2025-11-13T14:18:40+00:00 2024-12-31 990 2024-01-01 815174295 Indiana University Health Frankfort Inc INDI 3179634842 950 N MERIDIAN STREET 1200 INDIANAPOLIS IN 46204 Michael L Craig VP & CFO 8123539171 2025-11-13 2024 2025-03-06 01:10:19Z ARTHUR VASQUEZ 950 N MERIDIAN STREET 1200 INDIANAPOLIS IN 46204 31898027 false X SEE SCHEDULE O X 2017 IN Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. 14 8 191 64 0 1192 227 28225056 31895238 0 4615 2562 28230863 31898027 4500 13500 0 9684608 11329124 0 0 22675116 21460470 32364224 32803094 -4133361 -905067 34427681 36090734 43887465 46455586 -9459784 -10364852 Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. false false 31409507 13500 31895238 Indiana University Health Frankfort, Inc. (IU Health Frankfort Hospital), located in Frankfort, Indiana, opened a new, replacement hospital in 2020. The new patient-experience-centered hospital is a single-story facility that is approximately 48,000 square -feet. IU Health Frankfort Hospital offers a comprehensive range of healthcare services that includes 24-hour emergency care, laboratory and imaging services, surgical suites, physical and occupational therapy, as well as prenatal, cardiovascular, and pulmonary services. 31409507 true false false true false false false false false false true false false false true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false false false true true true false false true 0 0 191 true false false false false false false false false false false false false X 14 8 false false false false true true true true true false false false true true true true true true false false false false IN X CRAIG J JONES 3179634842 950 N MERIDIAN STREET SUITE 800 INDIANAPOLIS IN 46204 GARY D HENRIOTT DIRECTOR/CHAIR 2.0 5.0 X X 0 9000 0 PHILIP LIST Director (Part Year) / Legal Counsel Secretary (Part Year) 10.0 45.0 X X 0 273073 57009 AMANDA WHITLOCK DIRECTOR 2.0 4.0 X 0 6000 0 BEN HARPENAU DIRECTOR 2.0 4.0 X 0 6000 0 ERIKA UGIANSKIS MD DIRECTOR 2.0 53.0 X 0 922291 78678 JESSE MOORE DIRECTOR 2.0 4.0 X 0 5000 0 JOHNNY PARK DIRECTOR 2.0 4.0 X 0 5000 0 MARK BUONO MD Director 2.0 53.0 X 0 826411 68190 MICHELE S SAYSANA MD DIRECTOR (Part Year) 2.0 53.0 X 0 629341 29763 RUBAN NIRMALAN MD DIRECTOR 2.0 53.0 X 0 996753 68129 SHAN SHERIDAN DIRECTOR 2.0 4.0 X 0 6000 0 UMESH PATEL DIRECTOR 2.0 4.0 X 0 5000 0 WILLIAM Y LI MD DIRECTOR 2.0 53.0 X 0 197724 30637 YINGKEI HUI MD Director (Part Year) 2.0 4.0 X 0 38657 2974 ARTHUR VASQUEZ PRESIDENT (WCR) 10.0 45.0 X 0 848653 170264 MICHAEL L CRAIG CFO (Part Year) 5.0 50.0 X 0 375821 65857 TODD A WILLIAMS CFO (Part Year)/TREASURER (WCR) 10.0 45.0 X 0 440215 66454 WHITNEY A AIKEN Legal Counsel Secretary (Part Year) 10.0 45.0 X 0 182473 32904 KISHAN PATEL MD VP-Chief Physician Executive (WCR) 10.0 45.0 X 0 473047 66999 KOREEN C KYHNELL VP - HUMAN RESOURCES (WCR) 10.0 45.0 X 0 259251 70000 ROXANNE WICKLUND CNO (WCR) 10.0 45.0 X 0 357547 65710 AMANDA JAKES PHARMACIST 50.0 0 X 142149 0 36968 BRETT R BROVIAK Manager - Respiratory Care Services 50.0 0 X 130186 0 36735 KELLI R GREENO Supervisor - House 50.0 0 X 184436 0 27322 LESLIE M SMITH Director - Clinical Operations 50.0 0 X 133430 0 10247 RACHEL L GOEDE Supervisor - House 50.0 0 X 124247 0 38566 CARA L BREIDSTER FORMER OFFICER 0.0 55.0 X 0 351618 66113 CHRISTOPHER A MANSFIELD MD FORMER KEY EMPLOYEE 10.0 45.0 X 0 655505 66999 DEREK E EMPIE FORMER OFFICER 0.0 55.0 X 0 430208 77430 JAMES H PARSONS FORMER HIGHEST COMPENSATED EMPLOYEE 10.0 35.0 X 0 184617 53520 KRISTIN POST Former Officer 10.0 40.0 X 0 206013 40021 LAWRENCE STAUFFER FORMER Highest Compensated Employee 0.0 50.0 X 0 212769 50390 MARY E MINIER Former Highest Compensated Employee 20.0 35.0 X 0 204528 43382 RENEA SMITH Former Highest Compensated Employee 20.0 30.0 X 0 208926 13555 714448 9317441 1434816 true true false 227 227 NET PATIENT SERVICE REVENUE 622110 31895238 31895238 0 0 0 0 31895238 750 750 0 750 750 0 0 Other Operating Revenue 900099 1812 1812 0 0 0 0 1812 31898027 31895238 0 2562 X 13500 13500 9272340 8959684 312656 305291 294997 10294 1140214 1101767 38447 611279 590667 20612 1601 1601 10880852 10152839 728013 0 237661 221707 15954 55771 27886 27885 974153 974153 18341 17110 1231 1696187 1696187 1442076 1374137 67939 167413 167413 DRUGS AND MEDICAL SUPPLIES 3901509 3901509 HEALTH CLAIMS PAID TO PROVIDERS 1770641 1770641 BAD DEBT 278791 278791 ALL OTHER OPERATING EXPENSES 25431 24212 1219 10043 9720 323 0 32803094 31409507 1393587 0 5383650 6347896 0 0 0 0 293818 610112 43749 86048 40775052 11728374 28706464 29046678 0 0 0 0 34427681 36090734 1195689 1128807 0 0 42691776 45326779 43887465 46455586 X -9459784 -10364852 -9459784 -10364852 34427681 36090734 X -905067 -1 X false true true false X false false false false false false false false true 1601 1601 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY IU Health Frankfort, Inc. paid institutional membership dues to the American Hospital Association ("AHA"), Indiana Hospital Association ("IHA"), and 340B Health during 2024 in the amount of $3,639, $3,262, and $823, respectively. Each membership organization notified IU Health Frankfort that a portion of the dues it paid were used for lobbying purposes. The AHA used 32.00%, or $1,164 of 2024 membership dues paid by IU Health Frankfort for lobbying expenditures. The IHA used 11.78%, or $384 of the 2024 membership dues paid by IU Health Frankfort, for lobbying expenditures. 340B Health used 6.50%, or $53 of the 2024 membership dues paid by IU Health Frankfort, for lobbying expenditures. The total membership dues paid to these organizations by IU Health Frankfort during 2024 that were attributable to lobbying expenditures was $1,601. 1030133 1030133 27513288 3060176 24453112 452991 452991 0 11241656 8026133 3215523 536984 189074 347910 29046678 0 Federal Income Taxes 0 INTERCOMPANY PAYABLES (NET) 43791282 DUE TO THIRD PARTY PAYERS 1535497 45326779 X 0 0 0 0 0 0 0 0 0 0 0 0 Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote IU HEALTH FRANKFORT, INC. IS A SUBSIDIARY IN INDIANA UNIVERSITY HEALTH, INC.'S ("IU HEALTH") 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 which, as of December 31, 2024, and 2023, 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, 2024, and 2023, the Indiana University Health System had gross deferred tax assets of $110,705,348, and $141,386,173, respectively, relating to net operating loss carryovers. Indiana University Health Frankfort, Inc.'s portion of the December 31, 2024, and 2023 deferred tax assets is $0 and $0 respectively. Management determined that a full valuation allowance at December 31, 2024 and 2023 was necessary to reduce the deferred tax assets to the amount that would more likely than not be realized. Based on the weight of the evidence, if it is more likely than not that some portion or all of the deferred tax assets will not be realized, a valuation allowance to reduce the deferred tax assets is recorded. The decrease in the gross deferred tax asset and the valuation allowance for the current year is $30,681,000. At December 31, 2024, Indiana University Health System has available net operating loss carryforwards of $445,118,000, Indiana University Health Frankfort, Inc.'s portion is $0. Net operating losses generated from 2005 through 2017 will expire between 2025 and 2037. Net operating losses generated after 2017 do not expire. true true X true X 300 false 3072 1710101 1710101 0.05258 3754 7549926 4670203 2879723 0.08854 0 0.0 0 6826 9260027 4670203 4589824 0.14112 2 474 418862 418862 0.01288 0 0.0 1 2772 3010484 2936029 74455 0.00229 0 0.0 1 13500 13500 0.00042 4 3246 3442846 2936029 506817 0.01558 4 10072 12702873 7606232 5096641 0.15670 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 78954 6222744 6047657 175087 X true true 1 1 IU HEALTH FRANKFORT HOSPITAL 1300 S JACKSON STREET FRANKFORT IN 46041 HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-FRANKFORT-HOSPITAL 23-005039-1 X X X X IU HEALTH FRANKFORT HOSPITAL 1 false false true X X X X X X X X X 24 true false false true X HTTPS://IUHEALTH.ORG/IN-THE-COMMUNITY/COMMUNITY-BENEFIT true 25 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 FRANKFORT'S 2024 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORTS INCLUDE PRIORITIZED DESCRIPTIONS OF SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY. THE CHNA REPORTS IDENTIFIED THE FOLLOWING NEEDS TO BE ADDRESSED: - Access to healthcare services - Aging population and needs of older adults - Behavioral health (mental health and substance abuse) - Chronic disease prevention and management - Maternal and infant health and child well-being - Smoking, vaping and tobacco use - Social determinants of health (SDOH) Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - IU HEALTH FRANKFORT HOSPITAL. IU Health Frankfort The defined community per the most recent CHNA conducted in the current tax year (i.e., 2024) is Clinton County, Indiana, where the hospital resides. This CHNA relies on multiple data sources and community input gathered in January through June of 2024. The CHNA process was completed when the CHNA was made widely available to the public on December 19, 2024. Primary data summary IU Health Frankfort obtained the insight and views of those who live and service the county through community meetings (including those having public health expertise) and an internal survey. People and organizations representing a broad range of sectors, services and groups in the community were invited to attend. See Appendix C for a list of the organizations and community members that participated in the community input process. Community meetings In May 2024, IU Health facilitated three community meetings in person to receive input on the health needs in Clinton County, including a meeting of youth from local schools in the county and people living in recovery. The meetings were attended by 65 people in total. The significant community health needs from the 2021 CHNA of IU Health Frankfort was presented at the beginning of each of meeting. Participants were asked to share their feedback on the status of these health needs in Clinton County, any additions to the list of health needs, thoughts regarding the root causes of the health needs and the status of COVID-19 and its impacts. The meetings concluded by asking the participants to finalize the top health needs impacting the health of the community. Once this list was confirmed, they were asked to prioritize and select the top five health needs for their community (i.e., the significant community health needs). Highlights of the discussion during the community meetings include many, if not all, of the 2021 CHNA significant community health needs. Suggested additions to the list included improved sex education; teen pregnancy; childcare; transportation; pediatric care; SDOH, including access to affordable and safe housing; adverse childhood experiences (ACEs)-trauma response; medication assistance; maternal/obstetrics care; and youth centers for smaller communities. Additional highlights of the 2024 discussion include: - Low education attainment in the community - Accessing healthcare services in the community is challenging due to costs; language and culture; a need for more same-day appointments as well as extended office hours for evenings and weekends; trust; waitlists for services; affordable insurance and assistance is needed to help people find insurance coverage - The county needs more mental health services, especially in-person and crisis prevention services (e.g., Quick Response Team) - Community members want to feel comfortable accessing Narcan and other treatment services for substance abuse disorders - There are no services for people with eating disorders - More physical activity opportunities are desired Vaping is an issue - Transportation to healthcare services is a barrier due to costs, lack of personal vehicles or distances to services are not feasible for walking - There are limited to no resources for people experiencing homelessness in the community - Internet access is problematic for some people - public access (e.g., library) is not always convenient - Indiana's Family and Social Services Administration (FSSA) and the police department are now outside of town, which can be challenging for some to access - Participants would like to see more support in the community for local recovery homes and members of the recovery community - The youth in the community are experiencing substance use disorders, violence and neglect and could benefit from more prevention services (e.g., improved sex health education in schools) Participants from the community meetings identified the following needs as most significant for Clinton County, which are not listed in any order: - Access to healthcare services (including affordable and supportive care and flexible hours) - Access to mental health services (including more in-person services and insurance coverage) - Access to treatment for substance use disorders (including more in-person services and insurance coverage) - Housing (including affordable and safe) - Transportation Community meeting and survey participants Individuals from organizations representing different sectors and groups within the local community participated in the community input process. Participants included community members and representatives from the following organizations: - Bauer Family Resources - CareSource - Clinton County Health Department - Clinton County Women, Infants and Children (WIC) - Community Health Network - Healthy Communities of Clinton County - Indiana Youth Institute - INWell Indiana Professional Management Group (IPMG) - IU Health Frankfort - IU Health Plans - Learning Network of Clinton County - Nurse Family Partnership - Goodwill - People in recovery - Pregnancy Resource Center - Purdue Extension - Purdue University - Trinity Hope Center - United Healthcare - United Way for Clinton County - WeCare Recovery - Youth from local schools in Clinton County Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - IU HEALTH FRANKFORT HOSPITAL. In February 2025, IU Health's board of directors approved the implementation strategy for IU Health Frankfort to respond to the needs identified in their 2024 CHNA. IU Health Frankfort will address these community health needs in 2025-2027: * Access to healthcare services * Aging population and needs of older adults * Behavioral health (mental health and substance use) * Chronic disease prevention and management * Maternal and infant health and child well-being * Smoking, vaping and tobacco use * Social determinants of health IU Health Frankfort will address all the community health needs identified in the 2024 CHNA. In 2024, IU Health Frankfort addressed needs identified in the 2021 CHNA using the 2022-2024 implementation strategy plan adopted in April 2022. The hospital, along with community partners, prioritized and determined which of the significant needs identified in the CHNA could be adequately addressed by current or future initiatives, programs, resources, and collaborations. The 2022-2024 implementation strategy outlines how IU Health Frankfort planned to address significant needs including initiatives, strategies, internal/external collaborators, anticipated impact, and hospital resources. Significant Needs Hospital Addressed Below was the progress of the implementation strategy by significant need and its respective initiative(s). The hospital addressed 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; Health Education and Navigation; and Social Determinants of Health. Access to Healthcare Services Supported the Open Door Clinic (provided free or discounted healthcare services in the community). In 2024, the ODC referred 248 patients to IU Health Frankfort for covered services for a total value of $46,991. Created a pipeline, targeting youth and adults, for future healthcare leaders to access local opportunities. HR representatives from IU Health presented about healthcare careers to local high schools for the Career Explorer Program which allowed job shadowing to occur at IU Health Frankfort for local high schools, including the county alternative school. Supported community members accessing healthcare services regardless of their ability to pay. The hospital provided financial assistance to patients each year that included discounts, full charity, and personal hardship reductions. IU Health Patient Financial Counselors were certified Indiana Navigators. They assisted patients and families with information and helped them with applications for various health coverage programs. In 2024, the counselors served 115 people at IU Health Frankfort. In 2024 the Frankfort Same and Next Day Clinic had 5,044 appointments. Provided increased access to obstetrics and gynecology (OB/GYN) services. OB/GYN services were provided locally once a week, served 787 patients in 2024. Launched the Integrated Social Work Initiative in IU Health clinical settings. Virtual Integrated Social Work (VISW) assisted providers and patients with urgent complex situations such as abuse and neglect concerns, domestic violence, housing insecurity, and social barriers to care. This team of licensed social workers and coordinators were skilled in assessing and identifying social determinants of health (SDOH), provided resources, and made recommendations unique to the patient and their circumstances. ISW provided urgent medical social work services through an iPad cart to all primary care and pediatric primary care practices throughout the system. The SDOH screener PRAPARE was live in 73 primary care practices. ISW Social Determinants of Health Coordinators provided resources and support to patients with urgent needs identified in the screener. There was a total of 7,715 referrals in 2024. Of those referrals, 765 referrals made to ISW included patients seen at IU Health Arnett, IU Health Frankfort and IU Health White Memorial Hospitals. Aging Population and Needs of Seniors Further implemented IU Health Safe Medication Disposal Program. IU Health Frankfort continued to be a site for safe medication disposal and disposed of more than 480 gallons of medications. IU Health team members also distributed medication lock boxes when they attended community outreach activities. Coordinated local community outreach activities to senior population. IU Health donated water bottles to the Frankfort Senior Games participants and senior care kits to local older adult residences. During the 2024 WILO Senior Fair, IU Health was an event sponsor and provided 45 health screenings to participants. Behavioral Health Further implemented the Virtual Care Peer Recovery Coaching Program (provided patients who had substance use concerns with virtual behavioral health services). The Virtual Peer Recovery Coach program was discontinued in February 2023 as IU Health continued to assess and evolve its behavioral health services based on the needs of patients and the communities it served. Since 2018, this program had served 15 IU Health and two non-IU Health emergency department patients who struggled with substance use disorder through support to aid in recovery. IU Health continued to serve patients with a need for this service through the Virtual Behavioral Health team. Developed hospital and community infrastructure for crisis care to support community members with mental health and substance use concerns. IU Health collaborated with other providers in the region, as well as supported community organizations that provide assistance to community members with mental health and substance use concerns. It included sponsoring local recovery events, serving individuals in recovery, and providing grant funds to WeCare Recovery Home for space to allow therapy sessions for their residents and family visitations. IU Health provided grant funds to 3 community-based organizations to address youth mental health crisis by providing funding to implement #WoW Talk Teen Cafes. IU Health's Community Outreach and Engagement provided funding to CORE Community Center to implement Get SMART programming throughout Clinton County. This programming empowers youth to make decisions around mental health, substance use, and peer pressure. Healthy Communities of Clinton County hosted the Governor's Attorney General and IU Health was invited to participate in the panel discussion for the community. Team members were also there in the audience to support the day and discussion around mental health in Clinton County. Supported naloxone distribution in the community. Healthy Communities of Clinton County Coalition continued to provide 24/7 access to naloxone through the NaloxBox installed at their location by IU Health in 2021. In partnership with IU Health Positive Link, IU Health Frankfort Hospital had a NaloxBox installed outside of the IU Health Frankfort Emergency Department. More than 40 doses of naloxone were distributed from this NaloxBox in 2024. Provided comprehensive suicide prevention through the Zero Suicide Initiative. The program was live in all 92 IU Health Primary Care Practices around the state (included those located in IU Health Frankfort's defined community). Patients were screened for suicidal ideation. Virtual Integrated Behavioral Health (VIBH) expanded behavioral health access to patients and providers across the state. VIBH provided urgent psychiatric assessment for patients experiencing behavioral health crises, such as suicidal ideation, homicidal ideation, psychosis, and substance abuse disorders. Further implemented the emergency department (ED) virtual care program (provided patients virtual access to behavioral health services). Virtual Integrated Behavioral Health (VIBH) provided urgent psychiatric assessment for patients experiencing behavioral health crises, such as suicidal ideation, homicidal ideation, psychosis, and substance abuse disorders. A team of behavioral health professionals provided consultation through iPad carts located in emergency departments, urgent cares, and ambulatory care locations. In 2024, there were over 10,000 visits of which 1,989 visits included patients seeking care in the emergency departments in the West Central Region (which included IU Health Frankfort Hospital). This program was financially supported by the parent hospital, IU Health Inc., but was offered to and impacts patients in this hospital's defined community. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - IU HEALTH FRANKFORT HOSPITAL (CONTINUED). Chronic Disease and Chronic Disease Management Coordinated community outreach and education opportunities. IU Health Frankfort team members provided an estimated 25+ health screenings at the Heroes of Hope Event in Clinton County. IU Health sponsored the Stepping on Stigma 5K and sponsored the Mobile Food Finders Food Pantry during the months of March and September served over 100 Clinton County residents during each mobile food pantry offering through the IU Health Serves program and Days of Service. Further implemented the Centralized Tobacco Treatment Program (CTTP) (provided patients access to evidence-based tobacco treatment). The CTTP program was free to IU Health Primary Care patients. Once a patient's level of care was assessed, they were provided evidence-based tobacco cessation treatment with a trained Tobacco Treatment Specialist (TTSs). Patients had access to Ex, a new digital cessation app, and support from an Advance Practice Provider (APP) who evaluated and prescribed medication assisted therapy (MAT) for nicotine replacement. Education and support were provided to primary care practices which helped to expand services. Cross-functional teams worked together including the West Central Region TTSs for case conferencing and training. One focus in 2024 was on improving access and patient experience with medication management. CTTP improved patient tobacco treatment medication support by integrating systems and processes with a dedicated APP resource. They improved documentation to accurately report MAT, demonstrating 73% of patients used NRT/medication to quit. 362 medication management sessions were scheduled compared to 263 in 2023. 75% of patients completed their appointment with the APP. In 2024, the team had been trained to complete prior authorizations. The team focused on care continuation, care coordination (TTS/APP), scheduled patient follow-up appointments, and monitored adherence or complications. A focus on improving patient experience resulted in strong and consistent quit rates of 37% of active patients (increased from 33% in July 2024) and harm reduction (patients who reduced use of tobacco) of 61% (July 2022-December 2024). This was an increase from 56% in July. The team received frequent testimonials of lives changed and gratitude for a supportive, compassionate partner. There were 73 patients connected to Ex for additional nicotine cessation support. In 2024, CTTP received 1,767 referrals which was an all-time high for the program, scheduled 47% of them and completed at least one session with 67% of those scheduled. Additionally, 70% of patients seen completed two or more sessions. Over the program's life, CTTP had received 3,921 patient referrals (this information cannot be separated by hospital or region at this time). Health Education and Navigation Promoted findHelp.org to connect community members to health and social services. FindHelp.org was promoted to team member "Super Users" in the West Region. Community organizations were encouraged to manage their organizations' pages on the platform by attending a training session to remind organizations how to utilize the platform to its greatest potential, but most importantly claiming their page and keeping the information on the platform up to date. Supported Bridging the Gap. The Bridging the Gap program was paused due to system level initiatives around language services. IU Health Frankfort was contacted by a local partner at the end of the year to offer this training to our staff in 2025. Recruitment began for this training at the end of 2024. Social Determinants of Health Provided fiscal support to organizations addressing social determinants of health. IU Health offered community grants to organizations addressing social determinants of health. Three Clinton County organizations received funding to address social determinants of health, including Paul Phillippe Resource Center to help with transportation access. Established strategic collaborative relationships with local community-based organizations addressing social determinants of health. IU Health continued its partnership with Healthy Communities of Clinton County Coalition, Clinton County United Way, CORE Community Center and Paul Phillipe Resource Center. Through IU Health served, Days of Service, team members were able to put together tobacco cessation kits for Healthy Communities of Clinton County to utilize for their Tobacco Cessation programming. Supported career pathway development program. Team members from our human resources department visited Frankfort Crossing School in 2024 to meet with leaders about the program. Significant Needs Hospital Did Not Address IU Health Frankfort addressed all the significant health needs identified in the 2021 Community Health Needs Assessment. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - IU HEALTH FRANKFORT HOSPITAL. IN ADDITION TO FPG, IU HEALTH FRANKFORT 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 FRANKFORT HOSPITAL. IU Health Frankfort Hospital takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. Financial Assistance due to Financial Hardship A. To be eligible for Financial Assistance due to financial Hardship under this Policy, a patient or guarantor must: a. Submit a completed Financial Assistance Application with all supporting documentation and be approved in accordance with this Policy; b. Be an Indiana Resident as defined in this Policy; and B. If Uninsured, consult with a member of IU Health's Financial Counseling 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. C. Financial Assistance due to financial Hardship is only available for Qualifying Care, as defined in this Policy. D. 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. 2. Financial Assistance due to Personal Hardship A. In order to be eligible for Financial Assistance due to personal Hardship under this Policy, a patient or guarantor must: a. Submit a completed Financial Assistance Application with all supporting documentation and be approved in accordance with this Policy; b. Be an Indiana Resident as defined in this Policy; and c. If Uninsured, consult with a member of IU Health's Financial Counseling 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. B. An Uninsured or Underinsured patient or their guarantor may be eligible for Financial Assistance if the Household's outstanding Patient Responsibility exceeds 5% of the patient's or their guarantor's annual household income. C. If approved, the Household's balance will be reduced to 5% of the patient or guarantor's annual household income. 3. Eligibility Period A. If approved for Financial Assistance by IU Health under Sections IV.E-F, 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. B. As a condition of extending the ongoing Financial Assistance, the patient must comply with requests from IU Health to verify that the patient continues to meet the conditions for qualification. 4. Appeals and Assistance Granted By the Financial Assistance Committee A. 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 request must be submitted, along with any additional information or requested supporting documentation, if applicable. B. The Financial Assistance Committee will review requests for and may grant additional Financial Assistance, including but not limited to, the following: a. 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; b. Care approved by an IU Health Chief Medical Officer (CMO), Chief Executive Officer (CEO) or Chief Financial Off icer (CFO) of an IU Health facility or region, including medically necessary non-elective services for which no payment source can be identified; c. Care provided when it is known no payment source exists; d. Care provided, due to medical urgency, for which a payer denies payment; e. International humanitarian aid; and f. Other care identified by the Financial Assistance Committee that fulfills the IU Health Mission. C. All decisions of the Financial Assistance Committee are final. 5. Presumptive Eligibility A. A Financial Assistance Application is not required to receive Financial Assistance under this Presumptive Eligibility section. B. 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 the patient received Qualifying Care, as defined in this Policy. a. Medicaid (any state) b. Indiana Children's Special Health Care Services c. Healthy Indiana Plan d. Patients who are awarded Hospital Presumptive Eligibility (PE) e. Patients approved for the Eskenazi Health Advantage program f. A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. C. 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. a. IU Health may also periodically conduct a similar review on patient balances not placed with a collection agency, and presumptively quality patients for Financial Assistance. D. 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. 6. Exhaustion of Alternate Sources of Assistance A. Patients may be required to exhaust all other state and federal healthcare coverage assistance programs prior to receiving Financial Assistance due to financial or personal Hardship under this Policy including, but not limited to, Medicaid. B. Patients who may be eligible for coverage under an applicable health insurance policy must exhaust all insurance benefits. a. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. b. IU Health may request patients show proof that such a claim was properly submitted to the appropriate insurance provider before awarding Financial Assistance. C. 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. D. 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. 7. Patient Assets A. 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. B. 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 FRANKFORT HOSPITAL. IU HEALTH FRANKFORT TAKES SEVERAL OTHER MEASURES TO PUBLICIZE ITS FAP WITHIN THE COMMUNITY. THESE MEASURES INCLUDE THE FOLLOWING: 1. Post this Policy, a Plain Language Summary of this Policy, and the Financial Assistance Application on its website. 2. Provide patients with a Plain Language Summary of this Policy during registration and/or discharge. 3. Post conspicuous displays in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 4. Include a conspicuous written notice on all patient post-discharge billing statements notifying the patient about this Policy and the telephone number of the Customer Service Department which can assist patients with questions regarding this Policy. 5. Make available Customer Service representatives via telephone during normal business hours. 6. Mail copies of this Policy, a Plain Language Summary of this Policy, and a Financial Assistance Application to patients or their guarantor free of charge upon request. 7. Broadly communicate this Policy as a part of its general outreach efforts. 8. Educate patient-facing team members on this Policy and the process for referring patients to the program. 2 IU HEALTH FRANKFORT PAIN MANAGEMENT 1458 S Jackson St FRANKFORT IN 46041 Specialty Care IU HEALTH FRANKFORT LAB 1300 S Jackson St FRANKFORT IN 46041 LAB Schedule H, Part I, Line 6a REPORT PREPARED BY A RELATED ORG. IU Health Frankfort'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. 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 PERCENT OF TOTAL EXPENSE The amount of bad debt expense included on Form 990, Part IX, Line 25, column (A), but subtracted for purposes of calculating the percentage of total expense on Line 7, column (f) is $278,791. Bad debt expense is reported at cost based on the cost-to-charge ratio derived from worksheet 2, ratio of patient care cost-to-charges. Schedule H, Part I, Line 7 TOTAL COMMUNITY BENEFIT EXPENSE Schedule H, Part I, Line 7, Column (f), Percent of Total Expense, is based on column (e) Net Community Benefit Expense. The percent of total expense based on column (c) Total Community Benefit Expense, which does not include direct offsetting revenue, is 39.06%. Schedule H, Part II PROMOTION OF HEALTH IN COMMUNITIES SERVED IU Health White Frankfort 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 Frankfort 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 of these activities meet the definition of community benefit and have been reported as such. In 2024, IU Health Frankfort Hospital supported community building activities to promote the health of the community. IU Health Frankfort Hospital staff provided hospital representation and expertise by participating local emergency planning meetings. Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care IU HEALTH FRANKFORT HOSPITAL USES SEVERAL FACTORS OTHER THAN FEDERAL POVERTY GUIDELINES ("FPG") IN DETERMINING ELIGIBILITY FOR FREE CARE UNDER ITS FAP. THESE FACTORS INCLUDE THE FOLLOWING: 1. Financial Assistance due to Financial Hardship A. To be eligible for Financial Assistance due to financial Hardship under this Policy, a patient or guarantor must: a. Submit a completed Financial Assistance Application with all supporting documentation and be approved in accordance with this Policy; b. Be an Indiana Resident as defined in this Policy; and B. If Uninsured, consult with a member of IU Health's Financial Counseling 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. C. Financial Assistance due to financial Hardship is only available for Qualifying Care, as defined in this Policy. D. 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. 2. Financial Assistance due to Personal Hardship A. In order to be eligible for Financial Assistance due to personal Hardship under this Policy, a patient or guarantor must: a. Submit a completed Financial Assistance Application with all supporting documentation and be approved in accordance with this Policy; b. Be an Indiana Resident as defined in this Policy; and c. If Uninsured, consult with a member of IU Health's Financial Counseling 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. B. An Uninsured or Underinsured patient or their guarantor may be eligible for Financial Assistance if the Household's outstanding Patient Responsibility exceeds 5% of the patient's or their guarantor's annual household income. C. If approved, the Household's balance will be reduced to 5% of the patient or guarantor's annual household income. 3. Eligibility Period A. If approved for Financial Assistance by IU Health under Sections IV.E-F, 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. B. As a condition of extending the ongoing Financial Assistance, the patient must comply with requests from IU Health to verify that the patient continues to meet the conditions for qualification. 4. Appeals and Assistance Granted By the Financial Assistance Committee A. 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 request must be submitted, along with any additional information or requested supporting documentation, if applicable. B. The Financial Assistance Committee will review requests for and may grant additional Financial Assistance, including but not limited to, the following: a. 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; b. Care approved by an IU Health Chief Medical Officer (CMO), Chief Executive Officer (CEO) or Chief Financial Off icer (CFO) of an IU Health facility or region, including medically necessary non-elective services for which no payment source can be identified; c. Care provided when it is known no payment source exists; d. Care provided, due to medical urgency, for which a payer denies payment; e. International humanitarian aid; and f. Other care identified by the Financial Assistance Committee that fulfills the IU Health Mission. C. All decisions of the Financial Assistance Committee are final. 5. Presumptive Eligibility A. A Financial Assistance Application is not required to receive Financial Assistance under this Presumptive Eligibility section. B. 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 the patient received Qualifying Care, as defined in this Policy. a. Medicaid (any state) b. Indiana Children's Special Health Care Services c. Healthy Indiana Plan d. Patients who are awarded Hospital Presumptive Eligibility (PE) e. Patients approved for the Eskenazi Health Advantage program f. A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. C. 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. a. IU Health may also periodically conduct a similar review on patient balances not placed with a collection agency, and presumptively quality patients for Financial Assistance. D. 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. 6. Exhaustion of Alternate Sources of Assistance A. Patients may be required to exhaust all other state and federal healthcare coverage assistance programs prior to receiving Financial Assistance due to financial or personal Hardship under this Policy including, but not limited to, Medicaid. B. Patients who may be eligible for coverage under an applicable health insurance policy must exhaust all insurance benefits. a. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. b. IU Health may request patients show proof that such a claim was properly submitted to the appropriate insurance provider before awarding Financial Assistance. C. 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. D. 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. 7. Patient Assets A. 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. B. 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 7 Bad Debt Expense excluded from financial assistance calculation 278791 Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE AMOUNT REPORTED ON LINE 2 AS BAD DEBT IS REPORTED AT COST, AS CALCULATED USING THE COST TO CHARGE RATIO METHODOLOGY. Schedule H, Part III, Line 3 Bad Debt Expense Methodology IU HEALTH FRANKFORT 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 FRANKFORT 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 FRANKFORT 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 FRANKFORT'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. Qualifying 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 5% of annual household income or Amounts Generally Billed, whichever is less. Since the Indiana 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 $201,699,000 and $95,909,000 in 2024 and 2023, respectively. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance IU Health Frankfort's FAP and Written Debt Collection Policy describe the collection practices applicable to patients, including those who may qualify for financial assistance. 1. Financial Assistance Application Financial Assistance Applications must include the following documentation: - All sources of Income for the last three (3) months. - Most recent three (3) months of pay stubs or Supplemental Security Income via Social Security. - Most recent three (3) statements from checking and savings accounts, certificates of deposit, stocks, bonds and money market accounts. - Most recent state and Federal Income Tax forms including Schedules C, D, E, and F. In the event the patient or guarantor's income does not warrant the filing of a federal tax statement, the individual may submit a notarized affidavit attesting to the foregoing. - Most recent W-2 statement. - For patients or members of the Household who are currently unemployed, Wage Inquiry from WorkOne. - If applicable, divorce/dissolution decrees and child custody order. Patients or their guarantors wishing to apply for Financial Assistance due to Financial Hardship are encouraged to submit an Application within ninety (90) days of discharge. Patients or their guarantors may submit an Application up to two-hundred and forty (240) days from the date of their initial post-discharge billing statement from IU Health, however, accounts may be subject to Extraordinary Collection Actions (ECA) as soon as one-hundred and twenty (120) days after receipt of the initial post-discharge billing statement. Patients or their guarantors submitting an incomplete Financial Assistance Application will receive written notification of the Application's deficiency upon discovery by IU Health. The Application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health will suspend any ECA until the Application is complete or the expiration of the forty-five (45) day period. Patients with limited English proficiency may request a copy of this Policy, a Financial Assistance Application, and a Plain Language Summary in one of the below languages: - Arabic; - Burmese; - Burmese - Falam; - Burmese - Hakha Chin; - Mandarin/Chinese; or - Spanish The patient, and/or their representative, such as the patient's physician, family members, legal counsel, community or religious groups, social services or hospital personnel may request a Financial Assistance Application be mailed to a patient's primary mailing address free of charge. IU Health maintains the confidentiality of all Financial Assistance Applications and supporting documentation. IU Health will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance Application. 2. Financial Assistance Determinations IU Health will inform patients or guarantors of the results of their Application by providing the patient or guarantor with a Financial Assistance Determination within ninety (90) days of receiving a completed Application and all requested documentation. A patient's Financial Assistance Application and Financial Assistance Determination are specific to each date(s) of service and approved related encounters. If a patient or guarantor is granted less than full charity assistance and the patient or guarantor provides additional information for reconsideration, Revenue Cycle Services may amend a prior Financial Assistance Determination. 3. Extraordinary Collection Actions IU Health may refer delinquent patient accounts to a third-party collection agency after utilizing reasonable efforts to determine a patient's eligibility for assistance under this Policy. Reasonable efforts include the following: - IU Health will notify the patient of this Policy at least thirty (30) days prior to initiating an ECA. - IU Health will not initiate an ECA for at least one-hundred and twenty (120) days after the patient's initial post-discharge billing statement. - IU Health will review all Financial Assistance Applications received up to and including two-hundred and forty (240) days after the patient's initial post-discharge billing statement. IU Health will cease any ECAs it has initiated upon receipt of a Financial Assistance Application until a Financial Assistance Determination is made under this policy. - If an Application is Approved, IU Health will issue a revised statement, issue refunds, and make reasonable efforts to reverse ECAs as necessary. IU Health and its third-party collection agencies may initiate an ECA against a patient or their guarantor in accordance with this Policy and 26 C.F.R. § 1.501(r). ECAs may include the following: - Selling a patient or their guarantor's outstanding financial responsibility to a third party. - Reporting adverse information about the patient or their guarantor to consumer credit reporting agencies or credit bureaus. - Deferring or denying, or requiring a payment before providing, medically necessary care because of a patient or their guarantor's nonpayment of one or more bills for previously provided care covered under this Policy. - Actions requiring a legal or judicial process, including but not limited to placing a lien on a patient's or their guarantor's property, foreclosing on a patient's or their guarantor's real property, attaching or seizing a patient's or their guarantor's bank account or other personal property, commencing a civil action against a patient or their guarantor, causing a patient or guarantor's arrest, causing a patient and/or guarantor to be subject to a writ of body attachment, and garnishing a patient or guarantor's wages When it is necessary to engage in such action, IU Health and its third party collection agencies, will engage in fair, respectful and transparent collections activities. 4. Refunds Patients eligible for Financial Assistance under this Policy who remitted payment to IU Health in excess of their Patient Responsibility will be alerted to the overpayment as promptly after discovery as is reasonable given the nature of the overpayment. Patients with an outstanding account balance due on a separate account will have their refund applied to the outstanding balance. Patients without an outstanding account balance described above will be issued a refund check for their overpayment as soon as technically feasible. Schedule H, Part V, Section B, Line 16a FAP website - IU HEALTH FRANKFORT 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 FRANKFORT 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 FRANKFORT HOSPITAL: Line 16c URL: HTTPS://IUHEALTH.ORG/PAY-A-BILL/FINANCIAL-ASSISTANCE; Schedule H, Part VI, Line 2 Needs assessment Though IU Health Frankfort believes its CHNA process is comprehensive, the CHNA is done on a triennial basis. Between CHNA cycles, IU Health Frankfort 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 Frankfort 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 Frankfort has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health Frankfort is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health Frankfort 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 Frankfort 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 FRANKFORT IS LOCATED IN CLINTON COUNTY, INDIANA, A COUNTY LOCATED IN CENTRAL NORTHWEST INDIANA. CLINTON COUNTY INCLUDES ZIP CODES WITHIN THE TOWNS OF COLFAX, FOREST, FRANKFORT, KIRKLIN, MICHIGANTOWN, MULBERRY, ROSSVILLE AND SEDALIA. BASED ON THE MOST RECENT CENSUS BUREAU STATISTICS, CLINTON COUNTY'S POPULATION IS 32,895 AND 50.0% ARE FEMALE. Schedule H, Part VI, Line 5 Promotion of community health IU Health Frankfort is a subsidiary of IU Health, a tax-exempt healthcare organization, whose Board of Directors is composed of members, of which the majority is independent community members. IU Health Frankfort extends medical staff membership and clinical privileges to medical and allied health providers who meet the credentialing qualifications as well as any additional standards and rules set forth by its Board for medical staff appointment (in accordance with Indiana state law). Information on privileging and credentialing, including applying for membership, for IU Health Frankfort can be accessed on the IU Health website. A nondiscrimination clause is explicitly stated in IU Health Frankfort credentialing process. 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. In addressing the identified community priorities, IU Health Frankfort Hospital has partnered with a number of high quality, engaged community organizations and initiatives to help make health and wellness improvement a reality. Schedule H, Part VI, Line 6 Affiliated health care system Indiana University Health Frankfort 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 six regions that serve communities in Northwest, Northeast, Central and Southern Indiana. The 15 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 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 partners, conducted, and adopted its own community health needs assessment (CHNA) and implementation strategy. IU Health considered 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 initiatives as well as system-level strategies. 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 (IU Health Arnett and IU Health Ball) 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 received training in affiliate hospitals. Research conducted by IU School of Medicine faculty gave 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 partnered 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 identified and addressed significant needs unique to the communities they serve. However, some needs were common in communities served by multiple or all affiliate hospitals in the healthcare system and aligned with system priority areas, warranting a system-level strategy. The Community Health Division, along with additional internal partners such as the Office of Health Excellence Research and Engagement (HERE) and the IU Health Foundation, planed and provided technical assistance for system-level strategies that addressed these common needs including tobacco and nicotine cessation, infant and maternal health, hypertension, and social determinants of health. For example, the Community Health Division has launched a community health worker initiative throughout the system in outpatient and inpatient sites that did community outreach as part of the WeCare and iHEART initiatives. Each affiliate hospital collaborated with the Community Health Division to align and activate local resources to support local and system strategies. This benefits the community each affiliate hospital served and worked towards a statewide impact (system-level) on health outcomes. As part of the Community Health Division, the Community Outreach and Engagement Program's IU Health Serves initiative, a system-level team member volunteer program, sought to positively impact the health of communities IU Health affiliate hospitals serve and foster a culture of engagement and social responsibility. Each affiliate hospital coordinated the different initiatives of the program, including Days of Service. This was 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 $200 million Community Impact and Investment (CII) Fund was established in 2018 by IU Health to financially support high-impact community investing. The focus of these efforts addressed key social and environmental factors that impact different groups in the communities IU Health serves. Each affiliate hospital and its team members were eligible to pursue this grant opportunity with a community organization. Schedule H, Part VI, Line 7 State filing of community benefit report IN true PAUL PHILLIPPE RESOURCE CTR 401 W Walnut St Frankfort IN 46041 351759676 501(c)(3) 10000 Community Benefit 1 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds ALTHOUGH IU HEALTH FRANKFORT DOES NOT MONITOR THE USE OF GRANT FUNDS ONCE DISTRIBUTED, THROUGH DUE DILIGENCE THE ORGANIZATION HAS REASONABLY CONFIRMED THAT THE ENTITIES TO WHICH THE CONTRIBUTIONS ARE MADE ARE HIGHLY REPUTABLE IN THE COMMUNITY AND USE THE FUNDS FOR THE PURPOSES INTENDED. X X X X false true false false false false false true false PHILIP LIST Director (Part Year) / Legal Counsel Secretary (Part Year) 0 229388 0 35768 0 7917 0 10430 0 46579 0 330082 0 0 MARK BUONO MD Director 0 775682 0 47165 0 3564 0 9812 0 58378 0 894601 0 0 WILLIAM Y LI MD DIRECTOR 0 165299 0 30103 0 2322 0 7749 0 22888 0 228361 0 0 RUBAN NIRMALAN MD DIRECTOR 0 489535 0 506408 0 810 0 12204 0 55925 0 1064882 0 0 MICHELE S SAYSANA MD DIRECTOR (Part Year) 0 557155 0 70619 0 1567 0 6373 0 23390 0 659104 0 0 ERIKA UGIANSKIS MD DIRECTOR 0 589922 0 26945 0 305424 0 13800 0 64878 0 1000969 0 0 CARA L BREIDSTER FORMER OFFICER 0 309988 0 39308 0 2322 0 12104 0 54009 0 417731 0 0 DEREK E EMPIE FORMER OFFICER 0 373567 0 55399 0 1242 0 13800 0 63630 0 507638 0 0 KRISTIN POST Former Officer 0 172989 0 32664 0 360 0 7084 0 32937 0 246034 0 0 WHITNEY A AIKEN Legal Counsel Secretary (Part Year) 0 160510 0 16829 0 5134 0 7459 0 25445 0 215377 0 0 MICHAEL L CRAIG CFO (Part Year) 0 329178 0 43079 0 3564 0 13500 0 52357 0 441678 0 0 ARTHUR VASQUEZ PRESIDENT (WCR) 0 591884 0 254900 0 1869 0 116832 0 53432 0 1018917 0 0 TODD A WILLIAMS CFO (Part Year)/TREASURER (WCR) 0 378983 0 58910 0 2322 0 13176 0 53278 0 506669 0 0 CHRISTOPHER A MANSFIELD MD FORMER KEY EMPLOYEE 0 568986 0 85709 0 810 0 13800 0 53199 0 722504 0 0 KOREEN C KYHNELL VP - HUMAN RESOURCES (WCR) 0 219439 0 36618 0 3194 0 8298 0 61702 0 329251 0 0 KISHAN PATEL MD VP-Chief Physician Executive (WCR) 0 410604 0 61633 0 810 0 13800 0 53199 0 540046 0 0 ROXANNE WICKLUND CNO (WCR) 0 287317 0 63372 0 6858 0 11533 0 54177 0 423257 0 0 MARY E MINIER Former Highest Compensated Employee 0 164975 0 35314 0 4239 0 8075 0 35307 0 247910 0 0 JAMES H PARSONS FORMER HIGHEST COMPENSATED EMPLOYEE 0 165877 0 18290 0 450 0 7683 0 45837 0 238137 0 0 RENEA SMITH Former Highest Compensated Employee 0 181578 0 27348 0 0 0 937 0 12618 0 222481 0 0 LAWRENCE STAUFFER FORMER Highest Compensated Employee 0 187432 0 18388 0 6949 0 8604 0 41786 0 263159 0 0 BRETT R BROVIAK Manager - Respiratory Care Services 121191 0 6594 0 2401 0 5295 0 31440 0 166921 0 0 0 RACHEL L GOEDE Supervisor - House 113452 0 10630 0 165 0 5178 0 33388 0 162813 0 0 0 KELLI R GREENO Supervisor - House 144057 0 40161 0 218 0 7481 0 19841 0 211758 0 0 0 AMANDA JAKES PHARMACIST 129273 0 12780 0 96 0 6321 0 30647 0 179117 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation IU HEALTH FRANKFORT'S REGIONAL PRESIDENT IS EMPLOYED BY IU HEALTH, INC. IU HEALTH, INC., IU HEALTH FRANKFORT, 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 4b Supplemental nonqualified retirement plan ARTHUR VASQUEZ PARTICIPATES IN AN IU HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, PROVISIONS OF WHICH ARE DESIGNED TO RETAIN ITS CRITICAL EMPLOYEES. THE PLAN PROVIDES FOR AN ADDITIONAL RETIREMENT BENEFIT FOR SERVICE THROUGH NORMAL RETIREMENT OR OTHER KEY DATES. IF THE EXECUTIVE LEAVES PRIOR TO RETIREMENT OR OTHER KEY DATES, THE BENEFIT MAY BE FORFEITED OR REDUCED. EACH OF THE EXECUTIVES LISTED ABOVE HAVE AN AMOUNT INCLUDED IN COLUMN C, DEFERRED COMPENSATION, REPRESENTING THE CURRENT YEAR UNVESTED CONTRIBUTIONS MADE UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THESE AMOUNTS WERE NOT PAID TO THE EXECUTIVES DURING THE YEAR. Schedule J, Part I, Line 7 Non-fixed payments AMOUNTS DISCLOSED IN COLUMN B(II) INCLUDE A LONG-TERM INCENTIVE FOR CERTAIN EXECUTIVES. 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 TALENT MANAGEMENT AND EXECUTIVE COMPENSATION COMMITTEE AND BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT. LINE J - WEB SITE HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-FRANKFORT-HOSPITAL SECTION B, LINES 12, 13, 14, AND 16B - POLICIES IU HEALTH FRANKFORT IS PART OF THE IU HEALTH SYSTEM. AS THE SOLE MEMBER AND CONTROLLING PARENT OF IU HEALTH FRANKFORT, IU HEALTH AND ITS BOARD OF DIRECTORS HAVE MANDATED THAT CERTAIN POLICIES BE FOLLOWED TO ENSURE GREATER STANDARDIZATION THROUGHOUT THE SYSTEM. THUS, IU HEALTH FRANKFORT'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 FRANKFORT, INC. IS INDIANA UNIVERSITY HEALTH, INC. ("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 IU HEALTH FRANKFORT SHALL CONSIST OF UP TO FOURTEEN (14) VOTING MEMBERS ALL APPOINTED BY IU HEALTH, WHO SHALL INCLUDE UP TO TWO (2) DIRECTORS WHO RESIDE IN CLINTON COUNTY AND FOUR (4) PHYSICIAN REPRESENTATIVES FROM THE WEST CENTRAL REGION. THE PHYSICIAN DIRECTORS WILL BE IDENTIFIED THROUGH A NOMINATION PROCESS DEVELOPED BY THE WEST CENTRAL REGION AND SUBMITTED TO IU HEALTH FOR CONSIDERATION AND APPROVAL. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE FOLLOWING ARE SUBJECT TO IU HEALTH'S APPROVAL: - ANY PROPOSED AMENDMENT TO THE CORPORATION'S ARTICLES OF INCORPORATION OR THESE BYLAWS; - ADOPTION OF THE CORPORATION'S ANNUAL CAPITAL AND OPERATING BUDGETS; - APPROVAL OF ANY UNBUDGETED OPERATING OR CAPITAL BUDGET ITEMS OR DEVIATIONS, INCLUDING ANY ISSUANCE OR GUARANTEE OF ANY UNBUDGETED DEBT; - APPROVAL OF ANY STRATEGIC PLAN FOR THE CORPORATION, INCLUDING ANY AMENDMENTS TO A STRATEGIC PLAN; - APPROVAL OF ANY ENCUMBRANCE, SALE OR CONVEYANCE OF ASSETS; - ANY MERGER, CONSOLIDATION, JOINT VENTURE OR AFFILIATION INVOLVING THE CORPORATION OR ANY OF ITS AFFILIATES AND ANY OTHER ENTITY; - APPOINTMENT AND REMOVAL OF THE CORPORATION'S PRESIDENT AND OTHER OFFICERS; - CONSTRUCTION, ACQUISITION OR LEASE OF HOSPITAL BUILDINGS; - PROJECTS OR CONTRACTS THAT REQUIRE MEMBER APPROVAL IN ACCORDANCE WITH THE MEMBER'S RESOLUTION AND POLICY GOVERNING SYSTEM-WIDE CONTRACT EXECUTION AUTHORITY AND PAYMENT APPROVAL LIMITS; AND - THE DISSOLUTION OF THE CORPORATION OR ANY OF ITS AFFILIATES. Form 990, Part VI, Line 11b Review of form 990 by governing body THE CFO REVIEWED AND APPROVED THE FORM 990. FOLLOWING THE CFO'S 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 FRANKFORT 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 FRANKFORT'S ARTICLES OF INCORPORATION ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH THE INDIANA SECRETARY OF STATE'S WEBSITE. IU HEALTH FRANKFORT'S CONFLICT OF INTEREST PROCEDURES ARE DESCRIBED ON FORM 990, SCHEDULE O. IU HEALTH FRANKFORT 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 FRANKFORT'S FORM 990. Form 990, Part IX, Line 11g Other Fees Intercompany fees - Total Expense: 9933933, Program Service Expense: 9269487, Management and General Expenses: 664446, Fundraising Expenses: ; Contract Fees - Total Expense: 502135, Program Service Expense: 468427, Management and General Expenses: 33708, Fundraising Expenses: ; Professional fees - Total Expense: 299593, Program Service Expense: 279481, Management and General Expenses: 20112, Fundraising Expenses: ; Other Fees - Total Expense: 43314, Program Service Expense: 40406, Management and General Expenses: 2908, Fundraising Expenses: ; Consulting - Total Expense: 13976, Program Service Expense: 13038, Management and General Expenses: 938, Fundraising Expenses: ; Other Expense - Total Expense: 87901, Program Service Expense: 82000, Management and General Expenses: 5901, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Rounding - -1; Total - -1; INDIANA HEALTH INFO EXCHANGE INC 846 N SENATE AVE 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