COMMUNITY HEALTH NETWORK FOUNDATION INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH NETWORK FOUNDATION INC (EIN 51-0181688)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-10
- IRS object ID
- 202233149349303963
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-10T11:55:25-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 352123203 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KSM BUSINESS SERVICES INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 40857 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46240 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 510181688 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH NETWORK FOUNDATION | BusinessNameLine1Txt |
| Business Name Line2 | INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 3173555261 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7330 SHADELAND STATION 100 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46256 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOYCE IRWIN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3173555261 | PhoneNum |
| Signature | 2022-10-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JOYCE | PersonFirstNm |
| Person Last | IRWIN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CASSE TATE | PreparerPersonNm |
| PTIN | P01271193 | PTIN |
| Phone | 3175802000 | PhoneNum |
| Preparation | 2022-10-24 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOYCE IRWIN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7330 SHADELAND STATION 100 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46256 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $40,566,712 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ECOMMUNITY.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1976 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | COMMUNITY HEALTH NETWORK FOUNDATION, INC.'S ("CHF") MISSION IS TO SUPPORT COMMUNITY HEALTH NETWORK'S CAREGIVERS, WHO COMMIT TO IMPROVING THE HEALTH OF COMMUNITIES WE SERVE. CHF RAISES DONOR, FUNDER AND GRANT DOLLARS AND STEWARDS THEM THROUGH PROGRAMS AND SERVICES THAT PROVIDE EXCEPTIONAL PATIENT CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 21 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 18 | VotingMembersIndependentCnt |
| Total Employee | 20 | TotalEmployeeCnt |
| Total Volunteers | 37 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $11,334,032 | PYContributionsGrantsAmt |
| CY Contributions Grants | $13,338,527 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,680,763 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,429,561 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$877,266 | PYOtherRevenueAmt |
| CY Other Revenue | -$1,372,843 | CYOtherRevenueAmt |
| PY Total Revenue | $12,137,529 | PYTotalRevenueAmt |
| CY Total Revenue | $20,395,245 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $8,607,369 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $10,379,273 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,742,720 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,115,409 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $259,554 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $230,550 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,383,535 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $781,908 | PYOtherExpensesAmt |
| CY Other Expenses | $626,987 | CYOtherExpensesAmt |
| PY Total Expenses | $12,391,551 | PYTotalExpensesAmt |
| CY Total Expenses | $14,352,219 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$254,022 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,043,026 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $83,532,404 | TotalAssetsBOYAmt |
| Total Assets EOY | $96,702,775 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,226,322 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,243,656 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $80,306,082 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $92,459,119 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | COMMUNITY HEALTH NETWORK FOUNDATION, INC.'S ("CHF") MISSION IS TO SUPPORT COMMUNITY HEALTH NETWORK'S CAREGIVERS, WHO COMMIT TO IMPROVING THE HEALTH OF COMMUNITIES WE SERVE. CHF RAISES DONOR, FUNDER AND GRANT DOLLARS AND STEWARDS THEM THROUGH PROGRAMS AND SERVICES THAT PROVIDE EXCEPTIONAL PATIENT CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,115,091 | ExpenseAmt |
| Grant | $10,048,346 | GrantAmt |
| Revenue | $40,798 | RevenueAmt |
| Desc | PROVIDED OPERATIONAL AND CAPITAL FUNDS TO COMMUNITY HEALTH NETWORK ("CHNW") TO ACHIEVE ITS MISSION TO BUILD HEALTHIER COMMUNITIES. CHF DISTRIBUTED FUNDS TO WOMEN'S AND CHILDREN'S CARE, ONCOLOGY, AND TO SUPPORT NURSING EDUCATION AND SERVICES AND CARE FOR PATIENTS. CHNW'S MATERNAL SUBSTANCE USE AND NEONATAL ABSTINENCE SYNDROME PROGRAM LEADS THE STATE IN EFFORTS TO REMEDY THE OPIOID CRISIS FOR PREGNANT WOMEN AND THEIR INFANTS. CHF SUPPORTS SCHOOL-BASED NURSING AND BEHAVIORAL CARE FOR NEARLY 90,000 CHILDREN IN OVER 100 SCHOOLS. CHF DOLLARS SUPPORT YOUTH SUICIDE PREVENTION, PLAY THERAPY, YOUTH BEREAVEMENT SERVICES, FERTILITY PRESERVATION, WOMEN'S CARDIAC CARE AND BREAST SCREENING, ADOLESCENT CLINICS, A CAR SEAT PROGRAM, CHILDHOOD OBESITY AND ASTHMA PROGRAMS, AND THE BABE STORE, INCENTIVIZING PARENTS WITH FREE SUPPLIES TO RECEIVE INFANT WELLNESS CARE AND PARENTING EDUCATION. CHF FUNDS ONCOLOGY'S PATIENT ASSISTANCE FUND, INTEGRATIVE ONCOLOGY, SCREENINGS, NURSE NAVIGATORS, GENETIC TESTING, RESEARCH, AND SURVIVORSHIP PROGRAMS AND EDUCATION. CHF SUPPORTS EDUCATION, TRAINING, CERTIFICATION, RESEARCH, SCHOLARSHIPS, SUPPLIES, AND PROFESSIONAL PRACTICES FOR NURSES AND STUDENT NURSES, AND PATIENT CARE PROGRAMS, INCLUDING THE CENTER OF HOPE, CARING FOR VICTIMS OF VIOLENCE NEGLECT OR ABUSE. CHF DOLLARS SUPPORT CLIENT ASSISTANCE FOR SERIOUSLY MENTALLY ILL ADULTS, AND MEALS, SCREENINGS AND SOCIAL ENGAGEMENT OPPORTUNITIES FOR SENIORS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $330,927 | ExpenseAmt |
| Grant | $330,927 | GrantAmt |
| Desc | PROVIDED 85 EDUCATIONAL SCHOLARSHIPS TO NURSES AND OTHER PROFESSIONALS ASSOCIATED WITH COMMUNITY HEALTH NETWORK FOR MASTERS, BACHELOR, AND ASSOCIATE DEGREES AS WELL AS CERTIFICATIONS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $10,446,018 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | Yes (1) | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 20 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 21 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 18 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | KY | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRIAN MCCONNELL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3173554212 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8180 CLEARVISTA PARKWAY SUITE 200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46256 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| BRYAN A MILLS | ||||||||
| NON-VOTING DIRECTOR | 2.00 | 58.00 | Yes (X) | $0 | $2,234,163 | $976,236 | ||
| PATRICK MCGILL MD | ||||||||
| DIRECTOR | 2.00 | 53.00 | Yes (X) | $0 | $626,361 | $304,647 | ||
| ROBIN LEDYARD MD | ||||||||
| DIRECTOR | 2.00 | 48.00 | Yes (X) | $0 | $548,887 | $170,490 | ||
| JON JANSEN MD | ||||||||
| DIRECTOR | 2.00 | 48.00 | Yes (X) | $0 | $540,815 | $131,198 | ||
| GERRY BAILEY | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID BALDWIN | ||||||||
| CHAIRMAN | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| SUMEETA BHATIA | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JAN KEEFER | ||||||||
| TREASURER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CHOU-IL LEE | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JIM MACDONALD | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CANDELARIO MARTINEZ | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| LARRY MCQUEARY | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ANN MERKEL | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MARY BETH OAKES | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DEBORAH OATTS | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MYRA SELBY | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JOAN SERVAAS | ||||||||
| SECRETARY | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| FRANK SHORT | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT SHORTLE | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MARINA HADJIOANNOU WATERS | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DEBRA SIMMONS WILSON | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TIM WRIGHT | ||||||||
| VICE CHAIRMAN | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JOYCE IRWIN | ||||||||
| NON VOTING DIR/PRESIDENT | 50.00 | 0.00 | $432,450 | $0 | $178,027 | Yes (X) | ||
| ROBERT BAKER | ||||||||
| VP FOUNDATION OPERATIONS | 45.00 | 0.00 | $218,723 | $0 | $66,589 | Yes (X) | ||
| BENTE WEITEKAMP | ||||||||
| VP DEVELOPMENT | 45.00 | 0.00 | $215,214 | $0 | $84,997 | Yes (X) | ||
| RYAN CHELLI | ||||||||
| EXEC DIRECTOR - MARKETING | 45.00 | 0.00 | $203,143 | $0 | $49,086 | Yes (X) | ||
| LAURA PICKARD | ||||||||
| DEVELOPMENT DIRECTOR | 45.00 | 0.00 | $122,521 | $0 | $50,921 | Yes (X) | ||
| LIBBY PEDIGO | ||||||||
| DEVELOPMENT DIRECTOR | 45.00 | 0.00 | $114,304 | $0 | $54,300 | Yes (X) | ||
| MELISSA MAU | ||||||||
| DIRECTOR GRANT/COMPLIANCE | 45.00 | 0.00 | $118,008 | $0 | $35,406 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,424,363 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,950,226 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,101,897 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE PURSUANT GROUP | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5151 BELT LINE ROAD SUITE 900 | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | FUNDRAISING | ServicesDesc |
| Compensation | $230,550 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $2,637,166 | FundraisingAmt |
| Related Organizations | $3,956,824 | RelatedOrganizationsAmt |
| Government Grants | $4,357,850 | GovernmentGrantsAmt |
| All Other Contributions | $2,386,687 | AllOtherContributionsAmt |
| Noncash Contributions | $915,509 | NoncashContributionsAmt |
| Total Contributions | $13,338,527 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,089,754 | TotalRevenueColumnAmt |
| Exclusion | $1,089,754 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $25,721,658 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $18,381,851 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,339,807 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,339,807 | TotalRevenueColumnAmt |
| Exclusion | $7,339,807 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $375,975 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $2,637,166 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $1,789,616 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,413,641 | TotalRevenueColumnAmt |
| Exclusion | -$1,413,641 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOSPITAL PARKING | 900099 | $40,439 | $40,439 |
| LATE FEE INCOME | 900099 | $359 | $359 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $40,798 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,395,245 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $40,798 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $7,015,920 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,279,384 | TotalAmt |
| Program Services | $9,279,384 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,099,889 | TotalAmt |
| Program Services | $1,099,889 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $895,789 | TotalAmt |
| Management And General | $655,913 | ManagementAndGeneralAmt |
| Fundraising | $239,876 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,714,287 | TotalAmt |
| Management And General | $1,255,232 | ManagementAndGeneralAmt |
| Fundraising | $459,055 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,875 | TotalAmt |
| Management And General | $106,812 | ManagementAndGeneralAmt |
| Fundraising | $39,063 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,539 | TotalAmt |
| Management And General | $144,642 | ManagementAndGeneralAmt |
| Fundraising | $52,897 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,919 | TotalAmt |
| Management And General | $118,560 | ManagementAndGeneralAmt |
| Fundraising | $43,359 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,066 | TotalAmt |
| Management And General | $2,066 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,550 | TotalAmt |
| Fundraising | $230,550 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,280 | TotalAmt |
| Management And General | $17,280 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,734 | TotalAmt |
| Program Services | $3,104 | ProgramServicesAmt |
| Management And General | $3,630 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,275 | TotalAmt |
| Management And General | $73,412 | ManagementAndGeneralAmt |
| Fundraising | $1,863 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,438 | TotalAmt |
| Program Services | $14,219 | ProgramServicesAmt |
| Management And General | $14,219 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,905 | TotalAmt |
| Management And General | $78,905 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,745 | TotalAmt |
| Management And General | $5,745 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,106 | TotalAmt |
| Program Services | $36,553 | ProgramServicesAmt |
| Management And General | $36,553 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | FundraisingFundraisingAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|---|
| FUNDRAISING EXPENSE | $316,872 | $316,872 | ||
| BAD DEBT ALLOWANCE | $7,975 | $7,975 | ||
| BOARD OF DIRECTORS | $5,647 | $5,647 | ||
| DUES & SUBSCRIPTIONS | $4,894 | $4,894 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,050 | TotalAmt |
| Management And General | $4,050 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,352,219 | TotalAmt |
| Program Services | $10,446,018 | ProgramServicesAmt |
| Management And General | $2,522,666 | ManagementAndGeneralAmt |
| Fundraising | $1,383,535 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,508,740 | BOYAmt |
| EOY | $840,002 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,194,269 | BOYAmt |
| EOY | $1,466,931 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $178,108 | BOYAmt |
| EOY | $195,811 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $387,781 | BOYAmt |
| EOY | $550,901 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $790,389 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $297,766 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $565,728 | BOYAmt |
| EOY | $492,623 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,697,778 | BOYAmt |
| EOY | $93,156,507 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,532,404 | BOYAmt |
| EOY | $96,702,775 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $255,787 | BOYAmt |
| EOY | $196,991 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,970,535 | BOYAmt |
| EOY | $4,046,665 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,226,322 | BOYAmt |
| EOY | $4,243,656 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,415,047 | BOYAmt |
| EOY | $52,730,632 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,891,035 | BOYAmt |
| EOY | $39,728,487 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,306,082 | BOYAmt |
| EOY | $92,459,119 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,532,404 | BOYAmt |
| EOY | $96,702,775 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $6,043,026 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $6,031,758 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $78,253 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Supported Organizations | 7 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (7 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| COMMUNITY HEALTH NETWORK INC | ||||
| 350983617 | 3 | Yes (1) | $5,419,336 | $0 |
| COMMUNITY PHYSICIANS OF IN | ||||
| 205392766 | 10 | 0 | $2,617,861 | $0 |
| FAIRBANKS HOSPITAL INC | ||||
| 350811197 | 3 | 0 | $728,862 | $0 |
| COMMUNITY HOWARD REGIONAL HEALTH INC | ||||
| 351865344 | 3 | 0 | $420,139 | $0 |
| COMMUNITY HOME HEALTH SERVICES INC | ||||
| 350953467 | 10 | Yes (1) | $37,850 | $0 |
| COMMUNITY HOSP OF ANDERSON & MADISON CTY INC | ||||
| 351069822 | 3 | 0 | $400 | $0 |
| COMMUNITY HOSPITAL SOUTH INC | ||||
| 351088640 | 3 | Yes (1) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 7 | SupportedOrganizationsTotalCnt |
| Support Sum | $9,224,448 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,148,172 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,303,922 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,052,970 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,334,032 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,338,527 | CurrentTaxYearAmt |
| Total | $56,177,623 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,148,172 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,303,922 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,052,970 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,334,032 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,338,527 | CurrentTaxYearAmt |
| Total | $56,177,623 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $195,213 | SubstantialContributorsTotAmt |
| Public Support Total170 | $55,982,410 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,164,562 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,660,885 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,286,364 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,237,636 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,089,754 | CurrentTaxYearAmt |
| Total | $6,439,201 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $302,417 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $261,921 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $371,870 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $260,339 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $375,975 | CurrentTaxYearAmt |
| Total | $1,572,522 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $64,189,346 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $48,068 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.87210 | PublicSupportCY170Pct |
| Public Support PY170 | 0.86770 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | 0 | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | Yes (1) | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | 0 | MajorityDirTrstSupportedOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, SECTION A, LINE 1 | SUPPORTED ORGANIZATIONS NOT LISTED BY NAME COMMUNITY HEALTH NETWORK FOUNDATION IS ORGANIZED AND OPERATED EXCLUSIVELY TO BENEFIT, PERFORM, AND CARRY OUT THE CHARITABLE, EDUCATIONAL, AND OTHER PURPOSES OF COMMUNITY HEALTH NETWORK, INC., COMMUNITY HOSPITAL SOUTH, COMMUNITY HOME HEALTH SERVICES, AND ANY OTHER TAX-EXEMPT ORGANIZATION DESCRIBED IN 501(C)(3) AND 509(A)(1) OR 509(A)(2) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR CORRESPONDING PROVISIONS OF ANY SUBSEQUENT FEDERAL TAX LAWS THAT IS CONTROLLED AND MANAGED BY CHNW AS IS REQUIRED BY TREASURY REGULATION 1509(A)-4(H). |
| PART IV, SECTION A, LINE 6 | DESCRIPTION OF SUPPORT TO EXTERNAL ENTITY COMMUNITY HEALTH FOUNDATION, INC. ("CHF") ALSO PROVIDED SUPPORT TO OTHER ORGANIZATIONS IN THE COMMUNITY HEALTH NETWORK, AN INTEGRATED HEALTH DELIVERY SYSTEM. ALL OF THESE ORGANIZATIONS ARE SUBJECT TO THE COMMON CONTROL OF ONE OF THE NAMED SUPPORTED ORGANIZATIONS, COMMUNITY HEALTH NETWORK, INC. ("CHNW"). IN ADDITION TO THE GRANTS TO THESE ORGANIZATIONS, CHF ALSO MADE GRANTS TO A FEW OTHER ORGANIZATIONS THAT WERE NOT LISTED BY NAME OR CLASS IN THE ARTICLES OF INCORPORATION. HOWEVER, THE NAMED SUPPORTED ORGANIZATIONS BENEFITED DIRECTLY FROM THE GRANTS TO THESE ORGANIZATIONS BECAUSE THE INDIVIDUAL MEMBERS OF THE CHARITABLE CLASS BENEFITTED BY THE GRANTS WERE ALSO MEMBERS OF THE CHARITABLE CLASS SERVED BY THESE NAMED SUPPORTED ORGANIZATIONS. |
| PART IV, SECTION C, LINE 1 | HOW MANAGEMENT WAS VESTED CHF 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. IN ADDITION, CHNW MUST APPROVE ANY MODIFICATION, REPEAL, AMENDMENT, OR RESTATEMENT OF CHF'S ARTICLES OF INCORPORATION. FINALLY, CHNW MUST APPROVE ANY MATERIAL SALE OR DISPOSITION OF THE ASSETS OF CHF. COMMUNITY HOME HEALTH SERVICES, INC., ("CHHS"), COMMUNITY HOSPITAL SOUTH, INC. ("CHS") AND THE OTHER NAMED SUPPORTED ORGANIZATIONS HAVE SIMILARLY DELEGATED AUTHORITY TO CHNW. THUS, BASED UPON THIS GRANT OF AUTHORITY, MANAGEMENT OF CHF, CHNW, CHHS, AND CHS, THE NAMED SUPPORTED ORGANIZATIONS, ARE VESTED IN THE SAME PERSONS FOR ALL ORGANIZATIONS. |
| PART II, SECTION B, LINE 10 - OTHER INCOME | 2017-2021 FUNDRAISING REVENUE |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $22,952,175 | BeginningYearBalanceAmt |
| Contributions | $5,279,402 | ContributionsAmt |
| Investment Earnings Or Losses | $4,265,505 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $452,348 | GrantsOrScholarshipsAmt |
| Other Expenditures | $4,265,505 | OtherExpendituresAmt |
| Administrative Expenses | $1,446 | AdministrativeExpensesAmt |
| End Year Balance | $27,777,783 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $19,947,528 | BeginningYearBalanceAmt |
| Contributions | $3,348,130 | ContributionsAmt |
| Investment Earnings Or Losses | $2,464,267 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $332,474 | GrantsOrScholarshipsAmt |
| Other Expenditures | $2,464,267 | OtherExpendituresAmt |
| Administrative Expenses | $11,009 | AdministrativeExpensesAmt |
| End Year Balance | $22,952,175 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,358,853 | BeginningYearBalanceAmt |
| Contributions | $8,957,035 | ContributionsAmt |
| Investment Earnings Or Losses | $2,919,835 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $367,427 | GrantsOrScholarshipsAmt |
| Other Expenditures | $2,919,835 | OtherExpendituresAmt |
| Administrative Expenses | $933 | AdministrativeExpensesAmt |
| End Year Balance | $19,947,528 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,910,689 | BeginningYearBalanceAmt |
| Contributions | $224,848 | ContributionsAmt |
| Investment Earnings Or Losses | -$953,596 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $776,684 | GrantsOrScholarshipsAmt |
| Other Expenditures | -$953,596 | OtherExpendituresAmt |
| End Year Balance | $11,358,853 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,619,809 | BeginningYearBalanceAmt |
| Contributions | $2,647,526 | ContributionsAmt |
| Investment Earnings Or Losses | $1,756,574 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $350,371 | GrantsOrScholarshipsAmt |
| Other Expenditures | $1,756,574 | OtherExpendituresAmt |
| Administrative Expenses | $6,275 | AdministrativeExpensesAmt |
| End Year Balance | $11,910,689 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.60290 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.39710 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $460,086 | OtherCostOrOtherBasisAmt |
| Depreciation | $141,322 | DepreciationAmt |
| Book Value | $318,764 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $330,303 | OtherCostOrOtherBasisAmt |
| Depreciation | $156,444 | DepreciationAmt |
| Book Value | $173,859 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $492,623 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $4,046,665 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,046,665 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4 - INTENDED USES FOR ENDOWMENT FUNDS | FormAndLineReferenceDesc |
| Explanation | INVESTMENT PROCEEDS ARE USED TO PURCHASE EQUIPMENT, SUPPORT PROGRAMS, TRAIN AND EDUCATE MEDICAL STAFF, AND PROVIDE FOR OTHER CHARITABLE NEEDS OF COMMUNITY HEALTH NETWORK AND ITS PATIENTS AS ARE PERMITTED BY THE ENDOWMENT RESTRICTIONS. | ExplanationTxt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| Phone Solicitations | Yes (X) | PhoneSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (1) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
Organization Business Name OrganizationBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE PURSUANT GROUP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5151 BELT LINE RD 900 | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | STRATEGY/MAIL | ActivityTxt |
| Fundraiser Control Of Funds | 0 | FundraiserControlOfFundsInd |
| Gross Receipts | $295,704 | GrossReceiptsAmt |
| Retained By Contractor | $230,550 | RetainedByContractorAmt |
| Net To Organization | $65,154 | NetToOrganizationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | $295,704 | TotalGrossReceiptsAmt |
| Total Retained By Contractors | $230,550 | TotalRetainedByContractorsAmt |
| Total Net To Organization | $65,154 | TotalNetToOrganizationAmt |
| Licensed States | CA | LicensedStatesCd |
| Licensed States | FL | LicensedStatesCd |
| Licensed States | KY | LicensedStatesCd |
| Licensed States | IL | LicensedStatesCd |
| Licensed States | OH | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | 2022 GIVING GIG | Event1Nm |
| Gross Receipts Event1 | $1,597,275 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $1,449,423 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $147,852 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $442,425 | OtherDirectExpensesEvent1Amt |
| Event2 | 2021 GIVING GIG | Event2Nm |
| Gross Receipts Event2 | $1,415,866 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $1,187,743 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $228,123 | GrossRevenueEvent2Amt |
| Rent Facility Costs Event2 | $59,716 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $94,114 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $587,437 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $605,924 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $3,013,141 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $2,637,166 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $375,975 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $59,716 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $94,114 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $587,437 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,048,349 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $1,789,616 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$1,413,641 | NetIncomeSummaryAmt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCH G, PART I, LINE 3 - ADDITIONAL INFORMATION | NOTE: INDIANA DOES NOT REQUIRE REGISTRATION. |
| SCH G, PART I, LINE 2B, COL (V) - FUNDRAISING VS. REIMBURSEMENT EXPLANATION | THE PURSUANT GROUP $71,777 WAS PAID TO REIMBURSE FOR EXPENSES ITEMIZED SEPARATELY ON BILLINGS |
| SCH G, PAGE 3, PART IV - ADDITIONAL INFORMATION | THE PURSUANT GROUP WORKED WITH THE COMMUNITY HEALTH NETWORK FOUNDATION TO DEVELOP OUR ANNUAL GIVING, DONOR ACQUISITION, AND OTHER FUNDRAISING STRATEGIES AS WELL AS DEVELOPING CONTENT FOR EACH. THUS, THE AMOUNT SHOWN IN PART I, COLUMN V IS THE TOTAL AMOUNT PAID TO THE PURUANT GROUP FOR ALL SERVICES, AND IS NOT LIMITED TO THE FEE INCURRED FOR THE ACTIVITY THAT RAISED $295,704. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| COMMUNITY HEALTH NETWORK INC | ||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 350983617 | 501C3 | $5,419,336 | $0 | GENERAL SUPPORT |
| COMMUNITY PHYSICIANS OF IN INC | ||||||||
| 7240 SHADELAND STATION SUITE 300 | INDIANAPOLIS | IN | 46256 | 205392766 | 501C3 | $2,617,861 | $0 | GENERAL SUPPORT |
| FAIRBANKS HOSPITAL INC | ||||||||
| 8102 CLEARVISTA PARKWAY | INDIANAPOLIS | IN | 46256 | 350811197 | 501C3 | $728,862 | $0 | GENERAL SUPPORT |
| COMMUNITY HOWARD REGIONAL HEALTH INC | ||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 351865344 | 501C3 | $420,139 | $0 | GENERAL SUPPORT |
| COMMUNITY HOME HEALTH SERVICES INC | ||||||||
| 9894 EAST 121ST STREET | FISHERS | IN | 46037 | 350953467 | 501C3 | $37,850 | $0 | GENERAL SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 5 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (3 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| ONCOLOGY PATIENT ASSISTANCE | 909 | $284,000 |
| SCHOLARSHIPS | 85 | $330,927 |
| EMPLOYEE ASSISTANCE | 1109 | $484,962 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2 - PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS | FormAndLineReferenceDesc |
| Explanation | THE VAST MAJORITY OF COMMUNITY HEALTH NETWORK FOUNDATION'S ("CHF") GRANTS ARE MADE TO OTHER TAX-EXEMPT MEMBERS OF THE COMMUNITY HEALTH NETWORK OR TO OTHER PUBLIC CHARITIES INVOLVED IN HEALTH RELATED ACTIVITIES. PRIOR TO THE DISBURSEMENT OF ANY GRANT PROCEEDS, CHF ENSURES THAT THE PURPOSE OF THE GRANT IS CONSISTENT WITH CHF'S CHARITABLE PURPOSES AS DEFINED IN CODE SECTION 501(C)(3). THE TERMS OF ALL GRANTS REQUIRE THAT THE RECIPIENT EXPEND THE FUNDS SOLELY FOR CHARITABLE PURPOSES AS DEFINED BY CODE SECTION 501(C)(3). WITH REGARD TO GRANTS TO ORGANIZATIONS WITHIN THE NETWORK, CHF DOES NOT REQUIRE PERIODIC REPORTING REGARDING THE USE OF THE GRANT PROCEEDS SINCE ALL NETWORK MEMBERS ARE SUBJECT TO COMMON CONTROL BY A TAX-EXEMPT PARENT ORGANIZATION (CHNW). CHF ALSO AWARDS ACADEMIC SCHOLARSHIPS TO EMPLOYEES OF THE NETWORK UNDER THE TERMS OF A WRITTEN SCHOLARSHIP PROGRAM. CHF MONITORS THE RECIPIENT'S PROGRESS TOWARDS RECEIPT OF THE INTENDED CERTIFICATE OR DEGREE BY REQUIRING ACADEMIC RECORDS DURING THE SCHOLARSHIP PROGRAM. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRYAN A MILLS | ||||||||||||||
| NON-VOTING DIRECTOR | $0 | $1,277,485 | $0 | $122,430 | $0 | $834,248 | $0 | $947,622 | $0 | $28,614 | $0 | $3,210,399 | $0 | $122,430 |
| PATRICK MCGILL MD | ||||||||||||||
| DIRECTOR | $0 | $544,478 | $0 | $53,434 | $0 | $28,449 | $0 | $271,237 | $0 | $33,410 | $0 | $931,008 | $0 | $53,434 |
| ROBIN LEDYARD MD | ||||||||||||||
| DIRECTOR | $0 | $480,449 | $0 | $48,659 | $0 | $19,779 | $0 | $160,733 | $0 | $9,757 | $0 | $719,377 | $0 | $48,659 |
| JON JANSEN MD | ||||||||||||||
| DIRECTOR | $0 | $490,500 | $0 | $14,500 | $0 | $35,815 | $0 | $97,463 | $0 | $33,735 | $0 | $672,013 | $0 | $14,500 |
| JOYCE IRWIN | ||||||||||||||
| NON VOTING DIR/PRESIDENT | $341,052 | $0 | $63,100 | $0 | $28,298 | $0 | $167,383 | $0 | $10,644 | $0 | $610,477 | $0 | $33,191 | $0 |
| BENTE WEITEKAMP | ||||||||||||||
| VP DEVELOPMENT | $198,033 | $0 | $15,012 | $0 | $2,169 | $0 | $56,010 | $0 | $28,987 | $0 | $300,211 | $0 | $15,012 | $0 |
| ROBERT BAKER | ||||||||||||||
| VP FOUNDATION OPERATIONS | $202,523 | $0 | $15,000 | $0 | $1,200 | $0 | $51,065 | $0 | $15,524 | $0 | $285,312 | $0 | $15,000 | $0 |
| RYAN CHELLI | ||||||||||||||
| EXEC DIRECTOR - MARKETING | $187,399 | $0 | $13,670 | $0 | $2,074 | $0 | $49,086 | $0 | $0 | $0 | $252,229 | $0 | $13,670 | $0 |
| LAURA PICKARD | ||||||||||||||
| DEVELOPMENT DIRECTOR | $114,748 | $0 | $6,000 | $0 | $1,773 | $0 | $18,526 | $0 | $32,395 | $0 | $173,442 | $0 | $6,000 | $0 |
| LIBBY PEDIGO | ||||||||||||||
| DEVELOPMENT DIRECTOR | $107,048 | $0 | $5,521 | $0 | $1,735 | $0 | $21,981 | $0 | $32,319 | $0 | $168,604 | $0 | $5,521 | $0 |
| MELISSA MAU | ||||||||||||||
| DIRECTOR GRANT/COMPLIANCE | $110,730 | $0 | $5,564 | $0 | $1,714 | $0 | $22,822 | $0 | $12,584 | $0 | $153,414 | $0 | $5,564 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 - RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION | COMMUNITY HEALTH NETWORK FOUNDATION, INC. ("CHF") CEO/EXECUTIVE DIRECTOR IS PAID BY COMMUNITY HEALTH NETWORK, INC. ("CHNW"), A RELATED 501(C)(3) ORGANIZATION. CHNW USES THE FOLLOWING IN DETERMINING THE CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE, 2) INDEPENDENT COMPENSATION CONSULTANT, 3) COMPENSATION SURVEY OR STUDY, AND 4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINE 4 - SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS | JOYCE IRWIN SEVERANCE: 0 NONQUALIFIED: $22,175 EQUITY-BASED: 0 |
| PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS | COMMUNITY HEALTH NETWORK, INC. SECTION 457(F) PLAN COMMUNITY HEALTH NETWORK, INC. ("COMMUNITY") ADOPTED THIS COMMUNITY HEALTH NETWORK, INC. SECTION 457(F) PLAN ("PLAN") AS OF JANUARY 1, 2016 TO PROVIDE A SUPPLEMENTAL INCOME FOR RETIREMENT UPON VESTING IN THE BENEFIT AS DESCRIBED IN THE PLAN DOCUMENT. COMMUNITY HEALTH NETWORK FOUNDATION, INC. ("CHF") IS INCLUDED IN THE PLAN. THE PLAN IS INTENDED TO BE EXEMPT FROM THE REQUIREMENTS OF CODE SECTION 409A AS A SHORT-TERM DEFERRAL PROGRAM DESCRIBED UNDER TREAS. REG. 1.409A-1 (B)(4). THE PLAN IS DESIGNED UNDER CODE SECTION 457(F) AS A "TOP-HAT PLAN" (I.E. AN UNFUNDED DEFERRED COMPENSATION PLAN MAINTAINED FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES) PURSUANT TO SECTIONS 201(2), 301(A)(3) AND 401(A)(1) OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED ("ERISA"). ELIGIBILITY: INDIVIDUALS DESIGNATED BY THE BOARD OF DIRECTORS OF COMMUNITY HEALTH NETWORK, INC. CONTRIBUTIONS: ANNUALLY FROM 2021 TO 2025 COMMUNITY WILL CREDIT A CONTRIBUTION TO A PARTICIPANT'S ACCOUNT IN AN AMOUNT EQUAL TO TEN PERCENT OF THEIR BASE COMPENSATION AS DEFINED IN THE PARTICIPANT'S EMPLOYMENT AGREEMENT WITH COMMUNITY. VESTING: SINGLE VESTING METHOD ELECTED BY THE EMPLOYER, IN ITS DISCRETION, FOR EACH PARTICIPANT, WHICH APPLIES TO ALL EMPLOYER CONTRIBUTION CREDITS. UNLESS VESTED OR FORFEITED EARLIER, THE ENTIRE ACCOUNT SHALL VEST ON JANUARY 1, 2026. IN ADDITION, A PARTICIPANT'S ENTIRE ACCOUNT SHALL VEST ON THE PARTICIPANT'S DEATH, AN INVOLUNTARY TERMINATION OF THE PARTICIPANT'S EMPLOYMENT WITHOUT CAUSE (AS REASONABLY DETERMINED BY THE EMPLOYER), THE PARTICIPANT'S DISABILITY (AS DEFINED BY THE SOCIAL SECURITY ADMINISTRATION), OR THE PARTICIPANT'S VOLUNTARY TERMINATION FOR GOOD REASON. FORFEITURE: IF ACCOUNT IS NOT VESTED AS DESCRIBED ABOVE, THE ACCOUNT WILL BE COMPLETELY FORFEITED. AMOUNTS FORFEITED DURING A PLAN YEAR REMAIN A GENERAL ASSET OF COMMUNITY. COMMUNITY HEALTH NETWORK, INC. RESTORATION PLAN COMMUNITY HEALTH NETWORK, INC. ("COMMUNITY") ADOPTED THIS COMMUNITY HEALTH NETWORK RESTORATION PLAN ("PLAN") AS OF DECEMBER 1, 2017 TO PROVIDE A SUPPLEMENTAL INCOME FOR RETIREMENT UPON VESTING IN THE BENEFITS AS DESCRIBED IN THE PLAN DOCUMENT. COMMUNITY HEALTH NETWORK FOUNDATION, INC. ("CHF") IS INCLUDED IN THE PLAN. THE PLAN IS DESIGNED UNDER CODE SECTION 457(F) AS A "TOP-HAT PLAN" (I.E. AN UNFUNDED DEFERRED COMPENSATION PLAN MAINTAINED FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES PURSUANT TO SECTIONS 201(2), 301(A)(3) AND 401(A)(1) OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED ("ERISA"). ELIGIBILITY: INDIVIDUALS WHO HAVE THE TITLE OF PRESIDENT, SENIOR VICE PRESIDENT OR EXECUTIVE VICE PRESIDENT AND WHOSE PLAN COMPENSATION FOR THE APPLICABLE PLAN YEAR EXCEEDS THE ANNUAL COMPENSATION LIMIT UNDER CODE SECTION 401(A)(17), AS ADJUSTED FROM TIME TO TIME. CONTRIBUTIONS: 1. MATCHING CONTRIBUTIONS: IF A PARTICIPANT RECEIVES THE MAXIMUM PERMISSIBLE MATCHING CONTRIBUTION UNDER THE COMMUNITY HEALTH NETWORK 401(K) RETIREMENT PLAN, THEY WILL RECEIVE A MATCHING CONTRIBUTION IN THE PLAN THAT IS EQUAL TO THEIR COMPENSATION THAT IS GREATER THAN THE 401(K) PLAN LIMIT MULTIPLIED BY THE MAXIMUM PERMITTED MATCHING CONTRIBUTION PERCENTAGE IN THE 401(K) PLAN FOR THAT YEAR. 2. NON-ELECTIVE CONTRIBUTIONS: IF A PARTICPANT RECEIVES A NON-ELECTIVE CONTRIBUTION IN THE 401(K) PLAN, THEY WILL RECEIVE A NON-ELECTIVE CONTRIBUTION IN THE PLAN THAT IS EQUAL TO THEIR COMPENSATION THAT IS GREATER THAN THE 401(K) PLAN LIMIT MULTIPLIED BY THE NON-ELECTIVE CONTRIBUTION PERCENTAGE IN THE 401(K) PLAN FOR THAT YEAR. NOTE THAT NO NON-ELECTIVE CONTRIBUTIONS ARE CURRENTLY BEING MADE TO THE 401(K) PLAN. CONTRIBUTIONS WILL BE CREDITED TO A PARTICPANT'S ACCOUNT AS SOON AS ADMINISTRATIVELY FEASIBLE FOLLOWING THE END OF THE PLAN YEAR TO WHICH THE CONTRIBUTIONS RELATE. VESTING: A PARTICIPANT WILL BE 100% VESTED IN HIS ACCOUNT UPON THE EARLIEST TO OCCUR OF THE FOLLOWING: 1. ATTAINMENT OF AGE 65 PRIOR TO SEPARATION FROM SERVICE 2. DISABILITY 3. INVOLUNTARY SEPARATION FROM SERVICE FOR A REASON OTHER THAN FOR CAUSE 4. SEPARATION FROM SERVICE FOR GOOD REASON 5. A NONCOMPETITIVE PARTICPANT'S COMPLIANCE WITH ALL TERMS OF A NONCOMPETING AGREEMENT, OR 6. DEATH FORFEITURES: IF ACCOUNT IS NOT VESTED AS DESCRIBED ABOVE, THE ACCOUNT WILL BE COMPLETELY FORFEITED. AMOUNTS FORFEITED DURING A PLAN YEAR REMAIN A GENERAL ASSET OF COMMUNITY. |
| PART I, LINE 7 - NON-FIXED PAYMENTS PROVIDED | SENIOR LEADERSHIP INCENTIVE PROGRAM CHF PARTICIPATES IN THE NETWORK'S SENIOR LEADERSHIP INCENTIVE PROGRAM. CERTAIN INDIVIDUALS OF THE LEADERSHIP TEAM PARTICIPATE IN THIS PROGRAM. THE PROGRAM WAS ADOPTED BY THE EXECUTIVE COMPENSATION COMMITTEE, AND IS INTENDED TO INFLUENCE OUTSTANDING PERFORMANCE BY THE SENIOR LEADERS, AS MEASURED AGAINST ORGANIZATIONAL PERFORMANCE. THE PROGRAM IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPOSED ENTIRELY OF INDEPENDENT COMMUNITY MEMBERS. THE INCENTIVE COMPENSATION THAT IS AWARDED IS INCLUDED IN TOTAL COMPENSATION TO THE EXECUTIVE. THE TOTAL COMPENSATION (INCLUDING ANY PAYMENTS UNDER THE PROGRAM) IS SUBJECT TO THE REVIEW AND APPROVAL OF THE EXECUTIVE COMPENSATION COMMITTEE AND INDEPENDENT COMPENSATION CONSULTANT, IN CONSIDERATION OF CODE SECTION 4958 (AND THE CORRESPONDING TREASURY REGULATIONS) TO ENSURE THAT IT REFLECTS ARM'S LENGTH, FAIR MARKET TERMS. LONG TERM INCENTIVE PLAN CHNW 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, CHNW (TOGETHER WITH ITS INDEPENDENT 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 ARM'S LENGTH, FAIR MARKET TERMS. |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 5 | ContributionCnt |
| Noncash Contributions Rpt F990 | $3,620 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $19,119 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 10 | ContributionCnt |
| Noncash Contributions Rpt F990 | $130,425 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
Food Inventory FoodInventoryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 15 | ContributionCnt |
| Noncash Contributions Rpt F990 | $103,405 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp (4 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | PRINT MATERIALS | 8 | $318,655 | COST |
| Yes (X) | MISCELLANEOUS | 85 | $264,904 | COST |
| Yes (X) | JEWELRY | 4 | $40,561 | COST |
| Yes (X) | TRAVEL PACKAGE | 12 | $34,820 | COST |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | Yes (1) | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 32B: | FormAndLineReferenceDesc |
| Explanation | CHF USES AN INVESTMENT FIRM AND BROKERAGE FIRM TO SELL STOCK RECEIVED AS NONCASH CONTRIBUTIONS. SCH M- SUPPLEMENTAL INFORMATION PART I, COLUMN (B) IS THE NUMBER OF CONTRIBUTIONS RECEIVED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 4 - INDEPENDENT VOTING MEMBERS | CHF IS AN AFFILIATE OF COMMUNITY HEALTH NETWORK ("THE NETWORK"), AN INTEGRATED HEALTH DELIVERY SYSTEM. CHF, TOGETHER WITH THE OTHER TAX-EXEMPT AFFILIATES OF THE NETWORK, IS CONTROLLED BY A TAX-EXEMPT PARENT ORGANIZATION, COMMUNITY HEALTH NETWORK, INC. ("CHNW"). CHNW EXERCISES CONTROL OVER CHF THROUGH A SERIES OF GOVERNANCE RIGHTS: A) CHNW IS THE SOLE MEMBER OF CHF; B) AS THE SOLE MEMBER AND PER THE TERMS OF THE ARTICLES OF INCORPORATION, CHNW ELECTS ALL CHF DIRECTORS; C) CHF 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; D) CHNW MUST APPROVE ANY MODIFICATION, REPEAL, AMENDMENT, OR RESTATEMENT OF CHF'S ARTICLES OF INCORPORATION; AND E) CHNW MUST APPROVE ANY MATERIAL SALE OF DISPOSITION OF THE ASSETS OF CHF. WITH REGARD TO EXECUTIVE COMPENSATION, CHNW HAS DELEGATED AUTHORITY TO REVIEW AND APPROVE EXECUTIVE COMPENSATION, INCLUDING CHF'S EXECUTIVES, TO A NETWORK EXECUTIVE COMPENSATION COMMITTEE COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS. IN SUM, CHF HAS REMOVED ANY RISK OF INAPPROPRIATE RELATED PARTY TRANSACTIONS BY DELEGATING (THROUGH CHNW) ITS EXECUTIVE COMPENSATION DECISIONS TO A NETWORK EXECUTIVE COMPENSATION COMMITTEE AND ITS CONFLICT OF INTEREST DECISIONS TO A NETWORK AUDIT COMMITTEE, WITH EACH COMMITTEE COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS. |
| FORM 990, PART I, LINE 5, EMPLOYEES: | CHF EMPLOYEES ARE LEASED FROM COMMUNITY HEALTH NETWORK, INC. |
| FORM 990, PART V, LINE 1A - BOX 3 OF FORM 1096 | FORM 1099S WERE PROCESSED UNDER THE NAME AND FEDERAL IDENTIFICATION NUMBER OF COMMUNITY HEALTH NETWORK, INC. |
| FORM 990, PART VI, SECTION A, LINE 1A | LINE 1B - VOTING MEMBERS THAT ARE INDEPENDENT SEE FORM 990, PART I, LINE 4 REFERENCE ON SCHEDULE O ABOVE |
| FORM 990, PART VI, SECTION A, LINE 2 | RELATED PARTY INFORMATION AMONG OFFICERS BRYAN A. MILLS SERVED AS A DIRECTOR OF COMMUNITY PHYSICIANS OF INDIANA, INC. ("CPI"). JON JANSEN, M.D. RECEIVED COMPENSATION FROM CPI. BRYAN A. MILLS AND PATRICK MCGILL, M.D. SERVED AS A DIRECTOR OR OFFICER OF COMMUNITY HEALTH NETWORK, INC. ("CHNW"). BRYAN A. MILLS, ROBIN LEDYARD M.D., AND PATRICK MCGILL, M.D. RECEIVED COMPENSATION FROM CHNW. |
| FORM 990, PART VI, SECTION A, LINE 3 | MANAGEMENT DELEGATED CHF 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. IN ADDITION, CHNW MUST APPROVE ANY MODIFICATION, REPEAL, AMENDMENT, OR RESTATEMENT OF CHF'S ARTICLES OF INCORPORATION. FINALLY, CHNW MUST APPROVE ANY MATERIAL SALE OR DISPOSITION OF THE ASSETS OF CHF. |
| FORM 990, PART VI, SECTION A, LINE 6 | CLASSES OF MEMBERS OR STOCKHOLDERS COMMUNITY HEALTH NETWORK, INC. IS THE SOLE MEMBER OF CHF. |
| FORM 990, PART VI, SECTION A, LINE 7A | ELECTION OF MEMBERS AND THEIR RIGHTS CHNW, ACTING THROUGH ITS BOARD OF DIRECTORS, HAS THE AUTHORITY TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS OF CHF. |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS SUBJECT TO APPROVAL OF MEMBERS CHF 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; IN ADDITION, CHNW MUST APPROVE ANY MODIFICATION, REPEAL, AMENDMENT, OR RESTATEMENT OF CHF'S ARTICLES OF INCORPORATION; AND CHNW MUST APPROVE ANY MATERIAL SALE OF DISPOSITION OF THE ASSETS OF CHF. |
| FORM 990, PART VI, SECTION B, LINE 11B | ORGANIZATION'S PROCESS TO REVIEW FORM 990 AS DISCUSSED IN PART I, LINE 4, CHNW HAS ASSUMED RESPONSIBILITY FOR CHF'S AUDIT, COMPLIANCE, AND EXECUTIVE COMPENSATION MATTERS, INCLUDING SPECIFICALLY THE PREPARATION AND REVIEW OF CHF'S FORM 990. CHNW'S BOARD OF DIRECTORS HAS DELEGATED AUTHORITY FOR THE REVIEW OF CHF'S FORM 990 TO TWO COMMITTEES COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS: A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE COMPENSATION ASPECTS OF CHF'S FORM 990, AND B) THE NETWORK FINANCE COMMITTEE REVIEWED THE REMAINDER OF THE CHF'S FORM 990. IN ADDITION, CHF'S OUTSIDE ACCOUNTING FIRM AND LAW FIRM REVIEWED THE FORM 990 PRIOR TO FILING. CHF AND CHNW UTILIZED THIS PROCESS TO ENSURE THAT CHF'S FORM 990 RECEIVED SUBSTANTIVE REVIEW BY DIRECTORS AND PROFESSIONALS WITH SPECIFIC KNOWLEDGE OF CHF'S ACTIVITIES AND EXTENSIVE FINANCIAL, ACCOUNTING, AND TAX EXPERTISE. |
| FORM 990, PART VI, SECTION B, LINE 12C | ENFORCEMENT OF CONFLICTS POLICY AS DISCUSSED IN PART I, LINE 4, CHNW HAS ASSUMED RESPONSIBILITY FOR CHF'S AUDIT AND COMPLIANCE MATTERS. CHNW HAS ADOPTED A CONFLICT OF INTEREST POLICY THAT APPLIES TO CHF. 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 CHF. 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 CHF, 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 CHF. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION PROCESS FOR TOP OFFICIAL AS A MEMBER OF THE NETWORK, CHF IS SUBJECT TO THE EXECUTIVE COMPENSATION PRACTICES AND PROCEDURES OF CHNW, THE NETWORK PARENT. CHNW HAS ADOPTED AN EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY THAT APPLIES TO CHF. THE PURPOSE OF THE POLICY IS TO ENSURE THAT CHF'S 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 HAS DELEGATED AUTHORITY REGARDING CHF'S 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, ENGAGING AN INDEPENDENT COMPENSATION CONSULTANT TO PROVIDE REASONABLE COMPENSATION ANALYSIS AND/OR CONFIRM THE REASONABLENESS OF COMPENSATION, AND PROVIDING STAFF SUPPORT TO THE NETWORK EXECUTIVE COMPENSATION COMMITTEE. FORM 990, PART VI, LINE 15B - COMPENSATION PROCESS FOR OFFICERS SEE LINE 15A ABOVE |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS DISCLOSURE EXPLANATION A) THE ARTICLES OF INCORPORATION AND BUSINESS ENTITY REPORT 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 A MEMBER OF THE NETWORK, CHF HAS ADOPTED THE NETWORK CONFLICT OF INTEREST POLICY. WHILE THIS POLICY IS NOT AVAILABLE TO THE PUBLIC, THE NETWORK'S DEFINITION OF A 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) CHF 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. CHF DOES FILE THE 990 TAX RETURN ON AN ANNUAL BASIS WHICH IS AVAILABLE UPON REQUEST AND/OR AVAILABLE ON A DELAYED BASIS ON GUIDESTAR.ORG. D) COMMUNITY HEALTH NETWORK, INC. AND AFFILIATES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | FUND TRANSFER FROM FAIRBANKS HOSPITAL, INC. 79,313. FUND TRANSFER TO COMMUNITY HOSPITAL ANDERSON FOUNDATION, INC. -1,060. |
| FORM 990, PART XII, LINE 3A - REQUIRED AUDIT | CHF IS INCLUDED IN THE COMMUNITY HEALTH NETWORK, INC. A-133 AUDIT |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY HEALTH NETWORK INC | |||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 350983617 | HOSPITAL | IN | 501(C)(3) | LINE 3 | N/A | 0 | |
| COMMUNITY HOME HEALTH SERVICES INC | |||||||||||
| 9894 EAST 121ST STREET | FISHERS | IN | 46037 | 350953467 | HEALTH CARE | IN | 501(C)(3) | LINE 10 | Yes (1) | CHNW | |
| COMM HOSP OF ANDERSON & MADISON CTY | |||||||||||
| 1515 NORTH MADISON AVENUE | ANDERSON | IN | 46011 | 351069822 | HOSPITAL | IN | 501(C)(3) | LINE 3 | Yes (1) | CHNW | |
| COMMUNITY HOSP ANDERSON FDN INC | |||||||||||
| 1515 NORTH MADISON AVENUE | ANDERSON | IN | 46011 | 861053152 | SUPPORT | IN | 501(C)(3) | LINE 12A, I | Yes (1) | CHA | |
| COMMUNITY HOSPITAL SOUTH INC | |||||||||||
| 1402 EAST COUNTY LINE ROAD SOUTH | INDIANAPOLIS | IN | 46227 | 351088640 | HOSPITAL | IN | 501(C)(3) | LINE 3 | Yes (1) | CHNW | |
| COMMUNITY HOWARD REGIONAL HEALTH | |||||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 351865344 | HOSPITAL | IN | 501(C)(3) | LINE 3 | Yes (1) | CHNW | |
| COMM HOWARD REGIONAL HEALTH FDN | |||||||||||
| PO BOX 9011 | KOKOMO | IN | 46904 | 237309596 | SUPPORT | IN | 501(C)(3) | LINE 7 | N/A | 0 | |
| COMMUNITY PHYSICIANS OF IN INC | |||||||||||
| 7240 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 205392766 | PHYSICIAN SERVICES | IN | 501(C)(3) | LINE 10 | Yes (1) | CHNW | |
| FAIRBANKS HOSPITAL INC | |||||||||||
| 8102 CLEARVISTA PARKWAY | INDIANAPOLIS | IN | 46256 | 350811197 | HOSPITAL | IN | 501(C)(3) | LINE 3 | Yes (1) | CHNW | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| CHNJMH VENTURES LLC | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 462356266 | DIAG/REHAB | IN | N/A | 0 | 0 |
| COMMUNITY ENDOSCOPY CENTER LLC | |||||||||
| 1601 N MADISON AVENUE SUITE 300 | ANDERSON | IN | 46011 | 611464136 | HEALTH CARE | IN | N/A | 0 | 0 |
| COMMUNITY HEALTH AT HOME LLC | |||||||||
| 1700 EDISON DRIVE | MILFORD | OH | 451502729 | 833536760 | HEALTH CARE | IN | N/A | 0 | 0 |
| COMMUNITY HEALTH NETWORK REHAB HOSP LLC | |||||||||
| 680 S FOURTH STREET | LOUISVILLE | KY | 40202 | 453414249 | REHAB | IN | N/A | 0 | 0 |
| COMMUNITY HLTH NTWRK REHAB HOSP SOUTH LLC | |||||||||
| 680 S FOURTH STREET | LOUISVILLE | KY | 40202 | 821385366 | REHAB | IN | N/A | 0 | 0 |
| COMMUNITY HLTH NTWRK REHAB HOSP WEST LLC | |||||||||
| 330 SEVEN SPRINGS WAY | BRENTWOOD | TN | 37027 | 845110509 | REHAB | IN | N/A | 0 | 0 |
| EAST CAMPUS SURGERY CENTER LLC | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 352028517 | SURGERY | IN | N/A | 0 | 0 |
| HAMILTON SURGERY CENTER LLC | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 352061413 | SURGERY | IN | N/A | 0 | 0 |
| HEALTHBOX CHICAGO II LLC | |||||||||
| 33 SWEST MONROE STREET SUITE 1700 | CHICAGO | IL | 60603 | 463871950 | INVESTMENT | IL | N/A | 0 | 0 |
| HOWARD COMMUNITY SURGERY CTR LLC | |||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 352118748 | SURGERY | IN | N/A | 0 | 0 |
| INDIANAPOLIS ENDOSCOPY CENTER LLP | |||||||||
| 8315 E 56TH STREET | INDIANAPOLIS | IN | 46216 | 352010874 | HEALTH CARE | IN | N/A | 0 | 0 |
| MICHIGAN SURGERY INVESTMENT LLC | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 320147008 | SURGERY CENTERS | IN | N/A | 0 | 0 |
| NORTH CAMPUS OFFICE ASSOCIATES LP | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 351808625 | RENTAL PROPERTY | IN | N/A | 0 | 0 |
| NORTH CAMPUS SURGERY CENTER LLC | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 352147088 | SURGERY | IN | N/A | 0 | 0 |
| NORTHPOINT PEDIATRICS LLC | |||||||||
| 8101 CLEARVISTA PARKWAY SUITE 185 | INDIANAPOLIS | IN | 46256 | 351960566 | HEALTH CARE | IN | N/A | 0 | 0 |
| NORTHWEST SURGERY CENTER LLC | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 208754071 | SURGERY | IN | N/A | 0 | 0 |
| PILLARS HOUSING LP | |||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 161652671 | HOUSING | IN | N/A | 0 | 0 |
| PRIMARIA HEALTH LLC | |||||||||
| 9365 COUNSELORS ROW SUITE 210 | INDIANAPOLIS | IN | 46240 | 474728937 | CONSULTING | IN | N/A | 0 | 0 |
| SCP INDIANAPOLIS LLC | |||||||||
| 7430 SHADELAND AVENUE SUITE 100 | INDIANAPOLIS | IN | 46250 | 460639908 | HEALTH CARE | IN | N/A | 0 | 0 |
| SOUTH CAMPUS SURGERY CENTER LLC | |||||||||
| 1550 EAST COUNTY LINE ROAD | INDIANAPOLIS | IN | 46227 | 352038072 | SURGERY | IN | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHN ASSURANCE COMPANY LTD | |||||||||||||
| PO BOX 1051GT | GRAND CAYMAN | CJ | 980418913 | SELF INSURANCE | CJ | N/A | C | Yes (1) | |||||
| PILLARS COMMUNITY HOUSING INC | |||||||||||||
| 161652666 | HOUSING | N/A | C | Yes (1) | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| VISIONARY ENTERPRISES INC | |||||||||||||
| 351538433 | MANAGEMENT SERVICES | N/A | C | Yes (1) | 6626 EAST 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | IN | ||||
| VEI MICHIGAN INC | |||||||||||||
| 300097377 | MANAGEMENT SERVICES | N/A | C | Yes (1) | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| WESTVIEW DELIVERY SYSTEM INC | |||||||||||||
| 351910292 | MANAGEMENT SERVICES | N/A | C | Yes (1) | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| COMMUNITY HOWARD REGIONAL HEALTH INC | ||
| S | $235,319 | BOOK VALUE |
| COMMUNITY PHYSICIANS OF INDIANA INC | ||
| B | $2,617,861 | BOOK VALUE |
| COMMUNITY PHYSICIANS OF INDIANA INC | ||
| S | $2,750,468 | BOOK VALUE |
| FAIRBANKS HOSPITAL INC | ||
| B | $728,862 | BOOK VALUE |
| FAIRBANKS HOSPITAL INC | ||
| S | $728,812 | BOOK VALUE |