STRATEGY STUDIO / PUBLIC DATA EXPLORER

COMMUNITY PHYSICIANS OF INDIANA INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY PHYSICIANS OF INDIANA INC (EIN 20-5392766)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-09
IRS object ID
201713139349302116
Schema version
2016v3.0
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

FieldValueIRS element (for citing)
Return2017-11-09T12:13:43-05:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN352032768PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CASKEY & DAILY PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14745 STATESMEN DRIVE SUITE CAddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46250ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN205392766EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY PHYSICIANS OFBusinessNameLine1Txt
Business Name Line2INDIANA INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone3176218064PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17240 SHADELAND STATION SUITE 200AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46256ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRAMARAO YELETI MDPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone3176217454PhoneNum
Signature2017-10-19SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJAMES A CASKEY CPA CFPPreparerPersonNm
PTINP00172185PTIN
Phone3175852647PhoneNum
Preparation2017-11-01PreparationDt

Filing Security Information FilingSecurityInformation

FieldValueIRS element (for citing)
At Submission Creation Device Id3E83E976884D6852BF626D3B074032779D209233AtSubmissionCreationDeviceId
At Submission Filing Device Id3E83E976884D6852BF626D3B074032779D209233AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2018-03-14 21:41:22ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY PHYSICIAN NETWORKBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerRAMARAO YELETI MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line17240 SHADELAND STATION SUITE 200AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46256ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$268,085,473GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ECOMMUNITY.COM/CPI/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2006FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionCOMMUNITY 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 Body14VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee3281TotalEmployeeCnt
Total Volunteers3TotalVolunteersCnt
Total Gross UBI$14,708TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$10,887NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,005PYContributionsGrantsAmt
CY Contributions Grants$177,678CYContributionsGrantsAmt
PY Program Service Revenue$281,712,073PYProgramServiceRevenueAmt
CY Program Service Revenue$255,880,262CYProgramServiceRevenueAmt
PY Investment Income$6,624PYInvestmentIncomeAmt
CY Investment Income-$136,989CYInvestmentIncomeAmt
PY Other Revenue$8,922,028PYOtherRevenueAmt
CY Other Revenue$11,434,216CYOtherRevenueAmt
PY Total Revenue$290,642,730PYTotalRevenueAmt
CY Total Revenue$267,355,167CYTotalRevenueAmt
CY Grants And Similar Paid$6,500CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$351,686,146PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$385,504,579CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$131,792,362PYOtherExpensesAmt
CY Other Expenses$94,536,497CYOtherExpensesAmt
PY Total Expenses$483,478,508PYTotalExpensesAmt
CY Total Expenses$480,047,576CYTotalExpensesAmt
PY Revenues Less Expenses-$192,835,778PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$212,692,409CYRevenuesLessExpensesAmt
Total Assets BOY$63,504,828TotalAssetsBOYAmt
Total Assets EOY$63,709,147TotalAssetsEOYAmt
Total Liabilities BOY$830,264,928TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,035,716,537TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$766,760,100NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$972,007,390NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCOMMUNITY 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 SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$448,853,757ExpenseAmt
Grant$6,500GrantAmt
Revenue$267,299,770RevenueAmt
DescCOMMUNITY 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 2016, CPI'S PATIENT VISITS WERE 1,475,106.Desc
Total Program Service Expenses$448,853,757TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee3281EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJOSEPH M KESSLERPersonNm
Phone3176210395PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17330 SHADELAND STATION SUITE 200AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46256ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
BRYAN A MILLS
DIRECTOR2.0058.00Yes (X)$0$1,427,576$452,142
MICHAEL ROBERTSON MD
VICE CHAIRMA50.000.00Yes (X)$904,125$0$163,177Yes (X)
RAMARAO YELETI MD
PRESIDENT48.002.00Yes (X)$801,035$0$312,107Yes (X)
TIMOTHY HOBBS MD
DIRECTOR2.0048.00Yes (X)$0$728,080$272,804
FRANK COVINGTON MD
CHAIRMAN50.000.00Yes (X)$0$663,538$205,756Yes (X)
ANNETTE MOORE MD
DIRECTOR49.006.00Yes (X)$577,241$0$15,900
ERNEST O ASAMOAH MD
VICE CHARMN50.000.00Yes (X)$517,868$0$158,995Yes (X)
ANTHONY SANDERS MD
DIRECTOR50.000.00Yes (X)$512,243$0$96,912
ROBERT GOULET MD
DIRECTOR50.000.00Yes (X)$414,357$0$91,911
CHARLES PLATZ MD
DIRECTOR50.000.00Yes (X)$341,171$0$141,350
STEPHANIE OVERMARS MD
DIRECTOR50.000.00Yes (X)$340,289$0$104,986
CARRIE MELLOH MD
DIRECTOR50.000.00Yes (X)$194,708$0$102,001
MICHAEL ALLEY
DIRECTOR2.000.00Yes (X)$0$0$0
JASON BECKER
DIRECTOR2.006.00Yes (X)$0$0$0
STEVEN PLUMP
DIRECTOR2.006.00Yes (X)$0$0$0
ANTHONY JAVORKA
COO46.004.00$421,404$0$192,807Yes (X)
JAMES READ
CFO MARCH -50.000.00$0$230,771$50,674Yes (X)
JAMES CALLAHAN MD
PHYSICIAN50.000.00$1,881,218$0$269,001Yes (X)
DANIEL KIM MD
PHYSICIAN50.000.00$1,423,885$0$117,602Yes (X)
PREETHAM JETTY MD
PHYSICIAN50.000.00$1,386,977$0$295,772Yes (X)
DEEPAK GUTTIKONDA MD
PHYSICIAN50.000.00$1,356,128$0$218,134Yes (X)
KRISHNA MALINENI MD
PHYSICIAN50.000.00$1,203,167$0$277,249Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$12,275,816TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,049,965TotReportableCompRltdOrgAmt
Total Other Compensation$3,539,280TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K693IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ALDERSON PROPERTY SERVICES
425 W SOUTH SUITE 100INDIANAPOLISIN46225CONSTRUCTION$5,559,451
BAF CORPORATION
6084 FALL CREEK ROADINDIANAPOLISIN46220CONSTRUCTION$1,756,265
ST VINCENT HOSPITAL
10330 N MERIDIAN STREETINDIANAPOLISIN46290MEDICAL$1,582,600
WEATHERBY LOCUMS INC
6451 N FEDERAL HWY STE 801FORT LAUDERDALEFL33308TEMPORARY STAFF$1,471,851
HAYES BROTHERS INC
1241 E 400 SOUTHKOKOMOIN46902CONSTRUCTION$943,316
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K37CntrctRcvdGreaterThan100KCnt
Related Organizations$177,678RelatedOrganizationsAmt
Total Contributions$177,678TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICES621110$255,296,751$255,296,751
JANE PAULEY ADMIN FEES900099$366,663$366,663
PHYSICIAN FEES900099$207,904$207,904
RENTAL INCOME531120$8,944$8,944
FieldValueIRS element (for citing)
Total Program Service Revenue$255,880,262TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,962TotalRevenueColumnAmt
Exclusion$1,962ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$138,951OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$138,951OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$138,951TotalRevenueColumnAmt
Exclusion-$138,951ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$327,482GrossSalesOfInventoryAmt
Cost Of Goods Sold$591,355CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$263,873TotalRevenueColumnAmt
Related Or Exempt Func Income-$278,581RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$14,708UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
ONSITE SERVICE FEES900099$6,997,392$6,997,392
CORPORATE HEALTH PROMOTIONS900099$2,760,102$2,760,102
EMR INCENTIVE PAYMENTS900099$1,923,521$1,923,521

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,074TotalRevenueColumnAmt
Related Or Exempt Func Income$17,074RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$11,698,089OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$267,355,167TotalRevenueColumnAmt
Related Or Exempt Func Income$267,299,770RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$14,708UnrelatedBusinessRevenueAmt
Exclusion-$136,989ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$6,500TotalAmt
Program Services$6,500ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$6,404,587TotalAmt
Program Services$5,790,376ProgramServicesAmt
Management And General$614,211ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$328,650,166TotalAmt
Program Services$326,928,157ProgramServicesAmt
Management And General$1,722,009ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$9,461,669TotalAmt
Program Services$9,366,431ProgramServicesAmt
Management And General$95,238ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$26,014,849TotalAmt
Program Services$25,685,806ProgramServicesAmt
Management And General$329,043ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$14,973,308TotalAmt
Program Services$14,724,049ProgramServicesAmt
Management And General$249,259ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$20,766TotalAmt
Program Services$5,766ProgramServicesAmt
Management And General$15,000ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$10,070TotalAmt
Management And General$10,070ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$26,071,448TotalAmt
Management And General$26,071,448ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$487,984TotalAmt
Program Services$153,538ProgramServicesAmt
Management And General$334,446ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,821,406TotalAmt
Program Services$5,562,910ProgramServicesAmt
Management And General$258,496ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$433,243TotalAmt
Program Services$136,314ProgramServicesAmt
Management And General$296,929ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$26,378,942TotalAmt
Program Services$25,591,029ProgramServicesAmt
Management And General$787,913ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$444,573TotalAmt
Program Services$336,166ProgramServicesAmt
Management And General$108,407ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,267,059TotalAmt
Program Services$1,199,572ProgramServicesAmt
Management And General$67,487ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,429,356TotalAmt
Program Services$4,353,769ProgramServicesAmt
Management And General$75,587ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,436,248TotalAmt
Program Services$6,436,248ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$21,757,821$21,757,821
DUES, LICENSES, SUBSCRPTN$820,460$782,552$37,908
MEALS & ENTERTAINMENT$75,968$23,902$52,066
CORPORATE SPONSORSHIP$44,148$44,148

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$37,005TotalAmt
Program Services$12,851ProgramServicesAmt
Management And General$24,154ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$480,047,576TotalAmt
Program Services$448,853,757ProgramServicesAmt
Management And General$31,193,819ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$16,070BOYAmt
EOY$19,882EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$39,696,169BOYAmt
EOY$34,282,397EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$3,246,483BOYAmt
EOY$2,722,619EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,332,500BOYAmt
EOY$1,229,091EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$48,945,829LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$23,490,671LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$19,213,606BOYAmt
EOY$25,455,158EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$63,504,828BOYAmt
EOY$63,709,147EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$46,689,275BOYAmt
EOY$38,303,744EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$783,575,653BOYAmt
EOY$997,412,793EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$830,264,928BOYAmt
EOY$1,035,716,537EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$766,760,100BOYAmt
EOY-$972,007,390EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$766,760,100BOYAmt
EOY-$972,007,390EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$63,504,828BOYAmt
EOY$63,709,147EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$212,692,409ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$7,445,119OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$145,458CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$108,432CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,584CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,005CurrentTaxYearMinus1YearAmt
Current Tax Year$177,678CurrentTaxYearAmt
Total$442,157TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$173,142,889CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$174,357,109CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$238,686,388CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$291,082,148CurrentTaxYearMinus1YearAmt
Current Tax Year$267,832,292CurrentTaxYearAmt
Total$1,145,100,826TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$173,288,347CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$174,465,541CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$238,694,972CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$291,084,153CurrentTaxYearMinus1YearAmt
Current Tax Year$268,009,970CurrentTaxYearAmt
Total$1,145,542,983TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$1,145,542,983PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,331CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,058CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,924CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$24,760CurrentTaxYearMinus1YearAmt
Current Tax Year$1,962CurrentTaxYearAmt
Total$45,035TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,331CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,058CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,924CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$24,760CurrentTaxYearMinus1YearAmt
Current Tax Year$1,962CurrentTaxYearAmt
Total$45,035TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$43,220CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,680CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$20,176CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,129CurrentTaxYearMinus1YearAmt
Current Tax Year$5,708CurrentTaxYearAmt
Total$91,913TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$173,337,898CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$174,481,279CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$238,721,072CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$291,122,042CurrentTaxYearMinus1YearAmt
Current Tax Year$268,017,640CurrentTaxYearAmt
Total$1,145,679,931TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99990PublicSupportCY509Pct
Public Support PY5090.99990PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$25,842,155OtherCostOrOtherBasisAmt
Depreciation$9,893,915DepreciationAmt
Book Value$15,948,240BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$23,103,674OtherCostOrOtherBasisAmt
Depreciation$13,596,756DepreciationAmt
Book Value$9,506,918BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$25,455,158TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE FROM AFFILIATESDesc
Amt$997,412,793Amt
FieldValueIRS element (for citing)
Total Liability$997,412,793TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgYes (true)CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt
BRYAN A MILLS
DIRECTOR$1,233,291$73,920$120,365$417,734$34,408$1,879,718$73,920
MICHAEL ROBERTSON MD
VICE CHAIRMAN/SECRTY$621,098$91,218$191,809$131,347$34,230$1,067,302$91,218
RAMARAO YELETI MD
PRESIDENT$627,657$72,332$101,046$277,253$34,854$1,113,142$72,332
TIMOTHY HOBBS MD
DIRECTOR$546,192$161,600$20,288$247,459$25,345$1,000,884$161,600
FRANK COVINGTON MD
CHAIRMAN$420,396$32,472$210,670$192,180$13,576$869,294$32,472
ANNETTE MOORE MD
DIRECTOR$557,901$19,340$15,900$593,141
ERNEST O ASAMOAH MD
VICE CHARMN JAN-JUNE$485,118$31,416$1,334$123,424$35,571$676,863$31,416
ANTHONY SANDERS MD
DIRECTOR$394,373$39,891$77,979$74,202$22,710$609,155
ROBERT GOULET MD
DIRECTOR$302,036$51,103$61,218$80,908$11,003$506,268
CHARLES PLATZ MD
DIRECTOR$242,557$34,241$64,373$105,779$35,571$482,521$34,241
STEPHANIE OVERMARS MD
DIRECTOR$301,723$9,517$29,049$104,986$445,275$9,517
CARRIE MELLOH MD
DIRECTOR$167,388$12,196$15,124$67,344$34,657$296,709$12,196
ANTHONY JAVORKA
COO$378,361$41,215$1,828$155,436$37,371$614,211$41,215
JAMES READ
CFO MARCH - DECEMBER$190,858$39,913$37,904$12,770$281,445
JAMES CALLAHAN MD
PHYSICIAN$1,610,793$251,085$19,340$235,087$33,914$2,150,219$251,085
DANIEL KIM MD
PHYSICIAN$1,349,367$67,622$6,896$83,522$34,080$1,541,487
PREETHAM JETTY MD
PHYSICIAN$1,216,318$151,319$19,340$274,321$21,451$1,682,749$151,319
DEEPAK GUTTIKONDA MD
PHYSICIAN$1,243,482$93,306$19,340$182,563$35,571$1,574,262$93,306
KRISHNA MALINENI MD
PHYSICIAN$1,082,520$119,307$1,340$242,739$34,510$1,480,416

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PAGE 1, PART I, LINE 4BRYAN A. MILLS 0 118,000 0
SCHEDULE J, PART IIIPART 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. CHNW USES THE FOLLOWING IN DETERMINING THE CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE, 2) INDEPENDENT COMPENSATION CONSULTANT, 3) COMPENSATION SURVEY OR STUDY, AND 4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN BRYAN A. MILLS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THROUGH HIS EMPLOYER, CHNW, WHICH WAS PAYABLE IN 2016. PART I, LINE 5A - COMPENSATION CONTINGENT UPON REVENUES OF ORGANIZATION DR. ERNEST ASAMOAH, DR. JAMES CALLAHAN, DR. ROBERT GOULET, DR. DEEPAK GUTTIKONDA, DR. PREETHAM JETTY, DR. DANIEL KIM, DR. KRISHNA MALINENI, DR. CARRIE MELLOH, DR. ANNETTE MOORE, DR. STEPHANIE OVERMARS, DR. CHARLES PLATZ, DR. MICHAEL ROBERTSON, DR. ANTHONY SANDERS, AND DR. RAMARAO YELETI 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 ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSIONCOMMUNITY 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 990FORM 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 VFORM 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 VIFORM 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 AND THE FOLLOWING RECEIVED COMPENSATION FROM CHNW: FRANK COVINGTON, M.D. TIMOTHY HOBBS, M.D. BRYAN A. MILLS JAMES READ
FORM 990, PAGE 6, PART VI, LINE 3CPI 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 6CHNW IS THE SOLE MEMBER OF CPI.
FORM 990, PAGE 6, PART VI, LINE 7ACHNW, 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 7BTHE 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 11BAS 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 12CAS 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 15AAS 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 2016, THE NETWORK EXECUTIVE COMPENSATION COMMITTEE FOLLOWED THIS PROCESS FOR ALL SENIOR EXECUTIVE LEADERS.
FORM 990, PAGE 6, PART VI, LINE 15BSEE LINE 15A ABOVE
FORM 990, PAGE 6, PART VI, LINE 19A) 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 VIIFORM 990, PART VII, SECTION B - INDEPENDENT CONTRACTOR DISCLOSURE COMPENSATION TO ALDERSON PROPERTY SERVICES, BAF CORPORATION, AND HAYES BROTHERS, INC. INCLUDES MATERIAL COSTS.
FORM 990, PART XI, LINE 9COMMUNITY ACCOUNTABLE CARE ASSET TRANSFER 7,445,119

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
COMMUNITY HEALTH NETWORK INC
7330 SHADELAND STATION SUITE 200INDIANAPOLISIN46256350983617HOSPITALIN501C33NAfalse
COMMUNITY HEALTH NETWORK FOUNDATION
7240 SHADELAND STATION SUITE 125INDIANAPOLISIN46256510181688SUPPORTIN501C312BCHNWYes (true)
COMMUNITY HLTH SERVICES OF INDIANA
7330 SHADELAND STATION SUITE 200INDIANAPOLISIN46256454817436HLTH CAREIN501C33CHNWYes (true)
COMMUNITY HOME HEALTH SERVICES INC
9894 EAST 121ST STREETFISHERSIN46037350953467HLTH CAREIN501C310CHNWYes (true)
COMM HOSP OF ANDERSON & MADISON CTY
1515 NORTH MADISON AVENUEANDERSONIN46011351069822HOSPITALIN501C33CHNWYes (true)
COMMUNITY HOSP ANDERSON FDN INC
1515 NORTH MADISON AVENUEANDERSONIN46011861053152SUPPORTIN501C312ACHAYes (true)
COMMUNITY HOSPITAL SOUTH INC
1402 E COUNTY LINE ROAD SOUTHINDIANAPOLISIN46227351088640HOSPITALIN501C33CHNWYes (true)
COMMUNITY HOWARD REGIONAL HEALTH
3500 S LAFOUNTAIN STREETKOKOMOIN46902351865344HOSPITALIN501C33CHNWYes (true)
COMM HOWARD REGIONAL HEALTH FDN
PO BOX 9011KOKOMOIN46904237309596SUPPORTIN501C37NAfalse
COMMUNITY LTC INC
1031 MONTICELLO DRIVEANDERSONIN46011351877441HLTH CAREIN501C310CHAYes (true)
HEALTH INSTITUTE OF INDIANA INC
3660 GUION ROADINDIANAPOLISIN46222352022402FITNESSIN501C310CHNWYes (true)
INDIANAPOLIS OSTEOPATHIC HOSP INC
3630 GUION ROADINDIANAPOLISIN46222351094734HOSPITALIN501C33CHNWYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (17 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
BROWNSBURG OFFICE CENTER 2 LLP
321 E NORTHFIELDBROWNSBURGIN46112351929859LEASINGINN/Afalsefalse
CHNJMH VENTURES LLC
7330 SHADELAND STATION SUITE 200INDIANAPOLISIN46256462356266DIAG/REHABINN/Afalsefalse
COMMUNITY ENDOSCOPY CENTER LLC
1601 N MADISON AVENUE SUITE 300ANDERSONIN46011611464136HLTH CAREINN/Afalsefalse
COMM HEALTH NETWORK REHAB HOSP LLC
7343 CLEARVISTA DRIVEINDIANAPOLISIN46256453414249REHABINN/Afalsefalse
EAST CAMPUS SURGERY CENTER LLC
7330 SHADELAND STATION SUITE 200INDIANAPOLISIN46256352028517SURGERYINN/Afalsefalse
HAMILTON SURGERY CENTER LLC
7330 SHADELAND STATION SUITE 200INDIANAPOLISIN46256352061413SURGERYINN/Afalsefalse
HOWARD COMMUNITY SURGERY CTR LLC
3500 S LAFOUNTAIN STREETKOKOMOIN46902352118748SURGERYINN/Afalsefalse
HOWARD REGIONAL SPECIALTY CARE LLC
680 SOUTH FOURTH STREETLOUISVILLEKY40202371501021REHABINN/Afalsefalse
INDIANAPOLIS ENDOSCOPY CENTER LLC
7353 E 121ST STREETINDIANAPOLISIN46219352010874HLTH CAREINN/Afalsefalse
MICHIGAN SURGERY INVESTMENT LLC
7330 SHADELAND STATION SUITE 200INDIANAPOLISIN46256320147008SURG CTRSINN/Afalsefalse
NORTH CAMPUS OFFICE ASSOCIATES LP
7330 SHADELAND STATION SUITE 200INDIANAPOLISIN46256351808625RNTL PROPINN/Afalsefalse
NORTH CAMPUS SURGERY CENTER LLC
7330 SHADELAND STATION SUITE 200INDIANAPOLISIN46256352147088SURGERYINN/Afalsefalse
NORTHPOINT PEDIATRICS LLC
8101 CLEARVISTA PARKWAY SUITE 185INDIANAPOLISIN46256351960566HLTH CAREINN/Afalsefalse
NORTHWEST SURGERY CENTER LLC
7330 SHADELAND STATION SUITE 200INDIANAPOLISIN46256208754071SURGERYINN/Afalsefalse
PILLARS HOUSING LP
3500 S LAFOUNTAIN STREETKOKOMOIN46902161652671HOUSINGINN/Afalsefalse
PRIMARIA HEALTH LLC
9365 COUNSELORS ROW SUITE 210INDIANAPOLISIN46240474728937CONSULTINGINN/Afalsefalse
SOUTH CAMPUS SURGERY CENTER LLC
1550 EAST COUNTY LINE ROADINDIANAPOLISIN46227352038072SURGERYINN/Afalsefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdLegal Domicile StateLegalDomicileStateCd
CHN ASSURANCE COMPANY LTD
PO BOX 1051 GTGRAND CAYMANGRAND CAYMANCJ980418913INSURANCECJN/AYes (true)
PILLARS COMMUNITY HOUSING INC
161652666HOUSINGN/AYes (true)3500 S LAFOUNTAIN STREETKOKOMOIN46902IN
VISIONARY ENTERPRISES INC
351538433MGMT SRVSN/AYes (true)6626 EAST 75TH STREETINDIANAPOLISIN46250IN
VEI MICHIGAN INC
300097377MGMT SRVSN/AYes (true)940 N MAIN STREETANN HARBORMI48104MI
WESTVIEW DELIVERY SYSTEM INC
351910292MGMT SRVSN/AYes (true)3630 GUION ROADINDIANAPOLISIN46222IN
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (18 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
COMMUNITY HEALTH NETWORK FOUNDATION
C$177,678BOOK VALUE
COMMUNITY HEALTH NETWORK FOUNDATION
R$209,969BOOK VALUE
COMM HOSP OF ANDERSON & MADISON CTY
K$1,244,871BOOK VALUE
COMM HOSP OF ANDERSON & MADISON CTY
Q$3,710,680BOOK VALUE
COMM HOSP OF ANDERSON & MADISON CTY
R$63,003BOOK VALUE
COMMUNITY HOSPITAL SOUTH INC
K$721,464BOOK VALUE
COMMUNITY HOSPITAL SOUTH INC
S$5,750,705BOOK VALUE
COMMUNITY HOWARD REGIONAL HEALTH
R$3,535,823BOOK VALUE
HEALTH INSTITUTE OF INDIANA INC
K$226,819BOOK VALUE
HEALTH INSTITUTE OF INDIANA INC
S$665,571BOOK VALUE
HOWARD REGIONAL SPECIALTY CARE
R$371,076BOOK VALUE
INDIANAPOLIS OSTEOPATHIC HOSPITAL
S$269,718BOOK VALUE
NORTH CAMPUS OFFICE ASSOCIATES LP
K$888,496BOOK VALUE
NORTH CAMPUS OFFICE ASSOCIATES LP
S$72,572BOOK VALUE
VISIONARY ENTERPRISES INC
K$2,841,500BOOK VALUE
VISIONARY ENTERPRISES INC
Q$9,175,646BOOK VALUE
VISIONARY ENTERPRISES INC
R$76,705,602BOOK VALUE
WESTVIEW DELIVERY SYSTEM
R$71,603BOOK VALUE