Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 01-01-2021 , and ending 12-31-2021
BCheck if applicable:
CName of organization
Indiana University Health Inc
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
950 N MERIDIAN STREET 1200
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
INDIANAPOLIS, IN46204
D Employer identification number

35-1955872
E Telephone number

G Gross receipts $ 10,519,324,120
F Name and address of principal officer:
DENNIS M MURPHY
950 N MERIDIAN STREET 1200
INDIANAPOLIS,IN46204
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
HTTPS://IUHEALTH.ORG/
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1995
M State of legal domicile: IN
Part I
Summary
Activities & Governance 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 MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 15
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 13
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 24,655
6 Total number of volunteers (estimate if necessary) ............. 6 1,468
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 45,485,835
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 3,186,798
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 16,895,945 17,422,583
9 Program service revenue (Part VIII, line 2g) ......... 4,169,899,046 4,545,441,457
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 609,261,101 417,121,319
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 59,144,893 87,416,119
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 4,855,200,985 5,067,401,478
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 31,354,681 440,073,506
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 1,386,705,109 1,779,721,063
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 2,368,456,210 2,442,717,537
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 3,786,516,000 4,662,512,106
19 Revenue less expenses. Subtract line 18 from line 12....... 1,068,684,985 404,889,372
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 9,886,779,945 10,887,157,746
21 Total liabilities (Part X, line 26)............. 3,567,439,747 4,094,289,749
22 Net assets or fund balances. Subtract line 21 from line 20..... 6,319,340,198 6,792,867,997
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 2,388,312,025 including grants of $ 440,073,506 ) (Revenue $ 2,431,859,036 )
INDIANA UNIVERSITY HEALTH, INC. ("IU HEALTH") IS AN ACADEMIC HEALTH CENTER COMPRISED OF IU HEALTH METHODIST HOSPITAL, IU HEALTH UNIVERSITY HOSPITAL, AND RILEY HOSPITAL FOR CHILDREN AT IU HEALTH (TOGETHER REFERRED TO AS "IU HEALTH ACADEMIC HEALTH CENTER"), IU HEALTH SAXONY HOSPITAL, AND IU HEALTH MORGAN. IT ALSO OFFERS PHARMACY, HOME CARE, OUTPATIENT, AND EMERGENCY TRANSPORT SERVICES THROUGHOUT THE CENTRAL INDIANA AREA. IU HEALTH INCORPORATES A UNIQUE PARTNERSHIP WITH INDIANA UNIVERSITY SCHOOL OF MEDICINE ("IU SCHOOL OF MEDICINE"), ONE OF THE NATION'S LEADING MEDICAL SCHOOLS, TO GIVE PATIENTS ACCESS TO INNOVATIVE TREATMENTS AND THERAPIES, ALL WITHOUT REGARD TO THEIR ABILITY TO PAY. IU HEALTH IS ALSO THE PARENT ORGANIZATION OF THE IU HEALTH SYSTEM, INDIANA'S MOST COMPREHENSIVE HEALTH CARE SYSTEM. IU HEALTH METHODIST AND IU HEALTH UNIVERSITY HOSPITALS IU HEALTH METHODIST AND IU HEALTH UNIVERSITY HOSPITALS, LOCATED IN INDIANAPOLIS, INDIANA, ARE A 1,025-BED ADULT ACADEMIC HEALTH CENTER IN PARTNERSHIP WITH THE IU SCHOOL OF MEDICINE. IU HEALTH METHODIST HOSPITAL AND IU HEALTH UNIVERSITY HOSPITAL ARE DESIGNATED AS MAGNET HOSPITALS, RECOGNIZED FOR EXCELLENCE IN NURSING SERVICES AND HIGH-QUALITY CLINICAL OUTCOMES FOR PATIENTS. IU HEALTH UNIVERSITY HOSPITAL IS A LEADING ACADEMIC MEDICAL CENTER WITH A COMMITMENT TO DISSEMINATING RESEARCH FINDINGS WHILE IMPROVING THE QUALITY OF LIFE FOR PEOPLE ON A LOCAL, REGIONAL, NATIONAL AND INTERNATIONAL BASIS. IU HEALTH METHODIST HOSPITAL AND IU HEALTH UNIVERSITY HOSPITAL BOTH SERVE AN ADULT POPULATION. THESE HOSPITALS LEAD THE WAY IN COMMUNITY BENEFIT INITIATIVES. A SUBSTANTIAL PIECE OF COMMUNITY BENEFIT IS PROVIDING EXCELLENT CARE TO PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. RILEY HOSPITAL FOR CHILDREN AT IU HEALTH RILEY HOSPITAL FOR CHILDREN AT IU HEALTH, LOCATED IN INDIANAPOLIS, INDIANA, IS A 276-BED CHILDREN'S HOSPITAL THAT IS INDIANA'S LARGEST AND MOST COMPREHENSIVE PEDIATRIC HOSPITAL. IT IS REGULARLY RANKED AMONG THE TOP CHILDREN'S HOSPITALS IN THE COUNTY BY U.S. NEWS & WORLD REPORT'S BEST CHILDREN'S HOSPITALS. IN ADDITION TO CLINICAL EXPERTISE, RILEY HOSPITAL FOR CHILDREN AT IU HEALTH'S PARTNERSHIP WITH THE IU SCHOOL OF MEDICINE ENSURES THAT PATIENTS HAVE ACCESS TO THE MOST INNOVATIVE TREATMENTS AND THE LATEST RESEARCH AND TECHNOLOGY. RILEY HOSPITAL FOR CHILDREN AT IU HEALTH PROVIDES COMPREHENSIVE, FAMILY-CENTERED CARE TO MORE THAN 250,000 CHILDREN ANNUALLY THROUGH ITS STATEWIDE PRIMARY AND SPECIALTY CARE OFFICES, AND INPATIENT AND OUTPATIENT SERVICES AT ITS FLAGSHIP HOSPITAL. PEDIATRIC PATIENTS AND THEIR FAMILIES TRAVEL FROM ALL 92 INDIANA COUNTIES, THE REGION AND THE WORLD TO ACCESS THE NATIONALLY RECOGNIZED CLINICAL PROGRAMS OF RILEY HOSPITAL FOR CHILDREN AT IU HEALTH. RILEY HOSPITAL FOR CHILDREN AT IU HEALTH IS ALSO DESIGNATED AS A MAGNET HOSPITAL, RECOGNIZED FOR EXCELLENCE IN NURSING SERVICES AND HIGH-QUALITY CLINICAL OUTCOMES FOR PATIENTS. IU HEALTH SAXONY HOSPITAL IU HEALTH SAXONY HOSPITAL, LOCATED IN FISHERS, INDIANA, IS A 32-BED SPECIALTY CARE HOSPITAL PRIMARILY FOCUSING ON SURGICAL SERVICES FOR CARDIOVASCULAR AND ORTHOPEDICS. IT OPENED IN 2011 AND INCLUDES SIX OPERATING ROOMS, A FULL EMERGENCY DEPARTMENT, A HELIPAD FOR MEDICAL TRANSPORT AND A MEDICAL OFFICE COMPLEX. IU HEALTH SAXONY HOSPITAL IS ALSO HOME TO THE INDIANA UNIVERSITY HEALTH HIP AND KNEE CENTER. HERE, THE TEAM OF FELLOWSHIP TRAINED SURGEONS PERFORM MORE HIP AND KNEE REPLACEMENTS THAN ANY OTHER IU HEALTH FACILITY IN THE STATE. IU HEALTH MORGAN IU HEALTH MORGAN, AN OUTPATIENT DEPARTMENT OF THE IU HEALTH ACADEMIC HEALTH CENTER LOCATED IN MARTINSVILLE, INDIANA, OFFERS COVERAGE IN ADULT AND PEDIATRIC CARE; SPECIALTY CARE; EMERGENCY AND URGENT CARE; DIAGNOSTIC IMAGING INCLUDING 3D MAMMOGRAPHY; LAB TESTING; OUTPATIENT SURGICAL SERVICES; CANCER CARE, INCLUDING MEDICAL AND RADIATION ONCOLOGY; CARDIAC, PHYSICAL, SPEECH AND OCCUPATIONAL THERAPIES; SLEEP LAB; AND COMMUNITY HEALTH AND WELLNESS, INCLUDING MEDICAL NUTRITION THERAPY AND DIABETES CARE.
4b (Code:   ) (Expenses $ 696,110,527 including grants of $ 0 ) (Revenue $ 713,231,566 )
The laboratories of IU Health offer some of the most comprehensive laboratory services in Indiana. Open 24 hours a day, seven days a week, the laboratories perform more than 19 million tests a year. In addition to IU Health, laboratory testing services are provided to hospitals and physicians across the country.
4c (Code:   ) (Expenses $ 572,373,938 including grants of $ 0 ) (Revenue $ 586,451,640 )
AS THE PARENT OF THE INDIANA UNIVERSITY HEALTH SYSTEM, IU HEALTH FACILITATES EFFORTS AND SHARED SERVICES ON BEHALF OF AND FOR THE BENEFIT OF IU Health AND ITS AFFILIATES. CERTAIN COSTS RELATED TO PROVIDING THESE SHARED SERVICES ARE ALLOCATED OUT OR CHARGED TO THE AFFILIATES. FACILITATING THESE EFFORTS AND SERVICES ALLOWS IU Health AND ITS AFFILIATES TO BETTER CARRY OUT THEIR EXEMPT FUNCTIONS BY REDUCING COSTS, HAVING STANDARDIZED PRACTICES AND PROCEDURES, AND CREATING ECONOMIES OF SCALE.
(Code:   ) (Expenses $ 384,656,478 including grants of $ 0 ) (Revenue $ 394,117,215 )
MEMBER PREMIUM REVENUE
(Code:   ) (Expenses $ 328,538,088 including grants of $ 0 ) (Revenue $ 336,618,577 )
PHARMACY
(Code:   ) (Expenses $ 67,883,146 including grants of $ 0 ) (Revenue $ 84,746,963 )
ALL OTHER PROGRAMS
4d Other program services (Describe in Schedule O.)
(Expenses $ 781,077,712 including grants of $   ) (Revenue $ 815,482,755 )
4e Total program service expensesMediumBullet4,437,874,202
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part III..
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part III..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IX............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or 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? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
4,785
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
24,655
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
15
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
13
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
IN
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletCRAIG J JONES950 N MERIDIAN STREET SUITE 800   INDIANAPOLIS,IN46204 (317) 963-4842
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

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

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

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) BISHOP JULIUS C TRIMBLE
 
DIRECTOR/VICE-CHAIR
 6.0
.................
1.0 		X   X       35,000 0 0
(2) DENNIS M MURPHY
 
DIRECTOR/PRESIDENT & CEO
 60.0
.................
1.0 		X   X       4,742,504 0 904,309
(3) J SCOTT DAVISON
 
BOARD CHAIR / DIRECTOR
 6.0
.................
0 		X   X       0 0 0
(4) MICHAEL A MCROBBIE
 
DIRECTOR/VICE-CHAIR (Part Year)
 6.0
.................
0 		X   X       18,750 0 0
(5) Pamela Whitten
 
DIRECTOR/VICE-CHAIR (Part Year)
 6.0
.................
0 		X   X       0 0 0
(6) Alicia D Monroe MD
 
DIRECTOR (PART YEAR)
 6.0
.................
0 		X           35,000 0 0
(7) ANNE NOBLES
 
DIRECTOR
 6.0
.................
1.0 		X           37,500 0 0
(8) JAMES A DAVLIN V
 
DIRECTOR
 6.0
.................
0 		X           37,500 0 0
(9) JAY L HESS MD
 
DIRECTOR
 6.0
.................
6.0 		X           42,500 0 0
(10) Kristin Mays-Corbitt
 
DIRECTOR (PART YEAR)
 6.0
.................
0 		X           8,750 0 0
(11) KYLE L GRAZIER
 
DIRECTOR
 6.0
.................
0 		X           36,250 0 0
(12) LARRY H STEVENS MD
 
DIRECTOR
 6.0
.................
49.0 		X           37,500 694,928 20,085
(13) MAUREEN BISOGNANO
 
DIRECTOR
 6.0
.................
0 		X           37,500 0 0
(14) MICHAEL J MIRRO MD
 
DIRECTOR (PART YEAR)
 6.0
.................
0 		X           26,250 0 0
(15) Quinn Buckner
 
DIRECTOR (PART YEAR)
 6.0
.................
0 		X           8,750 0 0
(16) ROBERT A PALMER
 
DIRECTOR
 6.0
.................
0 		X           37,500 0 0
(17) THOMAS V EASTERDAY
 
DIRECTOR
 6.0
.................
0 		X           46,500 0 0
Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) ERIN R LEWIS
 
SECRETARY/SVP & GEN. COUNSEL
 51.0
.......................4.0 		    X       1,110,512 0 153,360
(19) JENNIFER M ALVEY
 
TREASURER/SVP & CFO
 51.0
.......................4.0 		    X       1,661,205 0 204,509
(20) DAVID A INGRAM MD
 
EVP & CME
 54.0
.......................1.0 		      X     0 1,336,305 186,729
(21) Gil Peri
 
President (Riley) (Part Year)
 55.0
.......................0 		      X     679,729 0 80,593
(22) MICHELLE A JANNEY RN
 
EVP & COO
 53.0
.......................2.0 		      X     2,270,904 0 32,752
(23) RYAN D NAGY MD
 
PRESIDENT (AAHC)
 54.0
.......................1.0 		      X     0 1,168,907 142,600
(24) BLAKE A DYE
 
SVP
 51.0
.......................4.0 		        X   1,288,837 0 48,092
(25) DANIEL E NEUFELDER
 
President (WCR) (Part Year)
 0.0
.......................55.0 		        X   1,232,749 0 45,742
(26) ELIZABETH DUNLAP
 
SVP, CHIEF HR OFFICER (Part Year)
 55.0
.......................0 		        X   2,196,518 0 460,649
(27) JEFFREY C BIRD MD
 
PRESIDENT (ECR)
 0.0
.......................55.0 		        X   1,348,455 0 50,692
(28) RONALD L STIVER
 
PRESIDENT (SHS)
 51.0
.......................4.0 		        X   1,627,123 0 177,596
(29) JONATHAN E GOTTLIEB MD
 
Former Key Employee
 0.0
.......................0.0 		          X 482,832 0 0
(30) KEVIN R ARMSTRONG
 
FORMER KEY EMPLOYEE
 55.0
.......................0 		          X 908,302 0 146,794
(31) MICHAEL L HARLOWE
 
FORMER KEY EMPLOYEE
 0.0
.......................55.0 		          X 0 335,507 35,151
(32) PARVEEN CHAND
 
FORMER KEY EMPLOYEE
 55.0
.......................0 		          X 558,043 0 58,680
(33) PAUL M CALKINS MD
 
FORMER KEY EMPLOYEE
 25.0
.......................30.0 		          X 579,291 0 36,526
(34) PAUL R HAUT MD
 
FORMER KEY EMPLOYEE
 0.0
.......................55.0 		          X 0 467,862 15,217
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 21,132,256 4,003,508 2,800,075
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet2,776
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
AYA HEALTHCARE INC

5930 Cornerstone Court West Ste 300
San Diego,CA92121 		Travel Nursing 32,968,823
Medefis

10826 Old Mill Road Suite 101
Omaha,NE68154 		Vendor Management 15,208,797
ARAMARK SERVICES

2400 Market St
Philadelphia,PA19103 		Food services 10,805,521
TRIMEDX LLC

5451 LAKEVIEW PKWY S DR
INDIANAPOLIS,IN46268 		CLINICAL ENGINEERING 9,919,704
FA WILHELM CONSTRUCTION CO INC

3914 Prospect St
INDIANAPOLIS,IN46203 		CONSTRUCTION 5,769,183
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet303
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 10,910,269
e Government grants (contributions)1e 6,025,882
f All other contributions, gifts, grants, and similar amounts not included above1f 486,432
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 17,422,583
Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 622110 2,431,859,036 2,431,859,036    
b REFERENCE LABORATORY 621500 713,231,566 697,198,871 16,032,695  
c MEMBER PREMIUM REVENUE 541900 394,117,215 394,117,215    
d SHARED SERVICES 900099 586,451,640 578,190,089 8,261,551  
e PHARMACY 446110 336,618,577 316,095,363 20,523,214  
f All other program service revenue. 83,163,423 82,751,427 411,996 0
g Total. Add lines 2a–2f .....MediumBullet 4,545,441,457
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 162,609,213 1,583,540   161,025,673
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   14,836,342 6a
b Less: rental expenses     6b
c Rental income or (loss) 0 14,836,342 6c
d Net rental income or (loss).......MediumBullet 14,836,342   317,332 14,519,010
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 2,762,175 5,703,672,573 7a
b Less: cost or other basis and sales expenses 2,266,421 5,449,656,221 7b
c Gain or (loss) 495,754 254,016,352 7c
d Net gain or (loss).........MediumBullet 254,512,106   174,574 254,337,532
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..MediumBullet      
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..MediumBullet        
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..MediumBullet        
Business Code Miscellaneous Revenue
11a CAFETERIA/FOOD SERVICE 721110 1,272,136     1,272,136
b PARKING 812930 1,615,869     1,615,869
c Education 900099 1,327,030     1,327,030
d All other revenue .... 68,364,742 0 -235,527 68,600,269
e Total. Add lines 11a–11d ...... MediumBullet 72,579,777
12 Total revenue. See instructions.....MediumBullet 5,067,401,478 4,501,795,541 45,485,835 502,697,519
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 439,649,262 439,649,262
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 424,244 424,244
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 ....... 0 0
5 Compensation of current officers, directors, trustees, and key employees ........... 12,285,627 11,886,556 399,071 0
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 2,052,201 1,985,540 66,661  
7 Other salaries and wages........ 1,368,974,312 1,324,506,310 44,468,002  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 44,741,459 43,288,135 1,453,324  
9 Other employee benefits ....... 264,424,313 255,835,093 8,589,220  
10 Payroll taxes ........... 87,243,151 84,409,257 2,833,894  
11 Fees for services (non-employees):        
a Management ...... 2,115,748   2,115,748  
b Legal ......... 9,560,956 4,780,478 4,780,478  
c Accounting ........... 411,956   411,956  
d Lobbying ........... 697,713   697,713  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 10,731,221   10,731,221  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 465,907,154 429,260,177 36,646,977 0
12 Advertising and promotion .... 18,504,967   18,504,967  
13 Office expenses ....... 33,090,141 30,417,349 2,672,792  
14 Information technology ...... 113,911,600 56,955,800 56,955,800  
15 Royalties ..        
16 Occupancy ........... 92,345,655 87,728,372 4,617,283  
17 Travel ............ 1,971,187 1,811,967 159,220  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 652 599 53  
20 Interest ........... 35,464,724 35,464,724    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 167,647,040 160,371,394 7,275,646  
23 Insurance ... 17,478,888   17,478,888  
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 1,018,346,625 1,018,346,625    
b HEALTH CLAIMS TO PROVIDERS 184,206,517 184,206,517    
c BAD DEBT 67,194,632 67,194,632    
d HOSPITAL ASSESSMENT FEE 87,361,567 87,361,567    
e All other expenses 115,768,594 111,989,604 3,778,990 0
25 Total functional expenses. Add lines 1 through 24e 4,662,512,106 4,437,874,202 224,637,904 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 84,637 1 134,222
2 Savings and temporary cash investments ......... 289,839,362 2 259,457,703
3 Pledges and grants receivable, net ...... 4,854,386 3 4,127,506
4 Accounts receivable, net ............. 503,584,689 4 625,354,373
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 ........... 65,051,944 7 68,209,589
8 Inventories for sale or use ............ 80,904,634 8 92,968,302
9 Prepaid expenses and deferred charges ...... 153,778,585 9 170,571,901
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 4,294,672,921
b Less: accumulated depreciation 10b 2,564,206,759 1,662,461,771 10c 1,730,466,162
11 Investments—publicly traded securities . 4,716,853,498 11 5,230,695,262
12 Investments—other securities. See Part IV, line 11 ..... 2,019,918,293 12 2,248,031,985
13 Investments—program-related. See Part IV, line 11 .. 369,040,454 13 293,558,859
14 Intangible assets ............... 7,586,056 14 7,852,193
15 Other assets. See Part IV, line 11 ........... 12,821,636 15 155,729,689
16 Total assets. Add lines 1 through 15 (must equal line 33)... 9,886,779,945 16 10,887,157,746
Liabilities 17 Accounts payable and accrued expenses ..... 615,410,111 17 2,341,758,083
18 Grants payable ...   18  
19 Deferred revenue ......... 11,322,948 19 11,048,272
20 Tax-exempt bond liabilities ......... 1,130,458,000 20 1,479,678,426
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 .. 221,628,321 23 112,684,995
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 1,588,620,367 25 149,119,973
26 Total liabilities. Add lines 17 through 25.. 3,567,439,747 26 4,094,289,749
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 6,317,484,334 27 6,791,012,133
28 Net assets with donor restrictions ........... 1,855,864 28 1,855,864
Organizations that do not follow FASB ASC 958, check here MediumBullet 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 ........... 6,319,340,198 32 6,792,867,997
33 Total liabilities and net assets/fund balances ........ 9,886,779,945 33 10,887,157,746
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
5,067,401,478
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
4,662,512,106
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
404,889,372
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
6,319,340,198
5
Net unrealized gains (losses) on investments ...............
5
417,126,431
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
-31,476,121
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-317,011,883
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
6,792,867,997
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2021)
Form 990 (2021)
Additional Data


Software ID: 21014044
Software Version: 2021v4.2
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Indiana University Health Inc
 
Employer identification number

35-1955872
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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 on 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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
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.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
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.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on 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.
9c
 
 
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
 
 
b
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) 2021

Schedule A (Form 990) 2021
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on 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
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
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.
2a
 
 
b
Did the activities described on 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.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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  
7
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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 2021 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-2021 		(iii)
Distributable
Amount for 2021
1 Distributable amount for 2021 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2021:
a From 2016.......  
b From 2017.......  
c From 2018.......  
d From 2019.......  
e From 2020.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2021 distributable amount  
i Carryover from 2016 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2021 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2021 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2021, 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 2021. 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 2022. Add lines
3j and 4c. 		 
8 Breakdown of line 7:
a Excess from 2017.....  
b Excess from 2018.....  
c Excess from 2019.....  
d Excess from 2020.....  
e Excess from 2021.....  
Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021
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) 2021


Additional Data


Software ID: 21014044
Software Version: 2021v4.2
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Name of the organization
Indiana University Health Inc
 
Employer identification number

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






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that 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) (2021)
Schedule B (Form 990) (2021) Page 2
Name of organization
Indiana University Health Inc
  		Employer identification number
35-1955872
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


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)
Schedule B (Form 990) (2021)
Page 3
Name of organization
Indiana University Health Inc
  		Employer identification number

35-1955872
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
Schedule B (Form 990) (2021)
Schedule B (Form 990) (2021)
Page 4
Name of organization
Indiana University Health Inc
  		Employer identification number

35-1955872
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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990) (2021)
Additional Data


Software ID: 21014044
Software Version: 2021v4.2
SCHEDULE C
(Form 990)

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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
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 Inc
 
Employer identification number

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

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

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

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

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2018 (b) 2019 (c) 2020 (d) 2021 (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) 2021


Schedule C (Form 990) 2021
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
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
581,773
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
115,940
j
Total. Add lines 1c through 1i ....................................................................................................
697,713
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
Part IV
Supplemental Information
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 1j OTHER ACTIVITIES SEVERAL MEMBERSHIP ORGANIZATIONS NOTIFIED IU HEALTH DURING 2021 THAT A PORTION OF THE DUES IT PAID WOULD BE USED FOR LOBBYING PURPOSES AS FOLLOWS: American Hospital Association: 23.32% or 25,000 INDIANA HOSPITAL ASSOCIATION: 8.19% OR $27,073 GREATER INDIANAPOLIS CHAMBER OF COMMERCE: 5.0% OR $2,500 INDIANA CHAMBER OF COMMERCE: 12% OR $6,090 CHILDREN'S HOSPITAL ASSOCIATION: 16.46% OR $28,674 ASSOCIATION OF AMERICAN MEDICAL COLLEGES: 2.13% OR $881 340B HEALTH: 8% OR $1,802 AMERICA'S ESSENTIAL HOSPITALS: 13% OR $17,420 NEXT GEN COALITION: 50% OR $5,000 National Association of ACOs: 15% OR 1,500 TOTAL PORTION OF DUES USED FOR LOBBYING PURPOSES: $115,940
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY DURING 2021, IU HEALTH SPENT A TOTAL OF $581,773 IN DIRECT FEDERAL AND STATE LOBBYING EXPENDITURES. During 2021, IU Health advocated before our federal legislative and executive branches on the following issues: - Federal COVID response and associated waivers, including COVID relief funds - Healthcare Reform Legislation (in general) - Pricing Transparency/Surprise Billing/Good Faith Pricing Estimates - Changes to Medicare/Medicaid reimbursement - Graduate Medical Education - Medicaid/Medicare Managed Care - Changes to OPPS/IPPS reimbursement - Accountable Care Organizations - 340B program - Critical Access and Rural Hospital Matters - Disproportionate Share Hospital Payments - Telemedicine/Telehealth - Electronic Health Records Interoperability - Organ Transplant Allocation and Regulatory Oversight - CMS Regulatory Requirements - Budget Matters - Billing and Reimbursement - Provider Workforce Matters During 2021, IU Health advocated before our state legislative branch on the following issues: - Provider Reimbursements - Medicaid Reimbursement Policies - Provider Licensure Matters - Smoking Cessation - Insurance Matters - Cost of Healthcare - Hospital Licensure - Medicaid Managed Care - Telehealth/Telemedicine - Public Safety - Pricing Transparency/Surprise Bills/Good Faith Pricing Estimates - Health Care Regulation - Social Services - Patient Safety Matters - Access to Health Care - Opioids/Addictions Services - Graduate Medical Education - Budget Allocations - Provider Workforce Matters
Schedule C (Form 990) 2021


Additional Data


Software ID: 21014044
Software Version: 2021v4.2

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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
2021
Open to Public Inspection
Name of the organization
Indiana University Health Inc
 
Employer identification number

35-1955872
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" 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 ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
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.
b
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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" 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 .... 1,855,864 1,855,864 1,855,864 4,888,281 4,888,281
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...       3,032,417  
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ...... 1,855,864 1,855,864 1,855,864 1,855,864 4,888,281
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet100 %
c
Term endowment SchDMd Bullet0 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" 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 .....   245,877,356 245,877,356
b Buildings ....   2,092,301,042 1,158,288,371 934,012,671
c Leasehold improvements   48,239,898 20,178,533 28,061,365
d Equipment ....   1,729,783,110 1,356,169,666 373,613,444
e Other .....   178,471,515 29,570,189 148,901,326
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 1,730,466,162
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
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
(A) ALTERNATIVE INVESTMENTS		 2,248,031,985 F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 2,248,031,985
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
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 133,831
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 149,119,973
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) 2021

Schedule D (Form 990) 2021
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 V, Line 4 Intended uses of endowment funds PERMANENTLY RESTRICTED NET ASSETS ARE GENERALLY RESTRICTED FOR INDIGENT AND OTHER PATIENT CARE SERVICES, MEDICAL EDUCATION AND RESEARCH PROGRAMS, AND MEDICAL SUPPLIES AND EQUIPMENT.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote 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, 2021 and 2020, 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, 2021 and 2020, the Indiana University Health System had gross deferred tax assets of $146,281,000 and $135,889,000 respectively, primarily relating to net operating loss carryovers. Management determined that a full valuation allowance at December 31, 2021 and 2020, 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 increase in the valuation allowance for the current year is $10,392,000. At December 31, 2021, Indiana University Health System has available net operating loss carryforwards of $588,158,000. Net operating losses generated from 2001 through 2017 will expire between 2022 and 2037. Net operating losses generated after 2017 do not expire.
Schedule D (Form 990) 2021


Additional Data


Software ID: 21014044
Software Version: 2021v4.2




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Indiana University Health Inc
 
Employer identification number

35-1955872
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region		 (f) Total expenditures
for and investments
in the region
Central America and the Caribbean 0 0 Investments N/A 1,782,588,692
North America (Canada & Mexico only) 0 0 Investments N/A 35,297,115
Central America and the Caribbean 0 0 UNRELATED TRADE/BUS. N/A 2,671,352
Central America and the Caribbean 0 0 Program Services SELF-INSURANCE 4,838,182
North America (Canada & Mexico only) 0 1 Speaking engagements N/A 392
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .... 0 1 1,825,395,733
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 1 1,825,395,733
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2021
Schedule F (Form 990) 2021
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of noncash
assistance 		(h) Description
of noncash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2021
Schedule F (Form 990) 2021Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
noncash
assistance 		(g) Description
of noncash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2021
Schedule F (Form 990) 2021
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2021
Schedule F (Form 990) 2021
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements CENTRAL AMERICA AND THE CARIBBEAN-Cash; NORTH AMERICA (CANADA & MEXICO ONLY)-Cash
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2021
Additional Data


Software ID: 21014044
Software Version: 2021v4.2



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet 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
2021
Open to Public Inspection
Name of the organization
Indiana University Health Inc
 
Employer identification number

35-1955872
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
 
No
%
c
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.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		  47,446 82,618,600   82,618,600 1.78 %
b Medicaid (from Worksheet 3, column a) . . . . .   140,262 1,285,289,851 784,038,848 501,251,003 10.80 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .         0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 187,708 1,367,908,451 784,038,848 583,869,603 12.58 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 22 78,738 20,374,140 1,325,288 19,048,852 0.41 %
f Health professions education (from Worksheet 5) . . . 3 5,909 122,217,800 17,700,349 104,517,451 2.25 %
g Subsidized health services (from Worksheet 6) . . . . 1 12,958 19,016,446 13,793,711 5,222,735 0.11 %
h Research (from Worksheet 7) . 1   17,000,000   17,000,000 0.37 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 6 53,273 427,903,554   427,903,554 9.22 %
j Total. Other Benefits . . 33 150,878 606,511,940 32,819,348 573,692,592 12.37 %
k Total. Add lines 7d and 7j . 33 338,586 1,974,420,391 816,858,196 1,157,562,195 24.95 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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         0 0 %
3 Community support 1 0 11,000,000 0 11,000,000 0.24 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members		         0 0 %
6 Coalition building 1 0 3,282 0 3,282 0 %
7 Community health improvement advocacy         0 0 %
8 Workforce development 1 770 16,111 0 16,111 0 %
9 Other         0 0 %
10 Total 3 770 11,019,393 0 11,019,393 0.24 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
25,050,407
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
373,927,946
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
433,903,768
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-59,975,822
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1BELTWAY SURGERY CENTERS LLC
  		AMBULATORY SURGERY CENTER 25.62 %   74.38 %
2SENATE STREET SURGERY CENTER LLC
  		AMBULATORY SURGERY CENTER 26.21 %   73.79 %
3INDIANA ENDOSCOPY CENTERS LLC
  		AMBULATORY SURGERY CENTER 26.01 %   73.99 %
4ROC SURGERY LLC
  		AMBULATORY SURGERY CENTER 29.7 %   70.3 %
5BALL OUTPATIENT SURGERY CENTER LLC
  		AMBULATORY SURGERY CENTER 28.18 %   71.82 %
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 INDIANA UNIVERSITY HEALTH
1701 N SENATE BLVD
INDIANAPOLIS,IN46202
HTTPS://IUHEALTH.ORG/
22-005051-1 		X X X X   X X   SEE PART V, SECTION C FOR ADDITIONAL INFORMATION  
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
INDIANA UNIVERSITY HEALTH
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): 		1
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 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 ................. 5 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.................................. 6a   No
b 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. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTPS://IUHEALTH.ORG/IN-THE-COMMUNITY/COMMUNITY-BENEFIT
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
INDIANA UNIVERSITY HEALTH
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
HTTPS://IUHEALTH.ORG/PAY-A-BILL/FINANCIAL-ASSISTANCE
b
HTTPS://IUHEALTH.ORG/PAY-A-BILL/FINANCIAL-ASSISTANCE
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
INDIANA UNIVERSITY HEALTH
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
INDIANA UNIVERSITY HEALTH
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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'S 2021 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORTS INCLUDE PRIORITIZED DESCRIPTIONS OF SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY. THE CHNA REPORTS IDENTIFIED THE FOLLOWING NEEDS TO BE ADDRESSED: - ACCESS TO HEALTH CARE SERVICES - Chronic disease and chronic disease management - DRUG AND SUBSTANCE ABUSE - Food insecurity and healthy eating - Health education and navigation - Maternal and infant health and child well-being - MENTAL HEALTH - Obesity, diabetes and physical inactivity - Smoking, tobacco use and exposure to secondhand smoke - SOCIAL DETERMINANTS OF HEALTH - Aging population and needs of seniors
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - IU Health Methodist Hospital, IU Health University Hospital, and Riley Hospital for Children. IU Health operates four hospital locations that are licensed as a single hospital by the Indiana State Department of Health. These hospital locations are as follows: - IU Health Methodist Hospital - IU Health University Hospital - Riley Hospital for Children at IU Health - IU Health Saxony Hospital IU Health Methodist Hospital, IU Health University Hospital, and Riley Hospital for Children are located in Indianapolis, Marion County, Indiana and are referred to as the IU Health Academic Health Center. IU Health Saxony Hospital is located in Fishers, Hamilton County, Indiana. Although licensed as a single hospital, each of these facilities serve different, although sometimes overlapping, portions of the community which present their own unique health needs. In order to take into account all of these unique health needs, IU Health conducted separate Community Health Needs Assessments ("CHNAs") for each of its four hospital locations. In conducting each of its most recent CHNAs, IU Health took into account input from persons who represent the broad interests of the communities it serves by hosting four community focus groups and conducting interviews. These focus groups engaged public health officials and community-based organizations that provide services and/or reflect community members who are medically underserved, low-income, or of a minority subpopulation to discuss the health needs of the service area and what role IU Health could play in addressing the identified needs. IU Health Academic Health Center The defined community per the most recent CHNA is Marion County, where the hospital resides. Marion County - Community Meetings and Interviews In collaboration with other local health systems - Ascension St. Vincent (Indianapolis) and Community Health Network - four virtual, community meetings were held May 25-27, 2021, to receive input from stakeholders regarding the health needs in Marion County. In total, the meetings were attended by 53 community organizations that provide services and/or reflect community residents who are under or uninsured; with undocumented status; older; Limited English Proficient; low-income; use or inject drugs; experience homelessness; Black, Indigenous, and people of color; LGBTQ; and populations impacted greatly by non-medical barriers of health such as poverty, food access and affordable housing. * Allen Chapel AME Church * Anthem Medicaid * Broadway United Methodist Church * City-County Council staff * City of Indianapolis, Division of Community Nutrition and Food Policy * Coalition for Our Immigrant Neighbors * Concerned Clergy of Indianapolis * Connections IN Health, Indiana Clinical and Translational Sciences Institute (CTSI), Indiana University School of Medicine * Covering Kids & Families of Indiana * Crossroads AME Church/Common Grounds Institute * First Baptist Church North Indianapolis * Gennesaret Free Clinic * Gleaners Food Bank of Indiana * Habitat for Humanity of Greater Indianapolis * Health by Design * Horizon House * Immigrant Welcome Center * Indiana Legal Services * Indiana Native American Indian Affairs Commission * Indiana Public Health Association * Indiana Department of Health * Indiana University Richard M. Fairbanks School of Public Health * Indianapolis City Council * Indianapolis Neighborhood Housing Partnership * Indianapolis Urban League * Indy Go * Indy Hunger Network * Jump IN for Healthy Kids * Marian University/College of Osteopathic Medicine * Marion County Public Health Department * Managed Health Services (MHS) Neighborhood Christian Legal Clinic * Nine13sports * Nurse Family Partnership of Goodwill of Central and Southern Indiana * Pathway to Recovery * Playworks * Raphael Health Center, Inc. * Richard M. Fairbanks Foundation * The Julian Center * United States Congress, Representative Andre Carson (staff) * University of Indianapolis * YMCA of Greater Indianapolis/Top 10 Coalition Secondary data and a preliminary list of community health need priorities were presented at the meetings. Each group was then asked questions about the preliminary list, including their reactions, additions to the proposed needs, thoughts regarding the causes of the needs, impacts of the COVID-19 pandemic and others. After this discussion, participants were given the opportunity to make additional comments before being asked to vote on what they believed were the most significant needs in the county. Participants were asked to choose three to five significant health needs via an online poll during and after the meeting. Preliminary needs identified include a wide-array of topics, including the COVID-19 pandemic, food insecurity, maternal and child health, racial and ethnic disparities, mental health and access to mental health providers, obesity and physical inactivity, poverty, educational achievement, housing, crime and community safety, public health funding and others. In addition to these topics, participants focused discussion around substance abuse and treatment, transportation barriers, culturally appropriate care and services (including language barriers), affordability of healthy food, smoking and tobacco use, access to and cost of primary care, health insurance, preventive health services, lack of providers within high-need areas, childcare, chronic conditions (including diabetes and hypertension), navigating existing resources, dental health needs, child health, job opportunities and trainings, technology barriers and digital-divide, post incarceration resources and social connectedness. For those unable to attend community meetings, a separate survey was distributed to receive their input on the most significant needs. These findings were combined with those of the community meeting participants. From this process, participants identified the following needs as most significant for Marion County: * Racial and ethnic health disparities * Obesity continues to be an issue, as well as diabetes, with rates increasing for adults. * Infant and maternal mortality are significant issues, with social determinants of health impacting access to prenatal care and other needed services. * HIV (human immunodeficiency virus) is still a concern, with some hope that the disease can be eradicated within the next decade through modern medicine and prevention strategies such as PrEP (pre-exposure prophylaxis). * Tobacco and vaping are issues, with a low cigarette tax in Indiana helping perpetuate its use. Environmental health - including old housing and air pollution - is leading to poor health, including lead poisoning, arsenic poisoning and pediatric asthma. The need for safe and stable housing is significant. * Health literacy is a need, particularly affecting Hispanic (or Latino) populations due to language barriers. Education disparities around health are also leading to genera* Access to mental and behavioral health services * Food insecurity and access to affordable, healthy food * Access to safe and affordable housing * Mental health * Poverty and associated community need A survey was also issued to internal providers at IU Health Methodist Hospital, asking them to identify priority needs among the patients they serve. Among 12 responses, the following issues were identified as the most significant: * Food insecurity and nutrition * Health disparities, particularly for racial and ethnic minority populations * Mental health * Poverty and income inequality The survey also asked about the impacts of the COVID-19 pandemic. Issues most often selected as significant impacts include: * Social isolation and loneliness * Health disparities * Digital divide (lack of internet or device access) * Economic disparities * Housing (inability to stay sheltered or pay rent/mortgage)
Schedule H, Part V, Section B, Line 5 Facility , 2 Facility , 2 - IU Health Methodist Hospital, IU Health University Hospital, and Riley Hospital for Children(continued). Two additional interviews were conducted in May 2021 with representatives of the county public health department and minority health organization to obtain subject-matter expertise into the health needs in Marion County. The following issues were discussed as significant: * Poverty is a significant issue and impacts almost all areas of wellbeing, including housing, accessing health services, nutrition, stress and mental health, chronic disease, transportation and others. The need for a living wage for all residents is significant. * Health disparities are significant, including large disparities in social determinants of health for racial and ethnic minority populations. * Health insurance is a significant barrier to optimal health, with restrictions in coverage leading to a lack of preventive health. * Mental health is a significant issue, with depression and anxiety both widespread. Self-medication through substance abuse is common. * Obesity continues to be an issue, as well as diabetes, with rates increasing for adults. * Infant and maternal mortality are significant issues, with social determinants of health impacting access to prenatal care and other needed services. * HIV (human immunodeficiency virus) is still a concern, with some hope that the disease can be eradicated within the next decade through modern medicine and prevention strategies such as PrEP (pre-exposure prophylaxis). * Tobacco and vaping are issues, with a low cigarette tax in Indiana helping perpetuate its use. Environmental health - including old housing and air pollution - is leading to poor health, including lead poisoning, arsenic poisoning and pediatric asthma. The need for safe and stable housing is significant. * Health literacy is a need, particularly affecting Hispanic (or Latino) populations due to language barriers. Education disparities around health are also leading to generational persistence of health disparities for racial and ethnic minority populations. * Food insecurity is Signiant, and food pantries may have irregular hours and face huge demand. * Education needs better funding, including adequate teacher compensation. * More community collaboration is needed with health systems and social service providers to identify community improvement and planned interventions. In regard to the COVID-19 pandemic, a wide array of impacts was noted, including: Testing was a large challenge at the beginning of the COVID-19 pandemic, due to inadequate federal resources and other limits. * The COVID-19 pandemic highlighted the impact of social determinants of health, as people experiencing homelessness faced huge concerns due to the inability to socially distance in shelters and access care. Hotels were turned into isolation areas for patients with COVID-19. Racial and ethnic disparities in testing, treatment and outcomes were highlighted by the COVID-19 pandemic. Elderly Black residents were particularly affected. * Care was delayed for a lot of individuals due to fear of going to a provider and being exposed to the virus, leading to unmet needs and emergency situations. * Community collaboration among providers led to a better response, including health systems offering testing and other aid to public health organizations. More collaboration and coordination will be needed in the future. * Vaccination disparities are evident, with Black populations disproportionately unable to access the vaccine if desired. * The need for better health information sharing (including the identification of health disparities) between organizations.
Schedule H, Part V, Section B, Line 5 Facility , 3 Facility , 3 - IU Health Saxony Hospital. The defined community per the most recent CHNA is Marion, Hamilton, Hancock and Madison Counties. The hospital resides in Hamilton County. Marion County - Community Meetings and Interviews (See above information) Hamilton County - Community Meetings and Interviews In collaboration with other local health systems - Ascension St. Vincent, Community Health Network and Riverview Health - two community meetings were held on May 20 (morning and afternoon), 2021, to receive input from stakeholders regarding the health needs in Hamilton County. The meetings were attended by 82 community organizations that provide services and/or reflect community residents who are under or uninsured; with undocumented status; older; Limited English Proficient; low-income; use or inject drugs; experience homelessness; Black, Indigenous, and people of color; LGBTQ; and populations impacted greatly by non-medical barriers of health such as poverty, food access and affordable housing. * Allen Chapel AME Church * Anthem Medicaid * Ascension St. Vincent * Aspire Indiana Health * Breathe Easy Hamilton County * Broadway United Methodist Church * Carmel Clay Schools * Central Indiana Council on Aging (CICOA) * City-County Council staff City of Indianapolis * City of Indianapolis, Division of Community Nutrition and Food Policy * City of Noblesville * Coalition for Our Immigrant Neighbors * Community Health Network * Concerned Clergy of Indianapolis * Connections IN Health, Indiana Clinical and Translational Sciences Institute (CTSI), Indiana University School of Medicine * Covering Kids & Families of Indiana * Crossroads AME Church/Common Grounds Institute * First Baptist Church North Indianapolis * Fishers Health Department * Gennesaret Free Clinic * Gleaners Food Bank of Indiana * Good Samaritan Network of Hamilton County * Habitat for Humanity of Greater Indianapolis * Hamilton County Community Foundation * Hamilton County Council on Alcohol and Other Drugs * Hamilton County Government * Hamilton County Harvest Food Bank * Hamilton County Head Start * Hamilton County Health Department * Hamilton County Meals on Wheels * Hancock County Health Department * Hancock Regional Hospital HAND, Inc. * Health by Design * Heart and Soul Free Clinic * HOPE Family Care Center * Horizon House * Immigrant Welcome Center * Indiana Legal Services * Indiana Native American Indian Affairs Commission * Indiana Public Health Association * Indiana Department of Health * Indiana University Richard M. Fairbanks School of Public Health * Indianapolis City Council Indianapolis Neighborhood Housing Partnership * Indianapolis Urban League * Indy Go * Indy Hunger Network * IU Health * IU Health Indy Suburban Region * IU Health Methodist Hospital * IU Health North Hospital * IU Health Saxony Hospital * IU Health University Hospital * Jump IN for Healthy Kids * Madison County Health Department * Marian University/College of Osteopathic Medicine * Marion County Public Health Department * Managed Health Services (MHS) * Neighborhood Christian Legal Clinic * Nine13sports * Noblesville Chamber of Commerce * Noblesville Schools * Noblesville Town Council * Nurse Family Partnership of Goodwill of Central and Southern Indiana * Pathway to Recovery * Playworks Prevail, Inc. * Prime Life Enrichment Purdue Extension * Raphael Health Center, Inc. * Richard M. Fairbanks Foundation * Riverview Health * Shepherd's Center of Hamilton County * Sheridan Community Schools * St. Elizabeth Seton Parish * The Julian Center * The Villages Health Families * Trinity Free Clinic * United States Congress, Representative Andre Carson (staff) * University of Indianapolis * YMCA of Greater Indianapolis/Top 10 Coalition Secondary data and a preliminary list of community health need priorities was presented at both meetings. Each group was then asked questions about the preliminary list, including their reactions, additions to the proposed needs, thoughts regarding the causes of the needs, impacts of the COVID-19 pandemic and others. After this discussion, participants were given the opportunity to make additional comments before being asked to vote on what they believed were the most significant needs in the county. Participants were asked to choose three to five significant health needs via an online poll during and after the meeting. Preliminary needs identified include several topics, including the COVID-19 pandemic, alcohol abuse, immunization rates, elderly needs, smoking and tobacco use, access to mental health services and statewide issues, such as health disparities and obesity. In addition to these topics, participants focused discussion on substance abuse and overdoses, mental health concerns, access to care disparities for various segments of the population, aging in place resources, transportation, limited clinical hours of providers, limited mental health providers, a continuum of care between various health services and food insecurity. From this process, participants identified the following needs as most significant for Hamilton County: * Access to and supply of mental health providers, particularly for low-income populations Needs of a growing senior population, including aging in place and cognitive care * Mental health * Alcohol use and excessive drinking * Access to care disparities, particularly for low-income populations A survey was also issued to internal providers at IU Health that serve Hamilton County, asking them to identify priority needs among the patients they serve. The following issues were identified as the most significant: * Healthcare and services for elderly residents * Mental health * Substance abuse * Access to healthcare services * Obesity Access to behavioral health services, including mental health and substance abuse The survey also asked about the impacts of the COVID-19 pandemic. Issues most often selected as significant impacts include: * Loss of health insurance * Social isolation and loneliness * Health disparities Two additional interviews were conducted with representatives of local public health departments to obtain subject-matter expertise into the health needs in Hamilton County. The following issues were discussed as significant: * Access to behavioral health services - both mental health and substance abuse - is a significant need, with few providers in the area and primary care physicians not often integrating behavioral health checks into care (a large increase in population has led to an undersupply of providers) * Mental health concerns are widespread, including an increase in child mental health needs (youth struggle with high expectations and stress in school) * Substance abuse and overdoses are significant concerns, with opioid usage being widespread (alcohol abuse is also common) * Transportation is a barrier in the community, with limited public options and routes * Insurance barriers are significant, with uninsured populations having few options and providers not accepting certain plans, such as Medicaid (while free and low-cost clinics exist, they cannot keep up with demand) * Food insecurity and access to healthy food is challenging for some groups, exacerbated by poverty and transportation (low-income housing is also limited) * The working poor often are vulnerable as they do not qualify for many programs but still live paycheck to paycheck (while Hamilton County compares well for poverty, the needs of low-income populations are often overlooked due to this, creating pockets of need) * Prevention is not a priority for most, and more programs and access to preventive health are needed * Sexually transmitted infections are an issue, particularly chlamydia * Cultural differences led to unmet needs for several immigrant communities including language barriers * LGBTQ+ populations are also underserved, often feeling uncomfortable going to available providers * Public health funding is limited, and service levels are impacted due to financial constraints * Time is a big barrier to optimal health, as parents are often too busy with work and children to pursue healthy living measures * More collaboration is needed between health systems, health departments, providers and social service organizations
Schedule H, Part V, Section B, Line 5 Facility , 4 Facility , 4 - IU Health Saxony Hospital (continued). In regard to the COVID-19 pandemic, a wide array of impacts was noted, including: * A lack of resources at local health departments - both funding and staff - led to difficulties throughout the pandemic, and many other services were foregone to focus on the pandemic (a need for a more robust public health infrastructure is highlighted) * The politicization of public health was widespread, and many guidelines and measures were met with criticism * Mental health issues worsened due to isolation, with children at particular risk * STI rates rose substantially * The pandemic highlighted the need for accurate health information, and providers need to focus on maintaining communication after COVID-19 Hancock County - Interview An interview was conducted with representatives of a local public health department to obtain subject-matter expertise into the health needs in Hancock County. Participants were asked to comment on a list of unfavorable health indicators, add other needs to significant indicators and discuss barriers and resources. The following issues were discussed as significant: * Participants were not surprised about the unfavorable secondary data indicators, including drunk-driving deaths, transportation, STIs, lack of social associations, obesity and access to mental health providers (in particular, a lack of mental health providers has been a consistent issue) * While there are areas to exercise, the built environment makes them difficult to access, including a lack of sidewalks and a high number of cycling accidents * Cost of healthcare is a significant issue, as well as the cost to access exercise opportunities * Mental health, obesity and physical inactivity, substance abuse, STIs and cost of healthcare services were identified as priority areas * A lack of knowledge of available resources is a barrier, as well as intrinsic motivation to improve one's health (navigation resources are needed) * Transportation is a significant barrier in the community, with limited access to public options and most traveling outside the county for work * Mental health stigma, while improving, is still a barrier * Health education, particularly for youth, is a significant need and could improve many health issues, such as obesity, mental health, substance abuse and chronic disease Madison County - Community Meeting and Interviews In collaboration with local health systems - Ascension St. Vincent and Community Health Network - a community meeting was held in June 10, 2021, to receive input from stakeholders regarding the health needs in Madison County. Secondary data and a preliminary list of community health need priorities was presented at the meeting. Each group was then asked questions about the preliminary list, including their reactions, additions to the proposed needs, thoughts regarding the causes of the needs, impacts of the COVID-19 pandemic and others. After this discussion, participants were given the opportunity to make additional comments before being asked to vote on what they believed were the most significant needs in the county. Participants were asked to choose three to five significant health needs via an online poll during and after the meeting. Preliminary needs identified include COVID-19, food insecurity, maternal and child health, mental health and suicide, elderly needs, obesity and physical inactivity, tobacco use, poverty, educational opportunities, housing, racial and ethnic health disparities statewide, air pollution and substance abuse. In addition to these topics, participants focused discussion on access to affordable healthy foods and nutrition knowledge, access to behavioral health providers (including mental health and substance abuse), vaping, homelessness, child abuse and trauma, transportation, walkability, childcare, chronic disease and health education needs. From this process, participants identified the following needs as most significant for Madison County: Mental health and suicide Access to healthy food, nutrition and knowledge of healthy eating practices Substance abuse Transportation and walkability Poverty Racial and ethnic health disparities An additional interview was conducted with a representative of a local public health department to obtain subject-matter expertise into the health needs in Madison County. The following issues were discussed as significant: * Obesity is a significant issue, with food insecurity and a lack of grocery stores contributing * Smoking is still an issue, largely tied into Madison County's culture and identity as an older, factory area * Low birthweight is a significant issue (while a problem for all mothers, clear racial disparities exist for Black infants and relatedly, prenatal care is an issue) * More health education is needed, particularly for youth * Providers and social service organizations need better collaboration and efforts to go into the community rather than expect residents to come to them (coordination is often lacking) * Transportation is a significant barrier, with few public transportation options outside of Anderson * Health inequities and disparities are prevalent, particularly for Black and Hispanic (or Latino) residents (cultural and language barriers are present for Hispanic populations) * Access to mental health care is difficult despite an adequate number of providers due to other barriers and a lack of continuum of care * Navigation of resources is difficult, with residents often unsure of where to go to meet needs In regard to the COVID-19 pandemic, several impacts were noted, including: * Disparities in vaccine coverage and uptake are clear, particularly among Black residents * All services from the health department needed to focus on the pandemic, meaning a temporary halt of others was necessary * Some business closures and issues with unemployment resulted * More focus is needed on public information dissemination as many look to the local health departments for guidance (departments need to make sure they are seen in the community and maintain communication with all partners)
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - IU Health Methodist Hospital and IU Health University Hospital. In conjunction with the CHNA, IU Health Inc.'s Board adopted an implementation strategy in April 2022 related to the 2021 CHNA. IU Health Inc. 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 Inc. includes IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health, and IU Health Saxony Hospital. The first three hospitals make up the Academic Health Center (AHC). IU Health Methodist Hospital and IU Health University Hospital will address the following community health needs between 2022 and 2024: 1. Access to Healthcare Services 2. Behavioral Health 3. Chronic Disease and Chronic Disease Management 4. Smoking, Tobacco Use and Exposure to Secondhand Smoke 5. Social Determinants of Health IU Health Methodist Hospital and IU Health University Hospital are unable to address all of the significant community health needs identified in the local community. This is not meant to minimize the importance of any health need or the integrity of the CHNA process. IU Health Methodist Hospital and IU Health University Hospital are mission and values driven hospitals; therefore, addressing community health needs that align with the hospitals' mission will have the greatest opportunity to activate and leverage hospital resources as well as maximize current strategic collaborations with community-based partners. IU Health Methodist Hospital and IU Health University Hospital are unable to address the following community health needs identified in the 2021 Community Health Needs Assessment. 1. Health Education and Navigation 2. Maternal and Infant Health and Child Well-being However, during 2021 IU Health Methodist Hospital and IU Health University Hospital continued to address the needs identified in the 2018 CHNA, through the implementation strategy adopted in April 2019 related to the 2018 CHNA. IU Health Methodist Hospital and IU Health University Hospital will address the following community health needs between 2019 and 2021: 1. Access to healthcare services 2. Drug and substance abuse (including opioids)* 3. Healthcare and social services for seniors 4. Mental health* 5. Obesity and diabetes 6. Smoking, tobacco use and exposure to secondhand smoke 7. Social determinants of health 8. Other statewide concerns: a. public health funding b. air pollution * IU Health uses the term behavioral health to refer to mental health and drug and substance abuse (including opioids). Access to Healthcare Services; Smoking, Tobacco Use and Exposure to Secondhand Smoke IU Health Methodist and University Hospitals' implementation strategy to address the identified need of Access to Healthcare and Smoking, Tobacco Use and Exposure to Secondhand Smoke includes the following: Provide health screenings in the community. Due to the coronavirus pandemic, many in person, community activities were canceled due to social distancing and community gathering restrictions. This impacted IU Health Inc.'s ability to offer health screenings in 2021. During this time, other community needs were identified including increasing the availability of COVID-19 vaccines in the community. During 2021, the Community Outreach and Engagement team coordinated 42 community vaccine clinics with various community-based partners to reach racial and ethnic, limited English proficient, and other individuals who were high risk for COVID-19. Over 1,800 doses of vaccine were given to community members in Marion County. Behavioral Health IU Health Methodist and University Hospitals' implementation strategy to address the identified need of Behavioral Health includes the following: Implement substance abuse programming. The IU Health Methodist Hospital Addiction Treatment & Chronic Pain Recovery Center provides an intensive outpatient program. The provider team includes physicians, nurse practitioners, registered nurses, therapists, recovery coaches, physical therapists and yoga instructors and art therapists. Services include group psychotherapy, 12-step program education, and connection to the recovery community, detox services, medication-assisted treatment, recovery coaching, case management, individual therapy, family therapy, relapse prevention skills, motivational interviewing, mindfulness/meditation, exercise therapy/yoga, art therapy, spirituality sessions and aftercare. To help lessen the spread of COVID-19 and for the safety of patients, virtual care was available to patients. Work with community organizations to determine roles in programming. In 2021, the community benefit grant program awarded funding to community-based organizations including Reach for Youth, Volunteers of America Ohio & Indiana (Fresh Start Recovery), Overdose Lifeline, and Central Indiana Community Foundation: Summer Youth Program Fund to provide a variety of services including support groups, individual and family counseling, and residential addictions treatment. Many of these organizations provide services to individuals who are under/uninsured. Obesity and Diabetes IU Health Methodist and University Hospitals' implementation strategy to address the identified need of Obesity and Diabetes includes the following: Healthy cooking classes in the community. Due to the staffing constraints and hospital clinical needs in 2021 due to COVID-19, the IU Health dieticians were unable to do these activities in the community. In 2021, the community benefit grant program provided funding to the Marion County Public Health Department to support the Fresh Bucks Program. The program enables households who utilize the USDA Supplemental Nutrition Assistance Program (SNAP) to afford healthier foods by providing a $1 for $1 match to purchase fresh, local produce at farmers markets, farm stands and through a new mobile market. As of November 2021, there were 748 participants with Fresh Bucks distribution at $37,592 (redemption rate of 87.5%). Social Determinants of Health IU Health Methodist and University Hospitals' implementation strategy to address the identified need of Social Determinants of Health includes the following: Expand the medical-legal partnership (MLP). In 2021, the MLP completed 20 intake interviews. Nineteen of those cases were selected/eligible for services. At the end of the year, this program closed 29 cases. All cases were provided legal services. In the last quarter of 2021, 172 hours were collectively attributable to the Methodist & University MLP. Help individuals and families in need of support connect to resources available in the Indianapolis community. IU Health Inc. Continues to support Aunt Bertha, an online platform for finding and connecting to social services across Indiana and the United States. All programs that appear on the aunt bertha site are offered for free or at a reduced cost and will help address patients' social determinants of health needs. In 2021, there were 15,427 sessions, 12,832 searches, and 108 referrals on the IU Health Aunt Bertha platform (i.e., both the community and staff site). Also in 2021, the community benefit grant program awarded funding to the Indy Hunger Network to support Community Compass, multiplatform technology that connects Marion County residents to information about available food assistance, including both screening questions for federal nutrition programs and location information for charitable food assistance, WIC clinics, and snap and WIC retail locations. Additionally, funding was awarded to Gleaners Food Bank to enhance the Pantry Innovation in 21 Counties (EPIC) Fund, established to revolutionize the network of pantries by improving their ability to receive and distribute nutritious food.
Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - IU Health Methodist Hospital and IU Health University Hospital (continued). Work with community organizations to determine roles in programming to provide housing resources to low-income community members. In 2021, the community benefit grant program awarded funding to community-based organizations including Habitat for Humanity, Family Promise of Greater Indianapolis, and Trinity Haven to help families with children experiencing homelessness; build housing for families who are low-income; and to support LGBTQ youth experiencing housing instability. Community Health Needs Not Being Addressed IU Health Methodist Hospital is unable to address those community health needs that do not relate directly to the hospital's mission to deliver healthcare. These are needs that other governmental agencies and/or community organizations have the most appropriate expertise and resources to address. IU Health Methodist Hospital is unable to address the following community health needs identified in the 2018 Community Health Needs Assessment: Healthcare and Social Services for Seniors Aging in place is very important for older adults, and IU Health recognizes the importance. There are several community collaborations that are working to better the lives of seniors in the Indianapolis community: Central Indiana Council on Aging (CICOA) in Indianapolis is focused on the Indianapolis community. Furthermore, agencies that focus on the State of Indiana are: Southwestern Indiana Regional Council on Aging (SWIRCA); Division of Aging in Indianapolis; and LifeStream Services, Inc. Funding for Public Health IU Health has a partnership with the Indiana Public Health Association. This organization works to advance public health services and education in the State of Indiana. IU Health's Government Affairs looks for opportunities to advocate for public health funding at the federal, state and local level. Air Pollution The hospital is unable to directly impact policy and implement strategies that address air pollution. However, other state and local governmental agencies and community organizations (e.g. the Hoosier Environmental Council) have the most appropriate expertise with which to address this issue.
Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - Riley Hospital for Children at Indiana University Health. In conjunction with the CHNA, IU Health Inc.'s Board adopted an implementation strategy in April 2022 related to the 2021 CHNA. IU Health Inc. 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 Inc. includes IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health (Riley), and IU Health Saxony Hospital. The first three hospitals make up the Academic Health Center (AHC). Riley Hospital for Children at Indiana University Health (Riley)will address the following community health needs between 2022 and 2024: 1. Access to Healthcare Services 2. Behavioral Health 3. Chronic Disease and Chronic Disease Management 4. Maternal and Infant Health and Child Well-being 5. Smoking, Tobacco Use and Exposure to Secondhand Smoke 6. Social Determinants of Health Riley Hospital for Children at IU Health is unable to address all of the significant community health needs identified in the local community. This is not meant to minimize the importance of any health need or the integrity of the CHNA process. Riley Hospital for Children at IU Health is a mission and values driven hospital; therefore, addressing community health needs that align with the hospital's mission will have the greatest opportunity to activate and leverage hospital resources as well as maximize current strategic collaborations with community-based partners. Riley Hospital for Children at IU Health is unable to address the following community health needs identified in the 2021 Community Health Needs Assessment. 1. Health Education and Navigation However, during 2021 Riley Hospital for Children at IU Health continued to address the needs identified in the 2018 CHNA, through the implementation strategy adopted in April 2019 related to the 2018 CHNA. Riley Hospital for Children at Indiana University Health will address the following community health needs between 2019 and 2021: 1. Maternal and infant health 2. Mental health* 3. Obesity and access to healthy food 4. Poverty and other social determinants of health 5. Smoking, tobacco use and exposure to secondhand smoke 6. Violence and injuries 7. Other statewide concerns: a. public health funding b. air pollution *IU Health uses the term behavioral health to refer to mental health. The implementation strategy to address the identified needs noted above includes the following: Maternal and Infant Health Riley Hospital for Children's implementation strategy to address the identified need of Maternal and Infant Health includes the following: Continue to collaborate with the Marion County Public Health Department in conducting the Fetal Infant Mortality Review (FIMR). The FIMR is an ongoing program that occurs on an as-needed basis. This review occurs in partnership with the Marion County Public Health Department and the Indiana Department of Health. Riley staff volunteer their time and expertise to the FIMR. The coalition made recommendations for systems changes and has coordinated community events for education and outreach with the community and supported maternal and child health leaders actively engaging with their communities on maternal and infant education. Provide continuing education to primary care providers in Indiana regarding safe sleep and available resources. In 2021, safe sleep 'classes' were discontinued in the community. COVID-19 drastically limited Riley's ability to serve the community, due to the hospital's visitor restrictions. Additionally, the trauma department was re-evaluating injury priorities for prevention with a focus on violent injuries as well as pedestrian injuries. Provide lactation training, childcare education and well-baby checks for new mothers in the community. For 2021, consultations could not be done in person which limited the number of consultations completed. Note: Riley did launch the Riley Children's Health maternity tower to centralize inpatient childbirth and newborn care among the three downtown Indianapolis IU Health hospitals. Riley now houses the largest number of neonatal intensive care unit beds in Indiana. Obesity and Access to Healthy Food Riley Hospital for Children's implementation strategy to address the identified need of Obesity and Access to Healthy Food includes the following: Healthy cooking classes in the community. Due to the staffing constraints and hospital clinical needs in 2021 due to COVID-19, the IU Health dieticians were unable to be present in the community doing these activities. Implement the 5-2-1-0 program in collaboration with local organizations. Riley provided a grant to Jump IN for Healthy Kids (Jump IN) in 2021. The organization developed a 3-year approach to engaging the community in understanding and acting on 5-2-1-0. They are partnering with Radio One and the sponsorship package will focus on Marion County. Jump IN did extensive work in 2021 focused on providing comprehensive training to childcare centers and integrating healthy best practices into Indiana's early childcare education provider culture and systems. Riley did launch a onsite food pantry. Since March 2021, 385 patient families and 140 team members from 75 different Indiana zip codes were served. This strategy did not appear in the 2019 implementation strategy but was undertaken in 2021 as it meets significant community health needs in relation to food insecurity and access to healthy food. Also in 2021, the community benefit grant program awarded funding to the YMCA of Greater Indianapolis to support the Top 10 Coalition's launch of the "Rethink Your Drink" campaign to encourage individuals and families to choose drinks without added sugar. This strategy did not appear in the April 2019 implementation strategy but was undertaken in 2021 as it meets significant community health needs in relation to obesity and access to healthy foods. Smoking, Tobacco Use and Exposure to Secondhand Smoke; Behavioral Health Riley Hospital for Children's implementation strategy to address the identified need of Smoking, Tobacco Use and Exposure to Secondhand Smoke and Behavioral Health includes the following: Patients, family members and caregivers of Riley patients will be screened for use of tobacco products, including vaping. Those who screen positive will be counseled regarding medical risks to self and/or patient and asked if they want to quit, or at least abstain while their child is in the hospital. If they agree, they will receive counseling from a core group of staff, also trained as certified tobacco treatment specialists. This program was not implemented in 2021 due to COVID-19. The IU Health Community Health Division has been planning a larger initiative to screen and refer patients and families for assistance that will launch in 2022.
Schedule H, Part V, Section B, Line 11 Facility , 4 Facility , 4 - Riley Hospital for Children at Indiana University Health (continued). Poverty and Other Social Determinants of Health Riley Hospital for Children's implementation strategy to address the identified need of Poverty and Other Social Determinants of Health includes the following: Expand the medical-legal partnership (MLP) The Riley MLP finished its second full year helping patients and families with their legal needs. The project continued to accept referrals and engage in off-site investigations and case-handling this quarter. The challenges of the COVID-19 pandemic continue to affect the rights of clients in the Indianapolis region and across the state, especially for children facing health-harming legal needs. This project shows the potential of legal interventions leading to improved health and wellness outcomes for the children and families served by Riley. Violence and Injuries Riley Hospital for Children's implementation strategy to address the identified need of Violence and Injuries includes the following: Provide free safe sitter classes to groups of low-income youth. Riley was unable to hold classes in the community due to COVID-19. The trauma department was re-evaluating injury priorities for prevention with a focus on violent injuries as well as pedestrian injuries. Community Health Needs Not Being Addressed Riley at IU Health is unable to address those community health needs that do not relate directly to the hospital's mission to deliver healthcare. These are needs that other governmental agencies and/or community organizations have the most appropriate expertise and resources to address. Riley at IU Health is unable to address the following community health needs identified in the Community Health Needs Assessment: Funding for Public Health IU Health has a partnership with the Indiana Public Health Association. This organization works to advance public health services and education in the State of Indiana. IU Health's Government Affairs Office looks for opportunities to advocate for public health funding at the federal, state and local level. Air Pollution The hospital is unable to directly impact policy and implement strategies that address air pollution. However, other state and local governmental agencies and community organizations (e.g. the Hoosier Environmental Council) have the most appropriate expertise with which to address this issue.
Schedule H, Part V, Section B, Line 11 Facility , 5 Facility , 5 - IU Health Saxony Hospital. In conjunction with the CHNA, IU Health Inc.'s Board adopted an implementation strategy in April 2022 related to the 2021 CHNA. IU Health Inc. 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 Inc. includes IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health, and IU Health Saxony Hospital. The first three hospitals make up the Academic Health Center (AHC). IU Health Saxony Hospital will address the following community health needs between 2022 and 2024: 1. Access to Healthcare Services 2. Aging Population and Needs of Seniors 3. Behavioral Health 4. Chronic Disease and Chronic Disease Management 5. Smoking, Tobacco Use and Exposure to Secondhand Smoke 6. Social Determinants of Health IU Health Saxony Hospital is unable to address all of the significant community health needs identified in the local community. This is not meant to minimize the importance of any health need or the integrity of the CHNA process. IU Health Saxony Hospital is a mission and values driven hospital; therefore, addressing community health needs that align with the hospital's mission will have the greatest opportunity to activate and leverage hospital resources as well as maximize current strategic collaborations with community-based partners. IU Health Saxony Hospital is unable to address the following community health needs identified in the 2021 Community Health Needs Assessment. 1. Health Education and Navigation 2. Maternal and Infant Health and Child Well-being However, during 2021 IU Health Saxony Hospital continued to address the needs identified in the 2018 CHNA, through the implementation strategy adopted in April 2019 related to the 2018 CHNA. 1. Access to Healthcare Services 2. Drug and Substance Abuse (including opioids and alcohol)* 3. Food Insecurity 4. Healthcare and Social Services for Seniors 5. Mental Health* 6. Obesity and Diabetes 7. Social Determinants of Health *IU Health uses the term Behavioral Health to refer to mental health and drug and substance abuse (including opioids). Access to Healthcare Services IU Health Saxony Hospital's implementation strategy to address the identified need of Access to Healthcare Services includes the following: Trinity Free Clinic health services for the uninsured and underinsured of Hamilton County. In 2021, IU Health Saxony provided funding to support the operations of Trinity Free Clinic's free pre- and Type II diabetes care clinic and to purchase glucose testing and monitoring equipment, A1C machines, logbooks and other medical supplies. In 2021, IU Health team members and physicians staffed the clinic for over 40 hours. Heart & Soul Health Clinic operations. In 2021, IU Health Saxony, in conjunction with IU Health North, supported the expansion of Heart & Soul Clinic's language services program, which helped over 200 non-English speaking patients receive informed medical care. Registration assistance for health insurance. During the first half of 2021, the IU Health Saxony Hospital Individual Solutions coordinators assisted over 20 individuals in health insurance enrollment. Community COVID-19 and flu vaccine clinics. IU Health Saxony Hospital partnered with internal staff and community organizations to offer ten free COVID-19 and flu vaccine clinics to in-need communities. In 2021, 582 COVID-19 vaccines and 377 flu vaccines were administered. Note: This strategy did not appear in the April 2019 implementation strategy but was undertaken in 2021 as it meets significant community health needs in relation to access to healthcare services. Behavioral Health (includes Drug & Substance Abuse and Mental Health) IU Health Saxony Hospital's implementation strategy to address the identified need of Behavioral Health includes the following: Partnership for a Healthy Hamilton County (PHHC). In 2021, PHHC underwent a name change and is now referred to as A Healthier Hamilton County: Systems of Care (SOC). IU Health Saxony provided funding for A Healthier Hamilton County: SOC to support the operations and foundation of their new peer-to-peer safe crisis de-escalation space project, Connecting Hamilton County and Tackling Stigma (CHATS). Peer recovery program. During the first half of 2021, over 20 patients were referred from the IU Health Saxony Hospital emergency department to the behavioral health peer recovery program and 86 percent of patient follow-ups were successful. IU Health Emergency Department (ED) Telepsych Program. The telepsych program staff continued to assist patients presenting in the ED with behavioral health conditions and IU Health Saxony Hospital nurses, social workers and providers were trained to initiate the telemedicine visits. Indiana Center for Prevention of Youth Abuse & Suicide (ICPYAS) support. In 2021, IU Health Saxony Hospital provided funding to ICPYAS to expand their evidence-based youth abuse and suicide prevention and awareness curriculum for children and adults in Hamilton County. In 2021, IU Health team members with child-facing roles were encouraged to participate in Stewards of Children trainings to increase awareness surrounding child sexual abuse. Four team members completed the program. Breathe Easy Hamilton County. IU Health Saxony Hospital supported Breathe Easy Hamilton County by providing letters of recommendation for the organization's tobacco cessation and prevention projects. Physician liaisons also placed Tobacco Quitline materials in IU Health physician practices to encourage referrals. Aspire Indiana program and operational support. In 2021, IU Health Saxony Hospital provided funding to Aspire Indiana Health to support their employment assistance program that provides job trainings, certifications and licensures to low-income and homeless individuals in Hamilton County. Approximately 40 community members received employment assistance as a result of the funding. Cherish Child Advocacy Center support. In 2021, IU Health Saxony Hospital provided funding to the Cherish Child Advocacy Center to assist with COVID-19 relief efforts that ensured clients could seek safe, in-person abuse intervention and prevention services. Note: This strategy did not appear in the April 2019 implementation strategy but was undertaken in 2021 as it meets significant community health needs in relation to behavioral health.
Schedule H, Part V, Section B, Line 11 Facility , 6 Facility , 6 - IU Health Saxony Hospital (continued). Food Insecurity IU Health Saxony Hospital's implementation strategy to address the identified need of Food Insecurity includes the following: Local Farmers' Markets In 2021, IU Health Saxony Hospital provided funding for the Fishers Farmers Market and the Saxony Market. Good Samaritan Network (GSN) of Hamilton County support. In 2021, IU Health Saxony Hospital provided funding for GSN's Holiday Assistance Program, which provided general sustenance and food for low-income individuals and families. Note: This strategy did not appear in the April 2019 implementation strategy but was undertaken in 2021 as it meets significant community health needs in relation to food insecurity. Fresh Bucks program. In 2021, IU Health Saxony Hospital began a pilot program, in partnership with the Fishers Farmers Market, to offer a double-up food incentive program for Supplemental Nutrition Assistance recipients to purchase healthy foods at the market, free of cost. Note: This strategy did not appear in the April 2019 implementation strategy but was undertaken in 2021 as it meets significant community health needs in relation to food insecurity. Healthcare and Social Services for Seniors IU Health Saxony Hospital's implementation strategy to address the identified need of Healthcare and Social Services for Seniors includes the following: Educational health programming for seniors. In 2021, three geriatric health seminars were led by IU Health Saxony Hospital staff on the topics of healthy nutrition, fall prevention and dementia. Approximately 50 seniors attended each seminar and over 90 percent of attendees reported an increase in knowledge based on presentation surveys. Health screenings for seniors. In order to maintain the safety of staff and community members, senior health screenings were not provided in 2021. In place of health screenings, IU Health Saxony offered free COVID-19 and flu vaccine clinics for seniors. Reaching Resources program through Shepherd's Center of Hamilton County. IU Health Saxony Hospital did not support the Reaching Resources program in 2021. In place of support for Reaching Resources, IU Health Saxony Hospital provided funding for a pilot program, in partnership with the Shepherd's Center, to increase access to geriatric behavioral health counseling. Home-based behavioral health services for seniors. In 2021, IU Health Saxony Hospital partnered with the Shepherd's Center of Hamilton County and the IU Health Connected Care team to launch a mental health counseling program for seniors to receive virtual, outpatient and home-based therapy. During the pilot year, 160 counseling sessions were administered. Obesity and Diabetes IU Health Saxony Hospital's implementation strategy to address the identified need of Obesity and Diabetes includes the following: Fresh & Fit program. In order to maintain the safety of staff and community members during the COVID-19 pandemic, IU Health Saxony Hospital did not host the Fresh & Fit program in 2021. The program will resume virtually in 2022. IU Health Days of Service. During the 2021 Days of Service, over 115 IU Health North and Saxony Hospital team members participated in socially distanced and remote projects for nearly 200 hours throughout the month of September. Team members completed physically active projects at local parks to make updates, additions and improvements to benefit the parks and, ultimately, lead to an increase in physical activity among community members. Mudsock Youth Athletics support. In 2021, IU Health Saxony Hospital provided funding to Mudsock Youth Athletics to expand their Player-in-Need scholarship program, which helps low-income families enroll their children in recreational sports at a free or reduced cost. Over 90 sports scholarships were granted as a result of the funding. IU Health Saxony also provided funding to purchase sports equipment to place in free equipment lockers to promote physical activity among children and families. Note: This strategy did not appear in the April 2019 implementation strategy but was undertaken in 2021 as it meets significant community health needs in relation to obesity and diabetes. Social Determinants of Health IU Health Saxony Hospital's implementation strategy to address the identified need of Social Determinants of Health includes the following: Prevail, Inc. Support. In 2021, IU Health Saxony Hospital provided funding to Prevail Inc.'s Safe Housing Solutions Plan, which ensures that individuals and families who experience abuse, crime, trauma or violence can maintain or attain housing and can access immediate funds to avoid homelessness. Note: This strategy did not appear in the April 2019 implementation strategy but was undertaken in 2021 as it meets significant community health needs in relation to social determinants of health. IU Health Saxony Hospital addressed all the community health needs based on their 2018 CHNA. There were no identified needs that were not addressed.
Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - INDIANA UNIVERSITY HEALTH. IN ADDITION TO FPG, IU HEALTH MAY TAKE INTO CONSIDERATION A PATIENT'S INCOME AND/OR ABILITY TO PAY IN THE CALCULATION OF A FINANCIAL ASSISTANCE AWARD.
Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - INDIANA UNIVERSITY HEALTH. IU Health 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 - INDIANA UNIVERSITY HEALTH. IU Health takes several other measures to broadly 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) 2021
Schedule H (Form 990) 2021
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?178
Name and address Type of Facility (describe)
1 INDIANA HAND TO SHLDR BELTWAY SRGRY CTR
8501 HARCOURT RD
INDIANAPOLIS,IN46260 		AMBULATORY SURGERY
2 IU HEALTH EAST WASHINGTON SURGERY CENTER
9660 E WASHINGTON ST STE 200
INDIANAPOLIS,IN46229 		AMBULATORY SURGERY
3 IU HEALTH MERIDIAN SOUTH SURGERY CENTER
8820 S MERIDIAN ST
INDIANAPOLIS,IN46217 		AMBULATORY SURGERY
4 IU HEALTH MULTI-SPECIALITY SURGERY CTR
10601 N MERIDIAN ST SUITE 250
INDIANAPOLIS,IN46290 		AMBULATORY SURGERY
5 IU HEALTH SPRING MILL SURGERY CENTER
10300 N ILLINOIS ST SUITES 1300 240
0
INDIANAPOLIS,IN46290 		AMBULATORY SURGERY
6 IU HEALTH BELTWAY SURGERY CENTER
151 PENNSYLVANIA PKWY
CARMEL,IN46280 		AMBULATORY SURGERY
7 IU HEALTH SPRING MILL SURGERY CENTER
10300 N ILLINOIS ST STE 1300 2400
CARMEL,IN46290 		AMBULATORY SURGERY
8 IU HEALTH HOME CARE
950 N MERIDIAN ST STE 700
INDIANAPOLIS,IN46204 		HOME HEALTH
9 IU HEALTH EXPRESSIONS HOME MEDICAL EQUIP
11725 N ILLINOIS ST SUITE 485
CARMEL,IN46032 		HOME HEALTH
10 IU HEALTH EXPRESSIONS HOME MEDICAL EQUIP
1701 N SENATE BLVD
INDIANAPOLIS,IN46202 		HOME HEALTH
11 IU HEALTH BALL MEM OUTPATIENT SURG CTR
2401 W UNIVERSITY AVE
MUNCIE,IN47303 		AMBULATORY SURGERY
12 IU HEALTH MORGAN
2209 JOHN R WOODEN DR
MARTINSVILLE,IN46151 		DIAGNOSTIC & OTHER OUTPATIENT
13 IU HEALTH EAGLE HIGHLANDS SURGERY CENTER
6850 PARKDALE PL
INDIANAPOLIS,IN46254 		AMBULATORY SURGERY
14 BELTWAY SURGERY CENTER SPRING MILL
200 W 103RD ST STE 2400
INDIANAPOLIS,IN46290 		AMBULATORY SURGERY
15 SENATE STREET SURGERY CENTER
1801 N SENATE BLVD
INDIANAPOLIS,IN46202 		AMBULATORY SURGERY
16 IU HEALTH UNIVERSITY RETAIL PHARMACY
550 N UNIVERSITY BLVD
INDIANAPOLIS,IN46202 		PHARMACY
17 IU HEALTH SAXONY SURGERY CENTER
13100 E 136TH ST
FISHERS,IN46037 		AMBULATORY SURGERY
18 INDIANA ENDOSCOPY CENTERS
10967 ALLISONVILLE RD STE 100
FISHERS,IN46038 		AMBULATORY SURGERY
19 INDIANA ENDOSCOPY CENTERS
1115 N RONALD REAGAN PKWY STE 347
AVON,IN46123 		AMBULATORY SURGERY
20 INDIANA ENDOSCOPY CENTERS
1801 N SENATE BLVD STE 710
INDIANAPOLIS,IN46202 		AMBULATORY SURGERY
21 IU HEALTH CICC - NORTH
10212 LANTERN RD
FISHERS,IN46038 		SPECIALTY CARE
22 IUH BLOOMINGTON HOSPITAL MAIN CAMPUS LAB
601 W 2ND ST 1ST FL
BLOOMINGTON,IN47403 		LAB
23 IU HEALTH BALL MEMORIAL HOSPITAL LAB
2401 UNIVERSITY AVE
MUNCIE,IN47303 		LAB
24 IU HEALTH CICC - EAST
6845 RAMA DR
INDIANAPOLIS,IN46219 		SPECIALTY CARE
25 IU HEALTH METHODIST RETAIL PHARMACY
1801 N SENATE BLVD STE 105
INDIANAPOLIS,IN46202 		PHARMACY
26 IU HEALTH ARNETT HOSPITAL LAB
5165 MCCARTY LN
LAFAYETTE,IN47905 		LAB
27 IU HEALTH WEST HOSPITAL LAB
1111 RONALD REAGAN PKWY SUITE A1110
AVON,IN46123 		LAB
28 GLEN LEHMAN ENDOSCOPY SUITE
550 N UNIVERSITY BLVD STE 4100
INDIANAPOLIS,IN46202 		AMBULATORY SURGERY
29 IU HEALTH NORTH HOSPITAL LAB
11700 N MERIDIAN ST
CARMEL,IN46032 		LAB
30 IU HEALTH SLEEP DISORDERS CENTER
714 N SENATE AVE STE 110
INDIANAPOLIS,IN46202 		SPECIALTY CARE
31 IU HEALTH HOSPICE
950 N MERIDIAN ST STE 700
INDIANAPOLIS,IN46204 		HOSPICE
32 IU HEALTH METHODIST MEDICAL PLAZA SOUTH
8830 S MERIDIAN ST
INDIANAPOLIS,IN46217 		DIAGNOSTIC & OTHER OUTPATIENT
33 IU HEALTH SLEEP APNEA EDUCATION CENTER
6004 W KILGORE AVE
MUNCIE,IN47304 		SPECIALTY CARE
34 IU HEALTH SLEEP DISORDERS CENTER
6004 W KILGORE AVE
MUNCIE,IN47304 		SPECIALTY CARE
35 IU HEALTH BALL MEMORIAL HOSPICE
2401 W UNIVERSITY AVE
MUNCIE,IN47303 		HOSPICE
36 IU HEALTH METHODIST MEDICAL PLAZA NORTH
151 PENNSYLVANIA PKWY
INDIANAPOLIS,IN46280 		DIAGNOSTIC & OTHER OUTPATIENT
37 IU HEALTH RILEY RETAIL PHARMACY
705 RILEY HOSPITAL DR ROC 1201
INDIANAPOLIS,IN46202 		PHARMACY
38 RILEY OUTPATIENT SURGERY CENTER
575 RILEY HOSPITAL DR
INDIANAPOLIS,IN46202 		AMBULATORY SURGERY
39 IU HEALTH SLEEP DISORDERS CENTER
1504 CLINIC DR
BEDFORD,IN47421 		SPECIALTY CARE
40 IU HEALTH SAXONY HOSPITAL LAB
13000 E 136TH ST
FISHERS,IN46037 		LAB
41 IU HEALTH NORTH RETAIL PHARMACY
11700 N MERIDIAN ST STE B106
CARMEL,IN46032 		PHARMACY
42 IU HEALTH WHITE MEMORIAL HOSPITAL LAB
720 S 6TH ST
MONTICELLO,IN47960 		LAB
43 IU HEALTH BALL MEMORIAL HOME CARE
2401 W UNIVERSITY AVE
MUNCIE,IN47303 		HOME HEALTH
44 IU HEALTH SLEEP DISORDERS CENTER
1411 W COUNTY LINE RD STE C
GREENWOOD,IN46142 		SPECIALTY CARE
45 IU HEALTH WEST RETAIL PHARMACY
1111 N RONALD REAGAN PKWY M105
AVON,IN46123 		PHARMACY
46 IU HEALTH PAOLI HOSPITAL LAB
642 W HOSPITAL RD
PAOLI,IN47454 		LAB
47 IU HEALTH BLOOMINGTON HOME CARE
333 E MILLER DR
BLOOMINGTON,IN47401 		HOME HEALTH
48 IU HEALTH ARNETT HOME CARE
3900 MCCARTY LN STE 103
LAFAYETTE,IN47905 		HOME HEALTH
49 IU HEALTH SAXONY RETAIL PHARMACY
13100 E 136TH ST STE 1000
FISHERS,IN46037 		PHARMACY
50 IU HEALTH BLACKFORD HOSPITAL LAB
410 PILGRIM BLVD
HARTFORD CITY,IN47348 		LAB
51 IU HEALTH TIPTON HOSPITAL LAB
1000 S MAIN ST
TIPTON,IN46072 		LAB
52 IU HEALTH RADIOLOGY
9650 E WASHINGTON ST
INDIANAPOLIS,IN46229 		RADIOLOGY
53 IU HEALTH LIFECARE
1633 N CAPITAL AVE STE 300
INDIANAPOLIS,IN46202 		DIAGNOSTIC & OTHER OUTPATIENT
54 IU HEALTH PHYSICAL THERAPY & REHAB
6866 W STONEGATE DR SUITE 106
ZIONSVILLE,IN46077 		REHABILITATION SERVICES
55 IU HEALTH PHYSICAL THERAPY & REHAB
404 E WASHINGTON ST STE B
INDIANAPOLIS,IN46204 		REHABILITATION SERVICES
56 IUH ADDICTION TREATMENT & RECOVERY CNTR
727 W 2ND ST
BLOOMINGTON,IN47403 		BEHAVIORAL HEALTH
57 IUH ADDICTION TREATMENT & RECOVERY CNTR
2209 JOHN R WOODEN DR
MARTINSVILLE,IN46151 		BEHAVIORAL HEALTH
58 IUH ADDICTION TREATMENT & RECOVERY CNTR
1758 W 100 S
PORTLAND,IN47371 		BEHAVIORAL HEALTH
59 IUH ADDICTION TREATMENT & RECOVERY CNTR
210 N TILLOTSON AVE
MUNCIE,IN47304 		BEHAVIORAL HEALTH
60 IU HEALTH OLCOTT CENTER
619 W 1ST ST
BLOOMINGTON,IN47403 		DIAGNOSTIC & OTHER OUTPATIENT
61 IU HEALTH METHODIST MEDICAL PLAZA
6850 PARKDALE PL
INDIANAPOLIS,IN46254 		DIAGNOSTIC & OTHER OUTPATIENT
62 ADULT AMBULATORY CARE CENTER
550 N UNIVERSITY BLVD STE 3500
INDIANAPOLIS,IN46202 		DIAGNOSTIC & OTHER OUTPATIENT
63 METHODIST MEDICAL PLAZA GEORGETOWN
4880 W CENTURY PLAZA RD
INDIANAPOLIS,IN46254 		DIAGNOSTIC & OTHER OUTPATIENT
64 IU HEALTH METHODIST MEDICAL TOWER
1633 N CAPITAL AVE
INDIANAPOLIS,IN46202 		DIAGNOSTIC & OTHER OUTPATIENT
65 IU HEALTH BLOOMINGTON HOSPITAL HOSPICE
619 W 1ST ST
BLOOMINGTON,IN47403 		HOSPICE
66 IU HEALTH BLOOMINGTON HOSPICE HOUSE
2810 S DEBORAH DR
BLOOMINGTON,IN47403 		HOSPICE
67 IU HEALTH ARNETT HOSPICE
3900 MCCARTY LN STE 104
LAFAYETTE,IN47905 		HOSPICE
68 IU HEALTH ARNETT SOUTHSIDE LAB
1 WALTER SCHOLER DR
LAFAYETTE,IN47909 		LAB
69 IU HEALTH METHODIST MEDICAL TOWER LAB
1633 N CAPITOL AVE
INDIANAPOLIS,IN46202 		LAB
70 IU HEALTH SPRINGMILL MEDICAL CLINIC LAB
10300 N ILLINOIS ST STE 1400
CARMEL,IN46290 		LAB
71 IUH JOE & SHELLY SCHWARZ CANCER CTR LAB
11700 N MERIDIAN ST
CARMEL,IN46032 		LAB
72 IU HEALTH FRANKFORT LAB
1300 S JACKSON ST
FRANKFORT,IN46041 		LAB
73 IUH METHODIST MED PLAZA BROWNSBURG LAB
1375 N GREEN ST STE 200
BROWNSBURG,IN46112 		LAB
74 IU HEALTH BALL MEMORIAL PHYSICIANS LAB
1420 S PILGRIM BLVD
YORKTOWN,IN47396 		LAB
75 IUH METHODIST MEDICAL PLAZA NORTH LAB
151 PENNSYLVANIA PKWY
CARMEL,IN46280 		LAB
76 IUH METHODIST PROFESSIONAL CENTER LAB
1801 N SENATE BLVD
INDIANAPOLIS,IN46202 		LAB
77 IU HEALTH MORGAN LAB
2209 JOHN R WOODEN DR
MARTINSVILLE,IN46151 		LAB
78 IU HEALTH ARNETT WESTSIDE LAB
253 SAGAMORE PKWY W
WEST LAFAYETTE,IN47906 		LAB
79 IU HEALTH ARNETT FERRY ST LAB
2600 FERRY ST
LAFAYETTE,IN47904 		LAB
80 IU HEALTH ARNETT GREENBUSH LAB
2600 GREENBUSH ST
LAFAYETTE,IN47904 		LAB
81 IU HEALTH BEDFORD HOSPITAL LAB
2900 W 16TH ST
BEDFORD,IN47421 		LAB
82 IU HEALTH SIP BEDFORD LAB
2900 W 16TH ST
BEDFORD,IN47421 		LAB
83 IU HEALTH PATHOLOGY LAB
350 W 11TH ST
INDIANAPOLIS,IN46202 		LAB
84 IU HEALTH ARNETT CANCER CARE LAB
420 N 26TH ST
LAFAYETTE,IN47904 		LAB
85 IU HEALTH GEORGETOWN MEDICAL PLAZA LAB
4880 CENTURY PLAZA RD STE 125
INDIANAPOLIS,IN46254 		LAB
86 ARLINGTON DIAGNOSTIC CENTER LAB
4935 W ARLINGTON RD
BLOOMINGTON,IN47404 		LAB
87 IU HEALTH JAY HOSPITAL OUTPATIENT LAB
500 W VOTAW ST
PORTLAND,IN47371 		LAB
88 UNIV HOSP AMBULATORY OUTPATIENT CNTR LAB
550 N UNIVERSITY BLVD RM 1005
INDIANAPOLIS,IN46202 		LAB
89 IU HEALTH LANDMARK OUTPATIENT LAB
550 LANDMARK AVE
BLOOMINGTON,IN47403 		LAB
90 IU HEALTH BETHEL LAB
5501 W BETHEL AVE SUITE C
MUNCIE,IN46304 		LAB
91 IUH METHODIST MED PLAZA EAGLE HIGHLANDS
6850 PARKDALE PL
INDIANAPOLIS,IN46254 		LAB
92 IU HEALTH MOORESVILLE LAB
820 SAMUEL MOORE PKWY
MOORESVILLE,IN46158 		LAB
93 IUH METHODIST MEDICAL PLAZA SOUTH LAB
8820 S MERIDIAN ST
INDIANAPOLIS,IN46217 		LAB
94 IUH METHODIST MEDICAL PLAZA EAST LAB
9650 E WASHINGTON ST
INDIANAPOLIS,IN46229 		LAB
95 IU HEALTH ADVANCED THERAPIES PHARMACY
355 W 16TH ST STE 1600 GH 1074
INDIANAPOLIS,IN46202 		PHARMACY
96 CONNECTED CARE-IU HEALTH SAXONY HOSPITAL
13000 E 136TH ST SUITE 3400
FISHERS,IN46037 		PRIMARY CARE
97 IU HEALTH MORGAN WALK-IN
2209 JOHN R WOODEN DR
MARTINSVILLE,IN46151 		PRIMARY CARE
98 IU HEALTH RADIOLOGY
13000 E 136TH ST
FISHERS,IN46037 		RADIOLOGY
99 IU HEALTH CANCER RADIATION CENTER
9149 STATE RD 37
BEDFORD,IN47421 		RADIOLOGY
100 IU HEALTH RADIOLOGY
820 SAMUEL MOORE PKWY
MOORESVILLE,IN46158 		RADIOLOGY
101 IU HEALTH RADIOLOGY
362 W 15TH ST
INDIANAPOLIS,IN46202 		RADIOLOGY
102 IU HEALTH MORGAN RADIOLOGY
2209 JOHN R WOODEN DR
MARTINSVILLE,IN46151 		RADIOLOGY
103 IU HEALTH RADIOLOGY
550 N UNIVERSITY BLVD UN 0663
INDIANAPOLIS,IN46202 		RADIOLOGY
104 IU HEALTH RADIOLOGY
893 S DELAWARE ST DC 2111
INDIANAPOLIS,IN46285 		RADIOLOGY
105 IU HEALTH RADIOLOGY
404 E WASHINGTON ST STE B
INDIANAPOLIS,IN46204 		RADIOLOGY
106 IU HEALTH RADIOLOGY
1801 N SENATE BLVD RM A 1157A
INDIANAPOLIS,IN46202 		RADIOLOGY
107 IU HEALTH RADIOLOGY
714 N SENATE AVE STE 100
INDIANAPOLIS,IN46202 		RADIOLOGY
108 IU HEALTH RADIOLOGY
151 PENNSYLVANIA PKWY SUITE 160
INDIANAPOLIS,IN46280 		RADIOLOGY
109 IU HEALTH RADIOLOGY
2598 W WHITE RIVER BLVD
MUNCIE,IN47303 		RADIOLOGY
110 IU HEALTH RADIOLOGY
1111 N RONALD REAGAN PKWY
AVON,IN46123 		RADIOLOGY
111 IU HEALTH RADIOLOGY
1000 S MAIN ST
TIPTON,IN46072 		RADIOLOGY
112 IU HEALTH RADIOLOGY
1375 N GREEN ST STE 200
BROWNSBURG,IN46112 		RADIOLOGY
113 IU HEALTH RADIOLOGY
11700 N MERIDIAN ST STE 160
CARMEL,IN46032 		RADIOLOGY
114 IUH ADULT SPEECH-LANGUAGE PATHOLOGY
550 N UNIVERSITY BLVD
INDIANAPOLIS,IN46202 		REHABILITATION SERVICES
115 IUH ADULT PHYSICAL THERAPY & REHAB SRVCS
13000 E 136TH ST SUITE 2100
FISHERS,IN46037 		REHABILITATION SERVICES
116 IUH REHAB & SPORTS MEDICINE CENTER EAST
328 S WOODCREST DR
BLOOMINGTON,IN47401 		REHABILITATION SERVICES
117 IU HEALTH OCCUPATIONAL SERVICES
3443 W 3RD ST
BLOOMINGTON,IN47404 		REHABILITATION SERVICES
118 IUH REHAB & SPORTS MEDICINE CENTER WEST
2650 COTA DR
BLOOMINGTON,IN47403 		REHABILITATION SERVICES
119 IU HEALTH PHYSICAL THERAPY & REHAB
4935 W ARLINGTON RD
BLOOMINGTON,IN47404 		REHABILITATION SERVICES
120 IU HEALTH PHYSICAL THERAPY & REHAB
1801 N SENATE BLVD STE 240
INDIANAPOLIS,IN46202 		REHABILITATION SERVICES
121 IUH OCCUP THRPY SVCS AT METHODIST HOSP
1801 N SENATE BLVD STE 530
INDIANAPOLIS,IN46202 		REHABILITATION SERVICES
122 NEUROREHABILITATION AND ROBOTICS
355 W 16TH ST STE 1078
INDIANAPOLIS,IN46202 		REHABILITATION SERVICES
123 IU HEALTH OCCUPATIONAL SERVICES
2900 W 16TH ST
BEDFORD,IN47421 		REHABILITATION SERVICES
124 IU HEALTH MORGAN REHABILITATION
2209 JOHN R WOODEN DR
MARTINSVILLE,IN46151 		REHABILITATION SERVICES
125 IU HEALTH PHYSICAL THERAPY & REHAB
550 N UNIVERSITY BLVD RM 4175
INDIANAPOLIS,IN46202 		REHABILITATION SERVICES
126 IUH ADULT PHYSICAL THERAPY & REHAB SVCS
1801 N SENAE BLVD STE 535
INDIANAPOLIS,IN46202 		REHABILITATION SERVICES
127 IUH PT OCCUPATIONAL THRPY& SPEECH THRPY
1300 S JACKSON ST
FRANKFORT,IN46141 		REHABILITATION SERVICES
128 IU HEALTH PHYSICAL THERAPY & REHAB
2401 W UNIVERSITY AVE
MUNCIE,IN47303 		REHABILITATION SERVICES
129 IU HEALTH PHYSICAL THERAPY & REHAB
1010 S MAIN ST SUITE 110
TIPTON,IN46072 		REHABILITATION SERVICES
130 IU HEALTH PHYSICAL THERAPY & REHAB
9670 E WASHINGTON ST STE 115
INDIANAPOLIS,IN46229 		REHABILITATION SERVICES
131 IU HEALTH PHYSICAL THERAPY & REHAB
2476 E 116TH ST G-100
CARMEL,IN46032 		REHABILITATION SERVICES
132 IU HEALTH PHYSICAL THERAPY & REHAB
410 PILGRIM BLVD
HARTFORD CITY,IN47348 		REHABILITATION SERVICES
133 IUH PEDIATRIC PHYSICAL THERAPY & REHAB
6820 PARKDALE PL STE 109
INDIANAPOLIS,IN46254 		REHABILITATION SERVICES
134 IU HEALTH PHYSICAL THERAPY & REHAB
14645 HAZEL DELL RD
NOBLESVILLE,IN46062 		REHABILITATION SERVICES
135 IU HEALTH HIP & KNEE CENTER
13000 E 136TH ST SUITE 2000
FISHERS,IN46037 		SPECIALTY CARE
136 IU HEALTH ADVANCED HEART & LUNG CARE
1801 N SENATE BLVD STE 2000
INDIANAPOLIS,IN46202 		SPECIALTY CARE
137 IU HEALTH SLEEP APNEA EDUCATION CENTER
601 W 2ND ST RM C1037
BLOOMINGTON,IN47403 		SPECIALTY CARE
138 IU HEALTH SLEEP DISORDERS CENTER
601 W 2ND ST RM 24-5
BLOOMINGTON,IN47403 		SPECIALTY CARE
139 IU HEALTH CARDIOVASCULAR SURGERY
707 W 2ND ST
BLOOMINGTON,IN47403 		SPECIALTY CARE
140 IU HEALTH ADVANCED PAIN CENTER
888 AUTO MALL RD
BLOOMINGTON,IN47401 		SPECIALTY CARE
141 IU HEALTH ORTHOPEDICS & SPORTS MEDICINE
2605 E CREEKS EDGE DR
BLOOMINGTON,IN47401 		SPECIALTY CARE
142 IU HEALTH CICC - METHODIST
1701 N SENATE BLVD C6
INDIANAPOLIS,IN46202 		SPECIALTY CARE
143 IU HEALTH CICC - SOUTH
8820 S MERIDIAN ST SUITE 230
INDIANAPOLIS,IN46217 		SPECIALTY CARE
144 IUH UNIV HOSP INTRVNTNAL& ADV PAIN THRPY
550 N UNIVERSITY BLVD STE 2007
INDIANAPOLIS,IN46202 		SPECIALTY CARE
145 IU HEALTH PRECISION GENOMICS PROGRAM
1030 W MICHIGAN ST STE 3307
INDIANAPOLIS,IN46202 		SPECIALTY CARE
146 IU HEALTH MELVIN & BREN SIMON CANCER CTR
1030 W MICHIGAN ST
INDIANAPOLIS,IN46202 		SPECIALTY CARE
147 IU HEALTH NEUROSCIENCE CENTER
362 W 15TH ST
INDIANAPOLIS,IN46202 		SPECIALTY CARE
148 IU HEALTH SLEEP APNEA EDUCATION CENTER
1411 W COUNTY LINE RD STE C
GREENWOOD,IN46142 		SPECIALTY CARE
149 IU HEALTH SLEEP DISORDERS CENTER
714 N SENATE AVE STE 110
INDIANAPOLIS,IN46202 		SPECIALTY CARE
150 IU HEALTH SLEEP APNEA EDUCATION CENTER
714 N SENATE AVE STE 110
INDIANAPOLIS,IN46202 		SPECIALTY CARE
151 IU HEALTH SLEEP DISORDERS CENTER
13100 E 136TH ST STE 3200
FISHERS,IN46037 		SPECIALTY CARE
152 IU HEALTH SLEEP DISORDERS CENTER
3900 MCCARTY LN STE 101
LAFAYETTE,IN47905 		SPECIALTY CARE
153 IU HEALTH ARNETT SLEEP APNEA EDUC CTR
3900 MCCARTY LN STE 102
LAFAYETTE,IN46202 		SPECIALTY CARE
154 MIDWEST EYE INSTITUTE
555 COUNTY LINE RD STE 102-103
GREENWOOD,IN46143 		SPECIALTY CARE
155 IU HEALTH SLEEP APNEA EDUCATION CENTER
13100 E 136TH ST STE 3200B
FISHERS,IN46037 		SPECIALTY CARE
156 IU HEALTH SLEEP DISORDERS CENTER
2209 JOHN R WOODEN DR
MARTINSVILLE,IN46151 		SPECIALTY CARE
157 IU HEALTH SLEEP DISORDERS CENTER
720 S 6TH ST
MONTICELLO,IN47960 		SPECIALTY CARE
158 IU HEALTH SLEEP DISORDERS CENTER
1300 S JACKSON ST
FRANKFORT,IN46041 		SPECIALTY CARE
159 IU HEALTH SLEEP DISORDERS CENTER
500 W VOTAW ST
PORTLAND,IN47371 		SPECIALTY CARE
160 IU HEALTH SLEEP DISORDERS CENTER
642 W HOSPITAL RD
TIPTON,IN47454 		SPECIALTY CARE
161 IU HEALTH SLEEP DISORDERS CENTER
1000 S MAIN ST
AVON,IN46072 		SPECIALTY CARE
162 IU HEALTH SLEEP DISORDERS CENTER
1115 N RONALD REAGAN PKWY STE 305
AVON,IN46123 		SPECIALTY CARE
163 IU HEALTH SLEEP APNEA EDUCATION CENTER
1115 N RONALD REAGAN PKWY STE 317
CARMEL,IN46123 		SPECIALTY CARE
164 IU HEALTH VOICE CENTER
1185 W CARMEL DR D-1A
CARMEL,IN46032 		SPECIALTY CARE
165 IU HEALTH SLEEP DISORDERS CENTER
11700 N MERIDIAN ST
CARMEL,IN46032 		SPECIALTY CARE
166 IU HEALTH SLEEP APNEA EDUCATION CENTER
11725 N ILLINOIS ST SUITE 485
CARMEL,IN46032 		SPECIALTY CARE
167 IU HEALTH EXECUTIVE HEALTH
11590 N MERIDIAN ST SUITE 410
CARMEL,IN46032 		SPECIALTY CARE
168 IU HEALTH SLEEP DISORDERS CENTER
11590 N MERIDIAN ST SUITE 300
CARMEL,IN46032 		SPECIALTY CARE
169 IU HEALTH URGENT CARE - BLOOMINGTON
326 S WOODCREST DR
BLOOMINGTON,IN47401 		URGENT CARE
170 IU HEALTH URGENT CARE - GREENWOOD
996 S SR 135 SUITE P
GREENWOOD,IN46143 		URGENT CARE
171 IU HEALTH URGENT CARE - AVON
10853 E US HWY 36
AVON,IN46123 		URGENT CARE
172 IU HEALTH URGENT CARE - BROAD RIPPLE
1036 BROAD RIPPLE AVE
INDIANAPOLIS,IN46220 		URGENT CARE
173 IU HEALTH URGENT CARE - DOWNTOWN INDPLS
222 W WASHINGTON ST
INDIANAPOLIS,IN46204 		URGENT CARE
174 IU HEALTH URGENT CARE - BROWNSBURG
90 E GARNER RD STE A
BROWNSBURG,IN46112 		URGENT CARE
175 IU HEALTH URGENT CARE - NOBLESVILLE
14645 HAZEL DELL ROAD SUITE 120
NOBLESVILLE,IN46062 		URGENT CARE
176 IU HEALTH URGENT CARE - LAFAYETTE
1 WALTER SCHOLER DR
LAFAYETTE,IN47909 		URGENT CARE
177 IU HEALTH URGENT CARE - FORT WAYNE NORTH
9821 LIMA RD STE 103
FORT WAYNE,IN46818 		URGENT CARE
178 IU HEALTH URGENT CARE - WEST LAFAYETTE
253 SAGAMORE PKWY W
WEST LAFAYETTE,IN47906 		URGENT CARE
179 IU Health Urgent Care Fort Wayne - Hope Drive
7411 Hope Drive Suite A
Fort Wayne,IN46815 		Urgent Care
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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 V, Section A LINE 1 - NAME, ADDRESS, AND WEBSITE IU HEALTH OPERATES SEVERAL HOSPITAL LOCATIONS UNDER A SINGLE HOSPITAL LICENSE ISSUED BY THE INDIANA STATE DEPARTMENT OF HEALTH. THE NAMES, ADDRESSES, AND PRIMARY WEBSITE ADDRESSES FOR EACH OF THESE LOCATIONS ARE AS FOLLOWS: IU HEALTH METHODIST HOSPITAL 1701 N. SENATE BLVD. INDIANAPOLIS, IN 46202 HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-METHODIST-HOSPITAL IU HEALTH UNIVERSITY HOSPITAL 550 UNIVERSITY BLVD. INDIANAPOLIS, IN 46202 HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-UNIVERSITY-HOSPITAL RILEY HOSPITAL FOR CHILDREN AT IU HEALTH 705 RILEY HOSPITAL DR. INDIANAPOLIS, IN 46202 HTTPS://WWW.RILEYCHILDRENS.ORG/ IU HEALTH METHODIST HOSPITAL, IU HEALTH UNIVERSITY HOSPITAL, AND RILEY HOSPITAL FOR CHILDREN AT IU HEALTH ARE COLLECTIVELY REFERRED TO AS THE IU HEALTH ACADEMIC HEALTH CENTER. IU HEALTH SAXONY HOSPITAL 13000 E. 136TH ST. FISHERS, IN 46037 HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-SAXONY-HOSPITAL
Schedule H, Part I, Line 7c 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 EXCLUDES DIRECT OFFSETTING REVENUE, IS 42.56%.
Schedule H, Part I, Line 7f PERCENT OF TOTAL EXPENSE THE AMOUNT OF BAD DEBT EXPENSE SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSE ON LINE 7, COLUMN (F) IS $70,066,452. THIS AMOUNT INCLUDES THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX, LINE 25, COLUMN (A), AND IU HEALTH'S PORTION OF THE BAD DEBT ATTRIBUTABLE TO THE JOINT VENTURES REPORTED ON SCHEDULE H, PART IV. 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 II PROMOTION OF HEALTH IN COMMUNITIES SERVED IU Health Inc. supports and/or participates in a variety of community-building activities that address the non-medical, root causes of health problems in the communities it serves. IU Health Inc. and its related hospital entities across the state of Indiana ("IU Health Statewide System") investments include economic development efforts across the state, workforce development opportunities, collaborate with like-minded organizations through coalitions that address key issues, and advocate for improvements in the health status of vulnerable populations. Some activities meet the definition of community benefit and have been reported as such. IU Health Inc. supported several different types of community building activities to promote the health of the community. These activities include: Economic Development Due to the relationship between health, safety and economic growth, IU Health Inc. has long seen the value in supporting sustainable economic growth and quality of place in Indianapolis and the surrounding metropolitan area. IU Health Inc. provided in-kind and financial support to the Indianapolis Chamber of Commerce's Accelerate Indy For All, the economic development strategy. The pillars of the strategy include educated and talented workers; innovative and enterprising business; attractive and connected places; and a vibrant and inviting image. Community Support IU Health Inc. Provided financial support to the Center for Leadership Development (CLD) to allow the organization to extend its reach to more Black youth across Central Indiana. CLD connects with schools, communities, businesses and industries, higher education, and funders to offer multiple quality development programs for middle and high school students and their parents that provide meaningful preparation for a higher level of academic and career achievement. Social determinants of health such as poverty and access to quality educational opportunities impact health and well-being. Supporting programs and initiatives in the community such as CLD provides opportunities for higher education and future economic stability to community members which can positively impact health, quality of life and health equity. Workforce Development Seeking opportunities to collaborate with educational institutes to promote the health sciences professions, IU Health Inc. has several departments that did community education and outreach to encourage students to explore and consider healthcare careers. As the healthcare industry faces workforce shortages, this presents an opportunity to inspire students, especially racial and ethnic minority students, to go to college or seek other post-secondary education alternatives. IU Health Inc. provided financial support to Ivy Tech Community College to expand existing capacity for nursing enrollment and education to increase nursing graduates. This activity seeks to address ongoing nursing shortages throughout the state that not only impact IU Health Inc., but other hospitals and healthcare systems too. The funds are to be used on facilities and staff recruitment; equipment; student support; and faculty compensation.
Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care IU Health uses several factors other than federal poverty guidelines ("FPG") 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, INC. INCLUDES COSTS ASSOCIATED WITH PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES BUT IS NOT ABLE TO SEGREGATE THE COSTS ASSOCIATED WITH PHYSICIAN CLINICS.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 70066452
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 $133,584,000 and $90,358,000 in 2021 and 2020, respectively.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs 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 MEDICARE COST REPORT. "ALLOWABLE COSTS" FOR MEDICARE COST REPORT PURPOSES, HOWEVER, ARE NOT REFLECTIVE OF ALL COSTS ASSOCIATED WITH IU HEALTH'S PARTICIPATION IN MEDICARE PROGRAMS. FOR EXAMPLE, THE MEDICARE COST REPORT EXCLUDES CERTAIN COSTS SUCH AS BILLED PHYSICIAN SERVICES, THE COSTS OF MEDICARE PARTS C AND D, FEE SCHEDULE REIMBURSED SERVICES, AND DURABLE MEDICAL EQUIPMENT SERVICES. INCLUSION OF ALL COSTS ASSOCIATED WITH IU HEALTH'S PARTICIPATION IN MEDICARE PROGRAMS WOULD SIGNIFICANTLY INCREASE THE MEDICARE SHORTFALL REPORTED ON SCHEDULE H, PART III, LINE 7. IU HEALTH'S MEDICARE SHORTFALL IS ATTRIBUTABLE TO REIMBURSEMENTS THAT ARE LESS THAN THE COST OF PROVIDING PATIENT CARE AND SERVICES TO MEDICARE BENEFICIARIES AND DOES NOT INCLUDE ANY AMOUNTS THAT RESULT FROM INEFFICIENCIES OR POOR MANAGEMENT. IU HEALTH ACCEPTS ALL MEDICARE PATIENTS KNOWING THAT THERE MAY BE SHORTFALLS; THEREFORE IT HAS TAKEN THE POSITION THAT 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.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance IU Health'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 - INDIANA UNIVERSITY HEALTH: Line 16a URL: HTTPS://IUHEALTH.ORG/PAY-A-BILL/FINANCIAL-ASSISTANCE;
Schedule H, Part V, Section B, Line 16b FAP Application website - INDIANA UNIVERSITY HEALTH: Line 16b URL: HTTPS://IUHEALTH.ORG/PAY-A-BILL/FINANCIAL-ASSISTANCE;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website - INDIANA UNIVERSITY HEALTH: Line 16c URL: HTTPS://IUHEALTH.ORG/PAY-A-BILL/FINANCIAL-ASSISTANCE;
Schedule H, Part VI, Line 2 Needs assessment IU Health operates four hospital locations that are licensed as a single hospital by the Indiana State Department of Health. These hospital locations are as follows: - IU Health Methodist Hospital - IU Health University Hospital - Riley Hospital for Children at IU Health - IU Health Saxony Hospital IU Health Methodist Hospital, IU Health University Hospital, and Riley Hospital for Children are located in Indianapolis, Marion County, Indiana and are referred to as the IU Health Academic Health Center. IU Health Saxony Hospital is located in Fishers, Hamilton County, Indiana. Although licensed as a single hospital, each of these facilities serve different, although sometimes overlapping, portions of the community which present their own unique health needs. In order to take into account all of these unique health needs, IU Health conducted separate Community Health Needs Assessments ("CHNAs") for each of its four hospital locations. In conducting each of its most recent CHNAs, IU Health took into account input from persons who represent the broad interests of the communities it serves by hosting four community focus groups and conducting interviews. These focus groups engaged public health officials and community-based organizations that provide services and/or reflect community members who are medically underserved, low-income, or of a minority subpopulation to discuss the health needs of the service area and what role IU Health could play in addressing the identified needs. Secondary data and a preliminary list of community health need priorities were presented at the meetings. Each group was then asked questions about the preliminary list, including their reactions, additions to the proposed needs, thoughts regarding the causes of the needs, impacts of the COVID-19 pandemic and others. After this discussion, participants were given the opportunity to make additional comments before being asked to vote on what they believed were the most significant needs in the county. Participants were asked to choose three to five significant health needs via an online poll during and after the meeting. For those unable to attend community meetings, a separate survey was distributed to receive their input on the most significant needs. These findings were combined with those of the community meeting participants. 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 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 SERVES A LARGE GEOGRAPHIC AREA IN CENTRAL INDIANA. IN COMPLETING CHNAS FOR ITS IU HEALTH ACADEMIC HEALTH CENTER AND IU HEALTH SAXONY HOSPITAL LOCATIONS, IU HEALTH DEFINED "COMMUNITY" AS THE COUNTY OF RESIDENCE FOR EACH HOSPITAL LOCATION. EACH INDIVIDUAL HOSPITAL LOCATION SERVES A UNIQUE SUBSECTION OF THE COMMUNITY FOR WHICH DETAILS ARE INCLUDED BELOW: IU HEALTH ACADEMIC HEALTH CENTER THE COMMUNITY FOR IU HEALTH ACADEMIC HEALTH CENTER'S PRIMARY SERVICE AREA IS DEFINED AS MARION COUNTY, THE COMMUNITY WHERE IU HEALTH ACADEMIC HEALTH CENTER IS LOCATED. THE SECONDARY SERVICE AREA IS COMPRISED OF ALL OTHER COUNTIES WITHIN THE STATE OF INDIANA. MARION COUNTY INCLUDES ZIP CODES WITHIN THE TOWNS OF BEECH GROVE, INDIANAPOLIS, LAWRENCE, SOUTHPORT, AND SPEEDWAY, PLUS PORTIONS OF PLAINFIELD, WHICH EXTENDS INTO HENDRICKS COUNTY. BASED ON THE CENSUS BUREAU DATA ESTIMATES FOR 2021, the most recent data available, MARION COUNTY'S POPULATION WAS 971,102 AND 51.8% WERE FEMALE. THE COUNTY'S POPULATION ESTIMATES BY RACE ARE 54.1% WHITE NON-HISPANIC, 29.1% BLACK NON-HISPANIC, 10.9% HISPANIC OR LATINO, 3.8% ASIAN, 0.4% AMERICAN INDIAN OR ALASKA NATIVE, AND 3.0% PERSONS REPORTING TWO OR MORE RACES. A VERY SMALL PERCENTAGE OF THE POPULATION IS ETHNIC GROUPS OTHER THAN THOSE LISTED ABOVE. IU HEALTH SAXONY HOSPITAL THE COMMUNITY FOR IU HEALTH SAXONY HOSPITAL'S PRIMARY SERVICE AREA IS DEFINED AS HAMILTON COUNTY, THE COUNTY WHERE IU HEALTH SAXONY HOSPITAL IS LOCATED, PLUS MARION, MADISON, AND HANCOCK COUNTIES. APPROXIMATELY 67% OF INPATIENT DISCHARGES ORIGINATE FROM THE PRIMARY SERVICE AREA. HAMILTON COUNTY INCLUDES ZIP CODES WITHIN THE TOWNS OF ARCADIA, ATLANTA, CARMEL, CICERO, FISHERS, NOBLESVILLE, SHERIDAN, AND WESTFIELD. BASED ON CENSUS BUREAU ESTIMATES FOR 2021, the most recent data available, HAMILTON COUNTY'S POPULATION WAS 356,650. JUST OVER HALF (51.2%) WERE FEMALE AND 48.8% WERE MALE. THE COUNTY'S POPULATION ESTIMATES BY RACE ARE 82.8% WHITE NON-HISPANIC, 4.5% BLACK, 4.3% HISPANIC OR LATINO, 6.5% ASIAN, 0.2% AMERICAN INDIAN OR ALASKA NATIVE, AND 2.1% TWO OR MORE RACES. A VERY SMALL PERCENTAGE OF THE POPULATION IS ETHNIC GROUPS OTHER THAN THOSE LISTED ABOVE.
Schedule H, Part VI, Line 5 Promotion of community health A MAJORITY OF IU HEALTH'S BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY MEMBERS WHO RESIDE IN IU HEALTH'S PRIMARY SERVICE AREAS. IU HEALTH EXTENDS MEDICAL PRIVILEGES TO ALL PHYSICIANS WHO MEET THE CREDENTIALING QUALIFICATIONS NECESSARY FOR APPOINTMENT TO ITS MEDICAL STAFF. IU HEALTH DOES NOT DENY APPOINTMENT ON THE BASIS OF GENDER, RACE, CREED, OR NATIONAL ORIGIN. IU HEALTH, IN CONJUNCTION WITH THE IU SCHOOL OF MEDICINE, TRAINS THE NEXT GENERATION OF PHYSICIANS IN AN EXCEPTIONAL ENVIRONMENT, BLENDING BREAKTHROUGH RESEARCH AND TREATMENTS WITH THE HIGHEST QUALITY OF PATIENT CARE. IU HEALTH'S FIVE-YEAR STRATEGY WAS UPDATED DURING 2019. IU HEALTH'S VISION IS TO MAKE INDIANA ONE OF THE HEALTHIEST STATES IN THE NATION BY PROVIDING THE BEST CARE, DESIGNED FOR OUR PATIENTS, AND THE FIVE YEAR STRATEGY WAS DESIGNED TO HELP IU HEALTH REALIZE THIS VISION. THE ELEMENTS OF IU HEALTH'S STRATEGY COMMUNITY HEALTH: AS THE LARGEST HEALTH SYSTEM IN THE STATE, AND IN PARTNERSHIP WITH THE STATE'S LARGEST MEDICAL SCHOOL - INDIANA UNIVERSITY SCHOOL OF MEDICINE - IU HEALTH HAS A SPECIAL OBLIGATION TO BE PART OF THE SOLUTION TO INDIANA'S SERIOUS HEALTH ISSUES. FOR COMMUNITY HEALTH, IU HEALTH'S FOCUS IS ON TACKLING FOUR OF THE MOST PRESSING HEALTH ISSUES IMPACTING INDIANA COMMUNITIES: HIGH RATES OF SMOKING, OBESITY, INFANT AND MATERNAL MORTALITY, AND POOR MENTAL HEALTH. SOME EFFORTS IN THIS AREA INCLUDE: - EXPANDING ACCESS TO BEHAVIORAL HEALTH SERVICES ACROSS THE IU HEALTH SYSTEM - THE CREATION OF A $100M COMMUNITY IMPACT INVESTMENT FUND TO SUPPORT PROJECTS THAT ADDRESS SERIOUS HEALTH ISSUES. POPULATION HEALTH: THIS IS THE CARE IU HEALTH PROVIDES PATIENTS FOR WHOM IU HEALTH HAS ACCEPTED SOME FINANCIAL RISK. FOR THESE PATIENTS, IU HEALTH IS REIMBURSED ON HOW WELL IU HEALTH IMPROVES PATIENT OUTCOMES AND MANAGE THE COST OF THEIR CARE, INSTEAD OF ON HOW MANY SERVICES IU HEALTH PROVIDES. FOR EXAMPLE, IU HEALTH MANAGES MORE THAN 60,000 MEDICARE PATIENTS IN ITS NEXT GENERATION ACCOUNTABLE CARE ORGANIZATION. FOR TWO YEARS NOW, IU HEALTH HAS REDUCED THE COSTS OF CARE FOR THOSE PATIENTS, WHILE ALSO IMPROVING A RANGE OF QUALITY METRICS. THIS HAS RESULTED IN BETTER CARE OUTCOMES, AS WELL AS SAVINGS FOR IU HEALTH AND THE MEDICARE ADVANTAGE PROGRAM. DESTINATION HEALTH: IU HEALTH TAKES CARE OF PATIENTS WITH THE MOST COMPLEX ILLNESSES AND TAKES ON THE TOUGHEST CASES THAT OTHER SYSTEMS ACROSS THE STATE DO NOT HAVE THE EXPERTISE OR THE RESOURCES TO HANDLE. IMPACT: THIS IS A NEW COMPONENT OF IU HEALTH'S STRATEGY AND REFLECTS EFFORTS TO EXPAND THE IMPACT IU HEALTH HAS ON PATIENTS AND COMMUNITIES ACROSS INDIANA. THIS INCLUDES PROVIDING EXCEPTIONAL CARE TO MORE PEOPLE AT IU HEALTH FACILITIES. IU HEALTH ALSO WANTS TO CREATE PARTNERSHIPS THAT WILL ENABLE IU HEALTH TO EXTEND SERVICES TO MORE PEOPLE ACROSS INDIANA. FOR EXAMPLE, A STRONG PARTNERSHIP WAS FORMED WITH UNION HOSPITAL IN TERRE HAUTE, WHICH USES IU HEALTH'S CERNER ELECTRONIC MEDICAL RECORD SYSTEM, INCLUDING CARE GUIDELINES AND ORDER SETS, TO BRING IU HEALTH CALIBER CARE TO UNION HOSPITAL PATIENTS. DIVERSITY AND INCLUSION: THE MISSION OF IU HEALTH'S OFFICE FOR DIVERSITY AND INCLUSION IS TO DRIVE A CULTURE OF ACCEPTANCE, INCLUSION, MUTUAL TRUST AND RESPECT IN ORDER TO BETTER SUPPORT THE PATIENTS AND COMMUNITIES THAT IU HEALTH SERVES. THE OFFICE FOCUSES ON INTERPERSONAL, INSTITUTATIONAL AND SOCIETAL ACTION TO TRANSFORM INTERNAL AND EXTERNAL COMMUNITIES INTO A PLACE WHERE ALL WILL THRIVE AND GROW.
Schedule H, Part VI, Line 6 Affiliated health care system Indiana University Health Inc. is part of Indiana University Health ("IU Health" or "the healthcare system"), which 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. The healthcare system is comprised of hospitals, physicians and allied services dedicated to providing preeminent care throughout Indiana and beyond. IU Health's affiliate hospitals are divided into five regions that serve communities in Northwest, Northeast, Central and Southern Indiana. The 16 hospitals in the healthcare system include 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 Hospital; 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; and IU Health White Memorial Hospital. Each affiliate hospital in the healthcare system conducts and adopts its own community health needs assessment (CHNA) and implementation strategy. IU Health considers the sum of these CHNAs and the implementation strategies part of a system wide goal of making Indiana one of the healthiest states in the nation. The affiliate hospitals are guided by a system wide mission to improve the health of IU Health patients and community through innovation, and excellence in care, education, research, and service. The healthcare 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. The healthcare system includes an Academic Health Center (i.e., IU Health Inc.), a regional academic health center (i.e., IU Health Bloomington Hospital) and several affiliate hospitals that work in partnership with the IU School of Medicine to train physicians, blending breakthrough research and treatments with the highest quality of patient care throughout IU Health. Each year, more than 1,000 residents and fellows receive training in affiliate 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. To further promote the health of the communities served by IU Health, the system-level Community Health Division team partners with state and local community-based organizations, community coalitions and governmental agencies to focus on clinical care, community investment and advocacy strategy that seeks to improve the health of communities. All affiliate hospitals in the healthcare system identifies and addresses significant health needs unique to the community they serve. Some of these health needs are common in communities served by multiple affiliate hospitals in the healthcare system and align with system priority areas, warranting a system level strategy. The Community Health Division plans and provides technical assistance for system-level strategies that address these common health needs including health inequities, tobacco, behavioral health access, infant and maternal health and social needs. Each affiliate hospital works collaboratively with the Community Health Division team to operationalize system-level strategies through the implementation of specific activities that align and activate local resources too. This benefits the community each affiliate hospital serves and works towards a statewide impact (system-level) on health outcomes. As part of the Community Health Division, IU Health Serves, a system-level team member volunteer program, seeks to positively impact the health of communities IU Health affiliate hospitals serve and foster 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. The Community Impact and Investment (CII) Fund is a $100 million board designated fund that is managed 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 affiliate hospital has a significant impact on and is 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 their surrounding communities. Each IU Health affiliate hospital and its team members are eligible to pursue this grant opportunity with a community organization or agency.
Schedule H, Part VI, Line 7 State filing of community benefit report IN
Schedule H (Form 990) 2021
Additional Data


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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
2021
Open to Public
Inspection
Name of the organization
Indiana University Health Inc
 
Employer identification number
35-1955872
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to 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 (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) 500 Festival Inc
21 Virginia Ave
Indianapolis,IN46204 		35-1004320 501(c)(4) 32,000 0 Cash Not applicable General Support
(2) Center for Interfaith Cooperation Inc
1100 W 42nd Street
Indianapolis,IN46208 		27-5336996 501(c)(3) 25,000 0 Cash Not applicable Community Benefit
(3) Child Advocates Inc
8200 Haverstick Road Suite 240
Indianapolis,IN46240 		35-1788240 501(c)(3) 10,000 0 Cash Not applicable Community Benefit
(4) Central Indiana Community Foundation
615 N Alabama St STE 119
Indianapolis,IN46204 		35-1793680 501(c)(3) 51,000 0 Cash Not applicable Community Benefit
(5) Covering Kids & Families
1100 W 42nd Street
Indianapolis,IN46208 		61-1520892 501(c)(3) 40,000 0 Cash Not applicable Community Benefit
(6) Family Promise
PO Box 441367
Indianapolis,IN46244 		35-1909912 501(c)(3) 25,000 0 Cash Not applicable Community Benefit
(7) Gennesaret Free Clinic Inc
615 N Alabama St
Indianapolis,IN46204 		35-1776518 501(c)(3) 30,000 0 Cash Not applicable Health Access
(8) Gleaners Food Bank of Indiana Inc
3737 Waldemere Ave
Indianapolis,IN46241 		35-1483868 501(c)(3) 100,000 0 Cash Not applicable Community Benefit
(9) Habitat for Humanity of Greater Indpls
3135 N Meridian St
Indianapolis,IN46208 		35-1715910 501(c)(3) 100,000 0 Cash Not applicable Community Benefit
(10) HealthNet Inc
3401 Raymond St
Indianapolis,IN46203 		35-1579827 501(c)(3) 1,254,000 0 Cash Not applicable General Support
(11) HVAF of Indiana
PO Box 441761
Indianapolis,IN46224 		35-1890547 501(c)(3) 22,000 0 Cash Not applicable General Support
(12) Indiana Diaper Bank
9511 Angola Court Suite 221
Indianapolis,IN46268 		82-5289150 501(c)(3) 10,000 0 Cash Not applicable General Support
(13) Indiana University Health Foundation Inc
1800 N Capitol Ave
Indianapolis,IN46202 		35-6043086 501(c)(3) 6,094,583 0 Cash Not applicable Spiritual Values/Community Health
(14) Indiana University School of Medicine
714 N Senate Ave
Indianapolis,IN46202 		35-6001673 Gov't Entity 416,000,000 0 Cash Not applicable Research/Training
(15) Indy Hunger Network Inc
9080 Dewberry Ct
Indianapolis,IN46260 		45-4833492 501(c)(3) 50,000 0 Cash Not applicable Nutrition Education
(16) Indy Public Safety Foundation
200 E Washington St Suite E241
Indianapolis,IN46204 		46-2975046 501(c)(3) 30,000 0 Cash Not applicable General Support
(17) Innovations for Learning
649 Michigan Ave
Evanston,IL60202 		36-3873652 501(c)(3) 9,000 0 Cash Not applicable Community Benefit
(18) Ivy Tech Foundation
2820 N Meridian St
Indianapolis,IN46208 		23-7073977 501(c)(3) 8,750,000 0 Cash Not applicable General Support
(19) Junior Achievement of Central Indiana Inc
9449 Priority Way
Indianapolis,IN46240 		35-1003695 501(c)(3) 35,000 0 Cash Not applicable Community Benefit
(20) LifeSmart Youth
615 Alabama St 228
Indianapolis,IN46204 		35-0869056 501(c)(3) 40,000 0 Cash Not applicable General Support
(21) Overdoses-Lifeline Inc
7331 Lakeside Dr
Indianapolis,IN46278 		47-1333720 501(c)(3) 20,000 0 Cash Not applicable Community Benefit
(22) Playworks Education Energized
380 Washington St
Oakland,CA94607 		94-3251867 501(c)(3) 15,000 0 Cash Not applicable Community Benefit
(23) Raphael Center
401 E 34th St
Indianapolis,IN46205 		35-1948768 501(c)(3) 30,000 0 Cash Not applicable Community Benefit
(24) Reach for Youth Inc
3505 N Washington Blvd
Indianapolis,IN46205 		23-7456842 501(c)(3) 15,000 0 Cash Not applicable General Support
(25) Trinity Haven
3561 N Pennsylvania St
Indianapolis,IN46205 		82-5358554 501(c)(3) 30,000 0 Cash Not applicable General Support
(26) United Way of Central Indiana Inc
PO Box 88409
Indianapolis,IN46208 		35-1007590 501(c)(3) 50,000 0 Cash Not applicable General Support
(27) Volunteers of America Ohio & Indiana
912 N Delaware St
Indianapolis,IN46202 		35-1914815 501(c)(3) 75,000 0 Cash Not applicable General Support
(28) YMCA of Greater Indianapolis
615 N Alabama St
Indianapolis,IN46204 		35-0868211 501(c)(3) 30,000 0 Cash Not applicable Community Benefit
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
27
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021

Schedule I (Form 990) 2021
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) SEE PART IV 5 424,244      
(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 III GRANTS AND OTHER ASSISTANCE TO INDIVIDUALS THE AMOUNT REPORTED ON SCHEDULE I, PART III, LINE 1 REPRESENTS FUNDS PROVIDED BY IU HEALTH TO IU SCHOOL OF MEDICINE TO SUPPORT MANAGEMENT AND/OR ADMINISTRATIVE POSITIONS.
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. ALTHOUGH IU HEALTH DOES NOT MONITOR THE USE OF GRANT FUNDS ONCE DISTRIBUTED, THROUGH DUE DILIGENCE THE ORGANIZATION HAS REASONABLY CONFIRMED THAT THE ENTITIES TO WHICH THE CONTRIBUTIONS ARE MADE ARE HIGHLY REPUTABLE IN THE COMMUNITY AND USE THE FUNDS FOR THE PURPOSES INTENDED.
Schedule I (Form 990) 2021



Additional Data


Software ID: 21014044
Software Version: 2021v4.2


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Indiana University Health Inc
 
Employer identification number

35-1955872
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes 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 .....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
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, 1099-MISC compensation, and/or 1099-NEC (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
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1DENNIS M MURPHY
 
DIRECTOR/PRESIDENT & CEO 		(i)

(ii)		 1,751,209
-------------
0 		2,302,791
-------------
0 		688,505
-------------
0 		876,439
-------------
0 		27,870
-------------
0 		5,646,813
-------------
0 		386,852
-------------
0
2LARRY H STEVENS MD
 
DIRECTOR 		(i)

(ii)		 37,500
-------------
537,091 		0
-------------
154,273 		0
-------------
3,564 		0
-------------
18,725 		0
-------------
1,360 		37,500
-------------
715,013 		0
-------------
0
3JENNIFER M ALVEY
 
TREASURER/SVP & CFO 		(i)

(ii)		 864,633
-------------
0 		626,404
-------------
0 		170,168
-------------
0 		171,727
-------------
0 		32,781
-------------
0 		1,865,714
-------------
0 		85,414
-------------
0
4ERIN R LEWIS
 
SECRETARY/SVP & GEN. COUNSEL 		(i)

(ii)		 649,406
-------------
0 		458,262
-------------
0 		2,844
-------------
0 		129,578
-------------
0 		23,782
-------------
0 		1,263,872
-------------
0 		0
-------------
0
5JONATHAN E GOTTLIEB MD
 
Former Key Employee 		(i)

(ii)		 0
-------------
0 		481,162
-------------
0 		1,671
-------------
0 		0
-------------
0 		0
-------------
0 		482,832
-------------
0 		0
-------------
0
6PAUL R HAUT MD
 
FORMER KEY EMPLOYEE 		(i)

(ii)		 0
-------------
364,649 		0
-------------
100,890 		0
-------------
2,322 		0
-------------
15,037 		0
-------------
180 		0
-------------
483,079 		0
-------------
0
7MICHAEL L HARLOWE
 
FORMER KEY EMPLOYEE 		(i)

(ii)		 0
-------------
262,162 		0
-------------
66,805 		0
-------------
6,541 		0
-------------
7,125 		0
-------------
28,026 		0
-------------
370,659 		0
-------------
0
8PAUL M CALKINS MD
 
FORMER KEY EMPLOYEE 		(i)

(ii)		 456,364
-------------
0 		100,000
-------------
0 		22,927
-------------
0 		11,600
-------------
0 		24,926
-------------
0 		615,817
-------------
0 		0
-------------
0
9KEVIN R ARMSTRONG
 
FORMER KEY EMPLOYEE 		(i)

(ii)		 426,354
-------------
0 		365,006
-------------
0 		116,942
-------------
0 		113,227
-------------
0 		33,567
-------------
0 		1,055,096
-------------
0 		54,522
-------------
0
10PARVEEN CHAND
 
FORMER KEY EMPLOYEE 		(i)

(ii)		 433,412
-------------
0 		103,889
-------------
0 		20,742
-------------
0 		18,504
-------------
0 		40,176
-------------
0 		616,724
-------------
0 		0
-------------
0
11MICHELLE A JANNEY RN
 
EVP & COO 		(i)

(ii)		 944,795
-------------
0 		805,012
-------------
0 		521,097
-------------
0 		18,725
-------------
0 		14,027
-------------
0 		2,303,656
-------------
0 		203,989
-------------
0
12RYAN D NAGY MD
 
PRESIDENT (AAHC) 		(i)

(ii)		 0
-------------
674,351 		0
-------------
492,281 		0
-------------
2,274 		0
-------------
142,327 		0
-------------
273 		0
-------------
1,311,507 		0
-------------
0
13DAVID A INGRAM MD
 
EVP & CME 		(i)

(ii)		 0
-------------
746,365 		0
-------------
583,904 		0
-------------
6,036 		0
-------------
186,729 		0
-------------
0 		0
-------------
1,523,034 		0
-------------
0
14Gil Peri
 
President (Riley) (Part Year) 		(i)

(ii)		 328,307
-------------
0 		200,000
-------------
0 		151,422
-------------
0 		60,577
-------------
0 		20,016
-------------
0 		760,322
-------------
0 		0
-------------
0
15RONALD L STIVER
 
PRESIDENT (SHS) 		(i)

(ii)		 689,031
-------------
0 		552,131
-------------
0 		385,961
-------------
0 		144,726
-------------
0 		32,870
-------------
0 		1,804,718
-------------
0 		163,465
-------------
0
16JEFFREY C BIRD MD
 
PRESIDENT (ECR) 		(i)

(ii)		 539,835
-------------
0 		383,684
-------------
0 		424,936
-------------
0 		18,725
-------------
0 		31,967
-------------
0 		1,399,147
-------------
0 		248,972
-------------
0
17BLAKE A DYE
 
SVP 		(i)

(ii)		 554,863
-------------
0 		379,981
-------------
0 		353,992
-------------
0 		18,725
-------------
0 		29,367
-------------
0 		1,336,929
-------------
0 		199,888
-------------
0
18DANIEL E NEUFELDER
 
President (WCR) (Part Year) 		(i)

(ii)		 374,698
-------------
0 		380,366
-------------
0 		477,685
-------------
0 		18,725
-------------
0 		27,017
-------------
0 		1,278,491
-------------
0 		247,552
-------------
0
19ELIZABETH DUNLAP
 
SVP, CHIEF HR OFFICER (Part Year) 		(i)

(ii)		 392,078
-------------
0 		479,008
-------------
0 		1,325,433
-------------
0 		435,640
-------------
0 		25,009
-------------
0 		2,657,167
-------------
0 		203,067
-------------
0
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
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 1a Tax indemnification and gross-up payments TAX GROSS-UPS WERE PROVIDED TO THREE OFFICERS, FOUR KEY EMPLOYEES, FIVE HIGHEST COMPENSATED EMPLOYEES, AND TWO FORMER KEY EMPLOYEES LISTED ON IU HEALTH'S FORM 990, PART VII, SECTION A. THE TAX GROSS-UPS WERE TREATED AS TAXABLE COMPENSATION.
Schedule J, Part I, Line 4a Severance or change-of-control payment Elizabeth Dunlap ENTERED INTO A SEVERANCE AGREEMENT WITH IU HEALTH DURING 2021. SEVERANCE OF $600,007 THAT WAS RECEIVED DURING 2021 IS INCLUDED IN COLUMN B(III), OTHER REPORTABLE COMPENSATION. DEFERRED SEVERANCE OF $416,915 IS INCLUDED IN COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan DENNIS M. MURPHY, MICHELLE A. JANNEY, R.N., RONALD L. STIVER, JENNIFER M. ALVEY, KEVIN R. ARMSTRONG, RYAN D. NAGY, M.D., ELIZABETH DUNLAP, ERIN R. LEWIS, Blake A. Dye, David A. Ingram, M.D., Daniel E. Neufelder, M.D., Gil Peri, AND Jeffrey C. Bird,M.D., 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. EACH OF THE EXECUTIVES LISTED ABOVE, WITH THE EXCEPTION OF JEFFREY C. BIRD, M.D., ELIZABETH DUNLAP, BLAKE DYE, MICHELLE A. JANNEY, R.N., AND DANIEL E. NEUFELDER HAVE AN AMOUNT INCLUDED IN COLUMN C, DEFERRED COMPENSATION, REPRESENTING THE CURRENT YEAR UNVESTED CONTRIBUTIONS MADE UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THESE AMOUNTS WERE NOT PAID TO THE EXECUTIVES DURING THE YEAR. THE FOLLOWING EXECUTIVES HAVE AN AMOUNT INCLUDED IN COLUMN B (III), OTHER REPORTABLE COMPENSATION, REPRESENTING THE CURRENT YEAR VESTED AMOUNTS RECEIVED UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: - JENNIFER M. ALVEY ($147,767) - KEVIN R. ARMSTRONG ($88,784) - JEFFREY C. BIRD ($398,625) - ELIZABETH DUNLAP ($707,947) - BLAKE DYE ($345,334) - MICHELLE A. JANNEY, R.N. ($474,555) - DENNIS M. MURPHY ($656,718) - DANIEL E. NEUFELDER ($452,147) - RONALD L. STIVER ($363,617) Dennis M. Murphy has a retention agreement which was signed in 2019. The anticipated vesting and payout date of the retention bonus is 1/1/25.
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 COMMITTEE ON Talent Management and Executive Compensation AND BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT.
Schedule J (Form 990) 2021

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Indiana University Health Inc
 
Employer identification number
35-1955872
Part Ⅰ
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer		 (i) Pool
financing
Yes No Yes No Yes No
A INDIANA FINANCE AUTHORITY
  		35-1602316 45471AEN8 05-05-2016 107,790,000 SERIES 2011L AND M BONDS   X   X   X
B INDIANA FINANCE AUTHORITY
  		35-1602316 45471ANR9 10-14-2014 80,777,895 SERIES 2014A BONDS   X   X   X
C INDIANA FINANCE AUTHORITY
  		35-1602316 45471ANY4 05-07-2015 314,416,912 SERIES 2015A BONDS   X   X   X
D INDIANA FINANCE AUTHORITY
  		35-1602316 45471APJ5 02-18-2016 290,611,029 SERIES 2016A, B, AND C BONDS   X   X   X
INDIANA FINANCE AUTHORITY
  		35-1602316 45470YEX5 07-02-2019 370,318,185 SERIES 2019A, B AND C BONDS   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 40,820,000 29,140,000   153,830,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 107,790,000 82,344,679 314,633,314 290,611,029
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 1,348,373 793,499 2,122,523 1,641,061
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 256,482,141      
11 Other spent proceeds ............. 107,790,000 81,551,179 312,510,791 288,969,968
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2016 2014 2015 2016
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2020, a current refunding issue)? ........ 		X     X   X X  
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........ 		  X X   X     X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
Part Ⅲ
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X   X   X   X  
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet        
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet        
6 Total of lines 4 and 5 ............. 0 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........ 		X   X   X   X  
Part Ⅳ
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........ X     X   X X  
c No rebate due? .........   X X   X     X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X     X   X X  
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part Ⅳ
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part Ⅴ
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part Ⅵ
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Schedule K, Part I Page 1, LINE A, COLUMN (F) - DESCRIPTION OF PURPOSE THE SERIES 2011L AND M BONDS WERE ISSUED ON MAY 25, 2011 IN ORDER TO PROVIDE FUNDING FOR THE NEW CONSTRUCTION OF BUILDINGS AND STRUCTURES AND THE PURCHASE OF EQUIPMENT. A 2016 REISSUANCE OF THE INDIANA FINANCE AUTHORITY HOSPITAL REVENUE BONDS, SERIES 2011L AND 2011M OCCURRED ON MAY 5, 2016, AND WAS TREATED AS A CURRENT REFUNDING OF SUCH BONDS.
Schedule K, Part I Page 1, LINE B, COLUMN (F) - DESCRIPTION OF PURPOSE THE SERIES 2014A BONDS WERE ISSUED IN ORDER TO ADVANCE REFUND THE SERIES 2006 AND SERIES 2009A BONDS OF INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL, INC., A RELATED 501(C)(3) TAX-EXEMPT ORGANIZATION, AND TO PAY CERTAIN EXPENSES RELATED TO THE ISSUANCE. THE SERIES 2006 AND SERIES 2009A BONDS WERE ISSUED ON MAY 31, 2006 AND DECEMBER 8, 2009, RESPECTIVELY. THE TOTAL PROCEEDS OF THE ISSUE EXCEEDS THE ISSUE PRICE DUE TO INVESTMENT EARNINGS.
Schedule K, Part I Page 1, LINE C, COLUMN (F) - DESCRIPTION OF PURPOSE THE SERIES 2015A BONDS WERE ISSUED IN ORDER TO ADVANCE REFUND THE SERIES 2006A BONDS AS WELL AS TAXABLE BONDS, SERIES 2011J AND K, AND A TAXABLE BANK LOAN. THE SERIES 2006B BONDS WERE ISSUED ON JANUARY 24, 2006. THE SERIES 2011J AND K BONDS WERE ISSUED ON MAY 5, 2011. THE TOTAL PROCEEDS OF THE ISSUE EXCEEDS THE ISSUE PRICE DUE TO INVESTMENT EARNINGS.
Schedule K, Part I Page 1, LINE D, COLUMN (F) - DESCRIPTION OF PURPOSE THE SERIES 2016A, B, AND C BONDS WERE ISSUED IN ORDER TO REFUND A PORTION OF THE SERIES 2006B BONDS. THE SERIES 2006B BONDS WERE ISSUED ON SEPTEMBER 14, 2006.
Schedule K, Part I Page 2, LINE A, COLUMN (F) - DESCRIPTION OF PURPOSE A MULTIPURPOSE ELECTION WAS MADE WITH RESPECT TO THE 2019ABC BONDS. THE SERIES 2019A AND B BONDS WERE ISSUED ON JULY 2, 2019 IN ORDER TO PROVIDE FUNDING FOR THE NEW CONSTRUCTION OF BUILDINGS AND STRUCTURES. THE SERIES 2019C BONDS WERE ISSUED IN ORDER TO REFUND A PORTION OF THE SERIES 2011A, 2011B, 2011C, 2011D, 2011E, 2011H, and 2011I BONDS. IF CALCULATING LINES III-4, III-5, AND III-6 FOR EACH OF THESE TWO COMPONENTS (ONE BEING 2019A AND B ("2019AB") AND ONE BEING 2019C ("2019C")), THE PERCENTAGES WOULD BE 0% with respect to 2019AB and 0% WITH RESPECT TO 2019C. THE TOTAL PROCEEDS OF THE ISSUE EXCEEDS THE ISSUE PRICE DUE TO INVESTMENT EARNINGS OF $1,482,141.
Schedule K, Part II, Line 3 TOTAL PROCEEDS OF ISSUE TOTAL PROCEEDS OF ISSUE DISCLOSED ON PART II, LINE 3 ARE SOMETIMES HIGHER THAN THE ISSUE PRICE DISCLOSED IN PART I DUE TO THE INVESTMENT EARNINGS ON THE BOND PROCEEDS: SCHEDULE K, PAGE 1, COLUMN B, SERIES 2014A BONDS: ISSUE PRICE: $80,777,895 EARNINGS: $1,566,784 TOTAL PROCEEDS: $82,344,679 SCHEDULE K, PAGE 1, COLUMN C, SERIES 2015A BONDS: ISSUE PRICE: $314,416,912 EARNINGS: $216,402 TOTAL PROCEEDS: $314,633,314 SCHEDULE K, PAGE 4, COLUMN A, SERIES 2019A, B AND C BONDS: ISSUE PRICE: $370,318,185 EARNINGS: $1,482,141 TOTAL PROCEEDS: $371,800,326
Schedule K, Part III LINES 4, 5, AND 6 - P.B.U. PERCENTAGES IU HEALTH GENERALLY ONLY FINANCES A PORTION OF EACH PROJECT WITH TAX-EXEMPT BONDS. FUNDS OTHER THAN TAX-EXEMPT BONDS ARE SUFFICIENT TO COVER THE AMOUNT OF ANY PRIVATE BUSINESS USE.
Schedule K, Part IV, Line 2c COLUMN B Issuer name: INDIANA FINANCE AUTHORITY The calculation for computing no rebate due was performed on 03/01/2016
Schedule K, Part IV, Line 2c COLUMN C Issuer name: INDIANA FINANCE AUTHORITY The calculation for computing no rebate due was performed on 05/11/2016
Schedule K (Form 990) 2021

Additional Data


Software ID: 21014044
Software Version: 2021v4.2


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

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Indiana University Health Inc
 
Employer identification number
35-1955872
Part Ⅰ
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer		 (i) Pool
financing
Yes No Yes No Yes No
A INDIANA FINANCE AUTHORITY
  		35-1602316 45471AEN8 05-05-2016 107,790,000 SERIES 2011L AND M BONDS   X   X   X
B INDIANA FINANCE AUTHORITY
  		35-1602316 45471ANR9 10-14-2014 80,777,895 SERIES 2014A BONDS   X   X   X
C INDIANA FINANCE AUTHORITY
  		35-1602316 45471ANY4 05-07-2015 314,416,912 SERIES 2015A BONDS   X   X   X
D INDIANA FINANCE AUTHORITY
  		35-1602316 45471APJ5 02-18-2016 290,611,029 SERIES 2016A, B, AND C BONDS   X   X   X
INDIANA FINANCE AUTHORITY
  		35-1602316 45470YEX5 07-02-2019 370,318,185 SERIES 2019A, B AND C BONDS   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 40,820,000 29,140,000   153,830,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 107,790,000 82,344,679 314,633,314 290,611,029
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 1,348,373 793,499 2,122,523 1,641,061
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 256,482,141      
11 Other spent proceeds ............. 107,790,000 81,551,179 312,510,791 288,969,968
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2016 2014 2015 2016
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2020, a current refunding issue)? ........ 		X     X   X X  
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........ 		  X X   X     X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
Part Ⅲ
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X   X   X   X  
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet        
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet        
6 Total of lines 4 and 5 ............. 0 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........ 		X   X   X   X  
Part Ⅳ
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........ X     X   X X  
c No rebate due? .........   X X   X     X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X     X   X X  
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part Ⅳ
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part Ⅴ
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part Ⅵ
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Schedule K, Part I Page 1, LINE A, COLUMN (F) - DESCRIPTION OF PURPOSE THE SERIES 2011L AND M BONDS WERE ISSUED ON MAY 25, 2011 IN ORDER TO PROVIDE FUNDING FOR THE NEW CONSTRUCTION OF BUILDINGS AND STRUCTURES AND THE PURCHASE OF EQUIPMENT. A 2016 REISSUANCE OF THE INDIANA FINANCE AUTHORITY HOSPITAL REVENUE BONDS, SERIES 2011L AND 2011M OCCURRED ON MAY 5, 2016, AND WAS TREATED AS A CURRENT REFUNDING OF SUCH BONDS.
Schedule K, Part I Page 1, LINE B, COLUMN (F) - DESCRIPTION OF PURPOSE THE SERIES 2014A BONDS WERE ISSUED IN ORDER TO ADVANCE REFUND THE SERIES 2006 AND SERIES 2009A BONDS OF INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL, INC., A RELATED 501(C)(3) TAX-EXEMPT ORGANIZATION, AND TO PAY CERTAIN EXPENSES RELATED TO THE ISSUANCE. THE SERIES 2006 AND SERIES 2009A BONDS WERE ISSUED ON MAY 31, 2006 AND DECEMBER 8, 2009, RESPECTIVELY. THE TOTAL PROCEEDS OF THE ISSUE EXCEEDS THE ISSUE PRICE DUE TO INVESTMENT EARNINGS.
Schedule K, Part I Page 1, LINE C, COLUMN (F) - DESCRIPTION OF PURPOSE THE SERIES 2015A BONDS WERE ISSUED IN ORDER TO ADVANCE REFUND THE SERIES 2006A BONDS AS WELL AS TAXABLE BONDS, SERIES 2011J AND K, AND A TAXABLE BANK LOAN. THE SERIES 2006B BONDS WERE ISSUED ON JANUARY 24, 2006. THE SERIES 2011J AND K BONDS WERE ISSUED ON MAY 5, 2011. THE TOTAL PROCEEDS OF THE ISSUE EXCEEDS THE ISSUE PRICE DUE TO INVESTMENT EARNINGS.
Schedule K, Part I Page 1, LINE D, COLUMN (F) - DESCRIPTION OF PURPOSE THE SERIES 2016A, B, AND C BONDS WERE ISSUED IN ORDER TO REFUND A PORTION OF THE SERIES 2006B BONDS. THE SERIES 2006B BONDS WERE ISSUED ON SEPTEMBER 14, 2006.
Schedule K, Part I Page 2, LINE A, COLUMN (F) - DESCRIPTION OF PURPOSE A MULTIPURPOSE ELECTION WAS MADE WITH RESPECT TO THE 2019ABC BONDS. THE SERIES 2019A AND B BONDS WERE ISSUED ON JULY 2, 2019 IN ORDER TO PROVIDE FUNDING FOR THE NEW CONSTRUCTION OF BUILDINGS AND STRUCTURES. THE SERIES 2019C BONDS WERE ISSUED IN ORDER TO REFUND A PORTION OF THE SERIES 2011A, 2011B, 2011C, 2011D, 2011E, 2011H, and 2011I BONDS. IF CALCULATING LINES III-4, III-5, AND III-6 FOR EACH OF THESE TWO COMPONENTS (ONE BEING 2019A AND B ("2019AB") AND ONE BEING 2019C ("2019C")), THE PERCENTAGES WOULD BE 0% with respect to 2019AB and 0% WITH RESPECT TO 2019C. THE TOTAL PROCEEDS OF THE ISSUE EXCEEDS THE ISSUE PRICE DUE TO INVESTMENT EARNINGS OF $1,482,141.
Schedule K, Part II, Line 3 TOTAL PROCEEDS OF ISSUE TOTAL PROCEEDS OF ISSUE DISCLOSED ON PART II, LINE 3 ARE SOMETIMES HIGHER THAN THE ISSUE PRICE DISCLOSED IN PART I DUE TO THE INVESTMENT EARNINGS ON THE BOND PROCEEDS: SCHEDULE K, PAGE 1, COLUMN B, SERIES 2014A BONDS: ISSUE PRICE: $80,777,895 EARNINGS: $1,566,784 TOTAL PROCEEDS: $82,344,679 SCHEDULE K, PAGE 1, COLUMN C, SERIES 2015A BONDS: ISSUE PRICE: $314,416,912 EARNINGS: $216,402 TOTAL PROCEEDS: $314,633,314 SCHEDULE K, PAGE 4, COLUMN A, SERIES 2019A, B AND C BONDS: ISSUE PRICE: $370,318,185 EARNINGS: $1,482,141 TOTAL PROCEEDS: $371,800,326
Schedule K, Part III LINES 4, 5, AND 6 - P.B.U. PERCENTAGES IU HEALTH GENERALLY ONLY FINANCES A PORTION OF EACH PROJECT WITH TAX-EXEMPT BONDS. FUNDS OTHER THAN TAX-EXEMPT BONDS ARE SUFFICIENT TO COVER THE AMOUNT OF ANY PRIVATE BUSINESS USE.
Schedule K, Part IV, Line 2c COLUMN B Issuer name: INDIANA FINANCE AUTHORITY The calculation for computing no rebate due was performed on 03/01/2016
Schedule K, Part IV, Line 2c COLUMN C Issuer name: INDIANA FINANCE AUTHORITY The calculation for computing no rebate due was performed on 05/11/2016
Schedule K (Form 990) 2021

Additional Data


Software ID: 21014044
Software Version: 2021v4.2

Schedule L
(Form 990)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Indiana University Health Inc
 
Employer identification number

35-1955872
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990) 2021
Schedule L (Form 990) 2021
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) JILAINE STEVENS
  		SPOUSE OF IUH, INC. DIRECTOR, LARRY STEVENS 77,660 COMPENSATION FOR SERVICES   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990) 2021


Additional Data


Software ID: 21014044
Software Version: 2021v4.2




SCHEDULE O
(Form 990)

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
2021
Open to Public
Inspection
Name of the organization
Indiana University Health Inc
 
Employer identification number

35-1955872
Return Reference Explanation
Form 990, Part III, Line 4d Description of other program services (Expenses $ 384,656,478 including grants of $ 0)(Revenue $ 394,117,215) MEMBER PREMIUM REVENUE
Form 990, Part III, Line 4d Description of other program services (Expenses $ 328,538,088 including grants of $ 0)(Revenue $ 336,618,577) PHARMACY
Form 990, Part III, Line 4d Description of other program services (Expenses $ 67,883,146 including grants of $ 0)(Revenue $ 84,746,963) ALL OTHER PROGRAMS
Form 990, Part VI, Line 2 FAMILY OR BUSINESS RELATIONSHIPS CERTAIN OFFICERS, DIRECTORS OR KEY EMPLOYEES OF INDIANA UNIVERSITY HEALTH, INC. (IU HEALTH) ALSO SERVE ON THE BOARDS OR AS OFFICERS OF RELATED OR UNRELATED FOR-PROFIT ORGANIZATIONS, AS NOTED BELOW. NO ADDITIONAL COMPENSATION WAS PROVIDED TO THESE INDIVIDUALS FOR THEIR SERVICE TO RELATED ORGANIZATIONS.
Form 990, Part VI, Line 15 PROCESS FOR DETERMINING COMPENSATION IU HEALTH USES A THOROUGH PROCESS TO DETERMINE THE COMPENSATION OF ITS PRESIDENT AND CHIEF EXECUTIVE OFFICER, OTHER OFFICERS, AND KEY EMPLOYEES. 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 PAY AND BENEFITS (COLLECTIVELY REFERRED TO AS "COMPENSATION") ON AN ANNUAL BASIS IN APRIL. 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 and compliance 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.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons IUH ASSURANCE SPC, LTD. JENNIFER ALVEY, MICHELLE JANNEY, ERIN LEWIS - Business relationship, IU HEALTH RISK RETENTION GROUP, INC. JENNIFER ALVEY, MICHELLE JANNEY, ERIN LEWIS - Business relationship, AMERICAN UNITED MUTUAL LIFE INSURANCE HOLDING COMPANY. J. SCOTT DAVISON, MICHAEL MCROBBIE - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholders THERE SHALL BE TWO CLASSES OF MEMBERS OF THE CORPORATION. ONE CLASS, KNOWN AS THE UNIVERSITY CLASS, SHALL CONSIST OF THOSE PERSONS SERVING FROM TIME TO TIME AS THE TRUSTEES OF INDIANA UNIVERSITY. THE OTHER CLASS, KNOWN AS THE METHODIST CLASS, SHALL CONSIST OF THE MEMBERS OF THE METHODIST HEALTH GROUP, INC.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body EXCEPT AS OTHERWISE PROVIDED IN THE ARTICLES OR BYLAWS, EACH CLASS OF MEMBERS SHALL BE ENTITLED TO ONE (1) VOTE UPON EACH QUESTION WHICH PROPERLY COMES BEFORE A MEETING OF THE MEMBERS. UNLESS OTHERWISE SPECIFIED BY LAW OR THE TRUSTEES OF INDIANA UNIVERSITY, THE VOTE OF THE UNIVERSITY CLASS SHALL BE DETERMINED BY A MAJORITY VOTE OF THE CONSTITUENTS OF THE UNIVERSITY CLASS WHO ARE PRESENT AT A MEETING AT WHICH A QUORUM IS PRESENT AND A QUORUM SHALL CONSIST OF A MAJORITY OF THE CONSTITUENTS OF THE UNIVERSITY CLASS. THE VOTE OF THE METHODIST CLASS SHALL BE DETERMINED BY A TWO-THIRDS (2/3) MAJORITY OF THE MEMBERS OF THE METHODIST HEALTH GROUP, INC. OR OTHERWISE AS SET FORTH FROM TIME TO TIME IN THE CONSTITUENT INSTRUMENTS OF THE METHODIST HEALTH GROUP, INC. BOTH MEMBER CLASSES MAY TAKE ACTION WITHOUT A MEETING IF A CONSENT IN WRITING SETTING FORTH THE ACTION SO TAKEN SHALL BE APPROVED BY AT LEAST EIGHTY (80) PERCENT OF THE CONSTITUENTS OF THE RESPECTIVE MEMBER CLASS OR SUCH GREATER PERCENTAGE AS THAT MEMBER CLASS DETERMINES TO BE NECESSARY FOR APPROVAL OF AN ACTION WITHOUT A MEETING. The Corporation shall, as specified in the Articles, have fifteen (15) Directors. WITH REGARD TO THE APPOINTMENT OF THE BOARD OF DIRECTORS OF THE CORPORATION, THE DIRECTORS, EACH OF WHOM SHALL HAVE ONE VOTE, WILL BE SELECTED AS FOLLOWS: (A) EIGHT (8) AT-LARGE DIRECTORS SHALL BE JOINTLY ELECTED BY THE AFFIRMATIVE VOTE OF BOTH MEMBER CLASSES (THE "AT-LARGE DIRECTORS"). (B) TWO (2) DIRECTORS SHALL BE APPOINTED BY THE METHODIST CLASS. (C) THE PRESIDENT OF INDIANA UNIVERSITY, THE DEAN OF INDIANA UNIVERSITY SCHOOL OF MEDICINE (THE "DEAN"), AND THE CHAIR OF THE IU BOARD OF TRUSTEES OR ANOTHER IU TRUSTEE DESIGNATED BY THE CHAIR OF THE BOARD OF TRUSTEES, SHALL EACH BE A STANDING DIRECTOR OF THE UNIVERSITY CLASS, REFERRED TO COLLECTIVELY AS "UNIVERSITY STANDING DIRECTORS". (D) THE BISHOP OF THE INDIANA AREA OF THE UNITED METHODIST CHURCH (THE "BISHOP") SHALL BE AN EX OFFICIO DIRECTOR. IF THE BISHOP DETERMINES THAT HE/SHE IS UNABLE TO SERVE AS DIRECTOR FOR AN UPCOMING YEAR, THE BISHOP MAY NAME A DESIGNEE TO SERVE AS A DIRECTOR BY PROVIDING NOTIFICATION OF SUCH DESIGNEE TO THE CORPORATION AT OR BEFORE THE ANNUAL MEETING OF THE CORPORATION. DIRECTORS NAMED IN (B) AND (D) ABOVE ARE REFERRED TO COLLECTIVELY HAS "METHODIST STANDING DIRECTORS. " (E) THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE CORPORATION (THE "PRESIDENT") SHALL BE AN EX OFFICIO DIRECTOR. NO MORE THAN TWENTY PERCENT (20%) OF THE DIRECTORS SHALL BE PHYSICIANS WHO ARE PROVIDING PROFESSIONAL SERVICES TO THE CORPORATION.
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 APPROVAL OF THE UNIVERSITY CLASS PRIOR TO IMPLEMENTATION: (A) ANY SALE, LEASE, TRANSFER OR OTHER ALIENATION OF THE INDIANA UNIVERSITY HOSPITALS REAL PROPERTY, AS DEFINED IN THE DEFINITIVE AGREEMENT, INCLUDING ANY ASSIGNMENT OF THE UNIVERSITY HOSPITALS LEASE BY AND BETWEEN THE TRUSTEES OF INDIANA UNIVERSITY AND THE CORPORATION, EXCEPT AS OTHERWISE AUTHORIZED BY RESOLUTION OR AGREEMENT OF THE TRUSTEES OF INDIANA UNIVERSITY. (B) ANY PROPOSAL BY THE CORPORATION WHICH CONFLICTS WITH THE FOLLOWING PRINCIPLE: THE CORPORATION WILL CONTINUE TO MAKE ALL PATIENTS AVAILABLE FOR MEDICAL EDUCATION UNLESS OTHERWISE REQUESTED BY THE PATIENT OR HIS/HER FAMILY, AS THE MAJOR CLINICAL TEACHING RESOURCE FOR THE INDIANA UNIVERSITY SCHOOL OF MEDICINE. (C) ANY CHANGE IN THE FORMULA USED TO CALCULATE THE AMOUNT OF SUPPORT PROVIDED TO THE INDIANA UNIVERSITY SCHOOL OF MEDICINE, AS REFERENCED IN THE ARTICLES OF INCORPORATION. (D) ANY PROPOSED ACTION REGARDING THE OPERATION OF INDIANA UNIVERSITY HOSPITALS, INCLUDING THE JAMES WHITCOMB RILEY HOSPITAL FOR CHILDREN, WHICH WOULD CONFLICT WITH OR BE CONTRARY TO THE REQUIREMENTS SET FORTH IN THE TRUSTEES RESOLUTIONS. (E) ANY SALE OR OTHER ALIENATION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OR OPERATIONS OF THE CORPORATION, AND ANY MERGER, CONSOLIDATION, CHANGE OF VOTING CONTROL OR OTHER REORGANIZATION OF THE CORPORATION. (F) AMENDMENT, ALTERATION OR REPEAL OF THE ARTICLES OF INCORPORATION (G) ANY DISSOLUTION OF THE CORPORATION, EXCEPT AS OTHERWISE REQUIRED BY LAW. (H) ANY REVISION TO, OR MODIFICATION OR REVOCATION OF THE CORE VALUES. (I) ANY TRANSFER OF THE MEMBERSHIP OF EITHER OF THE MEMBER CLASSES. (J) ANY AMENDMENT TO THE DEFINITIVE AGREEMENT. NOTWITHSTANDING ANY OTHER PROVISIONS OF THE ARTICLES OF INCORPORATION, THE FOLLOWING MATTERS REQUIRE THE APPROVAL OF THE METHODIST CLASS PRIOR TO IMPLEMENTATION: (A) ANY SALE OR OTHER ALIENATION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OR OPERATIONS OF THE CORPORATION, AND ANY MERGER, CONSOLIDATION, CHANGE OF VOTING CONTROL, OR OTHER REORGANIZATION OF THE CORPORATION. (B) AMENDMENT, ALTERATION OR REPEAL OF THE ARTICLES OF INCORPORATION. (C) ANY DISSOLUTION OF THE CORPORATION, EXCEPT AS OTHERWISE REQUIRED BY LAW. (D) ANY REVISIONS TO, OR MODIFICATIONS OR REVOCATION OF THE CORE VALUES. (E) ANY TRANSFER OF THE MEMBERSHIP OF EITHER OF THE MEMBER CLASSES. (F) ANY AMENDMENT TO THE DEFINITIVE AGREEMENT.
Form 990, Part VI, Line 11b Review of form 990 by governing body A THOROUGH PROCESS WAS USED BY IU HEALTH TO REVIEW THE FORM 990 AND RELATED SCHEDULES PRIOR TO ITS FILING. THE BOARD OF DIRECTORS' COMMITTEE ON VALUES, ETHICS, SOCIAL RESPONSIBILITY, AND PASTORAL SERVICES REVIEWED THE FOLLOWING SECTION OF THE FORM 990: 1. SCHEDULE H - HOSPITALS THE BOARD OF DIRECTORS' COMMITTEE ON Talent Management and Executive Compensation REVIEWED THE FOLLOWING SECTIONS OF THE FORM 990 1. PART VI - GOVERNANCE, MANAGEMENT, AND DISCLOSURE 2. PART VII - COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES, AND INDEPENDENT CONTRACTORS 3. SCHEDULE J - COMPENSATION INFORMATION THE BOARD OF DIRECTORS' AUDIT and compliance COMMITTEE WAS ALSO PROVIDED WITH A COMPLETE COPY OF THE FORM 990 AND RELATED SCHEDULES TO REVIEW. AFTER THE REVIEW FROM THE AFOREMENTIONED COMMITTEES, A COMPLETE COPY OF THE FORM 990 AND RELATED SCHEDULES WAS MADE AVAILABLE TO EACH BOARD MEMBER ON A SECURE INTRANET SITE. EACH MEMBER WAS ALSO INFORMED OF THE AVAILABILITY OF THE TAX DEPARTMENT TO ANSWER ANY QUESTIONS.
Form 990, Part VI, Line 12c Conflict of interest policy 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 19 Required documents available to the public IU HEALTH'S ARTICLES OF INCORPORATION ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH THE INDIANA SECRETARY OF STATE'S WEBSITE. IU HEALTH'S CONFLICT OF INTEREST PROCEDURES ARE DISCLOSED ON FORM 990, SCHEDULE O. IU HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH ITS BOND FILINGS AND AS AN ATTACHMENT TO THE FORM 990.
Form 990, Part VIII, Line 2f Other Program Service Revenue INCOME (LOSS) FROM PASS-THROUGH ENTITIES - Total Revenue: 57343250, Related or Exempt Function Revenue: 56931254, Unrelated Business Revenue: 411996, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; FEDERAL RECOVERY REVENUE - Total Revenue: 13610671, Related or Exempt Function Revenue: 13610671, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; RENT FROM RELATED 501(C)(3) ENTITITES - Total Revenue: 12209502, Related or Exempt Function Revenue: 12209502, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Telephone - Total Revenue: 278816, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 278816; OTHER - Total Revenue: 68085926, Related or Exempt Function Revenue: , Unrelated Business Revenue: -235527, Revenue Excluded from Tax Under Sections 512, 513, or 514: 68321453;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances EQUITY TRANSFER (SETTLEMENT OF DEBT/RESERVE): - -XXX-XX-XXXX; MARK-TO-MARKET ON INTEREST RATE SWAPS: - 18206932; Net Asset Transfers from Merged Entities - -45352960; Net Asset Transfers - Miscellaneous - -3665447;
Schedule F, Part I, Line 3 ACTIVITIES PER REGION THE AMOUNTS REPORTED ON SCHEDULE F, PART I, LINE 3 INCLUDE THE BOOK VALUES OF FOREIGN INVESTMENTS, INSURANCE PREMIUMS PAID DIRECTLY TO AN OFF-SHORE CAPTIVE, AND TRAVEL AND RELATED EXPENSES PAID TO ATTEND AND SPEAK AT SEMINARS AND CONFERENCES.
FORM 990, PART VII, SECTIN B, LINE 1 COMP OF FIVE HIGHEST PAID IND. CON FA WILHELM CONSTRUCTION COMPANY, INC. INCLUDES GOOD AND SERVICES ASSOCIATED WITH VARIOUS CONSTRUCTION PROJECTS. THESE WERE NOT EASILY SEPARATED FOR REPORTING ON FORM 990. THE $5,769,183 BEING REPORTED INCLUDES BOTH GOODS AND SERVICES PAID.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


Software ID: 21014044
Software Version: 2021v4.2
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Indiana University Health Inc
 
Employer identification number

35-1955872
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (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) IU HEALTH MANAGEMENT LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
80-0141954 		MANAGEMENT IN 7,112,421 0 IUH
 
(2) IUH POPULATION HEALTH MANAGEMENT LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
46-3913461 		HEALTHCARE IN 20,755,127 7,338,682 IUH
 
(3) ONCOLOGY AND HEMATOLOGY ASSOCIATES LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
35-1348013 		HEALTHCARE IN 0 0 IUH
 
(4) 1402 CAPITOL PARTNERS LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
83-4187736 		REAL ESTATE IN 0 0 IUH
 
(5) 1234 CAPITOL PARTNERS LLC
950 N MERIDIAN ST STE 800
INDIANAPOLIS,IN46204
83-4053020 		REAL ESTATE IN 0 0 IUH
 
(6) Cumberland Avenue Associates LLC
950 N Meridian St Ste 800
Indianapolis,IN46204
35-1955872 		Real Estate IN 0 0 IUH
 
(7) Senate Health Plans Solutions LLC
950 N Meridian St Ste 800
Indianapolis,IN46204
27-3736054 		Administrative Services IN 0 8,993,670 IUH
 
(8) Workplace Health Services LLC
950 N Meridian St Ste 800
Indianapolis,IN46204
20-0994452 		Occ. Health Svc. Contracts IN 0 10,406,977 IUH
 
(9) Indiana University Health Urgent Care Centers LLC
950 N Meridian St Ste 800
Indianapolis,IN46204
47-3832952 		Healthcare IN 9,267,112 2,431,524 IUH
 
Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


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

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)INDIANA HEALTH INFO EXCHANGE INC
846 N SENATE AVE

INDIANAPOLIS,IN46202
36-4550324 		HEALTHCARE IN 501(c)(3) Type I NA
 
 
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 ARNETT INC
950 N MERIDIAN STREET
Suite 300
INDIANAPOLIS,IN46204
26-3162145 		HEALTHCARE IN 501(c)(3) 3 IUH
 
Yes
 
(4)IU HEALTH BALL MEMORIAL HOSPITAL INC
950 N MERIDIAN STREET
Suite 300
INDIANAPOLIS,IN46204
35-0867958 		HEALTHCARE IN 501(c)(3) 3 IUH
 
Yes
 
(5)IU HEALTH JAY INC
950 N MERIDIAN STREET
Suite 300
INDIANAPOLIS,IN46204
82-2736786 		HEALTHCARE IN 501(c)(3) 3 IUH
 
Yes
 
(6)IU HEALTH BEDFORD INC
950 N MERIDIAN STREET
Suite 300
INDIANAPOLIS,IN46204
23-7042323 		HEALTHCARE IN 501(c)(3) 3 IUH
 
Yes
 
(7)IU HEALTH BLOOMINGTON INC
950 N MERIDIAN STREET
Suite 300
INDIANAPOLIS,IN46204
35-1720796 		HEALTHCARE IN 501(c)(3) 3 IUH
 
Yes
 
(8)IU HEALTH CARE ASSOCIATES INC
950 N MERIDIAN STREET
Suite 300
INDIANAPOLIS,IN46204
35-1747218 		HEALTHCARE IN 501(c)(3) 10 IUH
 
Yes
 
(9)INDIANA UNIVERSITY HEALTH FOUNDATION INC
1633 N CAPITOL AVE
SUITE 1200
INDIANAPOLIS,IN46202
35-6043086 		FUNDRAISING IN 501(c)(3) Type I IUH
 
Yes
 
(10)IU HEALTH FRANKFORT INC
950 N MERIDIAN STREET
Suite 300
INDIANAPOLIS,IN46204
81-5174295 		HEALTHCARE IN 501(c)(3) 3 IUH
 
Yes
 
(11)METHODIST HEALTH GROUP INC
950 N MERIDIAN STREET
Suite 800
INDIANAPOLIS,IN46204
35-0876390 		HEALTHCARE IN 501(c)(3) Type III-FI NA
 
 
No
(12)IU HEALTH MORGAN INC
950 N MERIDIAN STREET
Suite 800
INDIANAPOLIS,IN46204
27-3533027 		HEALTHCARE IN 501(c)(3) 10 IUH
 
Yes
 
(13)IU HEALTH NORTH HOSPITAL INC
950 N MERIDIAN STREET
Suite 300
INDIANAPOLIS,IN46204
35-1932442 		HEALTHCARE IN 501(c)(3) 3 IUH
 
Yes
 
(14)IU HEALTH PAOLI INC
950 N MERIDIAN STREET
Suite 300
INDIANAPOLIS,IN46204
35-2090919 		HEALTHCARE IN 501(c)(3) 3 IUH
 
Yes
 
(15)IU HEALTH PLANS NFP INC
950 N MERIDIAN STREET
Suite 800
INDIANAPOLIS,IN46204
46-3803873 		INSURANCE IN 501(c)(4)   IUH
 
Yes
 
(16)IU HEALTH TIPTON HOSPITAL INC
950 N MERIDIAN STREET
Suite 300
INDIANAPOLIS,IN46204
26-2772226 		HEALTHCARE IN 501(c)(3) 3 IUH
 
Yes
 
(17)IU HEALTH WEST HOSPITAL INC
950 N MERIDIAN STREET
Suite 300
INDIANAPOLIS,IN46204
35-1814660 		HEALTHCARE IN 501(c)(3) 3 IUH
 
Yes
 
(18)IU HEALTH WHITE MEMORIAL HOSPITAL INC
950 N MERIDIAN STREET
Suite 300
INDIANAPOLIS,IN46204
27-3532963 		HEALTHCARE IN 501(c)(3) 3 IUH
 
Yes
 
(19)IU MEDICAL GROUP FOUNDATION INC
340 W 10TH ST NO FS5100

INDIANAPOLIS,IN46202
20-1093251 		FUNDRAISING IN 501(c)(3) Type I NA
 
 
No
(20)IUHLP LIQUIDATION INC
950 N MERIDIAN STREET
Suite 800
INDIANAPOLIS,IN46204
35-1125434 		HEALTHCARE IN 501(c)(3) 10 IUH
 
Yes
 
(21)MDWISE MARKETPLACE INC
950 N MERIDIAN STREET
Suite 800
INDIANAPOLIS,IN46204
46-5270582 		INSURANCE IN 501(c)(4)   IUH
 
Yes
 
(22)METHODIST OCCUP HEALTH CENTERS INC
950 N MERIDIAN STREET
Suite 300
INDIANAPOLIS,IN46204
35-1844176 		HEALTHCARE IN 501(c)(3) 3 IUH
 
Yes
 
(23)RILEY CHEER GUILD INC
705 RILEY HOSPITAL DR

INDIANAPOLIS,IN46202
35-6018517 		FUNDRAISING IN 501(c)(3) Type III-FI NA
 
 
No
(24)UNIVERSITY FAMILY PHYSICIANS INC
950 N MERIDIAN STREET
Suite 800
INDIANAPOLIS,IN46204
23-7427350 		HEALTHCARE IN 501(c)(3) 10 IUHCA
 
Yes
 
(25)CLARIAN TRANSPLANT INSTITUTE INC
950 N MERIDIAN STREET
Suite 800
INDIANAPOLIS,IN46204
13-4350599 		HEALTHCARE IN 501(c)(3) 10 IUH
 
Yes
 
(26)IU HEALTH BLACKFORD HOSPITAL INC
950 N MERIDIAN STREET
Suite 300
INDIANAPOLIS,IN46204
01-0646166 		HEALTHCARE IN 501(c)(3) 3 IUHBMH
 
Yes
 
(27)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) 2021
Schedule R (Form 990) 2021
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(k)
Percentage
ownership
Yes No Yes No
(1) 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 IUH
  		Related 1,710,654 2,893,603   No 0 Yes   51 %
(3) BSC HOLDINGS LLC

950 N Meridian St Ste 800
INDIANAPOLIS,IN46204
45-2314634 		HEALTHCARE IN IUH
  		Related 42,944,077 47,067,262   No 0 Yes   51 %
(4) HEALTH VENTURE MANAGEMENT LLC

950 N Meridian St Ste 800
INDIANAPOLIS,IN46204
20-5740218 		MANAGEMENT IN IUH
  		Unrelated 3,909,672 11,809,904   No 2,900,535   No 99 %
(5) IEC HOLDINGS LLC

950 N Meridian St Ste 800
INDIANAPOLIS,IN46204
45-4148032 		HEALTHCARE IN IUH
  		Related 3,858,249 3,331,185   No 0 Yes   51 %
(6) INDIANA ENDOSCOPY CENTERS LLC

569 Brookwood Village Ste 901
BIRMINGHAM,AL35244
20-8398421 		HEALTHCARE IN NA
  		                 
(7) ROC SURGERY LLC

569 Brookwood Village Ste 901
BIRMINGHAM,AL35244
27-1497960 		HEALTHCARE IN NA
  		                 
(8) ROCS HOLDINGS LLC

950 N Meridian St Ste 800
INDIANAPOLIS,IN46204
45-4148369 		HEALTHCARE IN IUH
  		Related 2,672,834 2,077,065   No 0 Yes   51 %
(9) SENATE ST SURGERY CENTER LLC

569 Brookwood Village Ste 901
BIRMINGHAM,AL35244
42-1709357 		HEALTHCARE IN NA
  		                 
(10) SSSC HOLDINGS LLC

950 N Meridian St Ste 800
INDIANAPOLIS,IN46204
45-4148167 		HEALTHCARE IN IUH
  		Related 3,454,266 3,082,389   No 0 Yes   51 %
(11) IU HEALTH FORT WAYNE LLC

950 N Meridian St Ste 800
INDIANAPOLIS,IN46204
83-1224627 		HEALTHCARE IN IUH
  		Related -8,986,077 69,653,367   No 0 Yes   100 %
(12) BALL OUTPATIENT SUR CTR LLC

569 Brookwood Village Ste 901
BIRMINGHAM,AL35244
27-0275794 		HEALTHCARE IN NA
  		                 
(13) IUH SW FORT WAYNE ASC LLC

569 Brookwood Village Ste 901
Birmingham,AL35244
84-2206388 		Healthcare IN IUH
  		Related -1,316,852 -276,852   No 0 Yes   51.61 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) CERBERUS RESIDENTIAL OPPORT INST LTD

190 ELGIN AVENUE
GEORGE TOWN,GRAND CAYMAN  
CJ
INVESTMENTS CJ IUH
  		C Corporation 1,602,647 49,839,225 71.43 % Yes  
(2) IU HEALTH 457(B) PLAN

1100 N MARKET ST
WILMINGTON,DE19890
47-6948347 		INVESTMENTS IN IUH
  		Trust 1,611,300 64,260,070 100 % Yes  
(3) IU HEALTH ACO INC

950 N MERIDIAN ST
SUITE 800
INDIANAPOLIS,IN46204
45-4421020 		HEALTHCARE IN IUH
  		C Corporation 27,539,232 500,834 100 % Yes  
(4) IU HEALTH BOARD DESIGNATED TRUST

400 HOWARD ST
SAN FRANCISCO,CA94105
30-6309021 		INVESTMENTS IN IUH
  		Trust 50,726,929 404,732,868 100 % Yes  
(5) IU HEALTH PLANS HOLDING COMPANY INC

950 N MERIDIAN ST
SUITE 800
INDIANAPOLIS,IN46204
46-3794815 		INSURANCE IN IUH
  		C Corporation -12,052,970 20,825,056 100 % Yes  
(6) IU HEALTH PLANS INSURANCE COMPANY

950 N MERIDIAN ST
SUITE 800
INDIANAPOLIS,IN46204
81-1097215 		INSURANCE IN NA
  		C Corporation       Yes  
(7) IU HEALTH PLANS INC

950 N MERIDIAN ST
SUITE 800
INDIANAPOLIS,IN46204
26-2127080 		HMO IN NA
  		C Corporation       Yes  
(8) IU HEALTH RISK PURCHASING GROUP INC

151 MEETING ST
SUITE 301
CHARLESTON,SC29401
26-0202446 		INSURANCE IN IUH
  		C Corporation 0 10,604 100 % Yes  
(9) IU HEALTH RISK RETENTION GROUP INC

151 MEETING ST
SUITE 301
CHARLESTON,SC29401
20-1107674 		INSURANCE SC IUH
  		C Corporation 123,963 68,045,604 98 % Yes  
(10) IUH ASSURANCE SPC LTD

PO BOX 69 SOLARIS AVE
CAMANA BAY
  GRAND CAYMAN  
CJ
98-0395429 		INSURANCE CJ IUH
  		C Corporation 19,555,363 129,271,786 100 % Yes  
(11) PROTEUO FUND LP

PO BOX 31106 89 NEXUS WAY
CAMANA BAY
  GRAND CAYMAN  
CJ
98-1075227 		INVESTMENTS CJ IUH
  		C Corporation 15,794,432 264,824,683 100 % Yes  
(12) BMH MEDICAL PAVILION ASSOCIATION INC

2525 W UNIVERSITY AVE
MUNCIE,IN47303
35-1858408 		CONDO MANAGEMENT IN NA
  		C Corporation       Yes  
(13) University Surgeons Inc

950 N Meridian St Ste 800
Indianapolis,IN46204
20-2981280 		Physician Services IN NA
  		C Corporation       Yes  
(14) Pediatric Surgical Associates Inc

950 N Meridian St Ste 800
Indianapolis,IN46204
35-2122922 		Physician Services IN NA
  		C Corporation       Yes  
(15) Cardiothoracic Surgeons Inc

950 N Meridian St Ste 800
Indianapolis,IN46204
35-1416173 		Physician Services IN NA
  		C Corporation       Yes  
(16) 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) 2021
Schedule R (Form 990) 2021
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) IU HEALTH TIPTON HOSPITAL INC

 A 611,048 FMV
(2) IU HEALTH WHITE MEMORIAL HOSPITAL INC

 A 963,513 FMV
(3) IU HEALTH FOUNDATION INC

 B 6,094,583 FMV
(4) IU HEALTH FOUNDATION INC

 C 10,910,269 FMV
(5) IU HEALTH ARNETT INC

 J 498,503 FMV
(6) BELTWAY SURGERY CENTERS LLC

 J 737,510 FMV
(7) IU HEALTH PLANS INC

 J 129,514 FMV
(8) Indiana University Health Plans Holding Company Inc

 J 226,496 FMV
(9) IU HEALTH CARE ASSOCIATES INC

 J 6,336,869 FMV
(10) IU HEALTH PLANS NFP INC

 J 216,363 FMV
(11) IU HEALTH NORTH HOSPITAL INC

 J 2,098,593 FMV
(12) ROC SURGERY LLC

 J 615,283 FMV
(13) IU HEALTH TIPTON HOSPITAL INC

 J 231,372 FMV
(14) IU HEALTH WEST HOSPITAL INC

 J 603,430 FMV
(15) IU HEALTH BLOOMINGTON INC

 J 501,745 FMV
(16) IU HEALTH BALL MEMORIAL HOSPITAL INC

 K 315,761 FMV
(17) IU HEALTH FORT WAYNE LLC

 K 89,544 FMV
(18) IU HEALTH CARE ASSOCIATES INC

 K 51,420 FMV
(19) IU HEALTH NORTH HOSPITAL INC

 K 749,089 FMV
(20) IU HEALTH BEDFORD INC

 K 50,364 FMV
(21) IU HEALTH ACO INC

 L 9,964,718 FMV
(22) IU HEALTH ARNETT INC

 L 79,250,282 FMV
(23) IU HEALTH BEDFORD INC

 L 12,598,465 FMV
(24) IU HEALTH BLACKFORD INC

 L 4,076,006 FMV
(25) IU HEALTH BALL MEMORIAL HOSPITAL INC

 L 68,082,572 FMV
(26) IU HEALTH BALL MEMORIAL PHYSICIANS INC

 L 13,897,686 FMV
(27) BALL OUTPATIENT SURGERY CENTER LLC

 L 1,001,456 FMV
(28) BELTWAY SURGERY CENTER LLC

 L 8,855,524 FMV
(29) IU HEALTH BLOOMINGTON INC

 L 105,646,600 FMV
(30) IU HEALTH FRANKFORT HOSPITAL INC

 L 4,864,814 FMV
(31) IU HEALTH FORT WAYNE LLC

 L 1,444,903 FMV
(32) INDIANA UNIVERSITY HEALTH PLANS INC

 L 16,236,113 FMV
(33) HEALTH VENTURE MANAGEMENT LLC

 L 90,096 FMV
(34) INDIANA ENDOSCOPY CENTERS LLC

 L 781,017 FMV
(35) IU HEALTH CARE ASSOCIATES INC

 L 155,257,992 FMV
(36) IU HEALTH JAY INC

 L 7,960,864 FMV
(37) METHODIST OCCUPATIONAL HEALTH CENTERS INC

 L 2,119,908 FMV
(38) IU HEALTH PLANS NFP INC

 L 123,310,204 FMV
(39) IU HEALTH NORTH HOSPITAL INC

 L 38,344,172 FMV
(40) IU HEALTH PAOLI INC

 L 6,051,068 FMV
(41) ROC SURGERY LLC

 L 1,197,213 FMV
(42) IU HEALTH RISK RETENTION GROUP INC

 L 2,471,752 FMV
(43) SENATE STREET SURGERY CENTER LLC

 L 904,938 FMV
(44) IU HEALTH TIPTON HOSPITAL INC

 L 7,279,822 FMV
(45) IU HEALTH WEST HOSPITAL INC

 L 38,545,762 FMV
(46) IU HEALTH WHITE MEMORIAL HOSPITAL INC

 L 6,061,064 FMV
(47) Indiana University Health Plans Holding Company Inc

 L 1,741,257 FMV
(48) IU HEALTH BLOOMINGTON INC

 M 4,359,660 FMV
(49) HEALTH VENTURE MANAGEMENT LLC

 M 5,330,490 FMV
(50) IU HEALTH CARE ASSOCIATES INC

 M 157,057,579 FMV
(51) METHODIST OCCUPATIONAL HEALTH CENTERS INC

 M 1,804,893 FMV
(52) IU HEALTH NORTH HOSPITAL INC

 M 644,697 FMV
(53) IU HEALTH ACO INC

 O 81,250 FMV
(54) IU HEALTH ARNETT INC

 O 669,979 FMV
(55) IU HEALTH BEDFORD INC

 O 75,915 FMV
(56) IU HEALTH BALL MEMORIAL HOSPITAL INC

 O 604,500 FMV
(57) BALL OUTPATIENT SURGERY CENTER LLC

 O 68,824 FMV
(58) IU HEALTH BLOOMINGTON INC

 O 2,455,260 FMV
(59) IUH ASSURANCE SPC LTD

 O 650,000 FMV
(60) IU HEALTH TIPTON HOSPITAL INC

 O 219,017 FMV
(61) IU HEALTH CARE ASSOCIATES INC

 O 17,385,586 FMV
(62) IU HEALTH NORTH HOSPITAL INC

 O 582,888 FMV
(63) IU HEALTH WHITE MEMORIAL HOSPITAL INC

 O 96,460 FMV
(64) IU HEALTH WEST HOSPITAL INC

 O 212,434 FMV
(65) IUH ASSURANCE SPC LTD

 R 4,794,076 FMV
(66) IU HEALTH RISK RETENTION GROUP INC

 R 7,916,766 FMV
(67) BOSC HOLDINGS LLC

 S 1,520,820 FMV
(68) BSC HOLDINGS LLC

 S 42,203,823 FMV
(69) IEC HOLDINGS LLC

 S 3,736,337 FMV
(70) ROCS HOLDINGS LLC

 S 2,650,980 FMV
(71) SSSC HOLDINGS LLC

 S 3,151,290 FMV
(72) MDWISE MARKETPLACE INC

 S 4,080,000 FMV
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




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






























Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 2021

Additional Data


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