COMMUNITY HEALTH SYSTEMS INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH SYSTEMS INC (EIN 39-1919806)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-12
- IRS object ID
- 202311329349303896
- Schema version
- 2021v4.2
- 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) |
|---|---|---|
| Return | 2023-05-12T15:15:22-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 170 N RADNOR-CHESTER RD SUITE 200 | AddressLine1Txt |
| City | RADNOR | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19087 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391919806 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH SYSTEMS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 6083610311 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 74 ECLIPSE BOULEVARD | AddressLine1Txt |
| City | BELOIT | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 535116214 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHEN W SMITH | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 6083610311 | PhoneNum |
| Signature | 2023-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | STEPHEN | PersonFirstNm |
| Person Last | SMITH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SOLOMON MARDAKHAEV | PreparerPersonNm |
| PTIN | P01806552 | PTIN |
| Phone | 6105653930 | PhoneNum |
| Preparation | 2023-05-01 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEPHEN W SMITH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 74 ECLIPSE BOULEVARD | AddressLine1Txt |
| City | BELOIT | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 535116214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,400,862 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHSOFWI.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | 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. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 111 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,427,042 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,813,425 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,675,651 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,585,909 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,554 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,528 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $9,104,247 | PYTotalRevenueAmt |
| CY Total Revenue | $10,400,862 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,636,658 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,808,816 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,984,076 | PYOtherExpensesAmt |
| CY Other Expenses | $3,726,910 | CYOtherExpensesAmt |
| PY Total Expenses | $8,620,734 | PYTotalExpensesAmt |
| CY Total Expenses | $10,535,726 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $483,513 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$134,864 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,341,272 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,164,091 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,390,766 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,348,449 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,950,506 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,815,642 | NetAssetsOrFundBalancesEOYAmt |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,906,896 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $5,585,909 | RevenueAmt |
| Desc | COMMUNITY HEALTH SYSTEMS, INC. OPERATES ONE SITE, WHICH OFFERS A COMPLIMENT OF MEDICAL, BEHAVIORAL HEALTH, AND DENTAL SERVICES IN BELOIT AND DARLINGTON, WISCONSIN. DURING FISCAL YEAR 2022, THERE WERE 30,600 VISITS.DURING THE 2022 FISCAL YEAR, DENTAL SERVICES WERE RE-ESTABLISHED IN THE DARLINGTON, WISCONSIN CLINIC. IN ADDITION TO RESTORING DENTAL SERVICES, BEHAVIORAL HEALTH SERVICES WERE ADDED BOTH IN-PERSON AND VIRTUALLY IN THE CLINIC SPACE. | Desc |
| Total Program Service Expenses | $6,906,896 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 20 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 111 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEPHEN W SMITH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6083610311 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 74 ECLIPSE BOULEVARD | AddressLine1Txt |
| City | BELOIT | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 535116214 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| PATRICK KUELZ | ||||||||
| CHAIR | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MEGGE CASIQUE | ||||||||
| CHAIR (THRU APR) | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RUTH GRAY | ||||||||
| SECRETARY | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| KRISTIN LOEHR | ||||||||
| VICE CHAIR/TREASURER | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DANIEL BAROLSKY | ||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| TASHA LANA BELL | ||||||||
| DIRECTOR (THRU APR) | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| JEREMY BROWN | ||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| KATHERINE CLARK | ||||||||
| DIRECTOR (THRU MAR) | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| CECILIA GILLHOUSE | ||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| BRETT GRANT | ||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| GINNA ISUNZA | ||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| DORIS MULDER | ||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| ANDRE SAYLES | ||||||||
| DIRECTOR (THRU APR) | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| JAROD SCHUT | ||||||||
| DIRECTOR (THRU NOV) | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| STEPHEN W SMITH | ||||||||
| CHIEF EXECUTIVE DIRECTOR | 45.00 | Yes (X) | $142,021 | $0 | $13,477 | |||
| CARYN DAVIS | ||||||||
| DIRECTOR OF FINANCE | 45.00 | Yes (X) | $77,319 | $0 | $28,905 | |||
| DR TROY DOETCH | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | $192,122 | $0 | $17,767 | Yes (X) | |||
| DR CHRIS GREENWALDT | ||||||||
| DENTAL DIRECTOR | 40.00 | $157,339 | $0 | $14,697 | Yes (X) | |||
| DR FARHANA HAMID-SCANLIN | ||||||||
| NURSE PRACTITIONER | 40.00 | $129,368 | $0 | $8,676 | Yes (X) | |||
| DR MARIA MADONNA | ||||||||
| DENTIST | 40.00 | $141,845 | $0 | $23,466 | Yes (X) | |||
| DR LAURA ANDERSON | ||||||||
| NURSE PRACTITIONER | 40.00 | $111,551 | $0 | $7,787 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $951,565 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $114,775 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| OCHIN INC | |||||
| 1881 SW NAITO PARKWAY | PORTLAND | OR | 97201 | COMPUTER SOFTWARE SERVICE AND SUPPORT | $245,710 |
| APPLIED TECH SOLUTIONS INC | |||||
| 6662 RONALD REAGAN AVE | MADISON | WI | 53704 | IT SUPPORT CONSULTING SERVICES | $134,663 |
| ROCK COUNTY HUMAN SERVICES DEPARTMENT | |||||
| 1717 CENTER AVE | JANESVILLE | WI | 53546 | CONTRACTED PROVIDER SERVICES - APNP | $119,744 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,374,907 | GovernmentGrantsAmt |
| All Other Contributions | $438,518 | AllOtherContributionsAmt |
| Total Contributions | $4,813,425 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621300 | BusinessCd |
| Total Revenue Column | $5,538,009 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,538,009 | RelatedOrExemptFuncIncomeAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,900 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $47,900 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,585,909 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,528 | TotalRevenueColumnAmt |
| Exclusion | $1,528 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,400,862 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,585,909 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,528 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $695,807 | TotalAmt |
| Program Services | $456,275 | ProgramServicesAmt |
| Management And General | $239,532 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,728,008 | TotalAmt |
| Program Services | $3,368,156 | ProgramServicesAmt |
| Management And General | $1,359,852 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,867 | TotalAmt |
| Program Services | $6,342 | ProgramServicesAmt |
| Management And General | $62,525 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $897,762 | TotalAmt |
| Program Services | $357,545 | ProgramServicesAmt |
| Management And General | $540,217 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $418,372 | TotalAmt |
| Program Services | $285,351 | ProgramServicesAmt |
| Management And General | $133,021 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,345 | TotalAmt |
| Management And General | $12,345 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,267 | TotalAmt |
| Management And General | $46,267 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $824,131 | TotalAmt |
| Program Services | $325,404 | ProgramServicesAmt |
| Management And General | $498,727 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,425 | TotalAmt |
| Program Services | $1,268 | ProgramServicesAmt |
| Management And General | $53,157 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,282 | TotalAmt |
| Program Services | $11,391 | ProgramServicesAmt |
| Management And General | $58,891 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $394,288 | TotalAmt |
| Program Services | $240,925 | ProgramServicesAmt |
| Management And General | $153,363 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $315,298 | TotalAmt |
| Program Services | $223,200 | ProgramServicesAmt |
| Management And General | $92,098 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,316 | TotalAmt |
| Program Services | $11,550 | ProgramServicesAmt |
| Management And General | $21,766 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,092 | TotalAmt |
| Program Services | $13,433 | ProgramServicesAmt |
| Management And General | $31,659 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,158 | TotalAmt |
| Program Services | $42,158 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,672 | TotalAmt |
| Program Services | $150,599 | ProgramServicesAmt |
| Management And General | $121,073 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL & PHARMACY SUPP | $704,833 | $703,298 | $1,535 |
| BAD DEBT EXPENSE | $496,259 | $496,259 | |
| EQUIPMENT & MAINTENANCE | $298,168 | $196,715 | $101,453 |
| RECRUITMENT | $70,628 | $9,224 | $61,404 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,748 | TotalAmt |
| Program Services | $7,803 | ProgramServicesAmt |
| Management And General | $39,945 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,535,726 | TotalAmt |
| Program Services | $6,906,896 | ProgramServicesAmt |
| Management And General | $3,628,830 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $237,272 | BOYAmt |
| EOY | $156,874 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,504,227 | BOYAmt |
| EOY | $1,390,767 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $317,629 | BOYAmt |
| EOY | $142,557 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $530,564 | BOYAmt |
| EOY | $331,566 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,394 | BOYAmt |
| EOY | $20,394 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $106,260 | BOYAmt |
| EOY | $123,657 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,021,155 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,206,725 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,559,163 | BOYAmt |
| EOY | $1,814,430 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,763 | BOYAmt |
| EOY | $183,846 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,341,272 | BOYAmt |
| EOY | $4,164,091 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $512,706 | BOYAmt |
| EOY | $572,754 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,013 | BOYAmt |
| EOY | $1,260 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $820,047 | BOYAmt |
| EOY | $774,435 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,390,766 | BOYAmt |
| EOY | $1,348,449 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,950,506 | BOYAmt |
| EOY | $2,815,642 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,950,506 | BOYAmt |
| EOY | $2,815,642 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,341,272 | BOYAmt |
| EOY | $4,164,091 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$134,864 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,393,196 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,558,254 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,116,100 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,427,042 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,813,425 | CurrentTaxYearAmt |
| Total | $17,308,017 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,393,196 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,558,254 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,116,100 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,427,042 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,813,425 | CurrentTaxYearAmt |
| Total | $17,308,017 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $17,308,017 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,448 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $29,519 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $20,715 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,554 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,528 | CurrentTaxYearAmt |
| Total | $54,764 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $17,362,781 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $24,903,012 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99680 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99640 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,350,292 | OtherCostOrOtherBasisAmt |
| Depreciation | $450,723 | DepreciationAmt |
| Book Value | $899,569 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,012,494 | OtherCostOrOtherBasisAmt |
| Depreciation | $720,518 | DepreciationAmt |
| Book Value | $291,976 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,658,369 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,035,484 | DepreciationAmt |
| Book Value | $622,885 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,814,430 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAPITAL LEASE OBLIGATION | Desc |
| Amt | $774,435 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $774,435 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $9,904,603 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,904,603 | RevenueSubtotalAmt |
| Other Revenues Not Included | $496,259 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $496,259 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $10,400,862 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,039,467 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,039,467 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $496,259 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $496,259 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,535,726 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 496,259. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 496,259. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR TROY DOETCH | ||||||||||||||
| CHIEF MEDICAL OFFICER | $182,733 | $0 | $9,389 | $0 | $0 | $0 | $0 | $0 | $17,767 | $0 | $209,889 | $0 | $0 | $0 |
| DR CHRIS GREENWALDT | ||||||||||||||
| DENTAL DIRECTOR | $149,539 | $0 | $7,800 | $0 | $0 | $0 | $6,042 | $0 | $8,655 | $0 | $172,036 | $0 | $0 | $0 |
| DR MARIA MADONNA | ||||||||||||||
| DENTIST | $135,107 | $0 | $6,738 | $0 | $0 | $0 | $0 | $0 | $23,466 | $0 | $165,311 | $0 | $0 | $0 |
| STEPHEN W SMITH | ||||||||||||||
| CHIEF EXECUTIVE DIRECTOR | $134,902 | $0 | $7,119 | $0 | $0 | $0 | $504 | $0 | $12,973 | $0 | $155,498 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | BONUSES WERE PAID BASED ON PERFORMANCE AND WERE APPROVED BY THE BOARD OF DIRECTORS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. |