COMMUNITY HOSPITALS OF INDIANA INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HOSPITALS OF INDIANA INC (EIN 35-1088640)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-11
- IRS object ID
- 201113159349303081
- Schema version
- 2010v3.4
- 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 | 2011-11-11T14:06:16-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | 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 | 2010-01-01 | 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 | 2011-11-09 | 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 | 2011-11-11 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MICHAEL C BLANCHET | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 NORTH RITTER AVENUE | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46219 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 144041221 | 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 | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 893 | TotalNbrEmployees |
| Total Nbr Volunteers | 167 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 4658 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 206191 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 154961897 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 138800062 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 17938 | InvestmentIncomePriorYear |
| Investment Income Current Year | -49627 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 5903950 | OtherRevenuePriorYear |
| Other Revenue Current Year | 5023344 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 160888443 | TotalRevenuePriorYear |
| Total Revenue Current Year | 143979970 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 47265695 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 44980643 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 105076903 | OtherExpensePriorYear |
| Other Expenses Current Year | 87830563 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 152342598 | TotalExpensesPriorYear |
| Total Expenses Current Year | 132811206 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 8545845 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 11168764 | RevenuesLessExpensesCY |
| Total Assets BOY | 172848154 | TotalAssetsBOY |
| Total Assets EOY | 184350314 | TotalAssetsEOY |
| Total Liabilities BOY | 5522625 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 5856021 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 167325529 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 178494293 | 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 | 87896274 | Expense |
| Revenue | 138800062 | Revenue |
| Description | COMMUNITY HOSPITAL SOUTH ("CHS") IS AN ACUTE CARE HOSPITAL IN INDIANAPOLIS, INDIANA WITH 150 LICENSED BEDS. IN 2010, CHS SERVED 7,983 INPATIENTS FOR A TOTAL OF 27,644 INPATIENT DAYS OF SERVICE. CHS ALSO PROVIDED 76,214 OUTPATIENT VISITS, WHICH INCLUDED 34,272 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 | 87896274 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| 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 | false | 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 |
| Number Forms Transmitted With1096 | 51 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 893 | 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 | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| DON B ZIPERMAN MD | |||||||||
| DIRECTOR | 5.00 | X | 0 | 723131 | 155934 | ||||
| MICHAEL C BLANCHET | |||||||||
| DIRECTOR | 10.00 | X | 0 | 477664 | 63132 | X | |||
| RICHARD BOHNENKAMP MD | |||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | ||||
| DAVID HOLLANDER MD | |||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | ||||
| BEVERLEY PITTS | |||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | ||||
| STEVEN R PLUMP | |||||||||
| CHAIRMAN | 5.00 | X | 0 | 0 | 0 | X | |||
| KRISTIN T SHERMAN | |||||||||
| TREASURER/SE | 5.00 | X | 0 | 0 | 0 | X | |||
| RONALD H THIEME | |||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | ||||
| EDWARD P TODDERUD MD | |||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | ||||
| TONY LENNEN | |||||||||
| PRESIDENT | 40.00 | 303951 | 0 | 43107 | X | ||||
| JEFFERY KIRKHAM | |||||||||
| CFO - CHI | 5.00 | 0 | 242343 | 67006 | X | ||||
| CLIF KNIGHT MD | |||||||||
| VP - CHIEF M | 10.00 | 0 | 334768 | 58487 | X | ||||
| SUSAN LOTTICH MD | |||||||||
| PHYSICIAN | 40.00 | 823818 | 0 | 191621 | X | ||||
| CARA HAHS MD | |||||||||
| PHYSICIAN | 40.00 | 542448 | 0 | 14700 | X | ||||
| WILLIAM JONES | |||||||||
| NURSE ANESTH | 40.00 | 204848 | 0 | 28199 | X | ||||
| KEVIN LIEBRUM | |||||||||
| CRNA SITE CO | 40.00 | 188873 | 0 | 39684 | X | ||||
| JULIE MELVIN | |||||||||
| NURSE ANESTH | 40.00 | 162343 | 0 | 27407 | X | ||||
| FRANK COVINGTON MD | |||||||||
| MED DIR - PS | 5.00 | 0 | 581919 | 85382 | X | ||||
| CHARLES SALAZAR MD | |||||||||
| PHYSICIAN | 0.00 | 0 | 560521 | 24153 | X | ||||
| ABBY BEALL MD | |||||||||
| DIR - WOMEN/ | 10.00 | 0 | 280464 | 20371 | X | ||||
| THOMAS A FERRARA MD | |||||||||
| FORMER DIR - | 0.00 | 0 | 241904 | 44251 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2226281 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3442714 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 863434 | TotalOtherCompensation |
| Number Individuals GT100 K | 16 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Related Organizations | 206191 | RelatedOrganizations |
| Total Contributions | 206191 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 138800062 | TotalRevenueColumn |
| Related Or Exempt Function Income | 138800062 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 138800062 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4464 | TotalRevenueColumn |
| Exclusion | $4,464 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 7160 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 61251 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -54091 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -54091 | TotalRevenueColumn |
| Exclusion | -$54,091 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| LEASED EQUIPMENT | 532420 | 2130743 | 2130743 | |
| CAFETERIA | 722210 | 719145 | $719,145 | |
| SERVICE ALLOCATION | 900099 | 428926 | 428926 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1744530 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1744530 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 5023344 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 143979970 | TotalRevenueColumn |
| Related Or Exempt Function Income | 143104261 | RelatedOrExemptFunctionIncome |
| Exclusion | $669,518 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 347058 | Total |
| Management And General | 347058 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35065886 | Total |
| Program Services | 27757447 | ProgramServices |
| Management And General | 7308439 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 742265 | Total |
| Management And General | 742265 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6364743 | Total |
| Program Services | 4988826 | ProgramServices |
| Management And General | 1375917 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2460691 | Total |
| Program Services | 1931726 | ProgramServices |
| Management And General | 528965 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 551 | Total |
| Program Services | 551 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37312184 | Total |
| Program Services | 11555392 | ProgramServices |
| Management And General | 25756792 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 886 | Total |
| Program Services | 286 | ProgramServices |
| Management And General | 600 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28068974 | Total |
| Program Services | 26647477 | ProgramServices |
| Management And General | 1421497 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 688898 | Total |
| Program Services | 183932 | ProgramServices |
| Management And General | 504966 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2474403 | Total |
| Program Services | 1939492 | ProgramServices |
| Management And General | 534911 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31755 | Total |
| Program Services | 20700 | ProgramServices |
| Management And General | 11055 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12209 | Total |
| Program Services | 1589 | ProgramServices |
| Management And General | 10620 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1430475 | Total |
| Management And General | 1430475 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8697118 | Total |
| Program Services | 3856416 | ProgramServices |
| Management And General | 4840702 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 8966242 | 8966242 | |
| SECURITY EQUIPM & EXP | 50794 | 13562 | 37232 |
| DUES & SUBSCRIPTIONS | 34432 | 16178 | 18254 |
| PROPERTY TAX EXPENSE | 32401 | 8651 | 23750 |
| RECRUITMENT EXPENSE | 23711 | 6331 | 17380 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5530 | Total |
| Program Services | 1476 | ProgramServices |
| Management And General | 4054 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 132811206 | Total |
| Program Services | 87896274 | ProgramServices |
| Management And General | 44914932 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3450 | BOY |
| EOY | 3350 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24438983 | BOY |
| EOY | 23520126 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1898428 | BOY |
| EOY | 2468269 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 205558044 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 77617640 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 99334029 | BOY |
| EOY | 127940404 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47173264 | BOY |
| EOY | 30418165 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 172848154 | BOY |
| EOY | 184350314 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5509759 | BOY |
| EOY | 5847635 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12866 | BOY |
| EOY | 8386 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5522625 | BOY |
| EOY | 5856021 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 167325529 | BOY |
| EOY | 178494293 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 167325529 | BOY |
| EOY | 178494293 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 172848154 | BOY |
| EOY | 184350314 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 11168764 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
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 | 149499267 | OtherCostOrOtherBasis |
| Depreciation | 28340085 | Depreciation |
| Book Value | 121159182 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1097088 | OtherCostOrOtherBasis |
| Depreciation | 339336 | Depreciation |
| Book Value | 757752 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 51703811 | OtherCostOrOtherBasis |
| Depreciation | 47396365 | Depreciation |
| Book Value | 4307446 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2760878 | OtherCostOrOtherBasis |
| Depreciation | 1541854 | Depreciation |
| Book Value | 1219024 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 127940404 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE FROM AFFLIATED ENTITIES | Description |
| Book Value | 30418165 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 30418165 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | THIRD PARTY SETTLEMENTS | Description |
| Amount | $8,386 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 8386 | 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 | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 6442 | PersonsServed |
| Total Community Benefit Expense | 4126360 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 4126360 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03330 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 9474 | PersonsServed |
| Total Community Benefit Expense | 9371258 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3838429 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5532829 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04470 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 15916 | PersonsServed |
| Total Community Benefit Expense | 13497618 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3838429 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9659189 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07800 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 1671525 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 191 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1671334 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01350 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 126514 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 51428 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 75086 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 18648 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 18648 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 9 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 1816687 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 51619 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1765068 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01430 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 9 | NumberOfActivitiesOrPrograms |
| Persons Served | 15916 | PersonsServed |
| Total Community Benefit Expense | 15314305 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3890048 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11424257 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09230 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 641690 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 641690 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00520 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 641690 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 641690 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00520 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $3,114,137 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 34252476 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 39725914 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -5473438 | 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) |
|---|---|---|
| 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 |
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 (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER TESTING METHODS FOR FREE OR DISCOUNTED CARE | PART I LINE 3C | COMMUNITY HOSPITAL SOUTH INC PROVIDES FREE CARE TO LOW INCOME INDIVIDUALS USING THE FEDERAL POVERTY GUIDELINES BUT NOT DISCOUNTED CARE COST IS DETERMINED BASED ON THE COST TO CHARGE RATIO DERIVED IN WORKSHEET 2 PLEASE SEE THE ATTACHED FINANCIAL ASSISTANCE POLICY |
| 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 PART I LINE 7 COLUMN F PERCENT OF TOTAL EXPENSE 8966242 WAS REMOVED FROM THE TOTAL EXPENSES REPORTED ON FORM 990 PART IX LINE 25 RELATED TO BAD DEBT EXPENSES PART I LINE 7G SUBSIDIZED HEALTH SERVICES EXPLANATION SUBSIDIZED HEALTH SERVICES WERE NOT REPORTED FOR COMMUNITY HOSPITAL SOUTH INC |
| COMMUNITY BUILDING ACTIVITIES | PART II | COMMUNITY BUILDING ACTIVITIES ARE DISCUSSED WITHIN THE ATTACHED COMMUNITY BENEFIT REPORT |
| 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 THE AUDITED FINANCIAL STATEMENTS CONTAIN THE FOLLOWING TEXT WITHIN THE FOOTNOTES TO DESCRIBE BAD DEBT EXPENSE EXCLUDING CHA THE NETWORK OFFERS A 30 DISCOUNT TO UNINSURED PATIENTS THIS DISCOUNT IS RECORDED IN OTHER ALLOWANCEADJUSTMENTS WHICH ARE NETTED AGAINST NET PATIENT SERVICE REVENUE RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND AJDUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED 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 CHARITY CARE INCLUDES THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY AND WAS 69641000 AND 76215000 FOR THE YEARS ENDED DECEMBER 31 2010 AND 2009 RESPECTIVELY 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 |
| 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 4586516 AS SUCH THE TOTAL MEDICARE SHORTFALL FOR ALL MEDICARE PROGRAMS IS 10059954 MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS COMMUNITY BENEFIT BECAUSE MEDICARE REPRESENTS 4537 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 6 ARE DISCUSSED WITHIN THE ATTACHED COMMUNITY BENEFIT REPORT FOR A COPY OF THIS REPORT PLEASE CONTACT HOLLY MILLARD AT 317 3555860 PART VI ITEM 7 STATE FILING OF COMMUNITY BENEFIT REPORT INDIANA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | 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 (14 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DON B ZIPERMAN MD | |||||||||||||
| 591327 | 55983 | 75821 | 140039 | 15895 | 879065 | ||||||||
| MICHAEL C BLANCHET | |||||||||||||
| 474970 | 2694 | 55894 | 7238 | 540796 | |||||||||
| TONY LENNEN | |||||||||||||
| 302184 | 1767 | 14700 | 28407 | 347058 | |||||||||
| JEFFERY KIRKHAM | |||||||||||||
| 240940 | 1403 | 45191 | 21815 | 309349 | |||||||||
| CLIF KNIGHT MD | |||||||||||||
| 332833 | 1935 | 34625 | 23862 | 393255 | |||||||||
| SUSAN LOTTICH MD | |||||||||||||
| 553178 | 18129 | 173909 | 17712 | 1015439 | 252511 | 46595 | |||||||
| CARA HAHS MD | |||||||||||||
| 312625 | 17709 | 14700 | 557148 | 212114 | 46595 | ||||||||
| WILLIAM JONES | |||||||||||||
| 201904 | 2944 | 15157 | 13042 | 233047 | |||||||||
| KEVIN LIEBRUM | |||||||||||||
| 187996 | 877 | 9535 | 30149 | 228557 | |||||||||
| JULIE MELVIN | |||||||||||||
| 161499 | 844 | 5557 | 21850 | 189750 | |||||||||
| FRANK COVINGTON MD | |||||||||||||
| 496211 | 85708 | 56739 | 28643 | 667301 | |||||||||
| CHARLES SALAZAR MD | |||||||||||||
| 551790 | 8731 | 24153 | 584674 | ||||||||||
| ABBY BEALL MD | |||||||||||||
| 237852 | 36088 | 6524 | 12281 | 8090 | 300835 | 1037 | |||||||
| THOMAS A FERRARA MD | |||||||||||||
| 155324 | 86580 | 28432 | 15819 | 286155 | |||||||||
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | NON-FIXED PAYMENTS PROVIDED | Identifier |
| Return Reference | SCHEDULE J, PAGE 1, PART I, LINE 7 | ReturnReference |
| Explanation | DR. SUSAN LOTTICH AND DR. CARA HAHS ARE ELIGIBLE TO PARTICIPATE IN AN INCENTIVE COMPENSATION PLAN AS OUTLINED IN THEIR EMPLOYMENT AGREEMENT WITH COMMUNITY HOSPITALS OF INDIANA, INC. ("CHI"). CHI IS A TAX-EXEMPT ORGANIZATION AND IT DEVELOPED DR. LOTTICH'S AND DR. HAHS' COMPENSATION PLANS IN CONJUNCTION WITH AN INDEPENDENT COMPENSATION CONSULTANT. | 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 | INDIANA PROHEALTH NETWORK INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | SHARE BD MEMBER | Relationship |
| Amount Of Transaction | 4602996 | AmountOfTransaction |
| Description Of Transaction | HEALTH & PHARM PLANS | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 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 HOSPITALS OF INDIANA, INC. ("CHI"), A TAX-EXEMPT HOSPITAL. THROUGH CHI, CHS IS ULTIMATELY CONTROLLED BY COMMUNITY HEALTH NETWORK, INC. ("CHNW"), THE TAX-EXEMPT PARENT OF THE INTEGRATED HEALTH DELIVERY SYSTEM. CHI HAS THE FOLLOWING POWERS OVER CHS: A) CHI IS THE SOLE MEMBER OF CHS, B) CHI APPOINTS ALL OF THE MEMBERS OF CHS' BOARD OF DIRECTORS, C) THE CHI AND CHS BOARDS OF DIRECTORS ARE IDENTICAL WITH THE EXCEPTION THAT CHS' BOARD ALSO INCLUDES THE CHS MEDICAL OFFICER, D) CHI AND CHS HAVE IDENTICAL OFFICERS, AND E) CHI HAS THE AUTHORITY TO REMOVE ANY MEMBER OF CHS' BOARD OF DIRECTORS. CHI IS LIKEWISE CONTROLLED BY ITS PARENT, CHNW. CHI HAS EXERCISED ITS CONTROL OVER CHS TO ENSURE THAT CHNW HAS EXCLUSIVE AUTHORITY OVER THE FOLLOWING AFFAIRS OF CHS: STRATEGIC PLANNING; CAPITAL ACCESS, BUDGETING, AND ALLOCATION; AUDIT AND COMPLIANCE; EXECUTIVE COMPENSATION; AND DISPUTE RESOLUTION. WITH REGARD TO EXECUTIVE COMPENSATION, CHNW REVIEWS AND APPROVES EXECUTIVE COMPENSATION, INCLUDING CHS' EXECUTIVES, THROUGH THE DELIBERATIONS OF A NETWORK EXECUTIVE COMPENSATION COMMITTEE COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS. LIKEWISE, CHNW REVIEWS AND MANAGES CHS' CONFLICT OF INTEREST TRANSACTIONS THROUGH THE DELIBERATION OF A NETWORK AUDIT COMMITTEE COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS. |
| 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, EXCEPT FOR DR. BOHNENKAMP, ALSO SERVE AS DIRECTORS AND/OR OFFICERS OF COMMUNITY HOSPITALS OF INDIANA, INC. IN ADDITION, THE DIRECTORS SERVE AS DIRECTORS OF THE FOLLOWING ORGANIZATIONS: MICHAEL C. BLANCHET - COMMUNITY BUSINESS INNOVATIONS, INC. - COMMUNITY HOME HEALTH SERVICES, INC. - INDIANA PROHEALTH NETWORK, INC. STEVEN R. PLUMP - COMMUNITY HEALTH NETWORK, INC. KRISTIN T. SHERMAN - COMMUNITY HEALTH NETWORK, INC. RONALD H. THIEME - COMMUNITY HEALTH NETWORK, INC. EDWARD P. TODDERUD, M.D. - INDIANA SPECIALTY GROUP, LLC |
| 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. |
| 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 EVERY TAX-EXEMPT ORGANIZATION WITHIN THE NETWORK, INCLUDING 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 EVERY TAX-EXEMPT ORGANIZATION WITHIN THE NETWORK, INCLUDING 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 2010, THE NETWORK EXECUTIVE COMPENSATION COMMITTEE FOLLOWED THIS PROCESS FOR ALL CHIEF EXECUTIVE OFFICERS FOR ALL NETWORK ENTITIES; THE NETWORK CHIEF FINANCIAL OFFICER; THE NETWORK VICE PRESIDENT OF HUMAN RESOURCES; THE NETWORK VICE PRESIDENT OF MEDICAL AND ACADEMIC AFFAIRS; THE NETWORK VICE PRESIDENT OF CLINICAL STANDARDS, EDUCATION, AND RESEARCH; THE NETWORK VICE PRESIDENT OF LEGAL SERVICES; THE NETWORK CHIEF INFORMATION OFFICER; THE VICE PRESIDENT OF BUSINESS DEVELOPMENT AND MARKETING; THE EXECUTIVE DIRECTOR OF PROHEALTH; AND THE CHIEF FINANCIAL OFFICER OF INDIANA PROHEALTH NETWORK, INC. DURING 2010, THE CHIEF EXECUTIVE OFFICERS, CHIEF FINANCIAL OFFICERS, AND HUMAN RESOURCES REPRESENTATIVES FOR ALL NETWORK ENTITIES FOLLOWED A PROCESS WHEREBY SALARIES FOR ALL POSITIONS REPRESENTING MANAGER AND ABOVE 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. |
| ADDITIONAL INFORMATION | FORM 990, PART VII | FORM 990, PART VII - AVERAGE HOURS WORKED FOR RELATED ORGANIZATION ABBY BEALL, M.D. - 40 MICHAEL C. BLANCHET - 40 FRANK COVINGTON, M.D. - 40 THOMAS A. FERRARA, M.D. - 40 JEFFERY KIRKHAM - 40 CLIF KNIGHT, M.D. - 40 CHARLES SALAZAR, M.D. - 40 DON B. ZIPERMAN - 40 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (10 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 BUSINESS INNOVATIONS INC | ||||||||||
| 1500 NORTH RITTER AVENUE | INDIANAPOLIS | IN | 46219 | 352088279 | SHARE SRV | IN | 501C3 | 11B | CHNW | true |
| COMMUNITY HEALTH NETWORK INC | ||||||||||
| 1500 NORTH RITTER AVENUE | INDIANAPOLIS | IN | 46219 | 311038302 | PARENT | IN | 501C3 | 11B | NA | false |
| COMMUNITY HEALTH NETWORK FOUNDATION | ||||||||||
| 1500 NORTH RITTER AVENUE | INDIANAPOLIS | IN | 46219 | 510181688 | SUPPORT | IN | 501C3 | 11B | 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 | CHI | true |
| COMMUNITY HOSP ANDERSON FDN INC | ||||||||||
| 1515 NORTH MADISON AVENUE | ANDERSON | IN | 46011 | 861053152 | SUPPORT | IN | 501C3 | 7 | CHA | true |
| COMMUNITY LTC INC | ||||||||||
| 1031 MONTICELLO DRIVE | ANDERSON | IN | 46011 | 351877441 | HLTH CARE | IN | 501C3 | 9 | CHA | true |
| COMMUNITY HOSPITALS OF INDIANA INC | ||||||||||
| 1500 NORTH RITTER AVENUE | INDIANAPOLIS | IN | 46219 | 350983617 | HOSPITAL | IN | 501C3 | 3 | CHNW | false |
| COMMUNITY PHYSICIANS OF IN INC | ||||||||||
| 7240 SHADELAND STATION SUITE 300 | INDIANAPOLIS | IN | 46256 | 205392766 | PHY SRV | IN | 501C3 | 9 | CHI | true |
| THE INDIANA HEART HOSPITAL LLC | ||||||||||
| 8075 NORTH SHADELAND AVENUE | INDIANAPOLIS | IN | 46250 | 352123783 | HOSPITAL | IN | 501C3 | 3 | CHI | true |
Form990 Schedule R Part III Form990ScheduleRPartIII (14 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 |
|---|---|---|---|---|---|---|---|---|---|
| EAST CAMPUS SURGERY CENTER LLC | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 352028517 | SURGERY | IN | N/A | false | false |
| IMAGING EQUIPMENT LEASING CO LLC | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 201293154 | LEASING | 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 |
| 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 |
| SURGICARE LLC | |||||||||
| 2907 MCINTIRE DRIVE | BLOOMINGTON | IN | 47403 | 351975122 | SURGERY | 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 |
| IMAGING EQUIPMENT LEASING CO LLC | |||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 201293154 | LEASING | 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 |
| 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 |
| SURGICARE LLC | |||||||||
| 2907 MCINTIRE DRIVE | BLOOMINGTON | IN | 47403 | 351975122 | SURGERY | IN | N/A | false | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)
| Address Line1AddressForeign/AddressLine1 | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Direct Controlling Entity NADirectControllingEntityNA | 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 | |||||
| INDIANA PROHEALTH NETWORK INC | |||||||||||
| 351614719 | INSURANCE | N/A | 8180 CLEARVISTA PARKWAY SUITE 230 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VISIONARY ENTERPRISES INC | |||||||||||
| 351538433 | MGMT SRVS | N/A | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VEI MICHIGAN INC | |||||||||||
| 300097377 | MGMT SRVS | N/A | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| CHN ASSURANCE COMPANY LTD | |||||||||||
| PO BOX 1051GT | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | |||||
| INDIANA PROHEALTH NETWORK INC | |||||||||||
| 351614719 | INSURANCE | N/A | 8180 CLEARVISTA PARKWAY SUITE 230 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VISIONARY ENTERPRISES INC | |||||||||||
| 351538433 | MGMT SRVS | N/A | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VEI MICHIGAN INC | |||||||||||
| 300097377 | MGMT SRVS | N/A | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| 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 |
| 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 | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (18 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| COMMUNITY BUSINESS INNOVATIONS INC | ||
| A | 202716 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY BUSINESS INNOVATIONS INC | ||
| I | 2130743 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY BUSINESS INNOVATIONS INC | ||
| O | 16017952 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY BUSINESS INNOVATIONS INC | ||
| Q | 407461 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY HEALTH NETWORK FOUNDATION | ||
| C | 206191 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY HEALTH NETWORK FOUNDATION | ||
| Q | 90934 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY PHYSICIANS OF IN INC | ||
| R | 260730 | ACTUAL AMOUNT PER BOOKS |
| THE INDIANA HEART HOSPITAL LLC | ||
| R | 579644 | ACTUAL AMOUNT PER BOOKS |
| INDIANA PROHEALTH NETWORK INC | ||
| O | 4602996 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY BUSINESS INNOVATIONS INC | ||
| A | 202716 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY BUSINESS INNOVATIONS INC | ||
| I | 2130743 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY BUSINESS INNOVATIONS INC | ||
| O | 16017952 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY BUSINESS INNOVATIONS INC | ||
| Q | 407461 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY HEALTH NETWORK FOUNDATION | ||
| C | 206191 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY HEALTH NETWORK FOUNDATION | ||
| Q | 90934 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY PHYSICIANS OF IN INC | ||
| R | 260730 | ACTUAL AMOUNT PER BOOKS |
| THE INDIANA HEART HOSPITAL LLC | ||
| R | 579644 | ACTUAL AMOUNT PER BOOKS |
| INDIANA PROHEALTH NETWORK INC | ||
| O | 4602996 | ACTUAL AMOUNT PER BOOKS |
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