COMMUNITY HOSPITAL OF ANDERSON- MADISON COUNTY INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HOSPITAL OF ANDERSON- MADISON COUNTY INC (EIN 35-1069822)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-08
- IRS object ID
- 201833129349302448
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-08T15:04:49-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 352032768 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CASKEY & DAILY PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4745 STATESMEN DRIVE SUITE C | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46250 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351069822 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL OF ANDERSON AND | BusinessNameLine1Txt |
| Business Name Line2 | MADISON COUNTY INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 7652985125 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 NORTH MADISON AVENUE | AddressLine1Txt |
| City | ANDERSON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 460113453 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN B HARRIS | PersonNm |
| Person Title | VP OF FINANCE & CFO | PersonTitleTxt |
| Phone | 7656465103 | PhoneNum |
| Signature | 2018-10-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JAMES A CASKEY CPA CFP | PreparerPersonNm |
| PTIN | P00172185 | PTIN |
| Phone | 3175852647 | PhoneNum |
| Preparation | 2018-11-07 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 73.103.115.42 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-07 | IPDt |
| IP Tm | 12:00:23 | IPTm |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 3E83E976884D6852BF626D3B074032779D209233 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 3E83E976884D6852BF626D3B074032779D209233 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2018-06-14 16:35:46Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ELIZABETH S THARP | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 NORTH MADISON AVENUE | AddressLine1Txt |
| City | ANDERSON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 460113453 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $191,460,930 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.COMMUNITYANDERSON.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1961 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | DEEPLY COMMITTED TO THE COMMUNITIES WE SERVE, WE ENHANCE HEALTH AND WELL- BEING. TO SIMPLY DELIVER AN EXCEPTIONAL EXPERIENCE - WITH EVERY LIFE WE TOUCH. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 1410 | TotalEmployeeCnt |
| Total Volunteers | 96 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $391,834 | PYContributionsGrantsAmt |
| CY Contributions Grants | $351,547 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $169,005,885 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $172,895,270 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$1,183,149 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,537,692 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,028,331 | PYOtherRevenueAmt |
| CY Other Revenue | $1,231,591 | CYOtherRevenueAmt |
| PY Total Revenue | $169,242,901 | PYTotalRevenueAmt |
| CY Total Revenue | $178,016,100 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $301,004 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $287,592 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $76,598,055 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $83,727,367 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $65,637,933 | PYOtherExpensesAmt |
| CY Other Expenses | $67,499,566 | CYOtherExpensesAmt |
| PY Total Expenses | $142,536,992 | PYTotalExpensesAmt |
| CY Total Expenses | $151,514,525 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $26,705,909 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $26,501,575 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $244,856,770 | TotalAssetsBOYAmt |
| Total Assets EOY | $287,800,420 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $21,979,600 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $21,007,004 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $222,877,170 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $266,793,416 | NetAssetsOrFundBalancesEOYAmt |
| Mission | DEEPLY COMMITTED TO THE COMMUNITIES WE SERVE, WE ENHANCE HEALTH AND WELL- BEING. TO SIMPLY DELIVER AN EXCEPTIONAL EXPERIENCE - WITH EVERY LIFE WE TOUCH. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $140,429,238 | ExpenseAmt |
| Revenue | $173,192,474 | RevenueAmt |
| Desc | COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. ("CHA") IS AN ACUTE CARE MEDICAL FACILITY WITH 140 STAFFED BEDS (EXCLUDING NURSERY). IN 2017, THERE WERE 6,200 ADMISSIONS, 8,520 SURGERIES PERFORMED, 828 BIRTHS WITH A TOTAL OF 223,769 PATIENTS SERVED IN ALL DISCIPLINES. CHA PARTICIPATES IN MEDICARE, MEDICAID, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. WE PROVIDE AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. OUR STAFF MAKES EVERY EFFORT TO PROVIDE AN EFFECTIVE AND EFFICIENT HEALTH CARE DELIVERY SYSTEM. FINALLY, WE HAVE A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE THE MAJORITY. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $287,592 | ExpenseAmt |
| Grant | $287,592 | GrantAmt |
| Desc | COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. CONTRIBUTED TO A FEW LOCAL CHARITABLE ORGANIZATIONS. THE LARGEST DONATIONS ARE LISTED ON SCHEDULE I. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $140,716,830 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 170 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1410 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN B HARRIS | PersonNm |
| Phone | 7652985125 | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JASON FAHRLANDER | |||||||||
| DIRECTOR | 2.00 | 48.00 | Yes (X) | $0 | $659,889 | $270,815 | |||
| ELIZABETH S THARP | |||||||||
| PRESIDENT & | 50.00 | 0.00 | Yes (X) | $442,474 | $0 | $90,587 | Yes (X) | ||
| TROY ABBOTT MD | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $16,500 | $333,966 | $68,023 | |||
| D BENJAMIN MCCURDY MD | |||||||||
| DIRECTOR THR | 42.08 | 0.00 | Yes (X) | $148,596 | $0 | $0 | |||
| LARRY BLANKENSHIP MD | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $14,980 | $0 | $0 | |||
| THOMAS SHORT MD | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $12,000 | $0 | $0 | |||
| JULIE HETTINGA | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN KANE | |||||||||
| TREASURER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ARTHUR J LEAK | |||||||||
| VICE CHAIRMA | 2.00 | 5.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MARY JO LEE | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| RICK MOORE | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MARIE MORRIS | |||||||||
| SECRETARY | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| BILL O'NEAL PHD | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DANA STUART | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JAY B RICKER | |||||||||
| CHAIRMAN | 2.00 | 6.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JOHN B HARRIS | |||||||||
| VP OF FINANC | 50.00 | 0.00 | $351,906 | $0 | $77,723 | Yes (X) | |||
| KENNETH SHAVER MD | |||||||||
| SVP CHIEF PH | 2.00 | 48.00 | $0 | $311,195 | $99,642 | Yes (X) | |||
| SHERRI SIDWELL | |||||||||
| COO/VP INTG | 50.00 | 0.00 | $240,834 | $0 | $50,318 | Yes (X) | |||
| NIGHAT TAHIR MD | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $457,328 | $0 | $53,303 | Yes (X) | |||
| LEE ANN MCDANIEL | |||||||||
| CRNA | 50.00 | 0.00 | $386,415 | $0 | $40,679 | Yes (X) | |||
| CAROL WHITESEL | |||||||||
| VP PATIENT C | 50.00 | 0.00 | $302,072 | $0 | $71,179 | Yes (X) | |||
| MARK A FIELD | |||||||||
| CRNA | 50.00 | 0.00 | $258,657 | $0 | $42,738 | Yes (X) | |||
| LISA HALSTEAD | |||||||||
| VP LEGAL AFF | 50.00 | 0.00 | $249,805 | $0 | $168,303 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,881,567 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,305,050 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,033,310 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 63 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WR DUNKIN & SON INC | |||||
| 2409 W 18TH STREET | ANDERSON | IN | 46016 | CONSTRUCTION | $4,762,153 |
| NUGENT ELECTRIC | |||||
| 2106 OHIO AVENUE | ANDERSON | IN | 46016 | ELECTRICAL SRV | $914,564 |
| SOUTH BEND MEDICAL FOUNDATION INC | |||||
| 530 N LAFAYETTE BLVD | SOUTH BEND | IN | 466011098 | LABORATORY SRV | $733,934 |
| ACCELECARE WOUND CENTERS INC | |||||
| 10900 NE 4TH STREET SUITE 1920 | BELLEVUE | WA | 98004 | MEDICAL SERVICE | $638,243 |
| EPCHA PC | |||||
| 12953 PUBLISHERS DRIVE 200 | FISHERS | IN | 47360 | MEDICAL SERVICE | $607,992 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 31 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $286,547 | RelatedOrganizationsAmt |
| All Other Contributions | $65,000 | AllOtherContributionsAmt |
| Noncash Contributions | $65,000 | NoncashContributionsAmt |
| Total Contributions | $351,547 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT CARE SERVICE | 900099 | $167,490,887 | $167,490,887 |
| RENTAL INCOME - RELATED | 531120 | $3,546,762 | $3,546,762 |
| JOINT VENTURES | 621400 | $1,082,261 | $1,082,261 |
| CLINICAL RESEARCH | 541700 | $775,360 | $775,360 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $172,895,270 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,968,441 | TotalRevenueColumnAmt |
| Exclusion | $3,968,441 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,996,366 | SecuritiesAmt |
| Other | $17,715 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $13,443,054 | SecuritiesAmt |
| Other | $1,776 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$446,688 | SecuritiesAmt |
| Other | $15,939 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$430,749 | TotalRevenueColumnAmt |
| Exclusion | -$430,749 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA SALES | 722514 | $850,922 | $850,922 | |
| TELECOMMUNICATIONS | 900099 | $122,017 | $122,017 | |
| ESPRESSO TO GO INCOME | 900099 | $83,465 | $83,465 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $175,187 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $175,187 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,231,591 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $178,016,100 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $173,192,474 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $4,472,079 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $287,592 | TotalAmt |
| Program Services | $287,592 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,445,918 | TotalAmt |
| Program Services | $192,076 | ProgramServicesAmt |
| Management And General | $1,253,842 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,652,018 | TotalAmt |
| Program Services | $58,704,553 | ProgramServicesAmt |
| Management And General | $5,947,465 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,128,080 | TotalAmt |
| Program Services | $2,787,279 | ProgramServicesAmt |
| Management And General | $340,801 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,062,587 | TotalAmt |
| Program Services | $8,966,278 | ProgramServicesAmt |
| Management And General | $1,096,309 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,438,764 | TotalAmt |
| Program Services | $3,955,165 | ProgramServicesAmt |
| Management And General | $483,599 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,118 | TotalAmt |
| Program Services | $43,083 | ProgramServicesAmt |
| Management And General | $2,035 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $267,462 | TotalAmt |
| Program Services | $255,397 | ProgramServicesAmt |
| Management And General | $12,065 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,224 | TotalAmt |
| Management And General | $160,224 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,615,876 | TotalAmt |
| Program Services | $8,227,217 | ProgramServicesAmt |
| Management And General | $388,659 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,098 | TotalAmt |
| Program Services | $118,500 | ProgramServicesAmt |
| Management And General | $5,598 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,919,731 | TotalAmt |
| Program Services | $2,788,022 | ProgramServicesAmt |
| Management And General | $131,709 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $402,103 | TotalAmt |
| Program Services | $383,964 | ProgramServicesAmt |
| Management And General | $18,139 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,363,680 | TotalAmt |
| Program Services | $8,941,287 | ProgramServicesAmt |
| Management And General | $422,393 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $254,649 | TotalAmt |
| Program Services | $243,162 | ProgramServicesAmt |
| Management And General | $11,487 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,122 | TotalAmt |
| Program Services | $16,350 | ProgramServicesAmt |
| Management And General | $772 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $227,158 | TotalAmt |
| Program Services | $216,911 | ProgramServicesAmt |
| Management And General | $10,247 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,795,854 | TotalAmt |
| Program Services | $8,399,076 | ProgramServicesAmt |
| Management And General | $396,778 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,008,683 | TotalAmt |
| Program Services | $963,182 | ProgramServicesAmt |
| Management And General | $45,501 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $28,821,164 | $28,821,164 | |
| HAF PROGRAM FEES | $4,923,296 | $4,923,296 | |
| RENOVATION EXPENSE | $954,776 | $911,706 | $43,070 |
| DUES & SUBSCRIPTIONS | $323,790 | $309,184 | $14,606 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,782 | TotalAmt |
| Program Services | $262,386 | ProgramServicesAmt |
| Management And General | $12,396 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,514,525 | TotalAmt |
| Program Services | $140,716,830 | ProgramServicesAmt |
| Management And General | $10,797,695 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,247,397 | BOYAmt |
| EOY | $31,086,800 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,840,882 | BOYAmt |
| EOY | $21,629,622 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,618,435 | BOYAmt |
| EOY | $2,919,936 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $271,261 | BOYAmt |
| EOY | $800,580 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $158,623,283 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $88,814,484 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,428,828 | BOYAmt |
| EOY | $69,808,799 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,448,837 | BOYAmt |
| EOY | $160,089,721 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,001,130 | BOYAmt |
| EOY | $1,464,962 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $244,856,770 | BOYAmt |
| EOY | $287,800,420 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,421,388 | BOYAmt |
| EOY | $12,518,440 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,855,559 | BOYAmt |
| EOY | $5,242,255 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,702,653 | BOYAmt |
| EOY | $3,246,309 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,979,600 | BOYAmt |
| EOY | $21,007,004 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $222,877,170 | BOYAmt |
| EOY | $266,793,416 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $222,877,170 | BOYAmt |
| EOY | $266,793,416 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $244,856,770 | BOYAmt |
| EOY | $287,800,420 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $26,501,575 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $17,414,671 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,323,988 | OtherCostOrOtherBasisAmt |
| Book Value | $6,323,988 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $73,418,504 | OtherCostOrOtherBasisAmt |
| Depreciation | $35,175,477 | DepreciationAmt |
| Book Value | $38,243,027 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,197,015 | OtherCostOrOtherBasisAmt |
| Depreciation | $69,258 | DepreciationAmt |
| Book Value | $1,127,757 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $75,727,733 | OtherCostOrOtherBasisAmt |
| Depreciation | $51,784,614 | DepreciationAmt |
| Book Value | $23,943,119 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,956,043 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,785,135 | DepreciationAmt |
| Book Value | $170,908 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $69,808,799 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED THIRD PARTY SETTLEMENTS | $2,790,932 |
| DUE TO AFFILIATES | $455,377 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,246,309 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 6427 | PersonsServedCnt |
| Total Community Benefit Expns | $6,705,017 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,705,017 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04430 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,729,829 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,260,112 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,469,717 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04930 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 6427 | PersonsServedCnt |
| Total Community Benefit Expns | $38,434,846 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,260,112 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,174,734 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09360 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 34 | ActivitiesOrProgramsCnt |
| Persons Served | 19667 | PersonsServedCnt |
| Total Community Benefit Expns | $221,050 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $221,050 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 141 | PersonsServedCnt |
| Total Community Benefit Expns | $8,120 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,120 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 1000 | PersonsServedCnt |
| Total Community Benefit Expns | $9,863 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,863 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 37 | ActivitiesOrProgramsCnt |
| Persons Served | 20808 | PersonsServedCnt |
| Total Community Benefit Expns | $239,033 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $239,033 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 37 | ActivitiesOrProgramsCnt |
| Persons Served | 27235 | PersonsServedCnt |
| Total Community Benefit Expns | $38,673,879 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,260,112 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,413,767 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09530 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 510 | PersonsServedCnt |
| Total Community Benefit Expns | $2,696 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,696 | NetCommunityBenefitExpnsAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 510 | PersonsServedCnt |
| Total Community Benefit Expns | $2,696 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,696 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $6,827,941 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $61,888,611 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $77,530,515 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$15,641,904 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMM ENDOSCOPY CTR | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | ENDOSCOPY CENTER | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.41000 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.41000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMM HOSP OF ANDERSON & MADISON CTY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 NORTH MADISON AVENUE | AddressLine1Txt |
| City | ANDERSON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46011 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.COMMUNITYANDERSON.COM | WebsiteAddressTxt |
| State License | 17-005100-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | SEE PART VI, ADD'L INFORMATION | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMM HOSP OF ANDERSON & MADISON CTY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WEBAPP.ECOMMUNITY.COM/ABOUTUS/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WEBAPP.ECOMMUNITY.COM/ABOUTUS/ | StrategyWebsiteURLTxt |
| Strategy Attached | Yes (true) | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, COMM HOSP OF ANDERSON & MADISON CTY - PART V, LINE 5 | IN 2015, COMMUNITY HEALTH NETWORK CONDUCTED A CHNA TO UNDERSTAND THE GREATEST HEALTH NEEDS IN THE COMMUNITIES SERVED BY OUR HOSPITALS. THIS ASSESSMENT WAS IN LARGE PART A JOINT PROCESS AMONG FOUR INDIANA HEALTH SYSTEMS: COMMUNITY HEALTH NETWORK, IU HEALTH, ST. FRANCIS ALLIANCE, AND ST. VINCENT. COMBINED, THESE ARE THE LARGEST HEALTH SYSTEMS IN INDIANA. THROUGH THIS COLLABORATIVE PARTNERSHIP, COMMUNITY HEALTH DATA WAS COLLECTED IN THREE WAYS: 1. SECONDARY DATA COLLECTION: DATA ON HEALTH AND WELLNESS ISSUES WAS COLLECTED. SOURCES INCLUDE COUNTY HEALTH RANKINGS, CENSUS BUREAU DATA, VARIOUS REPORTS FROM THE INDIANA STATE DEPARTMENT OF HEALTH, AND OTHER NATIONAL REPORTS. INDIANA INDICATORS, COMMUNITY COMMONS, AND HEALTHY COMMUNITIES INSTITUTE DATA MANAGEMENT SYSTEMS ALSO CONTRIBUTED TO THE SECONDARY DATA USED. SOURCES OF THE SECONDARY DATA ARE IDENTIFIED THROUGHOUT THIS REPORT. 2. COMMUNITY HEALTH SURVEY: A CORE OF 20 MANDATORY QUESTIONS BASED ON PERCEPTION OF COMMUNITY AND PERSONAL NEEDS WERE CREATED. IN ADDITION, PROFESSIONALS ASSIGNED TO EACH COUNTY WORKED WITH ESTABLISHED COMMUNITY HEALTH COLLABORATIVES, LOCAL HOSPITALS, AND THE LOCAL HEALTH DEPARTMENT TO DEVELOP VOLUNTARY COMMUNITY HEALTH NEEDS ASSESSMENT TO CREATE 9 QUESTIONS SPECIFIC TO THE COUNTY. THIS RESULTED IN A SURVEY WITH 20 TO 29 QUESTIONS, DEPENDENT ON THE RESPONDENT'S COUNTY OF RESIDENTS. THE SURVEY WAS DISTRIBUTED ELECTRONICALLY AND ON PAPER. IN ADDITION TO THE QUANTITATIVE DATA, FREE TEXT RESPONSES WERE CODED AND CALCULATED TO PROVIDE FURTHER CLARIFICATION OF THE QUANTITATIVE DATA. 3. FOCUS GROUPS: IN ADDITION TO THE SURVEY THE PARTNERSHIP HOSTED FOCUS GROUPS THAT INCLUDED 15-60 COMMUNITY LEADERS FROM GOVERNMENTAL PUBLIC HEALTH, HEALTH CARE, SOCIAL SERVICE AGENCIES, RELATED NONPROFITS, CIVIC ORGANIZATIONS, AND GRASSROOTS/NEIGHBORHOOD ORGANIZATIONS. IN LARGER FOCUS GROUPS, SUB-GROUPS WERE UTILIZED TO GIVE ALL PARTICIPANTS A VOICE. EACH FOCUS GROUP DETERMINED THE TOP FOUR TO SIX HEALTH NEEDS IN THE COMMUNITY; POTENTIAL RESOURCES OR PARTNERS; AND SOME ACTIONS/INTERVENTIONS THAT MIGHT WORK BEST. OUTSIDE OF THE COLLABORATIVE, COMMUNITY HEALTH NETWORK INVITED KEY PUBLIC HEALTH INFORMANTS TO PROVIDE THEIR INPUT ON COMMUNITY HEALTH NEEDS. THE FOLLOWING INFORMANTS WERE INTERVIEWED: DUANE KRAMBECK- PRINCIPAL OF CHRISTIAN PARK ELEMENTARY SCHOOL IN INDIANAPOLIS PUBLIC SCHOOLS; MARY CONWAY, MSN, RN ADMINISTRATIVE COORDINATOR FOR NURSING SERVICES IN INDIANAPOLIS PUBLIC SCHOOLS; RANDY MILLER EXECUTIVE DIRECTOR OF DRUG FREE MARION COUNTY. THESE QUANTITATIVE AND QUALITATIVE DATA COLLECTION MECHANISMS HELPED IDENTIFY COMMUNITY HEALTH NEEDS AND SECONDARY DATA CONFIRMED THE NEEDS PERFORM BELOW STATE AVERAGES. FURTHER REVIEW OF THE HEALTH NEEDS DETERMINED THE EXTENT TO WHICH HEALTH INEQUITIES MAY EXIST AND WHICH SEGMENTS OF THE POPULATION ARE MORE NEGATIVELY IMPACTED. |
| FACILITY 1, COMM HOSP OF ANDERSON & MADISON CTY - PART V, LINE 6A | THE CHNA FOR COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC., WAS A JOINT PROCESS AMONG ALL OF THE COMMUNITY HEALTH NETWORK HOSPITALS WHICH INCLUDES: COMMUNITY HEALTH NETWORK, INC. (NORTH, EAST, & INDIANA HEART HOSPITAL, LLC), COMMUNITY HOSPITAL SOUTH, INC., COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC., COMMUNITY HOWARD REGIONAL HEALTH, INC., AND INDIANAPOLIS OSTEOPATHIC HOSPITAL, INC. IN ADDITION, THE HOSPITAL COLLABORATED WITH ST. FRANCIS ALLIANCE, IU HEALTH UNIVERSITY HOSPITAL, AND ST. VINCENT HOSPITAL. |
| FACILITY 1, COMM HOSP OF ANDERSON & MADISON CTY - PART V, LINE 6B | THE CHNA WAS ALSO CONDUCTED WITH HEALTHY COMMUNITIES INSTITUTE. |
| FACILITY 1, COMM HOSP OF ANDERSON & MADISON CTY - PART V, LINE 11 | CHA IS ADDRESSING THE SIGNIFICANT NEEDS OF THE COMMUNITY BASED ON INPUT PROVIDED BY COMMUNITY RESIDENTS, PUBLIC HEALTH PARTNERS, INTERNAL AND EXTERNAL LEADERSHIP WHO PARTICIPATED IN FOCUS GROUPS, STAKEHOLDER INTERVIEWS OR COMPLETED THE CHNA SURVEY THROUGHOUT THE CENTRAL INDIANA REGION. CHNA DATA WAS ANALYZED AND PRIORITIZED USING THESE KEY FACTORS: FEASIBILITY FOR OUR HOSPITALS TO IMPACT CHANGE, HEALTH SYSTEM EXPERTISE IN THE FIELD OF THE ASSESSED NEED, AND THE HOSPITALS ABILITY TO BE THE MOST EFFECTIVE WITH THE RESOURCES AVAILABLE. THE FOUR SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ALL OUR COMMUNITIES WERE: ACCESS TO HEALTHCARE; OBESITY; PEDIATRIC ASTHMA AND COMMUNITY DRIVEN INITIATIVES. A MISSION CENTERED ON HELPING OTHERS IS THE FOUNDATION OF EVERYTHING WE DO AT COMMUNITY HOSPITAL OF ANDERSON & MADISON COUNTY - AND EXTENDS FROM THE CARE WE PROVIDE TO THE COMMUNITIES WE SERVE THROUGH A BROAD SPECTRUM OF COMMUNITY BENEFIT ACTIVITIES OR PROGRAMS. OUR COMMUNITY BENEFIT RESPONDS TO IDENTIFIED COMMUNITY NEEDS AND MEETS AT LEAST ONE OF THE FOLLOWING CRITERIA: 1. IMPROVES ACCESS TO HEALTH CARE SERVICES. 2. ENHANCES HEALTH OF THE COMMUNITY. 3. ADVANCES MEDICAL OR HEALTH KNOWLEDGE. 4. RELIEVES OR REDUCES THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. OUR COMMUNITY BENEFIT IS ORGANIZED IN THREE CATEGORIES: CATEGORY 1: FINANCIAL ASSISTANCE-FREE OR DISCOUNTED HEALTH SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD TO PAY AND WHO MEET THE ELIGIBILITY CRITERIA OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. FINANCIAL ASSISTANCE IS REPORTED IN TERMS OF COSTS, NOT CHARGES. FINANCIAL ASSISTANCE DOES NOT INCLUDE BAD DEBT. CATEGORY 2: GOVERNMENT-SPONSORED MEANS-TESTED HEALTH CARE-UNPAID COSTS OF PUBLIC PROGRAMS FOR LOW-INCOME PERSONS - THE SHORTFALL CREATED WHEN A FACILITY RECEIVES PAYMENTS THAT ARE LESS THAN THE COST OF CARING FOR PUBLIC PROGRAM BENEFICIARIES. THIS PAYMENT SHORTFALL IS NOT THE SAME AS A CONTRACTUAL ALLOWANCE, WHICH IS THE FULL DIFFERENCE BETWEEN CHARGES AND GOVERNMENT PAYMENTS. CATEGORY 3: COMMUNITY BENEFIT SERVICES- PROGRAMS THAT RESPOND TO AN IDENTIFIED COMMUNITY HEALTH NEED AND ARE DESIGNED TO ACCOMPLISH ONE OR MORE COMMUNITY BENEFIT OBJECTIVES; PROGRAMS AND ACTIVITIES DIRECTED TO OR INCLUDING AT-RISK PERSONS, SUCH AS UNDERINSURED AND UNINSURED PERSONS AND PROGRAMS OFFERED TO THE BROAD COMMUNITY (INCLUDING AT-RISK PERSONS) DESIGNED TO IMPROVE COMMUNITY HEALTH. HIGHLIGHTS FOR COMMUNITY BENEFIT SERVICES THAT ALIGN WITH THE IDENTIFIED NEEDS INCLUDES: ACCESS TO HEALTHCARE: COMMUNITY HEALTH NETWORK SUPPORTS THE JANE PAULEY COMMUNITY HEALTH CENTER WHICH OPENED ITS DOORS IN SEPTEMBER 2009 TO PROVIDE PRIMARY HEALTH SERVICES TO EASTSIDE RESIDENTS, REGARDLESS OF INCOME OR INSURANCE COVERAGE. WITH 16 LOCATIONS, THE CENTER SERVES IN PARTNERSHIP WITH THE METROPOLITAN SCHOOL DISTRICT OF WARREN TOWNSHIP, COMMUNITY HEALTH NETWORK, THE COMMUNITY HEALTH NETWORK FOUNDATION, IU SCHOOL OF DENTISTRY AND HANCOCK REGIONAL HOSPITAL. SERVICES ARE PROVIDED ON A DISCOUNTED BASIS BASED ON THE PATIENT'S HOUSEHOLD INCOME. EASTSIDE INDIANAPOLIS NATIVE AND FORMER NBC NEWS ANCHOR JANE PAULEY LENT HER NAME TO THE FACILITY AS AN ADVOCATE FOR ACCESSIBLE HEALTHCARE SERVICES FOR PEOPLE UNDERSERVED BY TRADITIONAL HEALTHCARE MODELS. THE CENTER OFFERS A FULL RANGE OF SERVICES INCLUDING PRIMARY HEALTHCARE, CASE MANAGEMENT, PRESCRIPTION ASSISTANCE AND BEHAVIORAL HEALTH SERVICES, WHILE ALSO FOCUSING ON THE MANAGEMENT OF CHRONIC DISEASES. THE CENTER IS ABLE TO PROVIDE ALL OF THESE IN BOTH ENGLISH AND SPANISH. COMMUNITY HEALTH NETWORK'S SCHOOL-BASED PROGRAMS COVER A WIDE RANGE OF NEEDS FOR YOUTH ACROSS CENTRAL INDIANA. ONSITE NURSES, THERAPISTS AND PHYSICIANS ADDRESS STUDENTS' NEEDS IN THE SCHOOL AND AFTER-SCHOOL SETTING, HELPING TO ENSURE CONSISTENCY IN CARE AND LESS TIME AWAY FROM THE CLASSROOM OR PLAYING FIELD. THE VAST MAJORITY OF THESE SERVICES, INCLUDING ANY NURSING OR BEHAVIORAL HEALTH SUPPORT, ARE OFFERED FREE OF CHARGE TO SCHOOLS THANKS TO COMMUNITY'S ON-GOING COMMITMENT TO ENHANCING HEALTH FOR FUTURE GENERATIONS. FROM EVERYDAY SCRAPES AND BRUISES ON THE PLAYGROUND TO MANAGING CHRONIC ILLNESSES LIKE ASTHMA AND DIABETES, COMMUNITY NURSES OFFER SUPPORT FOR STUDENTS AT MORE THAN 100 SCHOOLS IN THE COMMUNITIES WE SERVE. THEIR WORK ENSURED A 97.2 PERCENT RETURN TO CLASSROOM RATE FOR STUDENTS WHO CAME TO THEM FOR CARE IN 2017. SPECIFIC SERVICES OFFERED TO STUDENTS INCLUDE: 1. MANAGEMENT OF INJURIES REQUIRING FIRST AID; 2. MANAGEMENT OF LIFE-THREATENING ALLERGIES, ASTHMA, DIABETES AND SEIZURES; 3. MANAGEMENT OF ANY HEALTH CONCERN AND REFERRAL TO APPROPRIATE CARE WHEN NEEDED; AND 4. EMERGENCY RESPONSE TO ANY HEALTH-RELATED CONCERN WITHIN THE SCHOOL BUILDING. IN ADDITION, FOR STUDENTS FACING CHRONIC HEALTH CONDITIONS AND ONGOING HEALTH NEEDS, MEDICATIONS PRESCRIBED BY PHYSICIANS ARE ADMINISTERED BY COMMUNITY'S SCHOOL-BASED NURSING STAFF. IN THE INSTANCE OF OCCASIONAL MEDICATION NEEDS, PARENTS FURNISH OVER-THE-COUNTER MEDICATIONS THAT ARE THEN ADMINISTERED BY NURSING STAFF. AND, FOR PREVENTATIVE CARE PURPOSES, NURSING STAFF ADMINISTER FLU VACCINES AT A NUMBER OF LOCAL CHARTER SCHOOLS TO ENSURE THE WELLNESS OF STUDENTS THROUGHOUT THE SCHOOL YEAR. OBESITY (ACCESS TO HEALTHY FOODS): COMMUNITY HEALTH NETWORK TOOK OVER THE DAY-TO-DAY OPERATIONAL MANAGEMENT OF THE CUPBOARD, A FOOD PANTRY THAT SERVES RESIDENTS OF LAWRENCE TOWNSHIP OF INDIANAPOLIS, AND ASSISTS AN ESTIMATED 300 FAMILIES PER WEEK, PROVIDES HEALTHIER FOOD OPTIONS AND HELPS RELIEVE THE STRAIN CAUSED BY FOOD INSECURITY. IN 2017, THE CUPBOARD PROVIDED SERVICES TO APPROXIMATELY 57,235 PERSONS. THE CUPBOARD IS A CLIENT-CHOICE FOOD PANTRY, SERVING RESIDENTS THROUGH PARTNERSHIPS WITH GLEANERS FOOD BANK OF INDIANA, MIDWEST FOOD BANK, AND LOCAL RELIGIOUS INSTITUTIONS AND BUSINESSES. THE FOOD PANTRY IS OPEN WEDNESDAYS FROM 10 A.M. TO 4 P.M. AND 6 P.M. TO 8 P.M., FRIDAYS FROM 10 A.M. TO 4 P.M. AND THE THIRD SATURDAY OF THE MONTH FROM 10 A.M. TO NOON. COMMUNITY HEALTH NETWORK SUPPORTS MANY URBAN FARMING AND FARMERS MARKET INITIATIVES THAT PROVIDE FRESH PRODUCE AND HEALTHY OPTIONS. FARMERS MARKETS ARE FOR EVERYONE. ACCESS TO AFFORDABLE, FRESH, AND HEALTHY WHOLE FOODS IS A CHALLENGE FOR MANY PEOPLE WHO RELY ON FOOD ASSISTANCE PROGRAMS LIKE SNAP THAT HELP LOW-INCOME FAMILIES AND INDIVIDUALS BUY FRESH, INDIANA-GROWN FOOD THAT PROVIDES REAL SUSTENANCE FOR THEMSELVES AND THEIR COMMUNITIES. FOR INSTANCE, COMMUNITY EMPLOYEES ALSO VOLUNTEER AND SUPPORT INDY URBAN ACRES WHICH IS AN ORGANIC FARM THAT DONATES 100% OF THE FRESH FRUITS AND VEGETABLES HARVESTED TO LOCAL FOOD PANTRIES THROUGH A PARTNERSHIP WITH GLEANERS FOOD BANK. SINCE 2011, INDY URBAN ACRES HAS GROWN INTO A MULTI- DISCIPLINARY FARM THAT PROVIDES FOOD EQUALITY FOR LOW-INCOME FAMILIES, EDUCATES THOUSANDS OF YOUTH THROUGH TOURS AND FARM-TO-PLATE WORKSHOPS, PROVIDES COMMUNITY ENGAGEMENT TO THOUSANDS OF VOLUNTEERS AND GROUPS, TEACHES TEENS VALUABLE JOB SKILLS AND HELPS IMPROVE INDY'S FOOD SYSTEM. ASTHMA: OUR PRESIDENT AND CEO, BRYAN MILLS, HAS JOINED WITH A NUMBER OF PARTNERS FROM HEALTHCARE AND THE BUSINESS COMMUNITY-INCLUDING THE INDIANA HOSPITAL ASSOCIATION, THE INDIANA STATE MEDICAL ASSOCIATION AND THE INDIANA CHAMBER OF COMMERCE-TO CREATE A NEW ORGANIZATION KNOWN AS THE ALLIANCE FOR A HEALTHIER INDIANA. IN 2016, THE GROUP ANNOUNCED PLANS TO TACKLE ITS FIRST CHALLENGE: THE HIGH RATE OF TOBACCO USE IN OUR STATE. TOBACCO USE LEADS TO DISEASE AND DISABILITY AND HARMS NEARLY EVERY ORGAN OF THE BODY. IT IS THE LEADING CAUSE OF PREVENTABLE DEATH. RESEARCH HAS SHOWN THAT SMOKE FROM CIGARS, CIGARETTES, AND PIPES HARMS YOUR BODY IN MANY WAYS, BUT IT IS ESPECIALLY HARMFUL TO THE LUNGS OF A PERSON WITH ASTHMA. TOBACCO SMOKE - INCLUDING SECONDHAND SMOKE - IS ONE OF THE MOST COMMON ASTHMA TRIGGERS. THE ALLIANCE ASKED INDIANA'S STATE LEGISLATURE TO CONSIDER A VARIETY OF MEASURES, INCLUDING HIGHER TOBACCO TAXES, AN INCREASE IN THE SMOKING AGE AND A REPEAL OF THE SMOKERS' BILL OF RIGHTS. COMMUNITY HEALTH NETWORK MADE A MAJOR INVESTMENT OF TIME AND RESOURCES INTO A COMBINED TOBACCO CAMPAIGN THIS YEAR, AND WHILE WE DID NOT GET THE TOBACCO TAX INCREASE WE SOUGHT, WE DID MOVE THE BALL FORWARD ON A TAX AND SECURE A PARTIAL VICTORY ON TOBACCO CESSATION FUNDING. INDIANA LEGISLATORS PROVIDED A 50% INCREASE IN STATE FUNDING FOR TOBACCO CESSATION SERVICES, BRINGING THE ANNUAL TOBACCO CESSATION BUDGET TO 7.5 MILLION. THE NEW ALLIANCE FOR A HEALTHIER INDIANA IS A GREAT EXAMPLE OF HOW WE AT COMMUNITY PARTNER WITH OTHERS TO FURTHER OUR WORK. FROM FOOD INSECURITY TO EDUCATIONAL CHALLENGES TO SUICIDE TO SMOKING AND OTHER ADDICTIONS, WE'RE COMMITTED TO TACKLING SOCIETAL ISSUES THAT AFFECT HEALTH AND QUALITY OF LIFE. COMMUNITY-DRIVEN INITIATIVES: COMMUNITY HEALTH NETWORK, CENTRAL INDIANA'S LARGEST PROVIDER OF BEHAVIORAL HEALTH SERVICES, ANNOUNCED ITS COMMITMENT TO BECOMING THE FIRST HEALTH CARE SYSTEM IN THE COUNTRY TO FULLY IMPLEMENT THE ZERO SUICIDE MODEL, DEVELOPED BY THE NATIONAL ACTION ALLIANCE FOR S |
| FACILITY 1, COMM HOSP OF ANDERSON & MADISON CTY - PART V, LINE 16J | CHA PUBLICIZES THE FACT THAT WE HAVE FINANCIAL ASSISTANCE AVAILABLE FOR THOSE WHO CANNOT PAY FOR HEALTHCARE. SIGNS ARE POSTED THROUGHOUT THE HOSPITAL (INCLUDING ER, THE ADMITTING OFFICE, AND THE PATIENT ACCOUNTS OFFICE) LETTING PEOPLE KNOW WE HAVE ASSISTANCE AVAILABLE. INFORMATION IS ALSO INCLUDED IN THE ADMISSION PACKET AS WELL AS ON THE CONSENT FORMS AND BILLS IN BOTH ENGLISH AND SPANISH. OUR POLICY IS ALSO POSTED ON OUR WEBSITE. WE HAVE DEDICATED AN ENTIRE PAGE ON OUR WEBSITE TO THOSE WITHOUT INSURANCE. THERE IS ALSO INFORMATION ON OUR BILLING STATEMENTS AND COLLECTION LETTERS INFORMING PATIENTS WE HAVE ASSISTANCE AVAILABLE. IN ADDITION, ALL CUSTOMER SERVICE STAFF AND FINANCIAL COUNSELORS ARE TRAINED TO SCREEN FOR POSSIBLE FINANCIAL ASSISTANCE. |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE | CHA ALSO CONSIDERS THE PATIENT'S MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY WHEN CONSIDERING THE PATIENT FOR FINANCIAL ASSISTANCE. |
| PART I, LINE 6A - RELATED ORGANIZATION INFORMATION | A COMMUNITY BENEFIT REPORT IS COMPLETED FOR THE COMMUNITY HEALTH NETWORK INCLUDING COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. ("CHA") AND OTHER TAX-EXEMPT AFFILIATES OF THE NETWORK. |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | A COST TO CHARGE RATIO WAS UTILIZED TO DETERMINE COSTS FOR LINES A THROUGH C IN THE TABLE. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. LINES E THROUGH I OF THE TABLE ARE BASED ON ACTUAL INCURRED EXPENSES. |
| PART II - COMMUNITY BUILDING ACTIVITIES | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT WHICH INCLUDES INFORMATION FOR COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | THE COST TO CHARGE RATIO UTILIZED FOR PURPOSES OF REPORTING BAD DEBT COSTS WAS DERIVED FROM WORKSHEET 2 AND IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. PART III, LINE 4 - BAD DEBT EXPENSE EXPLANATION CHA DOES NOT HAVE INDIVIDUALLY AUDITED FINANCIAL STATEMENTS. THE FINANCIAL RESULTS ARE INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMUNITY HEALTH NETWORK, INC. AND AFFILIATES. THE NETWORK AUDITED FINANCIAL STATEMENTS CONTAIN THE FOLLOWING TEXT WITHIN THE FOOTNOTES TO DESCRIBE BAD DEBT EXPENSE: THE NETWORK'S PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND CONTRACTUAL ADJUSTMENTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE NETWORK ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE, THE NETWORK ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS. GENERALLY, FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, INCLUDING PATIENT DEDUCTIBLES AND CO-INSURANCE, THE NETWORK RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS ADJUSTED THROUGH THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE NETWORK RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE NETWORK RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED OR ON THE BASIS OF DISCOUNTED RATES IF IN ACCORDANCE WITH POLICY. ON THE BASIS OF HISTORICAL EXPERIENCE, A PORTION OF THE NETWORK'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE NETWORK RECORDS A PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. PATIENT SERVICE REVENUE, NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS RECOGNIZED IN THE PERIOD FROM THESE MAJOR PAYOR SOURCES, IS AS FOLLOWS FOR THE YEARS ENDED DECEMBER 31, 2017 AND 2016, RESPECTIVELY: THIRD PARTY PAYORS SELF-PAY TOTAL ALL PAYORS 2017 PATIENT SERVICE REVENUE(NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) 2,297,067 69,582 2,366,649 ========== ======== ========== 2016 PATIENT SERVICE REVENUE(NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) 2,100,098 80,151 2,108,249 ========== ======== ========== THE NETWORK MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THE NETWORK PROVIDES 100% CHARITY CARE TO PATIENTS WHOSE INCOME LEVEL IS EQUAL TO OR BELOW 200% OF THE FEDERAL POVERTY LEVEL. PATIENTS WITH INCOME LEVELS RANGING FROM 200% - 300% OF THE CURRENT YEAR'S FEDERAL POVERTY LEVEL WILL QUALIFY FOR PARTIAL ASSISTANCE DETERMINED BY A SLIDING SCALE. THE NETWORK USES COST AS THE MEASUREMENT BASIS FOR CHARITY CARE DISCLOSURE PURPOSES WITH THE COST BEING IDENTIFIED AS THE DIRECT AND INDIRECT COSTS OF PROVIDING THE CHARITY CARE. CHARITY CARE AT COST WAS 5,701000 AND 6,426000 FOR THE YEARS ENDED DECEMBER 31, 2017 AND 2016, RESPECTIVELY. CHARITY CARE COST WAS ESTIMATED ON THE APPLICATION OF THE ASSOCIATED COST-TO-CHARGE RATIOS. THE DECREASE IN CHARITY CARE IS THE RESULT OF MORE PATIENTS BEING COVERED UNDER HEALTH EXCHANGE PROGRAMS MANDATED BY THE AFFORDABLE HEALTH CARE ACT AND THE HEALTHY INDIANA PLAN 2.0. BEGINNING JUNE 2012, THE STATE OF INDIANA OFFERED VOLUNTARY PARTICIPATION IN THE STATE OF INDIANA'S HOSPITAL ASSESSMENT FEE ("HAF") PROGRAM. THE STATE OF INDIANA IMPLEMENTED THIS PROGRAM TO UTILIZE SUPPLEMENTAL REIMBURSEMENT PROGRAMS FOR THE PURPOSE OF PROVIDING REIMBURSEMENT TO PROVIDERS TO OFFSET A PORTION OF THE COST OF PROVIDING CARE TO MEDICAID AND INDIGENT PATIENTS. THIS PROGRAM IS DESIGNED WITH INPUT FROM CENTERS FOR MEDICARE AND MEDICAID SERVICES AND IS FUNDED WITH A COMBINATION OF STATE AND FEDERAL RESOURCES, INCLUDING FEES OR TAXES LEVIED ON THE PROVIDERS. THE NETWORK RECOGNIZES REVENUES AND RELATED FEES ASSOCIATED WITH THE HAF PROGRAM IN THE PERIOD IN WHICH AMOUNTS ARE ESTIMABLE AND COLLECTION OF PAYMENT IS REASONABLY ASSURED. REIMBURSEMENT UNDER THE PROGRAM IS REFLECTED WITHIN NET PATIENT SERVICE REVENUE AND THE FEES PAID FOR PARTICIPATION IN THE HAF PROGRAM ARE RECORDED IN SUPPLIES AND OTHER EXPENSES WITHIN THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS. THE FEES AND REIMBURSEMENTS ARE SETTLED MONTHLY. REVENUE RECOGNIZED RELATED TO THE HAF PROGRAM WAS 104,425000 AND 91,018000 FOR THE YEARS ENDED DECEMBER 31, 2017 AND 2016, RESPECTIVELY. EXPENSE FOR FEES RELATED TO THE HAF PROGRAM WAS 53,997000 AND 40,623000 FOR THE YEARS ENDED DECEMBER 31, 2017 AND 2016, RESPECTIVELY. THE HAF PROGRAM RUNS ON AN ANNUAL CYCLE FROM JULY 1 TO JUNE 30 AND IS EFFECTIVE UNTIL JUNE 30, 2019. THE CONSOLIDATED BALANCE SHEET INCLUDES LESS THAN ONE MONTH OF HAF ACTIVITY, OR 876000 IN ESTIMATED THIRD-PARTY PAYOR PAYABLE AT DECEMBER 31, 2017 AND 3,470000 IN ESTIMATED THIRD-PARTY RECEIVABLE AT DECEMBER 31, 2016. ADJUSTMENTS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE MADE AFTER THE NETWORK HAS ANALYZED HISTORICAL CASH COLLECTIONS AND CONSIDERED THE IMPACT OF ANY KNOWN MATERIAL EVENTS. UNCOLLECTIBLE ACCOUNTS ARE WRITTEN-OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AFTER EXHAUSTING COLLECTION EFFORTS. ANY SUBSEQUENT RECOVERIES ARE RECORDED AGAINST THE PROVISION FOR BAD DEBTS. |
| PART III, LINE 8 - MEDICARE EXPLANATION | PER THE 990 INSTRUCTIONS, THE MEDICARE COST REPORT WAS UTILIZED TO DETERMINE THE MEDICARE SHORTFALL. HOWEVER, THE MEDICARE COST REPORT IS NOT REFLECTIVE OF ALL COSTS ASSOCIATED WITH MEDICARE PROGRAMS SUCH AS PHYSICIAN SERVICES AND SERVICES BILLED VIA FREE STANDING CLINICS. FURTHER, THE MEDICARE COST REPORT EXCLUDES REVENUES AND COSTS OF MEDICARE PARTS C AND D. THE MEDICARE SHORTFALL ATTRIBUTED TO THOSE AREAS NOT INCLUDED ON THE MEDICARE COST REPORT IS 5,856,638. AS SUCH, THE TOTAL MEDICARE SHORTFALL FOR ALL MEDICARE PROGRAMS IS 15,641,904. MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS COMMUNITY BENEFIT BECAUSE MEDICARE REPRESENTS 52.9% OF THE OVERALL PAYER MIX FOR COMMUNITY HOSPITAL OF ANERSON AND MADISON COUNTY, INC. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | SEE ATTACHED FINANCIAL ASSISTANCE POLICY. CHA WILL NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS EITHER DIRECTLY OR BY ANY DEBT COLLECTION AGENCY OR OTHER PARTY TO WHICH THE HOSPITAL HAS REFERRED THE PATIENT'S DEBT BEFORE REASONABLE EFFORTS ARE MADE TO DETERMINE WHETHER A RESPONSIBLE INDIVIDUAL(S) IS ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. |
| ADDITIONAL INFORMATION | PART V, SECTION A - FACILITY INFORMATION CHA IS AN ACUTE CARE MEDICAL FACILITY WITH 139 STAFFED BEDS. IN 2017, THERE WERE 6,200 ADMISSIONS WITH AN AVERAGE LENGTH OF STAY OF 3.93 DAYS. THERE WERE 33,556 EMERGENCY ROOM CASES RESPONDED TO IN OUR 24-HOUR/SEVEN DAY A WEEK EMERGENCY ROOM. 69% OF THE BIRTHS IN MADISON COUNTY WERE DELIVERED AT CHA FOR A TOTAL OF 828 BIRTHS IN 2017. PART VI, ITEMS 2 THROUGH 5 ARE DISCUSSED WITHIN THE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT. FOR A COPY OF THIS REPORT, PLEASE CONTACT HOLLY MILLARD AT (317) 355-5860. PART VI, ITEM 6 - AFFILIATED HEALTH CARE SYSTEM COMMUNITY HOSPITAL OF ANDERSON & MADISON COUNTY, INC. ("CHA") IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. SEE THE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT FOR HOW CHA IS INVOLVED IN PROMOTING THE HEALTH OF THE COMMUNITY IT SERVES. PART VI, ITEM 7 - STATE FILING OF COMMUNITY BENEFIT REPORT INDIANA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Business Name Line2RecipientBusinessName/BusinessNameLine2Txt |
|---|---|---|---|---|---|---|---|---|
| ALTERNATIVES INC | ||||||||
| PO BOX 1302 | ANDERSON | IN | 46015 | 310986769 | 501C3 | $12,500 | GENERAL SUPPORT | |
| ANDERSON IMPACT CENTER | ||||||||
| 630 NICHOL AVENUE | ANDERSON | IN | 46016 | 900521040 | 501C3 | $25,000 | GENERAL SUPPORT | |
| CHRISTIAN CENTER | ||||||||
| 625 MAIN STREET | ANDERSON | IN | 46016 | 351108615 | 501C3 | $5,300 | GENERAL SUPPORT | |
| CITY OF ANDERSON | ||||||||
| 120 E 8TH STREET | ANDERSON | IN | 46018 | 356000939 | GOV | $10,000 | GENERAL SUPPORT | |
| COMMUNITY HEALTH NETWORK FOUNDATION | ||||||||
| 7240 SHADELAND STATION SUITE 125 | INDIANAPOLIS | IN | 46256 | 510181688 | 501C3 | $10,000 | GENERAL SUPPORT | |
| COMMUNITY HOSPITAL ANDERSON FDN | ||||||||
| 1515 N MADISON AVENUE | ANDERSON | IN | 46011 | 861053152 | 501C3 | $81,456 | GENERAL SUPPORT | |
| FIRST UNITED METHODIST CHURCH | ||||||||
| 1215 JACKSON STREET | ANDERSON | IN | 46016 | 350874263 | 501C3 | $17,253 | BUDDY BAG PROGRAM | |
| HEALTH & HOSPITAL CORP OF MARION CO | ||||||||
| 3838 N RURAL STREET 8TH FLOOR | INDIANAPOLIS | IN | 46205 | 356005697 | GOV | $10,000 | GENERAL SUPPORT | |
| IVY TECH FOUNDATION | ||||||||
| 345 S HIGH STREET | MUNCIE | IN | 47305 | 237073977 | 501C3 | $20,000 | ANDERSON EXPANSION | |
| SECOND HARVEST FOOD BANK | ||||||||
| 6621 N OLD SR 3 | MUNCIE | IN | 47303 | 311111795 | 501C3 | $7,000 | GENERAL SUPPORT | OF EAST CENTRAL INDIANA |
| UNITED WAY OF MADISON COUNTY INC | ||||||||
| 1201 E 5TH STREET SUITE 1019 | ANDERSON | IN | 46015 | 351052350 | 501C3 | $40,000 | GENERAL SUPPORT | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 11 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | PRIOR TO THE DISBURSEMENT OF ANY GRANT PROCEEDS, CHA ENSURES THAT THE PURPOSE OF THE GRANT IS CONSISTENT WITH CHA'S CHARITABLE PURPOSES. THE TERMS OF ALL GRANTS REQUIRE THAT THE RECIPIENT EXPEND THE FUNDS SOLELY FOR CHARITABLE PURPOSES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JASON FAHRLANDER | ||||||||||||||
| DIRECTOR | $512,845 | $139,065 | $7,979 | $232,642 | $38,173 | $930,704 | $139,065 | |||||||
| ELIZABETH S THARP | ||||||||||||||
| PRESIDENT & CEO | $326,405 | $91,855 | $24,214 | $79,146 | $11,441 | $533,061 | $91,855 | |||||||
| TROY ABBOTT MD | ||||||||||||||
| DIRECTOR | $250,698 | $70,268 | $13,000 | $55,702 | $12,321 | $401,989 | $70,268 | $16,500 | $16,500 | |||||
| JOHN B HARRIS | ||||||||||||||
| VP OF FINANCE & CFO | $273,161 | $50,402 | $28,343 | $51,346 | $26,377 | $429,629 | $50,402 | |||||||
| KENNETH SHAVER MD | ||||||||||||||
| SVP CHIEF PHYSICIAN | $228,779 | $54,023 | $28,393 | $75,729 | $23,913 | $410,837 | ||||||||
| SHERRI SIDWELL | ||||||||||||||
| COO/VP INTG SERVICES | $183,573 | $55,505 | $1,756 | $35,808 | $14,510 | $291,152 | ||||||||
| NIGHAT TAHIR MD | ||||||||||||||
| PHYSICIAN | $236,108 | $176,460 | $44,760 | $18,900 | $34,403 | $510,631 | $84,000 | |||||||
| LEE ANN MCDANIEL | ||||||||||||||
| CRNA | $370,809 | $750 | $14,856 | $19,607 | $21,072 | $427,094 | $750 | |||||||
| CAROL WHITESEL | ||||||||||||||
| VP PATIENT CARE/CNO | $219,975 | $60,265 | $21,832 | $44,698 | $26,481 | $373,251 | $60,265 | |||||||
| MARK A FIELD | ||||||||||||||
| CRNA | $239,955 | $750 | $17,952 | $18,824 | $23,914 | $301,395 | $750 | |||||||
| LISA HALSTEAD | ||||||||||||||
| VP LEGAL AFFAIRS | $117,760 | $18,550 | $113,495 | $142,689 | $25,614 | $418,108 | $18,550 | |||||||
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 4 | LISA HALSTEAD 69,759 0 0 |
| SCHEDULE J, PART III | PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS 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 DR. TAHIR IS ELIGIBLE FOR AN INCENTIVE PAYMENT BASED ON PRODUCTIVITY. CHA DEVELOPED ITS COMPENSATION PLAN IN CONJUNCTION WITH AN INDEPENDENT COMPENSATION CONSULTANT. IN ADDITION, THE PLAN WAS APPROVED BY THE CHA EXECUTIVE COMPENSATION COMMITTEE, COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS. IN ADOPTING ITS INCENTIVE BASED COMPENSATION PLAN, CHA (TOGETHER WITH ITS INDEPENDENT COMPENSATION CONSULTANT, ITS EXTERNAL LEGAL COUNSEL, AND THE NETWORK EXEUTIVE COMPENSATION COMMITTEE) CONSIDERED AND APPLIED THE PROVISIONS OF CODE SECTION 4958 (AND THE CORRESPONDING TREASURY REGULATIONS) TO ENSURE THAT ITS COMPENSATION DECISIONS REFLECT ARMS LENGTH, FAIR MARKET TERMS. CERTAIN INDIVIDUALS OF THE LEADERSHIP TEAM PARTICIPATE IN A SENIOR LEADERSHIP INCENTIVE PROGRAM. THE PROGRAM WAS ADOPTED BY CHA'S 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 OF EXTERNAL BOARD 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 M IRS990ScheduleM
Real Estate Commercial RealEstateCommercialGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $65,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 1 | Form8283ReceivedCnt |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PAGE 2, PART II | FormAndLineReferenceDesc |
| Explanation | PART I, LINE 17 COLUMN (B) IS THE NUMBER OF CONTRIBUTIONS AS WELL AS THE NUMBER OF ITEMS RECEIVED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI | FORM 990, PART VI, LINE 2 - RELATED PARTY INFORMATION AMONG OFFICERS JASON FAHRLANDER, ARTHUR J. LEAK, AND JAY RICKER SERVED AS DIRECTORS AND/OR OFFICERS OF COMMUNITY HEALTH NETWORK, INC. JASON FAHRLANDER AND KENNETH SHAVER, M.D. RECEIVED COMPENSATION FROM COMMUNITY HEALTH NETWORK, INC. |
| FORM 990, PAGE 6, PART VI, LINE 3 | THROUGH AN AFFILIATION AGREEMENT EFFECTIVE SEPTEMBER 1, 1996, CHA'S BOARD OF TRUSTEES RETAINS CONTROL OVER MANAGEMENT DUTIES FOR CHA. HOWEVER, FOR THE FOLLOWING GOVERNANCE ITEMS, CHA INITIATES RECOMMENDATIONS TO THE COMMUNITY HEALTH NETWORK, INC. ("CHNW") BOARD OF DIRECTORS FOR ITS APPROVAL OF THE FOLLOWING: A) STRATEGIC AND OPERATING PLANS; B) ANNUAL OPERATING AND CAPITAL BUDGETS AND ANY UNBUDGETED CAPITAL EXPENDITURES; C) AMENDMENTS TO THE ARTICLES OR BYLAWS OF THE CHA BOARD OF TRUSTEES, THE BYLAWS OF THE CHA MEDICAL STAFF, OR TO THE AFFILIATION AGREEMENT; D) APPOINTMENT AND REMOVAL OF THE CHIEF EXECUTIVE OFFICER OF CHA; E) UNBUDGETED SALES, LEASES, OR TRANSFERS OF ASSETS ABOVE 500,000; F) INCURRENCE OF DEBT OTHER THAN IN THE ORDINARY COURSE OF BUSINESS OR IN ACCORDANCE WITH THE OPERATING PLANS, OPERATING BUDGET, OR CAPITAL BUDGET RECOMMENDED BY THE CHA BOARD OF TRUSTEES AND APPROVED BY THE CHNW BOARD OF DIRECTORS; G) CHANGE IN THE MISSION OF CHA; H) ELECTION OF NEW MEMBERS OR REAPPOINTMENT OF CURRENT MEMBERS TO THE CHA BOARD OF TRUSTEES; I) PARTICIPATION IN MANAGED CARE AND OTHER NETWORKS OR AFFILIATIONS; AND J) RELOCATION OF PHYSICIANS EMPLOYED BY OR UNDER CONTRACT WITH CHNW TO MADISON COUNTY. |
| FORM 990, PAGE 6, PART VI, LINE 4 | THE BY-LAWS OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. WERE AMENDED IN 2017. THE SIGNIFICANT CHANGES INCLUDE: 1. THE BOARD OF TRUSTEES WAS REDUCED TO 14 VOTING MEMBERS FROM 18. 2. THE REQUIRED NUMBER OF BOARD OF TRUSTEE MEMBERS THAT ARE MEDICAL STAFF AT CHA WAS REDUCED FROM 4 TO 3. 3. A MEMBER MAY PARTICIPATE IN AN ANNUAL, REGULAR, COMMITTEE, OR SPECIAL MEETING OF THE BOARD OF TRUSTEES BY OR THROUGH THE USE OF ANY MEANS OF COMMUNICATION BY WHICH ALL MEMBERS PARTICIPATING MAY SIMULTANEOUSLY HEAR EACH OTHER DURING THE MEETING. A MEMBER PARTICIPATING BY THIS MEANS IS CONSIDERED PRESENT IN PERSON AT THE MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 6 | COMMUNITY HEALTH NETWORK, INC. ("CHNW") IS THE SOLE MEMBER OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. ("CHA"). CHNW IS AN EXEMPT ORGANIZATION PURSUANT TO SECTION 501(C)(3). |
| FORM 990, PAGE 6, PART VI, LINE 7A | CHA'S BOARD OF TRUSTEES MEMBERSHIP IS DETERMINED AS FOLLOWS: A) CHNW, AS THE SOLE MEMBER OF CHA, SHALL NOMINATE AND ELECT ONE MEMBER OF CHA'S BOARD OF TRUSTEES, B) ONE MEMBER OF THE CHA BOARD OF TRUSTEES SHALL BE THE CHIEF EXECUTIVE OFFICER OF CHA, C) THREE MEMBERS SHALL BE ACTIVE MEMBERS OF THE CHA MEDICAL STAFF AND SHALL BE NOMINATED AND ELECTED BY THE CHA MEDICAL STAFF, AND RATIFIED BY THE CHA BOARD OF TRUSTEES, D) THE NINE REMAINING POSITIONS SHALL BE FILLED BY PERSONS ELECTED BY CHNW'S BOARD OF DIRECTORS, AND E) ADDITIONALLY, THE PRESIDENT OF THE MEDICAL STAFF SHALL SERVE AS AN EX OFFICIO, NONVOTING MEMBER OF THE BOARD OF TRUSTEES. |
| FORM 990, PAGE 6, PART VI, LINE 7B | CHNW, AS THE SOLE MEMBER OF CHA, MUST APPROVE THE FOLLOWING: A) STRATEGIC AND OPERATING PLANS; B) ANNUAL OPERATING AND CAPITAL BUDGETS AND ANY UNBUDGETED CAPITAL EXPENDITURES; C) AMENDMENTS TO THE ARTICLES OR BYLAWS OF THE CORPORATION AND THE BYLAWS OF THE MEDICAL STAFF OF THE CORPORATION, D) APPOINTMENT AND REMOVAL OF THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION; E) UNBUDGETED SALES, LEASES, OR TRANSFERS OF ASSETS ABOVE 500,000, WHICH AMOUNT MAY BE ADJUSTED FROM TIME TO TIME AS AGREED BY THE BOARD OF TRUSTEES AND THE BOARD OF DIRECTORS OF THE MEMBER; F) INCURRENCE OF DEBT OTHER THAN IN THE ORDINARY COURSE OF BUSINESS OR IN ACCORDANCE WITH THE OPERATING PLANS, OPERATING BUDGET, OR CAPITAL BUDGET RECOMMENDED BY THE BOARD OF TRUSTEES AND APPROVED BY THE BOARD OF DIRECTORS OF THE MEMBER; G) CHANGE IN THE MISSION OF THE CORPORATION; H) ELECTION OF NEW MEMBERS OR REAPPOINTMENT OF CURRENT MEMBERS TO THE BOARD OF TRUSTEES; I) PARTICIPATION IN MANAGED CARE AND OTHER NETWORKS OR AFFILIATIONS; AND J) RELOCATION OF PHYSICIANS EMPLOYED BY OR UNDER CONTRACT WITH THE MEMBER TO MADISON COUNTY. |
| FORM 990, PAGE 6, PART VI, LINE 11B | CHA'S BOARD OF TRUSTEES HAS DELEGATED AUTHORITY FOR THE REVIEW OF CHA'S FORM 990 TO THE EXECUTIVE COMMITTEE. IN ADDITION, CHA'S OUTSIDE ACCOUNTING FIRM AND LAW FIRM REVIEWED THE FORM 990 PRIOR TO FILING. CHA UTILIZED THIS PROCESS TO ENSURE THAT ITS FORM 990 RECEIVED SUBSTANTIVE REVIEW BY PROFESSIONALS WITH SPECIFIC KNOWLEDGE REGARDING CHA'S ACTIVITIES AND EXTENSIVE FINANCIAL, ACCOUNTING, AND TAX EXPERTISE. |
| FORM 990, PAGE 6, PART VI, LINE 12C | CHA HAS ADOPTED A CONFLICT OF INTEREST POLICY APPLICABLE TO ALL EMPLOYEES. THE CONFLICT OF INTEREST POLICY REQUIRES EMPLOYEES SUBMIT A CONFLICT OF INTEREST DISCLOSURE FORM UPON EMPLOYMENT WITH CHA AND ON AN ANNUAL BASIS THEREAFTER. PRIOR TO COMPLETING AND SIGNING THE DISCLOSURE, ALL EMPLOYEES MUST READ AND UNDERSTAND CHA'S CONFLICT OF INTEREST POLICY STATEMENT, WHICH PROVIDES THAT NO CHA EMPLOYEE SHALL MAKE A PROFIT BECAUSE OF HIS OR HER POSITION AT CHA. THE DISCLOSURE REQUIRES EMPLOYEES TO DISCLOSE, IN WRITING, ANY KNOWN FINANCIAL INTEREST THAT THE INDIVIDUAL (TOGETHER WITH THEIR SPOUSE AND FAMILY MEMBERS) HAS IN ANY BUSINESS ENTITY THAT CONDUCTS OR WILL POTENTIALLY CONDUCT BUSINESS WITH CHA. EMPLOYEES ARE ALSO REQUIRED TO IMMEDIATELY DISCLOSE TO THE CHA HUMAN RESOURCES DEPARTMENT ANY SUBSEQUENT CHANGES THAT ARISE MID-YEAR AND WOULD OTHERWISE BE REPORTED ON THE ANNUAL DISCLOSURE STATEMENT. IN ADDITION, THE CHA AMENDED AND RESTATED CODE OF BYLAWS PROVIDES A CONFLICT OF INTEREST POLICY FOR THE CHA BOARD OF TRUSTEES. CHA'S AMENDED AND RESTATED CODE OF BYLAWS REQUIRES ALL BOARD MEMBERS TO DISCLOSE ANY DUALITY OR CONFLICT OF INTEREST TO THE OTHER BOARD MEMBERS. THE DIRECTOR IS PROHIBITED FROM VOTING OR EXERTING ANY PERSONAL INFLUENCE ON ANY ISSUE THAT PRESENTS A CONFLICT OF INTEREST. THE DIRECTOR'S ABSTENTION FROM THE VOTE AND THE DETAILS CONCERNING THE CONFLICT OF INTEREST ARE REPORTED IN THE MEETING'S MINUTES. |
| FORM 990, PAGE 6, PART VI, LINE 15A | CHA HAS A COMPENSATION COMMITTEE COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR EVALUATING AND DETERMINING COMPENSATION FOR CHA'S EXECUTIVE PERSONNEL. IN DISCHARGING THESE DUTIES, THE COMPENSATION COMMITTEE APPLIES THE PRINCIPLES OF THE REBUTTABLE PRESUMPTION AS OUTLINED IN CODE SECTION 4958 AND THE CORRESPONDING TREASURY REGULATIONS. MOST NOTABLY, THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABILITY DATA WHEN SETTING COMPENSATION AND CONTEMPORANEOUSLY DOCUMENTS ITS DECISIONS AND THE PROCESS THAT IT EMPLOYS IN WRITING. IN ADDITION, THE COMPENSATION COMMITTEE PERIODICALLY RETAINS AN OUTSIDE COMPENSATION CONSULTANT TO PROVIDE INPUT REGARDING THE APPROPRIATENESS OF CHA'S COMPENSATION DECISIONS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SEE PART VI, LINE 15A ABOVE. FORM 990, PART VI, LINE 16B - JOINT VENTURE PROCEDURE JOINT VENTURE OPERATING AGREEMENTS INVOLVING CHA INCLUDE PROVISIONS TO PROTECT CHA'S TAX-EXEMPT STATUS. EACH AGREEMENT CONTAINS SPECIFIC LANGUAGE RELATED TO THE PROVISION OF HEALTH CARE SERVICES WITH FOCUS ON COMMUNITY HEALTH BENEFIT AND MUST FOLLOW A FORMAL REVIEW PROCESS PRIOR TO CONTRACT EXECUTION. CHA CONTINUALLY ENSURES THAT ITS TAX-EXEMPT STATUS IS PROTECTED BY ACTIVELY PARTICIPATING IN THE GOVERNANCE OF ALL JOINT VENTURES. |
| FORM 990, PAGE 6, PART VI, LINE 19 | A) 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) WHILE NOT AVAILABLE TO THE PUBLIC, CHA'S CONFLICT OF INTEREST POLICY IS DESCRIBED IN PART VI, LINE 12C. C) CHA 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. CHA 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 VII | PART VII, SECTION B - INDEPENDENT CONTRACTOR DISCLOSURE COMPENSATION TO WR DUNKIN & SON, INC. INCLUDES MATERIAL COSTS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| AUXILIARY OF COMMUNITY HOSPITAL | ||||||||||
| 1515 NORTH MADISON AVENUE | ANDERSON | IN | 46011 | 356065606 | SUPPORT | IN | 501C3 | 12A | NA | false |
| COMMUNITY HOSP ANDERSON FDN INC | ||||||||||
| 1515 NORTH MADISON AVENUE | ANDERSON | IN | 46011 | 861053152 | SUPPORT | IN | 501C3 | 12A | CHA | Yes (true) |
| COMMUNITY LTC INC | ||||||||||
| 1031 MONTICELLO DRIVE | ANDERSON | IN | 46011 | 351877441 | HLTH CARE | IN | 501C3 | 10 | CHA | Yes (true) |
| COMMUNITY HOME HEALTH SERVICES INC | ||||||||||
| 9894 EAST 121ST STREET | FISHERS | IN | 46037 | 350953467 | HLTH CARE | IN | 501C3 | 10 | CHNW | Yes (true) |
| COMMUNITY HEALTH NETWORK INC | ||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 350983617 | HOSPITAL | IN | 501C3 | 3 | NA | false |
| COMMUNITY HEALTH NETWORK FOUNDATION | ||||||||||
| 7240 SHADELAND STATION SUITE 125 | INDIANAPOLIS | IN | 46256 | 510181688 | SUPPORT | IN | 501C3 | 12B | CHNW | Yes (true) |
| COMMUNITY HLTH SERVICES OF INDIANA | ||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 454817436 | HLTH CARE | IN | 501C3 | 3 | CHNW | Yes (true) |
| COMMUNITY HOSPITAL SOUTH INC | ||||||||||
| 1402 E COUNTY LINE ROAD SOUTH | INDIANAPOLIS | IN | 46227 | 351088640 | HOSPITAL | IN | 501C3 | 3 | CHNW | Yes (true) |
| COMMUNITY PHYSICIANS OF IN INC | ||||||||||
| 7240 SHADELAND STATION SUITE 300 | INDIANAPOLIS | IN | 46256 | 205392766 | PHY SRV | IN | 501C3 | 10 | CHNW | Yes (true) |
| HEALTH INSTITUTE OF INDIANA INC | ||||||||||
| 3660 GUION ROAD | INDIANAPOLIS | IN | 46222 | 352022402 | FITNESS | IN | 501C3 | 10 | CHNW | Yes (true) |
| INDIANAPOLIS OSTEOPATHIC HOSP INC | ||||||||||
| 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | 351094734 | HOSPITAL | IN | 501C3 | 3 | CHNW | Yes (true) |
| COMMUNITY HOWARD REGIONAL HEALTH | ||||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 351865344 | HOSPITAL | IN | 501C3 | 3 | CHNW | Yes (true) |
| COMM HOWARD REGIONAL HEALTH FDN | ||||||||||
| PO BOX 9011 | KOKOMO | IN | 46904 | 237309596 | SUPPORT | IN | 501C3 | 7 | NA | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (18 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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHNJMH VENTURES LLC | ||||||||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 462356266 | DIAG/REHAB | IN | N/A | false | false | |||||
| COMMUNITYACCESSCARE IN DIALYSIS | ||||||||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 474634198 | DIALYSIS | IN | N/A | false | false | |||||
| COMMUNITY ENDOSCOPY CENTER | ||||||||||||||
| 1601 N MADISON AVENUE SUITE 300 | ANDERSON | IN | 46011 | 611464136 | HLTH CARE | IN | false | false | NA | RELATED | $1,061,486 | $576,950 | 0.41000 | |
| COMM HEALTH NETWORK REHAB HOSP LLC | ||||||||||||||
| 680 S FOURTH STREET | LOUISVILLE | KY | 40202 | 453414249 | REHAB | IN | N/A | false | false | |||||
| COMM HLTH NTWRK RHB HOSP SOUTH LLC | ||||||||||||||
| 680 S FOURTH STREET | LOUISVILLE | KY | 40202 | 821385366 | REHAB | IN | N/A | false | false | |||||
| EAST CAMPUS SURGERY CENTER LLC | ||||||||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 352028517 | SURGERY | IN | N/A | false | false | |||||
| HAMILTON SURGERY CENTER LLC | ||||||||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 352061413 | SURGERY | IN | N/A | false | false | |||||
| HOWARD COMMUNITY SURGERY CTR LLC | ||||||||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 352118748 | SURGERY | IN | N/A | false | false | |||||
| HOWARD REGIONAL SPECIALTY CARE LLC | ||||||||||||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | 371501021 | REHAB | IN | N/A | false | false | |||||
| INDIANAPOLIS ENDOSCOPY CENTER LLP | ||||||||||||||
| 8315 E 56TH STREET | INDIANAPOLIS | IN | 46216 | 352010874 | HLTH CARE | IN | N/A | false | false | |||||
| MICHIGAN SURGERY INVESTMENT LLC | ||||||||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 320147008 | SURG CTRS | IN | N/A | false | false | |||||
| NORTH CAMPUS OFFICE ASSOCIATES LP | ||||||||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 351808625 | RNTL PROP | IN | N/A | false | false | |||||
| NORTH CAMPUS SURGERY CENTERS LLC | ||||||||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 352147088 | SURGERY | IN | N/A | false | false | |||||
| NORTHPOINT PEDIATRICS LLC | ||||||||||||||
| 8101 CLEARVISTA PARKWAY SUITE 185 | INDIANAPOLIS | IN | 46256 | 351960566 | HLTH CARE | IN | N/A | false | false | |||||
| NORTHWEST SURGERY CENTER LLC | ||||||||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 208754071 | SURGERY | IN | N/A | false | false | |||||
| PILLARS HOUSING LP | ||||||||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 161652671 | HOUSING | IN | N/A | false | false | |||||
| PRIMARIA HEALTH LLC | ||||||||||||||
| 9365 COUNSELORS ROW SUITE 210 | INDIANAPOLIS | IN | 46240 | 474728937 | CONSULTING | IN | N/A | false | false | |||||
| SOUTH CAMPUS SURGERY CENTER LLC | ||||||||||||||
| 1550 EAST COUNTY LINE ROAD | INDIANAPOLIS | IN | 46227 | 352038072 | SURGERY | IN | N/A | false | false | |||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHN ASSURANCE COMPANY LTD | |||||||||||||
| PO BOX 1051GT | GRAND CAYMAN | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | Yes (true) | |||||
| PILLARS COMMUNITY HOUSING INC | |||||||||||||
| 161652666 | HOUSING | N/A | Yes (true) | 3500 SOUTH LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | |||||
| VISIONARY ENTERPRISES INC | |||||||||||||
| 351538433 | MGMT SRVCS | N/A | Yes (true) | 6626 EAST 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | IN | |||||
| VEI MICHIGAN INC | |||||||||||||
| 300097377 | MGMT SRVCS | N/A | Yes (true) | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | |||||
| WESTVIEW DELIVERY SYSTEM INC | |||||||||||||
| 351910292 | MGMT SRVCS | N/A | Yes (true) | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (12 entries)
| Business Name Line2OtherOrganizationName/BusinessNameLine2Txt | Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|---|
| COMMUNITY ENDOSCOPY CENTER | |||
| K-1 DISTRIBUTION | S | $975,390 | BOOK VALUE |
| COMMUNITY HOSP ANDERSON FDN INC | |||
| B | $81,456 | BOOK VALUE | |
| COMMUNITY HOSP ANDERSON FDN INC | |||
| C | $286,547 | BOOK VALUE | |
| COMMUNITY HOSP ANDERSON FDN INC | |||
| Q | $217,933 | BOOK VALUE | |
| COMMUNITY HOSP ANDERSON FDN INC | |||
| R | $228,927 | BOOK VALUE | |
| COMMUNITY HOME HEALTH SERVICES INC | |||
| Q | $51,972 | BOOK VALUE | |
| COMMUNITY LTC INC | |||
| Q | $1,510,869 | BOOK VALUE | |
| COMMUNITY PHYSICIANS OF IN INC | |||
| A | $1,377,353 | BOOK VALUE | |
| COMMUNITY PHYSICIANS OF IN INC | |||
| P | $4,953,052 | BOOK VALUE | |
| COMMUNITY PHYSICIANS OF IN INC | |||
| S | $130,517 | BOOK VALUE | |
| VISIONARY ENTERPRISES INC | |||
| P | $10,836,296 | BOOK VALUE | |
| VISIONARY ENTERPRISES INC | |||
| Q | $5,357,627 | BOOK VALUE | |