COMMUNITY HOSPITAL ANDERSON FOUNDATION INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HOSPITAL ANDERSON FOUNDATION INC (EIN 86-1053152)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-10
- IRS object ID
- 202213149349303296
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-10T11:55:27-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 352123203 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KSM BUSINESS SERVICES INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 40857 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46240 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861053152 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL ANDERSON | BusinessNameLine1Txt |
| Business Name Line2 | FOUNDATION INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 7652985133 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 N MADISON AVENUE | AddressLine1Txt |
| City | ANDERSON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46011 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TOM BANNON | PersonNm |
| Person Title | CHIEF FDN OFFICER | PersonTitleTxt |
| Phone | 7652985414 | PhoneNum |
| Signature | 2022-10-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TOM | PersonFirstNm |
| Person Last | BANNON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CASSE TATE | PreparerPersonNm |
| PTIN | P01271193 | PTIN |
| Phone | 3175802000 | PhoneNum |
| Preparation | 2022-10-24 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TOM BANNON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 N MADISON AVENUE | AddressLine1Txt |
| City | ANDERSON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46011 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,998,378 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ECOMMUNITY.COM/FOUNDATION-ANDERSON | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | COMMUNITY HOSPITAL ANDERSON FOUNDATION, INC. IS ENGAGED IN FUND RAISING ACTIVITIES TO ACQUIRE MONIES TO FURTHER THE PURPOSES AND MISSION OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. IN PROVIDING QUALITY MEDICAL CARE AND TREATMENT TO CITIZENS OF ANDERSON AND MADISON COUNTY, INDIANA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 3 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $366,842 | PYContributionsGrantsAmt |
| CY Contributions Grants | $470,622 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$210,608 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,362,143 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | -$1,025 | CYOtherRevenueAmt |
| PY Total Revenue | $156,234 | PYTotalRevenueAmt |
| CY Total Revenue | $2,831,740 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $336,152 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $443,218 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $239,062 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $305,338 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $198,716 | PYOtherExpensesAmt |
| CY Other Expenses | $106,515 | CYOtherExpensesAmt |
| PY Total Expenses | $773,930 | PYTotalExpensesAmt |
| CY Total Expenses | $855,071 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$617,696 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,976,669 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,744,155 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,878,437 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $258,653 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $396,926 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $16,485,502 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $18,481,511 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | COMMUNITY HOSPITAL ANDERSON FOUNDATION, INC. IS ENGAGED IN FUND RAISING ACTIVITIES TO ACQUIRE MONIES TO FURTHER THE PURPOSES AND MISSION OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. IN PROVIDING QUALITY MEDICAL CARE AND TREATMENT TO CITIZENS OF ANDERSON AND MADISON COUNTY, INDIANA. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $326,312 | ExpenseAmt |
| Grant | $318,953 | GrantAmt |
| Desc | A) PROVIDE CAPITAL IMPROVEMENTS & MEDICAL EQUIPMENT FOR USE BY COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. AND B) PROVIDE PROGRAMS DESIGNED TO EDUCATE THE PATIENTS OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. CONCERNING THEIR HEALTH NEEDS AND AVAILABLE MEDICAL TREATMENT. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $120,265 | ExpenseAmt |
| Grant | $120,265 | GrantAmt |
| Desc | PROVIDED FUNDS TO SUPPORT ANDERSON COMMUNITY. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,000 | ExpenseAmt |
| Grant | $4,000 | GrantAmt |
| Desc | PROVIDE SCHOLARSHIPS AND EDUCATION ASSISTANCE TO COMMUNITY HOSPITAL ANDERSON EMPLOYEES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $450,577 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | Yes (1) | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 1 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 3 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| DAF Excess Business Holdings | 0 | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | 0 | TaxableDistributionsInd |
| Distribution To Donor | 0 | DistributionToDonorInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TOM BANNON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7652985414 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 N MADISON AVENUE | AddressLine1Txt |
| City | ANDERSON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46011 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| ELIZABETH S THARP MBA BSN RN | |||||||
| DIRECTOR | 3.00 | 47.00 | Yes (X) | $0 | $455,650 | $152,649 | |
| CHARLIE WILLIAMS MD | |||||||
| DIRECTOR | 3.00 | 40.00 | Yes (X) | $0 | $368,777 | $98,291 | |
| IVY WALSH | |||||||
| SECRETARY | 3.00 | 0.00 | Yes (X) | $0 | $55,011 | $34,759 | Yes (X) |
| TOM BANNON | |||||||
| CHIEF FDN OFFICER | 31.00 | 12.00 | $113,450 | $75,634 | $68,494 | Yes (X) | |
| TIM ALFORD DDO | |||||||
| DIRECTOR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BOB DICKSON | |||||||
| DIRECTOR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| CHRISTINE DUDLEY | |||||||
| DIRECTOR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JOHN HARRIS | |||||||
| DIRECTOR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| RICK JULIAN | |||||||
| DIRECTOR THROUGH OCTOBER 2021 | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| LINDA J MILLER | |||||||
| DIRECTOR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MIKE MONTGOMERY | |||||||
| DIRECTOR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BEN ORCUTT | |||||||
| CHAIRMAN | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| LEROY QUASHIE PHD | |||||||
| DIRECTOR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| AARON REGER | |||||||
| TREASURER | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| LUKE RENNER | |||||||
| DIRECTOR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| NANCY RICKER | |||||||
| DIRECTOR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KEITH TRENT | |||||||
| DIRECTOR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BILL WATSON | |||||||
| DIRECTOR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BRYAN WILLIAMS | |||||||
| VICE CHAIRMAN | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| DAN YATES | |||||||
| DIRECTOR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $113,450 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $955,072 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $354,193 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $9,600 | FundraisingAmt |
| Related Organizations | $109,068 | RelatedOrganizationsAmt |
| All Other Contributions | $351,954 | AllOtherContributionsAmt |
| Total Contributions | $470,622 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $263,359 | TotalRevenueColumnAmt |
| Exclusion | $263,359 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,258,975 | SecuritiesAmt |
| Other | $302 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,160,493 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,098,482 | SecuritiesAmt |
| Other | $302 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,098,784 | TotalRevenueColumnAmt |
| Exclusion | $2,098,784 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $5,120 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $9,600 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $6,145 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,025 | TotalRevenueColumnAmt |
| Exclusion | -$1,025 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,831,740 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,361,118 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $439,218 | TotalAmt |
| Program Services | $439,218 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,000 | TotalAmt |
| Program Services | $4,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,450 | TotalAmt |
| Management And General | $113,450 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,659 | TotalAmt |
| Management And General | $141,659 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,512 | TotalAmt |
| Management And General | $13,512 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,937 | TotalAmt |
| Management And General | $19,937 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,780 | TotalAmt |
| Management And General | $16,780 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,599 | TotalAmt |
| Management And General | $7,599 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,360 | TotalAmt |
| Management And General | $11,360 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,680 | TotalAmt |
| Management And General | $76,680 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| COMMUNITY FARM | $7,359 | $7,359 | |
| ANNUITY | $1,600 | $1,600 | |
| BAD DEBT ALLOWANCE | $1,237 | $1,237 | |
| DUES | $616 | $616 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64 | TotalAmt |
| Management And General | $64 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $855,071 | TotalAmt |
| Program Services | $450,577 | ProgramServicesAmt |
| Management And General | $404,494 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $556,645 | BOYAmt |
| EOY | $349,431 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $39,533 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,187,510 | BOYAmt |
| EOY | $18,489,473 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,744,155 | BOYAmt |
| EOY | $18,878,437 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,797 | BOYAmt |
| EOY | $158 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $256,856 | BOYAmt |
| EOY | $396,768 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $258,653 | BOYAmt |
| EOY | $396,926 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,485,502 | BOYAmt |
| EOY | $16,822,456 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,659,055 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,485,502 | BOYAmt |
| EOY | $18,481,511 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,744,155 | BOYAmt |
| EOY | $18,878,437 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,976,669 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$58,274 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $76,553 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $1,061 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSP OF ANDERSON & MADISON COUNTY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351069822 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $318,953 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $318,953 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $618,475 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $778,995 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $694,561 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $366,842 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $470,622 | CurrentTaxYearAmt |
| Total | $2,929,495 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $618,475 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $778,995 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $694,561 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $366,842 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $470,622 | CurrentTaxYearAmt |
| Total | $2,929,495 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $2,929,495 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $113,094 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $125,817 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $406,019 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $367,577 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $263,359 | CurrentTaxYearAmt |
| Total | $1,275,866 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,834 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,662 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,105 | CurrentTaxYearMinus2YearsAmt |
| Total | $38,601 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $4,243,962 | TotalSupportAmt |
| Public Support CY170 | 0.69030 | PublicSupportCY170Pct |
| Public Support PY170 | 0.72040 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | 0 | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | Yes (1) | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, SECTION A, LINE 1 - SUPPORTED ORGANIZATIONS NOT | LISTED BY NAME COMMUNITY HOSPITAL ANDERSON FOUNDATION, INC. ("CHAF") ARTICLES OF INCORPORATION PROVIDE THAT IT MAY BENEFIT A CLASS OF NONPROFIT CORPORATIONS, THE MAJORITY OF WHOSE DIRECTORS ARE ELECTED BY COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. ("CHA"). |
| PART IV, SECTION A, LINE 6 - DESCRIPTION OF SUPPORT TO | EXTERNAL ENTITY CHAF MADE GRANTS TO ORGANIZATIONS THAT WERE NOT LISTED BY NAME OR CLASS IN ITS ARTICLES OF INCORPORATION. HOWEVER, THE NAMED SUPPORTED ORGANIZATION, CHA, BENEFITED DIRECTLY FROM THE GRANTS TO THESE ORGANIZATIONS BECAUSE THE INDIVIDUAL MEMBERS OF THE CHARITABLE CLASS BENEFITED BY THE GRANTS WERE ALSO MEMBERS OF THE CHARITABLE CLASS SERVED BY CHA, THE NAMED SUPPORTED ORGANIZATION. |
| PART II, LINE 10 - OTHER INCOME | GROSS RECEIPTS FROM FUNDRAISING ACTIVITIES |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Donor Advised Funds Held | 1 | DonorAdvisedFundsHeldCnt |
| Donor Advised Funds Contri | $5,304 | DonorAdvisedFundsContriAmt |
| Donor Advised Funds Grants | $2,456 | DonorAdvisedFundsGrantsAmt |
| Donor Advised Funds Vl EOY | $88,715 | DonorAdvisedFundsVlEOYAmt |
| Disclosed Org Leg Ctrl | Yes (1) | DisclosedOrgLegCtrlInd |
| Disclosed For Charitable Prps | Yes (1) | DisclosedForCharitablePrpsInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,873,139 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $472,264 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $19 | AdministrativeExpensesAmt |
| End Year Balance | $4,345,384 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,531,139 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $342,587 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $587 | AdministrativeExpensesAmt |
| End Year Balance | $3,873,139 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,672,600 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $983,446 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $120,000 | OtherExpendituresAmt |
| Administrative Expenses | $4,907 | AdministrativeExpensesAmt |
| End Year Balance | $3,531,139 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,055,109 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$229,545 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $150,000 | OtherExpendituresAmt |
| Administrative Expenses | $2,964 | AdministrativeExpensesAmt |
| End Year Balance | $2,672,600 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,754,192 | BeginningYearBalanceAmt |
| Contributions | $70,439 | ContributionsAmt |
| Investment Earnings Or Losses | $383,468 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $150,000 | OtherExpendituresAmt |
| Administrative Expenses | $2,990 | AdministrativeExpensesAmt |
| End Year Balance | $3,055,109 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $396,768 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $396,768 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4 - INTENDED USES FOR ENDOWMENT FUNDS | FormAndLineReferenceDesc |
| Explanation | THE INTENDED USES OF THE ENDOWMENT FUNDS ARE TO PROVIDE EQUIPMENT FOR COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. ("CHA") AND THE SURROUNDING COMMUNITY. THE FOUNDATION ALSO PROVIDES SCHOLARSHIPS AND OTHER EDUCATIONAL SUPPORT. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| COMM HOSP OF ANDERSON & MADISON CTY | ||||||||
| 1515 NORTH MADISON AVENUE | ANDERSON | IN | 46011 | 351069822 | 501C3 | $318,953 | $0 | GENERAL SUPPORT |
| ANDERSON COMMUNITY SCHOOLS | ||||||||
| 1600 HILLCREST AVENUE | ANDERSON | IN | 46011 | 356002149 | ANDERSON COMM SCHOOL | $28,000 | $0 | GENERAL SUPPORT |
| SOUTH MADISON COMMUNITY SCHOOL CORP | ||||||||
| 203 S HERITAGE WAY | PENDLETON | IN | 46064 | 351114508 | SOUTH MADSN COMM SCH | $18,700 | $0 | GENERAL SUPPORT |
| FRANKTON-LAPEL COMMUNITY SCHOOLS | ||||||||
| 7916 W 300 N | ANDERSON | IN | 46011 | 351263898 | FKTN-LAPEL COMM SCH | $13,500 | $0 | GENERAL SUPPORT |
| ELWOOD COMMUNITY SCHOOLS | ||||||||
| 1306 NORTH ANDERSON STREET | ELWOOD | IN | 46036 | 356002314 | ELWOOD COMM SCHOOLS | $6,800 | $0 | GENERAL SUPPORT |
| ALEXANDRIA COMMUNITY SCHOOLS | ||||||||
| 800 N CENTRAL NORTHWEST ENTRANCE | ALEXANDRIA | IN | 46001 | 351089433 | ALEXANDRIA COMM SCHO | $6,800 | $0 | GENERAL SUPPORT |
| MADISON-GRANT SCHOOLS | ||||||||
| 11700 S E 00 W | FAIRMOUNT | IN | 46928 | 351097806 | MDSN-GRANT SCHOOLS | $5,100 | $0 | GENERAL SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 7 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ELIZABETH S THARP MBA BSN RN | ||||||||||||||
| DIRECTOR | $0 | $394,082 | $0 | $41,001 | $0 | $20,567 | $0 | $133,154 | $0 | $19,495 | $0 | $608,299 | $0 | $41,001 |
| CHARLIE WILLIAMS MD | ||||||||||||||
| DIRECTOR | $0 | $332,841 | $0 | $14,500 | $0 | $21,436 | $0 | $66,401 | $0 | $31,890 | $0 | $467,068 | $0 | $14,500 |
| TOM BANNON | ||||||||||||||
| CHIEF FDN OFFICER | $104,425 | $69,617 | $7,802 | $5,201 | $1,223 | $816 | $29,110 | $19,407 | $11,986 | $7,991 | $154,546 | $103,032 | $7,802 | $5,201 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III - OTHER ADDITIONAL INFORMATION | PART I, LINE 1A - FRINGE OR EXPENSE EXPLANATION THE CHIEF FOUNDATION OFFICER WAS PROVIDED SOCIAL CLUB DUES BY COMMUNITY HOSPITAL ANDERSON FOUNDATION. THIS WAS NOT TAXABLE COMPENSATION. |
| PART I, LINE 3 - RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION | COMMUNITY HOSPITAL ANDERSON FOUNDATION, INC. CEO/EXECUTIVE DIRECTOR IS PAID BY COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. ("CHA"), A RELATED 501(C)(3) ORGANIZATION. CHA USES THE FOLLOWING IN DETERMINING THE CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE, 2) INDEPENDENT COMPENSATION CONSULTANT, 3) COMPENSATION SURVEY OR STUDY, AND 4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 7 - NON-FIXED PAYMENTS PROVIDED | THE CHIEF FOUNDATION OFFICER PARTICIPATES IN A SENIOR LEADERSHIP INCENTIVE PROGRAM. THE PROGRAM WAS ADOPTED BY THE COMMUNITY HEALTH NETWORK, INC'S ("CHNW") EXECUTIVE COMPENSATION COMMITTEE, AND IS INTENDED TO INFLUENCE OUTSTANDING PERFORMANCE, AS MEASURED AGAINST ORGANIZATIONAL PERFORMANCE. THE PROGRAM IS REVIEWED ANNUALLY BY CHNW'S EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPOSED ENTIRELY OF INDEPENDENT COMMUNITY MEMBERS. THE INCENTIVE COMPENSATION THAT IS AWARDED IS INCLUDED IN TOTAL COMPENSATION TO THE EXECUTIVE. THE TOTAL COMPENSATION (INCLUDING ANY PAYMENTS UNDER THE PROGRAM ) IS SUBJECT TO THE REVIEW AND APPROVAL OF THE EXECUTIVE COMPENSATION COMMITTEE AND INDEPENDENT COMPENSATION CONSULTANT, IN CONSIDERATION OF CODE SECTION 4958 (AND THE CORRESPONDING TREASURY REGULATIONS) TO ENSURE THAT IT REFLECTS ARM'S LENGTH, FAIR MARKET TERMS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 1A - BOX 3 OF FORM 1096 | FORM 1099'S WERE PROCESSED UNDER THE NAME AND FEDERAL IDENTIFICATION NUMBER OF COMMUNITY HEALTH NETWORK, INC. |
| FORM 990, PART VI, SECTION A, LINE 6 | CLASSES OF MEMBERS OR STOCKHOLDERS THE MEMBERS CONSIST OF THE BOARD OF DIRECTORS OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | ELECTION OF MEMBERS AND THEIR RIGHTS THE FOUNDATION'S ARTICLES OF INCORPORATION STATE THE CORPORATION SHALL HAVE ONE CLASS OF VOTING MEMBERS CONSISTING OF THE BOARD OF DIRECTORS OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. THE MEMBERS OF THE CORPORATION VOTE FOR AND ELECT THE FOUNDATION BOARD OF DIRECTORS. THE ARTICLES ALSO GIVE THE MEMBERS THE RIGHT TO FILL ANY VACANCY AMONG THE DIRECTORS AND THE BOARD OF DIRECTORS THE RIGHT TO REMOVE ANY DIRECTOR BY A VOTE OF THE MAJORITY. |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS SUBJECT TO APPROVAL OF MEMBERS THE FOUNDATION'S ARTICLES OF INCORPORATION STATE THE "MEMBERS" OF THE FOUNDATION ARE THE BOARD OF DIRECTORS OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. THEY ARE THE ONES WHO OFFICIALLY ELECT THE FOUNDATION BOARD OF DIRECTORS. THE FOUNDATION BOARD OF DIRECTORS ARE AUTHORIZED TO EXERCISE ALL POWERS RELATED TO THE FOUNDATION WITHOUT AUTHORIZATION OR APPROVAL OF THE MEMBERS OF THE FOUNDATION EXCEPT THOSE STATUTORILY REQUIRED APPROVALS UNDER THE INDIANA NONPROFIT ACT. |
| FORM 990, PART VI, SECTION B, LINE 11B | ORGANIZATION'S PROCESS TO REIVEW FORM 990 COMMUNITY HEALTH NETWORK, INC. ("CHNW") HAS ASSUMED RESPONSIBILITY FOR COMMUNITY HOSPITAL ANDERSON FOUNDATION'S ("CHAF") AUDIT, COMPLIANCE, FINANCE, AND EXECUTIVE COMPENSATION MATTERS, INCLUDING SPECIFICALLY THE PREPARATION AND REVIEW OF CHAF'S FORM 990. CHNW'S BOARD OF DIRECTORS HAS DELEGATED AUTHORITY FOR THE REVIEW OF CHAF'S FORM 990 TO TWO COMMITTEES COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS: A) THE CHNW EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE COMPENSATION ASPECTS OF CHAF'S FORM 990, AND B) THE CHNW FINANCE COMMITTEE REVIEWED THE REMAINDER OF THE FORM 990. IN ADDITION, CHAF'S OUTSIDE ACCOUNTING FIRM AND LAW FIRM REVIEWED THE FORM 990 PRIOR TO FILING. CHAF AND CHNW UTILIZED THIS PROCESS TO ENSURE THAT CHAF'S FORM 990 RECEIVED SUBSTANTIVE REVIEW BY DIRECTORS AND PROFESSIONALS WITH SPECIFIC KNOWLEDGE OF CHAF'S ACTIVITIES AND EXTENSIVE FINANCIAL, ACCOUNTING AND TAX EXPERTISE. |
| FORM 990, PART VI, SECTION B, LINE 12C | ENFORCEMENT OF CONFLICTS POLICY COMMUNITY HOSPITAL ANDERSON FOUNDATION, INC. MONITORS THE CONFLICT OF INTEREST POLICY BY MAKING SURE THAT THE FOUNDATION BOARD MEMBERS SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. THE EXECUTIVE COMMITTEE, WHICH CONSISTS OF THE OFFICERS, WOULD ADDRESS ANY CONFLICTS OF INTEREST. THE ANNUAL DISCLOSURE REQUIRES BOARD MEMBERS TO DISCLOSE, IN WRITING, ANY KNOWN FINANCIAL INTEREST THAT THE INDIVIDUAL (TOGETHER WITH FAMILY MEMBERS) HAS IN ANY BUSINESS ENTITY THAT TRANSACTS BUSINESS WITH CHAF. IN ADDITION, BOARD MEMBERS ARE REQUIRED TO IMMEDIATELY DISCLOSE ANY POSSIBLE CONFLICT OF INTEREST THAT ARISES MID-YEAR IN RELATION TO A PROPOSED TRANSACTION. THE CONFLICT OF INTEREST POLICY REQUIRES THAT ANY INDIVIDUAL WITH A CONFLICT BE RECUSED FROM THE DECISION MAKING PROCESS, THAT INDEPENDENT DIRECTORS OR COMMITTEE MEMBERS DETERMINE THAT THE PROPOSED TRANSACTION IS IN THE BEST INTEREST OF CHAF, AND THE TRANSACTION MUST BE APPROVED BY A VOTE OF INDEPENDENT DIRECTORS OR COMMITTEE MEMBERS WITHOUT THE PARTICIPATION OF ANY INTERESTED INDIVIDUAL. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION PROCESS FOR TOP OFFICIAL AS A MEMBER OF THE NETWORK, CHAF IS SUBJECT TO THE EXECUTIVE COMPENSATION PRACTICES AND PROCEDURES OF CHNW, THE NETWORK PARENT. CHNW HAS ADOPTED AN EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY THAT APPLIES TO CHAF. THE PURPOSE OF THE POLICY IS TO ENSURE THAT CHAF'S COMPENSATION ARRANGEMENTS WITH RELATED PARTIES ARE EVALUATED AND ENTERED AT ARMS LENGTH AND THAT ANY COMPENSATION THAT IS PAID TO A RELATED PARTY IS REASONABLE AND REFLECTS FAIR MARKET VALUE. THIS POLICY ENCOURAGES THE APPLICATION OF THE REBUTTABLE PRESUMPTION STANDARD OF CODE SECTION 4958 AND THE RELATED TREASURY REGULATIONS BY: A) EXCLUDING ANY INTERESTED PARTY FROM THE DECISION MAKING PROCESS, B) REQUIRING DISINTERESTED BOARD OR COMMITTEE MEMBERS TO OBTAIN AND RELY UPON COMPARABILITY DATA WHEN SETTING THE PROPOSED COMPENSATION TERMS, C) REQUIRING APPROVAL OF THE TRANSACTION IN ADVANCE BY DISINTERESTED DIRECTORS OR COMMITTE MEMBERS, AND D) REQUIRING CONTEMPORANEOUS DOCUMENTATION (I.E. MINUTES) REFLECTING THE DECISION AND THE PROCESS BY WHICH IT WAS MADE. CHNW HAS DELEGATED AUTHORITY REGARDING CHAF'S EXECUTIVE COMPENSATION TO A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE, COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS, WHICH IS RESPONSIBLE FOR APPLYING THE TERMS AND PROCESS OF THE EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY AS OUTLINED ABOVE, AND B) THE NETWORK VICE PRESIDENT OF HUMAN RESOURCES WHO IS RESPONSIBLE FOR OBTAINING COMPARATIVE SALARY MARKET DATA FOR THE CHIEF EXECUTIVE OFFICER, OFFICERS, AND KEY EMPLOYEES, ENGAGING AN INDEPENDENT COMPENSATION CONSULTANT TO PROVIDE REASONABLE COMPENSATION ANALYSIS AND/OR CONFIRM THE REASONABLENESS OF COMPENSATION, AND PROVIDING STAFF SUPPORT TO THE NETWORK EXECUTIVE COMPENSATION COMMITTEE. DURING 2021, THE NETWORK EXECUTIVE COMPENSATION COMMITTEE FOLLOWED THIS PROCESS FOR ALL SENIOR EXECUTIVE LEADERS. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS DISCLOSURE EXPLANATION A) THE ARTICLES OF INCORPORATION AND BUSINESS ENTITY REPORT ARE ON FILE WITH THE INDIANA SECRETARY OF STATE AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE INDIANA SECRETARY OF STATE OR FREE OF CHARGE ON THE SECRETARY OF STATE'S WEBSITE. B) WHILE NOT AVAILABLE TO THE PUBLIC, THE CONFLICT OF INTEREST POLICY IS DESCRIBED IN PART VI, LINE 12C. C) COMMUNITY HOSPITAL ANDERSON FOUNDATION, INC. DOES NOT HAVE INDIVIDUALLY AUDITED FINANCIAL STATEMENTS. ITS FINANCIAL RESULTS ARE INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMUNITY HEALTH NETWORK, INC. AND AFFILIATES. AS SUCH, THERE ARE NO INDIVIDUAL FINANCIAL STATEMENTS TO POST. COMMUNITY HOSPITAL ANDERSON FOUNDATION, INC. DOES FILE THE 990 TAX RETURN ON AN ANNUAL BASIS WHICH IS AVAILABLE UPON REQUEST AND/OR AVAILABLE ON A DELAYED BASIS ON GUIDESTAR.ORG. D) COMMUNITY HEALTH NETWORK, INC. AND AFFILIATES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | FUND TRANSFER FROM COMMUNITY HEALTH NETWORK FOUNDATION 1,061. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY HEALTH NETWORK INC | |||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 350983617 | HOSPITAL | IN | 501(C)(3) | LINE 3 | N/A | 0 | |
| COMMUNITY HEALTH NETWORK FOUNDATION | |||||||||||
| 7330 SHADELAND STATION SUITE 100 | INDIANAPOLIS | IN | 46256 | 510181688 | CHARITY | IN | 501(C)(3) | LINE 12B, II | Yes (1) | CHNW | |
| COMMUNITY HOME HEALTH SERVICES INC | |||||||||||
| 9894 EAST 121ST STREET | FISHERS | IN | 46037 | 350953467 | HEALTH CARE | IN | 501(C)(3) | LINE 10 | Yes (1) | CHNW | |
| COMM HOSP OF ANDERSON & MADISON CTY | |||||||||||
| 1515 N MADISON AVENUE | ANDERSON | IN | 46011 | 351069822 | HOSPITAL | IN | 501(C)(3) | LINE 3 | 0 | CHNW | |
| COMMUNITY HOSPITAL SOUTH INC | |||||||||||
| 1402 E COUNTY LINE ROAD SOUTH | INDIANAPOLIS | IN | 46227 | 351088640 | HOSPITAL | IN | 501(C)(3) | LINE 3 | Yes (1) | CHNW | |
| COMMUNITY HOWARD REGIONAL HEALTH | |||||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 351865344 | HOSPITAL | IN | 501(C)(3) | LINE 3 | Yes (1) | CHNW | |
| COMM HOWARD REGIONAL HEALTH FDN | |||||||||||
| PO BOX 9011 | KOKOMO | IN | 46904 | 237309596 | SUPPORT | IN | 501(C)(3) | LINE 7 | N/A | 0 | |
| COMMUNITY PHYSICIANS OF IN INC | |||||||||||
| 7240 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 205392766 | PHYSICIAN SERVICES | IN | 501(C)(3) | LINE 10 | Yes (1) | CHNW | |
| FAIRBANKS HOSPITAL INC | |||||||||||
| 8102 CLEARVISTA PARKWAY | INDIANAPOLIS | IN | 46256 | 350811197 | HOSPITAL | IN | 501(C)(3) | LINE 3 | Yes (1) | CHNW | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| CHNJMH VENTURES LLC | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 462356266 | DIAG/REHAB | IN | N/A | 0 | 0 |
| COMMUNITY ENDOSCOPY CENTER LLC | |||||||||
| 1601 N MADISON AVENUE SUITE 300 | ANDERSON | IN | 46011 | 611464136 | HEALTH CARE | IN | N/A | 0 | 0 |
| COMMUNITY HEALTH AT HOME LLC | |||||||||
| 1700 EDISON DRIVE | MILFORD | OH | 451502729 | 833536760 | HEALTH CARE | IN | N/A | 0 | 0 |
| COMMUNITY HEALTH NETWORK REHAB HOSP LLC | |||||||||
| 680 S FOURTH STREET | LOUISVILLE | KY | 40202 | 453414249 | REHAB | IN | N/A | 0 | 0 |
| COMMUNITY HEALTH NTWRK REHAB HOSP SOUTH LLC | |||||||||
| 680 S FOURTH STREET | LOUISVILLE | KY | 40202 | 821385366 | REHAB | IN | N/A | 0 | 0 |
| COMMUNITY HEALTH NTWRK REHAB HOSP WEST LLC | |||||||||
| 330 SEVEN SPRINGS WAY | BRENTWOOD | TN | 37027 | 845110509 | REHAB | IN | N/A | 0 | 0 |
| EAST CAMPUS SURGERY CENTER LLC | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 352028517 | SURGERY | IN | N/A | 0 | 0 |
| HAMILTON SURGERY CENTER LLC | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 352061413 | SURGERY | IN | N/A | 0 | 0 |
| HEALTHBOX CHICAGO II LLC | |||||||||
| 33 WEST MONROE STREET SUITE 1700 | CHICAGO | IL | 60603 | 463871950 | INVESTMENT | IL | N/A | 0 | 0 |
| HOWARD COMMUNITY SURGERY CTR LLC | |||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 352118748 | SURGERY | IN | N/A | 0 | 0 |
| INDIANAPOLIS ENDOSCOPY CENTER LLC | |||||||||
| 8315 E 56TH STREET | INDIANAPOLIS | IN | 46216 | 352010874 | HEALTH CARE | IN | N/A | 0 | 0 |
| MICHIGAN SURGERY INVESTMENT LLC | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 320147008 | SURGERY CENTERS | IN | N/A | 0 | 0 |
| NORTH CAMPUS OFFICE ASSOCIATES LP | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 351808625 | RENTAL PROPERTY | IN | N/A | 0 | 0 |
| NORTH CAMPUS SURGERY CENTERS LLC | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 352147088 | SURGERY | IN | N/A | 0 | 0 |
| NORTHPOINT PEDIATRICS LLC | |||||||||
| 8101 CLEARVISTA PARKWAY SUITE 185 | INDIANAPOLIS | IN | 46256 | 351960566 | HEALTH CARE | IN | N/A | 0 | 0 |
| NORTHWEST SURGERY CENTER LLC | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 208754071 | SURGERY | IN | N/A | 0 | 0 |
| PILLARS HOUSING LP | |||||||||
| 3500 SOUTH LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 161652671 | HOUSING | IN | N/A | 0 | 0 |
| PRIMARIA HEALTH LLC | |||||||||
| 9365 COUNSELORS ROW SUITE 210 | INDIANAPOLIS | IN | 46240 | 474728937 | CONSULTING | IN | N/A | 0 | 0 |
| SCP INDIANAPOLIS LLC | |||||||||
| 7430 SHADELAND AVENUE SUITE 100 | INDIANAPOLIS | IN | 46250 | 460639908 | HEALTH CARE | IN | N/A | 0 | 0 |
| SOUTH CAMPUS SURGERY CENTER LLC | |||||||||
| 1550 EAST COUNTY LINE ROAD | INDIANAPOLIS | IN | 46227 | 352038072 | SURGERY | IN | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHN ASSURANCE COMPANY LTD | |||||||||||||
| PO BOX 1051GT | GRAND CAYMAN | CJ | 980418913 | SELF INSURANCE | CJ | N/A | C | Yes (1) | |||||
| PILLARS COMMUNITY HOUSING INC | |||||||||||||
| 161652666 | HOUSING | N/A | C | Yes (1) | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| VISIONARY ENTERPRISES INC | |||||||||||||
| 351538433 | MANAGEMENT SERVICES | N/A | C | Yes (1) | 6626 EAST 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | IN | ||||
| VEI MICHIGAN INC | |||||||||||||
| 300097377 | MANAGEMENT SERVICES | N/A | C | Yes (1) | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| WESTVIEW DELIVERY SYSTEM | |||||||||||||
| 351910292 | MANAGEMENT SERVICES | N/A | C | Yes (1) | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
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