COMMUNITY HOSPITALS OF INDIANA INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HOSPITALS OF INDIANA INC (EIN 35-1088640)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-12
- IRS object ID
- 201443169349303404
- Schema version
- 2013v3.1
- 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 J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-12T13:07:35-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | 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 | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4745 STATESMEN DRIVE SUITE C | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46250 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351088640 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL SOUTH INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 3178877112 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1402 E COUNTY LINE ROAD SOUTH | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46227 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANTHONY LENNEN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3178877112 | PhoneNum |
| Signature | 2014-10-30 | 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 | 2014-11-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANTHONY LENNEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1402 E COUNTY LINE ROAD SOUTH | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46227 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $190,233,419 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ECOMMUNITY.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1989 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | COMMUNITY HOSPITAL SOUTH,INC. ("CHS") IS A 501(C)(3) CORPORATION SERVING THE HEALTH RELATED NEEDS OF THE CITIZENS OF THE INDIANAPOLIS METROPOLITAN AREA AND CENTRAL INDIANA. CHS OPERATES A GENERAL ACUTE CARE HOSPITAL AND PROVIDES INPATIENT, OUTPATIENT, EMERGENCY AND AMBULATORY HEALTH CARE SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 1017 | TotalEmployeeCnt |
| Total Volunteers | 245 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $33,707 | PYContributionsGrantsAmt |
| CY Contributions Grants | $332,858 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $169,858,075 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $184,713,350 | CYProgramServiceRevenueAmt |
| PY Investment Income | $15,764 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,700 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,609,561 | PYOtherRevenueAmt |
| CY Other Revenue | $5,185,511 | CYOtherRevenueAmt |
| PY Total Revenue | $174,517,107 | PYTotalRevenueAmt |
| CY Total Revenue | $190,233,419 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $61,207,331 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $63,386,405 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $90,239,766 | PYOtherExpensesAmt |
| CY Other Expenses | $92,401,363 | CYOtherExpensesAmt |
| PY Total Expenses | $151,447,097 | PYTotalExpensesAmt |
| CY Total Expenses | $155,787,768 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $23,070,010 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $34,445,651 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $230,047,350 | TotalAssetsBOYAmt |
| Total Assets EOY | $263,787,589 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,439,674 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,734,262 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $224,607,676 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $259,053,327 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | COMMUNITY HOSPITAL SOUTH,INC. ("CHS") IS A 501(C)(3) CORPORATION SERVING THE HEALTH RELATED NEEDS OF THE CITIZENS OF THE INDIANAPOLIS METROPOLITAN AREA AND CENTRAL INDIANA. CHS OPERATES A GENERAL ACUTE CARE HOSPITAL AND PROVIDES INPATIENT, OUTPATIENT, EMERGENCY AND AMBULATORY HEALTH CARE SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $103,624,519 | ExpenseAmt |
| Revenue | $189,898,861 | RevenueAmt |
| Desc | COMMUNITY HOSPITAL SOUTH ("CHS") IS AN ACUTE CARE HOSPITAL IN INDIANAPOLIS, INDIANA WITH 150 LICENSED BEDS. IN 2013, CHS SERVED 8,572 INPATIENTS FOR A TOTAL OF 30,538 INPATIENT DAYS OF SERVICE. CHS ALSO PROVIDED 124,385 OUTPATIENT VISITS, WHICH INCLUDED 44,439 EMERGENCY VISITS. COMMUNITY HOSPITAL SOUTH OFFERS MANY PATIENT FOCUSED HEALTHCARE SERVICES THAT INCLUDE WOMEN AND CHILDREN SERVICES, PEDIATRICS, ONCOLOGY, NEUROSCIENCES, ORTHOPEDICS, JOINT REPLACEMENT, BREAST CARE SERVICES, SURGERY SERVICES, REHABILITATION SERVICES, HEALTH PROMOTION SERVICES, AND EMERGENCY SERVICES. | Desc |
| Total Program Service Expenses | $103,624,519 | 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 | Yes (true) | 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 | false | 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 | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | 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 |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1017 | 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | 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 | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| 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 | BRIAN MCCONNELL | PersonNm |
| Phone | 3173554212 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7240 SHADELAND STATION SUITE 300 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46256 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 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 |
|---|---|---|---|---|---|---|---|---|---|
| BRYAN A MILLS | |||||||||
| DIRECTOR | 2.00 | 58.00 | Yes (X) | $0 | $1,133,983 | $121,280 | |||
| HANY HADDAD MD | |||||||||
| DIRECTOR | 2.00 | 40.00 | Yes (X) | $0 | $621,442 | $36,928 | |||
| KENNETH SHAVER MD | |||||||||
| DIRECTOR | 2.00 | 40.00 | Yes (X) | $0 | $271,486 | $35,863 | |||
| KATHRYN G BETLEY | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| JAMES MOREY | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| JEFFREY MOSSLER MD | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| MICHAEL PETERSON | |||||||||
| CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| STEVEN PLUMP | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| YVONNEE SHAHEEN | |||||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| KRISTEN SHERMAN | |||||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| CHARLES E STALEY | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| RUSSELL SWAN JR | |||||||||
| VICE CHAIRMA | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| RONALD THIEME | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| MICHAEL C BLANCHET | |||||||||
| COO - CHNW | 50.00 | $0 | $523,766 | $309,439 | Yes (X) | ||||
| ANTHONY LENNEN | |||||||||
| PRESIDENT | 50.00 | $397,866 | $0 | $75,019 | Yes (X) | ||||
| JEFFREY KIRKHAM | |||||||||
| CFO CLINICAL | 55.00 | $0 | $376,309 | $68,636 | Yes (X) | ||||
| SARAH KNISELY-KING | |||||||||
| COO/CHF NURS | 50.00 | $174,151 | $0 | $13,025 | Yes (X) | ||||
| RANDALL LEE MD | |||||||||
| VP CLINICAL | 45.00 | $352,488 | $0 | $33,631 | Yes (X) | ||||
| MICHAEL DAROSA DO | |||||||||
| PHYSICIAN | 45.00 | $199,236 | $0 | $32,574 | Yes (X) | ||||
| LUSHAWNA LAWSON | |||||||||
| PHARMACY DIR | 45.00 | $142,689 | $0 | $34,249 | Yes (X) | ||||
| PAULA EVERTS | |||||||||
| DIRECTOR OF | 45.00 | $130,075 | $0 | $45,404 | Yes (X) | ||||
| SANDRA LEMON | |||||||||
| SITE CLINICA | 45.00 | $128,623 | $0 | $19,654 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,525,128 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,926,986 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $825,702 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 29 | 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/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MID AMERICA CLINICAL LABS | |||||
| 2560 NORTH SHADELAND AVENUE | INDIANAPOLIS | IN | 46219 | LAB SERVICES | $3,611,359 |
| SUMMIT CONSTRUCTION CO INC | |||||
| 1107 BURDSAL PKWY PO BOX 88126 | INDIANAPOLIS | IN | 46208 | CONSTRUCTION | $3,152,233 |
| ALDERSON PROPERTY SERVICES | |||||
| 1530 AMERICAN WAY SUITE 210 | GREENWOOD | IN | 46143 | CONSTRUCTION | $910,244 |
| ROLLINS CONSTRUCTION CO LLC | |||||
| 3024 N RIDGEVIEW DRIVE | INDIANAPOLIS | IN | 46226 | CONSTRUCTION | $582,936 |
| BSA LIFESTRUCTURES INC | |||||
| PO BOX 6069 | INDIANAPOLIS | IN | 462066069 | ARCHITECTURAL | $557,565 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 73 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $332,858 | RelatedOrganizationsAmt |
| Total Contributions | $332,858 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 622110 | $184,283,129 | $184,283,129 |
| CATH LAB JOHNSON MEM JT VEN | 621500 | $233,627 | $233,627 |
| PET SCAN MISC REVENUE | 900099 | $102,000 | $102,000 |
| MEDICAL STAFF SERVICES | 900099 | $94,594 | $94,594 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $184,713,350 | TotalProgramServiceRevenueAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,700 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,700 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,700 | TotalRevenueColumnAmt |
| Exclusion | $1,700 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| LEASED EQUIPMENT | 532420 | $2,894,100 | $2,894,100 |
| EHR INCENTIVE PAYMENTS | 900099 | $1,133,784 | $1,133,784 |
| EQUITY INVESTMENT INCOME | 900003 | $683,301 | $683,301 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $474,326 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $474,326 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $5,185,511 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $190,233,419 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $189,898,861 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,700 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $660,061 | TotalAmt |
| Management And General | $660,061 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,499,214 | TotalAmt |
| Program Services | $37,333,014 | ProgramServicesAmt |
| Management And General | $9,166,200 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,386,822 | TotalAmt |
| Program Services | $1,050,137 | ProgramServicesAmt |
| Management And General | $1,336,685 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,536,900 | TotalAmt |
| Program Services | $8,341,397 | ProgramServicesAmt |
| Management And General | $2,195,503 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,303,408 | TotalAmt |
| Program Services | $2,626,875 | ProgramServicesAmt |
| Management And General | $676,533 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,722,240 | TotalAmt |
| Program Services | $9,727,712 | ProgramServicesAmt |
| Management And General | $23,994,528 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,186 | TotalAmt |
| Program Services | $996 | ProgramServicesAmt |
| Management And General | $3,190 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,519,084 | TotalAmt |
| Program Services | $3,385,390 | ProgramServicesAmt |
| Management And General | $1,133,694 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $465,021 | TotalAmt |
| Program Services | $213,167 | ProgramServicesAmt |
| Management And General | $251,854 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,877,764 | TotalAmt |
| Program Services | $1,486,507 | ProgramServicesAmt |
| Management And General | $391,257 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,662 | TotalAmt |
| Program Services | $33,614 | ProgramServicesAmt |
| Management And General | $13,048 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,145 | TotalAmt |
| Program Services | $13,956 | ProgramServicesAmt |
| Management And General | $8,189 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,139,443 | TotalAmt |
| Management And General | $6,139,443 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,468,920 | TotalAmt |
| Program Services | $4,336,797 | ProgramServicesAmt |
| Management And General | $6,132,123 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,928 | TotalAmt |
| Management And General | $2,928 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $27,892,279 | $27,892,279 | |
| HAF PROGRAM FEES | $7,159,835 | $7,159,835 | |
| DUES & SUBSCRIPTIONS | $31,202 | $81 | $31,121 |
| SECURITY EQUIPM & EXP | $20,252 | $9,284 | $10,968 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,402 | TotalAmt |
| Program Services | $13,478 | ProgramServicesAmt |
| Management And General | $15,924 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,787,768 | TotalAmt |
| Program Services | $103,624,519 | ProgramServicesAmt |
| Management And General | $52,163,249 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,725 | BOYAmt |
| EOY | $2,675 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,158,334 | BOYAmt |
| EOY | $23,158,667 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,648,271 | BOYAmt |
| EOY | $2,646,391 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $229,554,272 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $100,034,696 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,945,720 | BOYAmt |
| EOY | $129,519,576 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,292,300 | BOYAmt |
| EOY | $108,460,280 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $230,047,350 | BOYAmt |
| EOY | $263,787,589 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,897,728 | BOYAmt |
| EOY | $4,616,294 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $541,946 | BOYAmt |
| EOY | $117,968 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,439,674 | BOYAmt |
| EOY | $4,734,262 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $224,607,676 | BOYAmt |
| EOY | $259,053,327 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $224,607,676 | BOYAmt |
| EOY | $259,053,327 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $230,047,350 | BOYAmt |
| EOY | $263,787,589 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $34,445,651 | ReconcilationRevenueExpnssAmt |
| 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
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $497,000 | OtherCostOrOtherBasisAmt |
| Book Value | $497,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $163,143,666 | OtherCostOrOtherBasisAmt |
| Depreciation | $39,091,987 | DepreciationAmt |
| Book Value | $124,051,679 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,705,707 | OtherCostOrOtherBasisAmt |
| Depreciation | $877,919 | DepreciationAmt |
| Book Value | $827,788 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $61,447,021 | OtherCostOrOtherBasisAmt |
| Depreciation | $58,281,389 | DepreciationAmt |
| Book Value | $3,165,632 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,760,878 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,783,401 | DepreciationAmt |
| Book Value | $977,477 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $129,519,576 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE FROM AFFLIATED ENTITIES | Desc |
| Book Value | $108,460,280 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $108,460,280 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THIRD PARTY SETTLEMENT | Desc |
| Amt | $117,968 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $117,968 | 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 | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| 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 | 14337 | PersonsServedCnt |
| Total Community Benefit Expns | $7,497,347 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,497,347 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04810 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 15021 | PersonsServedCnt |
| Total Community Benefit Expns | $22,487,039 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,926,975 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,560,064 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05500 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 29358 | PersonsServedCnt |
| Total Community Benefit Expns | $29,984,386 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,926,975 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,057,411 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10310 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $3,799,350 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $108,555 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,690,795 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02370 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $598,825 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $179,762 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $419,063 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $291,873 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $291,873 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 13 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $4,690,048 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $288,317 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,401,731 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02820 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 13 | ActivitiesOrProgramsCnt |
| Persons Served | 29358 | PersonsServedCnt |
| Total Community Benefit Expns | $34,674,434 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,215,292 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,459,142 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13130 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,361,224 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $39,880,353 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $43,602,104 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$3,721,751 | 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 | NONE | BusinessNameLine1 |
| 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 | COMMUNITY HOSPITAL SOUTH | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1402 E COUNTY LINE ROAD SOUTH | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46227 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.ECOMMUNITY.COM | WebsiteAddressTxt |
| State License | 13-005109-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL SOUTH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.ECOMMUNITY.COM | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | WWW.COMMUNITYANDERSON.COM | OtherWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| Other Factors | Yes (X) | OtherFactorsInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, COMMUNITY HOSPITAL SOUTH - PART V, LINE 3 | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 1, COMMUNITY HOSPITAL SOUTH - PART V, LINE 4 | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 1, COMMUNITY HOSPITAL SOUTH - PART V, LINE 5C | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 1, COMMUNITY HOSPITAL SOUTH - PART V, LINE 7 | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 1, COMMUNITY HOSPITAL SOUTH - PART V, LINE 12I | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 1, COMMUNITY HOSPITAL SOUTH - PART V, LINE 14G | THE POLICY IS REFERENCED ON THE BILL. |
| FACILITY 1, COMMUNITY HOSPITAL SOUTH - PART V, LINE 20D | THE UNINSURED DISCOUNT WAS DETERMINED UTILIZING THE NETWORK'S TOP COMMERICIAL PAYORS. UNINSURED DISCOUNTS REPRESENT A STANDARD DISCOUNT ON CHARGES AS IT RELATES TO PATIENTS WHO HAVE NO INSURANCE COVERAGE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 7 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| COMMUNITY REGIONAL CANCER CENTER | ||||
| 1550 E COUNTY LINE ROAD SUITE 325 | INDIANAPOLIS | IN | 46227 | HEALTH CARE |
| COMM HEART & VASCULAR CV TESTING | ||||
| 1402 E COUNTY LINE ROAD 2200 | INDIANAPOLIS | IN | 46227 | HEALTH CARE |
| COMMUNITY IMAGING CENTER | ||||
| 333 E COUNTY LINE ROAD SUITE A | GREENWOOD | IN | 46143 | DIAGNOSTIC CENTER |
| CHS SLEEP DISORDERS CENTER | ||||
| 333 E COUNTY LINE ROAD SUITE D | GREENWOOD | IN | 46143 | HEALTH CARE |
| REHAB & SPORTS MEDICINE | ||||
| 98 SOUTHPARK BLVD | GREENWOOD | IN | 46143 | REHABILITATION |
| REHAB & SPORTS MEDICINE | ||||
| 1340 E COUNTY LINE ROAD U | INDIANAPOLIS | IN | 46227 | REHABILITATION |
| CENTER FOR WOMEN'S HEALTH | ||||
| 533 E COUNTY LINE ROAD 101 | GREENWOOD | IN | 46143 | HEALTH CARE |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A - RELATED ORGANIZATION INFORMATION | A COMMUNITY BENEFIT REPORT IS COMPLETED FOR THE COMMUNITY HEALTH NETWORK AS A WHOLE. COMMUNITY HOSPITAL SOUTH, INC. IS INCLUDED WITHIN THE NETWORK COMMUNITY BENEFIT REPORT. |
| 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 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. COMMUNITY HOSPITAL SOUTH, INC. UTILIZES AN AUTOMATED SOFTWARE SOLUTION TO ASSIST IN DETERMINING PATIENTS ELIGIBLE FOR FREE CARE. AS A RESULT OF THE IMPLEMENTATION OF THIS AUTOMATED SOLUTION, THERE IS VERY LITTLE BAD DEBT RECORDED FOR PATIENTS WHO WOULD BE ELIGIBLE FOR FREE CARE UNDER THE NETWORK POLICY. PART III, LINE 4 - BAD DEBT EXPENSE EXPLANATION THE AUDITED FINANCIAL STATEMENTS CONTAIN THE FOLLOWING TEXT WITHIN THE FOOTNOTES TO DESCRIBE BAD DEBT EXPENSE: THE NETWORK'S 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. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, INCLUDING PATIENT DEDUCTIBLES AND CO- INSURANCE, THE NETWORK RECORDS A PROVISION FOR BAD DEBTS AND CHARITY 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. FOR CHNW, CHS, VEI AND CHVH, ACCOUNTS THAT ARE SENT TO COLLECTION COMPANIES REMAIN AS ACCOUNTS RECEIVABLE ON THE BALANCE SHEET. THESE ACCOUNTS ARE NOT WRITTEN OFF UNLESS RETURNED FROM THE COLLECTION COMPANY, HOWEVER ARE FULLY RESERVED WITHIN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. AS SUCH THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS SIGNIFICANT FOR ACCOUNTS RECEIVABLE THAT HAVE BEEN FULLY RESERVED. 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 AND CHARITY 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, 2013 AND 2012, RESPECTIVELY: THIRD PARTY PAYORS SELF-PAY TOTAL ALL PAYORS 2013 PATIENT SERVICE REVENUE(NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) 1,666,086 94,024 1,760,110 ========== ======= ========== 2012 PATIENT SERVICE REVENUE(NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) 1,580,962 73,759 1,654,721 ========== ======= ========== 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 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 83,731000 AND 58,163000 FOR THE YEARS ENDED DECEMBER 31, 2013 AND 2012, RESPECTIVELY. CHARITY CARE COST WAS ESTIMATED ON THE APPLICATION OF THE ASSOCIATED COST-TO-CHARGE RATIOS. BEGINNING JUNE 2012, THE STATE OF INDIANA OFFERED VOLUNTARY PARTICIPATION IN THE STATE OF INDIANA'S HOSPITAL ASSESSMENT FEE ("HAF") PROGRAM, RETROACTIVE TO JULY, 1, 2011. 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. AS A RESULT OF PARTICIPATING IN THE HAF PROGRAM, FOR THE YEAR ENDED DECEMBER 31, 2012, THE NETWORK RECOGNIZED REIMBURSEMENTS OF 78,197000 AND FEES OF 43,453000 RELATED TO THE PERIOD JULY 1, 2011 THROUGH JUNE 30, 2012. THE NETWORK RECOGNIZES REVENUES AND RELATED FEES ASSOCIATED WITH THE HAF PROGRAM IN THE PERIOD IN WHICH AMOUNTS ARE ESTIMABLE AND COLLECTION OR 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. THE HAF PROGRAM RUNS ON AN ANNUAL CYCLE FROM JULY 1 TO JUNE 30 AND WAS ORIGINALLY EFFECTIVE UNTIL JUNE 30, 2013. THE PROGRAM WAS SUBSEQUENTLY RENEWED ON MARCH 21, 2014 EFFECTIVE THROUGH JUNE 30, 2017 WITH A RETROACTIVE EFFECTIVE DATE OF JULY 1, 2013. AS A RESULT OF THE RETROACTIVE DATE OF JULY 1, 2013, THE NETWORK HAS ACCRUED BOTH THE ESTIMATED REIMBURSEMENT AND EXPENSE FOR THE PERIOD JULY 1, 2013 THROUGH DECEMBER 31, 2013 IN ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS ON THE DECEMBER 31, 2013 BALANCE SHEET. THE CONSOLIDATED BALANCE SHEET AT DECEMBER 31, 2013 INCLUDES 46,036000 AND 35,240000 IN ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS RECEIVABLE AND PAYABLE, RESPECTIVELY, RELATED TO THE HAF PROGRAM. 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 PART C AND D. THE MEDICARE SHORTFALL ATTRIBUTED TO THOSE AREAS NOT INCLUDED ON THE MEDICARE COST REPORT IS 2,317,894. AS SUCH, THE TOTAL MEDICARE SHORTFALL FOR ALL MEDICARE PROGRAMS IS 6,039,645. MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS COMMUNITY BENEFIT BECAUSE MEDICARE REPRESENTS 43.53% OF THE OVERALL PAYER MIX FOR COMMUNITY HOSPITAL SOUTH, INC. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | SEE ATTACHED FINANCIAL ASSISTANCE POLICY. |
| ADDITIONAL INFORMATION | PART VI, ITEMS 2 THROUGH 5 ARE DISCUSSED WITHIN THE ATTACHED COMMUNITY BENEFIT 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 SOUTH, INC. ("CHS") IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. SEE THE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT FOR HOW CHS IS INVOLVED IN PROMOTING THE HEALTH OF THE COMMUNITY IT SERVES. PART VI, ITEM 7 - STATE FILING OF COMMUNITY BENEFIT REPORT INDIANA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRYAN A MILLS | ||||||||||||||
| DIRECTOR | $912,524 | $123,211 | $98,248 | $90,730 | $30,550 | $1,255,263 | $123,211 | |||||||
| HANY HADDAD MD | ||||||||||||||
| DIRECTOR | $502,388 | $100,000 | $19,054 | $15,300 | $21,628 | $658,370 | $100,000 | |||||||
| KENNETH SHAVER MD | ||||||||||||||
| DIRECTOR | $190,880 | $80,606 | $15,300 | $20,563 | $307,349 | |||||||||
| MICHAEL C BLANCHET | ||||||||||||||
| COO - CHNW | $18,864 | $504,902 | $299,500 | $9,939 | $833,205 | $504,000 | ||||||||
| ANTHONY LENNEN | ||||||||||||||
| PRESIDENT | $346,015 | $34,502 | $17,349 | $43,869 | $31,150 | $472,885 | $34,502 | |||||||
| JEFFREY KIRKHAM | ||||||||||||||
| CFO CLINICAL ENTERPR | $300,184 | $37,125 | $39,000 | $38,499 | $30,137 | $444,945 | $37,125 | |||||||
| SARAH KNISELY-KING | ||||||||||||||
| COO/CHF NURS EXEC | $158,860 | $6,673 | $8,618 | $13,025 | $187,176 | $6,673 | ||||||||
| RANDALL LEE MD | ||||||||||||||
| VP CLINICAL PERFORMN | $276,248 | $31,735 | $44,505 | $33,631 | $386,119 | |||||||||
| MICHAEL DAROSA DO | ||||||||||||||
| PHYSICIAN | $198,119 | $1,117 | $12,402 | $20,172 | $231,810 | |||||||||
| LUSHAWNA LAWSON | ||||||||||||||
| PHARMACY DIRECTOR | $121,803 | $9,430 | $11,456 | $9,367 | $24,882 | $176,938 | ||||||||
| PAULA EVERTS | ||||||||||||||
| DIRECTOR OF NURSING | $106,846 | $8,140 | $15,089 | $14,189 | $31,215 | $175,479 | ||||||||
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 4 | MICHAEL C. BLANCHET 504,000 0 0 |
| SCHEDULE J, PART III | PART I, LINE 3 - RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION COMMUNITY HOSPITAL SOUTH, INC. ("CHS") CEO/EXECUTIVE DIRECTOR IS PAID BY COMMUNITY HEALTH NETWORK, INC. ("CHNW"), A RELATED 501(C)(3) ORGANIZATION. CHNW USES THE FOLLOWING IN DETERMINING THE CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE, 2) INDEPENDENT COMPENSATION CONSULTANT, 3) COMPENSATION SURVEY OR STUDY, AND 4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN BRYAN A. MILLS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THROUGH HIS EMPLOYER, CHNW. DURING 2013, MR. MILLS DID NOT RECEIVE A PAYMENT FROM SUCH PLAN. PART I, LINE 7 - NON-FIXED PAYMENTS PROVIDED COMMUNITY HOSPITAL SOUTH, INC., PARTICIPATES IN THE NETWORK'S SENIOR LEADERSHIP INCENTIVE PROGRAM. CERTAIN INDIVIDUALS OF THE LEADERSHIP TEAM PARTICIPATE IN THIS PROGRAM. THE PROGRAM WAS ADOPTED BY THE EXECUTIVE COMPENSATION COMMITTEE, AND IS INTENDED TO INFLUENCE OUTSTANDING PERFORMANCE BY THE SENIOR LEADERS, AS MEASURED AGAINST BOTH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE. THE PROGRAM IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPOSED ENTIRELY OF INDEPENDENT COMMUNITY MEMBERS. THE INCENTIVE COMPENSATION THAT IS AWARDED IS INCLUDED IN TOTAL COMPENSATION TO THE EXECUTIVE. THE TOTAL COMPENSATION (INCLUDING ANY PAYMENTS UNDER THE PROGRAM) IS SUBJECT TO THE REVIEW AND APPROVAL OF THE EXECUTIVE COMPENSATION COMMITTEE AND INDEPENDENT COMPENSATION CONSULTANT, IN CONSIDERATION OF CODE SECTION 4958 (AND THE CORRESPONDING TREASURY REGULATIONS) TO ENSURE THAT IT REFLECTS ARMS LENGTH, FAIR MARKET TERMS. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VISIONARY ENTERPRISES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SHARE BD MEMBER | RelationshipDescriptionTxt |
| Transaction | $2,095,928 | TransactionAmt |
| Transaction | HLTH & PHARM/DESIGN | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | COMMUNITY HOSPITAL SOUTH,INC. ("CHS") IS A 501(C)(3) CORPORATION SERVING THE HEALTH RELATED NEEDS OF THE CITIZENS OF THE INDIANAPOLIS METROPOLITAN AREA AND CENTRAL INDIANA. CHS OPERATES A GENERAL ACUTE CARE HOSPITAL AND PROVIDES INPATIENT, OUTPATIENT, EMERGENCY AND AMBULATORY HEALTH CARE SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. |
| FORM 990 | FORM 990, PART I, LINE 4 - INDEPENDENT VOTING MEMBERS COMMUNITY HOSPITAL SOUTH, INC. ("CHS") IS AN AFFILIATE OF COMMUNITY HEALTH NETWORK ("THE NETWORK"), AN INTEGRATED HEALTH DELIVERY SYSTEM. CHS IS CONTROLLED BY ITS PARENT, COMMUNITY HEALTH NETWORK, INC ("CHNW"), THE TAX- EXEMPT PARENT OF THE INTEGRATED HEALTH DELIVERY SYSTEM. CHS' ARTICLES OF INCORPORATION AND BYLAWS WERE AMENDED EFFECTIVE 12/31/11 TO DESIGNATE THE MEMBERS OF THE BOARD OF DIRECTORS OF CHNW TO BE THE DIRECTORS OF CHS. CHNW EXERCISES CONTROL OVER CHS THROUGH A SERIES OF GOVERNANCE RIGHTS: A) CHNW IS THE SOLE MEMBER OF CHS; B) CHS HAS DELEGATED EXCLUSIVE AUTHORITY TO CHNW, ACTING THROUGH CHNW'S BOARD OF DIRECTORS, IN THE FOLLOWING SUBSTANTIVE AREAS: STRATEGIC PLANNING; CAPITAL ACCESS, BUDGETING AND ALLOCATION; AUDIT AND COMPLIANCE; EXECUTIVE COMPENSATION; AND DISPUTE RESOLUTION; C) CHNW MUST APPROVE ANY MODIFICATION, REPEAL, AMENDMENT, OR RESTATEMENT OF CHS' ARTICLES OF INCORPORATION; AND D) CHNW MUST APPROVE ANY SALE OR DISPOSITION OF SUBSTANTIALLY ALL OF THE ASSETS OF CHS. WITH REGARD TO EXECUTIVE COMPENSATION, CHNW HAS DELEGATED AUTHORITY TO REVIEW AND APPROVE EXECUTIVE COMPENSATION, INCLUDING CHS' EXECUTIVES, TO A NETWORK EXECUTIVE COMPENSATION COMMITTEE COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS. IN SUM, CHS HAS REMOVED ANY RISK OF INAPPROPRIATE RELATED PARTY TRANSACTIONS BY DELEGATING (THROUGH CHNW) ITS EXECUTIVE COMPENSATION DECISIONS TO A NETWORK EXECUTIVE COMPENSATION COMMITTEE AND ITS CONFLICT OF INTEREST DECISIONS TO A NETWORK AUDIT COMMITTEE, WITH EACH COMMITTEE COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS. FORM 990, PART I, LINE 5 - NUMBER OF EMPLOYEES CHS EMPLOYEES ARE LEASED FROM COMMUNITY HEALTH NETWORK, INC. |
| FORM 990, PART V | FORM 990, PART V, LINE 1A - BOX 3 OF FORM 1096 FORM 1099S WERE PROCESSED UNDER THE NAME AND FEDERAL IDENTIFICATION NUMBER OF COMMUNITY HEALTH NETWORK, INC. |
| FORM 990, PART VI | FORM 990, PART VI, LINE 1B - VOTING MEMBERS THAT ARE INDEPENDENT SEE FORM 990, PART I, LINE 4 REFERENCE ON SCHEDULE O ABOVE FORM 990, PART VI, LINE 2 - RELATED PARTY INFORMATION AMONG OFFICERS THE FOLLOWING DIRECTORS SERVED AS DIRECTORS OF VISIONARY ENTERPRISES, INC., A TAXABLE AFFILIATE OF CHNW: BRYAN A. MILLS DR. JEFFREY A. MOSSLER ALL OF THE DIRECTORS SERVED AS DIRECTORS OF COMMUNITY HEALTH NETWORK, INC. ("CHNW"). IN ADDITION, THE FOLLOWING DIRECTORS SERVED AS AN OFFICER OR WAS A KEY EMPLOYEE OF CHNW: MICHAEL C. BLANCHET JEFFREY KIRKHAM AND THE FOLLOWING RECEIVED COMPENSATION FROM CHNW: MICHAEL C. BLANCHET HANY HADDAD, M.D. JEFFREY KIRKHAM BRYAN A. MILLS THE FOLLOWING DIRECTORS SERVED AS A DIRECTOR OR OFFICER OF COMMUNITY PHYSICIANS OF INDIANA, INC. ("CPI"): JEFFREY KIRKHAM BRYAN A. MILLS AND THE FOLLOWING RECEIVED COMPENSATION FROM CPI: KENNETH SHAVER, M.D. |
| FORM 990, PAGE 6, PART VI, LINE 3 | CHS HAS DELEGATED EXCLUSIVE AUTHORITY TO CHNW, ACTING THROUGH CHNW'S BOARD OF DIRECTORS, IN THE FOLLOWING SUBSTANTIVE AREAS: STRATEGIC PLANNING, CAPITAL ACCESS, BUDGETING AND ALLOCATION; AUDIT AND COMPLIANCE; EXECUTIVE COMPENSATION; AND DISPUTE RESOLUTION. |
| FORM 990, PAGE 6, PART VI, LINE 6 | SEE FORM 990, PART I, LINE 4 REFERENCE ON SCHEDULE O ABOVE |
| FORM 990, PAGE 6, PART VI, LINE 7A | SEE FORM 990, PART I, LINE 4 REFERENCE ON SCHEDULE O ABOVE |
| FORM 990, PAGE 6, PART VI, LINE 7B | SEE FORM 990, PART I, LINE 4 REFERENCE ON SCHEDULE O ABOVE |
| FORM 990, PAGE 6, PART VI, LINE 11B | AS DISCUSSED IN PART I, LINE 4, CHNW HAS ASSUMED RESPONSIBILITY FOR CHS' AUDIT, COMPLIANCE, AND EXECUTIVE COMPENSATION MATTERS. CHNW'S BOARD OF DIRECTORS HAS DELEGATED AUTHORITY FOR THE REVIEW OF CHS' FORM 990 TO TWO COMMITTEES COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS: A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE COMPENSATION ASPECTS OF CHS' FORM 990, AND B) THE NETWORK FINANCE COMMITTEE REVIEWED THE REMAINDER OF THE CHS' FORM 990. IN ADDITION, CHS' OUTSIDE ACCOUNTING FIRM AND LAW FIRM REVIEWED THE FORM 990 PRIOR TO FILING. CHS AND CHNW UTILIZED THIS PROCESS TO ENSURE THAT CHS' FORM 990 RECEIVED SUBSTANTIVE REVIEW BY DIRECTORS AND PROFESSIONALS WITH SPECIFIC KNOWLEDGE OF CHS' ACTIVITIES AND EXTENSIVE FINANCIAL, ACCOUNTING, AND TAX EXPERTISE. |
| FORM 990, PAGE 6, PART VI, LINE 12C | AS DISCUSSED IN PART I, LINE 4, CHNW HAS ASSUMED RESPONSIBILITY FOR CHS' AUDIT AND COMPLIANCE MATTERS. CHNW HAS ADOPTED A CONFLICT OF INTEREST POLICY THAT APPLIES TO CHS. THE CONFLICT OF INTEREST POLICY REQUIRES DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO SUBMIT AN ANNUAL CONFLICT OF INTEREST DISCLOSURE. THE ANNUAL DISCLOSURE REQUIRES DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO DISCLOSE, IN WRITING, ANY KNOWN FINANCIAL INTEREST THAT THE INDIVIDUAL (TOGETHER WITH FAMILY MEMBERS) HAS IN ANY BUSINESS ENTITY THAT TRANSACTS BUSINESS WITH CHS. IN ADDITION, DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO IMMEDIATELY DISCLOSE ANY POSSIBLE CONFLICT OF INTEREST THAT ARISES MID-YEAR IN RELATION TO A PROPOSED TRANSACTION. THE CONFLICT OF INTEREST POLICY REQUIRES THAT ANY INDIVIDUAL WITH A CONFLICT BE RECUSED FROM THE DECISION MAKING PROCESS, THAT INDEPENDENT DIRECTORS OR COMMITTEE MEMBERS DETERMINE THAT THE PROPOSED TRANSACTION IS IN THE BEST INTEREST OF CHS, AND THE TRANSACTION MUST BE APPROVED BY A VOTE OF INDEPENDENT DIRECTORS OR COMMITTEE MEMBERS WITHOUT THE PARTICIPATION OF ANY INTERESTED INDIVIDUAL. THE ANNUAL CONFLICT DISCLOSURE STATEMENTS ARE SUBMITTED TO, AND REVIEWED BY, CHNW'S AUDIT COMMITTEE, COMPOSED OF INDEPENDENT DIRECTORS. IN ADDITION, THE EXECUTIVE STAFF AND GENERAL COUNSEL OF THE NETWORK ARE RESPONSIBLE FOR MONITORING ANY POSSIBLE CONFLICT TRANSACTIONS THAT ARISE AND MANAGING THEM TO ENSURE THAT ALL TRANSACTIONS REPRESENT ARMS LENGTH, FAIR MARKET VALUE TERMS FOR THE BENEFIT OF CHS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | AS DISCUSSED IN PART I, LINE 4, CHNW HAS ASSUMED RESPONSIBILITY FOR CHS' EXECUTIVE COMPENSATION MATTERS. CHNW HAS ADOPTED AN EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY THAT APPLIES TO CHS. THE PURPOSE OF THE POLICY IS TO ENSURE THAT CHS' COMPENSATION ARRANGEMENTS WITH RELATED PARTIES ARE EVALUATED AND ENTERED AT ARMS LENGTH AND THAT ANY COMPENSATION THAT IS PAID TO A RELATED PARTY IS REASONABLE AND REFLECTS FAIR MARKET VALUE. THIS POLICY ENCOURAGES THE APPLICATION OF THE REBUTTABLE PRESUMPTION STANDARD OF CODE SECTION 4958 AND THE RELATED TREASURY REGULATIONS BY: A) EXCLUDING ANY INTERESTED PARTY FROM THE DECISION MAKING PROCESS, B) REQUIRING DISINTERESTED BOARD OR COMMITTEE MEMBERS TO OBTAIN AND RELY UPON COMPARABILITY DATA WHEN SETTING THE PROPOSED COMPENSATION TERMS, C) REQUIRING APPROVAL OF THE TRANSACTION IN ADVANCE BY DISINTERESTED DIRECTORS OR COMMITTEE MEMBERS, AND D) REQUIRING CONTEMPORANEOUS DOCUMENTATION (I.E. MINUTES) REFLECTING THE DECISION AND THE PROCESS BY WHICH IT WAS MADE. CHNW ALSO DELEGATED AUTHORITY REGARDING CHS' EXECUTIVE COMPENSATION TO A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE, COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS, WHICH IS RESPONSIBLE FOR APPLYING THE TERMS AND PROCESS OF THE EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY AS OUTLINED ABOVE, AND B) THE NETWORK VICE PRESIDENT OF HUMAN RESOURCES WHO IS RESPONSIBLE FOR OBTAINING COMPARATIVE SALARY MARKET DATA FOR THE CHIEF EXECUTIVE OFFICER, OFFICERS, AND KEY EMPLOYEES, PERIODICALLY ENGAGING AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH REASONABLE COMPENSATION, AND PROVIDING STAFF SUPPORT TO THE NETWORK EXECUTIVE COMPENSATION COMMITTEE. DURING 2013, THE NETWORK EXECUTIVE COMPENSATION COMMITTEE FOLLOWED THIS PROCESS FOR ALL SENIOR EXECUTIVE LEADERS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SALARIES WERE COMPARED AGAINST COMPARATIVE SALARY MARKET DATA FOR ALL POSITIONS REPRESENTING MANAGERS, CHIEF EXECUTIVE OFFICERS, CHIEF FINANCIAL OFFICERS, AND HUMAN RESOURCES REPRESENTATIVES FOR ALL NETWORK ENTITIES. |
| 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) AS AN AFFILIATE OF CHNW, CHS HAS ADOPTED THE NETWORK CONFLICT OF INTEREST POLICY. WHILE THIS POLICY IS NOT AVAILABLE TO THE PUBLIC, THE NETWORK'S DEFINITION OF CONFLICT OF INTEREST AND HOW TO REPORT SUCH AN INCIDENT IS DESCRIBED IN THE NETWORK RESPONSIBILITY AND COMPLIANCE PROGRAM ("NRCP") MANUAL WHICH IS POSTED ON THE NETWORK'S WEBSITE, ECOMMUNITY.COM. THIS MANUAL IS AVAILABLE FOR THE PUBLIC TO REVIEW. C) CHS DOES NOT HAVE INDIVIDUALLY AUDITED FINANCIAL STATEMENTS. ITS FINANCIAL RESULTS ARE INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CHNW AND AFFILIATES. AS SUCH, THERE ARE NO INDIVIDUAL FINANCIAL STATEMENTS TO POST. CHS 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 IX, LINE 11G | PROFESSIONAL MEDICAL FEES 2,583,335 1,098,375 0 PURCHASED SERVICES 7,144,377 22,896,153 0 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY HEALTH NETWORK INC | ||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 350983617 | HOSP | IN | 501C3 | 3 | NA | false |
| COMMUNITY HEALTH NETWORK FOUNDATION | ||||||||||
| 7240 SHADELAND STATION SUITE 125 | INDIANAPOLIS | IN | 46256 | 510181688 | SUPPORT | IN | 501C3 | 11B | 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 HOME HEALTH SERVICES INC | ||||||||||
| 9894 EAST 121ST STREET | FISHERS | IN | 46037 | 350953467 | HLTH CARE | IN | 501C3 | 9 | CHNW | Yes (true) |
| COMM HOSP OF ANDERSON & MADISON CTY | ||||||||||
| 1515 NORTH MADISON AVENUE | ANDERSON | IN | 46011 | 351069822 | HOSPITAL | IN | 501C3 | 3 | CHNW | Yes (true) |
| COMMUNITY HOSP ANDERSON FDN INC | ||||||||||
| 1515 NORTH MADISON AVENUE | ANDERSON | IN | 46011 | 861053152 | SUPPORT | IN | 501C3 | 11A | CHA | 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 |
| COMMUNITY LTC INC | ||||||||||
| 1031 MONTICELLO DRIVE | ANDERSON | IN | 46011 | 351877441 | HLTH CARE | IN | 501C3 | 9 | CHA | Yes (true) |
| COMMUNITY PHYSICIANS OF IN INC | ||||||||||
| 7240 SHADELAND STATION SUITE 300 | INDIANAPOLIS | IN | 46256 | 205392766 | PHY SRV | IN | 501C3 | 9 | CHNW | Yes (true) |
| HEALTH INSTITUTE OF INDIANA INC | ||||||||||
| 3660 GUION ROAD | INDIANAPOLIS | IN | 46222 | 352022402 | FITNESS | IN | 501C3 | 9 | IOH | Yes (true) |
| INDIANA HEART HOSPITAL LLC | ||||||||||
| 8075 NORTH SHADELAND AVENUE | INDIANAPOLIS | IN | 46250 | 352123783 | HOSPITAL | IN | 501C3 | 3 | CHNW | Yes (true) |
| INDIANAPOLIS OSTEOPATHIC HOSP INC | ||||||||||
| 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | 351094734 | HOSPITAL | IN | 501C3 | 3 | CHNW | Yes (true) |
| WESTVIEW HOSPITAL FOUNDATION INC | ||||||||||
| 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | 311036451 | SUPPORT | IN | 501C3 | 11A | IOH | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (17 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| BROWNSBURG OFFICE CENTER 2 LLP | |||||||||
| 321 E NORTHFIELD | BROWNSBURG | IN | 46112 | 351929859 | LEASING | IN | N/A | false | false |
| CHNJMH VENTURES LLC | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 462356266 | DIAG/REHAB | IN | N/A | false | false |
| COMMUNITY ENDOSCOPY CENTER LLC | |||||||||
| 1601 N MADISON AVENUE SUITE 300 | ANDERSON | IN | 46011 | 611464136 | HLTH CARE | IN | N/A | false | false |
| COMM HEALTH NETWORK REHAB HOSP LLC | |||||||||
| 7343 CLEARVISTA DRIVE | INDIANAPOLIS | IN | 46256 | 453414249 | REHAB | IN | N/A | false | false |
| EAST CAMPUS SURGERY CENTER LLC | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 352028517 | SURGERY | IN | N/A | false | false |
| HAMILTON SURGERY CENTER LLC | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 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 |
| INDIANA SPECIALTY GROUP LLC | |||||||||
| 7240 SHADELAND STATION SUITE 300 | INDIANAPOLIS | IN | 46256 | 351976258 | HLTH CARE | IN | N/A | false | false |
| INDIANAPOLIS ENDOSCOPY CENTER LLC | |||||||||
| 7353 E 121ST STREET | INDIANAPOLIS | IN | 46219 | 352010874 | HLTH CARE | IN | N/A | false | false |
| MICHIGAN SURGERY INVESTMENT LLC | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 320147008 | SURG CTRS | IN | N/A | false | false |
| NORTH CAMPUS OFFICE ASSOCIATES LP | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 351808625 | RNTL PROP | IN | N/A | false | false |
| NORTH CAMPUS SURGERY CENTER LLC | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 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 | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 208754071 | SURGERY | IN | N/A | false | false |
| PILLARS HOUSING LP | |||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 161652671 | HOUSING | 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 (6 entries)
| Address Line1ForeignAddress/AddressLine1 | CityForeignAddress/City | Province Or StateForeignAddress/ProvinceOrState | CountryForeignAddress/Country | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHN ASSURANCE COMPANY LTD | |||||||||||||
| PO BOX 1051GT | GRAND CAYMAN | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | Yes (true) | |||||
| MIDWEST RACQUETBALL INC | |||||||||||||
| 351396016 | HLTH | N/A | Yes (true) | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | |||||
| PILLARS COMMUNITY HOUSING INC | |||||||||||||
| 161652666 | HOUSING | N/A | Yes (true) | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | |||||
| VISIONARY ENTERPRISES INC | |||||||||||||
| 351538433 | MGMT SRVS | N/A | Yes (true) | 6626 EAST 75TH STREET | INDIANAPOLIS | IN | 46250 | IN | |||||
| VEI MICHIGAN INC | |||||||||||||
| 300097377 | MGMT SRVS | N/A | Yes (true) | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | |||||
| WESTVIEW DELIVERY SYSTEM INC | |||||||||||||
| 351910292 | MGMT SRVS | N/A | Yes (true) | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | 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 | Yes (true) | 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 | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| COMMUNITY HEALTH NETWORK FOUNDATION | ||
| C | $332,858 | BOOK VALUE |
| COMMUNITY PHYSICIANS OF INDIANA INC | ||
| R | $542,559 | BOOK VALUE |
| VISIONARY ENTERPRISESINC | ||
| K | $71,150 | BOOK VALUE |
| VISIONARY ENTERPRISESINC | ||
| P | $2,024,778 | BOOK VALUE |
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