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FAMILY HEALTH SERVICES OF DARKE COUNTY INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
FAMILY HEALTH SERVICES OF DARKE COUNTY INC (EIN 34-1119524)
Tax period
2021-04-01 to 2022-03-31
Filed
2022-09-02
IRS object ID
202212459349301001
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

FieldValueIRS element (for citing)
Return2022-09-02T08:07:09-05:00ReturnTs
Tax Period End2022-03-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN310800053PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLARK SCHAEFER HACKETT & COBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line114 EAST MAIN STREET SUITE 500AddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45502ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-04-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN341119524EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FAMILY HEALTH SERVICES OF DARKE COUNTYBusinessNameLine1Txt
Business Name Line2INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlFAMIBusinessNameControlTxt
Phone9375483806PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15735 MEEKER RDAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationOHStateAbbreviationCd
ZIP45331ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJARED POLLICKPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone9375483806PhoneNum
Signature2022-08-31SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJAREDPersonFirstNm
Person LastPOLLICKPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJESSE YOUNG CPAPreparerPersonNm
PTINP01236247PTIN
Phone9373992000PhoneNum
Preparation2022-08-31PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJARED POLLICKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line15735 MEEKER RDAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationOHStateAbbreviationCd
ZIP45331ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$31,969,084GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressFAMILYHEALTHSERVICES.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1973FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionBUILDING HEALTHY LIVES TOGETHERActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee270TotalEmployeeCnt
Total Volunteers11TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$6,053,752PYContributionsGrantsAmt
CY Contributions Grants$6,195,699CYContributionsGrantsAmt
PY Program Service Revenue$24,065,912PYProgramServiceRevenueAmt
CY Program Service Revenue$25,433,842CYProgramServiceRevenueAmt
PY Investment Income$94,972PYInvestmentIncomeAmt
CY Investment Income$120,861CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$30,214,636PYTotalRevenueAmt
CY Total Revenue$31,750,402CYTotalRevenueAmt
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$16,978,091PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$19,332,124CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$8,229,699PYOtherExpensesAmt
CY Other Expenses$9,175,950CYOtherExpensesAmt
PY Total Expenses$25,207,790PYTotalExpensesAmt
CY Total Expenses$28,508,074CYTotalExpensesAmt
PY Revenues Less Expenses$5,006,846PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,242,328CYRevenuesLessExpensesAmt
Total Assets BOY$27,796,147TotalAssetsBOYAmt
Total Assets EOY$31,538,971TotalAssetsEOYAmt
Total Liabilities BOY$3,140,204TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,662,680TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$24,655,943NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$27,876,291NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE PRIMARY HEALTH CARE SERVICES FOR LOW-INCOME INDIVIDUALS BY MANAGING & OPERATING A HEALTH FACILITY & ITS PROGRAMS FOR ALL DARKE COUNTY RESIDENTS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$21,825,514ExpenseAmt
Revenue$21,185,425RevenueAmt
DescFAMILY HEALTH IS A SELF-SUSTAINING ORGANIZATION THAT BUILDS HEALTHY LIVES THROUGH THE PROVISION OF QUALITY, COMPREHENSIVE SERVICES. FAMILY HEALTH OFFERS MEDICAL SERVICES TO PATIENTS OF ALL AGES AS WELL AS DENTAL, BEHAVIORAL HEALTH, VISION, AND PHARMACY SERVICES. DURING THE 2022 FISCAL YEAR, THE CENTER HAD 27,433 PATIENTS AND 118,585 ENCOUNTERS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$2,465,111ExpenseAmt
Revenue$4,305,260RevenueAmt
DescC.H.N., LLC (CHN) IS A HOME HEALTH AGENCY CERTIFIED THROUGH OHIO DEPARTMENT OF HEALTH THAT IS COMMITTED TO MEETING THE HOME CARE NEEDS OF THE COMMUNITY. CHN PROVIDES SERVICES SUCH AS SKILLED NURSING, PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY, AND AIDE HOMEMAKER SERVICES.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$271,157ExpenseAmt
DescWOMEN, INFANTS, AND CHILDREN PROGRAM - PROVIDES NUTRITION AND BREASTFEEDING EDUCATION FOR PREGNANT WOMEN AND WOMEN WITH SMALL CHILDREN. DURING THE 2022 FISCAL YEAR, THE CENTER HAD 1,238 PARTICIPANTS IN THE WIC PROGRAM AND HAD 4,952 ENCOUNTERS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$24,561,782TotalProgramServiceExpensesAmt
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 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
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 ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document43IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee270EmployeeCnt
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 Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
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 CommitteesYes (1)MinutesOfCommitteesInd
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

FieldValueIRS element (for citing)
PersonAUSTIE AUKER FINANCE DIRECTORPersonNm
Phone9375483806PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15735 MEEKER ROADAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationOHStateAbbreviationCd
ZIP45331ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
SONJA ETZELL
PRESIDENT2.00Yes (X)Yes (X)$0$0$0
JOY GREER
VICE PRESIDENT2.00Yes (X)Yes (X)$0$0$0
CRYSTA BLOOMINGDALE
SECRETARY2.00Yes (X)Yes (X)$0$0$0
SCOTT CLUM
TREASURER2.00Yes (X)Yes (X)$0$0$0
KARA ALLREAD
PAST-PRESIDENT2.00Yes (X)$0$0$0
DAVID FARST
TRUSTEE2.00Yes (X)$0$0$0
TOM TREON
TRUSTEE2.00Yes (X)$0$0$0
KATHY O'DELL
TRUSTEE2.00Yes (X)$0$0$0
ROBB MAHER
TRUSTEE2.00Yes (X)$0$0$0
MIKE RIEMAN
TRUSTEE2.00Yes (X)$0$0$0
STEVE STENTZEL
TRUSTEE2.00Yes (X)$0$0$0
JARED POLLICK
EXECUTIVE DIRECTOR40.00Yes (X)$160,857$0$38,747
AUSTIE AUKER
FINANCE DIRECTOR40.00Yes (X)$90,292$0$11,334
CARLOS MENENDEZ
MEDICAL DIRECTOR40.00$263,318$0$42,048Yes (X)
KEN HARSHBARGER
FAMILY PHYSICIAN40.00$280,504$0$54,843Yes (X)
WILLIAM OSTERBUR
FAMILY PHYSICIAN40.00$296,054$0$37,816Yes (X)
JENNIFER RAWLINS
FAMILY PHYSICIAN40.00$241,453$0$31,697Yes (X)
EEMAN DAJANI
PEDIATRIC DENTIST40.00$237,067$0$31,833Yes (X)
THOMAS BROWN
FAMILY PHYSICIAN40.00$233,026$0$45,392Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,802,571TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$293,710TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K32IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ECLINICALWORKS LLC
PO BOX 847950BOSTONMA02284EMR SOFTWARE AND SERVICE$363,906
STAFFMARK INVESTMENT LLC
PO BOX 952386ST LOUISMO63195STAFFING COMPANY$123,121
CHARTER COMMUNICATIONS INC
PO BOX 6030CAROL STREAMIL60197TELECOMMUNICATIONS$107,050
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Government Grants$5,698,506GovernmentGrantsAmt
All Other Contributions$497,193AllOtherContributionsAmt
Noncash Contributions$464,000NoncashContributionsAmt
Total Contributions$6,195,699TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE624100$19,761,266$19,761,266
PHARMACY REVENUE446110$4,498,745$4,498,745
OTHER PROGRAM SERVICES624100$1,173,831$1,173,831
FieldValueIRS element (for citing)
Total Program Service Revenue$25,433,842TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$64,018TotalRevenueColumnAmt
Exclusion$64,018ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$275,525SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$218,682SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$56,843SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$56,843TotalRevenueColumnAmt
Related Or Exempt Func Income$56,843RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$31,750,402TotalRevenueColumnAmt
Related Or Exempt Func Income$25,490,685RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$64,018ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$301,230TotalAmt
Management And General$301,230ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$15,469,567TotalAmt
Program Services$13,792,468ProgramServicesAmt
Management And General$1,677,099ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$49,206TotalAmt
Program Services$49,206ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,420,968TotalAmt
Program Services$2,091,050ProgramServicesAmt
Management And General$329,918ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,091,153TotalAmt
Program Services$945,418ProgramServicesAmt
Management And General$145,735ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$28,800TotalAmt
Program Services$20,434ProgramServicesAmt
Management And General$8,366ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$273,965TotalAmt
Program Services$194,262ProgramServicesAmt
Management And General$79,703ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$43,065TotalAmt
Program Services$30,554ProgramServicesAmt
Management And General$12,511ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$494,242TotalAmt
Program Services$360,154ProgramServicesAmt
Management And General$134,088ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$140,752TotalAmt
Program Services$42,613ProgramServicesAmt
Management And General$98,139ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$582,716TotalAmt
Program Services$499,409ProgramServicesAmt
Management And General$83,307ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$115,378TotalAmt
Program Services$41,069ProgramServicesAmt
Management And General$74,309ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$3,524,398$3,431,746$92,652
CONTRACTUAL FEES$2,853,003$2,314,495$538,508
PHARMACY COSTS$464,000$464,000
COMMUNICATION$353,614$144,555$209,059

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$302,017TotalAmt
Program Services$140,349ProgramServicesAmt
Management And General$161,668ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$28,508,074TotalAmt
Program Services$24,561,782ProgramServicesAmt
Management And General$3,946,292ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$10,274,854BOYAmt
EOY$11,927,212EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$676,724BOYAmt
EOY$679,469EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$507,649BOYAmt
EOY$804,416EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,584,140BOYAmt
EOY$2,782,180EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$126,213BOYAmt
EOY$164,044EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$185,381BOYAmt
EOY$139,156EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$14,686,410LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,616,017LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$9,274,273BOYAmt
EOY$9,070,393EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,956,307BOYAmt
EOY$4,666,891EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,210,606BOYAmt
EOY$1,305,210EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$27,796,147BOYAmt
EOY$31,538,971EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,798,487BOYAmt
EOY$2,291,905EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$12,891BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,328,826BOYAmt
EOY$1,370,775EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,140,204BOYAmt
EOY$3,662,680EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$24,655,943BOYAmt
EOY$27,876,291EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$24,655,943BOYAmt
EOY$27,876,291EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$27,796,147BOYAmt
EOY$31,538,971EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$3,242,328ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$21,980NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
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$3,127,946CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,090,659CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,402,578CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,053,752CurrentTaxYearMinus1YearAmt
Current Tax Year$6,195,699CurrentTaxYearAmt
Total$21,870,634TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,127,946CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,090,659CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,402,578CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,053,752CurrentTaxYearMinus1YearAmt
Current Tax Year$6,195,699CurrentTaxYearAmt
Total$21,870,634TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$21,870,634PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$46,079CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$75,751CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$51,963CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$94,972CurrentTaxYearMinus1YearAmt
Current Tax Year$64,018CurrentTaxYearAmt
Total$332,783TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years-$66,710CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$28,015CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years-$128,671CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total-$167,366TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,095,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$623,586CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,082,104CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,516,550CurrentTaxYearMinus1YearAmt
Current Tax Year$1,173,831CurrentTaxYearAmt
Total$6,491,071TotalAmt
FieldValueIRS element (for citing)
Total Support$28,527,122TotalSupportAmt
Gross Receipts Rltd Activities$98,124,966GrossReceiptsRltdActivitiesAmt
Public Support CY1700.76670PublicSupportCY170Pct
Public Support PY1700.74470PublicSupportPY170Pct
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

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$263,199OtherCostOrOtherBasisAmt
Book Value$263,199BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,910,535OtherCostOrOtherBasisAmt
Depreciation$4,327,648DepreciationAmt
Book Value$7,582,887BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,454,696OtherCostOrOtherBasisAmt
Depreciation$1,288,369DepreciationAmt
Book Value$1,166,327BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$57,980OtherCostOrOtherBasisAmt
Book Value$57,980BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$9,070,393TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDEFERRED COMPENSATIONDesc
Amt$1,370,775Amt
FieldValueIRS element (for citing)
Total Liability$1,370,775TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$31,728,422TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$21,980NetUnrealizedGainsInvstAmt
Revenue Not Reported-$21,980RevenueNotReportedAmt
Revenue Subtotal$31,750,402RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$31,750,402TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$28,508,074TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$28,508,074ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$28,508,074TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationFHS IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE FHS'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. CHN IS ORGANIZED AS A SINGLE MEMBER LLC, IN WHICH, FHS IS THE SOLE MEMBER. AS SUCH, THE INCOME FROM CHN IS REPORTED ON THE TAX RETURN OF FHS. FHS' REPORTING RETURNS ARE SUBJECT TO AUDIT BY FEDERAL AND STATE TAXING AUTHORITIES.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
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 Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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
JARED POLLICK
EXECUTIVE DIRECTOR$142,467$0$18,390$0$0$0$17,820$0$20,927$0$199,604$0$0$0
CARLOS MENENDEZ
MEDICAL DIRECTOR$240,528$0$22,790$0$0$0$33,209$0$8,839$0$305,366$0$0$0
KEN HARSHBARGER
FAMILY PHYSICIAN$274,641$0$5,863$0$0$0$33,406$0$21,437$0$335,347$0$0$0
WILLIAM OSTERBUR
FAMILY PHYSICIAN$290,864$0$5,190$0$0$0$35,313$0$2,503$0$333,870$0$0$0
JENNIFER RAWLINS
FAMILY PHYSICIAN$236,277$0$5,176$0$0$0$29,278$0$2,419$0$273,150$0$0$0
EEMAN DAJANI
PEDIATRIC DENTIST$192,036$0$45,031$0$0$0$29,487$0$2,346$0$268,900$0$0$0
THOMAS BROWN
FAMILY PHYSICIAN$217,775$0$15,251$0$0$0$30,373$0$15,019$0$278,418$0$0$0

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$464,000NoncashContributionsRptF990Amt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PRESENTED TO MANAGEMENT AND THE FULL BOARD FOR THEIR REVIEW AND APPROVAL PRIOR TO SUBMISSION. AN INSPECTION COPY WILL BE HELD BY THE ADMINISTRATIVE DEPARTMENT FOR PUBLIC INSPECTION AT 5735 MEEKER ROAD. THE INSPECTION COPY IS NOT TO LEAVE THE PREMISES AND COPIES WILL NOT BE MADE FOR DISTRIBUTION UNLESS REQUESTED BY A BOARD MEMEBER FOR USE BY THAT BOARD MEMBER.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE CONFLICT OF INTEREST FORMS ANNUALLY. IF ANY CONFLICTS ARE IDENTIFIED THEY ARE MONITORED BY THE BOARD.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION PROCESS FOR EXECUTIVE DIRECTOR: THE SALARY AMOUNT IS SET BY THE BOARD. IN DETERMINING THE SALARY AMOUNT THE BOARD USES MGMA (MEDICAL GROUP MANAGEMENT ASSOCIATION), A SOURCE OF INDUSTRY DATA. COMPENSATION PROCESS FOR OFFICERS: THE SALARY AMOUNT IS SET BY THE EXECUTIVE DIRECTOR. FAMILY HEALTH SERVICES PAYS BASED ON THE INDUSTRY MEDIAN BY USING INDUSTRY DATA FROM MGMA AND NACHC (NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS).
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS ARE AVAILABLE UPON REQUEST AT 5735 MEEKER RD. THE DOCUMENTS OR COPIES THEREOF ARE NOT PERMITTED TO LEAVE THE PREMISES.
FORM 990, PART XII, LINE 2CPROCESS HAS NOT CHANGED SINCE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1COMPREHENSIVE HEALTH NETWORKBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15420 STATE ROUTE 571AddressLine1Txt
CityGREENVILLECityNm
State AbbreviationOHStateAbbreviationCd
ZIP45331ZIPCd
FieldValueIRS element (for citing)
EIN311242113EIN
Primary ActivitiesHOME HEALTH CAREPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd
Total Income$4,346,365TotalIncomeAmt
End Of Year Assets$3,762,514EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1FAMILY HEALTH SERVICES OF DARKE COUNTYBusinessNameLine1Txt