2024-05-13T09:33:21-05:00 2023-06-30 390758449 WIPFLI LLP 170 N RADNOR-CHESTER RD SUITE 200 RADNOR PA 19087 990 2022-07-01 391919806 COMMUNITY HEALTH SYSTEMS INC COMM 6083610311 74 ECLIPSE BOULEVARD BELOIT WI 535116214 STEPHEN W SMITH CHIEF EXECUTIVE OFFICER 6083610311 2024-05-10 1 STEPHEN SMITH 999009999 0 SOLOMON MARDAKHAEV P01806552 6105653930 2024-05-08 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z STEPHEN W SMITH 74 ECLIPSE BOULEVARD BELOIT WI 535116214 11590358 0 X WWW.CHSOFWI.ORG X 1997 WI OUR MISSION IS TO PROVIDE HEALTH AND SOCIAL SERVICES THAT WILL PROMOTE COMFORT, HEALING, AND PREVENTION OF ILLNESSES AND INJURIES. OUR SERVICES ARE CULTURALLY COMPETENT AND SENSITIVE, COMMUNITY ORIENTED, AND PROVIDED REGARDLESS OF INCOME. 11 11 130 13 0 0 4813425 4498647 5585909 7040577 1528 49384 0 1750 10400862 11590358 0 0 0 0 6808816 7967960 0 0 0 3726910 4091987 10535726 12059947 -134864 -469589 4164091 6394105 1348449 4048052 2815642 2346053 OUR MISSION IS TO PROVIDE HEALTH AND SOCIAL SERVICES THAT WILL PROMOTE COMFORT, HEALING, AND PREVENTION OF ILLNESSES AND INJURIES. OUR SERVICES ARE CULTURALLY COMPETENT AND SENSITIVE, COMMUNITY ORIENTED, AND PROVIDED REGARDLESS OF INCOME. 0 0 7247467 0 7040577 COMMUNITY HEALTH SYSTEMS, INC. OPERATES TWO SITES AND VARIOUS OUTREACH SITES IN LOCAL SCHOOLS, OFFERING A COMPLIMENT OF MEDICAL, DENTAL, BEHAVIORAL HEALTH, AND PSYCHIATRY SERVICES IN BELOIT AND DARLINGTON, WISCONSIN. DURING FISCAL YEAR 2023, THERE WERE 34,400 VISITS. 7247467 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 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 19 0 130 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X STEPHEN W SMITH 6083610311 74 ECLIPSE BOULEVARD BELOIT WI 535116214 DR CHRIS GREENWALDT DENTAL DIRECTOR 45.00 X 167179 0 14999 DR TROY DOETCH CHIEF MEDICAL OFFICER 32.00 X 163873 0 13073 STEPHEN W SMITH CHIEF EXECUTIVE DIRECTOR 45.00 X 153495 0 18814 DR NEILS BADIA DENTIST 40.00 X 141374 0 7935 DR FARHANA HAMID-SCANLIN NURSE PRACTITIONER 40.00 X 127868 0 7481 DR LAURA ANDERSON NURSE PRACTITIONER 40.00 X 113356 0 10130 BROOKLYN TRUMPY DIRECTOR OF COMPLIANCE, QUALITY & RISK 45.00 X 106674 0 7272 DR KIMBERLY NESTLER PSYCHIATRIST 10.00 X 103700 0 0 CARYN DAVIS DIRECTOR OF FINANCE 45.00 X 83350 0 30004 PATRICK KUELZ THRU NOV 2022 CHAIR 0.50 X X 0 0 0 KRISTIN LOEHR CHAIR/TREASURER 0.50 X X 0 0 0 RUTH GRAY VICE CHAIR 0.50 X X 0 0 0 DANIEL BAROLSKY SECRETARY 0.50 X X 0 0 0 YUSUF ADAMA FROM JAN 2023 DIRECTOR 0.50 X 0 0 0 JEREMY BROWN DIRECTOR 0.50 X 0 0 0 CECILIA GILLHOUSE DIRECTOR 0.50 X 0 0 0 JESSICA GONZALES FROM JUN 2023 DIRECTOR 0.50 X 0 0 0 BRETT GRANT DIRECTOR 0.50 X 0 0 0 LARA HERMANN FROM DEC 2022 DIRECTOR 0.50 X 0 0 0 GINNA ISUNZA THRU NOV 2022 DIRECTOR 0.50 X 0 0 0 DORIS MULDER DIRECTOR 0.50 X 0 0 0 BRENDA PINSON FROM NOV 2022 DIRECTOR 0.50 X 0 0 0 1160869 0 109708 8 0 1 0 OCHIN INC 1881 SW NAITO PARKWAY PORTLAND OR 97201 COMPUTER SOFTWARE SERVICE AND SUPPORT 315345 WIPFLI 10000 W INNOVATION DR SUITE 250 MILWAUKEE WI 53226 ACCOUNTING SERVICES 133774 KLOBUCAR CONSTRUCTION COMPANY 3217 E TORTOISE LANE BELOIT WI 53511 CONSTRUCTION SERVICES 122569 3 4480150 18497 4498647 PATIENT SERVICE REVENUE 621300 7005402 7005402 35175 35175 7040577 49384 49384 1750 0 1750 1750 1750 11590358 7040577 0 51134 555333 323900 231433 5877978 3589358 2288620 91660 91660 935374 421741 513633 507615 312341 195274 14053 14053 57825 57825 697459 272094 425365 116183 7607 108576 74083 1624 72459 476916 244010 232906 627402 407160 220242 31556 12258 19298 51326 25425 25901 44507 44507 322989 217709 105280 MEDICAL & PHARMACY SUPP 845411 843693 1718 BAD DEBT EXPENSE 465871 465871 EQUIPMENT 152256 42762 109494 LICENSES & SUBSCRIPTION 67515 15407 52108 46635 46635 12059947 7247467 4812480 0 156874 131175 1390767 807417 142557 374297 331566 508429 20394 33045 123657 136917 2753302 2015229 1814430 738073 183846 3664752 4164091 6394105 572754 629678 1260 1260 774435 3417114 1348449 4048052 X 2815642 2346053 2815642 2346053 4164091 6394105 -469589 0 X X 0 1 X 1 1 1 X 2558254 3116100 4427042 4813425 4498647 19413468 2558254 3116100 4427042 4813425 4498647 19413468 19413468 29519 20715 1554 1528 51134 104450 19517918 25866134 0.99460 0.99680 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1020494 814850 205644 1732808 1200379 532429 738073 DUE FROM THIRD-PARTY REIMBURSEMENT 181214 RIGHT-OF-USE ASSETS - OPERATING 2636324 RIGHT-OF-USE ASSETS - FINANCE 847214 3664752 3RD PARTY REIMBURSEMENT PAYABLE 738880 OPERATING LEASE LIABILITY 2678234 3417114 11124487 0 11124487 465871 465871 11590358 11594076 0 11594076 465871 465871 12059947 PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 465,871. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 465,871. X X 0 0 0 0 0 0 0 0 0 DR CHRIS GREENWALDT DENTAL DIRECTOR 167179 0 0 0 0 0 6775 0 8224 0 182178 0 0 0 DR TROY DOETCH CHIEF MEDICAL OFFICER 151583 0 0 0 12290 0 0 0 13073 0 176946 0 0 0 STEPHEN W SMITH CHIEF EXECUTIVE DIRECTOR 150570 0 0 0 2925 0 6293 0 12521 0 172309 0 0 0 FORM 990, PART VI, SECTION A, LINE 8B THE CORPORATION'S GOVERNING BODY DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE PREPARED FORM 990 IS REVIEWED AND APPROVED BY THE MEMBERS OF THE GOVERNING BODY AND MANAGEMENT BEFORE THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C CONFLICTS OF INTEREST MAY INCLUDE, BUT ARE NOT LIMITED TO RELATIONSHIPS, ASSOCIATIONS, OR BUSINESS DEALINGS WITH VENDORS, SUPPLIERS, OTHER HEALTHCARE ORGANIZATIONS, OR INDIVIDUALS. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMUNITY HEALTH SYSTEM, INC.'S (CHS) EXECUTIVE TEAM MEETING, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. THE CHAIRPERSON OF THE GOVERNING BOARD OR CHS EXECUTIVE TEAM SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR CHS EXECUTIVE TEAM SHALL DETERMINE WHETHER CHS CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT ISN'T REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR CHS EXECUTIVE TEAM SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN CHS' BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. IF THE GOVERNING BOARD OR CHS EXECUTIVE TEAM HAS REASONABLE CAUSE TO BELIEVE A MEMBER/EMPLOYEE HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE BOARD MEMBER/EMPLOYEE OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE BOARD MEMBER'S/EMPLOYEE'S RESPONSE AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE GOVERNING BOARD OR CHS EXECUTIVE TEAM WILL DETERMINE IF THE BOARD MEMBER/EMPLOYEE HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AND SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15 ON AN ANNUAL BASIS, THE CORPORATION'S HUMAN RESOURCE MANAGER PROVIDES THE MEMBERS OF THE GOVERNING BODY WITH COMPENSATION DATA FOR COMPARABLE POSITIONS AT SIMILAR ORGANIZATIONS FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) LATEST COMPENSATION SURVEYS. THE GOVERNING BODY ALSO PERFORMS AN ANNUAL PERFORMANCE REVIEW OF THE CORPORATION'S CHIEF EXECUTIVE OFFICER. THE MEMBERS OF THE GOVERNING BODY DETERMINE AND VOTE TO APPROVE THE COMPENSATION AMOUNTS FOR THE YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITEE AND THE FULL BOARD REVIEW AND APPROVE THE AUDIT.