2024-11-12T13:39:08+00:00 2023-12-31 990 2023-01-01 350867958 Indiana University Health Ball Memorial Hospital Inc INDI 3179634842 950 N MERIDIAN STREET 1200 INDIANAPOLIS IN 46204 Michael L Craig VP & CFO 8123539171 2024-11-12 true 2023 2024-10-15 13:58:12Z JEFFREY C BIRD MD 950 N MERIDIAN STREET 1200 INDIANAPOLIS IN 46204 611126894 false X HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-BALL-MEMORIAL-HOSPITAL X 1926 IN Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. 14 10 3128 196 5631438 0 4626341 6104717 546453069 575827879 2103937 19809251 2899372 2900591 556082719 604642438 0 0 226493076 192980346 0 0 305009509 352915253 531502585 545895599 24580134 58746839 681538095 730245191 64522565 52965674 617015530 677279517 X Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. false false 494309731 0 543761382 INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL IS A 379 BED ACUTE CARE HOSPITAL, WHICH OPERATES AS A REGIONAL REFERRAL CENTER AND TEACHING HOSPITAL, LOCATED IN MUNCIE, INDIANA. 20151876 0 22167906 Our network of pharmacies offers the convenience of one-stop shopping. With services designed to meet your needs, we will provide expert care and help patients make the best use of their medications. 4844304 0 5328937 IU HEALTH BALL MEMORIAL HOSPITAL, INC. PROVIDES SERVICES, WHICH INCLUDE COORDINATED ACTIVITIES AND POLICES, TO RELATED TAX-EXEMPT ORGANIZATIONS DESIGNED TO MEET THE MISSION OF THE INDIANA UNIVERSITY HEALTH SYSTEM. 3854161 0 4239738 RENT FROM RELATED 501(C)(3) ORGANIZATIONS 329567 0 362537 Clinical Research -29654 0 -32621 Income (Loss) from Pass-Through Entities 4154074 4569654 523459985 true true false true false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false true false false false false false true true true true false false true 0 0 3128 true true true false false false false false false false false false false false X 14 10 false false false false true true true true true false false true true true true true true true true true true IN X CRAIG J JONES 3179634842 950 N MERIDIAN STREET SUITE 800 INDIANAPOLIS IN 46204 DANIEL E BORGENHEIMER DIRECTOR/CHAIR (Part Year) 2.0 4.0 X X 0 0 0 J STEVEN RHEA DIRECTOR/SECRETARY/TREAS 2.0 4.0 X X 0 0 0 JEFFREY C BIRD MD DIRECTOR/PRESIDENT (ECR) 35.0 20.0 X X 0 985198 172192 JOHN D LITTLER DIRECTOR/CHAIR (Part Year) 2.0 4.0 X X 0 0 0 PETER M VOSS MD DIRECTOR/VICE CHAIR 25.0 30.0 X X 490221 0 64192 WILBUR R DAVIS DIRECTOR/VICE CHAIR 2.0 4.0 X X 0 1000 0 CHANTILLE ALLEN DIRECTOR (Part Year) 2.0 4.0 X 0 0 0 CHARLES R ROUTH MD DIRECTOR 2.0 53.0 X 0 282146 67475 Dea Bell Director (Part Year) 2.0 4.0 X 0 5000 0 DERRON L BISHOP PHD DIRECTOR 2.0 4.0 X 0 8000 0 GEOFFREY S MEARNS JD DIRECTOR 2.0 4.0 X 0 0 0 JOAN V CASTOR DIRECTOR 2.0 53.0 X 0 571413 131941 MICHAEL J FISHER DIRECTOR 2.0 7.0 X 0 0 0 PATRICK A CLEARY MD DIRECTOR 2.0 4.0 X 0 8000 0 TERRY W BAILEY DIRECTOR 2.0 4.0 X 0 6000 0 WILLIAM W HINKLE DIRECTOR 2.0 4.0 X 0 5000 0 JONATHAN W VANATOR CFO (ECR) 33.0 22.0 X 0 387519 67467 MICHELLE R ALTOBELLA VP-General Counsel, Asst Secretary (ECR) 2.0 55.0 X 0 259376 50502 BRIAN REED VP-HUMAN RESOURCES (ECR) 20.0 35.0 X 0 200039 60926 KREIGH COOK COO (ECR) (Part Year) 10.0 40.0 X 230105 0 37495 LORI A LUTHER COO (ECR) (Part Year) 25.0 30.0 X 379246 0 61965 MELISSA R HICKS VP & CNO (ECR) 10.0 45.0 X 272051 0 54187 RYAN M JOHNSTON MD VP & CMO (ECR) 10.0 45.0 X 441485 0 77187 ALVIS FOSTER Physicist-Radiation Medicine 55.0 0 X 252384 0 69195 CHRISTOPHER GAMBLE MD Associate CMO 55.0 0 X 357695 0 59475 JOSEPH BUTTS RADIATION PHYSICIST 55.0 0 X 238048 0 36042 Max E Barnhart Director - Pharmacy 55.0 0 X 219257 0 63701 TERRY A PENCE VP, OPERATIONS 43.0 2.0 X 325870 0 44205 DAVID A SCHWARTZ Clinical Nurse 40.0 X 0 272017 21741 3206361 2990708 1139887 241 true true false 0 6090691 14026 6104717 NET PATIENT SERVICE REVENUE 622110 543761382 543761382 PHARMACY 446110 22167906 16503847 5664059 SHARED SERVICES 541900 5328937 5328937 RENT FROM RELATED 501(C)(3) ORGS. 532000 4239738 4239738 Clinical Research 541700 362537 362537 -32621 0 -32621 0 575827879 19302173 19302173 606906 606906 0 606906 606906 6991534 0 6472828 11628 518706 -11628 507078 507078 All Other Revenue 900099 1439627 1439627 CAFETERIA/FOOD SERVICE 721110 676179 676179 GIFT SHOP 453220 177879 177879 0 0 0 0 2293685 604642438 570196441 5631438 22709842 X 0 0 0 0 2368817 2288942 79875 154727627 149510338 5217289 5088313 4916739 171574 20899937 20195208 704729 9895652 9561979 333673 19959 19959 25937 25937 130495897 121735733 8760164 0 1923407 1923407 932838 870217 62621 1209732 604866 604866 12852284 12852284 113857 106214 7643 74 74 24041705 22909058 1132647 2947306 2947306 DRUGS AND MEDICAL SUPPLIES 116569035 116569035 HOSPITAL ASSESSMENT FEES 29939739 29939739 BAD DEBT 25180503 25180503 REPAIR & MAINTENANCE 5238112 4886479 351633 1424868 1332577 92291 0 545895599 523459985 22435614 0 369353060 404150916 54656417 72075821 0 0 0 0 43445 9445 13835111 13863965 1406126 1203557 589998392 374430401 217734108 215567991 19495147 21152621 0 2442706 2180867 40008 40008 2531967 0 681538095 730245191 41022739 19962712 7830 0 0 0 23491996 33002962 64522565 52965674 X 617015530 677279517 617015530 677279517 681538095 730245191 X 58746839 1595801 191347 -270000 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 19959 19959 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY IU Health Ball Memorial Hospital paid institutional membership dues to the American Hospital Association ("AHA"), Indiana Hospital Association ("IHA"), and 340B Health during 2023 in the amount of $55,861, $38,965, and $13,896, respectively. Each membership organization notified IU Health Ball Memorial Hospital that a portion of the dues it paid were used for lobbying purposes. The AHA used 26.47%, or $14,786 of 2023 membership dues paid by IU Health Ball Memorial Hospital, for lobbying expenditures. The IHA used 10.78%, or $4,200 of the 2023 membership dues paid by IU Health Ball Memorial Hospital, for lobbying expenditures. 340B Health used 7.00%, or $973 of the 2023 membership dues paid by IU Health Ball Memorial Hospital, for lobbying expenditures. Total membership dues paid to these organizations by IU Health Ball Memorial Hospital during 2023 that were attributable to lobbying expenditures was $19,959. 6616096 6616096 283240426 217032820 66207606 429120 414593 14527 157438637 117709065 39729572 142274113 39273923 103000190 215567991 DUE TO THIRD-PARTY PAYERS 10450887 SELF-INSURANCE LIABILITIES 514640 INTERCOMPANY PAYABLES (NET) 20749920 ENVIRONMENTAL OBLIGATIONS 1042360 ALL OTHER LIABILITIES 245155 33002962 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote IU Health Ball Memorial Hospital is a subsidiary in IU Health's Consolidated Audited Financial Statements. THE INTERNAL REVENUE SERVICE (IRS) 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, 2023 AND 2022, 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, 2023 AND 2022, THE INDIANA UNIVERSITY HEALTH SYSTEM HAD GROSS DEFERRED TAX ASSETS OF $141,386,000 AND $145,194,000, RESPECTIVELY, RELATING TO NET OPERATING LOSS CARRYOVERS. MANAGEMENT DETERMINED THAT A FULL VALUATION ALLOWANCE AT DECEMBER 31, 2023 AND 2022 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 $3,009,000. AT DECEMBER 31, 2023, INDIANA UNIVERSITY HEALTH SYSTEM HAS AVAILABLE NET OPERATING LOSS CARRYFORWARDS OF $571,690,000, NET OPERATING LOSSES GENERATED FROM 2004 THROUGH 2017 EXPIRE BETWEEN 2024 AND 2037. NET OPERATING LOSSES GENERATED AFTER 2017 DO NOT EXPIRE. true true X true X 300 false true true true false true true 5513 4680767 0 4680767 0.0090 22672 118248734 117102414 1146320 0.0022 0 0.0 0 28185 122929501 117102414 5827087 0.0112 9 30056 2681305 144771 2536534 0.0049 3 2125 14866918 4633629 10233289 0.0197 2 6039 11609641 10480799 1128842 0.0022 1 138 1636656 615239 1021417 0.0020 3 23244 1822706 1387970 434736 0.0008 18 61602 32617226 17262408 15354818 0.0295 18 89787 155546727 134364822 21181905 0.0407 1 177 16260 0 16260 0.0000 1 41 22395 15000 7395 0.0000 1 67 9405 0 9405 0.0000 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 694 84662 0 84662 0.0002 1 1137 12835 0 12835 0.0000 1 477 178433 0 178433 0.0003 0 0 0 0 0 0.0 6 2593 323990 15000 308990 0.0006 false 4631012 106835217 109226250 -2391033 X true true 1 1 IU HEALTH BALL MEMORIAL HOSPITAL 2401 UNIVERSITY AVE MUNCIE IN 47303 HTTPS://IUHEALTH.ORG/FIND-LOCATIONS/IU-HEALTH-BALL-MEMORIAL-HOSPITAL 22-005079-1 X X X X X IU HEALTH BALL MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 21 true false false true X HTTPS://IUHEALTH.ORG/IN-THE-COMMUNITY/COMMUNITY-BENEFIT true 22 true HTTPS://IUHEALTH.ORG/IN-THE-COMMUNITY/COMMUNITY-BENEFIT false true X 300.0 0.0 X X X X X X X true true X X X true X https://iuhealth.org/pay-a-bill/financial-assistance X https://iuhealth.org/pay-a-bill/financial-assistance X https://iuhealth.org/pay-a-bill/financial-assistance X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E IU Health Ball Memorial Hospital's 2024 Community Health Needs Assessment (CHNA) Report includes a prioritized description of significant health needs in the community. The CHNA report identified the following needs as priorities for IU Health Ball Memorial Hospital: 1. Access to Healthcare Services 2. Aging Population and Needs of Seniors 3. Behavioral Health 4. Chronic Disease and Chronic Disease Management 5. Education, Workforce Training, and Unemployment 6. Maternal and Infant Health and Child Well-being 7. Smoking, Tobacco Use and Exposure to Secondhand Smoke 8. Social Determinants of Health Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - IU Health Ball Memorial Hospital. In conducting each its most recent CHNA, IU Health Ball took into account input from persons who represent the broad interests of the communities it serves by hosting eight community focus groups and four interviews. These events engaged public health officials and community-based organizations that provide services and/or reflect community members who are medically underserved, low-income, or of a minority subpopulation to discuss the health needs of the service area and what role IU Health could play in addressing the identified needs. IU Health Ball The defined community per the most recent CHNA is Blackford, Delaware, Jay and Randolph Counties, Indiana. The hospital resides in Delaware County. Blackford County - Community Meetings and Interview Two community meetings were held in 2021 to receive input from stakeholders regarding the health needs in Blackford County - one on April 23 and another on May 13. Secondary data and a preliminary list of community health need priorities was presented at both meetings. Each group was then asked questions about the preliminary list, including their reactions, additions to the proposed needs, thoughts regarding the causes, impacts of the COVID-19 pandemic and others. After these discussions, participants were given the opportunity to make additional comments before being asked to vote on the significant needs in the county. Participants were asked to choose three to five significant health needs in a poll during the meeting. Participants focused discussion on access to mental health services, health insurance barriers, substance abuse and addiction, tobacco use (including during pregnancy and among youth with vaping), a lack of health education, maternal and infant health, childcare, the disconnect between good education rates but lack of jobs, transportation barriers, a lack of knowledge of available resources and others. From this process, participants from the April 23 community meeting identified the following needs as most significant for Blackford County: * Access to mental health providers * Health literacy and education * Substance abuse (including opioids, alcohol and methamphetamines) * Obesity and associated conditions (diabetes, cardiovascular issues) Participants from the May 13 community meeting identified the following needs as most significant for Blackford County: * Substance abuse and addiction (including tobacco usage) * Access to healthcare services * Access to mental health services * Maternal, infant and child health and wellbeing In discussing the impacts of the COVID-19 pandemic on health, participants focused on isolation and its impacts on mental health, increase in substance abuse, impacts on child learning, increase in domestic violence and abuse, increasing physical inactivity and growing community conflict and negative attitudes (including towards frontline workers). An additional community survey was issued to stakeholders unable to attend community meetings, asking them to identify priority needs. Among two responses, the following issues were identified as the most significant by both respondents: * Substance abuse and addiction * Mental health and suicide * Poverty and lack of resources for low-income population * Lack of providers (specialists and mental health) The survey also asked about the impacts of the COVID-19 pandemic. Issues selected as significant impacts by both respondents include: * Social isolation and loneliness * Learning and development impacts among children An additional interview was conducted with a representative of a local public health department to obtain subject-matter expertise into the health needs in Blackford County. The following issues were discussed as significant: * Substance abuse and addiction is a significant issue * Mental health and access to mental health care are significant issues, amplified by the COVID-19 pandemic * Maternal and infant health issues exist, particularly around teen births and smoking during pregnancy * Smoking and obesity are two issues that have long been identified as issues in Blackford and continue to persist despite local work * Transportation is a large barrier to accessing services, particularly a lack of public transportation options * More community focus on health lifestyle is needed, including nutrition, physical activity, tobacco-free residents and accessible areas to exercise (health education plays a role here) Delaware County - Community Meetings and Interview Three community meetings were held in 2021 to receive input from stakeholders regarding the health needs in Delaware County (April 28, April 30 and May 6). Secondary data and a preliminary list of community health need priorities was presented at each meeting. Each group was then asked questions about the preliminary list, including their reactions, additions to the proposed needs, thoughts regarding the causes, impacts of the COVID-19 pandemic and others. After these discussions, participants were given the opportunity to make additional comments before being asked to vote on the significant needs in the county. Participants were asked to choose three to five significant health needs in a poll during the meeting. Participants focused discussion around social determinants of health and their impacts on health, generational poverty, mental health and its stigma, access to mental health services and lack of providers, health disparities (particularly for minority and LGBTQ+ populations), food insecurity and unhealthy eating, domestic violence and abuse, lack of transportation options, obesity and related conditions, substance abuse and overdoses, isolation and exacerbations due to the COVID-19 pandemic and lack of resources within local communities. From this process, participants identified the following needs as most significant for Delaware County: * Mental health * Poverty, including children in poverty * Health and financial education resources * Substance abuse (including opioids, alcohol, tobacco and others) In discussing the impacts of the COVID-19 pandemic on health, participants focused on isolation and its impacts on mental health, lack of preventive health and checkups and residents feared going to providers, highlighting of disparities (especially for racial and ethnic minority groups), housing issues, lack of vaccination demand and exposing weaknesses in safety-net programs. An additional interview was conducted with a representative of a local public health department to obtain subject-matter expertise into the health needs in Delaware County. The following issues were discussed as significant: * Mental health and a lack of mental health providers (particularly for children) are significant issues, amplified by the COVID-19 pandemic * An improvement in care coordination is needed, including triage from emergency departments and urgent care * Homelessness is an issue, especially among women * Physical inactivity and unhealthy eating are both issues, with more focus needed on youth education and programs in these areas * Elderly needs are a significant concern, especially with the oncoming increase in elderly populations * More providers are needed for specialty care The following COVID-19 feedback was noted: The pandemic has affected mental health, particularly among children Elderly have been affected greatly and disadvantaged as services move online due to technology knowledge and access barriers Jay County - Community Meetings and Interview Two community meetings were held in 2021 to receive input from stakeholders regarding the health needs in Jay County - one on April 21 and another on April 29. Secondary data and a preliminary list of community health need priorities was presented. Each group was then asked questions about the preliminary list, including their reactions, additions to the proposed needs, thoughts regarding the causes, impacts of the COVID-19 pandemic and others. After these discussions, participants were given the opportunity to make additional comments before being asked to vote on the significant needs in the county. Participants were asked to choose three to five significant health needs in a poll during the meeting. Participants focused discussion around an aging population and workforce, transportation as a barrier to accessing services (especially specialists, often not located in the community), disabled population needs, the need for health education, increasing mental health needs such as anxiety and depression, a lack of mental health providers, homelessness, poverty, substance abuse and addiction (along with stigma around seeking help), needs of migrant and Spanish-speaking communities and health insurance. Schedule H, Part V, Section B, Line 5 Facility , 2 Facility , 2 - IU Health Ball Memorial Hospital (Continued). From this process, participants from the April 21 community meeting identified the following needs as most significant for Jay County: * Substance abuse (including opioids and alcohol) * Access to healthcare services (including specialists) * Mental health and access to mental health services * Children in poverty * Transportation Participants from the April 29 community meeting identified the following needs as most significant for Jay County: * Mental health * Poverty Substance abuse (including opioids and alcohol) * Transportation * Health and wellness education In discussing the impacts of the COVID-19 pandemic on health, participants focused on isolation and its impacts on mental health, increase in pediatric mental health needs, increase in substance abuse, financial impacts on service organizations, lack of preventive care due to fear of going to providers and technology barriers creating a digital divide in an increasingly online world. An additional community survey was issued to stakeholders unable to attend community meetings, asking them to identify priority needs. Among three responses, the following issues were identified as the most significant by respondents: * Substance abuse and addiction (including alcohol) * Obesity, physical inactivity and unhealthy eating * Smoking and tobacco use * Domestic violence * Mental health * Community resources and providers The survey also asked about the impacts of the COVID-19 pandemic. Issues selected as significant impacts by respondents include: * Social isolation and loneliness * Unemployment or underemployment * Childcare access and costs * Learning and development in children * Distrust with the medical community Digital divide (lack of Internet or device access) An additional interview was conducted with representatives of a local public health department to obtain subject-matter expertise into the health needs in Jay County. The following issues were discussed as significant: * Poverty is an issue in the community and children in poverty is noticeable * Mental health is an issue and leads to further poverty concerns as mental issues often can lead to inability to work (a stigma around mental health still exists) * Substance abuse is prominent and generational in nature * Physical inactivity and access to exercise opportunities is a significant need * Smoking, tobacco usage and vaping are all common * Specialty services, such as dialysis and radiation treatment, are mostly not located in the county, leading to access issues that are exacerbated by transportation concerns * More health education programs are needed, particularly focused on youth and also elderly education on available resources for seniors * Amish residents are a vulnerable population, often difficult to access and provide information surrounding topics such as COVID-19 Randolph County - Community Meeting and Interview In collaboration with Ascension St. Vincent, a community meeting was held on June 2, to receive input from stakeholders regarding the health needs in Randolph County. Secondary data and a preliminary list of community health need priorities was presented at this meeting. Each group was then asked questions about the preliminary list, including their reactions, additions to the proposed needs, thoughts regarding the causes of the needs, impacts of the COVID-19 pandemic and others. After this discussion, participants were given the opportunity to make additional comments before being asked to vote on what they believed were the most significant needs in the county. Participants were asked to choose three to five significant health needs via an online poll during and after the meeting. Preliminary needs identified include a wide collection of topics, including accidents and injuries, elderly needs, food insecurity, maternal and child health, smoking, poverty, unemployment, supply of primary care and mental health providers and vaccinations. In addition to these topics, participants focused discussion on transportation barriers, tobacco and increasing e-cigarette usage, nutrition and the impacts of the COVID-19 pandemic on food availability, mental health, substance abuse and difficulties in recruiting emergency responders. From this process, participants identified the following needs as most significant for Randolph County: * Substance abuse and addiction * Transportation as a barrier * Supply of behavioral health providers (including mental health and substance abuse) An additional interview was conducted with representatives of a local public health department to obtain subject-matter expertise into the health needs in Randolph County. The following issues were discussed as significant: * Obesity and diabetes are significant needs in the community (a lack of physical activity and exercise opportunities contributes) * Healthy foods are often expensive and education around healthy eating is limited, particularly for elderly residents * Substance abuse issues are significant, particularly with opioid abuse (treatment services are limited and have long wait times, and providers often do not know where to refer those who are seeking help) * Poverty and transportation are two health barriers in the community, prominent in southern and western portions of the county * Hispanic (or Latino) populations, including migrant workers, are often underserved in the community, often lacking trust in providers, insurance and services directed towards them * Children are underserved in the community, particularly those in poverty or living in unstable situations * Due to the rural nature of the county, social services are limited * There is not a culture around health in place and breaking generational unhealthy lifestyles is difficult, particularly for issues such as nutrition, exercise and substance abuse The following COVID-19 feedback was noted: * The pandemic has affected the ability of social service organizations, including health departments, to do their normal work since all focus is on the pandemic (burnout among providers is common as well) * Mental health has been impacted, particularly among children due to isolation and learning impacts * There is also general anger in the community towards changing COVID-19 procedures, often creating confusion and distrust with new guidelines Community meeting and survey participants Individuals from a wide variety of organizations and communities participated in the interview process, community meetings and surveys. Participants included representatives from the following organizations: * A Better Life Briana's Hope * A Better Way Services, Inc. * Ball State University Office of Community Engagement * Blackford County Community Corrections * Blackford County Community Foundation * Blackford County Economic Development Corporation * Blackford County Health Department * Blackford County Schools * Blackford County Sheriff's Office * Bridges Community Services * Bryant Wesleyan Church * Centerstone Counseling and Mental Health * Citizens State Bank * City of Muncie * Delaware Community School Corporation * Delaware County Chamber of Commerce * Delaware County Health Department * First Presbyterian Church Portland * George and Frances Ball Foundation * Indiana General Assembly * IU Health * IU Health Ball * IU Health Ball Memorial Physicians * IU Health Blackford * IU Health Jay * Indy Container Board * Ivy Tech Community College * Jay Community Center * Jay County DCS * Jay County Health Department * Jay County Prosecutor * Jay County Sheriff's Office * Jay Randolph Developmental Services, Inc. * Jay School Corporation * LifeStream Services * Little Red Door * Meridian Health Services * Muncie Community Schools * Muncie OUTreach * Open Door Health Services * Portland Fire Department * Persimmon Ridge * Purdue Extension * Randolph County Foundation * Randolph County Health Department * Ross Community Center * Second Harvest Food Bank * Smith Insurance Services * Soup Kitchen of Muncie * Steven Knipp Hair Studio Muncie * The Rock Church * 8 Twelve Coalition * Urban Light Community Church * Westminster Village Muncie * Whitley Community Council, Inc. * WIC Family Services * YMCA of Central Indiana * YMCA of Muncie * Youth Opportunity Center Muncie * Youth Service Bureau of Jay County Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - IU HEALTH BALL MEMORIAL HOSPITAL. Along with the CHNA, IU Health Ball's Board adopted an implementation strategy in April 2022 in response to the 2021 CHNA. IU Health Ball, along with community partners, prioritized and determined which of the significant needs identified in its most recently conducted CHNA could be adequately addressed by current or future initiatives, programs, resources, and collaborations. The 2022-2024 implementation strategy outlines how IU Health Ball plans to address significant needs including initiatives, strategies, internal/external collaborators, anticipated impact, and hospital resources. Significant Needs Hospital Will Address Below is the progress of the implementation strategy by significant need and its respective initiative(s). The hospital is addressing the following significant needs between 2022 and 2024: Access to Healthcare Services; Aging Population and Needs of Seniors; Behavioral Health; Chronic Disease and Chronic Disease Management; Education, Workforce Training, and Unemployment; Maternal and Infant Health and Child Well-being; Smoking, Tobacco Use and Exposure to Secondhand Smoke; and Social Determinants of Health. Access to Healthcare Services * Support community members accessing healthcare services regardless of their ability to pay. The hospital provides financial assistance to patients each year that includes discounts, full charity, and personal hardship reductions. IU Health Patient Financial Counselors are certified Indiana Navigators. They can assist patients and families with information and help them with applications for various health coverage programs. In 2023, the counselors served 475 people at IU Health Ball Hospital. Implement Medical provider recruitment plan to address areas experiencing a shortage of primary and specialty care services. In 2023, 33 physicians and 4 nurse practitioners were recruited and hired to practice primary care and other specialties in the IU Health East Central Region. This included new primary care physicians in Upland, Daleville, Portland and Muncie, as well as primary care nurse practitioners in Albany, Yorktown and Muncie. Specialty care physicians were recruited for Urology, Internal Medicine, Neonatology, Cardiology Psychiatry services. Implement Mobile Integrated Health Care - Paramedicine. This program is operational in the IU Health East Central Region and includes an 80-hour paramedicine training program for Paramedic, EMS and Fire Department personnel; IU Health Paramedic and affiliate EMS organizations deploy at hospital or physician point of care to establish post-discharge care in a six-county area. This team had a total of 693 home visits in 2023 and supported 806 patients enrolled in the Heart/Lung Center that held a less than 1% readmission rate for the year. Aging Population and Needs of Seniors Support senior-focused programs at local events in the community. In 2023, IU Health teams engaged with senior centers in the East Central Region. This included support for a community senior health fair organized in Delaware County, a health-topic speaker series at the senior center in Blackford County, and a partnership with Purdue Extension in Jay County to offer falls prevention programming and other health topics for seniors at the Jay County Senior Center. Many of these connections were made in conjunction with Healthy Community Alliance partners and resources. falls prevention, heart health, medication safety, etc. Behavioral Health Partner to create City Crisis Center for Behavioral Health and Substance Use Disorder crisis assessment and resources. Since project inception, IU Health has worked with the Muncie Mayor's office, EMS, law enforcement, local coalitions and department of social work, and community members throughout the design and operations planning for the center. Due to issues with the city-owned building site, the project was put on hold in 2023. Further implement IU Health Ball Addiction Treatment and Recovery Center. In 2023, the ATRC Served 236 individuals, including 179 new patients in the program, and had an additional 62 persons enrolled in the Intensive Outpatient (IOP) program with a 97% successful completion rate. In 2023 Intensive Outpatient Services (IOP) ended and a shift was made to individual treatment. A new support group was added in 2023 as well. Further implement the Virtual Care Peer Recovery Coaching Program (provides patients who have substance use concerns with virtual behavioral health services). The Virtual Peer Recovery Coach program was discontinued in February 2023 as IU Health continues to assess and evolve its behavioral health services based on the needs of patients and the communities it serves. Since 2018, this program had served 15 IU Health and two non-IU Health emergency department patients struggling with substance use disorder through support to aid in recovery. IU Health continues to serve patients with a need for this service through the Virtual Behavioral Health team. Further implement emergency department (ED) virtual care program (provides patients virtual access to behavioral health services). There were 590 individuals assisted on-site in the ED by local providers at IU Health Ball. Virtual Integrated Behavioral Health (VIBH) expanded behavioral health access to patients and providers across the state. VIBH provided urgent psychiatric assessment for patients experiencing behavioral health crises, such as suicidal ideation, homicidal ideation, psychosis, and substance abuse disorders. A team of behavioral health professionals provided consultation through iPad carts located in emergency departments, urgent care, and ambulatory care locations. In 2023, there were over 11,000 visits of which 1,942 visits included patients seeking care in the East Central Region (which includes IU Health Ball). VIBH also provided brief behavioral health therapy and consultation for medication management to primary care patients aged 18 and older experiencing depression, anxiety, and other mood disorders. A team of behavioral health professionals provided problem solving treatment, cognitive behavioral therapy, and other evidence-based interventions. In 2023, there were over 6,000 visits of which 2,248 were provided to patients seeking help through IU Health Physicians ambulatory clinics. Chronic Disease and Chronic Disease Management Support the Healthy Community Alliance of East Central Indiana (HCA). Four community workgroups related to increased physical activity, improved nutrition and tobacco prevention and cessation were facilitated by IU Health Community Outreach personnel in a three-county area. Five new community Partners joined the HCA in 2023. 200 Quit Now toolkits were distributed to HCA Partners and members of the community in 2023. HCA partners collaborated to engage with senior, resource limited, minority and faith-based organizations by offering multiple community-based heart health, healthy eating, vaping education, access to care, screening events, healthy eating and food access programs to East Central Indiana in 2023. Support the expansion of the YMCA of Muncie. In 2023, IU Health provided $1,000,000 in initial funding towards a 5-year pledge of $5,000,000 to support construction of a new YMCA facility in Muncie. Construction of the new facility began in 2023. Provide outpatient nutrition counseling. No-cost nutrition counselling offered by IU Health Ball team members was promoted utilizing multiple outreach activities and community events during 2023. 1,748 participants participated in counseling in 2023. Bariatric and Medical Weight Loss Support Groups were offered 1-2 times per month with 68 participants in 2023. Further implement IU Health Days of Service (volunteer event engaging IU Health team members in activities that benefit the community). 2023 Day of Service efforts by IU Health Ball team members focused on housing improvements, community garden enhancements and donation of hygiene items to local shelter organizations. 193 team members contributed 263 hours of time to these projects. Education, Workforce Training, and Unemployment Offer vocational training and employment at IU Health Ball. Postsecondary vocational training for individuals with disabilities was offered on-site in partnership with the Erskine Green Training Institute at IU Health Ball Hospital; in 2023 the program trained 20 individuals; at the end of 2023, 13 program graduates were employed at IU Health facilities. Launch Healthcare Career Fellowship Track. This program has not yet been initiated. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - IU HEALTH BALL MEMORIAL HOSPITAL (Continued). Maternal and Infant Health and Child Well-being Further implement Healthy Beginnings Program. The Healthy Beginnings navigation program begins in the first trimester of pregnancy and continues through the first year of life. Navigators attend appointments with clients and connect them to community resources that address social determinants of health. Once the baby is born, navigators continue to engage with families to ensure that postpartum and infant needs are met. The program is open to Jay and Blackford County families. Overall HB impact in Blackford and Jay Counties increased by 40% from 2021 to 2022. Maternal Navigator cared for 852 pregnant patients in 2023 with 852 patient encounters. Infant Navigators had 1,176 encounters in 2023 with a total of 2,038 encounters. This includes referrals to WIC, lactation counseling (participant breastfeeding rate increased to 79% in 2023), childbirth classes, car seat fitting, safe sleep classes, healthy families, tobacco cessation, government assistance programs, family resource center/community partners and food pantries. Multiple family programs such as diaper events, childhood vaccination event, park health and safety program, and mental health series. Further implement Infant and Maternal Health Programs. In 2023 the Perinatal Coordinator for IU Health's East Central region worked with local providers to further implement a virtual care, remote monitoring system to achieve improvements for pregnant and postpartum women to enhance maternal, fetal, and newborn health by streamlining health promotion, optimizing prenatal visits, recognizing early maternal warning signs, such as blood pressure and mental health, and educating new families on newborn safety and developmental milestones. Further implement Pediatric Rehabilitation Services. In 2023, there were 14,410 total visits attended in the clinic setting. Program coverage in school settings was increased in 2023 to 2,008 hours of school coverage from 1,803 hours in 2022. Pediatric rehabilitation department continues to refer appropriate patients to First Steps, which helps with access to rehabilitation services for those in rural areas and urban areas. Smoking, Tobacco Use and Exposure to Secondhand Smoke Promote the use of Quit Now Indiana (1-800 Quit Now). Quit-Now Tobacco toolkits were distributed to community members at health fairs, special events and speaking opportunities in 2023. The Indiana Tobacco Quitline received referrals as follows in 2023: Blackford County, 33 referrals; Delaware County, 173 referrals; Jay County 34 referrals. Further implement the Centralized Tobacco Treatment Program (CTTP) (provides patients access to evidence-based tobacco treatment). The CTTP program is free to IU Health Primary Care patients. Once a patient's level of care is assessed, they are provided evidence-based tobacco cessation treatment with a trained Tobacco Treatment Specialist (TTSs). Patients had access to Clickotine, a digital cessation app, and support from an Advance Practice Provider (APP) to evaluate and prescribe medication assisted therapy (MAT) for nicotine replacement. Education and support were provided to PCP offices which helped to expand services. Cross-functional teams worked together including the West Central Region TTSs for case conferencing and training. The goal to increase access to Specialty Care patients is on hold until budget allows for additional staffing. The 2023 focus was on improving internal efficiencies to maximize resources and improve patient experience including data collection and reporting enhancements. An additional focus 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 70% of patients used NRT/medication to quit. There was a 30% increase in scheduled medication management appointments compared to 2022. The team focused on care continuation, care coordination (TTS/APP), scheduling patient follow-up appointments, and monitoring adherence or complications. These tactics also improved the engagement rate - 78% of scheduled medication management appointments were completed. The above focus on improving patient experience resulted in strong and consistent quit rates of 31% of active patients and harm reduction (patients who reduced use of tobacco) of 54% (July 2022-December 2023). The team received frequent testimonials of lives changed and gratitude for a supportive, compassionate partner. In 2023, CTTP received 1,149 referrals, scheduled 75% of them and completed at least one session with 82% of those scheduled. Additionally, 44% of patients seen completed 2 or more sessions. Over the program's life, CTTP has received 2,678 patient referrals. This program is financially supported by the parent hospital, IU Health Inc., but is offered to and impacts patients in this hospital's defined community. Social Determinants of Health Advance community collaborations and interventions with support from the Community Impact and Investment Fund (CII). Information about the 2023 CII funding opportunity was widely shared in the East Central Region. Applications from Marian University for their "Building Vibrant Schools in Muncie, Indiana" proposal and the Whitely Neighborhood Association for their Centennial District Resource Hub project were selected in 2023 to receive CII Funding amounting to $1.2M. Support school-based education and food access programs. IU Health Ball provided funding to support a health and nutrition focused program implemented for 800+ K-5 students at two Muncie schools. Additional funding supported Second Harvest Food Bank with outreach programs at nine Muncie Community Schools locations. These programs provided free food to 600+ families, while also offering afterschool activities and events to engage families and introduce career-based presentations. In 2023, the average participation at each school increased by 20% over the previous year, and the quantity of food provided at each school increased proportionally. Support the Muncie Neighborhood 8twelve Coalition. Funding from the IU Health CII Fund has allowed for significant infrastructure improvements in the Thomas Park / Avondale neighborhoods of Muncie, including over 4,000 feet of new sidewalks and a walking path completed in 2023; ongoing support of a local food pantry, and completion of a three-field soccer complex. In 2023, An organized soccer league with 61 youth members operated from April to August, with the fields also in use for community purposes throughout the year. Support Farmers Market Education Program. Families were engaged at local farmers markets and farmstands in the East Central Region with educational programming related to the nutritional value of fresh produce, selection, reading food labels and maintaining active lifestyles. Programming also included cooking demonstrations and implementation of IU Health Bucks to encourage increased usage of fresh produce in family meal planning and to incentivize participants to visit a local farmers market. Community partners serving high-needs audiences promoted the program and recruited participants. More than 100 families signed up to participate in 2023, and 80% of participating families reported increased produce consumption following the program. More than $3,100 of IU Health Bucks were distributed and redeemed for fresh produce through this program. Assist people from racial and ethnic minority groups with accessing health services in the community. Dual language handouts were acquired/developed/utilized in 2023 to promote community events and provide health and wellness information. Significant Needs Hospital Will Not Address IU Health Ball addressed all the significant health needs identified in the 2021 Community Health Needs Assessment. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - IU HEALTH BALL MEMORIAL HOSPITAL. IN ADDITION TO FPG, IU HEALTH BALL MEMORIAL HOSPITAL MAY TAKE INTO CONSIDERATION A PATIENT'S INCOME AND/OR ABILITY TO PAY IN CALCULATION OF A FINANCIAL ASSISTANCE AWARD. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - IU HEALTH BALL MEMORIAL HOSPITAL. IU Health Ball Memorial Hospital takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. Eligibility for Financial Assistance due to Financial or Personal Hardship In order to be eligible for Financial Assistance due to Financial or Personal Hardship under this Policy, a patient or guarantor must: - Submit a completed Financial Assistance Application with all supporting documentation and be approved in accordance with this Policy; - Be an Indiana Resident as defined in this Policy; and - If Uninsured, consult with a member of IU Health's Individual Solutions department to determine if health care coverage may be obtained from a government insurance or assistance product, the Health Insurance Marketplace, or from any other source of coverage. Financial Assistance due to Financial Hardship is only available for encounters where care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility. 2. Financial Assistance due to Financial Hardship The FPL income threshold under this section is as follows: - If one or more adults and zero dependents are in the household, the FPL Income Threshold is 200%. - If two or more adults and one or more dependents are in the household, the FPL Income Threshold is 250%. - If one adult and one or more dependents are in the household, the FPL Income Threshold is 300%. In some instances, an adult will also qualify as a dependent. When this occurs, IU Health will treat the adult as a dependent for purposes of the FPL calculation. IU Health will utilize the most recent FPL data available and will apply the FPL data to a patient or guarantor's account balance based upon the calendar date a completed Financial Assistance Application was received, not a patient's date of service. An Uninsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Gross Charges if approved. An Underinsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Patient Responsibility if approved. 3. Financial Assistance due to Personal Hardship An Uninsured or Underinsured patient or their guarantor whose household income is above the FPL income threshold may be eligible for Financial Assistance if the patient's outstanding Patient Responsibility exceeds 20% of the patient's or their guarantor's annual household income. - If approved, the patient's balance will be reduced to 20% of the patient or guarantor's annual household income or the Amounts Generally Billed, whichever is less. - IU Health will work with the patient or guarantor to identify a reasonable payment plan on the remainder of the balance. 4. Eligibility Period If approved for financial assistance by IU Health, the patient will be guaranteed financial assistance for treatment related to the underlying condition, for which the patient was originally screened and approved, through the remainder of the calendar year. As a condition of extending the on-going Financial Assistance, the patient must comply with requests from IU Health to verify that the patient continues to meet the conditions for qualification. 5. Appeals and Assistance Granted By the Financial Assistance Committee The Financial Assistance Committee will review and make determinations on all requests for appeals related to Financial Assistance. If a patient or guarantor seeks to appeal a Financial Assistance Determination, a written request must be submitted, along with the supporting documentation. The Financial Assistance Committee will review requests for and may grant additional Financial Assistance, including but not limited to, the following: - Assistance to patients who are seeking treatment that can only be provided in Indiana by IU Health or who would benefit from continued medical services from IU Health for continuity of care; - Care approved by the IU Health Chief Medical Officer (CMO) or the Chief Executive Officer (CEO) or CMO of an IU Health facility or region, including medically necessary non-elective services for which no payment source can be identified; - Care provided when it is known no payment source exists; - International humanitarian aid; and - Other care identified by the Financial Assistance Committee that fulfills the IU Health Mission. All decisions of the Financial Assistance Committee are final. 6. Presumptive Eligibility No Financial Assistance Application is required to receive Financial Assistance under this Presumptive Eligibility section. IU Health will deem patients or their guarantors presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs and care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility: - Medicaid (any state) - Indiana Children's Special Health Care Services - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. IU Health will conduct a quarterly review of all accounts placed with a collection agency partner for at least one hundred and twenty (120) days after the account is eligible for an ECA as set forth in this Policy. If the patient or guarantor's individual scoring criteria demonstrates the patient has a low likelihood and/or propensity to pay or no credit, the patient or guarantor may be deemed presumptively eligible for Financial Assistance. Financial Assistance may additionally be granted in the following circumstances: - If the patient or their guarantor is found to have filed a petition for bankruptcy. - If the patient is deceased and found to have no estate. - If the patient is deceased and was under 21 years of age at the time of death. 7. Exhaustion of Alternate Sources of Assistance Patients must exhaust all other state and federal assistance programs prior to receiving Financial Assistance due to Financial or Personal Hardship under this Policy including, but not limited to, Medicaid. Patients who may be eligible for coverage under an applicable health insurance policy must exhaust all insurance benefits. - This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. - IU Health may request patients show proof that such a claim was properly submitted to the appropriate insurance provider before awarding Financial Assistance. Eligible patients who receive medical care from an IU Health facility as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award. In the event Financial Assistance has already been granted in the above circumstances, IU Health reserves the right to reverse the Financial Assistance Determination in an amount equal to the amount IU Health would be entitled to receive had no Financial Assistance been awarded. 8. Patient Assets There are situations where a patient or their guarantor may have significant income or assets available to pay for healthcare services such as a legal settlement. The Financial Assistance Committee may evaluate the income or assets in determining Financial Hardship. IU Health may require a list of all property owned by the patient or guarantor and adjust a Financial Assistance Determination as a result. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - IU HEALTH BALL MEMORIAL HOSPITAL. IU Health Ball Memorial Hospital takes several other measures to publicize its FAP within the community. These measures include the following: 1. Post this Policy, a Plain Language Summary of this Policy, and the Financial Assistance Application on its website. 2. Provide patients with a Plain Language Summary of this Policy during registration and/or discharge. 3. Post conspicuous displays in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 4. Include a conspicuous written notice on all patient post-discharge billing statements notifying the patient about this Policy and the telephone number of the Customer Service Department which can assist patients with questions regarding this Policy. 5. Make available Customer Service representatives via telephone during normal business hours. 6. Mail copies of this Policy, a Plain Language Summary of this Policy, and a Financial Assistance Application to patients or their guarantor free of charge upon request. 7. Broadly communicate this Policy as a part of its general outreach efforts. 8. Educate patient-facing team members on this Policy and the process for referring patients to the program. 26 IU HEALTH BALL MEMORIAL OUTPATIENT SURGERY CENTER 2401 W UNIVERSITY AVE MUNCIE IN 47303 SURGERY CENTER IU HEALTH BALL MEMORIAL CANCER CENTER 2401 W UNIVERSITY AVE MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL MATERNAL & FETAL HEALTH 2401 W UNIVERSITY AVE MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL CARDIOVASCULAR SURGERY 2525 W UNIVERSITY AVE SUITE 300 MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL OTOLARYNGOLOGY 2525 W UNIVERSITY AVE MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS CARDIOLOGY 2525 W UNIVERSITY AVE MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS GASTROENTEROLOGY 2525 W UNIVERSITY AVE SUITE 300 MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL GENERAL & VASCULAR SURGERY 2525 W UNIVERSITY AVE SUITE 403 MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS HEART AND LUNG CENTER 2525 W UNIVERSITY AVE SUITE 300 MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS INFECTIOUS DISEASE 2401 W UNIVERSITY AVE MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS NEUROLOGY 2525 W UNIVERSITY AVE SUITE 401 MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS PHYSICAL MEDICINE & REHABSPINE PROGRAM 2525 W UNIVERSITY AVE SUITE 401 MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS PULMONARY & CRITICAL CARE MEDICINE 2525 W UNIVERSITY AVE SUITE 300 MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL OUTPATIENT BEHAVIORAL HEALTH 2401 W UNIVERSITY AVE SUITE 3500A MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL PHYSICIANS FAMILY MEDICINE RESIDENCY CENTER 221 CELIA AVE MUNCIE IN 47303 PRIMARY CARE IU HEALTH BALL MEMORIAL PHYSICIANS INTERNAL MEDICINE RESIDENCY CENTER 2401 W UNIVERSITY AVE SUITE 401 MUNCIE IN 47303 PRIMARY CARE IU HEALTH BALL MEMORIAL OUTPATIENT REHABILITATION CENTER 3300 W COMMUNITY DR MUNCIE IN 47304 REHABILITATION SERVICES IU HEALTH BALL MEMORIAL RADIOLOGY 2401 W UNIVERSITY AVE MUNCIE IN 47303 RADIOLOGY IU HEALTH INTERVENTIONAL RADIOLOGY - MUNCIE 2401 W UNIVERSITY AVE MUNCIE IN 47303 RADIOLOGY IU HEALTH PAVILION COMMUNITY PHARMACY 2401 W UNIVERSITY AVE OMP 1635 MUNCIE IN 47303 PHARMACY IU HEALTH YORKTOWN PHARMACY 1420 S PILGRIM BLVD YORKTOWN IN 47396 PHARMACY IU HEALTH FAMILY PHARMACY 5501 W BETHEL AVE MUNCIE IN 47304 PHARMACY IU HEALTH BALL MEMORIAL LAB 2401 W UNIVERSITY AVE MUNCIE IN 47303 LAB IU HEALTH BETHEL LAB 5501 W BETHEL AVE MUNCIE IN 47304 LAB IU HEALTH BALL MEMORIAL HOSPICE 2401 W UNIVERSITY AVE MUNCIE IN 47303 OTHER IU HEALTH BALL MEMORIAL HOME CARE 2401 W UNIVERSITY AVE MUNCIE IN 47303 OTHER Schedule H, Part I, Line 6a C.B. REPORT PREPARED BY A RELATED ORG. IU Health Ball Memorial Hospital's community benefit and other investments, encompassing its total community investment, are included in the IU Health Community Benefit Report which is prepared on behalf of and includes IU Health and its related hospital entities in the State of Indiana ("IU Health Statewide System"). The IU Health Community Benefit Report is made available to the public on IU Health's website at https://iuhealth.org/in-the-community/community-benefit. The IU Health Community Benefit Report is also distributed to numerous key organizations throughout the State of Indiana in order to broadly share the IU Health Statewide System's community benefit efforts. It is also available by request through the Indiana State Department of Health or IU Health. Schedule H, Part I, Line 7f BAD DEBT EXPENSE The amount of bad debt expense included on Form 990, Part IX, Line 25, column (A), but subtracted for purposes of calculating the percentage of total expense on Line 7, column (f) is $25,180,503. Bad debt expense is reported at cost based on the cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. Schedule H, Part I, Line 7 TOTAL COMMUNITY BENEFIT EXPENSE Schedule H, Part I, Line 7, Column (f), Percent of Total Expense, is based on column (e) Net Community Benefit Expense. The percent of total expense based on column (c) Total Community Benefit Expense, which does not include direct offsetting revenue, is 29.87%. Schedule H, Part II PROMOTION OF HEALTH IN COMMUNITIES SERVED IU Health Ball is a subsidiary of Indiana University Health. IU Health participates in a variety of community-building activities that address the social determinants of health in the communities it serves. IU Health and its related hospital entities across the State of Indiana investments include economic development efforts across the state, collaborate with like-minded organizations through coalitions that address key issues, and advocate for improvements in the health status of vulnerable populations. This includes making contributions to community-building activities by providing investments and resources to local community initiatives that address economic development, community support and workforce development. IU Health Ball partners with the following organizations and initiatives that focus on some of the root causes of health issues, such as lack of education, employment and poverty: Economic Development: IU Health Ball representatives served on multiple economic development boards and committees in 2023, such as the East Central Indiana Regional Partnership (ECIRP), Next Muncie, READI review board, Muncie/Delaware County Chamber of Commerce, Ball Brothers Foundation, and the Sherman and Marjorie Zeigler Foundation. In 2023, the hospital donated $15,000 to ECIRP. Coalition Building: IU Health Ball serves as the backbone organization providing resources to operate a three-county health coalition focused on obesity prevention and tobacco cessation to reduce the impact of chronic disease including cancer and heart disease. More than 150 organizations are partners in the "Healthy Community Alliance of East Central Indiana" coalition and each pledge to influence audiences to make positive choices regarding improved nutrition, increased physical activity or tobacco cessation. Coalition partners report a collective total audience size of more than 50,000 people. Community Health Improvement Advocacy: In 2023 IU Health Ball launched a community hypertension initiative in partnership with local Black and African American churches, and organized a health and wellness event focused on hypertension screening and diabetes prevention in an area of the community which has a 63% Black and African American population. Additionally, IU Health Ball team members served the ECR community and advocated for healthier lifestyle improvements in service to the Cardinal Greenway Board of Directors, as well as ongoing participation in the Tobacco Free-Delaware County and Tobacco Free Blackford County Coalitions in monthly advocacy meetings to promote tobacco cessation and policy changes throughout the community. Community Support: Representatives of IU Health Ball also served in numerous executive committees and boards of directors for organizations striving to improve community health status, including A Better Way, Altrusa, Ball Brothers Foundation, Center of Hope, Youth Opportunity Center, Community Foundation of Muncie and Delaware County, Delaware County Prevention Council, Little Red Door, Muncie Afghan Refugee Resettlement Committee, Open Door Health Center, Second Harvest Food Bank, Strengthening Indiana Families, Whitely Neighborhood Association, Women's Philanthropy Board and YMCA of Muncie. Physical Improvements and Housing: IU Health Ball partnered with the Greater Muncie Habitat for Humanity during its annual Day of Service event in 2023. Team members participated in a Habitat home-build event, made improvements to Habitat facilities, and constructed a wheelchair ramp for a local resident. Workforce Development: IU Health Ball has partnered with the ARC of Indiana to train students with intellectual and developmental disabilities to realize their goals of living, learning, working and fully participating in the community since 2016. Training for careers in the hospitality industry is provided at the Erskine-Green Training Center in downtown Muncie as well as on-the-job instruction at IUH BMH and other area hospitality providers. In 2023, the ARC program served 18 people and provided $79,000 in net community benefit. Team members from IU Health Ball also partnered with Muncie Community Schools to offer the "If you can see it, you can be it" one-day career education program for middle school students. Schedule H, Part I, Line 7g DESCRIBE SUBSIDIZED HEALTH SERVICE COSTS FROM PHYSICIAN CLINIC IU HEALTH BALL MEMORIAL HOSPITAL INCLUDES COSTS ASSOCIATED WITH PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES BUT IS NOT ABLE TO SEGREGATE THE COSTS ASSOCIATED WITH PHYSICIAN CLINICS. Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care IU HEALTH BALL MEMORIAL HOSPITAL USES SEVERAL FACTORS OTHER THAN FEDERAL POVERTY GUIDELINES ("FPG") IN DETERMINING ELIGIBILITY FOR FREE CARE UNDER ITS FAP. THESE FACTORS INCLUDE THE FOLLOWING: 1. ELIGIBILITY FOR FINANCIAL ASSISTANCE DUE TO FINANCIAL OR PERSONAL HARDSHIP IN ORDER TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE DUE TO FINANCIAL OR PERSONAL HARDSHIP UNDER THIS POLICY, A PATIENT OR GUARANTOR MUST: - SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION WITH ALL SUPPORTING DOCUMENTATION AND BE APPROVED IN ACCORDANCE WITH THIS POLICY. - BE AN INDIANA RESIDENT AS DEFINED IN THIS POLICY; AND - IF UNINSURED, CONSULT WITH A MEMBER OF IU HEALTH'S INDIVIDUAL SOLUTIONS DEPARTMENT TO DETERMINE IF HEALTH CARE COVERAGE MAY BE OBTAINED FROM A GOVERNMENT INSURANCE OR ASSISTANCE PRODUCT, THE HEALTH INSURANCE MARKETPLACE, OR FROM ANY OTHER SOURCE OF COVERAGE. FINANCIAL ASSISTANCE DUE TO FINANCIAL HARDSHIP IS ONLY AVAILABLE FOR ENCOUNTERS WHERE CARE WAS INITIATED VIA AN ELIGIBLE FACILITY'S EMERGENCY DEPARTMENT, DIRECT ADMISSION FROM A PHYSICIAN'S OFFICE, OR TRANSFER FROM ANOTHER HOSPITAL FACILITY. 2. FINANCIAL ASSISTANCE DUE TO FINANCIAL HARDSHIP THE FPL INCOME THRESHOLD UNDER THIS SECTION IS AS FOLLOWS: -IF ONE OR MORE ADULTS AND ZERO DEPENDENTS ARE IN THE HOUSEHOLD, THE FPL INCOME THRESHOLD IS 200%. -IF TWO OR MORE ADULTS AND ONE OR MORE DEPENDENTS ARE IN THE HOUSEHOLD, THE FPL INCOME THRESHOLD IS 250%. -IF ONE ADULT AND ONE OR MORE DEPENDENTS ARE IN THE HOUSEHOLD, THE FPL INCOME THRESHOLD IS 300%. IN SOME INSTANCES, AN ADULT WILL ALSO QUALIFY AS A DEPENDENT. WHEN THIS OCCURS, IU HEALTH BALL MEMORIAL HOSPITAL WILL TREAT THE ADULT AS A DEPENDENT FOR PURPOSES OF THE FPL CALCULATION. IU HEALTH BALL MEMORIAL HOSPITAL WILL UTILIZE THE MOST RECENT FPL DATA AVAILABLE AND WILL APPLY THE FPL DATA TO A PATIENT OR GUARANTOR'S ACCOUNT BALANCE BASED UPON THE CALENDAR DATE A COMPLETED FINANCIAL ASSISTANCE APPLICATION WAS RECEIVED, NOT A PATIENT'S DATE OF SERVICE. AN UNINSURED PATIENT OR THEIR GUARANTOR WHOSE HOUSEHOLD INCOME IS LESS THAN OR EQUAL TO THE FPL INCOME THRESHOLD MAY BE ELIGIBLE FOR FULL FINANCIAL ASSISTANCE UP TO 100% OF GROSS CHARGES IF APPROVED. AN UNDERINSURED PATIENT OR THEIR GUARANTOR WHOSE HOUSEHOLD INCOME IS LESS THAN OR EQUAL TO THE FPL INCOME THRESHOLD MAY BE ELIGIBLE FOR FULL FINANCIAL ASSISTANCE UP TO 100% OF PATIENT RESPONSIBILITY IF APPROVED. 3. FINANCIAL ASSISTANCE DUE TO PERSONAL HARDSHIP AN UNINSURED OR UNDERINSURED PATIENT OR THEIR GUARANTOR WHOSE HOUSEHOLD INCOME IS ABOVE THE FPL INCOME THRESHOLD MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE IF THE PATIENT'S OUTSTANDING PATIENT RESPONSIBILITY EXCEEDS 20% OF THE PATIENT'S OR THEIR GUARANTOR'S ANNUAL HOUSEHOLD INCOME. -IF APPROVED, THE PATIENT'S BALANCE WILL BE REDUCED TO 20% OF THE PATIENT OR GUARANTOR'S ANNUAL HOUSEHOLD INCOME OR THE AMOUNTS GENERALLY BILLED, WHICHEVER IS LESS. -IU HEALTH WILL WORK WITH THE PATIENT OR GUARANTOR TO IDENTIFY A REASONABLE PAYMENT PLAN ON THE REMAINDER OF THE BALANCE. 4. ELIGIBILITY PERIOD IF APPROVED FOR FINANCIAL ASSISTANCE BY IU HEALTH BALL MEMORIAL HOSPITAL, THE PATIENT WILL BE GUARANTEED FINANCIAL ASSISTANCE FOR TREATMENT RELATED TO THE UNDERLYING CONDITION, FOR WHICH THE PATIENT WAS ORIGINALLY SCREENED AND APPROVED, THROUGH THE REMAINDER OF THE CALENDAR YEAR. AS A CONDITION OF EXTENDING THE ON-GOING FINANCIAL ASSISTANCE, THE PATIENT MUST COMPLY WITH REQUESTS FROM IU HEALTH BALL MEMORIAL HOSPITAL TO VERIFY THAT THE PATIENT CONTINUES TO MEET THE CONDITIONS FOR QUALIFICATION. 5. APPEALS AND ASSISTANCE GRANTED BY THE FINANCIAL ASSISTANCE COMMITTEE THE FINANCIAL ASSISTANCE COMMITTEE WILL REVIEW AND MAKE DETERMINATIONS ON ALL REQUESTS FOR APPEALS RELATED TO FINANCIAL ASSISTANCE. IF A PATIENT OR GUARANTOR SEEKS TO APPEAL A FINANCIAL ASSISTANCE DETERMINATION, A WRITTEN REQUEST MUST BE SUBMITTED, ALONG WITH THE SUPPORTING DOCUMENTATION. THE FINANCIAL ASSISTANCE COMMITTEE WILL REVIEW REQUESTS FOR AND MAY GRANT ADDITIONAL FINANCIAL ASSISTANCE, INCLUDING BUT NOT LIMITED TO, THE FOLLOWING: -ASSISTANCE TO PATIENTS WHO ARE SEEKING TREATMENT THAT CAN ONLY BE PROVIDED IN INDIANA BY IU HEALTH OR WHO WOULD BENEFIT FROM CONTINUED MEDICAL SERVICES FROM IU HEALTH FOR CONTINUITY OF CARE; -CARE APPROVED BY THE IU HEALTH CHIEF MEDICAL OFFICER (CMO) OR THE CHIEF EXECUTIVE OFFICER (CEO) OR CMO OF AN IU HEALTH FACILITY OR REGION, INCLUDING MEDICALLY NECESSARY NON-ELECTIVE SERVICES FOR WHICH NO PAYMENT SOURCE CAN BE IDENTIFIED; -CARE PROVIDED WHEN IT IS KNOWN NO PAYMENT SOURCE EXISTS; -INTERNATIONAL HUMANITARIAN AID; AND -OTHER CARE IDENTIFIED BY THE FINANCIAL ASSISTANCE COMMITTEE THAT FULFILLS THE IU HEALTH MISSION. ALL DECISIONS OF THE FINANCIAL ASSISTANCE COMMITTEE ARE FINAL. 6. PRESUMPTIVE ELIGIBILITY NO FINANCIAL ASSISTANCE APPLICATION IS REQUIRED TO RECEIVE FINANCIAL ASSISTANCE UNDER THIS PRESUMPTIVE ELIGIBILITY SECTION. IU HEALTH BALL MEMORIAL HOSPITAL WILL DEEM PATIENTS OR THEIR GUARANTORS PRESUMPTIVELY ELIGIBLE FOR FINANCIAL ASSISTANCE IF THEY ARE FOUND TO BE ELIGIBLE FOR ONE OF THE FOLLOWING PROGRAMS AND CARE WAS INITIATED VIA AN ELIGIBLE FACILITY'S EMERGENCY DEPARTMENT, DIRECT ADMISSION FROM A PHYSICIAN'S OFFICE, OR TRANSFER FROM ANOTHER HOSPITAL FACILITY: -MEDICAID (ANY STATE) -INDIANA CHILDREN'S SPECIAL HEALTH CARE SERVICES -HEALTHY INDIANA PLAN -PATIENTS WHO ARE AWARDED HOSPITAL PRESUMPTIVE ELIGIBILITY (HPE) -A STATE AND/OR FEDERAL PROGRAM THAT VERIFIES THE PATIENT OR GUARANTOR'S GROSS HOUSEHOLD INCOME MEETS THE FPL INCOME THRESHOLD. IU HEALTH BALL MEMORIAL HOSPITAL WILL CONDUCT A QUARTERLY REVIEW OF ALL ACCOUNTS PLACED WITH A COLLECTION AGENCY PARTNER FOR AT LEAST ONE HUNDRED AND TWENTY (120) DAYS AFTER THE ACCOUNT IS ELIGIBLE FOR AN ECA AS SET FORTH IN THIS POLICY. IF THE PATIENT OR GUARANTOR'S INDIVIDUAL SCORING CRITERIA DEMONSTRATES THE PATIENT HAS A LOW LIKELIHOOD AND/OR PROPENSITY TO PAY OR NO CREDIT, THE PATIENT OR GUARANTOR MAY BE DEEMED PRESUMPTIVELY ELIGIBLE FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE MAY ADDITIONALLY BE GRANTED IN THE FOLLOWING CIRCUMSTANCES: -IF THE PATIENT OR THEIR GUARANTOR IS FOUND TO HAVE FILED A PETITION FOR BANKRUPTCY. -IF THE PATIENT IS DECEASED AND FOUND TO HAVE NO ESTATE. -IF THE PATIENT IS DECEASED AND WAS UNDER 21 YEARS OF AGE AT THE TIME OF DEATH. 7. EXHAUSTION OF ALTERNATE SOURCES OF ASSISTANCE PATIENTS MUST EXHAUST ALL OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS PRIOR TO RECEIVING FINANCIAL ASSISTANCE DUE TO FINANCIAL OR PERSONAL HARDSHIP UNDER THIS POLICY INCLUDING, BUT NOT LIMITED TO, MEDICAID. PATIENTS WHO MAY BE ELIGIBLE FOR COVERAGE UNDER AN APPLICABLE HEALTH INSURANCE POLICY MUST EXHAUST ALL INSURANCE BENEFITS. -THIS INCLUDES PATIENTS COVERED UNDER THEIR OWN POLICY AND THOSE WHO MAY BE ENTITLED TO BENEFITS FROM A THIRD-PARTY POLICY. -IU HEALTH MAY REQUEST PATIENTS SHOW PROOF THAT SUCH A CLAIM WAS PROPERLY SUBMITTED TO THE APPROPRIATE INSURANCE PROVIDER BEFORE AWARDING FINANCIAL ASSISTANCE. ELIGIBLE PATIENTS WHO RECEIVE MEDICAL CARE FROM AN IU HEALTH FACILITY AS A RESULT OF AN INJURY PROXIMATELY CAUSED BY A THIRD PARTY, AND LATER RECEIVE A MONETARY SETTLEMENT OR AWARD FROM SAID THIRD PARTY, MAY RECEIVE FINANCIAL ASSISTANCE FOR ANY OUTSTANDING BALANCE NOT COVERED BY THE SETTLEMENT OR AWARD. IN THE EVENT FINANCIAL ASSISTANCE HAS ALREADY BEEN GRANTED IN THE ABOVE CIRCUMSTANCES, IU HEALTH BALL MEMORIAL HOSPITAL RESERVES THE RIGHT TO REVERSE THE FINANCIAL ASSISTANCE DETERMINATION IN AN AMOUNT EQUAL TO THE AMOUNT IU HEALTH WOULD BE ENTITLED TO RECEIVE HAD NO FINANCIAL ASSISTANCE BEEN AWARDED. 8. PATIENT ASSETS THERE ARE SITUATIONS WHERE A PATIENT OR THEIR GUARANTOR MAY HAVE SIGNIFICANT INCOME OR ASSETS AVAILABLE TO PAY FOR HEALTHCARE SERVICES SUCH AS A LEGAL SETTLEMENT. THE FINANCIAL ASSISTANCE COMMITTEE MAY EVALUATE THE INCOME OR ASSETS IN DETERMINING FINANCIAL HARDSHIP. IU HEALTH BALL MEMORIAL HOSPITAL 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 25180503 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 a patient applies for financial assistance due to financial hardship. In determining the level of financial assistance based on household makeup, single person 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 University Health System does not pursue collection of these amounts, the discounted amounts are not reported as patient service revenue. The Indiana University Health System uses presumptive eligibility screening procedures for some forms of financial assistance and recognizes net patient service revenue on services provided to self-pay patients at the discounted rate at the time services are rendered. The estimated cost of charity care, using the consolidated cost to charge ratio, was $95,909,000 and $88,213,000 in 2023 and 2022, respectively. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs IU Health Ball Memorial Hospital has a Medicare shortfall for 2022. IU Health Ball Memorial Hospital's Medicare shortfall is attributable to reimbursements that are less than the cost of providing patient care and services to Medicare beneficiaries and does not include any amounts that result from inefficiencies of poor management in 2022. IU Health Ball Memorial Hospital accepts all Medicare patients knowing that there may be shortfalls; therefore, it has taken the position that any shortfall should be counted as part of its community benefit. Additionally, it is implied in Internal Revenue Service Revenue Ruling 69-545 that treating Medicare patients is a community benefit. Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with governmental health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. The amount reported on Schedule H, Part III, Line 6 is calculated, in accordance with the Form 990 instructions, using "allowable costs" from the IU Health Ball Memorial Hospital Medicare Cost Report. "Allowable costs" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health Ball Memorial Hospital's participation in Medicare programs. For example, the Medicare Cost Report excludes certain costs such as billed physician services, the costs of Medicare Parts C and D, fee schedule reimbursed services, and durable medical equipment services. Inclusion of all costs associated with IU Health Ball Memorial Hospital participation in Medicare programs would significantly reduce the Medicare surplus reported on Schedule H, Part III, Line 7. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance IU Health Ball Memorial Hospital's FAP and Written Debt Collection Policy describe the collection practices applicable to patients, including those who may qualify for financial assistance. 1. Financial Assistance Application Financial Assistance Applications must include the following documentation: - All sources of Income for the last three (3) months. - Most recent three (3) months of pay stubs or Supplemental Security Income via Social Security. - Most recent three (3) statements from checking and savings accounts, certificates of deposit, stocks, bonds and money market accounts. - Most recent state and Federal Income Tax forms including Schedules C, D, E, and F. In the event the patient or guarantor's income does not warrant the filing of a federal tax statement, the individual may submit a notarized affidavit attesting to the foregoing. - Most recent W-2 statement. - For patients or members of the Household who are currently unemployed, Wage Inquiry from WorkOne. - If applicable, divorce/dissolution decrees and child custody order. Patients or their guarantors wishing to apply for Financial Assistance due to Financial Hardship are encouraged to submit an Application within ninety (90) days of discharge. Patients or their guarantors may submit an Application up to two-hundred and forty (240) days from the date of their initial post-discharge billing statement from IU Health, however, accounts may be subject to Extraordinary Collection Actions (ECA) as soon as one-hundred and twenty (120) days after receipt of the initial post-discharge billing statement. Patients or their guarantors submitting an incomplete Financial Assistance Application will receive written notification of the Application's deficiency upon discovery by IU Health. The Application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health will suspend any ECA until the Application is complete or the expiration of the forty-five (45) day period. Patients with limited English proficiency may request a copy of this Policy, a Financial Assistance Application, and a Plain Language Summary in one of the below languages: - Arabic; - Burmese; - Burmese - Falam; - Burmese - Hakha Chin; - Mandarin/Chinese; or - Spanish The patient, and/or their representative, such as the patient's physician, family members, legal counsel, community or religious groups, social services or hospital personnel may request a Financial Assistance Application be mailed to a patient's primary mailing address free of charge. IU Health maintains the confidentiality of all Financial Assistance Applications and supporting documentation. IU Health will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance Application. 2. Financial Assistance Determinations IU Health will inform patients or guarantors of the results of their Application by providing the patient or guarantor with a Financial Assistance Determination within ninety (90) days of receiving a completed Application and all requested documentation. A patient's Financial Assistance Application and Financial Assistance Determination are specific to each date(s) of service and approved related encounters. If a patient or guarantor is granted less than full charity assistance and the patient or guarantor provides additional information for reconsideration, Revenue Cycle Services may amend a prior Financial Assistance Determination. 3. Extraordinary Collection Actions IU Health may refer delinquent patient accounts to a third-party collection agency after utilizing reasonable efforts to determine a patient's eligibility for assistance under this Policy. Reasonable efforts include the following: - IU Health will notify the patient of this Policy at least thirty (30) days prior to initiating an ECA. - IU Health will not initiate an ECA for at least one-hundred and twenty (120) days after the patient's initial post-discharge billing statement. - IU Health will review all Financial Assistance Applications received up to and including two-hundred and forty (240) days after the patient's initial post-discharge billing statement. IU Health will cease any ECAs it has initiated upon receipt of a Financial Assistance Application until a Financial Assistance Determination is made under this policy. - If an Application is Approved, IU Health will issue a revised statement, issue refunds, and make reasonable efforts to reverse ECAs as necessary. IU Health and its third-party collection agencies may initiate an ECA against a patient or their guarantor in accordance with this Policy and 26 C.F.R. § 1.501(r). ECAs may include the following: - Selling a patient or their guarantor's outstanding financial responsibility to a third party. - Reporting adverse information about the patient or their guarantor to consumer credit reporting agencies or credit bureaus. - Deferring or denying, or requiring a payment before providing, medically necessary care because of a patient or their guarantor's nonpayment of one or more bills for previously provided care covered under this Policy. - Actions requiring a legal or judicial process, including but not limited to placing a lien on a patient's or their guarantor's property, foreclosing on a patient's or their guarantor's real property, attaching or seizing a patient's or their guarantor's bank account or other personal property, commencing a civil action against a patient or their guarantor, causing a patient or guarantor's arrest, causing a patient and/or guarantor to be subject to a writ of body attachment, and garnishing a patient or guarantor's wages When it is necessary to engage in such action, IU Health and its third party collection agencies, will engage in fair, respectful and transparent collections activities. 4. Refunds Patients eligible for Financial Assistance under this Policy who remitted payment to IU Health in excess of their Patient Responsibility will be alerted to the overpayment as promptly after discovery as is reasonable given the nature of the overpayment. Patients with an outstanding account balance due on a separate account will have their refund applied to the outstanding balance. Patients without an outstanding account balance described above will be issued a refund check for their overpayment as soon as technically feasible. Schedule H, Part V, Section B, Line 16a FAP website - IU HEALTH BALL MEMORIAL HOSPITAL: Line 16a URL: https://iuhealth.org/pay-a-bill/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - IU HEALTH BALL MEMORIAL HOSPITAL: Line 16b URL: https://iuhealth.org/pay-a-bill/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - IU HEALTH BALL MEMORIAL HOSPITAL: Line 16c URL: https://iuhealth.org/pay-a-bill/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment Though IU Health Ball believes its CHNA process is comprehensive, the CHNA is done on a triennial basis. Between CHNA cycles, IU Health Ball gathers data and information to monitor the most current needs of the community. Additional sources of data and information include: * IU Health data analytics and information service teams; * Secondary data sources from Federal, state, and local entities with a focus on health behaviors, health outcomes, and social determinants of health; * Obtaining community organization and governmental agency perspectives; priority population perspectives; and other healthcare and hospital perspectives; * Reports that share findings and recommendations on certain populations within the community and/or health behaviors, health outcomes, or social determinants of health; * Evidence informed sources; and * Team member participation in partnering efforts (e.g., coalitions, advisory committees, task forces, etc.). The regular review of these sources of data and information rarely impact what the significant needs are between CHNA cycles. However, it does help influence the types or level of interventions to address the significant needs; prioritize resources to those groups or neighborhoods experiencing health disparities in the community; identify funding opportunities to support interventions; and strengthen or mobilize partnerships to improve health. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance IU Health Ball Memorial Hospital is committed to serving the healthcare needs of all of its patients regardless of their ability to pay for such services. To assist in meeting those needs, IU Health Ball Memorial Hospital has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health Ball Memorial Hospital is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health Ball Memorial Hospital will make a good faith effort to locate and obtain health insurance coverage for patients prior to considering patients for coverage under the FAP. IU Health Ball Memorial Hospital takes several measures to inform its patients of the FAP and FAP-eligibility. These measures include the following: 1. Post this Policy, a Plain Language Summary of this Policy, and the Financial Assistance Application on its website. 2. Provide patients with a Plain Language Summary of this Policy during registration and/or discharge. 3. Post conspicuous displays in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 4. Include a conspicuous written notice on all patient post-discharge billing statements notifying the patient about this Policy and the telephone number of the Customer Service Department which can assist patients with questions regarding this Policy. 5. Make available Customer Service representatives via telephone during normal business hours. 6. Mail copies of this Policy, a Plain Language Summary of this Policy, and a Financial Assistance Application to patients or their guarantor free of charge upon request. 7. Broadly communicate this Policy as a part of its general outreach efforts. 8. Educate patient-facing team members on this Policy and the process for referring patients to the program. Schedule H, Part VI, Line 4 Community information IU Health Ball Memorial Hospital is located in Delaware County, Indiana, a County located in central Indiana. Delaware County includes ZIP codes within the towns of Muncie, Eaton, Gaston, Selma, Albany, Daleville and Yorktown. Based on the most recent Census Bureau (2023) statistics, Delaware County's population is 112,321 persons with approximately 51.7% being female and 48.3% male. The County's population estimates by race are 85.1% White, 3.3% Hispanic or Latino, 7.5% Black, 1.5% Asian, 0.3% American Indian or Alaska Native, and 2.8% persons reporting two or more races. Delaware County has relatively low levels of educational attainment. The level of education most of the population has achieved is a high school degree (90.7%). As of 2023, 25.5% of the population had a bachelor's degree or higher. Schedule H, Part VI, Line 5 Promotion of community health IU Health Ball Memorial Hospital is governed by a Board of Directors, comprised of persons who primarily reside in the organization's primary service area. IU Health Ball extends medical staff privileges to all qualified physicians in its community for some or all of its clinical departments and specialties. IU Health does not deny appointments based on gender, race, creed or national origin. IU Health, in conjunction with the IU School of Medicine, trains the next generation of physicians in an exceptional environment. Blending breakthrough research and treatments with the highest quality of patient care. IU Health Ball invests in other initiatives and collaborations throughout the year to promote health and wellness in the community. Some of these include: - Lung cancer screenings using low dose CT imaging offered at reduced cost to community members meeting requirements set out by the National Comprehensive Cancer Network. The screening is intended to identify cancer at an early stage. In 2023, 668 individuals received this service. - Periodic screenings for cervical, skin or prostate cancers by appointment or free blood pressure and diabetes checks at health fairs and other public gatherings, as well as athletic and school-based physicals for students. In 2023, 1,111 individuals participated in one of these screenings or services. - Health programming is offered to local schools through the hospital's Family Medicine Residency program and other hospital health professionals. Topics include tobacco, puberty, nutrition, physical activity and breast self-exams. 125 students benefitted in 2023. - Over 102,000 hours of clinical educational experiences provided on site for students in the healthcare field studying nursing, pulmonary and physical rehabilitation, radiology and other topics. IU Health Ball partners with Ball State University, Ivy Tech Community College, Indiana Wesleyan University, Anderson University and other area institutions. Over 1,300 students served in 2023. - The IU Health Ball Research Center conducts local clinical trials in urology, infectious diseases, pain management and especially oncology, cardiology and coagulation. In 2023, 33 studies were conducted with 138 individuals participating. - Contributions of employee time and organizational resources toward encouraging team members to contribute to the area United Way campaign. This support provided socioeconomic resources to area residents, including organizations such as Boys and Girls Club Muncie, A Better Way, YWCA of Muncie, Motivate Our Minds, Muncie Mission, Second Harvest Food Bank, Meals on Wheels and more. - Additionally, team members at IU Health Ball participated in the IU Health Statewide System's team member community benefit service program, "IU Health Serves", team members across the state make a difference in the lives of thousands of Hoosiers every year. Schedule H, Part VI, Line 6 Affiliated health care system Indiana University Health Ball is part of Indiana University Health ("IU Health "the healthcare system"), which is Indiana's most comprehensive healthcare system. A unique partnership with the Indiana University School of Medicine ("IU School of Medicine"), one of the nation's leading medical schools, gives patients access to innovative treatments and therapies. The healthcare system is comprised of hospitals, physicians and allied services dedicated to providing preeminent patient care and community health improvement throughout Indiana. IU Health's affiliate hospitals are divided into six regions that serve communities in Northwest, Northeast, Central and Southern Indiana. The 16 hospitals in the healthcare system include IU Health Inc. (i.e., the IU Health Academic Health Center consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health and IU Health Saxony Hospital); IU Health Arnett; IU Health Ball; IU Health Bedford Hospital; IU Health 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, conducts and adopts its own community health needs assessment (CHNA) and implementation strategy. IU Health considers the sum of these CHNAs and the implementation strategies part of a system wide vision of making Indiana one of the healthiest states in the nation. The healthcare system and its affiliate hospitals are keenly aware of the positive impact it can have on improving the health of communities throughout the state of Indiana by investing in local, community-based 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 receive training in affiliate hospitals. Research conducted by IU School of Medicine faculty gives IU Health physicians and patients access to the most leading-edge and comprehensive treatment options. To further promote the health of the communities served by IU Health, the system-level Community Health Division partners with state and local community-based organizations, community coalitions and governmental agencies to focus on innovative models of care; community alliances and partnerships; anchor institution and advocacy strategies; and social determinants of health. All affiliate hospitals in the healthcare system identify and address significant needs unique to the communities they serve. However, some needs are common in communities served by multiple or all affiliate hospitals in the healthcare system and align with system priority areas, warranting a system level strategy. The Community Health Division, along with additional internal partners such as the Office of Health Equity Research and Evaluation (HERE) and the IU Health Foundation, plans and provides technical assistance for system-level strategies that address these common needs including health equity, tobacco and nicotine cessation, behavioral and substance use disorders, infant and maternal health, hypertension, and social determinants of health. For example, the Community Health Division is coordinating efforts to select and train community health workers who are placed throughout the system in outpatient and inpatient sites and do outreach through the WeCare and iHEART initiatives. These valued team members are from the communities being served by IU Health and have an intimate understanding of the needs of residents. Each affiliate hospital works collaboratively with the Community Health Division to align and activate local resources to support local and system strategies. This benefits the community each affiliate hospital serves and works towards a statewide impact (system-level) on health outcomes. As part of the Community Health Division, the Community Outreach and Engagement Program's IU Health Serves initiative, a system-level team member volunteer program, seeks to positively impact the health of communities IU Health affiliate hospitals serve and foster a culture of engagement and social responsibility. Each affiliate hospital coordinates the different initiatives of the program, including Days of Service. This is the largest volunteer event of the year, consisting of projects designed to engage each affiliate hospitals' team members in activities that address local, significant needs. The $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 will address key social and environmental factors that impact historically marginalized and minoritized populations in the communities IU Health serves. Through the grants provided by this CII Fund, IU Health can strategically and intentionally address the social, economic, and environmental factors that impact the health of affiliate hospitals' surrounding communities. Each affiliate hospital and its team members are eligible to pursue this grant opportunity with a community organization. Schedule H, Part VI, Line 7 State filing of community benefit report IN true true false false false false false true false JEFFREY C BIRD MD DIRECTOR/PRESIDENT (ECR) 0 603910 0 263314 0 117973 0 121200 0 50992 0 1157389 0 96303 PETER M VOSS MD DIRECTOR/VICE CHAIR 424351 0 62306 0 3564 0 13200 0 50992 0 554413 0 0 0 CHARLES R ROUTH MD DIRECTOR 0 176698 0 98590 0 6858 0 11501 0 55974 0 349621 0 0 JOAN V CASTOR DIRECTOR 0 370579 0 145314 0 55520 0 79944 0 51997 0 703354 0 0 JONATHAN W VANATOR CFO (ECR) 0 326963 0 59746 0 810 0 12328 0 55139 0 454986 0 0 MICHELLE R ALTOBELLA VP-General Counsel, Asst Secretary (ECR) 0 232260 0 25917 0 1199 0 10683 0 39818 0 309877 0 0 LORI A LUTHER COO (ECR) (Part Year) 320929 0 52515 0 5803 0 13200 0 48765 0 441211 0 0 0 MELISSA R HICKS VP & CNO (ECR) 235948 0 35631 0 472 0 11139 0 43048 0 326238 0 0 0 RYAN M JOHNSTON MD VP & CMO (ECR) 384347 0 55896 0 1242 0 13200 0 63987 0 518672 0 0 0 BRIAN REED VP-HUMAN RESOURCES (ECR) 0 179352 0 20328 0 359 0 8421 0 52504 0 260965 0 0 KREIGH COOK COO (ECR) (Part Year) 186851 0 15839 0 27415 0 9407 0 28088 0 267600 0 0 0 DAVID A SCHWARTZ Clinical Nurse 0 229062 0 42700 0 255 0 10871 0 10871 0 293758 0 0 TERRY A PENCE VP, OPERATIONS 104656 0 33721 0 187493 0 4171 0 40034 0 370075 0 0 0 CHRISTOPHER GAMBLE MD Associate CMO 330523 0 26362 0 810 0 9311 0 50164 0 417170 0 0 0 JOSEPH BUTTS RADIATION PHYSICIST 237272 0 500 0 276 0 9590 0 26452 0 274089 0 0 0 ALVIS FOSTER Physicist-Radiation Medicine 247823 0 3037 0 1524 0 10268 0 58928 0 321579 0 0 0 Max E Barnhart Director - Pharmacy 184097 0 20512 0 14648 0 9243 0 54459 0 282958 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation IU Health Ball Memorial Hospital's Regional President is employed by IU Health. IU Health, IU Health Ball and other related organizations have a process in place to determine the compensation for its officers and key employees. IU Health Human Resources uses market data from multiple compensation experts/vendors who utilize a variety of methods and procedures to obtain compensation ranges for comparable officers and employee positions. This market data and multiple other factors (including market pay benchmarks, internal equity, candidate/employee qualifications & performance, and business needs) are used to recommend compensation ranges for its officers and other employees, which are then used as a guide for setting reasonable compensation by management. Please see Schedule O for additional details. Schedule J, Part I, Line 4a Severance or change-of-control payment TERRY PENCE ENTERED INTO A SEVERANCE AGREEMENT WITH IU HEALTH DURING 2023. HE RECEIVED SEVERANCE OF $184,832 DURING 2023. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan JEFFREY C. BIRD M.D. AND JOAN V. CASTOR PARTICIPATE IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, PROVISIONS OF WHICH ARE DESIGNED TO RETAIN THESE CRITICAL EMPLOYEES. THE PLAN PROVIDES FOR AN ADDITIONAL RETIREMENT BENEFIT FOR SERVICE THROUGH NORMAL RETIREMENT OR OTHER KEY DATES. IF THE EXECUTIVE LEAVES PRIOR TO RETIREMENT OR OTHER KEY DATES, THE BENEFIT MAY BE FORFEITED OR REDUCED. EACH OF THE EXECUTIVES LISTED ABOVE HAVE AN AMOUNT INCLUDED IN COLUMN C, DEFERRED COMPENSATION, REPRESENTING THE CURRENT YEAR UNVESTED CONTRIBUTIONS MADE UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THESE AMOUNTS WERE NOT PAID TO THE EXECUTIVES DURING THE YEAR. THE FOLLOWING EXECUTIVES HAVE AN AMOUNT INCLUDED IN COLUMN B (III), OTHER REPORTABLE COMPENSATION, REPRESENTING THE CURRENT YEAR VESTED AMOUNTS RECEIVED UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: - JEFFREY C. BIRD, M.D.: $102,766 - JOAN V. CASTOR: $52,216 Schedule J, Part I, Line 7 Non-fixed payments AMOUNTS DISCLOSED IN COLUMN B(II) INCLUDE A LONG TERM INCENTIVE FOR CERTAIN EXECUTIVES. ALTHOUGH THESE PLANS ARE BASED ON A FIXED FORMULA THAT HAS BEEN APPROVED BY THE BOARD OF DIRECTORS BASED UPON CERTAIN QUALITATIVE AND QUANTITATIVE FACTORS AND GOALS, ALL DISCRETIONARY INCENTIVE PLANS MUST BE APPROVED BY THE COMMITTEE ON PERSONNEL AND COMPENSATION AND BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT. Dara Cook Mother of IU Ball Memorial Hospital Inc. COO, Kreigh Cook. 143316 Total Taxable and Non-Taxable compensation for employment in the normal course of business. false Form 990, Part III, Line 4d Description of other program services (Expenses $ 3,854,161 including grants of $ 0)(Revenue $ 4,239,738) RENT FROM RELATED 501(C)(3) ORGANIZATIONS Form 990, Part III, Line 4d Description of other program services (Expenses $ 329,567 including grants of $ 0)(Revenue $ 362,537) Clinical Research Form 990, Part III, Line 4d Description of other program services (Expenses $- 29,654 including grants of $ 0)(Revenue $- 32,621) Income (Loss) from Pass-Through Entities Form 990, Part VI, Line 13 PART VI, LINES 12, 13, 14, AND 16B - POLICIES IU HEALTH BALL MEMORIAL HOSPITAL IS PART OF THE IU HEALTH SYSTEM. AS THE SOLE MEMBER AND CONTROLLING PARENT OF IU HEALTH BALL MEMORIAL HOSPITAL, IU HEALTH AND ITS BOARD OF DIRECTORS HAVE MANDATED THAT CERTAIN POLICIES BE FOLLOWED TO ENSURE GREATER STANDARDIZATION THROUGHOUT THE SYSTEM. THUS, IU HEALTH BALL MEMORIAL HOSPITAL'S BOARD OF DIRECTORS WAS NOT REQUIRED TO SEPARATELY ADOPT A CONFLICT OF INTEREST, WHISTLEBLOWER, DOCUMENT RETENTION AND DESTRUCTION AND JOINT VENTURE POLICIES BECAUSE IU HEALTH'S BOARD OF DIRECTORS HAD ALREADY ADOPTED AND REQUIRED THESE POLICIES TO BE FOLLOWED BY ITS SUBSIDIARIES. Form 990, Part VI, Line 6 Classes of members or stockholders IU HEALTH BALL MEMORIAL HOSPITAL HAS ONE CLASS OF MEMBERSHIP AND THE SOLE MEMBER IS IU HEALTH. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body IU HEALTH ELECTS ONE MORE THAN ONE-HALF OF THE TOTAL NUMBER OF DIRECTORS. IMMEDIATELY FOLLOWING SUCH ELECTION THE REMAINDER ARE ELECTED BY THE DIRECTORS, EXCLUDING THOSE WHOSE TERMS ARE SET TO EXPIRE. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Notwithstanding any other provisions of the Articles of Incorporation, the following matters require the written approval of IU Health prior to implementation: - Authorization for the establishment or acquisition of any subsidiaries, affiliates or joint venture arrangements or acquisition of all or substantially all of the assets of any other business or entity; - Approval or amendment to any operating or capital budget; - Authorization of any unbudgeted operating or capital budget items or deviations, including any issuance or guarantee of any unbudgeted debt, greater than the budgeted amount by $1 million for any individual item or $3 million per fiscal year in the aggregate; - Authorization of any agreement to act as primary obligor, or to serve as a guarantor, surety or co-obligor with respect to the indebtedness of any other party, to borrow amounts from third-party lenders, or to loan money to any person or entity; - Approval of strategic plans and amendments, which will be integrated with IU Health's strategic plan; - Amendment or repeal of the Corporation's or an Affiliates articles of incorporation or bylaws (or other corresponding organizational documents of an Affiliate that is not a corporation); - Authorization of any merger, consolidation, reorganization, sale or transfer of all or substantially all of the Corporation's assets; - Authorization of any voluntary declaration of bankruptcy, plan of dissolution, any liquidating distribution of assets or other action related to its dissolution or liquidation; - Authorization of any pledge of, or grant any security interest or mortgage in, or otherwise encumber, any tangible assets of the Corporation in excess of $2,000,000, other than in the ordinary course of business or pursuant to a budget or strategic plan approved by IU Health; - Approval of any management agreement for the management of all or a substantial part of the Corporation's operations; or - Appointment or removal of any of the Corporation's Directors with or without cause. Form 990, Part VI, Line 11b Review of form 990 by governing body THE CFO REVIEWED AND APPROVED THE FORM 990. A COMPLETE COPY OF THE FORM 990 WAS MADE AVAILABLE TO EACH BOARD MEMBER PRIOR TO ITS FILING. EACH MEMBER WAS ALSO INFORMED OF THE AVAILABILITY OF IU HEALTH'S TAX DEPARTMENT TO ANSWER ANY QUESTIONS. Form 990, Part VI, Line 12c Conflict of interest policy IU Health Ball Memorial Hospital follows IU Health's Conflict of Interest Policy. IU Health's Conflict of Interest Policy includes the following provisions: All IU Health employees, associates, colleagues and contracted personnel, including employed physicians and paid medical directors ("IU Health Representatives") are covered by and subject to its Conflict of Interest Policy. IU Health regularly and consistently monitors and enforces compliance with the policy through the following procedures: (a) On an annual basis, each IU Health Representative at the level of Manager or above, together with every other person designated by the Corporate Compliance Department ("Department"), must complete, sign and submit a Conflict of Interest Questionnaire ("Questionnaire") to the Department. Governing board members, committee members, corporate officers, medical staff and researchers must comply with the administrative requirements noted in the respective policies and procedures relative to those areas. (b) An IU Health Representative must supplement a Questionnaire in writing, if after completion of the original Questionnaire, a situation arises, or may reasonably be expected to arise, that would change any answer or information on the original Questionnaire if the situation had existed or been anticipated at the time of completion of the original Questionnaire. (c) If a fully and properly completed Questionnaire reveals facts or other information that might reasonably indicate a Conflict of Interest or violation of the policy, the IU Health Representative completing the questionnaire must secure approval by his/her supervisor, evidenced in writing. (d) The Department will review each Questionnaire and determine whether a Conflict of Interest exists and, if so, whether and how it should or may be eliminated, avoided or managed in order to comply with the spirit of the policy and with the best interests of IU Health and its patients. In making the determination, the Corporate Compliance Department may consult with the IU Health Representative's supervisor and other appropriate individuals and groups. (e) The scope of the policy is not limited to those who are required to complete Questionnaires. If an IU Health Representative is involved in a situation or relationship that would constitute a violation of the policy in the absence of disclosure and approval as described above, then the IU Health Representative must disclose the matter to his/her supervisor, secure his/her supervisor's approval in writing, and disclose the matter to the Department. Otherwise, the IU Health Representative is in violation of the policy and subject to corrective action, up to and including termination. (f) The Chief Compliance Officer, in consultation with onsite Compliance personnel, may from time to time appoint standing or ad hoc committees to assist in resolving issues that arise under provisions of the policy. Form 990, Part VI, Line 15a Process to establish compensation of top management official IU Health Ball Memorial Hospital's Regional President is employed by IU Health. IU Health's process for determining compensation is as follows: The process includes the following: (1) The Board of Directors ("Board") has established a Talent Management and Executive Compensation Committee ("TMECC"), the purpose of which includes reviewing and making recommendations regarding executive (Senior Vice Presidents and above) pay and benefits (collectively referred to as "compensation") on an annual basis. The TMECC is made up of members of the Board that are neither physicians nor employees and do not otherwise have a conflict of interest regarding any of IU Health's compensation arrangements. The TMECC reviews an executive's entire compensation package including base salary, short-term and long-term incentives, health and welfare benefits, qualified and nonqualified retirement plans, as well as any additional fringe benefits. As deemed appropriate, the Committee on Finance, which is also made up of members of the Board, may also review executive compensation and benefits. (2) The TMECC engages an independent compensation consulting firm on an annual basis to conduct a compensation analysis for its executive group, which consists of employees at the level of senior vice president and above. The current compensation advisor is SullivanCotter. SullivanCotter performs its analysis in the form of a compensation survey ("survey") that includes relevant comparability data for compensation levels paid by similarly situated organizations (both governmental and tax exempt) for functionally comparable positions as well as the availability of similar services in the geographic area. SullivanCotter then prepares a survey report and provides recommendations to the TMECC, if deemed appropriate, on changes in executive compensation. A separate analysis using the same methodology is done for the President and Chief Executive Officer. (3) The TMECC then reviews SullivanCotter's report and recommendations and, if appropriate, votes on whether to recommend any changes in executive compensation to the Board. The TMECC will only recommend changes to the Board if they are consistent with the Board's philosophy on compensation matters and are deemed reasonable based upon the independent analysis provided by SullivanCotter. The TMECC's review, discussion and vote are documented in the minutes for the meeting. There are no executives present during the final discussion and approval. (4) The Board then reviews the report prepared by SullivanCotter as well as the recommendations of the TMECC as to any changes in executive compensation. As deemed appropriate, the Committee on Finance may also provide its review of the TMECC's recommendations on any changes in executive compensation. This review and discussion are documented in the minutes. (5) The Board then votes on whether to accept the TMECC's recommendations on any changes in executive compensation. Changes in executive compensation are made if approved by the TMECC and Board on an annual basis, or as necessary throughout the year. The discussion and approval are documented in the minutes of the meeting. There are no executives present during the final discussion and approval. IU Health's General Counsel also prepares a formal written opinion reviewing the executive compensation approval process, comparing it to the Intermediate Sanctions Test of IRC Section 4958. If warranted, IU Health's General Counsel may also provide comments regarding the executive compensation approval process as it relates to meeting the requirements for a rebuttable presumption of reasonableness as provided in the Intermediate Sanctions Test. (6) After the end of each year, the TMECC and Board also review the achievements of the executive group as it relates to the long-term and short-term shared and individual goals developed by the executives and the Board. These achievements may also be reviewed with the Committee on Finance. The Board, at its discretion, may approve bonus payments based upon the achievement of the goals. The discussion and vote of the TMECC and Board is documented in the minutes for each such meeting. The bonuses are not paid until approval is made by the Board. (7) The TMECC and Audit Committee also review Form 990 disclosures related to executive compensation as well as the organization's practices and approval processes prior to the filing of the Form 990 return with the Internal Revenue Service. Form 990, Part VI, Line 15b Process to establish compensation of other employees IU Health Ball Memorial 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. Form 990, Part VI, Line 19 Required documents available to the public IU HEALTH BALL MEMORIAL HOSPITAL'S ARTICLES OF INCORPORATION ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH THE INDIANA SECRETARY OF STATE'S WEBSITE. IU HEALTH BALL MEMORIAL HOSPITAL'S CONFLICT OF INTEREST PROCEDURES ARE DISCLOSED ON THE FORM 990, SCHEDULE O. IU HEALTH BALL MEMORIAL HOSPITAL IS A SUBSIDIARY IN IU HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS. IU HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH ITS BOND FILINGS AND AS AN ATTACHMENT TO IU HEALTH'S FORM 990 AS WELL AS IU HEALTH BALL MEMORIAL HOSPITAL FORM 990. Form 990, Part VIII, Line 2f Other Program Service Revenue Income (Loss) from Pass-Through Entities - Total Revenue: -32621, Related or Exempt Function Revenue: , Unrelated Business Revenue: -32621, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees Consulting - Total Expense: 108591, Program Service Expense: 101301, Management and General Expenses: 7290, Fundraising Expenses: ; Intercompany fees - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 7358480, Fundraising Expenses: ; Physician fees - Total Expense: 788701, Program Service Expense: 735756, Management and General Expenses: 52945, Fundraising Expenses: ; Contract service - Total Expense: 13868822, Program Service Expense: 12937811, Management and General Expenses: 931011, Fundraising Expenses: ; Other Expenses - Total Expense: 2181804, Program Service Expense: 2035340, Management and General Expenses: 146464, Fundraising Expenses: ; Professional Fees - Total Expense: 3932288, Program Service Expense: 3668314, Management and General Expenses: 263974, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances IC Paid In Capital - IUH - East Central Radiology - -270000; EAST CENTRAL RADIOLOGY LLC 950 N MERIDIAN ST STE 800 INDIANAPOLIS IN 46204 351907818 HEALTHCARE IN 407817 2267701 IUHBMH INDIANA HEALTH INFO EXCHANGE INC 846 N SENATE AVE INDIANAPOLIS IN 46202 364550324 HEALTHCARE IN 501(c)(3) Type I N/A false IU HEALTH BALL MEMORIAL PHYSICIANS INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS IN 46204 351925641 HEALTHCARE IN 501(c)(3) 10 IUHBMH true IU HEALTH NORTH HOSPITAL INC 950 N MERIDIAN STREET Suite 300 INDIANAPOLIS IN 46204 351932442 HEALTHCARE IN 501(c)(3) 3 IUH 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