4A (Expenses $ 70815814 including grants of $ 0) (Revenue $ 92745299)
IU HEALTH BEDFORD HOSPITAL IS A MODERN, JOINT COMMISSION APPROVED RURAL HEALTH CARE FACILITY WHICH OFFERS UP-TO-DATE TECHNOLOGY AND MEDICAL PRACTICES. IT ALSO EMPLOYS A PHYSICIAN GROUP PRACTICE, IU HEALTH SOUTHERN INDIANA PHYSICIANS, WHICH IS A MULTI-SPECIALTY PRACTICE PROVIDING MEDICAL SERVICES IN INTERNAL MEDICINE, FAMILY PRACTICE, GENERAL SURGERY, ORTHOPEDICS, OBSTETRICS AND GYNECOLOGY, AND PEDIATRICS. NURSE PRACTITIONERS IN ADULT AND PEDIATRIC PRIMARY CARE HAVE BEEN ADDED TO EXPAND MEDICAL CARE.

4B (Expenses $ 0 including grants of $ 0) (Revenue $ 8534567)
As of December 31, 2021, Indiana University Health Bedford Hospital 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 Bedford Hospital recognized $8,534,567 as other program service revenue. Indiana University Health Bedford Hospital will continue to monitor compliance with the terms and conditions of the Provider Relief Fund.

4C (Expenses $ 0 including grants of $ 0) (Revenue $ 907116)
"IU HEALTH BEDFORD RECEIVES ""SHARED SERVICES"" REVENUE BY SHARING/PROVIDING SERVICES WITH INDIANA UNIVERSITY HEALTH, INC. (""IU HEALTH""), INDIANA UNIVERSITY HEALTH CARE ASSOCIATES, INC. (""IU HEALTH PHYSICIANS""), INDIANA UNIVERSITY HEALTH Bloomington, INC. (""IU HEALTH Bloomington""), AND INDIANA UNIVERSITY HEALTH PAOLI, INC. (""IU HEALTH PAOLI"")."

Schedule H, Part V, Section B, Line 3E
IU Health Bedford'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 five needs as priorities for IU Health Bedford: 1. Access to Healthcare Services 2. Aging Population and Needs of Seniors 3. Behavioral Health 4. Chronic Disease and Chronic Disease Management 5. Maternal and Infant Health and Child Well-being 6. Social Determinants of Health

Schedule H, Part V, Section B, Line 5 Facility , 1
"Facility , 1 - IU HEALTH BEDFORD HOSPITAL. In conducting its most recent CHNA, IU Health Bedford Hospital took into account input from persons who represent the broad interests of the communities it serves by hosting four community focus groups. 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 Bedford Hospital The defined community per the most recent CHNA is Lawrence County, Indiana, where the hospital resides. Lawrence County - Community Meetings In collaboration with Ascension St. Vincent, four community meetings were held in 2021 to receive input from stakeholders regarding the health needs in Lawrence County - two on April 14 and two on May 6. Secondary data and a preliminary list of community health need priorities was presented at every meeting. Each group was then asked questions about the preliminary list, including additions to the proposed needs, thoughts regarding the causes of each issue, which health services are difficult to access, populations that have disproportionate access issues, the impacts of the COVID-19 pandemic and others. From this process, participants from community meetings identified the following needs as significant for Lawrence County: * Substance abuse, including opioids and alcohol * Mental health and access to mental health services * Transportation as a barrier to health services and basic needs * Health insurance restrictions and uninsured populations * Technology barriers and the ""digital divide"" * Elderly needs including aging in place and cognitive issues * Homelessness * Health literacy and a cultural stigma against seeking preventive care In discussing the impacts of the COVID-19 pandemic on health, participants focused on the delaying of healthcare due to fears of seeing providers, mental health impacts and isolation, impacts on children due to learning delays and social isolation, food insecurity, divisions due to political and health beliefs and increasing obesity due to people staying home. An additional community survey was issued to stakeholders unable to attend community meetings, asking them to identify priority needs. Among eight responses, the following issues were identified as the most significant by respondents: * Education access and quality * Economic stability * Access to quality healthcare services * Disparities in health access for certain populations The survey also asked about the impacts of the COVID-19 pandemic. Issues selected as significant impacts by respondents include: * Social isolation and loneliness * Learning and development in children * Digital divide (lack of Internet or device access) Community meeting and survey participants Individuals from a wide variety of organizations and communities participated in community meetings and surveys. Participants included representatives from the following organizations: * Ascension St. Vincent * Bedford Chamber of Commerce * Bedford Farmers Market * Bedford Public Library * Center Stone Community Mental Health * City of Bedford Community Development * Hoosier Uplands * IU Health * IU Health Bedford Hospital * IU Health Dementia Network * IU Health South Central Region * Lawrence County Health Department * Nurse Family Partnership * Purdue Extension * WIC Family Services"

Schedule H, Part V, Section B, Line 11 Facility , 1
"Facility , 1 - IU HEALTH BEDFORD HOSPITAL. In conjunction with the CHNA, IU Health Bedford Hospital's Board adopted an implementation strategy in April 2022 related to the 2021 CHNA. IU Health Bedford 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 Bedford 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 - 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 Bedford 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 Bedford 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 Beford Hospital will address the following community health needs between 2019 and 2021: - Access to Healthcare Services - Drug and Substance Abuse (including opioids and alcohol) - Behavioral Health (formerly, Mental Health)* - Obesity, Diabetes, and Physical Inactivity *IU Health uses the term "" Behavioral Health""behavioral Mental Health and Drug and Substance Abuse (including Opioids and Alcohol). Access to Healthcare Services IU Health Bedford Hospital's implementation strategy to address the identified need of Access to Healthcare includes the following: Collaborate with the Alzheimer's Resource Center to allow the hospital to become a Dementia/Alzheimer friendly location. Throughout 2021, IUH Bedford collaborated with the Alzheimer's Resource Center to allow IU Health Bedford Hospital to become a Dementia/Alzheimer's friendly location and increase team member knowledge of how to manage interactions with patients and families dealing with Alzheimer's and dementia. Collaborators include Registered Nurses, Alzheimer's Resource Center, Centerstone, Serenity Now, Systems of Care, and Wellness 4 Lawrence County. At least two training sessions were offered by team members who provided strategies to reduce stress for families affected by dementia and increase their confidence that the needs and wishes of the person living with Alzheimer's or other dementia were being met. In December 2021 IU Health Bedford Hospital became the first IU Health facility in the South Central region to achieve Level 1 Dementia-Friendly certification. Through an insurance navigator that aids patients and walk-in clients during business hours to enroll in medical health plans. In 2021 more than 500 patients were served by the navigator. Collaborate with nonprofits to increase the awareness and action toward providing mental/behavioral health programs and services throughout the community. Throughout 2021, IUH Bedford collaborated with Centerstone and the Systems of Care team to increase awareness and action toward behavioral health in Lawrence County. The impact increased collaborations and lead to expanded behavioral health needs resources and opportunities. Collaborators include Centerstone, Serenity Now, BHC, local schools, community members, Hoosier Uplands, the Respiratory Therapy department, a physician champion, school system wellness committees, and Smoke-free Bedford Coalition. The impact of the IU Health outreach and assistance enabled several patients to seek behavioral health care. Behavioral Health (includes Drug & Substance Abuse and Mental Health) IU Health Bedford Hospital's implementation strategy to address the identified need of Behavioral Health includes the following: Expand the Telehealth program to support behavioral health needs in the community. The impact is to increase access to behavioral health provider and expand the Telehealth program to support multiple behavioral health needs in the community. Collaborators in the community include IU Health Telehealth program, external providers, and Behavioral Health. Several virtual care doctors and all Hospitalists are trained in telehealth resources to provide available services to community members. Throughout 2021, this program increased the awareness of community resources that are available to the public and made it more convenient for patients to receive care during a pandemic. Collaborate with nonprofits to increase the awareness and action toward providing mental/behavioral health programs and services throughout the community. Collaboration with Centerstone and the Systems of Care teams increased consciousness and action of behavioral health issues in Lawrence County. The pandemic brought about a rise in this need as community members were asked to quarantine for more than 30 days at a time and remain in isolation from most community and public events. The impact was the rise in behavioral health issues in the facility and the need for increased collaborative efforts with law enforcement and mental health organizations to provide training for our team members on how to handle these situations. In 2021, collaborators included Centerstone, Serenity Now, local schools, the United Way, Hoosier Uplands, the Respiratory Therapy department, and Between the Crowd Services. The Emergency Management staff at Bedford conducted multiple trainings in the facility departments to address and educate staff about resources and appropriate reactions/precautions. Provide peer recovery coaches for holistic management and continuum of care management for patients. In 2021, peer recovery coaches for holistic management and continuum of care management for patients created awareness of and utilized resources that enable patients to connect with peer recovery coaches to guide a long-term treatment and recovery plan with the assistance of peer recovery coaches and community organizations. Also, ""train the trainer"" was completed, as well as a virtual training for others in the community. Provide education to Lawrence County middle school students on the effects of using tobacco and other related products. During 2019, IUH Bedford provided education to Lawrence County middle school students on the effects of using tobacco and other related products. This partnership was facilitated between school administration and staff to support this evidence-based cessation program in 2019. It was discontinued due to COVID-19 restrictions in 2020-2021. Provide free tobacco cessation classes, as well as expand to do outreach in local businesses. Encourage organizations to provide incentives for non-smokers. In 2021, IUH Bedford was unable to provide free tobacco cessation classes to community members, as was done in 2019 due to COVID-19 restrictions. Local businesses and organizations like Hoosier Uplands, the Lawrence County Health Department, and the North Lawrence Wellness Committee continued to provide incentives for non-smokers, while granting virtual access to free smoking cessation resources/courses. Collaborators included IU Health Bedford Hospital, IU Health Physicians Hematology and Oncology, IU Health Pulmonology and Respiratory Care, Lawrence County businesses, the Economic Growth Council, the Lawrence County Chamber, North Lawrence Wellness Committee, Boys and Girls Club, and Smoke-Free Bedford. Increase collaboration with Systems of Care to expand their impact in the community. In 2021 collaboration of the Systems of Care network expanded their impact in the community by creating awareness of events and meeting dates/time through various marketing channels in the IU Health network and with local media partners. Collaborators included the Lawrence County Coordinating Council Board (LCC) and local law enforcement agencies (including the Bedford Hospital Police Department) to assist and encourage access to virtual and in-person resources to individuals in 2021."

Schedule H, Part V, Section B, Line 11 Facility , 2
"Facility , 2 - IU HEALTH BEDFORD HOSPITAL (Continued). Provide education to healthcare providers on safe opioid prescription practices. During 2021, a drug take-back kiosk was utilized in the Bedford Medical Office Building that was accompanied by healthcare provider virtual education on safe opioid prescription practices twice throughout the year. The impact emphasized the need for safe opioid prescribing and to decrease the health burden that is derived from measurable prevention efforts. Collaborators include healthcare providers and law enforcement agencies. In 2021, this kiosk was emptied more than seven times through this program. - Obesity, Diabetes, and Physical Inactivity IU Health Bedford Hospital's implementation strategy to address the identified need of Obesity, Diabetes, and Physical Inactivity includes the following: Partner with community resources by providing educational materials to promote healthy eating habits and exercise. The impact was to promote healthy activity, lifestyles, and weight with the help of Registered Nurses, Dieticians, Purdue Extension- ""Dining with Diabetes"" programs, the City of Mitchell, the City of Bedford, and the Bedford Parks Department. During 2021, over 200 My Plate resources and nutrition guidelines were shared through virtual programs; youth and adults used these resources to create healthy meals that included all four food groups, as well as become cognizant of the fat and sugar content in many popular processed food and drinks. Collaborate with local entities to create or update trail connectors to local parks, schools and other landmarks. During 2021, IUH Bedford collaborated with local entities like the Bedford Parks Department, Purdue Extension, the Bedford Street Department, the Indiana Trails Association, and Stone Gate Academy to increase community access to free resources in the community. Awareness increased through IU Health employees, along with several community partners. IU Health Bedford Hospital hosted two local Healthy Results challenges on-site, in partnership with Purdue Extension's Food and Nutrition department. These opportunities allowed staff to receive points toward their employee wellness plans and increased the recognition of healthier options within our facility while encouraging active lifestyles. Team members are then able to share these strategies, knowledge, and resources with patients and visitors. Expand the GOAL and GOAL 2.0 program from Bloomington to Lawrence County. This program will increase childhood knowledge of healthy weight and activity. The focus is on developing healthy, sustainable habits with a registered dietitian during an eight-week program. An alternative is a four-week program with a dietitian providing hands-on cooking lessons to children and their parents about the basics of meal preparation and involving the youth in the process. Community connections and rapport were initiated in 2019 and continued to strengthen through 2021. Community Health Needs Not Being Addressed IU Health Bedford Hospital is unable to address those community health needs that do not relate directly to the hospital's mission to deliver health care. These are needs that other governmental agencies and/or community organizations have the most appropriate expertise and resources to address. Although IU Health cannot address these needs directly, it does support governmental and other agencies in their efforts to help with these needs. IU Health Bedford Hospital is unable to address the following community health needs identified in the Community Health Needs Assessment: Education, Workforce Training and Unemployment IU Health Bedford Hospital is in a collaborative relationship with local education and workforce development groups. Currently, we host a variety of medical students at the facility for training and encourage further education in the medical field. This relationship will continue, but impact is limited to this community health need."

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - IU HEALTH BEDFORD HOSPITAL. IN ADDITION TO FPG, IU HEALTH BEDFORD 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 BEDFORD HOSPITAL. IU Health Bedford 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 Bedford will treat the adult as a dependent for purposes of the FPL calculation. IU Health Bedford 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 Bedford, 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 Bedford 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 Bedford 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 Bedford 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 Bedford 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 BEDFORD HOSPITAL. IU Health takes several other measures to broadly 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 BEDFORD'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 HTTP://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 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 26.59%.

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 $4,803,779.

Schedule H, Part II PROMOTION OF HEALTH IN COMMUNITIES SERVED
"IU Health Bedford 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 Bedford 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. This includes making contributions to community-building activities by providing investments and resources to local community initiatives. Several examples include IU Beford Hospital's support of the following organizations and initiatives that focus on some of the root causes of health issues including access to care, food insecurity, homelessness, and public safety: - Red Cross - Local law enforcement officials - FEMA site in Lawrence County - Becky's Place (local shelter) - Bertha's Mission (food pantry) - Lawrence County Cancer Patient Services - Hope Resource - United Way - The Boys and Girls Club"

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 BEDFORD 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
4803779

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 BEDFORD 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 BEDFORD 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 BEDFORD 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 V, Section B, Line 16a FAP website
- IU HEALTH BEDFORD 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 BEDFORD 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 BEDFORD 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 I, Line 3c Eligibility criteria for free or discounted care
"IU HEALTH BEDFORD USES SEVERAL FACTORS OTHER THAN FEDERAL POVERTY GUIDELINES (""FPG"") IN DETERMINING ELIGIBILITY FOR FREE CARE UNDER ITS FAP. THESE FACTORS INCLUDE THE FOLLOWING: 1. ELIGIBILITY FOR FINANCIAL ASSISTANCE DUE TO FINANCIAL OR PERSONAL HARDSHIP IN ORDER TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE DUE TO FINANCIAL OR PERSONAL HARDSHIP UNDER THIS POLICY, A PATIENT OR GUARANTOR MUST: - SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION WITH ALL SUPPORTING DOCUMENTATION AND BE APPROVED IN ACCORDANCE WITH THIS POLICY; - BE AN INDIANA RESIDENT AS DEFINED IN THIS POLICY; AND - IF UNINSURED, CONSULT WITH A MEMBER OF IU HEALTH'S INDIVIDUAL SOLUTIONS DEPARTMENT TO DETERMINE IF HEALTH CARE COVERAGE MAY BE OBTAINED FROM A GOVERNMENT INSURANCE OR ASSISTANCE PRODUCT, THE HEALTH INSURANCE MARKETPLACE, OR FROM ANY OTHER SOURCE OF COVERAGE. FINANCIAL ASSISTANCE DUE TO FINANCIAL HARDSHIP IS ONLY AVAILABLE FOR ENCOUNTERS WHERE CARE WAS INITIATED VIA AN ELIGIBLE FACILITY'S EMERGENCY DEPARTMENT, DIRECT ADMISSION FROM A PHYSICIAN'S OFFICE, OR TRANSFER FROM ANOTHER HOSPITAL FACILITY. 2. FINANCIAL ASSISTANCE DUE TO FINANCIAL HARDSHIP THE FPL INCOME THRESHOLD UNDER THIS SECTION IS AS FOLLOWS: -IF ONE OR MORE ADULTS AND ZERO DEPENDENTS ARE IN THE HOUSEHOLD, THE FPL INCOME THRESHOLD IS 200%. -IF TWO OR MORE ADULTS AND ONE OR MORE DEPENDENTS ARE IN THE HOUSEHOLD, THE FPL INCOME THRESHOLD IS 250%. -IF ONE ADULT AND ONE OR MORE DEPENDENTS ARE IN THE HOUSEHOLD, THE FPL INCOME THRESHOLD IS 300%. IN SOME INSTANCES, AN ADULT WILL ALSO QUALIFY AS A DEPENDENT. WHEN THIS OCCURS, IU HEALTH BEDFORD WILL TREAT THE ADULT AS A DEPENDENT FOR PURPOSES OF THE FPL CALCULATION. IU HEALTH BEDFORD 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 BEDFORD, 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 BEDFORD 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 BEDFORD 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 BEDFORD 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 BEDFORD 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 BEDFORD 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 III, Line 4 Bad debt expense - financial statement footnote
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 and $90,358 in 2021 and 2020, respectively.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
"IU HEALTH BEDFORD DID NOT HAVE A MEDICARE SHORTFALL FOR 2021. IU HEALTH BEDFORD'S MEDICARE REIMBURSEMENTS ARE NORMALLY LESS THAN THE COST OF PROVIDING PATIENT CARE AND SERVICES TO MEDICARE BENEFICIARIES AND DO NOT INCLUDE ANY AMOUNTS THAT RESULT FROM INEFFICIENCIES OR POOR MANAGEMENT. IU HEALTH BEDFORD 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 BEDFORD MEDICARE COST REPORT. ""ALLOWABLE COSTS"" FOR MEDICARE COST REPORT PURPOSES, HOWEVER, ARE NOT REFLECTIVE OF ALL COSTS ASSOCIATED WITH IU HEALTH BEDFORD'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."

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 Bedford 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 Bedford 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 Bedford Hospital and key informant interviews with those possessing public health expertise. After completion of the CHNA, IU Health Bedford 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 BEDFORD'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 BEDFORD maintains the confidentiality of all Financial Assistance Applications and supporting documentation. IU HEALTH BEDFORD 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 BEDFORD 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 BEDFORD 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 BEDFORD IS LOCATED IN LAWRENCE COUNTY, A COUNTY LOCATED IN SOUTH CENTRAL INDIANA. LAWRENCE COUNTY INCLUDES ZIP CODES WITHIN THE TOWNS OF BEDFORD, HELTONVILLE, MITCHELL, OOLITIC, SPRINGVILLE, AND WILLIAMS. IN ADDITION TO IU HEALTH BEDFORD, DUNN MEMORIAL HOSPITAL AND FIRST CARE URGENT CARE AND ST. VINCENT IMMEDIATE CARE ARE LOCATED IN LAWRENCE COUNTY. BASED ON THE MOST RECENT CENSUS BUREAU (2021) STATISTICS, LAWRENCE COUNTY'S ESTIMATED POPULATION IS 45,011 PERSONS WITH APPROXIMATELY 50.5% BEING FEMALE AND 49.5% MALE. THE COUNTY'S POPULATION ESTIMATES BY RACE ARE 95.6% WHITE, 1.7% HISPANIC OR LATINO, 0.7% ASIAN, 0.5% BLACK, 0.4% AMERICAN INDIAN OR ALASKA NATIVE, AND 1.3% PERSONS REPORTING TWO OR MORE RACES. LAWRENCE COUNTY HAS RELATIVELY LOW LEVELS OF EDUCATIONAL ATTAINMENT. A HIGH SCHOOL DEGREE IS THE LEVEL OF EDUCATION MOST HAS ACHIEVED (88.3%). AN ADDITIONAL 15.8% HAD AN ASSOCIATE'S OR BACHELOR'S DEGREE.

Schedule H, Part VI, Line 5 Promotion of community health
IU Health Bedford Hospital is a subsidiary of Indiana University Health, Inc., a Tax-Exempt healthcare organization, whose board of directors is primarily composed of independent community members. IU Health and its related hospital entities across the state of Indiana, including IU Health Bedford Hospital, extend 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 Bedford Hospital's promotion of community health included the following highlights: Approximately 30 IU Health Bedford team members worked extra hours and shifts to make the vaccine clinic in Paoli a success. It would have been almost impossible to host the clinic without the additional team members' support. Mobile vaccine clinics were sent to Lehigh, a Lawrence County employer, to help their population of seasonal migrant workers get vaccinated. Dr. Jose Lopez who practices in Orleans donated his time to attend this clinic so that any medical questions or concerns could be conveyed in Spanish and to assist with the movement of the patients through the clinic. The IU Health vaccine team was able to vaccinate close to 100 people and get everyone back to work in a timely fashion. Sme of the family members that showed up were provided the vaccine too. Providing this service at the workplace was the most efficient and comfortable way to get the team vaccinated and help protect them from getting severe illness from the Covid-19 virus. A mobile vaccine clinic was also set up at the Bedford and Mitchell Middle Schools where about 70 children ages 16 to 18 were able to receive both the first and second dose of the Pfizer Covid vaccine. These community vaccine offerings from the IU Health Vaccine team enabled both parents and their children to receive the vaccine with ease and convenience without having to miss school or take off work. IU Health Bedford Hospital also worked collaboratively throughout 2021 with the Lawrence County Health Department and the Emergency Management Services of Lawrence County to ensure the long-term care facilities and rehabilitation centers in the community had enough PPE. These entities met weekly in an as part of the the Lawrence County Healthcare Coalition (LCHC) which includes many partners: Lawrence County Emergency Management Agency, Lawrence County Health Department, IU Bedford Hospital, Bliss Place, Core Nursing & Rehabilitation Center, Mitchell Manor, Westview Nursing & Rehabilitation Center, White River Lodge, Autumn Trace, Hoosier Uplands Home Health Care, Stone Belt, Living Well Home Care, Bedford Outpatient Rehab, IU EMS, Hoosier Uplands and Marion Fire Department. During the height of restriction, IU Health Bedford Hospital provided gloves and gowns to these organizations, as well as assisted with the collection and distribution of materials to other entities. IU Health Bedford Hospital also provided 100 first aid kits to community First Responders. The IU Health Emergency Management Department collaborated with the North Lawrence Career Center to provide vocational students updated nursing supplies, as well as training on workplace violence and safety in the workplace.

Schedule H, Part VI, Line 6 Affiliated health care system
"Indiana University Health Bedford 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 Bedford 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 Bedford 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."