COMMUNITY HOSPITAL OF ANDERSON- MADISON COUNTY INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HOSPITAL OF ANDERSON- MADISON COUNTY INC (EIN 35-1069822)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-11
- IRS object ID
- 201133159349302203
- 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 D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-11T08:56:11-06:00 | 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 | 351069822 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL OF ANDERSON AND | BusinessNameLine1 |
| Business Name Line2 | MADISON COUNTY INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COMM | NameControl |
| Phone | 7652984242 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 NORTH MADISON AVENUE | AddressLine1 |
| City | ANDERSON | City |
| State | IN | State |
| ZIP Code | 460113453 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN B HARRIS | Name |
| Title | VP OF FINANCE/CFO | Title |
| Phone | 7652984242 | Phone |
| Date Signed | 2011-11-08 | 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 | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | WILLIAM C VANNESS II MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 NORTH MADISON AVENUE | AddressLine1 |
| City | ANDERSON | City |
| State | IN | State |
| ZIP Code | 460113453 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 134195692 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.COMMUNITYANDERSON.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1961 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. IS TO SERVICE THE MEDICAL, HEALTH AND HUMAN SERVICE NEEDS OF THE PEOPLE IN ANDERSON, MADISON COUNTY, AND CONTIGUOUS COUNTIES WITH COMPASSION, DIGNITY, RESPECT, AND EXCELLENCE. SERVICE, ALTHOUGH FOCUSED ON INJURY, ILLNESS, AND DISEASE, WILL ALSO EMBRACE PREVENTION, EDUCATION, AND ALTERNATIVE SYSTEMS OF HEALTH CARE DELIVERY. COMMUNITY HOSPITALS OF ANDERSON AND MADISON COUNTY, INC. OFFERS STATE-OF-THE-ART SERVICES TO EXCEED THE NEEDS OF OUR PATIENTS. FROM BASIC MEDICAL SERVICES SUCH AS THE EMERGENCY DEPARTMENT AND OUR NEW GENERATIONS BIRTH PLACE, TO THE SUPPORT OF OUR BREAST HEALTH SPECIALIST AND DIABETES CARE CENTER EDUCATORS, WE ADD THAT SPECIAL TOUCH TO ANTICIPATE YOUR NEEDS BEFORE YOU ASK. OUR STAFF MAKES EVERY EFFORT TO PROVIDE AN EFFECTIVE AND EFFICIENT HEALTH CARE DELIVERY SYSTEM. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 18 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 15 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1253 | TotalNbrEmployees |
| Total Nbr Volunteers | 179 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 116035719 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 119663238 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 549220 | InvestmentIncomePriorYear |
| Investment Income Current Year | 9904 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4229408 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4451716 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 120814347 | TotalRevenuePriorYear |
| Total Revenue Current Year | 124124858 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 64615 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 64375 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 65163131 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 62300450 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 51565277 | OtherExpensePriorYear |
| Other Expenses Current Year | 60300440 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 116793023 | TotalExpensesPriorYear |
| Total Expenses Current Year | 122665265 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4021324 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1459593 | RevenuesLessExpensesCY |
| Total Assets BOY | 105041467 | TotalAssetsBOY |
| Total Assets EOY | 108413543 | TotalAssetsEOY |
| Total Liabilities BOY | 33006990 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 31163437 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 72034477 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 77250106 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. IS TO SERVICE THE MEDICAL, HEALTH AND HUMAN SERVICE NEEDS OF THE PEOPLE IN ANDERSON, MADISON COUNTY, AND CONTIGUOUS COUNTIES WITH COMPASSION, DIGNITY, RESPECT, AND EXCELLENCE. SERVICE, ALTHOUGH FOCUSED ON INJURY, ILLNESS, AND DISEASE, WILL ALSO EMBRACE PREVENTION, EDUCATION, AND ALTERNATIVE SYSTEMS OF HEALTH CARE DELIVERY. COMMUNITY HOSPITALS OF ANDERSON AND MADISON COUNTY, INC. OFFERS STATE-OF-THE-ART SERVICES TO EXCEED THE NEEDS OF OUR PATIENTS. FROM BASIC MEDICAL SERVICES SUCH AS THE EMERGENCY DEPARTMENT AND OUR NEW GENERATIONS BIRTH PLACE, TO THE SUPPORT OF OUR BREAST HEALTH SPECIALIST AND DIABETES CARE CENTER EDUCATORS, WE ADD THAT SPECIAL TOUCH TO ANTICIPATE YOUR NEEDS BEFORE YOU ASK. OUR STAFF MAKES EVERY EFFORT TO PROVIDE AN EFFECTIVE AND EFFICIENT HEALTH CARE DELIVERY SYSTEM. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 113408443 | Expense |
| Revenue | 119663238 | Revenue |
| Description | COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. ("CHA") IS AN ACUTE CARE MEDICAL FACILITY WITH 137 STAFFED BEDS (EXCLUDING NURSERY). IN 2010, THERE WERE 6,456 ADMISSIONS, 6,845 SURGERIES PERFORMED, 931 BIRTHS WITH A TOTAL OF 177,368 PATIENTS SERVED IN ALL DISCIPLINES. CHA PARTICIPATES IN MEDICARE, MEDICAID, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. WE PROVIDE AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. OUR STAFF MAKES EVERY EFFORT TO PROVIDE AN EFFECTIVE AND EFFICIENT HEALTH CARE DELIVERY SYSTEM. FINALLY, WE HAVE A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE THE MAJORITY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 64375 | Expense |
| Grants | 64375 | Grants |
| Description | COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. CONTRIBUTED TO A FEW LOCAL CHARITABLE ORGANIZATIONS. THE LARGEST DONATIONS ARE LISTED ON SCHEDULE I. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 113472818 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | 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 | false | 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 | true | 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 | 105 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1253 | 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 | 18 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 15 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | 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 | false | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| 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 | JOHN B HARRIS | NamePerson |
| Telephone Number | 7652985125 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 N MADISON AVENUE | AddressLine1 |
| City | ANDERSON | City |
| State | IN | State |
| ZIP Code | 46011 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| BRYAN A MILLS | ||||||||
| DIRECTOR | 5.00 | X | 0 | 1065810 | 288164 | |||
| WILLIAM C VANNESS II MD | ||||||||
| DIRECTOR & C | 40.00 | X | 450710 | 0 | 71528 | X | ||
| DAVID A SHAPIRO MD | ||||||||
| DIRECTOR | 5.00 | X | 12900 | 276096 | 32614 | |||
| D BENJAMIN MCCURDY MD | ||||||||
| DIRECTOR | 5.00 | X | 1200 | 0 | 0 | |||
| LARRY BLANKENSHIP MD | ||||||||
| DIRECTOR | 5.00 | X | 150 | 0 | 0 | |||
| MICHAEL L BAKER | ||||||||
| CHAIRMAN | 5.00 | X | 0 | 0 | 0 | X | ||
| DENNIS CARROLL | ||||||||
| VICE CHAIRMA | 5.00 | X | 0 | 0 | 0 | X | ||
| MARIAN DUNNICHAY | ||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |||
| WILLIAM HOBBS | ||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |||
| MARY JAMERSON | ||||||||
| SECRETARY | 5.00 | X | 0 | 0 | 0 | X | ||
| MICHAEL KIRBY | ||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |||
| ARTHUR J LEAK | ||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |||
| MARY JO LEE | ||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |||
| RICHARD MOUSTY | ||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |||
| ROBERT J PENSEC | ||||||||
| TREASURER | 5.00 | X | 0 | 0 | 0 | X | ||
| JOSEPH PORCARO MD | ||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |||
| LEROY A QUASHIE | ||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |||
| CHARLES STALEY | ||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |||
| SHIRLEY J WEATHERLY | ||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | |||
| JOHN B HARRIS | ||||||||
| VP OF FINANC | 40.00 | 227007 | 0 | 47733 | X | |||
| TAHIR ALI NAQVI MD | ||||||||
| PHYSICIAN | 40.00 | 1598593 | 0 | 929723 | X | |||
| RYAN HINDS MD | ||||||||
| PHYSICIAN | 40.00 | 340957 | 0 | 17703 | X | |||
| JARED ANDERSON MD | ||||||||
| PHYSICIAN | 40.00 | 336138 | 0 | 26680 | X | |||
| VIRGIL LOGHIN MD | ||||||||
| ANESTHESIOLO | 40.00 | 299534 | 0 | 14292 | X | |||
| LEE ANN MCDANIEL | ||||||||
| CRNA | 40.00 | 284432 | 0 | 35783 | X | |||
| ELIZABETH S THARP | ||||||||
| VP PATIENT C | 40.00 | 191617 | 0 | 36257 | X | |||
| LISA HALSTEAD | ||||||||
| VP PROF & AM | 40.00 | 183425 | 0 | 52763 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3926663 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1341906 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1553240 | TotalOtherCompensation |
| Number Individuals GT100 K | 49 | NumberIndividualsGT100K |
| Formers Listed | true | 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 |
|---|---|---|---|---|---|
| WR DUNKIN & SON INC | |||||
| 2409 W 18TH STREET | ANDERSON | IN | 46018 | CONSTRUCTION | 786403 |
| SOUTH BEND MEDICAL FOUNDATION INC | |||||
| 530 N LAFAYETTE BLVD | SOUTH BEND | IN | 466011098 | LABORATORY SRV | 602185 |
| UNITED HOSPITAL SERVICES LLC | |||||
| 9948 PARK DAVIS DRIVE | INDIANAPOLIS | IN | 46235 | LINEN SERVICES | 518451 |
| UROLOGY ASSOCIATES LLC | |||||
| 2525 W UNIVERSITY SUITE 504 | MUNCIE | IN | 47304 | MED/PHY GUAR | 439313 |
| WHITE RIVER ANESTHESIA LLC | |||||
| 1135 CORAL SPRINGS DRIVE | CICERO | IN | 460349216 | MED/PHY GUAR | 438520 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 26 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT CARE SERVICE | 900099 | 118528028 | 118528028 |
| CLINICAL RESEARCH | 541700 | 729406 | 729406 |
| JOINT VENTURES | 621400 | 405804 | 405804 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 119663238 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 728319 | TotalRevenueColumn |
| Exclusion | $728,319 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2731588 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2731588 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2731588 | TotalRevenueColumn |
| Exclusion | $2,731,588 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 9033210 | Securities |
| Other | 319209 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 10070834 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -1037624 | Securities |
| Other | 319209 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -718415 | TotalRevenueColumn |
| Exclusion | -$718,415 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| CAFETERIA SALES | 722210 | 574647 | $574,647 | |
| RADIOLOGY SERVICES | 621500 | 122935 | 122935 | |
| TELECOMMUNICATIONS | 517000 | 105677 | $105,677 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 916869 | TotalRevenueColumn |
| Related Or Exempt Function Income | 916869 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1720128 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 124124858 | TotalRevenueColumn |
| Related Or Exempt Function Income | 120703042 | RelatedOrExemptFunctionIncome |
| Exclusion | $3,421,816 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64375 | Total |
| Program Services | 64375 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 811228 | Total |
| Program Services | 14250 | ProgramServices |
| Management And General | 796978 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49252161 | Total |
| Program Services | 44852216 | ProgramServices |
| Management And General | 4399945 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2615158 | Total |
| Program Services | 2343687 | ProgramServices |
| Management And General | 271471 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6340706 | Total |
| Program Services | 5682497 | ProgramServices |
| Management And General | 658209 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3281197 | Total |
| Program Services | 2940586 | ProgramServices |
| Management And General | 340611 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 441894 | Total |
| Program Services | 418223 | ProgramServices |
| Management And General | 23671 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 267726 | Total |
| Program Services | 253384 | ProgramServices |
| Management And General | 14342 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9481136 | Total |
| Program Services | 8973250 | ProgramServices |
| Management And General | 507886 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 152643 | Total |
| Program Services | 144466 | ProgramServices |
| Management And General | 8177 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23241049 | Total |
| Program Services | 21896213 | ProgramServices |
| Management And General | 1344836 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 207899 | Total |
| Program Services | 196762 | ProgramServices |
| Management And General | 11137 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5196267 | Total |
| Program Services | 4917913 | ProgramServices |
| Management And General | 278354 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 247981 | Total |
| Program Services | 234697 | ProgramServices |
| Management And General | 13284 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1247787 | Total |
| Program Services | 1180945 | ProgramServices |
| Management And General | 66842 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6670274 | Total |
| Program Services | 6312960 | ProgramServices |
| Management And General | 357314 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 445555 | Total |
| Program Services | 421687 | ProgramServices |
| Management And General | 23868 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 11290401 | 11290401 | |
| PHYSICIAN RECRUITMENT | 844050 | 798836 | 45214 |
| PROPERTY TAX | 347968 | 329328 | 18640 |
| DUES & SUBSCRIPTIONS | 193173 | 182825 | 10348 |
| EMPLOYEE RECRUITMENT | 17465 | 16529 | 936 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7172 | Total |
| Program Services | 6788 | ProgramServices |
| Management And General | 384 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 122665265 | Total |
| Program Services | 113472818 | ProgramServices |
| Management And General | 9192447 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7739317 | BOY |
| EOY | 8201874 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20043355 | BOY |
| EOY | 20962932 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 488015 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1944344 | BOY |
| EOY | 2585041 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 260894 | BOY |
| EOY | 143746 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 124529178 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 82514414 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43158130 | BOY |
| EOY | 42014764 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29148575 | BOY |
| EOY | 32599214 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2746852 | BOY |
| EOY | 1417957 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 105041467 | BOY |
| EOY | 108413543 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10339563 | BOY |
| EOY | 9682910 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18760000 | BOY |
| EOY | 17195000 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3100000 | BOY |
| EOY | 3100000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 807427 | BOY |
| EOY | 1185527 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33006990 | BOY |
| EOY | 31163437 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 72034477 | BOY |
| EOY | 77250106 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 72034477 | BOY |
| EOY | 77250106 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 105041467 | BOY |
| EOY | 108413543 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1459593 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 3756036 | ReconcilationOtherChanges |
| 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 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 | 5956988 | OtherCostOrOtherBasis |
| Book Value | 5956988 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 62782333 | OtherCostOrOtherBasis |
| Depreciation | 42794780 | Depreciation |
| Book Value | 19987553 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 53900987 | OtherCostOrOtherBasis |
| Depreciation | 38211198 | Depreciation |
| Book Value | 15689789 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1888870 | OtherCostOrOtherBasis |
| Depreciation | 1508436 | Depreciation |
| Book Value | 380434 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 42014764 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO AFFILIATES | $725,994 |
| ESTIMATED THIRD PARTY SETTLEMENTS | $459,533 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1185527 | 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 | 5076 | PersonsServed |
| Total Community Benefit Expense | 2145030 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2145030 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01930 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12776997 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6406804 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6370193 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05720 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 5076 | PersonsServed |
| Total Community Benefit Expense | 14922027 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6406804 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8515223 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07650 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 36 | NumberOfActivitiesOrPrograms |
| Persons Served | 9069 | PersonsServed |
| Total Community Benefit Expense | 5793 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 5793 | NetCommunityBenefitExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 127 | PersonsServed |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 37 | NumberOfActivitiesOrPrograms |
| Persons Served | 9196 | PersonsServed |
| Total Community Benefit Expense | 5793 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 5793 | NetCommunityBenefitExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 37 | NumberOfActivitiesOrPrograms |
| Persons Served | 14272 | PersonsServed |
| Total Community Benefit Expense | 14927820 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6406804 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8521016 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07650 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 6 | PersonsServed |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 9 | NumberOfActivitiesOrPrograms |
| Persons Served | 234 | PersonsServed |
| Total Community Building Expense | 60902 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 60902 | NetCommunityBuildingExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 300 | PersonsServed |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 11 | NumberOfActivitiesOrPrograms |
| Persons Served | 540 | PersonsServed |
| Total Community Building Expense | 60902 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 60902 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $3,618,801 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 36759096 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 39471499 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -2712403 | 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 (2 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|
| COMM ENDOSCOPY CTR | ||
| ENDOSCOPY CENTER | 0.41000 | 0.49000 |
| MADISON MED ASSOC | ||
| REAL ESTATE | 0.30000 | 0.30000 |
| 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 | COMM HOSP OF ANDERSON & MADISON CTY | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 NORTH MADISON AVENUE | AddressLine1 |
| City | ANDERSON | City |
| State | IN | State |
| ZIP Code | 46011 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | SEE ADDITIONAL INFORMATION | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMM HOSP OF ANDERSON & MADISON CTY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 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 11290401 WAS REMOVED FROM THE TOTAL EXPENSES REPORTED ON FORM 990 PART IX LINE 25 RELATED TO BAD DEBT EXPENSES |
| COMMUNITY BUILDING ACTIVITIES | PART II | SEE ATTACHED COMMUNITY BENEFIT REPORT |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | BAD DEBT EXPENSE REPRESENTS THE AMOUNT OF UNCOLLECTIBLE ACCOUNTS RECEIVABLE WRITTEN OFF AFTER EXHAUSTING COLLECTION EFFORTS THE COST TO CHARGE RATIO WAS USED TO DETERMINE THE COST FACTOR IN THIS CALCULATION CHA DOES NOT HAVE INDIVIDUALLY AUDITED FINANCIAL STATEMENTS ITS FINANCIAL RESULTS ARE INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMUNITY HEALTH NETWORK INC AND AFFILIATES THE NETWORK 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 AT COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY INC PATIENTS WITHOUT INSURANCE COVERAGE ARE ELIGIBLE FOR A 10 UNINSURED DISCOUNT IF PATIENTS PAY THEIR BILL IN FULL WITHIN 30 DAYS OF RECEIVING IT THEY ARE ELIGIBLE FOR AN ADDITIONAL 20 DISCOUNT UNCOLLECTIBLE ACCOUNTS ARE WRITTEN OFF AGAINST ALLOWANCE FOR DOUBTFUL ACCOUNTS AFTER EXHAUSTING COLLECTION EFFORTS ANY SUBSEQUENT RECOVERIES ARE RECORDED AGAINST THE PROVISION OF 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 SERVICES AND CLINICS MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS COMMUNITY BENEFIT BECAUSE MEDICARE REPRESENTS 4967 OF THE OVERALL PAYER MIX FOR THIS ORGANIZATION |
| COLLECTION PRACTICES EXPLANATION | PART III LINE 9B | IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR HARDSHIP DURING THE COLLECTION PROCESS COLLECTION EFFORTS ARE STOPPED AND HARDSHIP IS GIVEN PART VI LINES 2 THROUGH 7 |
| NEEDS ASSESSMENT | PART VI | CHA MONITORS THE COMMUNITYS USE OF OUR FACILITY AND CONSISTENTLY ADDS NEW SERVICES BASED ON WHAT WE HAVE SEEN AS A NEED IN OUR COMMUNITY FOR EXAMPLE WE HAVE A GROWING HISPANIC POPULATION IN OUR COMMUNITY MANY OF WHOM SPEAK LITTLE TO NO ENGLISH A LARGE NUMBER OF THESE PATIENTS USE OUR PREGNANCY PLUS WOMENS CLINIC WE HAVE SINCE EMPLOYED A FULL TIME SPANISH INTERPRETER IN THIS DEPARTMENT WHO IS ALSO ONCALL TO THE REST OF THE HOSPITAL THIS MAKES IT MUCH EASIER FOR THESE PATIENTS TO RECEIVE OUR HEALTH CARE SERVICES IN THEIR OWN LANGUAGE CHA ALSO RESPONDS TO HEALTH CARE REQUESTS FROM THE COMMUNITY ORGANIZATIONS AND COMPANIES WILL OFTEN REQUEST SPEAKERS INFORMATION ON HEALTH CONDITIONS AND SERVICES ANDOR HEALTH CARE SCREENINGS CHA WILL EITHER PROVIDE THESE FOR THAT ORGANIZATION OR DIRECT THEM TO WHERE THEY CAN RECEIVE THEM INFORMATION ON HOW TO REQUEST THESE SERVICES IS AVAILABLE ON OUR WEBSITE WWWCOMMUNITYANDERSONCOM |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | ALL PATIENTS WITHOUT INSURANCE ARE SCREENED AT THE TIME OF REGISTRATION FOR ELIGIBILITY IN THE HEALTHY INDIANA PLAN IN AN EFFORT TO SCREEN 100 OF SELFPAY PATIENTS FOR POTENTIAL CHARITY CARE ELIGIBILITY COMMUNITY HOSPITAL UTILIZES DATA FROM TRUSTED THIRDPARTY VENDORS TO AUTOMATICALLY ESTIMATE THE FINANCIAL CONDITION OF EACH PATIENT THIS DATA IS COLLECTED FROM MULTIPLE SOURCES USING MULTIPLE METHODOLOGIES INCLUDING PREDICTIVE MODELING TO MAXIMIZE THE ACCURACY OF THESE FINANCIAL ESTIMATES TO ACCOMPLISH THESE TASKS COMMUNITY HOSPITAL USES TECHNOLOGY FROM VISION FINANCIAL HEADQUARTERED IN LAPORTE IN THIS TECHNOLOGY ENABLES COMMUNITY HOSPITAL TO AUTOMATICALLY GATHER FINANCIAL AND DEMOGRAPHIC INFORMATION FOR EACH PATIENT FROM THIRDPARTY DATA VENDORS INCLUDING EQUIFAX INC THIS PROVIDES AN ESTIMATION OF HOUSEHOLD SIZE AND INCOME REQUIRED TO CALCULATE FEDERAL POVERTY LEVEL VISION FINANCIAL AGGREGATES CENSUS INFORMATION PUBLIC RECORDS AND SELFREPORTED INFORMATION TO ESTIMATE THE FINANCIAL CONDITIONS OF CONSUMER HOUSEHOLDS EQUIFAX INC USES A DIFFERENT METHODOLOGY BASED ON AVAILABLE CREDIT BALANCES AND MONTHLY CREDIT OBLIGATIONS TO ESTIMATE INCOME AND HOUSEHOLD SIZE EACH OF THESE DATA VENDORS USE SOPHISTICATED PREDICTIVE MODELING TECHNIQUES TO INCREASE THE ACCURACY OF THESE ESTIMATES BASED ON MILLIONS OF HISTORICAL RECORDS ON A WEEKLY BASIS ALL SELF PAY ACCOUNTS WITH BALANCES DUE FROM THE PATIENT INPATIENT AND OUTPATIENT ARE CHECKED AGAINST THESE THIRDPARTY DATABASES AUTOMATICALLY AND SEGMENTED BASED ON FEDERAL POVERTY LEVEL AND THE GUIDELINES OF COMMUNITY HOSPITAL FINANCIAL ASSISTANCE PROGRAM THIS APPROACH IS CONSISTENTLY APPLIED LEVERAGING AUTOMATED ANALYTICS TECHNOLOGY IN AN UNBIASED FASHION TO ALL ACCOUNTS PATIENTS WHO ARE VERY LIKELY TO QUALIFY FOR FINANCIAL ASSISTANCE BASED ON THIRDPARTY FEDERAL POVERTY LEVEL ESTIMATES RECEIVE A CHARITY CARE ADJUSTMENT ACCORDING TO COMMUNITY HOSPITAL CHARITY CARE GUIDELINES PATIENTS AT HIGHER FEDERAL POVERTY LEVEL THRESHOLDS HAVE THE OPPORTUNITY TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION AND MEET WITH A FINANCIAL COUNSELOR TO DETERMINE PAYMENT AND ASSISTANCE OPTIONS THIS APPROACH ENABLES COMMUNITY HOSPITAL TO EFFICIENTLY SERVE THE COMMUNITY WHILE USING A CONSISTENT APPROACH TO IDENTIFYING ALL PATIENTS WITH A NEED FOR FINANCIAL ASSISTANCE ALSO WE NO LONGER PHONE PEOPLE OFFERING THEM ASSISTANCE WITH HEALTHY INDIANA PLAN SINCE THERE WAS A WAITING LIST |
| COMMUNITY INFORMATION | PART VI | CHA SERVES CITIZENS OF MADISON COUNTY INDIANA AS WELL AS OTHERS WITHIN THE SURROUNDING COUNTIES ACCORDING TO THE 2010 CENSUS MADISON COUNTY HAD A TOTAL POPULATION OF 132285 APPROXIMATELY 22 OF THE POPULATION WAS UNDER THE AGE OF 18 9 WAS AGE 18 TO 24 13 AGES 25 TO 34 27 FROM AGE 35 TO 54 13 AGES 55 TO 64 AND 16 WERE 65 YEARS OF AGE OR OLDER THE AVERAGE HOUSEHOLD INCOME IN MADISON COUNTY IN 2010 WAS 55936 COMPARED TO THE US AVERAGE OF 71071 THE COUNTY UNEMPLOYMENT RATE WAS 95 WHICH WAS HIGHER THAN THE US AVERAGE THE PAYER MIX OF PATIENTS SERVED IN 2010 WAS 60 GOVERNMENT PAYERS MEDICAREMEDICAID 34 COMMERCIAL INSURANCES AND 6 WITH NO INSURANCE THE RACIAL MAKEUP OF THE COUNTY WAS ABOUT 87 WHITE 8 AFRICAN AMERICAN 3 HISPANIC AND 2 OTHER RACES HISTORICALLY A LARGE PORTION OF RESIDENTS IN THE AREA WERE EMPLOYED BY GENERAL MOTORS AND OTHER FACTORIES HOWEVER IN RECENT YEARS MANY OF THE FACTORIES HAVE CLOSED NEW EMPLOYERS HAVE MOVED TO THE AREA IN RECENT YEARS INCLUDING NESTLE AND OTHER ORGANIZATIONS |
| HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE | PART VI | SEE NEEDS ASSESSMENT ABOVE |
| AFFILIATED HEALTH CARE INFORMATION | PART VI | SEE ATTACHED COMMUNITY BENEFIT REPORT |
| LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED | PART VI | INDIANA |
| ADDITIONAL INFORMATION | PART VI | PART V FACILITY INFORMATION OTHER CHA IS AN ACUTE CARE MEDICAL FACILITY WITH 137 STAFFED BEDS IN 2010 THERE WERE 6456 ADMISSIONS WITH AN AVERAGE LENGTH OF STAY OF 358 DAYS THERE WERE 30223 EMERGENCY ROOM CASES RESPONDED TO IN OUR 24HOURSEVEN DAY A WEEK EMERGENCY ROOM 68 OF THE BIRTHS IN MADISON COUNTY WERE DELIVERED AT CHA FOR A TOTAL OF 931 BIRTHS IN 2010 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| CITY OF ANDERSON PARKS DEPARTMENT | |||||||
| 1611 CHASE STREET | ANDERSON | IN | 46016 | 356000939 | GOV | 15675 | GENERAL SUPPORT |
| COMMUNITY HOSPITAL ANDERSON FDN | |||||||
| 1515 N MADISON AVENUE | ANDERSON | IN | 46011 | 861053152 | 3 | 5200 | GENERAL SUPPORT |
| HEALTH & HOSPITAL CORP OF MARION CO | |||||||
| 3838 N RURAL STREET 8TH FLOOR | INDIANAPOLIS | IN | 46205 | 356005697 | GOV | 10000 | GENERAL SUPPORT |
| SECOND HARVEST FOOD BANK | |||||||
| 6621 N OLD STATE ROAD 3 | MUNCIE | IN | 47303 | 311111795 | 3 | 8000 | GENERAL SUPPORT |
| UNITED WAY OF MADISON COUNTY INC | |||||||
| 1201 E 5TH STREET SUITE 1019 | ANDERSON | IN | 46015 | 351052350 | 3 | 10500 | GENERAL SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 2 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES | Identifier |
| Return Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | ReturnReference |
| Explanation | THE CONTRIBUTIONS TO VARIOUS LOCAL CHARITABLE ORGANIZATIONS WERE UNRESTRICTED DONATIONS. | Explanation |
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 | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | true | 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)
| 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 | 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 | ||||||||||||
| 751056 | 295514 | 19240 | 264294 | 23870 | 1353974 | |||||||
| WILLIAM C VANNESS II MD | ||||||||||||
| 317676 | 111640 | 21394 | 58481 | 13047 | 522238 | 20263 | ||||||
| DAVID A SHAPIRO MD | ||||||||||||
| 250636 | 25460 | 10986 | 21628 | 308710 | 12900 | 12900 | ||||||
| JOHN B HARRIS | ||||||||||||
| 170855 | 31684 | 24468 | 27092 | 20641 | 274740 | |||||||
| TAHIR ALI NAQVI MD | ||||||||||||
| 547741 | 998483 | 52369 | 904350 | 25373 | 2528316 | |||||||
| RYAN HINDS MD | ||||||||||||
| 315368 | 25589 | 17703 | 358660 | |||||||||
| JARED ANDERSON MD | ||||||||||||
| 315344 | 20794 | 7350 | 19330 | 362818 | ||||||||
| VIRGIL LOGHIN MD | ||||||||||||
| 296359 | 3175 | 4552 | 9740 | 313826 | ||||||||
| LEE ANN MCDANIEL | ||||||||||||
| 280404 | 3328 | 700 | 9370 | 26413 | 320215 | |||||||
| ELIZABETH S THARP | ||||||||||||
| 156537 | 28374 | 6706 | 22754 | 13503 | 227874 | |||||||
| LISA HALSTEAD | ||||||||||||
| 152800 | 29029 | 1596 | 22918 | 29845 | 236188 | |||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS | SCHEDULE J, PAGE 1, PART I, LINE 4 | BRYAN A. MILLS 0 0 295,514 |
| OTHER ADDITIONAL INFORMATION | SCHEDULE J, PART III | PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN BRYAN A. MILLS PARTICIPATES IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THROUGH HIS EMPLOYER, COMMUNITY BUSINESS INNOVATIONS, INC. MR. MILLS RECEIVED AN AWARD OF 100,000 TOWARDS THE PLAN, BUT DID NOT RECEIVE A PAYMENT FROM THE PLAN IN 2010. PART I, LINE 4C PERFORMANCE-BASED COMPENSATION ARRANGEMENT BRYAN A. MILLS PARTICIPATED IN TWO PERFORMANCE BASED PLANS WITH COMMUNITY BUSINESS INNOVATIONS, INC. AND VISIONARY ENTERPRISES, INC. DURING 2010, MR. MILLS RECEIVED A PAYOUT OF 295,514 FROM ONE PLAN. MR. MILLS RECEIVED AN AWARD OF 139,794 FROM THE OTHER PLAN, BUT DID NOT RECEIVE A PAYMENT FROM THAT PLAN IN 2010. PART I, LINE 7 - NON-FIXED PAYMENTS PROVIDED DR. NAQVI IS ELIGIBLE FOR AN INCENTIVE PAYMENT BASED ON PRODUCTIVITY. CHA DEVELOPED ITS COMPENSATION PLAN IN CONJUNCTION WITH AN INDEPENDENT COMPENSATION CONSULTANT. IN ADDITION, THE PLAN WAS APPROVED BY THE NETWORK EXECUTIVE COMPENSATION COMMITTEE, COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS. IN ADOPTING ITS INCENTIVE BASED COMPENSATION PLAN, CHA (TOGETHER WITH ITS INDENDEPENDENT COMPENSATION CONSULTANT, ITS EXTERNAL LEGAL COUNSEL, AND THE NETWORK EXECUTIVE COMPENSATION COMMITTEE) CONSIDERED AND APPLIED THE PROVISIONS OF CODE SECTION 4958 AND THE CORRESPONDING TREASURY REGULATIONS TO ENSURE THAT ITS COMPENSATION DECISIONS REFLECT ARMS LENGTH, FAIR MARKET TERMS. CERTAIN INDIVIDUALS OF THE LEADERSHIP TEAM PARTICIPATE IN A SENIOR LEADERSHIP INCENTIVE PROGRAM. THE PROGRAM IS UPDATED ANNUALLY AND DOCUMENTED AS A FORMAL PLAN. THE PARAMETERS CONTAINED IN THE PROGRAM REQUIRE THE APPROVAL OF CHA'S EXECUTIVE COMPENSATION COMMITTEE WHICH IS COMPRISED OF EXTERNAL BOARD MEMBERS. THE INCENTIVE PROGRAM IS BASED ON ORGANIZATIONAL PERFORMANCE AS WELL AS INDIVIDUAL PERFORMANCE. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | INDIANA PROHEALTH NETWORK INC | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | SHARE BD MEMBER | Relationship |
| Amount Of Transaction | 12024802 | AmountOfTransaction |
| Description Of Transaction | HLTH INSUR/PLAN FEES | 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 | THE MISSION OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. IS TO SERVICE THE MEDICAL, HEALTH AND HUMAN SERVICE NEEDS OF THE PEOPLE IN ANDERSON, MADISON COUNTY, AND CONTIGUOUS COUNTIES WITH COMPASSION, DIGNITY, RESPECT, AND EXCELLENCE. SERVICE, ALTHOUGH FOCUSED ON INJURY, ILLNESS, AND DISEASE, WILL ALSO EMBRACE PREVENTION, EDUCATION, AND ALTERNATIVE SYSTEMS OF HEALTH CARE DELIVERY. COMMUNITY HOSPITALS OF ANDERSON AND MADISON COUNTY, INC. OFFERS STATE-OF-THE-ART SERVICES TO EXCEED THE NEEDS OF OUR PATIENTS. FROM BASIC MEDICAL SERVICES SUCH AS THE EMERGENCY DEPARTMENT AND OUR NEW GENERATIONS BIRTH PLACE, TO THE SUPPORT OF OUR BREAST HEALTH SPECIALIST AND DIABETES CARE CENTER EDUCATORS, WE ADD THAT SPECIAL TOUCH TO ANTICIPATE YOUR NEEDS BEFORE YOU ASK. OUR STAFF MAKES EVERY EFFORT TO PROVIDE AN EFFECTIVE AND EFFICIENT HEALTH CARE DELIVERY SYSTEM. |
| ADDITIONAL INFORMATION | FORM 990, PART VI | FORM 990, PART VI, LINE 2 - RELATED PARTY INFORMATION AMONG OFFICERS MANY OF CHA'S DIRECTORS, OFFICERS, AND KEY EMPLOYEES SERVE IN AN EXECUTIVE ROLE FOR OTHER TAX-EXEMPT AND TAXABLE AFFILIATES THROUGHOUT THE NETWORK. SPECIFICALLY, THE FOLLOWING DIRECTORS SERVE AS DIRECTORS AND/OR OFFICERS OF THE FOLLOWING ORGANIZATIONS: MICHAEL L. BAKER - COMMUNITY HEALTH NETWORK, INC. BRYAN A. MILLS - COMMUNITY BUSINESS INNOVATIONS, INC. - COMMUNITY HEALTH NETWORK, INC. - COMMUNITY HEALTH NETWORK FOUNDATION, INC. - COMMUNITY HOME HEALTH SERVICES, INC. - COMMUNITY PHYSICIANS OF INDIANA, INC. - INDIANA PROHEALTH NETWORK, INC. - THE INDIANA HEART HOSPITAL, LLC - VISIONARY ENTERPRISES, INC. DAVID A. SHAPIRO, M.D. - COMMUNITY PHYSICIANS OF INDIANA, INC. WILLIAM C. VANNESS II, M.D. - COMMUNITY BUSINESS INNOVATIONS, INC. |
| MANAGEMENT DELEGATED | FORM 990, PAGE 6, PART VI, LINE 3 | THROUGH AN AFFILIATION AGREEMENT EFFECTIVE SEPTEMBER 1, 1996, CHA'S BOARD OF TRUSTEES RETAINS CONTROL OVER MANAGEMENT DUTIES FOR CHA. HOWEVER, FOR THE FOLLOWING GOVERNANCE ITEMS, CHA INITIATIES RECOMMENDATIONS TO THE COMMUNITY HOSPITALS OF INDIANA, INC. ("CHI") BOARD OF DIRECTORS FOR ITS APPROVAL FOR THE FOLLOWING: A) STRATEGIC AND OPERATING PLANS; B) ANNUAL OPERATING AND CAPITAL BUDGETS AND ANY UNBUDGETED CAPITAL EXPENDITURES; C) AMENDMENTS TO THE ARTICLES OR BYLAWS OF THE CHA BOARD OF TRUSTEES, THE BYLAWS OF THE CHA MEDICAL STAFF, OR TO THE AFFILIATION AGREEMENT; D) APPOINTMENT AND REMOVAL OF THE CHIEF EXECUTIVE OFFICER OF CHA; E) UNBUDGETED SALES, LEASES, OR TRANSFERS OF ASSETS ABOVE 500,000; F) INCURRENCE OF DEBT OTHER THAN IN THE ORDINARY COURSE OF BUSINESS OR IN ACCORDANCE WITH THE OPERATING PLANS, OPERATING BUDGET, OR CAPITAL BUDGET RECOMMENDED BY THE CHA BOARD OF TRUSTEES AND APPROVED BY THE CHI BOARD OF DIRECTORS; G) CHANGE IN THE MISSION OF CHA; H) ELECTION OF NEW MEMBERS OR REAPPOINTMENT OF CURRENT MEMBERS TO THE CHA BOARD OF TRUSTEES; I) PARTICIPATION IN MANAGED CARE AND OTHER NETWORKS OR AFFILIATIONS; AND J) RELOCATION OF PHYSICIANS EMPLOYED BY OR UNDER CONTRACT WITH CHI TO MADISON COUNTY. |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | COMMUNITY HOSPITALS OF INDIANA, INC. ("CHI") IS THE SOLE MEMBER OF COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. ("CHA"). CHI IS AN EXEMPT ORGANIZATION PURSUANT TO SECTION 501(C)(3). |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | CHA'S BOARD OF TRUSTEES MEMBERSHIP IS DETERMINED AS FOLLOWS: A) CHI, AS THE SOLE MEMBER OF CHA, SHALL NOMINATE AND ELECT ONE MEMBER OF CHA'S BOARD OF TRUSTEES, B) ONE MEMBER OF THE CHA BOARD OF TRUSTEES SHALL BE THE CHIEF EXECUTIVE OFFICER OF CHA, C) FOUR MEMBERS SHALL BE ACTIVE MEMBERS OF THE CHA MEDICAL STAFF AND SHALL BE NOMINATED AND ELECTED BY THE CHA MEDICAL STAFF, AND RATIFIED BY THE CHA BOARD OF TRUSTEES, D) THE TWELVE REMAINING POSITIONS SHALL BE FILLED BY PERSONS ELECTED BY CHI'S BOARD OF DIRECTORS, AND E) ADDITIONALLY, THE PRESIDENT OF THE MEDICAL STAFF SHALL SERVE AS AN EX OFFICIO, NONVOTING MEMBER OF THE BOARD OF TRUSTEES. |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PAGE 6, PART VI, LINE 7B | CHI, AS THE SOLE MEMBER OF CHA, MUST APPROVE THE FOLLOWING: A) STRATEGIC AND OPERATING PLANS; B) ANNUAL OPERATING AND CAPITAL BUDGETS AND ANY UNBUDGETED CAPITAL EXPENDITURES; C) AMENDMENTS TO THE ARTICLES OR BYLAWS OF THE CORPORATION AND THE BYLAWS OF THE MEDICAL STAFF OF THE CORPORATION, D) APPOINTMENT AND REMOVAL OF THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION; E) UNBUDGETED SALES, LEASES, OR TRANSFERS OF ASSETS ABOVE 500,000, WHICH AMOUNT MAY BE ADJUSTED FROM TIME TO TIME AS AGREED BY THE BOARD OF TRUSTEES AND THE BOARD OF DIRECTORS OF THE MEMBER; F) INCURRENCE OF DEBT OTHER THAN IN THE ORDINARY COURSE OF BUSINESS OR IN ACCORDANCE WITH THE OPERATING PLANS, OPERATING BUDGET, OR CAPITAL BUDGET RECOMMENDED BY THE BOARD OF TRUSTEES AND APPROVED BY THE BOARD OF DIRECTORS OF THE MEMBER; G) CHANGE IN THE MISSION OF THE CORPORATION; H) ELECTION OF NEW MEMBERS OR REAPPOINTMENT OF CURRENT MEMBERS TO THE BOARD OF TRUSTEES; I) PARTICIPATION IN MANAGED CARE AND OTHER NETWORKS OR AFFILIATIONS; AND J) RELOCATION OF PHYSICIANS EMPLOYED BY OR UNDER CONTRACT WITH THE MEMBER TO MADISON COUNTY. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE RETURN IS PREPARED BY AN OUTSIDE, INDEPENDENT ACCOUNTING FIRM AND REVIEWED BY LEGAL COUNSEL. IN ADDITION, ALL SECTIONS OF THE FORM 990 ARE REVIEWED BY THE EXECUTIVE COMMITTEE OF THE CHA BOARD OF TRUSTEES. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | CHA HAS ADOPTED A CONFLICT OF INTEREST POLICY APPLICABLE TO ALL EMPLOYEES. THE CONFLICT OF INTEREST POLICY REQUIRES EMPLOYEES SUBMIT A CONFLICT OF INTEREST DISCLOSURE FORM UPON EMPLOYMENT WITH CHA AND ON AN ANNUAL BASIS THEREAFTER. PRIOR TO COMPLETING AND SIGNING THE DISCLOSURE, ALL EMPLOYEES MUST READ AND UNDERSTAND CHA'S CONFLICT OF INTEREST POLICY STATEMENT, WHICH PROVIDES THAT NO CHA EMPLOYEE SHALL MAKE A PROFIT BECAUSE OF HIS OR HER POSITION AT CHA. THE DISCLOSURE REQUIRES EMPLOYEES TO DISCLOSE, IN WRITING, ANY KNOWN FINANCIAL INTEREST THAT THE INDIVIDUAL (TOGETHER WITH THEIR SPOUSE AND FAMILY MEMBERS) HAS IN ANY BUSINESS ENTITY THAT CONDUCTS OR WILL POTENTIALLY CONDUCT BUSINESS WITH CHA. EMPLOYEES ARE ALSO REQUIRED TO IMMEDIATELY DISCLOSE TO THE CHA HUMAN RESOURCES DEPARTMENT ANY SUBSEQUENT CHANGES THAT ARISE MID-YEAR AND WOULD OTHERWISE BE REPORTED ON THE ANNUAL DISCLOSURE STATEMENT. IN ADDITION, THE CHA AMENDED AND RESTATED CODE OF BYLAWS PROVIDES A CONFLICT OF INTEREST POLICY FOR THE CHA BOARD OF TRUSTEES. CHA'S AMENDED AND RESTATED CODE OF BYLAWS REQUIRES ALL BOARD MEMBERS TO DISCLOSE ANY DUALITY OR CONFLICT OF INTEREST TO THE OTHER BOARD MEMBERS. THE DIRECTOR IS PROHIBITED FROM VOTING OR EXERTING ANY PERSONAL INFLUENCE ON ANY ISSUE THAT PRESENTS A CONFLICT OF INTEREST. THE DIRECTOR'S ABSTENTION FROM THE VOTE AND THE DETAILS CONCERNING THE CONFLICT OF INTEREST ARE REPORTED IN THE MEETING'S MINUTES. FORM 990, PART VI, LINE 13 - WRITTEN WHISTLEBLOWER POLICY WHILE NO FORMAL WRITTEN POLICY EXISTS, CHA'S WHISTLEBLOWER APPROACH IS AS FOLLOWS: A) ANNUALLY ALL EMPLOYEES ARE REQUIRED TO COMPLETE MANDATORY NETWORK RESPONSIBILITY AND COMPLIANCE PROGRAM TRAINING ("NRCP"). THIS ELECTRONIC TRAINING INCLUDES A TRAINING SESSION ON HOW TO REPORT CONCERNS AND TO WHOM TO REPORT THE CONCERNS. B) IN THE NETWORK'S NRCP MANUAL WHICH IS AVAILABLE TO ALL EMPLOYEES VIA THE NETWORK'S INTRANET, IT STATES "THE NETWORK REALIZES THE RESPONSIBILITY AND SUPPORTS THE RIGHT OF EVERY INDIVIDUAL TO ADDRESS POTENTIAL VIOLATIONS OF NETWORK POLICIES AND PROCEDURES; LAWS, RULES, AND REGULATIONS; OR ETHICAL STANDARDS IN GOOD FAITH AND TO REQUEST GUIDANCE WITHOUT THE FEAR OF PUNISHMENT OR HARASSMENT FROM OTHERS INCLUDING CO-WORKERS, SUPERVISORS, AND LEADERSHIP. BOTH FEDERAL AND STATE FALSE CLAIMS ACTS PROHIBIT EMPLOYERS FROM RETALIATION AGAINST EMPLOYEES WHO FILE WHISTLEBLOWER ACTIONS. THEREFORE, RETRIBUTION, RETAILIATION, OR HARASSMENT OF ANY KIND AGAINST ANY PERSON WHO REQUESTS GUIDANCE OR BRINGS A VIOLATION, REAL OR PERCEIVED, TO LEADERSHIP'S OR THE GOVERNMENT'S ATTENTION IS FORBIDDEN." |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | CHA HAS A COMPENSATION COMMITTEE COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR EVALUATING AND DETERMINING COMPENSATION FOR CHA'S EXECUTIVE PERSONNEL. IN DISCHARGING THESE DUTIES, THE COMPENSATION COMMITTEE APPLIES THE PRINCIPLES OF THE REBUTTABLE PRESUMPTION AS OUTLINED IN CODE SECTION 4958 AND THE CORRESPONDING TREASURY REGULATIONS. MOST NOTABLY, THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABILITY DATA WHEN SETTING COMPENSATION AND CONTEMPORANEOUSLY DOCUMENTS ITS DECISIONS AND THE PROCESS THAT IT EMPLOYS IN WRITING. IN ADDITION, THE COMPENSATION COMMITTEE PERIODICALLY RETAINS AN OUTSIDE COMPENSATION CONSULTANT TO PROVIDE INPUT REGARDING THE APPROPRIATENESS OF CHA'S COMPENSATION DECISIONS. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | SEE PART VI, LINE 15A ABOVE. FORM 990, PART VI, LINE 16A - JOINT VENTURES SEE SCHEDULE H, PART IV |
| 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) CHA'S CONFLICT OF INTEREST POLICY IS ATTACHED TO THE FORM 990. C) CHA DOES NOT HAVE INDIVIDUALLY AUDITED FINANCIAL STATEMENTS. ITS FINANCIAL RESULTS ARE INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMUNITY HEALTH NETWORK, INC. AND AFFILIATES. AS SUCH, THERE ARE NO INDIVIDUAL FINANCIAL STATEMENTS TO POST. CHA DOES FILE THE 990 TAX RETURN ON AN ANNUAL BASIS WHICH IS AVAILABLE UPON REQUEST AND/OR AVAILABLE ON A DELAYED BASIS ON GUIDESTAR.COM. |
| ADDITIONAL INFORMATION | FORM 990, PART VII | FORM 990, PART VII - AVERAGE HOURS WORKED FOR RELATED ORGANIZATION BRYAN A. MILLS - 40 DAVID A. SHAPIRO, M.D. - 40 |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 5 | INCREASE IN INVESTMENT MARKET VALUE |
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 HOSP ANDERSON FDN INC | ||||||||||
| 1515 NORTH MADISON AVENUE | ANDERSON | IN | 46011 | 861053152 | CHARITY | IN | 501C3 | 7 | CHA | true |
| COMMUNITY LTC INC | ||||||||||
| 1031 MONTICELLO DRIVE | ANDERSON | IN | 46011 | 351877441 | HLTH CARE | IN | 501C3 | 9 | CHA | true |
| COMMUNITY HEALTH NETWORK INC | ||||||||||
| 1500 NORTH RITTER AVENUE | INDIANAPOLIS | IN | 46219 | 311038302 | SUPPORT | IN | 501C3 | 11B | NA | false |
| COMMUNITY BUSINESS INNOVATIONS INC | ||||||||||
| 1500 NORTH RITTER AVENUE | INDIANAPOLIS | IN | 46219 | 352088279 | SUPPORT | IN | 501C3 | 11B | CHNW | false |
| COMMUNITY HEALTH NETWORK FOUNDATION | ||||||||||
| 1500 NORTH RITTER AVENUE | INDIANAPOLIS | IN | 46219 | 510181688 | CHARITY | 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 |
| COMMUNITY HOSPITALS OF INDIANA INC | ||||||||||
| 1500 NORTH RITTER AVENUE | INDIANAPOLIS | IN | 46219 | 350983617 | HOSPITAL | IN | 501C3 | 3 | CHNW | false |
| COMMUNITY HOSPITAL SOUTH INC | ||||||||||
| 1402 E COUNTY LINE ROAD SOUTH | INDIANAPOLIS | IN | 46227 | 351088640 | HOSPITAL | IN | 501C3 | 3 | CHI | true |
| 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 | |||||||||
| 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 CENTERS 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 | |||||||||
| 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 CENTERS 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 SRVCS | N/A | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VEI MICHIGAN INC | |||||||||||
| 300097377 | MGMT SRVCS | 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 SRVCS | N/A | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VEI MICHIGAN INC | |||||||||||
| 300097377 | MGMT SRVCS | N/A | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | true | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | true | 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 | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (24 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| COMMUNITY HOSP ANDERSON FDN INC | ||
| P | 157555 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY HOSP ANDERSON FDN INC | ||
| R | 395667 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY LTC INC | ||
| A | 6644 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY LTC INC | ||
| D | 493544 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY LTC INC | ||
| I | 225074 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY LTC INC | ||
| P | 657088 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY BUSINESS INNOVATIONS INC | ||
| O | 1783285 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY HOME HEALTH SERVICES INC | ||
| P | 108300 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY PHYSICIANS OF IN INC | ||
| A | 651311 | ACTUAL AMOUNT PER BOOKS |
| THE INDIANA HEART HOSPITAL LLC | ||
| O | 402689 | ACTUAL AMOUNT PER BOOKS |
| INDIANA PROHEALTH NETWORK INC | ||
| O | 7893951 | ACTUAL AMOUNT PER BOOKS |
| INDIANA PROHEALTH NETWORK INC | ||
| P | 4130851 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY HOSP ANDERSON FDN INC | ||
| P | 157555 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY HOSP ANDERSON FDN INC | ||
| R | 395667 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY LTC INC | ||
| A | 6644 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY LTC INC | ||
| D | 493544 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY LTC INC | ||
| I | 225074 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY LTC INC | ||
| P | 657088 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY BUSINESS INNOVATIONS INC | ||
| O | 1783285 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY HOME HEALTH SERVICES INC | ||
| P | 108300 | ACTUAL AMOUNT PER BOOKS |
| COMMUNITY PHYSICIANS OF IN INC | ||
| A | 651311 | ACTUAL AMOUNT PER BOOKS |
| THE INDIANA HEART HOSPITAL LLC | ||
| O | 402689 | ACTUAL AMOUNT PER BOOKS |
| INDIANA PROHEALTH NETWORK INC | ||
| O | 7893951 | ACTUAL AMOUNT PER BOOKS |
| INDIANA PROHEALTH NETWORK INC | ||
| P | 4130851 | ACTUAL AMOUNT PER BOOKS |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE R | ReturnReference |
| Explanation | PART II IDENTIFICATION OF RELATED TAXEXEMPT ORGANIZATIONS COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY INC CHA EIN XXX-XX-XXXX IS AFFILIATED WITH COMMUNITY HOSPITALS OF INDIANA INC CHI EIN XXX-XX-XXXX AND COMMUNITY HEALTH NETWORK INC CHNW EIN XXX-XX-XXXX PURSUANT TO AN AFFILIATION AGREEMENT DATED SEPTEMBER 1 1996 BOTH CHI AND CHNW ARE EXEMPT ORGANIZATIONS PURSUANT TO SECTION 501C3 | Explanation |
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