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Nonprofiteer
← COMMUNITY PHYSICIANS OF INDIANA INC

Form 990 for tax year 2022

Filed by COMMUNITY PHYSICIANS OF INDIANA INC.

Totals

Total revenue
$403,533,241
Total expenses
$856,527,816
Contributions and grants received
$14,628,700
Grants paid
$0
Program services expenses (Part IX)
$703,845,588
Management and general expenses
$152,682,228
Fundraising expenses
$0
Program service expenses (Part III)
$703,845,588

Program services were 82.2% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • BRYAN MILLS

    DIRECTOR

    Total calculated
    $2,533,482
    From this org
    $0
    From related orgs
    $2,112,016
    Other
    $421,466
    Hours/week
    2 + 58 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,357,500 related
    Bonus
    $0 + $731,897 related
    Other
    $0 + $22,619 related
    Deferred
    $0 + $393,904 related
    Nontaxable benefits
    $0 + $27,562 related
    Filer's total
    $0 + $2,533,482 related

  • RAMARAO YELETI MD

    DIRECTOR

    Total calculated
    $1,479,296
    From this org
    $0
    From related orgs
    $1,289,408
    Other
    $189,888
    Hours/week
    2 + 58 related

    Schedule J breakdown matched by us

    Base
    $0 + $799,781 related
    Bonus
    $0 + $344,549 related
    Other
    $0 + $145,078 related
    Deferred
    $0 + $154,168 related
    Nontaxable benefits
    $0 + $35,720 related
    Filer's total
    $0 + $1,479,296 related

  • MICHAEL ROBERTSON MD

    DIRECTOR

    Total calculated
    $999,603
    From this org
    $949,953
    From related orgs
    $0
    Other
    $49,650
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $757,510
    Bonus
    $124,041
    Other
    $68,402
    Deferred
    $18,300
    Nontaxable benefits
    $33,862
    Filer's total
    $1,002,115

  • JOHN KUNZER MD MMM

    PRESIDENT

    Total calculated
    $963,908
    From this org
    $826,941
    From related orgs
    $0
    Other
    $136,967
    Hours/week
    48 + 2 related

    Schedule J breakdown matched by us

    Base
    $561,088
    Bonus
    $237,234
    Other
    $28,619
    Deferred
    $105,201
    Nontaxable benefits
    $31,766
    Filer's total
    $963,908

  • ERNEST ASAMOAH MD

    DIRECTOR

    Total calculated
    $661,791
    From this org
    $619,265
    From related orgs
    $0
    Other
    $42,526
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $536,254
    Bonus
    $77,318
    Other
    $5,693
    Deferred
    $18,300
    Nontaxable benefits
    $24,226
    Filer's total
    $661,791

  • ANNETTE MOORE MD

    TREASURER/SECRETARY

    Total calculated
    $628,197
    From this org
    $609,897
    From related orgs
    $0
    Other
    $18,300
    Hours/week
    52 + 3 related

    Schedule J breakdown matched by us

    Base
    $562,262
    Bonus
    $0
    Other
    $47,635
    Deferred
    $18,300
    Nontaxable benefits
    $0
    Filer's total
    $628,197

  • STEVE O'NEIL MD

    DIRECTOR

    Total calculated
    $568,338
    From this org
    $516,772
    From related orgs
    $0
    Other
    $51,566
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $410,720
    Bonus
    $71,038
    Other
    $35,014
    Deferred
    $18,300
    Nontaxable benefits
    $33,266
    Filer's total
    $568,338

  • ANTHONY SANDERS MD

    VICE CHAIRPERSON

    Total calculated
    $588,621
    From this org
    $533,437
    From related orgs
    $0
    Other
    $55,184
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $384,804
    Bonus
    $58,244
    Other
    $90,389
    Deferred
    $18,300
    Nontaxable benefits
    $39,396
    Filer's total
    $591,133

  • ROBERT GOULET MD

    DIRECTOR THROUGH JUNE 2022

    Total calculated
    $165,096
    From this org
    $150,455
    From related orgs
    $0
    Other
    $14,641
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $150,133
    Bonus
    $0
    Other
    $322
    Deferred
    $8,990
    Nontaxable benefits
    $5,651
    Filer's total
    $165,096

  • STEPHANIE MACKE DO

    CHAIRPERSON

    Total calculated
    $510,314
    From this org
    $505,276
    From related orgs
    $0
    Other
    $5,038
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $464,539
    Bonus
    $33,148
    Other
    $7,589
    Deferred
    $5,038
    Nontaxable benefits
    $0
    Filer's total
    $510,314

  • BARB WINNINGHAM DNP NP CNM

    DIRECTOR

    Total calculated
    $251,543
    From this org
    $213,968
    From related orgs
    $0
    Other
    $37,575
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $178,829
    Bonus
    $34,125
    Other
    $1,014
    Deferred
    $13,168
    Nontaxable benefits
    $24,407
    Filer's total
    $251,543

  • MICHAEL ALLEY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • BP HOUSE MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • MIKE LANGELLIER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • MAUREEN SAMPSON MD

    DIRECTOR

    Total calculated
    $650,563
    From this org
    $596,271
    From related orgs
    $0
    Other
    $54,292
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $385,174
    Bonus
    $45,503
    Other
    $165,594
    Deferred
    $18,300
    Nontaxable benefits
    $38,503
    Filer's total
    $653,074

  • KATHY KRUSIE

    CHIEF ADMINISTRATIVE OFFICER

    Total calculated
    $679,166
    From this org
    $0
    From related orgs
    $620,654
    Other
    $58,512
    Hours/week
    40 + 10 related

    Schedule J breakdown matched by us

    Base
    $0 + $474,864 related
    Bonus
    $0 + $123,173 related
    Other
    $0 + $22,617 related
    Deferred
    $0 + $37,634 related
    Nontaxable benefits
    $0 + $20,878 related
    Filer's total
    $0 + $679,166 related

  • JASON LANDIS

    VP - FINANCE

    Total calculated
    $324,831
    From this org
    $0
    From related orgs
    $296,468
    Other
    $28,363
    Hours/week
    10 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $249,655 related
    Bonus
    $0 + $45,751 related
    Other
    $0 + $1,062 related
    Deferred
    $0 + $18,016 related
    Nontaxable benefits
    $0 + $10,347 related
    Filer's total
    $0 + $324,831 related

  • JAMES CALLAHAN MD

    PHYSICIAN

    Total calculated
    $2,135,182
    From this org
    $2,083,072
    From related orgs
    $0
    Other
    $52,110
    Hours/week
    48 + 2 related

    Schedule J breakdown matched by us

    Base
    $1,739,801
    Bonus
    $134,577
    Other
    $208,694
    Deferred
    $18,300
    Nontaxable benefits
    $33,810
    Filer's total
    $2,135,182

  • RAJESH MALLELA MD

    PHYSICIAN

    Total calculated
    $2,142,102
    From this org
    $2,086,918
    From related orgs
    $0
    Other
    $55,184
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $1,640,111
    Bonus
    $241,183
    Other
    $205,624
    Deferred
    $18,300
    Nontaxable benefits
    $36,884
    Filer's total
    $2,142,102

  • SHAHERYAR ANSARI MD

    PHYSICIAN

    Total calculated
    $2,142,989
    From this org
    $2,091,514
    From related orgs
    $0
    Other
    $51,475
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $1,662,095
    Bonus
    $232,325
    Other
    $197,094
    Deferred
    $18,300
    Nontaxable benefits
    $33,560
    Filer's total
    $2,143,374

  • SAKKAPOL ONGWIJITWAT MD

    PHYSICIAN

    Total calculated
    $1,773,435
    From this org
    $1,718,393
    From related orgs
    $0
    Other
    $55,042
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $1,431,437
    Bonus
    $214,763
    Other
    $72,193
    Deferred
    $18,300
    Nontaxable benefits
    $36,742
    Filer's total
    $1,773,435

  • NITESH GADEELA MD

    PHYSICIAN

    Total calculated
    $1,739,611
    From this org
    $1,720,734
    From related orgs
    $0
    Other
    $18,877
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $1,418,357
    Bonus
    $202,855
    Other
    $99,522
    Deferred
    $18,300
    Nontaxable benefits
    $577
    Filer's total
    $1,739,611

  • ROBIN LEDYARD MD

    FORMER INTERIM PRESIDENT

    Total calculated
    $697,245
    From this org
    $0
    From related orgs
    $648,036
    Other
    $49,209
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $497,686 related
    Bonus
    $0 + $127,731 related
    Other
    $0 + $22,619 related
    Deferred
    $0 + $38,850 related
    Nontaxable benefits
    $0 + $10,359 related
    Filer's total
    $0 + $697,245 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3 - RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION
COMMUNITY PHYSICIANS OF INDIANA, INC. ("CPI") CEO/EXECUTIVE DIRECTOR'S COMPENSATION IS DETERMINED BY COMMUNITY HEALTH NETWORK, INC. ("CHNW"), A RELATED 501(C)(3) ORGANIZATION. CHNW USES THE FOLLOWING IN DETERMINING THE CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE, 2) INDEPENDENT COMPENSATION CONSULTANT, 3) COMPENSATION SURVEY OR STUDY, AND 4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN
COMMUNITY HEALTH NETWORK, INC. SECTION 457(F) PLAN COMMUNITY HEALTH NETWORK, INC. ("COMMUNITY") ADOPTED THIS COMMUNITY HEALTH NETWORK, INC. SECTION 457(F) PLAN ("PLAN") AS OF JANUARY 1, 2016 TO PROVIDE A SUPPLEMENTAL INCOME FOR RETIREMENT UPON VESTING IN THE BENEFIT AS DESCRIBED IN THE PLAN DOCUMENT. COMMUNITY PHYSICIANS OF INDIANA, INC. ("CPI") IS INCLUDED IN THE PLAN. THE PLAN IS INTENDED TO BE EXEMPT FROM THE REQUIREMENTS OF CODE SECTION 409A AS A SHORT-TERM DEFERRAL PROGRAM DESCRIBED UNDER TREAS. REG. 1.409A-1 (B)(4). THE PLAN IS DESIGNED UNDER CODE SECTION 457(F) AS A "TOP-HAT PLAN" (I.E. AN UNFUNDED DEFERRED COMPENSATION PLAN MAINTAINED FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES) PURSUANT TO SECTIONS 201(2), 301(A)(3) AND 401(A)(1) OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED ("ERISA"). ELIGIBILITY: INDIVIDUALS DESIGNATED BY THE BOARD OF DIRECTORS OF COMMUNITY HEALTH NETWORK, INC. CONTRIBUTIONS: ANNUALLY FROM 2021 TO 2025 COMMUNITY WILL CREDIT A CONTRIBUTION TO A PARTICIPANT'S ACCOUNT IN AN AMOUNT EQUAL TO TEN PERCENT OF THEIR BASE COMPENSATION AS DEFINED IN THE PARTICIPANT'S EMPLOYMENT AGREEMENT WITH COMMUNITY. VESTING: SINGLE VESTING METHOD ELECTED BY THE EMPLOYER, IN ITS DISCRETION, FOR EACH PARTICIPANT, WHICH APPLIES TO ALL EMPLOYER CONTRIBUTION CREDITS. UNLESS VESTED OR FORFEITED EARLIER, THE ENTIRE ACCOUNT SHALL VEST ON JANUARY 1, 2026. IN ADDITION, A PARTICIPANT'S ENTIRE ACCOUNT SHALL VEST ON THE PARTICIPANT'S DEATH, AN INVOLUNTARY TERMINATION OF THE PARTICIPANT'S EMPLOYMENT WITHOUT CAUSE (AS REASONABLY DETERMINED BY THE EMPLOYER), THE PARTICIPANT'S DISABILITY (AS DEFINED BY THE SOCIAL SECURITY ADMINISTRATION), OR THE PARTICIPANT'S VOLUNTARY TERMINATION FOR GOOD REASON. FORFEITURE: IF ACCOUNT IS NOT VESTED AS DESCRIBED ABOVE, THE ACCOUNT WILL BE COMPLETELY FORFEITED. AMOUNTS FORFEITED DURING A PLAN YEAR REMAIN A GENERAL ASSET OF COMMUNITY.
COMMUNITY HEALTH NETWORK, INC. RESTORATION PLAN
COMMUNITY HEALTH NETWORK, INC. ("COMMUNITY") ADOPTED THIS COMMUNITY HEALTH NETWORK RESTORATION PLAN ("PLAN") AS OF DECEMBER 1, 2017 TO PROVIDE A SUPPLEMENTAL INCOME FOR RETIREMENT UPON VESTING IN THE BENEFITS AS DESCRIBED IN THE PLAN DOCUMENT. COMMUNITY PHYSICIANS OF INDIANA, INC. ("CPI") IS INCLUDED IN THE PLAN. THE PLAN IS DESIGNED UNDER CODE SECTION 457(F) AS A "TOP-HAT PLAN" (I.E. AN UNFUNDED DEFERRED COMPENSATION PLAN MAINTAINED FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES PURSUANT TO SECTIONS 201(2), 301(A)(3) AND 401(A)(1) OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED ("ERISA"). ELIGIBILITY: INDIVIDUALS WHO HAVE THE TITLE OF PRESIDENT, SENIOR VICE PRESIDENT OR EXECUTIVE VICE PRESIDENT AND WHOSE PLAN COMPENSATION FOR THE APPLICABLE PLAN YEAR EXCEEDS THE ANNUAL COMPENSATION LIMIT UNDER CODE SECTION 401(A)(17), AS ADJUSTED FROM TIME TO TIME. CONTRIBUTIONS: 1. MATCHING CONTRIBUTIONS: IF A PARTICIPANT RECEIVES THE MAXIMUM PERMISSIBLE MATCHING CONTRIBUION UNDER THE COMMUNITY HEALTH NETWORK 401(K) RETIREMENT PLAN, THEY WILL RECEIVE A MATCHING CONTRIBUTION IN THE PLAN THAT IS EQUAL TO THEIR COMPENSATION THAT IS GREATER THAN THE 401(K) PLAN LIMIT MULTIPLIED BY THE MAXIMUM PERMITTED MATCHING CONTRIBUTION PERCENTAGE IN THE 401(K) PLAN FOR THAT YEAR. 2. NON-ELECTIVE CONTRIBUTIONS: IF A PARTICIPANT RECEIVES A NON-ELECTIVE CONTRIBUTION IN THE 401(K) PLAN, THEY WILL RECEIVE A NON-ELECTIVE CONTRIBUTION IN THE PLAN THAT IS EQUAL TO THEIR COMPENSATION THAT IS GREATER THAN THE 401(K) PLAN LIMIT MULTIPLIED BY THE NON-ELECTIVE CONTRIBUTION PERCENTAGE IN THE 401(K) PLAN FOR THAT YEAR. NOTE THAT NO NON-ELECTIVE CONTRIBUTIONS ARE CURRENTLY BEING MADE TO THE 401(K) PLAN. CONTRIBUTIONS WILL BE CREDITED TO A PARTICIPANT'S ACCOUNT AS SOON AS ADMINISTRATIVELY FEASIBLE FOLLOWING THE END OF THE PLAN YEAR TO WHICH THE CONTRIBUTIONS RELATE. VESTING: A PARTICIPANT WILL BE 100% VESTED IN HIS ACCOUNT UPON THE EARLIEST TO OCCUR OF THE FOLLOWING: 1. ATTAINMENT OF AGE 65 PRIOR TO SEPARATION FROM SERVICE 2. DISABILITY 3. INVOLUNTARY SEPARATION FROM SERVICE FOR A REASON OTHER THAN FOR CAUSE 4. SEPARATION FROM SERVICE FOR GOOD REASON 5. A NONCOMPETITIVE PARTICIPANT'S COMPLIANCE WITH ALL TERMS OF A NONCOMPETING AGREEMENT, OR 6. DEATH FORFEITURES: IF ACCOUNT IS NOT VESTED AS DESCRIBED ABOVE, THE ACCOUNT WILL BE COMPLETELY FORFEITED. AMOUNTS FORFEITED DURING A PLAN YEAR REMAIN A GENERAL ASSET OF COMMUNITY.
PART I, LINE 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 ORGANIZATIONAL 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 ARM'S LENGTH, FAIR MARKET TERMS. LONG TERM INCENTIVE PLAN CHNW 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, CHNW (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 ARM'S LENGTH, FAIR MARKET TERMS.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2022
Filed
8 November 2023
IRS schema version
2022v5.0
Source object
202303149349300225

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