COMMUNITY PHYSICIANS OF INDIANA INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY PHYSICIANS OF INDIANA INC (EIN 20-5392766)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-12
- IRS object ID
- 201303169349303335
- Schema version
- 2012v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-12T10:22:14-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CASKEY & DAILY PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| 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 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205392766 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY PHYSICIANS OF | BusinessNameLine1 |
| Business Name Line2 | INDIANA INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COMM | NameControl |
| Phone | 3176217474 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7240 SHADELAND STATION SUITE 300 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46256 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ANTHONY JAVORKA | Name |
| Title | CHIEF OPERATING OFFICER | Title |
| Phone | 3176217474 | Phone |
| Date Signed | 2013-10-31 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES A CASKEY CPA CFP | Name |
| Phone | 3175852647 | Phone |
| Date Prepared | 2013-11-12 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY PHYSICIAN NETWORK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | RAMARAO YELETI MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7240 SHADELAND STATION SUITE 300 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46256 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 173475807 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ECOMMUNITY.COM/CPI/ | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2006 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | COMMUNITY PHYSICIANS OF INDIANA, INC. IS A PHYSICIAN LED NONPROFIT CORPORATION, PART OF AN INTEGRATED HEALTH CARE NETWORK, WHICH SERVES AS THE LEADER IN PROVIDING COMPASSIONATE, QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES TO HELP PEOPLE ACHIEVE AND MAINTAIN OPTIMAL HEALTH IN THE COMMUNITY WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1993 | TotalNbrEmployees |
| Total Nbr Volunteers | 3 | TotalNbrVolunteers |
| Total Gross UBI | 97875 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 43220 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 10470 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 145458 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 85153124 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 165421189 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -39632 | InvestmentIncomePriorYear |
| Investment Income Current Year | -86791 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 375941 | OtherRevenuePriorYear |
| Other Revenue Current Year | 7420125 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 85499903 | TotalRevenuePriorYear |
| Total Revenue Current Year | 172899981 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 93621616 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 218299039 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 38262663 | OtherExpensePriorYear |
| Other Expenses Current Year | 57481490 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 131884279 | TotalExpensesPriorYear |
| Total Expenses Current Year | 275780529 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -46384376 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -102880548 | RevenuesLessExpensesCY |
| Total Assets BOY | 29218987 | TotalAssetsBOY |
| Total Assets EOY | 53201971 | TotalAssetsEOY |
| Total Liabilities BOY | 63447351 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 139242410 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -34228364 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -86040439 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | COMMUNITY PHYSICIANS OF INDIANA, INC. IS A PHYSICIAN LED NONPROFIT CORPORATION, PART OF AN INTEGRATED HEALTH CARE NETWORK, WHICH SERVES AS THE LEADER IN PROVIDING COMPASSIONATE, QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES TO HELP PEOPLE ACHIEVE AND MAINTAIN OPTIMAL HEALTH IN THE COMMUNITY WE SERVE. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 237607363 | Expense |
| Revenue | 165421189 | Revenue |
| Description | COMMUNITY PHYSICIANS OF INDIANA, INC. (CPI) IS A PHYSICIAN GOVERNED GROUP THAT IS PART OF A PATIENT-CENTERED, INTEGRATED HEALTH CARE NETWORK WHICH WILL, THROUGH CONTINUOUS QUALITY IMPROVEMENT, CONSISTENTLY PROVIDE A BETTER EXPERIENCE FOR PATIENTS, EMPLOYEES, PHYSICIANS, AND PAYERS AND THUS BECOME THEIR NETWORK OF CHOICE. CPI INTENDS TO BE RECOGNIZED AS THE PRIMARY CARE AND SPECIALTY CARE GROUP PRACTICE IN CENTRAL INDIANA, SETTING BENCHMARK STANDARDS IN PHYSICIAN LOYALTY, QUALITY, SERVICE, AND COST PERFORMANCE. IN 2012, CPI'S PATIENT VISITS WERE 826,367. | Description |
| Total Program Service Expense | 237607363 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | true | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Number Forms Transmitted With1096 | 43 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1993 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | ANTHONY JAVORKA | NamePerson |
| Telephone Number | 3176211591 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7240 SHADELAND STATION SUITE 300 | AddressLine1 |
| City | INDIANAPOLIS | City |
| State | IN | State |
| ZIP Code | 46256 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (24 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| BRYAN A MILLS | |||||||||
| DIRECTOR | 5.00 | 55.00 | X | 0 | 1113224 | 178029 | |||
| DAVID HALL MD | |||||||||
| DIRECTOR | 50.00 | X | 1098240 | 0 | 266906 | ||||
| MICHAEL ROBERTSON MD | |||||||||
| SECRETARY | 50.00 | X | 793470 | 0 | 212110 | X | |||
| RUSSELL DILLEY MD | |||||||||
| DIRECTOR | 50.00 | X | 784674 | 0 | 134027 | ||||
| RAMARAO YELETI MD | |||||||||
| DIRECTOR/PRE | 50.00 | X | 767239 | 0 | 201342 | X | |||
| SURESH DEVNANI MD | |||||||||
| DIRECTOR | 50.00 | X | 688933 | 0 | 249389 | ||||
| TIMOTHY HOBBS MD | |||||||||
| DIRECTOR | 5.00 | 45.00 | X | 0 | 668453 | 118464 | |||
| FRANK COVINGTON MD | |||||||||
| DIRECTOR | 5.00 | 45.00 | X | 0 | 584664 | 120409 | |||
| ERNEST O ASAMOAH MD | |||||||||
| CHAIRMAN | 50.00 | X | 431488 | 0 | 60586 | X | |||
| CHARLES PLATZ MD | |||||||||
| DIRECTOR | 50.00 | X | 322910 | 0 | 43762 | ||||
| WENDY T BYERS MD | |||||||||
| DIRECTOR | 50.00 | X | 271756 | 0 | 58839 | ||||
| WILFREDO SOUCHET MD | |||||||||
| DIRECTOR | 50.00 | X | 229986 | 0 | 66373 | ||||
| MICHAEL ALLEY | |||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | ||||
| JEFFREY MOSSLER MD | |||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | ||||
| STEVE PLUMP | |||||||||
| DIRECTOR | 5.00 | X | 0 | 0 | 0 | ||||
| ANTHONY JAVORKA | |||||||||
| COO | 50.00 | 332168 | 0 | 89676 | X | ||||
| THOMAS VANDERGRIFT | |||||||||
| COO THRU 08/ | 50.00 | 315609 | 0 | 234362 | X | ||||
| TERESA E CAMPBELL | |||||||||
| CFO THRU 08/ | 50.00 | 253723 | 0 | 224418 | X | ||||
| DEEPAK GUTTIKONDA MD | |||||||||
| PHYSICIAN | 50.00 | 1616587 | 0 | 108256 | X | ||||
| JOHN CUMMINGS MD | |||||||||
| PHYSICIAN | 50.00 | 1199217 | 0 | 290559 | X | ||||
| PREETHAM JETTY MD | |||||||||
| PHYSICIAN | 50.00 | 5.00 | 1174684 | 0 | 352705 | X | |||
| KRISHNA MALINENI MD | |||||||||
| PHYSICIAN | 50.00 | 1041189 | 0 | 144922 | X | ||||
| JILL DONALDSON MD | |||||||||
| PHYSICIAN | 50.00 | 959628 | 0 | 260091 | X | ||||
| DAVID A SHAPIRO MD | |||||||||
| FRMR DIR/TRE | 40.00 | 313974 | 0 | 55836 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 12595475 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2366341 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 3471061 | TotalOtherCompensation |
| Number Individuals GT100 K | 363 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| NEXTGEN HEALTHCARE INFORMATION | |||||
| PO BOX 809390 | CHICAGO | IL | 606809390 | SOFTWARE | 535151 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 75397 | TEMPORARY HELP | 461647 |
| BACOMPT SYSTEMS INC | |||||
| 12742 HAMILTON CROSSING BLVD | CARMEL | IN | 46032 | BILLING SERVICE | 461509 |
| REALMED CORPORATION | |||||
| 510 E 96TH STREET SUITE 400 | INDIANAPOLIS | IN | 46240 | BILLING SERVICE | 377066 |
| MID AMERICA CLINICAL LABS | |||||
| 6704 RELIABLE PKWY | CHICAGO | IL | 60680 | LAB SERVICES | 255889 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 21 | NumberOfContractorsGT100K |
| Related Organizations | 145458 | RelatedOrganizations |
| Total Contributions | 145458 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICES | 621110 | 164656922 | 164656922 |
| JANE PAULEY ADMIN FEES | 900099 | 352407 | 352407 |
| HOSPITALIST FEES | 900099 | 351443 | 351443 |
| CLINICAL RESEARCH STUDY | 900099 | 60417 | 60417 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 165421189 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6331 | TotalRevenueColumn |
| Exclusion | $6,331 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 79794 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 172916 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -93122 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -93122 | TotalRevenueColumn |
| Exclusion | -$93,122 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 161892 | GrossSalesOfInventory |
| Cost Of Goods Sold | 402910 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -241018 | TotalRevenueColumn |
| Related Or Exempt Function Income | -338893 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 97875 | UnrelatedBusinessRevenue |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| EPIC PRODUCTIVITY IMPACT | 900099 | 4006906 | 4006906 |
| EHR INCENTIVE PAYMENTS | 900099 | 3632917 | 3632917 |
| PURCHASE DISCOUNT | 900099 | 12545 | 12545 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8775 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8775 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 7661143 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 172899981 | TotalRevenueColumn |
| Related Or Exempt Function Income | 172743439 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 97875 | UnrelatedBusinessRevenue |
| Exclusion | -$86,791 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7730570 | Total |
| Program Services | 6439849 | ProgramServices |
| Management And General | 1290721 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 176444491 | Total |
| Program Services | 161543851 | ProgramServices |
| Management And General | 14900640 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7021402 | Total |
| Program Services | 6371502 | ProgramServices |
| Management And General | 649900 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19121005 | Total |
| Program Services | 17440022 | ProgramServices |
| Management And General | 1680983 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7981571 | Total |
| Program Services | 7062202 | ProgramServices |
| Management And General | 919369 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3203 | Total |
| Management And General | 3203 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10031953 | Total |
| Program Services | 626890 | ProgramServices |
| Management And General | 9405063 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 849066 | Total |
| Program Services | 431145 | ProgramServices |
| Management And General | 417921 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13177631 | Total |
| Program Services | 12223605 | ProgramServices |
| Management And General | 954026 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1895800 | Total |
| Program Services | 229642 | ProgramServices |
| Management And General | 1666158 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16761535 | Total |
| Program Services | 16008863 | ProgramServices |
| Management And General | 752672 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 178311 | Total |
| Program Services | 117637 | ProgramServices |
| Management And General | 60674 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 778346 | Total |
| Program Services | 560231 | ProgramServices |
| Management And General | 218115 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8170827 | Total |
| Program Services | 3662427 | ProgramServices |
| Management And General | 4508400 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3591919 | Total |
| Program Services | 3300083 | ProgramServices |
| Management And General | 291836 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 1143615 | 975248 | 168367 |
| DUES, LICENSES, SUBSCRPTN | 672058 | 529731 | 142327 |
| MEALS & ENTERTAINMENT | 175342 | 80290 | 95052 |
| RECRUITMENT | 47900 | 161 | 47739 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3984 | Total |
| Program Services | 3984 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 275780529 | Total |
| Program Services | 237607363 | ProgramServices |
| Management And General | 38173166 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23667 | BOY |
| EOY | 29429 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2542565 | BOY |
| EOY | 3331812 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11218636 | BOY |
| EOY | 29762587 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 39377 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1137192 | BOY |
| EOY | 3232946 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 146538 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1941995 | BOY |
| EOY | 2283480 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 31273842 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 17036838 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12159857 | BOY |
| EOY | 14237004 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 195075 | BOY |
| EOY | 65392 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 73406 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29218987 | BOY |
| EOY | 53201971 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10752521 | BOY |
| EOY | 38004490 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52694830 | BOY |
| EOY | 101237920 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63447351 | BOY |
| EOY | 139242410 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -34228364 | BOY |
| EOY | -86040439 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -34228364 | BOY |
| EOY | -86040439 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29218987 | BOY |
| EOY | 53201971 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -102880548 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 51068473 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| College Support Org170b1 Aiv | X | CollegeSupportOrg170b1Aiv |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 160167 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus1 Year | 10470 | CurrentTaxYearMinus1Year |
| Current Tax Year | 145458 | CurrentTaxYear |
| Total | 316095 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 160167 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus1 Year | 10470 | CurrentTaxYearMinus1Year |
| Current Tax Year | 145458 | CurrentTaxYear |
| Total | 316095 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 316095 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 114146 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 8987 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4501 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3721 | CurrentTaxYearMinus1Year |
| Current Tax Year | 6331 | CurrentTaxYear |
| Total | 137686 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12446 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 56334 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 51472 | CurrentTaxYearMinus2Years |
| Current Tax Year | 43220 | CurrentTaxYear |
| Total | 163472 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6433 | CurrentTaxYearMinus4Years |
| Total | 6433 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 623686 | TotalSupport |
| Gross Receipts From Admissions Etc | 480316598 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.50680 | PublicSupportPertcentage170 |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8917407 | OtherCostOrOtherBasis |
| Depreciation | 2972145 | Depreciation |
| Book Value | 5945262 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 22356435 | OtherCostOrOtherBasis |
| Depreciation | 14064693 | Depreciation |
| Book Value | 8291742 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 14237004 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE FROM AFFILIATES | $100,874,976 |
| DEFERRED LEASE INCENTIVE | $362,944 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 101237920 | TotalOfAmounts |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | true | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (21 entries)
| TitleTitle | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRYAN A MILLS | ||||||||||||||
| DIRECTOR | 821612 | 272000 | 19612 | 148211 | 29818 | 1291253 | 264000 | |||||||
| DAVID HALL MD | ||||||||||||||
| DIRECTOR | 898246 | 181440 | 18554 | 245896 | 21010 | 1365146 | 136339 | |||||||
| MICHAEL ROBERTSON MD | ||||||||||||||
| SECRETARY | 638191 | 67180 | 88099 | 182704 | 29406 | 1005580 | ||||||||
| RUSSELL DILLEY MD | ||||||||||||||
| DIRECTOR | 672589 | 47776 | 64309 | 105637 | 28390 | 918701 | ||||||||
| RAMARAO YELETI MD | ||||||||||||||
| DIRECTORPRESIDENT | 610650 | 80616 | 75973 | 169555 | 31787 | 968581 | 80616 | |||||||
| SURESH DEVNANI MD | ||||||||||||||
| DIRECTOR | 373370 | 53140 | 262423 | 223263 | 26126 | 938322 | ||||||||
| TIMOTHY HOBBS MD | ||||||||||||||
| DIRECTOR | 509972 | 155925 | 2556 | 95146 | 23318 | 786917 | 155925 | |||||||
| FRANK COVINGTON MD | ||||||||||||||
| DIRECTOR | 421412 | 163252 | 94142 | 26267 | 705073 | |||||||||
| ERNEST O ASAMOAH MD | ||||||||||||||
| CHAIRMAN | 428317 | 3171 | 33421 | 27165 | 492074 | |||||||||
| CHARLES PLATZ MD | ||||||||||||||
| DIRECTOR | 292224 | 30686 | 16698 | 27064 | 366672 | |||||||||
| WENDY T BYERS MD | ||||||||||||||
| DIRECTOR | 253414 | 18342 | 37838 | 21001 | 330595 | |||||||||
| WILFREDO SOUCHET MD | ||||||||||||||
| DIRECTOR | 159051 | 70935 | 41696 | 24677 | 296359 | |||||||||
| ANTHONY JAVORKA | ||||||||||||||
| COO | 305251 | 25213 | 1704 | 60899 | 28777 | 421844 | 25213 | |||||||
| THOMAS VANDERGRIFT | ||||||||||||||
| COO THRU 083112 | 157026 | 49249 | 109334 | 205371 | 28991 | 549971 | 32775 | |||||||
| TERESA E CAMPBELL | ||||||||||||||
| CFO THRU 083112 | 133918 | 42358 | 77447 | 201223 | 23195 | 478141 | 29213 | |||||||
| DEEPAK GUTTIKONDA MD | ||||||||||||||
| PHYSICIAN | 691650 | 924937 | 81091 | 27165 | 1724843 | |||||||||
| JOHN CUMMINGS MD | ||||||||||||||
| PHYSICIAN | 785210 | 176910 | 237097 | 258402 | 32157 | 1489776 | 176910 | |||||||
| PREETHAM JETTY MD | ||||||||||||||
| PHYSICIAN | 762425 | 53744 | 358515 | 325528 | 27177 | 1527389 | 165437 | |||||||
| KRISHNA MALINENI MD | ||||||||||||||
| PHYSICIAN | 715987 | 40308 | 284894 | 113839 | 31083 | 1186111 | 40308 | |||||||
| JILL DONALDSON MD | ||||||||||||||
| PHYSICIAN | 649971 | 176910 | 132747 | 238440 | 21651 | 1219719 | 176910 | |||||||
| DAVID A SHAPIRO MD | ||||||||||||||
| FRMR DIRTREASURER | 282407 | 31567 | 35111 | 20725 | 369810 | |||||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION | SCHEDULE J, PAGE 1, PART I, LINE 3 | 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. |
| SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS | SCHEDULE J, PAGE 1, PART I, LINE 4 | THOMAS VANDERGRIFT 70,765 0 0 TERESA E. CAMPBELL 63,076 0 0 |
| OTHER ADDITIONAL INFORMATION | SCHEDULE J, PART III | PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN BRYAN A. MILLS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THROUGH HIS EMPLOYER, COMMUNITY HEALTH NETWORK, INC. DURING 2012, MR. MILLS DID NOT RECEIVE A PAYMENT FROM THE PLAN. PART I, LINE 5A - COMPENSATION CONTINGENT UPON REVENUES OF ORGANIZATION DR. FRANK COVINGTON, DR. JOHN CUMMINGS, DR. SURESH DEVNANI, DR. RUSSELL DILLEY, DR. JILL DONALDSON, DR. DAVID HALL, DR. TIMOTHY HOBBS DR. KRISHNA MALINENI, DR. JETTY PREETHAM, DR. MICHAEL ROBERTSON, 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 L IRS990ScheduleL
Loan Table LoanTable (3 entries)
| Relationship With OrganizationRelationshipWithOrganization | Purpose Of LoanPurposeOfLoan | Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|---|---|
| KRISHNA MALINENI MD | |||||||
| HIGHEST COMPENSATED | MALPRACTICE TAIL COVERAGE | X | $63,000 | 25200 | false | true | true |
| JOHN CUMMINGS MD | |||||||
| HIGHEST COMPENSATED | MALPRACTICE TAIL COVERAGE | X | $38,153 | 9927 | false | true | true |
| SURESH DEVNANI MD | |||||||
| DIRECTOR/PHYSICIAN | MALPRACTICE TAIL COVERAGE | X | $12,000 | 4250 | false | true | true |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 39377 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| VISIONARY ENTERPRISES INC | |||
| SHARE BD MEMBER | 29556574 | HEALTH & PHARM PLANS | false |
| VISIONARY ENTERPRISES INC | |||
| SHARE BD MEMBER | 4706876 | RENT/WORK ORDERS | false |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE L PART V | ReturnReference |
| Explanation | THE LOAN TO DR SURESH DEVNANI WAS MADE TO HIM PRIOR TO HIS ELECTION AS A DIRECTOR OF CPI ALL LOANS MADE BY CPI REFLECT ARMSLENGTH FAIR MARKET VALUE TERMS AND WERE MADE IN ACCORDANCE WITH THE NETWORKS CONFLICT OF INTEREST POLICY AND EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | COMMUNITY PHYSICIANS OF INDIANA, INC. IS A PHYSICIAN LED NONPROFIT CORPORATION, PART OF AN INTEGRATED HEALTH CARE NETWORK, WHICH SERVES AS THE LEADER IN PROVIDING COMPASSIONATE, QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES TO HELP PEOPLE ACHIEVE AND MAINTAIN OPTIMAL HEALTH IN THE COMMUNITY WE SERVE. |
| ADDITIONAL INFORMATION | FORM 990 | FORM 990, PART I, LINE 4 - INDEPENDENT VOTING MEMBERS COMMUNITY PHYSICIANS OF INDIANA, INC. ("CPI") IS AN AFFILIATE OF COMMUNITY HEALTH NETWORK ("THE NETWORK"), AN INTEGRATED HEALTH DELIVERY SYSTEM. CPI, IS CONTROLLED BY ITS PARENT, COMMUNITY HEALTH NETWORK, INC. ("CHNW"), A TAX-EXEMPT HOSPITAL. CHNW HAS THE FOLLOWING POWERS OVER CPI: A) CHNW IS THE SOLE MEMBER OF CPI, B) CHNW APPOINTS ALL OF THE MEMBERS OF CPI'S BOARD OF DIRECTORS, C) CHNW HAS THE AUTHORITY TO REMOVE ANY MEMBER OF CPI'S BOARD OF DIRECTORS, D) CHNW MUST APPROVE ANY MODIFICATION, REPEAL, AMENDMENT, OR RESTATE- MENT 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 GOVERANCE AND MANAGEMENT TO CHNW. THE MAJORITY OF THE BOARD MEMBERS FOR CHNW ARE INDEPENDENT OUTSIDE DIRECTORS. |
| ADDITIONAL INFORMATION | FORM 990, PART V | FORM 990, PART V, LINE 2A - NUMBER OF EMPLOYEES CPI EMPLOYEES ARE LEASED FROM COMMUNITY HEALTH NETWORK, INC. |
| ADDITIONAL INFORMATION | FORM 990, PART VI | FORM 990, PART VI, LINE 1B - VOTING MEMBERS THAT ARE INDEPENDENT SEE FORM 990, PART I, LINE 4 REFERENCE ON SCHEDULE O ABOVE FORM 990, PART VI, LINE 2 - RELATED PARTY INFORMATION AMONG OFFICERS MANY OF CPI'S DIRECTORS, OFFICERS, AND KEY EMPLOYEES SERVE IN AN EXECUTIVE ROLE FOR OTHER TAX-EXEMPT AND TAXABLE AFFILIATES THROUGHOUT THE NETWORK. SPECIFICALLY, THE FOLLOWING DIRECTORS SERVE AS DIRECTORS AND/OR OFFICERS OF THE FOLLOWING ORGANIZATIONS: DR. TIMOTHY HOBBS - COMMUNITY HOWARD REGIONAL HEALTH, INC. BRYAN A. MILLS - COMMUNITY HEALTH NETWORK, INC. - COMMUNITY HEALTH NETWORK FOUNDATION, INC. - COMMUNITY HEALTH SERVICES OF INDIANA, INC. - COMMUNITY HOME HEALTH SERVICES, INC. - COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY, INC. - COMMUNITY HOSPITAL SOUTH, INC. - COMMUNITY WESTVIEW HOSPITAL, INC. - INDIANA HEART HOSPITAL, LLC - VISIONARY ENTERPRISES, INC. DR. JEFFREY A. MOSSLER - COMMUNITY HEALTH NETWORK, INC. - COMMUNITY HOME HEALTH SERVICES, INC. - COMMUNITY HOSPITAL SOUTH, INC. - INDIANA HEART HOSPITAL, LLC - VISIONARY ENTERPRISES, INC. STEVE PLUMP - COMMUNITY HEALTH NETWORK, INC. - COMMUNITY HOME HEALTH SERVICES, INC. - COMMUNITY HOSPITAL SOUTH, INC. - INDIANA HEART HOSPITAL, LLC DR. RAMARAO YELETI - COMMUNITY HEALTH NETWORK FOUNDATION, INC. |
| MANAGEMENT DELEGATED | FORM 990, PAGE 6, PART VI, LINE 3 | CPI DELEGATED AUTHORITY IN ITS ARTICLES OF INCORPORATION TO CHNW IN THE FOLLOWING SUBSTANTIVE AREAS: STRATEGIC PLANNING, CAPITAL ACCESS, BUDGETING AND ALLOCATION; AUDIT AND COMPLIANCE; EXECUTIVE COMPENSATION; AND DISPUTE RESOLUTION. CPI DELEGATED THESE AUTHORITIES TO ITS PARENT, CHNW, TO ENSURE THAT CPI'S ACTIVITIES WERE INTEGRATED INTO THE BROADER CHARITABLE EFFORTS OF THE NETWORK. |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | SEE FORM 990, PART I, LINE 4 REFERENCE ON SCHEDULE O ABOVE |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | SEE FORM 990, PART I, LINE 4 REFERENCE ON SCHEDULE O ABOVE |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PAGE 6, PART VI, LINE 7B | SEE FORM 990, PART I, LINE 4 REFERENCE ON SCHEDULE O ABOVE |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | AS DISCUSSED IN PART I, LINE 4, CHNW HAS ASSUMED RESPONSIBILITY FOR CPI'S AUDIT, COMPLIANCE, AND EXECUTIVE COMPENSATION MATTERS. CHNW'S BOARD OF DIRECTORS HAS DELEGATED AUTHORITY FOR THE REVIEW OF CPI'S FORM 990 TO TWO COMMITTEES COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS: A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE COMPENSATION ASPECTS OF CPI'S FORM 990, AND B) THE NETWORK FINANCE COMMITTEE REVIEWED THE REMAINDER OF CPI'S FORM 990. IN ADDITION, CPI'S OUTSIDE ACCOUNTING FIRM AND LAW FIRM REVIEWED THE FORM 990 PRIOR TO FILING. CPI AND CHNW UTILIZED THIS PROCESS TO ENSURE THAT CPI'S FORM 990 RECEIVED SUBSTANTIVE REVIEW BY DIRECTORS AND PROFESSIONALS WITH SPECIFIC KNOWLEDGE OF CPI'S ACTIVITIES AND EXTENSIVE FINANCIAL, ACCOUNTING, AND TAX EXPERTISE. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | AS DISCUSSED IN PART I, LINE 4, CHNW HAS ASSUMED RESPONSIBILITY FOR CPI'S AUDIT AND COMPLIANCE MATTERS. CHNW HAS ADOPTED A CONFLICT OF INTEREST POLICY THAT APPLIES TO CPI. THE CONFLICT OF INTEREST POLICY REQUIRES DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO SUBMIT AN ANNUAL CONFLICT OF INTEREST DISCLOSURE. THE ANNUAL DISCLOSURE REQUIRES DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO DISCLOSE, IN WRITING, ANY KNOWN FINANCIAL INTEREST THAT THE INDIVIDUAL (TOGETHER WITH FAMILY MEMBERS) HAS IN ANY BUSINESS ENTITY THAT TRANSACTS BUSINESS WITH CPI. IN ADDITION, DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO IMMEDIATELY DISCLOSE ANY POSSIBLE CONFLICT OF INTEREST THAT ARISES MID-YEAR IN RELATION TO A PROPOSED TRANSACTION. THE CONFLICT OF INTEREST POLICY REQUIRES THAT ANY INDIVIDUAL WITH A CONFLICT BE RECUSED FROM THE DECISION MAKING PROCESS, THAT INDEPENDENT DIRECTORS OR COMMITTEE MEMBERS DETERMINE THAT THE PROPOSED TRANSACTION IS IN THE BEST INTEREST OF CPI, AND THE TRANSACTION MUST BE APPROVED BY A VOTE OF INDEPENDENT DIRECTORS OR COMMITTEE MEMBERS WITHOUT THE PARTICIPATION OF ANY INTERESTED INDIVIDUAL. THE ANNUAL CONFLICT DISCLOSURE STATEMENTS ARE SUBMITTED TO, AND REVIEWED BY, CHNW'S AUDIT COMMITTEE, COMPOSED OF INDEPENDENT DIRECTORS. IN ADDITION, THE EXECUTIVE STAFF AND GENERAL COUNSEL OF THE NETWORK ARE RESPONSIBLE FOR MONITORING ANY POSSIBLE CONFLICT TRANSACTIONS THAT ARISE AND MANAGING THEM TO ENSURE THAT ALL TRANSACTIONS REPRESENT ARMS LENGTH, FAIR MARKET VALUE TERMS FOR THE BENEFIT OF CPI. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | AS DISCUSSED IN PART I, LINE 4, CHNW HAS ASSUMED RESPONSIBILITY FOR CPI'S EXECUTIVE COMPENSATION MATTERS. CHNW HAS ADOPTED AN EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY THAT APPLIES TO CPI. THE PURPOSE OF THE POLICY IS TO ENSURE THAT CPI'S COMPENSATION ARRANGEMENTS WITH RELATED PARTIES ARE EVALUATED AND ENTERED AT ARMS LENGTH AND THAT ANY COMPENSATION THAT IS PAID TO A RELATED PARTY IS REASONABLE AND REFLECTS FAIR MARKET VALUE. THIS POLICY ENCOURAGES THE APPLICATION OF THE REBUTTABLE PRESUMPTION STANDARD OF CODE SECTION 4958 AND THE RELATED TREASURY REGULATIONS BY: A) EXCLUDING ANY INTERESTED PARTY FROM THE DECISION MAKING PROCESS, B) REQUIRING DISINTERESTED BOARD OR COMMITTEE MEMBERS TO OBTAIN AND RELY UPON COMPARABILITY DATA WHEN SETTING THE PROPOSED COMPENSATION TERMS, C) REQUIRING APPROVAL OF THE TRANSACTION IN ADVANCE BY DISINTERESTED DIRECTORS OR COMMITTEE MEMBERS, AND D) REQUIRING CONTEMPORANEOUS DOCUMENTATION (I.E. MINUTES) REFLECTING THE DECISION AND THE PROCESS BY WHICH IT WAS MADE. CHNW ALSO DELEGATED AUTHORITY REGARDING CPI'S EXECUTIVE COMPENSATION TO A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE, COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS, WHICH IS RESPONSIBLE FOR APPLYING THE TERMS AND PROCESS OF THE EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY AS OUTLINED ABOVE, AND B) THE NETWORK VICE PRESIDENT OF HUMAN RESOURCES WHO IS RESPONSIBLE FOR OBTAINING COMPARATIVE SALARY MARKET DATA FOR THE CHIEF EXECUTIVE OFFICER, OFFICERS, AND KEY EMPLOYEES, PERIODICALLY ENGAGING AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH REASONABLE COMPENSATION, AND PROVIDING STAFF SUPPORT TO THE NETWORK EXECUTIVE COMPENSATION COMMITTEE. DURING 2012, THE NETWORK EXECUTIVE COMPENSATION COMMITTEE FOLLOWED THIS PROCESS FOR ALL SENIOR EXECUTIVE LEADERS. FOR ALL POSITIONS REPRESENTING MANAGERS, CHIEF EXECUTIVE OFFICERS, CHIEF FINANCIAL OFFICERS, AND HUMAN RESOURCES REPRESENTATIVES FOR ALL NETWORK ENTITIES SALARIES WERE COMPARED AGAINST COMPARATIVE SALARY MARKET DATA. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | SEE LINE 15A ABOVE |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | A) THE ARTICLES OF INCORPORATION AND CERTIFICATE OF EXISTENCE ARE ON FILE WITH THE INDIANA SECRETARY OF STATE AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE INDIANA SECRETARY OF STATE OR FREE OF CHARGE ON THE SECRETARY OF STATE'S WEBSITE. B) AS AN AFFILIATE OF CHNW, CPI HAS ADOPTED THE NETWORK CONFLICT OF INTEREST POLICY. WHILE THIS POLICY IS NOT AVAILABLE TO THE PUBLIC, THE NETWORK'S DEFINITION OF A CONFLICT OF INTEREST AND HOW TO REPORT SUCH AN INCIDENT IS DESCRIBED IN THE NETWORK RESPONSIBILITY AND COMPLIANCE PROGRAM ("NRCP") MANUAL WHICH IS POSTED ON THE NETWORK'S WEBSITE, ECOMMUNITY.COM. THIS MANUAL IS AVAILABLE FOR THE PUBLIC TO REVIEW. C) CPI DOES NOT HAVE INDIVIDUALLY AUDITED FINANCIAL STATEMENTS. ITS FINANCIAL RESULTS ARE INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CHNW AND AFFILIATES. AS SUCH, THERE ARE NO INDIVIDUAL FINANCIAL STATEMENTS TO POST. CPI DOES FILE THE 990 TAX RETURN ON AN ANNUAL BASIS WHICH IS AVAILABLE UPON REQUEST AND/OR AVAILABLE ON A DELAYED BASIS ON GUIDESTAR.COM. D) COMMUNITY HEALTH NETWORK, INC. AND AFFILIATES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 9 | ADDITIONAL PAID IN CAPITAL FROM CHNW 51,068,473 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (14 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 | true |
| COMMUNITY HLTH SERVICES OF INDIANA | ||||||||||
| 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | 454817436 | HLTH CARE | IN | 501C3 | 3 | CHNW | true |
| COMMUNITY HOME HEALTH SERVICES INC | ||||||||||
| 9894 EAST 121ST STREET | FISHERS | IN | 46037 | 350953467 | HLTH CARE | IN | 501C3 | 9 | CHNW | true |
| COMM HOSP OF ANDERSON & MADISON CTY | ||||||||||
| 1515 NORTH MADISON AVENUE | ANDERSON | IN | 46011 | 351069822 | HOSPITAL | IN | 501C3 | 3 | CHNW | true |
| COMMUNITY HOSP ANDERSON FDN INC | ||||||||||
| 1515 NORTH MADISON AVENUE | ANDERSON | IN | 46011 | 861053152 | SUPPORT | IN | 501C3 | 7 | CHA | true |
| COMMUNITY HOSPITAL SOUTH INC | ||||||||||
| 1402 E COUNTY LINE ROAD SOUTH | INDIANAPOLIS | IN | 46227 | 351088640 | HOSPITAL | IN | 501C3 | 3 | CHNW | true |
| COMMUNITY HOWARD REGIONAL HEALTH | ||||||||||
| 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | 351865344 | IMAG/HOSP | IN | 501C3 | 9 | CHNW | true |
| COMMUNITY LTC INC | ||||||||||
| 1031 MONTICELLO DRIVE | ANDERSON | IN | 46011 | 351877441 | HLTH CARE | IN | 501C3 | 9 | CHA | true |
| HEALTH INSTITUTE OF INDIANA INC | ||||||||||
| 3660 GUION ROAD | INDIANAPOLIS | IN | 46222 | 352022402 | FITNESS | IN | 501C3 | 9 | CWH | true |
| HOWARD REGIONAL HEALTH SYSTEM FDN | ||||||||||
| PO BOX 9011 | KOKOMO | IN | 46904 | 237309596 | SUPPPORT | IN | 501C3 | 7 | NA | false |
| INDIANA HEART HOSPITAL LLC | ||||||||||
| 8075 NORTH SHADELAND AVENUE | INDIANAPOLIS | IN | 46250 | 352123783 | HOSPITAL | IN | 501C3 | 3 | CHNW | true |
| INDIANAPOLIS OSTEOPATHIC HOSP INC | ||||||||||
| 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | 351094734 | HOSPITAL | IN | 501C3 | 3 | CHNW | true |
| WESTVIEW HOSPITAL FOUNDATION INC | ||||||||||
| 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | 311036451 | SUPPORT | IN | 501C3 | 11B | CWH | true |
Form990 Schedule R Part III Form990ScheduleRPartIII (64 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|
| BROWNSBURG OFFICE CENTER 2 LLP | |||||||||
| 321 E NORTHFIELD | BROWNSBURG | IN | 46112 | 351929859 | LEASING | 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 |
| 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 | N/A | false | false |
| HOWARD REGIONAL SPECIALTY CARE LLC | |||||||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | 371501021 | REHAB | IN | N/A | false | false |
| 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 121ST 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 |
| SURGICARE LLC | |||||||||
| 2907 MCINTIRE DRIVE | BLOOMINGTON | IN | 47403 | 351975122 | SURGERY | IN | N/A | false | false |
| BROWNSBURG OFFICE CENTER 2 LLP | |||||||||
| 321 E NORTHFIELD | BROWNSBURG | IN | 46112 | 351929859 | LEASING | 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 |
| 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 | N/A | false | false |
| HOWARD REGIONAL SPECIALTY CARE LLC | |||||||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | 371501021 | REHAB | IN | N/A | false | false |
| 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 121ST 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 |
| SURGICARE LLC | |||||||||
| 2907 MCINTIRE DRIVE | BLOOMINGTON | IN | 47403 | 351975122 | SURGERY | IN | N/A | false | false |
| BROWNSBURG OFFICE CENTER 2 LLP | |||||||||
| 321 E NORTHFIELD | BROWNSBURG | IN | 46112 | 351929859 | LEASING | 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 |
| 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 | N/A | false | false |
| HOWARD REGIONAL SPECIALTY CARE LLC | |||||||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | 371501021 | REHAB | IN | N/A | false | false |
| 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 121ST 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 |
| SURGICARE LLC | |||||||||
| 2907 MCINTIRE DRIVE | BLOOMINGTON | IN | 47403 | 351975122 | SURGERY | IN | N/A | false | false |
| BROWNSBURG OFFICE CENTER 2 LLP | |||||||||
| 321 E NORTHFIELD | BROWNSBURG | IN | 46112 | 351929859 | LEASING | 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 |
| 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 | N/A | false | false |
| HOWARD REGIONAL SPECIALTY CARE LLC | |||||||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | 371501021 | REHAB | IN | N/A | false | false |
| 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 121ST 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 |
| SURGICARE LLC | |||||||||
| 2907 MCINTIRE DRIVE | BLOOMINGTON | IN | 47403 | 351975122 | SURGERY | IN | N/A | false | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV (24 entries)
| Address Line1AddressForeign/AddressLine1 | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Legal Domicile StateLegalDomicileState |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHN ASSURANCE COMPANY LTD | ||||||||||||
| PO BOX 1051 GT | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | true | |||||
| MIDWEST RACQUETBALL INC | ||||||||||||
| 351396016 | HLTH | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| PILLARS COMMUNITY HOUSING INC | ||||||||||||
| 161652666 | HOUSING | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| VISIONARY ENTERPRISES INC | ||||||||||||
| 351538433 | MGMT SRVS | N/A | true | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VEI MICHIGAN INC | ||||||||||||
| 300097377 | MGMT SRVS | N/A | true | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| WESTVIEW DELIVERY SYSTEM INC | ||||||||||||
| 351910292 | MGMT SRVS | N/A | true | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | ||||
| CHN ASSURANCE COMPANY LTD | ||||||||||||
| PO BOX 1051 GT | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | true | |||||
| MIDWEST RACQUETBALL INC | ||||||||||||
| 351396016 | HLTH | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| PILLARS COMMUNITY HOUSING INC | ||||||||||||
| 161652666 | HOUSING | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| VISIONARY ENTERPRISES INC | ||||||||||||
| 351538433 | MGMT SRVS | N/A | true | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VEI MICHIGAN INC | ||||||||||||
| 300097377 | MGMT SRVS | N/A | true | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| WESTVIEW DELIVERY SYSTEM INC | ||||||||||||
| 351910292 | MGMT SRVS | N/A | true | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | ||||
| CHN ASSURANCE COMPANY LTD | ||||||||||||
| PO BOX 1051 GT | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | true | |||||
| MIDWEST RACQUETBALL INC | ||||||||||||
| 351396016 | HLTH | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| PILLARS COMMUNITY HOUSING INC | ||||||||||||
| 161652666 | HOUSING | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| VISIONARY ENTERPRISES INC | ||||||||||||
| 351538433 | MGMT SRVS | N/A | true | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VEI MICHIGAN INC | ||||||||||||
| 300097377 | MGMT SRVS | N/A | true | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| WESTVIEW DELIVERY SYSTEM INC | ||||||||||||
| 351910292 | MGMT SRVS | N/A | true | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | ||||
| CHN ASSURANCE COMPANY LTD | ||||||||||||
| PO BOX 1051 GT | GRAND CAYMAN | CJ | 980418913 | INSURANCE | CJ | N/A | true | |||||
| MIDWEST RACQUETBALL INC | ||||||||||||
| 351396016 | HLTH | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| PILLARS COMMUNITY HOUSING INC | ||||||||||||
| 161652666 | HOUSING | N/A | true | 3500 S LAFOUNTAIN STREET | KOKOMO | IN | 46902 | IN | ||||
| VISIONARY ENTERPRISES INC | ||||||||||||
| 351538433 | MGMT SRVS | N/A | true | 7330 SHADELAND STATION SUITE 200 | INDIANAPOLIS | IN | 46256 | IN | ||||
| VEI MICHIGAN INC | ||||||||||||
| 300097377 | MGMT SRVS | N/A | true | 940 N MAIN STREET | ANN HARBOR | MI | 48104 | MI | ||||
| WESTVIEW DELIVERY SYSTEM INC | ||||||||||||
| 351910292 | MGMT SRVS | N/A | true | 3630 GUION ROAD | INDIANAPOLIS | IN | 46222 | IN | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (20 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| COMMUNITY HEALTH NETWORK FDN INC | ||
| C | 145458 | BOOK VALUE |
| COMM HOSP OF ANDERSON & MADISON CTY | ||
| K | 653276 | BOOK VALUE |
| COMM HOSP OF ANDERSON & MADISON CTY | ||
| Q | 395000 | BOOK VALUE |
| COMM HOSP OF ANDERSON & MADISON CTY | ||
| R | 232960 | BOOK VALUE |
| COMMUNITY HOSPITAL SOUTH INC | ||
| S | 647272 | BOOK VALUE |
| COMMUNITY WESTVIEW HOSPITAL INC | ||
| R | 117900 | BOOK VALUE |
| INDIANA HEART HOSPITAL LLC | ||
| R | 7002640 | BOOK VALUE |
| VISIONARY ENTERPRISES INC | ||
| P | 22196316 | BOOK VALUE |
| VISIONARY ENTERPRISES INC | ||
| Q | 7360258 | BOOK VALUE |
| VISIONARY ENTERPRISES INC | ||
| K | 4706876 | BOOK VALUE |
| COMMUNITY HEALTH NETWORK FDN INC | ||
| C | 145458 | BOOK VALUE |
| COMM HOSP OF ANDERSON & MADISON CTY | ||
| K | 653276 | BOOK VALUE |
| COMM HOSP OF ANDERSON & MADISON CTY | ||
| Q | 395000 | BOOK VALUE |
| COMM HOSP OF ANDERSON & MADISON CTY | ||
| R | 232960 | BOOK VALUE |
| COMMUNITY HOSPITAL SOUTH INC | ||
| S | 647272 | BOOK VALUE |
| COMMUNITY WESTVIEW HOSPITAL INC | ||
| R | 117900 | BOOK VALUE |
| INDIANA HEART HOSPITAL LLC | ||
| R | 7002640 | BOOK VALUE |
| VISIONARY ENTERPRISES INC | ||
| P | 22196316 | BOOK VALUE |
| VISIONARY ENTERPRISES INC | ||
| Q | 7360258 | BOOK VALUE |
| VISIONARY ENTERPRISES INC | ||
| K | 4706876 | BOOK VALUE |