2023-11-14T14:40:31-06:00 2022-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2022-01-01 352051598 HANCOCK PHYSICIAN NETWORK LLC HANC 3174686236 ONE MEMORIAL SQUARE 50 GREENFIELD IN 46140 BRIAN MUCKERHEIDE PRESIDENT 3174686236 2023-11-14 1 BRIAN MUCKERHEIDE 999009999 0 EMILIE M KNIERIEM CPA P01330194 3176334705 2023-11-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z BRIAN MUCKERHEIDE ONE MEMORIAL SQUARE 50 GREENFIELD IN 46140 37135050 0 X HTTPS://WWW.HANCOCKREGIONALHOSPITAL.ORG/PHYSICIAN X LIMITED LIABILITY COMPANY 1997 IN TO IMPROVE THE HEALTH OF PATIENTS AND FAMILIES IN THE COMMUNITIES IT SERVES WITH RESPECT, INTEGRITY, AND CLINICAL EXCELLENCE. HANCOCK PHYSICIAN NETWORK'S VISION IS TO BE THE PREMIER PROVIDER OF QUALITY HEALTHCARE SERVICES TO HANCOCK AND SURROUNDING COUNTIES THAT ACHIEVES THE HIGHEST LEVEL OF PATIENT SATISFACTION, PATIENT OUTCOMES, AND QUALITY OF LIFE. 4 2 354 20 0 0 18519264 15653724 20814354 20510915 293 2695 0 967716 39333911 37135050 0 0 0 0 27035217 27571685 0 0 0 8448889 8716463 35484106 36288148 3849805 846902 11288141 11946260 4170972 3982189 7117169 7964071 X TO IMPROVE THE HEALTH OF PATIENTS AND FAMILIES IN THE COMMUNITIES IT SERVES WITH RESPECT, INTEGRITY, AND CLINICAL EXCELLENCE. HANCOCK PHYSICIAN NETWORK'S VISION IS TO BE THE PREMIER PROVIDER OF QUALITY HEALTHCARE SERVICES TO HANCOCK AND SURROUNDING COUNTIES THAT ACHIEVES THE HIGHEST LEVEL OF PATIENT SATISFACTION, PATIENT OUTCOMES, AND QUALITY OF LIFE. 0 0 29163829 21169153 HPN OWNS, OPERATES, AND MANAGES PHYSICIAN PRACTICES THAT PROVIDE PRIMARY CARE, BEHAVIORAL HEALTH SERVICES, AND SPECIALTY CARE FOR THE BENEFIT OF THE RESIDENTS OF ITS COMMUNITY. 29163829 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 27 0 1 354 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 2 0 0 0 0 1 1 1 1 0 0 0 1 0 0 1 0 0 0 IN X THE ORGANIZATION 3174686236 ONE MEMORIAL SQUARE STE 50 GREENFIELD IN 46140 DR RUDO MASHINDI PHYSICIAN 40.00 X 472063 0 82225 DR SCOTT CAPEN PHYSICIAN 40.00 X 471335 0 57118 DR ANAS AL SADI PHYSICIAN 40.00 X 399127 0 63900 DR DREW DUST PHYSICIAN 40.00 X 384675 0 54447 DR INDREK MEYER PHYSICIAN 40.00 X 367209 0 53778 BRIAN MUCKERHEIDE HPN PRESIDENT 40.00 X X 231493 0 74818 ALLISON TUSING ACCOUNTING DIRECTOR 40.00 X 120442 0 23165 BRAD MCNABB ASCENSION COO 1.00 X 0 0 0 CHRISTINE FREDRIC ASCENSION - CHIEF STRATEGY OFFICER 1.00 X 0 0 0 STEVE LONG HRH PRESIDENT & CEO (TERM END) 3.00 X 0 0 0 JON MILLER HRH CFO (TERM END) 3.00 X 0 0 0 2446344 0 409451 65 0 1 0 ELITE SERVICES INC PO BOX 2847 MUNCIE IN 47307 BUSINESS COMMUNICATION SERVICES 126668 1 15653724 15653724 NET PATIENT SERVICE REVENUE 621110 16023973 16023973 CLINICS AND URGENT CARE 621110 3981853 3981853 HOSPITALIST SERVICES 621110 505089 505089 20510915 2695 2695 HANCOCK RISE REVENUE 900099 379942 379942 ALLOCATED ADMINISTRATIVE REVENUE 900099 309478 309478 LTAC HOSPITAL REVENUE 900099 278296 278296 967716 37135050 21169153 0 312173 449918 372208 77710 22037165 18230883 3806282 554845 445957 108888 3197750 2570195 627555 1332007 1070602 261405 1719818 398340 1321478 221000 20324 200676 353782 201174 152608 347634 170006 177628 2122319 1932536 189783 60910 29787 31123 162685 154335 8350 537085 427700 109385 313348 310780 2568 MEDICAL SUPPLIES 2832090 2810407 21683 DUES & SUB. 36134 13873 22261 9658 4722 4936 36288148 29163829 7124319 0 5645605 2172363 4588130 2564123 2532119 368585 347179 6919786 4613317 2709828 2306469 11288141 11946260 4162158 3973375 8814 8814 4170972 3982189 X 7117169 7964071 7117169 7964071 11288141 11946260 846902 0 X 0 0 0 X SCHEDULE A, PART I, LINE 3: HANCOCK PHYSICIAN NETWORK HAS BEEN DETERMINED BY THE IRS TO BE A PUBLIC CHARITY UNDER IRS CODE SECTION 170(B)(1)(A)(III). PER SCHEDULE H INSTRUCTIONS, ONLY ORGANIZATIONS THAT OPERATE AT LEAST ONE FACILITY THAT IS, OR IS REQUIRED TO BE, LICENSED, REGISTERED, OR SIMILARLY RECOGNIZED BY THE STATE AS A HOSPITAL IS REQUIRED TO COMPLETE SCHEDULE H. HANCOCK PHYSICIAN NETWORK IS NOT LICENSED AS A HOSPITAL IN THE STATE OF INDIANA. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3787621 2459986 1327635 3036740 2153331 883409 95425 95425 2306469 DUE TO HANCOCK REGIONAL HOSPITAL 8814 8814 X X 0 0 0 0 0 0 0 0 0 DR RUDO MASHINDI PHYSICIAN 471063 0 1000 0 0 0 41000 0 41225 0 554288 0 0 0 DR SCOTT CAPEN PHYSICIAN 470335 0 1000 0 0 0 27000 0 30118 0 528453 0 0 0 DR ANAS AL SADI PHYSICIAN 398127 0 1000 0 0 0 29440 0 34460 0 463027 0 0 0 DR DREW DUST PHYSICIAN 363399 0 21276 0 0 0 41000 0 13447 0 439122 0 0 0 DR INDREK MEYER PHYSICIAN 366209 0 1000 0 0 0 20500 0 33278 0 420987 0 0 0 BRIAN MUCKERHEIDE HPN PRESIDENT 191493 0 40000 0 0 0 41000 0 33818 0 306311 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A MEMBER-MANAGED LLC; ITS MEMBERS ARE HANCOCK REGIONAL HOSPITAL AND ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION MAY ELECT OFFICERS OF HANCOCK PHYSICIAN NETWORK AND AUTHORIZE SUCH OFFICERS TO CONDUCT MATTERS FOR THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS APPOINT REPRESENTATIVES TO MAKE DECISIONS REGARDING THE ORGANIZATION, BUT ULTIMATE DECISION MAKING REMAINS WITH THE MEMBER ORGANIZATIONS. THE FOLLOWING ITEMS REQUIRE UNANIMOUS APPROVAL BY ALL MEMBERS: 1. AMENDING ARTICLES OF INCORPORATION, OPERATING AGREEMENT OR MISSION. 2. AUTHORIZING THE ISSUANCE OF ADDITIONAL MEMBERSHIP OR INCREASING A MEMBER'S INTEREST IN THE MEMBER'S ORGANIZATION. 3. MAKING A CAPITAL CALL MORE FREQUENTLY THAN ANNUALLY . 4. INCURRING DEBT ON BEHALF OF THE ORGANIZATION. 5. SELLING, LEASING, OR TRANSFERRING ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS. 6. ORGANIZING, ACQUIRING OR DISPOSING OF AN INTEREST IN A CORPORATION, COMPANY OR JOINT VENTURE. 7. ALLOWING A NEW MEMBER INTO THE ORGANIZATION. 8. EXPANDING THE ACTIVITIES OF THE ORGANIZATION BEYOND THE OWNERSHIP AND OPERATION OF PRIMARY CARE AND BEHAVIORAL HEALTH FACILITIES. 9. APPROVING ANY AGREEMENT FOR THE MANAGEMENT OF INPATIENT BEHAVIORAL HEALTH SERVICES. 10. APPROVING THE ANNUAL OPERATING BUDGET. 11. HIRING AND EVALUATION OF THE ORGANIZATION'S PRESIDENT. 12. ENTERING INTO, AMENDING OR TERMINATING CONTRACTS INVOLVING CAPITAL CALLS AND EXPENDITURES IN EXCESS OF CERTAIN AMOUNTS. 13. ASSIGNING RIGHTS OF THE ORGANIZATION OR ANY PROPERTY OF THE ORGANIZATION. 14. TAKING ANY ACTION THAT WOULD CONSTITUTE A BREACH OR DEFAULT OF ANY AGREEMENTS ENTERED INTO BY THE ORGANIZATION. 15. MAKING DECISIONS REGARDING DELETING OR CONSOLIDATING THE CLOSURE OR CONSOLIDATION OF PRACTICE LOCATIONS. 16. APPROVING COMPENSATION PLANS AND MODIFICATIONS TO SUCH PLANS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION'S GOVERNING BODY DOES NOT HAVE COMMITTEES. FORM 990, PART VI, SECTION B, LINE 11B THE HPN ACCOUNTING MANAGER AND COO REVIEW THE 990 IN DETAIL WHILE WORKING WITH TAX PREPARER BLUE AND CO. PRIOR TO FILING, THE FORM 990 AND REQUIRED SUPPLEMENTAL SCHEDULES WILL BE SENT TO ALL FOUR BOARD MEMBERS FOR REVIEW. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS & FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.