2025-11-13T15:02:26+00:00 2024-12-31 990 2024-01-01 351932442 Indiana University Health North Hospital Inc INDI 3179634842 950 N MERIDIAN STREET 1200 INDIANAPOLIS IN 46204 Frank Runion VP & CFO 3179634842 2025-11-13 2024 2025-03-06 01:10:19Z KENNETH D PUCKETT 950 N MERIDIAN STREET 1200 INDIANAPOLIS IN 46204 523970776 false X SEE SCHEDULE O X 1994 IN LEAD THE TRANSFORMATION OF HEALTHCARE THROUGH QUALITY, INNOVATION & EDUCATION, AND MAKE INDIANA ONE OF THE NATION'S HEALTHIEST STATES. 8 8 1619 0 4405 1253559 144568 171919 456359939 487110659 29874405 35772819 809852 907996 487188764 523963393 185 0 0 115300008 123898447 0 0 223236238 245277722 338536431 369176169 148652333 154787224 891723975 1037540922 29240185 20269909 862483790 1017271013 Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. false false 354170230 0 484726650 IU Health North Hospital provides leading family-centered care to Carmel and Hamilton County residents. As a full-service hospital for adults and children with an attached medical office building, IU Health North Hospital brings together physician offices, inpatient beds and operating rooms in a state-of-the-art facility where compassionate caregivers provide superior patient treatment. All patient rooms are private to optimize comfort for each individual and their family, and our wealth of services for adults and children ranges from cardiovascular and orthopedic care to maternity and cancer care. In January 2020, the IU Health Joe & Shelly Schwarz Cancer Center, an 88,000 square foot, two-story facility, opened on the south side of the IU Health North campus. The $55-million investment brings together, all under one roof, cancer services including radiation oncology, hematology-oncology, pharmacy, laboratory and patient navigation to surround patients and their loved ones with the care and support they need. As part of our commitment to fostering the health of our communities, we are proud to also offer the peace of mind that comes with the service and support of Riley Hospital for Children at IU Health's nationally-recognized programs. 1204058 0 1647905 IU Health North Hospital provides services, which include coordinated activities and polices, to related tax-exempt organizations designed to meet the mission of the Indiana University Health System. 537842 0 736104 IU Health North Hospital leases physician office and clinic space to tax-exempt related 501(c)(3) organizations. 355912130 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 false false true false false false false false false false false false false false false false false false true true true false false true 0 0 1619 true true true false false false false false false false false false false false X 8 8 false false false false true true true true true false false false true true true true true true false false false false IN X CRAIG J JONES 3179634842 950 N MERIDIAN STREET SUITE 800 INDIANAPOLIS IN 46204 KENNETH D PUCKETT DIRECTOR / PRESIDENT (ISR) 10.0 45.0 X X 0 1000489 194306 MARSHA A WURSTER Director/Chair (Part Year) 2.0 2.0 X X 0 0 0 MATT MURPHY Director/Vice-Chair (Part Year) 2.0 2.0 X X 0 7000 0 MICHELE M KAWIECKI Director/Chair (Part Year) 2.0 2.0 X X 0 12000 0 CHARLES E SCHALLIOL DIRECTOR (PART YEAR) 2.0 2.0 X 0 2000 0 CLAUDIA J SOMES MD DIRECTOR 2.0 2.0 X 0 7000 0 JAY L HESS MD DIRECTOR 2.0 10.0 X 0 46500 0 MEGAN CRITTENDON MD DIRECTOR 2.0 53.0 X 0 316442 39939 MICHAEL BECHER DIRECTOR (Part Year) 2.0 2.0 X 0 6000 0 MICHAEL TSANGARIS MD DIRECTOR (PART YEAR) 2.0 2.0 X 0 223735 20036 TONY PEARSON DIRECTOR (PART YEAR) 2.0 2.0 X 0 6000 0 CARA L BREIDSTER CFO (ISR) 35.0 20.0 X 0 351618 66113 JENNIFER GIROD Secretary 5.0 45.0 X 0 187201 17775 ATHANASIA S BANICH VP, COO (ISR) 30.0 25.0 X 347418 0 55603 CARRIE WING VP-CNO (ISR) 35.0 20.0 X 28577 254924 35494 HARPREETINDER SINGH MD VP-CMO (ISR) 30.0 25.0 X 483240 0 74251 TAMARAH D BROWNLEE REGIONAL VP-HR (ISR) 35.0 20.0 X 0 285807 47003 CHRISTEN N HOEPPNER Director-Operational Excellence 50.0 0 X 189210 832 39505 JANICE M VADAS DIRECTOR-ALLIED SERVICES 50.0 0 X 229551 0 10170 JULIA M MILLER Manager - Pharmacy 50.0 0 X 180322 0 26408 PATRICIA BOWLING Director-Surgical Services 50.0 0 X 178971 0 49887 SUN RIEHM Pharmacist 50.0 0 X 166890 0 66694 ALLISON P EMHARDT Former Officer 5.0 45.0 X 0 214962 46329 ARTHUR VASQUEZ FORMER KEY EMPLOYEE 0.0 55.0 X 0 848653 170264 DEREK E EMPIE FORMER OFFICER 0.0 55.0 X 0 430208 77430 DIANE L HESSON FORMER Highest Compensated Employee 0.0 50.0 X 0 193725 48617 PAUL M CALKINS MD FORMER KEY EMPLOYEE 0.0 55.0 X 0 355971 52208 1804179 4751067 1138032 true true false 0 164424 7495 171919 NET PATIENT SERVICE REVENUE 622110 484726650 484726650 SHARED SERVICES 541990 1647905 1647905 RENT FROM RELATED 501(C)(3) ORGS. 532000 736104 736104 0 0 0 0 487110659 35780202 35780202 752031 752031 0 752031 752031 7383 0 -7383 -7383 -7383 All Other Revenue 900099 142621 142621 TELEPHONE 517000 8939 8939 CAFETERIA/FOOD SERVICE 722514 4405 4405 0 0 0 0 155965 523963393 487110659 4405 36676410 X 1083737 1047194 36543 102232239 98785052 3447187 3125348 3019964 105384 11395776 11011520 384256 6061347 5856963 204384 30764 30764 198 99 99 19780 19780 80115052 75030471 5084581 0 244090 244090 1142044 1065379 76665 1060090 530045 530045 12812451 12812451 31415 29306 2109 15077695 14367358 710337 2307988 2307988 DRUGS AND MEDICAL SUPPLIES 98047930 98047930 Hospital Assessment Fee 23406168 23406168 BAD DEBT 9296730 9296730 NONCAPITALIZED EQUIPMENT 1337403 1273305 64098 347924 332195 15729 0 369176169 355912130 13264039 0 667398448 321345 57621897 66703520 0 0 0 0 8511641 9877889 861089 1139006 357486072 201255442 157330900 156230630 0 0 0 803268532 891723975 1037540922 16465638 17849832 0 0 12774547 2420077 29240185 20269909 X 862483789 1017271013 862483789 1017271013 891723974 1037540922 154787224 0 X false true true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 19780 19780 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY IU Health North Hospital paid institutional membership dues to the American Hospital Association ("AHA") and Indiana Hospital Association ("IHA") during 2024 in the amount of $52,881 and $24,257, respectively. Each membership organization notified IU Health North Hospital that a portion of the dues it paid were used for lobbying purposes. The AHA used 32.00%, or $16,922 of the 2024 membership dues paid by IU Health North Hospital, for lobbying expenditures. The IHA used 11.78%, or $2,858 of the 2024 membership dues paid by IU Health North Hospital, for lobbying expenditures. The total membership dues paid to these organizations by IU Health North Hospital during 2024 that were attributable to lobbying expenditures was $19,780. 196283882 76468124 119815758 313830 279745 34085 124901862 102556287 22345575 35986498 21951286 14035212 156230630 INTERCOMPANY RECEIVABLES (NET) 803268532 803268532 0 Federal Income Taxes 0 DUE TO THIRD-PARTY PAYERS 1828430 SELF-INSURANCE LIABILITIES 591647 INTERCOMPANY PAYABLES (NET) 0 2420077 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 North 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 North Hospital, Inc.'s portion of the December 31, 2024, and 2023 deferred tax assets is $58,342 and $58,681 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 North Hospital, Inc.'s portion is $234,577. 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 7238 5123227 5123227 0.01424 14866 67788791 48286182 19502609 0.05419 0 0.0 0 22104 72912018 48286182 24625836 0.06843 8 6125 940105 15847 924258 0.00257 2 313 419748 419748 0.00117 0 0.0 0 0.0 2 21862 120901 120901 0.00034 12 28300 1480754 15847 1464907 0.00407 12 50404 74392772 48302029 26090743 0.07250 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 200 3385 3385 0.00001 0 0.0 1 53 540 540 0.00000 0 0.0 2 253 3925 0 3925 0.00001 false 1797035 55027647 68754170 -13726523 X true true 1 1 IU HEALTH NORTH HOSPITAL 11700 N MERIDIAN ST CARMEL IN 46032 HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-NORTH-HOSPITAL 23-004171-1 X X X X X IU HEALTH NORTH 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 NORTH 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 NORTH HOSPITAL. IU Health North Hospital The defined community per the most recent CHNA conducted in the current tax year (i.e., 2024) is Boone, Hamilton, and Marion Counties, Indiana. The hospital resides in Hamilton 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 North Hospital obtained the insight and views of those who live in and service Boone, Hamilton and Marion counties through community meetings, a survey issued to those who were unable to attend the community meetings, a survey issued to internal healthcare providers and other team members from the hospital and key informants (including those possessing public health expertise). People and organizations representing a broad range of sectors, services and groups in the community were invited to attend. See Appendix C for a list of the organizations and community members that participated in the community input process. Boone County 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 Boone County. The following issues were discussed as significant: - The limited access to quality healthcare services including primary care, preventive screening and treatment, specialty care and prescription medications for chronic disease treatment. - Accessing healthcare services is challenging due to the costs, lack of health insurance and a shortage of providers. - Employment, poverty, debt and affordable, safe, quality housing impact health. - Accessing mental health and substance use treatment is challenging due to a shortage of providers, fear/stigma and trust. - Certain groups face worse health outcomes than the general population. - The county's top needs should include mental health and access to treatment for substance use disorders, access to healthcare services, chronic disease prevention and management and the aging population/ needs of older adults. Hamilton County In collaboration with Ascension St. Vincent, Community Health Network, Riverview Health and the Hamilton County Health Department, two meetings (in-person and virtual) were held in May 2024 to receive input on the health needs in Hamilton County. The meetings were attended by 43 people in total. The significant community health needs taken from the 2021 CHNAs of IU Health Saxony, Ascension St. Vincent, Community Health Network and Riverview Health were presented at the beginning of each meeting. Participants were asked to share their feedback on the status of these health needs in Hamilton County, any additions to the list of health needs, thoughts regarding the root causes of the health needs and the status of COVID-19 and its impacts. The meetings concluded by asking participants to finalize the top health needs impacting the health of the community. Once this list was confirmed, the participants were asked to prioritize and select the top health needs for their community (i.e., the significant community health needs). Highlights of discussion during the community meeting included many, if not all, of the 2021 CHNA significant community health needs. Suggested additions to the list include tobacco and vaping, especially among youth. Additional highlights of the 2024 discussion include: - Many individuals cannot afford healthcare - Navigating the healthcare system - Care coordination across healthcare systems needs to improve including sharing patients' health information - The challenges of older adults are great, including economic stability and its impact on providing for basic needs, fall risk and emergency calls for falls, lack of having a primary care doctor, a shortage of geriatricians to care for their unique needs, navigating different insurances and the need for more aging-in-place options, such as assisted living centers, senior living neighborhoods, and senior day centers to keep them safe - Significant shortage of affordable or covered (insurance) behavioral health providers who care for individuals before they reach a crisis as well as behavioral health inpatient care - Increasing mental health challenges for youth - There is no public transportation in Hamilton County; transportation is expensive and not having it may impact employment and the needs of certain populations such as older adults and people with disabilities - People seek to live and work outside of Hamilton County which causes workforce shortages, especially for jobs that pay a lower salary - Affordable housing in Hamilton County in safe and desirable areas is lacking (especially for people with lower incomes, older adults and people with disabilities); wages do not keep up with the housing expenses in the county - People prioritize which basic needs require spending money, which may mean healthcare is avoided - Food insecurity seems to be increasing - There is a lack of affordable, quality childcare options in the county, particularly for families who have children with disabilities or special needs - There is an increasing number of overdoses among all ages in Hamilton County - drugs can be bought online, and people are not always aware of their contents The Hamilton County discussion pointed out places and people who may not have enough support to stay healthy. When thinking about Hamilton County, these were the suggested changes to improve the health and well-being of the community. - A public shuttle with drivers that are bilingual - Developing more infrastructure for aging adults and ensuring more services and social opportunities are easily accessible - Emergency medical services (EMS) mobile integrated care services and home healthcare - Increase the availability of affordable, safe housing - More funding for community partners and programming - Connect more people to affordable healthcare and ensure assistance with financial assistance programs Participants from the community meetings identified the following needs as most significant in Hamilton County, which are not listed in any order. - Access to healthcare services - Aging population and needs of older adults - Mental health - Substance use disorders - Social determinants of health (especially housing, transportation and food insecurity) Schedule H, Part V, Section B, Line 5 Facility , 2 Facility , 2 - IU Health North Hospital (continued). Three interviews were conducted with a representative from the local public health department, city public health department and a social service agency to obtain subject-matter expertise on the health and well-being of those living in Hamilton County. The following issues were discussed as significant: - Care gaps and worsening health conditions are common due to access issues related to healthcare services, especially primary care, and not enough services are available to meet the demand in the county. Those with health insurance may not be using it as effectively as possible. Though there are great community-clinical linkages happening between specialists, healthcare providers, healthcare systems, LHDs and community based organizations, there is a need to increase comprehensive care for all in the community as well as integrate efforts to meet patients' physical, behavioral and social needs. - Methods to incentivize/empower more community members to engage in a healthier lifestyle and ensure the environment better supports a healthy lifestyle (e.g., walking and biking infrastructure). - Mental health got worse after the COVID-19 pandemic. There is a need for more prevention strategies and more mental health providers and services for all ages. Navigating existing resources can be hard for some groups in the community. Insurance often does not cover services, and self-pay can be expensive. Hamilton County residents are transported to neighboring counties for services which can be burdensome for individuals and families. Substance use disorders are an issue, including access to treatment services and the affordability and access to medication-assisted treatment. Older adults are self-medicating as they age which increases the risk of overdose. There are concerns that youth with mental health illness will fall behind in education attainment. - Substance use is common among youth as well as drinking and driving. Drug and alcohol use and overdoses are a problem for the county too. - Increased vaping and tobacco use in youth and its overall impact on health as one ages is a concern. - Oral and vision care services are hard to access due to individuals not having insurance coverage or Medicaid will not pay for services. - People living in rural communities in northern Hamilton County have a hard time accessing transportation and food in their communities. - Older adults are living longer, making their future financial security uncertain. These issues seem to be more problematic for this population: aging in place; mobility and ambulatory difficulty; food insecurity; greater needs for acute care; and caregiver strain. - Changes in the population and its impact on accessing care - Certain groups face worse health outcomes than the general population. - STI testing is hard to access in the community. The local health department needs more partners to expand those services into the community. - Many individuals do not have access to technology or the internet and have challenges using these mediums, which is where much of the current communication happens; therefore, information and resources can be missed. - Social determinants of health (SDOH) are negatively impacting the community, particularly due to the lack of affordable and safe housing, transportation (especially for people with special needs and older adults) and food insecurity. - The county must ensure it is prepared to address emerging issues such as climate change's impact on health, preparedness for disasters and the impact of technology on youth mental health. - The county should increase the use of the local health departments' (LHD) services and ensure collaborative partnerships between the LHD and community-based organizations. Marion County In collaboration with Ascension St. Vincent (Indianapolis) and Community Health Network, two meetings were held in May 2024 to receive input on the health needs in Marion County that primarily impact adults (separate meetings were held with a focus on maternal, infant and child health). The meetings were attended by 41 people in total. The prioritized community health needs taken from the 2021 CHNAs of IU Health hospitals, Ascension St. Vincent (Indianapolis) and Community Health Network were presented at the beginning of each meeting. Participants were asked to share their feedback on the status of these health needs in Marion County, any additions to the list of health needs, thoughts regarding the root causes of the health needs and the status of COVID-19 and its impacts. The meetings concluded by asking the participants to choose the top three most pressing health needs via written feedback or an online survey. Highlights of the community meetings' discussions included many, if not all, of the 2021 CHNA significant community health needs. Most participants agreed that COVID-19 seemed less of a problem in the community now. Suggested additions to the list included: - A more specific focus on certain SDOH, including unsafe and unaffordable housing; food insecurity and food literacy; poverty and jobs without a living wage; transportation to and from healthcare services; better and more timely public transportation; violence prevention; and discrimination - Medical legal partnerships are important to help people with landlord/tenant issues, immigration/naturalization, custody/visitation and expunging criminal records - Vaccinations - The many barriers for homelessness and housing instability (i.e., substance use and mental illness) - Sexually transmitted infections and infectious disease - Wait times are impacting access to home care and other healthcare services, especially for older adults and people with disabilities - Meeting social needs is important, but equally important is addressing the underlying root causes - There are fewer pharmacies in the community and people are having to travel farther to get their medications - Exposure to environmental contaminants is often overlooked - Grief and trauma and their impact on health - Social isolation and its impact on mental health - Enhancements to the built environment to encourage healthy lifestyles, increase safety and support different types of travel - Health literacy - Navigating healthcare services and better care coordination - Vaping needs to be included in tobacco use - Another barrier to accessing healthcare including technology, not everyone has a smart phone, data plan or access to the internet The Marion County discussion pointed out places and people who may not have enough support to stay healthy. When thinking about Marion County, the participants thought these were the greatest assets to promote health and well-being in the community. - People and their families - Multiple healthcare systems, schools, churches and a strong faith-based community - Many social services that could be accessed if people had knowledge of them - Transportation - Philanthropy and nonprofits - Community centers - Clinics and mobile units "meeting people where they are at" - Community health workers For those unable to attend the community meetings, a separate survey was distributed to receive their input on comparable questions posed during those meetings. Twelve people responded to the survey. These findings were combined with those of the community meeting participants. This process identified the following needs as the most significant for Marion County, which are not listed in any order: - Access to healthcare services (including trustworthy, supportive and affordable care, health education and flexibility in hours and days of service) - Access to mental health and substance use treatment (including more services for all people and behavioral and healthcare coordination) - Chronic disease prevention and management (especially hypertension and diabetes and their risk factors) - Social determinants of health (especially safe and affordable housing, food access, poverty and discrimination) - Violence prevention (including addressing its many forms [e.g., intimate partner and gun-related injuries] and root causes) In collaboration with Ascension St. Vincent (Indianapolis) and Community Health Network, two meetings were held in June 2024 (one in-person and the other virtual) to receive input on the health needs in Marion County that primarily impact maternal, infant and child health. The meetings were attended by 46 people in total. These meetings followed the same format as those meetings held in May with a focus on adults. Schedule H, Part V, Section B, Line 5 Facility , 3 Facility , 3 - IU Health North Hospital (continued). Highlights of the community meetings' discussions included many, if not all, of the 2021 CHNA significant community health needs. Suggested additions to the list of health needs included: - Access to substance use treatment for mothers and adolescents - Difficulties navigating the healthcare system and accessing services - Stigma around mental health and seeking services - Nutrition, drug use and sugar consumption education for youth - Families not completing well-child visits - Availability of healthcare appointments and bringing healthcare to mothers, youth and families (e.g., school and daycares) - Integrating healthcare into the community - Transportation to health and social services - Affordable food and medicines - Understanding trauma and its impact on health for all who interact with children and families - Trusting the healthcare system and providers - Housing - Dental and vision screenings for youth - The length of time between referral and visit to a physician, especially a specialty doctor - Family planning services/preconception - Better sex health education, especially in schools - Violence prevention and intentionally working to improve SDOH, especially poverty, to reduce violence in the community - Increased need for community health workers embedded in the community The Marion County discussion pointed out places and people who may not have enough support to stay healthy. When thinking about Marion County, the participants thought these were the greatest assets to promote health and well-being in the community. - Schools - Faith-based organizations - The influence healthcare systems could have in changing policy and systems in the communities - More community-based organizations and healthcare systems are investing in family resource navigators - Seeing more programs invest in programs and services that support the whole family, not just the children Safe Sleep programs - The program All Things to All People - SPARK - Dietitians and lactation consultants through programs like WIC - IU Health Congregational Care Network For those unable to attend the community meetings, a separate survey was distributed to receive their input on comparable questions posed during those meetings. Eight people responded to the survey. These findings were combined with those of the community meeting participants. This process identified the following needs as most significant for Marion County, which are not listed in any order: - Access to healthcare services (including trustworthy, supportive and affordable care, physically accessible and mobile units, health education, family planning, insurance and reproductive health) - Access to mental health and substance use treatment (especially more services for parents, pregnant women, after women have given birth and youth) - Maternal and infant mortality - Social determinants of health (especially safe, affordable and toxin free housing, childcare, food, transportation, economic stability and health disparities) - Violence prevention A survey was also issued to internal healthcare providers and team members at Riley Hospital for Children, asking them to identify the top health needs among the patients they serve. Among the 48 responses, these were the needs identified as most significant, which are not listed in any order: - Access to healthcare services - Access to mental health and substance use treatment (including services for pregnant women, parents and youth) - Maternal and infant health - Social determinants of health (especially housing, transportation to health and social services, food insecurity and economic stability) - Violence prevention Seven interviews were conducted with representatives from the local and state public health department, an organization focused on minority health, a Federally Qualified Health Center (FQHC), a large faith-based organization, an organization focused providing service to older adults and a food bank to obtain subject matter expertise on the health and well-being of those living in Marion County. The following issues were discussed as significant: - The overall health of the community is declining due to health conditions and behaviors such as obesity, preventable diseases, substance use disorder and vaping as well as a lack of transportation to health and social services, no access to healthy foods, limited access to safe and affordable housing and limited access to healthcare and mental health services. Seeing generations of families with obesity and childhood obesity is creating a generation of young adults with Type II Diabetes. - People of all ages are less likely to receive the information, life skills and resources needed to build healthy habits, and their environments do not support healthy behaviors. - Poor life expectancy and quality of life. - Not enough is being done to ensure optimal health for all community members. A better practice of disaggregating data and connecting it to factors that influence health is needed. There is a need to keep looking at the data to identify the prevalence of disease and risk factors and mortality in certain populations. - When thinking about the state, people living in rural areas experience differences in transportation to health and emergency services; access to healthy foods; access to the internet and technology for telehealth; and a lack of healthcare and mental health providers. - Mental health and substance use disorders are challenges because there are not enough providers to offer services to people of all ages; accidental drug and toxification overdoses; comorbidity between each; the stigma faced by those that are ill; the intersection of SDOH and mental illness (i.e., anxiety and depression) and when untreated or poorly managed, both can impact other health outcomes. - The gaps in the healthcare workforce impact the delivery of care. More providers are needed that focus on dental health, mental health, older adults, pediatrics and women's health as well as those that "look like the populations served." - Infant mortality is the number one indicator of the health of the community. Infant and maternal health and the many factors that impact it include ability to pay for services and insurance coverage, obesity, substance use disorder, smoking, lack of access to prenatal care, literacy (including health literacy) and language barriers and the unique needs of all pregnant women. Some communities have no prenatal, pregnancy or postpartum care for women nor any subsequent care options for their infants. - Continued collaboration is needed between hospitals, healthcare systems, FQHCs and the state and LHDs to understand the health profile of communities; share data; deliver comprehensive health prevention and promotion services; bring more flexibility in the delivery of services to better accommodate all patients and their families; implement innovative models of care; and track the impact of efforts on health outcomes. - Better collaboration (including data sharing) is needed between social services and healthcare providers to ensure a more comprehensive approach to addressing the interconnectivity between a person's physical, social and mental health. - SDOH poorly impacting people's health incudes economic stability and being paid a living wage; housing costs; accessing quality food, education, childcare and jobs with healthcare benefits; and transportation to medical and other services. Some SDOH, like food insecurity, are also tied not only to poor health outcomes, but violence, absenteeism and lack of education. - Violence prevention, especially in youth and young adults. There is a need to address all forms of violence including gun violence and intimate partner violence in the immigrant population. Need to support better gun safety in the community. - The awareness of trends and developments that may not rise to the top as "significant" but chronically plague the health of a community and need the attention of public health and healthcare including congenital syphilis, autism screenings and assessments for children, environmental health (e.g., lead poisoning prevention) and dental care. - Understanding the healthcare system and patient access points, the availability of healthcare services and insurance benefits as well as the lack of care coordination can be challenging for individuals and families. Schedule H, Part V, Section B, Line 5 Facility , 4 Facility , 4 - IU Health North Hospital (continued). 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: - A Healthier Hamilton County Systems of Care - Aspire Indiana Health - Boone County Health Department - Boys and Girls Club of Noblesville - Boys II Men - Breathe Easy Hamilton County - Care Patrol CareSource - Carmel Clay Schools - Center for Interfaith Cooperation - Central Indiana Community Foundation - Cherish Center - Child Care Answers - Children's TherAplay - CHIP Indy (Coalition for Homelessness Intervention and Prevention) - Cicero Fire Department - CICOA Aging and In-Home Solutions - City of Fishers EMS - City of Indianapolis-Department of Metropolitan Development - City of Noblesville EMS - City of Westfield - Coburn Place - Consulate of Mexico in Indianapolis - Council Member (County At-Large), Hamilton County Government - Covering Kids and Families of Indiana - Damien Center - Dove Recovery House for Women - Early Learning Indiana - Eastern Star Church - Eskenazi Health - Exodus Refugee Immigration - Family and Social Services Administration - Office of Early Childhood and Out-of-School Learning - Family Development Services/Head Start Hamilton County - Family Promise of Hamilton County - Fathers and Families Center - Fay Biccard Glick Neighborhood Center - Fishers Health Department - Genesys Solutions - Gleaners Good Samaritan Network - Goodwill of Central and Southern Indiana - Nurse Family Partnership - Grassroots Maternal and Child Health Initiative - Hamilton County Community Foundation - Hamilton County Council on Alcohol and Other Drugs - Hamilton County Health Department - Hamilton County Parks and Recreation Hamilton County Sheriff's Office - Hamilton County Veterans Corporation - Hamilton Heights - HAND - Health Access Ascension - Health by Design/Indiana Public Health Association - HealthNet Inc. - Heart and Soul Free Clinic - Hispanic Congregation Pastor - Hoosier Environmental Council - HOPE Family Care Center - Horizon House - Ignite Transform - Immigrant Welcome Center - Indiana Department of Health - Indiana Diaper Bank - Indiana Family to Family - Indiana Minority Health Coalition - Indiana Parkinson Foundation - Indiana Perinatal Quality Improvement Collaborative (IPQIC) - Indiana University Center for Global Health Equity - Indiana University Richard M. Fairbanks School of Public Health - Indianapolis Public Library - Indianapolis Public Schools - Indianapolis Public Schools (IPS) - Stronger Tomorrows Program - Indianapolis Recorder Newspaper - Indy Public Safety Foundation Inc. - IndyGo Foundation - Intend Indiana - Ivy Tech Hamilton County - Jane Pauley Community Health Center - Janus Developmental Services - John Boner Neighborhood Centers - Jump IN for Healthy Kids - Kids' Voice of Indiana - La Plaza - Latino Health Organization - Madam Walker Legacy Center - Managed Health Services (MHS) Indiana - Marion County Public Health Department - Martin Luther King Community Center - Medical-Legal Partnerships of Indiana Legal Services - Miracle Place - MLK Center Indianapolis - Mount Zion Baptist Church of Indianapolis - Mt. Carmel Baptist Church - Mudsock Youth Athletics - Near North Development Corporation - Noblesville Chamber of Commerce - Noblesville Fire Department - Noblesville Schools - Pathway to Recovery, Inc. - Playworks - Postpartum Support International - Indiana Chapter - PrimeLife Enrichment - Purdue Extension of Marion County - Raphael Health Center, Inc. - Reach For Youth, Inc. - Regenstrief Institute, Inc. - Rehab Hospital of Indiana - Saint Monica Catholic Church - Shepherd Community Center - Shepherd's Center of Hamilton County - Starfish Initiative - Student Impact of Westfield - Suburban North Club - The Indianapolis Foundation - The Milk Bank The Mind Trust - The O'Connor House - The Villages of Indiana, Inc. - Trinity Free Clinic - Volunteers of America Ohio and Indiana - YMCA of Greater Indianapolis/Top 10 Coalition - Youth Mentoring Initiative Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - IU HEALTH NORTH HOSPITAL. In April 2025, IU Health's board of directors approved the implementation strategy for IU Health North Hospital to respond to the needs identified in their 2024 CHNA. IU Health North Hospital will address these community health needs in 2025-2027: * Access to healthcare services * Aging population and needs of older adults * Behavioral health (mental health and substance use) * Chronic disease prevention and management * Maternal and infant health and child well-being * Smoking, vaping and tobacco use * Social determinants of health IU Health North Hospital will address all the community health needs identified in the 2024 CHNA. In 2024, IU Health North Hospital addressed needs identified in the 2021 CHNA using the 2022-2024 implementation strategy plan adopted in April 2022. The hospital, along with community partners, prioritized and determined which of the significant needs identified in the CHNA could be adequately addressed by current or future initiatives, programs, resources, and collaborations. The 2022-2024 implementation strategy outlines how IU Health North Hospital planned to address significant needs including initiatives, strategies, internal/external collaborators, anticipated impact, and hospital resources. Significant Needs Hospital Addressed Below was the progress of the implementation strategy by significant need and its respective initiative(s). The hospital addressed the following significant needs between 2022 and 2024: Access to Healthcare Services; Aging Population and Needs of Seniors; Behavioral Health; Chronic Disease and Chronic Disease Management; Maternal and Infant Health and Child Well-being; Smoking, Tobacco Use and Exposure to Secondhand Smoke; and Social Determinants of Health. Access to Healthcare Services * Supported the Trinity Free Clinic (free medical clinic that provided healthcare services to uninsured and low-income individuals in the community). In 2024, IU Health North Hospital provided a grant to Trinity Free Clinic to support their Bridging the Gap Program that trained individuals to obtain meaningful careers in healthcare. The funding was used to purchase materials necessary for the program, including EKG simulators, blood pressure training arms, classroom technology, laptop carts, stethoscopes and student workstations. Over 40 individuals were projected to complete the training and would simultaneously assist with the 10,000 patient visits that Trinity Free Clinic encounters each year. * Supported Heart & Soul Clinic's operations (free medical clinic that provided healthcare services to uninsured and low-income individuals in the community). IU Health North Hospital provided a grant to support Heart & Soul Clinic's language barrier reduction program to improve communication and accessibility for patients with limited English proficiency. The funding was used to retain bilingual staff members, fund Language Line software and implement Lexmark Translation Services. As a result, 565 patients received language services in 2024. * 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 237 people at IU Health North Hospital. * Provided vaccine clinics in the community. In 2024, IU Health North Hospital community outreach and clinical staff hosted six flu vaccine clinics in Hamilton County, resulting in over 250 vaccines. Clinics were held in vulnerable and vaccine-hesitant communities, such as food pantries and senior centers, to increase vaccine access, trust, and awareness among at-risk populations. Aging Population and Needs of Seniors Supported the Shepherd's Center of Hamilton County's (SCHC) (geriatric counseling program that offers virtual, outpatient and home-based therapy to improve mental well-being among seniors). In 2024, IU Health North Hospital provided funding to expand the number of counseling sessions offered by 30 percent, which equates to 250 additional free sessions for seniors and older adults. Additionally, IU Health North Hospital team members assembled 100 care packages that were donated to SCHC's program clients during their holiday assistance deliveries, and provided blood pressure screenings, as well as health education, at SCHC's Together Today gatherings. Offered programming at the PrimeLife Enrichment (PLE) senior center. IU Health clinicians and health professionals led four presentations at PLE to increase health knowledge among seniors and older adults. Presentation topics included heart health, geriatrics, hypertension, stroke and gastroenterology. 100 percent of attendees who completed post-program surveys reported an increase in knowledge after the presentations. In addition, a blood pressure screening event and a flu vaccine clinic were hosted at PLE, resulting in 61 vaccinations and four individuals screened for hypertension. IU Health North Hospital also provided a grant to expand PLE's transportation program for seniors who cannot drive, which increased the number of rides given to an average of 1,300 rides per month in 2024. Behavioral Health * Supported Indiana Center for prevention of Youth Abuse and Suicide (ICPYAS). IU Health North Hospital did not provide support to ICPYAS in 2024. The partnership was transferred to a different IU Health hospital, which had a community definition that was more aligned with ICPYAS' target population. * Supported Hamilton County organizations that provided services for residents who were victims of crime, abuse, and trauma or experienced general behavioral health challenges. In 2024, IU Health North Hospital provided funding to the Hamilton County Veterans Corporation to expand their second annual resource fair that connected veterans and service members as well as their families and caregivers to local resources. Over 400 individuals were connected with resources offered by 90 service agencies at the event. IU Health North Hospital also provided funding to the Ignite Transform nonprofit, which offered mental and physical wellness services for community members. The funding covered expenses to ensure that Ignite Transform's mental and physical wellness program was offered free-of-cost to community members in-need. The funding supported mental health seminars and wellness sessions for 400 unique individuals. * Further implemented the Virtual Care Peer Recovery Coaching Program (provided patients who had substance use concerns with virtual behavioral health services). The Virtual Peer Recovery Coach program was discontinued in February 2023 as IU Health continued to assess and evolve its behavioral health services based on the needs of patients and the communities it served. Since 2018, this program had served 15 IU Health and two non-IU Health emergency department patients who struggled with substance use disorder through support to aid in recovery. IU Health continued to serve patients with a need for this service through the Virtual Behavioral Health team. * Further implemented the Emergency Department (ED) virtual care program that provided patients virtual access to behavioral health services). Virtual Integrated Behavioral Health (VIBH) provided urgent psychiatric assessment for patients experiencing behavioral health crises, such as suicidal ideation, homicidal ideation, psychosis, and substance abuse disorders. A team of behavioral health professionals provided consultation through iPad carts located in emergency departments, urgent cares, and ambulatory care locations. In 2024, there were over 10,000 visits of which 871 visits included patients seeking care in the emergency departments in the Indy Suburban Region (which included IU Health North Hospital). This program was financially supported by the parent hospital, IU Health Inc., but was offered to and impacts patients in this hospital's defined community. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - IU HEALTH NORTH HOSPITAL (CONTINUED). Chronic Disease and Chronic Disease Management Implemented Fresh & Fit (a free 10-week fitness and nutrition program to improve overall physical and mental health). In 2024, 32 Hamilton County community members completed the Fresh & Fit program free-of-cost. The participants received daily workouts and motivation, a nutrition plan, fitness equipment and an at-home blood pressure monitor to track their blood pressure measurements. Between the pre-program and post-program health screenings, 69 percent of participants reduced their blood pressure levels, and 72 percent lowered their cholesterol. A total of 202.4 pounds (average of 8 pounds per person) were lost among participants between pre-program and post-program. On post-program assessments, 100 percent of participants reported that they plan to continue implementing healthy habits after program completion by maintaining a fitness and nutrition regimen into the future. Provided resources to support individuals living and coping with cancer. In 2024, IU Health North Hospital's Schwarz Cancer Center offered free integrative health classes, programming and support groups throughout the year for individuals living with cancer and their caregivers. The resources were available to both general community members and patients. Offerings included free bra fitting examinations, cooking for health classes, gentle exercise classes, support groups for specific cancer diagnoses, art therapy, music therapy and fireside discussions. In addition, IU Health North Hospital provided a grant to the Indiana Women in Need Foundation's Survivor Support program, which allocated financial assistance to low-income individuals undergoing cancer treatment. As a result of the 2024 funding, 15 individuals living with breast cancer received assistance and reported that the support relieved anxiety and allowed them to remain engaged in their treatment. Maternal and Infant Health and Child Well-being * Supported the HOPE Family Care Center (provided free medical, dental and counseling services to residents). In 2024, IU Health North Hospital provided funding to HOPE Family Care Center to support their behavioral health counseling program for uninsured and underinsured individuals in Hamilton County. The funding helped to expand the number of free counseling sessions offered to women, their families and other underserved individuals in the county. Offered free education and resources that reduce infant mortality and promote well-being for children and families. The IU Health North Hospital Childbirth Education team offered free resources throughout the year with a goal of preparing parents and guardians to foster healthy lifestyles for their children. The resources were available to both general community members and patients. Programming included free lactation consultations, breastfeeding support groups, parenting and grandparenting support groups, child and infant CPR, car seat safety, birthing classes and newborn basics classes. In addition, IU Health North Hospital provided funding to the Carmel Lions Club to expand initiatives impacting access to healthcare, child well-being and food insecurity. The funding was used to cover expenses for low-income families to enroll their children in Youth Diabetes Camp, which prepared children to effectively manage their diabetes diagnoses. Additional funding supported Operation Kid Sight, which increased the number of children who received screenings for amblyopia in 2024. The funds were also used to cover free eye exams, glasses, hearing aids and food distribution for low-income families in Hamilton County. Smoking, Tobacco Use and Exposure to Secondhand Smoke Supported the Tobacco Free Hamilton County Alliance (TFHC). In 2024, IU Health North Hospital supported Breathe Easy Hamilton County and the Tobacco Free Hamilton County Alliance by serving on a monthly committee aimed at developing solutions to reduce smoking, vaping and tobacco use in Hamilton County. IU Health North Hospital supported Breathe Easy Hamilton County events for adults and youth to educate about smoking, vaping and tobacco use and the associated harms. Further implemented the Centralized Tobacco Treatment Program (CTTP) (provided patients access to evidence-based tobacco treatment). The CTTP program was free to IU Health Primary Care patients. Once a patient's level of care was assessed, they were provided evidence-based tobacco cessation treatment with a trained Tobacco Treatment Specialist (TTSs). Patients had access to Ex, a new digital cessation app, and support from an Advance Practice Provider (APP) who evaluated and prescribed medication assisted therapy (MAT) for nicotine replacement. Education and support were provided to primary care practices which helped to expand services. Cross-functional teams worked together, including the West Central Region TTSs for case conferencing and training. One focus in 2024 was on improving access and patient experience with medication management. CTTP improved patient tobacco treatment medication support by integrating systems and processes with a dedicated APP resource. They improved documentation to accurately report MAT, demonstrating 73% of patients used NRT/medication to quit. 362 medication management sessions were scheduled compared to 263 in 2023. 75% of patients completed their appointment with the APP. In 2024, the team had been trained to complete prior authorizations. The team focused on care continuation, care coordination (TTS/APP), scheduled patient follow-up appointments, and monitored adherence or complications. A focus on improving patient experience resulted in strong and consistent quit rates of 37% of active patients (increased from 33% in July 2024) and harm reduction (patients who reduced use of tobacco) of 61% (July 2022-December 2024). This was an increase from 56% in July. The team received frequent testimonials of lives changed and gratitude for a supportive, compassionate partner. There were 73 patients connected to Ex for additional nicotine cessation support. In 2024, CTTP received 1,767 referrals which was an all-time high for the program, scheduled 47% of them and completed at least one session with 67% of those scheduled. Additionally, 70% of patients seen completed two or more sessions. Over the program's life, CTTP had received 3,921 patient referrals (this information cannot be separated by hospital or region at this time). Social Determinants of Health Supported Aspire Indiana Health (provided primary medical and behavioral healthcare and addressed non-medical barriers to health). In 2024, IU Health North Hospital provided funding to support Aspire Indiana Health's social determinants of health barrier program that offered assistance to individuals in Hamilton County who experience challenges with non-clinical needs, such as housing and employment. Over 50 individuals received social determinants of health assistance through the program. Supported access to healthy food and basic sustenance for families who were low-income and struggling to meet basic needs. In 2024, IU Health North Hospital team members assembled over 100 snack packs that were donated to Family Promise of Hamilton County, which was a local nonprofit that assisted individuals who were low-income or at risk for homelessness. IU Health North Hospital also provided free heart-healthy meals at Shepherd's Center of Hamilton County's Together Today program for in-need seniors and older adults. IU Health North Hospital offered additional support to various Hamilton County nonprofits that addressed social determinants of health in 2024. For example, IU Health North Hospital provided funding for the Carmel Youth Assistance Program's pilot transportation initiative that would provide reliable transportation options and resources for low-income families. Similarly, IU Health North Hospital donated 100 books to the Carmel Youth Assistance Program to support literacy and education for underserved children in Carmel. IU Health North Hospital team members also assembled and donated 125 hygiene kits to the Indy Hygiene Hub, which was a nonprofit that provided hygiene necessities to low-income individuals. Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - IU HEALTH NORTH HOSPITAL (CONTINUED). Significant Needs Hospital Would Not Address IU Health North Hospital was not addressing the following significant needs between 2022 and 2024: Health Education and Navigation Health Education and Navigation refers to services and resources that were available in the community, but people did not know how to get connected to them (e.g., how to obtain health insurance, understanding insurance benefits, navigating the healthcare system, language barriers and health literacy). IU Health North Hospital perceived this health need as being addressed under many initiatives that fall under the significant needs that the hospital was currently addressing. IU Health North Hospital would monitor this need to see if there were changes or opportunities in the future to address it further. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - IU HEALTH NORTH HOSPITAL. IN ADDITION TO FPG, IU HEALTH NORTH 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 NORTH HOSPITAL. IU Health North 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 NORTH HOSPITAL. IU Health North 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. 4 IU HEALTH NORTH METABOLIC & BARIATRIC SURGERY 11725 N ILLIONIS ST CARMEL IN 46032 Specialty Care IU HEALTH NORTH REHAB SERVICES 11700 N MERIDIAN ST SUITE K177 CARMEL IN 46032 REHABILITATION SERVICES IU HEALTH NORTH RETAIL PHARMACY 11700 N MERIDIAN ST B106 CARMEL IN 46032 PHARMACY IU HEALTH NORTH HOSPITAL LAB 11700 N MERIDIAN ST CARMEL IN 46032 LAB Schedule H, Part I, Line 6a C.B. REPORT PREPARED BY A RELATED ORG. IU Health North Hospital's community benefit and other investments, encompassing its total community investment, are included in the IU Health Community Benefit Report which is prepared on behalf of and includes IU Health and its related hospital entities in the State of Indiana. The IU Health Community Benefit Report is made available to the public on IU Health's website at https://iuhealth.org/in-the-community. 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 7c 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 EXCLUDES DIRECT OFFSETTING REVENUE, IS 20.67%. Schedule H, Part I, Line 7f PERCENT OF TOTAL EXPENSE The amount of bad debt expense subtracted for purposes of calculating the percentage of total expense on Line 7, column (f) is $9,296,730 Schedule H, Part II PROMOTION OF HEALTH IN COMMUNITIES SERVED IU Health North Hospital supports and/or participates in a variety of community-building activities that address the non-medical, root causes of health problems in the communities it serves. IU Health North Hospital and its related hospital entities across the state of Indiana ("IU Health Statewide System") investments include economic development efforts across the state, environmental improvement projects, workforce development opportunities, collaboration with like-minded organizations through coalitions that address key issues and advocating for improvements in the health status of vulnerable populations. IU Health North Hospital supported several types of community building activities to promote the health of the community. These activities include but are not limited to: Physical Improvements and Housing: IU Health North Hospital supports Habitat for Humanity of Hamilton County by funding neighborhood builds and providing staff support to build the homes. The projects increase affordable housing availability to underserved first-time homeowners. Coalition Building: IU Health team members participate on the governing boards of nonprofit organizations that seek to increase access to healthcare services, health equity, and advancing public health such as PrimeLife Enrichment senior center and Trinity Free Clinic. Additionally, IU Health team members participate in local coalitions to share resources and information as well as improve community and partner capacity to address health needs and advance health equity in the community. Workforce Development: IU Health North Hospital partnered with Carmel High School to connect with students interested in healthcare through the school's Certified Nursing Assistant program. During the first semester of 2024, IU Health clinical staff spoke to the students about their career roles, required skills and job experiences to help students excel in their career journey. Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care IU Health North Hospital uses several factors other than federal poverty guidelines ("FPG") in determining eligibility for free care under its FAP. These factors include the following: 1. Financial Assistance due to Financial Hardship A. To be eligible for Financial Assistance due to financial Hardship under this Policy, a patient or guarantor must: a. Submit a completed Financial Assistance Application with all supporting documentation and be approved in accordance with this Policy; b. Be an Indiana Resident as defined in this Policy; and B. If Uninsured, consult with a member of IU Health's Financial Counseling department to determine if health care coverage may be obtained from a government insurance or assistance product, the Health Insurance Marketplace, or from any other source of coverage. C. Financial Assistance due to financial Hardship is only available for Qualifying Care, as defined in this Policy. D. The FPL income threshold under this section is as follows: - If one or more adults and zero dependents are in the household, the FPL Income Threshold is 200%. - If two or more adults and one or more dependents are in the household, the FPL Income Threshold is 250%. - If one adult and one or more dependents are in the household, the FPL Income Threshold is 300%. *In some instances, an adult will also qualify as a dependent. When this occurs, IU Health will treat the adult as a dependent for purposes of the FPL calculation. 2. Financial Assistance due to Personal Hardship A. In order to be eligible for Financial Assistance due to personal Hardship under this Policy, a patient or guarantor must: a. Submit a completed Financial Assistance Application with all supporting documentation and be approved in accordance with this Policy; b. Be an Indiana Resident as defined in this Policy; and c. If Uninsured, consult with a member of IU Health's Financial Counseling department to determine if health care coverage may be obtained from a government insurance or assistance product, the Health Insurance Marketplace, or from any other source of coverage. B. An Uninsured or Underinsured patient or their guarantor may be eligible for Financial Assistance if the Household's outstanding Patient Responsibility exceeds 5% of the patient's or their guarantor's annual household income. C. If approved, the Household's balance will be reduced to 5% of the patient or guarantor's annual household income. 3. Eligibility Period A. If approved for Financial Assistance by IU Health under Sections IV.E-F, the patient will be guaranteed financial assistance for treatment related to the underlying condition, for which the patient was originally screened and approved, through the remainder of the calendar year. B. As a condition of extending the ongoing Financial Assistance, the patient must comply with requests from IU Health to verify that the patient continues to meet the conditions for qualification. 4. Appeals and Assistance Granted By the Financial Assistance Committee A. The Financial Assistance Committee will review and make determinations on all requests for appeals related to Financial Assistance. If a patient or guarantor seeks to appeal a Financial Assistance Determination, a request must be submitted, along with any additional information or requested supporting documentation, if applicable. B. The Financial Assistance Committee will review requests for and may grant additional Financial Assistance, including but not limited to, the following: a. Assistance to patients who are seeking treatment that can only be provided in Indiana by IU Health or who would benefit from continued medical services from IU Health for continuity of care; b. Care approved by an IU Health Chief Medical Officer (CMO), Chief Executive Officer (CEO) or Chief Financial Off icer (CFO) of an IU Health facility or region, including medically necessary non-elective services for which no payment source can be identified; c. Care provided when it is known no payment source exists; d. Care provided, due to medical urgency, for which a payer denies payment; e. International humanitarian aid; and f. Other care identified by the Financial Assistance Committee that fulfills the IU Health Mission. C. All decisions of the Financial Assistance Committee are final. 5. Presumptive Eligibility A. A Financial Assistance Application is not required to receive Financial Assistance under this Presumptive Eligibility section. B. IU Health will deem patients or their guarantors presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs and the patient received Qualifying Care, as defined in this Policy. a. Medicaid (any state) b. Indiana Children's Special Health Care Services c. Healthy Indiana Plan d. Patients who are awarded Hospital Presumptive Eligibility (PE) e. Patients approved for the Eskenazi Health Advantage program f. A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. C. IU Health will conduct a quarterly review of all accounts placed with a collection agency partner for at least one hundred and twenty (120) days after the account is eligible for an ECA as set forth in this Policy. If the patient or guarantor's individual scoring criteria demonstrates the patient has a low likelihood and/or propensity to pay or no credit, the patient or guarantor may be deemed presumptively eligible for Financial Assistance. a. IU Health may also periodically conduct a similar review on patient balances not placed with a collection agency, and presumptively quality patients for Financial Assistance. D. Financial Assistance may additionally be granted in the following circumstances: a. If the patient or their guarantor is found to have filed a petition for bankruptcy. b. If the patient is deceased and found to have no estate. c. If the patient is deceased and was under 21 years of age at the time of death. 6. Exhaustion of Alternate Sources of Assistance A. Patients may be required to exhaust all other state and federal healthcare coverage assistance programs prior to receiving Financial Assistance due to financial or personal Hardship under this Policy including, but not limited to, Medicaid. B. Patients who may be eligible for coverage under an applicable health insurance policy must exhaust all insurance benefits. a. This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. b. IU Health may request patients show proof that such a claim was properly submitted to the appropriate insurance provider before awarding Financial Assistance. C. Eligible patients who receive medical care from an IU Health facility as a result of an injury proximately caused by a third party and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award. D. In the event Financial Assistance has already been granted in the above circumstances, IU Health reserves the right to reverse the Financial Assistance Determination in an amount equal to the amount IU Health would be entitled to receive had no Financial Assistance been awarded. 7. Patient Assets A. There are situations where a patient or their guarantor may have significant income or assets available to pay for healthcare services such as a legal settlement. The Financial Assistance Committee may evaluate the income or assets in determining financial Hardship. B. IU Health may require a list of all property owned by the patient or guarantor and adjust a Financial Assistance Determination as a result. Schedule H, Part I, Line 6a Community benefit report prepared by related organization INDIANA UNIVERSITY HEALTH, INC. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 9296730 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 The amount reported on Schedule H, Part III, Line 6 is calculated, in accordance with the Form 990 instructions, using "allowable costs" from IU Health North Hospital's Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health North 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 North's participation in Medicare programs would significantly increase the Medicare shortfall reported on Schedule H, Part III, Line 7. IU Health North 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 or poor management. IU Health North 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. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance IU Health North 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 NORTH 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 NORTH 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 NORTH HOSPITAL: Line 16c URL: https://iuhealth.org/pay-a-bill/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment Though IU Health North Hospital believes its CHNA process is comprehensive, the CHNA is done on a triennial basis. Between CHNA cycles, IU Health North Hospital gathers data and information to monitor the most current needs of the community. Additional sources of data and information include: * IU Health data analytics and information service teams; * Secondary data sources from Federal, state, and local entities with a focus on health behaviors, health outcomes, and social determinants of health; * Obtaining community organization and governmental agency perspectives; priority population perspectives; and other healthcare and hospital perspectives; * Reports that share findings and recommendations on certain populations within the community and/or health behaviors, health outcomes, or social determinants of health; * Evidence informed sources; and * Team member participation in partnering efforts (e.g., coalitions, advisory committees, task forces, etc.). The regular review of these sources of data and information rarely impact what the significant needs are between CHNA cycles. However, it does help influence the types or level of interventions to address the significant needs; prioritize resources to those groups or neighborhoods experiencing health disparities in the community; identify funding opportunities to support interventions; and strengthen or mobilize partnerships to improve health. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance IU Health North 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 North Hospital has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health North Hospital is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health North 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 North 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 North Hospital is in Hamilton County, Indiana, a county located in central Indiana. Its service area counties include Marion, Hamilton, Boone, Hendricks, Hancock, Madison, and Tipton counties. Hamilton County includes ZIP codes within the towns of Arcadia, Atlanta, Carmel, Cicero, Fishers, Noblesville, Sheridan, and Westfield. Based on the most recent Census Bureau (2024) statistics, Hamilton County's population is 379,704 persons with approximately 50.7% being female and 49.3% male. Schedule H, Part VI, Line 5 Promotion of community health IU Health North Hospital is a subsidiary of Indiana University Health, Inc., a tax-exempt healthcare organization, whose Board of Directors is composed of members of which substantially all are independent community members. IU Health North Hospital extends medical staff membership and clinical privileges to medical and allied health providers who meet the credentialing qualifications as well as any additional standards and rules set forth by its Board for medical staff appointment (in accordance with Indiana state law). Information on privileging and credentialing, including applying for membership, for IU Health North Hospital can be accessed on the IU Health website. A nondiscrimination clause is explicitly stated in IU Health North Hospital credentialing process. IU Health, in conjunction with the IU School of Medicine, trains the next generation of physicians in an exceptional environment, blending breakthrough research and treatments with the highest quality of patient care. During 2024, IU Health North Hospital's promotion of community health included, but is not limited to, the following highlights: IU Health North Hospital maintained a strong presence across the northern Indianapolis suburbs and supported numerous not-for-profit agencies such as medical and dental clinics that provide care to the un- and under-insured, behavioral health organizations that provide health and social services to individuals in need, local parks departments and housing agencies that address neighborhood and environmental improvements, senior organizations that provide free resources and counseling to older adults, and organizations that address the social determinants of health for underserved populations. Schedule H, Part VI, Line 6 Affiliated health care system Indiana University Health North Hospital is part of Indiana University Health ("IU Health "the healthcare system"), which is Indiana's most comprehensive healthcare system. A unique partnership with the Indiana University School of Medicine ("IU School of Medicine"), one of the nation's leading medical schools, gives patients access to innovative treatments and therapies. The healthcare system is comprised of hospitals, physicians and allied services dedicated to providing preeminent patient care and community health improvement throughout Indiana. IU Health's affiliate hospitals are divided into six regions that serve communities in Northwest, Northeast, Central and Southern Indiana. The 15 hospitals in the healthcare system include IU Health Inc. (i.e., the IU Health Academic Health Center consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health and IU Health Saxony Hospital); IU Health Arnett; IU Health Ball;; IU Health Bloomington Hospital; IU Health Frankfort; IU Health Jay; IU Health North Hospital; IU Health Paoli Hospital; IU Health Tipton Hospital; IU Health West Hospital; and IU Health White Memorial Hospital. Each affiliate hospital in the healthcare system, along with community partners, conducted, and adopted its own community health needs assessment (CHNA) and implementation strategy. IU Health considered the sum of these CHNAs and the implementation strategies part of a system wide vision of making Indiana one of the healthiest states in the nation. The healthcare system and its affiliate hospitals are keenly aware of the positive impact it can have on improving the health of communities throughout the state of Indiana by investing in local, community-based initiatives as well as system-level strategies. The healthcare system includes an Academic Health Center (i.e., IU Health Inc.), a regional academic health center (i.e., IU Health Bloomington Hospital) and several affiliate hospitals (IU Health Arnett and IU Health Ball) that work in partnership with the IU School of Medicine to train physicians, blending breakthrough research and treatments with the highest quality of patient care throughout IU Health. Each year, more than 1,000 residents and fellows received training in affiliate hospitals. Research conducted by IU School of Medicine faculty gave IU Health physicians and patients access to the most leading-edge and comprehensive treatment options. To further promote the health of the communities served by IU Health, the system-level Community Health Division partnered with state and local community-based organizations, community coalitions and governmental agencies to focus on innovative models of care; community alliances and partnerships; anchor institution and advocacy strategies; and social determinants of health. All affiliate hospitals in the healthcare system identified and addressed significant needs unique to the communities they serve. However, some needs were common in communities served by multiple or all affiliate hospitals in the healthcare system and aligned with system priority areas, warranting a system-level strategy. The Community Health Division, along with additional internal partners such as the Office of Health Excellence Research and Engagement (HERE) and the IU Health Foundation, planed and provided technical assistance for system-level strategies that addressed these common needs including tobacco and nicotine cessation, infant and maternal health, hypertension, and social determinants of health. For example, the Community Health Division has launched a community health worker initiative throughout the system in outpatient and inpatient sites that did community outreach as part of the WeCare and iHEART initiatives. Each affiliate hospital collaborated with the Community Health Division to align and activate local resources to support local and system strategies. This benefits the community each affiliate hospital served and worked towards a statewide impact (system-level) on health outcomes. As part of the Community Health Division, the Community Outreach and Engagement Program's IU Health Serves initiative, a system-level team member volunteer program, sought to positively impact the health of communities IU Health affiliate hospitals serve and foster a culture of engagement and social responsibility. Each affiliate hospital coordinated the different initiatives of the program, including Days of Service. This was the largest volunteer event of the year, consisting of projects designed to engage each affiliate hospitals' team members in activities that address local, significant needs. The $200 million Community Impact and Investment (CII) Fund was established in 2018 by IU Health to financially support high-impact community investing. The focus of these efforts addressed key social and environmental factors that impact different groups in the communities IU Health serves. Each affiliate hospital and its team members were eligible to pursue this grant opportunity with a community organization. Schedule H, Part VI, Line 7 State filing of community benefit report IN X X X X false true false false false false false true false KENNETH D PUCKETT DIRECTOR / PRESIDENT (ISR) 0 631564 0 258569 0 110356 0 128220 0 66086 0 1194795 0 82802 MEGAN CRITTENDON MD DIRECTOR 0 276381 0 35819 0 4242 0 9436 0 30503 0 356381 0 0 MICHAEL TSANGARIS MD DIRECTOR (PART YEAR) 0 197761 0 20193 0 5781 0 8478 0 11558 0 243771 0 0 ALLISON P EMHARDT Former Officer 0 191788 0 22904 0 270 0 8917 0 37412 0 261291 0 0 DEREK E EMPIE FORMER OFFICER 0 373567 0 55399 0 1242 0 13800 0 63630 0 507638 0 0 CARA L BREIDSTER CFO (ISR) 0 309988 0 39308 0 2322 0 12104 0 54009 0 417731 0 0 JENNIFER GIROD Secretary 0 164135 0 16916 0 6150 0 7241 0 10534 0 204976 0 0 PAUL M CALKINS MD FORMER KEY EMPLOYEE 0 276784 0 75758 0 3429 0 11833 0 40375 0 408179 0 0 ARTHUR VASQUEZ FORMER KEY EMPLOYEE 0 591884 0 254900 0 1869 0 116832 0 53432 0 1018917 0 0 TAMARAH D BROWNLEE REGIONAL VP-HR (ISR) 0 254100 0 30897 0 810 0 11661 0 35342 0 332810 0 0 ATHANASIA S BANICH VP, COO (ISR) 311943 0 34935 0 540 0 12700 0 42903 0 403021 0 0 0 HARPREETINDER SINGH MD VP-CMO (ISR) 427677 0 51321 0 4242 0 13800 0 60451 0 557491 0 0 0 CARRIE WING VP-CNO (ISR) 28402 213671 80 40170 95 1083 1152 10304 2283 21755 32012 286983 0 0 DIANE L HESSON FORMER Highest Compensated Employee 0 168411 0 22802 0 2512 0 5656 0 42961 0 242342 0 0 PATRICIA BOWLING Director-Surgical Services 164272 0 13409 0 1290 0 7334 0 42553 0 228858 0 0 0 CHRISTEN N HOEPPNER Director-Operational Excellence 165655 832 23285 0 270 0 7984 33 31480 8 228674 873 0 0 JULIA M MILLER Manager - Pharmacy 171762 0 8440 0 120 0 7364 0 19044 0 206730 0 0 0 SUN RIEHM Pharmacist 163748 0 2626 0 516 0 7141 0 59553 0 233584 0 0 0 JANICE M VADAS DIRECTOR-ALLIED SERVICES 202160 0 26101 0 1290 0 9089 0 1081 0 239721 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation IU HEALTH NORTH HOSPITAL'S REGIONAL PRESIDENT IS EMPLOYED BY IU HEALTH. IU HEALTH, IU HEALTH NORTH HOSPITAL, AND OTHER RELATED ENTITIES HAVE A PROCESS IN PLACE TO DETERMINE THE COMPENSATION FOR THE OTHER OFFICERS AND KEY EMPLOYEES. IU HEALTH HUMAN RESOURCES USES MARKET DATA FROM MULTIPLE COMPENSATION EXPERTS/VENDORS WHO UTILIZE A VARIETY OF METHODS AND PROCEDURES TO OBTAIN COMPENSATION RANGES FOR COMPARABLE OFFICER AND EMPLOYEE POSITIONS. THIS MARKET DATA AND MULTIPLE OTHER FACTORS (INCLUDING MARKET PAY BENCHMARKS, INTERNAL EQUITY, CANDIDATE/EMPLOYEE QUALIFICATIONS & PERFORMANCE, AND BUSINESS NEEDS) ARE USED TO RECOMMEND COMPENSATION RANGES FOR ITS OFFICERS AND OTHER EMPLOYEES, WHICH ARE THEN USED AS A GUIDE FOR SETTING REASONABLE COMPENSATION BY MANAGEMENT. PLEASE SEE SCHEDULE O FOR ADDITIONAL DETAILS. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan KENNETH D. PUCKETT AND ARTHUR VASQUEZ PARTICIPATE IN AN IU HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, PROVISIONS OF WHICH ARE DESIGNED TO RETAIN THESE CRITICAL EMPLOYEES. THE PLAN PROVIDES FOR AN ADDITIONAL RETIREMENT BENEFIT FOR SERVICE THROUGH NORMAL RETIREMENT OR OTHER KEY DATES. IF THE EXECUTIVE LEAVES PRIOR TO RETIREMENT OR OTHER KEY DATES, THAT BENEFIT MAY BE FORFEITED OR REDUCED. THE EXECUTIVES LISTED ABOVE HAVE AN AMOUNT INCLUDED IN COLUMN C, DEFERRED COMPENSATION, REPRESENTING THE CURRENT YEAR UNVESTED CONTRIBUTIONS MADE UNDER THE SUPPLEMENTAL RETIREMENT PLAN. THESE AMOUNTS WERE NOT PAID TO THESE EXECUTIVES DURING THE YEAR. THE FOLLOWING EXECUTIVE HAS AN AMOUNT INCLUDED IN COLUMN B (III), OTHER REPORTABLE COMPENSATION, REPRESENTING THE CURRENT YEAR VESTED AMOUNTS RECEIVED UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: - KENNETH D. PUCKETT $100,855 Schedule J, Part I, Line 7 Non-fixed payments Amounts disclosed in Column B(ii) include a long-term 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 Board of Directors prior to any incentive payout. LINE J - WEB SITE HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-NORTH-HOSPITAL SECTION B, LINES 12, 13, 14, AND 16B - POLICIES IU Health North Hospital is part of the IU Health system. As the sole member and controlling parent of IU Health North 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 North Hospital's Board of Directors was not required to separately adopt a conflict of interest, whistleblower, document retention and destruction and joint venture policies because IU Health's Board of Directors had already adopted and required these policies to be followed by its subsidiaries. Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE MEMBER OF IU HEALTH NORTH HOSPITAL IS IU HEALTH, A 501(C)(3) TAX-EXEMPT ORGANIZATION. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE BOARD OF DIRECTORS OF THE IU HEALTH NORTH HOSPITAL SHALL CONSIST OF UP TO FIFTEEN (15) VOTING MEMBERS ALL APPOINTED BY IU HEALTH, WHO SHALL INCLUDE REPRESENTATIVES FROM THE MEDICAL STAFFS OF IU HEALTH NORTH HOSPITAL AND IU HEALTH WEST HOSPITAL, AND THE PRESIDENT OF THE INDIANAPOLIS SUBURBAN REGION, WHO SHALL BE AN EX-OFFICIO, VOTING DIRECTOR OF THE BOARD. AT ALL TIMES, THE IU HEALTH NORTH HOSPITAL DIRECTORS SHALL CONSIST OF THE SAME INDIVIDUALS APPOINTED BY IU HEALTH TO SERVE AS DIRECTORS OF IU HEALTH WEST HOSPITAL. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE BOARD OF DIRECTORS SHALL NOT, WITHOUT THE PRIOR APPROVAL OF THE IU HEALTH: - ANY PROPOSED AMENDMENT TO THE CORPORATION'S ARTICLES OF INCORPORATION OR THESE BYLAWS; - ADOPTION OF THE CORPORATION'S ANNUAL CAPITAL AND OPERATING BUDGETS; - APPROVAL OF ANY UNBUDGETED OPERATING OR CAPITAL BUDGET ITEMS OR DEVIATIONS, INCLUDING ANY ISSUANCE OR GUARANTEE OF ANY UNBUDGETED DEBT; - APPROVAL OF ANY STRATEGIC PLAN FOR THE CORPORATION, INCLUDING ANY AMENDMENTS TO A STRATEGIC PLAN; - APPROVAL OF ANY ENCUMBRANCE, SALE OR CONVEYANCE OF ASSETS; - ANY MERGER, CONSOLIDATION, JOINT VENTURE OR AFFILIATION INVOLVING THE CORPORATION OR ANY OF ITS AFFILIATES AND ANY OTHER ENTITY; - APPOINTMENT AND REMOVAL OF THE CORPORATION'S PRESIDENT AND OTHER OFFICERS; - CONSTRUCTION, ACQUISITION OR LEASE OF HOSPITAL BUILDINGS; - APPROVE ANY MANAGEMENT AGREEMENT FOR THE MANAGEMENT OF ALL OR SUBSTANTIAL PART OF IU HEALTH WEST HOSPITAL'S OPERATIONS; - PROJECTS OR CONTRACTS THAT REQUIRE MEMBER APPROVAL IN ACCORDANCE WITH THE MEMBER'S RESOLUTION AND POLICY GOVERNING SYSTEM-WIDE CONTRACT EXECUTION AUTHORITY AND PAYMENT APPROVAL LIMITS; AND - THE DISSOLUTION OF THE CORPORATION OR ANY OF ITS AFFILIATES. Form 990, Part VI, Line 11b Review of form 990 by governing body THE CFO REVIEWED AND APPROVED THE FORM 990. FOLLOWING THE CFO'S REVIEW AND APPROVAL, A COMPLETE COPY OF THE FORM 990 WAS MADE AVAILABLE TO EACH BOARD MEMBER PRIOR TO ITS FILING. EACH MEMBER WAS ALSO INFORMED OF THE AVAILABILITY OF IU HEALTH'S TAX DEPARTMENT TO ANSWER ANY QUESTIONS. Form 990, Part VI, Line 12c Conflict of interest policy IU HEALTH NORTH 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 North Hospital's Articles of Incorporation are available to the public through the Indiana Secretary of State's website. IU Health North Hospital's conflict of interest policy is described on Form 990, Schedule O. IU Health North Hospital is a consolidated subsidiary in the consolidated financial statements for IU Health. The consolidated financial statements for IU Health are available to the public through its bond filings and as an attachment to IU Health's Form 990 as well as IU Health North Hospital's Form 990. Form 990, Part IX, Line 11g Other Fees Professional fees - Total Expense: 969422, Program Service Expense: 904345, Management and General Expenses: 65077, Fundraising Expenses: ; Fees-Other Services - Total Expense: 108425, Program Service Expense: 101146, Management and General Expenses: 7279, Fundraising Expenses: ; Consulting - Total Expense: 565190, Program Service Expense: 527249, Management and General Expenses: 37941, Fundraising Expenses: ; Intercompany Fees - Total Expense: 73505206, Program Service Expense: 68864343, Management and General Expenses: 4640863, Fundraising Expenses: ; Physicians Fees - Total Expense: 126018, Program Service Expense: 117558, Management and General Expenses: 8460, Fundraising Expenses: ; Contract service - Total Expense: 4840791, Program Service Expense: 4515830, Management and General Expenses: 324961, Fundraising Expenses: ; INDIANA HEALTH INFO EXCHANGE INC 846 N SENATE AVE INDIANAPOLIS IN 46202 364550324 HEALTHCARE IN 501(c)(3) Type I NA false 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