COMMUNITY HOWARD REGIONAL HEALTH INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HOWARD REGIONAL HEALTH INC (EIN 35-1865344)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-12
- IRS object ID
- 201413169349302046
- Schema version
- 2013v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-12T11:07:18-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | 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 | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4745 STATESMEN DRIVE SUITE C | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46250 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351865344 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOWARD REGIONAL HEALTH | BusinessNameLine1 |
| Business Name Line2 | INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 7654538371 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3500 S LAFOUNTAIN STREET | AddressLine1 |
| City | KOKOMO | City |
| State | IN | State |
| ZIP Code | 46902 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RON LEWIS | PersonNm |
| Person Title | INTERIM CEO | PersonTitleTxt |
| Phone | 7654538371 | PhoneNum |
| Signature | 2014-11-04 | 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 | 2014-11-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JAMES ALENDER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3500 S LAFOUNTAIN STREET | AddressLine1 |
| City | KOKOMO | City |
| State | IN | State |
| ZIP Code | 46902 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $124,771,155 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ECOMMUNITY.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1992 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | OUR MISSION IS TO PROVIDE EXCEPTIONAL QUALITY, PATIENT-CENTERED CARE. IN KEEPING WITH OUR MISSION, WE EMBRACE THE FOLLOWING VALUES: COMPASSION AND UNDERSTANDING; CUSTOMER SERVICE; DEDICATION AND COMMITMENT TO PROVIDE THE HIGHEST QUALITY SERVICES AND TO MEET THE NEEDS OF OUR COMMUNITY; RESPECT FOR OUR PATIENTS, VISITORS, PHYSICIANS, AND STAFF; SAFETY; A SAFE AND POSITIVE WORKING ENVIRONMENT; AND TRUTH AND INTEGRITY IN ALL ENCOUNTERS AND SERVICES OFFERED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 1500 | TotalEmployeeCnt |
| Total Volunteers | 110 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,617,077 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,124,320 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $63,778,853 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $112,303,885 | CYProgramServiceRevenueAmt |
| PY Investment Income | $628,579 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,096,188 | CYInvestmentIncomeAmt |
| PY Other Revenue | $763,017 | PYOtherRevenueAmt |
| CY Other Revenue | $4,644,525 | CYOtherRevenueAmt |
| PY Total Revenue | $66,787,526 | PYTotalRevenueAmt |
| CY Total Revenue | $122,168,918 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $20,193 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $119,325 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $35,166,902 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $71,735,381 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $35,049,536 | PYOtherExpensesAmt |
| CY Other Expenses | $65,724,719 | CYOtherExpensesAmt |
| PY Total Expenses | $70,236,631 | PYTotalExpensesAmt |
| CY Total Expenses | $137,579,425 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,449,105 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$15,410,507 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $184,693,342 | TotalAssetsBOYAmt |
| Total Assets EOY | $182,696,536 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $98,656,428 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $107,136,442 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $86,036,914 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $75,560,094 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | OUR MISSION IS TO PROVIDE EXCEPTIONAL QUALITY, PATIENT-CENTERED CARE. IN KEEPING WITH OUR MISSION, WE EMBRACE THE FOLLOWING VALUES: COMPASSION AND UNDERSTANDING; CUSTOMER SERVICE; DEDICATION AND COMMITMENT TO PROVIDE THE HIGHEST QUALITY SERVICES AND TO MEET THE NEEDS OF OUR COMMUNITY; RESPECT FOR OUR PATIENTS, VISITORS, PHYSICIANS, AND STAFF; SAFETY; A SAFE AND POSITIVE WORKING ENVIRONMENT; AND TRUTH AND INTEGRITY IN ALL ENCOUNTERS AND SERVICES OFFERED. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $86,786,981 | ExpenseAmt |
| Revenue | $116,948,410 | RevenueAmt |
| Desc | COMMUNITY HOWARD REGIONAL HEALTH, INC. ("CHRH") OPERATES AN ACUTE CARE FULL SERVICE HOSPITAL IN KOKOMO, INDIANA WITH 162 LICENSED BEDS. IN 2013, CHRH SERVED 5,083 PATIENTS WITH A TOTAL OF 17,290 INPATIENT DAYS OF SERVICE. THE HOSPITAL ALSO PROVIDED 24,334 EMERGENCY VISITS. CHRH PROVIDES SERVICES INCLUDING WOMEN AND CHILDREN'S, CANCER CARE, CARDIAVASCULAR CARE, SURGICAL SERVICES, BEHAVIORAL HEALTH, AND PEDIATRIC SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $119,325 | ExpenseAmt |
| Grant | $119,325 | GrantAmt |
| Desc | PROVIDED DONATIONS TO OTHER ORGANIZATIONS IN THE CENTRAL INDIANA COMMUNITY SERVED BY CHRH. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $86,906,306 | 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 | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | 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 |
| IRP Document | 71 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1500 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RON LEWIS | PersonNm |
| Phone | 7654538456 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3500 S LAFOUNTAIN STREET | AddressLine1 |
| City | KOKOMO | City |
| State | IN | State |
| ZIP Code | 46902 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| BRYAN A MILLS | ||||||||
| DIRECTOR | 5.00 | 55.00 | Yes (X) | $0 | $1,133,983 | $121,280 | ||
| THOMAS P FISCHER | ||||||||
| DIRECTOR | 2.00 | 58.00 | Yes (X) | $0 | $716,959 | $17,700 | ||
| TIMOTHY HOBBS MD | ||||||||
| DIRECTOR | 5.00 | 45.00 | Yes (X) | $0 | $665,527 | $163,770 | ||
| DON BOWLING | ||||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ANDY CASTNER | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| BENJAMIN CHIU MD | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JAY FREEMAN | ||||||||
| CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| LYNETTE HAZELBAKER MD | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| TOM HILLIGOSS | ||||||||
| VICE CHAIRMA | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| LYNDA NARWOLD RN | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES ALENDER | ||||||||
| CEO | 60.00 | $381,120 | $0 | $57,655 | Yes (X) | |||
| THEODORE BROWN | ||||||||
| COO & CFO | 60.00 | $248,796 | $0 | $61,898 | Yes (X) | |||
| ALAN BIGGS | ||||||||
| CFO THRU MAR | 40.00 | $155,009 | $0 | $12,180 | Yes (X) | |||
| CHANGJIAN CHEN MD | ||||||||
| PHYSICIAN | 40.00 | $690,980 | $0 | $43,354 | Yes (X) | |||
| MOHAMMED NEKOOMARAM MD | ||||||||
| PHYSICIAN | 40.00 | $683,591 | $0 | $15,300 | Yes (X) | |||
| MICHELLE HAENDIGES MD | ||||||||
| PHYSICIAN | 40.00 | $657,105 | $0 | $39,793 | Yes (X) | |||
| CLIFFORD EVANS DO | ||||||||
| PHYSICIAN | 40.00 | $583,760 | $0 | $10,594 | Yes (X) | |||
| ANNETTE MOORE MD | ||||||||
| PHYSICIAN | 40.00 | $576,864 | $0 | $15,300 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,977,225 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,516,469 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $558,824 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 92 | 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/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| VINTAGE ARCHONICS | |||||
| 8205 LIMA ROAD | FORT WAYNE | IN | 46818 | ARCHITECTS | $1,296,452 |
| IU HEALTH PHYSICIANS | |||||
| 2568 RELIABLE PARKWAY | CHICAGO | IL | 60686 | HOSPITALISTS | $912,845 |
| ICE MILLER | |||||
| 27230 NETWORK PLACE | CHICAGO | IL | 606731272 | LEGAL | $736,135 |
| EMCARE INC | |||||
| 7032 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | ER PHYSICIANS | $604,402 |
| AUREUS NURSING LLC | |||||
| PO BOX 3037 | OMAHA | NE | 68103 | NURSING RN | $580,615 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 32 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $233,241 | RelatedOrganizationsAmt |
| Government Grants | $3,880,906 | GovernmentGrantsAmt |
| All Other Contributions | $10,173 | AllOtherContributionsAmt |
| Total Contributions | $4,124,320 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICES | 622110 | $110,447,089 | $110,447,089 |
| RENT | 531120 | $996,753 | $996,753 |
| LAB SERVICES | 621500 | $619,678 | $619,678 |
| MISCELLANEOUS MEDICAL REVENUE | 900099 | $240,365 | $240,365 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $112,303,885 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $560,556 | TotalRevenueColumnAmt |
| Exclusion | $560,556 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,913,624 | SecuritiesAmt |
| Other | $224,245 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,574,505 | SecuritiesAmt |
| Other | $27,732 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $339,119 | SecuritiesAmt |
| Other | $196,513 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $535,632 | TotalRevenueColumnAmt |
| Exclusion | $535,632 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EMR MEANINGFUL USE REVENUE | 900099 | $2,360,938 | $2,360,938 |
| EQUITY INVESTMENT INCOME | 900003 | $833,102 | $833,102 |
| EQUIPMENT RENTAL | 532420 | $713,929 | $713,929 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $736,556 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $736,556 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,644,525 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $122,168,918 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $116,948,410 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,096,188 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,325 | TotalAmt |
| Program Services | $119,325 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $916,658 | TotalAmt |
| Management And General | $916,658 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,220,228 | TotalAmt |
| Program Services | $42,479,201 | ProgramServicesAmt |
| Management And General | $14,741,027 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,403,851 | TotalAmt |
| Program Services | $1,361,098 | ProgramServicesAmt |
| Management And General | $2,042,753 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,521,069 | TotalAmt |
| Program Services | $659,871 | ProgramServicesAmt |
| Management And General | $5,861,198 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,673,575 | TotalAmt |
| Program Services | $2,695,628 | ProgramServicesAmt |
| Management And General | $977,947 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $720,614 | TotalAmt |
| Management And General | $720,614 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $298,389 | TotalAmt |
| Management And General | $298,389 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,342,415 | TotalAmt |
| Program Services | $6,351,267 | ProgramServicesAmt |
| Management And General | $5,991,148 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $705,785 | TotalAmt |
| Program Services | $708 | ProgramServicesAmt |
| Management And General | $705,077 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,487,959 | TotalAmt |
| Program Services | $2,822,260 | ProgramServicesAmt |
| Management And General | $3,665,699 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,560,195 | TotalAmt |
| Program Services | $1,560,195 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,221,817 | TotalAmt |
| Program Services | $293,110 | ProgramServicesAmt |
| Management And General | $1,928,707 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,150 | TotalAmt |
| Program Services | $78,683 | ProgramServicesAmt |
| Management And General | $101,467 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,897,071 | TotalAmt |
| Management And General | $1,897,071 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,660,346 | TotalAmt |
| Program Services | $14,039 | ProgramServicesAmt |
| Management And General | $9,646,307 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $865,444 | TotalAmt |
| Management And General | $865,444 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $21,736,370 | $21,736,370 | |
| HAF PROGRAM FEES | $6,449,951 | $6,449,951 | |
| DUES & SUBSCRIPTIONS | $201,801 | $64,729 | $137,072 |
| RECRUITING | $117,116 | $117,116 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $279,296 | TotalAmt |
| Program Services | $219,871 | ProgramServicesAmt |
| Management And General | $59,425 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,579,425 | TotalAmt |
| Program Services | $86,906,306 | ProgramServicesAmt |
| Management And General | $50,673,119 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,143,484 | BOYAmt |
| EOY | $68,239 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,594,147 | BOYAmt |
| EOY | $6,085,051 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,431,452 | BOYAmt |
| EOY | $25,490,141 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,471,924 | BOYAmt |
| EOY | $4,975,304 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $798,845 | BOYAmt |
| EOY | $773,371 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $111,524,297 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,947,915 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,710,951 | BOYAmt |
| EOY | $99,576,382 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,913,010 | BOYAmt |
| EOY | $24,447,135 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,181,059 | BOYAmt |
| EOY | $17,271,831 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,448,470 | BOYAmt |
| EOY | $4,009,082 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $184,693,342 | BOYAmt |
| EOY | $182,696,536 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,811,452 | BOYAmt |
| EOY | $14,279,874 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,420,000 | BOYAmt |
| EOY | $44,470,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,053,877 | BOYAmt |
| EOY | $9,969,558 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,943,314 | BOYAmt |
| EOY | $3,943,314 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,427,785 | BOYAmt |
| EOY | $34,473,696 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,656,428 | BOYAmt |
| EOY | $107,136,442 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,036,914 | BOYAmt |
| EOY | $75,560,094 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,036,914 | BOYAmt |
| EOY | $75,560,094 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $184,693,342 | BOYAmt |
| EOY | $182,696,536 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$15,410,507 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $6,279,852 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,346,165 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,728,000 | OtherCostOrOtherBasisAmt |
| Book Value | $4,728,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $87,792,606 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,432,297 | DepreciationAmt |
| Book Value | $83,360,309 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,571,855 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,957,844 | DepreciationAmt |
| Book Value | $8,614,011 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,431,836 | OtherCostOrOtherBasisAmt |
| Depreciation | $557,774 | DepreciationAmt |
| Book Value | $2,874,062 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $99,576,382 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $25,726,816 |
| DERIVATIVE INTEREST | $4,667,770 |
| THIRD PARTY SETTLEMENTS | $4,079,110 |
| CAPITAL LEASES |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $34,473,696 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,455,975 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,455,975 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03240 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,171,334 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,951,093 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,220,241 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06700 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,627,309 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,951,093 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,676,216 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09940 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $562,639 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,456 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $541,183 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $562,639 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,456 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $541,183 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,189,948 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,972,549 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,217,399 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10330 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,180,696 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $31,705,919 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $44,121,558 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$12,415,639 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOWARD COMM SURG CTR | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | SURGERY | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.55000 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.23000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | Facility Reporting GroupFacilityReportingGroupCd |
|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY HOWARD REGIONAL HEALTH | ||||||||||
| 1 | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | WWW.ECOMMUNITY.COM | 13-005007-1 | Yes (X) | Yes (X) | Yes (X) | A |
| HOWARD REGIONAL SPECIALTY CARE | ||||||||||
| 2 | 829 NORTH DIXON ROAD | KOKOMO | IN | 46901 | WWW.ECOMMUNITY.COM | 13-003868-1 | Yes (X) | A | ||
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | A | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.ECOMMUNITY.COM | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | WWW.COMMUNITYANDERSON.COM | OtherWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| Other Factors | Yes (X) | OtherFactorsInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, COMMUNITY HOWARD REGIONAL HEALTH - PART V, LINE 3 | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 1, COMMUNITY HOWARD REGIONAL HEALTH - PART V, LINE 4 | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 1, COMMUNITY HOWARD REGIONAL HEALTH - PART V, LINE 5C | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 1, COMMUNITY HOWARD REGIONAL HEALTH - PART V, LINE 7 | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 1, COMMUNITY HOWARD REGIONAL HEALTH - PART V, LINE 12I | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 1, COMMUNITY HOWARD REGIONAL HEALTH - PART V, LINE 14G | THE POLICY IS REFERENCED ON THE BILL. |
| FACILITY 1, COMMUNITY HOWARD REGIONAL HEALTH - PART V, LINE 20D | THE UNINSURED DISCOUNT WAS DETERMINED UTILIZING THE NETWORK'S TOP COMMERICIAL PAYORS. UNINSURED DISCOUNTS REPRESENT A STANDARD DISCOUNT ON CHARGES AS IT RELATES TO PATIENTS WHO HAVE NO INSURANCE COVERAGE. |
| FACILITY 2, HOWARD REGIONAL SPECIALTY CARE - PART V, LINE 3 | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 2, HOWARD REGIONAL SPECIALTY CARE - PART V, LINE 4 | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 2, HOWARD REGIONAL SPECIALTY CARE - PART V, LINE 5C | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 2, HOWARD REGIONAL SPECIALTY CARE - PART V, LINE 7 | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 2, HOWARD REGIONAL SPECIALTY CARE - PART V, LINE 12I | SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT |
| FACILITY 2, HOWARD REGIONAL SPECIALTY CARE - PART V, LINE 14G | THE POLICY IS REFERENCED ON THE BILL. |
| FACILITY 2, HOWARD REGIONAL SPECIALTY CARE - PART V, LINE 20D | THE UNINSURED DISCOUNT WAS DETERMINED UTILIZING THE NETWORK'S TOP COMMERICIAL PAYORS. UNINSURED DISCOUNTS REPRESENT A STANDARD DISCOUNT ON CHARGES AS IT RELATES TO PATIENTS WHO HAVE NO INSURANCE COVERAGE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 29 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (29 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| NORTH CENTRAL INDIANA PEDIATRIC CTR | ||||
| 3506 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| COMMUNITY ONCOLOGY | ||||
| 3506 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| WOMENS' CENTERIMAGING CENTER | ||||
| 2201 W BOULEVARD | KOKOMO | IN | 46902 | DIAGNOSTIC CENTER |
| COMMUNITY OBGYN CENTER | ||||
| 3510 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| COMMUNITY HOWARD GASTROENTEROLOGY | ||||
| 3611 S REED ROAD SUITE 108 | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| HAENDIGES & ASSOCIATES | ||||
| 2030 W BOULEVARD | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| KOKOMO PULMONARY PRACTICE | ||||
| 2401 COLUMBUS BLVD | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| SPINE & SPORTS MEDICINE CENTER | ||||
| 226 WEST ALTO ROAD | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| COMMUNITY HOWARD ORTHOPAEDICS | ||||
| 2312 SOUTH DIXON ROAD | KOKOMO | IN | 46901 | PHYSICIAN'S OFFICE |
| MEDICAL SURGICAL ASSOCIATES | ||||
| 401 E REYNOLDS DRIVE | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| REPLAY PHYSICAL THERAPY | ||||
| 2312 S DIXON ROAD 260 | KOKOMO | IN | 46902 | REHABILITATION CENTER |
| INDIANA SINUS & ENT | ||||
| 3425 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| COMMUNITY SURGERY CENTER | ||||
| 3503 S REED ROAD | KOKOMO | IN | 46902 | SURGERY CENTER |
| INTERVENTIONAL PAIN MANAGEMENT | ||||
| 3611 S REED ROAD SUITE 214 | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| KUENZLI INTERNAL MEDICINE | ||||
| 3512 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| KOKOMO SPORTS CENTER | ||||
| 111 W SOUTHWAY BLVD | KOKOMO | IN | 46902 | REHAB/FITNESS CENTER |
| HOWARD REG DIABETES & ENDOCRINOLOGY | ||||
| 3509 S REED ROAD | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| COMM PHY NTWK HEART & VASCULAR CARE | ||||
| 208 CORWIN LANE | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| SEDAGHAT INTERNAL MED & PEDIATRICS | ||||
| 118 S MERIDIAN STREET | GREENTOWN | IN | 46936 | PHYSICIAN'S OFFICE |
| ANDREW MANDERY MD FACS | ||||
| 1948 W BOULEVARD | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| NORTH CENTRAL IN CARDIO & THORACIC | ||||
| 3611 S REED ROAD SUITE 103 | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| FACIAL PLASTIC SURGERY & ENT | ||||
| 2220 WEST ALTO ROAD | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| COMMUNITY HOWARD WOUND CLINIC | ||||
| 408 SOUTHWAY BLVD EAST | KOKOMO | IN | 46902 | CLINIC |
| HEALTHY CHILDREN HEALTHY TEENS | ||||
| 117 - 119 W SYCAMORE STREET | KOKOMO | IN | 46902 | CLINIC |
| COMMUNITY FAMILY HEALTH CENTER | ||||
| 3508 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| COMMUNITY HOWARD INTERNAL MED & PED | ||||
| 806 S BERKLEY ROAD | KOKOMO | IN | 46901 | PHYSICIAN'S OFFICE |
| GATEWOOD INTERNAL MEDICINE | ||||
| 3611 S REED ROAD SUITE 212 | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| NORTH CENTRAL INDIANA INTERNISTS | ||||
| 3504 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | PHYSICIAN'S OFFICE |
| NORTH CENTRAL INDIANA PEDIATRIC CTR | ||||
| GRISSOM AEROPLEX 1200 KITTY HAWK | PERU | IN | 46970 | PHYSICIAN'S OFFICE |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A - RELATED ORGANIZATION INFORMATION | A COMMUNITY BENEFIT REPORT IS COMPLETED FOR THE COMMUNITY HEALTH NETWORK AS A WHOLE. COMMUNITY HOWARD REGIONAL HEALTH, INC. IS INCLUDED WITHIN THE NETWORK COMMUNITY BENEFIT REPORT. |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | A COST TO CHARGE RATIO WAS UTILIZED TO DETERMINE COSTS FOR LINES A THROUGH C IN THE TABLE. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. LINES E THROUGH I OF THE TABLE ARE BASED ON ACTUAL INCURRED EXPENSES. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | THE COST TO CHARGE RATIO UTILIZED FOR PURPOSES OF REPORTING BAD DEBT COSTS WAS DERIVED FROM WORKSHEET 2 AND IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. PART III, LINE 4 - BAD DEBT EXPENSE EXPLANATION THE AUDITED FINANCIAL STATEMENTS CONTAIN THE FOLLOWING TEXT WITHIN THE FOOTNOTES TO DESCRIBE BAD DEBT EXPENSE: THE NETWORK'S ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND CONTRACTUAL ADJUSTMENTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE NETWORK ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE, THE NETWORK ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, INCLUDING PATIENT DEDUCTIBLES AND CO- INSURANCE, THE NETWORK RECORDS A PROVISION FOR BAD DEBTS AND CHARITY IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS ADJUSTED THROUGH THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR CHNW, CHS, VEI AND CHVH, ACCOUNTS THAT ARE SENT TO COLLECTION COMPANIES REMAIN AS ACCOUNTS RECEIVABLE ON THE BALANCE SHEET. THESE ACCOUNTS ARE NOT WRITTEN OFF UNLESS RETURNED FROM THE COLLECTION COMPANY, HOWEVER ARE FULLY RESERVED WITHIN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. AS SUCH THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS SIGNIFICANT FOR ACCOUNTS RECEIVABLE THAT HAVE BEEN FULLY RESERVED. THE NETWORK RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE NETWORK RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED OR ON THE BASIS OF DISCOUNTED RATES IF IN ACCORDANCE WITH POLICY. ON THE BASIS OF HISTORICAL EXPERIENCE, A PORTION OF THE NETWORK'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE NETWORK RECORDS A PROVISION FOR BAD DEBTS AND CHARITY RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. PATIENT SERVICE REVENUE, NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS RECOGNIZED IN THE PERIOD FROM THESE MAJOR PAYOR SOURCES, IS AS FOLLOWS FOR THE YEARS ENDED DECEMBER 31, 2013 AND 2012, RESPECTIVELY: THIRD PARTY PAYORS SELF-PAY TOTAL ALL PAYORS 2013 PATIENT SERVICE REVENUE(NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) 1,666,086 94,024 1,760,110 ========== ======= ========== 2012 PATIENT SERVICE REVENUE(NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) 1,580,962 73,759 1,654,721 ========== ======= ========== THE NETWORK MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THE NETWORK PROVIDES 100% CHARITY CARE TO PATIENTS WHOSE INCOME LEVEL IS BELOW 200% OF THE FEDERAL POVERTY LEVEL. PATIENTS WITH INCOME LEVELS RANGING FROM 200% - 300% OF THE CURRENT YEAR'S FEDERAL POVERTY LEVEL WILL QUALIFY FOR PARTIAL ASSISTANCE DETERMINED BY A SLIDING SCALE. THE NETWORK USES COST AS THE MEASUREMENT BASIS FOR CHARITY CARE DISCLOSURE PURPOSES WITH THE COST BEING IDENTIFIED AS THE DIRECT AND INDIRECT COSTS OF PROVIDING THE CHARITY CARE. CHARITY CARE AT COST WAS 83,731000 AND 58,163000 FOR THE YEARS ENDED DECEMBER 31, 2013 AND 2012, RESPECTIVELY. CHARITY CARE COST WAS ESTIMATED ON THE APPLICATION OF THE ASSOCIATED COST-TO-CHARGE RATIOS. BEGINNING JUNE 2012, THE STATE OF INDIANA OFFERED VOLUNTARY PARTICIPATION IN THE STATE OF INDIANA'S HOSPITAL ASSESSMENT FEE ("HAF") PROGRAM, RETROACTIVE TO JULY, 1, 2011. THE STATE OF INDIANA IMPLEMENTED THIS PROGRAM TO UTILIZE SUPPLEMENTAL REIMBURSEMENT PROGRAMS FOR THE PURPOSE OF PROVIDING REIMBURSEMENT TO PROVIDERS TO OFFSET A PORTION OF THE COST OF PROVIDING CARE TO MEDICAID AND INDIGENT PATIENTS. THIS PROGRAM IS DESIGNED WITH INPUT FROM CENTERS FOR MEDICARE AND MEDICAID SERVICES AND IS FUNDED WITH A COMBINATION OF STATE AND FEDERAL RESOURCES, INCLUDING FEES OR TAXES LEVIED ON THE PROVIDERS. AS A RESULT OF PARTICIPATING IN THE HAF PROGRAM, FOR THE YEAR ENDED DECEMBER 31, 2012, THE NETWORK RECOGNIZED REIMBURSEMENTS OF 78,197000 AND FEES OF 43,453000 RELATED TO THE PERIOD JULY 1, 2011 THROUGH JUNE 30, 2012. THE NETWORK RECOGNIZES REVENUES AND RELATED FEES ASSOCIATED WITH THE HAF PROGRAM IN THE PERIOD IN WHICH AMOUNTS ARE ESTIMABLE AND COLLECTION OR PAYMENT IS REASONABLY ASSURED. REIMBURSEMENT UNDER THE PROGRAM IS REFLECTED WITHIN NET PATIENT SERVICE REVENUE AND THE FEES PAID FOR PARTICIPATION IN THE HAF PROGRAM ARE RECORDED IN SUPPLIES AND OTHER EXPENSES WITHIN THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS. THE FEES AND REIMBURSEMENTS ARE SETTLED MONTHLY. THE HAF PROGRAM RUNS ON AN ANNUAL CYCLE FROM JULY 1 TO JUNE 30 AND WAS ORIGINALLY EFFECTIVE UNTIL JUNE 30, 2013. THE PROGRAM WAS SUBSEQUENTLY RENEWED ON MARCH 21, 2014 EFFECTIVE THROUGH JUNE 30, 2017 WITH A RETROACTIVE EFFECTIVE DATE OF JULY 1, 2013. AS A RESULT OF THE RETROACTIVE DATE OF JULY 1, 2013, THE NETWORK HAS ACCRUED BOTH THE ESTIMATED REIMBURSEMENT AND EXPENSE FOR THE PERIOD JULY 1, 2013 THROUGH DECEMBER 31, 2013 IN ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS ON THE DECEMBER 31, 2013 BALANCE SHEET. THE CONSOLIDATED BALANCE SHEET AT DECEMBER 31, 2013 INCLUDES 46,036000 AND 35,240000 IN ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS RECEIVABLE AND PAYABLE, RESPECTIVELY, RELATED TO THE HAF PROGRAM. ADJUSTMENTS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE MADE AFTER THE NETWORK HAS ANALYZED HISTORICAL CASH COLLECTIONS AND CONSIDERED THE IMPACT OF ANY KNOWN MATERIAL EVENTS. UNCOLLECTIBLE ACCOUNTS ARE WRITTEN-OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AFTER EXHAUSTING COLLECTION EFFORTS. ANY SUBSEQUENT RECOVERIES ARE RECORDED AGAINST THE PROVISION FOR BAD DEBTS. |
| PART III, LINE 8 - MEDICARE EXPLANATION | PER THE 990 INSTRUCTIONS, THE MEDICARE COST REPORT WAS UTILIZED TO DETERMINE THE MEDICARE SHORTFALL. HOWEVER, THE MEDICARE COST REPORT IS NOT REFLECTIVE OF ALL COSTS ASSOCIATED WITH MEDICARE PROGRAMS SUCH AS PHYSICIAN SERVICES AND SERVICES BILLED VIA FREE STANDING CLINICS. FURTHER, THE MEDICARE COST REPORT EXCLUDES REVENUES AND COSTS OF MEDICARE PART C AND D. THE MEDICARE SHORTFALL ATTRIBUTED TO THOSE AREAS NOT INCLUDED ON THE MEDICARE COST REPORT IS 7,720,438. AS SUCH, THE TOTAL MEDICARE SHORTFALL FOR ALL MEDICARE PROGRAMS IS 20,136,077. MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS COMMUNITY BENEFIT BECAUSE MEDICARE REPRESENTS 49.46% OF THE OVERALL PAYER MIX FOR COMMUNITY HOWARD REGIONAL HEALTH, INC. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | SEE ATTACHED FINANCIAL ASSISTANCE POLICY. |
| ADDITIONAL INFORMATION | PART VI, ITEMS 2 THROUGH 5 ARE DISCUSSED WITHIN THE ATTACHED COMMUNITY BENEFIT REPORT. FOR A COPY OF THIS REPORT, PLEASE CONTACT HOLLY MILLARD AT (317) 355-5860. PART VI, ITEM 6 - AFFILIATED HEALTH CARE SYSTEM COMMUNITY HOWARD REGIONAL HEALTH, INC. ("CHRH") IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. SEE THE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT FOR HOW CHRH IS INVOLVED IN PROMOTING THE HEALTH OF THE COMMUNITY IT SERVES. PART VI, ITEM 7 - STATE FILING OF COMMUNITY BENEFIT REPORT INDIANA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (7 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| AMERICAN HEART ASSOCIATION | |||||||
| 6100 W 96TH STREET SUITE 200 | INDIANAPOLIS | IN | 46278 | 135613797 | 501C3 | $6,000 | GENERAL SUPPORT |
| COMMUNITY HEALTH NETWORK FOUNDATION | |||||||
| 7240 SHADELAND STATION SUITE 125 | INDIANAPOLIS | IN | 46256 | 510181688 | 501C3 | $5,400 | GENERAL SUPPORT |
| GREATER KOKOMO ECONOMIC DEVELOPMENT | |||||||
| 700 E FIRMIN SUITE 200 | KOKOMO | IN | 46902 | 351499686 | 501C3 | $10,650 | GENERAL SUPPORT |
| HOWARD COUNTY 4-H FAIR | |||||||
| PO BOX 275 610 EAST PAYTON ST | GREENTOWN | IN | 46936 | 356263604 | 501C4 | $25,000 | GENERAL SUPPORT |
| INDIANA UNIVERSITY FOUNDATION | |||||||
| 2300 S WASHINGTON | KOKOMO | IN | 46902 | 356018940 | 501C3 | $6,100 | FITNESS 2013 |
| MENTAL HEALTH AMERICA OF HOWARD CTY | |||||||
| 507 N WEBSTER | KOKOMO | IN | 46901 | 350965636 | 501C3 | $25,000 | GENERAL SUPPORT |
| UNITED WAY OF HOWARD COUNTY | |||||||
| 210 W WALNUT STREET | KOKOMO | IN | 46901 | 350877579 | 501C3 | $10,350 | GENERAL SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 6 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | PRIOR TO THE DISBURSEMENT OF ANY GRANT PROCEEDS, CHRH ENSURES THAT THE PURPOSE OF THE GRANT IS CONSISTENT WITH CHRH'S CHARITABLE PURPOSES. THE TERMS OF ALL GRANTS REQUIRE THAT THE RECIPIENT EXPEND THE FUNDS SOLELY FOR CHARITABLE PURPOSES. FOR THE FUNDS DONATED TO HELP SUPPORT MENTAL HEALTH AMERICA, THE FINANCIAL STATEMENTS ARE REVIEWED BY THE CHIEF ADMINISTRATIVE & CLINICAL OFFICER, BEHAVIORAL HEALTH DIVISION OF CHRH. | ExplanationTxt |
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 | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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 | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRYAN A MILLS | ||||||||||||||
| DIRECTOR | $912,524 | $123,211 | $98,248 | $90,730 | $30,550 | $1,255,263 | $123,211 | |||||||
| THOMAS P FISCHER | ||||||||||||||
| DIRECTOR | $580,157 | $84,337 | $52,465 | $15,300 | $2,400 | $734,659 | $84,337 | |||||||
| TIMOTHY HOBBS MD | ||||||||||||||
| DIRECTOR | $549,579 | $68,003 | $47,945 | $140,711 | $23,059 | $829,297 | $68,003 | |||||||
| JAMES ALENDER | ||||||||||||||
| CEO | $363,666 | $17,454 | $35,918 | $21,737 | $438,775 | |||||||||
| THEODORE BROWN | ||||||||||||||
| COO & CFO | $230,893 | $17,903 | $30,655 | $31,243 | $310,694 | |||||||||
| ALAN BIGGS | ||||||||||||||
| CFO THRU MARCH | $50,216 | $104,793 | $4,638 | $7,542 | $167,189 | $94,588 | ||||||||
| CHANGJIAN CHEN MD | ||||||||||||||
| PHYSICIAN | $515,584 | $1,538 | $15,300 | $28,054 | $734,334 | $173,858 | ||||||||
| MOHAMMED NEKOOMARAM MD | ||||||||||||||
| PHYSICIAN | $664,552 | $19,039 | $15,300 | $698,891 | ||||||||||
| MICHELLE HAENDIGES MD | ||||||||||||||
| PHYSICIAN | $625,988 | $31,117 | $9,635 | $30,158 | $696,898 | |||||||||
| CLIFFORD EVANS DO | ||||||||||||||
| PHYSICIAN | $499,283 | $84,477 | $10,594 | $594,354 | ||||||||||
| ANNETTE MOORE MD | ||||||||||||||
| PHYSICIAN | $557,825 | $19,039 | $15,300 | $592,164 | ||||||||||
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 4 | ALAN BIGGS 94,588 0 0 |
| SCHEDULE J, PART III | PART I, LINE 3 - RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION COMMUNITY HOWARD REGIONAL HEALTH, INC. ("CHRH") CEO/EXECUTIVE DIRECTOR IS PAID BY COMMUNITY HEALTH NETWORK, INC. ("CHNW"), A RELATED 501(C)(3) ORGANIZATION. CHNW USES THE FOLLOWING IN DETERMINING THE CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE, 2) INDEPENDENT COMPENSATION CONSULTANT, 3) COMPENSATION SURVEY OR STUDY, AND 4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN BRYAN A. MILLS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. DURING 2013, MR. MILLS DID NOT RECEIVE A PAYMENT FROM SUCH PLAN. PART I, LINE 7 - NON-FIXED PAYMENTS PROVIDED CHRH PARTICIPATES IN THE NETWORK'S SENIOR LEADERSHIP INCENTIVE PROGRAM. CERTAIN INDIVIDUALS OF THE LEADERSHIP TEAM PARTICIPATE IN THIS PROGRAM. THE PROGRAM WAS ADOPTED BY THE EXECUTIVE COMPENSATION COMMITTEE, AND IS INTENDED TO INFLUENCE OUTSTANDING PERFORMANCE BY THE SENIOR LEADERS, AS MEASURED AGAINST BOTH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE. THE PROGRAM IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPOSED ENTIRELY OF INDEPENDENT COMMUNITY MEMBERS. THE INCENTIVE COMPENSATION THAT IS AWARDED IS INCLUDED IN TOTAL COMPENSATION TO THE EXECUTIVE. THE TOTAL COMPENSATION (INCLUDING ANY PAYMENTS UNDER THE PROGRAM) IS SUBJECT TO THE REVIEW AND APPROVAL OF THE EXECUTIVE COMPENSATION COMMITTEE AND INDEPENDENT COMPENSATION CONSULTANT, IN CONSIDERATION OF CODE SECTION 4958 (AND THE CORRESPONDING TREASURY REGULATIONS) TO ENSURE THAT IT REFLECTS ARMS LENGTH, FAIR MARKET TERMS. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA FINANCE AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 351602316 | BondIssuerEIN |
| CUSIP | 45479RAB3 | CUSIPNum |
| Bond Issued | 2012-07-01 | BondIssuedDt |
| Issue Price | $45,420,000 | IssuePriceAmt |
| Purpose | SEE PART VI | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $950,000 | RetiredAmt |
| Total Proceeds | $45,420,000 | TotalProceedsAmt |
| Other Spent Proceeds | $45,420,000 | OtherSpentProceedsAmt |
| Current Refunding | Yes (true) | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (true) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (true) | EngageBondCounselContractsInd |
| Any Research Agreements | Yes (true) | AnyResearchAgreementsInd |
| Engage Bond Counsel Research | Yes (true) | EngageBondCounselResearchInd |
| Bond Iss Meet Prvt Sec Pymt Test | Yes (true) | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | Yes (true) | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | Yes (true) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE K - PURPOSE OF ISSUE DESCRIPTION | INDIANA FINANCE AUTHORITY CURRENT REFUNDING OF THE INDIANA HEALTH AND EDUCATIONAL FACILITY FINANCING AUTHORITY ADJUSTABLE RATE HOSPITAL REVENUE BONDS, SERIES 2005A AND 2005B (HOWARD REGIONAL HEALTH SYSTEM PROJECT) ISSUED ON AUGUST 31, 2005. |
| SCHEDULE K - ADDITIONAL INFORMATION | INDIANA FINANCE AUTHORITY PART III, LINE 7 - THE BOND IS NOT A PRIVATE ACTIVITY BOND BECAUSE IT DOES NOT MEET THE PRIVATE BUSINESS USE TEST. PART IV, LINE 2C COLUMN A - DATE REBATE COMPUTATION PERFORMED THE BONDS MET THE 6 MONTH SPENDING EXCEPTION AS OF THE ISSUE DATE OF 07/01/12. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KOKOMO SURGICAL GROUP LLC | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BD MBR - PARTNR | RelationshipDescriptionTxt |
| Transaction | $426,000 | TransactionAmt |
| Transaction | MEDICAL SERVICES | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | OUR MISSION IS TO PROVIDE EXCEPTIONAL QUALITY, PATIENT-CENTERED CARE. IN KEEPING WITH OUR MISSION, WE EMBRACE THE FOLLOWING VALUES: COMPASSION AND UNDERSTANDING; CUSTOMER SERVICE; DEDICATION AND COMMITMENT TO PROVIDE THE HIGHEST QUALITY SERVICES AND TO MEET THE NEEDS OF OUR COMMUNITY; RESPECT FOR OUR PATIENTS, VISITORS, PHYSICIANS, AND STAFF; SAFETY; A SAFE AND POSITIVE WORKING ENVIRONMENT; AND TRUTH AND INTEGRITY IN ALL ENCOUNTERS AND SERVICES OFFERED. |
| FORM 990, PART VI | FORM 990, PART VI, LINE 2 - RELATED PARTY INFORMATION AMONG OFFICERS THE FOLLOWING DIRECTORS SERVED AS DIRECTORS OR OFFICERS OF COMMUNITY HEALTH NETWORK, INC. ("CHNW) AND ALSO RECEIVED COMPENSATION FROM CHNW: THOMAS P. FISCHER TIMOTHY HOBBS, M.D. BRYAN A. MILLS |
| FORM 990, PAGE 6, PART VI, LINE 3 | CHRH HAS DELEGATED EXCLUSIVE AUTHORITY TO COMMUNITY HEALTH NETWORK ("CHNW"), ACTING THROUGH CHNW'S BOARD OF DIRECTORS, IN THE FOLLOWING SUBSTANTIVE AREAS: STRATEGIC PLANNING, CAPITAL ACCESS, BUDGETING AND ALLOCATION, AUDIT AND COMPLIANCE, EXECUTIVE COMPENSATION, AND DISPUTE RESOLUTION. IN ADDITION, CHNW MUST APPROVE ANY MODIFICATION, REPEAL, AMENDMENT, OR RESTATEMENT OF CHRH'S ARTICLES OF INCORPORATION. FINALLY, CHNW MUST APPROVE ANY MATERIAL SALE OR DISPOSITION OF THE ASSETS OF CHRH. |
| FORM 990, PAGE 6, PART VI, LINE 6 | COMMUNITY HEALTH NETWORK, INC. ("CHNW") IS THE SOLE MEMBER OF CHRH. CHNW IS AN EXEMPT ORGANIZATION PURSUANT TO SECTION 501(C)(3). |
| FORM 990, PAGE 6, PART VI, LINE 7A | COMMUNITY HEALTH NETWORK, INC. ("CHNW") AS THE SOLE MEMBER OF CHRH APPOINTS A MAJORITY OF THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 7B | THE FOLLOWING GOVERNANCE ITEMS REQUIRE THE WRITTEN APPROVAL OF CHNW: A) AMENDMENT OF ORGANIZATIONAL DOCUMENTS; B) THE INCURRENCE OF ANY UNBUDGETED INDEBTEDNESS OR LOANS ABOVE 750,000; C) THE FORMATION OF LEGAL ENTITIES, THE SALE, TRANSFER OR SUBSTANTIAL CHANGE IN USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF CHRH, OR THE DIVESTURE, DISSOLUTION, CLOSURE, MERGER, CONSOLIDATION OR REORGANIZATION OF CHRH; D) THE ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION OF PROPERTY WHEN SUCH TRANSACTION IS ABOVE 1,000,OOO, DURING ANY FISCAL YEAR; E) DISPOSITION OF ASSETS ON DISSOLUTION; F) APPROVAL OF THE ANNUAL CAPITAL AND OPERATING BUDGETS, PLANS, OR FORECASTS APPROVED BY THE BOARD; G) THE SELECTION OF THE INDEPENDENT AUDITING FIRM EITHER DIRECTLY OR THROUGH CHNW'S AUDIT AND COMPLIANCE COMMITTEE; H) THE DETERMINATION OF PHYSICIAN AND CEO COMPENSATION EITHER DIRECTLY OR THROUGH CHNW'S COMPENSATION COMMITTEE; I) ALL UNBUDGETED CAPITAL IMPROVEMENTS, ADDITIONS AND STRUCTURAL CHANGES TO THE PROPERTY GREATER THAN THE BUDGETED AMOUNT BY 500,000 PER FISCAL YEAR IN THE AGGREGATE; J) STRATEGIC PLANS, INCLUDING THE REGIONAL PLAN; AND K) THE HIRING AND FIRING OF THE CEO SUBJECT TO THE PRIOR OPPORTUNITY FOR THE BOARD TO REVIEW AND COMMENT. |
| FORM 990, PAGE 6, PART VI, LINE 11B | CHNW HAS ASSUMED RESPONSIBILITY FOR CHRH'S AUDIT, COMPLIANCE, AND EXECUTIVE COMPENSATION MATTERS. CHNW'S BOARD OF DIRECTORS HAS DELEGATED AUTHORITY FOR THE REVIEW OF CHRH'S FORM 990 TO TWO COMMITTEES COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS: A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE COMPENSATION ASPECTS OF CHRH'S FORM 990, AND B) THE NETWORK FINANCE COMMITTEE REVIEWED THE REMAINDER OF THE CHRH'S FORM 990. IN ADDITION, CHRH'S OUTSIDE ACCOUNTING FIRM AND LAW FIRM REVIEWED THE FORM 990 PRIOR TO FILING. CHRH AND CHNW UTILIZED THIS PROCESS TO ENSURE THAT CHRH'S FORM 990 RECEIVED SUBSTANTIVE REVIEW BY DIRECTORS AND PROFESSIONALS WITH SPECIFIC KNOWLEDGE OF CHRH'S ACTIVITIES AND EXTENSIVE FINANCIAL, ACCOUNTING, AND TAX EXPERTISE. |
| FORM 990, PAGE 6, PART VI, LINE 12C | CHRH HAS ADOPTED A CONFLICT OF INTEREST POLICY THAT APPLIES TO ITS DIRECTORS, OFFICERS, MANAGERS, MATERIAL MANAGEMENT ASSOCIATES AND KEY EMPLOYEES. THE CONFLICT POLICY REQUIRES THESE INDIVIDUALS TO SUBMIT AN ANNUAL WRITTEN CERTIFICATION OF COMPLIANCE UNDER WHICH THESE INDIVIDUALS MUST DISCLOSE (I) FINANCIAL OR OTHER INTERESTS THE INDIVIDUAL OR ANY FAMILY MEMBER HAS WITH ANY ENTITY ENGAGED IN THE DELIVERY OF HEALTH CARE SERVICES, BIOTECHNOLOGY COMPANIES, SOFTWARE COMPANIES PROVIDING EDUCATIONAL OR CONSULTING SERVICES OR ANY OTHER COMPANY OR ORGANIZATION THAT DOES OR CONTEMPLATES DOING BUSINESS WITH CHRH, AND (II) COMPENSATION OR GIFTS RECEIVED BY THE INDIVIDUAL OR ANY FAMILY MEMBER THAT MIGHT INFLUENCE THE INDIVIDUAL'S ACTIONS. THE DISCLOSURES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER, PRESIDENT/CEO AND BOARD OF DIRECTORS, AS APPROPRIATE. THE INTENT OF THE POLICY IS TO AVOID THE PARTICIPATION OF ANY INTERESTED PERSON IN THE CONSIDERATION OF A MATTER OR DECISION WHICH POSES A CONFLICT OF INTEREST FOR THAT INTERESTED PERSON. |
| FORM 990, PAGE 6, PART VI, LINE 15A | AS A MEMBER OF THE NETWORK, CHRH IS SUBJECT TO THE EXECUTIVE COMPENSATION PRACTICES AND PROCEDURES OF CHNW, THE NETWORK PARENT. CHNW HAS ADOPTED AN EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY THAT APPLIES TO CHRH. THE PURPOSE OF THE POLICY IS TO ENSURE THAT CHRH'S COMPENSATION ARRANGEMENTS WITH RELATED PARTIES ARE EVALUATED AND ENTERED AT ARMS LENGTH AND THAT ANY COMPENSATION THAT IS PAID TO A RELATED PARTY IS REASONABLE AND REFLECTS FAIR MARKET VALUE. THIS POLICY ENCOURAGES THE APPLICATION OF THE REBUTTABLE PRESUMPTION STANDARD OF CODE SECTION 4958 AND THE RELATED TREASURY REGULATIONS BY: A) EXCLUDING ANY INTERESTED PARTY FROM THE DECISION MAKING PROCESS, B) REQUIRING DISINTERESTED BOARD OR COMMITTEE MEMBERS TO OBTAIN AND RELY UPON COMPARABILITY DATA WHEN SETTING THE PROPOSED COMPENSATION TERMS, C) REQUIRING APPROVAL OF THE TRANSACTION IN ADVANCE BY DISINTERESTED DIRECTORS OR COMMITTEE MEMBERS, AND D) REQUIRING CONTEMPORANEOUS DOCUMENTATION (I.E. MINUTES) REFLECTING THE DECISION AND THE PROCESS BY WHICH IT WAS MADE. CHNW HAS DELEGATED AUTHORITY REGARDING CHRH'S EXECUTIVE COMPENSATION TO A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE, COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS, WHICH IS RESPONSIBLE FOR APPLYING THE TERMS AND PROCESS OF THE EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY AS OUTLINED ABOVE, AND B) THE NETWORK VICE PRESIDENT OF HUMAN RESOURCES WHO IS RESPONSIBLE FOR OBTAINING COMPARATIVE SALARY MARKET DATA FOR THE CHIEF EXECUTIVE OFFICER, OFFICERS, AND KEY EMPLOYEES, PERIODICALLY ENGAGING AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH REASONABLE COMPENSATION, AND PROVIDING STAFF SUPPORT TO THE NETWORK EXECUTIVE COMPENSATION COMMITTEE. DURING 2013, THE NETWORK EXECUTIVE COMPENSATION COMMITTEE FOLLOWED THIS PROCESS FOR ALL SENIOR EXECUTIVE LEADERS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SALARIES WERE COMPARED AGAINST COMPARATIVE SALARY MARKET DATA FOR ALL POSITIONS REPRESENTING MANAGERS, CHIEF EXECUTIVE OFFICERS, CHIEF FINANCIAL OFFICERS, AND HUMAN RESOURCES REPRESENTATIVES FOR ALL NETWORK ENTITIES. |
| 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) CHRH'S CONFLICT OF INTEREST POLICY IS NOT AVAILABLE TO THE PUBLIC. C) CHRH DOES NOT HAVE INDIVIDUALLY AUDITED FINANCIAL STATEMENTS. ITS FINANCIAL RESULTS ARE INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CHNW AND AFFILIATES. AS SUCH, THERE ARE NO INDIVIDUAL FINANCIAL STATEMENTS TO POST. CHRH DOES FILE THE 990 TAX RETURN ON AN ANNUAL BASIS WHICH IS AVAILABLE UPON REQUEST AND/OR AVAILABLE ON A DELAYED BASIS ON GUIDESTAR.ORG. D) COMMUNITY HEALTH NETWORK, INC. AND AFFILIATES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. |
| FORM 990, PART XI, LINE 9 | ADJUSTMENT TO A/R 330,262 CAPITAL ASSETS ADJUSTMENT 1,676,427 TOTAL ( 1,346,165) |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| ANDREW MANDERY MD PLASTIC SURG LLC | |||||||||
| 1948 W BOULEVARD | KOKOMO | IN | 46902 | 272583026 | SURGERY | IN | -$710,626 | -$1,753,595 | CHRH |
| COMM HOWARD PHYSICIAN NETWORK LLC | |||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 462962374 | BILLING | IN | -$8,116,054 | $1,224,137 | CHRH |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | 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 | 11B | 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 | 9 | 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 | 11A | CHA | Yes (true) |
| COMMUNITY HOSPITAL SOUTH INC | ||||||||||
| 1402 E COUNTY LINE ROAD SOUTH | INDIANAPOLIS | IN | 46227 | 351088640 | HOSPITAL | IN | 501C3 | 3 | CHNW | Yes (true) |
| COMM HOWARD REGIONAL HEALTH FDN | ||||||||||
| PO BOX 9011 | KOKOMO | IN | 46904 | 237309596 | SUPPORT | IN | 501C3 | 7 | NA | false |
| COMMUNITY LTC INC | ||||||||||
| 1031 MONTICELLO DRIVE | ANDERSON | IN | 46011 | 351877441 | HLTH CARE | IN | 501C3 | 9 | CHA | Yes (true) |
| COMMUNITY PHYSICIANS OF IN INC | ||||||||||
| 7240 SHADELAND STATION SUITE 300 | INDIANAPOLIS | IN | 46256 | 205392766 | PHY SRV | IN | 501C3 | 9 | CHNW | Yes (true) |
| HEALTH INSTITUTE OF INDIANA INC | ||||||||||
| 3660 GUION ROAD | INDIANAPOLIS | IN | 46222 | 352022402 | FITNESS | IN | 501C3 | 9 | IOH | Yes (true) |
| INDIANA HEART HOSPITAL LLC | ||||||||||
| 8075 NORTH SHADELAND AVENUE | INDIANAPOLIS | IN | 46250 | 352123783 | HOSPITAL | IN | 501C3 | 3 | CHNW | Yes (true) |
| INDIANAPOLIS OSTEOPATHIC HOSP INC | ||||||||||
| 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | 351094734 | HOSPITAL | IN | 501C3 | 3 | CHNW | Yes (true) |
| WESTVIEW HOSPITAL FOUNDATION INC | ||||||||||
| 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | 311036451 | SUPPORT | IN | 501C3 | 11A | IOH | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (17 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BROWNSBURG OFFICE CENTER 2 LLP | ||||||||||||||
| 321 E NORTHFIELD | BROWNSBURG | IN | 46112 | 351929859 | LEASING | IN | N/A | false | false | |||||
| CHNJMH VENTURES LLC | ||||||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 462356266 | DIAG/REHAB | 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 | ||||||||||||||
| 7343 CLEARVISTA DRIVE | INDIANAPOLIS | IN | 46256 | 453414249 | REHAB | IN | N/A | false | false | |||||
| EAST CAMPUS SURGERY CENTER LLC | ||||||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 352028517 | SURGERY | IN | N/A | false | false | |||||
| HAMILTON SURGERY CENTER LLC | ||||||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 352061413 | SURGERY | IN | N/A | false | false | |||||
| HOWARD COMMUNITY SURGERY CTR LLC | ||||||||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 352118748 | SURGERY | IN | false | Yes (true) | CHRH | RELATED | $1,753,747 | $1,908,397 | 0.55290 | |
| HOWARD REGIONAL SPECIALTY CARE LLC | ||||||||||||||
| 829 NORTH DIXON ROAD | KOKOMO | IN | 46901 | 371501021 | REHAB | IN | false | Yes (true) | CHRH | RELATED | -$185,582 | -$540,473 | 0.60000 | |
| INDIANA SPECIALTY GROUP LLC | ||||||||||||||
| 7240 SHADELAND STATION SUITE 300 | INDIANAPOLIS | IN | 46256 | 351976258 | HLTH CARE | IN | N/A | false | false | |||||
| INDIANAPOLIS ENDOSCOPY CENTER LLC | ||||||||||||||
| 7353 E 21ST STREET | INDIANAPOLIS | IN | 46219 | 352010874 | HLTH CARE | IN | N/A | false | false | |||||
| MICHIGAN SURGERY INVESTMENT LLC | ||||||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 320147008 | SURG CTRS | IN | N/A | false | false | |||||
| NORTH CAMPUS OFFICE ASSOCIATES LP | ||||||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 351808625 | RNTL PROP | IN | N/A | false | false | |||||
| NORTH CAMPUS SURGERY CENTER LLC | ||||||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 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 | ||||||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 208754071 | SURGERY | IN | N/A | false | false | |||||
| PILLARS HOUSING LP | ||||||||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 161652671 | HOUSING | 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 (6 entries)
| Address Line1ForeignAddress/AddressLine1 | CityForeignAddress/City | Province Or StateForeignAddress/ProvinceOrState | CountryForeignAddress/Country | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHN ASSURANCE COMPANY LTD | ||||||||||||||||||
| PO BOX 1051GT | GRAND CAYMAN | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | Yes (true) | ||||||||||
| MIDWEST RACQUETBALL INC | ||||||||||||||||||
| 351396016 | SPORTS CTR | Yes (true) | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | CHRH | C CORP | $471,242 | $1,508,917 | 1.00000 | ||||||
| PILLARS COMMUNITY HOUSING INC | ||||||||||||||||||
| 161652666 | HOUSING | Yes (true) | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | CHRH | C CORP | 1.00000 | ||||||||
| VEI MICHIGAN INC | ||||||||||||||||||
| 300097377 | MGMT SRVS | N/A | Yes (true) | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | IN | ||||||||||
| VISIONARY ENTERPRISES INC | ||||||||||||||||||
| 351538433 | MGMT SRVS | N/A | Yes (true) | 6626 EAST 75TH STREET | INDIANAPOLIS | IN | 46250 | IN | ||||||||||
| WESTVIEW DELIVERY SYSTEM INC | ||||||||||||||||||
| 351910292 | MGMT SRVS | N/A | Yes (true) | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | ||||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| COMM HOWARD REGIONAL HEALTH FDN | ||
| C | $233,241 | BOOK VALUE |
| COMMUNITY PHYSICIANS OF INDIANA | ||
| R | $71,572 | BOOK VALUE |
| HOWARD COMMUNITY SURGERY CENTER | ||
| J | $713,929 | BOOK VALUE |
| HOWARD REGIONAL SPECIALTY CARE | ||
| A | $684,000 | BOOK VALUE |
| HOWARD REGIONAL SPECIALTY CARE | ||
| Q | $191,496 | BOOK VALUE |
| VISIONARY ENTERPRISES INC | ||
| Q | $4,802,158 | BOOK VALUE |