FURP.ORG / PUBLIC DATA EXPLORER

HEALTH INSTITUTE OF INDIANA INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
HEALTH INSTITUTE OF INDIANA INC (EIN 35-2022402)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-07
IRS object ID
201823119349301917
Schema version
2017v2.3
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

FieldValueIRS element (for citing)
Return2018-11-07T13:14:32-05:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN352032768PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CASKEY & DAILY PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14745 STATESMEN DRIVE SUITE CAddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46250ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN352022402EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HEALTH INSTITUTE OF INDIANA INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHEALBusinessNameControlTxt
Phone3179207530PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13660 GUION ROADAddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46222ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSCOTT TEFFETELLERPersonNm
Person TitlePRES - EAST REGIONPersonTitleTxt
Phone3179207471PhoneNum
Signature2018-10-22SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJAMES A CASKEY CPA CFPPreparerPersonNm
PTINP00172185PTIN
Phone3175852647PhoneNum
Preparation2018-11-07PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address73.103.115.42IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-07IPDt
IP Tm11:42:06IPTm
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id3E83E976884D6852BF626D3B074032779D209233AtSubmissionCreationDeviceId
At Submission Filing Device Id3E83E976884D6852BF626D3B074032779D209233AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2018-06-14 16:35:46ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1HEALTHPLEX SPORTS CLUBBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerSCOTT TEFFETELLERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11500 N RITTER AVENUEAddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46219ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$3,991,042GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ECOMMUNITY.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionPROVIDING QUALITY HEALTHCARE TO THE CENTRAL INDIANA COMMUNITY WITH FACILITIES, SUPPORT, AND GROWTH FOR THE OSTEOPATHIC PROFESSION.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee158TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$233,084TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$70,712NetUnrelatedBusTxblIncmAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$3,839,835PYProgramServiceRevenueAmt
CY Program Service Revenue$3,494,201CYProgramServiceRevenueAmt
PY Investment Income-$350PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$554,148PYOtherRevenueAmt
CY Other Revenue$483,071CYOtherRevenueAmt
PY Total Revenue$4,393,633PYTotalRevenueAmt
CY Total Revenue$3,977,272CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,488,991PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,194,637CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,186,873PYOtherExpensesAmt
CY Other Expenses$1,790,079CYOtherExpensesAmt
PY Total Expenses$4,675,864PYTotalExpensesAmt
CY Total Expenses$3,984,716CYTotalExpensesAmt
PY Revenues Less Expenses-$282,231PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$7,444CYRevenuesLessExpensesAmt
Total Assets BOY$12,167,871TotalAssetsBOYAmt
Total Assets EOY$11,673,825TotalAssetsEOYAmt
Total Liabilities BOY$5,741,425TotalLiabilitiesBOYAmt
Total Liabilities EOY$5,254,823TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$6,426,446NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$6,419,002NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionPROVIDING QUALITY HEALTHCARE TO THE CENTRAL INDIANA COMMUNITY WITH FACILITIES, SUPPORT, AND GROWTH FOR THE OSTEOPATHIC PROFESSION.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$2,231,033ExpenseAmt
Revenue$3,080,580RevenueAmt
DescHEALTHPLEX IS A HEALTH AND WELLNESS FACILITY WITH AREAS DEVOTED TO CARDIAC REHABILITATION, CARDIOVASCULAR FITNESS, PHYSICAL AND OCCUPATIONAL THERAPY, AND STRENGTH TRAINING. WE PROVIDE HEALTH SCREENING AND RISK APPRAISALS, TRAINING BY DEGREED INSTRUCTORS, FACILITIES, AND EQUIPMENT FOR CARDIOVASCULAR HEALTH, PHYSICAL FITNESS, AND REHABILITATION. 33% OF OUR MEMBERS ARE SENIORS OR CHILDREN, BOTH AT RISK FROM PHYSICAL INACTIVITY. WE PROVIDE SPECIAL PROGRAMS TO MEET THEIR NEEDS. OUR POOLS ARE USED FOR PHYSICAL THERAPY, EXERCISE, AND REHABILITATION. PROGRAMS INCLUDE ARTHRITIS AQUATICS, SPECIALLY DESIGNED FOR DISABLED SENIORS, AND BEGINNING SWIMMING FOR MULTIPLE HANDICAPPED CHILDREN. WE SPONSOR HEALTH-BASED EDUCATION THROUGH COMMUNITY EXPOS FOR SENIORS, CPR CLASSES, CLASSES ON NUTRITION AND EXERCISE FOR INNER-CITY STUDENTS, BLACK EXPO SUMMER CELEBRATION, CHOLESTEROL SCREENING, DIABETIC EDUCATION, ARTHRITIS EDUCATION, AND OTHER MISCELLANEOUS PROGRAMS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$158,699ExpenseAmt
Revenue$495,566RevenueAmt
DescHEALTHPLEX OWNS A MEDICAL OFFICE BUILDING ("MOB") ATTACHED TO THE HEALTH AND WELLNESS FACILITY. A PORTION OF THE MOB IS LEASED TO PHYSICIANS ON THE MEDICAL STAFF AT COMMUNITY HEALTH NETWORK, INC. ("CHNW"). ANOTHER PORTION IS USED BY INDIANAPOLIS OSTEOPATHIC HOSPITAL, INC. ("IOH") FOR HOSPITAL DEPARTMENTS. THERE IS ALSO A PUBLIC/COMMUNITY EDUCATION MEETING ROOM WHICH IS USED FOR HEALTH EDUCATION PROGRAMS AND BY IOH FOR ADMINISTRATIVE PURPOSES. ANOTHER PORTION OF THE MOB IS THE BOARDROOM WHICH IS ALSO USED BY IOH FOR ADMINISTRATIVE PURPOSES, BY NON-PROFIT COMMUNITY GROUPS IN NEED OF A RENT-FREE MEETING PLACE AND SMALL GROUP HEALTH EDUCATIONAL PROGRAMS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$2,389,732TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee158EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBRIAN MCCONNELLPersonNm
Phone3173554212PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line18180 CLEARVISTA PWKY 200AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46256ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
BRYAN A MILLS
DIRECTOR1.0059.00Yes (X)$0$1,425,217$627,046
ANNETTE M MOORE MD
DIRECTOR1.0054.00Yes (X)$0$577,057$16,200
HANY HADDAD MD
DIRECTOR1.0054.00Yes (X)$0$467,573$42,332
CHARLES SCOTT VORE MD
DIRECTOR1.0045.00Yes (X)$0$210,000$0
GARY S ALETTO
DIRECTOR1.005.00Yes (X)$0$0$0
JASON E BECKER
DIRECTOR1.007.00Yes (X)$0$0$0
KATHRYN G BETLEY
DIRECTOR1.005.00Yes (X)$0$0$0
BRUCE F KING
VICE CHAIRMA1.005.00Yes (X)$0$0$0Yes (X)
ARTHUR J LEAK
DIRECTOR1.007.00Yes (X)$0$0$0
MICHAEL PETERSON
DIRECTOR1.005.00Yes (X)$0$0$0
STEVEN R PLUMP
DIRECTOR1.007.00Yes (X)$0$0$0
JAY RICKER
DIRECTOR THR1.007.00Yes (X)$0$0$0
YVONNE SHAHEEN
SECRETARY1.005.00Yes (X)$0$0$0Yes (X)
KRISTIN SHERMAN
TREASURER1.005.00Yes (X)$0$0$0Yes (X)
RUSSELL SWAN JR
CHAIRMAN1.005.00Yes (X)$0$0$0Yes (X)
BRIAN K WILLIAMS
DIRECTOR1.005.00Yes (X)$0$0$0
JOSEPH KESSLER
CHNW CFO1.0049.00$0$711,158$273,148Yes (X)
JASON FAHRLANDER
NETWORK COO1.0049.00$0$659,889$270,815Yes (X)
DAVID C WILLIAMS DO
PRES - WEST5.0045.00$0$568,158$171,353Yes (X)
SCOTT TEFFETELLER
PRES - EAST3.0047.00$0$524,321$148,243Yes (X)
JEFFERY KIRKHAM
FORMER OFFIC0.0050.00$0$350,252$97,557Yes (X)
ELIZABETH HALL
FORMER FINAN0.0045.00$0$120,957$93,053Yes (X)
FieldValueIRS element (for citing)
Tot Reportable Comp Rltd Org$5,614,582TotReportableCompRltdOrgAmt
Total Other Compensation$1,739,747TotalOtherCompensationAmt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ARAMARK CORPORATION
27310 NETWORK PLACECHICAGOIL60673FACILITIES SRV$248,237
IRISH MECHANICAL SERVICES INC
9151 FORD CIRCLE SUITE 200FISHERSIN46038EQUIPMENT MAINT$120,209
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEMBERSHIP DUES713940$2,278,220$2,278,220
HEALTH & WELLNESS CENTER713940$720,415$720,415
MEDICAL OFFICE BUILDING531120$495,566$495,566
FieldValueIRS element (for citing)
Total Program Service Revenue$3,494,201TotalProgramServiceRevenueAmt
Gross Sales Of Inventory$16,583GrossSalesOfInventoryAmt
Cost Of Goods Sold$13,770CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,813TotalRevenueColumnAmt
Related Or Exempt Func Income$2,813RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MGMT FEES - ONE AMERICA713940$233,084$233,084
CAFETERIA722514$168,042$168,042
MASSAGE THERAPY713940$78,699$78,699

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$433TotalRevenueColumnAmt
Related Or Exempt Func Income$433RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$480,258OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,977,272TotalRevenueColumnAmt
Related Or Exempt Func Income$3,576,146RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$233,084UnrelatedBusinessRevenueAmt
Exclusion$168,042ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,875,617TotalAmt
Program Services$1,298,613ProgramServicesAmt
Management And General$577,004ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$40,085TotalAmt
Program Services$28,630ProgramServicesAmt
Management And General$11,455ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$138,603TotalAmt
Program Services$91,454ProgramServicesAmt
Management And General$47,149ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$140,332TotalAmt
Program Services$95,081ProgramServicesAmt
Management And General$45,251ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$327,059TotalAmt
Program Services$277,398ProgramServicesAmt
Management And General$49,661ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$52,971TotalAmt
Program Services$44,543ProgramServicesAmt
Management And General$8,428ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$280,104TotalAmt
Program Services$63,768ProgramServicesAmt
Management And General$216,336ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,764TotalAmt
Program Services$526ProgramServicesAmt
Management And General$1,238ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$657,979TotalAmt
Program Services$196,801ProgramServicesAmt
Management And General$461,178ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$157TotalAmt
Management And General$157ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$348,150TotalAmt
Program Services$233,156ProgramServicesAmt
Management And General$114,994ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBT$58,994$58,994
UBI TAXES$55,310$55,310
DUES & LICENSES$5,520$355$5,165
MEDICAL SUPPLIES$299$299

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,772TotalAmt
Program Services$114ProgramServicesAmt
Management And General$1,658ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,984,716TotalAmt
Program Services$2,389,732ProgramServicesAmt
Management And General$1,594,984ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$183,812BOYAmt
EOY$960EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$57,397BOYAmt
EOY$7,366EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$8,951BOYAmt
EOY$13,168EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$24,421BOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$14,725,487LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,073,156LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$11,893,290BOYAmt
EOY$11,652,331EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$12,167,871BOYAmt
EOY$11,673,825EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$176,239BOYAmt
EOY$100,713EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$116,767BOYAmt
EOY$122,837EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,448,419BOYAmt
EOY$5,031,273EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,741,425BOYAmt
EOY$5,254,823EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,426,446BOYAmt
EOY$6,419,002EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,426,446BOYAmt
EOY$6,419,002EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$12,167,871BOYAmt
EOY$11,673,825EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$7,444ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,939,513CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,993,311CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,773,394CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,954,835CurrentTaxYearMinus1YearAmt
Current Tax Year$3,589,916CurrentTaxYearAmt
Total$19,250,969TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$253,738CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$180,557CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$179,273CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$156,764CurrentTaxYearMinus1YearAmt
Current Tax Year$168,042CurrentTaxYearAmt
Total$938,374TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,193,251CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,173,868CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,952,667CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,111,599CurrentTaxYearMinus1YearAmt
Current Tax Year$3,757,958CurrentTaxYearAmt
Total$20,189,343TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$20,189,343PublicSupportTotal509Amt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$112,540CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$114,461CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$84,237CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$44,169CurrentTaxYearMinus1YearAmt
Current Tax Year$70,712CurrentTaxYearAmt
Total$426,119TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,305,791CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,288,329CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,036,904CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,155,768CurrentTaxYearMinus1YearAmt
Current Tax Year$3,828,670CurrentTaxYearAmt
Total$20,615,462TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.97930PublicSupportCY509Pct
Public Support PY5090.97910PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,586,034OtherCostOrOtherBasisAmt
Depreciation$1,933,703DepreciationAmt
Book Value$11,652,331BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$40,334OtherCostOrOtherBasisAmt
Depreciation$40,334DepreciationAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,099,119OtherCostOrOtherBasisAmt
Depreciation$1,099,119DepreciationAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$11,652,331TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFILIATESDesc
Amt$5,031,273Amt
FieldValueIRS element (for citing)
Total Liability$5,031,273TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
BRYAN A MILLS
DIRECTOR$1,076,737$328,501$19,979$591,445$35,601$2,052,263$328,501
ANNETTE M MOORE MD
DIRECTOR$557,919$19,138$16,200$593,257
HANY HADDAD MD
DIRECTOR$266,697$200,876$16,200$26,132$509,905
CHARLES SCOTT VORE MD
DIRECTOR$210,000$210,000
JOSEPH KESSLER
CHNW CFO$534,616$150,563$25,979$247,015$26,133$984,306$150,563
JASON FAHRLANDER
NETWORK COO$512,845$139,065$7,979$232,642$38,173$930,704$139,065
DAVID C WILLIAMS DO
PRES - WEST REGION$127,880$143,806$296,472$163,315$8,038$739,511$143,806
SCOTT TEFFETELLER
PRES - EAST REGION$409,816$112,785$1,720$111,669$36,574$672,564$112,785
JEFFERY KIRKHAM
FORMER OFFICER$275,186$73,913$1,153$64,169$33,388$447,809$39,600
ELIZABETH HALL
FORMER FINANCE DIR$109,543$10,934$480$69,816$23,237$214,010$10,934

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PAGE 1, PART I, LINE 4DAVID C. WILLIAMS, D.O. 277,885 0 0
SCHEDULE J, PART IIIPART I, LINE 3 - RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION HEALTH INSTITUTE OF INDIANA, INC. ("HII") CEO/EXECUTIVE DIRECTOR IS PAID BY COMMUNITY HEALTH NETWORK, INC. ("CHNW"), A RELATED 501(C)(3) ORGANIZATION. CHNW 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 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN COMMUNITY HEALTH NETWORK, INC. SECTION 457(F) PLAN COMMUNITY HEALTH NETWORK, INC. ("COMMUNITY") ADOPTED THIS COMMUNITY HEALTH NETWORK, INC. SECTION 457(F) PLAN ("PLAN") AS OF JANUARY 1, 2016 TO PROVIDE A SUPPLEMENTAL INCOME FOR RETIREMENT UPON VESTING IN THE BENEFIT AS DESCRIBED IN THE PLAN DOCUMENT. THE PLAN IS INTENDED TO BE EXEMPT FROM THE REQUIREMENTS OF CODE SECTION 409A AS A SHORT-TERM DEFERRAL PROGRAM DESCRIBED UNDER TREAS. REG. 1.409A-1 (B)(4). THE PLAN IS DESIGNED UNDER CODE SECTION 457(F) AS A "TOP-HAT PLAN" (I.E. AN UNFUNDED DEFERRED COMPENSATION PLAN MAINTAINED FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES) PURSUANT TO SECTIONS 201(2), 301(A)(3) AND 401(A)(1) OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED ("ERISA"). ELIGIBILITY: INDIVIDUALS DESIGNATED BY THE BOARD OF DIRECTORS OF COMMUNITY HEALTH NETWORK, INC. CONTRIBUTIONS: ANNUALLY FROM 2016 TO 2020 COMMUNITY WILL CREDIT A CONTRIBUTION TO A PARTICIPANT'S ACCOUNT IN AN AMOUNT EQUAL TO TEN PERCENT OF THEIR BASE COMPENSATION AS DEFINED IN THE PARTICIPANT'S EMPLOYMENT AGREEMENT WITH COMMUNITY. VESTING: SINGLE VESTING METHOD ELECTED BY THE EMPLOYER, IN ITS DISCRETION, FOR EACH PARTICIPANT, WHICH APPLIES TO ALL EMPLOYER CONTRIBUTION CREDITS. IN ADDITION, A PARTICIPANT'S ENTIRE ACCOUNT SHALL VEST ON THE PARTICIPANT'S DEATH, AN INVOLUNTARY TERMINATION OF THE PARTICIPANT'S EMPLOYMENT WITHOUT CAUSE (AS REASONABLY DETERMINED BY THE EMPLOYER), OR THE PARTICIPANT'S DISABILITY (AS DEFINED BY THE SOCIAL SECURITY ADMINISTRATION). FORFEITURE: IF ACCOUNT IS NOT VESTED AS DESCRIBED ABOVE, THE ACCOUNT WILL BE COMPLETELY FORFEITED. AMOUNTS FORFEITED DURING A PLAN YEAR REMAIN A GENERAL ASSET OF COMMUNITY. COMMUNITY HEALTH NETWORK, INC. RESTORATION PLAN COMMUNITY HEALTH NETWORK, INC. ("COMMUNITY") ADOPTED THIS COMMUNITY HEALTH NETWORK RESTORATION PLAN ("PLAN") AS OF DECEMBER 1, 2017 TO PROVIDE A SUPPLEMENTAL INCOME FOR RETIREMENT UPON VESTING IN THE BENEFITS AS DESCRIBED IN THE PLAN DOCUMENT. THE PLAN IS DESIGNED UNDER CODE SECTION 457(F) AS A "TOP-HAT PLAN" (I.E. AN UNFUNDED DEFERRED COMPENSATION PLAN MAINTAINED FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES PURSUANT TO SECTIONS 201(2), 301(A)(3) AND 401(A)(1) OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED ("ERISA"). ELIGIBILITY: INDIVIDUALS WHO HAVE THE TITLE OF PRESIDENT, SENIOR VICE PRESIDENT OR EXECUTIVE VICE PRESIDENT AND WHOSE PLAN COMPENSATION FOR THE APPLICABLE PLAN YEAR EXCEEDS THE ANNUAL COMPENSATION LIMIT UNDER CODE SECTION 401(A) (17), AS ADJUSTED FROM TIME TO TIME. CONTRIBUTIONS: 1. MATCHING CONTRIBUTIONS: IF A PARTICIPANT RECEIVES THE MAXIMUM PERMISSIBLE MATCHING CONTRIBUTION UNDER THE 401(K) PLAN, THEY WILL RECEIVE A MATCHING CONTRIBUTION IN THE PLAN THAT IS EQUAL TO THEIR COMPENSATION THAT IS GREATER THAN THE 401(K) PLAN LIMIT MULTIPLIED BY THE MAXIMUM PERMITTED MATCHING CONTRIBUTION PERCENTAGE IN THE 401(K) PLAN FOR THAT YEAR. 2. NON-ELECTIVE CONTRIBUTIONS: IF A PARTICIPANT RECEIVES A NON-ELECTIVE CONTRIBUTION IN THE 401(K) PLAN, THEY WILL RECEIVE A NON-ELECTIVE CONTRIBUTION IN THE PLAN THAT IS EQUAL TO THEIR COMPENSATION THAT IS GREATER THAN THE 401(K) PLAN LIMIT MULTIPLIED BY THE NON-ELECTIVE CONTRIBUTION PERCENTAGE IN THE 401(K) PLAN FOR THAT YEAR. NOTE THAT NO NON-ELECTIVE CONTRIBUTIONS ARE CURRENTLY BEING MADE TO THE 401(K) PLAN. CONTRIBUTIONS WILL BE CREDITED TO A PARTICIPANT'S ACCOUNT AS SOON AS ADMINISTRATIVELY FEASIBLE FOLLOWING THE END OF THE PLAN YEAR TO WHICH THE CONTRIBUTIONS RELATE. VESTING: A PARTICIPANT WILL BE 100% VESTED IN HIS ACCOUNT UPON THE EARLIEST TO OCCUR OF THE FOLLOWING: 1. ATTAINMENT OF AGE 65 PRIOR TO SEPARATION FROM SERVICE 2. DISABILITY 3. INVOLUNTARY SEPARATION FROM SERVICE FOR A REASON OTHER THAN FOR CAUSE 4. SEPARATION FROM SERVICE FOR GOOD REASON 5. A NONCOMPETITIVE PARTICIPANT'S COMPLIANCE WITH ALL TERMS OF A NONCOMPETING AGREEMENT, OR 6. DEATH FORFEITURES: IF ACCOUNT IS NOT VESTED AS DESCRIBED ABOVE, THE ACCOUNT WILL BE COMPLETELY FORFEITED. AMOUNTS FORFEITED DURING A PLAN YEAR REMAIN A GENERAL ASSET OF COMMUNITY. PART I, LINE 7 - NON-FIXED PAYMENTS PROVIDED HEALTH INSTITUTE OF INDIANA, INC., PARTICIPATES IN THE NETWORK'S SENIOR LEADERSHIP INCENTIVE PROGRAM. CERTAIN INDIVIDUALS OF THE LEADERSHIP TEAM PARTICIPATE IN THIS PROGRAM. THE PROGRAM WAS ADOPTED BY THE EXECUTIVE COMPENSATION COMMITTEE, AND IS INTENDED TO INFLUENCE OUTSTANDING PERFORMANCE BY THE SENIOR LEADERS, AS MEASURED AGAINST BOTH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE. THE PROGRAM IS REVIEWED ANNUALLY BY THE 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 ARMS LENGTH, FAIR MARKET TERMS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990FORM 990, PART I, LINE 4 - INDEPENDENT VOTING MEMBERS HEALTH INSTITUTE OF INDIANA, INC. ("HII") IS AN AFFILIATE OF COMMUNITY HEALTH NETWORK ("THE NETWORK"), AN INTEGRATED HEALTH DELIVERY SYSTEM. HII IS CONTROLLED BY ITS PARENT, COMMUNITY HEALTH NETWORK, INC. ("CHNW"), THE TAX-EXEMPT PARENT OF THE INTEGRATED HEALTH DELIVERY SYSTEM. HII'S ARTICLES OF INCORPORATION AND BYLAWS DESIGNATE THE MEMBERS OF THE BOARD OF DIRECTORS OF CHNW TO BE THE DIRECTORS OF HII. CHNW EXERCISES CONTROL OVER HII THROUGH A SERIES OF GOVERNANCE RIGHTS: A) CHNW IS THE SOLE MEMBER OF HII; B) HII HAS DELEGATED EXCLUSIVE AUTHORITY TO CHNW, ACTING THROUGH CHNW'S BOARD OF DIRECTORS, IN THE FOLLOWING SUBSTANTIVE AREAS: STRATEGIC PLANNING; CAPITAL ACCESS, BUDGETING AND ALLOCATION; AUDIT AND COMPLIANCE; EXECUTIVE COMPENSATION; AND DISPUTE RESOLUTION; C) CHNW MUST APPROVE ANY MODIFICATION, REPEAL, AMENDMENT, OR RESTATEMENT OF HII'S ARTICLES OF INCORPORATION; AND D) CHNW MUST APPROVE ANY SALE OR DISPOSITION OF SUBSTANTIALLY ALL OF THE ASSETS OF HII. WITH REGARD TO EXECUTIVE COMPENSATION, CHNW HAS DELEGATED AUTHORITY TO REVIEW AND APPROVE EXECUTIVE COMPENSATION, INCLUDING HII'S EXECUTIVES, TO A NETWORK EXECUTIVE COMPENSATION COMMITTEE COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS. IN SUM, HII HAS REMOVED ANY RISK OF INAPPROPRIATE RELATED PARTY TRANSACTIONS BY DELEGATING (THROUGH CHNW) ITS EXECUTIVE COMPENSATION DECISIONS TO A NETWORK EXECUTIVE COMPENSATION COMMITTEE AND ITS CONFLICT OF INTEREST DECISIONS TO A NETWORK AUDIT COMMITTEE, WITH EACH COMMITTEE COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS.
FORM 990, PAGE 2, PART III, LINE 4AWE SPONSOR HEALTH-BASED EDUCATION THROUGH COMMUNITY EXPOS FOR SENIORS, CPR CLASSES, CLASSES ON NUTRITION AND EXERCISE FOR INNER-CITY STUDENTS, BLACK EXPO SUMMER CELEBRATION, CHOLESTEROL SCREENING, DIABETIC EDUCATION, ARTHRITIS EDUCATION, AND OTHER MISCELLANEOUS PROGRAMS.
FORM 990, PART VFORM 990, PART V, LINE 1A - BOX 3 OF FORM 1096 FORM 1099S WERE PROCESSED UNDER THE NAME AND FEDERAL IDENTIFICATION NUMBER OF COMMUNITY HEALTH NETWORK, INC.
FORM 990, PART VIFORM 990, PART VI, LINE 2 - RELATED PARTY INFORMATION AMONG OFFICERS THE BOARD OF DIRECTORS FOR HII IS THE SAME AS THE BOARD OF DIRECTORS FOR COMMUNITY HEALTH NETWORK, INC. ("CHNW"). JOSEPH KESSLER, BRYAN MILLS, SCOTT TEFFETELLER, AND DAVID WILLIAMS, D.O. RECEIVED COMPENSATION FROM CHNW. JASON FAHRLANDER SERVED AS AN OFFICER OF HII AND RECEIVED COMPENSATION FROM CHNW. THE FOLLOWING DIRECTORS SERVED AS A DIRECTOR OF COMMUNITY PHYSICIANS OF INDIANA, INC. ("CPI"): JASON BECKER BRYAN A. MILLS ANNETTE MOORE, M.D. STEVEN PLUMP AND ANNETTE MOORE, M.D. AND HANY HADDAD, M.D. RECEIVED COMPENSATION FROM CPI. THE FOLLOWING DIRECTORS SERVED AS DIRECTORS OF VISIONARY ENTERPRISES, INC., A TAXABLE AFFILIATE OF CHNW: BRUCE F. KING BRYAN A. MILLS
FORM 990, PAGE 6, PART VI, LINE 3HEALTH INSTITUTE OF INDIANA, INC. ("HII") HAS DELEGATED EXCLUSIVE AUTHORITY TO COMMUNITY HEALTH NETWORK, INC. ("CHNW") (THE SOLE MEMBER), ACTING THROUGH CHNW'S BOARD OF DIRECTORS, IN THE FOLLOWING SUBSTANTIVE AREAS: STRATEGIC PLANNING, CAPITAL ACCESS, BUDGETING AND ALLOCATION; AUDIT AND COMPLIANCE; NETWORK COMPENSATION; AND DISPUTE RESOLUTION. IN ADDITION, CHNW MUST APPROVE ANY MODIFICATION, REPEAL, AMENDMENT, OR RESTATEMENT OF HII'S ARTICLES OF INCORPORATION. FINALLY, CHNW MUST APPROVE ANY MATERIAL SALE OR DISPOSITION OF THE ASSETS OF HII.
FORM 990, PAGE 6, PART VI, LINE 6CHNW IS THE SOLE MEMBER OF HII.
FORM 990, PAGE 6, PART VI, LINE 7BSEE FORM 990, PART VI, LINE 3
FORM 990, PAGE 6, PART VI, LINE 11BHII IS AN AFFILIATE OF COMMUNITY HEALTH NETWORK ("THE NETWORK"), AN INTEGRATED HEALTH DELIVERY SYSTEM. HII HAS DELEGATED AUTHORITY FOR THE REVIEW OF THE FORM 990 TO TWO COMMITTEES COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS: A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE COMPENSATION ASPECTS OF HII'S FORM 990, AND B) THE NETWORK FINANCE COMMITTEE REVIEWED THE REMAINDER OF HII'S FORM 990. IN ADDITION, HII'S BOARD OF DIRECTORS AND THE NETWORK'S OUTSIDE ACCOUNTING FIRM AND LAW FIRM REVIEWED THE FORM 990 PRIOR TO FILING. HII UTILIZED THIS PROCESS TO ENSURE THAT HII'S FORM 990 RECEIVED SUBSTANTIVE REVIEW BY DIRECTORS AND PROFESSIONALS WITH SPECIFIC KNOWLEDGE OF HII'S ACTIVITIES AND EXTENSIVE FINANCIAL, ACCOUNTING, AND TAX EXPERTISE.
FORM 990, PAGE 6, PART VI, LINE 12CTHE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE IS ENFORCED BY THE BOARD OF DIRECTORS TO ENSURE THAT ALL TRANSACTIONS REPRESENT ARMS LENGTH, FAIR MARKET VALUE TERMS FOR THE BENEFIT OF HII. THE SCOPE OF THIS POLICY INCLUDES: BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF A COMMITTEE WITH BOARD-DELEGATED POWERS, OR KEY MANAGEMENT PERSONNEL WHO HAVE A DIRECT OR INDIRECT "FINANCIAL INTEREST". THE POLICY IS IN PLACE TO PROTECT HII AND ITS AFFILIATES' INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN INTERESTED PERSON OF THE CORPORATION. DIRECTORS, OFFICERS, COMMITTEE MEMBERS AND KEY MANAGEMENT PERSONNEL ARE REQUIRED TO COMPLETE A WRITTEN DISCLOSURE OF FINANCIAL INTERESTS ON AN ANNUAL BASIS. WHEN A POTENTIAL CONFLICT EXISTS, THE INTERESTED PARTY IS REQUIRED TO RECUSE HIMSELF OR HERSELF FROM THE DECISION MAKING PROCESS, AND THE DISINTERESTED MEMBERS OF THE BOARD OR COMMITTEE WILL VOTE ON WHETHER TO ENTER INTO THE TRANSACTION. THE MINUTES OF THE MEETINGS SHALL CONTAIN A RECITATION OF THE DISCLOSURE OF ANY CONFLICT OF INTEREST AND REPORT OF COMPLIANCE WITH THE PROCEDURES.
FORM 990, PAGE 6, PART VI, LINE 15ACHNW ASSUMED RESPONSIBILITY FOR HII'S EXECUTIVE COMPENSATION MATTERS. CHNW HAS ADOPTED AN EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY. THE PURPOSE OF THE POLICY IS TO ENSURE THAT CHNW'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 COMMITTEE MEMBERS, AND D) REQUIRING CONTEMPORANEOUS DOCUMENTATION (I.E. MINUTES) REFLECTING THE DECISION AND THE PROCESS BY WHICH IT WAS MADE. CHNW ALSO DELEGATED AUTHORITY REGARDING HII'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, PERIODICALLY ENGAGING AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH REASONABLE COMPENSATION, AND PROVIDING STAFF SUPPORT TO THE NETWORK EXECUTIVE COMPENSATION COMMITTEE. DURING 2017, THE NETWORK EXECUTIVE COMPENSATION COMMITTEE FOLLOWED THIS PROCESS FOR ALL SENIOR EXECUTIVE LEADERS.
FORM 990, PAGE 6, PART VI, LINE 15BSEE LINE 15A ABOVE
FORM 990, PAGE 6, PART VI, LINE 19A) THE ARTICLES OF INCORPORATION AND CERTIFICATE OF EXISTENCE 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) HII DOES NOT MAKE ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. C) HII DOES NOT HAVE INDIVIDUALLY AUDITED FINANCIAL STATEMENTS. ITS FINANCIAL RESULTS ARE INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CHNW AND AFFILIATES. AS SUCH, THERE ARE NO INDIVIDUAL FINANCIAL STATEMENTS TO POST. HII 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.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
COMMUNITY HEALTH NETWORK INC
7330 SHADELAND STATION SUITE 200INDIANAPOLISIN46256350983617HOSPITALIN501C33NAfalse
COMMUNITY HEALTH NETWORK FOUNDATION
7240 SHADELAND STATION SUITE 125INDIANAPOLISIN46256510181688CHARITYIN501C312BCHNWYes (true)
COMMUNITY HLTH SERVICES OF INDIANA
7330 SHADELAND STATION SUITE 200INDIANAPOLISIN46256454817436HLTH CAREIN501C33CHNWYes (true)
COMMUNITY HOME HEALTH SERVICES INC
9894 EAST 121ST STREETFISHERSIN46037350953467HLTH CAREIN501C310CHNWYes (true)
COMM HOSP OF ANDERSON & MADISON CTY
1515 NORTH MADISON AVENUEANDERSONIN46011351069822HOSPITALIN501C33CHNWYes (true)
COMMUNITY HOSP ANDERSON FDN INC
1515 NORTH MADISON AVENUEANDERSONIN46011861053152SUPPORTIN501C312ACHAYes (true)
COMMUNITY HOSPITAL SOUTH INC
1402 E COUNTY LINE ROAD SOUTHINDIANAPOLISIN46227351088640HOSPITALIN501C33CHNWYes (true)
COMMUNITY HOWARD REGIONAL HEALTH
3500 S LAFOUNTAIN STREETKOKOMOIN46902351865344HOSPITALIN501C33CHNWYes (true)
COMM HOWARD REGIONAL HEALTH FDN
PO BOX 9011KOKOMOIN46904237309596SUPPORTIN501C37NAfalse
COMMUNITY LTC INC
1031 MONTICELLO DRIVEANDERSONIN46011351877441HLTH CAREIN501C310CHAYes (true)
COMMUNITY PHYSICIANS OF IN INC
7240 SHADELAND STATION SUITE 300INDIANAPOLISIN46256205392766PHY SRVIN501C310CHNWYes (true)
INDIANAPOLIS OSTEOPATHIC HOSP INC
3630 GUION ROADINDIANAPOLISIN46222351094734HOSPITALIN501C33CHNWYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (18 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
CHNJMH VENTURES LLC
6626 E 75TH STREET SUITE 200INDIANAPOLISIN46250462356266DIAG/REHABINN/Afalsefalse
COMMUNITYACCESSCARE IN DIALYSIS
6626 E 75TH STREET SUITE 200INDIANAPOLISIN46250474634198DIALYSISINN/Afalsefalse
COMMUNITY ENDOSCOPY CENTER LLC
1601 N MADISON AVENUE SUITE 300ANDERSONIN46011611464136HLTH CAREINN/Afalsefalse
COMM HEALTH NETWORK REHAB HOSP LLC
680 S FOURTH STREETLOUISVILLEKY40202453414249REHABINN/Afalsefalse
COMM HLTH NTWRK RHB HOSP SOUTH LLC
680 S FOURTH STREETLOUISVILLEKY40202821385366REHABINN/Afalsefalse
EAST CAMPUS SURGERY CENTER LLC
6626 E 75TH STREET SUITE 200INDIANAPOLISIN46250352028517SURGERYINN/Afalsefalse
HAMILTON SURGERY CENTER LLC
6626 E 75TH STREET SUITE 200INDIANAPOLISIN46250352061413SURGERYINN/Afalsefalse
HOWARD COMMUNITY SURGERY CTR LLC
3500 S LAFOUNTAIN STREETKOKOMOIN46902352118748SURGERYINN/Afalsefalse
HOWARD REGIONAL SPECIALTY CARE LLC
680 SOUTH FOURTH STREETLOUISVILLEKY40202371501021REHABINN/Afalsefalse
INDIANAPOLIS ENDOSCOPY CENTER LLP
8315 E 56TH STREETINDIANAPOLISIN46216352010874HLTH CAREINN/Afalsefalse
MICHIGAN SURGERY INVESTMENT LLC
6626 E 75TH STREET SUITE 200INDIANAPOLISIN46250320147008SURG CTRSINN/Afalsefalse
NORTH CAMPUS OFFICE ASSOCIATES LP
6626 E 75TH STREET SUITE 200INDIANAPOLISIN46250351808625RNTL PROPINN/Afalsefalse
NORTH CAMPUS SURGERY CENTER LLC
6626 E 75TH STREET SUITE 200INDIANAPOLISIN46250352147088SURGERYINN/Afalsefalse
NORTHPOINT PEDIATRICS LLC
8101 CLEARVISTA PARKWAY SUITE 185INDIANAPOLISIN46256351960566HLTH CAREINN/Afalsefalse
NORTHWEST SURGERY CENTER LLC
6626 E 75TH STREET SUITE 200INDIANAPOLISIN46250208754071SURGERYINN/Afalsefalse
PILLARS HOUSING LP
3500 S LAFOUNTAIN STREETKOKOMOIN46902161652671HOUSINGINN/Afalsefalse
PRIMARIA HEALTH LLC
9365 COUNSELORS ROW SUITE 210INDIANAPOLISIN46240474728937HLTH CAREINN/Afalsefalse
SOUTH CAMPUS SURGERY CENTER LLC
1550 EAST COUNTY LINE ROADINDIANAPOLISIN46227352038072SURGERYINN/Afalsefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdLegal Domicile StateLegalDomicileStateCd
CHN ASSURANCE COMPANY LTD
PO BOX 1051GTGRAND CAYMANGRAND CAYMANCJ980418913INSURANCECJN/AYes (true)
PILLARS COMMUNITY HOUSING INC
161652666HOUSINGN/AYes (true)3500 S LAFOUNTAIN STREETKOKOMOIN46902IN
VISIONARY ENTERPRISES INC
351538433MGMT SRVSN/AYes (true)6626 EAST 75TH STREET SUITE 200INDIANAPOLISIN46250IN
VEI MICHIGAN INC
300097377MGMT SRVSN/AYes (true)940 N MAIN STREETANN HARBORMI48104IN
WESTVIEW DELIVERY SYSTEM INC
351910292MGMT SRVSN/AYes (true)3630 GUION ROADINDIANAPOLISIN46222IN
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (true)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
COMMUNITY PHYSICIANS OF INDIANA
A$187,757BOOK VALUE
COMMUNITY PHYSICIANS OF INDIANA
R$442,457BOOK VALUE
INDIANAPOLIS OSTEOPATHIC HOSPITAL
A$231,610BOOK VALUE
VISIONARY ENTERPRISES INC
P$138,010BOOK VALUE
WESTVIEW DELIVERY SYSTEM INC
A$55,461BOOK VALUE