2025-11-13T14:21:45+00:00 2024-12-31 990 2024-01-01 262772226 Indiana University Health Tipton Hospital Inc INDI 3179634842 950 N MERIDIAN STREET 1200 INDIANAPOLIS IN 46204 MICHAEL L CRAIG VP & CFO 2025-11-13 2024 2025-03-06 01:10:19Z KENNETH D PUCKETT 950 N MERIDIAN STREET 1200 INDIANAPOLIS IN 46204 50449557 false X SEE SCHEDULE O X 2008 IN Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. 7 7 246 64 0 58333 34601 44306055 46301636 2664279 2777597 51873 1378 47080540 49115212 0 0 14293897 14725651 0 0 30702981 30314616 44996878 45040267 2083662 4074945 86673598 75021031 16820191 5428248 69853407 69592783 X Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. false false 42716994 0 45816048 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. 342633 0 367491 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. 71251 0 76420 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. 38858 0 41677 IU HEALTH TIPTON HOSPITAL, INC. RECEIVES RENTAL REVENUE FROM A RELATED EXEMPT ORGANIZATION, IU HEALTH CARE ASSOCIATES, INC. FOR VARIOUS OFFICES AND CLINICS. 38858 41677 43169736 true true false true false 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 false false true true true false false true 0 0 246 true false false false false false false false false false false false false X 7 7 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 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 EMILY M FITZ MD DIRECTOR 1.0 0 X 0 266975 32075 JOELLEN SCOTT DIRECTOR 1.0 0 X 0 0 0 KATHLEEN E BOAZ DIRECTOR 1.0 0 X 0 3600 0 KURT HARE DIRECTOR 1.0 0 X 0 0 0 MICHAEL E HARPER MD DIRECTOR 1.0 0 X 0 0 0 CARA L BREIDSTER CFO (ISR) 10.0 45.0 X 0 351618 66113 KENNETH D PUCKETT Director / PRESIDENT (ISR) 10.0 45.0 X 0 1000489 194306 ATHANASIA S BANICH VP, COO (ISR) 15.0 40.0 X 0 347418 55603 CARRIE WING VP-CNO (ISR) 10.0 45.0 X 0 283501 35494 HARPREETINDER SINGH MD REGIONAL CMO (ISR) 10.0 45.0 X 0 483240 74251 TAMARAH D BROWNLEE REGIONAL VP-HR (ISR) 10.0 45.0 X 0 285807 47003 ANGELA K MORGAN MANAGER - PHARMACY DEPT. 50.0 0 X 169852 0 42951 LIESEL J DELAMATER COO/CNO Tipton 55.0 0 X 205777 0 54743 PATRICIA A HARRIS DIRECTOR-CLINICAL OPERATIONS 50.0 0 X 144147 0 14833 SARAH F BURKS Manager-Rehabilitation Services 50.0 0 X 134088 0 11208 STEVEN J SNELL Pharmacist 50.0 0 X 155905 0 24776 ARTHUR VASQUEZ FORMER KEY EMPLOYEE 0.0 55.0 X 0 848653 170264 MELISSA R HICKS Former Highest Compensated Employee 0.0 55.0 X 0 275836 46483 809769 4154337 870103 true true false 0 34601 34601 Net Patient Service Revenue 622110 45816048 45816048 Shared Services 541900 76420 76420 Rent from Related 501(c)(3) Orgs. 532000 41677 41677 Pharmacy 446110 367491 367491 0 0 0 0 46301636 2582064 2582064 0 0 1529878 1334345 195533 0 195533 195533 All Other Revenue 900099 1378 1378 0 0 0 0 1378 49115212 46301636 0 2778975 X 11794996 11397278 397718 427010 412612 14398 1669985 1613674 56311 833660 805550 28110 21600 21600 2551 2551 10308 10308 12998695 12161109 837586 0 59665 59665 109791 102421 7370 116210 58105 58105 2401624 2401624 12548 11706 842 459310 459310 1436775 1369086 67689 302646 302646 Drugs and Medical Supplies 8326284 8326284 Bad Debt 833533 833533 Hospital Assessment Fee 3105455 3105455 Noncapitalized Equipment 94282 89763 4519 23339 22226 1113 0 45040267 43169736 1870531 0 47247641 289180 4779687 5202802 0 0 0 0 1055755 1031713 67723 162385 18670624 14269773 5101607 4400851 6526132 7436372 0 0 7893300 7498635 14001753 48999093 86673598 75021031 5135510 3027721 0 0 11684681 2400527 16820191 5428248 X 55851653 60335461 14001754 9257322 69853407 69592783 86673598 75021031 X 4074945 408864 -4744433 X false true true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2551 2551 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 2024 in the amount of $6,670 and $3,543, 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 32.00%, or $2,134 of 2024 membership dues paid by IU Health Tipton Hospital, for lobbying expenditures. The IHA used 11.78%, or $417 of the 2024 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 2024 that were attributable to lobbying expenditures was $2,551. 14001754 -4744432 9257322 11602126 2399628 14001754 11380084 222042 11602126 9316324 2063760 11380084 7712716 1800 2107729 406456 99465 0 9316324 0.0 0.5243 0.4757 true false 2872457 2067754 804703 15410548 12124407 3286141 387619 77612 310007 4400851 INT. IN NET ASSETS OF FNDTN. 9257322 INTERCOMPANY RECEIVABLES (NET) 39741771 48999093 0 Federal Income Taxes 0 INTERCOMPANY PAYABLES (NET) 0 DUE TO THIRD-PARTY PAYERS 2373532 SELF INSURANCE LIABILITIES 26995 2400527 X 0 0 0 0 0 0 0 0 0 0 0 0 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 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 Tipton Hospital, 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 Tipton Hospital, 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 1441 1027914 1027914 0.02325 2923 9868021 5945988 3922033 0.08872 0 0.0 0 4364 10895935 5945988 4949947 0.11197 5 596 400537 400537 0.00906 1 38 328441 328441 0.00743 1 2375 3828969 3651707 177262 0.00401 0 0.0 2 1112 23800 23800 0.00054 9 4121 4581747 3651707 930040 0.02104 9 8485 15477682 9597695 5879987 0.13301 0 0.0 0 0.0 0 0.0 1 5404 5404 0.00012 0 0.0 1 1 1186 1186 0.00003 1 17 339 339 0.00001 0 0.0 0 0.0 3 18 6929 0 6929 0.00016 false 221303 12279912 12089043 190869 X true 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 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 TIPTON'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 Tipton Hospital. IU Health Tipton Hospital The defined community per the most recent CHNA conducted in the current tax year (i.e., 2024) is Hamilton and Tipton Counties, Indiana. The hospital resides in Tipton County. 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 Tipton Hospital obtained the insight and views of those who live in and service Boone, Hamilton and Marion counties through community meetings, a survey issued to those who were unable to attend the community meetings, a survey issued to internal healthcare providers and other team members from the hospital and key informants (including those possessing public health expertise). 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. Hamilton County In collaboration with Ascension St. Vincent, Community Health Network, Riverview Health and the Hamilton County Health Department, two meetings (in-person and virtual) were held in May 2024 to receive input on the health needs in Hamilton County. The meetings were attended by 43 people in total. The significant community health needs taken from the 2021 CHNAs of IU Health Saxony, Ascension St. Vincent, Community Health Network and Riverview Health were presented at the beginning of each meeting. Participants were asked to share their feedback on the status of these health needs in Hamilton 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 participants to finalize the top health needs impacting the health of the community. Once this list was confirmed, the participants were asked to prioritize and select the top health needs for their community (i.e., the significant community health needs). Highlights of discussion during the community meeting included many, if not all, of the 2021 CHNA significant community health needs. Suggested additions to the list include tobacco and vaping, especially among youth. Additional highlights of the 2024 discussion include: - Many individuals cannot afford healthcare - Navigating the healthcare system - Care coordination across healthcare systems needs to improve including sharing patients' health information - The challenges of older adults are great, including economic stability and its impact on providing for basic needs, fall risk and emergency calls for falls, lack of having a primary care doctor, a shortage of geriatricians to care for their unique needs, navigating different insurances and the need for more aging-in-place options, such as assisted living centers, senior living neighborhoods, and senior day centers to keep them safe - Significant shortage of affordable or covered (insurance) behavioral health providers who care for individuals before they reach a crisis as well as behavioral health inpatient care - Increasing mental health challenges for youth - There is no public transportation in Hamilton County; transportation is expensive and not having it may impact employment and the needs of certain populations such as older adults and people with disabilities - People seek to live and work outside of Hamilton County which causes workforce shortages, especially for jobs that pay a lower salary - Affordable housing in Hamilton County in safe and desirable areas is lacking (especially for people with lower incomes, older adults and people with disabilities); wages do not keep up with the housing expenses in the county - People prioritize which basic needs require spending money, which may mean healthcare is avoided - Food insecurity seems to be increasing - There is a lack of affordable, quality childcare options in the county, particularly for families who have children with disabilities or special needs - There is an increasing number of overdoses among all ages in Hamilton County - drugs can be bought online, and people are not always aware of their contents The Hamilton County discussion pointed out places and people who may not have enough support to stay healthy. When thinking about Hamilton County, these were the suggested changes to improve the health and well-being of the community. - A public shuttle with drivers that are bilingual - Developing more infrastructure for aging adults and ensuring more services and social opportunities are easily accessible - Emergency medical services (EMS) mobile integrated care services and home healthcare - Increase the availability of affordable, safe housing - More funding for community partners and programming - Connect more people to affordable healthcare and ensure assistance with financial assistance programs Participants from the community meetings identified the following needs as most significant in Hamilton County, which are not listed in any order. - Access to healthcare services - Aging population and needs of older adults - Mental health - Substance use disorders - Social determinants of health (especially housing, transportation and food insecurity) Schedule H, Part V, Section B, Line 5 Facility , 2 Facility , 2 - IU Health Tipton Hospital (Continued). Three interviews were conducted with a representative from the local public health department, city public health department and a social service agency to obtain subject-matter expertise on the health and well-being of those living in Hamilton County. The following issues were discussed as significant: - Care gaps and worsening health conditions are common due to access issues related to healthcare services, especially primary care, and not enough services are available to meet the demand in the county. Those with health insurance may not be using it as effectively as possible. Though there are great community-clinical linkages happening between specialists, healthcare providers, healthcare systems, LHDs and community based organizations, there is a need to increase comprehensive care for all in the community as well as integrate efforts to meet patients' physical, behavioral and social needs. - Methods to incentivize/empower more community members to engage in a healthier lifestyle and ensure the environment better supports a healthy lifestyle (e.g., walking and biking infrastructure). - Mental health got worse after the COVID-19 pandemic. There is a need for more prevention strategies and more mental health providers and services for all ages. Navigating existing resources can be hard for some groups in the community. Insurance often does not cover services, and self-pay can be expensive. Hamilton County residents are transported to neighboring counties for services which can be burdensome for individuals and families. Substance use disorders are an issue, including access to treatment services and the affordability and access to medication-assisted treatment. Older adults are self-medicating as they age which increases the risk of overdose. There are concerns that youth with mental health illness will fall behind in education attainment. - Substance use is common among youth as well as drinking and driving. Drug and alcohol use and overdoses are a problem for the county too. - Increased vaping and tobacco use in youth and its overall impact on health as one ages is a concern. - Oral and vision care services are hard to access due to individuals not having insurance coverage or Medicaid will not pay for services. - People living in rural communities in northern Hamilton County have a hard time accessing transportation and food in their communities. - Older adults are living longer, making their future financial security uncertain. These issues seem to be more problematic for this population: aging in place; mobility and ambulatory difficulty; food insecurity; greater needs for acute care; and caregiver strain. - Changes in the population and its impact on accessing care - Certain groups face worse health outcomes than the general population. - STI testing is hard to access in the community. The local health department needs more partners to expand those services into the community. - Many individuals do not have access to technology or the internet and have challenges using these mediums, which is where much of the current communication happens; therefore, information and resources can be missed. - Social determinants of health (SDOH) are negatively impacting the community, particularly due to the lack of affordable and safe housing, transportation (especially for people with special needs and older adults) and food insecurity. - The county must ensure it is prepared to address emerging issues such as climate change's impact on health, preparedness for disasters and the impact of technology on youth mental health. - The county should increase the use of the local health departments' (LHD) services and ensure collaborative partnerships between the LHD and community-based organizations. Tipton County One meeting was held in April 2024 to receive input on the health needs in Tipton County. The meeting was attended by 14 people in total. Highlights of the 2024 discussion include: - There is a lack of transportation to and from health services - The transportation options for older adults and people with disabilities is at capacity - Other forms of transportation, such as biking, are not easy to do in the county - There is a lack of affordable housing, including housing for older adults and people with low incomes - There is a need for more primary care and pediatric services, walk-in clinics, urgent care, access to screenings, same day appointments and pharmacy with flexible hours - More low-cost dental services are needed - More health education - There is a lack of awareness of the availability of social services in the community - There is a lack of affordable daycare options in the county - Addressing mental health is challenging because there is a need for more services, especially for students in Grades 8-12; stigma of metal health in teens; and costs and insurance coverage - Access to healthy foods is challenging and costly Participants from the community meeting identified the following needs as most significant in Tipton County, which are not listed in any order: - Access to healthcare services - Education, advocacy and support - Social determinants of health (especially housing, transportation, access to healthy foods and childcare) Two interviews were conducted with representatives from the local health department and a CBO to obtain subject-matter expertise on the health and well-being of those living in Tipton County. The following issues were discussed as significant: - Behavioral health (including substance use treatment) is a top priority and the need for more services in the community, including a psychiatrist. - Food access - Availability of childcare - Reducing stigma - Transportation to and from health appointments - Access to specialty healthcare providers - Certain groups face worse health outcomes than the general population. - Lack of awareness of the availability of the many services and supports available in the community and how to access them - Increasing partnerships with the health department, Department of Children and Families and other community partners to increase awareness of resources - Not duplicating services and ensuring sufficient services for health and behavioral health are available in the community 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: - 4C Health - A Healthier Hamilton County Systems of Care - Alternatives, Inc. - Boys and Girls Club - Boys and Girls Club of Noblesville - Breathe Easy Hamilton County - Care Patrol - Carmel Clay Schools - Cherish Center - Children's TherAplay - Cicero Fire Department - City of Carmel EMS - City of Fishers EMS - City of Noblesville EMS - City of Tipton Fire Department - City of Tipton Mayor - City of Westfield - Council Member (County At-Large), Hamilton County Government - Encore Lifestyle and Enrichment Center - Family Development Services/Head Start Hamilton County - Family Promise of Hamilton County - Family Resource Center - Hamilton County Community Foundation - Hamilton County Council on Alcohol and Other Drugs - Hamilton County Parks and Recreation - Hamilton County Sheriff's Office - Hamilton County Veterans Corporation - Hamilton Heights - HAND - Heart and Soul Free Clinic - HOPE Family Care Center - Ignite Transform - Indiana Parkinson Foundation - IU Health Tipton Hospital Emergency Department - Ivy Tech Hamilton County - Janus Developmental Services - Law Enforcement Representative - Meals on Wheels of Hamilton County - Mudsock Youth Athletics - Noblesville Chamber of Commerce - Noblesville Fire Department - Noblesville Schools - PrimeLife Enrichment - School Nurse - Tipton Community Schools - Shepherd's Center of Hamilton County - Student Impact of Westfield - Suburban North Club - The O'Connor House - The Waters of Tipton - Tipton County Health Department - Tri-Central School Corporation - Superintendent - Trinity Free Clinic - White River Christian Church - Youth Mentoring Initiative Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - IU Health Tipton Hospital. In March 2025, IU Health's board of directors approved the implementation strategy for IU Health Tipton Hospital to respond to the needs identified in their 2024 CHNA. IU Health Tipton Hospital 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 Tipton Hospital will address all the community health needs identified in the 2024 CHNA. In 2024, IU Health Tipton Hospital addressed needs identified in the 2021 CHNA using the 2022-2024 implementation strategy planned adopted in March 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 Tipton Hospital 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; Maternal and Infant Health and Child Well-being; and Social Determinants of Health. Access to Healthcare Services Provided vaccine clinics in the community. IU Health Tipton Hospital held one vaccine clinic in 2024. Free flu vaccines were offered to community members attending the hospital hosted health fair. In total 33 free flu vaccines were provided during the clinic. The Tipton County Health Department also provided vaccines to the community in 2024. With the size of the local community one community partner offering the clinics completed the need. Supported community members accessing healthcare services regardless of their ability to pay. The hospital provides financial assistance to patients each year that includes 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 90 people at IU Health Tipton Hospital. Aging Population and Needs of Seniors Supported 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 were needed annually to help with overall operation expenses. Helping with funding assures seniors had access to medical appointments, groceries, banking and other basic living needs. In 2024 the center provided 5,157 rides, over 4,000 of those were for seniors age 60+. The program provided around 600 rides to appointments at the hospital in 2024. Supported 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, who took a trip to a show at Beef & Boards Dinner Theatre. Around 21 seniors were able to attend that otherwise would not have had either the funds to go or the transportation. The members that attended commented that it helped their mental health by being able to attend trips like this. Many seniors don't have or found it difficult to provide their own transportation or couldn't take the cost of this out of their budget, the grant provides this trip to them free and provides the transportation. 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 continues to assess and evolve its behavioral health services based on the needs of patients and the communities it serves. Since 2018, this program had served 15 IU Health and two non-IU Health emergency department patients who struggled with substance use disorder through supported aid in recovery. IU Health continued to serve patients with a need for this service through the Virtual Behavioral Health team. 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 871 visits included patients seeking care in the emergency departments in the Indy Suburban Region (which included IU Health Tipton 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. Chronic Disease and Chronic Disease Management Supported community Smoking Cessation Program (educated and reduced 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 had not taken over this program at the time. Patients expressing an interest in quitting smoking through our local physician offices were evaluated on an individual basis for the best treatment planned. Physicians prescribed nicotine replacement patches/gum or Chantix (if insurance allows); others needing further help would be provided with additional tobacco resources including the Centralized Tobacco Treatment Program. Further implemented IU Health Serves Days of Service (volunteer event that engaged 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 three projects. These projects were a mixture of on-site, take-home and in the community. Projects for 2024 included 288 hygiene kits that were assembled and donated to the school systems to provide students in need throughout the year, playground enhancements at a local elementary school (all new mulch), handmade over 300 Christmas ornaments and bookmarks for a free community ornament tree during their holiday event in December. All these projects had a total of 45 team members volunteering their time for a total of 117 hours served. Offered Fresh & Fit (a free 10-week fitness and nutrition program to improved overall physical and mental health). Due to low participation numbers they decided to pause the program in 2024 in Tipton. They took the time to evaluate the program and how it might best work in their local community. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - IU Health Tipton Hospital (Continued). Provided community screenings and education initiatives. The hospital hosted a community health fair in 2024. A total of 66 community members attended and participated in the free screenings and education booths. The health fair offered a total of six free screenings (blood draw including glucose, A1C and cholesterol, blood pressures, sleep disorder screenings, balance and fall risk, pulmonary function testing and flu vaccines). A total of 120 free screenings and 33 free flu vaccines were provided. Also had over 20 booths offering health education or information on community resources. Note: The screening results from the lab draw at the health fair were sent directly to the patient in the mail. All patients participating in screenings were encouraged to follow-up with their physician to discuss their results. Participants also had access to a health directory if they needed a primary care physician in the area. 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 focused in 2024 was on improving access and patient experience with medication management. CTTP improved patient tobacco treatment medication supported 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 increased 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 supported. In 2024, CTTP received 1,767 referrals which were 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). Maternal and Infant Health and Child Well-being Further implemented Car Seat Program (education on properly fitting child safety seats). IU Health Tipton Hospital had two car seat technicians. The technicians conducted 30 car seat fittings throughout the year free of charge. They also attended a Family Resource and Safety Fair and Back to School Night and offered general education on car seat safety, expiration dates and information on how families in need could received assistance through the local program. Social Determinants of Health Supported local community programs that served families with lower incomes. Team members participated in a program called Laundry Lift. Community organizations signed up for a month to support the program by having volunteers at the laundry mat one day a month during set times and provide quarters, detergent and fabric softener so families could do their laundry that day for free. The hospital sponsored one day during the year assisting a total of 21 families. Supported My Closet - Tipton Community School Corporation (TCSC) (clothing pantry for TCSC students in need of basic clothing items). In 2024, IU Health Tipton provided a grant to the program "My Closet" at Tipton Community School Corporation. This program supported all students in need from pre-school through grade twelve. Families did not have to show a financial need, just simply had to ask to visit the closet. Students were taken in one at a time to help with confidentiality and were able to shop for a complete outfit (shirts, shoes, undergarments, socks, coats, gloves, hats) one time each semester. Evening appointments were available for families who attended together with their student. A local salon also offered vouchers for a free haircut. The program director works directly with the families, if she saw a need, then exceptions were made so the student had what they needed. From January - December 2024, there were a total of 202 student visits to the closet. Some of the items distributed included 104 winter coats, 25 shoe vouchers and 60 pairs of shoes were distributed directly from the inventory. Significant Needs Hospital Did Not Address IU Health Tipton Hospital was 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 were available in the community, but people did 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 would 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. 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 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. 4 IU HEALTH TIPTON HOSPITAL HEMATOLOGY-ONCOLOGY 1000 S MAIN ST SUITE B TIPTON IN 46072 Specialty Care IU HEALTH PRIMARY CARE - TIPTON 1060 S MAIN ST SUITE 4 TIPTON IN 46072 PRIMARY CARE IU HEALTH PRIMARY CARE - TIPTON 1010 S MAIN ST SUITE 110 SUITE 200 TIPTON IN 46072 PRIMARY CARE IU HEALTH TIPTON HOSPITAL LAB 1000 S MAIN ST TIPTON IN 46072 LAB 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 $833,533. 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 35.05%. 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. Advocacy: IU Health supports a local program, Laundry Lift, organized by a community partner. This program covers the cost of laundry expenses (loads of laundry and detergents) at the local laundry mat on a monthly basis. Coalition Building: IU Health team members participate in the Tipton Community Care Coalition and general local community meetings to share resources and information as well as improve community and partner capacity to address health needs and advance health equity in the community. Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care IU Health Tipton 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 6a Community benefit report prepared by related organization Indiana University Health, Inc. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 833533 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'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 8 Community benefit & methodology for determining medicare costs 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 III, Line 9b Collection practices for patients eligible for financial assistance IU Health Arnett follows IU Health's FAP and written debt collection policy describe the collection practices applicable to patients, including those who may qualify for financial assistance. 1. Financial Assistance Application Financial Assistance Applications must include the following documentation: - All sources of Income for the last three (3) months. - Most recent three (3) months of pay stubs or Supplemental Security Income via Social Security. - Most recent three (3) statements from checking and savings accounts, certificates of deposit, stocks, bonds and money market accounts. - Most recent state and Federal Income Tax forms including Schedules C, D, E, and F. In the event the patient or guarantor's income does not warrant the filing of a federal tax statement, the individual may submit a notarized affidavit attesting to the foregoing. - Most recent W-2 statement. - For patients or members of the Household who are currently unemployed, Wage Inquiry from WorkOne. - If applicable, divorce/dissolution decrees and child custody order. Patients or their guarantors wishing to apply for Financial Assistance due to Financial Hardship are encouraged to submit an Application within ninety (90) days of discharge. Patients or their guarantors may submit an Application up to two-hundred and forty (240) days from the date of their initial post-discharge billing statement from IU Health, however, accounts may be subject to Extraordinary Collection Actions (ECA) as soon as one-hundred and twenty (120) days after receipt of the initial post-discharge billing statement. Patients or their guarantors submitting an incomplete Financial Assistance Application will receive written notification of the Application's deficiency upon discovery by IU Health. The Application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health will suspend any ECA until the Application is complete or the expiration of the forty-five (45) day period. Patients with limited English proficiency may request a copy of this Policy, a Financial Assistance Application, and a Plain Language Summary in one of the below languages: - Arabic; - Burmese; - Burmese - Falam; - Burmese - Hakha Chin; - Mandarin/Chinese; or - Spanish The patient, and/or their representative, such as the patient's physician, family members, legal counsel, community or religious groups, social services or hospital personnel may request a Financial Assistance Application be mailed to a patient's primary mailing address free of charge. IU Health maintains the confidentiality of all Financial Assistance Applications and supporting documentation. IU Health will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance Application. 2. Financial Assistance Determinations IU Health will inform patients or guarantors of the results of their Application by providing the patient or guarantor with a Financial Assistance Determination within ninety (90) days of receiving a completed Application and all requested documentation. A patient's Financial Assistance Application and Financial Assistance Determination are specific to each date(s) of service and approved related encounters. If a patient or guarantor is granted less than full charity assistance and the patient or guarantor provides additional information for reconsideration, Revenue Cycle Services may amend a prior Financial Assistance Determination. 3. Extraordinary Collection Actions IU Health may refer delinquent patient accounts to a third-party collection agency after utilizing reasonable efforts to determine a patient's eligibility for assistance under this Policy. Reasonable efforts include the following: - IU Health will notify the patient of this Policy at least thirty (30) days prior to initiating an ECA. - IU Health will not initiate an ECA for at least one-hundred and twenty (120) days after the patient's initial post-discharge billing statement. - IU Health will review all Financial Assistance Applications received up to and including two-hundred and forty (240) days after the patient's initial post-discharge billing statement. IU Health will cease any ECAs it has initiated upon receipt of a Financial Assistance Application until a Financial Assistance Determination is made under this policy. - If an Application is Approved, IU Health will issue a revised statement, issue refunds, and make reasonable efforts to reverse ECAs as necessary. IU Health and its third-party collection agencies may initiate an ECA against a patient or their guarantor in accordance with this Policy and 26 C.F.R. § 1.501(r). ECAs may include the following: - Selling a patient or their guarantor's outstanding financial responsibility to a third party. - Reporting adverse information about the patient or their guarantor to consumer credit reporting agencies or credit bureaus. - Deferring or denying, or requiring a payment before providing, medically necessary care because of a patient or their guarantor's nonpayment of one or more bills for previously provided care covered under this Policy. - Actions requiring a legal or judicial process, including but not limited to placing a lien on a patient's or their guarantor's property, foreclosing on a patient's or their guarantor's real property, attaching or seizing a patient's or their guarantor's bank account or other personal property, commencing a civil action against a patient or their guarantor, causing a patient or guarantor's arrest, causing a patient and/or guarantor to be subject to a writ of body attachment, and garnishing a patient or guarantor's wages When it is necessary to engage in such action, IU Health and its third party collection agencies, will engage in fair, respectful and transparent collections activities. 4. Refunds Patients eligible for Financial Assistance under this Policy who remitted payment to IU Health in excess of their Patient Responsibility will be alerted to the overpayment as promptly after discovery as is reasonable given the nature of the overpayment. Patients with an outstanding account balance due on a separate account will have their refund applied to the outstanding balance. Patients without an outstanding account balance described above will be issued a refund check for their overpayment as soon as technically feasible. Schedule H, Part V, Section B, Line 16a FAP website - 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 statistics, Tipton County's population is 15,324 with approximately 49.9% being female and 50.1% male. 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 Tipton Hospital 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 Tipton Hospital can be accessed on the IU Health website. A nondiscrimination clause is explicitly stated in IU Health Tipton Hospital 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. During 2024, IU Health Tipton Hospital's promotion of community health included the following highlights: IU Health Tipton Hospital continues to be committed to maintaining strong partnerships with local non-profit organizations and community groups. The hospital focuses on promoting health education and raising awareness to improve overall well-being within the community in addition to actively supporting initiatives and events that benefit families in need. 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 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 X X X X false true false false false false false true false EMILY M FITZ MD DIRECTOR 0 250707 0 12228 0 4040 0 9075 0 23000 0 299050 0 0 CARA L BREIDSTER CFO (ISR) 0 309988 0 39308 0 2322 0 12104 0 54009 0 417731 0 0 KENNETH D PUCKETT Director / PRESIDENT (ISR) 0 631564 0 258569 0 110356 0 128220 0 66086 0 1194795 0 82802 ARTHUR VASQUEZ FORMER KEY EMPLOYEE 0 591884 0 254900 0 1869 0 116832 0 53432 0 1018917 0 0 TAMARAH D BROWNLEE REGIONAL VP-HR (ISR) 0 254100 0 30897 0 810 0 11661 0 35342 0 332810 0 0 ATHANASIA S BANICH VP, COO (ISR) 0 311943 0 34935 0 540 0 12700 0 42903 0 403021 0 0 HARPREETINDER SINGH MD REGIONAL CMO (ISR) 0 427677 0 51321 0 4242 0 13800 0 60451 0 557491 0 0 CARRIE WING VP-CNO (ISR) 0 242073 0 40250 0 1178 0 11456 0 24038 0 318995 0 0 MELISSA R HICKS Former Highest Compensated Employee 0 243839 0 31515 0 482 0 11225 0 35258 0 322319 0 0 LIESEL J DELAMATER COO/CNO Tipton 181689 0 23689 0 399 0 8556 0 46187 0 260520 0 0 0 PATRICIA A HARRIS DIRECTOR-CLINICAL OPERATIONS 133597 0 9419 0 1131 0 5719 0 9114 0 158980 0 0 0 ANGELA K MORGAN MANAGER - PHARMACY DEPT. 162077 0 7259 0 516 0 7059 0 35892 0 212803 0 0 0 STEVEN J SNELL Pharmacist 148324 0 6057 0 1524 0 6178 0 18598 0 180681 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 4b Supplemental nonqualified retirement plan KENNETH D. PUCKETT AND ARTHUR VASQUEZ PARTICIPATE 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: $100,855 Schedule J, Part I, Line 7 Non-fixed payments Amounts disclosed in Column B (ii) include a long-term 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 Board of Directors prior to any incentive payout. LINE J - WEB SITE HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-TIPTON-HOSPITAL Form 990, Part III, Line 4a-4c Description of program services (Expenses $ 38,858 including grants of $ 0)(Revenue $ 41,677) IU HEALTH TIPTON HOSPITAL, INC. RECEIVES RENTAL REVENUE FROM A RELATED EXEMPT ORGANIZATION, IU HEALTH CARE ASSOCIATES, INC. FOR VARIOUS OFFICES AND CLINICS. SECTION B, LINES 12, 13, 14, AND 16B - 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 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 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 IX, Line 11g Other Fees Professional fees - Total Expense: 130848, Program Service Expense: 122064, Management and General Expenses: 8784, Fundraising Expenses: ; Other Fees - Total Expense: 45618, Program Service Expense: 42556, Management and General Expenses: 3062, Fundraising Expenses: ; Consulting - Total Expense: 61698, Program Service Expense: 57556, Management and General Expenses: 4142, Fundraising Expenses: ; Intercompany fees - Total Expense: 11731362, Program Service Expense: 10963478, Management and General Expenses: 767884, Fundraising Expenses: ; Physician fees - Total Expense: 254071, Program Service Expense: 252389, Management and General Expenses: 1682, Fundraising Expenses: ; Contract service - Total Expense: 775098, Program Service Expense: 723066, Management and General Expenses: 52032, 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 - -4744432; 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