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 private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 01-01-2013 , 2013, and ending 12-31-2013
BCheck if applicable:
CName of organization
INDIANAPOLIS OSTEOPATHIC HOSPITAL
INC
Doing Business As
COMMUNITY WESTVIEW HOSPITAL
 
Number and street (or P.O. box if mail is not delivered to street address)
3630 GUION ROAD
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
INDIANAPOLIS, IN46222
D Employer identification number

35-1094734
E Telephone number

G Gross receipts $ 61,904,435
F Name and address of principal officer:
DAVID C WILLIAMS DO
3630 GUION ROAD
INDIANAPOLIS,IN46222
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.WESTVIEWHOSPITAL.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1961
M State of legal domicile: IN
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE QUALITY HEALTHCARE TO THE CENTRAL INDIANA COMMUNITY - REGARDLESS OF THEIR ABILITY TO PAY - WITH FACILITIES, SUPPORT AND GROWTH FOR THE OSTEOPATHIC PROFESSION THROUGH OUR INTERN/RESIDENT EDUCATION PROGRAMS, INCREASED PHYSICIAN PRACTICES, PRESENCE AND EXPERTISE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 10
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 4
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 737
6 Total number of volunteers (estimate if necessary) ............. 6 40
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 34,780 96,778
9 Program service revenue (Part VIII, line 2g) ......... 17,000,032 59,756,666
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 34,850 -402,805
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 911,678 1,914,599
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 17,981,340 61,365,238
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 80 0
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 13,115,516 41,580,182
16a Professional fundraising fees (Part IX, column (A), line 11e).....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet151,383    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 8,931,775 31,859,999
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 22,047,371 73,440,181
19 Revenue less expenses. Subtract line 18 from line 12....... -4,066,031 -12,074,943
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 50,825,600 53,056,959
21 Total liabilities (Part X, line 26)............. 15,110,508 29,197,698
22 Net assets or fund balances. Subtract line 21 from line 20..... 35,715,092 23,859,261
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 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: TO PROVIDE QUALITY HEALTHCARE TO THE CENTRAL INDIANA COMMUNITY - REGARDLESS OF THEIR ABILITY TO PAY - WITH FACILITIES, SUPPORT AND GROWTH FOR THE OSTEOPATHIC PROFESSION THROUGH OUR INTERN/RESIDENT EDUCATION PROGRAMS, INCREASED PHYSICIAN PRACTICES, PRESENCE AND EXPERTISE.
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 $ 36,372,983 including grants of $   ) (Revenue $ 49,744,212 )
AT INDIANAPOLIS OSTEOPATHIC HOSPITAL, INC. ("IOH") OUR OSTEOPATHIC PHILOSOPHY OF CARE MEANS WE TREAT YOU AS A WHOLE PERSON AND ASSESS YOUR ENTIRE LIFESTYLE. THE HOSPITAL OFFERS AN ARRAY OF SERVICES ON THE WESTSIDE OF INDIANAPOLIS, INDIANA, INCLUDING A 24-HOUR EMERGENCY ROOM, INTENSIVE ACUTE CARE NURSING UNITS, SURGICAL SERVICES, IMAGING SERVICES, LABORATORY SERVICES, CANCER CARE, CARDIOPULMONARY REHABILITATION, SLEEP LAB, RENAL/DIALYSIS SERVICES, INPATIENT AND OUTPATIENT REHABILITATION SERVICES, AND GERIATRIC PSYCHIATRIC CARE. THE HOSPITAL OFFERS A FULL RANGE OF DIAGNOSTIC, TREATMENT, MEDICAL AND SURGICAL SERVICES WITH A MEDICAL STAFF COMPRISED OF OVER 30 MEDICAL AND SURGICAL SPECIALTIES. THE HOSPITAL SERVED 1,673 INPATIENTS AND PROVIDED 88,842 OUTPATIENT VISITS, WHICH INCLUDED 10,084 EMERGENCY VISITS. THE IOH SURGERY DEPARTMENT PERFORMED 3,653 SURGERIES IN 2013.
4b (Code:   ) (Expenses $ 21,040,395 including grants of $   ) (Revenue $ 11,701,493 )
PHYSICIAN CLINICS - IN ADDITION TO THE HOSPITAL SERVICES THAT IOH PROVIDES, THE HOSPITAL ALSO PROVIDES SPECIALTY AND PRIMARY CARE IN ITS CLINICS. WITHIN THE CLINIC SITES, 104,027 ENCOUNTERS WERE ACCOMPLISHED IN 2013.
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet57,413,378
Form 990 (2013)
Form 990 (2013)
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 I..........
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 II........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III............................
5
 
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
Yes
 
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 other assistance to or for any foreign organization? 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 other assistance to or for foreign individuals? 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.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government 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 or 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 25a................
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
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II.................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV..................... Click to see attachment
28b
 
No
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
 
No
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 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
53
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
737
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
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
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 (2013)
Form 990 (2013)
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 or note to any line 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
10
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
4
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
 
No
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
Yes
 
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
 
No
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
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
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:
MediumBulletELIZABETH HALL3630 GUION ROADINDIANAPOLISIN46222 (317) 920-3273
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) BRYAN A MILLS........................................................................
DIRECTOR
 2.00
.......................58.00 		X           0 1,133,983 121,280
(2) DAVID C WILLIAMS DO........................................................................
DIRECTOR & C
 36.67
.......................18.33 		X   X       374,501 129,509 42,267
(3) ALLAN ARKUSH DO........................................................................
DIRECTOR
 42.00
.......................   		X           355,610 0 20,216
(4) DAVID HARRISON DO........................................................................
DIRECTOR
 42.00
.......................   		X           352,173 0 27,954
(5) LISA RICHTER DO........................................................................
DIRECTOR
 42.00
.......................   		X           252,118 0 9,044
(6) CINDY BROWN DO........................................................................
VICE CHAIRMA
 42.00
.......................   		X   X       151,004 0 15,559
(7) ROBERT BEHNING........................................................................
DIRECTOR
 2.00
.......................   		X           0 0 0
(8) ANDREW CARDIMEN........................................................................
SECRETARY/TR
 2.00
.......................   		X   X       0 0 0
(9) PAUL EVANS DO........................................................................
DIRECTOR
 2.00
.......................   		X           0 0 0
(10) MARIA WILEY........................................................................
CHAIRMAN
 2.00
.......................   		X   X       0 0 0
(11) JON ANDERSON........................................................................
CEO THRU JUN
 45.00
.......................   		    X       324,486 0 177,502
(12) DEBORAH LEE........................................................................
CNO
 45.00
.......................   		    X       176,584 0 11,041
(13) DOUG PENLEY........................................................................
COO
 45.00
.......................   		    X       169,633 0 29,735
(14) ELIZABETH HALL........................................................................
DIRECTOR OF
 45.00
.......................   		    X       88,898 0 20,256
(15) ROBERT MURRAY DO........................................................................
PHYSICIAN
 45.00
.......................   		        X   598,460 0 30,858
(16) THOMAS SOUTHERN MD........................................................................
PHYSICIAN
 45.00
.......................   		        X   502,784 0 16,410
(17) CASIMIR STARSIAK DO........................................................................
PHYSICIAN
 45.00
.......................   		        X   409,400 0 33,558
Form 990 (2013)
Form 990 (2013)
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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) DANNIEL G VLAHOVICH DO........................................................................
PHYSICIAN
 45.00
.......................   		        X   383,552 0 26,754
(19) TERRY IWASKO DO........................................................................
PHYSICIAN
 45.00
.......................   		        X   344,661 0 33,782






















1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 4,483,864 1,263,492 616,216
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet55
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
WESTVIEW ANESTHESIA GROUP8736 SANTANA LANEINDIANAPOLISIN46278 MEDICAL 577,000
JOEL NELSON MD, 4920 S NATURE WAYBLOOMINGTONIN47401 MEDICAL 218,100
DAVID GOLDENBERG MD, 8202 TWIN POINTE CIRCLEINDIANAPOLISIN46236 MEDICAL 188,110
REHAB ASSOCIATES OF INDIANA6330 E 75TH STREET SUITE 110INDIANAPOLISIN46250 MEDICAL 156,250
CENTER FOR EAR NOSE THROAT & ALLERGY12188A N MERIDIAN STREETCARMELIN46032 MEDICAL 126,667
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet5
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 96,778
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 96,778
Program Service RevenueAmt Business Code
2a PATIENT REVENUE 622110 58,163,736 58,163,736    
b PHYSICIAN CLINIC ADMIN FEES 900099 1,062,951 1,062,951    
c RENT - RELATED PURPOSE 531120 299,553 299,553    
d PHYSICIAN CLINIC - MISC REV 900099 230,426 230,426    
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 59,756,666
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 86,721     86,721
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   49,671
b Less: cost or other basis and sales expenses   539,197
c Gain or (loss)   -489,526
d Net gain or (loss)..........MediumBullet -489,526     -489,526
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      
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        
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        
Miscellaneous Revenue Business Code
11a EHR INCENTIVE PAYMENTS 900099 785,539 785,539    
b EQUITY INVESTMENT INCOME 900003 411,523 411,523    
c CAFETERIA SALES 722514 225,560     225,560
d All other revenue .... 491,977 491,977    
e Total. Add lines 11a–11d ...... MediumBullet 1,914,599
12 Total revenue. See Instructions......MediumBullet 61,365,238 61,445,705   -177,245
Form 990 (2013)
Form 990 (2013)
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 or note to any line 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    
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 2,576,119 1,498,413 1,077,706  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 31,749,965 23,942,994 7,806,971  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 723,487 542,615 180,872  
9 Other employee benefits ....... 4,252,378 3,189,284 1,063,094  
10 Payroll taxes ........... 2,278,233 1,708,675 569,558  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 44,534   44,534  
c Accounting ........... 71,159   71,159  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 10,549,823 8,217,966 2,331,857  
12 Advertising and promotion .... 310,655 232,991 46,598 31,066
13 Office expenses ....... 2,431,107 1,688,626 622,164 120,317
14 Information technology ...... 20,722   20,722  
15 Royalties ..        
16 Occupancy ........... 2,839,725 2,129,794 709,931  
17 Travel ............ 104,920 78,690 26,230  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 86,169 64,627 21,542  
20 Interest ........... 113,903 85,427 28,476  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 1,845,763 1,384,322 461,441  
23 Insurance .............. 1,048,886 498,821 550,065  
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 MEDICAL SUPPLIES 7,396,959 7,396,959    
b HOSPITAL ASSESSMENT FEE 3,519,675 3,519,675    
c INVSTM CAPTIVE INSUR LOSS 506,783 506,783    
d PHYSICIAN DEVELOPMENT 428,539 321,404 107,135  
e All other expenses 540,677 405,312 135,365  
25 Total functional expenses. Add lines 1 through 24e 73,440,181 57,413,378 15,875,420 151,383
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 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 1,512,167 1 3,413,502
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 7,674,997 4 7,513,953
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
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
  6  
7 Notes and loans receivable, net ............. 5,081,839 7 4,794,187
8 Inventories for sale or use .............. 737,212 8 614,464
9 Prepaid expenses and deferred charges .......... 335,567 9 81,757
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 27,055,134
b Less: accumulated depreciation ..... 10b 3,831,594 23,720,769 10c 23,223,540
11 Investments—publicly traded securities .......... 3,121,425 11 3,073,668
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..... 7,141,921 13 7,279,314
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 1,499,703 15 3,062,574
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 50,825,600 16 53,056,959
Liabilities 17 Accounts payable and accrued expenses ......... 7,942,300 17 6,321,296
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities .............   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
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..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 6,701,164 23 5,679,831
24 Unsecured notes and loans payable to unrelated third parties ....   24  
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.................... 467,044 25 17,196,571
26 Total liabilities. Add lines 17 through 25......... 15,110,508 26 29,197,698
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 .............. 35,715,092 27 23,859,261
28 Temporarily restricted net assets ...........   28  
29 Permanently restricted net assets ...........   29  
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 ........... 35,715,092 33 23,859,261
34 Total liabilities and net assets/fund balances ........ 50,825,600 34 53,056,959
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
61,365,238
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
73,440,181
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-12,074,943
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
35,715,092
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
219,112
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
23,859,261
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line 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 (2013)
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.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
INDIANAPOLIS OSTEOPATHIC HOSPITAL
INC
Employer identification number

35-1094734
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. 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) 2013

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.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Name of the organization
INDIANAPOLIS OSTEOPATHIC HOSPITAL
INC
Employer identification number

35-1094734
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 its Form 990PF, Part I, line 2, 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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 2
Name of organization
INDIANAPOLIS OSTEOPATHIC HOSPITAL
INC 		Employer identification number

35-1094734
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, RESTRICTEDRESTRICTED

$RESTRICTED


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 3
Name of organization
INDIANAPOLIS OSTEOPATHIC HOSPITAL
INC 		Employer identification number

35-1094734
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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 4
Name of organization
INDIANAPOLIS OSTEOPATHIC HOSPITAL
INC 		Employer identification number

35-1094734
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) (2013)

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. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
INDIANAPOLIS OSTEOPATHIC HOSPITAL
INC
Employer identification number

35-1094734
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) 2013

Schedule D (Form 990) 2013
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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. 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 .................   1,910,000 1,910,000
b Buildings ................   17,106,348 1,089,097 16,017,251
c Leasehold improvements ............   237,112 17,898 219,214
d Equipment ................   7,651,674 2,724,599 4,927,075
e Other .................   150,000   150,000
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 23,223,540
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) INVESTMENT IN AFFILIATES 7,279,314 C








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet 7,279,314
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) THIRD PARTY RECEIVABLE 1,437,586
(2) PHYSICIAN GRANTS 897,666
(3) OTHER RECEIVABLES 707,880
(4) DEFERRED FINANCING 19,442





Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 3,062,574
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
DUE TO AFFILIATES 14,626,676
THIRD PARTY SETTLEMENTS 2,136,804
CAPITAL LEASE 433,091






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 17,196,571
2. Liability for uncertain tax positions 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) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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
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.
Return Reference Explanation
Schedule D (Form 990) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
INDIANAPOLIS OSTEOPATHIC HOSPITAL
INC
Employer identification number

35-1094734
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		  1,083 539,471   539,471 0.740 %
b Medicaid (from Worksheet 3,
column a) .... 		  5,428 8,755,562 3,560,708 5,194,854 7.070 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		  6,511 9,295,033 3,560,708 5,734,325 7.810 %
Other Benefits
 7 5,835 13,919   13,919 0.020 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    1,541,217 597,316 943,901 1.290 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    2,238   2,238  
j Total. Other Benefits .. 7 5,835 1,557,374 597,316 960,058 1.310 %
k Total. Add lines 7d and 7j . 7 12,346 10,852,407 4,158,024 6,694,383 9.120 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
2,504,316
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
12,538,168
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
15,452,884
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-2,914,716
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1NORTHWEST SURG CTR
  		SURGERY 20.000 %   44.000 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 WESTVIEW HOSPITAL
3630 GUION ROAD
INDIANAPOLIS,IN46222
WWW.ECOMMUNITY.COM/WESTVIEW
13-005110-1 		X X   X     X      
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
WESTVIEW HOSPITAL
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 300.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference Explanation
FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 3 SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT
FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 4 SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT
FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 5C SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT
FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 7 SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 14 THE HOSPITAL'S POLICY DOES NOT INCLUDE PROVISIONS FOR PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. HOWEVER, THE HOSPITAL DOES PUBLICIZE ITS POLICY AS A MATTER OF PRACTICE. THE POLICY IS DISPLAYED IN THE EMERGENCY ROOM AND WAITING ROOMS THROUGHOUT THE CAMPUS. THERE IS SIGNAGE IN THE ADMITTING AREA DRAWING ATTENTION TO THE POLICY AND A COPY IS AVAILABLE TO PATIENTS UPON REQUEST.
FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 12I SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT
FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 14G THE POLICY IS REFERENCED ON THE BILL.
FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 20D ALL CARE REGARDLESS OF PAYOR IS BILLED AT THE SAME PRICE. ADJUSTMENTS TO THOSE AMOUNTS FOR PATIENTS WHO MAY NOT HAVE INSURANCE OR OTHERWISE QUALIFY FOR FINANCIAL ASSISTANCE ARE MADE TO THE GROSS REVENUE AMOUNTS ON THE BILL. WHEN THE PATIENT PROVIDES THE INFORMATION REQUIRED FOR FINANCIAL ASSISTANCE APPLICATION AND IS APPROVED (EITHER TOTAL OR PARTIAL CHARITY), THE ADJUSTMENTS TO BILLED AMOUNTS ARE MADE IMMEDIATELY IN THE SYSTEM AND THE PATIENT'S ACCOUNT THEN REFLECTS THE LOWER (OR ZERO) BALANCE DUE.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?22
Name and address Type of Facility (describe)
1 STIRLING CENTER FOR OSTEOPATHIC MED
3725 KENTUCKY AVENUE
INDIANAPOLIS,IN46241 		PRIMARY CARE CLINIC
2 CENTER FOR INTEGRATED MEDICINE
3660 N GUION ROAD
INDIANAPOLIS,IN46222 		PRIMARY CARE CLINIC
3 GLENDALE FAMILY MEDICINE
2620 KESSLER BLVD EAST DRIVE
INDIANAPOLIS,IN46220 		PRIMARY CARE CLINIC
4 ROCKVILLE PLAZA FAMILY PRACTICE
101 N GIRLS SCHOOL ROAD
INDIANAPOLIS,IN46214 		PRIMARY CARE CLINIC
5 SPEEDWAY FAMILY PHYSICIANS
1426 MAIN STREET
INDIANAPOLIS,IN46224 		PRIMARY CARE CLINIC
6 WESTVIEW PRIMARY CARE CENTER - GEO
5471 GEORGETOWN ROAD
INDIANAPOLIS,IN46254 		PRIMARY CARE CLINIC
7 WESTVIEW WOMEN'S SPECIALTY CARE CTR
3660 N GUION ROAD
INDIANAPOLIS,IN46222 		SPECIALTY CARE CENTER
8 INDIANA GENERAL SURGERY
3630 N GUION ROAD
INDIANAPOLIS,IN46222 		SPECIALTY CARE CENTER
9 STARSIAK ORTHOPEDICS AND SPORTS MED
3660 N GUION ROAD
INDIANAPOLIS,IN46222 		SPECIALTY CARE CENTER
10 WESTVIEW UROLOGY
3520 GUION ROAD
INDIANAPOLIS,IN46222 		SPECIALTY CARE CENTER
11 WESTVIEW BONE AND OMT CLINIC
3660 N GUION ROAD
INDIANAPOLIS,IN46222 		SPECIALTY CARE CENTER
12 BROWNSBURG FAMILY MEDICAL
321 E NORTHFIELD DRIVE 100
BROWNSBURG,IN46112 		PRIMARY CARE CLINIC
13 WESTVIEW RADIOLOGISTS
3660 N GUION ROAD
INDIANAPOLIS,IN46222 		SPECIALTY CARE CENTER
14 HEALTHPLEX INTERNAL MEDICINE
3660 N GUION ROAD
INDIANAPOLIS,IN46222 		PRIMARY CARE CLINIC
15 NORTHWEST FAMILY MEDICINE
7439 WOODLAND DRIVE SUITE 105
INDIANAPOLIS,IN46278 		PRIMARY CARE CLINIC
16 BETHESDA COLON AND RECTAL CENTER
3660 N GUION ROAD
INDIANAPOLIS,IN46222 		SPECIALTY CARE CENTER
17 BANTA AND ASSOCIATES
3077 E 98TH STREET SUITE 100
INDIANAPOLIS,IN46280 		SPECIALTY CARE CENTER
18 CTR FOR RHEUMATIC & IMMUNE DISORDER
3660 N GUION ROAD
INDIANAPOLIS,IN46222 		SPECIALTY CARE CENTER
19 MANDEL FAMILY PRACTICE
4007 N HIGH SCHOOL ROAD
INDIANAPOLIS,IN46254 		PRIMARY CARE CLINIC
20 SOUTHERN PLASTIC & RECONSTRUC SRG
3630 GUION ROAD
INDIANAPOLIS,IN46222 		SPECIALTY CARE CENTER
21 WESTVIEW GASTROENTEROLOGY
3520 GUION ROAD
INDIANAPOLIS,IN46222 		SPECIALTY CARE CENTER
22 OSTEOPATHIC INTEGRATED MEDICINE
17 MOORE STREET
MOORESVILLE,IN46158 		PRIMARY CARE CLINIC
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 3 SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT
FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 4 SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT
FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 5C SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT
FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 7 SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 14 THE HOSPITAL'S POLICY DOES NOT INCLUDE PROVISIONS FOR PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. HOWEVER, THE HOSPITAL DOES PUBLICIZE ITS POLICY AS A MATTER OF PRACTICE. THE POLICY IS DISPLAYED IN THE EMERGENCY ROOM AND WAITING ROOMS THROUGHOUT THE CAMPUS. THERE IS SIGNAGE IN THE ADMITTING AREA DRAWING ATTENTION TO THE POLICY AND A COPY IS AVAILABLE TO PATIENTS UPON REQUEST.
FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 12I SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT
FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 14G THE POLICY IS REFERENCED ON THE BILL.
FACILITY 1, WESTVIEW HOSPITAL - PART V, LINE 20D ALL CARE REGARDLESS OF PAYOR IS BILLED AT THE SAME PRICE. ADJUSTMENTS TO THOSE AMOUNTS FOR PATIENTS WHO MAY NOT HAVE INSURANCE OR OTHERWISE QUALIFY FOR FINANCIAL ASSISTANCE ARE MADE TO THE GROSS REVENUE AMOUNTS ON THE BILL. WHEN THE PATIENT PROVIDES THE INFORMATION REQUIRED FOR FINANCIAL ASSISTANCE APPLICATION AND IS APPROVED (EITHER TOTAL OR PARTIAL CHARITY), THE ADJUSTMENTS TO BILLED AMOUNTS ARE MADE IMMEDIATELY IN THE SYSTEM AND THE PATIENT'S ACCOUNT THEN REFLECTS THE LOWER (OR ZERO) BALANCE DUE.
Schedule H (Form 990) 2013
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, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
INDIANAPOLIS OSTEOPATHIC HOSPITAL
INC
Employer identification number

35-1094734
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
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
No
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) 2013

Schedule J (Form 990) 2013
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)BRYAN A MILLSDIRECTOR (i)
(ii)		  
912,524 		 
123,211 		 
98,248 		 
90,730 		 
30,550 		 
1,255,263 		 
41,070
(2)DAVID C WILLIAMS DODIRECTOR & CEO (i)
(ii)		 302,771
128,720 		400
  		71,330
789 		10,200
14,174 		11,036
6,857 		395,737
150,540 		 
 
(3)ALLAN ARKUSH DODIRECTOR (i)
(ii)		 328,349
  		3,923
  		23,338
  		10,200
  		10,016
  		375,826
  		3,923
 
(4)DAVID HARRISON DODIRECTOR (i)
(ii)		 320,820
  		10,000
  		21,353
  		10,200
  		17,754
  		380,127
  		 
 
(5)LISA RICHTER DODIRECTOR (i)
(ii)		 147,766
  		 
  		104,352
  		9,044
  		 
  		261,162
  		 
 
(6)CINDY BROWN DOVICE CHAIRMAN (i)
(ii)		 148,581
  		 
  		2,423
  		6,000
  		9,559
  		166,563
  		 
 
(7)JON ANDERSONCEO THRU JUNE 2013 (i)
(ii)		 141,529
  		22,918
  		160,039
  		153,862
  		23,640
  		501,988
  		 
 
(8)DEBORAH LEECNO (i)
(ii)		 142,184
  		17,578
  		16,822
  		11,041
  		 
  		187,625
  		 
 
(9)DOUG PENLEYCOO (i)
(ii)		 140,899
  		400
  		28,334
  		11,034
  		20,701
  		199,368
  		 
 
(10)ROBERT MURRAY DOPHYSICIAN (i)
(ii)		 597,664
  		 
  		796
  		10,200
  		20,658
  		629,318
  		 
 
(11)THOMAS SOUTHERN MDPHYSICIAN (i)
(ii)		 501,988
  		 
  		796
  		 
  		16,410
  		519,194
  		 
 
(12)CASIMIR STARSIAK DOPHYSICIAN (i)
(ii)		 400,449
  		 
  		8,951
  		10,200
  		23,358
  		442,958
  		 
 
(13)DANNIEL G VLAHOVICH DOPHYSICIAN (i)
(ii)		 382,989
  		 
  		563
  		10,200
  		16,554
  		410,306
  		 
 
(14)TERRY IWASKO DOPHYSICIAN (i)
(ii)		 344,136
  		 
  		525
  		10,200
  		23,582
  		378,443
  		 
 
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
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.
Return Reference Explanation
SCHEDULE J, PAGE 1, PART I, LINE 1A HEALTH CLUB DUES PAID FOR THE CEO AND CNO ARE INCLUDED IN THEIR WRITTEN EMPLOYMENT CONTRACT. THE CONTRACTS WERE APPROVED BY THE COMPENSATION COMMITTEE AND THE BOARD OF DIRECTORS. THE DUES ARE TREATED AS TAXABLE COMPENSATION.
SCHEDULE J, PAGE 1, PART I, LINE 4 JON ANDERSON 130,095 0 0
SCHEDULE J, PART III PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN BRYAN A. MILLS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THROUGH HIS EMPLOYER, CHNW. DURING 2013, MR. MILLS DID NOT RECEIVE A PAYMENT FROM THE PLAN. PART I, LINE 7 - NON-FIXED PAYMENTS PROVIDED INDIANAPOLIS OSTEOPATHIC HOSPITAL INC., PARTICIPATES IN THE NETWORK'S SENIOR LEADERSHIP INCENTIVE PROGRAM. CERTAIN INDIVIDUALS OF THE LEADERSHIP TEAM PARTICIPATE IN THIS PROGRAM. THE PROGRAM WAS ADOPTED BY THE EXECUTIVE COMPENSATION COMMITTEE, AND IS INTENDED TO INFLUENCE OUTSTANDING PERFORMANCE BY THE SENIOR LEADERS, AS MEASURED AGAINST BOTH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE. THE PROGRAM IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPOSED ENTIRELY OF INDEPENDENT COMMUNITY MEMBERS. THE INCENTIVE COMPENSATION THAT IS AWARDED IS INCLUDED IN TOTAL COMPENSATION TO THE EXECUTIVE. THE TOTAL COMPENSATION (INCLUDING ANY PAYMENTS UNDER THE PROGRAM) IS SUBJECT TO THE REVIEW AND APPROVAL OF THE EXECUTIVE COMPENSATION COMMITTEE AND INDEPENDENT COMPENSATION CONSULTANT, IN CONSIDERATION OF CODE SECTION 4958 (AND THE CORRESPONDING TREASURY REGULATIONS) TO ENSURE THAT IT REFLECTS ARMS LENGTH, FAIR MARKET TERMS.
Schedule J (Form 990) 2013

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.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
INDIANAPOLIS OSTEOPATHIC HOSPITAL
INC
Employer identification number

35-1094734
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
Total ......Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of 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) 2013
Schedule L (Form 990 or 990-EZ) 2013
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) VISIONARY ENTERPRISES INC SHR BOARD MBR 269,935 RENT EXPENSE   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2013

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.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
INDIANAPOLIS OSTEOPATHIC HOSPITAL
INC
Employer identification number

35-1094734
Return Reference Explanation
FORM 990 - ORGANIZATION'S MISSION TO PROVIDE QUALITY HEALTHCARE TO THE CENTRAL INDIANA COMMUNITY - REGARDLESS OF THEIR ABILITY TO PAY - WITH FACILITIES, SUPPORT AND GROWTH FOR THE OSTEOPATHIC PROFESSION THROUGH OUR INTERN/RESIDENT EDUCATION PROGRAMS, INCREASED PHYSICIAN PRACTICES, PRESENCE AND EXPERTISE.
FORM 990 EFFECTIVE AUGUST 1, 2011, INDIANAPOLIS OSTEOPATHIC HOSPITAL, INC. ("IOH") AFFILIATED WITH COMMUNITY HEALTH NETWORK, INC. THE INTENT OF THE AFFILIATION WAS TO PROVIDE EXPANDED SERVICES TO RESIDENTS IN CENTRAL INDIANA. AS A RESULT, IN 2012 IOH CHANGED ITS FISCAL YEAR-END FROM AN AUGUST 31ST YEAR-END TO A CALENDAR YEAR-END. THEREFORE, THE PRIOR YEAR AMOUNTS REFLECT ONLY FOUR MONTHS OF ACTIVITY FROM SEPTEMBER 1, 2012 TO DECEMBER 31, 2012.
FORM 990, PAGE 2, PART III, LINE 4A 10,084 EMERGENCY VISITS. THE IOH SURGERY DEPARTMENT PERFORMED 3,653 SURGERIES IN 2013.
FORM 990, PAGE 6, PART VI, LINE 3 IOH IS AN AFFILIATE OF COMMUNITY HEALTH NETWORK ("THE NETWORK"), AN INTEGRATED HEALTH DELIVERY SYSTEM. IOH, TOGETHER WITH THE OTHER TAX-EXEMPT AFFILIATES OF THE NETWORK, IS CONTROLLED BY A TAX-EXEMPT PARENT ORGANIZATION, COMMUNITY HEALTH NETWORK, INC. ("CHNW"). CHNW EXERCISES CONTROL OVER IOH THROUGH A SERIES OF GOVERNANCE RIGHTS: 1) CHNW IS THE SOLE MEMBER OF IOH; 2) APPOINTMENT OF ONE (1) CIVIC MEMBER OF THE BOARD OF DIRECTORS; 3) APPROVAL OF THE CORPORATION'S THREE-YEAR STRATEGIC PLAN THAT EXPRESSES ITS PHILOSOPHY, VISION, GOALS, OBJECTIVES AND ACTION PLANS; 4) APPROVAL OF ANY AMENDMENT TO THE ARTICLES AND BYLAWS; 5) APPROVAL OF ANY INDEBTEDNESS LOANS; 6) APPROVAL OF THE FORMATION OF LEGAL ENTITIES, THE SALE, TRANSFER OR SUBSTANTIAL CHANGE IN USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE DIVESTURE, DISSOLUTION, CLOSURE, MERGER, CONSOLIDATION OR REORGANIZAION OF THE CORPORATION; 7) APPROVAL OF THE ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION OF PROPERTY, OTHER THAN IN THE USUAL AND REGULAR COURSE OF BUSINESS, OR WHEN SUCH ACQUISITION, SALE, LEASE, OR OTHER ALIENATION IS ABOVE SPECIFIED FINANCIAL LEVELS; 8) APPROVAL OF ANY DISPOSITION OF ASSETS OF THE CORPORATION AT THE TIME OF ITS DISSOLUTION; 9) APPROVAL OF THE ANNUAL CAPITAL AND OPERATION BUDGETS; 10) APPROVAL OF THE INDEPENDENT AUDITING FIRM FOR THE CORPORATION; 11) APPROVAL OF EXECUTIVE AND PHYSICIAN COMPENSATION; AND 12) APPROVAL OF ALL CAPITAL IMPROVEMENTS, ADDITIONS AND STRUCTURAL CHANGES TO THE PROPERTY.
FORM 990, PAGE 6, PART VI, LINE 6 CHNW IS THE SOLE MEMBER OF IOH. CHNW IS AN EXEMPT ORGANIZATION PURSUANT TO SECTION 501(C)(3).
FORM 990, PAGE 6, PART VI, LINE 7A THE BOARD OF DIRECTORS SHALL CONSIST OF TEN (10) DIRECTORS, AT LEAST 1/2 OF WHOM SHALL BE COMMUNITY BUSINESS AND CIVIC LEADERS SELECTED FROM THE COMMUNITY AT LARGE. ONE DIRECTOR SHALL BE APPOINTED BY CHNW, AS THE SOLE MEMBER OF IOH. THE OTHER DIRECTORS SHALL BE ELECTED BY THE BOARD OF DIRECTORS FROM A SLATE OF CANDIDATES RECOMMENDED BY IOH'S NOMINATING COMMITTEE.
FORM 990, PAGE 6, PART VI, LINE 7B SEE FORM 990, PART VI, SECTION A, LINE 3
FORM 990, PAGE 6, PART VI, LINE 11B IOH IS AN AFFILIATE OF COMMUNITY HEALTH NETWORK ("THE NETWORK"), AN INTEGRATED HEALTH DELIVERY SYSTEM. IOH HAS DELEGATED AUTHORITY FOR THE REVIEW OF THE FORM 990 TO TWO COMMITTEES COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS: A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE COMPENSATION ASPECTS OF IOH'S FORM 990, AND B) THE NETWORK FINANCE COMMITTEE REVIEWED THE REMAINDER OF THE FORM 990. IN ADDITION, IOH'S BOARD OF DIRECTORS AND THE NETWORK'S OUTSIDE ACCOUNTING FIRM AND LAW FIRM REVIEWED THE FORM 990 PRIOR TO FILING. IOH UTILIZED THIS PROCESS TO ENSURE THAT IOH'S FORM 990 RECEIVED SUBSTANTIVE REVIEW BY DIRECTORS AND PROFESSIONALS WITH SPECIFIC KNOWLEDGE OF IOH'S ACTIVITIES AND EXTENSIVE FINANCIAL, ACCOUNTING, AND TAX EXPERTISE.
FORM 990, PAGE 6, PART VI, LINE 12C CHNW HAS ASSUMED RESPONSIBILITY FOR IOH'S AUDIT AND COMPLIANCE MATTERS. CHNW HAS ADOPTED A CONFLICT OF INTEREST POLICY THAT APPLIES TO IOH. THE CONFLICT OF INTEREST POLICY REQUIRES DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO SUBMIT AN ANNUAL CONFLICT OF INTEREST DISCLOSURE. THE ANNUAL DISCLOSURE REQUIRES DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO DISCLOSE, IN WRITING, ANY KNOWN FINANCIAL INTEREST THAT THE INDIVIDUAL (TOGETHER WITH FAMILY MEMBERS) HAS IN ANY BUSINESS ENTITY THAT TRANSACTS BUSINESS WITH IOH. IN ADDITION, DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO IMMEDIATELY DISCLOSE ANY POSSIBLE CONFLICT OF INTEREST THAT ARISES MID-YEAR IN RELATION TO A PROPOSED TRANSACTION. THE CONFLICT OF INTEREST POLICY REQUIRES THAT ANY INDIVIDUAL WITH A CONFLICT BE RECUSED FROM THE DECISION MAKING PROCESS, THAT INDEPENDENT DIRECTORS OR COMMITTEE MEMBERS DETERMINE THAT THE PROPOSED TRANSACTION IS IN THE BEST INTEREST OF IOH, AND THE TRANSACTION MUST BE APPROVED BY A VOTE OF INDEPENDENT DIRECTORS OR COMMITTEE MEMBERS WITHOUT THE PARTICIPATION OF ANY INTERESTED INDIVIDUAL. THE ANNUAL CONFLICT DISCLOSURE STATEMENTS ARE SUBMITTED TO, AND REVIEWED BY, CHNW'S AUDIT COMMITTEE, COMPOSED OF INDEPENDENT DIRECTORS. IN ADDITION, THE EXECUTIVE STAFF AND GENERAL COUNSEL OF THE NETWORK ARE RESPONSIBLE FOR MONITORING ANY POSSIBLE CONFLICT TRANSACTIONS THAT ARISE AND MANAGING THEM TO ENSURE THAT ALL TRANSACTIONS REPRESENT ARMS LENGTH, FAIR MARKET VALUE TERMS FOR THE BENEFIT OF IOH.
FORM 990, PAGE 6, PART VI, LINE 15A THE EXECUTIVE COMPENSATION AND CONFLICT COMPLIANCE COMMITTEE CONSISTS OF FOUR MEMBERS OF THE BOARD OF DIRECTORS WHO ARE APPROVED BY THE CHAIRMAN OF THE BOARD FROM THE INDEPENDENT CIVIC MEMBERS OF THE BOARD. (BOARD MEMBERS WHO RECEIVE DIRECT OR INDIRECT COMPENSATION FOR SERVICES AS AN EMPLOYEE OR INDEPENDENT CONTRACTOR OR HAVE A PERSONAL FINANCIAL INTEREST IN THE AFFAIRS OF THE CORPORATION SHALL NOT BE ELIGIBLE TO BE APPOINTED TO THE EXECUTIVE COMPENSATION AND CONFLICT COMPLIANCE COMMITTEE.) THIS COMMITTEE IS PROVIDED MARKET ANALYSIS, COMPARISONS AND RECOMENDATIONS FROM IOH'S LEGAL COUNSEL. THIS INDEPENDENT COMMITTEE SETS THE COMPENSATION LEVEL AND EMPLOYMENT TERMS FOR THE PRESIDENT/ADMINISTRATOR, CORPORATE OFFICERS, EMPLOYED PHYSICIANS, AND OTHER KEY EMPLOYEES AS DESIGNATED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. IN DISCHARGING THESE DUTIES, THE COMMITTEE APPLIES THE PRINCIPLES OF THE REBUTTABLE PRESUMPTION AS OUTLINED IN CODE SECTION 4958 AND THE CORRESPONDING TREASURY REGULATIONS. THE COMMITTEE ALSO REVIEWS, AT LEAST ANNUALLY, TRANSACTIONS AND ARRANGEMENTS OF THE CORPORATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE A RESULT OF ARM'S LENGTH NEGOTIATIONS. EFFECTIVE JULY 2013, CHNW ASSUMED RESPONSIBILITY FOR IOH'S EXECUTIVE COMPENSATION MATTERS. CHNW HAS ADOPTED AN EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY. THE PURPOSE OF THE POLICY IS TO ENSURE THAT CHNW'S COMPENSATION ARRANGEMENTS WITH RELATED PARTIES ARE EVALUATED AND ENTERED AT ARMS LENGTH AND THAT ANY COMPENSATION THAT IS PAID TO A RELATED PARTY IS REASONABLE AND REFLECTS FAIR MARKET VALUE. THIS POLICY ENCOURAGES THE APPLICATION OF THE REBUTTABLE PRESUMPTION STANDARD OF CODE SECTION 4958 AND THE RELATED TREASURY REGULATIONS BY: A) EXCLUDING ANY INTERESTED PARTY FROM THE DECISION MAKING PROCESS, B) REQUIRING DISINTERESTED BOARD OR COMMITTEE MEMBERS TO OBTAIN AND RELY UPON COMPARABILITY DATA WHEN SETTING THE PROPOSED COMPENSATION TERMS, C) REQUIRING APPROVAL OF THE TRANSACTION IN ADVANCE BY DISINTERESTED DIRECTORS OR COMMITTEE MEMBERS, AND D) REQUIRING CONTEMPORANEOUS DOCUMENTATION (I.E. MINUTES) REFLECTING THE DECISION AND THE PROCESS BY WHICH IT WAS MADE. CHNW ALSO DELEGATED AUTHORITY REGARDING IOH'S EXECUTIVE COMPENSATION TO A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE, COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS, WHICH IS RESPONSIBLE FOR APPLYING THE TERMS AND PROCESS OF THE EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY AS OUTLINED ABOVE, AND B) THE NETWORK VICE PRESIDENT OF HUMAN RESOURCES WHO IS RESPONSIBLE FOR OBTAINING COMPARATIVE SALARY MARKET DATA FOR THE CHIEF EXECUTIVE OFFICER, OFFICERS, AND KEY EMPLOYEES, PERIODICALLY ENGAGING AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH REASONABLE COMPENSATION, AND PROVIDING STAFF SUPPORT TO THE NETWORK EXECUTIVE COMPENSATION COMMITTEE. DURING 2013, THE NETWORK EXECUTIVE COMPENSATION COMMITTEE FOLLOWED THIS PROCESS FOR ALL SENIOR EXECUTIVE LEADERS.
FORM 990, PAGE 6, PART VI, LINE 15B SEE LINE 15A ABOVE
FORM 990, PAGE 6, PART VI, LINE 19 A) THE ARTICLES OF INCORPORATION AND CERTIFICATE OF EXISTENCE ARE ON FILE WITH THE INDIANA SECRETARY OF STATE AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE INDIANA SECRETARY OF STATE OR FREE OF CHARGE ON THE SECRETARY OF STATE'S WEBSITE. B) IOH DOES NOT MAKE ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. C) IOH DOES NOT HAVE INDIVIDUALLY AUDITED FINANCIAL STATEMENTS. ITS FINANCIAL RESULTS ARE INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CHNW AND AFFILIATES. AS SUCH, THERE ARE NO INDIVIDUAL FINANCIAL STATEMENTS TO POST. IOH DOES FILE THE 990 TAX RETURN ON AN ANNUAL BASIS WHICH IS AVAILABLE UPON REQUEST AND/OR AVAILABLE ON A DELAYED BASIS ON GUIDESTAR.ORG. D) COMMUNITY HEALTH NETWORK, INC. AND AFFILIATES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART IX, LINE 11G PURCHASED SERVICES 383,479 0 0 STIPEND 838,916 0 0 SERVICE EXPENSE 6,995,571 2,331,857 0
FORM 990, PART XI, LINE 9 FIXED ASSET ADJUSTMENT 457,882 ACCRUED EXPENSE ADJUSTMENT 238,770 TOTAL 219,112
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
INDIANAPOLIS OSTEOPATHIC HOSPITAL
INC
Employer identification number

35-1094734
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on 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










Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) COMMUNITY HEALTH NETWORK INC

7330 SHADELAND STATION SUITE 200

INDIANAPOLIS,IN46256
35-0983617 		HOSPITAL IN 501C3 3 NA
 
 
No
(2) COMMUNITY HEALTH NETWORK FOUNDATION

7240 SHADELAND STATION SUITE 125

INDIANAPOLIS,IN46256
51-0181688 		CHARITY IN 501C3 11B CHNW
 
Yes
 
(3) COMMUNITY HLTH SERVICES OF INDIANA

7330 SHADELAND STATION SUITE 200

INDIANAPOLIS,IN46256
45-4817436 		HLTH CARE IN 501C3 3 CHNW
 
Yes
 
(4) COMMUNITY HOME HEALTH SERVICES INC

9894 EAST 121ST STREET

FISHERS,IN46037
35-0953467 		HLTH CARE IN 501C3 9 CHNW
 
Yes
 
(5) COMM HOSP OF ANDERSON & MADISON CTY

1515 NORTH MADISON AVENUE

ANDERSON,IN46011
35-1069822 		HOSPITAL IN 501C3 3 CHNW
 
Yes
 
(6) COMMUNITY HOSP ANDERSON FDN INC

1515 NORTH MADISON AVENUE

ANDERSON,IN46011
86-1053152 		SUPPORT IN 501C3 11A CHA
 
Yes
 
(7) COMMUNITY HOSPITAL SOUTH INC

1402 E COUNTY LINE ROAD SOUTH

INDIANAPOLIS,IN46227
35-1088640 		HOSPITAL IN 501C3 3 CHNW
 
Yes
 
(8) COMMUNITY HOWARD REGIONAL HEALTH

3500 S LAFOUNTAIN STREET

KOKOMO,IN46902
35-1865344 		HOSPITAL IN 501C3 3 CHNW
 
Yes
 
(9) COMM HOWARD REGIONAL HEALTH FDN

PO BOX 9011

KOKOMO,IN46904
23-7309596 		SUPPORT IN 501C3 7 NA
 
 
No
(10) COMMUNITY LTC INC

1031 MONTICELLO DRIVE

ANDERSON,IN46011
35-1877441 		HLTH CARE IN 501C3 9 CHA
 
Yes
 
(11) COMMUNITY PHYSICIANS OF IN INC

7240 SHADELAND STATION SUITE 300

INDIANAPOLIS,IN46256
20-5392766 		PHY SRV IN 501C3 9 CHNW
 
Yes
 
(12) HEALTH INSTITUTE OF INDIANA INC

3660 GUION ROAD

INDIANAPOLIS,IN46222
35-2022402 		FITNESS IN 501C3 9 IOH
 
Yes
 
(13) INDIANA HEART HOSPITAL LLC

8075 NORTH SHADELAND AVENUE

INDIANAPOLIS,IN46250
35-2123783 		HOSPITAL IN 501C3 3 CHNW
 
Yes
 
(14) WESVIEW HOSPITAL FOUNDATION INC

3630 GUION ROAD

INDIANAPOLIS,IN46222
31-1036451 		SUPPORT IN 501C3 11A IOH
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(k)
Percentage
ownership
Yes No Yes No
(1) BROWNSBURG OFFICE CENTER 2 LLP

321 E NORTHFIELD
BROWNSBURG,IN46112
35-1929859 		LEASING IN CWH
  		RELATED 5,951 120,731   No   Yes   5.000 %
(2) CHNJMH VENTURES LLC

7330 SHADELAND STATION SUITE 200
INDIANAPOLIS,IN46256
46-2356266 		DIAG/REHAB IN N/A
         No     No  
(3) COMMUNITY ENDOSCOPY CENTER LLC

1601 N MADISON AVENUE SUITE 300
ANDERSON,IN46011
61-1464136 		HLTH CARE IN N/A
         No     No  
(4) COMM HEALTH NETWORK REHAB HOSP LLC

7343 CLEARVISTA DRIVE
INDIANAPOLIS,IN46256
45-3414249 		REHAB IN N/A
         No     No  
(5) EAST CAMPUS SURGERY CENTER LLC

7330 SHADELAND STATION SUITE 200
INDIANAPOLIS,IN46256
35-2028517 		SURGERY IN N/A
         No     No  
(6) HAMILTON SURGERY CENTER LLC

7330 SHADELAND STATION SUITE 200
INDIANAPOLIS,IN46256
35-2061413 		SURGERY IN N/A
         No     No  
(7) HOWARD COMMUNITY SURGERY CTR LLC

3500 S LAFOUNTAIN STREET
KOKOMO,IN46902
35-2118748 		SURGERY IN N/A
         No     No  
(8) HOWARD REGIONAL SPECIALTY CARE LLC

680 SOUTH FOURTH STREET
LOUISVILLE,KY40202
37-1501021 		REHAB IN N/A
         No     No  
(9) INDIANA SPECIALTY GROUP LLC

7240 SHADELAND STATION SUITE 300
INDIANAPOLIS,IN46256
35-1976258 		HLTH CARE IN N/A
         No     No  
(10) INDIANAPOLIS ENDOSCOPY CENTER LLC

7353 E 21ST STREET
INDIANAPOLIS,IN46219
35-2010874 		HLTH CARE IN N/A
         No     No  
(11) MICHIGAN SURGERY INVESTMENT LLC

7330 SHADELAND STATION SUITE 200
INDIANAPOLIS,IN46256
32-0147008 		SURG CTRS IN N/A
         No     No  
(12) NORTH CAMPUS OFFICE ASSOCIATES LP

7330 SHADELAND STATION SUITE 200
INDIANAPOLIS,IN46256
35-1808625 		RNTL PROP IN N/A
         No     No  
(13) NORTH CAMPUS SURGERY CENTER LLC

7330 SHADELAND STATION SUITE 200
INDIANAPOLIS,IN46256
35-2147088 		SURGERY IN N/A
         No     No  
(14) NORTHPOINT PEDIATRICS LLC

8101 CLEARVISTA PARKWAY SUITE 185
INDIANAPOLIS,IN46256
35-1960566 		HLTH CARE IN N/A
         No     No  
(15) NORTHWEST SURGERY CENTER LLC

7330 SHADELAND STATION SUITE 200
INDIANAPOLIS,IN46256
20-8754071 		SURGERY IN NA
  		RELATED 130,850 300,911   No   Yes   20.000 %
(16) PILLARS HOUSING LP

3500 S LAFOUNTAIN STREET
KOKOMO,IN46902
16-1652671 		HOUSING IN N/A
         No     No  
(17) SOUTH CAMPUS SURGERY CENTER LLC

1550 EAST COUNTY LINE ROAD
INDIANAPOLIS,IN46227
35-2038072 		SURGERY IN N/A
         No     No  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) CHN ASSURANCE COMPANY LTD

PO BOX 1051GT
GRAND CAYMAN,GRAND CAYMAN  
CJ
98-0418913 		INSURANCE CJ N/A
         Yes  
(2) MIDWEST RACQUETBALL INC

3500 S LAFOUNTAIN STREET
KOKOMO,IN46902
35-1396016 		HLTH IN N/A
         Yes  
(3) PILLARS COMMUNITY HOUSING INC

3500 S LAFOUNTAIN STREET
KOKOMO,IN46902
16-1652666 		HOUSING IN N/A
         Yes  
(4) VISIONARY ENTERPRISES INC

6626 EAST 75TH STREET
INDIANAPOLIS,IN46250
35-1538433 		MGMT SRVS IN N/A
         Yes  
(5) VEI MICHIGAN INC

940 N MAIN STREET
ANN HARBOR,MI48104
30-0097377 		MGMT SRVS IN N/A
         Yes  
(6) WESTVIEW DELIVERY SYSTEM INC

3630 GUION ROAD
INDIANAPOLIS,IN46222
35-1910292 		MGMT SRVS IN N/A
         Yes  


Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on 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
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
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
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
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
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) COMMUNITY PHYSICIANS OF IN INC

 S 60,011 BOOK VALUE
(2) HEALTH INSTITUTE OF INDIANA INC

 A 117,362 BOOK VALUE
(3) HEALTH INSTITUTE OF INDIANA INC

 B 256,667 BOOK VALUE
(4) HEALTH INSTITUTE OF INDIANA INC

 J 429,912 BOOK VALUE
(5) HEALTH INSTITUTE OF INDIANA INC

 Q 280,499 BOOK VALUE
(6) HEALTH INSTITUTE OF INDIANA INC

 S 287,652 BOOK VALUE
(7) VISIONARY ENTERPRISES INC

 J 269,935 BOOK VALUE
(8) WESTVIEW HOSPITAL FOUNDATION INC

 C 75,382 BOOK VALUE
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




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






























Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2013
Additional Data


Software ID:  
Software Version: