2024-05-02T12:43:04+00:00 2021-12-31 990 2021-01-01 350867958 Indiana University Health Ball Memorial Hospital Inc INDI 3179634842 950 N MERIDIAN STREET 1200 INDIANAPOLIS IN 46204 Jonathan W Vanator CFO 3179634842 2024-05-02 Jonathan W Vanator 999009999 2021 2023-04-26 12:10:37Z X JEFFREY C BIRD MD 950 N MERIDIAN STREET 1200 INDIANAPOLIS IN 46204 551913013 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. 18 13 3218 217 4862005 28064 4188491 8340120 491834289 538234243 6344451 1307230 4147992 4031420 506515223 551913013 1327973 79117 0 0 156002770 187529419 0 0 0 289425230 292400463 446755973 480008999 59759250 71904014 625091620 680109102 103765141 85668876 521326479 594440226 X Lead the transformation of healthcare through quality, innovation & education, and make Indiana one of the nation's healthiest states. false false 438513576 79117 497001330 INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL IS A 379 BED ACUTE-CARE AND TEACHING HOSPITAL THAT OFFERS A COMPREHENSIVE RANGE OF SERVICES TO CARE FOR ITS PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. IU HEALTH BALL HOSPITAL IS A PREFERRED HEALTHCARE FACILITY FOR RESIDENTS OF EAST CENTRAL INDIANA. THE HOSPITAL WAS FOUNDED IN 1929 AS BOTH A TEACHING HOSPITAL AND REGIONAL REFERRAL CENTER FOR MUNCIE, INDIANA, AND SURROUNDING COUNTIES. IU HEALTH BALL MEMORIAL HOSPITAL OFFERS 43 MEDICAL SPECIALTIES, INCLUDING CANCER CARE, CARDIOLOGY, ORTHOPEDICS AND SPECIALIZED SERVICES FOR WOMEN AND CHILDREN. THE IU HEALTH BALL HOSPITAL MEDICAL EDUCATION DEPARTMENT IS HOME TO THREE RESIDENCIES (FAMILY MEDICINE, INTERNAL MEDICINE AND A TRANSITIONAL YEAR), AS WELL AS A RESEARCH DEPARTMENT. MORE THAN 40 RESIDENT PHYSICIANS ARE TRAINED EVERY YEAR AT IU HEALTH BALL MEMORIAL HOSPITAL FAMILY MEDICINE AND INTERNAL MEDICINE FACILITIES. THEY CONDUCT MORE THAN 25,000 PATIENT VISITS ANNUALLY. 8407588 0 9528969 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. 5343252 0 6055921 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. 3191049 0 3616662 RENT FROM RELATED 501(C)(3) ORGANIZATIONS 0 0 17169356 As of December 31, 2021, Indiana University Health Ball Memorial Hospital, Inc. had received stimulus funds from the Provider Relief Fund under the provisions of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) and Paycheck Protection Program and Health Care Enhancement Act. Indiana University Health Ball Memorial Hospital recognized $17,169,356 as other program service revenue. Indiana University Health Ball Memorial Hospital, Inc. will continue to monitor compliance with the terms and conditions of the Provider Relief Fund. 3191049 20786018 455455465 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 true false true false false false false false false false false false false false false true true true true false false true 0 0 3218 true true true false false false false false false false false false false false X 18 13 true false false false true true true true true false false true true true true true true false true true true IN X CRAIG J JONES 3179634842 950 N MERIDIAN STREET SUITE 800 INDIANAPOLIS IN 46204 J STEVEN RHEA DIRECTOR/SECRETARY/TREAS 2.0 1.0 X X 0 0 0 JEFFREY C BIRD MD DIRECTOR/REGIONAL PRESIDENT (ECR) 35.0 20.0 X X 0 1348455 50692 JOHN D LITTLER DIRECTOR/CHAIR 2.0 2.0 X X 0 0 0 PETER M VOSS MD DIRECTOR/VICE CHAIR/CMO (ECR) 25.0 30.0 X X 504425 0 48556 WILBUR R DAVIS DIRECTOR/VICE CHAIR 2.0 1.0 X X 0 0 0 CHANTILLE ALLEN DIRECTOR (PART YEAR) 2.0 2.0 X 0 0 0 CHARLES R ROUTH MD DIRECTOR 2.0 53.0 X 0 287062 50547 DAMON ELMORE JD DIRECTOR 2.0 0 X 0 0 0 DANIEL E BORGENHEIMER DIRECTOR 2.0 2.0 X 0 0 0 DAVID A LITTLER DIRECTOR 2.0 2.0 X 0 0 0 DAVID W HYATT DIRECTOR 2.0 53.0 X 293884 0 50346 DERRON L BISHOP PHD DIRECTOR 2.0 2.0 X 0 0 0 GEOFFREY S MEARNS JD DIRECTOR 2.0 1.0 X 0 0 0 JOAN V CASTOR DIRECTOR 2.0 53.0 X 0 584050 118253 MICHAEL J FISHER DIRECTOR 2.0 4.0 X 0 0 0 PATRICK A CLEARY MD DIRECTOR 2.0 2.0 X 0 0 0 SAMUEL C KIM MD DIRECTOR 20.0 2.0 X 0 53840 0 TERRY W BAILEY DIRECTOR 2.0 2.0 X 0 0 0 WILLIAM W HINKLE DIRECTOR 2.0 2.0 X 0 0 0 JONATHAN W VANATOR CFO (ECR) 15.0 40.0 X 0 394728 44214 ANN M MCGUIRE VP-HUMAN RESOURCES REGIONAL (ECR)-PART YEAR 2.0 2.0 X 0 252844 11848 CARLA C COX RN VP & CNO (ECR) 35.0 20.0 X 319533 0 44150 LORI A LUTHER COO (ECR) 34.0 21.0 X 427171 0 49584 MEGAN HAYMAKER VP-HUMAN RESOURCES (ECR) (Part Year) 35.0 20.0 X 0 249496 20638 ALVIS FOSTER SENIOR RADIATION PHYSICIST 50.0 0 X 227318 0 56024 JOSEPH BUTTS RADIATION PHYSICIST 50.0 0 X 219809 0 16233 MAX E BARNHART ADMIN DIR-RETAIL PHARMACY OPS 50.0 0 X 206782 0 54287 RYAN M JOHNSTON MD ASSOCIATE - CMO 54.0 1.0 X 328333 0 51401 TERRY A PENCE VP, OPERATIONS 54.0 1.0 X 271749 0 40295 JUDITH L COLEMAN FORMER OFFICER 0.0 55.0 X 0 361715 48281 2799003 3532191 755347 276 true true false 0 8235633 104487 8340120 NET PATIENT SERVICE REVENUE 622110 497001330 497001330 FEDERAL RECOVERY REVENUE 900099 17169356 17169356 PHARMACY 446110 14229507 9528969 4700538 SHARED SERVICES 541900 6057013 6055921 1092 RENT FROM RELATED 501(C)(3) ORGS. 532000 3616662 3616662 160375 0 160375 0 538234243 212902 212902 1230307 1230307 0 1230307 1230307 1094328 0 1094328 1094328 1094328 CAFETERIA/FOOD SERVICE 721110 1038787 1038787 GIFT SHOP 453220 158218 158218 1604108 0 0 1604108 2801113 551913013 533372238 4862005 5338650 X 79117 79117 1568108 1359953 208155 149584606 144882910 4701696 5129589 4448672 680917 20987189 18201288 2785901 10259927 8897994 1361933 13183 13183 27650 27650 115150125 105861215 9288910 0 1145310 1145310 1535234 1411228 124006 647554 323777 323777 10472688 10472688 66292 60937 5355 120 120 21994078 21039566 954512 2764293 2764293 DRUGS AND MEDICAL SUPPLIES 102744927 102744927 BAD DEBT 9116201 9116201 HOSPITAL ASSESSMENT FEE 24699885 24699885 Noncapitalized Equipment 360286 360286 1662637 1494701 167936 0 480008999 455455465 24553534 0 325817627 354996941 71589 0 51136955 64147566 0 0 0 0 136556 110500 13073960 13932682 1783827 1806170 542638999 331765901 211310915 210873098 18503107 21378281 0 3104565 3112923 40008 40008 112511 9710933 625091620 680109102 78747849 30346166 9793 30830 0 0 25007499 55291880 103765141 85668876 X 521326479 594440226 521326479 594440226 625091620 680109102 71904014 1209733 0 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 13183 13183 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") and Indiana Hospital Association ("IHA") during 2021 in the amount of $43,633 and $36,727 respectively. Each membership organization notified IU Health Ball Memorial Hospital that a portion of the dues it paid was used for lobbying purposes. The AHA used 23.32%, or $10,175 of 2021 membership dues paid by IU Health Ball Memorial Hospital, for lobbying expenditures. The IHA used 8.19%, or $3,008 of the 2021 membership dues paid by IU Health Ball Memorial Hospital, for lobbying expenditures. 6616096 6616096 283234412 203495530 79738882 429120 364786 64334 129886092 102728005 27158087 122473279 25177580 97295699 210873098 DUE TO THIRD-PARTY PAYERS 44173403 SELF-INSURANCE LIABILITIES 541636 INTERCOMPANY PAYABLES (NET) 8914102 ENVIRONMENTAL OBLIGATIONS 1002320 ALL OTHER LIABILITIES 660419 55291880 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 that, as of December 31, 2021 and 2020, 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, 2021 and 2020, the Indiana University Health System had gross deferred tax assets of $146,281,000 and $135,889,000 respectively, primarily relating to net operating loss carryovers. Management determined that a full valuation allowance at December 31, 2021 and 2020, 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 increase in the valuation allowance for the current year is $10,392,000. At December 31, 2021, Indiana University Health System has available net operating loss carryforwards of $588,158,000. Net operating losses generated from 2001 through 2017 will expire between 2022 and 2037. Net operating losses generated after 2017 do not expire. true true X true X 300 false true true true false true true 8047 7593719 0 7593719 0.0161 21510 103134558 102026858 1107700 0.0024 0 0.0 0 29557 110728277 102026858 8701419 0.0185 23 79536 4078743 1432703 2646040 0.0056 3 2526 14757489 4164924 10592565 0.0225 1 1424 13088379 6836676 6251703 0.0133 1 128 1660279 676007 984272 0.0021 4 21126 1531715 783280 748435 0.0016 32 104740 35116605 13893590 21223015 0.0451 32 134297 145844882 115920448 29924434 0.0635 0 0 0 0 0 0.0 2 311 49423 0 49423 0.0001 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 1357 101486 0 101486 0.0002 2 1155 13271 0 13271 0.0000 1 25 88760 0 88760 0.0002 0 0 0 0 0 0.0 6 2848 252940 0 252940 0.0005 false 1646386 120037619 121882938 -1845319 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 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 2021 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. Schedule H, Part V, Section B, Line 5 Facility , 2 Facility , 2 - IU HEALTH BALL MEMORIAL HOSPITAL (CONT.). 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. 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 Schedule H, Part V, Section B, Line 5 Facility , 3 Facility , 3 - IU HEALTH BALL MEMORIAL HOSPITAL (CONT.). 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. In conjunction with the CHNA, IU Health Ball's Board adopted an implementation strategy in April 2022 related to the 2021 CHNA. IU Health Ball prioritized and determined which of the community health needs identified in its most recently conducted CHNA were most critical for it to address. IU Health Ball will address the following community health 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 - Social Determinants of Health* *IU Health uses the term Behavioral Health to refer to mental health and drug and substance abuse (including opioids and alcohol) *Chronic Disease and Chronic Disease Management includes needs such as obesity, diabetes, and physical inactivity *Social Determinants of Health includes needs such as food insecurity and healthy eating IU Health Ball will address all community health needs based on their 2021 Community Health Needs Assessment. There were no identified needs that will not be addressed. In addition, during 2021 IU Health Ball continued to address the needs identified in the 2018 CHNA, through the implementation strategy adopted in April 2019 related to the 2018 CHNA. IU Health Ball addressed the following community health needs in calendar year 2019 through 2021: - Access to Healthcare Services - Drug and Substance Abuse (including Opioids and Alcohol) - Food Insecurity and Healthy Eating - Mental Health - Obesity, Diabetes, and Physical Inactivity - Smoking and Tobacco Usage - Social Determinants of Health IU Health uses the term "Behavioral Health" to refer to Mental Health and Drug and Substance Abuse (including Opioids and Alcohol). Access to Healthcare Services IU Health Ball's implementation strategy to address the identified need of Access to Healthcare Services includes the following: Five-Year Physician Plan - Recruit new primary care, obstetric and mental health medical doctors to practice in East Central Region. In 2021, a new two-physician primary care clinic was established in Upland and included a FNP-BC to provide additional primary care support. A partnership with Taylor University began providing a student health center at this practice starting in the fall. A new clinic was opened in Muncie in the second half of 2021 with a newly recruited Family Medicine/OB physician. Another newly recruited Family Medicine Physician started in Portland in September. Three new APPs for Family Medicine have been recruited to join clinic opening in Albany late 2021. The capability for any primary care clinic to do acute behavioral health consults virtually was added in 2021. Obstetric Clinic - Provide two family medicine directors and a resident rotation at a subsidized rate to local federally qualified health center. IU Health Ball provided two family Medicine Directors plus a resident rotation at a subsidized rate to Open Door health Services. This has allowed Open Door to expand its obstetric capability to service low-income residents of East Central Indiana. The two physicians provided more than 9,000 patient encounters in 2021. Other OB Services are offered at IU Health Ball through its Family Medicine Program, Perinatal Center and physician practice facilities. Several other private practices offer OB Services to the community as well. Health and Wellness Collaboration with Ball State University *See Initiative Update under Obesity, Diabetes and Physical Inactivity Behavioral Health (includes Drug & Substance Abuse and Mental Health) IU Health Ball's implementation strategy to address the identified need of Behavioral Health includes the following: IU Health Ball Addiction Treatment and Recovery Center-Adult Intensive Outpatient Program (IOP) - Provide structured therapeutic recovery program. The IU Health Ball Addiction Treatment and Recovery Center opened in 2019 and now offers an Intensive Outpatient Program (IOP) - which includes Group therapy Recreation therapy and individual and family counseling services and peer recovery coaching. Medication Assisted Treatment (MAT) is also offered as well as an Individual outpatient Program and IOP Aftercare Program. During 2021, the Center assessed nearly 150 patients, and enrolled more than 150 in the IOP or individual track. Patients who have completed the IOP demonstrate a 35% increase in sobriety and pregnant women have demonstrated a 100% sobriety rate. Peer Recovery Program - Employ peer recovery coaches in the IU Health Ball Emergency Department (ED). 2019 was the first year that Peer Recovery services were offered in the IU Health Ball Emergency Department. Patients who enter the emergency department for an opioid-related health issue are deemed initially eligible for the Planned Outreach, Intervention, Naloxone, and Treatment (POINT) program; this includes patients admitted for opioid withdrawal symptoms, opioid intoxication, opioid overdose, endocarditis related to injection opioid use, and abscess related to injection opioid use. Peer recovery coaches (PRCs) are notified of these patients via the EMR track board and nurse/physician alerts (pager, telephone call). These patients are then approached by a peer recovery coach and asked to complete an opioid use disorder (OUD) screening tool. If symptoms indicate an OUD, they are offered peer recovery coaching services. Additionally, outside of their POINT program responsibilities, peer recovery coaches offer services to patients presenting with other substance used disorder issues (non-opioid). In 2021, nearly 600 Peer Recovery Sessions occurred, and 84.09% accepted care. Successful patient follow up was tracked at 86.22%. The program is budgeted for 2 full time and one part time peer recovery coaches and is typically staffed from 8a-4pm or 4pm-12am Monday-Sunday. Peer recovery coaches will immediately provide services if available. Indiana University is the organization providing the funding for the program at Ball through a federal research grant. Specific to the grant, Clean Slate is the primary provider for MAT. The IU Health Psychiatry hub collaborates with IUH Jay and IUH Blackford to provide peer recovery coach services. In addition, patients with SUD are being referred to the continuum of care of services including the IU Health Ball ATRC, MAT, inpatient facilities and other levels of care as indicated. Screening, Brief Intervention, and Referral to Treatment (SBIRT) for clinic patients. Screening, brief intervention and referral to treatment (SBIRT) was offered to patients at the IU Health Ball Family Medicine Residency Center in 2019 and 2020. In 2020, SBIRT screening for all patients was discontinued mid-year due to organizational changes in tracking requirements for depression screening, which was previously embedded in the SBIRT tracking. A depression-only screener is currently provided to all patients visiting the clinic. Drug Take Back Program - Provide prescription medication disposal kiosks at IU Health East Central Region facilities. Drug take-back kiosks were installed at four East Central Indiana locations: Pavilion Pharmacy at IU Health Ball in Muncie; IU Health Yorktown Pharmacy, Yorktown; IU Health Blackford Pharmacy, Hartford City; and IU Health Jay Hospital, Portland. The kiosks are open to the public and available during business hours. IU Health has installed drug take-back kiosks at four east central Indiana pharmacy locations: the kiosks are open to the public and available during business hours. In 2021, over 1,400 pounds of prescription medications were recovered. IU Health East Central Region Perinatal Coordinator - Enhance efforts to decrease infant mortality in the IU Health East Central Region. In 2021 the IU Health East Central Region (ECR) Perinatal Coordinator implemented a Tobacco Treatment Pilot Program in five ECR physician office settings designed to provide client consultations and referrals to 1-800 Quit Now, Baby and Me Tobacco Free program, and pharmacotherapy options. In 2021 the Indiana Department of Health awarded two years of funding for the implementation of a HIPAA compliant text messaging and remote monitoring virtual platform to all obstetrical practices in the ECR providing prenatal care and offering delivery services at IU Health Ball. Health and Wellness Collaboration with Ball State University *See Initiative Update under Obesity, Diabetes and Physical Inactivity Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - IU HEALTH BALL MEMORIAL HOSPITAL (CONT.). Food Insecurity and Healthy Eating IU Health Ball's implementation strategy to address the identified need of Food Insecurity and Healthy Eating includes the following: Healthy Community Alliance of East Central Indiana (HCA) *See Initiative Update under Obesity, Diabetes and Physical Inactivity East Central Indiana Food Council The East Central Indiana Food Council is a volunteer-run organization led by local activists interested in addressing community issues around new food policy, food waste reduction, healthy eating and food access. It receives support from the IU Health-driven Healthy Community Alliance initiative. The group has strategically grown from a Delaware County focus to include participants from Blackford and Jay Counties. The Council is composed of multiple community collaborators representing Ball State University, The Muncie Food Hub, IU Health, Purdue Extension, Second Harvest Food Bank, Grace Baptist Church, the Soup Kitchen of Muncie, Blood-n-Fire Ministries, Community and Family Services Food Pantries in Hartford City, Montpelier and Portland and the Children's Bureau; as well as local farmers and farmers market organizers. The Healthy Community Alliance Nutrition Workgroup was combined into the Food Council in June 2021 and this has brought additional partners into the collaborative discussions as well as integrating a more defined focus on healthy eating. The group organized educational activities and a field trip in July 2021 to tour an aquaculture facility which has long term potential to bring fresh produce to underserved areas. Families at the Farmers Market The Families at the Farmers Market in Muncie and Hartford City are offered in IU Health's ECR each year. In 2021, the program's in-person sessions were eliminated due to COVID-19 precautions. 68 families in Muncie and 29 families in Hartford City received a healthy lifestyle packet with coupons redeemable at local farmers markets and farm stands. Tobacco cessation information was also included. Head Start joined the collaboration and facilitated connections with families in Blackford County. 67% of survey participants stated they utilize fresh fruits/vegetables at "most meals" after completing the program; 100% of respondents stated they "Learned a Lot and reported they used the Farmers Market "2 or more times." Coupon redemption rates were slightly more than 50%. Several new farmers market locations were added to extend the footprint of the program. In 2021, area markets processed more than $2,800 worth of produce from area families primarily from underserved areas of the community. Collaborators - Minnetrista, Whitely Comm. Council, Ross Center, Minority Health Coalition, Ivy Tech, Boys/Girls Club, Buley Center, Open Door Health Services, Salvation Army, YWCA of ECI, YMCA/Appletree, Youth Opportunity Center, Hillcroft, Spangler Farms, Northern Tropics Greenhouse and IU Health Ball. Blackford County: Children and Family Services of Blackford County /WIC, Grace United Methodist Church, Growers and Makers Market, Common Grounds Coffee Shop, Blackford County Public Library, Purdue Extension, and IU Health Blackford Hospital. Muncie Neighborhood 8twelve Coalition *See Initiative Update under Social Determinants of Health Health and Wellness Collaboration with Ball State University *See Initiative Update under Obesity, Diabetes and Physical Inactivity Obesity, Diabetes, and Physical Inactivity IU Health Ball's implementation strategy to address the identified need of Obesity, Diabetes, and Physical Inactivity include the following: Healthy Community Alliance of East Central Indiana (HCA) The Healthy Community Alliance of East Central Indiana (HCA) engaged 149 collaborating organizations in three ECR counties- Delaware, Blackford and Jay during 2021. HCA makes multiple resources available to collaborators, including facilitated workgroup sessions in each county, materials such as Tobacco Cessation Toolkits and Healthy Lifestyle toolkits; and online resources such a e-newsletter, media messaging and access to community health data for each of the three counties. These resources are provided to all collaborating organizations free of charge. Most HCA Partner organizations are currently utilizing at least one of these provided resources to influence change amongst their audiences. To adapt to COVID-19 restrictions, in 2021 the HCA retooled its virtual workgroup process to focus on specific partner initiatives for obesity prevention and tobacco cessation and ways other partners can become engaged. One new partner was added in 2021. Health and Wellness Collaboration with Ball State University A collaboration with Ball State University has been established to develop and implement in-school physical activity and nutritional education curriculums at the elementary-school level in the Muncie Community Schools. In 2021 an in-school physical activity and nutritional education curriculum was instituted at Southview Elementary in Muncie, delivered in-person and including nutrition education, physical activities, instructional breaks and a Walking Challenge. A pilot program with similar curriculum was instituted at a second school, Grissom Elementary. East Central Indiana Food Council *See Initiative Update under Food Insecurity and Healthy Eating Families at the Farmers Market *See Initiative Update under Food Insecurity and Healthy Eating Muncie Neighborhood 812 Coalition *See Initiative Update under Social Determinants of Health Smoking and Tobacco Usage IU Health Ball's implementation strategy to address the identified need of Smoking and Tobacco Usage include the following: 1-800-QUIT-NOW: Indiana Tobacco Quitline - Educate staff regarding "Ask, Advise, Refer" process to refer patients and family members to the Indiana Tobacco Quitline. In 2021, after declining during the COVID-19 pandemic, the Indiana Tobacco Quit Line received a total of 114 referrals from the East Central Region; 76 from Delaware County, 20 from Blackford County and 18 from Jay County. Healthy Community Alliance of East Central Indiana (HCA) Tobacco Toolkits *See Initiative Update under Food Insecurity and Healthy Eating IU Health East Central Region Perinatal Coordinator - Tobacco Treatment Pilot Program *See Initiative Update under Behavioral Health Families at the Farmers Market *See Initiative Update under Food Insecurity and Healthy Eating Health and Wellness Collaboration with Ball State University *See Initiative Update under Obesity, Diabetes and Physical Inactivity Social Determinants of Health IU Health Ball's implementation strategy to address the identified need of Social Determinants of Health include the following: A comprehensive 3-year plan of engagement with the 8twelve Coalition was developed in 2019 in the form of a grant application for the IU Health Community Impact Fund. $1M was awarded over three years to make improvements in the Thomas-Avondale Neighborhood in Muncie related to food access, physical activity and blighted housing improvements in the area. Placemaking development support has brought new business planning and community gathering spaces into a formerly blighted area. In 2021 research was completed for potential implementation of community outreach/community health worker models. Community members now have access to expanded sports programing at the Ross Community Center, expanded healthy food pantry offerings serving approximately 1,500 people per month, and a new neighbor-owned and operated coffee shop in a food desert area. Three new soccer fields were completed in 2021 and 1,000 feet of ADA compliant new sidewalks have been installed to support active transportation for local residents. After convening with community residents, housing improvements were completed for eight neighborhood homes, including exterior and interior construction. Families from the Thomas Park Avondale Neighborhood participated once again in the IU Health Families at the Farmers Market program in 2021. Healthy lifestyle programming was offered at the Ross Community Center on multiple occasions in conjunction with the Healthy Community Alliance, Ball State University Healthy Lifestyle Center and other community partners. Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - IU HEALTH BALL MEMORIAL HOSPITAL (CONT.). Laundry Coupons IU Health Ball collaborates with members of the Healthy Community Alliance of East Central Indiana to distribute $20 laundry coupons to limited resource audiences in Delaware County. The coupons are distributed by the "Community Basket," a ministry of The Jar Community Church. Best described as a 'non-food' food bank, The Community Basket's goal is to provide members of our community who are in need with five hygiene, cleaning and paper items per visit. These are items that are not provided through Supplemental Nutrition Assistance Program (SNAP) benefits. In 2021, 500 IU Health-funded laundry coupons were distributed and 350 were redeemed. Internal collaborators are IU Health Ball Community Outreach and IU Health Ball Medical Staff. External collaborators are The Jar Community Church and the White Spot Laundry. East Central Indiana Food Council *See Initiative Update under Food Insecurity and Healthy Eating IU Health Ball addressed all community health needs based on their 2018 Community Health Needs Assessment. There were no identified needs that were not be addressed. 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. 23 IU Health Ball Memorial Cancer Center 2200 FOREST RIDGE RD STE 120 NEW CASTLE IN 47362 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH BALL MEMORIAL BARIATRIC & Medical Weight Loss 2901 W JACKSON ST MUNCIE IN 47303 SPECIALTY CARE 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 BLACKFORD PHARMACY 400 PILGRIM BLVD HARTFORD CITY IN 47348 PHARMACY IUH BALL MEMORIAL CANCER CNTR AT JAY CO 500 W Votaw Street PORTLAND IN 47371 SPECIALTY CARE IU HEALTH BALL MEMORIAL INTERVENTIONAL Pain Services 5501 W BETHEL AVE MUNCIE IN 47304 SPECIALTY CARE BALL STATE HEALTH CENTER PHARMACY 1500 NEELY AVE MUNCIE IN 47306 PHARMACY EAST CENTRAL RADIOLOGY 2598 W WHITE RIVER BLVD MUNCIE IN 47303 RADIOLOGY IU HEALTH BALL MEMORIAL OUTPATIENT CENTER 1420 S PILGRM BLVD YORKTOWN IN 47396 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH BALL MEMORIAL OUTPATIENT CENTER 1710 SPICELAND RD NEW CASTLE IN 47362 DIAGNOSTIC AND OTHER OUTPATIENT IU HEALTH FAMILY PHARMACY 5501 W BETHEL AVE MUNCIE IN 47304 PHARMACY BALL STATE STUDENT HEALTH CENTER 1500 NEELY AVE ROOM 106A MUNCIE IN 47306 PRIMARY CARE IU HEALTH BALL MEMORIAL RADIOLOGY 2401 W UNIVERSITY AVE MUNCIE IN 47303 RADIOLOGY IU HEALTH BALL MEMORIAL OUTPATIENT Rehabilitation 3300 W COMMUNITY DR MUNCIE IN 47304 REHABILITATION SERVICES IU HEALTH BALL MEMORIAL HOSPITAL Rehabilitation 3600 W Bethel Ave MUNCIE IN 47304 REHABILITATION SERVICES IU HEALTH BALL MEMORIAL CANCER CENTER 2401 W UNIVERSITY AVE MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL Maternal and 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 WOUND HEALING Services 2901 W JACKSON ST MUNCIE IN 47303 SPECIALTY CARE IU HEALTH BALL MEMORIAL VOSS CENTER For Women 5501 W BETHEL AVE SUITE C MUNCIE IN 47304 SPECIALTY CARE IU HEALTH BALL MEMORIAL OUTPATIENT Surgery 2401 W UNIVERSITY AVE MUNCIE IN 47303 SURGERY CENTER 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 $9,116,201. Bad debt expense is reported at cost based on the cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. Schedule H, Part I, Line 7 TOTAL COMMUNITY BENEFIT EXPENSE Schedule H, Part I, Line 7, Column (f), Percent of Total Expense, is based on column (e) Net Community Benefit Expense. The percent of total expense based on column (c) Total Community Benefit Expense, which does not include direct offsetting revenue, is 30.97%. 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 provided $45,321 in donations to area endeavors including the Economic Development Alliance Vision 2021 campaign ($30,000), Delaware/Muncie Metropolitan Planning Commission ($15,000); Economic endeavors also include executive participation in the Village Development Request(s) for Proposal (RFP) Project), the Board of Directors and Finance Committee of the Youth Opportunity Center, East Central Indiana Regional Partnership (ECIRP), and the Delaware (County) Advancement Corporation. 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. Representatives of IU Health Ball also served in numerous executive committees and boards of directors, including Open Door Health Center, Muncie Afghan Refugee Resettlement Committee, Starfish Initiative, READi Initiative, Sherman and Marjorie Zeigler Foundation, Ball Brothers Foundation, Muncie Central City Vision Planning Committee, Mobilizing Muncie, East Central Indiana Regional Partnership, TogetherDM, Delaware-Muncie Comprehensive Plan Steering Committee, and the Ball State University College of Health Search Committee. Community Health Improvement Advocacy: IU Health Ball funds a program that distributes coupons to limited-resource families good for self-service laundry. Coupons are distributed through a local 'community basket' (non-food pantry food pantry) run by the Jar Community Church. Coupons are redeemed at the White Spot Coin Laundry in Muncie, and IUH BMH reimburses the White Spot $20 for each coupon redeemed. In 2021, 350 coupons were redeemed at the White Spot Laundry for a total of $7,000. Additionally, IU Health Ball team members served the ECR community and advocated for healthier lifestyle improvement in service to the Cardinal Greenway Board of Directors, as well as ongoing participation in the Tobacco Free-Delaware County Coalition, by four team members represented in monthly advocacy meetings to promote tobacco cessation and policy changes throughout the community. Workforce Development: IU Health Ball has partnered with the ARC of Indiana to train students with intellectual and developmental disabilities 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 2021, the ARC program served 25 people and provided over $95,000 in net community benefit. The BMH Foundation has provided financial support for this program as well. Schedule H, Part I, Line 6a Community benefit report prepared by related organization INDIANA UNIVERSITY HEALTH, INC. Schedule H, Part I, Line 7g Subsidized Health Services IU HEALTH BALL 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 7 Bad Debt Expense excluded from financial assistance calculation 9116201 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 financial resources and are deemed to be medically indigent. 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 for this type of financial assistance are based on household makeup. Households without dependents are eligible for assistance if household income is less than or equal to 200% FPL, two adults and at least one dependent are eligible if household income is less than or equal to 250% FPL, and households with one adult and at least one dependent are eligible if household income is less than or equal to 300% FPL. 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 20% of annual household income. 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 $133,584,000 and $90,358,000 in 2021 and 2020, respectively. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs IU Health Ball Memorial Hospital has a Medicare shortfall for 2021. 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 2021. 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 Each IU Health hospital is dedicated to the community it serves. Each hospital conducts a CHNA to understand current community health needs and to inform strategies designed to improve community health, including initiatives designed to address social determinants of health. The CHNAs are conducted using widely accepted methodologies to identify the significant needs of a specific community. The assessments also are conducted to comply with federal laws and regulatory requirements that apply to tax-exempt hospitals. IU Health Ball Memorial Hospital assesses the health care needs of the communities it serves by conducting a Community Health Needs Assessment (CHNA) for its hospital location. For the 2021 CHNA, IU Health Ball Memorial Hospital obtained community input through focus groups of community stakeholders, additional surveys issued to stakeholders who were unable to attend community meetings, a survey issued to internal providers from IU Health Ball Memorial Hospital and key informant interviews with those possessing public health expertise. After completion of the CHNA, IU Health Ball Memorial Hospital reviewed secondary data, findings from other community health assessments of areas served by the hospital, input obtained from individuals who participated in community meetings, and input obtained from key stakeholders. The top health needs of the IU Health communities are those that are supported by multiple data sources. Additionally, the effectiveness of an intervention for each need and IU Health's ability to impact positive change was evaluated. IU Health believes its CHNA process is comprehensive and additional assessments are not required. 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 (2021) statistics, Delaware County's population is 111,871 persons with approximately 51.7% being female and 48.3% male. The county's population estimates by race are 86.2% White, 2.8% Hispanic or Latino, 7.3% Black, 1.4% Asian, 0.3% American Indian or Alaska Native, and 2.6% 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 (90.2%). As of 2021, 24.9% of the population had a bachelor's degree or higher. Schedule H, Part VI, Line 5 Promotion of community health Most of the IU Health Ball's governing body is comprised of persons who reside in the organization's primary service area who are neither employees nor independent contractors of the organization, nor family members thereof. IU Health Ball extends medical staff privileges to all qualified physicians in its community for some or all its 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 2021, 415 individuals received this service. - Periodic screenings for cervical 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 2021, 267 individuals participated in one of these screenings or services. - Health programming is offered to local schools through the hospital's Family Medicine Residency program, other hospital health professionals, and a partnership with the YMCA of Muncie to offer the "CATCH" (Coordinated Approach to Child Health) curriculum after-school program. Topics include tobacco, puberty, nutrition, physical activity and breast self-exam. 607 students benefitted in 2021. - Free nutritional and weight-management counseling on an outpatient basis for community members with a physician referral. 1,153 persons took part in learning about personal health improvements in 2021. - In 2021, the hospital provided funding to Second Harvest Food Bank of East Central Indiana to support programs including The Big Idea, Forward S.T.E.P.S. (Support Transforming Empowerment Pathways to Sustainability), Senior Safety Net, 0-5 Initiative, area soup kitchens and general food distribution in Delaware, Blackford and Jay counties. The grant also allows Second Harvest team members to visit local schools to distribute food, encourage family engagement, promote food-connected relationship building and educate students about careers, wellness and more. $120,000 was donated in 2021 as part of an overall $360,000 pledge over 3 years. - 72,000 hours of clinical educational experiences provided on site for students in the healthcare field studying nursing, pharmacy, radiology and other topics. IU Health Ball Memorial hospital partners with Ball State University, Ivy Tech Community College, Indiana Wesleyan University, Anderson University and other area institutions. 2,300 students served in 2021 - The IU Health Ball Research Center conducts local clinical trials experience in urology, infectious diseases, pain management and especially oncology, cardiology and coagulation. In 2021, 48 studies were conducted with 128 individuals participating. - IU Health Ball operated a COVID-19 vaccination clinic in its South Tower Atrium providing convenient access for members for the East Central Indiana community. Vaccination clinics were open a total of 1,139 hours and staffed by qualified team members. Nearly 48,000 vaccinations were given across 2021 to meet community demand. The vaccination clinic's reach also included rural school districts specifically invited to receive free COVID and influenza vaccinations. - A donation to Ivy Tech Foundation for the construction of a health professions training facility in the Ivy Tech School of Health Sciences Wing at the Muncie Campus. $250,000 was donated in 2021 as part of an overall $1M pledge over four years. - 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 Second Harvest Food Bank, A Better Way, YWCA of Muncie, Motivate Our Minds, Muncie Mission, and more. - Additionally, team members at IU Health Ball Hospital 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 care throughout Indiana and beyond. IU Health's affiliate hospitals are divided into five 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 Blackford 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 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 goal of making Indiana one of the healthiest states in the nation. The affiliate hospitals are guided by a system wide mission to improve the health of our patients and community through innovation, and excellence in care, education, research, and service. The healthcare system is keenly aware of the positive impact it can have on improving the health of communities throughout the state of Indiana by aligning resources in a system-level and strategic way. 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 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 team partners with state and local community-based organizations, community coalitions and governmental agencies to focus on clinical care, community investment and advocacy strategy that seeks to improve the health of communities. All affiliate hospitals in the healthcare system identifies and addresses significant health needs unique to the community they serve. Some of these health needs are common in communities served by multiple affiliate hospitals in the healthcare system and align with system priority areas, warranting a system level strategy. The Community Health Division plans and provides technical assistance for system-level strategies that address these common health needs including health inequities, tobacco, behavioral health access, infant and maternal health and social needs. Each affiliate hospital works collaboratively with the Community Health Division team to operationalize system-level strategies through the implementation of specific activities that align and activate local resources too. 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, IU Health Serves, 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. IU Health Ball 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 IU Health Ball team members in activities that address local, identified community health priorities. The Community Impact and Investment (CII) Fund is a $100 million board designated fund that is managed by the IU Health Foundation to financially support high impact community investing designed to address social determinants of health in communities IU Health serves. Each affiliate hospital has a significant impact on and is deeply invested in their local communities. 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 their surrounding communities. Each IU Health affiliate hospital and its team members are eligible to pursue this grant opportunity with a community organization or agency. Schedule H, Part VI, Line 7 State filing of community benefit report IN true Greater Muncie IN Habitat for Humanity 1923 S Hoyt Ave Muncie IN 47302 351706782 501(c)(3) 50000 General Support ROSS COMMUNITY CENTER 1110 W 10th St PO Box 3201 Muncie IN 47307 452050287 501(c)(3) 28000 General Support 2 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Although IU Ball Memorial Hospital does not monitor the use of the grant funds once distributed, through due diligence the organization has reasonably confirmed that the entities to which the contributions are made are highly reputable in the community and use the funds for the purpose intended. true true false false false false false true false JEFFREY C BIRD MD DIRECTOR/REGIONAL PRESIDENT (ECR) 0 539835 0 383684 0 424936 0 18725 0 31967 0 1399147 0 248972 PETER M VOSS MD DIRECTOR/VICE CHAIR/CMO (ECR) 371142 0 107040 0 26242 0 18725 0 29831 0 552980 0 0 0 DAVID W HYATT DIRECTOR 233473 0 58329 0 2081 0 17278 0 33068 0 344229 0 0 0 CHARLES R ROUTH MD DIRECTOR 0 211621 0 55441 0 20000 0 18505 0 32042 0 337609 0 0 JOAN V CASTOR DIRECTOR 0 337251 0 243198 0 3601 0 78127 0 40126 0 702303 0 0 JUDITH L COLEMAN FORMER OFFICER 0 259703 0 72456 0 29556 0 18725 0 29556 0 409996 0 0 JONATHAN W VANATOR CFO (ECR) 0 316645 0 77273 0 810 0 17223 0 26991 0 438942 0 0 CARLA C COX RN VP & CNO (ECR) 250515 0 62414 0 6604 0 18145 0 26005 0 363683 0 0 0 LORI A LUTHER COO (ECR) 320772 0 83335 0 23064 0 15810 0 33774 0 476755 0 0 0 ANN M MCGUIRE VP-HUMAN RESOURCES REGIONAL (ECR)-PART YEAR 0 7136 0 0 0 245708 0 10678 0 1170 0 264692 0 205618 MEGAN HAYMAKER VP-HUMAN RESOURCES (ECR) (Part Year) 0 154045 0 56037 0 39414 0 10467 0 10171 0 270134 0 0 MAX E BARNHART ADMIN DIR-RETAIL PHARMACY OPS 170932 0 29193 0 6657 0 14021 0 40266 0 261070 0 0 0 TERRY A PENCE VP, OPERATIONS 215866 0 52752 0 3130 0 17168 0 23127 0 312044 0 0 0 JOSEPH BUTTS RADIATION PHYSICIST 219629 0 0 0 180 0 13776 0 2456 0 236041 0 0 0 ALVIS FOSTER SENIOR RADIATION PHYSICIST 226526 0 0 0 792 0 15283 0 40741 0 283342 0 0 0 RYAN M JOHNSTON MD ASSOCIATE - CMO 279222 0 46043 0 3068 0 18651 0 32750 0 379734 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 Ann M. McGuire entered into a severance agreement with IU Health during 2020. Severance of $245,708 is included in column b(iii), other reportable compensation. In 2020, $205,618 was reported as deferred compensation. 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. Joan V. Castor has an amount included in column c, deferred compensation, representing the current year unvested contributions made under the supplemental retirement plan. No amount was actually paid to this executive during the year. THE FOLLOWING EXECUTIVE HAs AN AMOUNT INCLUDED IN COLUMN B (III), OTHER REPORTABLE COMPENSATION, REPRESENTING THE CURRENT YEAR VESTED AMOUNTS RECEIVED UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: - JEFFREY C. BIRD ($398,625) Schedule J, Part I, Line 7 Non-fixed payments Amounts disclosed in column B(ii) include a long-term and short-term incentive for certain executives and short-term incentive for other employees. Although these plans are based on a fixed formula that has been approved by the board of directors based upon certain qualitative and quantitative factors and goals. All discretionary incentive plans must be approved by the board of directors prior to any incentive payout. Form 990, Part III, Line 4d Description of other program services (Expenses $ 3,191,049 including grants of $ 0)(Revenue $ 3,616,662) RENT FROM RELATED 501(C)(3) ORGANIZATIONS Form 990, Part III, Line 4d Description of other program services (Expenses $ 0 including grants of $ 0)(Revenue $ 17,169,356) As of December 31, 2021, Indiana University Health Ball Memorial Hospital, Inc. had received stimulus funds from the Provider Relief Fund under the provisions of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) and Paycheck Protection Program and Health Care Enhancement Act. Indiana University Health Ball Memorial Hospital recognized $17,169,356 as other program service revenue. Indiana University Health Ball Memorial Hospital, Inc. will continue to monitor compliance with the terms and conditions of the Provider Relief Fund. 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 2 Family/business relationships amongst interested persons INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL: DIRECTOR OR OFFICER: JOHN D. AND DAVID A. LITTLER - Family relationship 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 15b Process to establish compensation of other employees 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. 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 WEB-SITE. 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 from pass thru entities - Total Revenue: 160375, Related or Exempt Function Revenue: , Unrelated Business Revenue: 160375, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue OTHER - Total Revenue: 1604108, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 1604108; Form 990, Part IX, Line 11g Other Fees SHARED SERVICES/PROF. FEES - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 9288910, Fundraising Expenses: ; AMENDED RETURN: FORM 990, PART VII & FORM 990, SCHEDULE J AMENDED RETURN AMENDED RETURN FILED TO CORRECT RELATED COMPENSATION REPORTED FOR JOAN V. CASTOR REASON FOR FILING AN AMENDED RETURN: ERRONEOUS OVERSTATEMENT OF JOAN V. CASTOR'S RELATED COMPENSATION DISCLOSED ON THE ORIGINALLY FILED 2021 FORM 990 SUMMARY OF CHANGES FORM 990, PART VII, LINE 2, COLUMN (E): AS ORIGINALLY FILED: $1,168,100 AS AMENDED: $584,050 FORM 990, PART VII, LINE 2 COLUMN (F): AS ORIGINALLY FILED: $169,979 AS AMENDED: $118,253 FORM 990, SCHEDULE J, PART II, LINE 2, ROW (ii), COLUMN (B)(i) AS ORIGINALLY FILED: $674,502 AS AMENDED: $337,251 FORM 990, SCHEDULE J, PART II, LINE 2, ROW (ii), COLUMN (B)(ii) AS ORIGINALLY FILED: $486,396 AS AMENDED: $243,198 FORM 990, SCHEDULE J, PART II, LINE 2, ROW (ii), COLUMN (B)(iii) AS ORIGINALLY FILED: $7,202 AS AMENDED: $3,601 FORM 990, SCHEDULE J, PART II, LINE 2, ROW (ii), COLUMN (C) AS ORIGINALLY FILED: $89,727 AS AMENDED: $78,127 FORM 990, SCHEDULE J, PART II, LINE 2, ROW (ii), COLUMN (D) AS ORIGINALLY FILED: $80,252 AS AMENDED: $40,126 FORM 990, SCHEDULE J, PART II, LINE 2, ROW (ii), COLUMN (E) AS ORIGINALLY FILED: $1,338,080 AS AMENDED: $702,303 FORM 990, SCHEDULE J, PART II, LINE 2, ROW (ii), 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