2011-11-11T14:06:16-06:00 2010-12-31 CASKEY & DAILY PC 4745 STATESMEN DRIVE SUITE C INDIANAPOLIS IN 46250 990 2010-01-01 351088640 COMMUNITY HOSPITAL SOUTH INC COMM 3173555822 1402 E COUNTY LINE ROAD SOUTH INDIANAPOLIS IN 46227 JEFFERY KIRKHAM 3173555822 2011-11-09 true JAMES A CASKEY CPA CFP 3175852647 2011-11-11 2010 2016-02-24 21:20:13Z MICHAEL C BLANCHET 1500 NORTH RITTER AVENUE INDIANAPOLIS IN 46219 144041221 false X WWW.ECOMMUNITY.COM X 1989 IN 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. 9 6 893 167 0 4658 206191 154961897 138800062 17938 -49627 5903950 5023344 160888443 143979970 0 0 47265695 44980643 0 0 105076903 87830563 152342598 132811206 8545845 11168764 172848154 184350314 5522625 5856021 167325529 178494293 X 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. false false 87896274 138800062 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. 87896274 true true false false false false false false false true false false true true false false true false false false false false false false false true false false false true false false false false false false false true false false false false false true true true false false true 51 0 true 893 true false false false false false false false false false false X 9 6 true true false false true true true true true false false false true true true true true true true false IN X JEFFERY KIRKHAM 3173555822 1500 N RITTER AVENUE INDIANAPOLIS IN 46219 X DON B ZIPERMAN MD 5.00 X 0 723131 155934 MICHAEL C BLANCHET 10.00 X X 0 477664 63132 RICHARD BOHNENKAMP MD 5.00 X 0 0 0 DAVID HOLLANDER MD 5.00 X 0 0 0 BEVERLEY PITTS 5.00 X 0 0 0 STEVEN R PLUMP 5.00 X X 0 0 0 KRISTIN T SHERMAN 5.00 X X 0 0 0 RONALD H THIEME 5.00 X 0 0 0 EDWARD P TODDERUD MD 5.00 X 0 0 0 TONY LENNEN 40.00 X 303951 0 43107 JEFFERY KIRKHAM 5.00 X 0 242343 67006 CLIF KNIGHT MD 10.00 X 0 334768 58487 SUSAN LOTTICH MD 40.00 X 823818 0 191621 CARA HAHS MD 40.00 X 542448 0 14700 WILLIAM JONES 40.00 X 204848 0 28199 KEVIN LIEBRUM 40.00 X 188873 0 39684 JULIE MELVIN 40.00 X 162343 0 27407 FRANK COVINGTON MD 5.00 X 0 581919 85382 CHARLES SALAZAR MD 0.00 X 0 560521 24153 ABBY BEALL MD 10.00 X 0 280464 20371 THOMAS A FERRARA MD 0.00 X 0 241904 44251 2226281 3442714 863434 16 true true false 206191 206191 PATIENT REVENUE 900099 138800062 138800062 138800062 4464 4464 7160 61251 -54091 -54091 -54091 LEASED EQUIPMENT 532420 2130743 2130743 CAFETERIA 722210 719145 719145 SERVICE ALLOCATION 900099 428926 428926 1744530 1744530 5023344 143979970 143104261 669518 347058 347058 35065886 27757447 7308439 742265 742265 6364743 4988826 1375917 2460691 1931726 528965 551 551 37312184 11555392 25756792 886 286 600 28068974 26647477 1421497 688898 183932 504966 2474403 1939492 534911 31755 20700 11055 12209 1589 10620 1430475 1430475 8697118 3856416 4840702 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 5530 1476 4054 132811206 87896274 44914932 0 3450 3350 24438983 23520126 1898428 2468269 205558044 77617640 99334029 127940404 47173264 30418165 172848154 184350314 5509759 5847635 12866 8386 5522625 5856021 X 167325529 178494293 167325529 178494293 172848154 184350314 11168764 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false 497000 497000 149499267 28340085 121159182 1097088 339336 757752 51703811 47396365 4307446 2760878 1541854 1219024 127940404 DUE FROM AFFLIATED ENTITIES 30418165 30418165 THIRD PARTY SETTLEMENTS 8386 8386 true true true X false true true false true true 6442 4126360 4126360 0.03330 9474 9371258 3838429 5532829 0.04470 15916 13497618 3838429 9659189 0.07800 5 1671525 191 1671334 0.01350 3 126514 51428 75086 0.00060 1 18648 18648 0.00020 9 1816687 51619 1765068 0.01430 9 15916 15314305 3890048 11424257 0.09230 1 641690 641690 0.00520 1 641690 641690 0.00520 true 3114137 34252476 39725914 -5473438 X true true NONE 1 1 COMMUNITY HOSPITAL SOUTH

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HEALTH CARE COMM HEART & VASCULAR CV TESTING

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HEALTH CARE COMMUNITY IMAGING CENTER

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REHABILITATION CENTER FOR WOMEN'S HEALTH

533 E COUNTY LINE ROAD 101 GREENWOOD IN 46143

HEALTH CARE 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 X X X X false false false false false false false true false 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 252511 18129 173909 17712 1015439 46595 CARA HAHS MD 312625 212114 17709 14700 557148 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 NON-FIXED PAYMENTS PROVIDED SCHEDULE J, PAGE 1, PART I, LINE 7 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. INDIANA PROHEALTH NETWORK INC SHARE BD MEMBER 4602996 HEALTH & PHARM PLANS false 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 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 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 CHN ASSURANCE COMPANY LTD PO BOX 1051GT GRAND CAYMAN CJ 980418913 INSURANCE CJ N/A INDIANA PROHEALTH NETWORK INC 8180 CLEARVISTA PARKWAY SUITE 230 INDIANAPOLIS IN 46256 351614719 INSURANCE IN N/A VISIONARY ENTERPRISES INC 7330 SHADELAND STATION SUITE 200 INDIANAPOLIS IN 46256 351538433 MGMT SRVS IN N/A VEI MICHIGAN INC 940 N MAIN STREET ANN HARBOR MI 48104 300097377 MGMT SRVS MI N/A CHN ASSURANCE COMPANY LTD PO BOX 1051GT GRAND CAYMAN CJ 980418913 INSURANCE CJ N/A INDIANA PROHEALTH NETWORK INC 8180 CLEARVISTA PARKWAY SUITE 230 INDIANAPOLIS IN 46256 351614719 INSURANCE IN N/A VISIONARY ENTERPRISES INC 7330 SHADELAND STATION SUITE 200 INDIANAPOLIS IN 46256 351538433 MGMT SRVS IN N/A VEI MICHIGAN INC 940 N MAIN STREET ANN HARBOR MI 48104 300097377 MGMT SRVS MI N/A false false true false false false false false true false false false false false true false false false 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