2025-11-13T14:09:54+00:00 2024-12-31 990 2024-01-01 350867958 Indiana University Health Ball Memorial Hospital Inc INDI 3179634842 950 N MERIDIAN STREET 1200 INDIANAPOLIS IN 46204 Michael L Craig VP & CFO 8123539171 2025-11-13 2024 2025-03-06 01:10:19Z JEFFREY C BIRD MD 950 N MERIDIAN STREET 1200 INDIANAPOLIS IN 46204 585369174 false X SEE SCHEDULE O X 1926 IN Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. 16 12 3174 297 681345 30465 6104717 7548190 575827879 545923862 19809251 22170120 2900591 5358132 604642438 581000304 805128 0 192980346 200844836 0 0 352915253 354399693 545895599 556049657 58746839 24950647 730245191 731859222 52965674 28303840 677279517 703555382 X Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. false false 500277687 805128 513597462 INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL IS A 379 BED ACUTE CARE HOSPITAL, WHICH OPERATES AS A REGIONAL REFERRAL CENTER AND TEACHING HOSPITAL, LOCATED IN MUNCIE, INDIANA. 24441646 0 25092399 Our network of pharmacies offers the convenience 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. 4427908 0 4545800 RENT FROM RELATED 501(C)(3) ORGANIZATIONS 2444849 0 2509943 IU HEALTH BALL MEMORIAL HOSPITAL, INC. PROVIDES SERVICES, WHICH INCLUDE COORDINATED ACTIVITIES AND POLICES, TO RELATED TAX-EXEMPT ORGANIZATIONS DESIGNED TO MEET THE MISSION OF THE INDIANA UNIVERSITY HEALTH SYSTEM. 219093 0 224926 Clinical Research 0 0 -46668 Income (Loss) from Pass-Through Entities 2663942 2688201 531811183 true true false true false false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false true false false false false false true true true true false false true 0 0 3174 true true true false false false false false false false false false false false X 16 12 false false false false true true true true true false false false true true true true true true false false true true IN X CRAIG J JONES 3179634842 950 N MERIDIAN STREET SUITE 800 INDIANAPOLIS IN 46204 DANIEL E BORGENHEIMER DIRECTOR/CHAIR 2.0 4.0 X X 0 0 0 J STEVEN RHEA Director/Secretary/Treasurer 2.0 4.0 X X 0 0 0 JEFFREY C BIRD MD DIRECTOR/PRESIDENT (ECR) 35.0 20.0 X X 0 1005128 176317 PETER M VOSS MD DIRECTOR/VICE CHAIR 25.0 30.0 X X 493143 51629 67799 WILBUR R DAVIS DIRECTOR/VICE CHAIR 2.0 4.0 X X 0 3000 0 CHARLES R ROUTH MD DIRECTOR 2.0 53.0 X 0 296767 62572 DEA BELL DIRECTOR 2.0 4.0 X 0 6000 0 DERRON L BISHOP PHD DIRECTOR 2.0 4.0 X 0 2000 0 DONALD J ENGEL DIRECTOR (PART YEAR) 2.0 4.0 X 0 0 0 GEOFFREY S MEARNS DIRECTOR 2.0 4.0 X 0 0 0 JOAN V CASTOR DIRECTOR 2.0 53.0 X 0 644641 136828 KEVIN D WOODGETT DIRECTOR (PART YEAR) 2.0 4.0 X 0 4000 0 MICHAEL J FISHER DIRECTOR 2.0 7.0 X 0 0 0 PATRICK A CLEARY MD DIRECTOR 2.0 4.0 X 0 4000 0 TERRY W BAILEY DIRECTOR 2.0 4.0 X 0 6000 0 WILLIAM W HINKLE DIRECTOR 2.0 4.0 X 0 6000 0 JONATHAN W VANATOR CFO (ECR) (PART YEAR) 33.0 22.0 X 0 468222 65683 MICHAEL L CRAIG CFO (Part Year) 5.0 50.0 X 0 375821 65857 MICHELLE R ALTOBELLA VP-General Counsel, Asst Secretary (ECR) 2.0 55.0 X 0 274361 53284 BRIAN REED VP-HUMAN RESOURCES (ECR) 20.0 35.0 X 0 211282 63512 KREIGH COOK COO (ECR) 10.0 40.0 X 307676 0 43866 MELISSA R HICKS VP & CNO (ECR) 10.0 45.0 X 275836 0 46483 RYAN M JOHNSTON MD VP & CMO (ECR) 10.0 45.0 X 446201 0 79162 ALVIS FOSTER Physicist-Radiation Medicine 55.0 0 X 253549 0 71441 CHRISTOPHER GAMBLE MD Associate CMO 55.0 0 X 371637 0 59974 JOSEPH BUTTS RADIATION PHYSICIST 55.0 0 X 244865 0 37402 JULIE M PAINTER PHYSICAL THERAPIST 55.0 0 X 232130 0 20877 REBECCA A CLARK VP & CNO 50.0 0 X 246766 0 49478 DAVID A SCHWARTZ Former Highest Compensated Employee 0.0 50.0 X 0 253586 21452 2871803 3612437 1121987 true true false 7522867 25323 7548190 NET PATIENT SERVICE REVENUE 622110 513597462 513597462 PHARMACY 446110 25092399 24364386 728013 SHARED SERVICES 541900 2509943 2509943 RENT FROM RELATED 501(C)(3) ORGS. 532000 4545800 4545800 Clinical Research 541700 224926 224926 -46668 0 -46668 0 545923862 21580323 21580323 621710 621710 0 621710 621710 4958667 4324903 43967 633764 -43967 589797 589797 All Other Revenue 900099 3953770 3953770 CAFETERIA/FOOD SERVICE 721110 584757 584757 GIFT SHOP 453220 197895 197895 0 0 0 0 4736422 581000304 545242517 681345 27528252 X 805128 805128 1930251 1865165 65086 0 154771 149552 5219 160468222 155057365 5410857 5428940 5245881 183059 22313405 21561015 752390 10549247 10193535 355712 56169 56169 23778 23778 33409 33409 144411389 134903908 9507481 0 1626854 1626854 2087071 1946966 140105 2305764 1152882 1152882 12152762 12152762 108016 100765 7251 46 46 24146318 23008743 1137575 3737009 0 3737009 DRUGS AND MEDICAL SUPPLIES 131633609 131633609 HOSPITAL ASSESSMENT FEES 31395887 31395887 All Other Expenses 536979 511243 25736 Noncapitalized Equipment 123150 117248 5902 21483 9483 12000 0 556049657 531811183 24238474 0 404150916 968656 3597 72075821 59429424 0 0 0 0 9445 0 13863965 15815746 1203557 1883337 582064783 370549644 215567991 211515139 21152621 24102906 0 2180867 2154803 40008 40008 0 415945606 730245191 731859222 19962712 19165918 0 0 0 0 0 8941 33002962 9128981 52965674 28303840 X 677279517 703555382 677279517 703555382 730245191 731859222 X 24950647 1325217 1 X false true true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 23778 23778 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY IU Health Ball Memorial Hospital paid institutional membership dues to the American Hospital Association ("AHA"), Indiana Hospital Association ("IHA"), and 340B Health during 2024 in the amount of $58,037, $40,305, and $7,046, respectively. Each membership organization notified IU Health Ball Memorial Hospital that a portion of the dues it paid were used for lobbying purposes. The AHA used 32.00%, or $18,572 of 2024 membership dues paid by IU Health Ball Memorial Hospital, for lobbying expenditures. The IHA used 11.78%, or $4,748 of the 2024 membership dues paid by IU Health Ball Memorial Hospital, for lobbying expenditures. 340B Health used 6.50%, or $458 of the 2024 membership dues paid by IU Health Ball Memorial Hospital, for lobbying expenditures. Total membership dues paid to these organizations by IU Health Ball Memorial Hospital during 2024 that were attributable to lobbying expenditures was $23,778. 6616096 6616096 282764206 222742479 60021727 429120 429120 0 141313466 101378766 39934700 150941895 45999279 104942616 211515139 OTHER INTERCOMPANY RECEIVABLES 415945606 415945606 0 Federal Income Taxes 0 DUE TO THIRD-PARTY PAYERS 6145084 SELF-INSURANCE LIABILITIES 767232 INTERCOMPANY PAYABLES (NET) 0 ENVIRONMENTAL OBLIGATIONS 1033984 ALL OTHER LIABILITIES 1182681 9128981 X 0 0 0 0 0 0 0 0 0 0 0 0 Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote IU Health Ball Memorial 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 Ball Memorial Hospital, Inc.'s portion of the December 31, 2024, and 2023 deferred tax assets is $6,334,603 and $5,248,853 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 Ball Memorial Hospital, Inc.'s portion is $23,277,563. 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 13393 11193714 11193714 0.02013 22683 123790112 122027486 1762626 0.00317 0 0.0 0 36076 134983826 122027486 12956340 0.02330 9 27675 3161559 139239 3022320 0.00544 4 2597 16519928 4505979 12013949 0.02161 1 8086 10570960 10112631 458329 0.00082 1 120 1914500 520314 1394186 0.00251 2 17958 2150331 1933714 216617 0.00039 17 56436 34317278 17211877 17105401 0.03076 17 92512 169301104 139239363 30061741 0.05406 1 1584 17081 17081 0.00003 1 37 41063 30000 11063 0.00002 1 39 9905 9905 0.00002 0 0.0 0 0.0 1 720 91866 91866 0.00017 1 277 8346 8346 0.00002 1 45 138019 138019 0.00025 0 0.0 6 2702 306280 30000 276280 0.00050 false 0 100444944 103550861 -3105917 X true true 1 1 IU HEALTH BALL MEMORIAL HOSPITAL 2401 UNIVERSITY AVE MUNCIE IN 47303 HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-BALL-MEMORIAL-HOSPITAL 22-005079-1 X X X X X IU HEALTH BALL MEMORIAL 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 BALL MEMORIAL HOSPITAL'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 BALL MEMORIAL HOSPITAL. IU Health Ball The defined community per the most recent CHNA conducted in the current tax year (i.e., 2024) is Blackford, Delaware, Jay and Randolph Counties, Indiana. The hospital resides in Delaware 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 Ball obtained the insight and views of those who live in and service Blackford, Delaware, Jay and Randolph counties through community meetings and key informant interviews (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. Blackford County In May, IU Health held two community meetings in Blackford County to gather input on local health needs. A total of 21 people attended. Participants reviewed secondary data and a draft list of health priorities. They shared reactions, suggested additions, and discussed possible causes of health issues. Key discussion highlights from 2024 include: - Chronic diseases and risk factors are widespread especially among the youth - The amount of health information and services is overwhelming - Access to healthcare is hard due to a local emergency room closing, discomfort with virtual care, health literacy, costs of services and insurance coverage (which also impacts mental health and dental services too) - Impacts on residents that delay healthcare or do not seek care - Access to mental health and substance use treatment is hard due to provider shortages, long waits and no medication treatment options - Limited support staff in schools such as social workers and guidance counselors for youth mental health needs - Prenatal care access - Limited dentists in the community - Sustainability of local coalitions trying to improve community health - Older adults face challenges with accessing healthcare services, transportation, fitness options and housing assistance. Social isolation is increasing as well as the demand for home care. - Local communities such as Montpelier do not have enough support to stay healthy - Social determinants of health, especially housing, poverty (especially in rural areas) and food insecurity are a concern Participants from the community meetings identified the following needs as most significant in Blackford County, which are not listed in any order. - Aging population and older adults (including social isolation) - Behavioral health (including mental health and substance use disorders) - Chronic disease prevention and management - Poverty (including impact on transportation, income inequality and children in poverty) - Smoking and vaping A representative from the local public health department was interviewed to learn more about the health and well-being of residents in Blackford County. The following issues were discussed as significant: - The health status of the community has not changed - Needs of the aging population and older adults - Physical inactivity - Maternal and child health - Community CPR and First Aid classes and Stop the Bleed courses are important resources - Changes in the population and its impact on accessing care - Substance use disorders in teens and younger adults - The limited healthcare services in certain communities such as Montpelier - Poverty in rural communities Delaware County In May, IU Health held three community meetings in Delaware County to gather input on local health needs. A total of 34 people attended. Participants reviewed secondary data and a draft list of health priorities. They shared reactions, suggested additions, and discussed possible causes of health issues. Key discussion highlights from 2024 include: - Communities with colleges have unique health needs - Changing the health of a community is slow and can be overwhelming - Chronic diseases and risk factors are widespread - The aging population is growing and there are no geriatricians in the community - Sexual health education in schools could increase knowledge such conditions as unplanned pregnancies and sexually transmitted infections (STIs) - There are more syphilis cases including pregnant women - More mental health treatment is needed - Recruiting and maintaining providers, especially specialists, is hard - Navigating the healthcare system with limited or no insurance is hard - Coordinated care could help more residents - Access to mental health and substance use treatment is hard due to long waits, limited preventive services, stigma and insurance coverage - Social determinants of health, especially poverty (including children living in poverty), unemployment, social isolation, unsafe and expensive housing, lack of transportation and quality education impact health - Certain groups face worse health outcomes than the general population. - Partners like 812 Coalition, Ball State, Muncie Mission, YWCA, Open Door, Addictions Coalition of Delaware County and Healthy Community Alliance are positive for the community - Philanthropy in the community is great - Schools are a great place to provide health education on prevention Participants from the community meetings identified the following needs as most significant in Delaware County, which are not listed in any order. - Accessing healthcare services (including better coordinated care, insurance coverage and health literacy) - Accessing mental health and substance use disorder treatment (for people of all ages) - Other social determinants of health (especially food insecurity, transportation and isolation) - Poverty - Safe, affordable and quality housing Five pastors participated in a focus group to provide input on the health needs of two census tracts in Muncie where more than 50% of the population is Black or African American. The needs and issues of recently incarcerated people convicted of felons returning to their communities was a focus. Needs include: - More family planning and obstetric services - Addressing poverty, stigma, food insecurity, poor housing - Increasing access to jobs - Continued support and training for employment from colleges and other partners - More positive, personal and community interactions An interview was conducted with a representative from the local public health department to obtain subject-matter expertise on the health and well-being of those living in Delaware County. The following issues were discussed as significant: - Though there are many people and organizations working on improving health outcomes in the community, progress is slow - Chronic diseases and their risk factors such as obesity, physical inactivity and diabetes are concerns - Mental illness and substance use disorders are an issue in the community - treatment options are fragmented or limited - Social determinants of health, especially (generational) poverty, food insecurity, quality education and apprenticeships and training for trade jobs are concerns - Certain groups face worse health outcomes than the general population. - Human trafficking in certain industries exists in the community Jay County In May, IU Health held two community meetings in Jay County to gather input on local health needs. A total of 17 people attended. Participants reviewed secondary data and a draft list of health priorities. They shared reactions, suggested additions, and discussed possible causes of health issues. Schedule H, Part V, Section B, Line 5 Facility , 2 Facility , 2 - IU HEALTH BALL MEMORIAL HOSPITAL (continued). Key discussion highlights from 2024 include: - Unaddressed trauma is affecting residents' health - Access to primary and specialty care is limited - Access to mental health and substance use treatment is hard due to discomfort with virtual care, providers shortages and limited services - Access to healthcare services is hard due to provider shortages, long wait times, health literacy, broadband gaps, and understanding insurance coverage - Changes in the population and its impact on accessing care - More support for older adults to age in place or seeking assisted living - Challenges recruiting and maintaining skilled maternal healthcare providers - Teen births are common - Accessing dental care is challenging due to provider shortages and lack of insurance coverage - Chronic disease risk factors are widespread in the community - Social determinants of health including no transportation; affordable, healthy food; limited housing options and poverty impact health - A local employer increased services for employees and families, which is positive - There are parks, trails and fitness centers in the community - Partners such as The Jay County Drug Prevention Coalition (JCDPC) help advocate for services and the needs of residents - Programs like Healthy Beginnings and Healthy Families are good for mothers, infants and families - Healthcare staff are appreciated in the community Participants from the community meetings identified the following needs as most significant in Jay County, which are not listed in any order: - Access to healthcare services (especially health literacy, more information on services and programs and language barriers) - Access to mental health and substance use treatment - Maternal and infant health - Smoking - Social determinant of health (especially children living in poverty and the food environment) A representative from the local public health department was interviewed to learn more about the health and well-being of residents in Jay County. The following issues were discussed as significant: - The health status of the community has not changed - There's a need for more healthcare, mental health and substance use services - Dental health in the community is poor - Smoking - Social determinants of health including food insecurity, cost of housing and transportation - A need for good maternal and infant health services - Certain groups face worse health outcomes than the general population. - Purdue Extension, community advocates, faith-based organizations and a mobile market are good community resources Randolph County A representative from the local public health department was interviewed to learn more about the health and well-being of residents in Randolph County. The following issues were discussed as significant: - Smoking, diabetes, mental health and maternal and infant care are concerns - Health First Indiana funds are addressing these issues - The amount of public health funding impacts how much local public health can address health needs - Changes in the population and its impact on accessing care and other services - The limited specialty care in the community - Housing and poverty - Community assets include good local governmental leaders, Health First Indiana funding, food pantries and grocery stores and healthcare providers - Rural communities have unique healthcare needs 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: - Ball State University - Blackford Senior Center - Blood n Fire ministries - Boys and Girls Clubs of Muncie - Build a Better Blackford - Christian Ministries - Citizens St. Bank - Walnut Street - City of Muncie - Community and Family Services, WIC - Concerned Clergy in Muncie - Delaware County Purdue Extension - Delaware County Sheriff's Office - East Central Indiana Area Health Education Center (ECI-AHEC) - East Central Indiana Regional Partnership (ECIRP) - FCC Indiana - George and Frances Ball Foundation - Heart of Indiana United Way - Indiana General Assembly - IU Health - IU Health Blackford - IU Health Jay - Indiana University School of Medicine - Jay Community Center - Jay County - Jay County Chamber of Commerce - Jay County Development Corporation - Jay County Drug Prevention Coalition, Inc. - Jay County Emergency Management - JRDS - Kitchen Kemist - LifeStream Services - Meridian Health Services - Muncie OUTreach LGBTQ+ Ctr - Muncie Sanitary District - Nonprofit Support Network - Open Door Health Services - Pennville Custom Cabinetry - Portland Fire Department - Positively Blackford - Purdue Extension - Second Harvest Food Bank - Shafer Leadership Academy - The Waters of Hartford City - Tobacco Free Blackford County - Tobacco Free Coalition - Toddlertown Early Learning Center - Tyson Foods - Urban Light Community Church - Westminster Village Muncie - Whitely Community Council - YMCA of Muncie Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - IU HEALTH BALL MEMORIAL HOSPITAL. In April 2025, IU Health's board of directors approved the implementation strategy for IU Health Ball to respond to the needs identified in their 2024 CHNA. IU Health Ball 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 Ball will address all the community health needs identified in the 2024 CHNA. In 2024, IU Health Ball addressed needs identified in the 2021 CHNA used the 2022-2024 implementation strategy plan adopted in April 2022. The hospital, along with community partnered, 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 Ball plans 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; Education, Workforce trained, and Unemployment; Maternal and Infant Health and Child Well-being; Smoking, Tobacco Use and Exposure to Secondhand Smoke; and Social Determinants of Health. Access to Healthcare Services * Supported community members accessing healthcare services regardless of their ability to pay. The hospital provided financial assistance to patients each year that included discounts, full charity, and personal hardship reductions. IU Health Patient Financial Counselors were certified Indiana Navigators. They assisted patients and families with information and helped them with applications for various health coverage programs. In 2024, the counselors served 686 people at IU Health Ball. Implemented a Medical provider recruitment plan to address areas experiencing a shortage of primary and specialty care services. In 2024, 26 new physicians were added to the region representing multiple specialties including Neurology, Podiatry, Hematology, Family Medicine, Primary Care, Anesthesiology, Cardiovascular Surgery, Infectious Disease, Hematology/Oncology, Orthopedic Surgery, and Sports Medicine. Implemented a Mobile Integrated Health Care - Paramedicine. This program was operational in the IU Health East Central Region and included an 80-hour paramedicine trained program for Paramedic, EMS and Fire Department personnel; IU Health Paramedic and affiliate EMS organizations were deployed at hospital or physician point of care to establish post-discharge care in a six-county area. This team had a total of 781 home visits in 2024 and supported 602 patients enrolled in the Heart/Lung Center, CV Surgery, IMRC, FMRC, Cardiology, and Pulmonology that held a 3.7% overall readmission rate for the year. Aging Population and Needs of Seniors Supported senior-focused programs at local events in the community. In 2024, IU Health partnered with Purdue Extension and the Blackford Community Foundation to purchase equipment for the Blackford Senior Center to provide access to virtual visits and patient portal for the senior residents of Blackford County. Education on utilizing the new equipment and services was also provided for Blackford residents. Additionally, IU Health teams engaged in support of a community senior health fair organized in Delaware County, and a partnership with Purdue Extension and the Health Department in Jay County to offer hypertension screenings and provide information on health topics for seniors at local food distribution events and community education classes. Many of these connections were made in conjunction with Healthy Community Alliance partnered and resources. Behavioral Health Partnered to create City Crisis Center for Behavioral Health and Substance Use Disorder crisis assessment and resources. Since project inception, IU Health had worked with the Muncie Mayor's office, EMS, law enforcement, local coalitions and department of social work, and community members throughout the design and operations planning for the center. Due to issues with the city-owned building site, the project was put on hold in 2023. In early 2024 site work resumed, and a contract to staff and operate the City Crisis Center was awarded to Meridian Health Services. The Crisis Center is expected to open sometime in 2025. Further implemented IU Health Ball Addiction Treatment and Recovery Center. During 2024, the ATRC provided 197 group therapy sessions, 832 individual therapy sessions and 107 peer recovery sessions. (In 2023 Intensive Outpatient Services (IOP) ended and a shift was made to individual treatment. A new support group was added in 2023 as well.) 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 had continued to assess and evolve its behavioral health services based on the needs of patients and the communities it served. Since 2018, this program had served 15 IU Health and two non-IU Health emergency department patients who struggled with substance use disorder through support to aid in recovery. IU Health continued to serve patients with a need for this service through the Virtual Behavioral Health team. Further developed and implemented Behavioral Health services into varied clinical settings. Virtual Integrated Behavioral Health (VIBH) expanded behavioral health access to patients and providers across the state. VIBH provided urgent psychiatric assessment for patients experiencing behavioral health crises, such as suicidal ideation, homicidal ideation, psychosis, and substance abuse disorders. A team of behavioral health professionals provided consultation through iPad carts located in emergency departments, urgent care, and ambulatory care locations. VIBH also provided brief behavioral health therapy and consultation for medication management to primary care patients aged 18 and older experiencing depression, anxiety, and other mood disorders. A team of behavioral health professionals provided problem solving treatment, cognitive behavioral therapy, and other evidence-based interventions. In 2024, there were over 10,000 visits of which 888 visits included patients seeking care at IU Health Methodist and Riley emergency departments and IU Health physicians' ambulatory practices Chronic Disease and Chronic Disease Management Supported the Healthy Community Alliance of East Central Indiana (HCA). Four community workgroups related to increased physical activity, improved nutrition and tobacco prevention and cessation were facilitated by IU Health Community Outreach personnel in a three-county area. Four new community partners joined the HCA in 2024. Coalition partners collaborated to design a new 1-800 QUIT NOW tobacco cessation toolkit and over 200 were distributed to HCA partnered and community members. HCA partners had continued to engage with senior, resource limited, minority and faith-based organizations by offering multiple community-based heart health, healthy eating, vaping education, access to care, screening events, healthy eating and food access programs to East Central Indiana in 2024. Supported the expansion of the YMCA of Muncie. In 2024, IU Health provided $1,000,000 in funding towards a 5-year pledge of $5,000,000 to support the construction of a new YMCA facility in Muncie. Construction of the new facility began in 2023 and opened in 2025. Provided outpatient nutrition counseling. No-cost nutrition counselling offered by IU Health Ball team members was promoted utilizing multiple outreach activities and community events during 2024. 1,356 participants participated in individual counseling or nutrition classes in 2024. 213 participants participated in counseling in 2024 in Jay and Blackford Counties. Bariatric and Medical Weight Loss Support Groups were offered 1-2 times per month with 22 participants in 2024. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - IU HEALTH BALL MEMORIAL HOSPITAL (CONTINUED). Further implemented IU Health Days of Service (volunteer event engaging IU Health team members in activities that benefit the community). 2024 Day of Service efforts by IU Health Ball team members focused on housing improvements, and assembly of 44 cases of meal kits donated to the Soup Kitchen of Muncie. 131 team members contributed 191 hours of time to these projects. Education, Workforce trained, and Unemployment Offered vocational training and employment at IU Health Ball. Postsecondary vocational training for individuals with disabilities was offered on-site in partnership with the Erskine Green training Institute at IU Health Ball Hospital; in 2024 the program trained 17 individuals; at the end of 2024, 34 program graduates were employed at IU Health facilities. Launched Healthcare Career Fellowship Track. This program was not launched in 2022-2024 due to logistical issues and other barriers. Maternal and Infant Health and Child Well-being Further implemented Healthy Beginnings Program. The Healthy Beginnings navigation program begins in the first trimester of pregnancy and continues through the first year of life. Navigators attended appointments with clients and connected them to community resources that address social determinants of health. Once the baby was born, navigators continued to engage with families to ensure that postpartum and infant needs were met. The program was open to Jay and Blackford County families. In 2024, the overall HB impact in Blackford County increased enrollments by 106%. 150 families were enrolled in postpartum in 2024. Maternal Navigator cared for 107 patients in 2024 with 718 patient encounters. Infant Navigators had 1,439 encounters in 2024. This includes referrals to WIC, childbirth classes, car seat fitting, safe sleep classes, healthy families, tobacco cessation, government assistance programs, family resource center/community partnered and food pantries. Multiple family programs such as diaper events, childhood vaccination event, park health and safety program, and mental health series. 89% of families in the Healthy Beginnings Program adhered to the well-baby appointments and vaccination schedules. Further implemented Infant and Maternal Health Programs. In 2024 a Maternal Navigator served to connect community resources to mothers-to-be; worked with provider teams to optimize prenatal visits, and recognize early maternal warning signs, such as blood pressure and mental health; and further assisted with navigating healthcare, appointments and services. 360 people served in 2024. Further implemented Pediatric Rehabilitation Services. In 2024, there were 14,436 total visits attended in the clinic setting. Program coverage in school settings increased in 2024 to 2,113 hours of school coverage from 2,008 hours in 2023. Pediatric rehabilitation department continued to refer appropriate patients to First Steps, which helped with access to rehabilitation services for those in rural areas and urban areas. Smoking, Tobacco Use and Exposure to Secondhand Smoke Promoted the use of Quit Now Indiana (1-800 Quit Now). Quit-Now Tobacco toolkits were distributed to community members at health fairs, special events and speaking opportunities in 2024. The Indiana Tobacco Quitline received referrals as follows in 2024: Blackford County, 25 referrals; Delaware County, 136 referrals; Jay County 21 referrals. 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 were supported by 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 expand services. Cross-functional teams worked together, including the West Central Region TTSs for case conferencing and training. One focus in 2024 was on improving access and patient experience with medication management. CTTP improved patient tobacco treatment medication 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 was an increase from 56% in July. The team received frequent testimonials of lives changed and gratitude for a supportive, compassionate partner. There were 73 patients connected to Ex for additional nicotine cessation support. In 2024, CTTP received 1,767 referrals which 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). Social Determinants of Health Advanced community collaborations and interventions with support from the Community Impact and Investment Fund (CII). Information about the 2024 CII funding opportunity was widely shared in the East Central Region. CII funding in the amount of $365,000 was approved to support Nextech for their "Muncie Catapult" proposal which would provide a collaboration between Nextech & TeenWorks to empower underserved teens for postsecondary & career success. Funding from the IU Health CII Fund had allowed for significant infrastructure improvements in the Thomas Park / Avondale neighborhoods of Muncie, including over 4,000 feet of new sidewalks and a walking path completed in 2023; ongoing support of a local food pantry, and completion of a three-field soccer complex. Following project completions, IU Health had continued to engage in 2024 with neighborhood organizations such as the Ross Community Center, Avondale Community Church and the Common Market to implement hypertension screenings and healthy lifestyle outreach. Supported school-based education and food access programs. Grants and data tracking for a three-year initiative to support Muncie Community Schools and Second Harvest Food Bank ended in 2023; in 2024 the hospital continued to support the school system by providing school based screenings and sports physicals as well as health topic education. Collaborative work to create a food rescue program at the Muncie Central High School was initiated by IU Health team members in 2024. Supported Farmers Market Education Program. Families were engaged at local farmers markets and farmstands in the East Central Region with educational programming related to the nutritional value of fresh produce, selection, reading food labels and maintaining active lifestyles. Programming also included cooking demonstrations and implementation of IU Health Bucks to encourage increased usage of fresh produce in family meal planning and to incentivize participants to visit a local farmers market. Community partners that served high-need audiences promoted the program and recruited participants. Nearly 100 families signed up to participate in 2024, and 100% of participated families reported increased knowledge about healthy eating. More than $3,000 of IU Health Bucks were distributed and redeemed for fresh produce through this program. Assisted community members with accessing health services. Dual language handouts were acquired/developed/utilized in 2024 to promote community events and provide health and wellness information. Significant Needs Hospital Did Not Address IU Health Ball addressed all the significant health needs identified in the 2021 Community Health Needs Assessment. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - IU HEALTH BALL MEMORIAL HOSPITAL. IN ADDITION TO FPG, IU HEALTH BALL MEMORIAL 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 BALL MEMORIAL HOSPITAL. IU Health Ball Memorial 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 BALL MEMORIAL HOSPITAL. IU Health Ball Memorial Hospital takes several other measures to publicize its FAP within the community. These measures include the following: 1. Post this Policy, a Plain Language Summary of this Policy, and the Financial Assistance Application on its website. 2. Provide patients with a Plain Language Summary of this Policy during registration and/or discharge. 3. Post conspicuous displays in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 4. Include a conspicuous written notice on all patient post-discharge billing statements notifying the patient about this Policy and the telephone number of the Customer Service Department which can assist patients with questions regarding this Policy. 5. Make available Customer Service representatives via telephone during normal business hours. 6. Mail copies of this Policy, a Plain Language Summary of this Policy, and a Financial Assistance Application to patients or their guarantor free of charge upon request. 7. Broadly communicate this Policy as a part of its general outreach efforts. 8. Educate patient-facing team members on this Policy and the process for referring patients to the program. 26 IU HEALTH BALL MEMORIAL OUTPATIENT SURGERY CENTER 2401 W UNIVERSITY AVE MUNCIE IN 47303 SURGERY CENTER IU HEALTH BALL MEMORIAL CANCER CENTER 2401 W UNIVERSITY AVE MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL MATERNAL & FETAL HEALTH 2401 W UNIVERSITY AVE MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL CARDIOVASCULAR SURGERY 2525 W UNIVERSITY AVE SUITE 300 MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL OTOLARYNGOLOGY 2525 W UNIVERSITY AVE MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS CARDIOLOGY 2525 W UNIVERSITY AVE MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS GASTROENTEROLOGY 2525 W UNIVERSITY AVE SUITE 300 MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL GENERAL & VASCULAR SURGERY 2525 W UNIVERSITY AVE SUITE 403 MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS HEART AND LUNG CENTER 2525 W UNIVERSITY AVE SUITE 300 MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS INFECTIOUS DISEASE 2401 W UNIVERSITY AVE MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS NEUROLOGY 2525 W UNIVERSITY AVE SUITE 401 MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS PHYSICAL MEDICINE & REHABSPINE PROGRAM 2525 W UNIVERSITY AVE SUITE 401 MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS PULMONARY & CRITICAL CARE MEDICINE 2525 W UNIVERSITY AVE SUITE 300 MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL OUTPATIENT BEHAVIORAL HEALTH 2401 W UNIVERSITY AVE SUITE 3500A MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS FAMILY MEDICINE RESIDENCY CENTER 221 CELIA AVE MUNCIE IN 47303 PRIMARY CARE IU HEALTH BALL MEMORIAL PHYSICIANS INTERNAL MEDICINE RESIDENCY CENTER 2401 W UNIVERSITY AVE SUITE 401 MUNCIE IN 47303 PRIMARY CARE IU HEALTH BALL MEMORIAL OUTPATIENT REHABILITATION CENTER 3300 W COMMUNITY DR MUNCIE IN 47304 REHABILITATION SERVICES IU HEALTH BALL MEMORIAL RADIOLOGY 2401 W UNIVERSITY AVE MUNCIE IN 47303 RADIOLOGY IU HEALTH INTERVENTIONAL RADIOLOGY - MUNCIE 2401 W UNIVERSITY AVE MUNCIE IN 47303 RADIOLOGY IU HEALTH PAVILION COMMUNITY PHARMACY 2401 W UNIVERSITY AVE OMP 1635 MUNCIE IN 47303 PHARMACY IU HEALTH YORKTOWN PHARMACY 1420 S PILGRIM BLVD YORKTOWN IN 47396 PHARMACY IU HEALTH FAMILY PHARMACY 5501 W BETHEL AVE MUNCIE IN 47304 PHARMACY IU HEALTH BALL MEMORIAL LAB 2401 W UNIVERSITY AVE MUNCIE IN 47303 LAB IU HEALTH BETHEL LAB 5501 W BETHEL AVE MUNCIE IN 47304 LAB IU HEALTH BALL MEMORIAL HOSPICE 2401 W UNIVERSITY AVE MUNCIE IN 47303 OTHER IU HEALTH BALL MEMORIAL HOME CARE 2401 W UNIVERSITY AVE MUNCIE IN 47303 OTHER Schedule H, Part I, Line 6a C.B. REPORT PREPARED BY A RELATED ORG. IU Health Ball Memorial 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 ("IU Health Statewide System"). 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 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 $0. Bad debt expense is reported at cost based on the cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. Schedule H, Part I, Line 7 TOTAL COMMUNITY BENEFIT EXPENSE Schedule H, Part I, Line 7, Column (f), Percent of Total Expense, is based on column (e) Net Community Benefit Expense. The percent of total expense based on column (c) Total Community Benefit Expense, which does not include direct offsetting revenue, is 30.45%. Schedule H, Part II PROMOTION OF HEALTH IN COMMUNITIES SERVED IU Health Ball is a subsidiary of Indiana University Health. IU Health participates in a variety of community-building activities that address the social determinants of health in the communities it serves. IU Health and its related hospital entities across the State of Indiana investments include economic development efforts across the state, collaborate with like-minded organizations through coalitions that address key issues, and advocate for improvements in the health status of vulnerable populations. This includes making contributions to community-building activities by providing investments and resources to local community initiatives that address economic development, community support and workforce development. IU Health Ball partners with the following organizations and initiatives that focus on some of the root causes of health issues, such as lack of education, employment and poverty: Economic Development: IU Health Ball representatives served on multiple economic development boards and committees in 2024, such as the East Central Indiana Regional Partnership (ECIRP), Next Muncie, Muncie/Delaware County Chamber of Commerce, and the Ball Brothers Foundation. In 2024, $30,000 was contributed to the Chamber's Vision 2027 initiative. Coalition Building: IU Health Ball serves as the backbone organization providing resources to operate a three-county health coalition focused on obesity prevention and tobacco cessation to reduce the impact of chronic disease including cancer and heart disease. More than 150 organizations are partners in the "Healthy Community Alliance of East Central Indiana" coalition and each pledge to influence audiences to make positive choices regarding improved nutrition, increased physical activity or tobacco cessation. Coalition partners report a collective total audience size of more than 50,000 people. Community Health Improvement Advocacy: In 2024 IU Health Ball continued to expand a community hypertension initiative begun in 2023 in partnership with local Black and African American churches and social services organizations. IU Health Ball also organized multiple health and wellness events focused on hypertension screening and diabetes prevention in high needs areas of the community including those with a majority Black and African American population. Additionally, IU Health Ball team members served the ECR community and advocated for healthier lifestyle improvements in service to the Cardinal Greenway Board of Directors, as well as ongoing participation in the Tobacco Free-Delaware County and Tobacco Free Blackford County Coalitions in monthly advocacy meetings to promote tobacco cessation and policy changes throughout the community. Community Support: Representatives of IU Health Ball also served in numerous executive committees and boards of directors for organizations striving to improve community health status, including Ball Brothers Foundation, Cardinal Greenways, Center of Hope, Youth Opportunity Center, Community Foundation of Muncie and Delaware County, Delaware County Prevention Council, Little Red Door, Muncie Afghan Refugee Resettlement Committee, Open Door Health Center, Second Harvest Food Bank, Whitely Neighborhood Association, Women's Philanthropy Board and YMCA of Muncie. Physical Improvements and Housing: IU Health Ball partnered with the Greater Muncie Habitat for Humanity during its annual Day of Service event in 2024. Team members built the entire framework of a 4-bedroom home onsite at the hospital, which was then transported to a community location later completed using IU Health volunteers for a local family. Workforce Development: IU Health Ball has partnered with the ARC of Indiana to train students with intellectual and developmental disabilities to realize their goals of living, learning, working and fully participating in the community since 2016. Training for careers in the hospitality industry is provided at the Erskine-Green Training Center in downtown Muncie as well as on-the-job instruction at IUH BMH and other area hospitality providers. In 2024, the ARC program served 17 people and provided nearly $74,000 in net community benefit. Schedule H, Part I, Line 7g DESCRIBE SUBSIDIZED HEALTH SERVICE COSTS FROM PHYSICIAN CLINIC IU HEALTH BALL MEMORIAL HOSPITAL INCLUDES COSTS ASSOCIATED WITH PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES BUT IS NOT ABLE TO SEGREGATE THE COSTS ASSOCIATED WITH PHYSICIAN CLINICS. Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care IU HEALTH BALL MEMORIAL HOSPITAL USES SEVERAL FACTORS OTHER THAN FEDERAL POVERTY GUIDELINES ("FPG") INDETERMINING 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 0 Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE AMOUNT REPORTED ON LINE 2 AS BAD DEBT IS REPORTED AT COST, AS CALCULATED USING THE COST TO CHARGE RATIO METHODOLOGY. Schedule H, Part III, Line 3 Bad Debt Expense Methodology IU Health will deem patients or their guarantors presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs and care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility: 1. Medicaid (any state) 2. Indiana Children's Special Health Care Services 3. Healthy Indiana Plan 4. Patients who are awarded Hospital Presumptive Eligibility (HPE) 5. A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. No Financial Assistance Application is required to receive Financial Assistance under this Presumptive Eligibility section. IU Health will conduct a quarterly review of all accounts placed with a collection agency partner for at least one hundred and twenty (120) days after the account is eligible for an ECA as set forth in this Policy. If the patient or guarantor's individual scoring criteria demonstrates the patient has a low likelihood and/or propensity to pay or no credit, the patient or guarantor may be deemed presumptively eligible for Financial Assistance. Financial Assistance may additionally be granted in the following circumstances: a) If the patient or their guarantor is found to have filed a petition for bankruptcy. b) If the patient is deceased and found to have no estate. c) If the patient is deceased and was under 21 years of age at the time of death. Due to this comprehensive methodology, IU Health does not believe any amount of bad debt is attributable to patients who may be eligible under the financial assistance policy and no portion of bad debt is included as community benefit. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote IU HEALTH'S CONSOLIDATED FINANCIAL STATEMENTS, FOOTNOTE 5, ADDRESSES BAD DEBT EXPENSE AS FOLLOWS: The Indiana University Health System does not require collateral or other security from its patients, substantially all of whom are residents of the State, for the delivery of health care services. However, consistent with industry practice, the Indiana University Health System routinely obtains assignment of (or is otherwise entitled to receive) patients' benefits payable under their health insurance programs, plans, or policies (e.g., Medicare, Medicaid, managed care payers, and commercial insurance policies). The Indiana University Health System uses a portfolio approach to account for categories of patient contracts as a collective group, rather than recognizing revenue on an individual contract basis. The portfolios consist of major payer classes for inpatient revenue and outpatient revenue. Based on the historical collection trends and other analysis, the Indiana University Health System believes that revenue recognized by utilizing the portfolio approach approximates the revenue that would have been recognized if an individual contract approach were used. In support of its mission, the Indiana University Health System provides care to uninsured and underinsured patients. The Indiana University Health System provides charity care to patients who lack 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 Ball Memorial Hospital has a Medicare shortfall for 2024. IU Health Ball Memorial Hospital's Medicare shortfall is attributable to reimbursements that are less than the cost of providing patient care and services to Medicare beneficiaries and does not include any amounts that result from inefficiencies of poor management in 2024. IU Health Ball Memorial 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 Ball Memorial Hospital Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health Ball Memorial Hospital'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 Ball Memorial Hospital 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 Ball Memorial Hospital'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 BALL MEMORIAL 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 BALL MEMORIAL 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 BALL MEMORIAL HOSPITAL: Line 16c URL: https://iuhealth.org/pay-a-bill/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment Though IU Health Ball believes its CHNA process is comprehensive, the CHNA is done on a triennial basis. Between CHNA cycles, IU Health Ball 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 Ball Memorial 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 Ball Memorial Hospital has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health Ball Memorial Hospital is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health Ball Memorial 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 Ball Memorial 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 Ball Memorial Hospital is located in Delaware County, Indiana, a County located in central Indiana. Delaware County includes ZIP codes within the towns of Muncie, Eaton, Gaston, Selma, Albany, Daleville and Yorktown. Based on the most recent Census Bureau statistics, Delaware County's population is 112,951 persons with approximately 51.6% being female and 48.4% male. Schedule H, Part VI, Line 5 Promotion of community health IU Health Ball is governed by a Board of Directors, comprised of persons who primarily reside in the organization's primary service area. IU Health Ball 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 Ball can be accessed on the IU Health website. A nondiscrimination clause is explicitly stated in IU Health Ball 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. IU Health Ball invests in other initiatives and collaborations throughout the year to promote health and wellness in the community. Some of these include: - Lung cancer screenings using low dose CT imaging offered at reduced cost to community members meeting requirements set out by the National Comprehensive Cancer Network. The screening is intended to identify cancer at an early stage. In 2024, 535 individuals received this service. - Periodic screenings for cervical, skin or prostate cancers by appointment or free blood pressure and diabetes checks at health fairs and other public gatherings, as well as athletic and school-based physicals for students. In 2024, 1,178 individuals participated in one of these screenings or services. - Health programming is offered to local schools through the hospital's Family Medicine Residency program and other hospital health professionals. Topics include tobacco, puberty, nutrition, physical activity and breast self-exams. 800 students benefitted in 2024. - Over 100,970 hours of clinical educational experiences provided on site for students in the healthcare field studying nursing, pulmonary and physical rehabilitation, radiology and other topics. IU Health Ball partners with Ball State University, Ivy Tech Community College, Indiana Wesleyan University, Anderson University and other area institutions. Nearly 1,300 students served in 2024. - The IU Health Ball Research Center conducts local clinical trials in urology, infectious diseases, pain management and especially oncology, cardiology and coagulation. In 2024, 36 studies were conducted with 120 individuals participating. - Contributions of employee time and organizational resources toward encouraging team members to contribute to the area United Way campaign. This support provided socioeconomic resources to area residents, including organizations such as Boys and Girls Club Muncie, A Better Way, YWCA of Muncie, Motivate Our Minds, Muncie Mission, Second Harvest Food Bank, Meals on Wheels, Open Door Health Services, 8twelve Coalition and Recovery Cafe. - Additionally, team members at IU Health Ball participated in the IU Health Statewide System's team member community benefit service program, "IU Health Serves", team members across the state make a difference in the lives of thousands of Hoosiers every year. Schedule H, Part VI, Line 6 Affiliated health care system Indiana University Health Ball is part of Indiana University Health ("IU Health "the healthcare system"), which is Indiana's most comprehensive healthcare system. A unique partnership with the Indiana University School of Medicine ("IU School of Medicine"), one of the nation's leading medical schools, gives patients access to innovative treatments and therapies. The healthcare system is comprised of hospitals, physicians and allied services dedicated to providing preeminent patient care and community health improvement throughout Indiana. IU Health's affiliate hospitals are divided into six regions that serve communities in Northwest, Northeast, Central and Southern Indiana. The 15 hospitals in the healthcare system include IU Health Inc. (i.e., the IU Health Academic Health Center consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health and IU Health Saxony Hospital); IU Health Arnett; IU Health Ball;; IU Health Bloomington Hospital; IU Health Frankfort; IU Health Jay; IU Health North Hospital; IU Health Paoli Hospital; IU Health Tipton Hospital; IU Health West Hospital; and IU Health White Memorial Hospital. Each affiliate hospital in the healthcare system, along with community partners, conducted, and adopted its own community health needs assessment (CHNA) and implementation strategy. IU Health considered the sum of these CHNAs and the implementation strategies part of a system wide vision of making Indiana one of the healthiest states in the nation. The healthcare system and its affiliate hospitals are keenly aware of the positive impact it can have on improving the health of communities throughout the state of Indiana by investing in local, community-based initiatives as well as system-level strategies. The healthcare system includes an Academic Health Center (i.e., IU Health Inc.), a regional academic health center (i.e., IU Health Bloomington Hospital) and several affiliate hospitals (IU Health Arnett and IU Health Ball) that work in partnership with the IU School of Medicine to train physicians, blending breakthrough research and treatments with the highest quality of patient care throughout IU Health. Each year, more than 1,000 residents and fellows received training in affiliate hospitals. Research conducted by IU School of Medicine faculty gave IU Health physicians and patients access to the most leading-edge and comprehensive treatment options. To further promote the health of the communities served by IU Health, the system-level Community Health Division partnered with state and local community-based organizations, community coalitions and governmental agencies to focus on innovative models of care; community alliances and partnerships; anchor institution and advocacy strategies; and social determinants of health. All affiliate hospitals in the healthcare system identified and addressed significant needs unique to the communities they serve. However, some needs were common in communities served by multiple or all affiliate hospitals in the healthcare system and aligned with system priority areas, warranting a system-level strategy. The Community Health Division, along with additional internal partners such as the Office of Health Excellence Research and Engagement (HERE) and the IU Health Foundation, planed and provided technical assistance for system-level strategies that addressed these common needs including tobacco and nicotine cessation, infant and maternal health, hypertension, and social determinants of health. For example, the Community Health Division has launched a community health worker initiative throughout the system in outpatient and inpatient sites that did community outreach as part of the WeCare and iHEART initiatives. Each affiliate hospital collaborated with the Community Health Division to align and activate local resources to support local and system strategies. This benefits the community each affiliate hospital served and worked towards a statewide impact (system-level) on health outcomes. As part of the Community Health Division, the Community Outreach and Engagement Program's IU Health Serves initiative, a system-level team member volunteer program, sought to positively impact the health of communities IU Health affiliate hospitals serve and foster a culture of engagement and social responsibility. Each affiliate hospital coordinated the different initiatives of the program, including Days of Service. This was the largest volunteer event of the year, consisting of projects designed to engage each affiliate hospitals' team members in activities that address local, significant needs. The $200 million Community Impact and Investment (CII) Fund was established in 2018 by IU Health to financially support high-impact community investing. The focus of these efforts addressed key social and environmental factors that impact different groups in the communities IU Health serves. Each affiliate hospital and its team members were eligible to pursue this grant opportunity with a community organization. Schedule H, Part VI, Line 7 State filing of community benefit report IN true Marian University 3200 Cold Spring Rd Indianapolis IN 46222 350868175 501(c)(3) 105128 Not applicable Community Benefit Whitely Community Council Inc PO BOX 665 Muncie IN 47308 351911000 501(c)(3) 700000 Not applicable Community Benefit 2 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds ALTHOUGH IU BALL MEMORIAL HEALTH DOES NOT MONITOR THE USE OF GRANT FUNDS ONCE DISTRIBUTED, THROUGH DUE DILIGENCE THE ORGANIZATION HAS REASONABLY CONFIRMED THAT THE ENTITIES TO WHICH THE CONTRIBUTIONS ARE MADE ARE HIGHLY REPUTABLE IN THE COMMUNITY AND USE THE FUNDS FOR THE PURPOSES INTENDED. X X X X false true false false false false false true false JEFFREY C BIRD MD DIRECTOR/PRESIDENT (ECR) 0 615805 0 259543 0 129780 0 123960 0 52357 0 1181445 0 103503 PETER M VOSS MD DIRECTOR/VICE CHAIR 433139 15437 56440 36192 3564 0 13800 1324 50358 2317 557301 55270 0 0 JOAN V CASTOR DIRECTOR 0 383981 0 200279 0 60381 0 82880 0 53948 0 781469 0 0 CHARLES R ROUTH MD DIRECTOR 0 177352 0 112557 0 6858 0 11923 0 50649 0 359339 0 0 MICHELLE R ALTOBELLA VP-General Counsel, Asst Secretary (ECR) 0 237733 0 35399 0 1229 0 11328 0 41956 0 327645 0 0 MICHAEL L CRAIG CFO (Part Year) 0 329178 0 43079 0 3564 0 13500 0 52357 0 441678 0 0 JONATHAN W VANATOR CFO (ECR) (PART YEAR) 0 335594 0 131818 0 810 0 11803 0 53880 0 533905 0 0 KREIGH COOK COO (ECR) 279864 0 27326 0 486 0 12505 0 31361 0 351542 0 0 0 MELISSA R HICKS VP & CNO (ECR) 243839 0 31515 0 482 0 11225 0 35258 0 322319 0 0 0 RYAN M JOHNSTON MD VP & CMO (ECR) 392288 0 52671 0 1242 0 13800 0 65362 0 525363 0 0 0 BRIAN REED VP-HUMAN RESOURCES (ECR) 0 183135 0 27779 0 368 0 8888 0 54624 0 274794 0 0 DAVID A SCHWARTZ Former Highest Compensated Employee 0 237983 0 14393 0 1210 0 10123 0 11329 0 275038 0 0 JOSEPH BUTTS RADIATION PHYSICIST 244589 0 0 0 276 0 9817 0 27585 0 282267 0 0 0 REBECCA A CLARK VP & CNO 181994 0 64195 0 577 0 10253 0 39225 0 296244 0 0 0 ALVIS FOSTER Physicist-Radiation Medicine 246952 0 5073 0 1524 0 10349 0 61092 0 324990 0 0 0 CHRISTOPHER GAMBLE MD Associate CMO 338135 0 32692 0 810 0 9095 0 50879 0 431611 0 0 0 JULIE M PAINTER PHYSICAL THERAPIST 105763 0 13689 0 112678 0 4992 0 15885 0 253007 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation IU Health Ball Memorial Hospital's Regional President is employed by IU Health. IU Health, IU Health Ball and other related organizations have a process in place to determine the compensation for its 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 officers 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 JOAN V. CASTOR PARTICIPATEs IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, PROVISIONS OF WHICH ARE DESIGNED TO RETAIN THESE CRITICAL EMPLOYEES. THE PLAN PROVIDES FOR AN ADDITIONAL RETIREMENT BENEFIT FOR SERVICE THROUGH NORMAL RETIREMENT OR OTHER KEY DATES. IF THE EXECUTIVE LEAVES PRIOR TO RETIREMENT OR OTHER KEY DATES, THE BENEFIT MAY BE FORFEITED OR REDUCED. THE EXECUTIVE LISTED ABOVE has AN AMOUNT INCLUDED IN COLUMN C, DEFERRED COMPENSATION, REPRESENTING THE CURRENT YEAR UNVESTED CONTRIBUTIONS MADE UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THESE AMOUNTS WERE NOT PAID TO THE EXECUTIVES DURING THE YEAR. THE FOLLOWING EXECUTIVE(S) HAVE AN AMOUNT INCLUDED IN COLUMN B (III), OTHER REPORTABLE COMPENSATION, REPRESENTING THE CURRENT YEAR VESTED AMOUNTS RECEIVED UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: - JOAN V. CASTOR: $56,550 Schedule J, Part I, Line 7 Non-fixed payments AMOUNTS DISCLOSED IN COLUMN B(II) INCLUDE A LONG TERM INCENTIVE FOR CERTAIN EXECUTIVES. ALTHOUGH THESE PLANS ARE BASED ON A FIXED FORMULA THAT HAS BEEN APPROVED BY THE BOARD OF DIRECTORS BASED UPON CERTAIN QUALITATIVE AND QUANTITATIVE FACTORS AND GOALS, ALL DISCRETIONARY INCENTIVE PLANS MUST BE APPROVED BY THE COMMITTEE ON PERSONNEL AND COMPENSATION AND BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT. Dara Cook Mother of IU Ball Memorial Hospital Inc. COO, Kreigh Cook. 154771 Total Taxable and Non-Taxable compensation for employment in the normal course of business. false LINE J - WEB SITE HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-BALL-MEMORIAL-HOSPITAL Form 990, Part III, Line 4a-4c Description of program services (Expenses $ 2,444,849 including grants of $ 0)(Revenue $ 2,509,943) IU HEALTH BALL MEMORIAL HOSPITAL, INC. PROVIDES SERVICES, WHICH INCLUDE COORDINATED ACTIVITIES AND POLICES, TO RELATED TAX-EXEMPT ORGANIZATIONS DESIGNED TO MEET THE MISSION OF THE INDIANA UNIVERSITY HEALTH SYSTEM. Form 990, Part III, Line 4a-4c Description of program services (Expenses $ 219,093 including grants of $ 0)(Revenue $ 224,926) Clinical Research Form 990, Part III, Line 4a-4c Description of program services (Expenses $ 0 including grants of $ 0)(Revenue $- 46,668) Income (Loss) from Pass-Through Entities SECTION B, LINES 12, 13, 14, AND 16B - POLICIES IU HEALTH BALL MEMORIAL HOSPITAL IS PART OF THE IU HEALTH SYSTEM. AS THE SOLE MEMBER AND CONTROLLING PARENT OF IU HEALTH BALL MEMORIAL 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 BALL MEMORIAL 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 IU HEALTH BALL MEMORIAL HOSPITAL HAS ONE CLASS OF MEMBERSHIP AND THE SOLE MEMBER IS IU HEALTH. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body IU HEALTH ELECTS ONE MORE THAN ONE-HALF OF THE TOTAL NUMBER OF DIRECTORS. IMMEDIATELY FOLLOWING SUCH ELECTION THE REMAINDER ARE ELECTED BY THE DIRECTORS, EXCLUDING THOSE WHOSE TERMS ARE SET TO EXPIRE. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Notwithstanding any other provisions of the Articles of Incorporation, the following matters require the written approval of IU Health prior to implementation: - Authorization for the establishment or acquisition of any subsidiaries, affiliates or joint venture arrangements or acquisition of all or substantially all of the assets of any other business or entity; - Approval or amendment to any operating or capital budget; - Authorization of any unbudgeted operating or capital budget items or deviations, including any issuance or guarantee of any unbudgeted debt, greater than the budgeted amount by $1 million for any individual item or $3 million per fiscal year in the aggregate; - Authorization of any agreement to act as primary obligor, or to serve as a guarantor, surety or co-obligor with respect to the indebtedness of any other party, to borrow amounts from third-party lenders, or to loan money to any person or entity; - Approval of strategic plans and amendments, which will be integrated with IU Health's strategic plan; - Amendment or repeal of the Corporation's or an Affiliates articles of incorporation or bylaws (or other corresponding organizational documents of an Affiliate that is not a corporation); - Authorization of any merger, consolidation, reorganization, sale or transfer of all or substantially all of the Corporation's assets; - Authorization of any voluntary declaration of bankruptcy, plan of dissolution, any liquidating distribution of assets or other action related to its dissolution or liquidation; - Authorization of any pledge of, or grant any security interest or mortgage in, or otherwise encumber, any tangible assets of the Corporation in excess of $2,000,000, other than in the ordinary course of business or pursuant to a budget or strategic plan approved by IU Health; - Approval of any management agreement for the management of all or a substantial part of the Corporation's operations; or - Appointment or removal of any of the Corporation's Directors with or without cause. 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 Ball Memorial 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 BALL MEMORIAL HOSPITAL'S ARTICLES OF INCORPORATION ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH THE INDIANA SECRETARY OF STATE'S WEBSITE. IU HEALTH BALL MEMORIAL HOSPITAL'S CONFLICT OF INTEREST PROCEDURES ARE DISCLOSED ON THE FORM 990, SCHEDULE O. IU HEALTH BALL MEMORIAL 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 BALL MEMORIAL HOSPITAL FORM 990. Form 990, Part VIII, Line 2f Other Program Service Revenue Income (Loss) from Pass-Through Entities - Total Revenue: -46668, Related or Exempt Function Revenue: , Unrelated Business Revenue: -46668, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees Consulting - Total Expense: 225236, Program Service Expense: 210116, Management and General Expenses: 15120, Fundraising Expenses: ; Intercompany fees - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 7919032, Fundraising Expenses: ; Physician fees - Total Expense: 557629, Program Service Expense: 520195, Management and General Expenses: 37434, Fundraising Expenses: ; Contract service - Total Expense: 15536905, Program Service Expense: 14493916, Management and General Expenses: 1042989, Fundraising Expenses: ; Other Expenses - Total Expense: 1815492, Program Service Expense: 1693618, Management and General Expenses: 121874, Fundraising Expenses: ; Professional Fees - Total Expense: 5527079, Program Service Expense: 5156047, Management and General Expenses: 371032, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Rounding - 1; Total - 1; EAST CENTRAL RADIOLOGY LLC 950 N MERIDIAN ST STE 800 INDIANAPOLIS IN 46204 351907818 HEALTHCARE IN 2468213 3172980 IUHBMH INDIANA HEALTH INFO EXCHANGE INC 846 N SENATE AVE INDIANAPOLIS IN 46202 364550324 HEALTHCARE IN 501(c)(3) Type I false IU HEALTH BALL MEMORIAL PHYSICIANS INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS IN 46204 351925641 HEALTHCARE IN 501(c)(3) 10 IUHBMH true IU HEALTH NORTH HOSPITAL INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS IN 46204 351932442 HEALTHCARE IN 501(c)(3) 3 IUH true IU HEALTH ARNETT INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS IN 46204 263162145 HEALTHCARE IN 501(c)(3) 3 IUH true IU HEALTH JAY INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS IN 46204 822736786 HEALTHCARE IN 501(c)(3) 3 IUH true 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