TY 2021 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) NATHAN KOVALCHICK...................................................................... CHAIRMAN	1.00 ................. 1.00	X	X		0	0	0
(2) T MICHAEL PRICE...................................................................... VICE CHAIRMAN	1.00 ................. 1.00	X	X		0	0	0
(3) FRANK ROBERTS...................................................................... SECRETARY	1.00 ................. 1.00	X	X		0	0	0
(4) BECKY STAPLETON...................................................................... TREASURER	1.00 .................	X	X		0	0	0
(5) STEPHEN A WOLFE...................................................................... PRESIDENT & CEO	34.00 ................. 6.00	X	X		671,890	0	133,974
(6) TODD BRICE...................................................................... BOARD MEMBER	1.00 ................. 1.00	X			0	0	0
(7) HILLARY CREELY...................................................................... BOARD MEMBER	1.00 ................. 1.00	X			0	0	0
(8) RUSSELL A DROZDIAK MD...................................................................... BOARD MEMBER	1.00 ................. 1.00	X			77,735	0	128
(9) MATTHEW N KLAIN MD...................................................................... BOARD MEMBER	1.00 .................	X			0	0	0
(10) LAURI A KUZNESKI...................................................................... BOARD MEMBER	1.00 .................	X			0	0	0
(11) CHRISTINA B LUBOLD MD...................................................................... BOARD MEMBER	1.00 .................	X			37,920	0	0
(12) JAMES R MARTIN...................................................................... BOARD MEMBER	1.00 ................. 1.00	X			0	0	0
(13) TIMOTHY CLARK SIMPSON MD...................................................................... BOARD MEMBER	1.00 ................. 39.00	X			0	393,089	21,107
(14) ROBERT A GONGAWARE...................................................................... CHIEF FINANCIAL OFFICER	34.00 ................. 6.00		X		290,502	0	24,384
(15) RICHARD NEFF MD...................................................................... CHIEF MEDICAL OFFICER	34.00 ................. 6.00		X		377,869	0	20,501
(16) BRETT BRAUN...................................................................... CHIEF OPERATING OFFICER	34.00 ................. 6.00		X		203,690	0	26,230
(17) WENDY HAISLIP...................................................................... CHIEF NURSING OFFICER	34.00 ................. 6.00			X	250,891	0	13,087

(A) Name and business address	(B) Description of services	(C) Compensation
CENTER FOR ORTHO & SPORTS MEDICINE 120 IRMC DR STE 160 INDIANA,PA15701	ORTHOPEDIC SERVICES	3,708,851
MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNEAPOLIS,MN554809146	REFERENCE LAB SERVICES	1,327,918
AHN ERHOSPITALIST GROUP 4535 DRESSLER RD NW CANTON,OH44718	HOSPITALISTS	1,295,357
BUTLER HEALTHCARE PROVIDERS ONE HOSPITAL WAY BUTLER,PA16001	HEALTHCARE SERVICES	887,413
INDIANA ANESTHESIA ASSOCIATES INC 835 HOSPITAL RD INDIANA,PA15701	ANESTHESIA SERVICES	702,896
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 28

- TIN:

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 REGIONAL MEDICAL CENTER

Employer identification number

25-0965404

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

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

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

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

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

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

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

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

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

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

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990) 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)		(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)		(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

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 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)		(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)		(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.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990) 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

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

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

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

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

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

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

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

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

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

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

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

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

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

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).

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

Did one or more disqualified persons (as defined 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.

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.

10a

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

10a

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

10b

Schedule A (Form 990) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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

11a

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

11b

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

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

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

Yes

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

Did the activities described 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.

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

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

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

Schedule A (Form 990) 2021

Page 6

Part V

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

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

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

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

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

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

Schedule A (Form 990) 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:
Software Version:

- TIN:

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 Bullet

Go 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 REGIONAL MEDICAL CENTER

Employer identification number

25-0965404

Part I-A

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

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

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

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 Bullet

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

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

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

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

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

Page 3

Part II-B

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

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

(a)

Yes|No

(b)

Amount

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

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

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

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

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

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

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

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

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

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

Yes

2,777

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

2,777

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1:	THE MEDICAL CENTER IS A MEMBER OF NATIONAL AND STATE HOSPITAL AND HEALTHCARE ASSOCIATIONS THAT PERFORM LOBBYING ACTIVITIES. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS IS LISTED AS LOBBYING EXPENDITURES.

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

INDIANA REGIONAL MEDICAL CENTER

Employer identification number

25-0965404

Part I

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

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

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

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

(ii)

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

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

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

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

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

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

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

1a	Beginning of year balance ....	6,899,000	6,554,000	7,090,000	5,333,000	5,432,000
b	Contributions ...	987,000	146,000	99,000	2,035,000	1,079,000
c	Net investment earnings, gains, and losses	350,000	234,000
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	787,000	35,000	635,000	278,000	1,178,000
f	Administrative expenses ....
g	End of year balance ......	7,449,000	6,899,000	6,554,000	7,090,000	5,333,000

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

100.000 %

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

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

Yes

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

3a(i)

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

3a(ii)

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

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	3,282,303		3,282,303
b	Buildings ....	77,302,255	34,258,511	43,043,744
c	Leasehold improvements
d	Equipment ....	132,837,133	75,876,295	56,960,838
e	Other .....	4,800,358	2,998,696	1,801,662
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				105,088,547

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........	15,027,284	C
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	15,027,284

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.)

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)MALPRACTICE INSURANCE RECOVERIES				3,536,987
(2)DEFERRED COMPENSATION				763,529
(3)OTHER ASSETS				3,390,517
(4)DUE FROM AFFILIATES				19,527,065
(5)OPERATING LEASE RIGHT OF USE ASSETS				3,543,333
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				30,761,431

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
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	48,780,739
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

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	200,513,871
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-14,963,829
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	34,692,578
e	Add lines 2a through 2d .....................			2e	19,728,749
3	Subtract line 2e from line 1..................			3	180,785,122
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	-1,156,239
c	Add lines 4a and 4b....................			4c	-1,156,239
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	179,628,883

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	184,834,142
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	26,687,151
e	Add lines 2a through 2d....................			2e	26,687,151
3	Subtract line 2e from line 1...................			3	158,146,991
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	4,526,524
c	Add lines 4a and 4b.....................			4c	4,526,524
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	162,673,515

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
PART V, LINE 4:	ENDOWMENT FUNDS ARE USED PRIMARILY TO PURCHASE CAPITAL EQUIPMENT.
PART X, LINE 2:	INDIANA REGIONAL MEDICAL CENTER IS A TAX-EXEMPT ORGANIZATION AND NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES IN ACCORDANCE WITH SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ON SUCH BASIS, IT WILL NOT INCUR ANY LIABILITY FOR INCOME TAXES, EXCEPT FOR POSSIBLE UNRELATED BUSINESS INCOME. MANAGEMENT ANNUALLY REVIEWS ITS TAX PROVISIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	TRANSFER (TO)/FROM AFFILIATES 787,251. CHANGE IN INTEREST IN INDIANA HEALTHCARE FOUNDATION 351,396. CHANGE IN PENSION AND POST-RETIREMENT LIABILITIES 8,662,245. OTHER CHANGES TO NET ASSETS 4,686. INVESTMENT MGT. FEES NETTED AGAINST REVENUE ON FINANCIALS -259,000. BAD DEBTS NETTED AGAINST REVENUE ON FINANCIALS -4,267,524. AFFILIATE REVENUE NOT REPORTED WITH MC 29,413,524.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	RENTAL EXPENSES -1,156,239.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	RENTAL EXPENSES 1,156,239. LOSS ON REFINANCING 700,954. AFFILIATE EXPENSES NOT REPORTED WITH MC 24,829,958.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	INVESTMENT MANAGEMENT FEES NETTED AGAINST REVENUE ON FINANCIALS 259,000. BAD DEBTS NETTED AGAINST REVENUE ON FINANCIALS 4,267,524.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

INDIANA REGIONAL MEDICAL CENTER

Employer identification number

25-0965404

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

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

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

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: . . . . . . . .

Yes

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

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

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

Yes

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

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	4,015	2,241,000		2,241,000	1.410 %
b	Medicaid (from Worksheet 3, column a) . . . . .	46,910	21,621,618	16,081,601	5,540,017	3.500 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	105,924	4,965,407		4,965,407	3.130 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	156,849	28,828,025	16,081,601	12,746,424	8.040 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	27,030	3,182,817	160,151	3,022,666	1.910 %
f	Health professions education (from Worksheet 5) . . .	42	72,000		72,000	0.050 %
g	Subsidized health services (from Worksheet 6) . . . .	9,804	18,840,682	9,415,667	9,425,015	5.950 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	36,876	22,095,499	9,575,818	12,519,681	7.910 %
k	Total. Add lines 7d and 7j .	193,725	50,923,524	25,657,419	25,266,105	15.950 %

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
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

4,268,000

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. ......

416,100

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

26,295,203

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

30,910,610

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

-4,615,407

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 COSM REALTY GROUP LTD	REAL ESTATE	40.000 %	0 %	30.000 %
22 INDIANA REHABILITATION SERVICES	REHABILITATION SERVICES	51.000 %	0 %	49.000 %
3
4
5
6
7
8
9
10
11
12
13

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)					Other (describe)
1	INDIANA REGIONAL MEDICAL CENTER 835 HOSPITAL ROAD INDIANA,PA15701 WWW.INDIANARMC.ORG 090701	X	X	X	URGENT CARE FACILITY; OFFSITE TESTING CENTERS

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 REGIONAL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): IRMC.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/

Other website (list url): PAH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21

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

Yes

If "Yes" (list url): IRMC.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/

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

10b

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

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

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

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	INDIANA REGIONAL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 100.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

HTTPS://WWW.IRMC.ORG/PATIENTS-AND-VISITORS/FINANCIAL-SERVICES/

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

HTTPS://WWW.IRMC.ORG/PATIENTS-AND-VISITORS/FINANCIAL-SERVICES/

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://WWW.IRMC.ORG/PATIENTS-AND-VISITORS/FINANCIAL-SERVICES/

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	INDIANA REGIONAL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 7

Part VFacility Information (continued)

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

	INDIANA REGIONAL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 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
INDIANA REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 5: IN THE FALL OF 2020, INDIANA REGIONAL MEDICAL CENTER (IRMC) AND PUNXSUTAWNEY AREA HOSPITAL (PAH) FORMALIZED A COLLABORATION UNDER ONE GOVERNING BOARD OF DIRECTORS CALLED THE PENNSYLVANIA MOUNTAINS CARE NETWORK (PMCN). THIS COLLABORATION HELPS TO SUSTAIN A HIGH LEVEL OF PATIENT CARE RESIDENTS ALREADY RECEIVE IN BOTH INDIANA AND JEFFERSON COUNTY.THE HOSPITAL WORKED WITH A CONSULTING FIRM, STRATEGY SOLUTIONS, INC. (SSI). THE PROCESS WAS LED BY THE VP OF PROFESSIONAL AND CORPORATE SERVICES. THE 2021 IRMC AND PAH CHNA WAS CONDUCTED TO IDENTIFY PRIMARY HEALTH ISSUES, CURRENT HEALTH STATUS AND NEEDS TO PROVIDE CRITICAL INFORMATION TO THOSE IN A POSITION TO MAKE A POSITIVE IMPACT ON THE HEALTH OF THE REGION'S RESIDENTS. THE RESULTS ENABLE COMMUNITY MEMBERS TO MORE STRATEGICALLY ESTABLISH PRIORITIES, DEVELOP INTERVENTIONS, AND DIRECT RESOURCES TO IMPROVE THE HEALTH OF PEOPLE LIVING IN THE COMMUNITY.IRMC IDENTIFIED COMMUNITY HEALTH NEEDS THROUGH A COLLABORATIVE PROCESS WITH PENNSYLVANIA MOUNTAIN HEALTH CARE NETWORK (PMCN) HOSPITALS. BUILDING PAST INITIATIVES, THE FY2021 PROCESS INCLUDED A COMPREHENSIVE SURVEY PROCESS, A IRMC CHNA TEAM PRIORITIZATION EXERCISE TO DETERMINE PRIORITIES AND ASSESSMENT OF PAST SUCCESSES AND FAILURES. AS THE CHNA LEVERAGED AND UTILIZED THE HOSPITAL'S PLANNING STAFF, A MULTI-PART PROCESS WAS EMPLOYED TO DEVELOP THIS IMPLEMENTATION STRATEGY AND COMMUNITY BENEFIT PLAN, INCLUDING THE FOLLOWING:- QUANTITATIVE DATA REVIEW AND ANALYSIS:- LITERATURE REVIEWS TO IDENTITY STATE AND NATIONAL BENCHMARKS, AND EVIDENCE BASED STRATEGIES THAT RELATED TO THE INDICATORS/METRICS MEASURED THROUGH THE QUANTITATIVE DATA SOURCES- QUALITATIVE DATA PROVIDED THROUGH THE SURVEY PROCESS AND DIALOGUES WITH COMMUNITY AND HEALTHCARE LEADERS IN THE REGION. THE CHNA UTILIZATIONS OF MULTIPLE TYPES OF RESEARCH ALLOWED FOR DATA COLLECTION ACROSS A BROAD RANGE OF INDICATORS RELATED TO OVERALL POPULATION HEALTH, SOCIAL DETERMINANTS OF HEALTH INCLUDED GEOGRAPHIC LOCATION DIFFERENCES IN HEALTH OUTCOMES AND THE NEEDS OF DISADVANTAGED POPULATIONS INCLUDING UNINSURED PERSON, LOW INCOME PERSONS AND MINORITY GROUPS WITHIN THE REGION. THE PENNSYLVANIA MOUNTAIN HEALTH CARE NETWORK HOSPITALS ARE COMMITTED TO SERVING PATIENTS IN THE REGION AND ARE USING SOUND AVAILABLE DATA TO GUIDE THE PLANNING PROCESS. IN ADDITION TO DATA COLLECTION AND RESEARCH, THE IRMC CHNA TEAM CONDUCTED A COMPREHENSIVE ONLINE SURVEY TO ASSESS THE NEEDS OF THE COMMUNITY AND IDENTIFY HEALTH PRIORITIES AT THE LOCAL LEVEL.IN ADDITION TO THE ASSESSMENT IRMC CHNA ALSO REVIEWED ITS EXISTING COMMUNITY BENEFIT ACTIVITIES- BOTH INTERNALLY AND IN CONJUNCTION WITH ITS PMCN PARTNERS TO ASSESS WHETHER THESE SERVICES WERE PROVIDING VALUE CONSISTENT WITH THE NEEDS OF THE COMMUNITY AND ITS RESIDENTS. SPECIFICALLY, THESE CONSIDERED KEY HEALTH FACTORS AND OUTCOMES RESULTANT FROM ASSOCIATED DEMOGRAPHIC, SOCIAL AND ECONOMIC IMPACTS, THE PHYSICAL ENVIRONMENT, HEALTHCARE ACCESS AND RESOURCE COORDINATION AND BEHAVIORAL TRENDS. BASICALLY CONNECTING THE REGIONS NEEDS TO THAT OF STATE AND NATION. WITH HEALTHY PEOPLE 2020, AND THE CMS STRATEGY CONNECTED TO THE PENNSYLVANIA DEPARTMENT OF HEALTH PRIORITIES, THIS CHNA IS CONNECTED TO EVIDENCE AND DATA BASED PRIORITIES.
INDIANA REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 6A: THE COMMUNITY NEEDS ASSESSMENT SERVED INDIANA REGIONAL MEDICAL CENTER AND PUNXSUTAWNEY AREA HOSPITAL.
INDIANA REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 11: DURING JULY AND AUGUST 2022 AND THEN OCTOBER 2022, IRMC CONDUCTED AN EVALUATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION STRATEGIES THAT HAVE BEEN UNDERWAY OVER THE FIRST YEAR OF THE IMPLEMENTATION PLAN (JULY 1, 2021, THROUGH JUNE 2022). THE EVALUATION PROCESS INCLUDED SUBMISSION AND REVIEW OF THE OUTCOMES AND IMPACT DATA THAT WAS TRACKED AND REPORTED DURING THE LAST FISCAL YEAR.GOAL 1: IMPROVE HEALTH STATUS BY INCREASING PARTICIPATION IN EDUCATION AND WELLNESS, FOCUSING ON OVERWEIGHT/OBESITY IRMC HAS CONTINUED TO OFFER OUR WELLNESS PROGRAM TO EMPLOYEES AND COMMUNITY PARTNERS - 1,327 PARTICIPANTS THIS YEAR - 833.6 TOTAL POUNDS LOST BY PROGRAM PARTICIPANTS, WITH AN AVERAGE WEIGHT LOSS OF 6.4 POUNDS - OFFERED 25 NUTRITIONAL CHALLENGES WITH 700 PARTICIPANTS, OF WHICH 75 COMPLETED THE CHALLENGE (10.7%)- PROVIDED 245 HEALTH COACHING SESSIONS AND HAD 15 EDUCATIONAL ENCOUNTERS IRMC HAS CONTINUED TO PROMOTE HEALTH AND WELLNESS TO THE COMMUNITY AT-LARGE - 901 PARTICIPANTS IN CORPORATE BEWELL PROGRAM - 15,179 VISITS TO S&T WELLNESS CENTER WITH 1,264 VISITS ON AVERAGE PER MONTH - PROVIDED MEDICAL NUTRITION THERAPY TO 891 PARTICIPANTS WHO LOST A TOTAL OF 25 POUNDS - PROVIDED SERVICES THROUGH THE BARIATRIC CENTER 323 NEW PATIENTS OF WHICH 55 WERE SURGICALFOLLOWED UP WITH 255 PATIENTS PERFORMED 8 BARIATRIC PROCEDURES SURGICAL PATIENTS LOST A TOTAL OF 161.3 POUNDS - OFFERED 23 EDUCATIONAL SESSIONS WITH A TOTAL OF 299 PARTICIPANTS - CONTINUED LEAN WEIGHT MANAGEMENT PROGRAM ONLINE WITH 34 PARTICIPANTS, WITH AVERAGE WEIGHT LOSS OF 11.7 POUNDSGOAL 2: INCREASE ACCESS TO MENTAL HEALTH SERVICES AND SUPPORTS IRMC SERVED A COMMUNITY NEED BY IMPLEMENTING A BH OUTREACH PROGRAM TO CONNECT EMERGENCY DEPARTMENT BH PATIENTS WITH OUTPATIENT - AMBULATORY SOCIAL WORKERS MADE 1,088 REFERRALS - AMBULATORY SOCIAL WORKERS CONNECTED WITH 158 PATIENTS - SPOKE WITH 55 BH PATIENTS POST-DISCHARGE - THE EMERGENCY DEPARTMENT HAD 1,209 BH RELATED VISITS (68% WERE FROM INDIANA COUNTY), WITH AVERAGE WAIT TIME TO TRANSFER TO MENTAL HEALTH FACILITY OF 14.86 HOURS IRMC CONTINUES TO PROVIDE EDUCATION AND OUTREACH - PARTICIPATED IN MENTAL HEALTH AWARENESS MONTH, HAD A TABLE OF RESOURCES AVAILABLE AT IRMC PARK AND ENGAGED IN CONVERSATIONS WITH COMMUNITY MEMBERS - IRMC IS AN ACTIVE MEMBER OF THE SUICIDE TASKFORCE AND INTERVENTION SUBCOMMITTEE IRMC MADE ONLINE RESOURCES AVAILABLE THROUGH THE HOSPITAL'S WEBPAGE AND ADDED LINKS TO OUTSIDE RESOURCESGOAL 3: DECREASE DRUG AND ALCOHOL USE IN INDIANA COUNTY BY CONTINUING TO COLLABORATE WITH THE ARMSTRONG-INDIANA-CLARION DRUG & ALCOHOL COMMISSION AND ARMOT ON PREVENTION, EDUCATION, INTERVENTION AND TREATMENT STRATEGIES IRMC CONTINUES OUR RELATIONSHIP WITH LOCAL PARTNERS - PARTICIPATED IN 7 COMMUNITY COLLABORATIVES - DISTRIBUTED 12 NARCAN KITS IN THE ED- ED LEADERSHIP AND ARMOT COLLABORATED TO DEVELOP STANDARD PROTOCOL FOR THOSE WHO SHOW UP IN ED OF AN OVERDOSE/RECEIVE SUBSTANCE USE DISORDER DIAGNOSIS. PROCESS CHANGED FROM OPT IN TO OPT OUT WHICH INCREASED THE NUMBER OF REFERRALS. - 307 PATIENTS PRESENTED TO THE ED WITH SUBSTANCE USE AS A FACTOR IRMC HAS CONTINUED TO REFER ED PATIENTS TO COMMUNITY PARTNERS - 245 REFERRED TO ARMOT - 85 COMPLETED TREATMENT - 18 PATIENTS RECEIVED BUPRENORPHINE IN THE ED- 8 PATIENTS REFERRED TO OPEN DOOR OR CROSSROADS BY ARMOTIRMC PROVIDES EDUCATION TO STAFF, PROVIDERS AND THE BROADER COMMUNITY IN AN EFFORT TO REDUCE STIGMA - 101 EDUCATIONAL EVENTS WITH 1,117 PARTICIPANTS - 1,117 NARCAN KITS DISTRIBUTED - EDUCATED 61 IRMC STAFF ON STIGMA REDUCTION WITH 100% REPORTING REDUCED STIGMA PRE/POST TRAINING IRMC HAS INCREASED ACCESS TO INPATIENT REHAB THROUGH LOCAL PARTNERSHIPS - 43 PATIENTS CONNECTED TO INPATIENT TREATMENT- 6 PATIENTS REFERRED TO OUTPATIENT TREATMENT- ARMOT PROGRAM HELPS TO INCREASE ACCESS TO INPATIENT TREATMENT FOR PATIENTS AT IRMC IRMC IS WORKING TO INCREASE AWARENESS OF AVAILABLE SERVICES - MARKETING EFFORTS TO PROMOTE WARMLINE FOR 24/7 ACCESS TO SERVICES - MEDIA CAMPAIGN TO PROMOTE AICDAC SERVICES. IRMC MADE ONLINE RESOURCES AVAILABLE THROUGH THE HOSPITAL WEBPAGE WITH LINKS TO EXTERNAL RESOURCES
INDIANA REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 16J: DIRECT MAILING TO THE COMMUNITY.

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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

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
PART I, LINE 7:	THE HOSPITAL USED A COST-TO-CHARGE RATIO IN DETERMINING THE FIGURES REPORTED IN THIS TABLE. THIS COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 RATIO OF PATIENT CARE COST TO CHARGES AND AS CALCULATED AND REPORTED ON THE MEDICARE COST REPORT. COMMUNITY PROGRAMS ARE RECORDED IN SPECIFIC GENERAL LEDGER COST CENTERS AND STRUCTURE ON THE COMMUNITY BENEFIT FORMS WITH NUMBER OF PERSONS SERVED.
PART I, LINE 7G:	NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC WERE INCLUDED IN THE AMOUNT ON PART I, LINE 7G.
PART I, LN 7 COL(F):	THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $4,262,580.
PART II, COMMUNITY BUILDING ACTIVITIES:	OUR MISSION IS TO SERVE THE HEALTHCARE NEEDS OF EVERY LIFE WE TOUCH WITH COMPASSION, RESPECT AND DIGNITY. ALL OF THE PROGRAMS OFFERED MEET COMMUNITY BENEFIT OBJECTIVES AND ARE RELATED TO OUR MISSION. IRMC OFFERS PROGRAMS THAT IMPROVE ACCESS TO HEALTH CARE SERVICES, ENHANCES HEALTH OF THE COMMUNITY WE SERVE, PROVIDES ADVANCED MEDICAL OR HEALTHCARE KNOWLEDGE AND RELIEVES SOME OF THE FINANCIAL OR PROGRAMMATIC BURDEN OF GOVERNMENT ON OUR COMMUNITY.INDIANA REGIONAL MEDICAL CENTER PROVIDES NUMEROUS COMMUNITY PROGRAMS AND ACTIVITIES THAT PROVIDE TREATMENT OR PROMOTE HEALTH AND HEALING TO OUR COMMUNITIES. OUR MOBILE MEDICAL SERVICES CONTINUES TO PROVIDE FREE BLOOD PRESSURE SCREENINGS IN 19 LOCATIONS IN INDIANA COUNTY. WE ALSO CONTINUE TO PARTICIPATE IN NUMEROUS FREE COMMUNITY EVENTS PROVIDING EDUCATION, SCREENING PROGRAMS AND FIRST AID SERVICES. OVER THE PAST YEAR, THE MOBILE MEDICAL HEALTH LOGGED OVER 2,500 PARTICIPANTS.WE ALSO PROVIDE NUMEROUS HEALTH FAIRS REACHING ALMOST 2,200 PARTICIPANTS, AND CLASSES AND EDUCATION PROGRAMS WITH OVER 4,000 PARTICIPANTS. A FEW OF THE FAIRS OR SERVICES PROVIDED ARE: ARTHRITIS, KNEE PAIN AND OSTEOPOROSIS SESSIONS PUT ON BY THE ORTHOPEDIC PHYSICIANS AND THE IRMC SUPPORT CLINICIANS, "BIKE TO SCHOOL" (SAFETY FOR CHILDREN), CHESTNUT RIDGE HEALTH FAIR, DIABETES, EXERCISE FOR SENIOR CENTERS, FIRST COMMONWEALTH BANK WEIGHT MANAGEMENT, FORTIFY YOUR SPINE, HEALTHY KIDS DAY, ROUTINE MULTIPHASIC BLOOD DRAWS FOR RURAL AREAS AND COMMUNITY MEMBERS THAT MAY NOT SEEK OUT HEALTH CARE, SERVICES PROVIDED TO NEW FLORENCE SENIOR CENTER AND NORTH CAMBRIA SENIOR CENTER (RURAL FACILITIES IN OUR SECONDARY MARKET AREA AND NO HOSPITAL CLOSE TO THEM), PROSTATE SCREENINGS, VACCINES FOR VETS (VETERANS), SKIN SCREENINGS, AS WELL AS A NUMBER OF OTHERS. THE INSTITUTE FOR HEALTHY LIVING AT INDIANA REGIONAL MEDICAL CENTER OFFERS HEALTH SERVICES AND EDUCATION PROGRAMS TO THE COMMUNITY AT NO CHARGE.THE CENTER FOR DIABETES CARE CONTINUES TO OFFER FREE EDUCATION SERVICES AT VARIOUS LOCATIONS THROUGHOUT THE COUNTY. IN ADDITION, THEY CONTINUE TO BE THE PRIMARY SPONSOR OF THE COUNTY'S DIABETES WALK. EACH MONTH STAFF AND MANAGEMENT AT IRMC PROVIDE SUPPORT TO A LOCAL FOOD BANK.PREVENTIVE HEALTH SERVICES - M. DORCAS CLARK WOMEN'S IMAGING CENTER AND THEIR STAFF HAVE PARTICIPATED IN NUMEROUS COMMUNITY EVENTS PROVIDING INFORMATION ABOUT THE IMPORTANCE OF BREAST HEALTH. BIRDIE'S CLOSET, A PROJECT DESIGNED TO HELP WOMEN COPE WITH APPEARANCE RELATED SIDE-EFFECTS OF CANCER TREATMENT WAS OPENED IN THE WOMEN'S IMAGING CENTER. SUPPORT HEALTH GROUPSFAMILY PROGRAMS - EARLY PREGNANCY, MATERNITY TOUR, DOCTOR DAD, BOF SERIES, BREASTFEEDING, ALL ABOUT BABY, LAMAZE, HOME ALONE, BABYSITTING, LET'S TALK GIRLS, BIG BROTHER, CPR, HEARTSAVER. 1,164 CONTACTS FOR THE YEAR.COMMUNITY CLASSES - PACE, TAI CHI, YOGA, CANCER, STRONG WOMEN, DROP WEIGHT, ORNISH, DIABETES, DROP 10. 3,580 CLASS HOURS.IN 2009, INDIANA REGIONAL MEDICAL CENTER OPENED A NEW FACILITY OFFERING URGENT CARE SERVICES IN THE BLAIRSVILLE COMMUNITY AS A RESPONSE TO MEDICAL SERVICES NEEDED IN THAT AREA. THIS FACILITY IS 12 MILES FROM THE HOSPITAL CAMPUS.IN 2012, INDIANA REGIONAL MEDICAL CENTER OPENED ITS SECOND URGENT CARE FACILITY TO SERVICE THE PRIMARY MARKET SHARE WHERE THERE WAS A NOTED DEMAND FOR THESE SERVICES. THE URGENT CARE CENTERS REQUIRE ADDITIONAL STAFFING ON BEHALF OF THE HOSPITAL AS IT IS A NEW/ADDED LOCATION; HOWEVER, THESE FACILITIES SIGNIFICANTLY IMPROVE THE CYCLE TIME OF THE PATIENT THROUGHOUT AND SERVICES FOR THE NON-EMERGENT SERVICES NEEDED.
PART III, LINE 2:	THE AMOUNT REPORTED IN PART III, LINE 2 IS ACTUAL BAD DEBTS (AT NET, NOT GROSS CHARGES) FOR THE YEAR.
PART III, LINE 3:	THE AMOUNT REPORTED IN PART III, LINE 3 IS DERIVED BY USING THE MEDICARE COST TO CHARGE RATIO FROM THE COST REPORT.A PORTION OF THE BAD DEBT SHOULD BE INCLUDED AS COMMUNITY BENEFIT AS THE HOSPITAL IS NOT ABLE TO DENY SERVICES TO ANY PATIENT PRESENTING TO THE EMERGENCY DEPARTMENT, REGARDLESS IF THE PATIENTS HAVE THE MEANS TO PAY. THE DEDUCTIBLE AND CO-INSURANCE BALANCES THAT ARE NOT PAID REDUCE THE NET REVENUES DUE TO THE HOSPITAL AS PART OF THE RESPECTIVE PATIENT'S INSURANCE COVERAGE. IN ADDITION, THERE IS A "COST" TO THE HOSPITAL FOR TREATING ALL PATIENTS. AS WITH THE UNREIMBURSED AMOUNTS OF THE MEDICAID PATIENT SERVICES, THE HOSPITAL SHOULD BE ABLE TO INCLUDE THE UNREIMBURSED COSTS OF THE SERVICES THAT RESULTED IN NO PAYMENT.
PART III, LINE 4:	THE FOLLOWING IS THE TEXT OF THE FOOTNOTE FROM THE AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: PATIENTS ACCOUNTS RECEIVABLE ARE RECORDED AT NET REALIZABLE VALUE AT THE TRANSACTION PRICE BASED ON STANDARD CHARGES FOR SERVICES PROVIDED, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO UNINSURED OR UNDERINSURED PATIENTS IN ACCORDANCE WITH ORGANIZATION'S POLICIES, AND/OR IMPLICIT PRICE CONCESSIONS PROVIDED TO UNINSURED OR UNDERINSURED PATIENTS AND DO NOT BEAR INTEREST. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT REVENUES IN THE PERIOD OF THE CHANGE.
PART III, LINE 8:	100% OF THE SHORTFALL IS A COMMUNITY BENEFIT. THE MEDICARE PROGRAM WAS DESIGNED TO COVER THE COSTS OF THE HOSPITALS USING THE COST BASE YEAR(S). IRMC IS A VERY LOW COST PROVIDER AND IS NOT ABLE TO COVER COSTS SINCE THE SEQUESTRATION REDUCTION, THE LESS ALL THE OTHER DOWNWARD ADJUSTMENTS TO THE NET MBI WHILE THE COSTS OF DRUGS, SUPPLIES, IMPLANTS, CLINCAL STAFF AND HEALTH BENEFITS CONTINUE TO INCREASE 5-20%. IRMC IS A SOLE COMMUNITY PROVIDER NOT RECEIVING SUFFICIENT SCH ADD ON TO COVER COSTS FOR ALL CARE NEEDED (BASE YEAR WAS TOO LONG AGO AND NOT AS RELEVANT TO CURRENT COSTS) TO BE PROVIDED AS THE ONLY PROVIDER IN THE DEFINED GEOGRAPHICAL AREA. ACTUAL AMOUNTS PER THE MEDICARE COST REPORT THAT DETERMINE THE REIMBURSEMENTS, PAYMENTS RECEIVED (THUS SETTLEMENTS) AND COSTS.
PART III, LINE 9B:	PATIENTS ARE EXPECTED TO PAY ALL BALANCES IN FULL WITHIN FIFTEEN DAYS OF A FINAL BILLING. IF THIS IS NOT POSSIBLE, PATIENTS WILL BE COUNSELED ON THE USE OF MEDICAL ASSISTANCE OR THE INDIANA CHARITY CARE PROGRAM, I-CARE.ON A MONTHLY BASIS, THE CREDIT SUPERVISOR WILL COMPILE A REPORT LISTING ALL ACCOUNTS, WHICH HAVE BEEN BILLED TO MEDICARE, AND ANY SECONDARY INSURANCE CARRIER WHERE APPLICABLE. A LISTING OF ACCOUNTS WHICH HAVE BEEN BILLED TO MEDICAL ASSISTANCE AS A SECONDARY PAYOR ARE REVIEWED BY THE CREDIT SUPERVISOR FOR AN AUTOMATIC WRITE OFF AFTER MEDICAL ASSISTANCE HAS PROCESSED THE ACCOUNT. ACCOUNTS WHICH HAVE BALANCES AFTER MEDICARE AND ALL SECONDARY PAYORS HAVE BEEN BILLED WILL BE PLACED WITH AN OUTSIDE COLLECTION AFTER TWO UNANSWERED STATEMENTS. AN EXCEPTION WILL BE MADE IN THE EVENT A PATIENT/GUARANTOR DOES NOT FOLLOW THROUGH WITH THE MEDICAL ASSISTANCE APPLICATION PROCESS, WHEN REQUESTED TO DO SO. THE AGENCY WILL ATTEMPT TO COLLECT THE ACCOUNT FOR SIX MONTHS. AFTER THAT TIME THE ACCOUNT WILL BE WRITTEN OFF AS MEDICARE BAD DEBT.THE IRMC COLLECTION POLICY CONTAINS PROVISIONS TO PROVIDE A SOFTER APPROACH FOR THOSE THAT IRMC HAS LEARNED WOULD QUALIFY FOR FINANCIAL ASSISTANCE. UPON RECEIPT OF THE CALL FROM THE PATIENT THAT THERE IS HARDSHIP IN PAYING THE BILL, THE IRMC COLLECTION REPRESENTATIVE SHARES THE INFORMATION FOR APPLICATION FOR BOTH MEDICAL ASSISTANCE AND CHARITY CARE. WHILE THE PATIENT'S ACCOUNT IS IN THIS PROCESS, THEIR ACCOUNT WILL NOT BE PROVIDED TO THE COLLECTION AGENCY.
PART VI, LINE 2:	THE IRMC CHNA WAS CONDUCTED TO IDENTIFY PRIMARY HEALTH ISSUES, CURRENT HEALTH STATUS, AND HEALTH NEEDS TO PROVIDE CRITICAL INFORMATION TO THOSE IN A POSITION TO MAKE A POSITIVE IMPACT ON THE HEALTH OF THE REGION'S RESIDENTS. THE RESULTS ENABLE COMMUNITY MEMBERS TO MORE STRATEGICALLY ESTABLISH PRIORITIES, DEVELOP INTERVENTIONS, AND DIRECT RESOURCES TO IMPROVE THE HEALTH OF PEOPLE LIVING IN THE COMMUNITY.TO GUIDE THIS ASSESSMENT, THE LEADERSHIP AT IRMC FORMED A STEERING COMMITTEE THAT CONSISTED OF HOSPITAL AND COMMUNITY LEADERS WHO REPRESENTED THE BROAD INTERESTS OF THEIR LOCAL REGION. THESE INCLUDED REPRESENTATIVES WHO UNDERSTOOD THE NEEDS AND ISSUES RELATED TO VARIOUS UNDERREPRESENTED GROUPS INCLUDING MEDICALLY UNDERSERVED POPULATIONS, LOW-INCOME PERSONS, MINORITY GROUPS, AND THOSE WITH CHRONIC DISEASE NEEDS, INDIVIDUALS WITH EXPERTISE IN PUBLIC HEALTH, AND INTERNAL PROGRAM MANAGERS. THE IRMC STEERING COMMITTEE MET TWO TIMES BETWEEN MARCH 2021 AND APRIL 2021 TO PROVIDE GUIDANCE ON THE VARIOUS COMPONENTS OF THE CHNA.SEE PART V OF SCHEDULE H FOR FURTHER DISCUSSION ON NEEDS ASSESSMENT.
PART VI, LINE 3:	AT REGISTRATION, PATIENTS WITHOUT INSURANCE ARE PHYSICALLY PROVIDED INFORMATION ABOUT MEDICAID AND OUR CHARITY CARE POLICY AND ENCOURAGED TO ENROLL (WE ARE AVAILABLE TO ASSIST THE CUSTOMER WITH ENROLLMENT). SIGNAGE IS ALSO POSTED THROUGHOUT THE FACILITY OUTLINING OUR CHARITY CARE PROGRAM. ALSO, ALL PATIENT STATEMENTS REFLECT INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS AVAILABLE TO THE PATIENTS. CHARITY CARE INFORMATION IS ALSO REFERENCED ON THE HOSPITAL'S WEB SITE.
PART VI, LINE 4:	THE POPULATION IN INDIANA COUNTY HAS BEEN DECREASING AND IS PROJECTED TO CONTINUE TO DECREASE INTO 2026. THE POPULATION IS PREDOMINATELY CAUCASIAN (94.3%) AND THERE IS A COMPARABLE NUMBER OF MALES (50.1%) AND FEMALES (49.9%). THE MEDIAN AGE IS 40.2 AND IS PROJECTED TO REMAIN STEADY OVER THE NEXT FIVE YEARS. JUST UNDER HALF OF THE POPULATION IS MARRIED (47.1%), WHILE 9.1% ARE DIVORCED AND 5.6% ARE WIDOWED. ONE IN TEN RESIDENTS (9.7%) DID NOT GRADUATE HIGH SCHOOL, WHILE 42.7% ARE HIGH SCHOOL OR EQUIVALENT GRADUATES. ONE IN TEN (11.0%) HAVE AN ADVANCED DEGREE. THE AVERAGE HOUSEHOLD INCOME IS $65,781, WITH A MEDIAN INCOME OF $50,130. MOST OF THE LABOR FORCE IS EMPLOYED (94.1%), WITH APPROXIMATELY HALF OF THOSE EMPLOYED HOLDING WHITE COLLAR OCCUPATIONS (49.2%).
PART VI, LINE 5:	IN THE MID-NINETIES, HOSPITALS AND HEALTHCARE FACILITIES BEGAN TO SHIFT THEIR ATTENTION FROM JUST SICK OR HOSPITAL BASED CARE TO INCLUDE ADDRESSING COMMUNITY HEALTH AND DISEASE PREVENTION. AS A FIRST STEP IN THAT DIRECTION, IRMC FORMED A COMMUNITY SERVICE DEPARTMENT WHOSE PURPOSE WAS TO DELIVER EDUCATION AND PREVENTATIVE SCREENINGS TO THE COMMUNITY-AT-LARGE. IN 2005, REALIZING THAT ALMOST EVERY DEPARTMENT IN THE HOSPITAL HAD OPPORTUNITIES TO PROMOTE HEALTH AND WELLNESS, IRMC CREATED THE INSTITUTE FOR HEALTHY LIVING, A VIRTUAL ORGANIZATION COORDINATING ALL ASPECTS OF COMMUNITY OUTREACH AND HEALTH IMPROVEMENT. IMPROVING AND SUSTAINING COMMUNITY HEALTH, HOWEVER, IS A COLLABORATIVE ENDEAVOR THAT INTEGRATES AS MANY KEY STAKEHOLDERS AS POSSIBLE. IN THAT REGARD, IRMC SPEARHEADED THE FORMATION OF THE INDIANA COUNTY COMMUNITY HEALTH ADVISORY COUNCIL (CHAC), AN ENTERPRISE REPRESENTING MEMBERS FROM VARIOUS COMMUNITY AGENCIES, ORGANIZATIONS AND SCHOOLS WHOSE PURPOSE IT IS TO IDENTIFY HEALTH NEEDS IN OUR COUNTY AND TO FIND WAYS TO MEET THEM. THE CHAC HAS BEEN ACTIVE SINCE 1996 AND IRMC SERVES AS ITS BASE AND CHAIRMANSHIP. INDIANA REGIONAL MEDICAL CENTER USES ITS OWN FUNDS TO ENHANCE BOTH THE CLINICAL STRATEGIES AND THE COMMUNITY STRATEGIES.CLINICAL STRATEGIES (A FEW EXAMPLES): RECRUITING ADDITIONAL PHYSICIANS FOR IDENTIFIED COMMUNITY NEEDS, EXPLORE DEVELOPMENT OF A FAMILY PRACTICE RESIDENCY PROGRAM TO FACILITATE RECRUITMENT AND RETENTION, ENLARGE THE MEDICAL FITNESS CENTER, ESTABLISH A WEIGHT LOSS TASK FORCE, DEVELOP A MEDICAL WEIGHT MANAGEMENT CENTER, PROVIDE FLU SHOTS TO ALL INPATIENTS DURING FLU SEASON, PROVIDE PNEUMONIA VACCINE TO ALL NON-VACCINATED INPATIENTS, ETC. COMMUNITY STRATEGIES (A FEW EXAMPLES): PARTNER WITH AGENCIES PROVIDING SERVICES AND EDUCATION TO YOUNG TEENS AND WOMEN, EVALUATE A PARTNERSHIP WITH EARLY HEAD START, IMPROVE VISIBILITY AND INFORMATION AVAILABLE ABOUT THE OB/GYN CLINIC, WORKED TO ESTABLISH PRACTICES IN THE MORE RURAL AREAS OF THE COUNTY THAT REQUIRE THE MEDICAL CENTER TO SUBSIDIZE DELIVERING CARE THERE, ESTABLISHED THE INDIANA AT CHESTNUT RIDGE FACILITY THAT OFFERS PRIMARY CARE AND URGENT-CARE AND WAS A SIGNIFICANT CAPITAL INVESTMENT, IMPLEMENT A PATIENT PORTAL TO IMPROVE PATIENT ACCESS TO MEDICAL RECORDS, BECAME A PROVIDER OF THE WE CAN! (WAYS TO ENHANCE CHILDREN'S ACTIVITY AND NUTRITION), PARTNERED WITH 7 ELEMENTARY SCHOOLS TO INSTALL PROJECT FIT AMERICA, IMPLEMENTED GROCERY STORE TOURS TO ASSIST PEOPLE WITH SEEKING HEALTHY CHOICES, PARTNER WITH 4 GROCERY STORES TO HAVE A DIETICIAN AVAILABLE TO HELP SHOPPERS MAKE HEALTHY CHOICES, CONDUCT THE ANNUAL "VACCINE FOR VETERANS" PROGRAM ON VETERANS DAY, EVALUATE THE POTENTIAL FOR PUBLIC PNEUMONIA VACCINE CLINICS, CONTINUE TO PROVIDE FREE FLU AND PNEUMONIA VACCINE TO HIGH-RISK, LOW INCOME RESIDENTS, ETC.
PART VI, LINE 6:	INDIANA REGIONAL MEDICAL CENTER HAS THE FOLLOWING AFFILIATED ENTITIES:INDIANA HEALTHCARE FOUNDATION CONDUCTS FUNDRAISING ACTIVITIES, SUCH AS THE COLUMBUS DAY GOLF OUTING AND LOVE OF LIFE GALA, IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTER. INDIANA REGIONAL MEDICAL CENTER AND PUNXSUTAWNEY AREA HOSPITAL JOINTLY FORMED INDIANA JEFFERSON RADIATION ONCOLOGY, INC. FOR THE PURPOSE OF ENHANCING THE QUALITY AND AVAILABILITY OF RADIATION ONCOLOGY SERVICES OFFERED TO PATIENTS IN INDIANA AND JEFFERSON COUNTIES, PA AND SURROUNDING AREAS.INDIANA HEALTHCARE PHYSICIAN SERVICES, INC. IS A NON-PROFIT HOSPITAL OWNED GROUP OF PRACTICES OWNED AND OPERATED TO SERVE THE RURAL AREAS OF INDIANA AND SURROUNDING COMMUNITIES. WE PROVIDE ACCESSIBLE, COST EFFECTIVE QUALITY HEALTHCARE WITHIN THE RURAL COMMUNITIES OF INDIANA AND SURROUNDING COUNTIES. WE SUPPORT AND WORK COLLABORATIVELY WITH OTHER NON-PROFIT AGENCIES WITHIN OUR SITES.INDIANA HEALTHCARE PROPERTIES HOLDS AND MANAGES PROPERTY IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTER.
PART VI, LINE 7:	N/A

Schedule H (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
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 REGIONAL MEDICAL CENTER

Employer identification number

25-0965404

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Yes

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? ....

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

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

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

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

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

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

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

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

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

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

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

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

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

Cat. No. 50053T

Schedule J (Form 990) 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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1STEPHEN A WOLFE PRESIDENT & CEO	(i) (ii)	525,013 ------------- 0	146,877 ------------- 0	0 ------------- 0	89,500 ------------- 0	44,474 ------------- 0	805,864 ------------- 0	0 ------------- 0
2TIMOTHY CLARK SIMPSON MD BOARD MEMBER	(i) (ii)	0 ------------- 373,589	0 ------------- 0	0 ------------- 19,500	0 ------------- 1,828	0 ------------- 19,279	0 ------------- 414,196	0 ------------- 0
3RICHARD NEFF MD CHIEF MEDICAL OFFICER	(i) (ii)	343,286 ------------- 0	27,255 ------------- 0	7,328 ------------- 0	2,060 ------------- 0	18,441 ------------- 0	398,370 ------------- 0	0 ------------- 0
4PATRICK SHANNON DO PHYSICIAN	(i) (ii)	268,730 ------------- 0	0 ------------- 0	3,400 ------------- 0	28,062 ------------- 0	19,683 ------------- 0	319,875 ------------- 0	0 ------------- 0
5ROBERT A GONGAWARE CHIEF FINANCIAL OFFICER	(i) (ii)	256,443 ------------- 0	34,059 ------------- 0	0 ------------- 0	12,822 ------------- 0	11,562 ------------- 0	314,886 ------------- 0	0 ------------- 0
6ADENIRAN HAASTRUP MD PHYSICIAN	(i) (ii)	206,686 ------------- 0	83,750 ------------- 0	15,000 ------------- 0	0 ------------- 0	4,537 ------------- 0	309,973 ------------- 0	0 ------------- 0
7TOLUTOPE OZAH PHYSICIAN	(i) (ii)	229,586 ------------- 0	25,000 ------------- 0	30,999 ------------- 0	0 ------------- 0	8,910 ------------- 0	294,495 ------------- 0	0 ------------- 0
8MARK VOLOVIC CHIEF INFORMATION OFFICER	(i) (ii)	220,012 ------------- 0	31,445 ------------- 0	0 ------------- 0	8,800 ------------- 0	19,525 ------------- 0	279,782 ------------- 0	0 ------------- 0
9WENDY HAISLIP CHIEF NURSING OFFICER	(i) (ii)	215,015 ------------- 0	25,876 ------------- 0	10,000 ------------- 0	6,150 ------------- 0	6,937 ------------- 0	263,978 ------------- 0	0 ------------- 0
10JASON RASEFSKE DO PHYSICIAN	(i) (ii)	236,865 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	18,774 ------------- 0	255,639 ------------- 0	0 ------------- 0
11GLORIA KOLONICH CRNA PHYSICIAN	(i) (ii)	214,646 ------------- 0	0 ------------- 0	0 ------------- 0	13,371 ------------- 0	6,962 ------------- 0	234,979 ------------- 0	0 ------------- 0
12BRETT BRAUN CHIEF OPERATING OFFICER	(i) (ii)	178,213 ------------- 0	25,477 ------------- 0	0 ------------- 0	7,129 ------------- 0	19,101 ------------- 0	229,920 ------------- 0	0 ------------- 0
13JAMES KINNEER CHIEF HUMAN RESOURCE OFFICER	(i) (ii)	169,118 ------------- 0	21,488 ------------- 0	0 ------------- 0	8,456 ------------- 0	19,913 ------------- 0	218,975 ------------- 0	0 ------------- 0

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

PART I, LINE 1A

INDIANA REGIONAL MEDICAL CENTER PAYS COUNTRY CLUB MEMBERSHIP DUES FOR THE PRESIDENT & CEO, WHICH IS NOT INCLUDED IN HIS COMPENSATION. THE MEMBERSHIP IS A CORPORATE MEMBERSHIP USED FOR BUSINESS PURPOSES ONLY.

PART I, LINE 4B

INDIANA REGIONAL MEDICAL CENTER HAS A SUPPLEMENTAL, NONQUALIFIED RETIREMENT PLAN UNDER IRC SECTION 457(F) FOR PRESIDENT & CEO, STEPHEN A. WOLFE. NO AMOUNTS WERE PAID TO HIM, AND CONTRIBUTIONS TO THE PLAN WERE $75,000 DURING CALENDAR YEAR 2021. INDIANA HEALTHCARE PHYSICIAN SERVICES HAS A 457(F) PLAN AVAILABLE FOR THEIR PHYSICIANS. FOLLOWING PHYSICIANS WERE MEMBERS OF THE PLAN DURING THE CALENDAR YEAR 2021: - DR. PATRICK SHANNON: NO AMOUNTS WERE PAID TO HIM, AND CONTRIBUTIONS TO THE PLAN WERE $20,000.

Schedule J (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

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

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.
SchKMediumBullet

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 REGIONAL MEDICAL CENTER

Employer identification number
25-0965404

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
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	INDIANA COUNTY HOSPITAL AUTHORITY - SERIES 2018	25-1697319		06-01-2018	36,200,000	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	3,820,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	36,200,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	369,993
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............	35,830,007
12 Other unspent proceeds .............
13 Year of substantial completion .............	2020
	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
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
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

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

Cat. No. 50193E

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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		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?
c Are there any research agreements that may result in private business use of bond-financed property? .............		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?
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 ....	0 %
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 .........	0 %
6 Total of lines 4 and 5 .............	0 %
7 Does the bond issue meet the private security or payment test? ...		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
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

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
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X
b Exception to rebate? ........		X
c No rebate due? .........		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

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
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
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
7 Has the organization established written procedures to monitor the requirements of section 148? ...	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

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
SCHEDULE K, PART I, BOND ISSUES:	(A) ISSUER NAME: INDIANA COUNTY HOSPITAL AUTHORITY - SERIES 2018 (F) DESCRIPTION OF PURPOSE: PAYMENT OF 2009 S&T NOTE, 2011 DEBT, 2014B BONDS, 2014C NOTE, FINANCE CAPITAL PROJECTS, AND PAY ISSUANCE COSTS

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

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 REGIONAL MEDICAL CENTER

Employer identification number

25-0965404

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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

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

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) MATTHEW KLAIN	DIRECTOR	693,314	SEE PART V		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
SCHEDULE L, PART IV:	MATTHEW KLAIN IS A DIRECTOR OF THE IRMC BOARD. HE IS THE OWNER OF THE MATTHEW KLAIN GROUP WHICH IS COMPENSATED FOR PHYSICIAN SERVICES PROVIDED TO IRMC.

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

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 REGIONAL MEDICAL CENTER

Employer identification number

25-0965404

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	PENNSYLVANIA MOUNTAINS CARE NETWORK ("PMCN") IS THE SOLE CORPORATE MEMBER OF INDIANA REGIONAL MEDICAL CENTER ("IRMC").
FORM 990, PART VI, SECTION A, LINE 7A	THE INDIVIDUALS WHO SERVE AS DIRECTORS OF PMCN SHALL CONSTITUTE THE BOARD OF THIS CORPORATION. THEIR TERM OF OFFICE SHALL COINCIDE WITH THEIR TERM OF OFFICE AS DIRECTORS OF PMCN. RESIGNATION OR REMOVAL AS A DIRECTOR OF PMCN SHALL CONSTITUTE RESIGNATION OR REMOVAL AS A DIRECTOR OF THIS CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7B	PMCN SHALL POSSESS ALL OF THE RIGHTS OF A MEMBER, AS DEFINED BY THE PENNSYLVANIA NONPROFIT CORPORATION LAW, AND SHALL EXERCISE THE FOLLOWING RESERVED POWERS WITH RESPECT TO THIS CORPORATION: (A) AMENDMENT TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THIS CORPORATION; (B) THE SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL THE PROPERTY OR ASSETS OF THIS CORPORATION; (C) MERGER OR CONSOLIDATION OF THIS CORPORATION WITH ANY OTHER CORPORATION; (D) DISSOLUTION OF THIS CORPORATION; (E) APPROVAL OF THE OPERATING AND CAPITAL BUDGETS FOR THIS CORPORATION; AND (F) ANY OTHER MATTER RELATING TO THIS CORPORATION THAT BY LAW REQUIRES THE APPROVAL OF THE MEMBERS OF A NONPROFIT CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11B	THE RETURN WAS REVIEWED IN DETAIL BY THE DIRECTOR OF FINANCE/CONTROLLER AND THE CFO. EACH BOARD MEMBER WAS PROVIDED ACCESS TO THE FORM 990 ON THE "BOARD SHARED DRIVE" BEFORE FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	EVERY MEMBER OF THE BOARD, AND EVERY INDIVIDUAL APPOINTED TO THE BOARD OR BOARD COMMITTEES, AS WELL AS ALL KEY MANAGEMENT PERSONNEL AND PHYSICIAN LEADERS, ARE REQUIRED TO EXECUTE A CONFLICT OF INTEREST DISCLOSURE STATEMENT, WHICH WILL BE UPDATED AT LEAST ON AN ANNUAL BASIS OR AS ADDITIONAL CONFLICTING INTERESTS ARISE. IN ADDITION, EVERY MEMBER OF THE BOARD WILL SPECIFICALLY ACKNOWLEDGE THE CONFLICT OF INTEREST POLICY AND HIS/HER ATTEMPT TO ABIDE BY IT BY SIGNING THE ACKNOWLEDGEMENT FORM. EVERY BOARD COMMITTEE MEMBER, OFFICER, KEY MANAGEMENT EMPLOYEE, AND PHYSICIAN LEADER IS REQUIRED TO SIGN THIS ACKNOWLEDGEMENT AS WELL. THE ACKNOWLEDGEMENT AND DISCLOSURE FORMS WILL BE KEPT ON FILE BY THE CHIEF EXECUTIVE OFFICER, AND THE CHAIRMAN AND VICE-CHAIRMAN WILL BE FAMILIAR WITH THE STATEMENTS THAT ARE FILED BY BOARD MEMBERS IN ORDER TO GUIDE THEIR CONDUCT IN THE EVENT A CONFLICT ARISES. EVERY PERSON COVERED BY THIS POLICY SHALL SUBMIT IN WRITING TO THE CHIEF EXECUTIVE OFFICER A CONFLICT OF INTEREST DISCLOSURE STATEMENT LISTING ALL FINANCIAL AND CONFLICTING INTERESTS. EACH STATEMENT WILL BE RESUBMITTED WITH ANY NECESSARY CHANGES EACH YEAR OR AS ANY ADDITIONAL CONFLICTING OR FINANCIAL INTERESTS ARISE. THE CHAIRMAN OF THE BOARD SHALL BECOME FAMILIAR WITH ALL SUCH DISCLOSURE STATEMENTS IN CASE A CONFLICT ARISES. THE VICE CHAIRMAN OF THE BOARD SHALL BE FAMILIAR WITH THE DISCLOSURE STATEMENT FILED BY THE CHAIRMAN. PENALTIES FOR NON-COMPLIANCE: FAILURE TO COMPLY WITH THIS POLICY SHALL CONSTITUTE GROUNDS FOR REMOVAL FROM OFFICE AND, IN THE CASE OF KEY MANAGEMENT PERSONNEL, TERMINATION OF EMPLOYMENT.
FORM 990, PART VI, SECTION B, LINE 15	POSITIONS FOR OFFICERS AND KEY EMPLOYEES ARE REVIEWED ON AN ANNUAL BASIS. APPROPRIATE COMPARISONS ARE MADE ON A REGIONAL AND NATIONAL LEVEL IN ORDER TO MAINTAIN A FAIR AND EQUITABLE COMPENSATION STRUCTURE. AN EXTERNAL CONSULTANT IS UTILIZED TO PREPARE COMPARATIVE SALARY DATA FOR THE BOARD'S REVIEW. ALL RECOMMENDATIONS ARE APPROVED BY THE BOARD OF DIRECTORS AND DOCUMENTED IN THE BOARD MINUTES.
FORM 990, PART VI, SECTION C, LINE 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G	PHYSICIANS FEES: PROGRAM SERVICE EXPENSES 6,773,075. MANAGEMENT AND GENERAL EXPENSES 1,643,820. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,416,895. CONSULTATION FEES: PROGRAM SERVICE EXPENSES 2,077,244. MANAGEMENT AND GENERAL EXPENSES 504,145. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,581,389. COLLECTIONS: PROGRAM SERVICE EXPENSES 861,221. MANAGEMENT AND GENERAL EXPENSES 209,017. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,070,238. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,146,184. MANAGEMENT AND GENERAL EXPENSES 763,576. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,909,760. PRINTING & MICROFILMING: PROGRAM SERVICE EXPENSES 49,466. MANAGEMENT AND GENERAL EXPENSES 12,005. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 61,471. OUTSIDE MEDICAL FEES: PROGRAM SERVICE EXPENSES 1,520,634. MANAGEMENT AND GENERAL EXPENSES 369,056. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,889,690. MAINTENANCE SERVICES: PROGRAM SERVICE EXPENSES 1,991,910. MANAGEMENT AND GENERAL EXPENSES 483,435. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,475,345. RECRUITMENT SERVICES: PROGRAM SERVICE EXPENSES 299,034. MANAGEMENT AND GENERAL EXPENSES 72,575. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 371,609.
FORM 990, PART XI, LINE 9:	TRANSFER (TO)/FROM AFFILIATES 787,251. CHANGE IN INTEREST IN INDIANA HEALTHCARE FOUNDATION 351,396. CHANGE IN PENSION AND POST-RETIREMENT LIABILITIES 8,662,245. OTHER CHANGES TO NET ASSETS 299. LOSS ON REFINANCING -700,954. CHANGE IN VALUE OF IJO 4,583,566.

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:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

INDIANA REGIONAL MEDICAL CENTER

Employer identification number

25-0965404

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)INDIANA JEFFERSON ONCOLOGY LLC 835 HOSPITAL ROAD INDIANA,PA15701 90-0406301	RADIATION ONCOLOGY SERVICES	PA	501(C)(3)	LINE 12A, I			No
(2)INDIANA TOTAL THERAPY INC 835 HOSPITAL ROAD INDIANA,PA15701 26-3843582	THERAPY SERVICES	PA	501(C)(3)	LINE 10	INDIANA HEALTHCARE PHYSICIAN SERVICES		No
(3)INDIANA HEALTHCARE FOUNDATION 835 HOSPITAL ROAD INDIANA,PA15701 25-1574302	FUNDRAISING IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTER	PA	501(C)(3)	LINE 12A, I	INDIANA REGIONAL MEDICAL CENTER	Yes
(4)INDIANA HEALTHCARE PHYSICIAN SERVICES INC 835 HOSPITAL ROAD INDIANA,PA15701 25-1842046	PROVIDE HEALTH CARE	PA	501(C)(3)	LINE 3	INDIANA REGIONAL MEDICAL CENTER	Yes
(5)INDIANA HEALTHCARE PROPERTIES 835 HOSPITAL ROAD INDIANA,PA15701 25-1524635	HOLD & MANAGE PROPERTY IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTER	PA	501(C)(3)	LINE 12A, I	INDIANA REGIONAL MEDICAL CENTER	Yes
(6)SPIRITLIFE INC 170 FR MARTIN TELENSON LANE PENN RUN,PA15765 46-3997001	DETOXIFICATION AND REHABILITATIVE SERVICES	PA	501(C)(3)	LINE 10	INDIANA REGIONAL MEDICAL CENTER	Yes
(7)INDIANA AMBULATORY SURGICAL ASSOCIATES INC 835 HOSPITAL ROAD INDIANA,PA15701 23-2923182	AMBULATORY SURGERY	PA	501(C)(3)	LINE 12A, I	INDIANA REGIONAL MEDICAL CENTER	Yes
(8)PENNSYLVANIA MOUNTAINS CARE NETWORK 835 HOSPITAL ROAD INDIANA,PA15701 47-4638568	SUPPORT FOR HEALTHCARE ORGNAIZATIONS	PA	501(C)(3)	LINE 12A, I	N/A		No
(9)PUNXSUTAWNEY AREA HOSPITAL INC 81 HILLCREST DRIVE PUNXSUTAWNEY,PA15767 25-0965210	HOSPITAL	PA	501(C)(3)	LINE 3	PENNSYLVANIA MOUNTAINS CARE NETWORK		No
(10)IRMC BHS MULTISPECIALTY PHYSICIAN GROUP ONE HOSPITAL WAY BUTLER,PA16001 81-3115773	HEALTHCARE SERVICES	PA	501(C)(3)	LINE 3	N/A		No

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

Cat. No. 50135Y

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) COSM REALTY GROUP LTD 1265 WAYNE AVENUE STE 307 INDIANA,PA15701 03-0439684	REAL ESTATE	PA	INDIANA REGIONAL MEDICAL CENTER	RELATED	47,098	3,351,438		No			No	48.750 %
(2) INDIANA REHABILITATION SERVICES LLC 855 SPRINGDALE DR STE 200 EXTON,PA19341 20-2214391	REHABILITATION SERVICES	PA	N/A	UNRELATED	56,342	79,424		No			No	51.000 %
(3) MEDCARE EQUIPMENT COMPANY LLC 115 EQUITY DRIVE GREENSBURG,PA15601 26-1361520	EQUIPMENT	PA	N/A	UNRELATED	384,035	1,334,357		No			No	1.750 %
(4) PENNSYLVANIA MOUNTAINS HEALTHCARE ALLIANCE LLC 150 MCCRACKEN RUN ROAD DUBOIS,PA15801 25-1852975	HEALTHCARE SERVICES	PA	INDIANA REGIONAL MEDICAL CENTER	UNRELATED	30,501	256,932		No		Yes		9.760 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No

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

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

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

Yes

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

Yes

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

Yes

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

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

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

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

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

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

Yes

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

Yes

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

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

Yes

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

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

Yes

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

Yes

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

Yes

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

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

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

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)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 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

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO SERVE THE HEALTHCARE NEEDS OF EVERY LIFE WE TOUCH WITH COMPASSION, RESPECT, AND DIGNITY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	1,283
6	Total number of volunteers (estimate if necessary) .............	6	11
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	469,878
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	400,404

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	242,239	5,990,336
9	Program service revenue (Part VIII, line 2g) .........	170,491,382	164,057,306
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	7,688,734	5,260,452
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	5,647,168	4,320,789
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	184,069,523	179,628,883
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
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)	75,020,547	79,189,639
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	99,275,660	83,483,876
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	174,296,207	162,673,515
19	Revenue less expenses. Subtract line 18 from line 12.......	9,773,316	16,955,368
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	273,249,507	279,036,107
21	Total liabilities (Part X, line 26).............	144,152,396	134,263,654
22	Net assets or fund balances. Subtract line 21 from line 20.....	129,097,111	144,772,453

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 130,251,311 including grants of $ 0 ) (Revenue $ 164,057,306 )
	IRMC CONTINUES TO BE A RESOURCE TO THE COMMUNITY PROVIDING FREE HEALTHCARE RELATED EVENTS PROMOTING EDUCATION, SCREENING PROGRAMS AND FIRST AID SERVICE. THE INSTITUTE FOR HEALTHY LIVING AT IRMC OFFERS HEALTH SERVICES AND EDUCATIONAL PROGRAMS AT NO CHARGE SUCH AS: 3 SIGN OF HEART DISEASE TO NEVER IGNOREABI SCREENINGAGONY OF DE'FEETBLOOD PRESSURE CLINICBONE DENSITY SCREENINGBOTHERED BY BUNIONS EVENTCONTINUED ON SCHEDULE O.BREAST HEALTH EVENT DR. CLARK VIRTUAL EVENTCHEERS TO YOUR HEARTCHOLESTEROL SCREENINGCOLORECTAL EDUCATION SEMINARCOMMUNITY HEALTH COACHINGDIABETES EDUCATIONDR. QURESHI SKIN CARE SEMINARDR. TRALE KNEE PAIN EVENTDR. SCHOLL - VIRTUAL CHRONIC PAIN EVENTFIT NOT FADFARMERS MARKET TABLEFREE S&T WELLNESS GYM MEMBERSHIPSGET YOUR REAR IN GEAR COLORECTAL WALKGINGERBREAD MAN SPORTS NUTRITION GIRLS NIGHT OUTGROCERS FIGHT CANCERGROCERY STORE TOURHC SOCIAL EMOTION LEARNING DAYHEART BREAK IN A BOTTLE - PRESCRIPTION DRUG ABUSE HEART HEALTH EDUCATION AND PILATES - DR. LINTON FRAZIERHEART HEALTH EXPOHERNIA SCREENINGIMPERFECT HEART SEMINARINDIANA CHAMBER OF COMMERCE WOMEN'S SUMMITINDIANA COUNTY FAIRIUP HEALTH FAIRLISTEN TO YOUR HEART - HEART HEALTH SCREENINGMEET THE CRAMERSMENTAL NOTES - MENTAL HEALTH SEMINARPARKINSON SUPPORT GROUP EDUCATIONPELVIC FLOOR SEMINARPROSTATE SCREENINGSENIOR EXPOSMOKING CESSATION PROGRAMSTROKE EDUCATION EVENTTORRANCE HEALTH FAIRTOUCHDOWN FOR HEALTH ORTHOPEDIC EDUCATIONUNTIL THERE'S A CURE - WOMEN'S CANCER EDUCATIONWALK WITH THE DOCSWOMEN'S HEALTH EDUCATION ZOOMYOU ARE THE ONE IN 2021 HEALTH EDUCATION SERIESPREVENTIVE HEALTH SERVICES, GENERAL/OTHER: M. DORCAS CLARK WOMEN'S IMAGING CENTER: THE WOMEN'S IMAGING CENTER AND THEIR STAFF HAVE PARTICIPATED IN NUMEROUS COMMUNITY EVENTS PROVIDING INFORMATION ABOUT THE IMPORTANCE OF BREAST HEALTH. BIRDIE'S CLOSET, A PROJECT DESIGNED TO HELP WOMEN COPE WITH APPEARANCE-RELATED SIDE-EFFECTS OF CANCER TREATMENT, WAS OPENED IN THE WOMEN'S IMAGING CENTER.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses130,251,311

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)			(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
(A) Name and title
(18) JAMES KINNEER........................................................................ CHIEF HUMAN RESOURCE OFFICER	20.00 .......................20.00	X		190,606	0	28,369
(19) MARK VOLOVIC........................................................................ CHIEF INFORMATION OFFICER	34.00 .......................6.00	X		251,457	0	28,325
(20) ADENIRAN HAASTRUP MD........................................................................ PHYSICIAN	40.00 .......................		X	305,436	0	4,537
(21) TOLUTOPE OZAH........................................................................ PHYSICIAN	40.00 .......................		X	285,585	0	8,910
(22) PATRICK SHANNON DO........................................................................ PHYSICIAN	40.00 .......................		X	272,130	0	47,745
(23) JASON RASEFSKE DO........................................................................ PHYSICIAN	40.00 .......................		X	236,865	0	18,774
(24) GLORIA KOLONICH CRNA........................................................................ PHYSICIAN	40.00 .......................		X	214,646	0	20,333

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,667,222	393,089	396,404

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	5,790,084

f	All other contributions, gifts, grants, and similar amounts not included above		1f	200,252

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

h Total. Add lines 1a-1f.......		5,990,336

		Business Code
2a	NET PATIENT SVC REV	621990	163,936,600	163,936,600
b	HEALTH CLASSES/COUNSEL	624100	75,537	75,537
c	RENTAL REVENUE-AFFILIATES	531120	40,942	40,942
d	HOSPICE PRESCRIPTIONS	621990	4,227	4,227
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		164,057,306

3 Investment income (including dividends, interest, and othersimilar amounts) ......			2,213,182			2,213,182
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........			5,627			5,627
		(ii) Personal	(i) Real
6a	Gross rents		1,688,298	6a
b	Less: rental expenses		1,156,239	6b
c	Rental income or (loss)		532,059	6c
d	Net rental income or (loss).......			532,059			532,059
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	26,130	3,063,141	7a
b	Less: cost or other basis and sales expenses	42,001	0	7b
c	Gain or (loss)	-15,871	3,063,141	7c
d	Net gain or (loss).........			3,047,270			3,047,270
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA REV		900099	713,826			713,826
b	PURCH DISC & REBATES		900099	683,746			683,746
c	MANAGEMENT FEES		900099	651,732			651,732
d	All other revenue ....			1,733,799		469,878	1,263,921
e	Total. Add lines 11a–11d ......			3,783,103
12	Total revenue. See instructions.....			179,628,883	164,057,306	469,878	9,111,363

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	2,469,600	1,974,198	495,402
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	60,173,358	48,102,582	12,070,776
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,185,487	2,546,478	639,009
9	Other employee benefits .......	9,226,640	7,375,776	1,850,864
10	Payroll taxes ...........	4,134,554	3,305,162	829,392
11	Fees for services (non-employees):
a	Management ......	116,927		116,927
b	Legal .........	271,375		271,375
c	Accounting ...........	157,325		157,325
d	Lobbying ...........	2,777		2,777
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	259,000		259,000
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	20,776,397	16,718,768	4,057,629
12	Advertising and promotion ....	737,836	28,702	709,134
13	Office expenses .......	1,300,255	1,275,030	25,225
14	Information technology ......	4,458,173	1,606,726	2,851,447
15	Royalties ..
16	Occupancy ...........	1,662,998	1,221,638	441,360
17	Travel ............	298,426	165,328	133,098
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	22,719	22,719
20	Interest ...........	1,755,779	1,755,779
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	11,001,836	9,562,796	1,439,040
23	Insurance ...	2,618,012	2,092,839	525,173
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	30,182,457	29,596,917	585,540
b	BAD DEBT EXPENSE	4,262,580	0	4,262,580
c	CLEANING SVCS & SUPPLIE	1,204,348	962,756	241,592
d	DIETARY/FOOD	925,862	740,134	185,728
e	All other expenses	1,468,794	1,196,983	271,811
25	Total functional expenses. Add lines 1 through 24e	162,673,515	130,251,311	32,422,204	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1	7,259
2	Savings and temporary cash investments .........			13,284,389	2	14,185,735
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			18,072,867	4	18,802,310
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 .......
					5
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) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			2,987,251	8	3,168,324
9	Prepaid expenses and deferred charges ......			1,973,683	9	1,968,905
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	218,222,049
b	Less: accumulated depreciation	10b	113,133,502	108,921,543	10c	105,088,547
11	Investments—publicly traded securities .			101,697,756	11	89,831,542
12	Investments—other securities. See Part IV, line 11 .....			12,093,146	12	15,027,284
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			222,594	14	194,770
15	Other assets. See Part IV, line 11 ...........			13,996,278	15	30,761,431
16	Total assets. Add lines 1 through 15 (must equal line 33)...			273,249,507	16	279,036,107

17	Accounts payable and accrued expenses .....	25,655,843	17	29,608,459
18	Grants payable ...		18
19	Deferred revenue .........		19	5,171,329
20	Tax-exempt bond liabilities .........	53,635,487	20	32,069,404
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 .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23	18,633,723
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	64,861,066	25	48,780,739
26	Total liabilities. Add lines 17 through 25..	144,152,396	26	134,263,654

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	122,197,487	27	137,321,182
28	Net assets with donor restrictions ...........	6,899,624	28	7,451,271
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	129,097,111	32	144,772,453
33	Total liabilities and net assets/fund balances ........	273,249,507	33	279,036,107