Form 990 for tax year 2022

Revenue

Part VIII, the statement of revenue.

• 1d · Related organizations

  $156,036

• 1e · Government grants (contributions)

  $404,988

• 2a · Program service revenue: Net Patient Service Revenenue

  total $45,992,360 · related or exempt $45,992,360

• 2b · Program service revenue: Rent from Related 501(c)(3) Orgs.

  total $315,990 · related or exempt $315,990

• 2f · All other program service revenue

  total $0 · related or exempt $0 · unrelated business $0 · excluded $0

• 3 · Investment income

  total $307,256 · excluded $307,256

• 6a · Gross rents

  real property $114,051

• 6c · Rental income or loss

  real property $114,051 · personal property $0

• 6d · Net rental income or loss

  total $114,051 · excluded $114,051

• 7c · Gain or loss

  securities $0 · other assets $0

• 11a · Other revenue: All Other Revenue

  total $38,052 · excluded $38,052

• 11d · All other revenue

  total $0 · related or exempt $0 · unrelated business $0 · excluded $0

• 11e · Other revenue, total

  $38,052

Functional expenses

Part IX, the statement of functional expenses.

• 1 · Grants to domestic organizations and governments

  total $5,150 · program services $5,150

• 2 · Grants to domestic individuals

  total $5,000 · program services $5,000

• 5 · Compensation of officers, directors and key employees

  total $282,497 · program services $273,835 · management and general $8,662

• 7 · Other salaries and wages

  total $11,008,513 · program services $10,670,964 · management and general $337,549

• 8 · Pension plan contributions

  total $405,986 · program services $393,537 · management and general $12,449

• 9 · Other employee benefits

  total $1,470,512 · program services $1,425,422 · management and general $45,090

• 10 · Payroll taxes

  total $778,467 · program services $754,597 · management and general $23,870

• 11b · Fees: legal

  total $1,619 · management and general $1,619

• 11g · Fees: other

  total $11,819,602 · program services $11,068,948 · management and general $750,654 · fundraising $0

• 13 · Office expenses

  total $11,281 · program services $10,565 · management and general $716

• 14 · Information technology

  total $53,876 · program services $26,938 · management and general $26,938

• 16 · Occupancy

  total $1,640,585 · program services $1,640,585

• 17 · Travel

  total $15,610 · program services $14,619 · management and general $991

• 19 · Conferences, conventions and meetings

  total $1,228 · program services $1,150 · management and general $78

• 20 · Interest

  total $928,054 · program services $928,054

• 22 · Depreciation, depletion and amortization

  total $2,086,049 · program services $1,970,463 · management and general $115,586

• 23 · Insurance

  total $191,255 · management and general $191,255

• 24a · Other expenses: Drugs and Medical Supplies

  total $5,997,892 · program services $5,997,892

• 24b · Other expenses: Bad Debt

  total $2,130,190 · program services $2,130,190

• 24c · Other expenses: Hospital Assessment Fee

  total $2,506,824 · program services $2,506,824

• 24e · All other expenses

  total $1,122,553 · program services $1,051,260 · management and general $71,293 · fundraising $0

Balance sheet

Part X, book values.

• 1 · Cash, non-interest-bearing

  beginning of year $0 · end of year $0

• 2 · Savings and temporary cash investments

  beginning of year $38,894,552 · end of year $41,833,696

• 3 · Pledges and grants receivable

  beginning of year $21,690 · end of year $180,753

• 4 · Accounts receivable

  beginning of year $4,858,176 · end of year $4,549,792

• 5 · Loans and receivables from officers and key people

  beginning of year $0 · end of year $0

• 6 · Loans and receivables from disqualified persons

  beginning of year $0 · end of year $0

• 7 · Other notes and loans receivable

  end of year $0

• 8 · Inventories for sale or use

  beginning of year $586,764 · end of year $683,052

• 9 · Prepaid expenses and deferred charges

  beginning of year $167,309 · end of year $84,079

• 10a · Land, buildings and equipment: cost or other basis

  $44,536,801

• 10b · Land, buildings and equipment: accumulated depreciation

  $17,526,756

• 10c · Land, buildings and equipment, net

  beginning of year $28,395,699 · end of year $27,010,045

• 12 · Investments: other securities

  beginning of year $0

• 13 · Investments: program-related

  beginning of year $0

• 15 · Other assets

  beginning of year $188,509 · end of year $383,425

• 17 · Accounts payable and accrued expenses

  beginning of year $6,136,634 · end of year $4,928,529

• 22 · Loans and payables to officers and key people

  beginning of year $0 · end of year $0

• 25 · Other liabilities

  beginning of year $23,025,367 · end of year $21,014,671

• 27 · Net assets without donor restrictions

  beginning of year $43,746,510 · end of year $48,612,500

• 28 · Net assets with donor restrictions

  beginning of year $204,188 · end of year $169,142

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation

IU HEALTH WHITE MEMORIAL HOSPITAL'S REGIONAL PRESIDENT IS EMPLOYED BY IU HEALTH, INC. IU HEALTH WHITE MEMORIAL HOSPITAL'S PRESIDENT IS EMPLOYED BY IU HEALTH WHITE MEMORIAL HOSPITAL, INC. IU HEALTH, INC., IU HEALTH WHITE 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.

Schedule J, Part I, Line 4a Severance or change-of-control payment

ALLISON SHUTTZ ENTERED INTO A SEVERANCE AGREEMENT WITH IU HEALTH ARNETT DURING 2022. SHE RECEIVED SEVERANCE OF $203,980 DURING 2022.

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan

ARTHUR VASQUEZ PARTICIPATES IN AN IU HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, PROVISIONS OF WHICH ARE DESIGNED TO RETAIN ITS 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. ARTHUR VASQUEZ HAS AN AMOUNT INCLUDED IN COLUMN C, DEFERRED COMPENSATION, REPRESENTING THE CURRENT YEAR UNVESTED CONTRIBUTIONS MADE UNDER THE SUPPLEMENTAL RETIREMENT PLAN. NO AMOUNTS WERE ACTUALLY PAID TO THIS EXECUTIVE DURING THE YEAR.

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 TALENT MANAGEMENT AND EXECUTIVE COMPENSATION COMMITTEE AND BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

• BELTWAY SURGERY CENTERS LLC

  HEALTHCARE · IN

  Directly controlled by NA

• BOSC HOLDINGS LLC

  HEALTHCARE · IN

  Directly controlled by NA

• BSC HOLDINGS LLC

  HEALTHCARE · IN

  Directly controlled by NA

• HEALTH VENTURE MANAGEMENT LLC

  MANAGEMENT · IN

  Directly controlled by NA

• IEC HOLDINGS LLC

  HEALTHCARE · IN

  Directly controlled by NA

• INDIANA ENDOSCOPY CENTERS LLC

  HEALTHCARE · IN

  Directly controlled by NA

• ROC SURGERY LLC

  HEALTHCARE · IN

  Directly controlled by NA

• ROCS HOLDINGS LLC

  HEALTHCARE · IN

  Directly controlled by NA

• SENATE ST SURGERY CENTER LLC

  HEALTHCARE · IN

  Directly controlled by NA

• SSSC HOLDINGS LLC

  HEALTHCARE · IN

  Directly controlled by NA

• BALL OUTPATIENT SUR CTR LLC

  HEALTHCARE · IN

  Directly controlled by NA

• IU HEALTH SOUTHWEST FORT WAYNE AMBULATORY SURGERY CTR LLC

  Healthcare · IN

  Directly controlled by NA

• IU HEALTH FORT WAYNE SW ASC HOLDINGS LLC

  HEALTHCARE · IN

  Directly controlled by NA

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

• CERBERUS RESIDENTIAL OPPORT INST LTD

  C Corporation · INVESTMENTS · CJ · controlled entity

  Directly controlled by NA

• IU HEALTH 457(B) PLAN

  Trust · INVESTMENTS · IN · controlled entity

  Directly controlled by NA

• IU HEALTH ACO INC

  C Corporation · HEALTHCARE · IN · controlled entity

  Directly controlled by NA

• IU HEALTH BOARD DESIGNATED TRUST

  Trust · INVESTMENTS · IN · controlled entity

  Directly controlled by NA

• IU HEALTH PLANS INC

  C Corporation · HMO · IN · controlled entity

  Directly controlled by NA

• IU HEALTH RISK PURCHASING GROUP INC

  C Corporation · INSURANCE · IN · controlled entity

  Directly controlled by NA

• IU HEALTH RISK RETENTION GROUP INC

  C Corporation · INSURANCE · SC · controlled entity

  Directly controlled by NA

• IUH ASSURANCE SPC LTD

  C Corporation · INSURANCE · CJ · controlled entity

  Directly controlled by NA

• PROTEUO FUND LP

  C Corporation · INVESTMENTS · CJ · controlled entity

  Directly controlled by NA

• BMH MEDICAL PAVILION ASSOCIATION INC

  C Corporation · CONDO MANAGEMENT · IN · controlled entity

  Directly controlled by NA

• University Surgeons Inc

  C Corporation · Physician Services · IN · controlled entity

  Directly controlled by NA

• Pediatric Surgical Associates Inc

  C Corporation · Physician Services · IN · controlled entity

  Directly controlled by NA

• Cardiothoracic Surgeons Inc

  C Corporation · Physician Services · IN · controlled entity

  Directly controlled by NA

• University Vascular Surgery Inc

  C Corporation · Physician Services · IN · controlled entity

  Directly controlled by NA