COMMUNITY PHYSICIANS OF INDIANA INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY PHYSICIANS OF INDIANA INC (EIN 20-5392766)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-07
- IRS object ID
- 201803119349301920
- Schema version
- 2017v2.3
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-07T13:14:32-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | 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 | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205392766 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY PHYSICIANS OF | BusinessNameLine1Txt |
| Business Name Line2 | INDIANA INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 3176218064 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7240 SHADELAND STATION SUITE 200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46256 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN KUNZER MD MMM | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3176217454 | PhoneNum |
| Signature | 2018-10-22 | 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 | 2018-11-06 | 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 | 2018-11-06 | IPDt |
| IP Tm | 14:42:08 | IPTm |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 3E83E976884D6852BF626D3B074032779D209233 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 3E83E976884D6852BF626D3B074032779D209233 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY PHYSICIAN NETWORK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN KUNZER MD MMM | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7240 SHADELAND STATION SUITE 200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46256 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $295,469,396 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ECOMMUNITY.COM/CPI/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2006 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | COMMUNITY PHYSICIANS OF INDIANA, INC. IS A PHYSICIAN LED NONPROFIT CORPORATION, PART OF AN INTEGRATED HEALTH CARE NETWORK, WHICH SERVES AS THE LEADER IN PROVIDING COMPASSIONATE, QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES TO HELP PEOPLE ACHIEVE AND MAINTAIN OPTIMAL HEALTH IN THE COMMUNITY WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 3391 | TotalEmployeeCnt |
| Total Volunteers | 3 | TotalVolunteersCnt |
| Total Gross UBI | $17,849 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $15,064 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $177,678 | PYContributionsGrantsAmt |
| CY Contributions Grants | $153,753 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $255,880,262 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $291,092,714 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$136,989 | PYInvestmentIncomeAmt |
| CY Investment Income | -$91,487 | CYInvestmentIncomeAmt |
| PY Other Revenue | $11,434,216 | PYOtherRevenueAmt |
| CY Other Revenue | $3,840,912 | CYOtherRevenueAmt |
| PY Total Revenue | $267,355,167 | PYTotalRevenueAmt |
| CY Total Revenue | $294,995,892 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $6,500 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $385,504,579 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $433,030,377 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $94,536,497 | PYOtherExpensesAmt |
| CY Other Expenses | $140,594,128 | CYOtherExpensesAmt |
| PY Total Expenses | $480,047,576 | PYTotalExpensesAmt |
| CY Total Expenses | $573,624,505 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$212,692,409 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$278,628,613 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $63,709,147 | TotalAssetsBOYAmt |
| Total Assets EOY | $77,415,574 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,035,716,537 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,328,051,577 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$972,007,390 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,250,636,003 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | COMMUNITY PHYSICIANS OF INDIANA, INC. IS A PHYSICIAN LED NONPROFIT CORPORATION, PART OF AN INTEGRATED HEALTH CARE NETWORK, WHICH SERVES AS THE LEADER IN PROVIDING COMPASSIONATE, QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES TO HELP PEOPLE ACHIEVE AND MAINTAIN OPTIMAL HEALTH IN THE COMMUNITY WE SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $501,528,010 | ExpenseAmt |
| Revenue | $294,915,777 | RevenueAmt |
| Desc | COMMUNITY PHYSICIANS OF INDIANA, INC. (CPI) IS A PHYSICIAN GOVERNED GROUP THAT IS PART OF A PATIENT-CENTERED, INTEGRATED HEALTH CARE NETWORK WHICH WILL, THROUGH CONTINUOUS QUALITY IMPROVEMENT, CONSISTENTLY PROVIDE A BETTER EXPERIENCE FOR PATIENTS, EMPLOYEES, PHYSICIANS, AND PAYERS AND THUS BECOME THEIR NETWORK OF CHOICE. CPI INTENDS TO BE RECOGNIZED AS THE PRIMARY CARE AND SPECIALTY CARE GROUP PRACTICE IN CENTRAL INDIANA, SETTING BENCHMARK STANDARDS IN PHYSICIAN LOYALTY, QUALITY, SERVICE, AND COST PERFORMANCE. IN 2017, CPI'S PATIENT VISITS WERE 2,348,805. | Desc |
| Total Program Service Expenses | $501,528,010 | 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 | false | 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 | false | OperateHospitalInd |
| Grants To Organizations | false | 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 | 3391 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | 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 | false | InvestmentInJointVentureInd |
| 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 | BRIAN MCCONNELL | PersonNm |
| Phone | 3173554212 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8180 CLEARVISTA PARKWAY SUITE 200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46256 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 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 |
|---|---|---|---|---|---|---|---|---|---|
| BRYAN A MILLS | |||||||||
| DIRECTOR | 2.00 | 58.00 | Yes (X) | $0 | $1,425,217 | $627,046 | |||
| RAMARAO YELETI MD | |||||||||
| PRESIDENT JA | 48.00 | 2.00 | Yes (X) | $729,994 | $248,128 | $341,650 | Yes (X) | ||
| MICHAEL ROBERTSON MD | |||||||||
| CHAIRMAN | 50.00 | 0.00 | Yes (X) | $941,658 | $0 | $176,960 | Yes (X) | ||
| TIMOTHY HOBBS MD | |||||||||
| DIRECTOR | 2.00 | 48.00 | Yes (X) | $0 | $807,985 | $254,076 | |||
| STEVE O'NEIL MD | |||||||||
| DIRECTOR | 50.00 | 0.00 | Yes (X) | $649,935 | $0 | $169,777 | |||
| ERNEST O ASAMOAH MD | |||||||||
| DIRECTOR | 50.00 | 0.00 | Yes (X) | $635,785 | $0 | $97,614 | |||
| ANNETTE MOORE MD | |||||||||
| TREASURER | 49.00 | 6.00 | Yes (X) | $577,057 | $0 | $16,200 | Yes (X) | ||
| ROBIN LEDYARD MD | |||||||||
| INTR PRES AU | 50.00 | 0.00 | Yes (X) | $487,451 | $0 | $154,976 | Yes (X) | ||
| ANTHONY SANDERS MD | |||||||||
| DIRECTOR | 50.00 | 0.00 | Yes (X) | $486,189 | $0 | $105,335 | |||
| ROBERT GOULET MD | |||||||||
| DIRECTOR | 50.00 | 0.00 | Yes (X) | $450,944 | $0 | $76,982 | |||
| FRANK COVINGTON MD | |||||||||
| DIRECTOR | 50.00 | 0.00 | Yes (X) | $0 | $445,660 | $73,053 | |||
| STEPHANIE OVERMARS MD | |||||||||
| DIRECTOR | 50.00 | 0.00 | Yes (X) | $439,894 | $0 | $66,246 | |||
| CHARLES PLATZ MD | |||||||||
| VICE CHAIRMA | 50.00 | 0.00 | Yes (X) | $406,164 | $0 | $92,212 | Yes (X) | ||
| MICHAEL ALLEY | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JASON BECKER | |||||||||
| DIRECTOR | 2.00 | 6.00 | Yes (X) | $0 | $0 | $0 | |||
| STEVEN PLUMP | |||||||||
| DIRECTOR | 2.00 | 6.00 | Yes (X) | $0 | $0 | $0 | |||
| ANTHONY JAVORKA | |||||||||
| COO | 46.00 | 4.00 | $0 | $592,470 | $388,652 | Yes (X) | |||
| JAMES READ | |||||||||
| CFO JAN - AU | 50.00 | 0.00 | $0 | $296,393 | $75,250 | Yes (X) | |||
| GWEN O'MALLEY | |||||||||
| SVP AMBULATO | 50.00 | 0.00 | $381,000 | $0 | $108,867 | Yes (X) | |||
| JASON LANDIS | |||||||||
| EXC DIRECTOR | 50.00 | 0.00 | $0 | $235,308 | $55,853 | Yes (X) | |||
| JAMES CALLAHAN MD | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $1,900,901 | $0 | $115,044 | Yes (X) | |||
| DANIEL KIM MD | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $1,550,902 | $0 | $51,072 | Yes (X) | |||
| KRISHNA MALINENI MD | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $1,506,609 | $0 | $286,076 | Yes (X) | |||
| RAJESH MALLELA MD | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $1,479,113 | $0 | $167,291 | Yes (X) | |||
| PREETHAM JETTY MD | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $1,440,696 | $0 | $249,190 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $14,064,292 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,051,161 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $3,749,422 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 792 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | 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 |
|---|---|---|---|---|---|
| ALDERSON PROPERTY SERVICES | |||||
| 425 W SOUTH SUITE 100 | INDIANAPOLIS | IN | 46225 | CONSTRUCTION | $3,187,009 |
| BAF CORPORATION | |||||
| 6084 FALL CREEK ROAD | INDIANAPOLIS | IN | 46220 | CONSTRUCTION | $2,200,222 |
| OTOLARYNGOLOGY ASSOCIATES LLC | |||||
| 9002 N MERIDIAN STREET SUITE 222 | INDIANAPOLIS | IN | 46260 | MEDICAL | $1,612,496 |
| WEATHERBY LOCUMS INC | |||||
| 7259 BINGHAM JUNCTION BLVD | MIDVALE | UT | 84047 | TEMPORARY STAFF | $813,429 |
| IU HEALTH PHYSICIANS | |||||
| 2568 RELIABLE PARKWAY | CHICAGO | IL | 60686 | MEDICAL | $812,525 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 40 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $153,753 | RelatedOrganizationsAmt |
| Total Contributions | $153,753 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICES | 621110 | $290,823,296 | $290,823,296 |
| PHYSICIAN FEES | 900099 | $269,418 | $269,418 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $291,092,714 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,467 | TotalRevenueColumnAmt |
| Exclusion | $8,467 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $654 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $100,608 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$99,954 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$99,954 | TotalRevenueColumnAmt |
| Exclusion | -$99,954 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $394,294 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $372,896 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,398 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,549 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $17,849 | UnrelatedBusinessRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CORPORATE HEALTH PROMOTIONS | 900099 | $2,828,372 | $2,828,372 |
| EMR INCENTIVE PAYMENTS | 900099 | $978,390 | $978,390 |
| LEGAL REIMBURSEMENT | 900099 | $10,902 | $10,902 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,850 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,850 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,819,514 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $294,995,892 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $294,915,777 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $17,849 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$91,487 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,592,890 | TotalAmt |
| Program Services | $6,210,219 | ProgramServicesAmt |
| Management And General | $1,382,671 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $368,927,486 | TotalAmt |
| Program Services | $368,373,427 | ProgramServicesAmt |
| Management And General | $554,059 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,659,409 | TotalAmt |
| Program Services | $11,620,649 | ProgramServicesAmt |
| Management And General | $38,760 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,372,693 | TotalAmt |
| Program Services | $27,177,935 | ProgramServicesAmt |
| Management And General | $194,758 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,477,899 | TotalAmt |
| Program Services | $17,308,616 | ProgramServicesAmt |
| Management And General | $169,283 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,594,706 | TotalAmt |
| Management And General | $67,594,706 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,084,626 | TotalAmt |
| Program Services | $362,150 | ProgramServicesAmt |
| Management And General | $722,476 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,106,822 | TotalAmt |
| Program Services | $5,813,181 | ProgramServicesAmt |
| Management And General | $293,641 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $235,432 | TotalAmt |
| Program Services | $78,609 | ProgramServicesAmt |
| Management And General | $156,823 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,514,558 | TotalAmt |
| Program Services | $27,825,129 | ProgramServicesAmt |
| Management And General | $689,429 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $374,874 | TotalAmt |
| Program Services | $302,400 | ProgramServicesAmt |
| Management And General | $72,474 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,800,601 | TotalAmt |
| Program Services | $1,788,410 | ProgramServicesAmt |
| Management And General | $12,191 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,858,232 | TotalAmt |
| Program Services | $4,787,911 | ProgramServicesAmt |
| Management And General | $70,321 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,132,766 | TotalAmt |
| Program Services | $6,132,766 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $22,611,972 | $22,611,972 | |
| DUES, LICENSES, SUBSCRPTN | $1,089,877 | $1,078,426 | $11,451 |
| MEALS & ENTERTAINMENT | $124,557 | $41,589 | $82,968 |
| RECRUITMENT | $27,562 | $9,203 | $18,359 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,543 | TotalAmt |
| Program Services | $5,418 | ProgramServicesAmt |
| Management And General | $32,125 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $573,624,505 | TotalAmt |
| Program Services | $501,528,010 | ProgramServicesAmt |
| Management And General | $72,096,495 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,882 | BOYAmt |
| EOY | $19,785 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,282,397 | BOYAmt |
| EOY | $27,592,594 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,722,619 | BOYAmt |
| EOY | $17,801,741 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,229,091 | BOYAmt |
| EOY | $1,117,954 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $57,676,814 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $26,909,224 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,455,158 | BOYAmt |
| EOY | $30,767,590 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $115,910 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,709,147 | BOYAmt |
| EOY | $77,415,574 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,303,744 | BOYAmt |
| EOY | $30,317,281 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $45,626 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $997,412,793 | BOYAmt |
| EOY | $1,297,688,670 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,035,716,537 | BOYAmt |
| EOY | $1,328,051,577 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$972,007,390 | BOYAmt |
| EOY | -$1,250,636,003 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$972,007,390 | BOYAmt |
| EOY | -$1,250,636,003 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,709,147 | BOYAmt |
| EOY | $77,415,574 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$278,628,613 | ReconcilationRevenueExpnssAmt |
| 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 | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $108,432 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,584 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,005 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $177,678 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $153,753 | CurrentTaxYearAmt |
| Total | $450,452 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $174,357,109 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $238,686,388 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $291,082,148 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $267,832,292 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $295,217,275 | CurrentTaxYearAmt |
| Total | $1,267,175,212 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $174,465,541 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $238,694,972 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $291,084,153 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $268,009,970 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $295,371,028 | CurrentTaxYearAmt |
| Total | $1,267,625,664 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $1,267,625,664 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,058 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,924 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $24,760 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,962 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,467 | CurrentTaxYearAmt |
| Total | $47,171 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,058 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,924 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $24,760 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,962 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,467 | CurrentTaxYearAmt |
| Total | $47,171 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,680 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,176 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,129 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,887 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,064 | CurrentTaxYearAmt |
| Total | $68,936 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $174,481,279 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $238,721,072 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $291,122,042 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $268,022,819 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $295,394,559 | CurrentTaxYearAmt |
| Total | $1,267,741,771 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99990 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99990 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $31,477,537 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,042,685 | DepreciationAmt |
| Book Value | $19,434,852 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,199,277 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,866,539 | DepreciationAmt |
| Book Value | $11,332,738 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $30,767,590 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE FROM AFFILIATES | $1,297,615,572 |
| GUARANTEE LIABILITY | $73,098 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,297,688,670 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (true) | 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 (22 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 | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRYAN A MILLS | ||||||||||||||
| DIRECTOR | $1,076,737 | $328,501 | $19,979 | $591,445 | $35,601 | $2,052,263 | $328,501 | |||||||
| RAMARAO YELETI MD | ||||||||||||||
| PRESIDENT JAN - JULY | $216,153 | $31,975 | $248,128 | $216,153 | $653,766 | $76,228 | $303,084 | $38,566 | $1,071,644 | |||||
| MICHAEL ROBERTSON MD | ||||||||||||||
| CHAIRMAN | $653,316 | $173,015 | $146,177 | $33,383 | $1,118,618 | $115,327 | $115,327 | |||||||
| TIMOTHY HOBBS MD | ||||||||||||||
| DIRECTOR | $594,203 | $187,902 | $25,880 | $228,044 | $26,032 | $1,062,061 | $187,902 | |||||||
| STEVE O'NEIL MD | ||||||||||||||
| DIRECTOR | $471,060 | $146,798 | $136,193 | $33,584 | $819,712 | $32,077 | ||||||||
| ERNEST O ASAMOAH MD | ||||||||||||||
| DIRECTOR | $527,124 | $1,137 | $61,040 | $36,574 | $733,399 | $107,524 | $107,524 | |||||||
| ANNETTE MOORE MD | ||||||||||||||
| TREASURER | $557,919 | $19,138 | $16,200 | $593,257 | ||||||||||
| ROBIN LEDYARD MD | ||||||||||||||
| INTR PRES AUG - DEC | $370,877 | $1,527 | $124,865 | $30,111 | $642,427 | $115,047 | ||||||||
| ANTHONY SANDERS MD | ||||||||||||||
| DIRECTOR | $425,825 | $1,312 | $82,093 | $23,242 | $591,524 | $59,052 | $58,302 | |||||||
| ROBERT GOULET MD | ||||||||||||||
| DIRECTOR | $357,237 | $28,699 | $66,719 | $10,263 | $527,926 | $65,008 | $65,008 | |||||||
| FRANK COVINGTON MD | ||||||||||||||
| DIRECTOR | $325,081 | $41,214 | $79,365 | $58,543 | $14,510 | $518,713 | $41,214 | |||||||
| STEPHANIE OVERMARS MD | ||||||||||||||
| DIRECTOR | $324,911 | $25,897 | $66,246 | $506,140 | $89,086 | $89,086 | ||||||||
| CHARLES PLATZ MD | ||||||||||||||
| VICE CHAIRMAN | $247,288 | $68,997 | $55,638 | $36,574 | $498,376 | $89,879 | $89,879 | |||||||
| ANTHONY JAVORKA | ||||||||||||||
| COO | $321,581 | $175,605 | $95,284 | $356,893 | $31,759 | $981,122 | $110,869 | |||||||
| JAMES READ | ||||||||||||||
| CFO JAN - AUGUST | $257,444 | $37,904 | $1,045 | $63,340 | $11,910 | $371,643 | $37,904 | |||||||
| GWEN O'MALLEY | ||||||||||||||
| SVP AMBULATORY SERV | $268,650 | $19,206 | $94,877 | $13,990 | $489,867 | $93,144 | ||||||||
| JASON LANDIS | ||||||||||||||
| EXC DIRECTOR FINANCE | $188,073 | $46,439 | $796 | $47,095 | $8,758 | $291,161 | ||||||||
| JAMES CALLAHAN MD | ||||||||||||||
| PHYSICIAN | $1,662,576 | $19,138 | $80,058 | $34,986 | $2,015,945 | $219,187 | $219,187 | |||||||
| DANIEL KIM MD | ||||||||||||||
| PHYSICIAN | $1,495,320 | $1,138 | $16,200 | $34,872 | $1,601,974 | $54,444 | $54,444 | |||||||
| KRISHNA MALINENI MD | ||||||||||||||
| PHYSICIAN | $1,278,553 | $1,138 | $248,191 | $37,885 | $1,792,685 | $226,918 | $226,839 | |||||||
| RAJESH MALLELA MD | ||||||||||||||
| PHYSICIAN | $1,177,827 | $141,590 | $128,217 | $39,074 | $1,646,404 | $159,696 | ||||||||
| PREETHAM JETTY MD | ||||||||||||||
| PHYSICIAN | $1,163,105 | $19,138 | $230,024 | $19,166 | $1,689,886 | $258,453 | $258,421 | |||||||
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 4 | ANTHONY JAVORKA 89,308 0 0 |
| SCHEDULE J, PART III | PART I, LINE 3 - RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION COMMUNITY PHYSICIANS OF INDIANA, INC. ("CPI") CEO/EXECUTIVE DIRECTOR IS PAID BY COMMUNITY HEALTH NETWORK, INC. ("CHNW"), A RELATED 501(C)(3) ORGANIZATION AND CPI. CHNW AND CPI USE 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 PLAN COMMUNITY HEALTH NETWORK, INC. SECTION 457(F) PLAN COMMUNITY HEALTH NETWORK, INC. ("COMMUNITY") ADOPTED THIS COMMUNITY HEALTH NETWORK, INC. SECTION 457(F) PLAN ("PLAN") AS OF JANUARY 1, 2016 TO PROVIDE A SUPPLEMENTAL INCOME FOR RETIREMENT UPON VESTING IN THE BENEFIT AS DESCRIBED IN THE PLAN DOCUMENT. THE PLAN IS INTENDED TO BE EXEMPT FROM THE REQUIREMENTS OF CODE SECTION 409A AS A SHORT-TERM DEFERRAL PROGRAM DESCRIBED UNDER TREAS. REG. 1.409A-1 (B)(4). THE PLAN IS DESIGNED UNDER CODE SECTION 457(F) AS A "TOP-HAT PLAN" (I.E. AN UNFUNDED DEFERRED COMPENSATION PLAN MAINTAINED FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES) PURSUANT TO SECTIONS 201(2), 301(A)(3) AND 401(A)(1) OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED ("ERISA"). ELIGIBILITY: INDIVIDUALS DESIGNATED BY THE BOARD OF DIRECTORS OF COMMUNITY HEALTH NETWORK, INC. CONTRIBUTIONS: ANNUALLY FROM 2016 TO 2020 COMMUNITY WILL CREDIT A CONTRIBUTION TO A PARTICIPANT'S ACCOUNT IN AN AMOUNT EQUAL TO TEN PERCENT OF THEIR BASE COMPENSATION AS DEFINED IN THE PARTICIPANT'S EMPLOYMENT AGREEMENT WITH COMMUNITY. VESTING: SINGLE VESTING METHOD ELECTED BY THE EMPLOYER, IN ITS DISCRETION, FOR EACH PARTICIPANT, WHICH APPLIES TO ALL EMPLOYER CONTRIBUTION CREDITS. IN ADDITION, A PARTICIPANT'S ENTIRE ACCOUNT SHALL VEST ON THE PARTICIPANT'S DEATH, AN INVOLUNTARY TERMINATION OF THE PARTICIPANT'S EMPLOYMENT WITHOUT CAUSE (AS REASONABLY DETERMINED BY THE EMPLOYER), OR THE PARTICIPANT'S DISABILITY (AS DEFINED BY THE SOCIAL SECURITY ADMINISTRATION). FORFEITURE: IF ACCOUNT IS NOT VESTED AS DESCRIBED ABOVE, THE ACCOUNT WILL BE COMPLETELY FORFEITED. AMOUNTS FORFEITED DURING A PLAN YEAR REMAIN A GENERAL ASSET OF COMMUNITY. COMMUNITY HEALTH NETWORK, INC. RESTORATION PLAN COMMUNITY HEALTH NETWORK, INC. ("COMMUNITY") ADOPTED THIS COMMUNITY HEALTH NETWORK RESTORATION PLAN ("PLAN") AS OF DECEMBER 1, 2017 TO PROVIDE A SUPPLEMENTAL INCOME FOR RETIREMENT UPON VESTING IN THE BENEFITS AS DESCRIBED IN THE PLAN DOCUMENT. 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 5A - COMPENSATION CONTINGENT UPON REVENUES OF ORGANIZATION DR. ERNEST ASAMOAH, DR. JAMES CALLAHAN, DR. ROBERT GOULET, DR. PREETHAM JETTY, DR. DANIEL KIM, DR. ROBIN LEDYARD, DR. KRISHNA MALINENI, DR. RAJESH MALLELA, DR. ANNETTE MOORE, GWEN O'MALLEY, DR. STEVE O'NEIL, DR. STEPHANIE OVERMARS, DR. CHARLES PLATZ, DR. MICHAEL ROBERTSON, AND DR. ANTHONY SANDERS ARE ELIGIBLE TO PARTICIPATE IN COMMUNITY PHYSICIANS OF INDIANA, INC.'S ("CPI") INCENTIVE COMPENSATION PLAN. CPI DEVELOPED ITS COMPENSATION PLAN IN CONJUNCTION WITH AN INDEPENDENT COMPENSATION CONSULTANT. IN ADDITION, THE PLAN WAS APPROVED BY THE NETWORK EXECUTIVE COMPENSATION COMMITTEE, COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS. IN ADOPTING ITS INCENTIVE-BASED COMPENSATION PLAN, CPI (TOGETHER WITH ITS INDEPENDENT COMPENSATION CONSULTANT, ITS EXTERNAL LEGAL COUNSEL, AND THE NETWORK EXECUTIVE COMPENSATION COMMITTEE) CONSIDERED AND APPLIED THE PROVISIONS OF CODE SECTION 4958 AND THE CORRESPONDING TREASURY REGULATIONS TO ENSURE THAT ITS COMPENSATION DECISIONS REFLECT ARMS LENGTH, FAIR MARKET TERMS. PART I, LINE 7 - NON-FIXED PAYMENTS PROVIDED CPI 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. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | COMMUNITY PHYSICIANS OF INDIANA, INC. IS A PHYSICIAN LED NONPROFIT CORPORATION, PART OF AN INTEGRATED HEALTH CARE NETWORK, WHICH SERVES AS THE LEADER IN PROVIDING COMPASSIONATE, QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES TO HELP PEOPLE ACHIEVE AND MAINTAIN OPTIMAL HEALTH IN THE COMMUNITY WE SERVE. |
| FORM 990 | FORM 990, PART I, LINE 4 - INDEPENDENT VOTING MEMBERS COMMUNITY PHYSICIANS OF INDIANA, INC. ("CPI") IS AN AFFILIATE OF COMMUNITY HEALTH NETWORK ("THE NETWORK"), AN INTEGRATED HEALTH DELIVERY SYSTEM. CPI IS CONTROLLED BY ITS PARENT, COMMUNITY HEALTH NETWORK, INC. ("CHNW"), A TAX-EXEMPT HOSPITAL. CHNW HAS THE FOLLOWING POWERS OVER CPI: A) CHNW IS THE SOLE MEMBER OF CPI, B) CHNW APPOINTS ALL OF THE MEMBERS OF CPI'S BOARD OF DIRECTORS, C) CHNW HAS THE AUTHORITY TO REMOVE ANY MEMBERS OF CPI'S BOARD OF DIRECTORS, D) CHNW MUST APPROVE ANY MODIFICATION, REPEAL, AMENDMENT, OR RESTATEMENT OF CPI'S ARTICLES OF INCORPORATION, AND E) CHNW MUST APPROVE ANY SALE OF SUBSTANTIALLY ALL OF CPI'S ASSETS. CHNW HAS EXERCISED ITS CONTROL OVER CPI TO ENSURE THAT CHNW HAS EXCLUSIVE AUTHORITY OVER THE FOLLOWING AFFAIRS OF CPI: STRATEGIC PLANNING, CAPITAL ACCESS, BUDGETING AND ALLOCATION, AUDIT AND COMPLIANCE, EXECUTIVE COMPENSATION, AND DISPUTE RESOLUTION. WITH REGARD TO EXECUTIVE COMPENSATION, CHNW REVIEWS AND APPROVES EXECUTIVE COMPENSATION, INCLUDING CPI'S EXECUTIVES, THROUGH THE DELIBERATIONS OF A NETWORK EXECUTIVE COMPENSATION COMMITTEE COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS. LIKEWISE, CHNW REVIEWS AND MANAGES CPI'S CONFLICT OF INTEREST TRANSACTIONS THROUGH THE DELIBERATIONS OF A NETWORK AUDIT COMMITTEE COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS. IN SUM, CPI IS CONTROLLED BY CHNW. CPI HAS DELEGATED SUBSTANTIAL AUTHORITY REGARDING ITS GOVERNANCE AND MANAGEMENT TO CHNW. THE MAJORITY OF THE BOARD MEMBERS FOR CHNW ARE INDEPENDENT OUTSIDE DIRECTORS. |
| FORM 990, PART V | FORM 990, PART V, LINE 1A - BOX 3 OF FORM 1096 FORM 1099'S WERE PROCESSED UNDER THE NAME AND FEDERAL IDENTIFICATION NUMBER OF COMMUNITY HEALTH NETWORK, INC. FORM 990, PART V, LINE 2A - NUMBER OF EMPLOYEES CPI EMPLOYEES ARE LEASED FROM COMMUNITY HEALTH NETWORK, INC. |
| FORM 990, PART VI | FORM 990, PART VI, LINE 1B - VOTING MEMBERS THAT ARE INDEPENDENT SEE FORM 990, PART I, LINE 4 REFERENCE ON SCHEDULE O ABOVE FORM 990, PART VI, LINE 2 - RELATED PARTY INFORMATION AMONG OFFICERS THE FOLLOWING DIRECTORS SERVED AS A DIRECTOR OR OFFICER OF COMMUNITY HEALTH NETWORK, INC. ("CHNW"): JASON BECKER TIMOTHY HOBBS, M.D. ANTHONY JAVORKA BRYAN A. MILLS ANNETTE MOORE, M.D. STEVEN PLUMP RAMARAO YELETI, M.D. AND THE FOLLOWING RECEIVED COMPENSATION FROM CHNW: FRANK COVINGTON, M.D. TIMOTHY HOBBS, M.D. JASON LANDIS BRYAN A. MILLS JAMES READ RAMARAO YELETI, M.D. |
| FORM 990, PAGE 6, PART VI, LINE 3 | CPI DELEGATED AUTHORITY IN ITS ARTICLES OF INCORPORATION TO CHNW IN THE FOLLOWING SUBSTANTIVE AREAS: STRATEGIC PLANNING, CAPITAL ACCESS, BUDGETING AND ALLOCATION; AUDIT AND COMPLIANCE; EXECUTIVE COMPENSATION; AND DISPUTE RESOLUTION. CPI DELEGATED THESE AUTHORITIES TO ITS PARENT, CHNW, TO ENSURE THAT CPI'S ACTIVITIES WERE INTEGRATED INTO THE BROADER CHARITABLE EFFORTS OF THE NETWORK. |
| FORM 990, PAGE 6, PART VI, LINE 6 | CHNW IS THE SOLE MEMBER OF CPI. |
| FORM 990, PAGE 6, PART VI, LINE 7A | CHNW, ACTING THROUGH ITS BOARD OF DIRECTORS, HAS THE AUTHORITY TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS OF CPI. |
| FORM 990, PAGE 6, PART VI, LINE 7B | THE FOLLOWING GOVERNANCE DECISIONS REQUIRE THE APPROVAL OF CHNW, ACTING THROUGH ITS BOARD OF DIRECTORS: 1) ANY MATERIAL SALE OR OTHER DISPOSITION OF THE ASSETS OF CPI; AND 2) THE MODIFICATION, REPEAL, AMENDMENT, OR RESTATEMENT OF THE ARTICLES OF INCORPORATION. |
| FORM 990, PAGE 6, PART VI, LINE 11B | AS DISCUSSED IN PART I, LINE 4, CHNW HAS ASSUMED RESPONSIBILITY FOR CPI'S AUDIT, COMPLIANCE, AND EXECUTIVE COMPENSATION MATTERS. CHNW'S BOARD OF DIRECTORS HAS DELEGATED AUTHORITY FOR THE REVIEW OF CPI'S FORM 990 TO TWO COMMITTEES COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS: A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE COMPENSATION ASPECTS OF CPI'S FORM 990, AND B) THE NETWORK FINANCE COMMITTEE REVIEWED THE REMAINDER OF CPI'S FORM 990. IN ADDITION, CPI'S OUTSIDE ACCOUNTING FIRM AND LAW FIRM REVIEWED THE FORM 990 PRIOR TO FILING. CPI AND CHNW UTILIZED THIS PROCESS TO ENSURE THAT CPI'S FORM 990 RECEIVED SUBSTANTIVE REVIEW BY DIRECTORS AND PROFESSIONALS WITH SPECIFIC KNOWLEDGE OF CPI'S ACTIVITIES AND EXTENSIVE FINANCIAL, ACCOUNTING, AND TAX EXPERTISE. |
| FORM 990, PAGE 6, PART VI, LINE 12C | AS DISCUSSED IN PART I, LINE 4, CHNW HAS ASSUMED RESPONSIBILITY FOR CPI'S AUDIT AND COMPLIANCE MATTERS. CHNW HAS ADOPTED A CONFLICT OF INTEREST POLICY THAT APPLIES TO CPI. THE CONFLICT OF INTEREST POLICY REQUIRES DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO SUBMIT AN ANNUAL CONFLICT OF INTEREST DISCLOSURE. THE ANNUAL DISCLOSURE REQUIRES DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO DISCLOSE, IN WRITING, ANY KNOWN FINANCIAL INTEREST THAT THE INDIVIDUAL (TOGETHER WITH FAMILY MEMBERS) HAS IN ANY BUSINESS ENTITY THAT TRANSACTS BUSINESS WITH CPI. IN ADDITION, DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO IMMEDIATELY DISCLOSE ANY POSSIBLE CONFLICT OF INTEREST THAT ARISES MID-YEAR IN RELATION TO A PROPOSED TRANSACTION. THE CONFLICT OF INTEREST POLICY REQUIRES THAT ANY INDIVIDUAL WITH A CONFLICT BE RECUSED FROM THE DECISION MAKING PROCESS, THAT INDEPENDENT DIRECTORS OR COMMITTEE MEMBERS DETERMINE THAT THE PROPOSED TRANSACTION IS IN THE BEST INTEREST OF CPI, AND THE TRANSACTION MUST BE APPROVED BY A VOTE OF INDEPENDENT DIRECTORS OR COMMITTEE MEMBERS WITHOUT THE PARTICIPATION OF ANY INTERESTED INDIVIDUAL. THE ANNUAL CONFLICT DISCLOSURE STATEMENTS ARE SUBMITTED TO, AND REVIEWED BY, CHNW'S AUDIT COMMITTEE, COMPOSED OF INDEPENDENT DIRECTORS. IN ADDITION, THE EXECUTIVE STAFF AND GENERAL COUNSEL OF THE NETWORK ARE RESPONSIBLE FOR MONITORING ANY POSSIBLE CONFLICT TRANSACTIONS THAT ARISE AND MANAGING THEM TO ENSURE THAT ALL TRANSACTIONS REPRESENT ARMS LENGTH, FAIR MARKET VALUE TERMS FOR THE BENEFIT OF CPI. |
| FORM 990, PAGE 6, PART VI, LINE 15A | AS DISCUSSED IN PART I, LINE 4, CHNW HAS ASSUMED RESPONSIBILITY FOR CPI'S EXECUTIVE COMPENSATION MATTERS. CHNW HAS ADOPTED AN EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY THAT APPLIES TO CPI. THE PURPOSE OF THE POLICY IS TO ENSURE THAT CPI'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 ALSO DELEGATED AUTHORITY REGARDING CPI'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 2017, 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 CERTIFICATE OF EXISTENCE ARE ON FILE WITH THE INDIANA SECRETARY OF STATE AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE INDIANA SECRETARY OF STATE OR FREE OF CHARGE ON THE SECRETARY OF STATE'S WEBSITE. B) AS AN AFFILIATE OF CHNW, CPI HAS ADOPTED THE NETWORK CONFLICT OF INTEREST POLICY. WHILE THIS POLICY IS NOT AVAILABLE TO THE PUBLIC, THE NETWORK'S DEFINITION OF A CONFLICT OF INTEREST AND HOW TO REPORT SUCH AN INCIDENT IS DESCRIBED IN THE NETWORK RESPONSIBILITY AND COMPLIANCE PROGRAM ("NRCP") MANUAL WHICH IS POSTED ON THE NETWORK'S WEBSITE, ECOMMUNITY.COM. THIS MANUAL IS AVAILABLE FOR THE PUBLIC TO REVIEW. C) CPI 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. CPI 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 VII | FORM 990, PART VII, SECTION B - INDEPENDENT CONTRACTOR DISCLOSURE COMPENSATION TO ALDERSON PROPERTY SERVICES AND BAF CORPORATION INCLUDES MATERIAL COSTS. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES 0 1,220,143 0 PURCHASED SERVICES 0 66,374,563 0 TOTAL 0 67,594,706 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 | ||||||||||
| 7240 SHADELAND STATION SUITE 125 | 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) |
| COMMUNITY HOWARD REGIONAL HEALTH | ||||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 351865344 | 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) |
| 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 (18 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| CHNJMH VENTURES LLC | |||||||||
| 6626 E 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | 462356266 | DIAG/REHAB | IN | N/A | 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 | N/A | false | false |
| HOWARD REGIONAL SPECIALTY CARE LLC | |||||||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | 371501021 | REHAB | IN | N/A | false | false |
| INDIANAPOLIS ENDOSCOPY CENTER LLP | |||||||||
| 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 |
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHN ASSURANCE COMPANY LTD | |||||||||||||
| PO BOX 1051 GT | GRAND CAYMAN | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | Yes (true) | |||||
| PILLARS COMMUNITY HOUSING INC | |||||||||||||
| 161652666 | HOUSING | N/A | Yes (true) | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | |||||
| VISIONARY ENTERPRISES INC | |||||||||||||
| 351538433 | MGMT SRVS | N/A | Yes (true) | 6626 EAST 75TH STREET SUITE 200 | INDIANAPOLIS | IN | 46250 | IN | |||||
| VEI MICHIGAN INC | |||||||||||||
| 300097377 | MGMT SRVS | N/A | Yes (true) | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | |||||
| 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 | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | 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 | Yes (true) | 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 | Yes (true) | 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 (19 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| COMMUNITY HEALTH NETWORK FOUNDATION | ||
| C | $153,753 | BOOK VALUE |
| COMMUNITY HEALTH NETWORK FOUNDATION | ||
| R | $191,945 | BOOK VALUE |
| COMMUNITY HOME HEALTH SERVICES INC | ||
| R | $64,414 | BOOK VALUE |
| COMM HOSP OF ANDERSON & MADISON CTY | ||
| K | $1,377,353 | BOOK VALUE |
| COMM HOSP OF ANDERSON & MADISON CTY | ||
| Q | $4,953,052 | BOOK VALUE |
| COMM HOSP OF ANDERSON & MADISON CTY | ||
| R | $130,517 | BOOK VALUE |
| COMMUNITY HOSPITAL SOUTH INC | ||
| K | $721,464 | BOOK VALUE |
| COMMUNITY HOSPITAL SOUTH INC | ||
| S | $1,119,416 | BOOK VALUE |
| COMMUNITY HOWARD REGIONAL HEALTH | ||
| K | $1,169,266 | BOOK VALUE |
| COMMUNITY HOWARD REGIONAL HEALTH | ||
| S | $1,078,376 | BOOK VALUE |
| HEALTH INSTITUTE OF INDIANA INC | ||
| K | $187,757 | BOOK VALUE |
| HEALTH INSTITUTE OF INDIANA INC | ||
| S | $442,457 | BOOK VALUE |
| INDIANAPOLIS OSTEOPATHIC HOSPITAL | ||
| R | $190,248 | BOOK VALUE |
| NORTH CAMPUS OFFICE ASSOCIATES LP | ||
| K | $807,538 | BOOK VALUE |
| NORTH CAMPUS OFFICE ASSOCIATES LP | ||
| R | $72,572 | BOOK VALUE |
| VISIONARY ENTERPRISES INC | ||
| K | $2,879,195 | BOOK VALUE |
| VISIONARY ENTERPRISES INC | ||
| Q | $10,342,910 | BOOK VALUE |
| VISIONARY ENTERPRISES INC | ||
| S | $4,840,771 | BOOK VALUE |
| WESTVIEW DELIVERY SYSTEM | ||
| R | $125,467 | BOOK VALUE |