COMMUNITY HOWARD REGIONAL HEALTH INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: COMMUNITY HOWARD REGIONAL HEALTH INC (EIN 35-1865344)
Tax period: 2018-01-01 to 2018-12-31
Filed: 2019-10-29
IRS object ID: 201923029349301662
Schema version: 2018v3.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2019-10-29T14:13:36-05:00	ReturnTs
Tax Period End	2018-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	352032768	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CASKEY & DAILY PC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	4745 STATESMEN DRIVE SUITE C	AddressLine1Txt
City	INDIANAPOLIS	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46250	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	351865344	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HOWARD REGIONAL HEALTH	BusinessNameLine1Txt
Business Name Line2	INC	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	COMM	BusinessNameControlTxt
Phone	7654538371	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3500 S LAFOUNTAIN STREET	AddressLine1Txt
City	KOKOMO	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46902	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JOSEPH T HOOPER	PersonNm
Person Title	PRES - HOWARD REGION	PersonTitleTxt
Phone	7654538371	PhoneNum
Signature	2019-10-17	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JAMES A CASKEY CPA CFP	PreparerPersonNm
PTIN	P00172185	PTIN
Phone	3175852647	PhoneNum
Preparation	2019-10-29	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	73.103.115.42	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2019-10-29	IPDt
IP Tm	15:08:05	IPTm
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	9B095E6EB8FEEDD76144B834BDE29E92059B38C1	AtSubmissionCreationDeviceId
At Submission Filing Device Id	9B095E6EB8FEEDD76144B834BDE29E92059B38C1	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-03-31 21:24:44Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JOSEPH T HOOPER	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3500 S LAFOUNTAIN STREET	AddressLine1Txt
City	KOKOMO	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46902	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$172,475,676	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.ECOMMUNITY.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1992	FormationYr
Legal Domicile State	IN	LegalDomicileStateCd
Activity Or Mission	OUR MISSION IS TO PROVIDE EXCEPTIONAL QUALITY, PATIENT-CENTERED CARE. IN KEEPING WITH OUR MISSION, WE EMBRACE THE FOLLOWING VALUES: COMPASSION AND UNDERSTANDING; CUSTOMER SERVICE; DEDICATION AND COMMITMENT TO PROVIDE THE HIGHEST QUALITY SERVICES AND TO MEET THE NEEDS OF OUR COMMUNITY; RESPECT FOR OUR PATIENTS, VISITORS, PHYSICIANS, AND STAFF; SAFETY; A SAFE AND POSITIVE WORKING ENVIRONMENT; AND TRUTH AND INTEGRITY IN ALL ENCOUNTERS AND SERVICES OFFERED.	ActivityOrMissionDesc
Voting Members Governing Body	8	VotingMembersGoverningBodyCnt
Voting Members Independent	6	VotingMembersIndependentCnt
Total Employee	915	TotalEmployeeCnt
Total Volunteers	100	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$52,831	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$4,320,651	PYContributionsGrantsAmt
CY Contributions Grants	$4,619,141	CYContributionsGrantsAmt
PY Program Service Revenue	$136,910,781	PYProgramServiceRevenueAmt
CY Program Service Revenue	$162,851,579	CYProgramServiceRevenueAmt
PY Investment Income	$734,680	PYInvestmentIncomeAmt
CY Investment Income	$981,380	CYInvestmentIncomeAmt
PY Other Revenue	$4,022,539	PYOtherRevenueAmt
CY Other Revenue	$3,893,709	CYOtherRevenueAmt
PY Total Revenue	$145,988,651	PYTotalRevenueAmt
CY Total Revenue	$172,345,809	CYTotalRevenueAmt
PY Grants And Similar Paid	$62,593	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$160,762	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$49,391,882	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$50,975,811	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$71,630,042	PYOtherExpensesAmt
CY Other Expenses	$76,359,626	CYOtherExpensesAmt
PY Total Expenses	$121,084,517	PYTotalExpensesAmt
CY Total Expenses	$127,496,199	CYTotalExpensesAmt
PY Revenues Less Expenses	$24,904,134	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$44,849,610	CYRevenuesLessExpensesAmt
Total Assets BOY	$160,385,763	TotalAssetsBOYAmt
Total Assets EOY	$176,077,603	TotalAssetsEOYAmt
Total Liabilities BOY	$31,719,076	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$6,045,795	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$128,666,687	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$170,031,808	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	OUR MISSION IS TO PROVIDE EXCEPTIONAL QUALITY, PATIENT-CENTERED CARE. IN KEEPING WITH OUR MISSION, WE EMBRACE THE FOLLOWING VALUES: COMPASSION AND UNDERSTANDING; CUSTOMER SERVICE; DEDICATION AND COMMITMENT TO PROVIDE THE HIGHEST QUALITY SERVICES AND TO MEET THE NEEDS OF OUR COMMUNITY; RESPECT FOR OUR PATIENTS, VISITORS, PHYSICIANS, AND STAFF; SAFETY; A SAFE AND POSITIVE WORKING ENVIRONMENT; AND TRUTH AND INTEGRITY IN ALL ENCOUNTERS AND SERVICES OFFERED.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$89,786,585	ExpenseAmt
Revenue	$166,339,008	RevenueAmt
Desc	COMMUNITY HOWARD REGIONAL HEALTH, INC. ("CHRH") OPERATES AN ACUTE CARE FULL SERVICE HOSPITAL IN KOKOMO, INDIANA WITH 162 LICENSED BEDS. IN 2018, THE MAIN HOSPITAL SERVED 4,529 INPATIENTS WITH A TOTAL OF 16,429 INPATIENT DAYS OF SERVICE. THE HOSPITAL ALSO PROVIDED 267,327 OUTPATIENT VISITS, WHICH INCLUDED 26,917 EMERGENCY VISITS. CHRH PROVIDES SERVICES INCLUDING WOMEN AND CHILDREN'S HEALTHCARE, CANCER CARE, CARDIOVASCULAR CARE, SURGICAL SERVICES, BEHAVIORAL HEALTH, AND PEDIATRIC SERVICES.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$160,762	ExpenseAmt
Grant	$160,762	GrantAmt
Desc	PROVIDED DONATIONS TO OTHER ORGANIZATIONS IN THE CENTRAL INDIANA COMMUNITY SERVED BY CHRH.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$89,947,347	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	false	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	915	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	8	GoverningBodyVotingMembersCnt
Independent Voting Member	6	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (true)	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	false	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	IN	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	JOSEPH T HOOPER	PersonNm
Phone	7654538547	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3500 S LAFOUNTAIN STREET	AddressLine1Txt
City	KOKOMO	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46902	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 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	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
TIMOTHY HOBBS MD
DIRECTOR	2.00	48.00	Yes (X)	$0	$756,209	$279,807
JASON FAHRLANDER
DIRECTOR	2.00	48.00	Yes (X)	$0	$713,853	$318,157
JOHN KUNZER MD
DIRECTOR	2.00	48.00	Yes (X)	$0	$539,832	$162,827
LYNETTE HAZELBAKER MD
CHAIRMAN	2.00	0.00	Yes (X)	$623	$0	$0	Yes (X)
BENJAMIN CHIU MD
VICE CHAIRMA	2.00	0.00	Yes (X)	$0	$0	$0	Yes (X)
DIANE COGDELL
DIRECTOR	2.00	0.00	Yes (X)	$0	$0	$0
ROBERT HAYES
DIRECTOR	2.00	0.00	Yes (X)	$0	$0	$0
TOM HILLIGOSS
DIRECTOR	2.00	0.00	Yes (X)	$0	$0	$0
BRIDGET WHITMORE
SECRETARY	2.00	0.00	Yes (X)	$0	$0	$0	Yes (X)
BECKY VENT
DIRECTOR	2.00	0.00	Yes (X)	$0	$0	$0
JOSEPH T HOOPER
PRES - HOWAR	58.00	2.00		$443,902	$0	$125,076	Yes (X)
JOHN BILO
EXEC DIR OF	50.00	0.00		$0	$220,884	$63,662	Yes (X)
DESHINI MOONESINGHE MD
SVP PHYS EXE	8.33	41.67		$149,223	$300,490	$111,247		Yes (X)
JENNIFER HINDMAN
VP COO REGIO	50.00	0.00		$214,729	$0	$56,059		Yes (X)
JOHN SCHILTZ MD
PSYCHIATRIST	50.00	0.00		$339,901	$0	$47,812			Yes (X)
LAXESHKUMAR PATEL MD
PSYCHIATRIST	50.00	0.00		$283,063	$0	$47,712			Yes (X)
CARL RATLIFF MD
PSYCHIATRIST	50.00	0.00		$281,015	$0	$28,059			Yes (X)
RYAN MESHULAM MD
PSYCHIATRIST	50.00	0.00		$208,747	$0	$20,617			Yes (X)
JACQUELYN WHOBREY
VP PATIENT S	50.00	0.00		$172,851	$0	$31,869			Yes (X)
JEFFERY KIRKHAM
FORMER CFO C	0.00	50.00		$0	$335,181	$79,473				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,094,054	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,866,449	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,372,377	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	43	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
MID AMERICA CLINICAL LABORATORIES
2560 N SHADELAND AVENUE	INDIANAPOLIS	IN	462190163	LAB SERVICES	$3,235,360
HAYES BROTHERS INC
1241 EAST 400 SOUTH	KOKOMO	IN	46902	MAINTENANCE	$1,755,335
VIZIENT INC
290 E JOHN CARPENTER FREEWAY	IRVING	TX	75062	TEMP STAFFING	$805,703
J AND J ELECTRIC OF INDIANA INC
3180 W ST ROAD 18	KOKOMO	IN	46903	ELECTRICAL WORK	$804,252
CERNER CORPORATION
2800 ROCKCREEK PKWY	KANSAS CITY	MO	64117	SOFTWARE MAINT	$688,228

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	25	CntrctRcvdGreaterThan100KCnt
Related Organizations	$246,433	RelatedOrganizationsAmt
Government Grants	$4,372,708	GovernmentGrantsAmt
Total Contributions	$4,619,141	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICES	621110	$159,880,081	$159,880,081
RENT	531120	$2,971,498	$2,971,498

Field	Value	IRS element (for citing)
Total Program Service Revenue	$162,851,579	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,075,774	TotalRevenueColumnAmt
Exclusion	$1,075,774	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$35,473	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$129,867	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$94,394	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$94,394	TotalRevenueColumnAmt
Exclusion	-$94,394	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
EQUITY INVESTMENT INCOME	900003	$2,825,060	$2,825,060
MANAGEMENT FEES - HOSPITAL	900099	$628,252	$628,252
COFFEE SHOP/DIETARY SALES	722515	$406,280		$406,280

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$34,117	TotalRevenueColumnAmt
Related Or Exempt Func Income	$34,117	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$3,893,709	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$172,345,809	TotalRevenueColumnAmt
Related Or Exempt Func Income	$166,339,008	RelatedOrExemptFuncIncomeAmt
Exclusion	$1,387,660	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$160,762	TotalAmt
Program Services	$160,762	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$995,379	TotalAmt
Program Services	$16,122	ProgramServicesAmt
Management And General	$979,257	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$40,268,477	TotalAmt
Program Services	$34,094,044	ProgramServicesAmt
Management And General	$6,174,433	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,281,144	TotalAmt
Program Services	$1,053,065	ProgramServicesAmt
Management And General	$228,079	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$5,554,798	TotalAmt
Program Services	$4,591,793	ProgramServicesAmt
Management And General	$963,005	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,876,013	TotalAmt
Program Services	$2,382,804	ProgramServicesAmt
Management And General	$493,209	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$200,185	TotalAmt
Management And General	$200,185	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$19,354	TotalAmt
Management And General	$19,354	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$29,817,972	TotalAmt
Program Services	$6,977,895	ProgramServicesAmt
Management And General	$22,840,077	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$46,573	TotalAmt
Program Services	$9,709	ProgramServicesAmt
Management And General	$36,864	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,696,667	TotalAmt
Program Services	$1,759,261	ProgramServicesAmt
Management And General	$937,406	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$418,217	TotalAmt
Program Services	$140,581	ProgramServicesAmt
Management And General	$277,636	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$5,162,864	TotalAmt
Program Services	$4,267,806	ProgramServicesAmt
Management And General	$895,058	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$124,777	TotalAmt
Program Services	$97,587	ProgramServicesAmt
Management And General	$27,190	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$54,563	TotalAmt
Program Services	$41,738	ProgramServicesAmt
Management And General	$12,825	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$41,177	TotalAmt
Program Services	$22,250	ProgramServicesAmt
Management And General	$18,927	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$6,267,954	TotalAmt
Program Services	$3,936,839	ProgramServicesAmt
Management And General	$2,331,115	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$838,232	TotalAmt
Program Services	$3,466	ProgramServicesAmt
Management And General	$834,766	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$23,466,049	$23,466,049
HAF PROGRAM FEES	$6,820,463	$6,820,463
PROPERTY TAX	$133,888	$22,863	$111,025
DUES & SUBSCRIPTIONS	$113,275	$18,151	$95,124

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$137,416	TotalAmt
Program Services	$64,099	ProgramServicesAmt
Management And General	$73,317	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$127,496,199	TotalAmt
Program Services	$89,947,347	ProgramServicesAmt
Management And General	$37,548,852	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,662	BOYAmt
EOY	$1,655	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$686,408	BOYAmt
EOY	$29,893	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$20,972,021	BOYAmt
EOY	$19,778,451	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$3,503,236	BOYAmt
EOY	$3,625,228	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$242,473	BOYAmt
EOY	$172,430	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$138,382,438	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$40,291,113	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$94,335,014	BOYAmt
EOY	$98,091,325	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$32,526,689	BOYAmt
EOY	$30,062,084	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$5,043,724	BOYAmt
EOY	$5,488,195	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$50,279	BOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$3,024,257	BOYAmt
EOY	$18,828,342	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$160,385,763	BOYAmt
EOY	$176,077,603	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$5,527,439	BOYAmt
EOY	$2,755,596	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$26,191,637	BOYAmt
EOY	$3,290,199	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$31,719,076	BOYAmt
EOY	$6,045,795	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$128,666,687	BOYAmt
EOY	$170,031,808	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$128,666,687	BOYAmt
EOY	$170,031,808	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$160,385,763	BOYAmt
EOY	$176,077,603	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$44,849,610	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$3,484,489	NetUnrlzdGainsLossesInvstAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	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 (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

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

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,583,000	OtherCostOrOtherBasisAmt
Book Value	$4,583,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$101,927,886	OtherCostOrOtherBasisAmt
Depreciation	$21,235,331	DepreciationAmt
Book Value	$80,692,555	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$112,695	OtherCostOrOtherBasisAmt
Depreciation	$50,656	DepreciationAmt
Book Value	$62,039	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$27,565,029	OtherCostOrOtherBasisAmt
Depreciation	$16,618,837	DepreciationAmt
Book Value	$10,946,192	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,193,828	OtherCostOrOtherBasisAmt
Depreciation	$2,386,289	DepreciationAmt
Book Value	$1,807,539	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$98,091,325	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
DUE FROM AFFILIATES	$9,721,297
THIRD PARTY RECEIVABLE	$9,107,045

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$18,828,342	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
THIRD PARTY SETTLEMENTS	$2,964,154
OTHER	$326,045

Field	Value	IRS element (for citing)
Total Liability	$3,290,199	TotalLiabilityAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	1316	PersonsServedCnt
Total Community Benefit Expns	$215,912	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$215,912	NetCommunityBenefitExpnsAmt
Total Expense	0.00170	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Persons Served	1316	PersonsServedCnt
Total Community Benefit Expns	$215,912	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$215,912	NetCommunityBenefitExpnsAmt
Total Expense	0.00170	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	10	ActivitiesOrProgramsCnt
Persons Served	10165	PersonsServedCnt
Total Community Benefit Expns	$2,155,906	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$300,735	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,855,171	NetCommunityBenefitExpnsAmt
Total Expense	0.01460	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	299	PersonsServedCnt
Total Community Benefit Expns	$7,860	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$7,860	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	64	PersonsServedCnt
Total Community Benefit Expns	$8,732	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$8,732	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	15	ActivitiesOrProgramsCnt
Persons Served	10528	PersonsServedCnt
Total Community Benefit Expns	$2,172,498	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$300,735	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,871,763	NetCommunityBenefitExpnsAmt
Total Expense	0.01470	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	15	ActivitiesOrProgramsCnt
Persons Served	11844	PersonsServedCnt
Total Community Benefit Expns	$2,388,410	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$300,735	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,087,675	NetCommunityBenefitExpnsAmt
Total Expense	0.01640	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$9,992	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$9,992	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$11,967	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$11,967	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$21,959	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$21,959	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$822,869	BadDebtExpenseAmt
Reimbursed By Medicare	$34,394,041	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$40,411,594	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$6,017,553	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	HOWARD COMM SURG CTR	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	SURGERY	PrimaryActivitiesTxt
Org Profit Or Ownership	0.51000	OrgProfitOrOwnershipPct
Physicians Profit Or Ownership	0.27000	PhysiciansProfitOrOwnershipPct

Field	Value	IRS element (for citing)
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Facility Reporting GroupFacilityReportingGroupCd
COMMUNITY HOWARD REGIONAL HEALTH
1	3500 S LAFOUNTAIN STREET	KOKOMO	IN	46902	WWW.ECOMMUNITY.COM	18-005007-1	Yes (X)	Yes (X)	Yes (X)	A
HOWARD REGIONAL SPECIALTY CARE
2	829 NORTH DIXON ROAD	KOKOMO	IN	46901	WWW.ECOMMUNITY.COM	18-003868-1	Yes (X)			A

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	A	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	12	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
Other	Yes (X)	OtherInd
CHNA Conducted	18	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WEBAPP.ECOMMUNITY.COM/ABOUTUS/	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	18	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	WEBAPP.ECOMMUNITY.COM/ABOUTUS/	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
GROUP A, FACILITY 1, COMMUNITY HOWARD REGIONAL HEALTH - PART V, LINE 5	IN 2018, COMMUNITY HEALTH NETWORK CONDUCTED A CHNA TO UNDERSTAND THE GREATEST HEALTH NEEDS IN THE COMMUNITIES SERVED BY OUR HOSPITALS. THIS ASSESSMENT WAS IN LARGE PART A JOINT PROCESS AMONG FOUR INDIANA HEALTH SYSTEMS: COMMUNITY HEALTH NETWORK, IU HEALTH, ST. FRANCIS ALLIANCE, AND ST. VINCENT. COMBINED, THESE ARE THE LARGEST HEALTH SYSTEMS IN INDIANA. THROUGH THIS COLLABORATIVE PARTNERSHIP, COMMUNITY HEALTH DATA WAS COLLECTED IN THREE WAYS: 1. SECONDARY DATA COLLECTION: DATA ON HEALTH AND WELLNESS ISSUES WAS COLLECTED. SOURCES INCLUDE COUNTY HEALTH RANKINGS, CENSUS BUREAU DATA, VARIOUS REPORTS FROM THE INDIANA STATE DEPARTMENT OF HEALTH, AND OTHER NATIONAL REPORTS. INDIANA INDICATORS, COMMUNITY COMMONS, AND HEALTHY COMMUNITIES INSTITUTE DATA MANAGEMENT SYSTEMS ALSO CONTRIBUTED TO THE SECONDARY DATA USED. SOURCES OF THE SECONDARY DATA ARE IDENTIFIED THROUGHOUT THE COMMUNITY BENEFITS REPORT. 2. COMMUNITY HEALTH SURVEY: A CORE OF 20 MANDATORY QUESTIONS BASED ON PERCEPTION OF COMMUNITY AND PERSONAL NEEDS WERE CREATED. IN ADDITION, PROFESSIONALS ASSIGNED TO EACH COUNTY WORKED WITH ESTABLISHED COMMUNITY HEALTH COLLABORATIVES, LOCAL HOSPITALS, AND THE LOCAL HEALTH DEPARTMENT TO DEVELOP VOLUNTARY COMMUNITY HEALTH NEEDS ASSESSMENT TO CREATE 9 QUESTIONS SPECIFIC TO THE COUNTY. THIS RESULTED IN A SURVEY WITH 20 TO 29 QUESTIONS, DEPENDENT ON THE RESPONDENT'S COUNTY OF RESIDENCE. THE SURVEY WAS DISTRIBUTED ELECTRONICALLY AND ON PAPER. IN ADDITION TO THE QUANTITATIVE DATA, FREE TEXT RESPONSES WERE CODED AND CALCULATED TO PROVIDE FURTHER CLARIFICATION OF THE QUANTITATIVE DATA. 3. FOCUS GROUPS: IN ADDITION TO THE SURVEY THE PARTNERSHIP HOSTED FOCUS GROUPS THAT INCLUDED 15-60 COMMUNITY LEADERS FROM GOVERNMENTAL PUBLIC HEALTH, HEALTH CARE, SOCIAL SERVICE AGENCIES, RELATED NONPROFITS, CIVIC ORGANIZATIONS, AND GRASSROOTS/NEIGHBORHOOD ORGANIZATIONS. IN LARGER FOCUS GROUPS, SUB-GROUPS WERE UTILIZED TO GIVE ALL PARTICIPANTS A VOICE. EACH FOCUS GROUP DETERMINED THE TOP FOUR TO SIX HEALTH NEEDS IN THE COMMUNITY; POTENTIAL RESOURCES OR PARTNERS; AND SOME ACTIONS/INTERVENTIONS THAT MIGHT WORK BEST. OUTSIDE OF THE COLLABORATIVE, COMMUNITY HEALTH NETWORK INVITED KEY PUBLIC HEALTH INFORMANTS TO PROVIDE THEIR INPUT ON COMMUNITY HEALTH NEEDS. THE FOLLOWING INFORMANTS WERE INTERVIEWED: DUANE KRAMBECK - PRINCIPAL OF CHRISTIAN PARK ELEMENTARY SCHOOL IN INDIANAPOLIS PUBLIC SCHOOLS; MARY CONWAY, MSN, RN ADMINISTRATIVE COORDINATOR FOR NURSING SERVICES IN INDIANAPOLIS PUBLIC SCHOOLS; AND RANDY MILLER EXECUTIVE DIRECTOR OF DRUG FREE MARION COUNTY. THESE QUANTITATIVE AND QUALITATIVE DATA COLLECTION MECHANISMS HELPED IDENTIFY COMMUNITY HEALTH NEEDS AND SECONDARY DATA CONFIRMED THE NEEDS PERFORM BELOW STATE AVERAGES. FURTHER REVIEW OF THE HEALTH NEEDS DETERMINED THE EXTENT TO WHICH HEALTH INEQUITIES MAY EXIST AND WHICH SEGMENTS OF THE POPULATION ARE MORE NEGATIVELY IMPACTED.
GROUP A, FACILITY 1, COMMUNITY HOWARD REGIONAL HEALTH - PART V, LINE 6A	THE CHNA FOR COMMUNITY HOWARD REGIONAL HEALTH, INC. WAS A JOINT PROCESS AMONG ALL OF THE COMMUNITY HEALTH NETWORK HOSPITALS WHICH INCLUDES: COMMUNITY HEALTH NETWORK, INC. (NORTH, EAST, & INDIANA HEART HOSPITAL, LLC), COMMUNITY HOSPITAL SOUTH, INC., COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC., COMMUNITY HOWARD REGIONAL HEALTH, INC., AND INDIANAPOLIS OSTEOPATHIC HOSPITAL, INC. IN ADDITION, THE HOSPITAL COLLABORATED WITH FRANCISCAN ST. FRANCIS HEALTH, IU HEALTH UNIVERSITY HOSPITAL, AND ST. VINCENT HOSPITAL.
GROUP A, FACILITY 1, COMMUNITY HOWARD REGIONAL HEALTH - PART V, LINE 6B	THE CHNA WAS ALSO CONDUCTED WITH HEALTHY COMMUNITIES INSTITUTE.
GROUP A, FACILITY 1, COMMUNITY HOWARD REGIONAL HEALTH - PART V, LINE 11	CHRH IS ADDRESSING THE SIGNIFICANT NEEDS OF THE COMMUNITY BASED ON INPUT PROVIDED BY COMMUNITY RESIDENTS, PUBLIC HEALTH PARTNERS, INTERNAL AND EXTERNAL LEADERSHIP WHO PARTICIPATED IN FOCUS GROUPS, STAKEHOLDER INTERVIEWS OR COMPLETED THE CHNA SURVEY THROUGHOUT THE CENTRAL INDIANA REGION. CHNA DATA WAS ANALYZED AND PRIORITIZED USING THESE KEY FACTORS: FEASIBILITY FOR OUR HOSPITALS TO IMPACT CHANGE, HEALTH SYSTEM EXPERTISE IN THE FIELD OF THE ASSESSED NEED, AND THE HOSPITALS ABILITY TO BE THE MOST EFFECTIVE WITH THE RESOURCES AVAILABLE. THE FOUR SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ALL OUR COMMUNITIES WERE: ACCESS TO HEALTHCARE; OBESITY; PEDIATRIC ASTHMA AND COMMUNITY DRIVEN INITIATIVES. A MISSION CENTERED ON HELPING OTHERS IS THE FOUNDATION OF EVERYTHING WE DO AT COMMUNITY HEALTH NETWORK - AND EXTENDS FROM THE CARE WE PROVIDE TO THE COMMUNITIES WE SERVE THROUGH A BROAD SPECTRUM OF COMMUNITY BENEFIT ACTIVITIES OR PROGRAMS. OUR COMMUNITY BENEFIT RESPONDS TO IDENTIFIED COMMUNITY NEEDS AND MEETS AT LEAST ONE OF THE FOLLOWING CRITERIA: 1. IMPROVES ACCESS TO HEALTH CARE SERVICES. 2. ENHANCES HEALTH OF THE COMMUNITY. 3. ADVANCES MEDICAL OR HEALTH KNOWLEDGE. 4. RELIEVES OR REDUCES THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. OUR COMMUNITY BENEFIT IS ORGANIZED IN THREE CATEGORIES: CATEGORY 1: FINANCIAL ASSISTANCE-FREE OR DISCOUNTED HEALTH SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD TO PAY AND WHO MEET THE ELIGIBILITY CRITERIA OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. FINANCIAL ASSISTANCE IS REPORTED IN TERMS OF COSTS, NOT CHARGES. FINANCIAL ASSISTANCE DOES NOT INCLUDE BAD DEBT. CATEGORY 2: GOVERNMENT-SPONSORED MEANS-TESTED HEALTH CARE-UNPAID COSTS OF PUBLIC PROGRAMS FOR LOW-INCOME PERSONS - THE SHORTFALL CREATED WHEN A FACILITY RECEIVES PAYMENTS THAT ARE LESS THAN THE COST OF CARING FOR PUBLIC PROGRAM BENEFICIARIES. THIS PAYMENT SHORTFALL IS NOT THE SAME AS A CONTRACTUAL ALLOWANCE, WHICH IS THE FULL DIFFERENCE BETWEEN CHARGES AND GOVERNMENT PAYMENTS. CATEGORY 3: COMMUNITY BENEFIT SERVICES- PROGRAMS THAT RESPOND TO AN IDENTIFIED COMMUNITY HEALTH NEED AND ARE DESIGNED TO ACCOMPLISH ONE OR MORE COMMUNITY BENEFIT OBJECTIVES; PROGRAMS AND ACTIVITIES DIRECTED TO OR INCLUDING AT-RISK PERSONS, SUCH AS UNDERINSURED AND UNINSURED PERSONS AND PROGRAMS OFFERED TO THE BROAD COMMUNITY (INCLUDING AT-RISK PERSONS) DESIGNED TO IMPROVE COMMUNITY HEALTH. HIGHLIGHTS FOR COMMUNITY BENEFIT SERVICES THAT ALIGN WITH THE IDENTIFIED NEEDS INCLUDES: ACCESS TO HEALTHCARE: COMMUNITY HEALTH NETWORK SUPPORTS THE JANE PAULEY COMMUNITY HEALTH CENTER WHICH OPENED ITS DOORS IN SEPTEMBER 2009 TO PROVIDE PRIMARY HEALTH SERVICES TO EASTSIDE RESIDENTS, REGARDLESS OF INCOME OR INSURANCE COVERAGE. WITH 16 LOCATIONS, THE CENTER SERVES IN PARTNERSHIP WITH THE METROPOLITAN SCHOOL DISTRICT OF WARREN TOWNSHIP, COMMUNITY HEALTH NETWORK, THE COMMUNITY HEALTH NETWORK FOUNDATION, IU SCHOOL OF DENTISTRY AND HANCOCK REGIONAL HOSPITAL. SERVICES ARE PROVIDED ON A DISCOUNTED BASIS BASED ON THE PATIENT'S HOUSEHOLD INCOME. EASTSIDE INDIANAPOLIS NATIVE AND FORMER NBC NEWS ANCHOR JANE PAULEY LENT HER NAME TO THE FACILITY AS AN ADVOCATE FOR ACCESSIBLE HEALTHCARE SERVICES FOR PEOPLE UNDERSERVED BY TRADITIONAL HEALTHCARE MODELS. THE CENTER OFFERS A FULL RANGE OF SERVICES INCLUDING PRIMARY HEALTHCARE, CASE MANAGEMENT, PRESCRIPTION ASSISTANCE AND BEHAVIORAL HEALTH SERVICES, WHILE ALSO FOCUSING ON THE MANAGEMENT OF CHRONIC DISEASES. THE CENTER IS ABLE TO PROVIDE ALL OF THESE IN BOTH ENGLISH AND SPANISH. COMMUNITY HEALTH NETWORK'S SCHOOL-BASED PROGRAMS COVER A WIDE RANGE OF NEEDS FOR YOUTH ACROSS CENTRAL INDIANA. ONSITE NURSES, THERAPISTS AND PHYSICIANS ADDRESS STUDENTS' NEEDS IN THE SCHOOL AND AFTER-SCHOOL SETTING, HELPING TO ENSURE CONSISTENCY IN CARE AND LESS TIME AWAY FROM THE CLASSROOM OR PLAYING FIELD. THE VAST MAJORITY OF THESE SERVICES, INCLUDING ANY NURSING OR BEHAVIORAL HEALTH SUPPORT, ARE OFFERED FREE OF CHARGE TO SCHOOLS THANKS TO COMMUNITY'S ON-GOING COMMITMENT TO ENHANCING HEALTH FOR FUTURE GENERATIONS. FROM EVERYDAY SCRAPES AND BRUISES ON THE PLAYGROUND TO MANAGING CHRONIC ILLNESSES LIKE ASTHMA AND DIABETES, COMMUNITY NURSES OFFER SUPPORT FOR STUDENTS AT MORE THAN 100 SCHOOLS IN THE COMMUNITIES WE SERVE. THEIR WORK ENSURED A 97.2 PERCENT RETURN TO CLASSROOM RATE FOR STUDENTS WHO CAME TO THEM FOR CARE IN 2018. SPECIFIC SERVICES OFFERED TO STUDENTS INCLUDE: 1. MANAGEMENT OF INJURIES REQUIRING FIRST AID; 2. MANAGEMENT OF LIFE-THREATENING ALLERGIES, ASTHMA, DIABETES AND SEIZURES; 3. MANAGEMENT OF ANY HEALTH CONCERN AND REFERRAL TO APPROPRIATE CARE WHEN NEEDED; AND 4. EMERGENCY RESPONSE TO ANY HEALTH-RELATED CONCERN WITHIN THE SCHOOL BUILDING. IN ADDITION, FOR STUDENTS FACING CHRONIC HEALTH CONDITIONS AND ONGOING HEALTH NEEDS, MEDICATIONS PRESCRIBED BY PHYSICIANS ARE ADMINISTERED BY COMMUNITY'S SCHOOL-BASED NURSING STAFF. IN THE INSTANCE OF OCCASIONAL MEDICATION NEEDS, PARENTS FURNISH OVER-THE-COUNTER MEDICATIONS THAT ARE THEN ADMINISTERED BY NURSING STAFF. AND, FOR PREVENTATIVE CARE PURPOSES, NURSING STAFF ADMINISTER FLU VACCINES AT A NUMBER OF LOCAL CHARTER SCHOOLS TO ENSURE THE WELLNESS OF STUDENTS THROUGHOUT THE SCHOOL YEAR. OBESITY (ACCESS TO HEALTHY FOODS): COMMUNITY HEALTH NETWORK TOOK OVER THE DAY-TO-DAY OPERATIONAL MANAGEMENT OF THE CUPBOARD, A FOOD PANTRY THAT SERVES RESIDENTS OF LAWRENCE TOWNSHIP OF INDIANAPOLIS, AND ASSISTS AN ESTIMATED 300 FAMILIES PER WEEK, PROVIDES HEALTHIER FOOD OPTIONS AND HELPS RELIEVE THE STRAIN CAUSED BY FOOD INSECURITY. IN 2018, THE CUPBOARD PROVIDED SERVICES TO APPROXIMATELY 57,235 PERSONS. THE CUPBOARD IS A CLIENT-CHOICE FOOD PANTRY, SERVING RESIDENTS THROUGH PARTNERSHIPS WITH GLEANERS FOOD BANK OF INDIANA, MIDWEST FOOD BANK, AND LOCAL RELIGIOUS INSTITUTIONS AND BUSINESSES. THE FOOD PANTRY IS OPEN WEDNESDAYS FROM 10 A.M. TO 4 P.M. AND 6 P.M. TO 8 P.M., FRIDAYS FROM 10 A.M. TO 4 P.M. AND THE THIRD SATURDAY OF THE MONTH FROM 10 A.M. TO NOON. COMMUNITY HEALTH NETWORK SUPPORTS MANY URBAN FARMING AND FARMERS MARKET INITIATIVES THAT PROVIDE FRESH PRODUCE AND HEALTHY OPTIONS. FARMERS MARKETS ARE FOR EVERYONE. ACCESS TO AFFORDABLE, FRESH, AND HEALTHY WHOLE FOODS IS A CHALLENGE FOR MANY PEOPLE WHO RELY ON FOOD ASSISTANCE PROGRAMS LIKE SNAP THAT HELP LOW-INCOME FAMILIES AND INDIVIDUALS BUY FRESH, INDIANA-GROWN FOOD THAT PROVIDES REAL SUSTENANCE FOR THEMSELVES AND THEIR COMMUNITIES. FOR INSTANCE, COMMUNITY EMPLOYEES ALSO VOLUNTEER AND SUPPORT INDY URBAN ACRES WHICH IS AN ORGANIC FARM THAT DONATES 100% OF THE FRESH FRUITS AND VEGETABLES HARVESTED TO LOCAL FOOD PANTRIES THROUGH A PARTNERSHIP WITH GLEANERS FOOD BANK. SINCE 2011, INDY URBAN ACRES HAS GROWN INTO A MULTI- DISCIPLINARY FARM THAT PROVIDES FOOD EQUALITY FOR LOW-INCOME FAMILIES, EDUCATES THOUSANDS OF YOUTH THROUGH TOURS AND FARM-TO-PLATE WORKSHOPS, PROVIDES COMMUNITY ENGAGEMENT TO THOUSANDS OF VOLUNTEERS AND GROUPS, TEACHES TEENS VALUABLE JOB SKILLS AND HELPS IMPROVE INDY'S FOOD SYSTEM. ASTHMA: OUR PRESIDENT AND CEO, BRYAN MILLS, HAS JOINED WITH A NUMBER OF PARTNERS FROM HEALTHCARE AND THE BUSINESS COMMUNITY-INCLUDING THE INDIANA HOSPITAL ASSOCIATION, THE INDIANA STATE MEDICAL ASSOCIATION AND THE INDIANA CHAMBER OF COMMERCE-TO CREATE A NEW ORGANIZATION KNOWN AS THE ALLIANCE FOR A HEALTHIER INDIANA. IN 2016, THE GROUP ANNOUNCED PLANS TO TACKLE ITS FIRST CHALLENGE: THE HIGH RATE OF TOBACCO USE IN OUR STATE. TOBACCO USE LEADS TO DISEASE AND DISABILITY AND HARMS NEARLY EVERY ORGAN OF THE BODY. IT IS THE LEADING CAUSE OF PREVENTABLE DEATH. RESEARCH HAS SHOWN THAT SMOKE FROM CIGARS, CIGARETTES, AND PIPES HARMS YOUR BODY IN MANY WAYS, BUT IT IS ESPECIALLY HARMFUL TO THE LUNGS OF A PERSON WITH ASTHMA. TOBACCO SMOKE - INCLUDING SECONDHAND SMOKE - IS ONE OF THE MOST COMMON ASTHMA TRIGGERS. THE ALLIANCE ASKED INDIANA'S STATE LEGISLATURE TO CONSIDER A VARIETY OF MEASURES, INCLUDING HIGHER TOBACCO TAXES, AN INCREASE IN THE SMOKING AGE AND A REPEAL OF THE SMOKERS' BILL OF RIGHTS. COMMUNITY HEALTH NETWORK MADE A MAJOR INVESTMENT OF TIME AND RESOURCES INTO A COMBINED TOBACCO CAMPAIGN THIS YEAR, AND WHILE WE DID NOT GET THE TOBACCO TAX INCREASE WE SOUGHT, WE DID MOVE THE BALL FORWARD ON A TAX AND SECURE A PARTIAL VICTORY ON TOBACCO CESSATION FUNDING. INDIANA LEGISLATORS PROVIDED A 50% INCREASE IN STATE FUNDING FOR TOBACCO CESSATION SERVICES, BRINGING THE ANNUAL TOBACCO CESSATION BUDGET TO 7.5 MILLION. THE NEW ALLIANCE FOR A HEALTHIER INDIANA IS A GREAT EXAMPLE OF HOW WE AT COMMUNITY PARTNER WITH OTHERS TO FURTHER OUR WORK. FROM FOOD INSECURITY TO EDUCATIONAL CHALLENGES TO SUICIDE TO SMOKING AND OTHER ADDICTIONS, WE'RE COMMITTED TO TACKLING SOCIETAL ISSUES THAT AFFECT HEALTH AND QUALITY OF LIFE. COMMUNITY-DRIVEN INITIATIVES COMMUNITY HEALTH NETWORK, CENTRAL INDIANA'S LARGEST PROVIDER OF BEHAVIORAL HEALTH SERVICES, ANNOUNCED ITS COMMITMENT TO BECOMING THE FIRST HEALTH CARE SYSTEM IN THE COUNTRY TO FULLY IMPLEMENT THE ZERO SUICIDE MODEL, DEVELOPED BY THE NATIONAL ACTION ALLIANCE FOR SUICIDE PREVENTION AND O
GROUP A, FACILITY 2, HOWARD REGIONAL SPECIALTY CARE - PART V, LINE 5	IN 2018, COMMUNITY HEALTH NETWORK CONDUCTED A CHNA TO UNDERSTAND THE GREATEST HEALTH NEEDS IN THE COMMUNITIES SERVED BY OUR HOSPITALS. THIS ASSESSMENT WAS IN LARGE PART A JOINT PROCESS AMONG FOUR INDIANA HEALTH SYSTEMS: COMMUNITY HEALTH NETWORK, IU HEALTH, ST. FRANCIS ALLIANCE, AND ST. VINCENT. COMBINED, THESE ARE THE LARGEST HEALTH SYSTEMS IN INDIANA. THROUGH THIS COLLABORATIVE PARTNERSHIP, COMMUNITY HEALTH DATA WAS COLLECTED IN THREE WAYS: 1. SECONDARY DATA COLLECTION: DATA ON HEALTH AND WELLNESS ISSUES WAS COLLECTED. SOURCES INCLUDE COUNTY HEALTH RANKINGS, CENSUS BUREAU DATA, VARIOUS REPORTS FROM THE INDIANA STATE DEPARTMENT OF HEALTH, AND OTHER NATIONAL REPORTS. INDIANA INDICATORS, COMMUNITY COMMONS, AND HEALTHY COMMUNITIES INSTITUTE DATA MANAGEMENT SYSTEMS ALSO CONTRIBUTED TO THE SECONDARY DATA USED. SOURCES OF THE SECONDARY DATA ARE IDENTIFIED THROUGHOUT THE COMMUNITY BENEFITS REPORT. 2. COMMUNITY HEALTH SURVEY: A CORE OF 20 MANDATORY QUESTIONS BASED ON PERCEPTION OF COMMUNITY AND PERSONAL NEEDS WERE CREATED. IN ADDITION, PROFESSIONALS ASSIGNED TO EACH COUNTY WORKED WITH ESTABLISHED COMMUNITY HEALTH COLLABORATIVES, LOCAL HOSPITALS, AND THE LOCAL HEALTH DEPARTMENT TO DEVELOP VOLUNTARY COMMUNITY HEALTH NEEDS ASSESSMENT TO CREATE 9 QUESTIONS SPECIFIC TO THE COUNTY. THIS RESULTED IN A SURVEY WITH 20 TO 29 QUESTIONS, DEPENDENT ON THE RESPONDENT'S COUNTY OF RESIDENCE. THE SURVEY WAS DISTRIBUTED ELECTRONICALLY AND ON PAPER. IN ADDITION TO THE QUANTITATIVE DATA, FREE TEXT RESPONSES WERE CODED AND CALCULATED TO PROVIDE FURTHER CLARIFICATION OF THE QUANTITATIVE DATA. 3. FOCUS GROUPS: IN ADDITION TO THE SURVEY THE PARTNERSHIP HOSTED FOCUS GROUPS THAT INCLUDED 15-60 COMMUNITY LEADERS FROM GOVERNMENTAL PUBLIC HEALTH, HEALTH CARE, SOCIAL SERVICE AGENCIES, RELATED NONPROFITS, CIVIC ORGANIZATIONS, AND GRASSROOTS/NEIGHBORHOOD ORGANIZATIONS. IN LARGER FOCUS GROUPS, SUB-GROUPS WERE UTILIZED TO GIVE ALL PARTICIPANTS A VOICE. EACH FOCUS GROUP DETERMINED THE TOP FOUR TO SIX HEALTH NEEDS IN THE COMMUNITY; POTENTIAL RESOURCES OR PARTNERS; AND SOME ACTIONS/INTERVENTIONS THAT MIGHT WORK BEST. OUTSIDE OF THE COLLABORATIVE, COMMUNITY HEALTH NETWORK INVITED KEY PUBLIC HEALTH INFORMANTS TO PROVIDE THEIR INPUT ON COMMUNITY HEALTH NEEDS. THE FOLLOWING INFORMANTS WERE INTERVIEWED: DUANE KRAMBECK - PRINCIPAL OF CHRISTIAN PARK ELEMENTARY SCHOOL IN INDIANAPOLIS PUBLIC SCHOOLS; MARY CONWAY, MSN, RN ADMINISTRATIVE COORDINATOR FOR NURSING SERVICES IN INDIANAPOLIS PUBLIC SCHOOLS; AND RANDY MILLER EXECUTIVE DIRECTOR OF DRUG FREE MARION COUNTY. THESE QUANTITATIVE AND QUALITATIVE DATA COLLECTION MECHANISMS HELPED IDENTIFY COMMUNITY HEALTH NEEDS AND SECONDARY DATA CONFIRMED THE NEEDS PERFORM BELOW STATE AVERAGES. FURTHER REVIEW OF THE HEALTH NEEDS DETERMINED THE EXTENT TO WHICH HEALTH INEQUITIES MAY EXIST AND WHICH SEGMENTS OF THE POPULATION ARE MORE NEGATIVELY IMPACTED.
GROUP A, FACILITY 2, HOWARD REGIONAL SPECIALTY CARE - PART V, LINE 6A	THE CHNA FOR COMMUNITY HOWARD REGIONAL HEALTH, INC. WAS A JOINT PROCESS AMONG ALL OF THE COMMUNITY HEALTH NETWORK HOSPITALS WHICH INCLUDES: COMMUNITY HEALTH NETWORK, INC. (NORTH, EAST, & INDIANA HEART HOSPITAL, LLC), COMMUNITY HOSPITAL SOUTH, INC., COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC., COMMUNITY HOWARD REGIONAL HEALTH, INC., INDIANA HEART HOSPITAL, LLC, AND INDIANAPOLIS OSTEOPATHIC HOSPITAL, INC. IN ADDITION, THE HOSPITAL COLLABORATED WITH FRANCISCAN ST. FRANCIS HEALTH, IU HEALTH UNIVERSITY HOSPITAL, AND ST. VINCENT HOSPITAL.
GROUP A, FACILITY 2, HOWARD REGIONAL SPECIALTY CARE - PART V, LINE 6B	THE CHNA WAS ALSO CONDUCTED WITH HEALTHY COMMUNITIES INSTITUTE.
GROUP A, FACILITY 2, HOWARD REGIONAL SPECIALTY CARE - PART V, LINE 11	CHRH IS ADDRESSING THE SIGNIFICANT NEEDS OF THE COMMUNITY BASED ON INPUT PROVIDED BY COMMUNITY RESIDENTS, PUBLIC HEALTH PARTNERS, INTERNAL AND EXTERNAL LEADERSHIP WHO PARTICIPATED IN FOCUS GROUPS, STAKEHOLDER INTERVIEWS OR COMPLETED THE CHNA SURVEY THROUGHOUT THE CENTRAL INDIANA REGION. CHNA DATA WAS ANALYZED AND PRIORITIZED USING THESE KEY FACTORS: FEASIBILITY FOR OUR HOSPITALS TO IMPACT CHANGE, HEALTH SYSTEM EXPERTISE IN THE FIELD OF THE ASSESSED NEED, AND THE HOSPITALS ABILITY TO BE THE MOST EFFECTIVE WITH THE RESOURCES AVAILABLE. THE FOUR SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ALL OUR COMMUNITIES WERE: ACCESS TO HEALTHCARE; OBESITY; PEDIATRIC ASTHMA AND COMMUNITY DRIVEN INITIATIVES. A MISSION CENTERED ON HELPING OTHERS IS THE FOUNDATION OF EVERYTHING WE DO AT COMMUNITY HEALTH NETWORK - AND EXTENDS FROM THE CARE WE PROVIDE TO THE COMMUNITIES WE SERVE THROUGH A BROAD SPECTRUM OF COMMUNITY BENEFIT ACTIVITIES OR PROGRAMS. OUR COMMUNITY BENEFIT RESPONDS TO IDENTIFIED COMMUNITY NEEDS AND MEETS AT LEAST ONE OF THE FOLLOWING CRITERIA: 1. IMPROVES ACCESS TO HEALTH CARE SERVICES. 2. ENHANCES HEALTH OF THE COMMUNITY. 3. ADVANCES MEDICAL OR HEALTH KNOWLEDGE. 4. RELIEVES OR REDUCES THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. OUR COMMUNITY BENEFIT IS ORGANIZED IN THREE CATEGORIES: CATEGORY 1: FINANCIAL ASSISTANCE-FREE OR DISCOUNTED HEALTH SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD TO PAY AND WHO MEET THE ELIGIBILITY CRITERIA OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. FINANCIAL ASSISTANCE IS REPORTED IN TERMS OF COSTS, NOT CHARGES. FINANCIAL ASSISTANCE DOES NOT INCLUDE BAD DEBT. CATEGORY 2: GOVERNMENT-SPONSORED MEANS-TESTED HEALTH CARE-UNPAID COSTS OF PUBLIC PROGRAMS FOR LOW-INCOME PERSONS - THE SHORTFALL CREATED WHEN A FACILITY RECEIVES PAYMENTS THAT ARE LESS THAN THE COST OF CARING FOR PUBLIC PROGRAM BENEFICIARIES. THIS PAYMENT SHORTFALL IS NOT THE SAME AS A CONTRACTUAL ALLOWANCE, WHICH IS THE FULL DIFFERENCE BETWEEN CHARGES AND GOVERNMENT PAYMENTS. CATEGORY 3: COMMUNITY BENEFIT SERVICES- PROGRAMS THAT RESPOND TO AN IDENTIFIED COMMUNITY HEALTH NEED AND ARE DESIGNED TO ACCOMPLISH ONE OR MORE COMMUNITY BENEFIT OBJECTIVES; PROGRAMS AND ACTIVITIES DIRECTED TO OR INCLUDING AT-RISK PERSONS, SUCH AS UNDERINSURED AND UNINSURED PERSONS AND PROGRAMS OFFERED TO THE BROAD COMMUNITY (INCLUDING AT-RISK PERSONS) DESIGNED TO IMPROVE COMMUNITY HEALTH. HIGHLIGHTS FOR COMMUNITY BENEFIT SERVICES THAT ALIGN WITH THE IDENTIFIED NEEDS INCLUDES: ACCESS TO HEALTHCARE: COMMUNITY HEALTH NETWORK SUPPORTS THE JANE PAULEY COMMUNITY HEALTH CENTER WHICH OPENED ITS DOORS IN SEPTEMBER 2009 TO PROVIDE PRIMARY HEALTH SERVICES TO EASTSIDE RESIDENTS, REGARDLESS OF INCOME OR INSURANCE COVERAGE. WITH 16 LOCATIONS, THE CENTER SERVES IN PARTNERSHIP WITH THE METROPOLITAN SCHOOL DISTRICT OF WARREN TOWNSHIP, COMMUNITY HEALTH NETWORK, THE COMMUNITY HEALTH NETWORK FOUNDATION, IU SCHOOL OF DENTISTRY AND HANCOCK REGIONAL HOSPITAL. SERVICES ARE PROVIDED ON A DISCOUNTED BASIS BASED ON THE PATIENT'S HOUSEHOLD INCOME. EASTSIDE INDIANAPOLIS NATIVE AND FORMER NBC NEWS ANCHOR JANE PAULEY LENT HER NAME TO THE FACILITY AS AN ADVOCATE FOR ACCESSIBLE HEALTHCARE SERVICES FOR PEOPLE UNDERSERVED BY TRADITIONAL HEALTHCARE MODELS. THE CENTER OFFERS A FULL RANGE OF SERVICES INCLUDING PRIMARY HEALTHCARE, CASE MANAGEMENT, PRESCRIPTION ASSISTANCE AND BEHAVIORAL HEALTH SERVICES, WHILE ALSO FOCUSING ON THE MANAGEMENT OF CHRONIC DISEASES. THE CENTER IS ABLE TO PROVIDE ALL OF THESE IN BOTH ENGLISH AND SPANISH. COMMUNITY HEALTH NETWORK'S SCHOOL-BASED PROGRAMS COVER A WIDE RANGE OF NEEDS FOR YOUTH ACROSS CENTRAL INDIANA. ONSITE NURSES, THERAPISTS AND PHYSICIANS ADDRESS STUDENTS' NEEDS IN THE SCHOOL AND AFTER-SCHOOL SETTING, HELPING TO ENSURE CONSISTENCY IN CARE AND LESS TIME AWAY FROM THE CLASSROOM OR PLAYING FIELD. THE VAST MAJORITY OF THESE SERVICES, INCLUDING ANY NURSING OR BEHAVIORAL HEALTH SUPPORT, ARE OFFERED FREE OF CHARGE TO SCHOOLS THANKS TO COMMUNITY'S ON-GOING COMMITMENT TO ENHANCING HEALTH FOR FUTURE GENERATIONS. FROM EVERYDAY SCRAPES AND BRUISES ON THE PLAYGROUND TO MANAGING CHRONIC ILLNESSES LIKE ASTHMA AND DIABETES, COMMUNITY NURSES OFFER SUPPORT FOR STUDENTS AT MORE THAN 100 SCHOOLS IN THE COMMUNITIES WE SERVE. THEIR WORK ENSURED A 97.2 PERCENT RETURN TO CLASSROOM RATE FOR STUDENTS WHO CAME TO THEM FOR CARE IN 2018. SPECIFIC SERVICES OFFERED TO STUDENTS INCLUDE: 1. MANAGEMENT OF INJURIES REQUIRING FIRST AID; 2. MANAGEMENT OF LIFE-THREATENING ALLERGIES, ASTHMA, DIABETES AND SEIZURES; 3. MANAGEMENT OF ANY HEALTH CONCERN AND REFERRAL TO APPROPRIATE CARE WHEN NEEDED; AND 4. EMERGENCY RESPONSE TO ANY HEALTH-RELATED CONCERN WITHIN THE SCHOOL BUILDING. IN ADDITION, FOR STUDENTS FACING CHRONIC HEALTH CONDITIONS AND ONGOING HEALTH NEEDS, MEDICATIONS PRESCRIBED BY PHYSICIANS ARE ADMINISTERED BY COMMUNITY'S SCHOOL-BASED NURSING STAFF. IN THE INSTANCE OF OCCASIONAL MEDICATION NEEDS, PARENTS FURNISH OVER-THE-COUNTER MEDICATIONS THAT ARE THEN ADMINISTERED BY NURSING STAFF. AND, FOR PREVENTATIVE CARE PURPOSES, NURSING STAFF ADMINISTER FLU VACCINES AT A NUMBER OF LOCAL CHARTER SCHOOLS TO ENSURE THE WELLNESS OF STUDENTS THROUGHOUT THE SCHOOL YEAR. OBESITY (ACCESS TO HEALTHY FOODS): COMMUNITY HEALTH NETWORK TOOK OVER THE DAY-TO-DAY OPERATIONAL MANAGEMENT OF THE CUPBOARD, A FOOD PANTRY THAT SERVES RESIDENTS OF LAWRENCE TOWNSHIP OF INDIANAPOLIS, AND ASSISTS AN ESTIMATED 300 FAMILIES PER WEEK, PROVIDES HEALTHIER FOOD OPTIONS AND HELPS RELIEVE THE STRAIN CAUSED BY FOOD INSECURITY. IN 2018, THE CUPBOARD PROVIDED SERVICES TO APPROXIMATELY 57,235 PERSONS. THE CUPBOARD IS A CLIENT-CHOICE FOOD PANTRY, SERVING RESIDENTS THROUGH PARTNERSHIPS WITH GLEANERS FOOD BANK OF INDIANA, MIDWEST FOOD BANK, AND LOCAL RELIGIOUS INSTITUTIONS AND BUSINESSES. THE FOOD PANTRY IS OPEN WEDNESDAYS FROM 10 A.M. TO 4 P.M. AND 6 P.M. TO 8 P.M., FRIDAYS FROM 10 A.M. TO 4 P.M. AND THE THIRD SATURDAY OF THE MONTH FROM 10 A.M. TO NOON. COMMUNITY HEALTH NETWORK SUPPORTS MANY URBAN FARMING AND FARMERS MARKET INITIATIVES THAT PROVIDE FRESH PRODUCE AND HEALTHY OPTIONS. FARMERS MARKETS ARE FOR EVERYONE. ACCESS TO AFFORDABLE, FRESH, AND HEALTHY WHOLE FOODS IS A CHALLENGE FOR MANY PEOPLE WHO RELY ON FOOD ASSISTANCE PROGRAMS LIKE SNAP THAT HELP LOW-INCOME FAMILIES AND INDIVIDUALS BUY FRESH, INDIANA-GROWN FOOD THAT PROVIDES REAL SUSTENANCE FOR THEMSELVES AND THEIR COMMUNITIES. FOR INSTANCE, COMMUNITY EMPLOYEES ALSO VOLUNTEER AND SUPPORT INDY URBAN ACRES WHICH IS AN ORGANIC FARM THAT DONATES 100% OF THE FRESH FRUITS AND VEGETABLES HARVESTED TO LOCAL FOOD PANTRIES THROUGH A PARTNERSHIP WITH GLEANERS FOOD BANK. SINCE 2011, INDY URBAN ACRES HAS GROWN INTO A MULTI- DISCIPLINARY FARM THAT PROVIDES FOOD EQUALITY FOR LOW-INCOME FAMILIES, EDUCATES THOUSANDS OF YOUTH THROUGH TOURS AND FARM-TO-PLATE WORKSHOPS, PROVIDES COMMUNITY ENGAGEMENT TO THOUSANDS OF VOLUNTEERS AND GROUPS, TEACHES TEENS VALUABLE JOB SKILLS AND HELPS IMPROVE INDY'S FOOD SYSTEM. ASTHMA: OUR PRESIDENT AND CEO, BRYAN MILLS, HAS JOINED WITH A NUMBER OF PARTNERS FROM HEALTHCARE AND THE BUSINESS COMMUNITY-INCLUDING THE INDIANA HOSPITAL ASSOCIATION, THE INDIANA STATE MEDICAL ASSOCIATION AND THE INDIANA CHAMBER OF COMMERCE-TO CREATE A NEW ORGANIZATION KNOWN AS THE ALLIANCE FOR A HEALTHIER INDIANA. IN 2016, THE GROUP ANNOUNCED PLANS TO TACKLE ITS FIRST CHALLENGE: THE HIGH RATE OF TOBACCO USE IN OUR STATE. TOBACCO USE LEADS TO DISEASE AND DISABILITY AND HARMS NEARLY EVERY ORGAN OF THE BODY. IT IS THE LEADING CAUSE OF PREVENTABLE DEATH. RESEARCH HAS SHOWN THAT SMOKE FROM CIGARS, CIGARETTES, AND PIPES HARMS YOUR BODY IN MANY WAYS, BUT IT IS ESPECIALLY HARMFUL TO THE LUNGS OF A PERSON WITH ASTHMA. TOBACCO SMOKE - INCLUDING SECONDHAND SMOKE - IS ONE OF THE MOST COMMON ASTHMA TRIGGERS. THE ALLIANCE ASKED INDIANA'S STATE LEGISLATURE TO CONSIDER A VARIETY OF MEASURES, INCLUDING HIGHER TOBACCO TAXES, AN INCREASE IN THE SMOKING AGE AND A REPEAL OF THE SMOKERS' BILL OF RIGHTS. COMMUNITY HEALTH NETWORK MADE A MAJOR INVESTMENT OF TIME AND RESOURCES INTO A COMBINED TOBACCO CAMPAIGN THIS YEAR, AND WHILE WE DID NOT GET THE TOBACCO TAX INCREASE WE SOUGHT, WE DID MOVE THE BALL FORWARD ON A TAX AND SECURE A PARTIAL VICTORY ON TOBACCO CESSATION FUNDING. INDIANA LEGISLATORS PROVIDED A 50% INCREASE IN STATE FUNDING FOR TOBACCO CESSATION SERVICES, BRINGING THE ANNUAL TOBACCO CESSATION BUDGET TO 7.5 MILLION. THE NEW ALLIANCE FOR A HEALTHIER INDIANA IS A GREAT EXAMPLE OF HOW WE AT COMMUNITY PARTNER WITH OTHERS TO FURTHER OUR WORK. FROM FOOD INSECURITY TO EDUCATIONAL CHALLENGES TO SUICIDE TO SMOKING AND OTHER ADDICTIONS, WE'RE COMMITTED TO TACKLING SOCIETAL ISSUES THAT AFFECT HEALTH AND QUALITY OF LIFE. COMMUNITY-DRIVEN INITIATIVES COMMUNITY HEALTH NETWORK, CENTRAL INDIANA'S LARGEST PROVIDER OF BEHAVIORAL HEALTH SERVICES, ANNOUNCED ITS COMMITMENT TO BECOMING THE FIRST HEALTH CARE SYSTEM IN THE COUNTRY TO FULLY IMPLEMENT THE ZERO SUICIDE MODEL, DEVELOPED BY THE NATIONAL ACTION ALLIANCE FOR SUICIDE PREVENTION AND O

Field	Value	IRS element (for citing)
Facility	3	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
COMMUNITY COUNSELING CENTER
205 N JACKSON	FRANKFORT	IN	46041	HEALTH CARE
FRANCES HOUSE CSS
3322 FRANCES LANE	KOKOMO	IN	46901	HEALTH CARE
ASSERTIVE COMMUNITY TREATMENT
416 PILLARS PLACE	KOKOMO	IN	46902	HEALTH CARE

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE	CHRH ALSO CONSIDERS THE PATIENT'S MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY WHEN CONSIDERING THE PATIENT FOR FINANCIAL ASSISTANCE.
PART I, LINE 6A - RELATED ORGANIZATION INFORMATION	A COMMUNITY BENEFIT REPORT IS COMPLETED FOR THE COMMUNITY HEALTH NETWORK INCLUDING COMMUNITY HOWARD REGIONAL HEALTH, INC. AND OTHER TAX-EXEMPT AFFILIATES OF THE NETWORK.
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION	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 II - COMMUNITY BUILDING ACTIVITIES SEE ATTACHED IRS SCHEDULE H SUPPLEMENTAL INFORMATION REPORT
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY	THE COST TO CHARGE RATIO UTILIZED FOR PURPOSES OF REPORTING BAD DEBT COSTS WAS DERIVED FROM WORKSHEET 2 AND IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. ADDITIONALLY, COMMUNITY HEALTH NETWORK ADOPTED A NEW STANDARE RELATED TO REVENUE RECOGNITION AND CODIFIED IN THE FASB ACCOUNTING STANDARDS CODIFICATION ("ASC) AS TOPIC 606 ("ASC 606") IN FISCAL YEAR 2018. BECAUSE OF THE ADOPTION OF THIS STANDARD FROM AN ACCOUNTING PRESENTATION STAND POINT THE NETWORK NO LONGER EXPLICITLY REPORTS BAD DEBT EXPENSE ON THE AUDITED FINANCIAL STATEMENTS. HOWEVER, THE NETWORK STILL DOES INCUR A SIGNIFICAN AMOUNT OF ADJUSTMENTS TO PATIENT'S ACCOUNTS FOR THOSE WHO DO NOT PAY THEIR PATIENT BALANCE WHICH RESULTS IN A SIGNIFICANT AND MATERIAL COST TO THE NETWORK. AS SUCH THE NETWORK WILL CONTINUE TO REPORT IN LINE 2 THE AMOUNT OF ADJUSTMENTS RELATED TO ADJUSTMENTS PREVIOUSLY IDENTIFIED AS BAD DEBT. PART III, LINE 4 - BAD DEBT EXPENSE EXPLANATION THE AUDITED FINANCIAL STATEMENTS CONTAIN THE FOLLOWING TEXT WITHIN THE FOOTNOTES TO DESCRIBE BAD DEBT EXPENSE: PATIENT ACCOUNTS RECEIVABLE AT DECEMBER 31, 2018 ARE REPORTED AT THE AMOUNTS THAT REFLECTS THE CONSIDERATION WHICH THE NETWORK EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE, AS FURTHER DESCRIBED IN THE NOTE 2. AT DECEMBER 31, 2017, THE NETWORK'S PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS OF 541,715000 AND CONTRACTUAL ADJUSTMENTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE NETWORK ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE NETWORK ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS. GENERALLY, FOR RECEIVABLES ASSOCIATED WITH UNINSURED PATIENTS, INCLUDING PATIENT DEDUCTIBLES AND CO- INSURANCE, THE NETWORK RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS ADJUSTED THROUGH THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. 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 WRITTEN-OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AFTER EXHAUSTING COLLECTION EFFORTS. ANY SUBSEQUENT RECOVERIES ARE RECORDED AGAINST THE PROVISION FOR BAD DEBTS. CERTAIN ACCOUNTS THAT ARE SENT TO COLLECTION COMPANIES REMAIN AS ACCOUNTS RECEIVABLE ON THE BALANCE SHEET. THESE ACCOUNTS ARE NOT WRITTEN OFF UNLESS RETURNED FROM THE COLLECTION COMPANY, HOWEVER THEY ARE FULLY RESERVED WITHIN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE COLLECTION OF OUTSTANDING RECEIVABLES FOR MEDICARE, MEDICAID, MANAGED CARE AND COMMERCIAL INSURANCE PAYERS, AND PATIENTS IS THE NETWORK'S PRIMARY SOURCE OF CASH AND IS CRITICAL TO THE NETWORK'S OPERATING PERFORMANCE. THE PRIMARY COLLECTION RISKS RELATE TO UNINSURED PATIENT ACCOUNTS AND PATIENT ACCOUNTS FOR WHICH THE PRIMARY INSURANCE CARRIER HAS PAID THE AMOUNTS COVERED BY THE APPLICABLE AGREEMENT, BUT PATIENT RESPONSIBILITY AMOUNTS (DEDUCTIBLES AND COPAYMENTS) REMAIN OUTSTANDING. THE NETWORK GRANTS CREDIT WITHOUT COLLATERAL TO ITS PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY PAYER AGREEMENTS. THE CONCENTRATION OF NET RECEIVABLES BY PRIMARY PAYER CLASS FOR BOTH PATIENTS AND THIRD-PARTY PAYERS AT DECEMBER 31, 2018 AND 2017 IS AS FOLLOWS: 2018 2017 MEDICARE 23% 22% MEDICAID 11% 13% MANAGED CARE & COMMERCIAL INSURANCE 53% 50% PATIENTS 13% 15% ---- ---- 100% 100% THE NETWORK MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THE NETWORK PROVIDES 100% CHARITY CARE TO PATIENTS WHOSE INCOME LEVEL IS EQUAL TO OR BELOW 200% OF THE FEDERAL POVERTY LEVEL. PATIENTS WITH INCOME LEVELS RANGING FROM 200% - 300% OF THE CURRENT YEAR'S FEDERAL POVERTY LEVEL WILL QUALIFY FOR PARTIAL ASSISTANCE DETERMINED BY A SLIDING SCALE. THE NETWORK USES COST AS THE MEASUREMENT BASIS FOR CHARITY CARE DISCLOSURE PURPOSES WITH THE COST BEING IDENTIFIED AS THE DIRECT AND INDIRECT COSTS OF PROVIDING THE CHARITY CARE. CHARITY CARE AT COST WAS 10,719000 AND 5,701000 FOR THE YEARS ENDED DECEMBER 31, 2018 AND 2017, RESPECTIVELY. CHARITY CARE COST WAS ESTIMATED ON THE APPLICATION OF THE ASSOCIATED COST-TO-CHARGE RATIOS. IN MAY 2014, THE FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ISSUED A NEW STANDARD RELATED TO REVENUE RECOGNITION AND CODIFIED IN THE FASB ACCOUNTING STANDARDS CODIFICATION ("ASC") AS TOPIC 606 ("ASC 606"). THE NETWORK ADOPTED THE NEW STANDARD EFFECTIVE JANUARY 1, 2018, USING THE MODIFIED RETROSPECTIVE METHOD. AS A RESULT, UPON THE NETWORK'S ADOPTION OF ASC 606 THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS THE PROVISION FOR BAD DEBTS IN THE STATEMENT OF OPERATIONS IS NOW REFLECTED AS IMPLICIT PRICE CONCESSIONS (AS DEFINED IN ASC 606) AND THEREFORE IS INCLUDED AS A REDUCTION TO NET OPERATING REVENUES IN 2018. FOR CHANGES IN CREDIT ISSUES NOT ASSESSED AT THE DATE OF SERVICE, THE NETWORK PROSPECTIVELY RECOGNIZES THOSE AMOUNTS IN OTHER OPERATING EXPENSES ON THE STATEMENT OF OPERATIONS. THE ADOPTION OF THE NEW STANDARD DID NOT HAVE AN IMPACT ON THE NETWORK'S RECOGNITION OF NET REVENUES FOR ANY PERIODS PRIOR TO ADOPTION. THE NETWORK'S REVENUES FOR THE YEAR ENDED DECEMBER 31, 2018 ARE PRESENTED NET OF ESTIMATED IMPLICIT PRICE CONCESSION IN REVENUE DEDUCTIONS. THE NETWORK HAS ELIMINATED THE PRESENTATION OF "ALLOWANCES FOR DOUBTFUL ACCOUNTS" ON ITS CONSOLIDATED BALANCE SHEETS AND THE PRESENTATION OF "PROVISIONS FOR BAD DEBTS" ON ITS CONSOLIDATED STATEMENTS OF OPERATIONS AS A RESULT OF THE ADOPTION OF THE NEW STANDARD. OTHER THAN THESE CHANGES IN PRESENTATION ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CONSOLIDATED BALANCE SHEET, THE ADOPTION OF ASC 606 DID NOT HAVE A MATERIAL IMPACT ON THE CONSOLIDATED RESULTS OF OPERATIONS FOR THE YEAR ENDED DECEMBER 31, 2018. FOR THE YEAR ENDED DECEMBER 31, 2018, THE NETWORK'S REVENUES GENERALLY RELATE TO CONTRACTS WITH PATIENTS IN WHICH THE NETWORK'S PERFORMANCE OBLIGATIONS ARE TO PROVIDE HEALTH CARE SERVICES TO THE PATIENTS. PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE NETWORK EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS AND THIRD-PARTY PAYERS (INCLUDING GOVERNMENT PROGRAMS AND MANAGED CARE AND COMMERCIAL INSURANCE COMPANIES), AND INCLUDE VARIABLE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS, REVIEWS, AND INVESTIGATIONS. GENERALLY, THE NETWORK BILLS THE PATIENTS AND THIRD-PARTY PAYERS SEVERAL DAYS AFTER THE SERVICES ARE PERFORMED OR THE PATIENT IS DISCHARGED FROM THE FACILITY. REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED. THE NETWORK DETERMINES THE TRANSACTION PRICE BASED ON STANDARD CHARGES, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD-PARTY PAYERS, DISCOUNTS PROVIDED TO UNINSURED PATIENTS IN ACCORDANCE WITH THE NETWORK'S POLICY, AND IMPLICIT PRICE CONCESSIONS. PERFORMANCE OBLIGATIONS ARE DETERMINED BASED ON THE NATURE OF THE SERVICES PROVIDED BY THE NETWORK. REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED OVER TIME IS RECOGNIZED BASED ON ACTUAL CHARGES INCURRED IN RELATION TO TOTAL EXPECTED OR ACTUAL CHARGES. THE NETWORK BELIEVES THAT THIS METHOD PROVIDES A FAITHFUL DEPICTION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATION. GENERALLY, PERFORMANCE OBLIGATIONS SATISFIED OVER TIME RELATE TO PATIENTS IN OUR HOSPITALS RECEIVING INPATIENT ACUTE CARE SERVICES. THE NETWORK MEASURES THE PERFORMANCE OBLIGATION FROM ADMISSION INTO THE HOSPITAL TO THE POINT WHEN IT IS NO LONGER REQUIRED TO PROVIDE SERVICES TO THAT PATIENT, WHICH IS GENERALLY AT THE TIME OF DISCHARGE. REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED AT A POINT IN TIME, WHICH INCLUDES OUTPATIENT SERVICES, IS GENERALLY RECOGNIZED WHEN SERVICES ARE PROVIDED TO OUR PATIENTS AND THE NETWORK DOES NOT BELIEVE IT IS REQUIRED TO PROVIDE ADDITIONAL SERVICES TO THE PATIENT. BECAUSE ALL OF ITS PERFORMANCE OBLIGATIONS RELATE TO CONTRACTS WITH A DURATION OF LESS THAN ONE YEAR, THE NETWORK HAS ELECTED TO APPLY THE OPTIONAL EXEMPTION PROVIDED IN FASB ASC 606-10-50-14A AND, THEREFORE, IS NOT REQUIRED TO DISCLOSE THE AGGREGATE AMOUNT OF THE TRANSACTION PRICE ALLOCATED TO PERFORMANCE OBLIGATIONS THAT ARE UNSATISFIED OR PARTIALLY UNSATISFIED AT THE END OF THE REPORTING PERIOD. THE UNSATISFIED OR PARTIALLY UNSATISFIED PERFORMANCE OB
PART III, LINE 8 - MEDICARE EXPLANATION	PER THE 990 INSTRUCTIONS THE MEDICARE COST REPORT WAS UTILIZED TO DETERMINE THE MEDICARE SHORTFALL. HOWEVER, THE MEDICARE COST REPORT IS NOT REFLECTIVE OF ALL COSTS ASSOCIATED WITH MEDICARE PROGRAMS SUCH AS PHYSICIAN SERVICES AND SERVICES BILLED VIA FREE STANDING CLINICS. FURTHER THE MEDICARE COST REPORT EXCLUDES REVENUES AND COSTS OF MEDICARE PARTS C AND D. THE MEDICARE SHORTFALL ATTRIBUTED TO THOSE AREAS NOT INCLUDED ON THE MEDICARE COST REPORT IS 2,708,632. AS SUCH, THE TOTAL MEDICARE SHORTFALL FOR ALL MEDICARE PROGRAMS IS 8,725,915. MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS COMMUNITY BENEFIT BECAUSE MEDICARE REPRESENTS 51.41% OF THE OVERALL PAYER MIX FOR THIS ORGANIZATION.
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION	NOTWITHSTANDING ANY OTHER PROVISION OF ANY OTHER POLICY AT COMMUNITY REGARDING BILLING AND COLLECTION MATTERS, COMMUNITY WILL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS BEFORE IT MAKES REASONABLE EFFORTS TO DETERMINE WHETHER AN INDIVIDUAL WHO HAS AN UNPAID BILL FROM COMMUNITY IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY. THE ACTIONS COMMUNITY MAY TAKE IN THE EVENT OF NONPAYMENT AND THE PROCESS AND TIME FRAMES FOR TAKING THESE ACTIONS ARE MORE FULLY DESCRIBED IN COMMUNITY'S BILLING AND COLLECTIONS POLICY.
PART VI, LINE 2 - NEEDS ASSESSMENT	THE IDENTIFICATION OF HEALTH NEEDS FOR CHNW REGIONS WAS CARRIED OUT USING TWO TYPES OF DATA: (1) PRIMARY DATA OBTAINED THROUGH AN ONLINE SURVEY OF CHNW HEALTHCARE PROVIDERS (E.G. PHYSICIANS, NURSES, AND SOCIAL WORKERS) AND A SURVEY OF COMMUNITY RESIDENTS IN EACH CHNW REGION. TO SUPPLEMENT THIS DATA AND IDENTIFY POPULATION-SPECIFIC HEALTH NEEDS AMONG COMMUNITY MEMBERS IN THE HOWARD REGION IN PARTICULAR, FOCUS GROUPS WITH COMMUNITY STAKEHOLDERS WERE ALSO CONDUCTED. (2) SECONDARY DATA FROM THE HEALTHY COMMUNITIES INSTITUTE (HCI) DASHBOARD AND OTHER LOCAL AND NATIONAL AGENCIES (E.G. COUNTY HEALTH RANKINGS). THESE DATA SOURCES ARE DESCRIBED IN THE FOLLOWING SECTIONS: PRIMARY DATA: THIS ASSESSMENT USED THREE SOURCES OF COMMUNITY INPUT: 1) AN ONLINE SURVEY OF CHNW PROVIDERS; 2) FOCUS GROUPS WITH COMMUNITY STAKEHOLDER ORGANIZATIONS; AND 3) A COMMUNITY SURVEY. IMPORTANTLY, FOCUS GROUPS CONDUCTED FOR THIS CHNA INCLUDED REPRESENTATIVES FROM A GOVERNMENTAL HEALTH DEPARTMENT. THE PRIMARY DATA GATHERING AND ANALYSIS PROCESS IS DESCRIBED IN MORE DETAIL BELOW. CHNW PROVIDER SURVEY: AN ONLINE SURVEY OF CHNW HEALTH PROVIDERS WAS CONDUCTED IN APRIL 2018 TO COLLECT CHNW PROVIDER PERCEPTIONS ABOUT WHAT POPULATIONS WERE AT GREATEST SOCIAL/MEDICAL DISADVANTAGE AND WHICH COMMUNITY CIRCUMSTANCES IMPACTING POPULATION HEALTH WERE MOST URGENT. ANY CLINICIAN THAT INTERACTS WITH PATIENTS WAS INVITED TO PARTICIPATE IN THE PROVIDER SURVEY. THE SURVEY WAS DESIGNED BY POLIS AND THE FAIRBANKS SCHOOL OF PUBLIC HEALTH (FSPH) IN PARTNERSHIP WITH CHNW AND IMPLEMENTED USING QUALTRICS, AN ONLINE SURVEY SERVICE. A TOTAL OF 819 CHNW PROVIDERS RESPONDED TO THE SURVEY. SEVEN PERCENT (7%, N=58) OF THOSE NAMED THE HOWARD REGION AS THEIR REGION OF PRIMARY PRACTICE OR SERVICE. THE MAJORITY OF THE RESPONDENTS FROM THE HOWARD REGION WERE PT/OT/SPEECH THERAPIST (23%), OTHER (21%), AND NURSE (12%), FOLLOWED BY BEHAVIORAL HEALTH PROVIDER (14%), PRIMARY (10%), AND SPECIALTY HEALTHCARE PROVIDER (10%), ADMINISTRATOR (5%), AND SOCIAL WORKER/CASE MANAGER (5%). FOCUS GROUPS: A FOCUS GROUP WITH COMMUNITY STAKEHOLDER ORGANIZATIONS FROM THE HOWARD REGION WAS ORGANIZED BY CHNW AND DESIGNED AND CONDUCTED BY FSPH ON APRIL 10, 2018. REPRESENTATIVES FROM FIFTEEN ORGANIZATIONS IN HOWARD COUNTY PARTICIPATED IN THE CHNW HOWARD REGION FOCUS GROUP. A VARIETY OF ORGANIZATION TYPES, INCLUDING SCHOOL SYSTEMS, SOCIAL SERVICES, HEALTHCARE, STATE GOVERNMENT, LAW ENFORCEMENT, AND GOVERNMENTAL PUBLIC HEALTH WERE REPRESENTED IN THE FOCUS GROUPS. FOCUS GROUP PARTICIPANTS WERE ASKED TO INDICATE THE TWO MOST IMPORTANT UNMET NEEDS AFFECTING THE HEALTH OF THEIR COMMUNITY AND THE TWO MOST VULNERABLE POPULATIONS. AT THE END OF THE FOCUS GROUPS, PARTICIPANTS WERE ASKED TO DISCUSS POSSIBLE SOLUTIONS TO ADDRESS THE UNMET NEEDS AMONG THE MOST VULNERABLE POPULATIONS. THE FOLLOWING COMMUNITY STAKEHOLDER ORGANIZATIONS PARTICIPATED IN THE APRIL 10, 2018 FOCUS GROUP IN THE HOWARD REGION: 1. YMCA 2. KOKOMO SCHOOLS 3. GILEAD HOUSE 4. UNITED WAY (211) 5. SAMARITAN CAREGIVERS 6. PROJECT ACCESS 7. HOWARD COUNTY HEALTH DEPARTMENT 8. KOKOMO CITY COUNCIL 9. MENTAL HEALTH AMERICA - HOWARD COUNTY 10. INDIANA MINORITY HEALTH COALITION 11. INDIANA HEALTH CENTER 12. TAYLOR SCHOOL CORPORATION 13. WESTERN SCHOOL CORPORATION 14. KOKOMO RESCUE 15. KOKOMO HOUSING AUTHORITY KEY INFORMANT INTERVIEWS WERE ALSO CONDUCTED WITH THE STATE OF INDIANA'S TOP HEALTH LEADERS: DIRECTOR OF THE MARION COUNTY PUBLIC HEALTH DEPARTMENT, THE COMMISSIONER FOR THE INDIANA STATE DEPARTMENT OF HEALTH, AND THE FAMILY AND SOCIAL SERVICES ADMINISTRATION. COMMUNITY SURVEY: THE FIVE MAJOR HOSPITAL SYSTEMS IN INDIANAPOLIS REFERRED TO AS THE INDIANAPOLIS HOSPITAL COLLABORATIVE AND INCLUDING CHNW, JOINTLY CONTRACTED THE UNIVERSITY OF EVANSVILLE AND THE INDIANA UNIVERSITY CENTER FOR SURVEY RESEARCH (CSR) TO DESIGN AND CONDUCT A BROAD COMMUNITY SURVEY IN 2018. THIS SURVEY WAS DESIGNED AND CONDUCTED INDEPENDENTLY OF THE CHNA ACTIVITIES CONDUCTED BY POLIS AND FSPH. TWO QUESTIONS FROM THIS SURVEY WERE USED AS MEASURES OF COMMUNITY CONCERN FOR THE CHNW CHNA. ONE QUESTION ASKED RESPONDENTS TO CHOOSE WHAT THEY PERCEIVED AS TOP HEALTH CONCERNS IN THEIR COMMUNITY AND A SECOND QUESTION ASKED RESPONDENTS TO INDICATE HOW IMPORTANT LISTED HEALTH AND COMMUNITY SERVICES WERE FOR THEIR COMMUNITY. AS PART OF THEIR SURVEY EFFORT, CSR SELECTED RANDOM, ADDRESS-BASED POPULATION SAMPLES FROM EACH OF THE FIVE CHNW REGIONS AND ADMINISTERED A MAIL SURVEY TO THOSE SAMPLES. THE SURVEY RESULTS WERE ALGORITHMICALLY WEIGHTED BY CSR TO CONTROL FOR DIFFERENCES IN THE DEMOGRAPHIC MAKEUP OF SURVEY PARTICIPANTS COMPARED TO THE TOTAL POPULATION OF EACH REGION. IDENTIFICATION OF SIGNIFICANT COMMUNITY HEALTH NEED COMMUNITY HEALTH NEEDS AND ISSUES PRESENTED IN THIS REPORT WERE CONSIDERED SIGNIFICANT IF THEY WERE IDENTIFIED AS PROBLEMATIC IN TWO OR MORE OF THE PRIMARY AND SECONDARY DATA SOURCES DESCRIBED IN THIS SECTION. FOR EXAMPLE, FOOD INSECURITY WAS MENTIONED AS PROBLEMATIC IN THE PROVIDER SURVEY, IN FOCUS GROUPS, AND IN THE COMMUNITY SURVEY. POVERTY WAS FOUND TO BE ABOVE AVERAGE IN SECONDARY DATA, AND PROVIDERS RESPONDING TO THE PROVIDER SURVEY IDENTIFIED LOW-INCOME/IMPOVERISHED PEOPLE TO BE AT THE GREATEST DISADVANTAGE IN THE HOWARD REGION. SECONDARY DATA: THE COMMUNITY HEALTH NETWORK COMMUNITY DASHBOARD DEVELOPED BY HCI WAS USED AS A PRIMARY SOURCE OF SECONDARY DATA. THIS DASHBOARD INCLUDES DATA FROM THE INDIANA HOSPITAL ASSOCIATION, AS WELL AS THE INDIANA STATE DEPARTMENT OF HEALTH, NATIONAL CANCER INSTITUTE, CENTERS FOR DISEASE CONTROL AND PREVENTION, CENTERS FOR MEDICAID AND MEDICARE SERVICES, NATIONAL CENTER FOR HIV/AIDS, VIRAL HEPATITIS, STD AND TB PREVENTION, INSTITUTE FOR HEALTH METRICS AND EVALUATION, COUNTY HEALTH RANKINGS, US CENSUS BUREAU, US DEPARTMENT OF AGRICULTURE, AND OTHER SOURCES. ADDITIONAL STATE AND NATIONAL SECONDARY DATA SOURCES WERE ACCESSED BY THE CHNA TEAM FOR MORE RECENT AND GEOGRAPHICALLY SPECIFIC INFORMATION, INCLUDING THE FOLLOWING: AMERICAN LUNG ASSOCIATION, ANNIE E. CASEY FOUNDATION, CENTERS FOR DISEASE CONTROL AND PREVENTION NATIONAL CENTER FOR HIV/AIDS, VIRAL HEPATITIS, STD, AND TB PREVENTION (CDC-NCHHSTP) ATLAS, COUNTY HEALTH RANKINS, FEEDING AMERICA, HEALTH INDICATORS WAREHOUSE, INDIANA STATE DEPARTMENT OF HEALTH (ISDH), INDIANA UNIVERSITY CENTER FOR HEALTH POLICY, SG2, CLARITAS, US CENSUS BUREAU, THE YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM (YRBSS), PUBLISHED BY THE CENTERS FOR DISEASE CONTROL. DATA LIMITATIONS SECONDARY DATA: ONE OF THE MOST NOTABLE LIMITATIONS OF THE SECONDARY DATA WAS THAT DIFFERENT DATA SOURCES APPLIED DIFFERENT MODELS TO ESTIMATE COMMUNITY HEALTH INDICATORS. SOME INDICATORS WERE BASED ON ADMINISTRATIVE DATA WHILE OTHERS WERE BASED ON SAMPLE SURVEYS. IN ADDITION, SECONDARY DATA WAS SOURCED FROM DIFFERENT DATA YEARS, BASED ON DATA AVAILABILITY. THE YEAR OF THE AVAILABLE DATA RANGED FROM A 2010-2014 FIVE-YEAR AVERAGE IN SOME CASES TO 2018 IN OTHERS. ANOTHER NOTABLE LIMITATION WAS THAT WHEN MORTALITY AND MORBIDITY RATES WERE NOT AVAILABLE, HOSPITALIZATION RATES WERE USED. HOSPITALIZATION RATES ARE AVAILABLE FROM STATE HOSPITAL ASSOCIATIONS AND ARE OFTEN USED AS SURROGATE MEASURES OF COMMUNITY HEALTH NEED. HOSPITALIZATION RATES TYPICALLY ARE BASED ON PATIENT HOME ADDRESS VERSUS TREATMENT LOCATION, WHICH IS APPROPRIATE WHEN ATTEMPTING TO USE THESE RATES TO MEASURE COMMUNITY HEALTH. HOWEVER, A LIMITATION IS THAT HOSPITALIZATION RATES MAY UNDERREPORT THE RATE OF A HEALTH CONDITION BECAUSE HOSPITALIZATION RATES ONLY CAPTURE DATA FROM INDIVIDUALS WHO SEEK HOSPITAL CARE AND DO NOT CAPTURE DATA FROM INDIVIDUALS WHO HAVE THE HEALTH CONDITION BUT DO NOT RECEIVE ASSOCIATED HOSPITAL CARE. ANOTHER LIMITATION IS THAT POPULATIONS WITH CLOSER PROXIMITY TO A HOSPITAL FACILITY MAY BE MORE LIKELY TO SEEK TREATMENT FOR HEALTH CONDITIONS AND, AS SUCH, AREAS WITH A HOSPITAL FACILITY MAY APPEAR TO HAVE POPULATIONS WITH HIGHER RATES OF HEALTH CONDITIONS. ANOTHER LIMITATION WAS THAT THE GEOGRAPHIC LEVEL OF AVAILABLE DATA DID NOT ALWAYS MATCH THE HOSPITAL SERVICE AREA (REGION). CHNW REGIONS WERE DEFINED AS COLLECTIONS OF ZIP CODES BUT NOT ALL DATA ARE AVAILABLE AT THE ZIP CODE LEVEL. IN CASES WHERE ONLY COUNTY-LEVEL DATA WERE AVAILABLE, THE TOTAL POPULATION WITHIN THE INTERSECTIONS OF THE CHNW REGION AND THE COUNTY(IES) WERE USED TO GENERATE WEIGHTED VALUES AND BUILD REGIONAL ESTIMATES. PROVIDER SURVEY: THE PRINCIPAL LIMITATION OF THE PROVIDER SURVEY WAS THAT IT WAS NOT CONDUCTED USING A RANDOM SAMPLING TECHNIQUE AND MAY REFLECT RESPONSE BIAS. THIS MEANS THAT THE RESPONSES WERE NOT NECESSARILY REPRESENTATIVE OF THE FULL POPULATION OF CHNW PROVIDERS. ANOTHER LIMITATION WAS THAT RESPONDENTS WERE ASKED TO SELECT FROM PRE-DEFINED LISTS OF DISADVANTAGED POPULATIONS AND POTENTIAL CONCERNS. WHILE THE LIST OF POSSIBLE CONCERNS WAS DEVELOPED BASED ON EXPERT KNOWLEDGE, IT IS POSSIBLE THAT THERE WERE OTHER CONCERNS THAT WERE NOT LISTED. COMMUNITY SURVEY: A GENERAL LIMITATION OF BROAD COMMUN
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	COMMUNITY WILL UNDERTAKE THE FOLLOWING EFFORTS TO WIDELY PUBLICIZE ITS FINANCIAL ASSISTANCE POLICY: 1) WRITTEN NOTIFICATION - A PLAIN LANGUAGE SUMMARY WILL BE POSTED IN EACH PATIENT REGISTRATION AND WAITING AREA AND AVAILABLE ONLINE AT ECOMMUNITY.COM. IN THE CASE OF SERVICES RENDERED IN THE HOME, THE FINANCIAL ASSISTANCE SUMMARY WILL BE PROVIDED TO THE RESPONSIBLE PARTY DURING THE FIRST IN-HOME VISIT. ALL PUBLICATIONS AND INFORMATIONAL MATERIALS RELATED TO THE FINANCIAL ASSISTANCE PROGRAM WILL BE TRANSLATED INTO LANGUAGES APPROPRIATE TO THE POPULATION IN THE SERVICE AREA. 2) ORAL NOTIFICATION: ALL POINTS OF ACCESS WILL MAKE EVERY EFFORT TO INFORM EACH RESPONSIBLE PARTY ABOUT THE EXISTENCE OF COMMUNITY'S FINANCIAL ASSISTANCE PROGRAM IN THE APPROPRIATE LANGUAGE DURING ANY PRE-ADMISSION, REGISTRATION, ADMISSION OR DISCHARGE PROCESS. ADDITIONALLY, THE POST- SERVICE COLLECTION PROCESS WILL INTEGRATE NOTIFICATION OF THE AVAILABILITY OF ASSISTANCE INTO THE STANDARD PROCESS WHEN COLLECTION EFFORTS FAIL. 3) STATEMENT NOTIFICATION: STATEMENTS WILL PROVIDE INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAM. 4) "ABOUT YOUR BILL: FREQUENTLY ASKED QUESTIONS:" COPIES OF THESE DOCUMENTS WILL BE AVAILABLE IN PATIENT REGISTRATION AREAS, THROUGH THE BUSINESS OFFICES AND PATIENT FINANCIAL COUNSELORS. 5) COMMUNITY WILL MAKE REASONABLE EFFORTS TO INFORM AND NOTIFY RESIDENTS OF THE COMMUNITY SERVED ABOUT THE FINANCIAL ASSISTANCE POLICY IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. MODES OF DELIVERY OF THIS INFORMATION MAY INCLUDE NEWSLETTERS, BROCHURES AND/OR THE PROVISION OF ONLINE ACCESS. WWW.ECOMMUNITY.COM/FINANCIAL-ASSISTANCE-POLICY
PART VI, LINE 4 - COMMUNITY INFORMATION	1. THE CURRENT POPULATION IS 82,363. A FIVE-YEAR TREND (2012-2016) SHOWS POPULATION AT 86,536 2. WHITES COMPRISED 86.7% OF THE POPULATION, WITH AFRICAN-AMERICANS AT 6.6%, HISPANIC/LATINOS AT 2.9% AND OTHER RACE OR ETHNICITY AT 3.7% 3. THE FASTEST GROWING AGE GROUP IS 65+ AT 11.9 % 4. THE HOWARD REGION WILL EXPERIENCE 0.5% GROWTH BETWEEN 2018-20235. 5. THE HOWARD REGION HAS A HOUSEHOLD MEDIAN INCOME OF 46,709, WITH 20% OF THE HOUSEHOLDS HAVING AN ANNUAL INCOME OF 100,000 OR MORE
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	A MAJORITY OF COMMUNITY HEALTH NETWORK'S (COMMUNITY) BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY MEMBERS WHO RESIDE IN COMMUNITY'S PRIMARY SERVICE AREAS. COMMUNITY EXTENDS MEDICAL PRIVILEGES TO ALL PHYSICIANS WHO MEET THE CREDENTIALING QUALIFICATIONS NECESSARY FOR APPOINTMENT TO ITS MEDICAL STAFF. COMMUNITY DOES NOT DENY APPOINTMENT BASED ON GENDER, RACE, CREED, OR NATIONAL ORIGIN. COMMUNITY, IN COLLABORATION WITH MARIAN UNIVERSITY OSTEOPATHIC SCHOOL OF MEDICINE, TRAINS THE NEXT GENERATION OF PHYSICIANS IN A LEARNING ENVIRONMENT. COMMUNITY APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM	COMMUNITY HOWARD REGIONAL HEALTH, INC. ("CHRH") IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. SEE THE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT FOR HOW CHRH IS INVOLVED IN PROMOTING THE HEALTH OF THE COMMUNITY IT SERVES.
PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT	INDIANA

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
HOWARD COUNTY 4-H FAIR
PO BOX 275 610 EAST PAYTON ST	GREENTOWN	IN	46936	356263604	501C4	$35,000	PIONEER VILLG DR OFF
IVY TECH FOUNDATION
1815 E MORGAN STREET	KOKOMO	IN	46903	237073977	501C3	$75,000	CAMPUS TRANSFRMTN

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt
Total Other Org	1	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PAGE 1, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	PRIOR TO THE DISBURSEMENT OF ANY GRANT PROCEEDS, CHRH ENSURES THAT THE PURPOSE OF THE GRANT IS CONSISTENT WITH CHRH'S CHARITABLE PURPOSES. THE TERMS OF ALL GRANTS REQUIRE THAT THE RECIPIENT EXPEND THE FUNDS SOLELY FOR CHARITABLE PURPOSES.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt
TIMOTHY HOBBS MD
DIRECTOR	$570,084	$132,525	$53,600	$254,472	$25,335	$1,036,016	$132,525
JASON FAHRLANDER
DIRECTOR	$585,644	$120,375	$7,834	$281,028	$37,129	$1,032,010	$120,375
JOHN KUNZER MD
DIRECTOR	$435,349	$78,972	$25,511	$130,059	$32,768	$702,659
JOSEPH T HOOPER
PRES - HOWARD REGION								$343,574	$80,325	$20,003	$101,901	$23,175	$568,978	$80,325
JOHN BILO
EXEC DIR OF FINANCE	$188,080	$31,881	$923	$42,673	$20,989	$284,546	$31,881
DESHINI MOONESINGHE MD
SVP PHYS EXEC - FEB	$283,969		$16,521	$97,191	$8,289	$405,970		$70,270	$75,898	$3,055	$4,233	$1,534	$154,990	$75,898
JENNIFER HINDMAN
VP COO REGION								$182,325	$31,423	$981	$30,845	$25,214	$270,788	$31,423
JOHN SCHILTZ MD
PSYCHIATRIST								$286,342		$53,559	$16,500	$31,312	$387,713
LAXESHKUMAR PATEL MD
PSYCHIATRIST								$281,139		$1,924	$16,500	$31,212	$330,775
CARL RATLIFF MD
PSYCHIATRIST								$263,537		$17,478	$16,500	$11,559	$309,074
RYAN MESHULAM MD
PSYCHIATRIST								$205,948		$2,799	$12,711	$7,906	$229,364
JACQUELYN WHOBREY
VP PATIENT SRV, CNE								$158,017	$14,202	$632	$31,869		$204,720
JEFFERY KIRKHAM
FORMER CFO CLNCL ENT	$286,143	$47,798	$1,240	$60,262	$19,211	$414,654	$47,798

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE J, PART III	FormAndLineReferenceDesc
Explanation	PART I, LINE 3 - RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION COMMUNITY HOWARD REGIONAL HEALTH, INC. ("CHRH") 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 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS 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. 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 401(K) 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 PARTICIPANT 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 PARTICIPANT'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 PARTICIPANT'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 CHRH PARTICIPATES IN THE NETWORK'S SENIOR LEADERSHIP INCENTIVE PROGRAM. CERTAIN INDIVIDUALS OF THE LEADERSHIP TEAM PARTICIPATE IN THIS PROGRAM. THE PROGRAM WAS ADOPTED BY THE EXECUTIVE COMPENSATION COMMITTEE, AND IS INTENDED TO INFLUENCE OUTSTANDING PERFORMANCE BY THE SENIOR LEADERS, AS MEASURED AGAINST BOTH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE. THE PROGRAM IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPOSED ENTIRELY OF INDEPENDENT COMMUNITY MEMBERS. THE INCENTIVE COMPENSATION THAT IS AWARDED IS INCLUDED IN TOTAL COMPENSATION TO THE EXECUTIVE. THE TOTAL COMPENSATION (INCLUDING ANY PAYMENTS UNDER THE PROGRAM) IS SUBJECT TO THE REVIEW AND APPROVAL OF THE EXECUTIVE COMPENSATION COMMITTEE AND INDEPENDENT COMPENSATION CONSULTANT, IN CONSIDERATION OF CODE SECTION 4958 (AND THE CORRESPONDING TREASURY REGULATIONS) TO ENSURE THAT IT REFLECTS ARMS LENGTH, FAIR MARKET TERMS.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSION	OUR MISSION IS TO PROVIDE EXCEPTIONAL QUALITY, PATIENT-CENTERED CARE. IN KEEPING WITH OUR MISSION, WE EMBRACE THE FOLLOWING VALUES: COMPASSION AND UNDERSTANDING; CUSTOMER SERVICE; DEDICATION AND COMMITMENT TO PROVIDE THE HIGHEST QUALITY SERVICES AND TO MEET THE NEEDS OF OUR COMMUNITY; RESPECT FOR OUR PATIENTS, VISITORS, PHYSICIANS, AND STAFF; SAFETY; A SAFE AND POSITIVE WORKING ENVIRONMENT; AND TRUTH AND INTEGRITY IN ALL ENCOUNTERS AND SERVICES OFFERED.
FORM 990, PART V	FORM 990, PART V, LINE 1A - BOX 3 OF FORM 1096 FORM 1096 WAS PROCESSED UNDER THE NAME AND FEDERAL IDENTIFICATION NUMBER OF COMMUNITY HEALTH NETWORK, INC.
FORM 990, PART VI	FORM 990, PART VI, LINE 2 - RELATED PARTY INFORMATION AMONG OFFICERS JOHN KUNZER, M.D. SERVED AS A KEY EMPLOYEE OF COMMUNITY HEALTH NETWORK. THE FOLLOWING SERVED AS OFFICERS/KEY EMPLOYEES OF COMMUNITY HEALTH NETWORK, INC. ("CHNW") AND ALSO RECEIVED COMPENSATION FROM CHNW: JASON FAHRLANDER TIMOTHY HOBBS, M.D. DESHINI MOONESINGHE, M.D. JOHN BILO ALSO RECEIVED COMPENSATION FROM CHNW.
FORM 990, PAGE 6, PART VI, LINE 3	CHRH HAS DELEGATED EXCLUSIVE AUTHORITY TO COMMUNITY HEALTH NETWORK ("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 CHRH'S ARTICLES OF INCORPORATION. FINALLY, CHNW MUST APPROVE ANY MATERIAL SALE OR DISPOSITION OF THE ASSETS OF CHRH.
FORM 990, PAGE 6, PART VI, LINE 6	COMMUNITY HEALTH NETWORK, INC. ("CHNW") IS THE SOLE MEMBER OF CHRH. CHNW IS AN EXEMPT ORGANIZATION PURSUANT TO SECTION 501(C)(3).
FORM 990, PAGE 6, PART VI, LINE 7A	COMMUNITY HEALTH NETWORK, INC. ("CHNW") AS THE SOLE MEMBER OF CHRH APPOINTS A MAJORITY OF THE BOARD OF DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 7B	THE FOLLOWING GOVERNANCE ITEMS REQUIRE THE WRITTEN APPROVAL OF CHNW: A) AMENDMENT OF ORGANIZATIONAL DOCUMENTS; B) THE INCURRENCE OF ANY UNBUDGETED INDEBTEDNESS OR LOANS ABOVE 750,000; C) THE FORMATION OF LEGAL ENTITIES, THE SALE, TRANSFER OR SUBSTANTIAL CHANGE IN USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF CHRH, OR THE DIVESTURE, DISSOLUTION, CLOSURE, MERGER, CONSOLIDATION OR REORGANIZATION OF CHRH; D) THE ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION OF PROPERTY WHEN SUCH TRANSACTION IS ABOVE 1,000,OOO, DURING ANY FISCAL YEAR; E) DISPOSITION OF ASSETS ON DISSOLUTION; F) APPROVAL OF THE ANNUAL CAPITAL AND OPERATING BUDGETS, PLANS, OR FORECASTS APPROVED BY THE BOARD; G) THE SELECTION OF THE INDEPENDENT AUDITING FIRM EITHER DIRECTLY OR THROUGH CHNW'S AUDIT AND COMPLIANCE COMMITTEE; H) THE DETERMINATION OF PHYSICIAN AND CEO COMPENSATION EITHER DIRECTLY OR THROUGH CHNW'S COMPENSATION COMMITTEE; I) ALL UNBUDGETED CAPITAL IMPROVEMENTS, ADDITIONS AND STRUCTURAL CHANGES TO THE PROPERTY GREATER THAN THE BUDGETED AMOUNT BY 500,000 PER FISCAL YEAR IN THE AGGREGATE; J) STRATEGIC PLANS, INCLUDING THE REGIONAL PLAN; AND K) THE HIRING AND FIRING OF THE CEO SUBJECT TO THE PRIOR OPPORTUNITY FOR THE BOARD TO REVIEW AND COMMENT.
FORM 990, PAGE 6, PART VI, LINE 11B	CHNW HAS ASSUMED RESPONSIBILITY FOR CHRH'S AUDIT, COMPLIANCE, AND EXECUTIVE COMPENSATION MATTERS. CHNW'S BOARD OF DIRECTORS HAS DELEGATED AUTHORITY FOR THE REVIEW OF CHRH'S FORM 990 TO TWO COMMITTEES COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS: A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE COMPENSATION ASPECTS OF CHRH'S FORM 990, AND B) THE NETWORK FINANCE COMMITTEE REVIEWED THE REMAINDER OF THE CHRH'S FORM 990. IN ADDITION, CHRH'S OUTSIDE ACCOUNTING FIRM AND LAW FIRM REVIEWED THE FORM 990 PRIOR TO FILING. CHRH AND CHNW UTILIZED THIS PROCESS TO ENSURE THAT CHRH'S FORM 990 RECEIVED SUBSTANTIVE REVIEW BY DIRECTORS AND PROFESSIONALS WITH SPECIFIC KNOWLEDGE OF CHRH'S ACTIVITIES AND EXTENSIVE FINANCIAL, ACCOUNTING, AND TAX EXPERTISE.
FORM 990, PAGE 6, PART VI, LINE 12C	CHRH HAS ADOPTED A CONFLICT OF INTEREST POLICY THAT APPLIES TO ITS DIRECTORS, OFFICERS, MANAGERS, MATERIAL MANAGEMENT ASSOCIATES AND KEY EMPLOYEES. THE CONFLICT POLICY REQUIRES THESE INDIVIDUALS TO SUBMIT AN ANNUAL WRITTEN CERTIFICATION OF COMPLIANCE UNDER WHICH THESE INDIVIDUALS MUST DISCLOSE (I) FINANCIAL OR OTHER INTERESTS THE INDIVIDUAL OR ANY FAMILY MEMBER HAS WITH ANY ENTITY ENGAGED IN THE DELIVERY OF HEALTH CARE SERVICES, BIOTECHNOLOGY COMPANIES, SOFTWARE COMPANIES PROVIDING EDUCATIONAL OR CONSULTING SERVICES OR ANY OTHER COMPANY OR ORGANIZATION THAT DOES OR CONTEMPLATES DOING BUSINESS WITH CHRH, AND (II) COMPENSATION OR GIFTS RECEIVED BY THE INDIVIDUAL OR ANY FAMILY MEMBER THAT MIGHT INFLUENCE THE INDIVIDUAL'S ACTIONS. THE DISCLOSURES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER, PRESIDENT/CEO AND BOARD OF DIRECTORS, AS APPROPRIATE. THE INTENT OF THE POLICY IS TO AVOID THE PARTICIPATION OF ANY INTERESTED PERSON IN THE CONSIDERATION OF A MATTER OR DECISION WHICH POSES A CONFLICT OF INTEREST FOR THAT INTERESTED PERSON.
FORM 990, PAGE 6, PART VI, LINE 15A	AS A MEMBER OF THE NETWORK, CHRH 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 CHRH. THE PURPOSE OF THE POLICY IS TO ENSURE THAT CHRH'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 CHRH'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, PERIODICALLY ENGAGING AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH REASONABLE COMPENSATION, AND PROVIDING STAFF SUPPORT TO THE NETWORK EXECUTIVE COMPENSATION COMMITTEE. DURING 2018, THE NETWORK EXECUTIVE COMPENSATION COMMITTEE FOLLOWED THIS PROCESS FOR ALL SENIOR EXECUTIVE LEADERS.
FORM 990, PAGE 6, PART VI, LINE 15B	SEE LINE 15A ABOVE
FORM 990, PAGE 6, PART VI, LINE 19	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) CHRH'S CONFLICT OF INTEREST POLICY IS NOT AVAILABLE TO THE PUBLIC. C) CHRH 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. CHRH 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 IX, LINE 11G	PURCHASED SERVICES 5,728,496 21,751,763 0 PROFESSIONAL FEES 1,249,399 1,088,314 0 TOTAL 6,977,895 22,840,077 0

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
COMMUNITY HEALTH NETWORK INC
7330 SHADELAND STATION SUITE 200	INDIANAPOLIS	IN	46256	350983617	HOSPITAL	IN	501C3	3	NA	false
COMMUNITY HEALTH NETWORK FOUNDATION
7330 SHADELAND STATION SUITE 100	INDIANAPOLIS	IN	46256	510181688	SUPPORT	IN	501C3	12B	CHNW	Yes (true)
COMMUNITY HLTH SERVICES OF INDIANA
7330 SHADELAND STATION SUITE 200	INDIANAPOLIS	IN	46256	454817436	HLTH CARE	IN	501C3	3	CHNW	Yes (true)
COMMUNITY HOME HEALTH SERVICES INC
9894 EAST 121ST STREET	FISHERS	IN	46037	350953467	HLTH CARE	IN	501C3	10	CHNW	Yes (true)
COMM HOSP OF ANDERSON & MADISON CTY
1515 NORTH MADISON AVENUE	ANDERSON	IN	46011	351069822	HOSPITAL	IN	501C3	3	CHNW	Yes (true)
COMMUNITY HOSP ANDERSON FDN INC
1515 NORTH MADISON AVENUE	ANDERSON	IN	46011	861053152	SUPPORT	IN	501C3	12A	CHA	Yes (true)
COMMUNITY HOSPITAL SOUTH INC
1402 E COUNTY LINE ROAD SOUTH	INDIANAPOLIS	IN	46227	351088640	HOSPITAL	IN	501C3	3	CHNW	Yes (true)
COMM HOWARD REGIONAL HEALTH FDN
PO BOX 9011	KOKOMO	IN	46904	237309596	SUPPORT	IN	501C3	7	NA	false
COMMUNITY LTC INC
1031 MONTICELLO DRIVE	ANDERSON	IN	46011	351877441	HLTH CARE	IN	501C3	10	CHA	Yes (true)
COMMUNITY PHYSICIANS OF IN INC
7240 SHADELAND STATION SUITE 300	INDIANAPOLIS	IN	46256	205392766	PHY SRV	IN	501C3	10	CHNW	Yes (true)
HEALTH INSTITUTE OF INDIANA INC
3660 GUION ROAD	INDIANAPOLIS	IN	46222	352022402	FITNESS	IN	501C3	10	CHNW	Yes (true)
INDIANAPOLIS OSTEOPATHIC HOSP INC
3630 GUION ROAD	INDIANAPOLIS	IN	46222	351094734	HOSPITAL	IN	501C3	3	CHNW	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (19 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	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct
CHNJMH VENTURES LLC
6626 E 75TH STREET SUITE 200	INDIANAPOLIS	IN	46250	462356266	DIAG/REHAB	IN	N/A	false	false
COMMUNITYACCESSCARE IN DIALYSIS
6626 E 75TH STREET SUITE 200	INDIANAPOLIS	IN	46250	474634198	DIALYSIS	IN	N/A	false	false
COMMUNITY ENDOSCOPY CENTER LLC
1601 N MADISON AVENUE SUITE 300	ANDERSON	IN	46011	611464136	HLTH CARE	IN	N/A	false	false
COMM HEALTH NETWORK REHAB HOSP LLC
680 S FOURTH STREET	LOUISVILLE	KY	40202	453414249	REHAB	IN	N/A	false	false
COMM HLTH NTWRK RHB HOSP SOUTH LLC
680 S FOURTH STREET	LOUISVILLE	KY	40202	821385366	REHAB	IN	N/A	false	false
EAST CAMPUS SURGERY CENTER LLC
6626 E 75TH STREET SUITE 200	INDIANAPOLIS	IN	46250	352028517	SURGERY	IN	N/A	false	false
HAMILTON SURGERY CENTER LLC
6626 E 75TH STREET SUITE 200	INDIANAPOLIS	IN	46250	352061413	SURGERY	IN	N/A	false	false
HOWARD COMMUNITY SURGERY CTR LLC
3500 S LAFOUNTAIN STREET	KOKOMO	IN	46902	352118748	SURGERY	IN		false	Yes (true)	CHRH	RELATED	$2,500,802	$2,578,276	0.51000
HOWARD REGIONAL SPECIALTY CARE LLC
680 SOUTH FOURTH STREET	LOUISVILLE	KY	40202	371501021	REHAB	KY		false	Yes (true)	CHRH	RELATED	$296,957	-$181,420	0.60000
INDIANAPOLIS ENDOSCOPY CENTER LLC
8315 E 56TH STREET	INDIANAPOLIS	IN	46216	352010874	HLTH CARE	IN	N/A	false	false
MICHIGAN SURGERY INVESTMENT LLC
6626 E 75TH STREET SUITE 200	INDIANAPOLIS	IN	46250	320147008	SURG CTRS	IN	N/A	false	false
NORTH CAMPUS OFFICE ASSOCIATES LP
6626 E 75TH STREET SUITE 200	INDIANAPOLIS	IN	46250	351808625	RNTL PROP	IN	N/A	false	false
NORTH CAMPUS SURGERY CENTER LLC
6626 E 75TH STREET SUITE 200	INDIANAPOLIS	IN	46250	352147088	SURGERY	IN	N/A	false	false
NORTHPOINT PEDIATRICS LLC
8101 CLEARVISTA PARKWAY SUITE 185	INDIANAPOLIS	IN	46256	351960566	HLTH CARE	IN	N/A	false	false
NORTHWEST SURGERY CENTER LLC
6626 E 75TH STREET SUITE 200	INDIANAPOLIS	IN	46250	208754071	SURGERY	IN	N/A	false	false
PILLARS HOUSING LP
3500 S LAFOUNTAIN STREET	KOKOMO	IN	46902	161652671	HOUSING	IN	N/A	false	false
PRIMARIA HEALTH LLC
9365 COUNSELORS ROW SUITE 210	INDIANAPOLIS	IN	46240	474728937	CONSULTING	IN	N/A	false	false
SCP INDIANAPOLIS LLC
7430 SHADELAND AVENUE SUITE 100	INDIANAPOLIS	IN	46250	460639908	HLTH CARE	IN	N/A	false	false
SOUTH CAMPUS SURGERY CENTER LLC
1550 EAST COUNTY LINE ROAD	INDIANAPOLIS	IN	46227	352038072	SURGERY	IN	N/A	false	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	OwnershipOwnershipPct
CHN ASSURANCE COMPANY LTD
PO BOX 1051GT	GRAND CAYMAN	GRAND CAYMAN	CJ	980418913	SELF INSUR	CJ	N/A	Yes (true)
PILLARS COMMUNITY HOUSING INC
				161652666	HOUSING			Yes (true)	3500 S LAFOUNTAIN STREET	KOKOMO	IN	46902	IN	CHRH	C CORP	1.00000
VEI MICHIGAN INC
				300097377	MGMT SRVS		N/A	Yes (true)	940 N MAIN STREET	ANN HARBOR	MI	48104	IN
VISIONARY ENTERPRISES INC
				351538433	MGMT SRVS		N/A	Yes (true)	6626 EAST 75TH STREET SUITE 200	INDIANAPOLIS	IN	46250	IN
WESTVIEW DELIVERY SYSTEM INC
				351910292	MGMT SRVS		N/A	Yes (true)	3630 GUION ROAD	INDIANAPOLIS	IN	46222	IN

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (8 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt	Business Name Line2OtherOrganizationName/BusinessNameLine2Txt
COMM HOWARD REGIONAL HEALTH FD
C	$236,433	BOOK VALUE
COMMUNITY PHYSICIANS OF INDIANA
A	$1,135,526	BOOK VALUE
COMMUNITY PHYSICIANS OF INDIANA
R	$1,209,751	BOOK VALUE
HOWARD COMMUNITY SURGERY CENTER
J	$826,597	BOOK VALUE
HOWARD COMMUNITY SURGERY CENTER
S	$2,380,589	BOOK VALUE	K-1 DISTRIBUTIONS
HOWARD REGIONAL SPECIALTY CARE
A	$684,000	BOOK VALUE
HOWARD REGIONAL SPECIALTY CARE
Q	$628,252	BOOK VALUE
HOWARD REGIONAL SPECIALTY CARE
R	$1,848,807	BOOK VALUE