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
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 01-01-2012 , 2012, and ending 12-31-2012
BCheck if applicable:
CName of organization
INDIANA UNIVERSITY HEALTH CARE ASSOCIATES
INC
Doing Business As
IU HEALTH PHYSICIANS
 
Number and street (or P.O. box if mail is not delivered to street address)
950 N MERIDIAN STREET SUITE 800
Suite
Room/suite
City or town, state or country, and ZIP + 4
INDIANAPOLIS, IN46204
D Employer identification number

35-1747218
E Telephone number

G Gross receipts $ 457,006,909
F Name and address of principal officer:
JOHN F FITZGERALD MD
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: 1987
M State of legal domicile: IN
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: Deliver preeminent medical care and services to our patients and communities through outstanding and innovative medical leadership and practice, while supporting excellence in education and research.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 13
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 2
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 2,834
6 Total number of volunteers (estimate if necessary) ............. 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 166,252
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -228
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 45,009,804
9 Program service revenue (Part VIII, line 2g) ......... 311,159,527 404,234,787
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 139,319 132,393
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 5,937,416 6,036,655
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 317,236,262 455,413,639
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 5,000
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) 246,342,425 350,605,797
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–24e).... 137,507,062 154,649,132
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 383,849,487 505,259,929
19 Revenue less expenses. Subtract line 18 from line 12....... -66,613,225 -49,846,290
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 68,877,343 91,514,852
21 Total liabilities (Part X, line 26)............. 48,444,803 68,794,801
22 Net assets or fund balances. Subtract line 21 from line 20..... 20,432,540 22,720,051
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 MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
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: Deliver preeminent medical care and services to our patients and communities through outstanding and innovative medical leadership and practice, while supporting excellence in education and research.
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 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 $ 424,184,021 including grants of $ 5,000 ) (Revenue $ 404,234,787 )
Indiana University Health Care Associates, Inc. ("IU Health Physicians") is the fastest growing, most complete multi-specialty physician group in the State of Indiana. Comprised of the most comprehensive network of primary care and specialty physicians, IU Health Physicians provides patients with the most innovative treatments and latest technologies offering more treatment options than anywhere in the state. IU Health Physicians also partners with the Indiana University School of Medicine to create unique research and teaching opportunities vital to medical advancement. IU Health Physicians is focused on providing high quality patient-centered care placing the highest priority on the needs of the patient and their families, without regard to the patient's ability to pay.
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 expensesMediumBullet424,184,021
Form 990 (2012)
Form 990 (2012)
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 (see instructions)? 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, or have a section 501(h) election in effect during the tax year? 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 IIIClick to see attachment............................
5
 
No
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 for escrow or custodial account liability; 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
 
No
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, line 10?
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 VIIClick 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 VIIIClick 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 IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part XClick 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 XClick 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 and XII 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 and XII 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, Parts I and IV.........
14b
 
No
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 United States? If “Yes,” complete Schedule F, Parts II and IV
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 United States? If “Yes,” complete Schedule F, Parts III and IV...
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 (see instructions)....
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 hospital facilities? If “Yes,” complete Schedule H....
20a
 
No
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2012)
Form 990 (2012)
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...
21
 
No
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........
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, line 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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
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
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
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, highest 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
Yes
 
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 direct or indirect 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, Part II, III, or IV, and Part 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 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
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
164
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
2,834
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, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
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 as charitable contributions?...
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. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the 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 amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
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 .....................
1a
13
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
2
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
 
No
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 this 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
 
No
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
 
 
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:
MediumBulletBROC BUDDE950 N MERIDIAN STREET SUITE 800INDIANAPOLISIN46204 (317) 962-4575
Form 990 (2012)
Form 990 (2012)
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. 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 organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(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) RICHARD F GRAFFIS MD........................................................................
CHAIRMAN/STAFF PHYSICIAN
 55.0
.......................55.0 		X   X       11,309 794,562 40,512
(2) ERIC S WILLIAMS MD........................................................................
V. CHAIR./SERVICE LINE CHIEF
 25.0
.......................0.0 		X   X       117,378 0 4,347
(3) D WADE CLAPP MD........................................................................
DIRECTOR
 2.0
.......................0.0 		X           0 0 0
(4) ARTHUR C COFFEY MD........................................................................
DIR./TREAS./SERVICE LINE CHIEF
 55.0
.......................55.0 		X   X       146,458 568,132 33,226
(5) DAVID W CRABB MD........................................................................
DIRECTOR
 2.0
.......................55.0 		X           0 140,603 10,678
(6) HERBERT E CUSHING MD........................................................................
DIRECTOR/SEC./MED. DIRECTOR
 15.0
.......................0.0 		X   X       249,553 0 13,847
(7) GARY L DUNNINGTON MD........................................................................
DIR./PHY. (10/01 - 12/31)
 55.0
.......................0.0 		X           165,123 0 11,619
(8) ROBERT J HAVLIK MD........................................................................
DIRECTOR (01/01 - 09/30)
 2.0
.......................0.0 		X           0 0 0
(9) RYAN C KITCHELL........................................................................
DIRECTOR (05/10 - 12/31)
 2.0
.......................55.0 		X           0 545,544 122,934
(10) ABIGAIL F KLEMSZ MD........................................................................
DIRECTOR
 2.0
.......................0.0 		X           0 0 0
(11) MICHAEL R NIEMEIER MD........................................................................
DIRECTOR/SERVICE LINE CHIEF
 55.0
.......................0.0 		X           381,879 0 45,457
(12) SAMUEL L ODLE........................................................................
DIRECTOR (01/01 - 07/13)
 2.0
.......................55.0 		X           0 6,190,549 37,429
(13) ISADORE RIVAS........................................................................
DIRECTOR (01/01 - 05/09)
 2.0
.......................55.0 		X           0 323,333 20,980
(14) CHARLES M SHUFFLEBARGER MD........................................................................
DIRECTOR/SERVICE LINE CHIEF
 55.0
.......................0.0 		X           296,075 0 19,204
(15) LARRY H STEVENS MD........................................................................
DIRECTOR/SERVICE LINE CHIEF
 55.0
.......................0.0 		X           166,069 0 15,194
(16) JAMES G TERWILLIGER........................................................................
DIRECTOR (09/23 - 12/31)
 2.0
.......................55.0 		X           0 416,621 105,217
(17) JOHN F FITZGERALD MD........................................................................
CEO
 55.0
.......................0.0 		    X       462,061 0 103,891
Form 990 (2012)
Form 990 (2012)
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 (list any hours for related organizations below dotted line) 		(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) CAROL D KARP........................................................................
CFO
 55.0
.......................0.0 		    X       189,179 0 38,684
(19) KIMBERLEE C SHERBROOKE........................................................................
COO
 55.0
.......................0.0 		      X     276,573 0 30,997
(20) JOHN C KOHNE MD........................................................................
CME
 18.0
.......................37.0 		      X     257,341 522,479 45,666
(21) STEPHEN H POLLOM MD........................................................................
SERVICE LINE CHIEF
 55.0
.......................0.0 		      X     331,217 0 40,796
(22) PETER W BRUNN........................................................................
VP, HOSPITAL-BASED
 55.0
.......................0.0 		      X     212,082 0 40,112
(23) KYLE L ALLEN........................................................................
VP, PRIMARY CARE (01/01-10/07)
 55.0
.......................55.0 		      X     174,167 42,366 23,719
(24) CELIA D SURFACE-BRUDER........................................................................
VP, PRIMARY CARE (10/08-12/31)
 55.0
.......................0.0 		      X     151,501 0 24,298
(25) MICHAEL D OBER MD........................................................................
EXECUTIVE DIRECTOR
 55.0
.......................0.0 		      X     309,278 0 19,421
(26) MARK P CAIN MD........................................................................
STAFF PHYSICIAN
 55.0
.......................0.0 		        X   963,600 0 19,412
(27) RICHARD C RINK MD........................................................................
STAFF PHYSICIAN
 55.0
.......................0.0 		        X   935,948 0 19,336
(28) RICHARD BIHRLE MD........................................................................
STAFF PHYSICIAN
 55.0
.......................0.0 		        X   928,686 0 19,204
(29) MICHAEL O KOCH MD........................................................................
SERVICE LINE CHIEF
 55.0
.......................0.0 		        X   909,857 0 19,412
(30) RICHARD S FOSTER MD........................................................................
STAFF PHYSICIAN
 55.0
.......................0.0 		        X   905,054 0 19,204
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 8,540,388 9,544,189 944,796
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet835
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
 
No
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
UNIVERSITY MEDICAL DIAGNOSTIC ASSOC, PO BOX 44994INDIANAPOLISIN46244 MEDICAL 22,947,371
INDIANA UNIVERSITY, PO BOX 66271INDIANAPOLISIN46266 MEDICAL 12,012,950
INDIANA RADIOLOGY PARTNERS INC, 950 N MERIDIAN ST STE 800INDIANAPOLISIN46204 MEDICAL 3,870,978
WISHARD ANESTHESIA GROUP LLC, 1001 W 10TH STINDIANAPOLISIN46202 MEDICAL 3,650,873
UNIVERSITY PEDIATRIC ASSOCIATES IN, 550 N MERIDIAN STINDIANAPOLISIN46204 MEDICAL 2,208,174
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet45
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 45,000,000
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		9,804
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 45,009,804
Program Service Revenue Business Code
2a SHARED SERVICES 541900 243,455,569 243,289,317 166,252 0
b NET PATIENT SERVICE REVENUE 621110 155,869,534 155,869,534 0 0
c ELECTRONIC HEALTH RECORDS INCENTIVE 900099 4,581,061 4,581,061 0 0
d RENT FROM RELATED 501(C)(3) ORGS. 532000 238,645 238,645 0 0
e CLINICAL RESEARCH 541700 79,806 79,806 0 0
f All other program service revenue . 10,172 10,172   0
g Total. Add lines 2a–2f........MediumBullet 404,234,787
Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 109,591     109,591
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 1,013,763  
b Less: rental expenses 1,167,067  
c Rental income or (loss) -153,304 0
d Net rental income or (loss).......MediumBullet -153,304     -153,304
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 445,995 3,010
b Less: cost or other basis and sales expenses 426,203  
c Gain or (loss) 19,792 3,010
d Net gain or (loss)..........MediumBullet 22,802     22,802
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 ALL OTHER REVENUE 900099 6,189,959 0 0 6,189,959
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 6,189,959
12 Total revenue. See Instructions......MediumBullet 455,413,639 404,068,535 166,252 6,169,048
Form 990 (2012)
Form 990 (2012)
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).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 5,000 5,000
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 .... 4,361,012 3,958,878 402,134  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 26,800 24,329 2,471  
7 Other salaries and wages 290,475,779 263,690,644 26,785,135  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 17,608,579 13,599,755 4,008,824  
9 Other employee benefits ....... 25,412,545 19,409,288 6,003,257  
10 Payroll taxes ........... 12,721,082 11,043,179 1,677,903  
11 Fees for services (non-employees):        
a Management ...... 618,745   618,745  
b Legal ......... 561,241   561,241  
c Accounting ........... 275,830   275,830  
d Lobbying ........... 2,750   2,750  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 14,062   14,062  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 65,903,230 44,240,766 21,662,464  
12 Advertising and promotion .... 265,666 4,892 260,774  
13 Office expenses ....... 3,757,415 2,816,058 941,357  
14 Information technology ...... 1,991,978 1,812,236 179,742  
15 Royalties .. 0      
16 Occupancy ........... 14,603,618 13,960,598 643,020  
17 Travel ............ 363,741 211,976 151,765  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 17,808 12,082 5,726  
20 Interest ........... 45,891 24,064 21,827  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 2,470,120 2,027,670 442,450  
23 Insurance .............. 5,001,675 4,740,630 261,045  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a BAD DEBT 29,666,953 29,666,953 0 0
b DRUGS AND MEDICAL SUPPLIES 8,378,178 8,378,178 0 0
c RECRUITMENT 844,658 65,396 779,262 0
d INCOME TAX EXPENSE 5,545 0 5,545  
e All other expenses 19,860,028 4,491,449 15,368,579  
25 Total functional expenses. Add lines 1 through 24e 505,259,929 424,184,021 81,075,908 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 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 10,695 1 14,395
2 Savings and temporary cash investments ......... 0 2 3,678
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 46,260,827 4 66,957,612
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 87,138
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 1,413,019 7 1,260,344
8 Inventories for sale or use .............. 0 8 0
9 Prepaid expenses and deferred charges .......... 2,579,323 9 3,046,178
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 26,145,593
b Less: accumulated depreciation ..... 10b 13,534,132 10,947,428 10c 12,611,461
11 Investments—publicly traded securities .......... 0 11 0
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 ..... 7,637 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 7,658,414 15 7,534,046
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 68,877,343 16 91,514,852
Liabilities 17 Accounts payable and accrued expenses ......... 38,569,352 17 57,706,789
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 2,916
20 Tax-exempt bond liabilities ............. 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other 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 .. 474,731 23 830,296
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.................... 9,400,720 25 10,254,800
26 Total liabilities. Add lines 17 through 25......... 48,444,803 26 68,794,801
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 20,432,540 27 22,720,051
28 Temporarily restricted net assets ........... 0 28 0
29 Permanently restricted net assets ........... 0 29 0
Organizations that do not follow SFAS 117 (ASC 958), 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 ........... 20,432,540 33 22,720,051
34 Total liabilities and net assets/fund balances ........ 68,877,343 34 91,514,852
Form 990 (2012)
Form 990 (2012)
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
455,413,639
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
505,259,929
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-49,846,290
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
20,432,540
5
Net unrealized gains (losses) on investments ...............
5
6,117
6
Donated services and use of facilities .................
6
0
7
Investment expenses .....................
7
0
8
Prior period adjustments .....................
8
0
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
52,127,684
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
22,720,051
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
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 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?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
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
 
No
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
 
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
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
2012
Open to Public
Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH CARE ASSOCIATES
INC
Employer identification number

35-1747218
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 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
Provide the following information about the supported organization(s).
(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 monetary support
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . 3,040,342 0 0 0 45,009,804 48,050,146
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...... 21,794,831 60,461,533 217,100,267 311,003,051 399,487,474 1,009,847,156
3 Gross receipts from activities that are not an unrelated trade or business under section 513.. 137,893 864,798 7,739,538 6,375,474 10,771,020 25,888,723
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...           0
5 The value of services or facilities furnished by a governmental unit to the organization without charge..           0
6 Total. Add lines 1 through 5. 24,973,066 61,326,331 224,839,805 317,378,525 455,268,298 1,083,786,025
7a Amounts included on lines 1, 2, and 3 received from disqualified persons... 0 0 0 0 0 0
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. 0 3,093,972 27,666,033 45,828,532 59,006,057 135,594,594
c Add lines 7a and 7b.. 0 3,093,972 27,666,033 45,828,532 59,006,057 135,594,594
8 Public support (Subtract line 7c from line 6.)           948,191,431
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
9 Amounts from line 6... 24,973,066 61,326,331 224,839,805 317,378,525 455,268,298 1,083,786,025
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 1,087,676 3,817,378 2,619,461 1,260,522 1,572,359 10,357,396
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.     17,437     17,437
c Add lines 10a and 10b. 1,087,676 3,817,378 2,636,898 1,260,522 1,572,359 10,374,833
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.           0
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..           0
13 Total support. (Add lines 9, 10c, 11, and 12.).. 26,060,742 65,143,709 227,476,703 318,639,047 456,840,657 1,094,160,858
14
Section C. Computation of Public Support Percentage
15
15
86.659 %
16
16
87.231 %
Section D. Computation of Investment Income Percentage
17
17
0.948 %
18
18
1.381 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

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
2012
Name of the organization
INDIANA UNIVERSITY HEALTH CARE ASSOCIATES
INC
Employer identification number

35-1747218
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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 2
Name of organization
INDIANA UNIVERSITY HEALTH CARE ASSOCIATES
INC 		Employer identification number

35-1747218
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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 3
Name of organization
INDIANA UNIVERSITY HEALTH CARE ASSOCIATES
INC 		Employer identification number

35-1747218
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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 4
Name of organization
INDIANA UNIVERSITY HEALTH CARE ASSOCIATES
INC 		Employer identification number

35-1747218
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) (2012)

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
2012
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, Part V, 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 CARE ASSOCIATES
INC
Employer identification number

35-1747218
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 Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2012

Schedule C (Form 990 or 990-EZ) 2012
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 SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) Total
             
2a Lobbying nontaxable 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) 2012


Schedule C (Form 990 or 990-EZ) 2012
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)
No
Yes
(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)? ....
 
No
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? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
2,750
j
Total. Add lines 1c through 1i ...............................
2,750
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, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Identifier Return Reference Explanation
Schedule C, Part II-B Line 1i - Other Activities Indiana University Health Care Associates, Inc. ("IU Health Physicians") paid institutional membership dues to the American Medical Group Association ("AMGA") during 2012 in the amount of $13,750. The AMGA notified IU Health Physicians that a portion of the dues it paid were used for lobbying purposes. The AMGA used 20%, or $2,750 of 2012 membership dues paid by IU Health Physicians, for lobbying expenditures.
Schedule C (Form 990 or 990EZ) 2012

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
2012
Open to Public Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH CARE ASSOCIATES
INC
Employer identification number

35-1747218
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 section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, 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 XIII, 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, 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 XIII.
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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
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)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII 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 .................      
b Buildings ................   584,628 360,251 224,377
c Leasehold improvements ............   5,590,287 1,915,741 3,674,546
d Equipment ................   16,544,310 11,022,839 5,521,471
e Other .................   3,426,368 235,301 3,191,067
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 12,611,461
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
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
(1) PENSION AND OTHER RET. ASSETS 7,066,697
(2) INSURANCE POLICIES (CSV) 467,349







Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 7,534,046
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
INTERCOMPANY PAYABLES (NET) 704,551
PENSION AND OTHER RETIREMENT LIABILITIES 9,550,249







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 10,254,800
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 4
Part XI 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 XIII.) ............ 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 XIII.) ........... 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 XII 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 XIII.) ............ 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 XIII.) ............ 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 XIII
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Schedule D, Part X - Other Liabilities Line 2 - FIN 48 (ASC 740) Footnote Indiana University Health Care Associates, Inc. is a subsidiary in the consolidated financial statements of Indiana University Health, Inc. ("IU Health"). IU Health adopted FIN 48 in 2007. No disclosures were required in 2012 under GAAP as IU Health does not have any material tax contingencies that required disclosures in the footnotes.
Schedule D (Form 990) 2012

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
2012
Open to Public Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH CARE ASSOCIATES
INC
Employer identification number

35-1747218
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 of the expenses described above? If "No," complete Part III to explain....
1b
 
 
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
 
 
3
Indicate which, if any, of the following the filing organization used 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
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 (E) amounts for that individual.
(A) Name and Title (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)RICHARD F GRAFFIS MDCHAIRMAN/STAFF PHYSICIAN (i)
(ii)		 11,309
530,045 		0
163,274 		0
101,243 		0
21,020 		0
19,492 		11,309
835,074 		0
0
(2)ARTHUR C COFFEY MDDIR./TREAS./SERVICE LINE CHIEF (i)
(ii)		 141,993
554,967 		0
0 		4,465
13,165 		13,353
0 		7,864
12,009 		167,675
580,141 		0
0
(3)DAVID W CRABB MDDIRECTOR (i)
(ii)		 0
139,126 		0
0 		0
1,477 		0
9,533 		0
1,145 		0
151,281 		0
0
(4)HERBERT E CUSHING MDDIRECTOR/SEC./MED. DIRECTOR (i)
(ii)		 248,049
0 		0
0 		1,504
0 		12,560
0 		1,287
0 		263,400
0 		0
0
(5)GARY L DUNNINGTON MDDIR./PHY. (10/01 - 12/31) (i)
(ii)		 165,123
0 		0
0 		0
0 		11,110
0 		509
0 		176,742
0 		0
0
(6)RYAN C KITCHELLDIRECTOR (05/10 - 12/31) (i)
(ii)		 0
477,947 		0
38,401 		0
29,196 		0
96,622 		0
26,312 		0
668,478 		0
0
(7)MICHAEL R NIEMEIER MDDIRECTOR/SERVICE LINE CHIEF (i)
(ii)		 363,589
0 		0
0 		18,290
0 		17,500
0 		27,957
0 		427,336
0 		0
0
(8)SAMUEL L ODLEDIRECTOR (01/01 - 07/13) (i)
(ii)		 0
356,249 		0
196,059 		0
5,638,241 		0
21,020 		0
16,409 		0
6,227,978 		0
3,970,628
(9)ISADORE RIVASDIRECTOR (01/01 - 05/09) (i)
(ii)		 0
102,842 		0
8,250 		0
212,241 		0
2,063 		0
18,917 		0
344,313 		0
0
(10)CHARLES M SHUFFLEBARGER MDDIRECTOR/SERVICE LINE CHIEF (i)
(ii)		 293,800
0 		1,309
0 		966
0 		17,500
0 		1,704
0 		315,279
0 		0
0
(11)LARRY H STEVENS MDDIRECTOR/SERVICE LINE CHIEF (i)
(ii)		 153,936
0 		0
0 		12,133
0 		10,931
0 		4,263
0 		181,263
0 		0
0
(12)JAMES G TERWILLIGERDIRECTOR (09/23 - 12/31) (i)
(ii)		 0
323,645 		0
57,250 		0
35,726 		0
79,520 		0
25,697 		0
521,838 		0
0
(13)JOHN F FITZGERALD MDCEO (i)
(ii)		 409,639
0 		44,201
0 		8,221
0 		102,711
0 		1,180
0 		565,952
0 		0
0
(14)CAROL D KARPCFO (i)
(ii)		 180,378
0 		0
0 		8,801
0 		13,724
0 		24,960
0 		227,863
0 		0
0
(15)KIMBERLEE C SHERBROOKECOO (i)
(ii)		 265,302
0 		0
0 		11,271
0 		29,293
0 		1,704
0 		307,570
0 		0
0
(16)JOHN C KOHNE MDCME (i)
(ii)		 136,070
276,262 		13,596
27,604 		107,675
218,613 		6,937
14,084 		8,133
16,512 		272,411
553,075 		0
194,402
(17)STEPHEN H POLLOM MDSERVICE LINE CHIEF (i)
(ii)		 300,755
0 		8,128
0 		22,334
0 		17,500
0 		23,296
0 		372,013
0 		0
0
(18)PETER W BRUNNVP, HOSPITAL-BASED (i)
(ii)		 210,276
0 		0
0 		1,806
0 		14,926
0 		25,186
0 		252,194
0 		0
0
(19)KYLE L ALLENVP, PRIMARY CARE (01/01-10/07) (i)
(ii)		 159,631
41,831 		0
0 		14,536
535 		12,294
2,135 		7,322
1,968 		193,783
46,469 		0
0
(20)CELIA D SURFACE-BRUDERVP, PRIMARY CARE (10/08-12/31) (i)
(ii)		 136,071
0 		0
0 		15,430
0 		10,828
0 		13,470
0 		175,799
0 		0
0
(21)MICHAEL D OBER MDEXECUTIVE DIRECTOR (i)
(ii)		 308,700
0 		0
0 		578
0 		17,500
0 		1,921
0 		328,699
0 		0
0
(22)MARK P CAIN MDSTAFF PHYSICIAN (i)
(ii)		 952,634
0 		10,000
0 		966
0 		17,500
0 		1,912
0 		983,012
0 		0
0
(23)RICHARD C RINK MDSTAFF PHYSICIAN (i)
(ii)		 925,676
0 		7,500
0 		2,772
0 		17,500
0 		1,836
0 		955,284
0 		0
0
(24)RICHARD BIHRLE MDSTAFF PHYSICIAN (i)
(ii)		 915,914
0 		10,000
0 		2,772
0 		17,500
0 		1,704
0 		947,890
0 		0
0
(25)MICHAEL O KOCH MDSERVICE LINE CHIEF (i)
(ii)		 898,051
0 		10,000
0 		1,806
0 		17,500
0 		1,912
0 		929,269
0 		0
0
(26)RICHARD S FOSTER MDSTAFF PHYSICIAN (i)
(ii)		 896,998
0 		6,250
0 		1,806
0 		17,500
0 		1,704
0 		924,258
0 		0
0
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule J, Part I - Questions Regarding Compensation Line 4a - Severance or Change-of-Control Payments Isadore Rivas received 2012 severance of $169,616 from Indiana University Health, Inc. This amount is included in column b (iii), other reportable compensation.
Schedule J, Part I - Questions Regarding Compensation Line 4b - Supplemental Nonqualified Retirement Plan Richard F. Graffis, M.D., Samuel L. Odle, John C. Kohne, M.D., and John F. Fitzgerald, M.D. participate in supplemental executive retirement plan of Indiana University Health, Inc., 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. For John F. Fitzgerald, M.D, an amount is 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 Richard F. Graffis, M.D. John C. Kohne, M.D., and Samuel L. Odle, $75,270, $323,516, and $5,543,808, respectively, is included in column b(iii), other reportable compensation, representing the amount received under his 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 plans must be approved by the Board of Directors prior to any incentive payout.
Schedule J (Form 990) 2012

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, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH CARE ASSOCIATES
INC
Employer identification number

35-1747218
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) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
(1) LARRY H STEVENS MD SEE PART V SEE PART V   X 98,000 87,138   No Yes   Yes  
Total ......Small Bullet $ 87,138
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 assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2012
Schedule L (Form 990 or 990-EZ) 2012
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) IU HEALTH RISK RETENTION GROUP INC SEE PART V 6,976,632 SEE PART V   No
(2) IUH ASSURANCE LTD SEE PART V 222,240 SEE PART V   No
(3) UNIVERSITY SURGEONS INC SEE PART V 104,982 SEE PART V   No
(4) KELLY L ALLEN SEE PART V 26,800 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 II - Loans To and/or From Interested Persons Columns (b) and (c) - Relationship and Purpose of Loan Indiana University Health Care Associates, Inc. entered into a promissory note and forgivable loan agreement with Larry H. Stevens, M.D. as part of his employment contract.
Schedule L, Part IV - Business Transactions Involving Interested Persons Line 1, Columns (b) and (d) - Relationship and Description of Transaction Charles M. Shufflebarger, M.D. and John F. Fitzgerald, M.D. served on the board of directors of IU Health Risk Retention Group, Inc. Indiana University Health Care Associates, Inc. ("IU Health Physicians") purchased insurance coverage from IU Health Risk Retention Group, Inc. on an arm's length basis. Charles M. Shufflebarger, M.D. and John F. Fitzgerald, M.D. served on the board of directors of IUH Assurance, Ltd. IU Health Physicians purchased insurance coverage from IUH Assurance, Ltd. on an arm's length basis. Gary L. Dunnington, M.D. is the owner and President of University Surgeons, Inc. ("USI"). USI provides medical services to IU Health Physicians and is compensated for such services on an arm's length basis. Kelly L. Allen, the daughter of Kyle L. Allen, served and was compensated as an employee of IU Health Physicians.
Schedule L (Form 990 or 990-EZ) 2012

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
2012
Open to Public
Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH CARE ASSOCIATES
INC
Employer identification number

35-1747218
Identifier Return Reference Explanation
Part VI, Section A - Governing Body and Management Line 1b - Number of Voting Members that are Independent Indiana University Health Care Associates, Inc. is part of a multi-entity hospital system controlled by Indiana University Health, Inc., a 501(c)(3) tax-exempt organization whose board is comprised of voting members, of which substantially all are independent community members.
Part VI, Section A - Governing Body and Management Line 2 - Family or Business Relationships James G. Terwilliger, John F. Fitzgerald, M.D. and John C. Kohne, M.D. served on the board of managers of Health Venture Management, LLC. No additional compensation is provided. Ryan C. Kitchell and John F. Fitzgerald, M.D. served on the board of directors of Indiana University Health Plans, Inc. No additional compensation is provided. Charles M. Shufflebarger, M.D. and John F. Fitzgerald, M.D. served on the board of directors of IUH Assurance, Ltd. and IU Health Risk Retention Group, Inc. No additional compensation is provided.
Part VI, Section A - Governing Body and Management Lines 6, 7a and 7b - Members or Stockholders Line 6: Indiana University Health Care Associates, Inc. ("IU Health Physicians") has two Members, which are designated as the Class A Member and the Class B Member. The Class A Member consists of those individuals who serve from time to time as the Trustees of Indiana University ("IU"). The Class B Member is Indiana University Health, Inc. ("IU Health"). Line 7a: The Board of Directors consists of: (a) two individuals appointed by IU as the Class A Member, (b) three individuals appointed by IU Health as the Class B Member, (c) four Associates appointed by IU as the Class A Member, and (d) four Associates appointed by IU Health as the Class B Member. A physician or any non-physician health care provider approved by IU Health Physicians may be an Associate of IU Health Physicians if he or she (a) has medical staff privileges (if applicable) and conducts a substantial practice activity at a hospital affiliated with IU Health, at William M. Wishard Hospital, Larue D. Carter Memorial Hospital or the Richard L. Roudebush Medical Center or at some other site authorized by the Corporation; (b) holds a faculty position with the Indiana University School of Medicine; and (c) is party to an employment agreement with IU Health Physicians or, if not party to an employment agreement, meets the written criteria for nonemployee Associate status approved by the Board and the members from time to time. Line 7b: Any decision by the Board of Directors to amend, supplement, or repeal all or any part of the provisions contained in the Articles of Incorporation must be duly approved by a vote of both Members.
Part VI, Section A - Governing Body and Management Line 11b - Form 990 Provided to Governing Body Indiana University Health Care Associates, Inc. ("IU Health Physicians") has established the following process for the review of the Form 990 and related schedules before it is filed: The Chief Financial Officer reviewed and approved the Form 990 and related schedules. After the review and approval from the Chief Financial Officer, a complete copy of the Form 990 and related 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 Lines 12, 13, 14, and 16a Indiana University Health Care Associates, Inc. ("IU Health Physicians") is part of the Indiana University Health, Inc. ("IU Health") system. As a member of IU Health Physicians, IU Health and its Board of Directors have mandated that certain policies be followed to ensure greater standardization throughout the system. Thus, IU Health Physicians' Board of Directors was not required to separately adopt a conflict of interest, whistleblower, document retention and destruction and joint venture policies because IU Health's Board of Directors had already adopted and required these policies to be followed by its subsidiaries.
Part VI, Section B - Policies Line 12c - Conflict of Interest Policy Indiana University Health Care Associates, Inc. ("IU Health Physicians") has a Conflict of Interest Policy, the purpose of which is to protect IU Health Physician's interests when it is contemplating entering into a transaction or arrangement that might benefit the private interest of an officer, director, or employee. Each employee that is manager level or above, including officers and directors, is required to annually sign a statement which affirms that such person (1) has received a copy of the conflict of interest policy; (2) has read and understands the policy; (3) has agreed to comply with the policy; and (4) understands and acknowledges that the Corporation is a tax-exempt organization and that in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. If an interest is disclosed, the form requires that the discloser's supervisor sign the form to indicate his/her knowledge and approval of the interest. The form is then submitted to Corporate Compliance for review. If the disclosure is by the CEO/President, it is reviewed by the board chairman for approval. If the disclosure is by a member of the board of directors, the General Counsel/Chief Compliance Officer reviews the disclosures and determines whether to consent. Board members with a conflict of interest cannot participate in any decision related to that conflict. Breach of the conflict of interest policy, including failure to complete and update the questionnaire and failure to disclose an interest that should be disclosed, may subject an individual to disciplinary action, including dismissal.
Part VI, Section B - Policies Line 15 - Process for Determining Compensation Indiana University Health Care Associates, Inc. ("IU Health Physicians") has the following process in place to determine the compensation for its CEO, CFO and other executives. IU Health Physicians engages an independent compensation consultant who utilizes a variety of methods and procedures to establish market ranges for the CEO, CFO, and other executives. The market ranges provided by the independent consultant is used by the executive Compensation Committee to review and establish the yearly pay increases for the CEO. The Compensation Committee reviews the market data for the CFO and other executives and delegates the annual pay increase decision to the CEO, who uses the market data to drive the annual pay increase decisions.
Part VI, Section C - Disclosure Line 19 - Public Disclosure Indiana University Health Care Associates, Inc.'s ("IU Health Physicians") Articles of Incorporation are available for public inspection through the Indiana Secretary of State's web-site. IU Health Physicians' conflict of interest procedures are disclosed on the Form 990, Schedule O. IU Health Physicians is a consolidated subsidiary in the consolidated financial statements for Indiana University Health, Inc. ("IU Health"). The consolidated financial statements for IU Health are available to the public through its bond filings.
Part VII, Section A - Governing Body and Management Line 1a, Column (B) - Average hours per week During different parts of 2012, Richard F. Graffis, M.D. devoted 55 hours per week as the Executive Vice President and Chief Medical Officer of Indiana University Health, Inc. and a Staff Physician of Indiana University Health Care Associates, Inc. ("IU Health Physicians"). During different parts of 2012, Arthur C. Coffey, M.D. devoted 55 hours per week as a Staff Physician of CCSG, LLC and a Service Line Chief of IU Health Physicians. During different parts of 2012, Kyle L. Allen devoted 55 hours per week as the Vice President, Primary Care of IU Health Physicians and Chief Practice Officer of Indiana University Health Arnett, Inc.
Part IX - Statement of Functional Expenses Line 11g - Other Fees for Services Line 11g includes amounts paid for the following: Shared Services/Professional Fees - $65,903,230
Part XI - Reconciliation of Net Assets Line 9 - Other Changes in Net Assets or Fund Balances During 2012, Indiana University Health, Inc. ("IU Health"), a related 501(c)(3) tax-exempt organization, made an equity transfer to Indiana University Health Care Associates, Inc. ("IU Health Physicians") of $54,835,777. Since IU Health Physicians joined the IU Health system, IU Health has provided funds to support IU Health Physicians' exempt purpose. Although there was never any intent for IU Health Physicians to repay IU Health, these amounts were recorded as intercompany balances rather than equity transfers. During 2012, IU Health and IU Health Physicians made adjustments to their books and records to reflect these intercompany balances as equity transfers for both book and tax purposes. Also during 2012, IU Health Physicians made an equity transfer to Indiana University Health North Hospital, Inc. and The Indiana Clinic Support Services, LLC in the amount of -$561,144 and -$1,494,793, respectively. IU Health Physicians also recorded a change in pension liability in the amount of -$652,156.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

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
2012
Open to Public Inspection
Name of the organization
INDIANA UNIVERSITY HEALTH CARE ASSOCIATES
INC
Employer identification number

35-1747218
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) 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) ICEM LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-1076521 		HEALTHCARE IN 0 0 IUHCA
 
(2) ICEM-BALL LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-1076389 		HEALTHCARE IN 0 0 IUHCA
 
(3) ICEM-METHODIST LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-1059994 		HEALTHCARE IN 0 0 IUHCA
 
(4) ICEM-UNIVERSITY-RILEY LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-1060212 		HEALTHCARE IN 249,856 0 IUHCA
 
(5) ICEM-WISHARD LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-1076327 		HEALTHCARE IN 0 0 IUHCA
 
(6) INDIANA CLINIC-ANESTHESIA LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-1321819 		HEALTHCARE IN 17,160,358 0 IUHCA
 
(7) INDIANA CLINIC-CRITICAL CARE LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
26-4529552 		HEALTHCARE IN 0 0 IUHCA
 
(8) INDIANA CLINIC-FAMILY MEDICINE LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-2619667 		HEALTHCARE IN 4,145,880 0 IUHCA
 
(9) INDIANA CLINIC-NEUROLOGY LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
26-4529479 		HEALTHCARE IN 89,161 0 IUHCA
 
(10) INDIANA CLINIC-SURGERY LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-1740662 		HEALTHCARE IN 16,516,416 0 IUHCA
 
(11) INDIANA CLINIC-UROLOGY LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-0181780 		HEALTHCARE IN 3,627,039 0 IUHCA
 
(12) THE INDIANA CLINIC SUPPORT SERVICES LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
26-4225448 		HEALTHCARE IN 0 5,605,164 IUHCA
 
Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to 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 entity?
Yes No
(1) CLARIAN TRANSPLANT INSTITUTE INC

950 N MERIDIAN ST STE 800

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

200 HIGH PARK AVE

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

200 HIGH PARK AVE

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

714 S ROGERS ST

BLOOMINGTON,IN47402
26-3571507 		HEALTHCARE IN 501(C)(3) 9 IUHB
 
Yes
 
(5) INDIANA RADIOLOGY PARTNERS INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
20-1017034 		HEALTHCARE IN 501(C)(3) 3 IUH
 
Yes
 
(6) INDIANA UNIVERSITY HEALTH INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
35-1955872 		HEALTHCARE IN 501(C)(3) 3 NA
 
 
No
(7) IU HEALTH ARNETT FOUNDATION INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
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 		HEALTHCARE IN 501(C)(3) 11 I IUHBMH
 
Yes
 
(15) IU HEALTH LAPORTE HOSPITAL INC

PO BOX 250

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

PO BOX 250

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

2209 JOHN R WOODEN DR

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

950 N MERIDIAN ST STE 800

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

PO BOX 499

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

PO BOX 499

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

1000 S MAIN ST

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

950 N MERIDIAN ST STE 800

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

720 S SIXTH ST

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

340 W 10TH ST NO FS5100

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

1800 N CAPITOL AVE

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

950 N MERIDIAN ST STE 800

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

950 N MERIDIAN ST STE 800

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

950 N MERIDIAN ST STE 800

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

950 N MERIDIAN ST STE 800

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

950 N MERIDIAN ST STE 800

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

2209 JOHN R WOODEN DR

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

2209 JOHN R WOODEN DR

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

1949 HOSPITAL DR

MARTINSVILLE,IN46151
35-1968564 		HEALTHCARE IN 501(C)(3) 3 IUHMH
 
Yes
 
(34) IU HEALTH WHITE MEMORIAL FOUNDATION

PO BOX 952

MONTICELLO,IN47960
35-1671806 		FUNDRAISING IN 501(C)(3) 11 III-O IUHWMH
 
Yes
 
(35) UNIVERSITY FAMILY PHYSICIANS INC

950 N MERIDIAN ST STE 800

INDIANAPOLIS,IN46204
23-7427350 		HEALTHCARE IN 501(C)(3) 9 IUHCA
 
Yes
 
(36) REHABILITATION HOSPITAL OF INDIANA INC

4141 SHORE DR

INDIANAPOLIS,IN46254
35-1786005 		HEALTHCARE IN 501(C)(3) 3 MHH
 
Yes
 
(37) RHI FOUNDATION INC

4141 SHORE DR

INDIANAPOLIS,IN46254
35-1932349 		FUNDRAISING IN 501(C)(3) 11 I RHI
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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 BSCH
  		N/A 0 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
  		N/A 0 0   No 0   No 0 %
(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
  		N/A 0 0   No 0   No 0 %
(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
  		N/A 0 0   No 0   No 0 %
(10) EAGLE HIGHLANDS SURGERY CENTER LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
35-2259204 		HEALTHCARE IN EHSCH
  		N/A 0 0   No 0   No 0 %
(11) EHSC HOLDINGS LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
45-4147879 		HEALTHCARE IN IUH
  		N/A 0 0   No 0   No 0 %
(12) HEALTH VENTURE MANAGEMENT LLC

950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
20-5740218 		MANAGEMENT IN IUH
  		N/A 0 0   No 0   No 0 %
(13) IEC HOLDINGS LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
45-4148032 		HEALTHCARE IN IUH
  		N/A 0 0   No 0   No 0 %
(14) INDIANA ENDOSCOPY CENTERS LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
20-8398421 		HEALTHCARE IN IECH
  		N/A 0 0   No 0   No 0 %
(15) BSC HOLDINGS LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
45-2314634 		HEALTHCARE IN IUH
  		N/A 0 0   No 0   No 0 %
(16) MID-AMERICA SURGERY CENTER LLC

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

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
27-1497960 		HEALTHCARE IN ROCSH
  		N/A 0 0   No 0   No 0 %
(18) ROCS HOLDINGS LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
45-4148369 		HEALTHCARE IN IUH
  		N/A 0 0   No 0   No 0 %
(19) SENATE STREET SURGERY CENTER LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
42-1709357 		HEALTHCARE IN SSSCH
  		N/A 0 0   No 0   No 0 %
(20) SSSC HOLDINGS LLC

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
45-4148167 		HEALTHCARE IN IUH
  		N/A 0 0   No 0   No 0 %
(21) CARDINAL HEALTH ALLIANCE LLC

2401 W UNIVERSITY AVE
MUNCIE,IN47303
35-1966281 		MANAGED CARE IN IUHBMH
  		N/A 0 0   No 0   No 0 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) BMH MEDICAL PAVILION ASSOCIATION INC

2525 W UNIVERSITY AVE
MUNCIE,IN47303
35-1858408 		CONDO MANAGEMENT IN IUHBMH
  		C 0 0 0 % Yes  
(2) CARDINAL HEALTH VENTURES INC

950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
35-1611424 		MANAGEMENT IN IUHBMH
  		C 0 0 0 % Yes  
(3) CHV CAPITAL INC

950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
26-0752507 		VENTURE CAPITAL IN IUH
  		C 0 0 0 % Yes  
(4) IU HEALTH ACO INC

950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
45-4421020 		HEALTHCARE IN IUH
  		C 0 0 0 % Yes  
(5) IU HEALTH BOARD DESIGNATED TRUST

400 HOWARD ST
SAN FRANCISCO,CA94105
30-6309021 		INVESTMENTS IN IUH
  		T 0 0 0 % Yes  
(6) IU HEALTH NTGI S&P500 FUND CF

PO BOX 804358
CHICAGO,IL60680
30-6298263 		INVESTMENTS IN IUH
  		T 0 0 0 % Yes  
(7) IU HEALTH PLANS INC

1776 MERIDIAN ST STE 300
INDIANAPOLIS,IN46202
26-2127080 		HMO IN IUH
  		C 0 0 0 % Yes  
(8) IU HEALTH RISK PURCHASING GROUP INC

151 MEETING ST STE 301
CHARLESTON,SC29401
26-0202446 		INSURANCE IN IUH
  		C 0 0 0 % Yes  
(9) IU HEALTH RISK RETENTION GROUP INC

151 MEETING ST STE 301
CHARLESTON,SC29401
20-1107674 		INSURANCE SC IUH
  		C 0 0 0 % Yes  
(10) IU HEALTH SOUTHERN IN PHYSICIANS INC

PO BOX 1149
BLOOMINGTON,IN47402
35-1913875 		HEALTHCARE IN IUHB
  		C 0 0 0 % Yes  
(11) IUH ASSURANCE LTD

PO BOX 69
SOLARIS AVE.,GRAND CAYMAN  
CJ
98-0395429 		INSURANCE CJ IUH
  		C 0 0 0 % Yes  
(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 % Yes  
(13) PARKMOR DRUG INC

1501 S MAIN ST
GOSHEN,IN46526
13-1394980 		PHARMACY SALES IN GHS
  		C 0 0 0 % Yes  
(14) PILR INC

200 HIGH PARK AVE
GOSHEN,IN46526
20-4294750 		DEVELOPMENT IN GHS
  		C 0 0 0 % Yes  
(15) RADIATION ONCOLOGY RESOURCES INC

200 HIGH PARK AVE
GOSHEN,IN46526
26-2008424 		HEALTHCARE IN GHS
  		C 0 0 0 % Yes  
(16) SCANS INC

950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
45-3080392 		HEALTHCARE IN CHVF1
  		C 0 0 0 % Yes  
(17) UNIVERSITY HEALTH MANAGEMENT INC

950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-2891143 		MANAGEMENT IN CHV
  		C 0 0 0 % Yes  
(18) UNIVERSITY HEALTH MGMT (CHINA) INC

950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
27-3891311 		MANAGEMENT IN CHV
  		C 0 0 0 % Yes  
(19) PROTEUO FUND LP

PO BOX 31106
89 NEXUS WAY,GRAND CAYMAN  
CJ
98-1075227 		INVESTMENTS CJ IUH
  		C 0 0 0 % Yes  
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
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 Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
 
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
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-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) IU MEDICAL GROUP FOUNDATION INC

 C 45,000,000 FMV
(2) BELTWAY SURGERY CENTERS LLC

 J 245,897 FMV
(3) IU HEALTH NORTH HOSPITAL INC

 J 200,383 FMV
(4) IU HEALTH NORTH HOSPITAL INC

 K 68,858 FMV
(5) IU HEALTH WEST HOSPITAL INC

 K 167,137 FMV
(6) IU HEALTH ARNETT INC

 L 866,025 FMV
(7) IU HEALTH BALL MEMORIAL HOSPITAL INC

 L 1,740,892 FMV
(8) IU HEALTH BALL MEMORIAL PHYSICIANS INC

 L 62,717 FMV
(9) BELTWAY SURGERY CENTERS LLC

 L 121,600 FMV
(10) IU HEALTH BLOOMINGTON INC

 L 156,395 FMV
(11) CLARIAN TRANSPLANT INSTITUTE INC

 L 89,188 FMV
(12) INDIANA RADIOLOGY PARTNERS INC

 L 214,130 FMV
(13) IU HEALTH NORTH HOSPITAL INC

 L 3,920,538 FMV
(14) ROC SURGERY LLC

 L 120,000 FMV
(15) UNIVERSITY FAMILY PHYSICIANS INC

 L 14,560,945 FMV
(16) IU HEALTH WEST HOSPITAL INC

 L 2,525,251 FMV
(17) METHODIST OCCUPATIONAL HEALTH CENTERS INC

 M 169,288 FMV
(18) IU HEALTH NORTH HOSPITAL INC

 M 99,860 FMV
(19) IU HEALTH WEST HOSPITAL INC

 M 62,500 FMV
(20) INDIANA RADIOLOGY PARTNERS INC

 O 71,949 FMV
(21) IU HEALTH RISK RETENTION GROUP INC

 R 6,976,632 FMV
(22) IUH ASSURANCE LTD

 R 222,240 FMV
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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 section 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) 2012
Schedule R (Form 990) 2012
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


Software ID:  
Software Version: