is given to Gleaners Food Bank. In just two months of harvest, more than 1400 pounds of produce was grown on .5 acres and delivered to Gleaners Food Bank. Riley School Gardens: In an effort to increase access to nutritious foods and reduce the incidence of obesity among youth, Riley Hospital for Children at Indiana University Health partnered with Keep Indianapolis Beautiful (KIB) and Indianapolis Public Schools (IPS) to establish school gardens at 10 IPS schools throughout the city. IU Health Bucks: IU Health Bucks is an incentive program designed to increase produce consumption among underserved populations using state-issued Farmers Market Vouchers. Participants who spent their state-issued vouchers at the North United Methodist Church Farmers' Market in Indianapolis received additional IU Health "Market Money" to spend on produce. 233 low-income families participated in the pilot program, spending $3,500 on healthy, local produce. Walk Indiana: IU Health Ball Memorial Hospital contributes resources for the implementation of a unique non-competitive walking marathon held in Muncie, Indiana. The program emphasizes walking as a lifestyle choice to enhance health and fitness. Community walking groups were offered during spring and summer months to help community members prepare for the main event held in September. IU Health Ball Memorial staff members provided free blood pressure screenings and health information at each training session. Nearly 500 individuals participated in the Walk Indiana event in September, 2011. Access to Affordable Healthcare One of the first steps to improved health outcomes is having access to healthcare resources. To show its commitment to providing affordable healthcare access, IU Health treats all patients regardless of their ability to pay. IU Health is also working to raise awareness and work to identify individuals within our communities that have barriers to care and connect these individuals with better access and consistency of healthcare resources to meet their needs. Injury Prevention IU Health strives to create safe communities by helping to reduce preventable injuries such as bicycle, motor vehicle, and fall related injuries, as injuries are the leading cause of death for people 1 - 44 years old. The CDC reports 160,000 people die and 50 million people are injured each year, costing over $80 billion in medical costs. IU Health works to provide the necessary tools, such as helmets and education to communities of need to prevent injuries for youth and adults. Additionally, IU Health supports the advocacy of policies, such as the texting while driving ban, to help provide infrastructure to instill the awareness of injury prevention in our communities. Bicycle Helmet Safety Campaign: Outfitted 4,042 children statewide (ages 6-14) with free, properly fitted bicycle helmets and provided bicycle safety education. This initiative resulted in a 37% increase in helmet usage post-activation. IU Health Child Passenger Safety Campaign: On National Seat Check Saturday, IU Health launched a statewide campaign to decrease the incidence of children traveling unrestrained or restrained incorrectly. CPS Technicians distributed 122 free car seats and found that 85% of the 205 car seats inspected were installed improperly. CICOA Aging and In-Home Solutions: Safe at Home Event - targeted homeowners over the age of 65 or persons of any age with a disability to make their homes safe and accessible for daily living. Volunteers made safety modifications to 22 homes including securing grab bars in bathrooms, installing handrails and banisters on steps, repairing steps, and installing comfort height toilets. K-12 Education In 2011, IU Health partnered with the United Way to implement a Kindergarten readiness program for at-risk children called Kindergarten Countdown. IU Health's significant investment in this program allowed hundreds of soon-to-be students to receive necessary vaccinations and screenings as well as attend a 4-week summer camp to enhance their school readiness. With IU Health's support, the program was expanded across the IPS district and into 10 additional IU Health communities, including IU Health Ball Memorial Hospital. Community Revitalization During IU Health's third annual Day of Service, 1,611 employees joined the fight against childhood obesity by increasing access to active places to play and fresh nutritious foods for low-income school children across Indiana. Community assets left behind as a result of the event included: 3 new school playgrounds, 12 improved sc
STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI IN,
Schedule H (Form 990) 2011
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH INC
 
Employer identification number
35-1955872
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) INDIANA UNIVERSITY SCHOOL OF MEDICINE714 N SENATE AVE
INDIANAPOLIS,IN46202 		35-6001673 501(C)(3) 12,787,724 0 N/A N/A ACADEMIC SUPPORT
(2) METHODIST RESEARCH INSTITUTE INC950 N MERIDIAN ST
INDIANAPOLIS,IN46204 		35-1007590 501(C)(3) 2,437,472 0 N/A N/A GENERAL SUPPORT
(3) CLARIAN TRANSPLANT INSTITUTE INC950 N MERIDIAN ST
INDIANAPOLIS,IN46204 		13-4350599 501(C)(3) 999,996 0 N/A N/A GENERAL SUPPORT
(4) HEALTHNET INC3401 RAYMOND ST
INDIANAPOLIS,IN46203 		35-1579827 501(C)(3) 254,000 0 N/A N/A GENERAL SUPPORT
(5) INDIANA SPORTS CORPORATION201 S CAPITOL AVE
INDIANAPOLIS,IN46225 		31-0975117 501(C)(3) 213,433 0 N/A N/A GENERAL SUPPORT
(6) CICOA FOUNDATION INC4755 KINGSWAY DR
INDIANAPOLIS,IN46205 		35-1859069 501(C)(3) 165,000 0 N/A N/A GENERAL SUPPORT
(7) UNITED WAY OF CENTRAL INDIANA INCPO BOX 88409
INDIANAPOLIS,IN46208 		35-1007590 501(C)(3) 130,000 0 N/A N/A GENERAL SUPPORT
(8) INDIANA UNIVERSITY FOUNDATIONPO BOX 500
BLOOMINGTON,IN47402 		35-6018940 501(C)(3) 76,500 0 N/A N/A GENERAL SUPPORT
(9) INDIANA STATE FAIR FOUNDATION INC1202 E 38TH ST
INDIANAPOLIS,IN46205 		45-2784384 501(C)(3) 50,000 0 N/A N/A GENERAL SUPPORT
(10) COALITION TO PROTECT AMERICA'S HEALTH CAREPO BOX 30211
BETHESDA,MD20824 		52-2253225 501(C)(4) 50,000 0 N/A N/A GENERAL SUPPORT
(11) HABITAT FOR HUMANITY OF GREATER INDPLS1011 E 22ND ST
INDIANAPOLIS,IN46204 		35-1715910 501(C)(3) 40,000 0 N/A N/A GENERAL SUPPORT
(12) CENTRAL INDIANA CORPORATE PARTNERSHIP INC111 MONUMENT CIRCLE
INDIANAPOLIS,IN46204 		35-2065459 501(C)(6) 35,000 0 N/A N/A GENERAL SUPPORT
(13) INDIANAPOLIS DOWNTOWN INC111 MONUMENT CIRCLE
INDIANAPOLIS,IN46204 		35-1877771 501(C)(3) 30,000 0 N/A N/A GENERAL SUPPORT
(14) INDIANAPOLIS MEDICAL SOCIETY FOUNDATION631 E NEW YORK ST
INDIANAPOLIS,IN46202 		35-1810091 501(C)(3) 25,000 0 N/A N/A GENERAL SUPPORT
(15) THE ALBERT SCHWEITZER FELLOWSHIP109 BROOKLINE AVE
BOSTON,MA02215 		13-1982786 501(C)(3) 25,000 0 N/A N/A GENERAL SUPPORT
(16) CROSSROADS COUNCIL OF BOY SCOUTS OF AMERICA7125 FALL CREEK RD
INDIANAPOLIS,IN46256 		35-0867962 501(C)(3) 23,500 0 N/A N/A GENERAL SUPPORT
(17) 500 FESTIVAL INC21 VIRGINIA AVE
INDIANAPOLIS,IN46204 		35-1004320 501(C)(4) 18,500 0 N/A N/A GENERAL SUPPORT
(18) THE HEALTH FOUNDATION OF GREATER INDPLS429 E VERMONT ST
INDIANAPOLIS,IN46202 		35-6203550 501(C)(3) 10,000 0 N/A N/A GENERAL SUPPORT
(19) INDIANA FISCAL POLICY INSTITUTE INC14350 MUNDY DR
NOBLESVILLE,IN46060 		35-0411770 501(C)(3) 7,500 0 N/A N/A GENERAL SUPPORT
(20) JUVENILE DIABETES RESEARCH FOUNDATION INC26 BROADWAY 14TH FL
NEW YORK,NY10004 		23-1907729 501(C)(3) 5,100 0 N/A N/A GENERAL SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
17
3
Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image
3
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2011

Schedule I (Form 990) 2011
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
Schedule I, Part I - General Information on Grants and Assistance Line 2 - Organization's Procedures for Monitoring the Use of Grant Funds Although Indiana University Health, Inc. does not monitor the use of grant funds once distributed, through due diligence the organization has reasonably confirmed that the entities to which the contributions are made are highly reputable in the community and use the funds for the purposes intended.
Schedule I (Form 990) 2011


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH INC
 
Employer identification number

35-1955872
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) DANIEL F EVANS JR (i)
(ii)		 1,020,135
0 		373,097
0 		56,764
0 		818,859
0 		20,989
0 		2,289,844
0 		0
0
(2) JAMES E LINGEMAN MD (i)
(ii)		 20,000
707,331 		0
7,000 		0
19,272 		0
17,150 		0
21,307 		20,000
772,060 		0
0
(3) MARVIN G PEMBER (i)
(ii)		 436,425
0 		262,280
0 		311,677
0 		2,416,465
0 		20,390
0 		3,447,237
0 		290,387
0
(4) ISADORE RIVAS (i)
(ii)		 269,767
0 		59,840
0 		13,507
0 		20,652
0 		17,313
0 		381,079
0 		0
0
(5) RYAN C KITCHELL (i)
(ii)		 318,226
0 		18,281
0 		284
0 		20,652
0 		26,551
0 		383,994
0 		0
0
(6) NORMAN G TABLER JR (i)
(ii)		 359,104
0 		155,627
0 		102,104
0 		20,652
0 		15,819
0 		653,306
0 		0
0
(7) RICHARD F GRAFFIS MD (i)
(ii)		 524,541
0 		218,988
0 		99,435
0 		20,652
0 		17,837
0 		881,453
0 		0
0
(8) SAMUEL L ODLE (i)
(ii)		 610,071
0 		262,252
0 		65,866
0 		1,079,478
0 		26,115
0 		2,043,782
0 		0
0
(9) LINDA Q EVERETT (i)
(ii)		 332,599
0 		142,290
0 		17,493
0 		92,362
0 		23,269
0 		608,013
0 		0
0
(10) DANIEL L FINK (i)
(ii)		 205,423
0 		132,418
0 		628,856
0 		472,233
0 		27,603
0 		1,466,533
0 		189,435
0
(11) JOHN C KOHNE MD (i)
(ii)		 404,511
0 		106,801
0 		2,772
0 		94,813
0 		21,846
0 		630,743
0 		0
0
(12) DEBRA L UHL (i)
(ii)		 262,568
0 		33,613
0 		1,806
0 		20,652
0 		17,056
0 		335,695
0 		0
0
(13) JIM JORGENSON (i)
(ii)		 224,896
0 		37,773
0 		1,806
0 		19,204
0 		17,313
0 		300,992
0 		0
0
(14) MARILYN COX (i)
(ii)		 188,198
0 		134,874
0 		5,452
0 		369,849
0 		21,250
0 		719,623
0 		0
0
(15) LINDA CHASE (i)
(ii)		 191,268
0 		11,550
0 		26,210
0 		18,259
0 		17,265
0 		264,552
0 		0
0
(16) RICHARD S HELSPER (i)
(ii)		 247,000
0 		0
0 		966
0 		20,652
0 		1,004
0 		269,622
0 		0
0
(17) DIANE J THOMPSON (i)
(ii)		 198,795
0 		21,391
0 		34,792
0 		198,435
0 		9,825
0 		463,238
0 		0
0
(18) TALAL S HAMDAN MD (i)
(ii)		 738,966
0 		0
0 		37,572
0 		0
0 		22,739
0 		799,277
0 		0
0
(19) SAMI M AASAR MD (i)
(ii)		 748,858
0 		0
0 		21,282
0 		0
0 		28,515
0 		798,655
0 		0
0
(20) LAWRENCE S KLEIN MD (i)
(ii)		 739,974
0 		0
0 		38,873
0 		0
0 		17,072
0 		795,919
0 		0
0
(21) BLAIR S MACPHAIL MD (i)
(ii)		 727,941
0 		0
0 		38,118
0 		0
0 		27,846
0 		793,905
0 		0
0
(22) EDWARD A HARLAMERT MD (i)
(ii)		 748,381
0 		0
0 		21,618
0 		0
0 		22,448
0 		792,447
0 		0
0
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule J, Part I - Questions Regarding Compensation Line 1b - Gross-Up Payments and Personal Services Samuel L. Odle received financial planning services, of which the expense and the tax gross-up on the expense, were properly included on his Form W-2 as taxable wages. These financial planning services were approved by the Board of Directors.
Schedule J, Part I - Questions Regarding Compensation Line 4a - Severance or Change-of-Control Payments Daniel L. Fink received 2011 severance of $234,012 from Indiana University Health, Inc. This amount is included in column b (iii), other reportable compensation. Included in column C, other deferred compensation, is $454,373 of deferred compensation and benefits. Diane J. Thompson received 2011 severance of $33,136 from Indiana University health, Inc. This amount is included in column b (iii), other reportable compensation. Included in column C, other deferred compensation is $181,248 of deferred compensation and benefits.
Schedule J, Part I - Questions Regarding Compensation Line 4b - Supplemental Nonqualified Retirement Plan Daniel F. Evans Jr., Marvin G. Pember, Norman G. Tabler, Jr., Richard F. Graffis, M.D., Samuel L. Odle, Linda Q. Everett, Daniel L. Fink, John C. Kohne, M.D. and Marilyn Cox participate in a supplemental executive retirement plan, provisions of which are designed to retain these critical employees. The plan provides for an additional retirement benefit for service through normal retirement or other key dates. If the executive leaves prior to retirement or other key dates, the benefit may be forfeited or reduced. With the exception of Marvin G. Pember, Norman G. Tabler, Jr., Richard F. Graffis, M.D., and Daniel L. Fink, each of these executives has an amount included in column c, deferred compensation, representing the current year increase in the accrued benefit and/or current year contributions. No amount was actually paid to these executives during the year. For Marvin G. Pember, Norman G. Tabler, Jr., Richard F. Graffis, M.D., and Daniel L. Fink, $290,387, $52,611, $72,782, and $391,277 respectively, is included in column b(iii), other reportable compensation, representing the amount received under their vested supplemental executive retirement plan
Schedule J, Part I - Questions Regarding Compensation Line 7 - Non-Fixed Payments Amounts disclosed in Column B(ii) include a long-term and short-term incentive for certain executives and short-term incentive for other employees. Although these plans are based on a fixed formula that has been approved by the Board of Directors based upon certain qualitative and quantitative factors and goals, all discretionary incentive payments must be approved by the Committee on Personnel and Compensation and Board of Directors prior to any incentive payout.
Schedule J (Form 990) 2011

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH INC
 
Employer identification number
35-1955872
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A INDIANA HEALTH AND EDUCATIONAL FACILITY FINANCING
  		35-1611409 45479RAH0 01-24-2006 325,003,005 SERIES 2006A BONDS   X   X   X
B INDIANA HEALTH AND EDUCATIONAL FACILITY FINANCING
  		35-1611409 45479RBL0 09-14-2006 387,109,760 SERIES 2006B BONDS   X   X   X
C INDIANA FINANCE AUTHORITY
  		35-1602316   04-09-2010 28,000,000 TAX-EXEMPT LEASE, 2010   X   X   X
D INDIANA FINANCE AUTHORITY
  		35-1602316 45471AEB4 04-19-2011 228,195,000 SERIES 2011A, B, C, D, AND E BONDS   X   X   X
INDIANA FINANCE AUTHORITY
  		35-1602316 45471AED0 05-05-2011 274,815,000 SERIES 2011F, G, H AND I BONDS   X   X   X
INDIANA FINANCE AUTHORITY
  		35-1602316   05-25-2011 111,435,000 SERIES 2011L AND M BONDS   X   X   X
INDIANA FINANCE AUTHORITY
  		35-1602316 45471AFX5 12-07-2011 221,617,127 SERIES 2011N BONDS   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . 0 26,005,000 0 21,500,000
2 Amount of bonds legally defeased . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . 348,013,874 388,586,019 28,000,000 228,199,331
4 Gross proceeds in reserve funds . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . 29,904,769 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . 1,947,719 2,286,019 0 740,000
8 Credit enhancement from proceeds . . . . . . . . . . 0 0 0 0
9 Working capital expenditures from proceeds . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . 316,161,386 0 28,000,000 70,004,331
11 Other spent proceeds . . . . . . . . . . . 0 0 0 0
12 Other unspent proceeds . . . . . . . . . . . 0 0 0 0
13 Year of substantial completion . . . . . . . . . . . 2007 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . .   X X     X X  
15 Were the bonds issued as part of an advance refunding issue? . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . X   X   X     X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X   X   X  
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2011
Schedule K (Form 990) 2011
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . X   X   X   X  
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . X   X   X   X  
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? . X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.00000% 0.00000% 0.00000% 0.00000%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.00000% 0.00000% 0.00000% 0.00000%
6 Total of lines 4 and 5 . . .. . . . . . . . . 0.00000% 0.00000% 0.00000% 0.00000%
7 Does the bond issue meet the private security or payment test? . . . X   X   X   X  
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue?   X   X X   X  
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . 0
  		0
  		0
  		 
 
c Term of hedge . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was a hedge terminated? . . . . .                
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .   X X     X   X
b Name of provider . . . . . . 0
  		SEE PART VI
  		0
  		0
 
c Term of GIC . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . . X   X          
5 Were any gross proceeds invested beyond an available temporary period? . . . . . . X     X   X   X
6 Did the bond issue qualify for an exception to rebate? .   X X     X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .   X X     X   X
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
See Schedule O for Schedule K, Part V, Supplemental Information 0  
See Schedule O for Schedule K, Part V, Supplemental Information 0  
Schedule K (Form 990) 2011

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH INC
 
Employer identification number
35-1955872
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A INDIANA HEALTH AND EDUCATIONAL FACILITY FINANCING
  		35-1611409 45479RAH0 01-24-2006 325,003,005 SERIES 2006A BONDS   X   X   X
B INDIANA HEALTH AND EDUCATIONAL FACILITY FINANCING
  		35-1611409 45479RBL0 09-14-2006 387,109,760 SERIES 2006B BONDS   X   X   X
C INDIANA FINANCE AUTHORITY
  		35-1602316   04-09-2010 28,000,000 TAX-EXEMPT LEASE, 2010   X   X   X
D INDIANA FINANCE AUTHORITY
  		35-1602316 45471AEB4 04-19-2011 228,195,000 SERIES 2011A, B, C, D, AND E BONDS   X   X   X
INDIANA FINANCE AUTHORITY
  		35-1602316 45471AED0 05-05-2011 274,815,000 SERIES 2011F, G, H AND I BONDS   X   X   X
INDIANA FINANCE AUTHORITY
  		35-1602316   05-25-2011 111,435,000 SERIES 2011L AND M BONDS   X   X   X
INDIANA FINANCE AUTHORITY
  		35-1602316 45471AFX5 12-07-2011 221,617,127 SERIES 2011N BONDS   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . 0 26,005,000 0 21,500,000
2 Amount of bonds legally defeased . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . 348,013,874 388,586,019 28,000,000 228,199,331
4 Gross proceeds in reserve funds . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . 29,904,769 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . 1,947,719 2,286,019 0 740,000
8 Credit enhancement from proceeds . . . . . . . . . . 0 0 0 0
9 Working capital expenditures from proceeds . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . 316,161,386 0 28,000,000 70,004,331
11 Other spent proceeds . . . . . . . . . . . 0 0 0 0
12 Other unspent proceeds . . . . . . . . . . . 0 0 0 0
13 Year of substantial completion . . . . . . . . . . . 2007 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . .   X X     X X  
15 Were the bonds issued as part of an advance refunding issue? . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . X   X   X     X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X   X   X  
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2011
Schedule K (Form 990) 2011
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . X   X   X   X  
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . X   X   X   X  
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? . X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.00000% 0.00000% 0.00000% 0.00000%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.00000% 0.00000% 0.00000% 0.00000%
6 Total of lines 4 and 5 . . .. . . . . . . . . 0.00000% 0.00000% 0.00000% 0.00000%
7 Does the bond issue meet the private security or payment test? . . . X   X   X   X  
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue?   X   X X   X  
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . 0
  		0
  		0
  		 
 
c Term of hedge . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was a hedge terminated? . . . . .                
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .   X X     X   X
b Name of provider . . . . . . 0
  		SEE PART VI
  		0
  		0
 
c Term of GIC . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . . X   X          
5 Were any gross proceeds invested beyond an available temporary period? . . . . . . X     X   X   X
6 Did the bond issue qualify for an exception to rebate? .   X X     X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .   X X     X   X
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
See Schedule O for Schedule K, Part V, Supplemental Information 0  
See Schedule O for Schedule K, Part V, Supplemental Information 0  
Schedule K (Form 990) 2011

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH INC
 
Employer identification number

35-1955872
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2011
Schedule L (Form 990 or 990-EZ) 2011
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) CHV CAPITAL INC SEE PART V 104,310 SEE PART V   No
(2) HEALTH VENTURE MANAGEMENT LLC SEE PART V 2,722,560 SEE PART V   No
(3) CHV FUND I LLC SEE PART V 624,996 SEE PART V   No
(4) IU HEALTH PLANS INC SEE PART V 80,202,388 SEE PART V   No
(5) CLARIAN HEALTH WEST LLC SEE PART V 8,817,965 SEE PART V   No
(6) CLARIAN HEALTH NORTH LLC SEE PART V 30,106,922 SEE PART V   No
(7) IUH ASSURANCE LTD SEE PART V 5,866,170 SEE PART V   No
(8) IU HEALTH RISK RETENTION GROUP INC SEE PART V 10,185,431 SEE PART V   No
(9) SENATE STREET SURGERY CENTER LLC SEE PART V 5,116,071 SEE PART V   No
(10) ROC SURGERY LLC SEE PART V 3,106,104 SEE PART V   No
(11) THE HEALTHCARE GROUP LLC SEE PART V 584,914 SEE PART V   No
(12) HILL-ROM HOLDINGS INC SEE PART V 5,731,849 SEE PART V   No
(13) NOMORECLIPBOARDCOM SEE PART V 90,000 SEE PART V   No
(14) JAMIE M RIVAS SEE PART V 61,202 SEE PART V   No
(15) JUSTIN HELSPER SEE PART V 40,189 SEE PART V   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L, Part IV - Business Transactions Involving Interested Persons Line 1, Columns (b) and (d) - Relationship and Description of Transaction Daniel F. Evans, Jr. serves on the Board of Directors of CHV Capital, Inc. Indiana University Health, Inc. ("IU Health") performs services for CHV Capital, Inc. and is compensated for such services on an arm's length basis. Additionally, CHV Capital, Inc. pays rent to IU Health on an arm's length basis. Marvin G. Pember and John C. Kohne, M.D. serve on the Board of Managers of Health Venture Management, LLC. IU Health performs services for Health Venture Management, LLC and is compensated for such services on an arm's length basis. Additionally, Health Venture Management, LLC performs services for IU Health and is compensated for such services on an arm's length basis. Daniel F. Evans, Jr. serves on the Board of Managers of CHV Fund I, LLC. CHV Fund I, LLC provides investment management services to IU Health and is compensated for such services on an arm's length basis. Norman G. Tabler, Jr. is an officer and serves on the Board of Directors of Indiana University Health Plans, Inc. Marvin G. Pember and Ryan C. Kitchell each served on the board of directors of Indiana University Health Plans, Inc. during a portion of 2011. IU Health performs services for Indiana University Health Plans, Inc. and is compensated for such services on an arm's length basis. Additionally, IU Health receives capitated payments from Indiana University Health Plans, Inc. Additionally, Indiana University Health Plans, Inc. pays rent to IU Health on an arm's length basis. Daniel F. Evans, Jr. and Samuel L. Odle serve on the Board of Managers of Clarian Health West, LLC. Marvin G. Pember and Isadore Rivas each served on the board of directors of Clarian Health West, LLC during a portion of 2011. IU Health has made an interest-bearing loan to Clarian Health West, LLC on an arm's length basis. IU Health and Clarian Health West, LLC also perform services for each other and are compensated for such services on an arm's length basis. Additionally, Clarian Health West, LLC pays rent to IU Health on an arm's length basis. Daniel F. Evans, Jr. and Samuel L. Odle serve on the Board of Managers of Clarian Health North, LLC. Marvin G. Pember and Ryan C. Kitchell each served on the board of directors of Clarian Health North, LLC during a portion of 2011. IU Health has made an interest-bearing loan to Clarian Health North, LLC on an arm's length basis. IU Health and Clarian Health North, LLC also perform services for each other and are compensated for such services on an arm's length basis. Additionally, Clarian Health North, LLC pays rent to IU Health on an arm's length basis. Norman G. Tabler, Jr. is an officer and serves on the Board of Directors of IUH Assurance, Ltd. IU Health purchases insurance from IUH Assurance, Ltd. on an arm's length basis. Norman G. Tabler, Jr. is an officer and serves on the Board of Directors of IU Health Risk Retention Group, Inc. IU Health performs services for IU Health Risk Retention Group, Inc. and is compensated for such services on an arm's length basis. Additionally, IU Health purchases insurance from IU Health Risk Retention Group, Inc. on an arm's length basis. John C. Kohne, M.D., Linda Q. Everett, and Isadore Rivas serve on the Board of Managers of Senate Street Surgery Center, LLC. IU Health performs services for Senate Street Surgery Center, LLC and is compensated for such services on an arm's length basis. Additionally, Senate Street Surgery Center, LLC pays rent to IU Health on an arm's length basis. Marilyn Cox serves on the Board of Managers of ROC Surgery, LLC. IU Health performs services for ROC Surgery, LLC and is compensated for such services on an arm's length basis. Additionally, ROC Surgery, LLC pays rent to IU Health on an arm's length basis. Daniel F. Evans, Jr. serves on the Board of Managers of The HealthCare Group, LLC. Marvin G. Pember and Ryan C. Kitchell each served on the board of directors of The Healthcare Group, LLC during a portion of 2011. During 2011, IU Health made contributions to The HealthCare Group, LLC, along with other owners, in proportion to its ownership interest in the organization, to cover its unfunded losses. Charles E. Golden serves on the Board of Directors of Hill-Rom Holdings, Inc. From time to time, IU Health purchases products from Hill-Rom during the ordinary course of business on an arm's length basis. William R. Cast, M.D. serves as an officer of NOMORECLIPBOARD.com. From time to time, IU Health purchases products from NOMORECLIPBOARD.com during the ordinary course of business on an arm's length basis. Jamie M. Rivas, the daughter-in-law of Isadore Rivas, VP-Finance & Interim CFO of IU Health, serves and is compensated as an employee of IU Health. Justin K. Helsper, the son of Richard S. Helsper, a former key employee of IU Health, serves and is compensated as an employee of IU Health.
Schedule L (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH INC
 
Employer identification number

35-1955872
Identifier Return Reference Explanation
Part III, Line 4a Statement of Program Service Accomplishments Indiana University Health System With hospitals in more than a dozen Indiana communities and services across the state, the Indiana University Health System is the state's largest and most comprehensive health system. The system's strength is grounded in its unique partnership with Indiana University School of Medicine - one of the nation's leading medical schools. Each year, millions of people across Indiana and beyond receive expert, patient-centered care at IU Health. Indiana University Health, Inc. The parent organization of the Indiana University Health System is Indiana University Health, Inc. ("IU Health"). Our Mission IU Health is committed to provide a unified standard of preeminent care to individuals in Indiana and across the globe. Partnering with Indiana University and the Indiana Conference of the United Methodist Church, IU Health is dedicated to its mission to improve the health of its patients and community through innovation and excellence in care, education, research and service. Our Values At IU Health, we value: - Comprehensive patient care, including mind, body and spirit - Excellence in education for healthcare providers - Quality of care and respect for life - Charity, equality and justice in healthcare - Leadership in health promotion and wellness - Excellence in research - An internal community of mutual trust and respect Our Vision IU Health strives to be a preeminent leader in clinical care, education, research and service. Our excellence is measured by objective evidence and established best practices. Exemplary levels of respect and dignity are given to patients and their families, while professionalism and collegiality mark relationships among team members. IU Health continues to focus on innovation and excellence through collaboration among its hospitals and its affiliation with Indiana University School of Medicine. Impacting Communities Improving the health of patients and communities is the mission of Indiana University Health. This is achieved in a number of ways - by delivering innovation and excellence in clinical care, through research and in serving the communities in which we live and work. Each year, IU Health consults with community partners to identify and assess the greatest health needs in the communities we serve. In neighborhoods across Indiana, IU Health works as a driving force to improve community health and wellness by addressing these needs. IU Health follows federal guidelines for reporting community benefit and other community investments. Community benefits include charity care, unreimbursed costs of public programs, such as Medicaid and certain other services that provide treatment or promote health and healing in response to community needs. 2011 Community Outreach Priorities Access to high-quality healthcare is just one factor that influences the health of individuals and communities. Various social and environmental factors also play an important role. To identify and commit to this year's community health outreach priorities, Indiana University Health analyzed community needs assessments from local and national organizations, including the county health departments, Indiana State Department of Health, Centers for Disease Control and Prevention and United Way of Central Indiana. The health system's community outreach priorities for 2011 were the following: Health Priorities - Obesity prevention - Injury prevention - Access to healthcare Quality of Life Priorities - K-12 education - Community revitalization
Part III, Line 4a (Continued) Statement of Program Service Accomplishments Obesity Prevention Addressing the issue of widespread obesity continues to be a critical health priority for Indiana. The state ranks 15th nationally in the percentage of adults classified as obese. Perhaps more alarming, nearly 29 percent of Hoosier children and 65 percent of adults are overweight or obese. The health consequences of obesity are significant, and include increased risk for developing otherwise preventable diseases such as heart disease and type 2 diabetes. IU Health has spearheaded a number of innovative community-based programs focused on fighting obesity by increasing the availability of affordable, healthy food for Indiana residents with the greatest need. Garden on the Go Garden on the Go, a cornerstone of IU Health's obesity prevention strategy, is a year-round mobile produce delivery program designed to improve access to affordable, fresh fruits and vegetables for residents living in disadvantaged and underserved Indianapolis neighborhoods. Launched in May 2011 with weekly stops, Garden on the Go is an easy, economical solution for families, offering urban shoppers a market-like experience to buy nutritious produce. Program Highlights and Impact - Expanded from 12 to 16 stops in September 2011, Garden on the Go served thousands of community members with a total of 8,281 point-of-sale transactions by year's end. - In an Indiana State Department of Health-sponsored survey, 83 percent of repeat Garden on the Go customers reported purchasing more produce because of the mobile delivery program. - Garden on the Go was recognized by both the February 2012 White House and the 2012 National Black Caucus as a benchmark representation of a replicable community partnership model aimed at combating obesity. Indy Urban Acres In 2011 IU Health, Indy Parks & Recreation and Indianapolis Parks Foundation broke ground on Indy Urban Acres - an eight-acre organic urban farm to grow fresh fruits and vegetables for food bank patrons. In two months the farm harvested more than 1,400 pounds of produce from plantings on just one half-acre. Fulfilling basic nutritional requirements and addressing the prevalence of obesity in Indiana, Indy Urban Acres brings healthy, fresh food alternatives to the tables of Hoosiers in need. Gleaners Food Bank makes scheduled pick-ups at Indy Urban Acres and then distributes the food to hunger relief agencies in 21 central and southeastern counties. "This resource, which is in our own backyard, has the ability to get healthy foods into the hands that need them the most." said Cindy Hubert, Gleaners President and CEO. Riley School Gardens Riley Hospital for Children at Indiana University Health joined with Keep Indianapolis Beautiful, Inc. and Indianapolis Public Schools in the fight against childhood obesity in Indianapolis. With nearly 30 percent of Hoosier adolescents classified as overweight or obese, the Riley School Gardens program is part of IU Health's statewide, comprehensive initiative to fight the obesity epidemic by improving access to healthy foods and safe places for physical activity in high-poverty neighborhoods. In partnership with Keep Indianapolis Beautiful, Inc. and Indianapolis Public Schools, Riley Hospital for Children at Indiana University Health constructed 10 school gardens in the Spring of 2011. This sustainable Riley School Gardens program involved children in growing, harvesting, and preparing seasonal produce, to ensure access to nutritious food, and create a living learning environment for students.
Part III, Line 4a (Continued) Statement of Program Service Accomplishments Injury Prevention Effective injury prevention efforts save lives. This is especially true when considering the number of children who are injured each year due to poor child passenger and bicycle safety. To help keep our young people safe in vehicles and at play, IU Health has implemented statewide efforts to improve child passenger safety and to increase the use of bicycle helmets. Child Passenger Safety Campaign Motor vehicle injuries are the leading cause of death among children in the United States. But many of these deaths can be prevented. Placing children in age and size appropriate car seats and booster seats reduces serious and fatal injuries by more than half. IU Health's statewide child passenger safety campaign educates the community on the safety concerns of children traveling unrestrained or incorrectly restrained in vehicles. Coordinated with the Automotive Safety Program at Riley Hospital for Children at Indiana University Health, the campaign aims to decrease the number of preventable injuries associated with these unsafe practices. In September 2011 IU Health conducted eight coordinated car seat clinics in communities across the state as part of Child Passenger Safety Week and the National Car Seat Check Saturday initiative. Program Highlights and Impact - In addition to donating 122 car seats to Indiana families, IU Health system hospitals performed 205 car seat inspections, helping 176 families (86 percent) correctly re-install their child safety seats. - To enhance campaign success, IU Health coordinated the system-wide services of 49 child passenger safety technicians and more than 40 "Strength That Cares" volunteers. - Throughout the year, at permanent fitting stations located in our IU Health hospitals across the state, over 1,100 car seat inspections have been conducted and more than 340 car seats have been provided to families in need. Bicycle Helmet Safety Campaign IU Health engages and educates Indiana children on the importance of bicycle safety. The campaign focuses on bicycle safety education, as well as offering free properly fitted helmets to kids. IU Health conducted bicycle helmet fittings at 21 summer camps throughout the state in 2011 and also held eight large community-based bicycle safety events in Indianapolis. Program Highlights and Impact - In 13 communities with IU Health locations, 4,042 children received bicycle helmet fittings or education about bicycle safety. - IU Health's campaign made a positive impact at Indiana summer camps. Based on post-camp surveys administered after five months, 98 percent of parents or guardians of children who attended the safety presentations reported their children were still practicing or had made improvement in consistent helmet use or bicycle safety skills. Injury Prevention One appreciative mother said, "It was really a great treat to get the helmet and more importantly to know it was fitted correctly. I really appreciated the take home education we reviewed together and hope these tips stick with them as they grow up." Access to Affordable Healthcare With more than 550,000 Hoosiers without health insurance, IU Health recognizes one of the most critical needs in our communities is access to affordable quality health care. IU Health works in a number of ways to ensure everyone has access to healthcare by supporting community clinics to purchase medication or equipment they need to serve the community or by providing quality healthcare at no cost. IU Health knows one of the biggest barriers to accessing healthcare is the inability to pay for services, so IU Health offers a generous Financial Assistance Program, providing care at no cost to qualifying individuals who make 200% or less of the Federal Poverty Guidelines, about $44,000 for a family of four. The Financial Assistance Program provides healthcare services on a sliding scale for those over 200% of the Federal Poverty Guidelines. IU Health's Academic Health Center has a close relationship with HealthNet clinics to serve the healthcare needs of the underserved and uninsured residents of Marion County. Three of HealthNet's sixteen clinics are located on IU Health's Academic Health Center campus. Quality of Life Priorities "Being healthy" is much more than the absence of disease. The health of individuals and communities is shaped by social and environmental factors as well. To truly improve overall health, it is essential to understand community needs and create innovative strategies to meet them. That's why IU Health is committed to impacting K-12 education and community revitalization - two important Quality of Life priorities. K-12 Education: Kindergarten Countdown Program In 2011 IU Health partnered with United Way to launch Kindergarten Countdown - a school readiness program for at-risk children. Through IU Health's significant investment in this signature program, hundreds of soon-to-be kindergarten students received necessary vaccinations and health screenings, as well as help for their parents with school registration. Children also attended a four-week summer "camps" specially designed to strengthen and build basic skills and enhance learning readiness. With support from IU Health, the program was implemented across the Indianapolis Public Schools district and expanded into 10 additional IU Health communities across Indiana. The camps proved valuable: Students who attended camps in the Indianapolis Public School district last year saw an 11 percent increase from pre- to post-camp literacy test scores. According to the Centers for Disease Control and Prevention (CDC), lower grades, test scores and educational attainment are consistently linked to violence and physical inactivity. By ensuring our children are ready to learn from a young age, we're also ensuring their future good health.
Part III, Line 4a (Continued) Statement of Program Service Accomplishments Community Revitalization: It is well-precedented for hospitals and health care systems, particularly those located in or around an urban center, to be deeply engaged in the revitalization of the communities that they serve. IU Health has adopted an "in our backyard" approach to community revitalization by focusing on the neighborhoods immediately surrounding our existing (and developing) assets within our communities. To support this commitment, IU Health participated in the Mid-North Quality of Life Planning process. Quality of Life Planning is a proven method for neighbors to use in creating the future they desire for their community. The Mid-North Neighborhoods Plan is created by stakeholders in six Mid-North neighborhoods through a process of engagement, relationship-building and collective decision-making. These processes lead to a set of neighborhood priorities and goals. These are then transformed into a comprehensive plan. To support the goal of Mid-North area residents embracing holistic wellness and living healthier lifestyles, IU Health along with other local community partners are working towards establishing a new health and wellness facility for area families, individuals, employees and students. "Strength That Cares" Day of Service Showing "Strength That Cares," more than 1,600 IU Health employees participated in the third annual Day of Service in 2011. To help address childhood obesity and promote active lifestyles, employees constructed three new playgrounds and refurbished an additional 12 at Indiana elementary schools. IU Health teams also planted five school gardens for growing nutritious produce for low-income school children across the state. The work completed in just one day made a difference in the lives of 65,000 Indiana residents who now have more safe, secure and convenient places to play and stay active. Financial Assistance and Unreimbursed Care Extending Our Healthcare Reach: High-Quality Care and Access for All To ensure all patients have access to quality healthcare, Indiana University Health treats patients, regardless of their ability to pay. The financial assistance program of IU Health is designed for those who are uninsured, low income or underinsured. Quality Care and Coverage Using federal poverty guidelines to determine eligibility, IU Health offers an extensive financial assistance program to ensure care is within a patient's reach. Financial assistance, also called charity care, means providing free medical care or care at a reduced cost to low-income individuals. Although there are some variations between hospitals, generally the IU Health financial assistance program provides support this way: - Free care for those earning up to 200 percent of federal poverty guidelines. - Discounted care on a sliding scale for families earning 200 to 400 percent of federal poverty guidelines. - Discounted care on a sliding scale for uninsured families earning 400-650 of federal poverty guidelines. - Free care to patients whose health insurance - if he or she has any - does not cover all medical expenses and whose medical expenses would make them indigent if forced to cover all costs. Patients are given information about IU Health's financial assistance program during registration, and it is included on billing statements. Patients can also find the financial assistance application online at http://iuhealth.org/patients/billing-center/financial-assistance/ Unreimbursed Costs In addition to providing free or reduced-cost services, IU Health absorbs unreimbursed costs from government-sponsored programs based on income level, such as Medicaid, the Children's Health Insurance Program (CHIP), local and state government programs for persons not eligible for Medicaid, and other programs. Community Health Improvement Services Reaching Beyond Hospital Walls In addition to providing preeminent patient care in hospitals, Indiana University Health is a partner in promoting healthier Indiana communities. A Healthy Start to Education at the Indiana State Fair For hundreds of at-risk young children enrolled in the Kindergarten Countdown school readiness program, a two-day celebration at the 2011 Indiana State Fair continued preparations for a successful transition to school. At the fair, hundreds of soon-to-be kindergartners and their parents took part in free vision screenings and oral health evaluations, practiced getting on and off a real school bus and learned tips for packing healthy lunches and snacks. The State Fair celebration was the culmination of Kindergarten Countdown, a statewide effort between IU Health and United Way of Central Indiana that strives to prepare more at-risk children for success in school. Advancing Newborn Care in Indiana In 2011, Riley Hospital for Children at IU Health launched a unique newborn resuscitation simulation outreach program, designed to improve care provided in delivery rooms across the state. Riley developed the program to help strengthen the skills of resuscitation teams in outlying hospitals. The simulation helps teams gain experience dealing with life-threatening or high-risk delivery room situations. Expert members of Riley's simulation team traveled the state, completing newborn resuscitation training at many hospitals across the state.
Part III, Line 4a (Continued) Statement of Program Service Accomplishments Health Professions Education For a Better Future: Improving Tomorrow's Care Providing high-quality care and the latest treatments is only possible when there are people educated and expertly trained to deliver them. Indiana University Health takes pride in its unique partnership with Indiana University School of Medicine and works as an active partner to train and educate the next generation of healthcare professionals. IU Health also provides programming and education to increase the skills and knowledge of current providers. Charles Warren Fairbanks Center for Medical Ethics The Fairbanks Center for Medical Ethics at IU Health educates physicians, nurses, allied health professionals and other professionals about contemporary ethics issues in healthcare. Educational programs include the Fairbanks Fellowship in Clinical Ethics, the Fairbanks Lecture Series, multiple practicum and internship opportunities for graduate students, law students, and medical and pediatric residents. In-service presentations for patient care staff at IU Health hospitals are also conducted. IU Health Learning Alliance The IU Health Learning Alliance provides accredited training programs for those interested in pursuing careers in the healthcare field (physicians, nurses, health science technologists, etc.). In addition to coordinating outreach programs, the alliance offers a variety of classes to the public and provides thousands of hours of continuing education and community, wellness and patient education every year. Subsidized Health Services Providing Essential Care: Reaching Out to Those in Need Providing necessary healthcare and services that wouldn't exist in a community is an important priority of Indiana University Health. The system offers a number of programs aimed at improving the health and well-being of those in need. By providing these services, even at a financial loss, IU Health is able to increase access to needed services for people in our communities, especially the most vulnerable. Behavioral and Spiritual Health Lack of mental health services is a problem plaguing most communities. Serving both children and adults, IU Health Behavioral Health offers a broad range of programming to help assure each patient's total wellbeing. Services include assessment and diagnosis, inpatient and outpatient psychiatric care and chemical dependency treatment and consultation. In every case, treatment programs and services are customized to individual needs. Part of IU Health, the Buchanan Counseling Center has provided pastoral counseling and psychological services on an outpatient basis for more than 40 years. The center's counselors are educated and trained in theology, psychology, mental health counseling and an array of treatment methods. Buchanan Counseling Center integrates faith and spirituality to promote wholeness, and physical and spiritual wellbeing. The center offers services on an adjusted fee scale, and anyone desiring services will receive them, regardless of their ability to pay. Diabetes Services Certified diabetes educators at IU Health Diabetes Centers provide exemplary diagnostic, treatment and educational resources to help people with diabetes learn about and manage their illness so they can enjoy a healthy life. Research Discovering New Treatments: Improving Health by Innovation Cultivating research excellence is an important part of the mission of Indiana University Health. Research and new treatment discovery is instrumental in improving patient care and outcomes. As an academic health center, IU Health actively supports researchers by providing access to the latest technology and facilities - fostering an environment that makes innovation and breakthroughs in research possible. First to offer Trifecta heart valve In June 2011, IU Health became the first health system in the state to offer the Trifecta valve, a new stented tissue valve replacement for diseased, damaged or malfunctioning aortic heart valves. The Trifecta valve mimics the flow of a natural, healthy heart and was designed for the optimization of blood flow, less strain on the heart and long-term durability. Berlin Heart Device approved by FDA With support from Riley Hospital for Children at IU Health, the U.S. Food and Drug Administration in late 2011 approved use of the Berlin Heart Device in the U.S. While the device was implanted extensively worldwide, it did not have FDA approval. This left North American hospitals like Riley at IU Health without access to the one mechanical heart support system designed for children. This prompted Riley at IU Health to ask the FDA for special permission to import and implant the Berlin Heart. Riley at IU Health later established a protocol for obtaining the Berlin Heart, shared that with other institutions and served as a catalyst for use of the device in North America. First Melody implants performed at Riley at IU Health In 2011, Riley Hospital for Children at IU Health performed the first three Melody Transcatheter Pulmonary Valve implants in Indiana. The Melody valve is used to repair a blocked or leaky pulmonary heart valve that has already been replaced to correct congenital heart defects. This new treatment immediately restores pulmonary valve function and is considerably less invasive. Financial and In-Kind Contributions Paying It Forward: Community Collaboration and Partnerships Working to improve the health of communities is a team effort. That's why Indiana University Health partners with like-minded organizations to make a greater impact on the health and wellbeing of people across Indiana.
Part III, Line 4a (Continued) Statement of Program Service Accomplishments Plainfield Parks and Recreation In 2011, IU Health West Hospital launched a multi-year relationship as the official healthcare partner of Plainfield Parks and Recreation. In addition to providing a permanent on-site presence at the state-of-the-art Plainfield Recreation and Aquatic Center, the hospital offers free health and wellness education, and counseling on healthier snack bar options at the city's parks. The partnership also creates an avenue for hospital patients graduating from programs like physical therapy or cardiovascular rehabilitation to access high-quality, safe fitness environments through Plainfield's parks. John Stewart Foundation To raise awareness of sudden cardiac arrest (SCA) among student athletes, Indiana University Health Cardiovascular donated 2 automatic external defibrillators (AEDs) to Indianapolis Public Schools and the John Stewart Foundation. John Stewart was an Indiana high school basketball star who, in 1999, collapsed on the basketball court and died from SCA. If used immediately, an AED is the only treatment that can help reverse sudden cardiac arrest - making AED availability at school sporting events critical to saving young lives. Indianapolis Medical Society - Project Health IU Health supports Project Health. A program of the Indianapolis Medical Society, Project Health is a community partnership aimed at improving access to healthcare for low-income, uninsured Indianapolis residents. Project Health combines donated physician care, hospital services, medication assistance and case management to maximize existing community resources and enhance coordination among services providers. Juvenile Diabetes Research Foundation (JDRF) Riley Hospital for Children at IU Health provided a donation to support the Juvenile Diabetes Research Foundation, the leading global organization focused on type 1 diabetes research. The goal of JDRF is to improve the lives of people affected by type 1 diabetes through support of the most promising opportunities to cure, better treat and prevent the disease. Community Building Building Bridges: Strengthening Community Bonds To positively impact the health and wellness of vulnerable populations, Indiana University Health supports economic development across the state that targets this need. Kindergarten Countdown IU Health partnered with United Way of Central Indiana (UWCI) and the Indiana Association of United Ways in 2011 to help more at-risk children successfully transition into school. Through the UWCI's Kindergarten Countdown, underserved children are equipped with the basic skills needed for success in kindergarten. The program has three primary components: helping families navigate the school registration process; promoting school readiness through pre-kindergarten summer camps; and encouraging first-day-of-school attendance. With help from IU Health, Kindergarten Countdown was expanded throughout the entire IPS district and introduced into more than a dozen IU Health communities across Indiana. Center for Leadership Development IU Health provided support to the Center for Leadership Development (CLD). By focusing on character, education, leadership and service, CLD works to expose African-American youth to some of the nation's richest experiences focused on inspiring youth achievement. Indy Reads Indy Reads serves central Indiana adults 18 years of age and older who read at or below the sixth-grade level or who are learning English as a second language. IU Health provided support to Indy Reads in 2011. Junior Achievement of Central Indiana, Inc. IU Health supported Junior Achievement of Central Indiana, Inc., an organization providing learning experiences for area students centered on life skills, job skills, financial literacy, entrepreneurship and a fundamental understanding of economics and the free enterprise system. Academic Health Center Indiana University Health Methodist Hospital Indiana University Health Methodist Hospital, founded in 1908, is a national and regional healthcare leader with a long-standing tradition of preeminent patient care and clinical excellence. For 10 consecutive years, IU Health Methodist Hospital has been ranked among the top 50 hospitals nationally in U.S.News & World Report's "America's Best Hospitals" guide. The hospital is home to a number of award-winning clinical programs, including cardiovascular, transplant and neuroscience. IU Health Methodist Hospital also hosts one of the largest critical care departments in the nation and is one of only two adult Level One Trauma Centers in Indiana. The Fairbanks Center for Medical Ethics - one of the few clinically based medical ethics centers in the U.S. - also is housed at IU Health Methodist Hospital. 2011 Community Benefit Highlights - In 2011, dedicated staff at IU Health Methodist Hospital reached over 6,000 community members through educational programming such as cancer screenings and injury prevention classes. - IU Health Methodist Hospital provides a 24 hour nurse line staffed by specially trained registered nurses who assess the situation and advise callers how to get the right care, at the right time, in the right setting. In 2011, over 4,000 community members received assistance from this IU Health service. Indiana University Health University Hospital Indiana University Health University Hospital, a major teaching hospital, offers patients access to the treatments, therapies and procedures found only in the most advanced academic medical centers. Patients benefit from the hospital's close affiliation with Indiana University School of Medicine (IUSM). In fact, many of the treatment advances start in IUSM research laboratories and are incorporated into patient care through clinical programs at IU Health University Hospital. Several clinical programs at IU Health University Hospital have been consistently ranked among the best in the nation by U.S. News and World Report. IU Simon Cancer Center - a collaboration between IU Health and IUSM - is the state's only National Cancer Center (NCI)-designated cancer center providing patient care. IU Health University Hospital is also home to IU Health Transplant, the largest and most comprehensive center of its kind in the region and the fourth largest by volume in the nation.
Part III, Line 4a (Continued) Statement of Program Service Accomplishments Riley Hospital for Children at Indiana University Health Riley Hospital for Children at Indiana University Health is one of the nation's leading children's hospitals. As Indiana's first and most comprehensive pediatric hospital, Riley Hospital at IU Health is nationally ranked in all 10 pediatric specialty areas rated by U.S.News and World Report. The hospital's unique partnership with Indiana University School of Medicine ensures Riley's highly skilled physicians have access to the most innovative treatments and the latest research and technology. Each year, Riley Hospital at IU Health provides comprehensive, family-centered care to more than 215,000 children through its inpatient and outpatient programs. Pediatric patients and their families travel from across Indiana, the region and the world to access Riley's nationally recognized clinical programs. In January 2011, the first phase of the Riley Hospital for Children Simon Family Tower opened. This new 10-story inpatient building, designed to add capacity, increase efficiency and enhance patient satisfaction, is scheduled for completion in 2013. 2011 Community Benefit Highlights - In 2011, health educators at Riley Hospital for Children at IU Health reached nearly 10,000 community members through educational programming such as Safe Sitter, CPR and injury prevention classes. - Riley Community Education and Child Advocacy helps families prevent injuries to all children (including children with special needs) with child safety products and education through two first-in-the-nation programs - the Riley Safety Store and Safe Escape. - Riley at IU Health provides Indiana's largest number of continuing medical education programs for physicians and other health care professionals Awards and Attributes - Ten specialty programs ranked among the top children's hospitals in the nation by U.S. News & World Report's 2011-2012 edition of America's Best Children's Hospitals - All Indiana pediatricians listed in America's Top Doctors, a national consumer publication, have Riley at IU Health-based practices Indiana University Health North Hospital Located in Carmel, Ind., Indiana University Health North Hospital is a full-service hospital offering patients a broad range of clinical services - from expert cardiovascular care and maternity services to the renowned pediatric programs of Riley Hospital for Children at IU Health North Hospital. The 189-bed facility features dedicated pavilions for women, children and specialty surgery, as well as an attached medical office building. All patient rooms are private, including those in the neonatal and pediatric intensive care units, to ensure a comfortable, healing environment for patients and families. IU Health North Hospital is committed to offering patients a preeminent healthcare experience. Recognized both nationally and internationally for patient satisfaction, the hospital continues from year to year to perform above state and national averages in patient satisfaction as reported by the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS). 2011 Community Benefit Highlights - IU Health North Hospital provided support and associate volunteers for a playground enhancement project at Sheridan Elementary School in Sheridan, Ind. - Additionally, the hospital supports the Trinity Free Clinic to assist in improving access to affordable healthcare to community members in need. - At the Carmel Farmer's Market, IU Health North Hospital associates provided cooking demonstrations to promote good nutrition. Children's activities hosted by the hospital promoted wellness. - IU Health North Hospital presented its annual Pumpkin Patch Festival featuring a 5K run/walk, bicycle safety course, interactive health information booths and family-friendly activities. Awards and Attributes - Full Chest Pain Center Accreditation - Society of Chest Pain Centers (SCPC) - Health Care Organization of the Month Award - Studer Group - Path to Excellence Award - NRC Picker - Bariatric Surgery Center of Excellence - American Society of Metabolic & Bariatric Surgery Accredited Heart Failure Center - Healthcare Accreditation Colloquium - Breast Imaging Center of Excellence designation - American College of Radiology - Best Hospital Metro Indianapolis - #3 US News & World Report - 2011 Specialty Award for Prostatectomy and 2010/2011 Distinguished Hospital Award for Outstanding Patient Experience - HealthGrades Indiana University Health West Hospital A 129-bed community hospital in Avon, Ind., Indiana University Health West Hospital was built with the comfort and needs of patients, families and visitors in mind. For patient privacy, the hospital features multiple corridors and elevators to separate patient and public areas. IU Health West Hospital provides a full range of healthcare services, including maternity, orthopedics and cancer care. 2011 Community Benefit Highlights - IU Health West Hospital collaborated with Habitat for Humanity in 2011 to conduct a "panel build." The build, which took place on the hospital campus, facilitates construction of every wall, the floor and the ceiling of a Habitat home. The panels are then transported to the home site. Community volunteers worked alongside hospital employee and family volunteers on this Habitat for Humanity project. - In spring 2011, IU Health West Hospital started a free walking club for community members to improve their health and fitness. The hospital provided walkers with a free pedometer and monthly educational web postings. - The Diabetes Center at IU Health West Hospital helps newly-diagnosed or at-risk patients take an active role in managing their diabetes so they can enjoy life. Certified diabetes educators provide a wide range of diagnostic, treatment and educational resources to help patients learn more about their illness. Working with a diabetes educator is free to patients, as is all of IU Health West Hospital's diabetes education and support programming. Awards and Attributes - Community Achievement Award from United Way of Central Indiana recognizing IU Health West's commitment to community partnership and support of initiatives that relate to the hospital's mission. Indiana University Health Saxony Hospital Indiana University Health Saxony Hospital is the newest hospital to join the IU Health system. Opened in December 2011, the 42-bed hospital, located in Fishers, Ind., is a unique specialty care hospital focusing on cardiovascular, orthopedic, spine care and emergency services. IU Health Saxony Hospital includes six technologically advanced surgical suites, an intensive care unit, three cardiac catheterization labs, a 24/7 emergency department, a LifeLine helipad for medical transport and an adjacent medical office building. The office building houses offices for medical and surgical specialists, including Riley Children's Specialists; as well as a sleep lab, outpatient surgery center, and facilities for cardiac rehabilitation and physical, occupational and speech therapies. The hospital also offers on-site diagnostics, such as MRI, CT and nuclear medicine. A Women's Imaging Center provides mammography, ultrasound and bone density studies. 2011 Community Benefit Highlights - Public walking trails on the IU Health Saxony Hospital campus provide a place for area residents to exercise. Health and wellness tips are posted along the routes. - IU Health Saxony Hospital was built according to the Green Guidelines for Healthcare (GGHC) and is an officially registered GGHC project. The GGHC designation means the hospital was built with respect for the environment and to promote the health and wellbeing of patients, families, visitors and employee associates. Additionally, "sustainable use" efforts were pursued during the hospital's design and construction. Sustainable use projects include land use and construction practices, management of storm water runoff, planting of sustainable landscapes, and reducing transportation emissions and light pollution.
Part VI, Section A - Governing Body and Management Line 2 - Family or Business Relationships Marvin G. Pember and John C. Kohne, M.D. serve on the board of managers of Health Venture Management, LLC. No additional compensation is provided. Norman G. Tabler, Jr. is an officer and serves on the board of directors of Indiana University Health Plans, Inc. Marvin G. Pember and Ryan C. Kitchell each served on the board of directors of Indiana University Health Plans, Inc. during a portion of 2011. No additional compensation is provided. Daniel F. Evans, Jr. and Samuel L. Odle serve on the board of managers of Clarian Health West, LLC. Marvin G. Pember and Isadore Rivas each served on the board of managers of Clarian Health West, LLC during a portion of 2011. No additional compensation is provided. Daniel F. Evans, Jr. and Samuel L. Odle serve on the board of managers of Clarian Health North, LLC. Marvin G. Pember and Ryan C. Kitchell each served on the board of managers of Clarian Health North, LLC during a portion of 2011. No additional compensation is provided. John C. Kohne, M.D., Isadore Rivas, and Linda Q. Everett serve on the board of managers of Senate Street Surgery Center, LLC. No additional compensation is provided. Daniel F. Evans, Jr. serves on the board of managers of The Healthcare Group. Marving G. Pember and Ryan C. Kitchell each served on the board of managers of The Healthcare Group, LLC during a portion of 2011. No additional compensation is provided. V. William Hunt and D. Craig Brater, M.D. serve on the board of managers of Indiana Proteomics Consortium, LLC. D. Craig Brater, M.D. is the Interim Chairman and Daniel F. Evans, Jr. and Michael A. McRobbie, Ph.D. serve on the board of directors of BioCrossroads.
Part VI, Section A - Governing Body and Management Line 4 - Significant Changes to Organizational Documents Indiana University Health, Inc. ("IU Health") filed Articles of Amendment to the Articles of Incorporation with the Indiana Secretary of State's Office effective August 19, 2011 to change the number of directors and number of at-large directors. Article IX, Section 1 is amended to read "The corporation shall have thirteen (13) to fifteen (15) directors" and Article IX, Section 3(A) is amended to read: "Nine (9) to Ten (10) 'at-large directors' shall be jointly elected by the affimative vote of both member classes."
Part VI, Section A - Governing Body and Management Lines 6, 7a and 7b - Members or Stockholders Line 6: Indiana University Health, Inc. ("IU Health") has two classes of members. One class, known as the University Class, shall consist of those persons serving from time to time as the Trustees of Indiana University. The other class, known as the Methodist Class, shall consist of the Members of the Methodist Health Group, Inc. Line 7a: The University Class shall have one vote (regardless of the number of persons in that class) on each matter submitted to a vote at an annual or special meeting of the members of the Corporation, and the Methodist Class shall have one vote (regardless of the number of persons in that class) on each matter submitted to a vote at an annual or special meeting of the members of the Corporation. With regard to the appointment of the Board of Directors of the Corporation, nine (9) to ten (10) "at-large directors" shall be jointly elected by the affirmative vote of both member classes. One (1) director shall be elected by the University Class. One (1) director shall be elected by the Methodist Class following a nomination by the Leadership Council of the Methodist Medical Group, Inc., an Indiana nonprofit corporation. In the event that Methodist Medical Group, Inc. or its Leadership Council ceases to exist or is no longer predominantly composed of physicians who utilize Methodist Hospital as their primary hospital, the Methodist Class shall designate another Methodist Hospital-based physician organization to nominate this director. If an appropriate physician organization does not exist, the Methodist Class shall elect a physician, giving preference to one who is Methodist Hospital-based. Additionally, the Dean of Indiana University School of Medicine, Bishop of the Indiana Area of the United Methodist Church, and the President and Chief Executive Officer of the Corporation shall be ex-officio directors. Line 7b: Notwithstanding any other provisions of the Articles of Incorporation, the following matters require the approval of the University Class prior to implementation: - Any sale, lease, transfer or other alienation of the Indiana University Hospitals real property, as defined in the Definitive Agreement, including any assignment of the University Hospital's lease by and between the Trustees of Indiana University and IU Health, except as otherwise authorized by resolution or agreement of the Trustees of Indiana University. - Any proposal by IU Health which conflicts with the following principle: IU Health will continue to make all patients available for medical education unless otherwise requested by the patient or his/her family, as the major clinical teaching resource for the Indiana University School of Medicine. - Any change in the financial support to the Indiana School of Medicine, as referenced in the Articles of Incorporation. - Any proposed action regarding the operation of Indiana University Hospitals, including the James Whitcomb Riley Hospital for Children, which would conflict with or be contrary to the requirements set forth in the Trustees Resolutions. - Any sale or other alienation of all or substantially all of the assets or operations of IU Health, and any merger, consolidation, change of voting control or other reorganization of IU Health. - Amendment, alteration or repeal of the Articles of Incorporation - Any dissolution of IU Health, except as otherwise required by law. - Any revision to, or modification or revocation of the Core Values. - Any transfer of the membership of either of the member classes. - Any amendment to the Definitive Agreement. Notwithstanding any other provisions of the Articles of Incorporation, the following matters require the approval of the Methodist Class prior to implementation: - Any sale, lease, transfer or other alienation of the Methodist Hospital, Inc. ("MHI") Real Property, as defined in the Definitive Agreement, including any assignment of that certain MHI Lease by and between MHI and IU Health, except as otherwise authorized by resolution or agreement of Methodist Health Group, Inc. - Any sale or other alienation of all or substantially all of the assets or operations of IU Health, and any merger, consolidation, change of voting control, or other reorganization of IU Health. - Amendment, alteration or repeal of the Articles of Incorporation. - Any dissolution of IU Health, except as otherwise required by law. - Any revisions to, or modifications or revocation of the Core Values. - Any transfer of the membership of either of the member classes. - Any amendment to the Definitive Agreement.
Part VI, Section A - Governing Body and Management Line 11b - Form 990 Provided to Governing Body Indiana University Health, Inc. ("IU Health') uses a thorough process for the review of the Form 990 and related schedules before it is filed. The Chief Financial Officer and General Counsel reviewed and approved the Form 990 and related schedules. The Board Committee on Values, Ethics, Social Responsibility & Pastoral Services reviewed and approved the following sections of the Form 990: 1. Part III - Statement of Program Service Accomplishments 2. Schedule H - Hospitals 3. Schedule I - Grants and Other Assistance to Organizations, Governments, and Individuals in the U.S. The Board Committee on Personnel & Compensation reviewed and approved the following section of the Form 990: 1. Part VI - Governance, Management, and Disclosure 2. Part VII - Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors 3. Schedule J - Compensation Information 4. Schedule L - Transactions with Interested Persons Additionally, the Audit Committee was provided a copy of the complete Form 990 and schedules to review and approve. After the review and approval from the above listed committees, a complete copy of the Form 990 and schedules was made available to each board member on a secure intranet site. Each member was informed of the availability of the Tax Department to answer any questions.
Part VI, Section B - Policies Line 12c - Conflict of Interest Policy Indiana University Health, Inc. ("IU Health") has a Conflict of Interest Policy, the purpose of which is to protect IU Health's interests when it is contemplating entering into a transaction or arrangement that might benefit the private interest of an officer, director, or employee. Each employee that is manager level or above, including officers and directors, is required to annually sign a statement which affirms that such person (1) has received a copy of the conflict of interest policy; (2) has read and understands the policy; (3) has agreed to comply with the policy; and (4) understands and acknowledges that the Corporation is a tax-exempt organization and that in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. If an interest is disclosed, the form requires that the discloser's supervisor sign the form to indicate his or her knowledge and approval of the interest. The form is then submitted to Corporate Compliance for review. If the disclosure is by the President & CEO, it is reviewed by the Chairman of the Board of Directors for approval. If the disclosure is by a member of the Board of Directors, the General Counsel and Chief Compliance Officer reviews the disclosures and determines whether to consent. Board members with a conflict of interest cannot participate in any decision related to that conflict. Breach of the Conflict of Interest Policy, including failure to complete and update the questionnaire, and failure to disclose an interest that should be disclosed, may subject an individual to disciplinary action, including dismissal.
Part VI, Section B - Policies Line 15 - Process for Determining Compensation 1. The Board of Directors has established a Committee on Personnel and Compensation. The individuals on this Committee are made up of individuals who are on the Board and who do not have a conflict of interest with Indiana University Health, Inc. ("IU Health"). There are no physicians or employees on this Committee. This Committee develops and reviews annually the executive compensation philosophy, market analysis as to comparability and reasonableness. One of the purposes of this Committee is to review, approve and make recommendations regarding executive compensation and benefits to the IU Health Board. As deemed appropriate, this Committee also reviews the same detail with the Committee on Finance. The Committee on Finance is represented by certain members of the Board as well. 2. Each year the Committee on Personnel and Compensation engages an outside compensation consulting firm to conduct a compensation and benefits study for all senior vice presidents and above. The current compensation advisor is the Hay Group. Hay Group performs an independent compensation survey. The relevant comparability data includes: compensation and benefit levels paid by similarly situated organizations (both governmental and tax exempt) for functionally comparable positions as well as the availability of similar services in the geographic area. The Committee reviews the entire compensation package including: base compensation, short term and long term incentive plans, basic health and welfare benefits, qualified and nonqualified plans as well as any additional fringe benefits. Further, Hay Group will provide recommendations based upon the reasonable compensation information as it relates to salary increases, bonuses and benefits that are consistent with the compensation philosophy of the Committee. A separate analysis using the same methodology is done for the Chief Executive Officer. 3. The Committee reviews the salary survey and, if appropriate, makes recommendations on increases in salary and any changes in bonuses or benefits. The Committee's goal is to ensure that the total compensation and benefits package is reasonable based upon the independent data provided by Hay Group. The Committee votes on any changes in compensation or benefits. This review, discussion and vote are documented in the minutes for the meeting. There are no executives present during the final discussion and approval of compensation. 4. The Board reviews the report prepared by the Hay Group as well as the recommendations of the Committee on Personnel and Compensation as to changes in compensation approved by the Committee. As requested, the Committee on Finance also provides its review of recommendations on changes in executive compensation and benefits. This review, discussion and vote are documented in the minutes. 5. The Board then reviews the recommendations provided by the Committee on Personnel and Compensation and votes on the changes as well. No additional compensation or benefits are paid to the executives until the changes have been approved by the Committee and the Board. The discussion and approval are documented in the minutes of the meeting. There are no executives present during the final discussion and approval of compensation. The General Counsel prepares a formal written opinion reviewing the compensation and benefits approval process, comparing that process to the Intermediate Sanctions Test of IRC Section 4958 and, if the facts warrant, provides comments regarding the compensation and benefits approval process as this relates to meeting the requirements for a rebuttable presumption of reasonableness as provided in the Intermediate Sanctions Test. 6. After the end of each year, the Committee and Board also reviews the achievements of the executive group as it relates to the long-term and short-term shared and individual goals developed by the executive and the Board. These achievements may also be reviewed with the Committee on Finance. The Board, at its discretion, may approve bonus payments based upon the achievement of the goals and the compensation survey. The discussion and vote of the Committee and Board is documented in the minutes for each such meeting. The bonuses are not paid until approval is made by the Board. 7. The Committee on Personnel and Compensation and Audit Committee also review the required Form 990 disclosures related to executive compensation and benefits as well as compensation practices and approval processes prior to the filing of the Form 990 return with the Internal Revenue Service.
Part VI, Section C - Disclosure Line 19 - Public Disclosure Indiana University Health, Inc.'s ("IU Health") Articles of Incorporation are available for public inspection through the Indiana Secretary of State's web-site. IU Health's conflict of interest procedures are disclosed on the Form 990, Schedule O. IU Health's Consolidated Audited Financial Statements are available for public inspection through its bond filings.
Part VII, Section A - Governing Body and Management Line 1a, Column (B) - Average hours per week James E. Lingeman, M.D. is a Staff Physician for Indiana University Health Care Associates, Inc. d/b/a Indiana University Health Physicians and devotes 55 hours per week.
Part XI - Reconciliation of Net Assets Line 5 - Other Changes in Net Assets or Fund Balances During 2011, Indiana University Health, Inc. recorded the following other changes in net assets or fund balances: Unrealized Gain/(Loss) on Investments: -82,732,465 Income/(Loss) - Related 501(c)(3) organizations: -66,898,246 Book/Tax Differences - Pass-Through Entities: -154,088,434 Unrealized Gain/(Loss) on Restricted Net Assets: -787,400 Donated Property, Plant, and Equipment: 51,643 FAS 136 Adjustments: -288,359 Change in Pension Obligation: -5,551,961 Net Asset Transfers: 22,397,858
Schedule K, Part I - Bond Issues Page 1 - Line A, Column (f) - Description of Purpose The Series 2006A Bonds were issued in order to provide funding for new construction of buildings and structures and purchase of equipment.
Schedule K, Part I - Bond Issues Page 1 - Line B, Column (f) - Description of Purpose The Series 2006B Bonds were issued in order to refund the Series 1996B and C, 2000B and C, and 2003H and I Bonds. The Series 1996B and C, 2000B and C, and 2003H and I Bonds were issued on December 31, 1996, November 21, 2000, and August 12, 2003, respectively.
Schedule K, Part I - Bond Issues Page 1 - Line C, Column (f) - Description of Purpose The Tax-Exempt Lease, 2010 was used to provide funding for critical care aircraft.
Schedule K, Part I - Bond Issues Page 1 - Line D, Column (f) - Description of Purpose The Series 2011A, B, C, D, and E Bonds were issued to provide funding for new construction of buildings and structures and purchase equipment. Additionally, the Bonds were issued in order to refund the Series 2008A, B, C, and D Bonds. The 2008A, B, C, and D Bonds were issued on September 11, 2008.
Schedule K, Part I - Bond Issues Page 2 - Line A, Column (f) - Description of Purpose The Series 2011F, G, H, and I Bonds were issued in order to refund the Series 2005A, B, C, and D Bonds. The Series 2005A, B, C, and D Bonds were issued on November 15, 2005.
Schedule K, Part I - Bond Issues Page 2 - Line B, Column (f) - Description of Purpose The Series 2011 L and M Bonds were issued in order to provide funding for new construction of buildings and structures and purchase of equipment.
Schedule K, Part I - Bond Issues Page 2 - Line C, Column (f) - Description of Purpose The Series 2011N Bonds were issued in order to refund the Series 2011 E bonds issued on April 19, 2011 and the 2011F and G Bonds issued on May 5, 2011. The Series 2011N bonds were also issued to pay off a portion of a taxable line of credit, which was used for new construction of buildings and structures and purchase of equipment. The series 2011N bonds were also issues to refund Bloomington Hospitals Series 1999B Bonds (a related 501(c)(3) organization). The Series 1999B bonds were issues on November 17, 1999.
Schedule K, Part II - Proceeds Line 3 - Total Proceeds of issue Total proceeds of issue disclosed on Part II, Line 3 are sometimes higher than the issue price disclosed in Part I due to the investment earings on the bond proceed: Series 2006A Bonds: Issue price $323,003,005 Earnings 23,010,869 Total proceeds 348,013,874 Series 2006B Bonds: Issue price $387,109,760 Earnings 1,476,259 Total proceeds 388,586,019 Series 2011A,B,C,D,E Bonds: Issue Price $228,195,000 Earnings 4,331 Total proceeds 228,199,331 Series 2011F,G,H,I Bonds: Issue Price $274,815,000 Earnings 39 Total proceeds 274,815,039 Series 2011LM Bonds: Issue Price $111,435,000 Earnings 2,350 Total proceeds 111,437,350 Additionally, the unspent proceeds will be used for capital expenditures within the next 3 years.
Schedule K, Part III - Private Business Use Lines 4, 5, and 6 - Private Business Use Percentages Indiana University Health, Inc. generally only finances a portion of each project with tax-exempt bonds.
Schedule K, Part IV, Column B - Arbitrage Line 4 b & c - Name of Provider and Term of GIC GIC provided by Citigroup Financial Products, Inc. with a term of 0.3 years.
Attachment 1 FORM 990, PART V, LINE 4B - FOREIGN COUNTRIES Japan Mexico Turkey Brazil
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH INC
 
Employer identification number

35-1955872
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity







(1) CCCG LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
20-3949968 		HEALTHCARE IN 3,743,219 155,710 IUH
 
(2) CCSG LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
26-1921481 		HEALTHCARE IN 6,828,703 731,323 IUH
 
(3) CLARIAN HEALTH NORTH LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
43-1980602 		HEALTHCARE IN 37,100,383 245,444,529 IUH
 
(4) CLARIAN HEALTH WEST LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
43-1980611 		HEALTHCARE IN 97,445,453 163,345,538 IUH
 
(5) CLARIAN NEUROLOGY GROUP LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
26-3052008 		HEALTHCARE IN 0 0 IUH
 
(6) CLARIAN QUALITY PARTNERS LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
26-3603579 		HEALTHCARE IN 623,785 336,605 IUH
 
(7) CLARIAN SAXONY MEDICAL CENTER LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
26-2414219 		HEALTHCARE IN 0 0 IUH
 
(8) HEART PARTNERS OF INDIANA LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
20-1123537 		HEALTHCARE IN 6,893,813 2,175,545 IUH
 
(9) IU HEALTH MANAGEMENT LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
80-0141954 		MANAGEMENT IN 7,855,012 0 IUH
 
(10) IU HEALTH SAXONY SURGERY CENTER LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-5271091 		HEALTHCARE IN 4,009 2,865,476 IUH
 
(11) SENATE HEALTH PLANS SOLUTIONS LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-3736054 		MANAGEMENT IN 6,901,458 3,380,125 IUH
 
Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) BALL MEMORIAL HOSPITAL AUXILIARY INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
35-6025400 		HEALTHCARE IN 501(C)(3) 11 III-FI IUHBMH
 
Yes
 
(2) CLARIAN TRANSPLANT INSTITUTE INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
13-4350599 		HEALTHCARE IN 501(C)(3) 9 IUH
 
Yes
 
(3) GOSHEN HEALTH SYSTEM INC

200 HIGH PARK AVE

GOSHEN,IN46527
35-1974765 		HEALTHCARE IN 501(C)(3) 11 I IUH
 
Yes
 
(4) GOSHEN HOSPITAL ASSOCIATION INC

200 HIGH PARK AVE

GOSHEN,IN46527
35-6001540 		HEALTHCARE IN 501(C)(3) 3 GHS
 
Yes
 
(5) HEALTHLINC INC

714 S ROGERS ST

BLOOMINGTON,IN46402
26-3571507 		HEALTHCARE IN 501(C)(3) 9 IUHB
 
Yes
 
(6) INDIANA RADIOLOGY PARTNERS INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
20-1017034 		HEALTHCARE IN 501(C)(3) 3 IUH
 
Yes
 
(7) IU HEALTH ARNETT FOUNDATION INC

2600 GREENBUSH ST

LAFAYETTE,IN47904
35-6079797 		FUNDRAISING IN 501(C)(3) 11 I IUHA
 
Yes
 
(8) IU HEALTH ARNETT INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
26-3162145 		HEALTHCARE IN 501(C)(3) 3 IUH
 
Yes
 
(9) IU HEALTH BALL MEMORIAL HOSPITAL INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
35-0867958 		HEALTHCARE IN 501(C)(3) 3 IUH
 
Yes
 
(10) IU HEALTH BALL MEMORIAL PHYSICIANS INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
35-1925641 		HEALTHCARE IN 501(C)(3) 9 IUHBMH
 
Yes
 
(11) IU HEALTH BEDFORD INC

2900 W 16TH ST

BEDFORD,IN47421
23-7042323 		HEALTHCARE IN 501(C)(3) 3 IUH
 
Yes
 
(12) IU HEALTH BLACKFORD HOSPITAL INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
01-0646166 		HEALTHCARE IN 501(C)(3) 3 IUHBMH
 
Yes
 
(13) IU HEALTH BLOOMINGTON INC

PO BOX 1149

BLOOMINGTON,IN47403
35-1720796 		HEALTHCARE IN 501(C)(3) 3 IUH
 
Yes
 
(14) IU HEALTH BMH FOUNDATION INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
31-1111784 		FUNDRAISING IN 501(C)(3) 11 I IUHBMH
 
Yes
 
(15) IU HEALTH CARE ASSOCIATES INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
35-1747218 		HEALTHCARE IN 501(C)(3) 9 IUH
 
Yes
 
(16) IU HEALTH LAPORTE HOSPITAL INC

PO BOX 250

LAPORTE,IN46352
35-1125434 		HEALTHCARE IN 501(C)(3) 3 IUH
 
Yes
 
(17) IU HEALTH LAPORTE PHYSICIANS INC

PO BOX 250

LAPORTE,IN46352
31-1070868 		HEALTHCARE IN 501(C)(3) 3 IUHLH
 
Yes
 
(18) IU HEALTH MORGAN HOSPITAL INC

2209 JOHN R WOODEN DR

MARTINSVILLE,IN46151
27-3533027 		HEALTHCARE IN 501(C)(3) 3 IUH
 
Yes
 
(19) IU HEALTH NORTH HOSPITAL INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
35-1932442 		HEALTHCARE IN 501(C)(3) 3 IUH
 
Yes
 
(20) IU HEALTH PAOLI HOSP FOUNDATION INC

PO BOX 499

PAOLI,IN47454
31-0992486 		FUNDRAISING IN 501(C)(3) 11 III-0 IUHP
 
Yes
 
(21) IU HEALTH PAOLI INC

PO BOX 2499

PAOLI,IN47454
35-2090919 		HEALTHCARE IN 501(C)(3) 3 IUHB
 
Yes
 
(22) IU HEALTH TIPTON HOSPITAL INC

1000 S MAIN ST

TIPTON,IN46072
26-2772226 		HEALTHCARE IN 501(C)(3) 3 IUH
 
Yes
 
(23) IU HEALTH WEST HOSPITAL INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
35-1814660 		HEALTHCARE IN 501(C)(3) 3 IUH
 
Yes
 
(24) IU HEALTH WHITE MEMORIAL HOSPITAL INC

720 S SIXTH ST

MONTICELLO,IN47960
27-3532963 		HEALTHCARE IN 501(C)(3) 3 IUH
 
Yes
 
(25) IU MEDICAL GROUP FOUNDATION INC

340 W 10TH ST NO FS5100

INDIANAPOLIS,IN46202
20-1093251 		FUNDRAISING IN 501(C)(3) 11 II NA
 
 
No
(26) METHODIST HEALTH FOUNDATION INC

1800 N CAPITOL AVE

INDIANAPOLIS,IN46202
35-6043086 		FUNDRAISING IN 501(C)(3) 11 I IUH
 
Yes
 
(27) METHODIST HEALTH GROUP INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
35-0876390 		HEALTHCARE IN 501(C)(3) 11 III-FI NA
 
 
No
(28) METHODIST MEDICAL GROUP INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
35-1945384 		HEALTHCARE IN 501(C)(3) 3 IUH
 
Yes
 
(29) METHODIST OCCUP HEALTH CENTERS INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
35-1844176 		HEALTHCARE IN 501(C)(3) 3 IUH
 
Yes
 
(30) METHODIST RESEARCH INSTITUTE INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
35-2023710 		HEALTHCARE IN 501(C)(3) 11 I IUH
 
Yes
 
(31) MH HEALTHCARE INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
35-1766531 		HEALTHCARE IN 501(C)(3) 3 MMG
 
Yes
 
(32) MORGAN CO MEM HOSP FOUNDATION INC

2209 JOHN R WOODEN DR

MARTINSVILLE,IN46151
35-2035162 		FUNDRAISING IN 501(C)(3) 11 II IUHMH
 
Yes
 
(33) MORGAN CO MEM HOSP GUILD INC

2209 JOHN R WOODEN DR

MARTINSVILLE,IN46151
31-0886844 		FUNDRAISING IN 501(C)(3) 11 III-FI IUHMH
 
Yes
 
(34) MORGAN HEALTH SERVICES INC

1949 HOSPITAL DR

MARTINSVILLE,IN46151
35-1968564 		HEALTHCARE IN 501(C)(3) 3 IUHMH
 
Yes
 
(35) WHITE CO MEM HOSP FOUNDATION INC

PO BOX 952

MONTICELLO,IN47960
35-1671806 		FUNDRAISING IN 501(C)(3) 11 III-0 IUHWMH
 
Yes
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) BALL OUTPATIENT SURGERY CENTER LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
27-0275794 		HEALTHCARE IN BOSCH
  		N/A 0 0   No 0   No 0 %
(2) BELTWAY SURGERY CENTERS LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
35-2072586 		HEALTHCARE IN IUHSC
  		RELATED 7,780,319 0   No 0   No 0 %
(3) BLOOMINGTON ENDOSCOPY CENTERS LLC

PO BOX 1149
BLOOMINGTON,IN47402
35-2117943 		HEALTHCARE IN IUHB
  		N/A 0 0   No 0   No 0 %
(4) BMH OUTPATIENT SURGERY SERVICES LLC

2401 W UNIVERSITY AVE
MUNCIE,IN47303
20-4567998 		HEALTHCARE IN IUHBMH
  		N/A 0 0   No 0   No 0 %
(5) BOSC HOLDINGS LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
45-4147343 		HEALTHCARE IN IUH
  		RELATED 0 0   No 0   No 51.000 %
(6) CARDINAL HEALTH INITIATIVES LLC

950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
30-0102702 		PURCHASING IN IUHBMH
  		N/A 0 0   No 0   No 0 %
(7) CHV FUND I LLC

950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
26-2523206 		VENTURE CAPITAL IN IUH
  		EXCLUDED -1,560,306 12,111,004   No 0   No 100.000 %
(8) CHV FUND MANAGEMENT LLC

950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
26-2523151 		VENTURE CAPITAL IN CHV
  		N/A 0 0   No 0   No 0 %
(9) CLARIAN HEALTH NETWORK LLC

950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
35-2055030 		HEALTHCARE IN IUH
  		RELATED 0 0   No 0   No 66.700 %
(10) CLARIAN HEALTH NORTH LLC

950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
43-1980602 		HEALTHCARE IN IUH
  		RELATED 15,439,335 0   No 0 Yes   0 %
(11) CLARIAN HEALTH WEST LLC

950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
43-1980611 		HEALTHCARE IN IUH
  		RELATED 3,524,756 0   No 0 Yes   0 %
(12) CTF INTERNATIONAL GROWTH PORTFOLIO

280 CONGRESS ST STE 500
BOSTON,MA02210
20-0231923 		INVESTMENTS MA IUH
  		EXCLUDED 6,149,768 0   No 0   No 0 %
(13) EAGLE HIGHLANDS SURGERY CENTER LLC

3000 RIVERCHASE GALLERIA STE 500
BIRGMINGHAM,AL35244
35-2259204 		HEALTHCARE IN EHSCH
  		RELATED 601,561 0   No 0   No 0 %
(14) EHSC HOLDINGS LLC

3000 RIVERCHASE GALLERIA STE 500
BIRGMINGHAM,AL35244
45-4147879 		HEALTHCARE IN IUH
  		RELATED 0 0   No 0   No 51.000 %
(15) HEALTH VENTURE MANAGEMENT LLC

950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
20-5740218 		MANAGEMENT IN IUH
  		RELATED -1,626,675 496,823   No -970,939   No 99.000 %
(16) IEC HOLDINGS LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
45-4148032 		HEALTHCARE IN IUH
  		RELATED 0 0   No 0   No 51.000 %
(17) INDIANA ENDOSCOPY CENTERS LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
20-8398421 		HEALTHCARE IN IECH
  		RELATED 2,879,579 0   No 0   No 0 %
(18) INDIANA LAKES MANAGED CARE ORG LLC

310 S MAIN ST
GOSHEN,IN46526
35-1946663 		HEALTHCARE IN GHS
  		N/A 0 0   No 0   No 0 %
(19) IUH SURGERY CENTERS LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
45-2314634 		HEALTHCARE IN IUH
  		RELATED 10,522,537 22,374,597   No 0   No 51.000 %
(20) MID-AMERICA SURGERY CENTER LLC

2401 W UNIVERSITY AVE
MUNCIE,IN47303
35-2002953 		HEALTHCARE IN CDHV
  		N/A 0 0   No 0   No 0 %
(21) ROC SURGERY LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
27-1497960 		HEALTHCARE IN ROCSH
  		RELATED 710,147 0   No 0   No 0 %
(22) ROCS HOLDINGS LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
45-4148369 		HEALTHCARE IN IUH
  		RELATED 0 0   No 0   No 51.000 %
(23) SENATE STREET SURGERY CENTER LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
42-1709357 		HEALTHCARE IN SSSCH
  		RELATED 1,712,258 0   No 0   No 0 %
(24) SSSC HOLDINGS LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
45-4148167 		HEALTHCARE IN IUH
  		RELATED 0 0   No 0   No 51.000 %
(25) THE HEALTHCARE GROUP LLC

1776 MERIDIAN ST STE 300
INDIANAPOLIS,IN46202
35-2067373 		MANAGED CARE IN IUH
  		UNRELATED 1,136,995 190,152   No 1,124,459   No 0 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) BMH MEDICAL PAVILION ASSOCIATION INC
2525 W UNIVERSITY AVE
MUNCIE,IN47303
35-1858408 		CONDO MANAGEMENT IN IUHBMH
  		C 0 0 0 %
(2) CARDINAL HEALTH VENTURES INC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
35-1611424 		MANAGEMENT IN IUHBMH
  		C 0 0 0 %
(3) CHV CAPITAL INC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
26-0752507 		VENTURE CAPITAL IN IUH
  		C 624,996 112,212 100.000 %
(4) IU HEALTH ACO INC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
45-4421020 		HEALTHCARE IN IUH
  		C 0 0 0 %
(5) IU HEALTH BOARD DESIGNATED TRUST
400 HOWARD ST
SAN FRANCISCO,CA94105
30-6309021 		INVESTMENTS IN IUH
  		T -489,991 0 100.000 %
(6) IU HEALTH NTGI S&P500 FUND CF
PO BOX 804358
CHICAGO,IL60680
30-6298263 		INVESTMENTS IN IUH
  		T 1,296,516 0 100.000 %
(7) IU HEALTH PLANS INC
1776 MERIDIAN ST STE 300
INDIANAPOLIS,IN46202
26-2127080 		HMO IN IUH
  		C 107,627,202 8,076,258 100.000 %
(8) IU HEALTH RISK PURCHASING GROUP INC
151 MEETING ST STE 301
CHARLESTON,SC29401
26-0202446 		INSURANCE IN IUH
  		C 0 0 100.000 %
(9) IU HEALTH RISK RETENTION GROUP INC
151 MEETING ST STE 301
CHARLESTON,SC29401
20-1107674 		INSURANCE SC IUH
  		C 3,430,505 8,638,274 97.000 %
(10) IU HEALTH SOUTHERN IN PHYSICIANS INC
PO BOX 1149
BLOOMINGTON,IN47402
35-1913875 		HEALTHCARE IN IUHB
  		C 0 0 0 %
(11) IUH ASSURANCE LTD
720 W BAY RD
PO BOX 69,GRAND CAYMAN  
CJ
98-0395429 		INSURANCE CJ IUH
  		C -224,982 89,303,244 100.000 %
(12) OCC-HEALTH REVENUE SYSTEMS INC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
20-3308057 		WORK COMP PPO IN MOHC
  		C 0 0 0 %
(13) PARKMOR DRUG INC
1501 S MAIN ST
GOSHEN,IN46526
13-1394980 		PHARMACY SALES IN GHS
  		C 0 0 0 %
(14) PILR INC
200 HIGH PARK AVE
GOSHEN,IN46526
20-4294750 		DEVELOPMENT IN GHS
  		C 0 0 0 %
(15) RADIATION ONCOLOGY RESOURCES INC
200 HIGH PARK AVE
GOSHEN,IN46526
26-2008424 		HEALTHCARE IN GHS
  		C 0 0 0 %
(16) SCANS INC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
45-3080392 		HEALTHCARE IN CHVF1
  		C 0 0 0 %
(17) UNIVERSITY HEALTH MANAGEMENT INC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-2891143 		MANAGEMENT IN CHV
  		C 0 0 0 %
(18) UNIVERSITY HEALTH MGMT (CHINA) INC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-3891311 		MANAGEMENT IN CHV
  		C 0 0 0 %
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
Yes
 
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) IU HEALTH ARNETT INC

 A 13,101,079 FMV
(2) IU HEALTH BEDFORD INC

 A 295,250 FMV
(3) GOSHEN HOSPITAL ASSOCIATION INC

 A 1,848,543 FMV
(4) HEALTH VENTURE MANAGEMENT LLC

 A 95,674 FMV
(5) IU HEALTH TIPTON HOSPITAL INC

 A 253,349 FMV
(6) IU HEALTH WHITE MEMORIAL HOSPITAL INC

 A 80,911 FMV
(7) CLARIAN TRANSPLANT INSTITUTE INC

 B 999,996 FMV
(8) METHODIST RESEARCH INSTITUTE INC

 B 2,437,472 FMV
(9) METHODIST HEALTH FOUNDATION INC

 C 448,754 FMV
(10) IU HEALTH ARNETT INC

 I 429,885 FMV
(11) IU HEALTH BALL MEMORIAL HOSPITAL INC

 I 264,156 FMV
(12) BELTWAY SURGERY CENTERS LLC

 I 1,031,342 FMV
(13) CHV CAPITAL INC

 I 62,950 FMV
(14) EAGLE HIGHLANDS SURGERY CENTER LLC

 I 411,890 FMV
(15) IU HEALTH CARE ASSOCIATES INC

 I 4,203,381 FMV
(16) SENATE STREET SURGERY CENTER LLC

 I 142,464 FMV
(17) IU HEALTH BALL MEMORIAL HOSPITAL INC

 J 346,620 FMV
(18) IU HEALTH CARE ASSOCIATES INC

 J 64,635 FMV
(19) IU HEALTH ARNETT INC

 K 30,612,611 FMV
(20) IU HEALTH BEFORD INC

 K 776,330 FMV
(21) IU HEALTH BLACKFORD HOSPITAL INC

 K 309,628 FMV
(22) IU HEALTH BALL MEMORIAL HOSPITAL INC

 K 33,156,011 FMV
(23) BALL OUTPATIENT SURGERY CENTER LLC

 K 1,429,696 FMV
(24) BELTWAY SURGERY CENTERS LLC

 K 4,436,600 FMV
(25) IU HEALTH BLOOMINGTON INC

 K 2,987,317 FMV
(26) CLARIAN TRANSPLANT INSTITUTE INC

 K 198,984 FMV
(27) EAGLE HIGHLANDS SURGERY CENTER LLC

 K 1,960,841 FMV
(28) GOSHEN HOSPITAL ASSOCIATION INC

 K 1,349,510 FMV
(29) IU HEALTH PLANS INC

 K 346,099 FMV
(30) INDIANA ENDOSCOPY CENTERS LLC

 K 1,391,338 FMV
(31) INDIANA RADIOLOGY PARTNERS INC

 K 3,863,599 FMV
(32) IU HEALTH CARE ASSOCIATES INC

 K 19,864,101 FMV
(33) IU HEALTH LAPORTE INC

 K 1,583,419 FMV
(34) METHODIST OCCUPATIONAL HEALTH CENTERS INC

 K 911,478 FMV
(35) ROC SURGERY LLC

 K 2,767,552 FMV
(36) IU HEALTH RISK RETENTION GROUP INC

 K 1,335,000 FMV
(37) SENATE STREET SURGERY CENTER LLC

 K 2,033,602 FMV
(38) IU HEALTH TIPTON HOSPITAL INC

 K 351,452 FMV
(39) IU HEALTH ARNETT INC

 L 99,574 FMV
(40) IU HEALTH BALL MEMORIAL PHYSICIANS INC

 L 72,000 FMV
(41) CHV FUND I LLC

 L 624,996 FMV
(42) CLARIAN TRANSPLANT INSTITUE INC

 L 2,893,416 FMV
(43) IU HEALTH NORTH HOSPITAL INC

 L 567,920 FMV
(44) HEALTH VENTURE MANAGEMENT LLC

 L 2,586,877 FMV
(45) IU HEALTH CARE ASSOCIATES INC

 L 42,370,365 FMV
(46) METHODIST OCCUPATIONAL HEALTH CENTERS INC

 L 2,305,929 FMV
(47) IU HEALTH ARNETT INC

 N 507,018 FMV
(48) IU HEALTH BEDFORD INC

 N 291,816 FMV
(49) IU HEALTH BLACKFORD HOSPITAL INC

 N 775,937 FMV
(50) IU HEALTH BALL MEMORIAL HOSPITAL INC

 N 877,711 FMV
(51) IU HEALTH PLANS INC

 N 155,838 FMV
(52) IU HEALTH CARE ASSOCIATES INC

 N 8,952,615 FMV
(53) ROC SURGERY LLC

 N 108,552 FMV
(54) IU HEALTH TIPTON HOSPITAL INC

 N 256,873 FMV
(55) INDIANA RADIOLOGY PARTNERS INC

 N 408,049 FMV
(56) IUH ASSURANCE LTD

 Q 5,866,170 FMV
(57) IU HEALTH RISK RETENTION GROUP INC

 Q 10,185,431 FMV
(58) IU HEALTH PLANS INC

 Q 80,202,388 FMV
(59) THE HEALTHCARE GROUP LLC

 Q 584,914 FMV
(60) INDIANA ENDOSCOPY CENTERS LLC

 R 4,193,475 FMV
(61) IUH SURGERY CENTERS LLC

 R 4,227,900 FMV
(62) CLARIAN HEALTH NORTH LLC

 R 9,821,865 FMV
(63) ROC SURGERY LLC

 R 230,000 FMV
(64) SENATE STREET SURGERY CENTERS LLC

 R 2,937,200 FMV
(65) CLARIAN HEALTH WEST LLC

 R 6,426,000 FMV
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(e)
Are all
partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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