TY 2020 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) J STEVEN RHEA DIRECTOR/SECRETARY/TREAS	2.0 ................. 0	X	X	0	0	0
(2) JEFFREY C BIRD MD DIRECTOR/REGIONAL PRESIDENT (ECR)	25.0 ................. 30.0	X	X	0	747,116	130,370
(3) JOHN D LITTLER DIRECTOR/CHAIR	2.0 ................. 2.0	X	X	0	0	0
(4) PETER M VOSS MD DIRECTOR/VICE CHAIR/CMO (ECR)	25.0 ................. 30.0	X	X	413,509	0	40,761
(5) WILBUR R DAVIS DIRECTOR/VICE CHAIR	2.0 ................. 0	X	X	0	0	0
(6) CHARLES R ROUTH MD DIRECTOR	2.0 ................. 53.0	X		0	290,587	39,724
(7) DAMON ELMORE JD DIRECTOR	2.0 ................. 0	X		0	0	0
(8) DANIEL E BORGENHEIMER DIRECTOR	2.0 ................. 1.0	X		0	0	0
(9) DAVID A LITTLER DIRECTOR	2.0 ................. 1.0	X		0	3,600	0
(10) DAVID W HYATT DIRECTOR	2.0 ................. 52.0	X		288,680	0	48,538
(11) DERRON L BISHOP PHD DIRECTOR	2.0 ................. 0	X		0	0	0
(12) GEOFFREY S MEARNS JD DIRECTOR	2.0 ................. 0	X		0	0	0
(13) JOAN V CASTOR DIRECTOR	2.0 ................. 53.0	X		0	460,520	104,031
(14) KIRK W SHAFER DIRECTOR (PART YEAR)	2.0 ................. 0	X		0	0	0
(15) MICHAEL J FISHER DIRECTOR	2.0 ................. 3.0	X		0	0	0
(16) PATRICK A CLEARY MD DIRECTOR	4.0 ................. 0	X		8,227	0	7,329
(17) SAMUEL C KIM MD DIRECTOR	20.0 ................. 0	X		71,280	0	0

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) TERRY W BAILEY DIRECTOR	2.0 .......................0	X					0	0	0
(19) WILLIAM W HINKLE DIRECTOR	2.0 .......................1.0	X					0	3,200	0
(20) JONATHAN W VANATOR CFO (ECR)	15.0 .......................40.0		X				0	372,058	43,631
(21) ANN M MCGUIRE VP-HUMAN RESOURCES REGIONAL (ECR)-PART YEAR	30.0 .......................20.0			X			0	230,605	230,742
(22) CARLA C COX RN VP & CNO (ECR)	30.0 .......................20.0			X			282,881	0	40,641
(23) LORI A LUTHER COO (ECR)	32.0 .......................23.0			X			408,555	0	44,542
(24) ALVIS FOSTER SENIOR RADIATION PHYSICIST	50.0 .......................0				X		223,080	0	47,636
(25) JOSEPH BUTTS RADIATION PHYSICIST	40.0 .......................0				X		210,251	0	16,104
(26) MAX E BARNHART ADMIN DIR-RETAIL PHARMACY OPS	55.0 .......................0				X		197,821	0	46,695
(27) RYAN M JOHNSTON MD ASSOCIATE - CMO	54.0 .......................1.0				X		299,048	0	49,883
(28) TERRY A PENCE VP, OPERATIONS	54.0 .......................1.0				X		266,425	0	42,630
(29) DAVID A SCHWARTZ FORMER HIGHEST COMPENSATED EMPLOYEE	0.0 .......................40.0					X	0	209,797	13,308
(30) JUDITH L COLEMAN FORMER OFFICER	0.0 .......................55.0					X	0	366,850	39,639

(A) Name and business address	(B) Description of services	(C) Compensation
HAGERMAN INCHARMON CONST JOINT VENTURE 10315 ALLISONVILLE ROAD FISHERS,IN46038	CONSTRUCTION	13,564,106
MEDEFIS PO BOX 5068 NEW YORK,NY100875068	STAFFING	2,198,510
MERIDIAN HEALTH SERVICES 240 N TILLOTSON AVENUE MUNCIE,IN47304	MGMT/LEASED EMP	1,667,023
DHP MANAGEMENT SERVICES PO BOX 634850 CINCINNATI,OH452634850	MGMT/LEASED EMP	1,354,691
UNITED HOSPITAL SERVICES LLC 9948 PARK DAVIS DR INDIANAPOLIS,IN46235	LAUNDRY SERVICES	1,297,552
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 27

- TIN:

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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

Indiana University Health Ball Memorial Hospital Inc

Employer identification number

35-0867958

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 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2020

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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 VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2020 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2019 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2020. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2019. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2020

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2020 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2019 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2020 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2019 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2020. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2019. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2020

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2020

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described in 11a above?

11b

A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2020

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2020

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2020 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2020	(iii) Distributable Amount for 2020
1 Distributable amount for 2020 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2020:
a From 2015.......
b From 2016.......
c From 2017.......
d From 2018.......
e From 2019.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2020 distributable amount
i Carryover from 2015 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2020 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2020 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2021. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2016.....
b Excess from 2017.....
c Excess from 2018.....
d Excess from 2019.....
e Excess from 2020.....

Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Name of the organization

Indiana University Health Ball Memorial Hospital Inc

Employer identification number

35-0867958

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2

Name of organization Indiana University Health Ball Memorial Hospital Inc

Part I Contributors	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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 3

Name of organization Indiana University Health Ball Memorial Hospital Inc		Employer identification number 35-0867958

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) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 4


Name of organization Indiana University Health Ball Memorial Hospital Inc			Employer identification number 35-0867958
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2020)

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Indiana University Health Ball Memorial Hospital Inc

Employer identification number

35-0867958

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2020

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2020

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

12,302

Total. Add lines 1c through 1i ....................................................................................................

12,302

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	IU Health Ball Memorial Hospital paid institutional membership dues to the American Hospital Association ("AHA") and Indiana Hospital Association ("IHA") during 2020 in the amount of $41,666 and $36,007 respectively. Each membership organization notified IU Health Ball Memorial Hospital that a portion of the dues it paid was used for lobbying purposes. The AHA used 23.32%, or $9,717 of 2020 membership dues paid by IU Health Ball Memorial Hospital, for lobbying expenditures. The IHA used 7.18%, or $2,585 of the 2020 membership dues paid by IU Health Ball Memorial Hospital, for lobbying expenditures.

Return Reference

Explanation

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

IU Health Ball Memorial Hospital paid institutional membership dues to the American Hospital Association ("AHA") and Indiana Hospital Association ("IHA") during 2020 in the amount of $41,666 and $36,007 respectively. Each membership organization notified IU Health Ball Memorial Hospital that a portion of the dues it paid was used for lobbying purposes. The AHA used 23.32%, or $9,717 of 2020 membership dues paid by IU Health Ball Memorial Hospital, for lobbying expenditures. The IHA used 7.18%, or $2,585 of the 2020 membership dues paid by IU Health Ball Memorial Hospital, for lobbying expenditures.

Schedule C (Form 990 or 990EZ) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

Indiana University Health Ball Memorial Hospital Inc

Employer identification number

35-0867958

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2020

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
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 ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .......................

3a(i)

(ii) Related organizations .......................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

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" on 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 .....	6,616,097		6,616,097
b	Buildings ....	366,291,143	212,612,772	153,678,371
c	Leasehold improvements	429,120	339,883	89,237
d	Equipment ....	126,948,648	94,637,014	32,311,634
e	Other .....	22,151,020	3,535,444	18,615,576
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				211,310,915

Schedule D (Form 990) 2020

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on 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........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on 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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	25,007,499
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) 2020

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on 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 (losses) 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' on 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, Part X, Line 2 FIN 48 (ASC 740) footnote

IU Health Ball Memorial Hospital is a subsidiary in IU Health's Consolidated Audited Financial Statements. The Internal Revenue Service (IRS) has determined that Indiana University Health and certain of its affiliated entities are tax-exempt organizations as defined in Section 501(c)(3) of the Internal Revenue Code (IRC). Indiana University Health and its tax-exempt affiliates are, however, subject to federal and state income taxes on unrelated business income under the provisions of IRC Section 511. Deferred income taxes that, as of December 31, 2020 and 2019, have no net carrying value reflect the net tax effect of temporary differences between the carrying amounts of assets and liabilities for financial reporting and the amounts used for income tax purposes. As of December 31, 2020, and 2019, the Indiana University Health System had gross deferred tax assets of $135,889,000 and $143,157,000, respectively, primarily relating to net operating loss carryovers. Management determined that a full valuation allowance at December 31, 2020 and 2019, was necessary to reduce the deferred tax assets to the amount that would more likely than not be realized. Based on the weight of the evidence, if it is more likely than not that some portion or all of the deferred tax assets will not be realized, a valuation allowance to reduce the deferred tax assets is recorded. The decrease in the valuation allowance for the current year was $7,264,000. At December 31, 2020, the Indiana University Health System has available net operating loss carryforwards of $546,376,000. Net operating losses generated from 2000 through 2017 will expire between 2021 and 2037. Net operating losses generated after 2017 do not expire.

Schedule D (Form 990) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

Indiana University Health Ball Memorial Hospital Inc

Employer identification number

35-0867958

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other 30000 %

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: . . . . . . . .

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

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) . . .		6,141	6,003,168	0	6,003,168	1.43 %
b	Medicaid (from Worksheet 3, column a) . . . . .		17,369	90,059,205	84,177,638	5,881,567	1.40 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	23,510	96,062,373	84,177,638	11,884,735	2.84 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	22	15,515	2,693,765	117,217	2,576,548	0.61 %
f	Health professions education (from Worksheet 5) . . .	3	2,245	14,376,293	4,116,851	10,259,442	2.45 %
g	Subsidized health services (from Worksheet 6) . . . .	2	1,031	1,828,819	326,927	1,501,892	0.36 %
h	Research (from Worksheet 7) .	1	110	1,622,195	502,777	1,119,418	0.27 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	3	1,564	1,689,864	1,299,000	390,864	0.09 %
j	Total. Other Benefits . .	31	20,465	22,210,936	6,362,772	15,848,164	3.78 %
k	Total. Add lines 7d and 7j .	31	43,975	118,273,309	90,540,410	27,732,899	6.62 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020

Schedule H (Form 990) 2020

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					0	0 %
2	Economic development	2	622	60,259	450	59,809	0.01 %
3	Community support					0	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members					0	0 %
6	Coalition building	1	1,370	114,043	0	114,043	0.03 %
7	Community health improvement advocacy	2	572	11,252	0	11,252	0 %
8	Workforce development	1	17	60,474	0	60,474	0.01 %
9	Other					0	0 %
10	Total	6	2,581	246,028	450	245,578	0.06 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

5,387,634

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. ......

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

Enter total revenue received from Medicare (including DSH and IME).....

119,128,843

Enter Medicare allowable costs of care relating to payments on line 5.....

122,603,427

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-3,474,584

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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 %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2020

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?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	IU HEALTH BALL MEMORIAL HOSPITAL 2401 UNIVERSITY AVE MUNCIE,IN47303 HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-BALL-MEMORIAL-HOSPITAL 20-005079-1	X	X	X	X	X

Schedule H (Form 990) 2020

Page 4

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)

	IU HEALTH BALL MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

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 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): https://iuhealth.org/in-the-community/community-benefit

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): https://iuhealth.org/in-the-community/community-benefit

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, 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) 2020

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	IU HEALTH BALL MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 300.0%
and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

https://iuhealth.org/pay-a-bill/financial-assistance

The FAP application form was widely available on a website (list url):

https://iuhealth.org/pay-a-bill/financial-assistance

A plain language summary of the FAP was widely available on a website (list url):
https://iuhealth.org/pay-a-bill/financial-assistance

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 6

Part VFacility Information (continued)

Billing and Collections

	IU HEALTH BALL MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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 all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized 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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	IU HEALTH BALL MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2020

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 3E	IU Health Ball Memorial Hospital's 2018 Community Health Needs Assessment (CHNA) Report includes a prioritized description of significant health needs in the community. The CHNA report identified the following seven needs as priorities for IU Health Ball Memorial Hospital: - Access to Health Care Services - Drug and Substance Abuse - Food Insecurity and Healthy Eating - Mental Health - Obesity, Diabetes, and Lack of Physical Activity - Smoking and Tobacco Usage - Social Determinants of Health
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - IU HEALTH BALL MEMORIAL HOSPITAL. In conducting its most recent Community Health Needs Assessment ("CHNA") IU Health Ball Memorial Hospital took into account input from persons who represent the broad interests of the communities it serves. Primary data were gathered in three different methodologies for this assessment: Community Meetings, Key Stakeholder Interviews, and a Community Survey. For purposes of this CHNA, IU Health Ball Memorial Hospital's community is defined as Delaware, Jay, and Randolph Counties, Indiana. These three counties accounted for 80.9 percent of the hospital's inpatient cases in 2016. Community Meetings - Delaware County On May 10, 2018, two meetings of community representatives were held at the IU Health Ball Memorial Hospital in Muncie, the county seat of Delaware County. The first meeting was attended by 23 community members, and the second meeting was attended by 14 community members. The community members were invited by IU Health because they represent important community organizations and sectors such as: local health departments, non-profit organizations, local business, health care providers, and schools. Through this meeting, IU Health sought a breadth of perspectives on the community's health needs. The specific organizations represented at the meetings are listed below. - Alpha Center - BY5 - Ball State University - Bethel Point Rehab - Bridges Community Services - Boys and Girls Club of Muncie - Building Better Communities/Ball State University - Cancer Services of East Central Indiana - City of Muncie - Delaware County Government - Delaware County Health Department - Delaware County Senior Center - IU Health Ball Memorial Hospital - IU Health East Central Region - Meridian Health Services - Muncie/Delaware County Chamber of Commerce - Open Door Health Services - Purdue Extension - Second Harvest Food Bank - Transition Resources Corporation - Head Start - Westminster Village - YWCA of Muncie - Youth Opportunity Center The meeting began with a presentation that discussed the goals and status of the CHNA process and the purpose of the community meetings. Then, secondary data were presented, along with a summary of the most unfavorable community health indicators. For Delaware County, those indicators were (in alphabetical order): - Adult smoking - Housing problems in Delaware County - Infant mortality and low birth weight births - Mental health and supply of mental health providers - Physical inactivity and access to healthy food - Poverty rates and children in poverty - Supply of primary care physicians and dentists Participants then were asked to discuss whether the identified, unfavorable indicators accurately identified the most significant community health issues and were encouraged to add issues that they believed were significant. Several issues were added at the meetings, such as: chronic disease, cancer, services for the elderly, adverse childhood experiences, social associations/ connectedness, obesity, health literacy, addictions, access to specialty physicians, built environment, lead problems, and supply of primary care physicians and dentists. In addition, physical inactivity and access to healthy food were split into their own line items, instead of being combined. During the meetings, a range of other topics was discussed, including: - Differences in secondary data for mental health indicators - Inter-relatedness of needs - Services for the elderly - Difference between obesity, physical activity, and access to healthy food After discussing the needs identified through secondary data and adding others to the list, each participant was asked through a voting process to identify "three to five" they consider to be most significant. From this process, the groups identified the following needs as most significant for Delaware County: The results from the first meeting were as follows: - Mental health and supply of mental health providers - Poverty rates and children in poverty - Obesity - Tied for fourth: Adult smoking and adverse childhood experiences The results from the second meeting were as follows: - Addictions - Physical activity/obesity - Access to healthy foods - Adult smoking - Infant mortality Interviews - Delaware County On May 10, 2018, an interview was also conducted with a representative of the Delaware county health department. The interview was conducted to assure that appropriate and additional input was received from governmental public health officials. The results of the community meetings were discussed and insights were sought regarding significant community health needs, why such needs are present, and how they can be addressed. The interview was guided by a structured protocol. The interview was guided by a structured protocol that focused on opinions regarding significant community health needs, describing why such needs are present, and seeking ideas for how to address them. The interviewee confirmed that some of the top needs identified by the community meeting group were some of the most significant in the community. These needs were: - Mental health, addictions, and supply of mental health providers (including rehabilitation and addiction services) - Poverty rates and children in poverty - Obesity - Physical inactivity - Access to healthy foods Drug addiction was identified as a major issue, and it was believed that receiving long term treatment is not an option for many seeking treatments. Few resources were believed to exist in the county, and resources outside of the county were thought to have long wait lists. Poverty is a significant issue, with Delaware County ranking as one of the highest poverty counties in the state. The community was thought to be in a difficult period after the decline of industry in the region, with issues stemming from this including: - Losing population and tax base - Poor infrastructure, particularly for roads - Failure to attract employers to the area due to infrastructure concerns - Failure to retain a locally-educated population from the local Ball State University Access to healthy food was identified as a key contributor to the significant obesity issue, exacerbated by poverty and the growing rate of fast food restaurants in the county. While healthy options were thought to exist on a smaller scale, cheaper unhealthy food is more readily accessible. A lack of regular exercise was also identified as a main contributor to the issue of obesity, particularly among poorer communities. Many neighborhoods did not have a built environment to support regular exercise, with issues such as crime, lack of sidewalks, heavy traffic, and others contributing to an unsafe physical environment. Infant mortality was identified as a significant issue, with a lack of parent education on child safety (such as infants sleeping in the same bed as parents or other children) contributing. A lack of social associations, connectedness, and support systems was thought to play a role in many of the county issues, particularly with mental health and addiction problems. Communicable diseases, particularly Hepatitis C and HIV, are increasingly common due to intravenous drug use in the community. The need for a central resource to refer residents with mental health, behavioral health, and addiction needs was identified as a significant need. The need for more public outreach and education programs on nutrition and physical activity, in places other than a clinical setting, was identified. Adult smoking and resultant chronic diseases were also identified as issues. Community Meetings - Jay County On May 23, 2018, two meetings of community representatives were held at the IU Health Jay Hospital in Portland, the county seat of Jay County. The meetings were attended by 28 community members invited by IU Health because they represent important community organizations and sectors such as: local health departments, police/ fire departments, non-profit organizations, local business, health care providers, local policymakers, faith-based organizations, and schools.
Schedule H, Part V, Section B, Line 5 Facility , 2	Facility , 2 - IU HEALTH BALL MEMORIAL HOSPITAL (CONT.). Through the meetings, IU Health sought a breadth of perspectives on the community's health needs. The specific organizations represented at the meetings are listed below. - Community & Family Services - Crown Pointe Senior Living - First Merchants Bank - Fort Recovery Industries - Geneva Town Council - IU Health Jay Hospital - Jay-Randolph Developmental Services, Inc. - Jay County Chamber - Jay County Child Services - Jay County Community Development - Jay County Council - Jay County Health Department - Jay County Ministerial Association - Jay County Tourism - Jay Schools - John Jay Center for Learning - Life Stream - Meridian Health Services - Pennville Town Council - Persimmon Ridge Rehab - Portland Fire Department - Portland Foundation - Portland Police Department - Swiss Village, Inc. - United Way of Jay The meeting began with a presentation that discussed the goals and status of the CHNA process and the purpose of the community meetings. Then, secondary data were presented, along with a summary of the most unfavorable community health indicators. For Jay County, those indicators were (in alphabetical order): - Adult smoking and smoking during pregnancy - Air pollution - Diabetes mortality rate - Food environment - Infant mortality rates - Low educational attainment levels - Obesity, physical inactivity, and access to exercise opportunities - Poverty rates - Undersupply of primary care physicians and mental health professionals Meeting participants then were asked to discuss whether the identified, unfavorable indicators accurately identified the most significant community health issues and were encouraged to add issues that they believed were significant. Several issues were added, such as: substance abuse, preventative care for children, low health literacy, lack of parenting skill, prescription medication cost barriers, cancer, mental health, childhood obesity, faith and spirituality, senior programming, and breastfeeding initiatives. During the meetings, a range of other topics were discussed, including: - Neonatal Abstinence Syndrome - Generational poverty - Single parent families - Responsibility and accountability - Quality of job applicants - Lack of options for healthy food After discussing the needs identified through secondary data and adding others to the list, each participant was asked through a voting process to identify "three to five" they consider to be most significant. From this process, the groups identified the following needs as most significant for Jay County: - Substance abuse - Mental health - Undersupply of primary care physicians and mental health professionals - Physical inactivity - Parenting skills Interviews - Jay County On May 23, 2018, an interview was also conducted with a representative of the Jay county health department. The interview was conducted to assure that appropriate and additional input was received from governmental public health officials. The results of the community meetings were discussed and insights were sought regarding significant community health needs, why such needs are present, and how they can be addressed. The interview was guided by a structured protocol that focused on opinions regarding significant community health needs, describing why such needs are present, and seeking ideas for how to address them. The interviewee identified the following three needs as the most significant, with each of these needs having also been prioritized by the community meeting participants as significant: - Substance Abuse - Mental Health - Physical Inactivity Poverty and drug abuse were thought to be significant issues in the community, and contributing factors in the need for improved parenting education and skills development. Few options and providers are available for substance abuse and mental health treatment, and there is also little information about where to go outside of the county for treatment. The need for increased access to rehabilitation that is closer to home and affordable was identified as a priority. Obesity was identified as a significant concern, with physical inactivity a primary contributor to obesity and related chronic conditions. While there was thought to be an adequate amount of outdoor space for recreation, more education for younger residents about healthy living was identified as a need to ensure that motivation for physical activity remains into adulthood. Poor diet was also thought to be an issue in the community, particularly with the majority of restaurant options in the community being fast food. Involvement and collaboration within the business community for healthy living initiatives was identified as a programmatic need. If organizations came together for physical fitness goals and insurance incentives for healthy eating and exercise, there could be a large reduction of obesity in the community. Smoking was also thought to still be an issue despite progress being made, and more smoking cessation efforts were thought to be needed. The need for a central resource that could direct residents to any resource needed in the community - whether health or basic living needs - was identified as a needed service. Poverty was identified as an issue, and while jobs were thought to be available, some residents were not pursuing these opportunities due to personal motivation, low pay, or mental health reasons. Transportation was also identified as an issue in both accessing healthcare services and for employment purposes. Community Meetings - Randolph County A separate community meeting was not held for Randolph County; however, feedback was obtained from several representatives from the Randolph County Health Department. This feedback appears in the Interviews section of this report. Interviews - Randolph County On July 28, 2018, an interview was also conducted with representatives of the Randolph county health department. The interview was conducted to assure that appropriate and additional input was received from governmental public health officials. The results of the community meetings were discussed and insights were sought regarding significant community health needs, why such needs are present, and how they can be addressed. The interview was guided by a structured protocol that focused on opinions regarding significant community health needs, describing why such needs are present, and seeking ideas for how to address them. The interviewees confirmed that the following issues, identified from problematic secondary data indicators, were significant in the community: - Adult smoking - Infant mortality and low birth weight births - Mental health and supply of mental health providers - Physical inactivity and access to healthy food - Poverty rates and children in poverty - Supply of primary care physicians and dentists Drug overdoses were also identified as an issue, and thought to be a primary contributor to the poor outcomes in accident mortality rates for Randolph County. While Randolph County had a lower infant mortality rate than bordering Jay and Delaware Counties, interviewees believed this may be because complicated infant health cases were being sent to IU Health Ball Memorial Hospital in Delaware County. Substance abuse and access to addiction treatment programs were thought to be a significant need. Transportation was also identified as a significant issue. Both drug use and a related rise in Hepatitis C cases were identified as current issues and as issues that may increase in severity in the near future. In response to programs most needed in the community, interviewees identified funding for smoking cessation programs, free glucometer programs, expanded immunization capabilities, and vaccines for the public as particular needs. Community Survey To inform the CHNA, a community survey was conducted by the Indiana Hospital Collaborative. Across Indiana, 9,161 completed questionnaires were received by all participating hospitals in the Indiana Hospital Collaborative, for an overall response rate of 11.6 percent; 5,030 questionnaires were received from the 17 Indiana counties served by one or more IU Health hospitals. For IU Health Ball Memorial Hospital, surveys were received from 851 community households. According to the responses, these households included 1,587 adults. The community survey indicates that substance use or abuse, obesity, poverty, and chronic diseases represent top concerns in the community served by IU Health Ball Memorial Hospital.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - IU HEALTH BALL MEMORIAL HOSPITAL. In conjunction with the CHNA, IU Health Ball Memorial Hospital's Board adopted an implementation strategy in April 2019 related to the 2018 CHNA. IU Health Ball Memorial Hospital prioritized and determined which of the community health needs identified in its most recently conducted CHNA were most critical for it to address. IU Health Ball Memorial Hospital will address the following community health needs between 2019 and 2021: - Access to Healthcare Services - Drug and Substance Abuse (including Opioids and Alcohol) - Food Insecurity and Healthy Eating - Mental Health - Obesity, Diabetes, and Physical Inactivity - Smoking and Tobacco Usage - Social Determinants of Health IU Health uses the term "Behavioral Health" to refer to Mental Health and Drug and Substance Abuse (including Opioids and Alcohol). Access to Healthcare IU Health Ball Memorial Hospital's implementation strategy to address the identified need of Access to Healthcare includes the following: - Utilize IU Health's internal recruitment resources. - Leverage IU Health Ball Memorial Residency Programs for potential recruits. - Maintain and update facilities' plan and initiatives to support incoming practices. - Form work groups around identified health needs for region. - Composition of work groups to include identified Ball State University stakeholders and other relevant community partners. - Develop collaboration plan to support/enhance/expand IU Health Ball Memorial Hospital Community Health Needs Assessment strategies around identified health needs. - Recruit new primary care, obstetric and mental health medical doctors to practice in East Central Region. - In 2020, six new primary care providers joined the IU Health East Central Region (three physicians, two FNPs, one WHNP). Two of the new providers are in Jay County, two are based in Grant County, and two in Delaware County, where the provider footprint was expanded with the addition of an existing physician practice into the IU Health physician network. Also, in 2020, a north Muncie provider was relocated to the far East side of the city to expand the IU Health provider footprint further to the east in Delaware County. Additionally, virtual visits were expanded so that all primary care providers have the capability to provide virtual visits to their patients as insurance allows. In Jay County, a new program focused solely on Women's Health and prenatal and postnatal care was established. These new primary care providers, locations and services allow for increased access and expertise for East Central Indiana patients. . - Provide two family medicine directors and a resident rotation at a subsidized rate to local federally qualified health center (FQHC) Open Door Health Services to expand obstetrics capacity to serve low-income residents. -IU Health provided two family Medicine Directors plus a resident rotation at a subsidized rate to Open Door health Services. This has allowed Open Door to expand its obstetric capability to service low-income residents of East Central Indiana. The two physicians provided a total of 7,912 patient encounters in 2020. Other OB Services are offered at IU Health Ball Memorial Hospital through its Family Medicine Program, Perinatal Center and physician practice facilities. Several other private practices offer OB Services to the community as well. - Collaborate with Ball State University regarding health improvement initiatives at Muncie Community Schools. - A collaboration with Ball State University has been established develop and implement in-school physical activity and nutritional education curriculums at the elementary-school level in the Muncie Community Schools. The primary tasks completed in year 1 (2020) included the assembly of team members and development of a physical activity and nutrition education curriculum including assessment procedures (and purchasing of educational materials). An initial 6-week pilot program at Southview Elementary School in Muncie, delivered via Google Classroom was initiated with physical activity and nutrition components. A teacher survey was administered and reported 66% of teachers utilized the "brain break" activity and 75% felt the nutrition lessons were grade appropriate. Barriers were identified and will inform operations in year 2 (2021) of the program. Behavioral Health (includes Drug & Substance Abuse and Mental Health) IU Health Ball Memorial Hospital's implementation strategy to address the identified need of Behavioral Health includes the following: - Provide structured therapeutic recovery program. - Assist in the establishment of a community network of existing substance use disorders (SUD) related concerns. - Apply for Health Resources and Services Administration (HRSA) grant funding for a full time psychologist and postdoctoral fellow to be placed in the internal medicine residency. - Form work groups around identified health needs for region. - Composition of work groups to include identified Ball State University stakeholders and other relevant community partners. - Develop collaboration plan to support/enhance/expand IU Health Ball Memorial Hospital Community Health Needs Assessment strategies around identified health needs. - Apply for grant funding to expand virtual IOP to serve other East Central Region facilities. - The IU Health Ball Addiction Treatment and Recovery Center opened in 2019 and now offers an Intensive Outpatient Program (IOP) - which includes Group therapy Recreation therapy and individual and family counseling services and peer recovery coaching. Medication Assisted Treatment (MAT) is also offered as well as an Individual outpatient Program and IOP Aftercare Program. Between July 2019 and December 2019 the Center provided 67 assessments and had 44 persons enrolled in IOP and/or Individual Track. Those numbers increased to 130 and 107, respectively in 2020. Patients who have completed the IOP demonstrate a 35% increase in sobriety and pregnant women have demonstrated a 100% sobriety rate. Virtual IOP Services- In September of 2020 a Virtual IOP was launched at IU Health Jay Hospital with support from the CARA First Responders Grant. This allowed the employment of 2 part time Peer Recovery Coaches. They are employed by the Jay Outpatient Behavioral Health Clinic and serve as co-facilitators of the IOP to patients presenting on site at that location. Both locations receive the IOP services, with patient settings in two different locations. Numerous community partners are engaged for referrals and resources including NA, AA, Briana's Hope, A Better Life, Celebrate Recovery, Smart Recovery, plus faith-based partnerships and community resource partners. Referral partners include IU Health Ball Emergency Department and Family Medicine Residency, Volunteers of America Fresh Start in Winchester and Delaware County Corrections. ATRC staff have also engaged with the Addictions Council of Delaware County in 2020 and are serving on subgroups. One subgroup is focusing on bringing a Women's Residential Treatment Program to Delaware County and the other is a syringe/needle exchange effort. - Employ peer recovery coaches in the IU Health Ball Memorial Hospital Emergency Department (ED). - 2019 was the first year that Peer Recovery services were offered in the IU Health Ball Memorial Hospital Emergency Department. Patients who enter the emergency department for an opioid-related health issue are deemed initially eligible for the Planned Outreach, Intervention, Naloxone, and Treatment (POINT) program; this includes patients admitted for opioid withdrawal symptoms, opioid intoxication, opioid overdose, endocarditis related to injection opioid use, and abscess related to injection opioid use. Peer recovery coaches (PRCs) are notified of these patients via the EMR track board and nurse/physician alerts (pager, telephone call). These patients are then approached by a peer recovery coach and asked to complete an opioid use disorder (OUD) screening tool. If symptoms indicate an OUD, they are offered peer recovery coaching services. Additionally, outside of their POINT program responsibilities, peer recovery coaches offer services to patients presenting with other substance use disorder issues (non-opioid). In 2019, PRCs encountered a total of 83 patients and 75% accepted care. In 2020, PRCs had 352 patient encounters and 77% accepted care.
Schedule H, Part V, Section B, Line 11 Facility , 2	Facility , 2 - IU HEALTH BALL MEMORIAL HOSPITAL (CONT.). The program is budgeted for 2 full time and one part time peer recovery coaches and is typically staffed from 8a-4pm or 4pm-12am Monday-Sunday. Peer recovery coaches will immediately provide services if available. Indiana University is the organization providing the funding for the program at Ball through a federal research grant. Specific to the grant, Clean Slate is the primary provider for MAT. The IU Health Psychiatry hub collaborates with IUH Jay and IUH Blackford to provide peer recovery coach services. In addition, patients with SUD are being referred to the continuum of care of services including the IUH Ball ATRC, MAT, inpatient facilities and other levels of care as indicated. - Provide Screening, Brief Intervention, and Referral to Treatment (SBIRT) process for family medicine clinic patients. - In 2020, SBIRT screening for all patients was discontinued mid-year due to organizational changes in tracking requirements for depression screening, which was previously embedded in the SBIRT tracking. A depression-only screener is currently provided to all patients. - Provide prescription medication disposal kiosks at IU Health East Central Region facilities. - Drug take-back kiosks have been installed at four East Central Indiana locations: Pavilion Pharmacy at IU Health Ball Memorial Hospital in Muncie; IU Health Yorktown Pharmacy, Yorktown; IU Health Blackford Pharmacy, Hartford City; and IU Health Jay Hospital, Portland. The kiosks are open to the public and available during business hours. In 2019, 874 pounds of prescription meds were recovered at Pavilion, 230 pounds at Blackford, 161 pounds at Yorktown, and 161 pounds at Jay, for a total of 1,426 pounds. In 2020, 897 pounds of meds were collected from the four locations and destroyed. Currently, no other community partners are actively promoting this program. - Provide Perinatal Coordinator to facilitate and collaborate within the hospital and with outside physician offices and community agencies to enhance efforts to decrease infant mortality in the IU Health East Central Region. - In 2019 and 2020 The IU Health ECR Perinatal Coordinator facilitated the development of 36 collaborators to enhance efforts to decrease infant mortality and improve the health of newborns and women. Access to community resources has increased due to ECR efforts that include: promotion of Baby and Me Tobacco Free program; implementation of a Tobacco Treatment Pilot Program in 5 ECR physician office settings designed to provide client consultations and referrals to 1-800 Quit Now, Baby and Me Tobacco Free program, and pharmacotherapy options. In 2020 IUH Jay received an ISDH OB Navigation grant which has provided for OB Navigation for clients in Jay Blackford Co. initiated to provide continuum of care throughout pregnancy. Physician practices in the region received Safe Sleep education and resources, and a partnership with IU Health Ball Lactation Services resulted in the development of telemedicine lactation services at IU Health Jay Hospital. Improved OB care was addressed with Post-Partum Hemorrhage and OB Hypertension initiatives, plus access to care through Emergency Room visits and Labor and Delivery collaboration. - Internally at IU Health Ball Hospital, an Intraprofessional Model of Care for NICU rounds with discharge planning was developed to decrease LOS & barriers to discharge; the ECR Fetal Care Team was initiated to improve consultation and support provided to parents receiving diagnosis of lethal anomaly for their baby. Virtual video tours were developed for expectant parents; Music Therapy was initiated in the NICU for infants with Neonatal Abstinence Syndrome. Internal collaborators include 17 Departments at IU Health Ball Memorial Hospital ranging from medical units to ancillary services such as marketing. In 2020 a new collaboration was initiated with IUH Ball Maternal Fetal Health, Neonatology, Palliative Care and nursing leadership to develop and initiate ECR Fetal Care Team with a focus on improving consultation and support provided to parents receiving diagnosis of lethal anomaly for their baby. - IU Health Jay submitted and received an ISDH grant which supports a new OB Navigation program called Healthy Beginnings. Launched in 2020, The Healthy Beginnings Program is a comprehensive women's health model that focuses on access to care and improving maternal/infant health outcomes by utilizing care coordination, outpatient services, and community collaboration. The goal of the program is to keep prenatal and postnatal care local to pregnant women in their own communities with delivery occurring at IUH Ball Memorial Hospital. - Relationships were established with the ECR Community Outreach Department, and the IU Health System Tobacco Collaborative. Externally, collaborations were developed with The Tobacco Free Delaware County Coalition, Open Door Health Services, Baby and Me Tobacco Free Program, Indiana State Department of Health (ISDH), Indiana Perinatal Quality Improvement Collaboration (IPQIC), and Meridian Health Services programs for Maternal Treatment, Peds Rehab and physician practices. - The IU Health ECR Perinatal Coordinator has facilitated the development of 33 collaborators to enhance efforts to decrease infant mortality. Access to community resources has increased due to ECR efforts that include: promotion of Baby and Me Tobacco Free program, new physician practice Safe Sleep and tobacco cessation education, and a new telemedicine lactation program. Improved OB care was addressed with Post Partum Hemorrhage and OB Hypertension initiatives. Internally at IU Health Ball Hospital, an Intraprofessional Model of Care for NICU rounds with discharge planning was developed to decrease LOS & barriers to discharge from 57% to 13% (focused on LOS, infant mortality). Internal collaborators include 17 Departments at IU Health Ball Memorial Hospital ranging from medical units to ancillary services such as marketing. Externally, collaborations were developed with Open Door Health Services, Baby and Me Tobacco Free Program, Indiana State Department of Health (ISDH), Indiana Perinatal Quality Improvement Collaboration (IPQIC), IU Health Jay County Hospital, and Meridian Health Services programs for Maternal Treatment, Peds Rehab and physician practices. - Collaborate with Ball State University regarding health improvement initiatives at Muncie Community Schools. - A collaboration with Ball State University has been established develop and implement in-school physical activity and nutritional education curriculums at the elementary-school level in the Muncie Community Schools. The primary tasks completed in year 1 (2020) included the assembly of team members and development of a physical activity and nutrition education curriculum including assessment procedures (and purchasing of educational materials). An initial 6-week pilot program at Southview Elementary School in Muncie, delivered via Google Classroom was initiated with physical activity and nutrition components. A teacher survey was administered and reported 66% of teachers utilized the "brain break" activity and 75% felt the nutrition lessons were grade appropriate. Barriers were identified and will inform operations in year 2 (2021) of the program. Food Insecurity and Healthy Eating IU Health Ball Memorial Hospital's implementation strategy to address the identified need of Food Insecurity and Healthy Eating includes the following: - Facilitate organization recruitment and engagement using the collective impact model around improved nutrition, increased physical activity and tobacco cessation. - Organize workgroups and develop partner tools for audience engagement. - Engage local organizations to recruit low-income families to participate. - Form work groups around identified health needs for region. - Composition of work groups to include identified Ball State University stakeholders and other relevant community partners. - Develop collaboration plan to support/enhance/expand IU Health Ball Memorial Hospital Community Health Needs Assessment strategies around identified health needs. - Provide opportunities for families to learn about nutrition value of fresh produce, physical activity and tobacco cessation. - In 2019 a comprehensive 3 year plan of engagement with the 8twelve Coalition was developed in the form of a grant application for the IU Health Community Impact Fund. $1M was awarded to make improvements related to food access, physical activity and housing in the area. Organizing is underway to begin improvements in 2020 with completion in 2022. - Support communication, organization and facilitation of local collaboration to advance new food policy, food waste reduction, and food access.
Schedule H, Part V, Section B, Line 11 Facility , 3	Facility , 3 - IU HEALTH BALL MEMORIAL HOSPITAL (CONT.). - The East Central Indiana Food Council is a volunteer-run organization led by local activists interested in addressing community issues around food access and nutrition. It receives support from the IU Health-driven Healthy Community Alliance initiative. The group has strategically grown from a Delaware County focus to include participants from Blackford and Jay Counties. The Council is composed of multiple community collaborators representing Ball State University, The Muncie Food Hub, IU Health, Purdue Extension, Second Harvest Food Bank, Grace Baptist Church, the Soup Kitchen of Muncie, Blood-n-Fire Ministries, Community and Family Services Food Pantries in Hartford City, Montpelier and Portland and the Children's Bureau; as well as local farmers and farmers market organizers. In 2019 the group offered guidance to area schools and farmers regarding the process of bringing local farm products to schools, with the outcome of a new online resource for accessing mandatory forms and policies and connections made between schools and farmers. In response to Covid-19, the group held a special philanthropy session in 2020 where funders talked directly with food support organizations directly about their needs. The result was that groups received funding for initiatives such as additional equipment; and the Muncie Food Hub partnered with IU Health to offer free produce for 15 weeks delivered to 10 different locations in Delaware, Blackford and Jay Counties. Sites included food pantries, childcare centers, community centers and healthcare organizations where vulnerable populations were able to be reached. - Build and maintain Healthy Community Alliance (HCA) website and other communication tools to support partner engagement. - The Healthy Community Alliance of East Central Indiana (HCA) currently engages 149 collaborating organizations in 3 ECR counties- Delaware, Blackford and Jay. In 2019 and 2020, 10 new Partners were added to the network- Crossroads Financial Credit Union, Jay County Development Corporation, Jay County Drug Prevention Coalition, Jay Community Schools, Home Health Angels, United Way of Jay County, Alexandria Care Center, John Jay Center for Learning, United Day Care Center of Delaware County, Community Partners Children's Bureau. The HCA makes multiple resources available to collaborators, including facilitated workgroup sessions in each county, materials such as Tobacco Cessation Toolkits and Healthy Lifestyle toolkits; and online resources such a e-newsletter, media messaging and access to community health data for each of the three counties. These resources are provided to all collaborating organizations free of charge. In 2020 the HCA began offering webinar programming as a way to engage Partners in accessing resources and programming in all three counties. The CDC Change tool survey process was conducted in both Delaware and Jay Counties in 2020 by HCA Partner organizations with HCA Partner support. In Blackford County, HCA efforts led to programming and curriculum changes at the Blackford Community School System. A 2019 survey found that 105 of HCA Partner organizations are currently utilizing at least one of these provided resources to influence change amongst their audiences. The Healthy Community Alliance is organized and facilitated by IU Health East Central Region Hospitals and receives resources from IU Health Ball Memorial Hospital for Partner materials and support. - Offer IU Health Bucks to participants so they may fully engage in farmers' market experience. - IU Health offers the Families at the Farmers Market in Muncie and Hartford City each year. Collaborators - Minnetrista, Whitely Comm. Council, Ross Center, Minority Health Coalition, Ivy Tech, Boys/Girls Club, Buley Center, Open Door Health Services, Salvation Army, YWCA of ECI, YMCA/Appletree, Youth Opportunity Center, Hillcroft, Spangler Farms, Northern Tropics Greenhouse and IU Health Ball Hospital. Blackford County: Children and Family Services of Blackford County /WIC, Grace United Methodist Church, Growers and Makers Market, Common Grounds Coffee Shop, Blackford County Public Library, Purdue Extension, and IU Health Blackford Hospital. - In 2020, the program's in-person sessions were eliminated due to Covid-19 precautions. 68 families in Muncie and 29 families in Hartford City received a healthy eating packet with coupons redeemable at local farmers markets and farm stands. Head Start joined the collaboration and facilitated connections with families in Blackford County. 67% of survey participants stated they utilize fresh fruits/vegetables at "most meals" after completing the program; 100% of respondents stated they "Learned a Lot"; and reported they used the Farmers Market "2 or more times." Coupon redemption rates were slightly more than 50% each year. - Collaborate with Ball State University regarding health improvement initiatives at Muncie Community Schools. - A collaboration with Ball State University has been established develop and implement in-school physical activity and nutritional education curriculums at the elementary-school level in the Muncie Community Schools. The primary tasks completed in year 1 (2020) included the assembly of team members and development of a physical activity and nutrition education curriculum including assessment procedures (and purchasing of educational materials). An initial 6-week pilot program at Southview Elementary School in Muncie, delivered via Google Classroom was initiated with physical activity and nutrition components. A teacher survey was administered and reported 66% of teachers utilized the "brain break" activity and 75% felt the nutrition lessons were grade appropriate. Barriers were identified and will inform operations in year 2 (2021) of the program. Obesity, Diabetes, and Physical Inactivity IU Health Ball Memorial Hospital's implementation strategy to address the identified need of Obesity, Diabetes, and Physical Inactivity include the following: - Facilitate organization recruitment and engagement using the collective impact model around improved nutrition, increased physical activity and tobacco cessation. - Organize workgroups and develop partner tools for audience engagement. - Engage local organizations to recruit low-income families to participate. - Form work groups around identified health needs for region. - Composition of work groups to include identified Ball State University stakeholders and other relevant community partners. - Develop collaboration plan to support/enhance/expand IU Health Ball Memorial Hospital Community Health Needs Assessment strategies around identified health needs. - Support communication, organization and facilitation of local collaboration to advance new food policy, food waste reduction, and food access. - The East Central Indiana Food Council is a volunteer-run organization led by local activists interested in addressing community issues around food access and nutrition. It receives support from the IU Health-driven Healthy Community Alliance initiative. The group has strategically grown from a Delaware County focus to include participants from Blackford and Jay Counties. The Council is composed of multiple community collaborators representing Ball State University, The Muncie Food Hub, IU Health, Purdue Extension, Second Harvest Food Bank, Grace Baptist Church, the Soup Kitchen of Muncie, Blood-n-Fire Ministries, Community and Family Services Food Pantries in Hartford City, Montpelier and Portland and the Children's Bureau; as well as local farmers and farmers market organizers. In 2019 the group offered guidance to area schools and farmers regarding the process of bringing local farm products to schools, with the outcome of a new online resource for accessing mandatory forms and policies and connections made between schools and farmers. In response to Covid-19, the group held a special philanthropy session in 2020 where funders talked directly with food support organizations directly about their needs. The result was that groups received funding for initiatives such as additional equipment; and the Muncie Food Hub partnered with IU Health to offer free produce for 15 weeks delivered to 10 different locations in Delaware, Blackford and Jay Counties. Sites included food pantries, childcare centers, community centers and healthcare organizations where vulnerable populations were able to be reached. - Build and maintain Healthy Community Alliance (HCA) website and other communication tools to support partner engagement.
Schedule H, Part V, Section B, Line 11 Facility , 4	Facility , 4 - IU HEALTH BALL MEMORIAL HOSPITAL (CONT.). - The Healthy Community Alliance of East Central Indiana (HCA) currently engages 149 collaborating organizations in 3 ECR counties- Delaware, Blackford and Jay. In 2019 and 2020, 10 new Partners were added to the network- Crossroads Financial Credit Union, Jay County Development Corporation, Jay County Drug Prevention Coalition, Jay Community Schools, Home Health Angels, United Way of Jay County, Alexandria Care Center, John Jay Center for Learning, United Day Care Center of Delaware County, Community Partners Children's Bureau. The HCA makes multiple resources available to collaborators, including facilitated workgroup sessions in each county, materials such as Tobacco Cessation Toolkits and Healthy Lifestyle toolkits; and online resources such a e-newsletter, media messaging and access to community health data for each of the three counties. These resources are provided to all collaborating organizations free of charge. In 2020 the HCA began offering webinar programming as a way to engage Partners in accessing resources and programming in all three counties. The CDC Change tool survey process was conducted in both Delaware and Jay Counties in 2020 by HCA Partner organizations with HCA Partner support. In Blackford County, HCA efforts led to programming and curriculum changes at the Blackford Community School System. A 2019 survey found that 105 of HCA Partner organizations are currently utilizing at least one of these provided resources to influence change amongst their audiences. The Healthy Community Alliance is organized and facilitated by IU Health East Central Region Hospitals and receives resources from IU Health Ball Memorial Hospital for Partner materials and support. Provide opportunities for families to learn about nutrition value of fresh produce, physical activity and tobacco cessation. - In 2019 a comprehensive 3-year plan of engagement with the 8twelve Coalition was developed in the form of a grant application for the IU Health Community Impact Fund. $1M was awarded to make improvements in the Thomas-Avondale Neighborhood related to food access, physical activity and blighted housing improvements in the area. In 2020 significant progress was made: old factory parking lot surfaces were removed to make way for new soccer fields at the Ross Community Center; a sidewalk inventory was completed; pedestrian traffic counters were put in operation; and planning for new pantry spaces and an enclosed community garden space was started. Additionally, placemaking development support has brought a new coffee shop and community gathering spaces into a formerly blighted area, setting the stage for additional development in 2021. Community members now have access to expanded sports programing at the Ross Community Center, expanded healthy food pantry offerings, and a new neighbor-owned and operated coffee shop in a food desert area. - Offer IU Health Bucks to participants so they may fully engage in farmers' market experience. - IU Health offers the Families at the Farmers Market in Muncie and Hartford City each year. Collaborators - Minnetrista, Whitely Comm. Council, Ross Center, Minority Health Coalition, Ivy Tech, Boys/Girls Club, Buley Center, Open Door Health Services, Salvation Army, YWCA of ECI, YMCA/Appletree, Youth Opportunity Center, Hillcroft, Spangler Farms, Northern Tropics Greenhouse and IU Health Ball Hospital. Blackford County: Children and Family Services of Blackford County /WIC, Grace United Methodist Church, Growers and Makers Market, Common Grounds Coffee Shop, Blackford County Public Library, Purdue Extension, and IU Health Blackford Hospital. - In 2020, the program's in-person sessions were eliminated due to Covid-19 precautions. 68 families in Muncie and 29 families in Hartford City received a healthy eating packet with coupons redeemable at local farmers markets and farm stands. Head Start joined the collaboration and facilitated connections with families in Blackford County. 67% of survey participants stated they utilize fresh fruits/vegetables at "most meals" after completing the program; 100% of respondents stated they "Learned a Lot"; and reported they used the Farmers Market "2 or more times." Coupon redemption rates were slightly more than 50% each year. - Collaborate with Ball State University regarding health improvement initiatives at Muncie Community Schools. - A collaboration with Ball State University has been established develop and implement in-school physical activity and nutritional education curriculums at the elementary-school level in the Muncie Community Schools. The primary tasks completed in year 1 (2020) included the assembly of team members and development of a physical activity and nutrition education curriculum including assessment procedures (and purchasing of educational materials). An initial 6-week pilot program at Southview Elementary School in Muncie, delivered via Google Classroom was initiated with physical activity and nutrition components. A teacher survey was administered and reported 66% of teachers utilized the "brain break" activity and 75% felt the nutrition lessons were grade appropriate. Barriers were identified and will inform operations in year 2 (2021) of the program. Smoking and Tobacco Usage IU Health Ball Memorial Hospital's implementation strategy to address the identified need of Smoking and Tobacco Usage include the following: - Facilitate organization recruitment and engagement using the collective impact model around improved nutrition, increased physical activity and tobacco cessation. - Organize workgroups and develop partner tools for audience engagement. - Engage local organizations to recruit low-income families to participate. - Form work groups around identified health needs for region. - Composition of work groups to include identified Ball State University stakeholders and other relevant community partners. - Develop collaboration plan to support/enhance/expand IU Health Ball Memorial Hospital Community Health Needs Assessment strategies around identified health needs. - Build and maintain Healthy Community Alliance (HCA) website and other communication tools to support partner engagement. - The Healthy Community Alliance of East Central Indiana (HCA) currently engages 149 collaborating organizations in 3 ECR counties- Delaware, Blackford and Jay. In 2019 and 2020, 10 new Partners were added to the network- Crossroads Financial Credit Union, Jay County Development Corporation, Jay County Drug Prevention Coalition, Jay Community Schools, Home Health Angels, United Way of Jay County, Alexandria Care Center, John Jay Center for Learning, United Day Care Center of Delaware County, Community Partners Children's Bureau. The HCA makes multiple resources available to collaborators, including facilitated workgroup sessions in each county, materials such as Tobacco Cessation Toolkits and Healthy Lifestyle toolkits; and online resources such a e-newsletter, media messaging and access to community health data for each of the three counties. These resources are provided to all collaborating organizations free of charge. In 2020 the HCA began offering webinar programming as a way to engage Partners in accessing resources and programming in all three counties. The CDC Change tool survey process was conducted in both Delaware and Jay Counties in 2020 by HCA Partner organizations with HCA Partner support. In Blackford County, HCA efforts led to programming and curriculum changes at the Blackford Community School System. A 2019 survey found that 105 of HCA Partner organizations are currently utilizing at least one of these provided resources to influence change amongst their audiences. The Healthy Community Alliance is organized and facilitated by IU Health East Central Region Hospitals and receives resources from IU Health Ball Memorial Hospital for Partner materials and support.
Schedule H, Part V, Section B, Line 11 Facility , 5	Facility , 5 - IU HEALTH BALL MEMORIAL HOSPITAL. - Provide opportunities for families to learn about nutrition value of fresh produce, physical activity and tobacco cessation. - The East Central Indiana Food Council is a volunteer-run organization led by local activists interested in addressing community issues around food access and nutrition. It receives support from the IU Health-driven Healthy Community Alliance initiative. The group has strategically grown from a Delaware County focus to include participants from Blackford and Jay Counties. The Council is composed of multiple community collaborators representing Ball State University, The Muncie Food Hub, IU Health, Purdue Extension, Second Harvest Food Bank, Grace Baptist Church, the Soup Kitchen of Muncie, Blood-n-Fire Ministries, Community and Family Services Food Pantries in Hartford City, Montpelier and Portland and the Children's Bureau; as well as local farmers and farmers market organizers. In 2019 the group offered guidance to area schools and farmers regarding the process of bringing local farm products to schools, with the outcome of a new online resource for accessing mandatory forms and policies and connections made between schools and farmers. In response to Covid-19, the group held a special philanthropy session in 2020 where funders talked directly with food support organizations directly about their needs. The result was that groups received funding for initiatives such as additional equipment; and the Muncie Food Hub partnered with IU Health to offer free produce for 15 weeks delivered to 10 different locations in Delaware, Blackford and Jay Counties. Sites included food pantries, childcare centers, community centers and healthcare organizations where vulnerable populations were able to be reached. - Offer IU Health Bucks to participants so they may fully engage in farmers' market experience. - IU Health offers the Families at the Farmers Market in Muncie and Hartford City each year. Collaborators - Minnetrista, Whitely Comm. Council, Ross Center, Minority Health Coalition, Ivy Tech, Boys/Girls Club, Buley Center, Open Door Health Services, Salvation Army, YWCA of ECI, YMCA/Appletree, Youth Opportunity Center, Hillcroft, Spangler Farms, Northern Tropics Greenhouse and IU Health Ball Hospital. Blackford County: Children and Family Services of Blackford County /WIC, Grace United Methodist Church, Growers and Makers Market, Common Grounds Coffee Shop, Blackford County Public Library, Purdue Extension, and IU Health Blackford Hospital. - In 2020, the program's in-person sessions were eliminated due to Covid-19 precautions. 68 families in Muncie and 29 families in Hartford City received a healthy eating packet with coupons redeemable at local farmers markets and farm stands. Head Start joined the collaboration and facilitated connections with families in Blackford County. 67% of survey participants stated they utilize fresh fruits/vegetables at "most meals" after completing the program; 100% of respondents stated they "Learned a Lot"; and reported they used the Farmers Market "2 or more times." Coupon redemption rates were slightly more than 50% each year. - Educate staff regarding "Ask, Advise, Refer" process to refer patients and family members to the Indiana Tobacco Quitline. - In 2020, numbers declined in the face of the pandemic. the Indiana Tobacco Quit Line received 152 referrals; 103 from Delaware County, 20 from Blackford, and 29 from Jay. A process is not currently in place to determine the source of referrals. - Provide Perinatal Coordinator to facilitate and collaborate within the hospital and with outside physician offices and community agencies to enhance efforts to decrease infant mortality in the IU Health East Central Region. - In 2019 and 2020 The IU Health ECR Perinatal Coordinator facilitated the development of 36 collaborators to enhance efforts to decrease infant mortality and improve the health of newborns and women. Access to community resources has increased due to ECR efforts that include: promotion of Baby and Me Tobacco Free program; implementation of a Tobacco Treatment Pilot Program in 5 ECR physician office settings designed to provide client consultations and referrals to 1-800 Quit Now, Baby and Me Tobacco Free program, and pharmacotherapy options. In 2020 IUH Jay received an ISDH OB Navigation grant which has provided for OB Navigation for clients in Jay Blackford Co. initiated to provide continuum of care throughout pregnancy. Physician practices in the region received Safe Sleep education and resources, and a partnership with IU Health Ball Lactation Services resulted in the development of telemedicine lactation services at IU Health Jay Hospital. Improved OB care was addressed with Post-Partum Hemorrhage and OB Hypertension initiatives, plus access to care through Emergency Room visits and Labor and Delivery collaboration. Internally at IU Health Ball Hospital, an Intraprofessional Model of Care for NICU rounds with discharge planning was developed to decrease LOS & barriers to discharge; the ECR Fetal Care Team was initiated to improve consultation and support provided to parents receiving diagnosis of lethal anomaly for their baby. Virtual video tours were developed for expectant parents; Music Therapy was initiated in the NICU for infants with Neonatal Abstinence Syndrome. Internal collaborators include 17 Departments at IU Health Ball Memorial Hospital ranging from medical units to ancillary services such as marketing. In 2020 a new collaboration was initiated with IUH Ball Maternal Fetal Health, Neonatology, Palliative Care and nursing leadership to develop and initiate ECR Fetal Care Team with a focus on improving consultation and support provided to parents receiving diagnosis of lethal anomaly for their baby. IU Health Jay submitted and received an ISDH grant which supports a new OB Navigation program called Healthy Beginnings. Launched in 2020, The Healthy Beginnings Program is a comprehensive women's health model that focuses on access to care and improving maternal/infant health outcomes by utilizing care coordination, outpatient services, and community collaboration. The goal of the program is to keep prenatal and postnatal care local to pregnant women in their own communities with delivery occurring at IUH Ball Memorial Hospital. Relationships were established with the ECR Community Outreach Department, and the IU Health System Tobacco Collaborative. Externally, collaborations were developed with The Tobacco Free Delaware County Coalition, Open Door Health Services, Baby and Me Tobacco Free Program, Indiana State Department of Health (ISDH), Indiana Perinatal Quality Improvement Collaboration (IPQIC), and Meridian Health Services programs for Maternal Treatment, Peds Rehab and physician practices. Collaborate with Ball State University regarding health improvement initiatives at Muncie Community Schools. - A collaboration with Ball State University has been established develop and implement in-school physical activity and nutritional education curriculums at the elementary-school level in the Muncie Community Schools. The primary tasks completed in year 1 (2020) included the assembly of team members and development of a physical activity and nutrition education curriculum including assessment procedures (and purchasing of educational materials). An initial 6-week pilot program at Southview Elementary School in Muncie, delivered via Google Classroom was initiated with physical activity and nutrition components. A teacher survey was administered and reported 66% of teachers utilized the "brain break" activity and 75% felt the nutrition lessons were grade appropriate. Barriers were identified and will inform operations in year 2 (2021) of the program.
Schedule H, Part V, Section B, Line 11 Facility , 6	Facility , 6 - IU HEALTH BALL MEMORIAL HOSPITAL. Social Determinants of Health IU Health Ball Memorial Hospital's implementation strategy to address the identified need of Social Determinants of Health include the following: - Offer coupons to those experiencing homelessness and low-income audiences in conjunction with local food pantry program. - Investigate potential partnership levels and investments with community-building activities related to food access, housing, and employment for underserved audiences. - Form work groups around identified health needs for region. - Composition of work groups to include identified Ball State University stakeholders and other relevant community partners. - Develop collaboration plan to support/enhance/expand IU Health Ball Memorial Hospital Community Health Needs Assessment strategies around identified health needs. - Collaborate with local laundromat to offer coupon program. - IU Health Ball Memorial Hospital collaborates with members of the Healthy Community Alliance of East Central Indiana to distribute $20 laundry coupons to limited resource audiences in Delaware County. The coupons are distributed by the "Community Basket," a ministry of The Jar Community Church. Best described as a 'non-food' food bank, The Community Basket's goal is to provide members of our community who are in need with five hygiene, cleaning and paper items per visit. These are items that are not provided through SNAP benefits. In 2019 670 IU Health-funded laundry coupons were distributed and 492 were redeemed. Internal collaborators are IU Health Ball Memorial Hospital Community Outreach and IU Health Ball Memorial Hospital Medical Staff. External collaborators are The Jar Community Church and the White Spot Laundry. In 2020, 500 were distributed and 210 were redeemed. - Support communication, organization and facilitation of local collaboration to advance new food policy, food waste reduction, and food access. - The East Central Indiana Food Council is a volunteer-run organization led by local activists interested in addressing community issues around food access and nutrition. It receives support from the IU Health-driven Healthy Community Alliance initiative. The group has strategically grown from a Delaware County focus to include participants from Blackford and Jay Counties. The Council is composed of multiple community collaborators representing Ball State University, The Muncie Food Hub, IU Health, Purdue Extension, Second Harvest Food Bank, Grace Baptist Church, the Soup Kitchen of Muncie, Blood-n-Fire Ministries, Community and Family Services Food Pantries in Hartford City, Montpelier and Portland and the Children's Bureau; as well as local farmers and farmers market organizers. In 2019 the group offered guidance to area schools and farmers regarding the process of bringing local farm products to schools, with the outcome of a new online resource for accessing mandatory forms and policies and connections made between schools and farmers. In response to Covid-19, the group held a special philanthropy session in 2020 where funders talked directly with food support organizations directly about their needs. The result was that groups received funding for initiatives such as additional equipment; and the Muncie Food Hub partnered with IU Health to offer free produce for 15 weeks delivered to 10 different locations in Delaware, Blackford and Jay Counties. Sites included food pantries, childcare centers, community centers and healthcare organizations where vulnerable populations were able to be reached. - Collaborate with Ball State University regarding health improvement initiatives at Muncie Community Schools. - A collaboration with Ball State University has been established develop and implement in-school physical activity and nutritional education curriculums at the elementary-school level in the Muncie Community Schools. The primary tasks completed in year 1 (2020) included the assembly of team members and development of a physical activity and nutrition education curriculum including assessment procedures (and purchasing of educational materials). An initial 6-week pilot program at Southview Elementary School in Muncie, delivered via Google Classroom was initiated with physical activity and nutrition components. A teacher survey was administered and reported 66% of teachers utilized the "brain break" activity and 75% felt the nutrition lessons were grade appropriate. Barriers were identified and will inform operations in year 2 (2021) of the program. IU Health Ball Memorial Hospital will address all community health needs based on their 2018 Community Health Needs Assessment. There were no identified needs that will not be addressed.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - IU HEALTH BALL MEMORIAL HOSPITAL. IN ADDITION TO FPG, IU HEALTH BALL MEMORIAL HOSPITAL MAY TAKE INTO CONSIDERATION A PATIENT'S INCOME AND/OR ABILITY TO PAY IN CALCULATION OF A FINANCIAL ASSISTANCE AWARD.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - IU HEALTH BALL MEMORIAL HOSPITAL. IU Health Ball Memorial Hospital takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. Eligibility for Financial Assistance due to Financial or Personal Hardship In order to be eligible for Financial Assistance due to Financial or Personal Hardship under this Policy, a patient or guarantor must: - Submit a completed Financial Assistance Application with all supporting documentation and be approved in accordance with this Policy; - Be an Indiana Resident as defined in this Policy; and - If Uninsured, consult with a member of IU Health's Individual Solutions department to determine if health care coverage may be obtained from a government insurance or assistance product, the Health Insurance Marketplace, or from any other source of coverage. Financial Assistance due to Financial Hardship is only available for encounters where care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility. 2. Financial Assistance due to Financial Hardship The FPL income threshold under this section is as follows: - If one or more adults and zero dependents are in the household, the FPL Income Threshold is 200%. - If two or more adults and one or more dependents are in the household, the FPL Income Threshold is 250%. - If one adult and one or more dependents are in the household, the FPL Income Threshold is 300%. In some instances, an adult will also qualify as a dependent. When this occurs, IU Health will treat the adult as a dependent for purposes of the FPL calculation. IU Health will utilize the most recent FPL data available and will apply the FPL data to a patient or guarantor's account balance based upon the calendar date a completed Financial Assistance Application was received, not a patient's date of service. An Uninsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Gross Charges if approved. An Underinsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Patient Responsibility if approved. 3. Financial Assistance due to Personal Hardship An Uninsured or Underinsured patient or their guarantor whose household income is above the FPL income threshold may be eligible for Financial Assistance if the patient's outstanding Patient Responsibility exceeds 20% of the patient's or their guarantor's annual household income. - If approved, the patient's balance will be reduced to 20% of the patient or guarantor's annual household income or the Amounts Generally Billed, whichever is less. - IU Health will work with the patient or guarantor to identify a reasonable payment plan on the remainder of the balance. 4. Eligibility Period If approved for financial assistance by IU Health, the patient will be guaranteed financial assistance for treatment related to the underlying condition, for which the patient was originally screened and approved, through the remainder of the calendar year. As a condition of extending the on-going Financial Assistance, the patient must comply with requests from IU Health to verify that the patient continues to meet the conditions for qualification. 5. Appeals and Assistance Granted By the Financial Assistance Committee The Financial Assistance Committee will review and make determinations on all requests for appeals related to Financial Assistance. If a patient or guarantor seeks to appeal a Financial Assistance Determination, a written request must be submitted, along with the supporting documentation. The Financial Assistance Committee will review requests for and may grant additional Financial Assistance, including but not limited to, the following: - Assistance to patients who are seeking treatment that can only be provided in Indiana by IU Health or who would benefit from continued medical services from IU Health for continuity of care; - Care approved by the IU Health Chief Medical Officer (CMO) or the Chief Executive Officer (CEO) or CMO of an IU Health facility or region, including medically necessary non-elective services for which no payment source can be identified; - Care provided when it is known no payment source exists; - International humanitarian aid; and - Other care identified by the Financial Assistance Committee that fulfills the IU Health Mission. All decisions of the Financial Assistance Committee are final. 6. Presumptive Eligibility No Financial Assistance Application is required to receive Financial Assistance under this Presumptive Eligibility section. IU Health will deem patients or their guarantors presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs and care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility: - Medicaid (any state) - Indiana Children's Special Health Care Services - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. IU Health will conduct a quarterly review of all accounts placed with a collection agency partner for at least one hundred and twenty (120) days after the account is eligible for an ECA as set forth in this Policy. If the patient or guarantor's individual scoring criteria demonstrates the patient has a low likelihood and/or propensity to pay or no credit, the patient or guarantor may be deemed presumptively eligible for Financial Assistance. Financial Assistance may additionally be granted in the following circumstances: - If the patient or their guarantor is found to have filed a petition for bankruptcy. - If the patient is deceased and found to have no estate. - If the patient is deceased and was under 21 years of age at the time of death. 7. Exhaustion of Alternate Sources of Assistance Patients must exhaust all other state and federal assistance programs prior to receiving Financial Assistance due to Financial or Personal Hardship under this Policy including, but not limited to, Medicaid. Patients who may be eligible for coverage under an applicable health insurance policy must exhaust all insurance benefits. - This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. - IU Health may request patients show proof that such a claim was properly submitted to the appropriate insurance provider before awarding Financial Assistance. Eligible patients who receive medical care from an IU Health facility as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award. In the event Financial Assistance has already been granted in the above circumstances, IU Health reserves the right to reverse the Financial Assistance Determination in an amount equal to the amount IU Health would be entitled to receive had no Financial Assistance been awarded. 8. Patient Assets There are situations where a patient or their guarantor may have significant income or assets available to pay for healthcare services such as a legal settlement. The Financial Assistance Committee may evaluate the income or assets in determining Financial Hardship. IU Health may require a list of all property owned by the patient or guarantor and adjust a Financial Assistance Determination as a result.
Schedule H, Part V, Section B, Line 16 Facility , 1	Facility , 1 - IU HEALTH BALL MEMORIAL HOSPITAL. IU Health Ball Memorial Hospital takes several other measures to publicize its FAP within the community. These measures include the following: 1. Post this Policy, a Plain Language Summary of this Policy, and the Financial Assistance Application on its website. 2. Provide patients with a Plain Language Summary of this Policy during registration and/or discharge. 3. Post conspicuous displays in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 4. Include a conspicuous written notice on all patient post-discharge billing statements notifying the patient about this Policy and the telephone number of the Customer Service Department which can assist patients with questions regarding this Policy. 5. Make available Customer Service representatives via telephone during normal business hours. 6. Mail copies of this Policy, a Plain Language Summary of this Policy, and a Financial Assistance Application to patients or their guarantor free of charge upon request. 7. Broadly communicate this Policy as a part of its general outreach efforts. 8. Educate patient-facing team members on this Policy and the process for referring patients to the program.

Schedule H (Form 990) 2020

Page 9

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?24
Name and address		Type of Facility (describe)
1	IU Health Ball Memorial Cancer Center 2200 FOREST RIDGE RD STE 120 NEW CASTLE,IN47362	DIAGNOSTIC AND OTHER OUTPATIENT
2	IU HEALTH BALL MEMORIAL BARIATRIC & Medical Weight Loss 2901 W JACKSON ST MUNCIE,IN47303	SPECIALTY CARE
3	IU HEALTH PAVILION COMMUNITY PHARMACY 2401 W UNIVERSITY AVE OMP 1635 MUNCIE,IN47303	PHARMACY
4	IU HEALTH YORKTOWN PHARMACY 1420 S PILGRIM BLVD YORKTOWN,IN47396	PHARMACY
5	IU HEALTH BLACKFORD PHARMACY 400 PILGRIM BLVD HARTFORD CITY,IN47348	PHARMACY
6	IUH BALL MEMORIAL CANCER CNTR AT JAY CO 500 W Votaw Street PORTLAND,IN47371	SPECIALTY CARE
7	IU HEALTH BALL MEMORIAL INTERVENTIONAL Pain Services 5501 W BETHEL AVE MUNCIE,IN47304	SPECIALTY CARE
8	BALL STATE HEALTH CENTER PHARMACY 1500 NEELY AVE MUNCIE,IN47306	PHARMACY
9	EAST CENTRAL RADIOLOGY 2598 W WHITE RIVER BLVD MUNCIE,IN47303	RADIOLOGY
10	IU HEALTH BALL MEMORIAL OUTPATIENT CENTER 1420 S PILGRM BLVD YORKTOWN,IN47396	DIAGNOSTIC AND OTHER OUTPATIENT
11	IU HEALTH BALL MEMORIAL OUTPATIENT CENTER 1710 SPICELAND RD NEW CASTLE,IN47362	DIAGNOSTIC AND OTHER OUTPATIENT
12	IU HEALTH FAMILY PHARMACY 5501 W BETHEL AVE MUNCIE,IN47304	PHARMACY
13	BALL STATE STUDENT HEALTH CENTER 1500 NEELY AVE ROOM 106A MUNCIE,IN47306	PRIMARY CARE
14	IU HEALTH BALL MEMORIAL RADIOLOGY 2401 W UNIVERSITY AVE MUNCIE,IN47303	RADIOLOGY
15	IU HEALTH BALL MEMORIAL OUTPATIENT Rehabilitation 3300 W COMMUNITY DR MUNCIE,IN47304	REHABILITATION SERVICES
16	IU HEALTH BALL MEMORIAL HOSPITAL Rehabilitation 3600 W Bethel Ave MUNCIE,IN47304	REHABILITATION SERVICES
17	IU HEALTH BALL MEMORIAL CANCER CENTER 2401 W UNIVERSITY AVE MUNCIE,IN47303	SPECIALTY CARE
18	IU HEALTH BALL MEMORIAL Maternal and Fetal Health 2401 W UNIVERSITY AVE MUNCIE,IN47303	SPECIALTY CARE
19	IU HEALTH BALL MEMORIAL CARDIOVASCULAR Surgery 2525 W University Ave Suite 300 MUNCIE,IN47303	SPECIALTY CARE
20	IU HEALTH BALL MEMORIAL OTOLARYNGOLOGY 2525 W University Ave MUNCIE,IN47303	SPECIALTY CARE
21	IU HEALTH BALL MEMORIAL WOUND HEALING Services 2901 W JACKSON ST MUNCIE,IN47303	SPECIALTY CARE
22	IU HEALTH BALL MEMORIAL VOSS CENTER For Women 5501 W BETHEL AVE SUITE C MUNCIE,IN47304	SPECIALTY CARE
23	IU HEALTH BALL MEMORIAL OUTPATIENT Surgery 2401 W UNIVERSITY AVE MUNCIE,IN47303	SURGERY CENTER

Schedule H (Form 990) 2020

Page 10

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
Schedule H, Part I, Line 6a C.B. REPORT PREPARED BY A RELATED ORG.	IU Health Ball Memorial Hospital's community benefit and other investments, encompassing its total community investment, are included in the IU Health Community Benefit Report which is prepared on behalf of and includes IU Health and its related hospital entities in the State of Indiana ("IU Health Statewide System"). The IU Health Community Benefit Report is made available to the public on IU Health's website at https://iuhealth.org/in-the-community/community-benefit. The IU Health Community Benefit Report is also distributed to numerous key organizations throughout the State of Indiana in order to broadly share the IU Health Statewide System's community benefit efforts. It is also available by request through the Indiana State Department of Health or IU Health.
Schedule H, Part I, Line 7f BAD DEBT EXPENSE	The amount of bad debt expense included on Form 990, Part IX, Line 25, column (A), but subtracted for purposes of calculating the percentage of total expense on Line 7, column (f) is $28,222,286. Bad debt expense is reported at cost based on the cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges.
Schedule H, Part I, Line 7 TOTAL COMMUNITY BENEFIT EXPENSE	Schedule H, Part I, Line 7, Column (f), Percent of Total Expense, is based on column (e) Net Community Benefit Expense. The percent of total expense based on column (c) Total Community Benefit Expense, which does not include direct offsetting revenue, is 28.26%.
Schedule H, Part II PROMOTION OF HEALTH IN COMMUNITIES SERVED	IU Health Ball Memorial Hospital is a subsidiary of IU Health. IU Health participates in a variety of community-building activities that address the social determinants of health in the communities it serves. IU Health and its related hospital entities across the State of Indiana invest in economic development efforts across the state, collaborate with like-minded organizations through coalitions that address key issues, and advocate for improvements in the health status of vulnerable populations. This includes making contributions to community-building activities by providing investments and resources to local community initiatives that addressed economic development, community support and workforce development. IU Health Ball Memorial Hospital partners or collaborates with the following organizations and initiatives that focus on some of the root causes of health issues, such as lack of education, employment and poverty: - 8twelve Coalition - Addictions Coalition of Delaware County - The Arc of Indiana - Ball State University - Career Fairs at Indiana Colleges and Universities - East Central Indiana Regional Partnership - Greater Muncie Habitat for Humanity - Healthy Community Alliance of East Central Indiana - Hillcroft Services - Hosting of medical explorer program for youth - Ivy Tech Community College - Muncie Action Plan - Muncie Community Schools - Muncie-Delaware County Chamber of Commerce - Muncie Drug Task Force - Muncie Food Hub Partnership - Purdue Extension - Ross Community Center - Second Harvest- Food Bank, Poverty Alleviation, Big Idea - Tobacco Free Blackford County Coalition - Tobacco Free Delaware County Coalition - Tobacco Free Jay County Coalition - United Way - Whitely Neighborhood Association - YMCA Muncie- Mitchell Early Childhood and Family Center - Youth Opportunity Center Additionally, through the IU Health Statewide System's team member community benefit service program, "IU Health Serves", team members across the state make a difference in the lives of thousands of Hoosiers every year.
Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care	IU Health Ball Memorial Hospital uses several factors other than Federal Poverty Guidelines ("FPGs") in determining eligibility for free care under its FAP. These factors include the following: 1. Eligibility for Financial Assistance due to Financial or Personal Hardship In order to be eligible for Financial Assistance due to Financial or Personal Hardship under this Policy, a patient or guarantor must: - Submit a completed Financial Assistance Application with all supporting documentation and be approved in accordance with this Policy; - Be an Indiana Resident as defined in this Policy; and - If Uninsured, consult with a member of IU Health's Individual Solutions department to determine if health care coverage may be obtained from a government insurance or assistance product, the Health Insurance Marketplace, or from any other source of coverage. Financial Assistance due to Financial Hardship is only available for encounters where care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility. 2. Financial Assistance due to Financial Hardship The FPL income threshold under this section is as follows: - If one or more adults and zero dependents are in the household, the FPL Income Threshold is 200%. - If two or more adults and one or more dependents are in the household, the FPL Income Threshold is 250%. - If one adult and one or more dependents are in the household, the FPL Income Threshold is 300%. In some instances, an adult will also qualify as a dependent. When this occurs, IU Health will treat the adult as a dependent for purposes of the FPL calculation. IU Health will utilize the most recent FPL data available and will apply the FPL data to a patient or guarantor's account balance based upon the calendar date a completed Financial Assistance Application was received, not a patient's date of service. An Uninsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Gross Charges if approved. An Underinsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Patient Responsibility if approved. 3. Financial Assistance due to Personal Hardship An Uninsured or Underinsured patient or their guarantor whose household income is above the FPL income threshold may be eligible for Financial Assistance if the patient's outstanding Patient Responsibility exceeds 20% of the patient's or their guarantor's annual household income. - If approved, the patient's balance will be reduced to 20% of the patient or guarantor's annual household income or the Amounts Generally Billed, whichever is less. - IU Health will work with the patient or guarantor to identify a reasonable payment plan on the remainder of the balance. 4. Eligibility Period If approved for financial assistance by IU Health, the patient will be guaranteed financial assistance for treatment related to the underlying condition, for which the patient was originally screened and approved, through the remainder of the calendar year. As a condition of extending the on-going Financial Assistance, the patient must comply with requests from IU Health to verify that the patient continues to meet the conditions for qualification. 5. Appeals and Assistance Granted By the Financial Assistance Committee The Financial Assistance Committee will review and make determinations on all requests for appeals related to Financial Assistance. If a patient or guarantor seeks to appeal a Financial Assistance Determination, a written request must be submitted, along with the supporting documentation. The Financial Assistance Committee will review requests for and may grant additional Financial Assistance, including but not limited to, the following: - Assistance to patients who are seeking treatment that can only be provided in Indiana by IU Health or who would benefit from continued medical services from IU Health for continuity of care; - Care approved by the IU Health Chief Medical Officer (CMO) or the Chief Executive Officer (CEO) or CMO of an IU Health facility or region, including medically necessary non-elective services for which no payment source can be identified; - Care provided when it is known no payment source exists; - International humanitarian aid; and - Other care identified by the Financial Assistance Committee that fulfills the IU Health Mission. All decisions of the Financial Assistance Committee are final. 6. Presumptive Eligibility No Financial Assistance Application is required to receive Financial Assistance under this Presumptive Eligibility section. IU Health will deem patients or their guarantors presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs and care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility: - Medicaid (any state) - Indiana Children's Special Health Care Services - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. IU Health will conduct a quarterly review of all accounts placed with a collection agency partner for at least one hundred and twenty (120) days after the account is eligible for an ECA as set forth in this Policy. If the patient or guarantor's individual scoring criteria demonstrates the patient has a low likelihood and/or propensity to pay or no credit, the patient or guarantor may be deemed presumptively eligible for Financial Assistance. Financial Assistance may additionally be granted in the following circumstances: - If the patient or their guarantor is found to have filed a petition for bankruptcy. - If the patient is deceased and found to have no estate. - If the patient is deceased and was under 21 years of age at the time of death. 7. Exhaustion of Alternate Sources of Assistance Patients must exhaust all other state and federal assistance programs prior to receiving Financial Assistance due to Financial or Personal Hardship under this Policy including, but not limited to, Medicaid. Patients who may be eligible for coverage under an applicable health insurance policy must exhaust all insurance benefits. - This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. - IU Health may request patients show proof that such a claim was properly submitted to the appropriate insurance provider before awarding Financial Assistance. Eligible patients who receive medical care from an IU Health facility as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award. In the event Financial Assistance has already been granted in the above circumstances, IU Health reserves the right to reverse the Financial Assistance Determination in an amount equal to the amount IU Health would be entitled to receive had no Financial Assistance been awarded. 8. Patient Assets There are situations where a patient or their guarantor may have significant income or assets available to pay for healthcare services such as a legal settlement. The Financial Assistance Committee may evaluate the income or assets in determining Financial Hardship. IU Health may require a list of all property owned by the patient or guarantor and adjust a Financial Assistance Determination as a result.
Schedule H, Part I, Line 7g Subsidized Health Services	IU Health Ball Memorial Hospital does not include any costs associated with physician clinics as subsidized health services.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	28222286
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	THE AMOUNT REPORTED ON LINE 2 AS BAD DEBT IS REPORTED AT COST, AS CALCULATED USING THE COST TO CHARGE RATIO METHODOLOGY.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	IU Health will deem patients or their guarantors presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs and care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility: 1. Medicaid (any state) 2. Indiana Children's Special Health Care Services 3. Healthy Indiana Plan 4. Patients who are awarded Hospital Presumptive Eligibility (HPE) 5. A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. No Financial Assistance Application is required to receive Financial Assistance under this Presumptive Eligibility section. IU Health will conduct a quarterly review of all accounts placed with a collection agency partner for at least one hundred and twenty (120) days after the account is eligible for an ECA as set forth in this Policy. If the patient or guarantor's individual scoring criteria demonstrates the patient has a low likelihood and/or propensity to pay or no credit, the patient or guarantor may be deemed presumptively eligible for Financial Assistance. Financial Assistance may additionally be granted in the following circumstances: a) If the patient or their guarantor is found to have filed a petition for bankruptcy. b) If the patient is deceased and found to have no estate. c) If the patient is deceased and was under 21 years of age at the time of death. Due to this comprehensive methodology, IU Health does not believe any amount of bad debt is attributable to patients who may be eligible under the financial assistance policy and no portion of bad debt is included as community benefit.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	IU HEALTH'S CONSOLIDATED FINANCIAL STATEMENTS, FOOTNOTE 5, ADDRESSES BAD DEBT EXPENSE AS FOLLOWS: The Indiana University Health System does not require collateral or other security from its patients, substantially all of whom are residents of the State, for the delivery of health care services. However, consistent with industry practice, the Indiana University Health System routinely obtains assignment of (or is otherwise entitled to receive) patients' benefits payable under their health insurance programs, plans, or policies (e.g., Medicare, Medicaid, managed care payers, and commercial insurance policies). The Indiana University Health System uses a portfolio approach to account for categories of patient contracts as a collective group, rather than recognizing revenue on an individual contract basis. The portfolios consist of major payer classes for inpatient revenue and outpatient revenue. Based on the historical collection trends and other analysis, the Indiana University Health System believes that revenue recognized by utilizing the portfolio approach approximates the revenue that would have been recognized if an individual contract approach were used. In support of its mission, the Indiana University Health System provides care to uninsured and underinsured patients. The Indiana University Health System provides charity care to patients who lack financial resources and are deemed to be medically indigent. Financial assistance is available to qualifying uninsured and underinsured patients receiving care at an Indiana University Health System hospital location. Under its financial assistance policy, the Indiana University Health System provides medically necessary care to uninsured patients. Financial assistance up to the full amount of patient financial responsibility is available for uninsured and underinsured patients receiving care via the emergency department, direct admission from a physician's office, or transfer from another hospital. The federal poverty level (FPL) thresholds for this type of financial assistance are based on household makeup. Households without dependents are eligible for assistance if household income is less than or equal to 200% FPL, two adults and at least one dependent are eligible if household income is less than or equal to 250% FPL, and households with one adult and at least one dependent are eligible if household income is less than or equal to 300% FPL. Individuals with medical bills totaling more than 20% of annual household income, regardless of FPL, qualify for catastrophic assistance and are eligible for a reduction in patient financial responsibility to 20% of annual household income. Since the Indiana University Health System does not pursue collection of these amounts, the discounted amounts are not reported as patient service revenue. The Indiana University Health System uses presumptive eligibility screening procedures for some forms of financial assistance and recognizes net patient service revenue on services provided to self-pay patients at the discounted rate at the time services are rendered. The estimated cost of charity care, using the consolidated cost to charge ratio, was $90,358,000 and $96,693,000 in 2020 and 2019, respectively.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	IU Health Ball Memorial Hospital has a Medicare shortfall for 2020. IU Health Ball Memorial Hospital's Medicare reimbursements, however, are less than the cost of providing patient care and services to Medicare beneficiaries and do not include any amounts that result from inefficiencies or poor management in 2020. IU Health Ball Memorial Hospital accepts all Medicare patients knowing that there may be shortfalls; therefore, it has taken the position that any shortfall should be counted as part of its community benefit. Additionally, it is implied in Internal Revenue Service Revenue Ruling 69-545 that treating Medicare patients is a community benefit. Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with governmental health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. The amount reported on Schedule H, Part III, Line 6 is calculated, in accordance with the Form 990 instructions, using "allowable costs" from the IU Health Ball Memorial Hospital Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health Ball Memorial Hospital's participation in Medicare programs. For example, the Medicare Cost Report excludes certain costs such as billed physician services, the costs of Medicare Parts C and D, fee schedule reimbursed services, and durable medical equipment services. Inclusion of all costs associated with IU Health Ball Memorial Hospital participation in Medicare programs would significantly increase the shortfall reported on Schedule H, Part III, Line 7.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	IU Health Ball Memorial Hospital's FAP and Written Debt Collection Policy describe the collection practices applicable to patients, including those who may qualify for financial assistance. 1. Financial Assistance Application Financial Assistance Applications must include the following documentation: - All sources of Income for the last three (3) months. - Most recent three (3) months of pay stubs or Supplemental Security Income via Social Security. - Most recent three (3) statements from checking and savings accounts, certificates of deposit, stocks, bonds and money market accounts. - Most recent state and Federal Income Tax forms including Schedules C, D, E, and F. In the event the patient or guarantor's income does not warrant the filing of a federal tax statement, the individual may submit a notarized affidavit attesting to the foregoing. - Most recent W-2 statement. - For patients or members of the Household who are currently unemployed, Wage Inquiry from WorkOne. - If applicable, divorce/dissolution decrees and child custody order. Patients or their guarantors wishing to apply for Financial Assistance due to Financial Hardship are encouraged to submit an Application within ninety (90) days of discharge. Patients or their guarantors may submit an Application up to two-hundred and forty (240) days from the date of their initial post-discharge billing statement from IU Health, however, accounts may be subject to Extraordinary Collection Actions (ECA) as soon as one-hundred and twenty (120) days after receipt of the initial post-discharge billing statement. Patients or their guarantors submitting an incomplete Financial Assistance Application will receive written notification of the Application's deficiency upon discovery by IU Health. The Application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health will suspend any ECA until the Application is complete or the expiration of the forty-five (45) day period. Patients with limited English proficiency may request a copy of this Policy, a Financial Assistance Application, and a Plain Language Summary in one of the below languages: - Arabic; - Burmese; - Burmese - Falam; - Burmese - Hakha Chin; - Mandarin/Chinese; or - Spanish The patient, and/or their representative, such as the patient's physician, family members, legal counsel, community or religious groups, social services or hospital personnel may request a Financial Assistance Application be mailed to a patient's primary mailing address free of charge. IU Health maintains the confidentiality of all Financial Assistance Applications and supporting documentation. IU Health will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance Application. 2. Financial Assistance Determinations IU Health will inform patients or guarantors of the results of their Application by providing the patient or guarantor with a Financial Assistance Determination within ninety (90) days of receiving a completed Application and all requested documentation. A patient's Financial Assistance Application and Financial Assistance Determination are specific to each date(s) of service and approved related encounters. If a patient or guarantor is granted less than full charity assistance and the patient or guarantor provides additional information for reconsideration, Revenue Cycle Services may amend a prior Financial Assistance Determination. 3. Extraordinary Collection Actions IU Health may refer delinquent patient accounts to a third-party collection agency after utilizing reasonable efforts to determine a patient's eligibility for assistance under this Policy. Reasonable efforts include the following: - IU Health will notify the patient of this Policy at least thirty (30) days prior to initiating an ECA. - IU Health will not initiate an ECA for at least one-hundred and twenty (120) days after the patient's initial post-discharge billing statement. - IU Health will review all Financial Assistance Applications received up to and including two-hundred and forty (240) days after the patient's initial post-discharge billing statement. IU Health will cease any ECAs it has initiated upon receipt of a Financial Assistance Application until a Financial Assistance Determination is made under this policy. - If an Application is Approved, IU Health will issue a revised statement, issue refunds, and make reasonable efforts to reverse ECAs as necessary. IU Health and its third-party collection agencies may initiate an ECA against a patient or their guarantor in accordance with this Policy and 26 C.F.R. § 1.501(r). ECAs may include the following: - Selling a patient or their guarantor's outstanding financial responsibility to a third party. - Reporting adverse information about the patient or their guarantor to consumer credit reporting agencies or credit bureaus. - Deferring or denying, or requiring a payment before providing, medically necessary care because of a patient or their guarantor's nonpayment of one or more bills for previously provided care covered under this Policy. - Actions requiring a legal or judicial process, including but not limited to placing a lien on a patient's or their guarantor's property, foreclosing on a patient's or their guarantor's real property, attaching or seizing a patient's or their guarantor's bank account or other personal property, commencing a civil action against a patient or their guarantor, causing a patient or guarantor's arrest, causing a patient and/or guarantor to be subject to a writ of body attachment, and garnishing a patient or guarantor's wages When it is necessary to engage in such action, IU Health and its third party collection agencies, will engage in fair, respectful and transparent collections activities. 4. Refunds Patients eligible for Financial Assistance under this Policy who remitted payment to IU Health in excess of their Patient Responsibility will be alerted to the overpayment as promptly after discovery as is reasonable given the nature of the overpayment. Patients with an outstanding account balance due on a separate account will have their refund applied to the outstanding balance. Patients without an outstanding account balance described above will be issued a refund check for their overpayment as soon as technically feasible.
Schedule H, Part V, Section B, Line 16a FAP website	- IU HEALTH BALL MEMORIAL HOSPITAL: Line 16a URL: https://iuhealth.org/pay-a-bill/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	- IU HEALTH BALL MEMORIAL HOSPITAL: Line 16b URL: https://iuhealth.org/pay-a-bill/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- IU HEALTH BALL MEMORIAL HOSPITAL: Line 16c URL: https://iuhealth.org/pay-a-bill/financial-assistance;
Schedule H, Part VI, Line 2 Needs assessment	Communities are multifaceted and so are their health needs. IU Health Ball Memorial Hospital understands that the health of individuals and communities are shaped by various social and environmental factors, along with health behaviors and additional influences. IU Health Ball Memorial Hospital assesses the health care needs of the communities it serves by conducting a community health needs assessment, (CHNA). For the 2018 CHNA, IU Health Ball Memorial Hospital conducted the community survey data collection in collaboration with Indiana University, University of Evansville and an Indiana Hospital Collaborative, including Community Health Network, Franciscan Alliance, St. Vincent Health and other hospital partners. After completion of the CHNA, IU Health Ball Memorial Hospital reviewed secondary data, findings from other community health assessments of areas served by the hospital, input obtained from individuals who participated in community meetings, input obtained from key stakeholders, and a community survey to identify and analyze the needs identified by each source. The top health needs of the IU Health Ball Memorial Hospital community are those that are supported by multiple data sources. Additionally, the effectiveness of an intervention for each need and IU Health's ability to impact positive change was evaluated. IU Health believes its CHNA process is comprehensive and additional assessments are not required.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	IU Health Ball Memorial Hospital is committed to serving the healthcare needs of all of its patients regardless of their ability to pay for such services. To assist in meeting those needs, IU Health Ball Memorial Hospital has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health Ball Memorial Hospital is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health Ball Memorial Hospital will make a good faith effort to locate and obtain health insurance coverage for patients prior to considering patients for coverage under the FAP. IU Health Ball Memorial Hospital takes several measures to inform its patients of the FAP and FAP-eligibility. These measures include the following: 1. Post this Policy, a Plain Language Summary of this Policy, and the Financial Assistance Application on its website. 2. Provide patients with a Plain Language Summary of this Policy during registration and/or discharge. 3. Post conspicuous displays in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 4. Include a conspicuous written notice on all patient post-discharge billing statements notifying the patient about this Policy and the telephone number of the Customer Service Department which can assist patients with questions regarding this Policy. 5. Make available Customer Service representatives via telephone during normal business hours. 6. Mail copies of this Policy, a Plain Language Summary of this Policy, and a Financial Assistance Application to patients or their guarantor free of charge upon request. 7. Broadly communicate this Policy as a part of its general outreach efforts. 8. Educate patient-facing team members on this Policy and the process for referring patients to the program.
Schedule H, Part VI, Line 4 Community information	IU Health Ball Memorial Hospital is located in Delaware County, Indiana, a county located in central Indiana. Delaware County includes ZIP codes within the towns of Muncie, Eaton, Gaston, Selma, Albany, Daleville and Yorktown. Based on the most recent Census Bureau (2020) statistics, Delaware County's population is 111,903 persons with approximately 51.8% being female and 48.2% male. The county's population estimates by race are 86.6% White, 2.6% Hispanic or Latino, 7.2% Black, 1.3% Asian, 0.3% American Indian or Alaska Native, and 2.4% persons reporting two or more races. Delaware County has relatively low levels of educational attainment. The level of education most of the population has achieved is a high school degree (89.7%). As of 2020, 23.7% of the population had a bachelor's degree or higher.
Schedule H, Part VI, Line 5 Promotion of community health	IU Health Ball Memorial Hospital is a subsidiary of Indiana University Health, Inc., a tax-exempt healthcare organization, whose Board of Directors is composed of members, of which substantially all are independent community members. IU Health Ball Memorial Hospital serves as the backbone organization providing resources to operate a three-county health coalition focused on obesity prevention and tobacco cessation as a means to reduce the impact of chronic disease including cancer and heart disease. More than 150 organizations are partners in the "Healthy Community Alliance of East Central Indiana" coalition and each pledges to influence audiences to make positive choices regarding improved nutrition, increased physical activity or tobacco cessation. Coalition partners report a collective total audience size of more than 50,000 people. The HCA makes multiple resources available to collaborators, including facilitated workgroup sessions in each county, materials such as Tobacco Cessation Toolkits and Healthy Lifestyle toolkits; and online resources such as an e-newsletter, media messaging and access to community health data for each of the three counties. These resources are provided to all collaborating organizations free of charge. In 2020 the HCA began offering webinar programming as a way to engage Partners in accessing resources and programming in all three counties. In 2019, the hospital convened a group of community partners to address social determinants of health in the Thomas Park/Avondale neighborhood, an impoverished area with high obesity rates, food access issues and blighted housing. A comprehensive 3-year plan of engagement with the 8twelve Coalition was developed in the form of a grant application for the IU Health Community Impact Fund. $1M was awarded to make improvements in the Thomas-Avondale Neighborhood related to food access, physical activity and blighted housing improvements in the area. In 2020 significant progress was made: old factory parking lot surfaces were removed to make way for new soccer fields at the Ross Community Center; a sidewalk inventory was completed; pedestrian traffic counters were put in operation; and planning for new pantry spaces and an enclosed community garden space was started. Additionally, placemaking development support has brought a new coffee shop and community gathering spaces into a formerly blighted area, setting the stage for additional development in 2021. The hospital participates in the facilitation of a regional food council which brings collaborative partners together around improvements in food policy, food waste and food access, while providing a forum for small food distribution operations. In response to Covid-19, the group held a special philanthropy session in 2020 where funders talked directly with food support organizations directly about their needs. The result was that groups received funding for initiatives such as additional equipment; and the Muncie Food Hub partnered with IU Health to offer free produce for 15 weeks delivered to 10 different locations in Delaware, Blackford and Jay Counties. Sites included food pantries, childcare centers, community centers and healthcare organizations where vulnerable populations were able to be reached. IU Health has installed drug take-back kiosks at four east central Indiana pharmacy locations: the kiosks are open to the public and available during business hours. In 2020, 897 pounds of prescription medications were recovered. As an additional obesity prevention initiative, IU Health Ball Memorial Hospital partners with Muncie's Minnetrista farmers market and nearly ten other community partners to offer "families at the farmers market." This program consists of workshops that offer a wellness-based presentation on utilizing tasty natural herbs, ideal healthy recipes for children, or a diabetes component. Grocery shopping tips are often a part of the educational lectures, including a better understanding of nutritional labels and food storage. Participating families also receive free "IU Health Bucks" to shop for produce in the farmers market. In 2020, the program's in-person sessions were eliminated due to Covid-19 precautions, but participating families were still able to receive educational materials and IU Health Bucks. The hospital also partnered with the YMCA to offer the "Catch" (coordinated approach to child health) curriculum within an after-school program for elementary students, who received an additional 15-30 minutes of physical activity each day and learned about nutritional facts. Additionally, to assist with the community accessing healthcare, IU Health Ball Memorial Hospital offers comprehensive cervical cancer screenings free of charge. In 2020, screeners performed 12 cervical exams. Because the average adult smoking rate in Delaware County is more than 20% and peaks at 36% in some areas of the community served, the hospital also offers a low cost lung cancer screening for heavy smokers intended to identify cancer at an early stage. 309 persons were screened in 2020. In 2020, IU Health East Central Region Hospitals partnered with Open Door Health Services to offer mobile flu shot clinics in October and November. Limited resource and minority audiences were prioritized by offering free vaccinations at churches, schools, community centers and food distribution events in Delaware, Blackford and Jay Counties.
Schedule H, Part VI, Line 6 Affiliated health care system	IU Health Ball Memorial Hospital is part of the IU Health Statewide System. The IU Health Statewide system is Indiana's most comprehensive healthcare system. A unique partnership with the Indiana University School of Medicine ("IU School of Medicine"), one of the nation's leading medical schools, gives patients access to innovative treatments and therapies. IU Health is comprised of hospitals, physicians and allied services dedicated to providing preeminent care throughout Indiana and beyond. National Recognition - Eight hospitals designated as Magnet by the American Nurses Credentialing Center recognizing excellence in nursing care. - U.S. News & World Report - Annual Rankings - IU Health Medical Center is nationally ranked for the 23rd year in a row. IU Health Medical Center is nationally ranked in 3 adult specialties and 10 pediatric specialties and rated high performing in 5 adult specialties and 6 procedures and conditions. - IU Health has five hospitals that are considered high performing in certain procedures and conditions: IU Health Ball, IU Health Arnett, IU Health North, IU Health West, and IU Health Bloomington hospitals. - Riley Hospital for Children at IU Health is nationally ranked in 10 pediatric specialties. IU Health Statewide System Hospitals in the system include the following: - IU Health Inc. (i.e., the IU Health Academic Health Center consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health, and IU Health Saxony Hospital) - IU Health Arnett - IU Health Ball - IU Health Bedford Hospital - IU Health Blackford - IU Health Bloomington Hospital - IU Health Frankfort - IU Health Jay - IU Health North Hospital - IU Health Paoli Hospital - IU Health Tipton Hospital - IU Health West Hospital - IU Health White Memorial Hospital The system is divided into five regions that serve communities in Northwest, Northeast, Central, and Southern Indiana. IU Health Inc. has significant statewide reach as a: 1) teaching hospital, 2) research activities with the IU School of Medicine and other national collaborations, 3) Riley's network of locations throughout the state due to its pediatric expertise, and 4) Riley's trauma department is the only Level I Pediatric Trauma Center in Indiana. Although each hospital in the system conducts and adopts its own CHNA and implementation strategy, the system considers the sum of these plans part of a system wide goal of making Indiana one of the healthiest states in the nation. The hospitals are guided by a system wide mission to improve the health of our patients and community through innovation, and excellence in care, education, research, and service. The system is keenly aware of the positive impact it can have on improving the health of communities throughout the state of Indiana by aligning resources in a system-level and strategic way. Education and Research The system includes the Academic Health Center that works in partnership with the IU School of Medicine to train physicians, blending breakthrough research and treatments with the highest quality of patient care. Each year, more than 1,000 residents and fellows receive training in IU Health hospitals. Research conducted by IU School of Medicine faculty gives IU Health physicians and patients access to the most leading-edge and comprehensive treatment options. In 2017, IU Health and the IU School of Medicine announced that they would invest $50 million over six years in the Strategic Research Initiative (SRI), a new research collaboration that has enhanced the institutions' joint capabilities in fundamental scientific investigation, translational research and clinical trials. The initial focus is on projects in the fields of neuroscience, cancer and cardiovascular disease with the goal to fund transformative proposals that will fundamentally change the understanding of these diseases and lead to important new therapies for patients. The three target research areas represent research strengths at IU School of Medicine, key strategic service lines for IU Health, and important medical needs in a time of an aging population and rising healthcare costs. One of the most significant outcomes of this initiative includes the Indiana University Melvin and Bren Simon Cancer Center receiving the National Cancer Institute's (NCI)-designated status of "comprehensive." This designation was achieved in August 2019 making the center the only NCI-designated Comprehensive Cancer Center in Indiana and one of just 51 in the nation. Community Health To further promote the health of the communities served by the system, the system-level Community Health team builds the capabilities and competencies to impact team members, risk lives, and patients throughout the system. Additionally, the team partners with state and local community-based organizations, community coalitions, and governmental agencies to pursue a system-level advocacy/collaboration strategy that seeks to improve the health of communities. All hospitals in the system identify and address significant health needs unique to the community it serves. However, because some of these health needs are common in communities served by multiple hospitals in the system, they warrant a system level strategy. Community Health plans and provides technical assistance for system-level strategies that address these common health needs including health equity, tobacco treatment, behavioral health access, and social needs. Each hospital works collaboratively with the Community Health team to operationalize system-level strategies through the implementation of specific activities that align and activate local resources. This benefits the community each hospital serves and works towards a statewide impact (system-level) on health outcomes. IU Health Serves IU Health Serves, a system-level team member volunteer program, seeks to positively impact the health of communities the IU Health Statewide System serves and fosters a culture of engagement and social responsibility. IU Health Inc. coordinates the different initiatives of the program, including Days of Service. This is the largest volunteer event of the year, consisting of projects designed to engage IU Health Inc. team members in activities that address local, identified community health priorities. Community Impact Investment (CII) Fund The CII Fund is a $100 million board designated fund to be managed and overseen by the IU Health Foundation to financially support high impact community investing designed to address social determinants of health in communities IU Health serves. Each IU Health hospital has a significant impact on and are deeply invested in their local communities. Through the grants provided by this CII Fund, IU Health can strategically and intentionally address the social, economic and environmental factors that impact the health of our surrounding communities. Each IU Health hospital and its team members are eligible for this grant opportunity.
Schedule H, Part VI, Line 7 State filing of community benefit report	IN

Schedule H (Form 990) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
Indiana University Health Ball Memorial Hospital Inc

Employer identification number
35-0867958

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) Youth Opportunity Center 3700 W Kilgore Ave Muncie,IN47304	35-1805697	501(c)(3)	300,000	General Support
(2) Delaware Advancement Corporation PO Box 842 Muncie,IN47308	31-1111841	501(c)(3)	37,500	General Support
(3) East Central Indiana Regional Partnership PO Box 1912 Muncie,IN47308	20-4381437	501(c)(3)	10,125	General Support
(4) Ivy Tech Foundation 50 W Fall Creek Parkway North Dr Indianapolis,IN46208	23-7073977	501(c)(3)	250,000	General Support
(5) Little Red Door Cancer Agency 1801 N Meridian Street Indianapolis,IN46202	35-0914096	501(c)(3)	10,000	General Support
(6) Ross Community Center Inc 1110 W 10th St PO Box 3201 Muncie,IN47307	45-2050287	501(c)(3)	546,000	General Support
(7) Greater Muncie IN Habitat for Humanity 1923 S Hoyt Ave Muncie,IN47302	35-1706782	501(c)(3)	50,000	General Support
(8) Ball State University 2000 W University Ave Muncie,IN47306	35-6000221	Government	28,000	General Support
(9) YMCA of Muncie 500 S Mulberry St Muncie,IN47305	35-0868215	501(c)(3)	75,000	General Support
(10) Muncie OUTreach Muncie Pride 310 E Charles St Muncie,IN47305	46-3729237	501(c)(3)	5,000	General Support

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2020

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	Although IU Ball Memorial Hospital does not monitor the use of the grant funds once distributed, through due diligence the organization has reasonably confirmed that the entities to which the contributions are made are highly reputable in the community and use the funds for the purpose intended.

Schedule I (Form 990) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow

Attach to Form 990.
Graphic Arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

Indiana University Health Ball Memorial Hospital Inc

Employer identification number

35-0867958

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on 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 .....

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 on Line 1a? ....

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on 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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2020

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 on 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 in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JEFFREY C BIRD MD DIRECTOR/REGIONAL PRESIDENT (ECR)	(i) (ii)	0 ------------- 511,071	0 ------------- 223,027	0 ------------- 13,018	0 ------------- 106,852	0 ------------- 23,518	0 ------------- 877,486	0 ------------- 0
2PETER M VOSS MD DIRECTOR/VICE CHAIR/CMO (ECR)	(i) (ii)	315,972 ------------- 0	46,038 ------------- 0	51,500 ------------- 0	18,400 ------------- 0	22,361 ------------- 0	454,270 ------------- 0	0 ------------- 0
3DAVID W HYATT DIRECTOR	(i) (ii)	227,666 ------------- 0	31,563 ------------- 0	29,451 ------------- 0	16,895 ------------- 0	31,643 ------------- 0	337,218 ------------- 0	0 ------------- 0
4CHARLES R ROUTH MD DIRECTOR	(i) (ii)	0 ------------- 216,138	0 ------------- 54,949	0 ------------- 19,500	0 ------------- 18,654	0 ------------- 21,071	0 ------------- 330,311	0 ------------- 0
5JOAN V CASTOR DIRECTOR	(i) (ii)	0 ------------- 307,781	0 ------------- 149,350	0 ------------- 3,389	0 ------------- 72,403	0 ------------- 31,628	0 ------------- 564,551	0 ------------- 0
6JUDITH L COLEMAN FORMER OFFICER	(i) (ii)	0 ------------- 267,902	0 ------------- 52,568	0 ------------- 46,380	0 ------------- 18,400	0 ------------- 21,239	0 ------------- 406,489	0 ------------- 0
7JONATHAN W VANATOR CFO (ECR)	(i) (ii)	0 ------------- 298,417	0 ------------- 35,959	0 ------------- 37,682	0 ------------- 18,234	0 ------------- 25,397	0 ------------- 415,688	0 ------------- 0
8CARLA C COX RN VP & CNO (ECR)	(i) (ii)	222,265 ------------- 0	30,380 ------------- 0	30,236 ------------- 0	16,820 ------------- 0	23,821 ------------- 0	323,521 ------------- 0	0 ------------- 0
9LORI A LUTHER COO (ECR)	(i) (ii)	313,590 ------------- 0	44,822 ------------- 0	50,144 ------------- 0	18,400 ------------- 0	26,142 ------------- 0	453,098 ------------- 0	0 ------------- 0
10ANN M MCGUIRE VP-HUMAN RESOURCES REGIONAL (ECR)-PART YEAR	(i) (ii)	0 ------------- 170,715	0 ------------- 23,351	0 ------------- 36,539	0 ------------- 219,125	0 ------------- 11,617	0 ------------- 461,347	0 ------------- 0
11DAVID A SCHWARTZ FORMER HIGHEST COMPENSATED EMPLOYEE	(i) (ii)	0 ------------- 199,492	0 ------------- 10,040	0 ------------- 265	0 ------------- 13,308	0 ------------- 0	0 ------------- 223,105	0 ------------- 0
12MAX E BARNHART ADMIN DIR-RETAIL PHARMACY OPS	(i) (ii)	169,058 ------------- 0	22,211 ------------- 0	6,552 ------------- 0	13,534 ------------- 0	33,161 ------------- 0	244,516 ------------- 0	0 ------------- 0
13TERRY A PENCE VP, OPERATIONS	(i) (ii)	208,730 ------------- 0	29,502 ------------- 0	28,193 ------------- 0	15,816 ------------- 0	26,814 ------------- 0	309,055 ------------- 0	0 ------------- 0
14JOSEPH BUTTS RADIATION PHYSICIST	(i) (ii)	208,637 ------------- 0	600 ------------- 0	1,014 ------------- 0	13,622 ------------- 0	2,483 ------------- 0	226,355 ------------- 0	0 ------------- 0
15ALVIS FOSTER SENIOR RADIATION PHYSICIST	(i) (ii)	219,872 ------------- 0	600 ------------- 0	2,608 ------------- 0	15,207 ------------- 0	32,429 ------------- 0	270,716 ------------- 0	0 ------------- 0
16RYAN M JOHNSTON MD ASSOCIATE - CMO	(i) (ii)	273,195 ------------- 0	25,372 ------------- 0	480 ------------- 0	18,259 ------------- 0	31,625 ------------- 0	348,931 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2020

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, Part I, Line 3 Arrangement used to establish the top management official's compensation	IU Health Ball Memorial Hospital's Regional President is employed by IU Health. IU Health, IU Health Ball and other related organizations have a process in place to determine the compensation for its officers and key employees. IU Health Human Resources uses market data from multiple compensation experts/vendors who utilize a variety of methods and procedures to obtain compensation ranges for comparable officers and employee positions. This market data and multiple other factors (including market pay benchmarks, internal equity, candidate/employee qualifications & performance, and business needs) are used to recommend compensation ranges for its officers and other employees, which are then used as a guide for setting reasonable compensation by management. Please see Schedule O for additional details.
Schedule J, Part I, Line 4a Severance or change-of-control payment	Ann M. McGuire entered into a severance agreement with IU Health during 2020. No severance was received during 2020. Deferred severance of $205,618 is included in column C, retirement and other deferred compensation.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	Jeffrey C. Bird M.D. and Joan V. Castor participate in a supplemental executive retirement plan, provisions of which are designed to retain these critical employees. The plan provides for an additional retirement benefit for service through normal retirement or other key dates. If the executive leaves prior to retirement or other key dates, the benefit may be forfeited or reduced. Jeffrey C. Bird M.D. and Joan V. Castor have an amount included in column c, deferred compensation, representing the current year unvested contributions made under the supplemental retirement plan. No amount was actually paid to these executives during the year.
Schedule J, Part I, Line 7 Non-fixed payments	Amounts disclosed in column B(ii) include a long-term and short-term incentive for certain executives and short-term incentive for other employees. Although these plans are based on a fixed formula that has been approved by the board of directors based upon certain qualitative and quantitative factors and goals. All discretionary incentive plans must be approved by the board of directors prior to any incentive payout.

Schedule J (Form 990) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- TIN:

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

Indiana University Health Ball Memorial Hospital Inc

Employer identification number

35-0867958

Return Reference	Explanation
Form 990, Part III, Line 4d Description of other program services	(Expenses $ 2,513,214 including grants of $ 0)(Revenue $ 3,277,746) RENT FROM RELATED 501(C)(3) ORGANIZATIONS
Form 990, Part III, Line 4d Description of other program services	(Expenses $ 189,019 including grants of $ 0)(Revenue $ 246,520) CLINICAL RESEARCH
Form 990, Part III, Line 4d Description of other program services	(Expenses $ 0 including grants of $ 0)(Revenue $ 16,022,882) As of December 31, 2020, Indiana University Health Ball Memorial Hospital, Inc. had received stimulus funds from the Provider Relief Fund under the provisions of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) and Paycheck Protection Program and Health Care Enhancement Act. Indiana University Health Ball Memorial Hospital recognized $16,022,882 as other program service revenue. Indiana University Health Ball Memorial Hospital, Inc. will continue to monitor compliance with the terms and conditions of the Provider Relief Fund.
Form 990, Part VI, Line 13 PART VI, LINES 12, 13, 14, AND 16B - POLICIES	IU HEALTH BALL MEMORIAL HOSPITAL IS PART OF THE IU HEALTH SYSTEM. AS THE SOLE MEMBER AND CONTROLLING PARENT OF IU HEALTH BALL MEMORIAL HOSPITAL, IU HEALTH AND ITS BOARD OF DIRECTORS HAVE MANDATED THAT CERTAIN POLICIES BE FOLLOWED TO ENSURE GREATER STANDARDIZATION THROUGHOUT THE SYSTEM. THUS, IU HEALTH BALL MEMORIAL HOSPITAL'S BOARD OF DIRECTORS WAS NOT REQUIRED TO SEPARATELY ADOPT A CONFLICT OF INTEREST, WHISTLEBLOWER, DOCUMENT RETENTION AND DESTRUCTION AND JOINT VENTURE POLICIES BECAUSE IU HEALTH'S BOARD OF DIRECTORS HAD ALREADY ADOPTED AND REQUIRED THESE POLICIES TO BE FOLLOWED BY ITS SUBSIDIARIES.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL: DIRECTOR OR OFFICER: JOHN D. AND DAVID A. LITTLER - Family relationship
Form 990, Part VI, Line 6 Classes of members or stockholders	IU HEALTH BALL MEMORIAL HOSPITAL HAS ONE CLASS OF MEMBERSHIP AND THE SOLE MEMBER IS IU HEALTH.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	IU HEALTH ELECTS ONE MORE THAN ONE-HALF OF THE TOTAL NUMBER OF DIRECTORS. IMMEDIATELY FOLLOWING SUCH ELECTION THE REMAINDER ARE ELECTED BY THE DIRECTORS, EXCLUDING THOSE WHOSE TERMS ARE SET TO EXPIRE.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	Notwithstanding any other provisions of the Articles of Incorporation, the following matters require the written approval of IU Health prior to implementation: - Authorization for the establishment or acquisition of any subsidiaries, affiliates or joint venture arrangements or acquisition of all or substantially all of the assets of any other business or entity; - Approval or amendment to any operating or capital budget; - Authorization of any unbudgeted operating or capital budget items or deviations, including any issuance or guarantee of any unbudgeted debt, greater than the budgeted amount by $1 million for any individual item or $3 million per fiscal year in the aggregate; - Authorization of any agreement to act as primary obligor, or to serve as a guarantor, surety or co-obligor with respect to the indebtedness of any other party, to borrow amounts from third-party lenders, or to loan money to any person or entity; - Approval of strategic plans and amendments, which will be integrated with IU Health's strategic plan; - Amendment or repeal of the Corporation's or an Affiliates articles of incorporation or bylaws (or other corresponding organizational documents of an Affiliate that is not a corporation); - Authorization of any merger, consolidation, reorganization, sale or transfer of all or substantially all of the Corporation's assets; - Authorization of any voluntary declaration of bankruptcy, plan of dissolution, any liquidating distribution of assets or other action related to its dissolution or liquidation; - Authorization of any pledge of, or grant any security interest or mortgage in, or otherwise encumber, any tangible assets of the Corporation in excess of $2,000,000, other than in the ordinary course of business or pursuant to a budget or strategic plan approved by IU Health; - Approval of any management agreement for the management of all or a substantial part of the Corporation's operations; or - Appointment or removal of any of the Corporation's Directors with or without cause.
Form 990, Part VI, Line 11b Review of form 990 by governing body	THE CFO REVIEWED AND APPROVED THE FORM 990. A COMPLETE COPY OF THE FORM 990 WAS MADE AVAILABLE TO EACH BOARD MEMBER PRIOR TO ITS FILING. EACH MEMBER WAS ALSO INFORMED OF THE AVAILABILITY OF IU HEALTH'S TAX DEPARTMENT TO ANSWER ANY QUESTIONS.
Form 990, Part VI, Line 12c Conflict of interest policy	IU Health Ball Memorial Hospital follows IU Health's Conflict of Interest Policy. IU Health's Conflict of Interest Policy includes the following provisions: All IU Health employees, associates, colleagues and contracted personnel, including employed physicians and paid medical directors ("IU Health Representatives") are covered by and subject to its Conflict of Interest Policy. IU Health regularly and consistently monitors and enforces compliance with the policy through the following procedures: (a) On an annual basis, each IU Health Representative at the level of Manager or above, together with every other person designated by the Corporate Compliance Department ("Department"), must complete, sign and submit a Conflict of Interest Questionnaire ("Questionnaire") to the Department. Governing board members, committee members, corporate officers, medical staff and researchers must comply with the administrative requirements noted in the respective policies and procedures relative to those areas. (b) An IU Health Representative must supplement a Questionnaire in writing, if after completion of the original Questionnaire, a situation arises, or may reasonably be expected to arise, that would change any answer or information on the original Questionnaire if the situation had existed or been anticipated at the time of completion of the original Questionnaire. (c) If a fully and properly completed Questionnaire reveals facts or other information that might reasonably indicate a Conflict of Interest or violation of the policy, the IU Health Representative completing the questionnaire must secure approval by his/her supervisor, evidenced in writing. (d) The Department will review each Questionnaire and determine whether a Conflict of Interest exists and, if so, whether and how it should or may be eliminated, avoided or managed in order to comply with the spirit of the policy and with the best interests of IU Health and its patients. In making the determination, the Corporate Compliance Department may consult with the IU Health Representative's supervisor and other appropriate individuals and groups. (e) The scope of the policy is not limited to those who are required to complete Questionnaires. If an IU Health Representative is involved in a situation or relationship that would constitute a violation of the policy in the absence of disclosure and approval as described above, then the IU Health Representative must disclose the matter to his/her supervisor, secure his/her supervisor's approval in writing, and disclose the matter to the Department. Otherwise, the IU Health Representative is in violation of the policy and subject to corrective action, up to and including termination. (f) The Chief Compliance Officer, in consultation with onsite Compliance personnel, may from time to time appoint standing or ad hoc committees to assist in resolving issues that arise under provisions of the policy.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	IU Health Ball Memorial Hospital's Regional President is employed by IU Health. IU Health's process for determining compensation is as follows: The process includes the following: (1) The Board of Directors ("Board") has established a Talent Management and Executive Compensation Committee ("TMECC"), the purpose of which includes reviewing and making recommendations regarding executive (Senior Vice Presidents and above) pay and benefits (collectively referred to as "compensation") on an annual basis. The TMECC is made up of members of the Board that are neither physicians nor employees and do not otherwise have a conflict of interest regarding any of IU Health's compensation arrangements. The TMECC reviews an executive's entire compensation package including base salary, short-term and long-term incentives, health and welfare benefits, qualified and nonqualified retirement plans, as well as any additional fringe benefits. As deemed appropriate, the Committee on Finance, which is also made up of members of the Board, may also review executive compensation and benefits. (2) The TMECC engages an independent compensation consulting firm on an annual basis to conduct a compensation analysis for its executive group, which consists of employees at the level of senior vice president and above. The current compensation advisor is SullivanCotter. SullivanCotter performs its analysis in the form of a compensation survey ("survey") that includes relevant comparability data for compensation levels paid by similarly situated organizations (both governmental and tax exempt) for functionally comparable positions as well as the availability of similar services in the geographic area. SullivanCotter then prepares a survey report and provides recommendations to the TMECC, if deemed appropriate, on changes in executive compensation. A separate analysis using the same methodology is done for the President and Chief Executive Officer. (3) The TMECC then reviews SullivanCotter's report and recommendations and, if appropriate, votes on whether to recommend any changes in executive compensation to the Board. The TMECC will only recommend changes to the Board if they are consistent with the Board's philosophy on compensation matters and are deemed reasonable based upon the independent analysis provided by SullivanCotter. The TMECC's review, discussion and vote are documented in the minutes for the meeting. There are no executives present during the final discussion and approval. (4) The Board then reviews the report prepared by SullivanCotter as well as the recommendations of the TMECC as to any changes in executive compensation. As deemed appropriate, the Committee on Finance may also provide its review of the TMECC's recommendations on any changes in executive compensation. This review and discussion are documented in the minutes. (5) The Board then votes on whether to accept the TMECC's recommendations on any changes in executive compensation. Changes in executive compensation are made if approved by the TMECC and Board on an annual basis, or as necessary throughout the year. The discussion and approval are documented in the minutes of the meeting. There are no executives present during the final discussion and approval. IU Health's General Counsel also prepares a formal written opinion reviewing the executive compensation approval process, comparing it to the Intermediate Sanctions Test of IRC Section 4958. If warranted, IU Health's General Counsel may also provide comments regarding the executive compensation approval process as it relates to meeting the requirements for a rebuttable presumption of reasonableness as provided in the Intermediate Sanctions Test. (6) After the end of each year, the TMECC and Board also review the achievements of the executive group as it relates to the long-term and short-term shared and individual goals developed by the executives and the Board. These achievements may also be reviewed with the Committee on Finance. The Board, at its discretion, may approve bonus payments based upon the achievement of the goals. The discussion and vote of the TMECC and Board is documented in the minutes for each such meeting. The bonuses are not paid until approval is made by the Board. (7) The TMECC and Audit Committee also review Form 990 disclosures related to executive compensation as well as the organization's practices and approval processes prior to the filing of the Form 990 return with the Internal Revenue Service. IU Health Ball Memorial Hospital and other related entities have a process in place to determine the compensation for the other officers and key employees. IU Health Human Resources uses market data from multiple compensation experts/vendors who utilize a variety of methods and procedures to obtain compensation ranges for comparable officer and employee positions. This market data and multiple other factors (including market pay benchmarks, internal equity, candidate/employee qualifications & performance, and business needs) are used to recommend compensation ranges for its officers and other employees, which are then used as a guide for setting reasonable compensation by management.
Form 990, Part VI, Line 19 Required documents available to the public	IU HEALTH BALL MEMORIAL HOSPITAL'S ARTICLES OF INCORPORATION ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH THE INDIANA SECRETARY OF STATE'S WEB-SITE. IU HEALTH BALL MEMORIAL HOSPITAL'S CONFLICT OF INTEREST PROCEDURES ARE DISCLOSED ON THE FORM 990, SCHEDULE O. IU HEALTH BALL MEMORIAL HOSPITAL IS A SUBSIDIARY IN IU HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS. IU HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH ITS BOND FILINGS AND AS AN ATTACHMENT TO IU HEALTH'S FORM 990 AS WELL AS IU HEALTH BALL MEMORIAL HOSPITAL FORM 990.
Form 990, Part VII, Section B, Line 1, Column (A) Comp. of the Five Highest Paid Ind. Contractors	Hagerman Inc./Harmon Joint Venture includes goods and services associated with the renovation construction of the North Tower plus portions of the East and West Wings of Indiana University Health Ball Memorial Hospital. These were not easily separated for reporting on the 990. The $13,564,106 being reported includes both goods and services paid.
Form 990, Part VIII, Line 2f Other Program Service Revenue	Income from Passthrough Entities - Total Revenue: 117293, Related or Exempt Function Revenue: , Unrelated Business Revenue: 117293, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Clinical Research - Total Revenue: 246520, Related or Exempt Function Revenue: 246520, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	ALL OTHER REVENUE - Total Revenue: 1650486, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 1650486;
Form 990, Part IX, Line 11g Other Fees	SHARED SERVICES/PROF. FEES - Total Expense: XXX-XX-XXXX, Program Service Expense: 46950636, Management and General Expenses: 57272548, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	EQUITY TRANSFER (SETTLEMENT OF DEBT) to IU Health Ball Memorial Physicians - -41963977; Fixed Asset Transfer from Ball Memorial Hospital Foundation - 7701042;

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

Indiana University Health Ball Memorial Hospital Inc

Employer identification number

35-0867958

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
(1) EAST CENTRAL RADIOLOGY LLC 950 N MERIDIAN ST STE 800 INDIANAPOLIS,IN46204 35-1907818	HEALTHCARE	IN	1,737,253	2,474,999	IUHBMH

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?
(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	Yes	No
(1)INDIANA HEALTH INFO EXCHANGE INC 846 N SENATE AVE INDIANAPOLIS,IN46202 36-4550324	HEALTHCARE	IN	501(c)(3)	Type I	N/A		No
(2)IU HEALTH BALL MEMORIAL PHYSICIANS INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 35-1925641	HEALTHCARE	IN	501(c)(3)	10	IUHBMH	Yes
(3)IU HEALTH NORTH HOSPITAL INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 35-1932442	HEALTHCARE	IN	501(c)(3)	3	IUH	Yes
(4)IU HEALTH BMH FOUNDATION INC 950 N MERIDIAN STREET Suite 800 INDIANAPOLIS,IN46204 31-1111784	FUNDRAISING	IN	501(c)(3)	Type I	IUHBMH	Yes
(5)IU HEALTH ARNETT INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 26-3162145	HEALTHCARE	IN	501(c)(3)	3	IUH	Yes
(6)IU HEALTH JAY INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 82-2736786	HEALTHCARE	IN	501(c)(3)	3	IUH	Yes
(7)IU HEALTH BEDFORD INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 23-7042323	HEALTHCARE	IN	501(c)(3)	3	IUH	Yes
(8)IU HEALTH BLOOMINGTON INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 35-1720796	HEALTHCARE	IN	501(c)(3)	3	IUH	Yes
(9)IU HEALTH CARE ASSOCIATES INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 35-1747218	HEALTHCARE	IN	501(c)(3)	10	IUH	Yes
(10)INDIANA UNIVERSITY HEALTH FOUNDATION INC 1633 N CAPITOL AVE SUITE 1200 INDIANAPOLIS,IN46202 35-6043086	FUNDRAISING	IN	501(c)(3)	Type I	IUH	Yes
(11)IU HEALTH FRANKFORT INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 81-5174295	HEALTHCARE	IN	501(c)(3)	3	IUH	Yes
(12)METHODIST HEALTH GROUP INC 950 N MERIDIAN STREET Suite 800 INDIANAPOLIS,IN46204 35-0876390	HEALTHCARE	IN	501(c)(3)	Type III-FI	N/A		No
(13)IU HEALTH MORGAN INC 950 N MERIDIAN STREET Suite 800 INDIANAPOLIS,IN46204 27-3533027	HEALTHCARE	IN	501(c)(3)	10	IUH	Yes
(14)INDIANA UNIVERSITY HEALTH INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 35-1955872	HEALTHCARE	IN	501(c)(3)	3	NA		No
(15)IU HEALTH PAOLI INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 35-2090919	HEALTHCARE	IN	501(c)(3)	3	IUH	Yes
(16)IU HEALTH PLANS NFP INC 950 N MERIDIAN STREET Suite 800 INDIANAPOLIS,IN46204 46-3803873	INSURANCE	IN	501(c)(4)		IUH	Yes
(17)IU HEALTH TIPTON HOSPITAL INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 26-2772226	HEALTHCARE	IN	501(c)(3)	3	IUH	Yes
(18)IU HEALTH WEST HOSPITAL INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 35-1814660	HEALTHCARE	IN	501(c)(3)	3	IUH	Yes
(19)IU HEALTH WHITE MEMORIAL HOSPITAL INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 27-3532963	HEALTHCARE	IN	501(c)(3)	3	IUH	Yes
(20)IU MEDICAL GROUP FOUNDATION INC 340 W 10TH ST NO FS5100 INDIANAPOLIS,IN46202 20-1093251	FUNDRAISING	IN	501(c)(3)	Type I	N/A		No
(21)IUHLP LIQUIDATION INC 950 N MERIDIAN STREET Suite 800 INDIANAPOLIS,IN46204 35-1125434	HEALTHCARE	IN	501(c)(3)	10	IUH	Yes
(22)MDWISE MARKETPLACE INC 950 N MERIDIAN STREET Suite 800 INDIANAPOLIS,IN46204 46-5270582	INSURANCE	IN	501(c)(4)		IUH	Yes
(23)MDWISE NETWORK INC 950 N MERIDIAN STREET Suite 800 INDIANAPOLIS,IN46204 47-2619552	INSURANCE	IN	501(c)(4)		IUH	Yes
(24)METHODIST OCCUP HEALTH CENTERS INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 35-1844176	HEALTHCARE	IN	501(c)(3)	3	IUH	Yes
(25)RILEY CHEER GUILD INC 705 RILEY HOSPITAL DR INDIANAPOLIS,IN46202 35-6018517	FUNDRAISING	IN	501(c)(3)	Type III-FI	N/A		No
(26)UNIVERSITY FAMILY PHYSICIANS INC 950 N MERIDIAN STREET Suite 800 INDIANAPOLIS,IN46204 23-7427350	HEALTHCARE	IN	501(c)(3)	10	IUHCA	Yes
(27)CLARIAN TRANSPLANT INSTITUTE INC 950 N MERIDIAN STREET Suite 800 INDIANAPOLIS,IN46204 13-4350599	HEALTHCARE	IN	501(c)(3)	10	IUH	Yes
(28)IU HEALTH BLACKFORD HOSPITAL INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS,IN46204 01-0646166	HEALTHCARE	IN	501(c)(3)	3	IUHBMH	Yes
(29)16 Tech Community Corporation 1220 Waterway Blvd Indianapolis,IN46202 81-0853467	Economic Development	IN	501(c)(3)	Type I	NA		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2020

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	(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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) BELTWAY SURGERY CENTERS LLC 569 Brookwood Village Ste 901 BIRMINGHAM,AL35244 35-2072586	HEALTHCARE	IN	NA
(2) BOSC HOLDINGS LLC 950 N Meridian St Ste 800 INDIANAPOLIS,IN46204 45-4147343	HEALTHCARE	IN	NA
(3) BSC HOLDINGS LLC 950 N Meridian St Ste 800 INDIANAPOLIS,IN46204 45-2314634	HEALTHCARE	IN	NA
(4) CHV FUND I LLC 950 N Meridian St Ste 800 INDIANAPOLIS,IN46204 26-2523206	VENTURE CAPITAL	IN	NA
(5) CHV FUND II MANAGEMENT LLC 950 N Meridian St Ste 800 INDIANAPOLIS,IN46204 37-1717823	VENTURE CAPITAL	IN	NA
(6) CHV FUND II LLC 950 N Meridian St Ste 800 INDIANAPOLIS,IN46204 80-0902337	VENTURE CAPITAL	IN	NA
(7) CHV FUND MANAGEMENT LLC 950 N Meridian St Ste 800 INDIANAPOLIS,IN46204 26-2523151	VENTURE CAPITAL	IN	NA
(8) EAGLE HIGH SURG CENTER LLC 569 Brookwood Village Ste 901 BIRMINGHAM,AL35244 35-2259204	HEALTHCARE	IN	NA
(9) EHSC HOLDINGS LLC 950 N Meridian St Ste 800 INDIANAPOLIS,IN46204 45-4147879	HEALTHCARE	IN	NA
(10) EWASC HOLDINGS LLC 950 N Meridian St Ste 800 INDIANAPOLIS,IN46204 47-3087761	HEALTHCARE	IN	NA
(11) HEALTH VENTURE MANAGEMENT LLC 950 N Meridian St Ste 800 INDIANAPOLIS,IN46204 20-5740218	MANAGEMENT	IN	NA
(12) IEC HOLDINGS LLC 950 N Meridian St Ste 800 INDIANAPOLIS,IN46204 45-4148032	HEALTHCARE	IN	NA
(13) INDIANA ENDOSCOPY CENTERS LLC 569 Brookwood Village Ste 901 BIRMINGHAM,AL35244 20-8398421	HEALTHCARE	IN	NA
(14) IUH EWA SURGERY CTR LLC 569 Brookwood Village Ste 901 BIRMINGHAM,AL35244 47-3102482	HEALTHCARE	IN	NA
(15) IUH SAXONY SURGERY CTR LLC 569 Brookwood Village Ste 901 BIRMINGHAM,AL35244 27-5271091	HEALTHCARE	IN	NA
(16) ROC SURGERY LLC 569 Brookwood Village Ste 901 BIRMINGHAM,AL35244 27-1497960	HEALTHCARE	IN	NA
(17) ROCS HOLDINGS LLC 950 N Meridian St Ste 800 INDIANAPOLIS,IN46204 45-4148369	HEALTHCARE	IN	NA
(18) SENATE ST SURGERY CENTER LLC 569 Brookwood Village Ste 901 BIRMINGHAM,AL35244 42-1709357	HEALTHCARE	IN	NA
(19) SSC HOLDINGS LLC 950 N Meridian St Ste 800 INDIANAPOLIS,IN46204 46-4472887	HEALTHCARE	IN	NA
(20) SSSC HOLDINGS LLC 950 N Meridian St Ste 800 INDIANAPOLIS,IN46204 45-4148167	HEALTHCARE	IN	NA
(21) IU HEALTH FORT WAYNE LLC 950 N Meridian St Ste 800 INDIANAPOLIS,IN46204 83-1224627	HEALTHCARE	IN	NA
(22) BALL OUTPATIENT SUR CTR LLC 569 Brookwood Village Ste 901 BIRMINGHAM,AL35244 27-0275794	HEALTHCARE	IN	NA

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?
(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	Yes	No
(1) CERBERUS RESIDENTIAL OPPORT INST LTD 190 ELGIN AVENUE GEORGE TOWN,GRAND CAYMAN CJ	INVESTMENTS	CJ	N/A	C Corporation				Yes
(2) CHV CAPITAL INC 950 N MERIDIAN ST SUITE 800 INDIANAPOLIS,IN46204 26-0752507	VENTURE CAPITAL	IN	N/A	C Corporation				Yes
(3) IU HEALTH 457(B) PLAN 1100 N MARKET ST WILMINGTON,DE19890 47-6948347	INVESTMENTS	IN	N/A	Trust				Yes
(4) IU HEALTH ACO INC 950 N MERIDIAN ST SUITE 800 INDIANAPOLIS,IN46204 45-4421020	HEALTHCARE	IN	N/A	C Corporation				Yes
(5) IU HEALTH BOARD DESIGNATED TRUST 400 HOWARD ST SAN FRANCISCO,CA94105 30-6309021	INVESTMENTS	IN	N/A	Trust				Yes
(6) IU HEALTH NTGI S&P500 FUND CF PO BOX 804358 CHICAGO,IL60680 30-6298263	INVESTMENTS	IN	N/A	Trust				Yes
(7) IU HEALTH PLANS HOLDING COMPANY INC 950 N MERIDIAN ST SUITE 800 INDIANAPOLIS,IN46204 46-3794815	INSURANCE	IN	N/A	C Corporation				Yes
(8) IU HEALTH PLANS INSURANCE COMPANY 950 N MERIDIAN ST SUITE 800 INDIANAPOLIS,IN46204 81-1097215	INSURANCE	IN	N/A	C Corporation				Yes
(9) IU HEALTH PLANS INC 950 N MERIDIAN ST SUITE 800 INDIANAPOLIS,IN46204 26-2127080	HMO	IN	N/A	C Corporation				Yes
(10) IU HEALTH RISK PURCHASING GROUP INC 151 MEETING ST SUITE 301 CHARLESTON,SC29401 26-0202446	INSURANCE	IN	N/A	C Corporation				Yes
(11) IU HEALTH RISK RETENTION GROUP INC 151 MEETING ST SUITE 301 CHARLESTON,SC29401 20-1107674	INSURANCE	SC	N/A	C Corporation				Yes
(12) IUH ASSURANCE SPC LTD PO BOX 69 94 SOLARIS AVE CAMANA BAY GRAND CAYMAN CJ 98-0395429	INSURANCE	CJ	N/A	C Corporation				Yes
(13) PROTEUO FUND LP PO BOX 69 94 SOLARIS AVE CAMANA BAY GRAND CAYMAN CJ 98-1075227	INVESTMENTS	CJ	NA	C Corporation				Yes
(14) BMH MEDICAL PAVILION ASSOCIATION INC 2525 W UNIVERSITY AVE MUNCIE,IN47303 35-1858408	CONDO MANAGEMENT	IN	N/A	C Corporation				Yes
(15) University Surgeons Inc 950 N Meridian St Ste 800 Indianapolis,IN46204 20-2981280	Physician Services	IN	NA	C Corporation				Yes
(16) Pediatric Surgical Associates Inc 950 N Meridian St Ste 800 Indianapolis,IN46204 35-2122922	Physician Services	IN	NA	C Corporation				Yes
(17) Cardiothoracic Surgeons Inc 950 N Meridian St Ste 800 Indianapolis,IN46204 35-1416173	Physician Services	IN	NA	C Corporation				Yes
(18) University Vascular Surgery Inc 950 N Meridian St Ste 800 Indianapolis,IN46204 35-1832370	Physician Services	IN	NA	C Corporation				Yes

Schedule R (Form 990) 2020

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

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) IUH BALL MEMORIAL HOSPITAL FOUNDATION INC	C	95,148	FMV
(2) IU HEALTH BALL MEMORIAL PHYSICIANS INC	J	2,086,783	FMV
(3) BALL OUTPATIENT SURGERY CENTER LLC	J	854,156	FMV
(4) IUH BALL MEMORIAL HOSPITAL FOUNDATION INC	K	465,844	FMV
(5) IU HEALTH BLACKFORD HOSPITAL INC	L	3,607,956	FMV
(6) IU HEALTH BALL MEMORIAL PHYSICIANS INC	L	357,206	FMV
(7) BALL OUTPATIENT SURGERY CENTER LLC	L	221,081	FMV
(8) IU HEALTH CARE ASSOCIATES INC	M	5,406,570	FMV
(9) METHODIST OCCUPATIONAL HEALTH CENTERS INC	M	505,777	FMV
(10) IU HEALTH BLACKFORD HOSPITAL INC	O	203,752	FMV
(11) IU HEALTH RISK RETENTION GROUP INC	R	1,518,112	FMV
(12) IUH ASSURANCE SPC LTD	R	524,942	FMV
(13) IU HEALTH JAY INC	L	1,141,355	FMV
(14) IU HEALTH BALL MEMORIAL PHYSICIANS INC	R	41,963,977	FMV
(15) INDIANA UNIVERSITY HEALTH FOUNDATION INC	C	3,747,969	FMV
(16) IU HEALTH BALL MEMORIAL PHYSICIANS INC	C	83,335	FMV
(17) IU Health Ball Memorial Hospital Foundation INC	S	7,701,041	FMV

Schedule R (Form 990) 2020

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2020

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) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

1	Briefly describe the organization’s mission or most significant activities: Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	18
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2020 (Part V, line 2a) ......	5	2,932
6	Total number of volunteers (estimate if necessary) .............	6	58
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	5,302,727
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	3,264,304	4,188,491
9	Program service revenue (Part VIII, line 2g) .........	483,570,310	491,834,289
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	8,396,227	6,344,451
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	6,759,951	4,147,992
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	501,990,792	506,515,223
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	885,902	1,327,973
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)	141,580,865	156,002,770
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	282,972,949	289,425,230
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	425,439,716	446,755,973
19	Revenue less expenses. Subtract line 18 from line 12.......	76,551,076	59,759,250
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	615,068,428	625,091,620
21	Total liabilities (Part X, line 26).............	119,462,667	103,765,141
22	Net assets or fund balances. Subtract line 21 from line 20.....	495,605,761	521,326,479

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 346,682,992 including grants of $ 1,327,973 ) (Revenue $ 452,145,747 )
	INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL IS A 379 BED ACUTE-CARE AND TEACHING HOSPITAL THAT OFFERS A COMPREHENSIVE RANGE OF SERVICES TO CARE FOR ITS PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. IU HEALTH BALL HOSPITAL IS A PREFERRED HEALTHCARE FACILITY FOR RESIDENTS OF EAST CENTRAL INDIANA. THE HOSPITAL WAS FOUNDED IN 1929 AS BOTH A TEACHING HOSPITAL AND REGIONAL REFERRAL CENTER FOR MUNCIE, INDIANA, AND SURROUNDING COUNTIES. IU HEALTH BALL MEMORIAL HOSPITAL OFFERS 43 MEDICAL SPECIALTIES, INCLUDING CANCER CARE, CARDIOLOGY, ORTHOPEDICS AND SPECIALIZED SERVICES FOR WOMEN AND CHILDREN. THE IU HEALTH BALL HOSPITAL MEDICAL EDUCATION DEPARTMENT IS HOME TO THREE RESIDENCIES (FAMILY MEDICINE, INTERNAL MEDICINE AND A TRANSITIONAL YEAR), AS WELL AS A RESEARCH DEPARTMENT. MORE THAN 40 RESIDENT PHYSICIANS ARE TRAINED EVERY YEAR AT IU HEALTH BALL MEMORIAL HOSPITAL FAMILY MEDICINE AND INTERNAL MEDICINE FACILITIES. THEY CONDUCT MORE THAN 25,000 PATIENT VISITS ANNUALLY.

4b	(Code: ) (Expenses $ 6,949,072 including grants of $ 0 ) (Revenue $ 9,063,016 )
	OUR NETWORK OF PHARMACIES OFFERS THE CONVENIENCE OF ONE-STOP SHOPPING. WE PROVIDE EXPERT CARE AND HELP PATIENTS MAKE THE BEST USE OF THEIR MEDICATIONS.

4c	(Code: ) (Expenses $ 4,428,484 including grants of $ 0 ) (Revenue $ 5,775,651 )
	IU HEALTH BALL MEMORIAL HOSPITAL, INC. PROVIDES SERVICES, WHICH INCLUDE COORDINATED ACTIVITIES AND POLICES, TO RELATED TAX-EXEMPT ORGANIZATIONS DESIGNED TO MEET THE MISSION OF THE INDIANA UNIVERSITY HEALTH SYSTEM.

	(Code: ) (Expenses $ 2,513,214 including grants of $ 0 ) (Revenue $ 3,277,746 )
	RENT FROM RELATED 501(C)(3) ORGANIZATIONS

	(Code: ) (Expenses $ 189,019 including grants of $ 0 ) (Revenue $ 246,520 )
	CLINICAL RESEARCH

	(Code: ) (Expenses $ 0 including grants of $ 0 ) (Revenue $ 16,022,882 )
	As of December 31, 2020, Indiana University Health Ball Memorial Hospital, Inc. had received stimulus funds from the Provider Relief Fund under the provisions of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) and Paycheck Protection Program and Health Care Enhancement Act. Indiana University Health Ball Memorial Hospital recognized $16,022,882 as other program service revenue. Indiana University Health Ball Memorial Hospital, Inc. will continue to monitor compliance with the terms and conditions of the Provider Relief Fund.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 2,702,233 including grants of $ ) (Revenue $ 19,547,148 )
4e	Total program service expenses360,762,781

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,669,757	2,684,332	986,206

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	3,926,452
e	Government grants (contributions)		1e	262,039

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		4,188,491

		Business Code
2a	NET PATIENT SERVICE REVENUE	622110	452,145,747	452,145,747
b	FEDERAL RECOVERY REVENUE	900099	16,022,882	16,022,882
c	PHARMACY	446110	14,238,792	9,063,016	5,175,776
d	SHARED SERVICES	541900	5,785,309	5,775,651	9,658
e	RENT FROM RELATED 501(C)(3) ORGS.	532000	3,277,746	3,277,746
f	All other program service revenue.		363,813	246,520	117,293	0
g	Total. Add lines 2a–2f .....		491,834,289

3 Investment income (including dividends, interest, and othersimilar amounts) ......			3,478,359			3,478,359
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		929,547	6a
b	Less: rental expenses		238,840	6b
c	Rental income or (loss)	0	690,707	6c
d	Net rental income or (loss).......			690,707			690,707
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	1,397,632	12,423,306	7a
b	Less: cost or other basis and sales expenses		10,954,846	7b
c	Gain or (loss)	1,397,632	1,468,460	7c
d	Net gain or (loss).........			2,866,092			2,866,092
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA/FOOD SERVICE		721110	1,606,723			1,606,723
b	GIFT SHOP		453220	200,076			200,076
c
d	All other revenue ....			1,650,486	0	0	1,650,486
e	Total. Add lines 11a–11d ......			3,457,285
12	Total revenue. See instructions.....			506,515,223	486,531,562	5,302,727	10,492,443

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,327,973	1,327,973
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	1,568,108	1,359,953	208,155
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........	121,798,162	105,630,314	16,167,848
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	4,360,817	3,781,949	578,868
9	Other employee benefits .......	19,410,723	16,834,086	2,576,637
10	Payroll taxes ...........	8,864,960	7,688,199	1,176,761
11	Fees for services (non-employees):
a	Management ......	1,515,712	9,735	1,505,977
b	Legal .........
c	Accounting ...........
d	Lobbying ...........	12,302		12,302
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	23,862		23,862
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	104,223,184	46,950,636	57,272,548	0
12	Advertising and promotion ....	66,969	371	66,598
13	Office expenses .......	1,604,968	1,192,877	412,091
14	Information technology ......	677,659	543,767	133,892
15	Royalties ..
16	Occupancy ...........	11,356,070	11,345,461	10,609
17	Travel ............	53,453	47,475	5,978
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	8,356	6,611	1,745
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	22,316,122	21,729,295	586,827
23	Insurance ...	2,635,831		2,635,831
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	DRUGS AND MEDICAL SUPPLIES	87,386,742	87,386,742
b	BAD DEBT	28,222,286	28,222,286
c	HOSPITAL ASSESSMENT FEE	23,955,256	23,955,256
d	Noncapitalized Equipment	2,846,946	596,973	2,249,973
e	All other expenses	2,519,512	2,152,822	366,690	0
25	Total functional expenses. Add lines 1 through 24e	446,755,973	360,762,781	85,993,192	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1
2	Savings and temporary cash investments .........			323,996,464	2	325,817,627
3	Pledges and grants receivable, net ......			31,021	3	71,589
4	Accounts receivable, net .............			56,105,173	4	51,136,955
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			150,139	7	136,556
8	Inventories for sale or use ............			8,938,631	8	13,073,960
9	Prepaid expenses and deferred charges ......			2,429,067	9	1,783,827
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	522,436,028
b	Less: accumulated depreciation	10b	311,125,113	203,222,104	10c	211,310,915
11	Investments—publicly traded securities .			16,935,269	11	18,503,107
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			3,118,157	13	3,104,565
14	Intangible assets ...............			40,008	14	40,008
15	Other assets. See Part IV, line 11 ...........			102,395	15	112,511
16	Total assets. Add lines 1 through 15 (must equal line 33)...			615,068,428	16	625,091,620

17	Accounts payable and accrued expenses .....	28,826,764	17	78,747,849
18	Grants payable ...		18
19	Deferred revenue .........	13,142	19	9,793
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 any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..		23
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	90,622,761	25	25,007,499
26	Total liabilities. Add lines 17 through 25..	119,462,667	26	103,765,141

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	495,605,761	27	521,326,479
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	495,605,761	32	521,326,479
33	Total liabilities and net assets/fund balances ........	615,068,428	33	625,091,620