2018-11-07T13:14:32-05:00 2017-12-31 352032768 CASKEY & DAILY PC 4745 STATESMEN DRIVE SUITE C INDIANAPOLIS IN 46250 990 2017-01-01 205392766 COMMUNITY PHYSICIANS OF INDIANA INC COMM 3176218064 7240 SHADELAND STATION SUITE 200 INDIANAPOLIS IN 46256 JOHN KUNZER MD MMM PRESIDENT 3176217454 2018-10-22 true JAMES A CASKEY CPA CFP P00172185 3175852647 2018-11-06 73.103.115.42 2018-11-06 14:42:08 P 3E83E976884D6852BF626D3B074032779D209233 3E83E976884D6852BF626D3B074032779D209233 2017 2019-02-21 02:37:17Z COMMUNITY PHYSICIAN NETWORK JOHN KUNZER MD MMM 7240 SHADELAND STATION SUITE 200 INDIANAPOLIS IN 46256 295469396 false X WWW.ECOMMUNITY.COM/CPI/ X 2006 IN 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. 15 3 3391 3 17849 15064 177678 153753 255880262 291092714 -136989 -91487 11434216 3840912 267355167 294995892 6500 0 0 385504579 433030377 0 0 94536497 140594128 480047576 573624505 -212692409 -278628613 63709147 77415574 1035716537 1328051577 -972007390 -1250636003 X 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. false false 501528010 294915777 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. 501528010 true true false false false false false false false false true false false false true false false true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false false true X 0 0 true 3391 true true true false false false false false false false false false X 15 3 true true false false true true true true true false false false true true true true true false false false IN X BRIAN MCCONNELL 3173554212 8180 CLEARVISTA PARKWAY SUITE 200 INDIANAPOLIS IN 46256 X BRYAN A MILLS DIRECTOR 2.00 58.00 X 0 1425217 627046 RAMARAO YELETI MD PRESIDENT JA 48.00 2.00 X X 729994 248128 341650 MICHAEL ROBERTSON MD CHAIRMAN 50.00 0.00 X X 941658 0 176960 TIMOTHY HOBBS MD DIRECTOR 2.00 48.00 X 0 807985 254076 STEVE O'NEIL MD DIRECTOR 50.00 0.00 X 649935 0 169777 ERNEST O ASAMOAH MD DIRECTOR 50.00 0.00 X 635785 0 97614 ANNETTE MOORE MD TREASURER 49.00 6.00 X X 577057 0 16200 ROBIN LEDYARD MD INTR PRES AU 50.00 0.00 X X 487451 0 154976 ANTHONY SANDERS MD DIRECTOR 50.00 0.00 X 486189 0 105335 ROBERT GOULET MD DIRECTOR 50.00 0.00 X 450944 0 76982 FRANK COVINGTON MD DIRECTOR 50.00 0.00 X 0 445660 73053 STEPHANIE OVERMARS MD DIRECTOR 50.00 0.00 X 439894 0 66246 CHARLES PLATZ MD VICE CHAIRMA 50.00 0.00 X X 406164 0 92212 MICHAEL ALLEY DIRECTOR 2.00 0.00 X 0 0 0 JASON BECKER DIRECTOR 2.00 6.00 X 0 0 0 STEVEN PLUMP DIRECTOR 2.00 6.00 X 0 0 0 ANTHONY JAVORKA COO 46.00 4.00 X 0 592470 388652 JAMES READ CFO JAN - AU 50.00 0.00 X 0 296393 75250 GWEN O'MALLEY SVP AMBULATO 50.00 0.00 X 381000 0 108867 JASON LANDIS EXC DIRECTOR 50.00 0.00 X 0 235308 55853 JAMES CALLAHAN MD PHYSICIAN 50.00 0.00 X 1900901 0 115044 DANIEL KIM MD PHYSICIAN 50.00 0.00 X 1550902 0 51072 KRISHNA MALINENI MD PHYSICIAN 50.00 0.00 X 1506609 0 286076 RAJESH MALLELA MD PHYSICIAN 50.00 0.00 X 1479113 0 167291 PREETHAM JETTY MD PHYSICIAN 50.00 0.00 X 1440696 0 249190 14064292 4051161 3749422 792 false true false ALDERSON PROPERTY SERVICES 425 W SOUTH SUITE 100 INDIANAPOLIS IN 46225 CONSTRUCTION 3187009 BAF CORPORATION 6084 FALL CREEK ROAD INDIANAPOLIS IN 46220 CONSTRUCTION 2200222 OTOLARYNGOLOGY ASSOCIATES LLC 9002 N MERIDIAN STREET SUITE 222 INDIANAPOLIS IN 46260 MEDICAL 1612496 WEATHERBY LOCUMS INC 7259 BINGHAM JUNCTION BLVD MIDVALE UT 84047 TEMPORARY STAFF 813429 IU HEALTH PHYSICIANS 2568 RELIABLE PARKWAY CHICAGO IL 60686 MEDICAL 812525 40 153753 153753 PATIENT SERVICES 621110 290823296 290823296 PHYSICIAN FEES 900099 269418 269418 291092714 8467 8467 654 100608 -99954 -99954 -99954 394294 372896 21398 3549 17849 CORPORATE HEALTH PROMOTIONS 900099 2828372 2828372 EMR INCENTIVE PAYMENTS 900099 978390 978390 LEGAL REIMBURSEMENT 900099 10902 10902 1850 1850 3819514 294995892 294915777 17849 -91487 X 7592890 6210219 1382671 368927486 368373427 554059 11659409 11620649 38760 27372693 27177935 194758 17477899 17308616 169283 67594706 67594706 1084626 362150 722476 6106822 5813181 293641 235432 78609 156823 28514558 27825129 689429 374874 302400 72474 1800601 1788410 12191 4858232 4787911 70321 6132766 6132766 MEDICAL SUPPLIES 22611972 22611972 DUES, LICENSES, SUBSCRPTN 1089877 1078426 11451 MEALS & ENTERTAINMENT 124557 41589 82968 RECRUITMENT 27562 9203 18359 37543 5418 32125 573624505 501528010 72096495 0 19882 19785 34282397 27592594 2722619 17801741 1229091 1117954 57676814 26909224 25455158 30767590 115910 63709147 77415574 38303744 30317281 45626 997412793 1297688670 1035716537 1328051577 X -972007390 -1250636003 -972007390 -1250636003 63709147 77415574 -278628613 X false true X true false X 108432 8584 2005 177678 153753 450452 174357109 238686388 291082148 267832292 295217275 1267175212 174465541 238694972 291084153 268009970 295371028 1267625664 1267625664 6058 5924 24760 1962 8467 47171 6058 5924 24760 1962 8467 47171 9680 20176 13129 10887 15064 68936 174481279 238721072 291122042 268022819 295394559 1267741771 0.99990 0.99990 0.00000 0.00000 X 31477537 12042685 19434852 26199277 14866539 11332738 30767590 DUE FROM AFFILIATES 1297615572 GUARANTEE LIABILITY 73098 1297688670 true true false true false false false true false BRYAN A MILLS DIRECTOR 1076737 328501 19979 591445 35601 2052263 328501 RAMARAO YELETI MD PRESIDENT JAN - JULY 653766 216153 76228 31975 303084 38566 1071644 248128 216153 MICHAEL ROBERTSON MD CHAIRMAN 653316 115327 173015 146177 33383 1118618 115327 TIMOTHY HOBBS MD DIRECTOR 594203 187902 25880 228044 26032 1062061 187902 STEVE O'NEIL MD DIRECTOR 471060 32077 146798 136193 33584 819712 ERNEST O ASAMOAH MD DIRECTOR 527124 107524 1137 61040 36574 733399 107524 ANNETTE MOORE MD TREASURER 557919 19138 16200 593257 ROBIN LEDYARD MD INTR PRES AUG - DEC 370877 115047 1527 124865 30111 642427 ANTHONY SANDERS MD DIRECTOR 425825 59052 1312 82093 23242 591524 58302 ROBERT GOULET MD DIRECTOR 357237 65008 28699 66719 10263 527926 65008 FRANK COVINGTON MD DIRECTOR 325081 41214 79365 58543 14510 518713 41214 STEPHANIE OVERMARS MD DIRECTOR 324911 89086 25897 66246 506140 89086 CHARLES PLATZ MD VICE CHAIRMAN 247288 89879 68997 55638 36574 498376 89879 ANTHONY JAVORKA COO 321581 175605 95284 356893 31759 981122 110869 JAMES READ CFO JAN - AUGUST 257444 37904 1045 63340 11910 371643 37904 GWEN O'MALLEY SVP AMBULATORY SERV 268650 93144 19206 94877 13990 489867 JASON LANDIS EXC DIRECTOR FINANCE 188073 46439 796 47095 8758 291161 JAMES CALLAHAN MD PHYSICIAN 1662576 219187 19138 80058 34986 2015945 219187 DANIEL KIM MD PHYSICIAN 1495320 54444 1138 16200 34872 1601974 54444 KRISHNA MALINENI MD PHYSICIAN 1278553 226918 1138 248191 37885 1792685 226839 RAJESH MALLELA MD PHYSICIAN 1177827 159696 141590 128217 39074 1646404 PREETHAM JETTY MD PHYSICIAN 1163105 258453 19138 230024 19166 1689886 258421 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. 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 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 true COMMUNITY HLTH SERVICES OF INDIANA 7330 SHADELAND STATION SUITE 200 INDIANAPOLIS IN 46256 454817436 HLTH CARE IN 501C3 3 CHNW true COMMUNITY HOME HEALTH SERVICES INC 9894 EAST 121ST STREET FISHERS IN 46037 350953467 HLTH CARE IN 501C3 10 CHNW true COMM HOSP OF ANDERSON & MADISON CTY 1515 NORTH MADISON AVENUE ANDERSON IN 46011 351069822 HOSPITAL IN 501C3 3 CHNW true COMMUNITY HOSP ANDERSON FDN INC 1515 NORTH MADISON AVENUE ANDERSON IN 46011 861053152 SUPPORT IN 501C3 12A CHA true COMMUNITY HOSPITAL SOUTH INC 1402 E COUNTY LINE ROAD SOUTH INDIANAPOLIS IN 46227 351088640 HOSPITAL IN 501C3 3 CHNW true COMMUNITY HOWARD REGIONAL HEALTH 3500 S LAFOUNTAIN STREET KOKOMO IN 46902 351865344 HOSPITAL IN 501C3 3 CHNW 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 true HEALTH INSTITUTE OF INDIANA INC 3660 GUION ROAD INDIANAPOLIS IN 46222 352022402 FITNESS IN 501C3 10 CHNW true INDIANAPOLIS OSTEOPATHIC HOSP INC 3630 GUION ROAD INDIANAPOLIS IN 46222 351094734 HOSPITAL IN 501C3 3 CHNW true 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 CHN ASSURANCE COMPANY LTD PO BOX 1051 GT GRAND CAYMAN GRAND CAYMAN CJ 980418913 INSURANCE CJ N/A true PILLARS COMMUNITY HOUSING INC 3500 S LAFOUNTAIN STREET KOKOMO IN 46902 161652666 HOUSING IN N/A true VISIONARY ENTERPRISES INC 6626 EAST 75TH STREET SUITE 200 INDIANAPOLIS IN 46250 351538433 MGMT SRVS IN N/A true VEI MICHIGAN INC 940 N MAIN STREET ANN HARBOR MI 48104 300097377 MGMT SRVS MI N/A true WESTVIEW DELIVERY SYSTEM INC 3630 GUION ROAD INDIANAPOLIS IN 46222 351910292 MGMT SRVS IN N/A true false false true false false false false false false true true false false false false true true true true COMMUNITY HEALTH NETWORK FOUNDATION C 153753 BOOK VALUE COMMUNITY HEALTH NETWORK FOUNDATION R 191945 BOOK VALUE COMMUNITY HOME HEALTH SERVICES INC R 64414 BOOK VALUE COMM HOSP OF ANDERSON & MADISON CTY K 1377353 BOOK VALUE COMM HOSP OF ANDERSON & MADISON CTY Q 4953052 BOOK VALUE COMM HOSP OF ANDERSON & MADISON CTY R 130517 BOOK VALUE COMMUNITY HOSPITAL SOUTH INC K 721464 BOOK VALUE COMMUNITY HOSPITAL SOUTH INC S 1119416 BOOK VALUE COMMUNITY HOWARD REGIONAL HEALTH K 1169266 BOOK VALUE COMMUNITY HOWARD REGIONAL HEALTH S 1078376 BOOK VALUE HEALTH INSTITUTE OF INDIANA INC K 187757 BOOK VALUE HEALTH INSTITUTE OF INDIANA INC S 442457 BOOK VALUE INDIANAPOLIS OSTEOPATHIC HOSPITAL R 190248 BOOK VALUE NORTH CAMPUS OFFICE ASSOCIATES LP K 807538 BOOK VALUE NORTH CAMPUS OFFICE ASSOCIATES LP R 72572 BOOK VALUE VISIONARY ENTERPRISES INC K 2879195 BOOK VALUE VISIONARY ENTERPRISES INC Q 10342910 BOOK VALUE VISIONARY ENTERPRISES INC S 4840771 BOOK VALUE WESTVIEW DELIVERY SYSTEM R 125467 BOOK VALUE