2012-11-12T12:31:10-06:00 2011-12-31 CASKEY & DAILY PC 4745 STATESMEN DRIVE SUITE C INDIANAPOLIS IN 46250 990 2011-01-01 350983617 COMMUNITY HOSPITALS OF INDIANA INC COMM 3173555822 1500 NORTH RITTER AVENUE INDIANAPOLIS IN 46219 JEFFERY KIRKHAM 3173555822 2012-11-07 true JAMES A CASKEY CPA CFP 3175852647 2012-11-06 2011 2016-02-24 21:20:13Z MICHAEL C BLANCHET 1500 NORTH RITTER AVENUE INDIANAPOLIS IN 46219 847515337 false X WWW.ECOMMUNITY.COM X 1952 IN COMMUNITY HOSPITALS OF INDIANA, INC. ("CHI") IS A 501(C)(3) CORPORATION SERVING THE HEALTH RELATED NEEDS OF THE CITIZENS OF THE INDIANAPOLIS METROPOLITAN AREA AND CENTRAL INDIANA. CHI OPERATES TWO GENERAL ACUTE CARE HOSPITALS AND PROVIDES INPATIENT, OUTPATIENT, EMERGENCY AND AMBULATORY HEALTH CARE SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. 3 2 4781 630 -283575 -283575 3614198 5178632 588793998 609290975 12549777 31710930 53055557 62352073 658013530 708532610 0 0 245806820 271118550 0 0 342553334 317544176 588360154 588662726 69653376 119869884 1170939660 1483674583 619328600 880337052 551611060 603337531 X COMMUNITY HOSPITALS OF INDIANA, INC. ("CHI") IS A 501(C)(3) CORPORATION SERVING THE HEALTH RELATED NEEDS OF THE CITIZENS OF THE INDIANAPOLIS METROPOLITAN AREA AND CENTRAL INDIANA. CHI OPERATES TWO GENERAL ACUTE CARE HOSPITALS AND PROVIDES INPATIENT, OUTPATIENT, EMERGENCY AND AMBULATORY HEALTH CARE SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. false false 384055712 609290975 COMMUNITY HOSPITALS OF INDIANA, INC. OPERATES TWO ACUTE CARE FULL SERVICE HOSPITALS IN INDIANAPOLIS, INDIANA WITH 1,029 LICENSED BEDS. IN 2011, COMMUNITY HOSPITALS SERVED 32,307 INPATIENTS FOR A TOTAL OF 149,793 INPATIENT DAYS OF SERVICE. THE TWO HOSPITALS ALSO PROVIDED 938,906 OUTPATIENT VISITS, WHICH INCLUDED 110,927 EMERGENCY VISITS AND 481,624 MENTAL HEALTH VISITS. COMMUNITY HOSPITALS OFFERS MANY PATIENT FOCUSED HEALTHCARE SERVICES THAT INCLUDE WOMEN AND CHILDREN SERVICES, PEDIATRICS, ONCOLOGY, MENTAL HEALTH SERVICES, NEUROSCIENCES, ORTHOPEDICS, JOINT REPLACEMENT, BREAST CARE SERVICES, SURGERY SERVICES, REHABILITATION SERVICES, HEALTH PROMOTION SERVICES, EMERGENCY SERVICES, AND TRAINING AND EDUCATION FOR HEALTH CARE PROFESSIONALS. 384055712 true true false false false false false false false false true false true true true false false true false false false false false false false false true true false false true true false false false false false false false false true true false false false false false true true true false false true X 229 0 true 4781 true false true CJ false false false false false false false false X 3 2 true true false false true true true true true false false false true true true true true true true true false IN X JEFFERY KIRKHAM 3173555822 1500 N RITTER AVENUE INDIANAPOLIS IN 46219 X MICHAEL C BLANCHET 40.00 X X 500069 0 350826 STEVEN R PLUMP 5.00 X X 0 0 0 KRISTIN T SHERMAN 5.00 X X 0 0 0 TONY LENNEN 5.00 X 0 328925 133178 BARBARA SUMMERS 55.00 X 276662 0 288561 JEFFERY KIRKHAM 55.00 X 271324 0 274763 ROBIN LEDYARD MD 55.00 X 271179 0 140472 JOHN T CUMMINGS MD 50.00 X 1266628 0 525218 DAVID C HALL MD 50.00 X 1016195 0 184196 ROBERT B SLOAN JR MD 50.00 X 959942 0 53164 JILL W DONALDSON MD 50.00 X 730979 0 245150 ROSEMARIE JONES MD 50.00 X 686607 0 487101 STEVE HULTGREN 16.15 X 58325 86099 143914 6037910 415024 2826543 210 true true false CARDINAL HEALTH 2353 PROSPECT DRIVE AURORA IL 60504 PHARMACEUTICALS 34460003 OWENS AND MINOR 12199 COLLECTION CENTER DRIVE CHICAGO IL 60693 MEDICAL SUPPLY 20724239 MID AMERICA CLINICAL LABS 2560 NORTH SHADELAND AVENUE INDIANAPOLIS IN 46219 LAB SERVICES 12245386 ROLLINS CONSTRUCTION 3024 N RIDGEVIEW DRIVE INDIANAPOLIS IN 46226 CONSTRUCTION 11512771 COMMUNITY IMAGING ASSOCIATES 7205 SHADELAND STATION INDIANAPOLIS IN 46256 X-RAY IMAGING 8580285 301 743241 4435391 5178632 PATIENT SERVICES 900099 609290975 609290975 609290975 21702645 21702645 5438874 5438874 5438874 5438874 148450625 540387 138982727 9467898 540387 10008285 10008285 EQUITY INVESTMENT INCOME 900003 21685385 21685385 LEASED EQUIPMENT 532420 8330534 8330534 EHR/EPIC INCENTIVE PAYMENTS 900099 5832207 5832207 21065073 21348648 -283575 56913199 708532610 666487749 -283575 37149804 2373856 205826 2168030 217951674 163284546 54667128 5255398 235980 5019418 31261346 23197171 8064175 14276276 10729908 3546368 2513142 2513142 754534 754534 486200 486200 137003456 58949450 78054006 39515 16942 22573 105068773 99327602 5741171 5480816 2345598 3135218 17448551 12947524 4501027 721285 449458 271827 186115 57796 128319 9445340 9445340 32616633 11120202 21496431 3078680 57723 3020957 PROPERTY TAX 1631734 698325 933409 DUES & SUBSCRIPTIONS 618956 238891 380065 RECRUITMENT 118256 50609 67647 GRANT DISBURSEMENTS 112426 48114 64312 219764 94047 125717 588662726 384055712 204607014 0 60033743 82171501 79330664 89844080 461344 402230 7720914 8001495 5870391 7463136 837879928 458318642 381852222 379561286 336322921 335152652 166595042 340237782 204916 12387312 132547503 228453109 1170939660 1483674583 158412594 146059884 419603642 405863554 5146206 29646206 36166158 298767408 619328600 880337052 X 551611060 603337531 551611060 603337531 1170939660 1483674583 X 119869884 -68143413 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false 4916784 4916784 448727175 174220212 274506963 19617388 7137834 12479554 357105330 269922236 87183094 7513251 7038360 474891 379561286 CLOSELY-HELD EQUITY INTERESTS 340237782 C 340237782 DUE FROM AFFILIATED ENTITIES 180516620 FUNDS HELD BY TRUSTEE 19185980 THIRD PARTY RECEIVABLE 8825768 OTHER RECEIVABLES 7699413 DEFERRED FINANCING COSTS 6647140 CHN ASSURANCE PREMIUM 3111119 OTHER ASSETS 1507823 OVERFUNDED PENSION/RTRMT 959246 228453109 DUE TO AFFILIATES 163048050 UNDERFUNDED PENSION FAS 158 130409058 OTHER LT LIABILITY 4598012 THIRD PARTY SETTLEMENTS 712288 298767408 true true X true X true X true true false true true 29531 15481960 15481960 0.02630 53873 83789720 62815169 20974551 0.03560 83404 99271680 62815169 36456511 0.06190 16 674 9353853 1572848 7781005 0.01320 7 887 9315203 2040279 7274924 0.01240 2 587 123 123 2 1065025 1065025 0.00180 2 3520 3520 29 2148 19737724 3613127 16124597 0.02740 29 85552 119009404 66428296 52581108 0.08930 1 6 1698 1698 13 13044 9238 9238 1 84794 28895 55899 0.00010 6 1097 12904 1000 11904 32 75342 4406168 408510 3997658 0.00680 11 603 1020906 128442 892464 0.00150 64 90092 5535708 566847 4968861 0.00840 true 11635273 124042757 133161155 -9118398 X true true NORTHPOINT PEDIATRIC PROVIDE PHYSICIANS SERVICES 0.49000 0.51000 COMMUNITY IMAGING PROVIDE MEDICAL IMAGING SERVICES 0.50000 0.50000 IN SPECIALTY GROUP PROVIDE SPECIALTY PHYSICIAN SERVICES 0.70000 0.30000 EAST CAMPUS SURG CTR PROVIDE OUTPATIENT SURGERY SERVICES 0.51000 0.49000 MID AM CLINCIAL LABS PROVIDE LABORATORY SERVICES 0.22000 NORTH CAMPUS SURG PROVIDE OUTPATIENT SURGERY SERVICES 0.49000 MICHIGAN SURGERY INV PROVIDE OUTPATIENT SURGERY SERVICES 0.40000 UNITED HOSPITAL SERV PROVIDE LINEN SERVICES 0.13000 HAMILTON SURGERY CTR PROVIDE OUTPATIENT SURGERY SERVICES 0.11000 0.49000 INDPLS ENDOSCOPY CTR PROVIDE MEDICAL SERVICES 0.19000 0.49000 2 1 COMMUNITY HOSPITAL NORTH

7150 CLEARVISTA DRIVE INDIANAPOLIS IN 46256

X X X X 2 COMMUNITY HOSPITAL EAST

1500 NORTH RITTER AVENUE INDIANAPOLIS IN 46219

X X X X COMMUNITY HOSPITAL NORTH 1 true X X X X X X X X X X 11 true true true X X X X X X X X X X X X false true true 200.0 true 300.0 true X X true true X X X X X true X X false true X false false COMMUNITY HOSPITAL EAST 2 true X X X X X X X X X X 11 true true true X X X X X X X X X X X X false true true 200.0 true 300.0 true X X true true X X X X X true X X false true X false false 67 COMMUNITY REGIONAL CANCER CENTER

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HEALTH CARE COMMUNITY IMAGING CENTER NORTH

8181 CLEARVISTA PKWY INDIANAPOLIS IN 46256

HEALTH CARE COMMUNITY BREAST CARE

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HEALTH CARE SLEEP WAKE DISORDERS

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HEALTH CARE COMMUNITY IMAGING CTR NOBLESVILLE

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DIAGNOSTIC CENTER CHE SLEEP WAKE DISORDERS

1400 N RITTER AVENUE 481 INDIANAPOLIS IN 46219

HEALTH CARE REHAB & SPORTS MEDICINE

2040 N SHADELAND AVENUE INDIANAPOLIS IN 46219

REHABILITATION MATERNAL FETAL MEDICINE

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HEALTH CARE COMMUNITY NEUROSURGERY

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HEALTH CARE HRC OP THERAPY

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HEALTH CARE REHAB & SPORTS MEDICINE

6922 HILLSDALE COURT INDIANAPOLIS IN 46250

REHABILITATION FAMILY PRACTICE CENTER

10122 E 10TH STREET 100 INDIANAPOLIS IN 46229

HEALTH CARE GALLAHUE ADDICTIONS

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HEALTH CARE GMHC LAWRENCE OP

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HEALTH CARE WARREN OP OFFICE

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HEALTH CARE MEDCHECK CASTLETON

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HEALTH CARE REHAB & SPORTS MEDICINE

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REHABILITATION GALLAHUE MENTAL HEALTH SERVICES

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HEALTH CARE GALLAHUE MENTAL HEALTH SERVICES

2040 N SHADELAND AVENUE SUITE 250 INDIANAPOLIS IN 46219

HEALTH CARE COMMUNITY IMAGING CENTER

11911 N MERIDIAN STREET 175 CARMEL IN 46032

DIAGNOSTIC CENTER GALLAHUE MENTAL HEALTH SERVICES

7 E HENDRICKS STREET SHELBYVILLE IN 46176

HEALTH CARE GALLAHUE MENTAL HEALTH SERVICES

2201 HILLCREST DRIVE ANDERSON IN 46012

HEALTH CARE COMMUNITY SPINE CENTER

7120 E CLEARVISTA DRIVE 1500 INDIANAPOLIS IN 46256

HEALTH CARE COMMUNITY GENERAL SURGEONS

1400 N RITTER AVENUE 330 INDIANAPOLIS IN 46219

HEALTH CARE SLEEP WAKE DISORDERS

11911 N MERIDIAN STREET 140 CARMEL IN 46032

HEALTH CARE MEDCHECK CARMEL

1911 N MERIDIAN STREET 150 CARMEL IN 46032

HEALTH CARE MEDCHECK GREENWOOD

1664 W SMITH VALLEY ROAD SUITE B GREENWOOD IN 46142

HEALTH CARE MEDCHECK EAST

1703 N POST ROAD INDIANAPOLIS IN 46219

HEALTH CARE ORTHOPEDIC SURGEONS OF CENTRAL IN

1400 N RITTER AVENUE 510 INDIANAPOLIS IN 46219

HEALTH CARE COMM OCCUPATIONAL HEALTH CENTER

1709 N POST ROAD INDIANAPOLIS IN 46219

HEALTH CARE DAY THERAPY

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HEALTH CARE COMMUNITY BARIATRICS SURGEONS

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HEALTH CARE FORGE AHEAD CLUBHOUSE

1640 N RITTER AVENUE INDIANAPOLIS IN 46201

HEALTH CARE OUTPATIENT WORK COMP REHAB

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HEALTH CARE WORK COMP REHAB

1713 N POST ROAD INDIANAPOLIS IN 46219

REHABILITATION WORK COMP REHAB

6922 HILLSDALE COURT INDIANAPOLIS IN 46250

REHABILITATION HRC NEUROPSYCH SERVICES

7250 CLEARVISTA DRIVE 327 INDIANAPOLIS IN 46256

HEALTH CARE HRC NEUROPSYCHOLOGY

8501 E 56TH STREET 140 INDIANAPOLIS IN 46216

HEALTH CARE MEDCHECK ANDERSON

1030 S SCATTERFIELD ROAD ANDERSON IN 46012

HEALTH CARE OCCUPATIONAL HEALTH

8177 CLEARVISTA PKWY INDIANAPOLIS IN 46256

HEALTH CARE SHELBYVILLE GROUP HOME

18 E MECHANIC STREET SHELBYVILLE IN 46176

HEALTH CARE NORTH RIVER CROSS ORTHOPEDICS

18051 RIVER ROAD NOBLESVILLE IN 46062

HEALTH CARE COMMUNITY SLEEP SPECIALISTS

7250 CLEARVISTA DRIVE 330 INDIANAPOLIS IN 46256

HEALTH CARE GREENFIELD OCCUPATIONAL HEALTH

124 W MUSKEGAN DRIVE GREENFIELD IN 46140

HEALTH CARE WOMEN'S & CHILDREN'S CARE CENTER

2040 N SHADELAND AVENUE SUITE 300 INDIANAPOLIS IN 46219

HEALTH CARE OLIO ROAD IMAGING CENTER

13121 OLIO ROAD 110 FISHERS IN 46037

DIAGNOSTIC CENTER REHAB & SPORTS MEDICINE

10122 E 10TH STREET 225 INDIANAPOLIS IN 46229

REHABILITATION YOUTH DAY PROGRAM

6950 HILLSDALE COURT INDIANAPOLIS IN 46250

HEALTH CARE COMM REPRODUCTIVE ENDOCRINOLOGY

7250 CLEARVISTA DRIVE SUITE 365 INDIANAPOLIS IN 46256

HEALTH CARE ASSISTED FERTILITY

8040 CLEARVISTA PKWY 510 INDIANAPOLIS IN 46256

HEALTH CARE OCCUPATIONAL HEALTH

1030 S SCATTERFIELD ROAD ANDERSON IN 46012

HEALTH CARE REHAB & SPORTS MEDICINE

11911 N MERIDIAN STREET 170 CARMEL IN 46032

REHABILITATION REHAB & SPORTS MEDICINE

740 W GREEN MEADOWS DRIVE 120 GREENFIELD IN 46140

REHABILITATION COMMUNITY IMAGING CENTER

740 W GREEN MEADOWS DRIVE 120 GREENFIELD IN 46140

DIAGNOSTIC CENTER EVENING THERAPY

6950 HILLSDALE COURT INDIANAPOLIS IN 46250

HEALTH CARE COMMUNITY SLEEP SPECIALISTS

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HEALTH CARE MEDCHECK EXPRESS FISHERS

8300 E 96TH STREET FISHERS IN 46038

HEALTH CARE MEDCHECK EXPRESS NOBLESVILLE

16865 CLOVER ROAD NOBLESVILLE IN 46060

HEALTH CARE CHN BARIATRIC SERVICES

7250 CLEARVISTA DRIVE 355 INDIANAPOLIS IN 46256

HEALTH CARE MEDCHECK EXPRESS INDIANAPOLIS

10617 E WASHINGTON STREET INDIANAPOLIS IN 46229

HEALTH CARE LIFECHECK

7250 CLEARVISTA DRIVE 227 INDIANAPOLIS IN 46256

HEALTH CARE BEHAVIORAL MEDICINE

6950 HILLSDALE COURT INDIANAPOLIS IN 46250

HEALTH CARE GMHC OUTPATIENT ADDICTION TREATMENT

145 GREEN MEADOWS DRIVE GREENFIELD IN 46140

HEALTH CARE MEDCHECK NOBLESVILLE

9669 E 146TH STREET 100 NOBLESVILLE IN 46060

HEALTH CARE HOOK REHAB SILP HOME

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REHABILITATION BREAST HEALTH NAVIGATORS

1550 E COUNTY LINE ROAD 325 INDIANAPOLIS IN 46227

HEALTH CARE GMHC HANCOCK INTENSIVE ADDICTION TR

145 GREEN MEADOWS DRIVE GREENFIELD IN 46140

HEALTH CARE RELATED ORGANIZATION INFORMATION PART I LINE 6A A COMMUNITY BENEFIT REPORT IS COMPLETED FOR THE COMMUNITY HEALTH NETWORK AS A WHOLE COMMUNITY HOSPITALS OF INDIANA INC IS INCLUDED WITHIN THE NETWORK COMMUNITY BENEFIT REPORT COSTING METHODOLOGY EXPLANATION PART I LINE 7 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 I LINE 7G SUBSIDIZED HEALTH SERVICES EXPLANATION SUBSIDIZED HEALTH CARE REPORTED DOES NOT INCLUDE COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS BAD DEBT EXPENSE EXPLANATION PART III LINE 4 THE COST TO CHARGE RATIO UTILIZED FOR PURPOSES OF REPORTING BAD DEBT COSTS WAS DERIVED FROM WORKSHEET 2 AND IS BASED ON THE ORGANIZATIONS AUDITED FINANCIAL STATEMENTS COMMUNITY HOSPITALS OF INDIANA INC UTILIZES AN AUTOMATED SOFTWARE SOLUTION TO ASSIST IN DETERMINING PATIENTS ELIGIBLE FOR FREE CARE AS A RESULT OF THE IMPLEMENTATION OF THIS AUTOMATED SOLUTION THERE IS VERY LITTLE BAD DEBT RECORDED FOR PATIENTS WHO WOULD BE ELIGIBLE FOR FREE CARE UNDER THE NETWORK POLICY THE AUDITED FINANCIAL STATEMENTS CONTAIN THE FOLLOWING TEXT WITHIN THE FOOTNOTES TO DESCRIBE BAD DEBT EXPENSE THE NETWORKS ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS 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 DOUBTFUL ACCOUNTS PROVISION FOR BAD DEBTS AND PROVISION FOR CHARITY MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE THE NETWORK ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS PROVISION FOR BAD DEBTS AND CHARITY FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COINSURANCES FOR RECEIVABLES ASSOCIATED WITH SELFPAY PATIENTS 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 CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CHNW CHS VEI AND IHH ACCOUNTS THAT ARE SENT TO COLLECTION COMPANIES THE ACCOUNTS REMAIN AS ACCOUNTS RECEIVABLE ON THE BALANCE SHEET THESE ACCOUNTS ARE NOT WRITTEN OFF UNLESS RETURNED FROM THE COLLECTION COMPANY AS SUCH THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS SIGNIFICANT FOR THIS COMPONENT OF THE ACCOUNTS RECEIVABLE THE NETWORKS ALLOWANCE FOR DOUBTFUL ACCOUNTS INCREASED BY 956 IN FISCAL YEAR 2011 FROM FISCAL YEAR 2010 THIS INCREASE IS THE RESULT OF ACCOUNTS THAT WERE TRANSFERRED TO THE COLLECTION COMPANY DURING FISCAL YEAR 2011 FOR CHNW CHS VEI AND IHH ACCOUNTS TRANSFERRED TO COLLECTIONS DURING FISCAL YEAR 2011 REPRESENTED 1086 OF THE TOTAL GROSS ACCOUNTS RECEIVABLE IN FISCAL YEAR 2011 WESTVIEW WAS CONSOLIDATED ONTO THE NETWORK FINANCIAL STATEMENTS WHICH ATTRIBUTED TO 2985000 OF THE OVERALL INCREASE FROM FISCAL YEAR 2010 THE NETWORK HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2011 OR 2010 THE NETWORK RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRDPARTY 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 NETWORKS 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 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 WRITTENOFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AFTER EXHAUSTING COLLECTION EFFORTS ANY SUBSEQUENT RECOVERIES ARE RECORDED AGAINST THE PROVISION FOR BAD DEBTS THE NETWORK MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES THE NETWORK PROVIDES CHARITY CARE TO PATIENTS WHOSE INCOME LEVEL IS BELOW 200 OF THE FEDERAL POVERTY LEVEL EFFECTIVE JANUARY 1 2010 THE NETWORK EARLY ADOPTED ACCOUNTING STANDARDS UPDATE ASU NO 201023 HEALTH CARE ENTITIES TOPIC 954 MEASURING CHARITY CARE FOR DISCLOSURE AS A RESULT OF ASU NO 201023 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 INCLUDES THE AMOUNT OF COSTS FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY AND WAS 26939000 AND 25693000 FOR THE YEARS ENDED DECEMBER 31 2011 AND 2010 RESPECTIVELY CHARITY CARE COST WAS DETERMINED ON THE APPLICATION OF THE ASSOCIATED COSTTO CHARGE RATIOS MEDICARE EXPLANATION PART III LINE 8 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 15514536 AS SUCH THE TOTAL MEDICARE SHORTFALL FOR ALL MEDICARE PROGRAMS IS 24632934 MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS COMMUNITY BENEFIT BECAUSE MEDICARE REPRESENTS 3021 OF THE OVERALL PAYER MIX FOR COMMUNITY HOSPITALS OF INDIANA INC COLLECTION PRACTICES EXPLANATION PART III LINE 9B SEE ATTACHED FINANCIAL ASSISTANCE POLICY ADDITIONAL INFORMATION PART VI PART VI ITEMS 2 THROUGH 5 ARE DISCUSSED WITHIN THE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT FOR A COPY OF THIS REPORT PLEASE CONTACT HOLLY MILLARD AT 317 3555860 PART VI ITEM 6 AFFILIATED HEALTH CARE SYSTEM COMMUNITY HOSPITALS OF INDIANA INC CHI IS PART OF AN AFFILIATED HEALTH CARE SYSTEM SEE THE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT FOR HOW CHI IS INVOLVED IN PROMOTING THE HEALTH OF THE COMMUNITY IT SERVES PART VI ITEM 7 STATE FILING OF COMMUNITY BENEFIT REPORT INDIANA COMMUNITY HOSPITAL NORTH LINE NUMBER 1 PART V LINE 1J PART V LINE 1J SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT COMMUNITY HOSPITAL NORTH LINE NUMBER 1 PART V LINE 3 PART V LINE 3 SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT COMMUNITY HOSPITAL NORTH LINE NUMBER 1 PART V LINE 4 PART V LINE 4 SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT COMMUNITY HOSPITAL NORTH LINE NUMBER 1 PART V LINE 5C PART V LINE 5C SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT COMMUNITY HOSPITAL NORTH LINE NUMBER 1 PART V LINE 6I PART V LINE 6I SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT COMMUNITY HOSPITAL NORTH LINE NUMBER 1 PART V LINE 7 PART V LINE 7 SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT COMMUNITY HOSPITAL NORTH LINE NUMBER 1 PART V LINE 19D PART V LINE 19D THE UNINSURED DISCOUNT WAS DETERMINED UTILIZING THE NETWORKS TOP COMMERICIAL PAYORS PER THE NETWORKS AUDITED FINANCIAL STATEMENTS REGARDING UNINSURED DISCOUNTS COSTS FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THE NETWORKS UNINSURED DISCOUNT POLICY APPROXIMATED 6956000 AND 5417000 FOR THE YEARS ENDED DECEMBER 31 2011 AND 2010 RESPECTIVELY UNINSURED DISCOUNTS REPRESENT A STANDARD DISCOUNT ON CHARGES AS IT RELATES TO PATIENTS WHO HAVE NO INSURANCE COVERAGE UNINSURED DISCOUNT COST WAS DETERMINED BASED ON THE APPLICATION OF THE ASSOCIATED COSTTOCHARGE RATIOS TO CHARGES COMMUNITY HOSPITAL EAST LINE NUMBER 2 PART V LINE 1J PART V LINE 1J SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT COMMUNITY HOSPITAL EAST LINE NUMBER 2 PART V LINE 3 PART V LINE 3 SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT COMMUNITY HOSPITAL EAST LINE NUMBER 2 PART V LINE 4 PART V LINE 4 SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT COMMUNITY HOSPITAL EAST LINE NUMBER 2 PART V LINE 5C PART V LINE 5C SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT COMMUNITY HOSPITAL EAST LINE NUMBER 2 PART V LINE 6I PART V LINE 6I SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT COMMUNITY HOSPITAL EAST LINE NUMBER 2 PART V LINE 7 PART V LINE 7 SEE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT COMMUNITY HOSPITAL EAST LINE NUMBER 2 PART V LINE 19D PART V LINE 19D THE UNINSURED DISCOUNT WAS DETERMINED UTILIZING THE NETWORKS TOP COMMERICIAL PAYORS PER THE NETWORKS AUDITED FINANCIAL STATEMENTS REGARDING UNINSURED DISCOUNTS COSTS FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THE NETWORKS UNINSURED DISCOUNT POLICY APPROXIMATED 6956000 AND 5417000 FOR THE YEARS ENDED DECEMBER 31 2011 AND 2010 RESPECTIVELY UNINSURED DISCOUNTS REPRESENT A STANDARD DISCOUNT ON CHARGES AS IT RELATES TO PATIENTS WHO HAVE NO INSURANCE COVERAGE UNINSURED DISCOUNT COST WAS DETERMINED BASED ON THE APPLICATION OF THE ASSOCIATED COSTTOCHARGE RATIOS TO CHARGES false false false true false false false true false MICHAEL C BLANCHET 489882 10187 343806 7020 850895 TONY LENNEN 327130 1795 108763 24415 462103 BARBARA SUMMERS 275590 1072 268066 20495 565223 JEFFERY KIRKHAM 269875 1449 252298 22465 546087 ROBIN LEDYARD MD 269713 1466 117759 22713 411651 JOHN T CUMMINGS MD 788638 160775 317215 497412 27806 1791846 315993 DAVID C HALL MD 892508 105600 18087 151039 33157 1200391 57017 ROBERT B SLOAN JR MD 894645 65297 31813 21351 1013106 JILL W DONALDSON MD 651815 45995 33169 223602 21548 976129 ROSEMARIE JONES MD 563482 76317 46808 487101 1173708 STEVE HULTGREN 57901 85499 424 600 49717 76892 7080 10225 115122 173216 RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION SCHEDULE J, PAGE 1, PART I, LINE 3 COMMUNITY HOSPITALS OF INDIANA, INC. ("CHI") 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. COMPENSATION CONTINGENT UPON REVENUES OF ORGANIZATION SCHEDULE J, PAGE 1, PART I, LINE 5A DR. JOHN CUMMINGS, DR. DAVID HALL, DR. JILL DONALDSON, AND DR. ROSEMARIE JONES ARE ELIGIBLE TO PARTICIPATE IN CHI'S INCENTIVE COMPENSATION PLAN. CHI 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, CHI (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. NON-FIXED PAYMENTS PROVIDED SCHEDULE J, PAGE 1, PART I, LINE 7 COMMUNITY HOSPITALS OF INDIANA, INC., 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. IN HLTH FACILITY FINANCING AUTHORIT 351611409 45479QAU3 2005-05-04 157491981 NORTH HOSP EXPANSION false false false IN HLTH FACILITY FINANCING AUTHORIT 351611409 45479QAY5 2005-05-04 37500000 NORTH HOSP EXPANSION false false false INDIANA FINANCE AUTHORITY 351602316 45471AAM4 2009-06-30 100000000 SOUTH HOSP EXPANSION false false false 11335000 159591906 10229475 11119328 1453597 3768763 133020743 2007 false false true true 3500000 37500020 1838231 345682 216893 35099214 2007 false false true true 2060000 100013940 842000 499875 98672065 2010 false false true true false true true true true true 0.01440 0.01440 true false true true true true true 0.01440 0.01440 true false true true true true true 0.00840 0.00840 true false false false true FSA CAPITAL 2.3 true true false false true false true FSA CAPITAL 2.3 true true false false true false false false true X DIFFERENCES IN ISSUE PRICE EXPLANATION SCHEDULE K IN HLTH FACILITY FINANCING AUTHORIT PART II LINE 3A ISSUE PRICE XXX-XX-XXXX INTEREST EARNED 2099925 IN HLTH FACILITY FINANCING AUTHORIT PART II LINE 3B ISSUE PRICE 37500000 INTEREST EARNED 20 INDIANA FINANCE AUTHORITY PART II LINE 3C ISSUE PRICE 100000000 INTEREST EARNED 13940 THOMAS LEDYARD MD FAMILY MEMBER 184018 WAGES false INDIANA PROHEALTH NETWORK INC SHARE BD MEMBER 85547201 SERVICE REVENUE false ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION COMMUNITY HOSPITALS OF INDIANA, INC. ("CHI") IS A 501(C)(3) CORPORATION SERVING THE HEALTH RELATED NEEDS OF THE CITIZENS OF THE INDIANAPOLIS METROPOLITAN AREA AND CENTRAL INDIANA. CHI OPERATES TWO GENERAL ACUTE CARE HOSPITALS AND PROVIDES INPATIENT, OUTPATIENT, EMERGENCY AND AMBULATORY HEALTH CARE SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. ADDITIONAL INFORMATION FORM 990 FORM 990, PART I, LINE 4 - INDEPENDENT VOTING MEMBERS CHI IS AN AFFILIATE OF COMMUNITY HEALTH NETWORK ("THE NETWORK"), AN INTEGRATED HEALTH DELIVERY SYSTEM. CHI, TOGETHER WITH THE OTHER TAX-EXEMPT AFFILIATES OF THE NETWORK, IS CONTROLLED BY A TAX-EXEMPT PARENT ORGANIZATION, COMMUNITY HEALTH NETWORK, INC. ("CHNW"). CHNW EXERCISES CONTROL OVER CHI THROUGH A SERIES OF GOVERNANCE RIGHTS: A) CHNW IS THE SOLE MEMBER OF CHI; B) CHNW HAS THE AUTHORITY TO APPROVE THREE-FOURTHS OF THE DIRECTORS THAT ARE ELECTED TO CHI'S BOARD OF DIRECTORS; C) CHI HAS DELEGATED EXCLUSIVE AUTHORITY TO 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; D) CHNW MUST APPROVE ANY MODIFICATION, REPEAL, AMENDMENT, OR RESTATEMENT OF CHI'S ARTICLES OF INCORPORATION; AND E) CHNW MUST APPROVE ANY CLOSURE OF A HOSPITAL THAT IS OWNED BY CHI OR THE SALE OR DISPOSITION OF SUBSTANTIALLY ALL OF CHI'S ASSETS. WITH REGARD TO EXECUTIVE COMPENSATION, CHNW HAS DELEGATED AUTHORITY TO REVIEW AND APPROVE EXECUTIVE COMPENSATION, INCLUDING CHI'S EXECUTIVES, TO A NETWORK EXECUTIVE COMPENSATION COMMITTEE COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS. IN SUM, CHI HAS REMOVED ANY RISK OF INAPPROPRIATE RELATED PARTY TRANSACTIONS BY DELEGATING (THROUGH CHNW) ITS EXECUTIVE COMPENSATION DECISIONS TO A NETWORK EXECUTIVE COMPENSATION COMMITTEE AND ITS CONFLICT OF INTEREST DECISIONS TO A NETWORK AUDIT COMMITTEE, WITH EACH COMMITTEE COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS. CHI'S PHYSICIANS CONSTITUTE A SECOND CLASS OF MEMBERS. AS A CLASS, THE PHYSICIANS HAVE THE FOLLOWING RIGHTS: A) TO ELECT ONE-FOURTH OF THE BOARD OF DIRECTORS OF CHI, B) TO APPROVE ANY MODIFICATION, REPEAL, AMENDMENT, OR RESTATEMENT OF CHI'S ARTICLES OF INCORPORATION, AND C) TO APPROVE ANY CLOSURE OF A HOSPITAL THAT IS OWNED BY CHI OR THE SALE OR DISPOSITION OF SUBSTANTIALLY ALL OF CHI'S ASSETS. FORM 990, PART I, LINE 5 - NUMBER OF EMPLOYEES CHI EMPLOYEES ARE LEASED FROM COMMUNITY HEALTH NETWORK, INC. ADDITIONAL INFORMATION FORM 990, PART V FORM 990, PART V, LINE 3B - FILING FORM 990-T FORM 990-T IS BEING FILED TO SUPPPORT THE NET OPERATING LOSS DEDUCTION. FINANCIAL ACCOUNTS IN FOREIGN COUNTRIES FORM 990, PART V, LINE 4B CAYMAN ISLANDS 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 CHI'S DIRECTORS, OFFICERS, AND KEY EMPLOYEES SERVE IN AN EXECUTIVE ROLE FOR OTHER TAX-EXEMPT AND TAXABLE AFFILIATES THROUGHOUT THE NETWORK. ALL CHI'S DIRECTORS AND/OR OFFICERS ALSO SERVE AS DIRECTORS AND/OR OFFICERS OF COMMUNITY HOSPITAL SOUTH, INC. IN ADDITION, THE FOLLOWING DIRECTORS AND/OR OFFICERS SERVE AS DIRECTORS AND/OR OFFICERS OF THE FOLLOWING ORGANIZATIONS: MICHAEL C. BLANCHET - COMMUNITY HEALTH NETWORK, INC. - COMMUNITY HOME HEALTH SERVICES, INC. - INDIANA PROHEALTH NETWORK, INC. STEVEN R. PLUMP - COMMUNITY HEALTH NETWORK, INC. KRISTIN T. SHERMAN - COMMUNITY HEALTH NETWORK, INC. MANAGEMENT DELEGATED FORM 990, PAGE 6, PART VI, LINE 3 CHI HAS DELEGATED EXCLUSIVE AUTHORITY TO 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. 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, CHI HAS DELEGATED AUTHORITY FOR AUDIT, COMPLIANCE, AND EXECUTIVE COMPENSATION TO CHNW. CHNW'S BOARD OF DIRECTORS HAS DELEGATED AUTHORITY FOR THE REVIEW OF CHI'S FORM 990 TO TWO COMMITTEES COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS: A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE COMPENSATION ASPECTS OF CHI'S FORM 990, AND B) THE NETWORK FINANCE COMMITTEE REVIEWED THE REMAINDER OF THE CHI'S FORM 990. IN ADDITION, CHI'S OUTSIDE ACCOUNTING FIRM AND LAW FIRM REVIEWED THE FORM 990 PRIOR TO FILING. CHI AND CHNW UTILIZED THIS PROCESS TO ENSURE THAT CHI'S FORM 990 RECEIVED SUBSTANTIVE REVIEW BY DIRECTORS AND PROFESSIONALS WITH SPECIFIC KNOWLEDGE OF CHI'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, CHI HAS DELEGATED AUTHORITY FOR AUDIT AND COMPLIANCE TO CHNW. CHNW HAS ADOPTED A CONFLICT OF INTEREST POLICY THAT APPLIES TO EVERY TAX-EXEMPT ORGANIZATION WITHIN THE NETWORK, INCLUDING CHI. 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 CHI. 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 CHI, 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 CHI. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A AS DISCUSSED IN PART I, LINE 4, CHI HAS DELEGATED AUTHORITY FOR EXECUTIVE COMPENSATION TO CHNW. CHNW HAS ADOPTED AN EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY THAT APPLIES TO CHI. THE PURPOSE OF THE POLICY IS TO ENSURE THAT CHI'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 CHI'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 2011, THE NETWORK EXECUTIVE COMPENSATION COMMITTEE FOLLOWED THIS PROCESS FOR ALL CHIEF EXECUTIVE OFFICERS FOR ALL NETWORK ENTITIES; THE NETWORK CHIEF FINANCIAL OFFICER; THE NETWORK VICE PRESIDENT OF HUMAN RESOURCES; THE NETWORK VICE PRESIDENT OF MEDICAL AND ACADEMIC AFFAIRS; THE NETWORK VICE PRESIDENT OF LEGAL SERVICES; THE NETWORK CHIEF INFORMATION OFFICER; AND THE VICE PRESIDENT OF BUSINESS DEVELOPMENT AND MARKETING. FOR ALL POSITIONS REPRESENTING MANAGER AND ABOVE, THE CHIEF EXECUTIVE OFFICERS, CHIEF FINANCIAL OFFICERS, AND HUMAN RESOURCES REPRESENTATIVES FOR ALL NETWORK ENTITIES FOLLOWED A PROCESS WHEREBY 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 A SUBSIDIARY OF CHNW, CHI HAS ADOPTED THE NETWORK CONFLICT OF INTEREST POLICY. WHILE THIS POLICY IS NOT AVAILABLE TO THE PUBLIC, THE NETWORK'S DEFINITION OF 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) CHI 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. CHI 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. ADDITIONAL INFORMATION FORM 990, PART VII FORM 990, PART VII - AVERAGE HOURS WORKED FOR RELATED ORGANIZATION MICHAEL C. BLANCHET - 20 STEVE HULTGREN - 23.85 JEFFERY KIRKHAM - 10 TONY LENNEN - 50 OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 UNDERFUNDED PENSION LIABILITY (102,506,524) INVESTMENT MARKET VALUE ( 41,226,210) EQUITY INVESTMENT NON-CONTROLLING INTEREST ( 248,414) EQUITY CONTRIBUTION ( 18,100,000) TRANSFER OF FUND BALANCE FROM MERGER OF COMMUNITY HEALTH NETWORK, INC. ("CHNW") 93,937,735 TOTAL ( 68,143,413) EFFECTIVE DECEMBER 31, 2011, CHNW WAS MERGED INTO CHI. 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CENTER LLC Q 338959 BOOK VALUE NORTH CAMPUS SURGERY CENTER LLC R 479122 BOOK VALUE VISIONARY ENTERPRISES INC A 1094287 BOOK VALUE VISIONARY ENTERPRISES INC J 3829958 BOOK VALUE VISIONARY ENTERPRISES INC O 12545439 BOOK VALUE VISIONARY ENTERPRISES INC P 2132371 BOOK VALUE VISIONARY ENTERPRISES INC Q 481589 BOOK VALUE VISIONARY ENTERPRISES INC R 1117125 BOOK VALUE INDIANAPOLIS OSTEOPATHIC HOSPITAL P 65216 BOOK VALUE COMMUNITY HEALTH NETWORK FOUNDATION C 743241 BOOK VALUE COMMUNITY HEALTH NETWORK FOUNDATION G 182000 BOOK VALUE COMMUNITY HEALTH NETWORK FOUNDATION R 1474915 BOOK VALUE COMMUNITY HEALTH NETWORK FOUNDATION J 39234 BOOK VALUE COMMUNITY HOME HEALTH SERVICES INC O 261620 BOOK VALUE COMMUNITY HOME HEALTH SERVICES INC P 694551 BOOK VALUE COMMUNITY HOME HEALTH SERVICES INC Q 96781 BOOK VALUE COMMUNITY HOME HEALTH SERVICES INC R 130000 BOOK VALUE COMM HOSP OF ANDERSON & MADISON CTY P 1636650 BOOK VALUE COMM HOSP OF ANDERSON & MADISON CTY Q 210682 BOOK VALUE COMMUNITY HOSPITAL SOUTH 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HEALTH NETWORK FOUNDATION J 39234 BOOK VALUE COMMUNITY HOME HEALTH SERVICES INC O 261620 BOOK VALUE COMMUNITY HOME HEALTH SERVICES INC P 694551 BOOK VALUE COMMUNITY HOME HEALTH SERVICES INC Q 96781 BOOK VALUE COMMUNITY HOME HEALTH SERVICES INC R 130000 BOOK VALUE COMM HOSP OF ANDERSON & MADISON CTY P 1636650 BOOK VALUE COMM HOSP OF ANDERSON & MADISON CTY Q 210682 BOOK VALUE COMMUNITY HOSPITAL SOUTH INC R 66016487 BOOK VALUE COMMUNITY PHYSICIANS OF IN INC B 30564245 BOOK VALUE COMMUNITY PHYSICIANS OF IN INC R 23216298 BOOK VALUE CHN ASSURANCE COMPANY LTD O 1336435 BOOK VALUE CHN ASSURANCE COMPANY LTD Q 1593040 BOOK VALUE EAST CAMPUS SURGERY CENTER LLC Q 189360 BOOK VALUE INDIANA HEART HOSPITAL LLC A 3971634 BOOK VALUE INDIANA HEART HOSPITAL LLC O 1210748 BOOK VALUE INDIANA HEART HOSPITAL LLC P 3228168 BOOK VALUE INDIANA HEART HOSPITAL LLC R 106267331 BOOK VALUE INDIANA PROHEALTH NETWORK INC O 26852919 BOOK VALUE INDIANA PROHEALTH NETWORK INC P 49777094 BOOK VALUE INDIANA PROHEALTH NETWORK INC R 8917188 BOOK VALUE MICHIGAN SURGERY INVESTMENT LLC A 261538 BOOK VALUE NORTH CAMPUS SURGERY CENTER LLC Q 338959 BOOK VALUE NORTH CAMPUS SURGERY CENTER LLC R 479122 BOOK VALUE VISIONARY ENTERPRISES INC A 1094287 BOOK VALUE VISIONARY ENTERPRISES INC J 3829958 BOOK VALUE VISIONARY ENTERPRISES INC O 12545439 BOOK VALUE VISIONARY ENTERPRISES INC P 2132371 BOOK VALUE VISIONARY ENTERPRISES INC Q 481589 BOOK VALUE VISIONARY ENTERPRISES INC R 1117125 BOOK VALUE INDIANAPOLIS OSTEOPATHIC HOSPITAL P 65216 BOOK VALUE