COMMUNITY HOSPITALS OF INDIANA INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HOSPITALS OF INDIANA INC (EIN 35-1088640)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-13
- IRS object ID
- 201303179349303835
- Schema version
- 2012v2.3
- 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 J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-13T13:10:24-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CASKEY & DAILY PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| 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 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351088640 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL SOUTH INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COMM | NameControl |
| Phone | 3173555822 | Phone |
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 |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JEFFERY KIRKHAM | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 3173555822 | Phone |
| Date Signed | 2013-10-31 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES A CASKEY CPA CFP | Name |
| Phone | 3175852647 | Phone |
| Date Prepared | 2013-11-13 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | THOMAS P FISCHER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7330 SHADELAND STATION SUITE 200 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46256 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 174521269 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ECOMMUNITY.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1989 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1016 | TotalNbrEmployees |
| Total Nbr Volunteers | 188 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 65077 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 33707 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 152973513 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 169858075 | ProgramServiceRevenueCY |
| Investment Income Current Year | 15764 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 6498555 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4609561 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 159537145 | TotalRevenuePriorYear |
| Total Revenue Current Year | 174517107 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 52901211 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 61207331 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 83592561 | OtherExpensePriorYear |
| Other Expenses Current Year | 90239766 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 136493772 | TotalExpensesPriorYear |
| Total Expenses Current Year | 151447097 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 23043373 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 23070010 | RevenuesLessExpensesCY |
| Total Assets BOY | 206686035 | TotalAssetsBOY |
| Total Assets EOY | 230047350 | TotalAssetsEOY |
| Total Liabilities BOY | 5148369 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 5439674 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 201537666 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 224607676 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 103224845 | Expense |
| Revenue | 169858075 | Revenue |
| Description | COMMUNITY HOSPITAL SOUTH ("CHS") IS AN ACUTE CARE HOSPITAL IN INDIANAPOLIS, INDIANA WITH 150 LICENSED BEDS. IN 2012, CHS SERVED 8,356 INPATIENTS FOR A TOTAL OF 29,154 INPATIENT DAYS OF SERVICE. CHS ALSO PROVIDED 116,989 OUTPATIENT VISITS, WHICH EXCLUDED 41,429 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. | Description |
| Total Program Service Expense | 103224845 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1016 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JEFFERY KIRKHAM | NamePerson |
| Telephone Number | 3173555822 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 N RITTER AVENUE | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46219 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| BRYAN A MILLS | ||||||||
| DIRECTOR | 2.00 | 55.00 | X | 0 | 1113224 | 178029 | ||
| HANY HADDAD MD | ||||||||
| DIRECTOR | 2.00 | 40.00 | X | 0 | 619485 | 139495 | ||
| KENNETH SHAVER MD | ||||||||
| DIRECTOR | 2.00 | 40.00 | X | 0 | 274586 | 54259 | ||
| KATHRYN G BETLEY | ||||||||
| CHAIRMAN | 2.00 | X | 0 | 0 | 0 | X | ||
| DENNIS CARROLL | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| CAREY LIKENS | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| JAMES MOREY | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| JEFFREY MOSSLER MD | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| MICHAEL PETERSON | ||||||||
| VICE CHAIRMA | 2.00 | X | 0 | 0 | 0 | X | ||
| STEVEN PLUMP | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| YVONNEE SHAHEEN | ||||||||
| SECRETARY | 2.00 | X | 0 | 0 | 0 | X | ||
| KRISTEN SHERMAN | ||||||||
| TREASURER | 2.00 | X | 0 | 0 | 0 | X | ||
| RUSSELL SWAN JR | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| RONALD THIEME | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| MICHAEL C BLANCHET | ||||||||
| COO - CHNW | 50.00 | 0 | 691026 | 894883 | X | |||
| ANTHONY LENNEN | ||||||||
| PRESIDENT | 50.00 | 415693 | 0 | 84884 | X | |||
| JEFFERY KIRKHAM | ||||||||
| CFO CLINICAL | 55.00 | 0 | 373872 | 420954 | X | |||
| SHERYL KING MD | ||||||||
| PHYSICIAN | 45.00 | 424591 | 0 | 64665 | X | |||
| RANDALL LEE MD | ||||||||
| VP MEDICAL A | 45.00 | 351348 | 0 | 15000 | X | |||
| KERRY SAWIN | ||||||||
| NURSING ADMI | 45.00 | 206736 | 0 | 155657 | X | |||
| JOSHUA SALYER DO | ||||||||
| PHYSICIAN | 45.00 | 205763 | 0 | 24724 | X | |||
| MARTY HENDERSON CRNA | ||||||||
| OB ANESTHETI | 45.00 | 199108 | 0 | 17338 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1803239 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3072193 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 2049888 | TotalOtherCompensation |
| Number Individuals GT100 K | 34 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MID AMERICA CLINICAL LABS | |||||
| 2560 NORTH SHADELAND AVENUE | INDIANAPOLIS | IN | 46219 | LAB SERVICES | 3370262 |
| INPATIENT SERVICES OF INDIANA | |||||
| 7032 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | HOSPITALISTS | 2160741 |
| ROLLINS CONSTRUCTION CO LLC | |||||
| 3024 N RIDGEVIEW DRIVE | INDIANAPOLIS | IN | 46226 | CONSTRUCTION | 1689545 |
| BSA LIFESTRUCTURES INC | |||||
| PO BOX 6069 | INDIANAPOLIS | IN | 462066069 | ARCHITECTURAL | 847697 |
| ARAMARK | |||||
| 25271 NETWORK PLACE | CHICAGO | IL | 606731252 | DIETARY MGMT | 515861 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 69 | NumberOfContractorsGT100K |
| Related Organizations | 33707 | RelatedOrganizations |
| Total Contributions | 33707 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT REVENUE | Description |
| Business Code | 622110 | BusinessCode |
| Total Revenue Column | 169858075 | TotalRevenueColumn |
| Related Or Exempt Function Income | 169858075 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 169858075 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 19401 | TotalRevenueColumn |
| Exclusion | $19,401 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 525 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4162 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -3637 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -3637 | TotalRevenueColumn |
| Related Or Exempt Function Income | -3637 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| LEASED EQUIPMENT | 532420 | 2345395 | 2345395 |
| EHR INCENTIVE PAYMENTS | 900099 | 675466 | 675466 |
| EQUITY INVESTMENT INCOME | 900003 | 606809 | 606809 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 981891 | TotalRevenueColumn |
| Related Or Exempt Function Income | 981891 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 4609561 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 174517107 | TotalRevenueColumn |
| Related Or Exempt Function Income | 174463999 | RelatedOrExemptFunctionIncome |
| Exclusion | $19,401 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 500577 | Total |
| Management And General | 500577 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45002077 | Total |
| Program Services | 37146688 | ProgramServices |
| Management And General | 7855389 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2162593 | Total |
| Program Services | 743534 | ProgramServices |
| Management And General | 1419059 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10382982 | Total |
| Program Services | 8476283 | ProgramServices |
| Management And General | 1906699 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3159102 | Total |
| Program Services | 2513008 | ProgramServices |
| Management And General | 646094 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34545823 | Total |
| Program Services | 10450141 | ProgramServices |
| Management And General | 24095682 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1195 | Total |
| Program Services | 312 | ProgramServices |
| Management And General | 883 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4465342 | Total |
| Program Services | 4219926 | ProgramServices |
| Management And General | 245416 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 664122 | Total |
| Program Services | 234731 | ProgramServices |
| Management And General | 429391 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2237986 | Total |
| Program Services | 1827009 | ProgramServices |
| Management And General | 410977 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63092 | Total |
| Program Services | 32049 | ProgramServices |
| Management And General | 31043 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14700 | Total |
| Program Services | 5408 | ProgramServices |
| Management And General | 9292 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3739852 | Total |
| Management And General | 3739852 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10034096 | Total |
| Program Services | 4142108 | ProgramServices |
| Management And General | 5891988 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10372 | Total |
| Management And General | 10372 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 25601112 | 24631063 | 970049 |
| HAF PROGRAM FEES | 8777264 | 8777264 | |
| DUES & SUBSCRIPTIONS | 61957 | 17243 | 44714 |
| SECURITY EQUIPM & EXP | 17290 | 6111 | 11179 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5563 | Total |
| Program Services | 1967 | ProgramServices |
| Management And General | 3596 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 151447097 | Total |
| Program Services | 103224845 | ProgramServices |
| Management And General | 48222252 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2425 | BOY |
| EOY | 2725 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24399806 | BOY |
| EOY | 26158334 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2632225 | BOY |
| EOY | 2648271 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 221639359 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 92693639 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 130633171 | BOY |
| EOY | 128945720 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49018408 | BOY |
| EOY | 72292300 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 206686035 | BOY |
| EOY | 230047350 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5148369 | BOY |
| EOY | 4897728 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 541946 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5148369 | BOY |
| EOY | 5439674 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 201537666 | BOY |
| EOY | 224607676 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 201537666 | BOY |
| EOY | 224607676 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 206686035 | BOY |
| EOY | 230047350 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 23070010 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 497000 | OtherCostOrOtherBasis |
| Book Value | 497000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 158111510 | OtherCostOrOtherBasis |
| Depreciation | 35455294 | Depreciation |
| Book Value | 122656216 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1534316 | OtherCostOrOtherBasis |
| Depreciation | 689652 | Depreciation |
| Book Value | 844664 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 58735655 | OtherCostOrOtherBasis |
| Depreciation | 54845461 | Depreciation |
| Book Value | 3890194 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2760878 | OtherCostOrOtherBasis |
| Depreciation | 1703232 | Depreciation |
| Book Value | 1057646 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 128945720 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM AFFLIATED ENTITIES | 72292300 |
| THIRD PARTY SETTLEMENTS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 72292300 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | THIRD PARTY SETTLEMENT | Description |
| Amount | $541,946 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 541946 | TotalOfAmounts |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 9643 | PersonsServed |
| Total Community Benefit Expense | 6132347 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 6132347 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04050 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 12775 | PersonsServed |
| Total Community Benefit Expense | 21729801 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14419704 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7310097 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04830 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 22418 | PersonsServed |
| Total Community Benefit Expense | 27862148 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14419704 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13442444 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08880 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 790731 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8011 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 782720 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00520 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 618489 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 147355 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 471134 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00310 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 330659 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 330659 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 1739879 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 155366 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1584513 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01050 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 22418 | PersonsServed |
| Total Community Benefit Expense | 29602027 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14575070 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15026957 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09920 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $2,671,422 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 35899942 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 43094517 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -7194575 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NONE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL SOUTH | BusinessNameLine1 |
Address Address
| 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 | WWWECOMMUNITYCOM | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL SOUTH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Other | X | Other |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | true | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | false | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200.0 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 300.0 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| State Regulation | X | StateRegulation |
| Other Factors | X | OtherFactors |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 7 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (7 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| 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 |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| RELATED ORGANIZATION INFORMATION | PART I LINE 6A | 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 |
| COSTING METHODOLOGY EXPLANATION | PART I LINE 7 | 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 |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | THE COST TO CHARGE RATIO UTILIZED FOR PURPOSES OF REPORTING BAD DEBT COSTS WAS DERIVED FROM WORKSHEET 2 AND IS BASED ON THE ORGANIZATIONS 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 NETWORKS 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 PROVISION FOR BAD DEBTS AND PROVISION FOR CHARITY MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS 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 SELFPAY PATIENTS INCLUDING PATIENT DEDUCTIBLES AND COINSURANCE 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 CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CHNW CHS VEI AND CHVH ACCOUNTS THAT ARE SENT TO COLLECTION COMPANIES THE ACCOUNTS 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 THIS COMPONENT OF THE ACCOUNTS RECEIVABLE THE NETWORK RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRDPARTY 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 NETWORKS 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 DISCOUNTS AND CHARITY ALLOWANCES RECOGNIZED IN THE PERIOD FROM THESE MAJOR PAYOR SOURCES IS AS FOLLOWS FOR THE YEARS ENDED DECEMBER 31 2012 AND 2011 RESPECTIVELY THIRD PARTY PAYORS SELFPAY TOTAL ALL PAYORS 2012 PATIENT SERVICE REVENUENET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS 1580962 73759 1654721 2011 PATIENT SERVICE REVENUENET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS 1276969 55994 1332963 BEGINNING JUNE 2012 THE STATE OF INDIANA BEGAN OFFERING VOLUNTARY PARTICIPATION IN THE STATE OF INDIANAS HOSPITAL ASSESSMENT FEE HAF PROGRAM THE OFFICE OF MEDICAID PLANNING AND POLICY DEEMED THE PROGRAM TO BE EFFECTIVE RETROACTIVE TO JULY 1 2011 THE HAF PROGRAM RUNS ON AN ANNUAL CYCLE FROM JULY 1 TO JUNE 30 AND IS EFFECTIVE UNTIL JUNE 30 2013 WITH OPTIONS TO RENEW THE 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 EXPENSES ASSOCIATED WITH THE HAF PROGRAM IN THE PERIOD IN WHICH AMOUNTS ARE ESTIMABLE AND COLLECTION IS REASONABLY ASSURED REIMBURSEMENT UNDER THE PROGRAM IS REFLECTED AS CONTRA CONTRACTUAL ALLOWANCES 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 AS A RESULT OF PARTICIPATING IN THE PROGRAM THE NETWORK RECOGNIZED IN 2012 HAF RETROACTIVE REIMBURSEMENTS OF 78197000 AND PAID RETROACTIVE FEES OF 43453000 RELATED TO THE PERIOD JULY 1 2011 THROUGH JUNE 30 2012 ON AN ONGOING BASIS THE FEES AND REIMBURSEMENTS ARE SETTLED MONTHLY 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 WRITTENOFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AFTER EXHAUSTING COLLECTION EFFORTS ANY SUBSEQUENT RECOVERIES ARE RECORDED AGAINST THE PROVISION FOR BAD DEBTS THE NETWORK MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES THE NETWORK PROVIDES 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 YEARS 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 INCLUDES THE AMOUNT OF COSTS INCURRED FOR SERVICES AND SUPPLIES FURNISHED UNDER THE CHARITY CARE POLICY AND WAS 58163000 AND 26939000 FOR THE YEARS ENDED DECEMBER 31 2012 AND 2011 RESPECTIVELY CHARITY CARE COST WAS ESTIMATED ON THE APPLICATION OF THE ASSOCIATED COSTTOCHARGE RATIOS |
| MEDICARE EXPLANATION | PART III LINE 8 | 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 4459065 AS SUCH THE TOTAL MEDICARE SHORTFALL FOR ALL MEDICARE PROGRAMS IS 11653640 MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS COMMUNITY BENEFIT BECAUSE MEDICARE REPRESENTS 4408 OF THE OVERALL PAYER MIX FOR COMMUNITY HOSPITAL SOUTH INC |
| COLLECTION PRACTICES EXPLANATION | PART III LINE 9B | SEE ATTACHED FINANCIAL ASSISTANCE POLICY |
| ADDITIONAL INFORMATION | PART VI | 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 3555860 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 |
| COMMUNITY HOSPITAL SOUTH LINE NUMBER 1 PART V LINE 3 | PART V LINE 3 | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| COMMUNITY HOSPITAL SOUTH LINE NUMBER 1 PART V LINE 4 | PART V LINE 4 | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| COMMUNITY HOSPITAL SOUTH LINE NUMBER 1 PART V LINE 5C | PART V LINE 5C | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| COMMUNITY HOSPITAL SOUTH LINE NUMBER 1 PART V LINE 7 | PART V LINE 7 | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| COMMUNITY HOSPITAL SOUTH LINE NUMBER 1 PART V LINE 12H | PART V LINE 12H | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| COMMUNITY HOSPITAL SOUTH LINE NUMBER 1 PART V LINE 14G | PART V LINE 14G | THE POLICY IS REFERENCED ON THE BILL |
| COMMUNITY HOSPITAL SOUTH LINE NUMBER 1 PART V LINE 20D | PART V LINE 20D | THE UNINSURED DISCOUNT WAS DETERMINED UTILIZING THE NETWORKS TOP COMMERICIAL PAYORS UNINSURED DISCOUNTS REPRESENT A STANDARD DISCOUNT ON CHARGES AS IT RELATES TO PATIENTS WHO HAVE NO INSURANCE COVERAGE |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| TitleTitle | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRYAN A MILLS | ||||||||||||||
| DIRECTOR | 821612 | 272000 | 19612 | 148211 | 29818 | 1291253 | 264000 | |||||||
| HANY HADDAD MD | ||||||||||||||
| DIRECTOR | 516047 | 101250 | 2188 | 115000 | 24495 | 758980 | 101250 | |||||||
| KENNETH SHAVER MD | ||||||||||||||
| DIRECTOR | 193480 | 81106 | 35212 | 19047 | 328845 | |||||||||
| MICHAEL C BLANCHET | ||||||||||||||
| COO - CHNW | 520592 | 167825 | 2609 | 885389 | 9494 | 1585909 | 161700 | |||||||
| ANTHONY LENNEN | ||||||||||||||
| PRESIDENT | 335327 | 78516 | 1850 | 55752 | 29132 | 500577 | 78516 | |||||||
| JEFFERY KIRKHAM | ||||||||||||||
| CFO CLINICAL ENTERPR | 295857 | 76444 | 1571 | 394162 | 26792 | 794826 | 70875 | |||||||
| SHERYL KING MD | ||||||||||||||
| PHYSICIAN | 303536 | 16442 | 104613 | 37500 | 27165 | 489256 | 20000 | |||||||
| RANDALL LEE MD | ||||||||||||||
| VP MEDICAL AFFAIRS | 285224 | 64550 | 1574 | 15000 | 366348 | 68985 | ||||||||
| KERRY SAWIN | ||||||||||||||
| NURSING ADMIN | 181081 | 24628 | 1027 | 132749 | 22908 | 362393 | ||||||||
| JOSHUA SALYER DO | ||||||||||||||
| PHYSICIAN | 196924 | 7750 | 1089 | 15596 | 9128 | 230487 | ||||||||
| MARTY HENDERSON CRNA | ||||||||||||||
| OB ANESTHETIST | 197688 | 600 | 820 | 17338 | 216446 | |||||||||
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE J, PART III | ReturnReference |
| Explanation | 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 III - OTHER ADDITIONAL INFORMATION PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN BRYAN A. MILLS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THROUGH HIS EMPLOYER, CHNW. DURING 2012, MR. MILLS DID NOT RECEIVE A PAYMENT FROM SUCH PLAN. PART I, LINE 7 - NON-FIXED PAYMENTS PROVIDED DR. SHERYL KING AND DR. JOSHUA SALYER ARE ELIGIBLE TO PARTICIPATE IN AN INCENTIVE COMPENSATION PLAN AS OUTLINED IN THEIR EMPLOYMENT AGREEMENTS WITH CHNW. CHNW IS A TAX-EXEMPT ORGANIZATION AND IT DEVELOPED THE COMPENSATION PLAN IN CONJUNCTION WITH AN INDEPENDENT COMPENSATION CONSULTANT. 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. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VISIONARY ENTERPRISES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | SHARE BD MEMBER | Relationship |
| Amount Of Transaction | 3368323 | AmountOfTransaction |
| Description Of Transaction | HEALTH & PHARM PLANS | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (15 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | 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. |
| ADDITIONAL INFORMATION | 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 GOVERANCE 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. |
| ADDITIONAL INFORMATION | FORM 990, PART V | FORM 99, 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. |
| ADDITIONAL INFORMATION | 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 MANY OF CHS' DIRECTORS, OFFICERS, AND KEY EMPLOYEES SERVE IN AN EXECUTIVE ROLE FOR OTHER TAX-EXEMPT AND TAXABLE AFFILIATES THROUGHOUT THE NETWORK. ALL CHS' DIRECTORS AND/OR OFFICERS ALSO SERVE AS DIRECTORS AND/OR OFFICERS OF COMMUNITY HEALTH NETWORK, INC., COMMUNITY HOME HEALTH SERVICES, INC., AND INDIANA HEART HOSPITAL, LLC. IN ADDITION, THE FOLLOWING DIRECTORS SERVE AS DIRECTORS OF THE FOLLOWING ORGANIZATIONS: DENNIS CARROLL - COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. BRYAN MILLS - COMMUNITY HEALTH NETWORK FOUNDATION, INC. - COMMUNITY HEALTH SERVICES OF INDIANA, INC. - COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. - COMMUNITY PHYSICIANS OF INDIANA, INC. - COMMUNITY WESTVIEW HOSPITAL, INC. - VISIONARY ENTERPRISES, INC. JEFFREY A. MOSSLER, M.D. - COMMUNITY PHYSICIANS OF INDIANA, INC. - VISIONARY ENTERPRISES, INC. STEVEN PLUMP - COMMUNITY PHYSICIANS OF INDIANA, INC. |
| MANAGEMENT DELEGATED | 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. |
| SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS | FORM 990, PAGE 6, PART VI, LINE 4 | THE 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. |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | SEE FORM 990, PART I, LINE 4 REFERENCE ON SCHEDULE O ABOVE |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | SEE FORM 990, PART I, LINE 4 REFERENCE ON SCHEDULE O ABOVE |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PAGE 6, PART VI, LINE 7B | SEE FORM 990, PART I, LINE 4 REFERENCE ON SCHEDULE O ABOVE |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | 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. |
| ENFORCEMENT OF CONFLICTS POLICY | 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. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | 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 2012, THE NETWORK EXECUTIVE COMPENSATION COMMITTEE FOLLOWED THIS PROCESS FOR ALL SENIOR EXECUTIVE LEADERS. FOR ALL POSITIONS REPRESENTING MANAGERS, CHIEF EXECUTIVE OFFICERS, CHIEF FINANCIAL OFFICERS, AND HUMAN RESOURCES REPRESENTATIVES FOR ALL NETWORK ENTITIES SALARIES WERE COMPARED AGAINST COMPARATIVE SALARY MARKET DATA. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | SEE LINE 15A ABOVE |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | 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.COM. D) COMMUNITY HEALTH NETWORK, INC. AND AFFILIATES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. |
| OTHER FEES FOR SERVICES | FORM 990, PART IX, LINE 11G | PROFESSIONAL MEDICAL FEES 2,478,259 1,497,439 0 PURCHASED SERVICES 7,971,882 22,598,243 0 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (14 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 | true |
| COMMUNITY HLTH SERVICES OF INDIANA | ||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 454817436 | HLTH CARE | IN | 501C3 | 3 | CHNW | true |
| COMMUNITY HOME HEALTH SERVICES INC | ||||||||||
| 9894 EAST 121ST STREET | FISHERS | IN | 46037 | 350953467 | HLTH CARE | IN | 501C3 | 9 | CHNW | true |
| COMM HOSP OF ANDERSON & MADISON CTY | ||||||||||
| 1515 NORTH MADISON AVENUE | ANDERSON | IN | 46011 | 351069822 | HOSPITAL | IN | 501C3 | 3 | CHNW | true |
| COMMUNITY HOSP ANDERSON FDN INC | ||||||||||
| 1515 NORTH MADISON AVENUE | ANDERSON | IN | 46011 | 861053152 | SUPPORT | IN | 501C3 | 7 | CHA | true |
| COMMUNITY HOWARD REGIONAL HEALTH | ||||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 351865344 | IMAG/HOSP | IN | 501C3 | 9 | CHNW | true |
| COMMUNITY LTC INC | ||||||||||
| 1031 MONTICELLO DRIVE | ANDERSON | IN | 46011 | 351877441 | HLTH CARE | IN | 501C3 | 9 | CHA | true |
| COMMUNITY PHYSICIANS OF IN INC | ||||||||||
| 7240 SHADELAND STATION SUITE 300 | INDIANAPOLIS | IN | 46256 | 205392766 | PHY SRV | IN | 501C3 | 9 | CHNW | true |
| HEALTH INSTITUTE OF INDIANA INC | ||||||||||
| 3660 GUION ROAD | INDIANAPOLIS | IN | 46222 | 352022402 | FITNESS | IN | 501C3 | 9 | CWH | true |
| HOWARD REGIONAL HEALTH SYSTEM FDN | ||||||||||
| PO BOX 9011 | KOKOMO | IN | 46904 | 237309596 | SUPPPORT | IN | 501C3 | 7 | NA | false |
| INDIANA HEART HOSPITAL LLC | ||||||||||
| 8075 NORTH SHADELAND AVENUE | INDIANAPOLIS | IN | 46250 | 352123783 | HOSPITAL | IN | 501C3 | 3 | CHNW | true |
| INDIANAPOLIS OSTEOPATHIC HOSP INC | ||||||||||
| 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | 351094734 | HOSPITAL | IN | 501C3 | 3 | CHNW | true |
| WESTVIEW HOSPITAL FOUNDATION INC | ||||||||||
| 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | 311036451 | SUPPORT | IN | 501C3 | 11B | CWH | true |
Form990 Schedule R Part III Form990ScheduleRPartIII (64 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|
| BROWNSBURG OFFICE CENTER 2 LLP | |||||||||
| 321 E NORTHFIELD | BROWNSBURG | IN | 46112 | 351929859 | LEASING | 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 |
| 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 |
| SURGICARE LLC | |||||||||
| 2907 MCINTIRE DRIVE | BLOOMINGTON | IN | 47403 | 351975122 | SURGERY | IN | N/A | false | false |
| BROWNSBURG OFFICE CENTER 2 LLP | |||||||||
| 321 E NORTHFIELD | BROWNSBURG | IN | 46112 | 351929859 | LEASING | 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 |
| 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 |
| SURGICARE LLC | |||||||||
| 2907 MCINTIRE DRIVE | BLOOMINGTON | IN | 47403 | 351975122 | SURGERY | IN | N/A | false | false |
| BROWNSBURG OFFICE CENTER 2 LLP | |||||||||
| 321 E NORTHFIELD | BROWNSBURG | IN | 46112 | 351929859 | LEASING | 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 |
| 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 |
| SURGICARE LLC | |||||||||
| 2907 MCINTIRE DRIVE | BLOOMINGTON | IN | 47403 | 351975122 | SURGERY | IN | N/A | false | false |
| BROWNSBURG OFFICE CENTER 2 LLP | |||||||||
| 321 E NORTHFIELD | BROWNSBURG | IN | 46112 | 351929859 | LEASING | 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 |
| 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 |
| SURGICARE LLC | |||||||||
| 2907 MCINTIRE DRIVE | BLOOMINGTON | IN | 47403 | 351975122 | SURGERY | IN | N/A | false | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV (24 entries)
| Address Line1AddressForeign/AddressLine1 | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Legal Domicile StateLegalDomicileState |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHN ASSURANCE COMPANY LTD | ||||||||||||
| PO BOX 1051GT | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | true | |||||
| MIDWEST RACQUETBALL INC | ||||||||||||
| 351396016 | HLTH | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| PILLARS COMMUNITY HOUSING INC | ||||||||||||
| 161652666 | HOUSING | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| VISIONARY ENTERPRISES INC | ||||||||||||
| 351538433 | MGMT SRVS | N/A | true | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VEI MICHIGAN INC | ||||||||||||
| 300097377 | MGMT SRVS | N/A | true | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| WESTVIEW DELIVERY SYSTEM INC | ||||||||||||
| 351910292 | MGMT SRVS | N/A | true | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | ||||
| CHN ASSURANCE COMPANY LTD | ||||||||||||
| PO BOX 1051GT | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | true | |||||
| MIDWEST RACQUETBALL INC | ||||||||||||
| 351396016 | HLTH | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| PILLARS COMMUNITY HOUSING INC | ||||||||||||
| 161652666 | HOUSING | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| VISIONARY ENTERPRISES INC | ||||||||||||
| 351538433 | MGMT SRVS | N/A | true | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VEI MICHIGAN INC | ||||||||||||
| 300097377 | MGMT SRVS | N/A | true | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| WESTVIEW DELIVERY SYSTEM INC | ||||||||||||
| 351910292 | MGMT SRVS | N/A | true | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | ||||
| CHN ASSURANCE COMPANY LTD | ||||||||||||
| PO BOX 1051GT | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | true | |||||
| MIDWEST RACQUETBALL INC | ||||||||||||
| 351396016 | HLTH | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| PILLARS COMMUNITY HOUSING INC | ||||||||||||
| 161652666 | HOUSING | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| VISIONARY ENTERPRISES INC | ||||||||||||
| 351538433 | MGMT SRVS | N/A | true | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VEI MICHIGAN INC | ||||||||||||
| 300097377 | MGMT SRVS | N/A | true | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| WESTVIEW DELIVERY SYSTEM INC | ||||||||||||
| 351910292 | MGMT SRVS | N/A | true | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | ||||
| CHN ASSURANCE COMPANY LTD | ||||||||||||
| PO BOX 1051GT | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | true | |||||
| MIDWEST RACQUETBALL INC | ||||||||||||
| 351396016 | HLTH | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| PILLARS COMMUNITY HOUSING INC | ||||||||||||
| 161652666 | HOUSING | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| VISIONARY ENTERPRISES INC | ||||||||||||
| 351538433 | MGMT SRVS | N/A | true | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VEI MICHIGAN INC | ||||||||||||
| 300097377 | MGMT SRVS | N/A | true | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| WESTVIEW DELIVERY SYSTEM INC | ||||||||||||
| 351910292 | MGMT SRVS | N/A | true | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| COMMUNITY HEALTH NETWORK FOUNDATION | ||
| S | 664957 | BOOK VALUE |
| COMMUNITY PHYSICIANS OF INDIANA INC | ||
| R | 647272 | BOOK VALUE |
| INDIANA HEART HOSPITAL LLC | ||
| R | 3152659 | BOOK VALUE |
| VISIONARY ENTERPRISES INC | ||
| R | 562057 | BOOK VALUE |
| VISIONARY ENTERPRISESINC | ||
| P | 2806266 | BOOK VALUE |
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