4A (Expenses $ 264484215 including grants of $ 407370) (Revenue $ 384760943)
IU Health North Hospital provides leading family-centered care to Carmel and Hamilton County residents. As a full-service hospital for adults and children with an attached medical office building, IU Health North Hospital brings together physician offices, inpatient beds and operating rooms in a state-of-the-art facility where compassionate caregivers provide superior patient treatment. All patient rooms are private to optimize comfort for each individual and their family, and our wealth of services for adults and children ranges from cardiovascular and orthopedic care to maternity and cancer care. In January 2020, the IU Health Joe & Shelly Schwarz Cancer Center, an 88,000 square foot, two-story facility, opened on the south side of the IU Health North campus. The $55-million investment brings together, all under one roof, cancer services including radiation oncology, hematology-oncology, pharmacy, laboratory and patient navigation to surround patients and their loved ones with the care and support they need. As part of our commitment to fostering the health of our communities, we are proud to also offer the peace of mind that comes with the service and support of Riley Hospital for Children at IU Health's nationally-recognized programs.

4B (Expenses $ 0 including grants of $ 0) (Revenue $ 1141309)
As of December 31, 2021, Indiana University Health North 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 North Hospital recognized $1,141,309 as other program service revenue. Indiana University Health North Hospital, Inc. will continue to monitor compliance with the terms and conditions of the Provider Relief Fund.

4C (Expenses $ 1324655 including grants of $ 0) (Revenue $ 1927054)
IU Health North Hospital provides services, which include coordinated activities and polices, to related tax-exempt organizations designed to meet the mission of the Indiana University Health System.

4D (Expenses $ 612951 including grants of $ 0) (Revenue $ 891697)
IU Health North Hospital leases physician office and clinic space to tax-exempt related 501(c)(3) organizations.

Schedule H, Part V, Section B, Line 3E
IU Health North 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 North: 1. Access to Healthcare Services 2. Aging Population and Needs of Seniors 3. Behavioral Health 4. Chronic Disease and Chronic Disease Management 5. Health Education and Navigation 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 NORTH HOSPITAL. In conducting its most recent CHNA, IU Health North Hospital took into account input from persons who represent the broad interests of the communities it serves by hosting six community focus groups and five 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 North Hospital The defined community per the most recent CHNA is Boone, Hamilton, and Marion Counties, Indiana. The hospital resides in Hamilton County. Boone County - Interview An interview was conducted with representatives of a local public health department to obtain subject-matter expertise into the health needs in Boone County. Participants were asked to comment on a list of unfavorable health indicators, add other needs to significant indicators and discuss barriers and resources. The following issues were discussed as significant: * Participants were not surprised about the unfavorable secondary data indicators, including excessive drinking, income inequality, lack of social associations and sexually transmitted infections * Physical inactivity is a significant need, and recent infrastructure projects have sought to increase exercise * Mental health is a significant concern and an increasing need during the COVID-19 pandemic Affordable housing options are limited, and allowing seniors to age in place through safe housing is a need * Elderly needs are significant in several areas, including mental health, transportation and housing Excessive drinking, sexually transmitted infections, physical inactivity, senior care and housing were identified as priority needs * More health education is needed with programs that target youth for substance abuse and STIs Hamilton County - Community Meetings and Interviews In collaboration with other local health systems - Ascension St. Vincent, Community Health Network and Riverview Health - two community meetings were held in May 2021 to receive input from stakeholders regarding the health needs in Hamilton County. 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 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 several topics, including COVID-19, alcohol abuse, immunization rates, elderly needs, smoking and tobacco use, access to mental health services and statewide issues, such as health disparities and obesity. In addition to these topics, participants focused discussion on substance abuse and overdoses, mental health concerns, access to care disparities for various segments of the population, aging in place resources, transportation, limited clinical hours of providers, limited mental health providers, a continuum of care between various health services and food insecurity. From this process, participants identified the following needs as most significant for Hamilton County: * Access to and supply of mental health providers, particularly for low-income populations Needs of a growing senior population, including aging in place and cognitive care * Mental health * Alcohol use and excessive drinking * Access to care disparities, particularly for low-income populations A survey was also issued to internal providers at IU Health that serve Hamilton County, asking them to identify priority needs among the patients they serve. The following issues were identified as the most significant: * Healthcare and services for elderly residents * Mental health * Substance abuse * Access to healthcare services * Obesity * Access to behavioral health services, including mental health and substance abuse The survey also asked about the impacts of the COVID-19 pandemic. Issues most often selected as significant impacts include: * Loss of health insurance * Social isolation and loneliness * Health disparities Two additional interviews were conducted with representatives of local public health departments to obtain subject-matter expertise into the health needs in Hamilton County. The following issues were discussed as significant: * Access to behavioral health services - both mental health and substance abuse - is a significant need, with few providers in the area and primary care physicians not often integrating behavioral health checks into care (a large increase in population has led to an undersupply of providers) * Mental health concerns are widespread, including an increase in child mental health needs (youth struggle with high expectations and stress in school) * Substance abuse and overdoses are significant concerns, with opioid usage being widespread (alcohol abuse is also common) * Transportation is a barrier in the community with limited public options and routes * Insurance barriers are significant, with uninsured populations having few options and providers not accepting certain plans, such as Medicaid (while free and low-cost clinics exist, they cannot keep up with demand) * Food insecurity and access to healthy food is challenging for some groups, exacerbated by poverty and transportation (low-income housing is also limited) * The working poor often are vulnerable as they do not qualify for many programs but still live paycheck to paycheck (while Hamilton County compares well for poverty, the needs of low-income populations are often overlooked due to this, creating pockets of need) * Prevention is not a priority for most and more programs and access to preventive health are needed * Sexually transmitted infections are an issue, particularly chlamydia * Cultural differences lead to unmet need for several immigrant communities due to language barriers and others * LGBTQ+ populations are also underserved, often feeling uncomfortable going to available providers * Public health funding is limited, and service levels are impacted due to financial constraints * Time is a big barrier to optimal health, as parents are often too busy with work and children to pursue healthy living measures * More collaboration is needed between health systems, health departments, providers and social service organizations In regard to the COVID-19 pandemic, a wide array of impacts was noted including: * A lack of resources at local health departments - both funding and staff - led to difficulties throughout the pandemic, and many other services were foregone to focus on the pandemic (a need for a more robust public health infrastructure is highlighted) * The politicization of public health was widespread, and many guidelines and measures were met with criticism * Mental health issues worsened due to isolation, with children at particular risk * STI rates rose substantially * The pandemic highlighted the need for accurate health information, and providers need to focus on maintaining communication after COVID-19 Marion County - Community Meetings and Interviews In collaboration with other local health systems - Ascension St. Vincent and Community Health Network - four community meetings were held in May 2021 to receive input from stakeholders regarding the health needs in Marion County. Secondary data and a preliminary list of community health need priorities was presented at all meetings. 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-array of topics, including COVID-19, food insecurity, maternal and child health, racial and ethnic disparities, mental health and access to mental health providers, obesity and physical inactivity, poverty, educational achievement, housing, crime and community safety, public health funding and others.

Schedule H, Part V, Section B, Line 5 Facility , 2
Facility , 2 - IU HEALTH NORTH HOSPITAL ( CONT.). In addition to these topics, participants focused discussion around substance abuse and treatment, transportation barriers, culturally appropriate care and services (including language barriers), affordability of healthy food, smoking and tobacco use, access to and cost of primary care, health insurance, preventive health services, lack of providers within high-need areas, childcare, chronic conditions (including diabetes and hypertension), navigating existing resources, dental health needs, child health, job opportunities and trainings, technology barriers and digital-divide, post-incarceration resources and social connectedness. For those unable to attend community meetings, a separate survey was distributed to receive their input into the most significant needs. These findings were combined with those of the community meeting participants. From this process, participants identified the following needs as most significant for Marion County: * Racial and ethnic health disparities * Access to mental and behavioral healthcare services * Food insecurity and access to affordable, healthy food * Access to safe and affordable housing * Mental health * Poverty and associated community need A survey was also issued to internal providers at the Academic Medical Center, asking them to identify priority needs among the patients they serve. Among 12 responses, the following issues were identified as the most significant: * Food insecurity and nutrition * Health disparities, particularly for racial and ethnic minority populations * Mental health * Poverty and income inequality The survey also asked about the impacts of the COVID-19 pandemic. Issues most often selected as significant impacts include: * Social isolation and loneliness * Health disparities * Digital divide (lack of internet or device access) * Economic disparities * Housing (inability to stay sheltered, pay rent or mortgage) Two additional interviews were conducted with representatives of a local public health department and health equity organization to obtain subject-matter expertise into the health needs in Marion County. The following issues were discussed as significant: * Poverty is a significant issue and impacts almost all areas of wellbeing, including housing, accessing health services, nutrition, stress and mental health, chronic disease, transportation and others (the need for a living wage for all residents is significant) * Health disparities are significant, including large disparities in social determinants of health for racial and ethnic minority populations * Health insurance is a significant barrier to optimal health, with restrictions in coverage leading to a lack of preventive health * Mental health is a significant issue, with depression and anxiety both widespread (self-medication through substance abuse is common) * Obesity continues to be an issue, as well as diabetes, with rates increasing for adults * Infant and maternal mortality are significant issues, with social determinants of health impacting access to prenatal care and other needed services * HIV is still a concern, with some hope that the disease can be eradicated within the next decade through modern medicine and available tools such as PrEP (pre-exposure prophylaxis) * Tobacco and vaping are issues, with a low cigarette tax in Indiana perpetuating the issue * Environmental health - including old housing and air pollution - is leading to poor health, including lead poisoning, arsenic poisoning and pediatric asthma (the need for safe and stable housing is significant) * Health literacy is a need, particularly affecting Hispanic (or Latino) populations due to language barriers (education disparities around health are also leading to generational persistence of health disparities for racial and ethnic minority populations) * Food insecurity is significant and food pantries may have irregular hours and face huge demand * Education needs better funding, including adequate teacher compensation * More community collaboration is needed, with health systems and social service providers sitting at the same table to talk about community improvement and planned interventions In regard to the COVID-19 pandemic, a wide array of impacts were noted, including: * Testing was a large challenge throughout the beginning of the pandemic, due to inadequate federal resources and other limits * The pandemic highlighted the impact of social determinants of health, as homeless populations faced huge concerns due to inability to socially distance in shelters and access care (hotels were turned into isolation areas for patients with COVID-19) * Racial and ethnic disparities in testing, treatment and outcomes were highlighted by the pandemic (elderly Black residents were particularly affected) * Care was delayed for a lot of individuals due to fear of going to a provider and being exposed to the virus, leading to unmet needs and emergency situations * Community collaboration among providers led to a better response, including health systems offering testing and other aid to public health organizations (more collaboration and coordination will be needed in the future) * Vaccination disparities are evident, with Black populations disproportionately unable to access the vaccine if desired * The need for better health information sharing (including the identification of health disparities) between organizations 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: * Ascension St. Vincent * Allen Chapel AME Church * Anthem Medicaid * Aspire Indiana Health * Boone County Health Department * Breathe Easy Hamilton County * Broadway United Methodist Church * Carmel Clay Schools * Central Indiana Council on Aging (CICOA) * City of Indianapolis * City-County Council staff * City of Indianapolis, Division of Community Nutrition and Food Policy * City of Noblesville * Coalition for Our Immigrant Neighbors * Community Health Network * Concerned Clergy of Indianapolis * Connections IN Health, Indiana Clinical and Translational Sciences Institute (CTSI), Indiana University School of Medicine * Covering Kids & Families of Indiana * Crossroads AME Church/Common Grounds Institute * First Baptist Church North Indianapolis * Fishers Health Department * Gennesaret Free Clinic * Gleaners Food Bank of Indiana * Good Samaritan Network of Hamilton County * Habitat for Humanity of Greater Indianapolis * Hamilton County Community Foundation * Hamilton County Council on Alcohol and Other Drugs * Hamilton County Government * Hamilton County Harvest Food Bank * Hamilton County Head Start * Hamilton County Health Department * Hamilton County Meals on Wheels * HAND, Inc. * Health by Design * Heart and Soul Free Clinic * HOPE Family Care Center * Horizon House * Immigrant Welcome Center * Indiana Legal Services * Indiana Native American Indian Affairs Commission * Indiana Public Health Association * Indiana Department of Health * Indiana University Richard M. Fairbanks School of Public Health * Indianapolis City Council * Indianapolis Neighborhood Housing Partnership * Indianapolis Urban League * Indy Go * Indy Hunger Network * IU Health * IU Health Indy Suburban Region * IU Health Methodist Hospital * IU Health North Hospital * IU Health Saxony Hospital * IU Health University Hospital * Jump IN for Healthy Kids * Marion County Health Department * Marian University/College of Osteopathic Medicine * Marion County Public Health Department * Managed Health Services (MHS) * Neighborhood Christian Legal Clinic * Nine13sports * Noblesville Chamber of Commerce * Noblesville Schools * Noblesville Town Council * Nurse Family Partnership of Goodwill of Central and Southern Indiana * Pathway to Recovery * Playworks * Prevail, Inc. * Prime Life Enrichment * Purdue Extension * Raphael Health Center, Inc. * Richard M. Fairbanks Foundation * Riverview Health * Shepherd's Center of Hamilton County * Sheridan Community Schools * St. Elizabeth Seton Parish * The Julian Center * The Villages Health Families * Trinity Free Clinic * United States Congress, Representative Andre Carson (staff) * University of Indianapolis * YMCA of Greater Indianapolis/Top 10 Coalition

Schedule H, Part V, Section B, Line 11 Facility , 1
"Facility , 1 - IU HEALTH NORTH HOSPITAL. In conjunction with the CHNA, IU Health North Hospital's Board adopted an implementation strategy in April 2022 related to the 2021 CHNA. IU Health North Hospital 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 North Hospital 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* - 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 North Hospital is unable to address all of the significant community health needs identified in the local community. This is not meant to minimize the importance of any health need or the integrity of the CHNA process. IU Health North Hospital is a mission and values driven hospital; therefore, addressing community health needs that align with the hospital's mission will have the greatest opportunity to activate and leverage hospital resources as well as maximize current strategic collaborations with community-based partners. IU Health North is unable to address the following community health needs identified in the 2021 Community Health Needs Assessment: - Health Education and Navigation However, during 2021 IU Health North Hospital 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 North Hospital will address the following community health needs between 2019 and 2021: - Access to Healthcare Services - Drug and Substance Abuse (including Opioids and Alcohol) - Food Insecurity - Healthcare and Social Services for Seniors - Mental Health* - Obesity and Diabetes - 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 North Hospital's implementation strategy to address the identified need of Access to Healthcare includes the following: Trinity Free Clinic health services for the uninsured and underinsured of Hamilton County. In 2021, IU Health North Hospital provided funding to support the operations of Trinity Free Clinic's free pre- and Type II diabetes care clinic and to purchase glucose testing and monitoring equipment, A1C machines, logbooks and other medical supplies. In 2021, IU Health team members and physicians staffed the clinic for over 40 hours. Heart & Soul Health Clinic operations. In 2021, IU Health North Hospital provided funding to expand Heart & Soul Clinic's language services program, which helped over 200 non-English speaking patients receive informed medical care. Registration assistance for health insurance. In 2021, the IU Health North Hospital Individual Solutions coordinators assisted over 100 individuals in health insurance enrollment. Community COVID-19 and flu vaccine clinics. IU Health North Hospital partnered with internal staff and community organizations to offer ten free COVID-19 and flu vaccine clinics to in-need communities. In 2021, 582 COVID-19 vaccines and 377 flu vaccines were administered. Note: This strategy did not appear in the April 2019 implementation strategy but was undertaken in 2021 as it meets significant community health needs in relation to access to healthcare services. Behavioral Health (includes Drug & Substance Abuse and Mental Health) IU Health North Hospital's implementation strategy to address the identified need of Behavioral Health includes the following: Partnership for a Healthy Hamilton County (PHHC). In 2021, PHHC underwent a name change and is now referred to as A Healthier Hamilton County: Systems of Care (SOC). IU Health North Hospital provided funding for A Healthier Hamilton County: SOC to support the operations and foundation of their new peer-to-peer safe crisis de-escalation space project, Connecting Hamilton County and Tackling Stigma (CHATS). Peer recovery program. During the first half of 2021, over 45 patients were referred from the IU Health North Hospital emergency department to the behavioral health peer recovery program and 86 percent of patient follow-ups were successful. IU Health Emergency Department (ED) Telepsych Program. The telepsych program staff continued to assist patients presenting in the ED with behavioral health conditions and IU Health North Hospital nurses, social workers and providers were trained to initiate the telemedicine visits. Indiana Center for Prevention of Youth Abuse & Suicide (ICPYAS) support. In 2021, IU Health North Hospital provided funding to ICPYAS to expand their evidence-based youth abuse and suicide prevention and awareness curriculum for children and adults in Hamilton County. In 2021, IU Health team members with child-facing roles were encouraged to participate in Stewards of Children trainings to increase awareness surrounding child sexual abuse. Four team members completed the program. Breathe Easy Hamilton County. IU Health North Hospital supported Breathe Easy Hamilton County by providing letters of recommendation for the organization's tobacco cessation and prevention projects. Physician liaisons also placed Tobacco Quitline materials in IU Health physician practices to encourage referrals. Aspire Indiana program and operational support. In 2021, IU Health North Hospital provided funding to Aspire Indiana Health to support their employment assistance program that provides job trainings, certifications and licensures to low-income and homeless individuals in Hamilton County. Approximately 40 community members received employment assistance as a result of the funding. Cherish Child Advocacy Center support. In 2021, IU Health North Hospital provided funding to the Cherish Child Advocacy Center to assist with COVID-19 relief efforts that ensured clients could seek safe, in-person abuse intervention and prevention services. Note: This strategy did not appear in the April 2019 implementation strategy but was undertaken in 2021 as it meets significant community health needs in relation to behavioral health. HOPE Family Care Center support. IU Health North Hospital provided funding to expand HOPE Family Care Center's behavioral health services. In 2021, 68 unique individuals received counseling sessions, which is a 160 percent increase from 2020. Note: This strategy did not appear in the April 2019 implementation strategy but was undertaken in 2021 as it meets significant community health needs in relation to behavioral health. Food Insecurity IU Health North Hospital's implementation strategy to address the identified need of Food Insecurity includes the following: Local Farmers Markets. In 2021, IU Health North Hospital provided funding for the Carmel Farmers Market (summer and winter) and the Zionsville Farmers Market. Good Samaritan Network (GSN) of Hamilton County support. In 2021, IU Health North Hospital provided funding for GSN's Holiday Assistance Program, which provided general sustenance and food for low-income individuals and families. Note: This strategy did not appear in the April 2019 implementation strategy but was undertaken in 2021 as it meets significant community health needs in relation to food insecurity."

Schedule H, Part V, Section B, Line 11 Facility , 2
Facility , 2 - IU HEALTH NORTH HOSPITAL. Healthcare and Social Services for Seniors IU Health North Hospital's implementation strategy to address the identified need of Healthcare and Social Services for Seniors includes the following: Educational health programming for seniors. In 2021, three geriatric health seminars were led by IU Health staff on the topics of healthy nutrition, fall prevention and dementia. Approximately 50 seniors attended each seminar and over 90 percent of attendees reported an increase in knowledge based on presentation surveys. Health screenings for seniors. In order to maintain the safety of staff and community members, senior health screenings were not provided in 2021. In place of health screenings, IU Health North Hospital offered free COVID-19 and flu vaccine clinics for seniors. Reaching Resources program through Shepherd's Center of Hamilton County. IU Health North Hospital did not support the Reaching Resources program in 2021. In place of support for Reaching Resources, IU Health North Hospital provided funding for a pilot program, in partnership with the Shepherd's Center, to increase access to geriatric behavioral health counseling. Home-based behavioral health services for seniors. In 2021, IU Health North Hospital partnered with the Shepherd's Center of Hamilton County and the IU Health Connected Care team to launch a mental health counseling program for seniors to receive virtual, outpatient and home-based therapy. During the pilot year, 160 counseling sessions were administered. Obesity and Diabetes IU Health North Hospital's implementation strategy to address the identified need of Obesity and Diabetes includes the following: Fresh & Fit program. In order to maintain the safety of staff and community members during the COVID-19 pandemic, IU Health North Hospital did not host the Fresh & Fit program in 2021. The program will resume virtually in 2022. IU Health Days of Service. During the 2021 Days of Service, over 115 IU Health North Hospital and Saxony hospital team members participated in socially distanced and remote projects for nearly 200 hours throughout the month of September. Team members completed physically active projects at local parks to make updates, additions and improvements to benefit the parks and, ultimately, lead to an increase in physical activity among community members. Social Determinants of Health IU Health North Hospital's implementation strategy to address the identified need of Social Determinants of Health includes the following: Prevail, Inc. Support. In 2021, IU Health North Hospital provided funding to Prevail Inc.'s Safe Housing Solutions Plan, which ensures that individuals and families who experience abuse, crime, trauma or violence can maintain or attain housing and can access immediate funds to avoid homelessness. Note: This strategy did not appear in the April 2019 implementation strategy but was undertaken in 2021 as it meets significant community health needs in relation to social determinants of health. IU Health North Hospital addressed all the community health needs based on their 2018 CHNA. There were no identified needs that were not be addressed.

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - IU HEALTH NORTH HOSPITAL. IN ADDITION TO FPG, IU HEALTH NORTH HOSPITAL MAY TAKE INTO CONSIDERATION A PATIENT'S INCOME AND/OR ABILITY TO PAY IN CALCULATION OF A FINANCIAL ASSISTANCE AWARD.

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - IU HEALTH NORTH HOSPITAL. IU Health North Hospital takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. 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 NORTH HOSPITAL. IU Health North Hospital takes several other measures to publicize its FAP within the community. These measures include the following: 1. Post this Policy, a Plain Language Summary of this Policy, and the Financial Assistance Application on its website. 2. Provide patients with a Plain Language Summary of this Policy during registration and/or discharge. 3. Post conspicuous displays in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 4. Include a conspicuous written notice on all patient post-discharge billing statements notifying the patient about this Policy and the telephone number of the Customer Service Department which can assist patients with questions regarding this Policy. 5. Make available Customer Service representatives via telephone during normal business hours. 6. Mail copies of this Policy, a Plain Language Summary of this Policy, and a Financial Assistance Application to patients or their guarantor free of charge upon request. 7. Broadly communicate this Policy as a part of its general outreach efforts. 8. Educate patient-facing team members on this Policy and the process for referring patients to the program.

Schedule H, Part I, Line 6a C.B. REPORT PREPARED BY A RELATED ORG.
IU Health North Hospital's community benefit and other investments, encompassing its total community investment, are included in the IU Health Community Benefit Report which is prepared on behalf of and includes IU Health and its related hospital entities in the State of Indiana. The IU Health Community Benefit Report is made available to the public on IU Health's website at https://iuhealth.org/in-the-community. The IU Health Community Benefit Report is also distributed to numerous key organizations throughout the State of Indiana in order to broadly share the IU Health Statewide System's community benefit efforts. It is also available by request through the Indiana State Department of Health or IU Health.

Schedule H, Part I, Line 7c TOTAL COMMUNITY BENEFIT EXPENSE
SCHEDULE H, PART I, LINE 7, COLUMN (F), PERCENT OF TOTAL EXPENSE, IS BASED ON COLUMN (E) NET COMMUNITY BENEFIT EXPENSE. THE PERCENT OF TOTAL EXPENSE BASED ON COLUMN (C) TOTAL COMMUNITY BENEFIT EXPENSE, WHICH EXCLUDES DIRECT OFFSETTING REVENUE, IS 17.65%.

Schedule H, Part I, Line 7f PERCENT OF TOTAL EXPENSE
The amount of bad debt expense subtracted for purposes of calculating the percentage of total expense on Line 7, column (f) is $7,958,530. 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 II PROMOTION OF HEALTH IN COMMUNITIES SERVED
"IU Health North Hospital supports and/or participates in a variety of community-building activities that address the non-medical, root causes of health problems in the communities it serves. IU Health North Hospital and its related hospital entities across the state of Indiana (""IU Health Statewide System"") investments include economic development efforts across the state, workforce development opportunities, collaborate with like-minded organizations through coalitions that address key issues, and advocate for improvements in the health status of vulnerable populations. Some activities meet the definition of community benefit and have been reported as such."

Schedule H, Part I, Line 6a Community benefit report prepared by related organization
INDIANA UNIVERSITY HEALTH, INC.

Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation
7958530

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 8 Community benefit & methodology for determining medicare costs
"The amount reported on Schedule H, Part III, Line 6 is calculated, in accordance with the Form 990 instructions, using ""allowable costs"" from IU Health North Hospital's Medicare Cost Report. ""Allowable costs"" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health North Hospital's participation in Medicare programs. For example, the Medicare Cost Report excludes certain costs such as billed physician services, the costs of Medicare Parts C and D, fee schedule reimbursed services, and durable medical equipment services. Inclusion of all costs associated with IU Health North's participation in Medicare programs would significantly increase the Medicare shortfall reported on Schedule H, Part III, Line 7. IU Health North Hospital's Medicare shortfall is attributable to reimbursements that are less than the cost of providing patient care and services to Medicare beneficiaries and does not include any amounts that result from inefficiencies or poor management. IU Health North Hospital accepts all Medicare patients knowing that there may be shortfalls; therefore it has taken the position that any shortfall should be counted as part of its community benefit. Additionally, it is implied in Internal Revenue Service Revenue Ruling 69-545 that treating Medicare patients is a community benefit. Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with governmental health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community."

Schedule H, Part V, Section B, Line 16a FAP website
- IU HEALTH NORTH HOSPITAL: Line 16a URL: https://iuhealth.org/pay-a-bill/financial-assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
- IU HEALTH NORTH HOSPITAL: Line 16b URL: https://iuhealth.org/pay-a-bill/financial-assistance;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- IU HEALTH NORTH HOSPITAL: Line 16c URL: https://iuhealth.org/pay-a-bill/financial-assistance;

Schedule H, Part VI, Line 7 State filing of community benefit report
IN

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 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 North 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 North 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 North Hospital and key informant interviews with those possessing public health expertise. After completion of the CHNA, IU Health North 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 III, Line 9b Collection practices for patients eligible for financial assistance
IU Health North Hospital's FAP and Written Debt Collection Policy describe the collection practices applicable to patients, including those who may qualify for financial assistance. 1. Financial Assistance Application Financial Assistance Applications must include the following documentation: - All sources of Income for the last three (3) months. - Most recent three (3) months of pay stubs or Supplemental Security Income via Social Security. - Most recent three (3) statements from checking and savings accounts, certificates of deposit, stocks, bonds and money market accounts. - Most recent state and Federal Income Tax forms including Schedules C, D, E, and F. In the event the patient or guarantor's income does not warrant the filing of a federal tax statement, the individual may submit a notarized affidavit attesting to the foregoing. - Most recent W-2 statement. - For patients or members of the Household who are currently unemployed, Wage Inquiry from WorkOne. - If applicable, divorce/dissolution decrees and child custody order. Patients or their guarantors wishing to apply for Financial Assistance due to Financial Hardship are encouraged to submit an Application within ninety (90) days of discharge. Patients or their guarantors may submit an Application up to two-hundred and forty (240) days from the date of their initial post-discharge billing statement from IU Health, however, accounts may be subject to Extraordinary Collection Actions (ECA) as soon as one-hundred and twenty (120) days after receipt of the initial post-discharge billing statement. Patients or their guarantors submitting an incomplete Financial Assistance Application will receive written notification of the Application's deficiency upon discovery by IU Health. The Application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health will suspend any ECA until the Application is complete or the expiration of the forty-five (45) day period. Patients with limited English proficiency may request a copy of this Policy, a Financial Assistance Application, and a Plain Language Summary in one of the below languages: - Arabic; - Burmese; - Burmese - Falam; - Burmese - Hakha Chin; - Mandarin/Chinese; or - Spanish The patient, and/or their representative, such as the patient's physician, family members, legal counsel, community or religious groups, social services or hospital personnel may request a Financial Assistance Application be mailed to a patient's primary mailing address free of charge. IU Health maintains the confidentiality of all Financial Assistance Applications and supporting documentation. IU Health will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance Application. 2. Financial Assistance Determinations IU Health will inform patients or guarantors of the results of their Application by providing the patient or guarantor with a Financial Assistance Determination within ninety (90) days of receiving a completed Application and all requested documentation. A patient's Financial Assistance Application and Financial Assistance Determination are specific to each date(s) of service and approved related encounters. If a patient or guarantor is granted less than full charity assistance and the patient or guarantor provides additional information for reconsideration, Revenue Cycle Services may amend a prior Financial Assistance Determination. 3. Extraordinary Collection Actions IU Health may refer delinquent patient accounts to a third-party collection agency after utilizing reasonable efforts to determine a patient's eligibility for assistance under this Policy. Reasonable efforts include the following: - IU Health will notify the patient of this Policy at least thirty (30) days prior to initiating an ECA. - IU Health will not initiate an ECA for at least one-hundred and twenty (120) days after the patient's initial post-discharge billing statement. - IU Health will review all Financial Assistance Applications received up to and including two-hundred and forty (240) days after the patient's initial post-discharge billing statement. IU Health will cease any ECAs it has initiated upon receipt of a Financial Assistance Application until a Financial Assistance Determination is made under this policy. - If an Application is Approved, IU Health will issue a revised statement, issue refunds, and make reasonable efforts to reverse ECAs as necessary. IU Health and its third-party collection agencies may initiate an ECA against a patient or their guarantor in accordance with this Policy and 26 C.F.R.  1.501(r). ECAs may include the following: - Selling a patient or their guarantor's outstanding financial responsibility to a third party. - Reporting adverse information about the patient or their guarantor to consumer credit reporting agencies or credit bureaus. - Deferring or denying, or requiring a payment before providing, medically necessary care because of a patient or their guarantor's nonpayment of one or more bills for previously provided care covered under this Policy. - Actions requiring a legal or judicial process, including but not limited to placing a lien on a patient's or their guarantor's property, foreclosing on a patient's or their guarantor's real property, attaching or seizing a patient's or their guarantor's bank account or other personal property, commencing a civil action against a patient or their guarantor, causing a patient or guarantor's arrest, causing a patient and/or guarantor to be subject to a writ of body attachment, and garnishing a patient or guarantor's wages When it is necessary to engage in such action, IU Health and its third party collection agencies, will engage in fair, respectful and transparent collections activities. 4. Refunds Patients eligible for Financial Assistance under this Policy who remitted payment to IU Health in excess of their Patient Responsibility will be alerted to the overpayment as promptly after discovery as is reasonable given the nature of the overpayment. Patients with an outstanding account balance due on a separate account will have their refund applied to the outstanding balance. Patients without an outstanding account balance described above will be issued a refund check for their overpayment as soon as technically feasible.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
IU Health North Hospital is committed to serving the healthcare needs of all of its patients regardless of their ability to pay for such services. To assist in meeting those needs, IU Health North Hospital has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health North Hospital is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health North Hospital will make a good faith effort to locate and obtain health insurance coverage for patients prior to considering patients for coverage under the FAP. IU Health North Hospital takes several measures to inform its patients of the FAP and FAP-eligibility. These measures include the following: 1. Post this Policy, a Plain Language Summary of this Policy, and the Financial Assistance Application on its website. 2. Provide patients with a Plain Language Summary of this Policy during registration and/or discharge. 3. Post conspicuous displays in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 4. Include a conspicuous written notice on all patient post-discharge billing statements notifying the patient about this Policy and the telephone number of the Customer Service Department which can assist patients with questions regarding this Policy. 5. Make available Customer Service representatives via telephone during normal business hours. 6. Mail copies of this Policy, a Plain Language Summary of this Policy, and a Financial Assistance Application to patients or their guarantor free of charge upon request. 7. Broadly communicate this Policy as a part of its general outreach efforts. 8. Educate patient-facing team members on this Policy and the process for referring patients to the program.

Schedule H, Part VI, Line 4 Community information
IU Health North Hospital is in Hamilton County, Indiana, a county located in central Indiana. Its service area counties include Marion, Hamilton, Boone, Hendricks, Hancock, Madison, and Tipton counties. Hamilton County includes ZIP codes within the towns of Arcadia, Atlanta, Carmel, Cicero, Fishers, Noblesville, Sheridan, and Westfield. Based on the most recent Census Bureau (2021) statistics, Hamilton County's population is 356,650 persons with approximately 50.7% being female and 49.3% male. The county's population estimates by race are 81.5% White, 4.9% Black, 4.6% Hispanic or Latino, 7%% Asian, 0.2% American Indian or Alaska Native, and 2.3% persons reporting two or more races. Hamilton County has relatively high levels of educational attainment. Among residents ages 25 and up, 97.1% completed their education with a high school diploma or equivalent. Among resident ages 25 and up, 59.4% earned a bachelor's degree or higher.

Schedule H, Part VI, Line 5 Promotion of community health
IU Health North Hospital is a subsidiary of Indiana University Health, Inc., a tax-exempt healthcare organization, whose Board of Directors is composed of members of which substantially all are independent community members. IU Health and its related hospital entities across the state of Indiana, including IU Health North Hospital, extends medical privileges to all physicians who meet the credentialing qualifications necessary for appointment to its medical staff. 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. During 2021, IU Health North Hospital's promotion of community health included the following highlights: In 2021, IU Health North Hospital maintained a strong presence across the northern Indianapolis suburbs in Hamilton County and supported numerous not-for-profit agencies including local parks departments, medical and dental clinics that provide care to the un- and under-insured, behavioral health agencies and organizations that provide health and social services to seniors who are in need.

Schedule H, Part VI, Line 6 Affiliated health care system
"Indiana University Health North Hospital is part of Indiana University Health (""IU Health"" or ""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 North Hospital coordinates the different initiatives of the program, including Days of Service. This is the largest volunteer event of the year, consisting of projects designed to engage IU Health North Hospital 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."