2023-11-14T16:34:09+00:00 2022-12-31 990 2022-01-01 262772226 Indiana University Health Tipton Hospital Inc INDI 3179634842 950 N MERIDIAN STREET 1200 INDIANAPOLIS IN 46204 CARA L BREIDSTER CFO 2023-11-14 CARA BREIDSTER 999009999 2022 2023-04-26 12:10:37Z KENNETH D PUCKETT 950 N MERIDIAN STREET 1200 INDIANAPOLIS IN 46204 53013309 false X HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-TIPTON-HOSPITAL X 2008 IN Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. 6 6 284 49 0 0 45044 299368 55514949 50732715 340455 372386 379950 131496 56280398 51535965 34 1707 0 15746354 17052027 0 0 30021027 29923566 45767415 46977300 10512983 4558665 87383510 83740320 26667904 18862550 60715606 64877770 X Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. false false 44914702 1707 50340131 IU HEALTH TIPTON HOSPITAL IS A 25-BED ACUTE-CARE AND CRITICAL ACCESS HOSPITAL THAT OFFERS A BROAD RANGE OF SERVICES TO CARE FOR ITS PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. IU HEALTH TIPTON HOSPITAL PROVIDES LEADING-EDGE, PATIENT-CENTERED CARE, AS WELL AS PERSONALIZED NURSING CARE, IN A WIDE RANGE OF MEDICAL SPECIALTIES TO RESIDENTS OF TIPTON COUNTY AND ITS SURROUNDING COMMUNITIES. 267937 0 300302 PHARMACY SERVICES: OUR NETWORK OF PHARMACIES OFFERS THE EASE OF "ONE-STOP" SHOPPING. WITH SERVICES DESIGNED TO MEET YOUR NEEDS, WE WILL PROVIDE EXPERT CARE AND HELP PATIENTS MAKE THE BEST USE OF THEIR MEDICATIONS. 54609 0 61206 IU HEALTH TIPTON HOSPITAL, INC. RECEIVES "SHARED SERVICES" REVENUE BY SHARING/PROVIDING SERVICES WITH INDIANA UNIVERSITY HEALTH CARE ASSOCIATES, INC., INDIANA UNIVERSITY HEALTH NORTH HOSPITAL, INC., AND INDIANA UNIVERSITY HEALTH, INC. 27727 0 31076 IU HEALTH TIPTON HOSPITAL, INC. RECEIVES RENTAL REVENUE FROM A RELATED EXEMPT ORGANIZATION, IU HEALTH CARE ASSOCIATES, INC. FOR VARIOUS OFFICES AND CLINICS. 27727 31076 45264975 true true false true false false false false true true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 0 0 284 true false false false false false false false false false false false false X 6 6 false false false false true true true true true false false true true true true true true true true false IN X CRAIG J JONES 3179634842 950 N MERIDIAN ST SUITE 800 INDIANAPOLIS IN 46204 LINDA G JOINES DIRECTOR / SECRETARY 1.0 0 X X 0 3600 0 STEVEN A WERTZ DIRECTOR / CHAIR 1.0 0 X X 0 3600 0 BEN B HOBBS DIRECTOR 1.0 0 X 0 3600 0 DAVID L VORIS DIRECTOR 1.0 0 X 0 3600 0 DESTRY W LAMBERT MD DIRECTOR (PART YEAR) 1.0 0 X 0 0 0 Michael E Harper MD DIRECTOR (PART YEAR) 1.0 0 X 0 3000 0 TAMERA N BROWN DIRECTOR 1.0 0 X 0 3600 0 CARA L BREIDSTER REGIONAL CFO (ISR) 10.0 45.0 X 0 338130 66652 KENNETH DOUG PUCKETT REGIONAL PRESIDENT (ISR) 10.0 45.0 X 0 932429 176139 MICHAEL L HARLOWE PRESIDENT (PART YEAR) 55.0 0.0 X 322619 0 254423 ATHANASIA SOULA BANICH VP, Regional COO (ISR) 15.0 40.0 X 0 295551 50077 CARRIE WING VP-CNO (ISR) (Part Year) 10.0 45.0 X 0 201000 11362 LISA A SPARKS REGIONAL CNO (ISR) (Part Year) 10.0 45.0 X 0 281144 58461 TAMARAH D BROWNLEE REGIONAL VP-HR (ISR) 10.0 45.0 X 0 215065 55869 ANGELA K MORGAN MANAGER - PHARMACY DEPT. 50.0 0 X 159518 0 56288 CHRISTINE MARVIN CLINICAL NURSE 50.0 0 X 158446 0 38099 MELISSA J BAXTER-STANDRIDGE Clinical Nurse-Shift Coordinator 50.0 0 X 194348 0 19380 PAMELA RILEY CLINICAL NURSE 50.0 0 X 186094 0 33286 SANDRA MOSBAUGH CLINICAL NURSE 48.0 2.0 X 193555 7095 37400 ARTHUR VASQUEZ FORMER KEY EMPLOYEE 0.0 55.0 X 0 592106 122681 MELISSA R HICKS Former Highest Compensated Employee 0.0 55.0 X 0 258373 29630 1214579 3141892 1009748 28 true true false 0 0 0 0 178792 120576 0 0 299368 Net Patient Service Revenue 622110 50340131 50340131 Shared Services 541900 61206 61206 Rent from Related 501(c)(3) Orgs. 532000 31076 31076 Pharmacy 446110 300302 300302 0 0 0 0 50732715 485786 485786 0 0 1363944 1477344 -113400 0 -113400 -113400 131496 0 0 131496 131496 51535965 50732715 0 503882 X 1707 1707 577042 559348 17694 0 13337262 12928307 408955 462286 448111 14175 1775120 1720690 54430 900317 872711 27606 2099 2099 11298 11298 11530991 10798666 732325 0 13308 12463 845 53081 26541 26540 2309700 2309700 15262 14293 969 563111 563111 1896688 1791594 105094 241082 241082 Bad Debt 1214042 1214042 Drugs and Medical Supplies 8914381 8914381 Hospital Assessment Fee 1444667 1444667 Noncapitalized Equipment 624064 624064 1089792 1020579 69213 0 46977300 45264975 1712325 0 0 46139505 44523861 0 6742818 4646004 0 0 0 0 0 1059928 1209511 116526 117675 19671609 13782806 6334893 5888803 6595755 6014759 0 0 8682630 8287964 11711455 13051743 87383510 83740320 2816861 3003762 0 0 23851043 15858788 26667904 18862550 X 49335521 53275644 11380085 11602126 60715606 64877770 87383510 83740320 X 4558665 -618542 222041 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2099 2099 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY IU Health Tipton Hospital paid institutional membership dues to the American Hospital Association ("AHA") and Indiana Hospital Association ("IHA") during 2022 in the amount of $6,731 and $3,674, respectively. Each membership organization notified IU Health Tipton Hospital that a portion of the dues it paid were used for lobbying purposes. The AHA used 26.47%, or $1,782 of 2022 membership dues paid by IU Health Tipton Hospital, for lobbying expenditures. The IHA used 8.63%, or $317 of the 2022 membership dues paid by IU Health Tipton Hospital, for lobbying expenditures. The total membership dues paid to these organizations by IU Health Tipton Hospital during 2022 that were attributable to lobbying expenditures was $2,099. 11380084 222042 11602126 9316324 2063760 11380084 7712716 1800 2107729 406456 99465 0 9316324 9019574 24796 -857577 228218 159671 86188 7712716 8318829 14939 808027 37773 967 83481 9019574 0.0 0.64 0.36 true false 0 0 0 0 0 2872457 1750721 1121736 14763999 10838041 3925958 2035153 1194044 841109 5888803 INT. IN NET ASSETS OF FNDTN. 11602125 INTERCOMPANY RECEIVABLES (NET) 1449618 13051743 INTERCOMPANY PAYABLES (NET) 12986306 DUE TO THIRD-PARTY PAYERS 2756769 SELF INSURANCE LIABILITIES 22597 OPERATING LEASE LIABILITIES 93116 15858788 X Schedule D, Part V, Line 4 Intended uses of endowment funds TEMPORARILY AND PERMANENTLY RESTRICTED NET ASSETS REPRESENT ENDOWMENTS HELD BY TIPTON COUNTY FOUNDATION, INC., AN UNRELATED 501(C)(3) TAX EXEMPT ORGANIZATION, OF WHICH INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL, INC. IS THE BENEFICIARY. THE USES OF THE FUNDS ARE IN ACCORDANCE WITH THE DONOR-RESTRICTIONS OF EACH ENDOWMENT. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote IU Health Tipton Hospital is a subsidiary in IU Health's Consolidated Audited Financial Statements. The Internal Revenue Service has determined that Indiana University Health and certain of its affiliated entities are tax-exempt organizations as defined in Section 501(c)(3) of the Internal Revenue Code (IRC). Indiana University Health and its tax-exempt affiliates are, however, subject to federal and state income taxes on unrelated business income under the provisions of IRC Section 511. Deferred income taxes that, as of December 31, 2022 and 2021, have no net carrying value reflect the net tax effect of temporary differences between the carrying amounts of assets and liabilities for financial reporting and the amounts used for income tax purposes. As of December 31, 2022 and 2021, the Indiana University Health System had gross deferred tax assets of $145,194,000 and $146,281,000, respectively, primarily relating to net operating loss carryovers. Management determined that a full valuation allowance at December 31, 2022 and 2021, was necessary to reduce the deferred tax assets to the amount that would more likely than not be realized. Based on the weight of the evidence, if it is more likely than not that some portion or all of the deferred tax assets will not be realized, a valuation allowance to reduce the deferred tax assets is recorded. At December 31, 2022, Indiana University Health System has available net operating loss carryforwards of $583,788,000. Net operating losses generated from 2001 through 2017 will expire between 2022 and 2037. Net operating losses generated after 2017 do not expire. true true X true X 300 false true true true false true true 663 472352 0 472352 0.0103 2778 9981111 5681208 4299903 0.0940 0 0 0 0 0.0 0 3441 10453463 5681208 4772255 0.1043 4 234 523671 0 523671 0.0114 2 68 691667 0 691667 0.0151 1 386 1116991 988853 128138 0.0028 0 0 0 0 0 0.0 2 2721 169662 0 169662 0.0037 9 3409 2501991 988853 1513138 0.0331 9 6850 12955454 6670061 6285393 0.1373 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 0 1003 0 1003 0.0000 0 0 0 0 0 0.0 1 1 808 0 808 0.0000 1 20 386 0 386 0.0000 0 0 0 0 0 0.0 0 0 0 0 0 0.0 3 21 2197 0 2197 0.0000 false 340710 13682839 13572352 110487 X true 1 1 IU HEALTH TIPTON HOSPITAL 1000 S MAIN ST TIPTON IN 46072 HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-TIPTON-HOSPITAL 23-005049-1 X X X X IU HEALTH TIPTON HOSPITAL 1 false false true X X X X X X X X X 21 true false false true X https://iuhealth.org/in-the-community/community-benefit true 22 true https://iuhealth.org/in-the-community/community-benefit false true X 300.0 0.0 X X X X X X X true true X X X true X https://iuhealth.org/pay-a-bill/financial-assistance X https://iuhealth.org/pay-a-bill/financial-assistance X https://iuhealth.org/pay-a-bill/financial-assistance X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E IU Health Tipton Hospital's 2021 Community Health Needs Assessment (CHNA) Report includes a prioritized description of significant health needs in the community. The CHNA report identified the following needs as priorities for IU Health Tipton Hospital: 1. Access to Healthcare Services 2. Aging Population and Needs of Seniors 3. Behavioral Health 4. Chronic Disease and Chronic Disease Management 5. Health Education and Navigation 6. Maternal and Infant Health and Child Well-being 7. Social Determinants of Health Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - IU HEALTH TIPTON HOSPITAL. In conducting each its most recent CHNA, IU Health Tipton Hospital took into account input from persons who represent the broad interests of the communities it serves by hosting four community focus groups and four interviews. These events engaged public health officials and community-based organizations that provide services and/or reflect community members who are medically underserved, low-income, or of a minority subpopulation to discuss the health needs of the service area and what role IU Health could play in addressing the identified needs. IU Health Tipton Hospital The defined community per the most recent CHNA is Hamilton and Tipton Counties, Indiana. The hospital resides in Tipton County. Hamilton County - Community Meetings and Interviews In collaboration with other local health systems - Ascension St. Vincent, Community Health Network and Riverview Health - two community meetings were held in May 2021 to receive input from stakeholders regarding the health needs in Hamilton County. Secondary data and a preliminary list of community health need priorities was presented at both meetings. Each group was then asked questions about the preliminary list, including their reactions, additions to the proposed needs, thoughts regarding the causes of the needs, impacts of the COVID-19 pandemic and others. After this discussion, participants were given the opportunity to make additional comments before being asked to vote on what they believed were the most significant needs in the county. Participants were asked to choose three to five significant health needs via an online poll during and after the meeting. Preliminary needs identified include several topics, including COVID-19, alcohol abuse, immunization rates, elderly needs, smoking and tobacco use, access to mental health services and statewide issues, such as health disparities and obesity. In addition to these topics, participants focused discussion on substance abuse and overdoses, mental health concerns, access to care disparities for various segments of the population, aging in place resources, transportation, limited clinical hours of providers, limited mental health providers, a continuum of care between various health services and food insecurity. From this process, participants identified the following needs as most significant for Hamilton County: * Access to and supply of mental health providers, particularly for low-income populations Needs of a growing senior population, including aging in place and cognitive care * Mental health * Alcohol use and excessive drinking * Access to care disparities, particularly for low-income populations A survey was also issued to internal providers at IU Health that serve Hamilton County, asking them to identify priority needs among the patients they serve. The following issues were identified as the most significant: * Healthcare and services for elderly residents * Mental health * Substance abuse * Access to healthcare services * Obesity * Access to behavioral health services, including mental health and substance abuse The survey also asked about the impacts of the COVID-19 pandemic. Issues most often selected as significant impacts include: * Loss of health insurance * Social isolation and loneliness * Health disparities Two additional interviews were conducted with representatives of local public health departments to obtain subject-matter expertise into the health needs in Hamilton County. The following issues were discussed as significant: * Access to behavioral health services - both mental health and substance abuse - is a significant need, with few providers in the area and primary care physicians not often integrating behavioral health checks into care (a large increase in population has led to an undersupply of providers) * Mental health concerns are widespread, including an increase in child mental health needs (youth struggle with high expectations and stress in school) * Substance abuse and overdoses are significant concerns, with opioid usage being widespread (alcohol abuse is also common) * Transportation is a barrier in the community with limited public options and routes * Insurance barriers are significant, with uninsured populations having few options and providers not accepting certain plans, such as Medicaid (while free and low-cost clinics exist, they cannot keep up with demand) * Food insecurity and access to healthy food is challenging for some groups, exacerbated by poverty and transportation (low-income housing is also limited) * The working poor often are vulnerable as they do not qualify for many programs but still live paycheck to paycheck (while Hamilton County compares well for poverty, the needs of low-income populations are often overlooked due to this, creating pockets of need) * Prevention is not a priority for most and more programs and access to preventive health are needed * Sexually transmitted infections are an issue, particularly chlamydia * Cultural differences lead to unmet need for several immigrant communities due to language barriers and others * LGBTQ+ populations are also underserved, often feeling uncomfortable going to available providers * Public health funding is limited, and service levels are impacted due to financial constraints * Time is a big barrier to optimal health, as parents are often too busy with work and children to pursue healthy living measures * More collaboration is needed between health systems, health departments, providers and social service organizations In regard to the COVID-19 pandemic, a wide array of impacts was noted including: * A lack of resources at local health departments - both funding and staff - led to difficulties throughout the pandemic, and many other services were foregone to focus on the pandemic (a need for a more robust public health infrastructure is highlighted) * The politicization of public health was widespread, and many guidelines and measures were met with criticism * Mental health issues worsened due to isolation, with children at particular risk * STI rates rose substantially * The pandemic highlighted the need for accurate health information, and providers need to focus on maintaining communication after COVID-19 Tipton County - Community Meetings and Interviews Two community meetings were held in April 2021 to receive input from stakeholders regarding the health needs in Tipton County. Secondary data was presented, and each group was asked to discuss their reactions to the data, needs identified from the data, thoughts regarding the causes of the needs, impacts of the COVID-19 pandemic and others. After this discussion, participants were given the opportunity to make additional comments before being asked to select what they believed were the most significant needs in the county. Participants focused discussion on elderly needs, sedentary lifestyles, mental health concerns and stigma, technology barriers and broadband access, ensuring programs are accessible to Hispanic (or Latino) populations, affordable housing, need for local leadership to collaborate on issues, pediatric healthcare, financial barriers to healthcare, youth programming (particularly for exercise) and a lack of built environment that promotes health (sidewalks, safe walking areas, etc.). From this process, participants identified the following needs as most significant for Tipton County: * Mental health * Technology barriers, access to broadband and the digital divide * Elderly needs and health concerns * Physical inactivity and sedentary lifestyles * Pediatric health In discussing the impacts of the COVID-19 pandemic on health, participants focused on food insecurity, isolation and its impacts on mental health (including for elderly and children), financial challenges on local businesses and community divides on topics such as regulations and social issues. An additional community survey was issued to stakeholders unable to attend community meetings, asking them to identify priority needs. Among seven responses, the following issues were identified as the most significant by respondents: * Mental health and access to mental health services * Substance abuse * Elderly health needs and care * Physical inactivity, sedentary lifestyles and access to exercise opportunities The survey also asked about the impacts of the COVID-19 pandemic. Issues selected as significant impacts by both respondents include: * Social isolation and loneliness * Unemployment or underemployment * Loss of health insurance * Food access and affordability Schedule H, Part V, Section B, Line 5 Facility , 2 Facility , 2 - IU HEALTH TIPTON HOSPITAL (CONTINUED). Two additional interviews were conducted with representatives of a local public health department and health associations to obtain subject-matter expertise into the health needs in Tipton County. The following issues were discussed as significant: * Health education is needed for many to improve health (residents do not understand how to access healthcare and often use expensive options unknowingly, such as emergency departments; more education for youth is needed so later life choices are healthy) * Chronic disease and education surrounding conditions are significant needs, particularly to manage conditions such as diabetes * Mental health, the stigma around mental health and accessing mental health services are all significant needs in the community * Technology barriers and access to broadband significantly impact the ability to access healthcare services * Affordable housing is difficult to access, and homelessness is a need * Navigating available resources is difficult, as few know what is available and who to contact for services * Migrant populations are underserved, as many do not engage with the health system due to fears and safety concerns * Elderly populations are also vulnerable, particularly due to technology barriers and aging in place concerns * Access to workforce development opportunities and training is needed * Maternity care is difficult to access, particularly for deliveries (more training is needed at local hospitals to handle emergency delivery situations) In regard to the COVID-19 pandemic, the following was noted: * Elderly were particularly affected due to fears around the virus, leading to staying at home and isolation * Mental health issues have increased dramatically amid a lot of uncertainty about the future and what the new normal may be (many also are fearful of the vaccine and need more education and data about its efficacy) Community meeting and survey participants Individuals from a wide variety of organizations and communities participated in the interview process, community meetings and surveys. Participants included representatives from the following organizations: * Anthem * Area Five Agency on Aging * Ascension St. Vincent * Aspire Indiana Health * Boys and Girls Club of Tipton County * Breathe Easy Hamilton County * Carmel Clay Schools * Central Indiana Council on Aging (CICOA) * City of Noblesville * Community Health Network * Encore Lifestyle and Enrichment Center * Fishers Health Department * Four County * Good Samaritan Network of Hamilton County * Good Shepherd Food Pantry * Hamilton County Community Foundation * Hamilton County Council on Alcohol and Other Drugs * Hamilton County Government * Hamilton County Harvest Food Bank * Hamilton County Head Start * Hamilton County Health Department * Hamilton County Meals on Wheels * HAND, Inc. * Heart and Soul Free Clinic * HOPE Family Care Center * Indiana Rural Health Association * IU Health * IU Health Indy Suburban Region * IU Health North Hospital * IU Health Tipton Hospital * Noblesville Chamber of Commerce * Noblesville Schools * Noblesville Town Council * Prevail, Inc. * Prime Life Enrichment * Purdue Extension * Riverview Health * Shepherd's Center of Hamilton County * Sheridan Community Schools * St. Elizabeth Seton Parish * The Villages Health Families * Tipton Chamber of Commerce * Tipton Community School Corporation * Tipton County Domestic Violence Victim Advocate * Tipton County Foundation * Tipton County Health Department * Tipton Fire Department * Tri-Central School Corporation * Trinity Free Clinic Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - IU HEALTH TIPTON HOSPITAL. Along with the CHNA, IU Health Tipton Hospital's Board adopted an implementation strategy in April 2022 in response to the 2021 CHNA. IU Health Tipton Hospital, along with community partners, prioritized and determined which of the significant needs identified in its most recently conducted CHNA could be adequately addressed by current or future initiatives, programs, resources, and collaborations. The 2022-2024 implementation strategy outlines how IU Health Tipton Hospital plans to address significant needs including initiatives, strategies, internal/external collaborators, anticipated impact, and hospital resources. Significant Needs Hospital Will Address Below is the progress of the implementation strategy by significant need and its respective initiative(s). The hospital is addressing the following significant needs between 2022 and 2024: Access to Healthcare Services; Aging Population and Needs of Seniors; Behavioral Health; Chronic Disease and Chronic Disease Management; Maternal and Infant Health and Child Well-being; and Social Determinants of Health. Access to Healthcare Services - Provide vaccine clinics in the community. - IU Health Tipton Hospital did not hold any vaccine clinics in 2022. The Tipton County Health Department provided vaccine clinics to the community in 2022. Going forward, the hospital plans to partner with the health department and/or other organizations to provide flu vaccines at established events and clinics in the community. - Support community members accessing healthcare services regardless of their ability to pay. - IU Health Tipton Hospital provides financial assistance to patients each year. Additionally, IU Health Patient Financial Counselors are certified Indiana Navigators. They can assist patients with information and help them with applications for various health coverage programs. Aging Population and Needs of Seniors - Support the Encore Transportation Program (community transportation program for seniors to access necessary services and appointments). - IU Health Tipton Hospital provided a grant to help support the Encore Transportation Program. Funds are needed annually to help with operation expenses, helping with funding assures seniors have access to medical appointments, groceries, banking and other basic living needs. In 2022 the center provided 7,040 rides, welcomed approximately 70 new members and had a combined participation of over 4,000 to all of their programs for the year. The program provided a total of 810 rides to appointments at the hospital in 2022. - Support senior-focused programs at local events in the community. - IU Health Tipton Hospital provided a grant to the Encore Center to purchase tickets for their members to take a trip to a show at Beef & Boards Dinner Theatre. Around 20 seniors were able to attend that otherwise would not have either had the funds to go or the transportation. The members attending commented that it helped their mental health being able to attend trips like this. Many seniors don't have or find it difficult to provide their own transportation or couldn't take the cost of this out of their budget, our grant provides this trip to them free and provides the transportation. - In December we also donated cleaning kits to the center to provide their members. The kits were part of our annual Days of Service project and contained dish soap, furniture polish, sponges, window cleaner, cleaning cloth, etc. The members gathered for a Christmas event and received the bags as part of their gift. Providing these bags helped provide the basic cleaning items for free. Behavioral Health - Further implement Virtual Care Peer Recovery Coaching Program (provides patients with substance use concerns with virtual behavioral health services). - The Virtual Care Peer Recovery Coaching Program is currently implemented at IU Health Tipton Hospital, and patients are referred to the program through hospital clinicians. The program data is managed and overseen by the IU Health Behavioral Health team. - Further implement emergency department (ED) virtual care program (provides patients virtual access to behavioral health services). - In 2022, behavioral health services were provided to patients in crisis via the emergency department virtual care program. Chronic Disease and Chronic Disease Management - Support community Smoking Cessation Program (educate and reduce the use of tobacco products in community members interested in quitting smoking). - The hospital team member that led this program retired in 2022 and a replacement has not taken over this program at this time. Patients expressing an interest in quitting smoking through our local physician offices are evaluated on an individual basis for the best treatment plan. Physicians will prescribe nicotine replacement patches/gum or Chantix (if insurance allows); others needing further help will be provided additional tobacco resources including the Centralized Tobacco Treatment Program. - Further implement IU Health Serves Days of Service (volunteer event engaging IU Health team members in activities that benefit the community). - IU Health Tipton Hospital participated in the annual Days of Service with a total of six projects. These projects were a mixture of on-site, take-home and in the community. Projects for 2022 included 300 hygiene kits that were assembled and donated to the school systems to provide students in need throughout the year, providing the funds for 10 families to do their laundry for free during our laundry lift evening at the local laundry mat, sealed over 200 wooden fence pickets (previously designed by team members) at the local park to keep them protected from the weather, assembled and donated 150 household cleaning kits to families in need through community partners, assembled and donated 200 Christmas stockings to local nursing home residents and seniors, hand made over 300 Christmas ornaments for a free community ornament tree during our holiday event in December. All of these projects had a total of 37 team members volunteering their time for a total of 114 hours served. - Implement Fresh & Fit (a free 10-week fitness and nutrition program to improve overall physical and mental health). - The Fresh + Fit program was successfully rolled out to the Tipton community in 2022. Fresh + Fit is a ten-week program designed to improve the health of individuals and families by guiding them to build healthy lifestyles through fitness and nutrition. A total of 19 participants started the program and ended up completing the program, a 58% completion rate. While our numbers were high for Tipton, they are right about where we had anticipated them being. This was a manageable number for the first year offering it to our community. In our little group there was a total of 151.8 pounds lost and 72% improvement in blood pressure, other measurements were also improved. - Provide community screenings and education initiatives. - We had our annual Prostate Cancer Screenings scheduled for September, unfortunately even with normal promotions of the screening we did not have enough interest from the community to complete this event in 2022. We have found that stand alone screening events are not successful in our community. Our plan is to work on combining screenings with existing events and meetings that we are already planning to attend in the future. - Further implement the Centralized Tobacco Treatment Program (CTTP) (provides patients access to evidence-based tobacco treatment). - Between July 2021 to March 2022, training took place in all adult primary care clinics in the IU Health System on the CTTP program, including the availability of services and how to make referrals into the free program for patients. In 2022, for the Indy Suburban Region (including IU Health Tipton Hospital), there were 11 referrals to the CTTP (66% of patients scheduled counseling with a TTS because of the referral; 55% of patients completed the session). A total of 449 patients, including 41 in the CTTP, enrolled in Clickotine. Maternal and Infant Health and Child Well-being - Further implement Car Seat Program (education on properly fitting child safety seats). - IU Health Tipton Hospital currently has one car seat technician. The technician conducted 23 car seat fittings throughout the year free of charge. She also attended a Family Resource and Safety Fair and offered general education on car seat safety, expiration dates and information on how they can receive assistance through the local program. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - IU HEALTH TIPTON HOSPITAL (Continue). Social Determinants of Health - Support local, community programs that serve families with lower incomes. - Team members participated in a new program called Laundry Lift. Community organizations can sign up for a month to support the program by having volunteers at the laundry mat one day a month during set times and providing the quarters, detergent and fabric softener so families can do their laundry that day for free. The hospital sponsored two days during the year assisting a total of 20 families. - Support My Closet - Tipton Community School Corporation (TCSC) (clothing pantry for TCSC students in need of basic clothing items). - In 2022, IU Health Tipton provided a grant to the program "My Closet" at Tipton Community School Corporation. This program supports all students in need in grades pre-school through grade twelve. Families do not have to show a financial need, just simply ask to visit the closet. Students are taken in one at a time to help with confidentiality and are able to shop for a complete outfit (shirts, shoes, under garments, socks, coats, gloves, hats) one time each semester. A local salon also offers vouchers for a free haircut. The program director works directly with the families, if she sees a need, then exceptions are made so the student has what they need. From June 2022 - January 4, 2023, there were a total of 122 student visits to the closet. Sixty-seven students received winter coats, 37 students received vouchers for shoes and 21 students received shoes on-site. Significant Needs Hospital Will Not Address IU Health Tipton Hospital is unable to address the following community health needs identified in the 2021 Community Health Needs Assessment. Health Education and Navigation Health Education and Navigation Health education and navigation refers to services and resources that are available in the community, but people do not know how to get connected to them (e.g., how to obtain health insurance, understanding insurance benefits, navigating the healthcare system, language barriers and health literacy). IU Health Tipton Hospital perceives this health need as being addressed under many initiatives in Access to Healthcare Services. IU Health Tipton Hospital will monitor this need to see if there are changes or opportunities in the future to address it further. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - IU HEALTH TIPTON HOSPITAL. IN ADDITION TO FPG, IU HEALTH TIPTON HOSPITAL MAY TAKE INTO CONSIDERATION A PATIENT'S INCOME AND/OR ABILITY TO PAY IN CALCULATION OF A FINANCIAL ASSISTANCE AWARD. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - IU HEALTH TIPTON HOSPITAL. IU Health Tipton Hospital takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. Eligibility for Financial Assistance due to Financial or Personal Hardship In order to be eligible for Financial Assistance due to Financial or Personal Hardship under this Policy, a patient or guarantor must: - Submit a completed Financial Assistance Application with all supporting documentation and be approved in accordance with this Policy; - Be an Indiana Resident as defined in this Policy; and - If Uninsured, consult with a member of IU Health's Individual Solutions department to determine if health care coverage may be obtained from a government insurance or assistance product, the Health Insurance Marketplace, or from any other source of coverage. Financial Assistance due to Financial Hardship is only available for encounters where care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility. 2. Financial Assistance due to Financial Hardship The FPL income threshold under this section is as follows: - If one or more adults and zero dependents are in the household, the FPL Income Threshold is 200%. - If two or more adults and one or more dependents are in the household, the FPL Income Threshold is 250%. - If one adult and one or more dependents are in the household, the FPL Income Threshold is 300%. In some instances, an adult will also qualify as a dependent. When this occurs, IU Health will treat the adult as a dependent for purposes of the FPL calculation. IU Health will utilize the most recent FPL data available and will apply the FPL data to a patient or guarantor's account balance based upon the calendar date a completed Financial Assistance Application was received, not a patient's date of service. An Uninsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Gross Charges if approved. An Underinsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Patient Responsibility if approved. 3. Financial Assistance due to Personal Hardship An Uninsured or Underinsured patient or their guarantor whose household income is above the FPL income threshold may be eligible for Financial Assistance if the patient's outstanding Patient Responsibility exceeds 20% of the patient's or their guarantor's annual household income. - If approved, the patient's balance will be reduced to 20% of the patient or guarantor's annual household income or the Amounts Generally Billed, whichever is less. - IU Health will work with the patient or guarantor to identify a reasonable payment plan on the remainder of the balance. 4. Eligibility Period If approved for financial assistance by IU Health, the patient will be guaranteed financial assistance for treatment related to the underlying condition, for which the patient was originally screened and approved, through the remainder of the calendar year. As a condition of extending the on-going Financial Assistance, the patient must comply with requests from IU Health to verify that the patient continues to meet the conditions for qualification. 5. Appeals and Assistance Granted By the Financial Assistance Committee The Financial Assistance Committee will review and make determinations on all requests for appeals related to Financial Assistance. If a patient or guarantor seeks to appeal a Financial Assistance Determination, a written request must be submitted, along with the supporting documentation. The Financial Assistance Committee will review requests for and may grant additional Financial Assistance, including but not limited to, the following: - Assistance to patients who are seeking treatment that can only be provided in Indiana by IU Health or who would benefit from continued medical services from IU Health for continuity of care; - Care approved by the IU Health Chief Medical Officer (CMO) or the Chief Executive Officer (CEO) or CMO of an IU Health facility or region, including medically necessary non-elective services for which no payment source can be identified; - Care provided when it is known no payment source exists; - International humanitarian aid; and - Other care identified by the Financial Assistance Committee that fulfills the IU Health Mission. All decisions of the Financial Assistance Committee are final. 6. Presumptive Eligibility No Financial Assistance Application is required to receive Financial Assistance under this Presumptive Eligibility section. IU Health will deem patients or their guarantors presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs and care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility: - Medicaid (any state) - Indiana Children's Special Health Care Services - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. IU Health will conduct a quarterly review of all accounts placed with a collection agency partner for at least one hundred and twenty (120) days after the account is eligible for an ECA as set forth in this Policy. If the patient or guarantor's individual scoring criteria demonstrates the patient has a low likelihood and/or propensity to pay or no credit, the patient or guarantor may be deemed presumptively eligible for Financial Assistance. Financial Assistance may additionally be granted in the following circumstances: - If the patient or their guarantor is found to have filed a petition for bankruptcy. - If the patient is deceased and found to have no estate. - If the patient is deceased and was under 21 years of age at the time of death. 7. Exhaustion of Alternate Sources of Assistance Patients must exhaust all other state and federal assistance programs prior to receiving Financial Assistance due to Financial or Personal Hardship under this Policy including, but not limited to, Medicaid. Patients who may be eligible for coverage under an applicable health insurance policy must exhaust all insurance benefits. - This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. - IU Health may request patients show proof that such a claim was properly submitted to the appropriate insurance provider before awarding Financial Assistance. Eligible patients who receive medical care from an IU Health facility as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award. In the event Financial Assistance has already been granted in the above circumstances, IU Health reserves the right to reverse the Financial Assistance Determination in an amount equal to the amount IU Health would be entitled to receive had no Financial Assistance been awarded. 8. Patient Assets There are situations where a patient or their guarantor may have significant income or assets available to pay for healthcare services such as a legal settlement. The Financial Assistance Committee may evaluate the income or assets in determining Financial Hardship. IU Health may require a list of all property owned by the patient or guarantor and adjust a Financial Assistance Determination as a result. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - IU HEALTH TIPTON HOSPITAL. IU Health Tipton Hospital takes several other measures to broadly publicize its FAP within the community. These measures include the following: 1. Post this Policy, a Plain Language Summary of this Policy, and the Financial Assistance Application on its website. 2. Provide patients with a Plain Language Summary of this Policy during registration and/or discharge. 3. Post conspicuous displays in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 4. Include a conspicuous written notice on all patient post-discharge billing statements notifying the patient about this Policy and the telephone number of the Customer Service Department which can assist patients with questions regarding this Policy. 5. Make available Customer Service representatives via telephone during normal business hours. 6. Mail copies of this Policy, a Plain Language Summary of this Policy, and a Financial Assistance Application to patients or their guarantor free of charge upon request. 7. Broadly communicate this Policy as a part of its general outreach efforts. 8. Educate patient-facing team members on this Policy and the process for referring patients to the program. 2 IU HEALTH TIPTON HOSPITAL LAB 1000 S MAIN ST TIPTON IN 46072 LAB IU HEALTH TIPTON HOSPITAL HEMATOLOGY-ONCOLOGY 1000 S MAIN ST SUITE B TIPTON IN 46072 Specialty Care Schedule H, Part I, Line 6a C.B. REPORT PREPARED BY A RELATED ORG. IU HEALTH TIPTON HOSPITAL'S COMMUNITY BENEFIT AND OTHER INVESTMENTS, ENCOMPASSING ITS TOTAL COMMUNITY INVESTMENT, ARE INCLUDED IN THE IU HEALTH COMMUNITY BENEFIT REPORT WHICH IS PREPARED ON BEHALF OF AND INCLUDES IU HEALTH AND ITS RELATED HOSPITAL ENTITIES IN THE STATE OF INDIANA. THE IU HEALTH COMMUNITY BENEFIT REPORT IS MADE AVAILABLE TO THE PUBLIC ON IU HEALTH'S WEBSITE AT: HTTPS://IUHEALTH.ORG/IN-THE-COMMUNITY/COMMUNITY-BENEFIT. THE IU HEALTH COMMUNITY BENEFIT REPORT IS ALSO DISTRIBUTED TO NUMEROUS KEY ORGANIZATIONS THROUGHOUT THE STATE OF INDIANA IN ORDER TO BROADLY SHARE THE IU HEALTH STATEWIDE SYSTEM'S COMMUNITY BENEFIT EFFORTS. IT IS ALSO AVAILABLE BY REQUEST THROUGH THE INDIANA STATE DEPARTMENT OF HEALTH OR IU HEALTH. Schedule H, Part I, Line 7f BAD DEBT EXPENSE Bad debt expense is reported on a cost based on the cost-to-charge ratio derived from Worksheet 2, ratio of patient care-cost-to charges. The amount of bad debt expense included on Form 990, Part IX, Line 25, column (A), but subtracted for purposes of calculating the percentage of total expense on Line 7, column (f) is $1,214,042. Schedule H, Part I, Line 7 TOTAL COMMUNITY BENEFIT EXPENSE SCHEDULE H, PART I, LINE 7, COLUMN (F), PERCENT OF TOTAL EXPENSE, IS BASED ON COLUMN (E) NET COMMUNITY BENEFIT EXPENSE. THE PERCENT OF TOTAL EXPENSE BASED ON COLUMN (C) TOTAL COMMUNITY BENEFIT EXPENSE, WHICH DOES NOT INCLUDE DIRECT OFFSETTING REVENUE, IS 28.31%. Schedule H, Part II PROMOTION OF HEALTH IN COMMUNITIES SERVED IU Health Tipton Hospital supports and/or participates in a variety of community-building activities that address the non-medical, root causes of health problems in the communities it serves. IU Health Tipton Hospital and its related hospital entities across the state of Indiana ("IU Health Statewide System") investments include economic development efforts across the state, workforce development opportunities, collaborate with like-minded organizations through coalitions that address key issues, and advocate for improvements in the health status of vulnerable populations. Some activities meet the definition of community benefit and have been reported as such. Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care IU Health uses several factors other than federal poverty guidelines ("FPG") in determining eligibility for free care under its FAP. These factors include the following: 1. Eligibility for Financial Assistance due to Financial or Personal Hardship In order to be eligible for Financial Assistance due to Financial or Personal Hardship under this Policy, a patient or guarantor must: - Submit a completed Financial Assistance Application with all supporting documentation and be approved in accordance with this Policy; - Be an Indiana Resident as defined in this Policy; and - If Uninsured, consult with a member of IU Health's Individual Solutions department to determine if health care coverage may be obtained from a government insurance or assistance product, the Health Insurance Marketplace, or from any other source of coverage. Financial Assistance due to Financial Hardship is only available for encounters where care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility. 2. Financial Assistance due to Financial Hardship The FPL income threshold under this section is as follows: - If one or more adults and zero dependents are in the household, the FPL Income Threshold is 200%. - If two or more adults and one or more dependents are in the household, the FPL Income Threshold is 250%. - If one adult and one or more dependents are in the household, the FPL Income Threshold is 300%. In some instances, an adult will also qualify as a dependent. When this occurs, IU Health will treat the adult as a dependent for purposes of the FPL calculation. IU Health will utilize the most recent FPL data available and will apply the FPL data to a patient or guarantor's account balance based upon the calendar date a completed Financial Assistance Application was received, not a patient's date of service. An Uninsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Gross Charges if approved. An Underinsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Patient Responsibility if approved. 3. Financial Assistance due to Personal Hardship An Uninsured or Underinsured patient or their guarantor whose household income is above the FPL income threshold may be eligible for Financial Assistance if the patient's outstanding Patient Responsibility exceeds 20% of the patient's or their guarantor's annual household income. - If approved, the patient's balance will be reduced to 20% of the patient or guarantor's annual household income or the Amounts Generally Billed, whichever is less. - IU Health will work with the patient or guarantor to identify a reasonable payment plan on the remainder of the balance. 4. Eligibility Period If approved for financial assistance by IU Health, the patient will be guaranteed financial assistance for treatment related to the underlying condition, for which the patient was originally screened and approved, through the remainder of the calendar year. As a condition of extending the on-going Financial Assistance, the patient must comply with requests from IU Health to verify that the patient continues to meet the conditions for qualification. 5. Appeals and Assistance Granted By the Financial Assistance Committee The Financial Assistance Committee will review and make determinations on all requests for appeals related to Financial Assistance. If a patient or guarantor seeks to appeal a Financial Assistance Determination, a written request must be submitted, along with the supporting documentation. The Financial Assistance Committee will review requests for and may grant additional Financial Assistance, including but not limited to, the following: - Assistance to patients who are seeking treatment that can only be provided in Indiana by IU Health or who would benefit from continued medical services from IU Health for continuity of care; - Care approved by the IU Health Chief Medical Officer (CMO) or the Chief Executive Officer (CEO) or CMO of an IU Health facility or region, including medically necessary non-elective services for which no payment source can be identified; - Care provided when it is known no payment source exists; - International humanitarian aid; and - Other care identified by the Financial Assistance Committee that fulfills the IU Health Mission. All decisions of the Financial Assistance Committee are final. 6. Presumptive Eligibility No Financial Assistance Application is required to receive Financial Assistance under this Presumptive Eligibility section. IU Health will deem patients or their guarantors presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs and care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility: - Medicaid (any state) - Indiana Children's Special Health Care Services - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. IU Health will conduct a quarterly review of all accounts placed with a collection agency partner for at least one hundred and twenty (120) days after the account is eligible for an ECA as set forth in this Policy. If the patient or guarantor's individual scoring criteria demonstrates the patient has a low likelihood and/or propensity to pay or no credit, the patient or guarantor may be deemed presumptively eligible for Financial Assistance. Financial Assistance may additionally be granted in the following circumstances: - If the patient or their guarantor is found to have filed a petition for bankruptcy. - If the patient is deceased and found to have no estate. - If the patient is deceased and was under 21 years of age at the time of death. 7. Exhaustion of Alternate Sources of Assistance Patients must exhaust all other state and federal assistance programs prior to receiving Financial Assistance due to Financial or Personal Hardship under this Policy including, but not limited to, Medicaid. Patients who may be eligible for coverage under an applicable health insurance policy must exhaust all insurance benefits. - This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. - IU Health may request patients show proof that such a claim was properly submitted to the appropriate insurance provider before awarding Financial Assistance. Eligible patients who receive medical care from an IU Health facility as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award. In the event Financial Assistance has already been granted in the above circumstances, IU Health reserves the right to reverse the Financial Assistance Determination in an amount equal to the amount IU Health would be entitled to receive had no Financial Assistance been awarded. 8. Patient Assets There are situations where a patient or their guarantor may have significant income or assets available to pay for healthcare services such as a legal settlement. The Financial Assistance Committee may evaluate the income or assets in determining Financial Hardship. IU Health may require a list of all property owned by the patient or guarantor and adjust a Financial Assistance Determination as a result. Schedule H, Part I, Line 6a Community benefit report prepared by related organization Indiana University Health, Inc. Schedule H, Part I, Line 7g Subsidized Health Services IU HEALTH TIPTON INCLUDES COSTS ASSOCIATED WITH PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES BUT IS NOT ABLE TO SEGREGATE THE COSTS ASSOCIATED WITH PHYSICIAN CLINICS. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 1214042 Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE BAD DEBT EXPENSE REPORTED ON SCHEDULE H, PART III, LINE 2 IS REPORTED AT COST, AS CALCULATED USING THE COST TO CHARGE RATIO METHODOLOGY. Schedule H, Part III, Line 3 Bad Debt Expense Methodology IU Health will deem patients or their guarantors presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs and care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility: 1. Medicaid (any state) 2. Indiana Children's Special Health Care Services 3. Healthy Indiana Plan 4. Patients who are awarded Hospital Presumptive Eligibility (HPE) 5. A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. No Financial Assistance Application is required to receive Financial Assistance under this Presumptive Eligibility section. IU Health will conduct a quarterly review of all accounts placed with a collection agency partner for at least one hundred and twenty (120) days after the account is eligible for an ECA as set forth in this Policy. If the patient or guarantor's individual scoring criteria demonstrates the patient has a low likelihood and/or propensity to pay or no credit, the patient or guarantor may be deemed presumptively eligible for Financial Assistance. Financial Assistance may additionally be granted in the following circumstances: a) If the patient or their guarantor is found to have filed a petition for bankruptcy. b) If the patient is deceased and found to have no estate. c) If the patient is deceased and was under 21 years of age at the time of death. Due to this comprehensive methodology, IU Health does not believe any amount of bad debt is attributable to patients who may be eligible under the financial assistance policy and no portion of bad debt is included as community benefit. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote IU Health Tipton Hospital is a subsidiary in the consolidated audited financial statements of IU Health. IU HEALTH'S CONSOLIDATED FINANCIAL STATEMENTS, FOOTNOTE 5, ADDRESSES BAD DEBT EXPENSE AS FOLLOWS: The Indiana University Health System does not require collateral or other security from its patients, substantially all of whom are residents of the State, for the delivery of health care services. However, consistent with industry practice, the Indiana University Health System routinely obtains assignment of (or is otherwise entitled to receive) patients' benefits payable under their health insurance programs, plans, or policies (e.g., Medicare, Medicaid, managed care payers, and commercial insurance policies). The Indiana University Health System uses a portfolio approach to account for categories of patient contracts as a collective group, rather than recognizing revenue on an individual contract basis. The portfolios consist of major payer classes for inpatient revenue and outpatient revenue. Based on the historical collection trends and other analysis, the Indiana University Health System believes that revenue recognized by utilizing the portfolio approach approximates the revenue that would have been recognized if an individual contract approach were used. In support of its mission, the Indiana University Health System provides care to uninsured and underinsured patients. The Indiana University Health System provides charity care to patients who lack the financial resources to pay for their medical care. Financial assistance is available to qualifying uninsured and underinsured patients receiving care at an Indiana University Health System hospital location. Under its financial assistance policy, the Indiana University Health System provides medically necessary care to uninsured patients. Financial assistance up to the full amount of patient financial responsibility is available for uninsured and underinsured patients receiving care via the emergency department, direct admission from a physician's office, or transfer from another hospital. The federal poverty level (FPL) thresholds are used when determining the level of financial assistance based on household makeup. Households without dependents are eligible for assistance if household income is less than or equal to 200% FPL, two adults and at least one dependent are eligible if household income is less than or equal to 250% FPL, and households with one adult and at least one dependent are eligible if household income is less than or equal to 300% FPL. Individuals with medical bills totaling more than 20% of annual household income, regardless of FPL, qualify for catastrophic assistance and are eligible for a reduction in patient financial responsibility to 20% of annual household income. Since the Indiana University Health System does not pursue collection of these amounts, the discounted amounts are not reported as patient service revenue. The Indiana University Health System uses presumptive eligibility screening procedures for some forms of financial assistance and recognizes net patient service revenue on services provided to self-pay patients at the discounted rate at the time services are rendered. The estimated cost of charity care, using the consolidated cost to charge ratio, was $88,213,000 and $133,584,000 in 2022 and 2021, respectively. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs IU Health Tipton Hospital did not have a Medicare shortfall in 2022. IU Health Tipton Hospital accepts all Medicare patients knowing that there may be shortfalls; therefore it has taken the position that any shortfall should be counted as part of its community benefit. Additionally, it is implied in Internal Revenue Service Revenue Ruling 69-545 that treating Medicare patients is a community benefit. Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with governmental health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. The amount reported on Schedule H, Part III, Line 6 is calculated, in accordance with the Form 990 instructions, using "allowable costs" from the IU Health Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health's participation in Medicare programs. For example, the Medicare Cost Report excludes certain costs such as billed physician services, the costs of Medicare Parts C and D, fee schedule reimbursed services, and durable medical equipment services. Inclusion of all costs associated with IU Health Tipton Hospital's participation in Medicare programs would significantly reduce the Medicare surplus reported on Schedule H, Part III, Line 7. Schedule H, Part V, Section B, Line 16a FAP website - IU HEALTH TIPTON HOSPITAL: Line 16a URL: https://iuhealth.org/pay-a-bill/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - IU HEALTH TIPTON HOSPITAL: Line 16b URL: https://iuhealth.org/pay-a-bill/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - IU HEALTH TIPTON HOSPITAL: Line 16c URL: https://iuhealth.org/pay-a-bill/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment Though IU Health Tipton Hospital believes its CHNA process is comprehensive, the CHNA is done on a triennial basis. Between CHNA cycles, IU Health Tipton Hospital gathers data and information to monitor the most current needs of the community. Additional sources of data and information include: * IU Health data analytics and information service teams; * Secondary data sources from Federal, state, and local entities with a focus on health behaviors, health outcomes, and social determinants of health; * Obtaining community organization and governmental agency perspectives; priority population perspectives; and other healthcare and hospital perspectives; * Reports that share findings and recommendations on certain populations within the community and/or health behaviors, health outcomes, or social determinants of health; * Evidence informed sources; and * Team member participation in partnering efforts (e.g., coalitions, advisory committees, task forces, etc.). The regular review of these sources of data and information rarely impact what the significant needs are between CHNA cycles. However, it does help influence the types or level of interventions to address the significant needs; prioritize resources to those groups or neighborhoods experiencing health disparities in the community; identify funding opportunities to support interventions; and strengthen or mobilize partnerships to improve health. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance IU Health Tipton Hospital is committed to serving the healthcare needs of all of its patients regardless of their ability to pay for such services. To assist in meeting those needs, IU Health Tipton Hospital has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health Tipton Hospital is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health Tipton Hospital will make a good faith effort to locate and obtain health insurance coverage for patients prior to considering patients for coverage under the FAP. IU Health Tipton Hospital takes several measures to inform its patients of the FAP and FAP-eligibility. These measures include the following: 1. Post this Policy, a Plain Language Summary of this Policy, and the Financial Assistance Application on its website. 2. Provide patients with a Plain Language Summary of this Policy during registration and/or discharge. 3. Post conspicuous displays in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 4. Include a conspicuous written notice on all patient post-discharge billing statements notifying the patient about this Policy and the telephone number of the Customer Service Department which can assist patients with questions regarding this Policy. 5. Make available Customer Service representatives via telephone during normal business hours. 6. Mail copies of this Policy, a Plain Language Summary of this Policy, and a Financial Assistance Application to patients or their guarantor free of charge upon request. 7. Broadly communicate this Policy as a part of its general outreach efforts. 8. Educate patient-facing team members on this Policy and the process for referring patients to the program. Schedule H, Part VI, Line 4 Community information IU Health Tipton Hospital is located in Tipton County, Indiana, a county located in central Indiana. Tipton County includes ZIP codes within the towns of Tipton, Elwood, Windfall City, Kempton, and Sharpsville. Based on the most recent Census Bureau (2022) statistics, Tipton County's population is 15,361, with approximately 49.8% being female and 50.2% male. The county's population estimates by race are 96.7% white, 3.1% Hispanic, 0.8% Black, 0.9% Asian, 0.3% American Indian or Alaska Native, and 1.3% persons reporting two or more races. Tipton County has relatively Moderate levels of educational attainment. Among residents ages 25 and up, 90.6% completed their education with a high school diploma or equivalent. 25.9% had a bachelor's degree or higher. About 9.2% ended their formal education before finishing high school. Schedule H, Part VI, Line 5 Promotion of community health IU Health Tipton Hospital is a subsidiary of Indiana University Health, Inc., a tax-exempt healthcare organization, whose Board of Directors is composed of members of which substantially all are independent community members. IU Health and its related hospital entities across the state of Indiana, including IU Health Tipton Hospital, extend medical privileges to all physicians who meet the credentialing qualifications necessary for appointments to its medical staff. IU Health does not deny appointments based on gender, race, creed or national origin. IU Health, in conjunction with the IU School of Medicine, trains the next generation of physicians in an exceptional environment, blending breakthrough research and treatments with the highest quality of patient care. During 2022, IU Health Tipton Hospital's promotion of community health included the following highlights: IU Health Tipton Hospital continued its support of the transportation program operated by the local senior center through grant funding. The transportation program provides necessary rides to healthcare appointments, pharmacy, grocery store, banking, and other destinations for basic living needs. The hospital also helped support through grant funding a trip to Beef & Boards for those members interested in attending. The seniors attending received the tickets for free as well as transportation to and from the event. They were all very gracious of the opportunity to safely be together and attend such a nice event during the holiday season. Schedule H, Part VI, Line 6 Affiliated health care system Indiana University Health Tipton Hospital is part of Indiana University Health ("IU Health "the healthcare system"), which is Indiana's most comprehensive healthcare system. A unique partnership with the Indiana University School of Medicine ("IU School of Medicine"), one of the nation's leading medical schools, gives patients access to innovative treatments and therapies. The healthcare system is comprised of hospitals, physicians and allied services dedicated to providing preeminent patient care and community health improvement throughout Indiana. IU Health's affiliate hospitals are divided into five regions that serve communities in Northwest, Northeast, Central and Southern Indiana. The 16 hospitals in the healthcare system include IU Health Inc. (i.e., the IU Health Academic Health Center consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health and IU Health Saxony Hospital); IU Health Arnett; IU Health Ball; IU Health Bedford Hospital; IU Health Blackford Hospital; IU Health Bloomington Hospital; IU Health Frankfort; IU Health Jay; IU Health North Hospital; IU Health Paoli Hospital; IU Health Tipton Hospital; IU Health West Hospital; and IU Health White Memorial Hospital. Each affiliate hospital in the healthcare system, along with community stakeholders, conducts and adopts its own community health needs assessment (CHNA) and implementation strategy. IU Health considers the sum of these CHNAs and the implementation strategies part of a system wide vision of making Indiana one of the healthiest states in the nation. The healthcare system and its affiliate hospitals are keenly aware of the positive impact it can have on improving the health of communities throughout the state of Indiana by investing in local, community-based activities. The healthcare system includes an Academic Health Center (i.e., IU Health Inc.), a regional academic health center (i.e., IU Health Bloomington Hospital) and several affiliate hospitals that work in partnership with the IU School of Medicine to train physicians, blending breakthrough research and treatments with the highest quality of patient care throughout IU Health. Each year, more than 1,000 residents and fellows receive training in affiliate hospitals. Research conducted by IU School of Medicine faculty gives IU Health physicians and patients access to the most leading-edge and comprehensive treatment options. To further promote the health of the communities served by IU Health, the system-level Community Health Division team partners with state and local community-based organizations, community coalitions and governmental agencies to focus on innovative models of care; community alliances and partnerships; anchor institution and advocacy strategies; and social determinants of health. All affiliate hospitals in the healthcare system identify and address significant needs unique to the communities they serve. These needs are identified through the CHNA process. Some of these needs are common in communities served by multiple affiliate hospitals in the healthcare system and align with system priority areas, warranting a system level strategy. The Community Health Division, along with additional internal stakeholders such as the Office of Health Equity Research and Evaluation, plans and provides technical assistance for system-level strategies that address these common needs including health equity, tobacco, behavioral health access, infant and maternal health, hypertension, and social determinants of health. Each affiliate hospital works collaboratively with the Community Health Division to align and activate local resources to support these strategies. This benefits the community each affiliate hospital serves and works towards a statewide impact (system-level) on health outcomes. As part of the Community Health Division, Community Outreach and Engagement Program's IU Health Serves, a system-level team member volunteer program, seeks to positively impact the health of communities IU Health affiliate hospitals serve and foster a culture of engagement and social responsibility. Each affiliate hospital coordinates the different initiatives of the program, including Days of Service. This is the largest volunteer event of the year, consisting of projects designed to engage each affiliate hospitals' team members in activities that address local, significant needs. The Community Impact and Investment (CII) Fund is a $200 million dollar board designated fund that is managed by the IU Health Foundation to financially support high impact community investing. The focus of these efforts will address social determinants of health and health disparities that impact marginalized and minoritized populations in the communities IU Health serves. Through the grants provided by this CII Fund, IU Health can strategically and intentionally address the social, economic, and environmental factors that impact the health of affiliate hospitals' surrounding communities. Each affiliate hospital and its team members are eligible to pursue this grant opportunity with a community organization or agency. Schedule H, Part VI, Line 7 State filing of community benefit report IN true true false false false false false true false KENNETH DOUG PUCKETT REGIONAL PRESIDENT (ISR) 0 578318 0 252437 0 101674 0 121102 0 55037 0 1108568 0 54003 MICHAEL L HARLOWE PRESIDENT (PART YEAR) 244340 0 26759 0 51520 0 227865 0 26558 0 577042 0 0 0 CARA L BREIDSTER REGIONAL CFO (ISR) 0 277473 0 36663 0 23994 0 12119 0 54533 0 404782 0 0 ARTHUR VASQUEZ FORMER KEY EMPLOYEE 0 500988 0 89248 0 1869 0 88651 0 34029 0 714786 0 0 LISA A SPARKS REGIONAL CNO (ISR) (Part Year) 0 253938 0 24884 0 2322 0 11604 0 46858 0 339605 0 0 TAMARAH D BROWNLEE REGIONAL VP-HR (ISR) 0 191301 0 19135 0 4629 0 9211 0 46658 0 270934 0 0 CARRIE WING VP-CNO (ISR) (Part Year) 0 121000 0 30000 0 50000 0 4062 0 7301 0 212362 0 0 ATHANASIA SOULA BANICH VP, Regional COO (ISR) 0 268165 0 25831 0 1556 0 10024 0 40053 0 345629 0 0 MELISSA R HICKS Former Highest Compensated Employee 0 235427 0 22482 0 464 0 10484 0 19146 0 288003 0 0 ANGELA K MORGAN MANAGER - PHARMACY DEPT. 149374 0 4770 0 5373 0 6831 0 49456 0 215805 0 0 0 MELISSA J BAXTER-STANDRIDGE Clinical Nurse-Shift Coordinator 154108 0 35287 0 4953 0 7805 0 11576 0 213728 0 0 0 PAMELA RILEY CLINICAL NURSE 117168 0 68785 0 141 0 6077 0 27209 0 219380 0 0 0 SANDRA MOSBAUGH CLINICAL NURSE 139992 5129 53435 1961 128 5 7898 290 28178 1034 229631 8419 0 0 CHRISTINE MARVIN CLINICAL NURSE 114205 0 31636 0 12605 0 6550 0 31549 0 196545 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation IU HEALTH TIPTON HOSPITAL'S REGIONAL PRESIDENT IS EMPLOYED BY IU HEALTH. IU HEALTH, IU HEALTH NORTH, IU HEALTH TIPTON, AND OTHER RELATED ENTITIES HAVE A PROCESS IN PLACE TO DETERMINE THE COMPENSATION FOR THE OTHER OFFICERS AND KEY EMPLOYEES. IU HEALTH HUMAN RESOURCES USES MARKET DATA FROM MULTIPLE COMPENSATION EXPERTS/VENDORS WHO UTILIZE A VARIETY OF METHODS AND PROCEDURES TO OBTAIN COMPENSATION RANGES FOR COMPARABLE OFFICER AND EMPLOYEE POSITIONS. THIS MARKET DATA AND MULTIPLE OTHER FACTORS (INCLUDING MARKET PAY BENCHMARKS, INTERNAL EQUITY, CANDIDATE/EMPLOYEE QUALIFICATIONS & PERFORMANCE, AND BUSINESS NEEDS) ARE USED TO RECOMMEND COMPENSATION RANGES FOR ITS OFFICERS AND OTHER EMPLOYEES, WHICH ARE THEN USED AS A GUIDE FOR SETTING REASONABLE COMPENSATION BY MANAGEMENT. PLEASE SEE SCHEDULE O FOR ADDITIONAL DETAILS. Schedule J, Part I, Line 4a Severance or change-of-control payment MICHAEL HARLOWE ENTERED INTO A SEVERANCE AGREEMENT WITH IU HEALTH DURING 2022. SEVERANCE OF $49,466 THAT WAS RECEIVED DURING 2022 IS INCLUDED IN COLUMN B(III), OTHER REPORTABLE COMPENSATION. DEFERRED SEVERANCE OF $ 227,865 IS INCLUDED IN COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan KENNETH D. PUCKETT AND ARTHUR VASQUEZ PARTICIPATED IN AN IU HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, PROVISIONS OF WHICH ARE DESIGNED TO RETAIN THESE CRITICAL EMPLOYEES. THE PLAN PROVIDES FOR AN ADDITIONAL RETIREMENT BENEFIT FOR SERVICES THROUGH NORMAL RETIREMENT OR OTHER KEY DATES. IF THIS EXECUTIVE LEAVES PRIOR TO RETIREMENT OR OTHER KEY DATES, THAT BENEFIT MAY BE FORFITED OR REDUCED. THE EXECUTIVES LISTED ABOVE HAVE AN AMOUNT INCLUDED IN COLUMN C, DEFERRED COMPENSATION, REPRESENTING THE CURRENT YEAR UNVESTED CONTRIBUTIONS MADE UNDER THE SUPPLEMENTAL RETIREMENT PLAN. THESE AMOUNTS WERE NOT PAID TO THESE EXECUTIVES DURING THE YEAR. THE FOLLOWING EXECUTIVE HAS AN AMOUNT INCLUDED IN COLUMN B (III), OTHER REPORTABLE COMPENSATION, REPRESENTING THE CURRENT YEAR VESTED AMOUNTS RECEIVED UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: - KENNETH D. PUCKETT ($60,038) Schedule J, Part I, Line 7 Non-fixed payments Amounts disclosed in Column B (ii) include a long-term and short-term incentive for certain executives and short-term incentive for other employees. Although these plans are based on a fixed formula that has been approved by the Board of Directors based upon certain qualitative and quantitative factors and goals, all discretionary incentive plans must be approved by the Board of Directors prior to any incentive payout. Form 990, Part III, Line 4d Description of other program services (Expenses $ 27,727 including grants of $ 0)(Revenue $ 31,076) IU HEALTH TIPTON HOSPITAL, INC. RECEIVES RENTAL REVENUE FROM A RELATED EXEMPT ORGANIZATION, IU HEALTH CARE ASSOCIATES, INC. FOR VARIOUS OFFICES AND CLINICS. Form 990, Part VI, Line 13 PART VI, LINES 12, 13, AND 14 - POLICIES IU HEALTH TIPTON HOSPITAL IS PART OF THE IU HEALTH SYSTEM. AS THE SOLE MEMBER AND CONTROLLING PARENT OF IU HEALTH TIPTON HOSPITAL, IU HEALTH AND ITS BOARD OF DIRECTORS HAVE MANDATED THAT CERTAIN POLICIES BE FOLLOWED TO ENSURE GREATER STANDARDIZATION THROUGHOUT THE SYSTEM. THUS, IU HEALTH TIPTON HOSPITAL'S BOARD OF DIRECTORS WAS NOT REQUIRED TO SEPARATELY ADOPT A CONFLICT OF INTEREST, WHISTLEBLOWER, DOCUMENT RETENTION AND DESTRUCTION AND JOINT VENTURE POLICIES BECAUSE IU HEALTH'S BOARD OF DIRECTORS HAD ALREADY ADOPTED AND REQUIRED THESE POLICIES TO BE FOLLOWED BY ITS SUBSIDIARIES. Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE MEMBER OF IU HEALTH TIPTON HOSPITAL IS IU HEALTH, A 501(C)(3) TAX-EXEMPT ORGANIZATION. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE BOARD OF DIRECTORS OF THE IU HEALTH TIPTON HOSPITAL SHALL RANGE FROM THREE (3) TO SEVEN (7), WITH IU HEALTH HAVING THE RIGHT TO APPOINT ONE (1) MORE THAN ONE-HALF (1/2) OF THE DIRECTORS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE FOLLOWING ACTIONS REQUIRE IU HEALTH'S PRIOR APPROVAL: -THE APPOINTMENT OR REMOVAL OF ANY DIRECTOR; -THE AMENDMENT OF THE ARTICLES OF INCORPORATION; -THE AMENDMENT OF THE BYLAWS; -THE APPROVAL OF IU HEALTH TIPTON HOSPITAL'S ANNUAL CAPITAL AND OPERATING BUDGETS; -THE INCURRENCE OF EXPENSES FOR ANY UNBUDGETED OPERATING OR CAPITAL BUDGET ITEMS OR DEVIATIONS, INCLUDING ANY ISSUANCE OR GUARANTEE OF DEBT NOT INCLUDED IN IU HEALTH TIPTON HOSPITAL'S APPROVED BUDGET FOR THE CURRENT FISCAL YEAR, BUT ONLY TO THE EXTENT THAT SUCH EXPENSES EXCEED BUDGETED AMOUNTS BY (A) $100,000 PER FISCAL YEAR PER BUDGET LINE ITEM OR (B) $500,000 PER FISCAL YEAR IN THE AGGREGATE; -THE ADOPTION OF ANY STRATEGIC PLAN FOR IU HEALTH TIPTON HOSPITAL, INCLUDING ANY AMENDMENTS THERETO; -THE ENCUMBRANCE, SALE, LEASE, TRANSFER OR OTHER ALIENATION OF MORE THAN 5% OF THE NET BOOK VALUE OF IU HEALTH TIPTON HOSPITAL'S ASSETS, MEASURED ON A CONSOLIDATED BASIS DURING ANY FISCAL YEAR; -THE ADDITION OF ANY MEMBERS OF IU HEALTH TIPTON HOSPITAL; -THE CREATION OF ANY NEW AFFILIATES OF IU HEALTH TIPTON HOSPITAL; -THE APPROVAL OF ANY MERGER, CONSOLIDATION, JOINT VENTURE OR AFFILIATION INVOLVING IU HEALTH TIPTON HOSPITAL OR ANY OF ITS AFFILIATES; AND -THE DISSOLUTION OF IU HEALTH TIPTON HOSPITAL OR ANY OF ITS AFFILIATES. Form 990, Part VI, Line 11b Review of form 990 by governing body The Indianapolis Suburban Chief Financial Officer and Finance Committee reviewed and approved the Form 990. Following their review and approval, a complete copy of the Form 990 was made available to each board member prior to its filing. Each member was also informed of the availability of IU Health's Tax Department to answer any questions. Form 990, Part VI, Line 12c Conflict of interest policy IU Health Tipton Hospital follows IU Health's Conflict of Interest Policy. IU Health's Conflict of Interest Policy includes the following provisions: All IU Health employees, associates, colleagues and contracted personnel, including employed physicians and paid medical directors ("IU Health Representatives") are covered by and subject to its Conflict of Interest Policy. IU Health regularly and consistently monitors and enforces compliance with the policy through the following procedures: (a) On an annual basis, each IU Health Representative at the level of Manager or above, together with every other person designated by the Corporate Compliance Department ("Department"), must complete, sign and submit a Conflict of Interest Questionnaire ("Questionnaire") to the Department. Governing board members, committee members, corporate officers, medical staff and researchers must comply with the administrative requirements noted in the respective policies and procedures relative to those areas. (b) An IU Health Representative must supplement a Questionnaire in writing, if after completion of the original Questionnaire, a situation arises, or may reasonably be expected to arise, that would change any answer or information on the original Questionnaire if the situation had existed or been anticipated at the time of completion of the original Questionnaire. (c) If a fully and properly completed Questionnaire reveals facts or other information that might reasonably indicate a Conflict of Interest or violation of the policy, the IU Health Representative completing the questionnaire must secure approval by his/her supervisor, evidenced in writing. (d) The Department will review each Questionnaire and determine whether a Conflict of Interest exists and, if so, whether and how it should or may be eliminated, avoided or managed in order to comply with the spirit of the policy and with the best interests of IU Health and its patients. In making the determination, the Corporate Compliance Department may consult with the IU Health Representative's supervisor and other appropriate individuals and groups. (e) The scope of the policy is not limited to those who are required to complete Questionnaires. If an IU Health Representative is involved in a situation or relationship that would constitute a violation of the policy in the absence of disclosure and approval as described above, then the IU Health Representative must disclose the matter to his/her supervisor, secure his/her supervisor's approval in writing, and disclose the matter to the Department. Otherwise, the IU Health Representative is in violation of the policy and subject to corrective action, up to and including termination. (f) The Chief Compliance Officer, in consultation with onsite Compliance personnel, may from time to time appoint standing or ad hoc committees to assist in resolving issues that arise under provisions of the policy. Form 990, Part VI, Line 19 Required documents available to the public IU HEALTH TIPTON HOSPITAL'S ARTICLES OF INCORPORATION ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH THE INDIANA SECRETARY OF STATE'S WEBSITE. IU HEALTH TIPTON HOSPITAL'S CONFLICT OF INTEREST PROCEDURES DESCRIBED ON FORM 990, SCHEDULE O. IU HEALTH TIPTON HOSPITAL IS A SUBSIDIARY IN IU HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS. IU HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH ITS BOND FILINGS AND AS AN ATTACHMENT TO IU HEALTH'S FORM 990 AS WELL AS IU HEALTH TIPTON HOSPITAL'S FORM 990. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue All Other Revenue - Total Revenue: 131496, Related or Exempt Function Revenue: , Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 131496; Form 990, Part IX, Line 11g Other Fees Professional fees - Total Expense: 127791, Program Service Expense: 119675, Management and General Expenses: 8116, Fundraising Expenses: ; Fees - other services - Total Expense: 62039, Program Service Expense: 58099, Management and General Expenses: 3940, Fundraising Expenses: ; Consulting - Total Expense: 24390, Program Service Expense: 22841, Management and General Expenses: 1549, Fundraising Expenses: ; Intercompany fees - Total Expense: 10002142, Program Service Expense: 9366913, Management and General Expenses: 635229, Fundraising Expenses: ; Physician fees - Total Expense: 303402, Program Service Expense: 284133, Management and General Expenses: 19269, Fundraising Expenses: ; Contract service - Total Expense: 1011227, Program Service Expense: 947005, Management and General Expenses: 64222, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN INTEREST IN RESTRICTED NET ASSETS OF FOUNDATIONS - 222041; Form 990, Part VI, Line 15 Process for determining compensation IU HEALTH TIPTON HOSPITAL'S REGIONAL PRESIDENT IS EMPLOYED BY IU HEALTH, INC. IU HEALTH'S PROCESS FOR DETERMINING COMPENSATION IS AS FOLLOWS: (1) THE BOARD OF DIRECTORS ("BOARD") HAS ESTABLISHED A TALENT MANAGEMENT AND EXECUTIVE COMPENSATION COMMITTEE ("TMECC"), THE PURPOSE OF WHICH INCLUDES REVIEWING AND MAKING RECOMMENDATIONS REGARDING EXECUTIVE PAY AND BENEFITS (COLLECTIVELY REFERRED TO AS "COMPENSATION") ON AN ANNUAL BASIS IN APRIL. THE TMECC IS MADE UP OF MEMBERS OF THE BOARD THAT ARE NEITHER PHYSICIANS NOR EMPLOYEES AND DO NOT OTHERWISE HAVE A CONFLICT OF INTEREST REGARDING ANY OF IU HEALTH'S COMPENSATION ARRANGEMENTS. THE TMECC REVIEWS AN EXECUTIVE'S ENTIRE COMPENSATION PACKAGE INCLUDING BASE SALARY, SHORT TERM AND LONG-TERM INCENTIVES, HEALTH AND WELFARE BENEFITS, QUALIFIED AND NONQUALIFIED RETIREMENT PLANS, AS WELL AS ANY ADDITIONAL FRINGE BENEFITS. AS DEEMED APPROPRIATE, THE COMMITTEE ON FINANCE, WHICH IS ALSO MADE UP OF MEMBERS OF THE BOARD, MAY ALSO REVIEW EXECUTIVE COMPENSATION AND BENEFITS. (2) THE TMECC ENGAGES AN INDEPENDENT COMPENSATION CONSULTING FIRM ON AN ANNUAL BASIS TO CONDUCT A COMPENSATION ANALYSIS FOR ITS EXECUTIVE GROUP, WHICH CONSISTS OF EMPLOYEES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. THE CURRENT COMPENSATION ADVISOR IS SULLIVANCOTTER. SULLIVANCOTTER PERFORMS ITS ANALYSIS IN THE FORM OF A COMPENSATION SURVEY ("SURVEY") THAT INCLUDES RELEVANT COMPARABILITY DATA FOR COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS (BOTH GOVERNMENTAL AND TAX EXEMPT) FOR FUNCTIONALLY COMPARABLE POSITIONS AS WELL AS THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA. SULLIVANCOTTER THEN PREPARES A SURVEY REPORT AND PROVIDES RECOMMENDATIONS TO THE TMECC, IF DEEMED APPROPRIATE, ON CHANGES IN EXECUTIVE COMPENSATION. A SEPARATE ANALYSIS USING THE SAME METHODOLOGY IS DONE FOR THE PRESIDENT AND CHIEF EXECUTIVE OFFICER. (3) THE TMECC THEN REVIEWS SULLIVANCOTTER'S REPORT AND RECOMMENDATIONS AND, IF APPROPRIATE, VOTES ON WHETHER TO RECOMMEND ANY CHANGES IN EXECUTIVE COMPENSATION TO THE BOARD. THE TMECC WILL ONLY RECOMMEND CHANGES TO THE BOARD IF THEY ARE CONSISTENT WITH THE BOARD'S PHILOSOPHY ON COMPENSATION MATTERS AND ARE DEEMED REASONABLE BASED UPON THE INDEPENDENT ANALYSIS PROVIDED BY SULLIVANCOTTER. THE TMECC'S REVIEW, DISCUSSION AND VOTE ARE DOCUMENTED IN THE MINUTES FOR THE MEETING. THERE ARE NO EXECUTIVES PRESENT DURING THE FINAL DISCUSSION AND APPROVAL. (4) THE BOARD THEN REVIEWS THE REPORT PREPARED BY SULLIVANCOTTER AS WELL AS THE RECOMMENDATIONS OF THE TMECC AS TO ANY CHANGES IN EXECUTIVE COMPENSATION. AS DEEMED APPROPRIATE, THE COMMITTEE ON FINANCE MAY ALSO PROVIDE ITS REVIEW OF THE TMECC'S RECOMMENDATIONS ON ANY CHANGES IN EXECUTIVE COMPENSATION. THIS REVIEW AND DISCUSSION ARE DOCUMENTED IN THE MINUTES. (5) THE BOARD THEN VOTES ON WHETHER TO ACCEPT THE TMECC'S RECOMMENDATIONS ON ANY CHANGES IN EXECUTIVE COMPENSATION. CHANGES IN EXECUTIVE COMPENSATION ARE MADE IF APPROVED BY THE TMECC AND BOARD ON AN ANNUAL BASIS, OR AS NECESSARY THROUGHOUT THE YEAR. THE DISCUSSION AND APPROVAL ARE DOCUMENTED IN THE MINUTES OF THE MEETING. THERE ARE NO EXECUTIVES PRESENT DURING THE FINAL DISCUSSION AND APPROVAL. IU HEALTH'S GENERAL COUNSEL ALSO PREPARES A FORMAL WRITTEN OPINION REVIEWING THE EXECUTIVE COMPENSATION APPROVAL PROCESS, COMPARING IT TO THE INTERMEDIATE SANCTIONS TEST OF IRC SECTION 4958. IF WARRANTED, IU HEALTH'S GENERAL COUNSEL MAY ALSO PROVIDE COMMENTS REGARDING THE EXECUTIVE COMPENSATION APPROVAL PROCESS AS IT RELATES TO MEETING THE REQUIREMENTS FOR A REBUTTABLE PRESUMPTION OF REASONABLENESS AS PROVIDED IN THE INTERMEDIATE SANCTIONS TEST. (6) AFTER THE END OF EACH YEAR, THE TMECC AND BOARD ALSO REVIEW THE ACHIEVEMENTS OF THE EXECUTIVE GROUP AS IT RELATES TO THE LONG-TERM AND SHORT-TERM SHARED AND INDIVIDUAL GOALS DEVELOPED BY THE EXECUTIVES AND THE BOARD. THESE ACHIEVEMENTS MAY ALSO BE REVIEWED WITH THE COMMITTEE ON FINANCE. THE BOARD, AT ITS DISCRETION, MAY APPROVE BONUS PAYMENTS BASED UPON THE ACHIEVEMENT OF THE GOALS. THE DISCUSSION AND VOTE OF THE TMECC AND BOARD IS DOCUMENTED IN THE MINUTES FOR EACH SUCH MEETING. THE BONUSES ARE NOT PAID UNTIL APPROVAL IS MADE BY THE BOARD. (7) THE TMECC AND AUDIT COMMITTEE ALSO REVIEW FORM 990 DISCLOSURES RELATED TO EXECUTIVE COMPENSATION AS WELL AS THE ORGANIZATION'S PRACTICES AND APPROVAL PROCESSES PRIOR TO THE FILING OF THE FORM 990 RETURN WITH THE INTERNAL REVENUE SERVICE. IU HEALTH TIPTON HOSPITAL'S PRESIDENT WAS EMPLOYED BY IU HEALTH TIPTON HOSPITAL DURING 2022. IU HEALTH TIPTON HOSPITAL AND OTHER RELATED ENTITIES HAVE A PROCESS IN PLACE TO DETERMINE THE COMPENSATION FOR OFFICERS AND KEY EMPLOYEES. IU HEALTH HUMAN RESOURCES USES MARKET DATA FROM MULTIPLE COMPENSATION EXPERTS/VENDORS WHO UTILIZE A VARIETY OF METHODS AND PROCEDURES TO OBTAIN COMPENSATION RANGES FOR COMPARABLE OFFICER AND EMPLOYEE POSITIONS. THIS MARKET DATA AND MULTIPLE OTHER FACTORS (INCLUDING MARKET PAY BENCHMARKS, INTERNAL EQUITY, CANDIDATE/EMPLOYEE QUALIFICATIONS & PERFORMANCE, AND BUSINESS NEEDS) ARE USED TO RECOMMEND COMPENSATION RANGES FOR ITS OFFICERS AND OTHER EMPLOYEES, WHICH ARE THEN USED AS A GUIDE FOR SETTING REASONABLE COMPENSATION BY MANAGEMENT. 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