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COMMUNITY HEALTH SYSTEMS INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HEALTH SYSTEMS INC (EIN 39-1919806)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-04-20
IRS object ID
202201109349301535
Schema version
2020v4.2
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

FieldValueIRS element (for citing)
Return2022-04-20T16:01:20-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1170 NORTH RADNOR-CHESTER ROAD SUITEAddressLine1Txt
Address Line2200AddressLine2Txt
CityRADNORCityNm
State AbbreviationPAStateAbbreviationCd
ZIP19087ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391919806EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH SYSTEMS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone6083610311PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line174 ECLIPSE BOULEVARDAddressLine1Txt
CityBELOITCityNm
State AbbreviationWIStateAbbreviationCd
ZIP535116214ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSTEPHEN W SMITHPersonNm
Person TitleCHIEF EXECUTIVE OFFICERPersonTitleTxt
Phone6083610311PhoneNum
Signature2022-04-20SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSTEPHENPersonFirstNm
Person LastSMITHPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSOLOMON MARDAKHAEVPreparerPersonNm
PTINP01806552PTIN
Phone6105653930PhoneNum
Preparation2022-04-14PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSTEPHEN W SMITHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line174 ECLIPSE BOULEVARDAddressLine1Txt
CityBELOITCityNm
State AbbreviationWIStateAbbreviationCd
ZIP535116214ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$9,104,247GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CHSOFWI.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionOUR 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 Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee96TotalEmployeeCnt
Total Volunteers14TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,116,100PYContributionsGrantsAmt
CY Contributions Grants$4,427,042CYContributionsGrantsAmt
PY Program Service Revenue$4,223,528PYProgramServiceRevenueAmt
CY Program Service Revenue$4,675,651CYProgramServiceRevenueAmt
PY Investment Income$18,170PYInvestmentIncomeAmt
CY Investment Income$1,554CYInvestmentIncomeAmt
PY Other Revenue$2,545PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$7,360,343PYTotalRevenueAmt
CY Total Revenue$9,104,247CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,329,290PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,636,658CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,658,700PYOtherExpensesAmt
CY Other Expenses$2,984,076CYOtherExpensesAmt
PY Total Expenses$7,987,990PYTotalExpensesAmt
CY Total Expenses$8,620,734CYTotalExpensesAmt
PY Revenues Less Expenses-$627,647PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$483,513CYRevenuesLessExpensesAmt
Total Assets BOY$4,148,741TotalAssetsBOYAmt
Total Assets EOY$4,341,272TotalAssetsEOYAmt
Total Liabilities BOY$1,681,748TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,390,766TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,466,993NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,950,506NetAssetsOrFundBalancesEOYAmt
MissionOUR 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 Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$5,830,409ExpenseAmt
Grant$0GrantAmt
Revenue$4,675,651RevenueAmt
DescCOMMUNITY HEALTH SYSTEMS, INC. OPERATES ONE SITE, WHICH OFFERS A COMPLIMENT OF MEDICAL, BEHAVIORAL HEALTH, AND DENTAL SERVICES IN BELOIT, WISCONSIN. DURING FISCAL YEAR 2021, THERE WERE 30,800 VISITS. IN RESPONSE TO THE SARS-COV-2 PANDEMIC, THE CLINIC WAS ABLE TO SHIFT SERVICES TO THE TELEHEALTH/VIRTUAL VISIT MODEL TO MAINTAIN CAPACITY.Desc
Total Program Service Expenses$5,830,409TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document12IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee96EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1STEPHEN W SMITHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6083610311PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line174 ECLIPSE BOULEVARDAddressLine1Txt
CityBELOITCityNm
State AbbreviationWIStateAbbreviationCd
ZIP535116214ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
MEGGE CASIQUE
CHAIR0.50Yes (X)Yes (X)$0$0$0
PATRICK KUELZ
VICE CHAIR0.50Yes (X)Yes (X)$0$0$0
RUTH GRAY
SECRETARY0.50Yes (X)Yes (X)$0$0$0
LINDA GARZA
SECRETARY (THRU 1/21)0.50Yes (X)Yes (X)$0$0$0
KRISTIN LOEHR
TREASURER0.50Yes (X)Yes (X)$0$0$0
LANA TASHA BELL
DIRECTOR0.50Yes (X)$0$0$0
JEREMY BROWN
DIRECTOR0.50Yes (X)$0$0$0
KATHARINE CLARK
DIRECTOR0.50Yes (X)$0$0$0
CECILIA GILLHOUSE
DIRECTOR0.50Yes (X)$0$0$0
GINNA ISUNZA
DIRECTOR0.50Yes (X)$0$0$0
DORIS MULDER
DIRECTOR0.50Yes (X)$0$0$0
ANDRE SAYLES
DIRECTOR0.50Yes (X)$0$0$0
JAROD SCHUT
DIRECTOR0.50Yes (X)$0$0$0
BRIAN WILSON
DIRECTOR (THRU 5/21)0.50Yes (X)$0$0$0
STEPHEN W SMITH
CHIEF OPERATING OFFICER/INTERIM CEO (FROM 6/21)45.00Yes (X)$106,682$0$12,770
MARY E JOHNSON
CHIEF EXECUTIVE OFFICER (THRU 6/21)45.00Yes (X)$160,704$0$16,208
CARYN DAVIS
DIRECTOR OF FINANCE45.00Yes (X)$71,459$0$27,601
DR TROY DOETCH
CHIEF MEDICAL OFFICER40.00$176,646$0$19,376Yes (X)
DR CYNTHIA RIFFLE
DENTAL DIRECTOR45.00$152,858$0$2,617Yes (X)
DR CHRIS GREENWALDT
DENTIST40.00$127,654$0$15,239Yes (X)
DR FARHANA HAMID-SCANLIN
NURSE PRACTITIONER40.00$122,808$0$5,771Yes (X)
DR JOHN TRAN
DENTIST40.00$119,990$0$7,295Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,038,801TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$106,877TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K7IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1OCHIN INCBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line11881 SW NAITO PARKWAYAddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97201ZIPCd
FieldValueIRS element (for citing)
ServicesCOMPUTER SOFTWARE SERVICE AND SUPPORTServicesDesc
Compensation$189,221CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Government Grants$4,396,563GovernmentGrantsAmt
All Other Contributions$30,479AllOtherContributionsAmt
Total Contributions$4,427,042TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Business621300BusinessCd
Total Revenue Column$4,657,561TotalRevenueColumnAmt
Related Or Exempt Func Income$4,657,561RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,090TotalRevenueColumnAmt
Related Or Exempt Func Income$18,090RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$4,675,651TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,554TotalRevenueColumnAmt
Exclusion$1,554ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,104,247TotalRevenueColumnAmt
Related Or Exempt Func Income$4,675,651RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,554ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$363,498TotalAmt
Program Services$240,330ProgramServicesAmt
Management And General$123,168ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,292,180TotalAmt
Program Services$2,159,675ProgramServicesAmt
Management And General$1,132,505ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$68,000TotalAmt
Management And General$68,000ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,584,699TotalAmt
Program Services$1,162,748ProgramServicesAmt
Management And General$421,951ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$328,281TotalAmt
Program Services$224,596ProgramServicesAmt
Management And General$103,685ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$16,866TotalAmt
Management And General$16,866ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$668,094TotalAmt
Program Services$293,355ProgramServicesAmt
Management And General$374,739ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$40,431TotalAmt
Program Services$17,619ProgramServicesAmt
Management And General$22,812ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$38,621TotalAmt
Program Services$14,767ProgramServicesAmt
Management And General$23,854ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$284,066TotalAmt
Program Services$261,059ProgramServicesAmt
Management And General$23,007ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$367,379TotalAmt
Program Services$245,799ProgramServicesAmt
Management And General$121,580ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,175TotalAmt
Program Services$262ProgramServicesAmt
Management And General$2,913ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$34,373TotalAmt
Program Services$22,976ProgramServicesAmt
Management And General$11,397ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$44,483TotalAmt
Program Services$44,610ProgramServicesAmt
Management And General-$127ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$241,327TotalAmt
Program Services$115,382ProgramServicesAmt
Management And General$125,945ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,725TotalAmt
Management And General$1,725ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL & PHARMACY SUPP$566,157$561,080$5,077
BAD DEBT EXPENSE$394,110$394,110
EQUIPMENT & MAINTENANCE$205,894$50,697$155,197
DUES$52,803$9,932$42,871

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$24,572TotalAmt
Program Services$11,412ProgramServicesAmt
Management And General$13,160ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,620,734TotalAmt
Program Services$5,830,409ProgramServicesAmt
Management And General$2,790,325ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$102,675BOYAmt
EOY$237,272EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,490,138BOYAmt
EOY$1,504,227EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$216,516BOYAmt
EOY$317,629EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$429,101BOYAmt
EOY$530,564EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$20,394BOYAmt
EOY$20,394EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$101,621BOYAmt
EOY$106,260EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$3,494,215LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,935,052LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,722,533BOYAmt
EOY$1,559,163EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$65,763BOYAmt
EOY$65,763EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,148,741BOYAmt
EOY$4,341,272EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$468,146BOYAmt
EOY$512,706EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$143,458BOYAmt
EOY$58,013EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,070,144BOYAmt
EOY$820,047EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,681,748BOYAmt
EOY$1,390,766EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,466,993BOYAmt
EOY$2,950,506EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,466,993BOYAmt
EOY$2,950,506EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,148,741BOYAmt
EOY$4,341,272EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$483,513ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,582,302CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,393,196CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,558,254CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,116,100CurrentTaxYearMinus1YearAmt
Current Tax Year$4,427,042CurrentTaxYearAmt
Total$15,076,894TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,582,302CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,393,196CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,558,254CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,116,100CurrentTaxYearMinus1YearAmt
Current Tax Year$4,427,042CurrentTaxYearAmt
Total$15,076,894TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$15,076,894PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$722CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,448CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$29,519CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$20,715CurrentTaxYearMinus1YearAmt
Current Tax Year$1,554CurrentTaxYearAmt
Total$53,958TotalAmt
FieldValueIRS element (for citing)
Total Support$15,130,852TotalSupportAmt
Gross Receipts Rltd Activities$25,265,805GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99640PublicSupportCY170Pct
Public Support PY1700.99590PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,350,292OtherCostOrOtherBasisAmt
Depreciation$436,443DepreciationAmt
Book Value$913,849BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$899,924OtherCostOrOtherBasisAmt
Depreciation$614,860DepreciationAmt
Book Value$285,064BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,243,999OtherCostOrOtherBasisAmt
Depreciation$883,749DepreciationAmt
Book Value$360,250BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,559,163TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescCAPITAL LEASE OBLIGATIONDesc
Amt$820,047Amt
FieldValueIRS element (for citing)
Total Liability$820,047TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$8,710,137TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$394,110OtherRevenueAmt
Revenue Not Reported-$394,110RevenueNotReportedAmt
Revenue Subtotal$9,104,247RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$9,104,247TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$8,226,624TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$8,226,624ExpensesSubtotalAmt
Other Expenses Not Included$394,110OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$394,110ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$8,620,734TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:BAD DEBT EXPENSE -394,110.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 394,110.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DR TROY DOETCH
CHIEF MEDICAL OFFICER$176,646$0$0$0$0$0$0$0$19,376$0$196,022$0$0$0
MARY E JOHNSON
CHIEF EXECUTIVE OFFICER (THRU 6/21)$147,844$0$10,000$0$2,860$0$4,743$0$11,465$0$176,912$0$0$0
DR CYNTHIA RIFFLE
DENTAL DIRECTOR$152,858$0$0$0$0$0$0$0$2,617$0$155,475$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 6FormAndLineReferenceDesc
ExplanationMARY E. JOHNSON WAS ELIGIBLE FOR A BONUS BASED ON ACHIEVING A SET OF STATED GOALS AND PERFORMANCE REVIEW BY THE BOARD OF DIRECTORS. THE BONUS WAS NOT TO EXCEED $10,000 AND WAS APPROVED BY THE BOARD OF DIRECTORS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 8BTHE 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 11BTHE 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 12CCONFLICTS 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 15ON 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 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.