FAMILY HEALTH SERVICES OF DARKE COUNTY INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- FAMILY HEALTH SERVICES OF DARKE COUNTY INC (EIN 34-1119524)
- Tax period
- 2020-04-01 to 2021-03-31
- Filed
- 2021-12-09
- IRS object ID
- 202143439349300504
- Schema version
- 2020v4.1
- 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 | 2021-12-09T08:00:54-06:00 | ReturnTs |
| Tax Period End | 2021-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 310800053 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARK SCHAEFER HACKETT & CO | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14 EAST MAIN STREET SUITE 500 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45502 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341119524 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAMILY HEALTH SERVICES OF DARKE COUNTY | BusinessNameLine1Txt |
| Business Name Line2 | INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FAMI | BusinessNameControlTxt |
| Phone | 9375483806 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5735 MEEKER RD | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45331 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JARED POLLICK | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 9375483806 | PhoneNum |
| Signature | 2021-12-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JARED | PersonFirstNm |
| Person Last | POLLICK | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JESSE YOUNG CPA | PreparerPersonNm |
| PTIN | P01236247 | PTIN |
| Phone | 9373992000 | PhoneNum |
| Preparation | 2021-12-08 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JARED POLLICK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5735 MEEKER RD | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45331 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $30,214,636 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | FAMILYHEALTHSERVICES.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | BUILDING HEALTHY LIVES TOGETHER | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 306 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,402,578 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,053,752 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,614,291 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,065,912 | CYProgramServiceRevenueAmt |
| PY Investment Income | $51,963 | PYInvestmentIncomeAmt |
| CY Investment Income | $94,972 | CYInvestmentIncomeAmt |
| PY Other Revenue | $194,905 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $23,263,737 | PYTotalRevenueAmt |
| CY Total Revenue | $30,214,636 | 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 | $13,968,413 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,978,091 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,678,856 | PYOtherExpensesAmt |
| CY Other Expenses | $8,229,699 | CYOtherExpensesAmt |
| PY Total Expenses | $20,647,269 | PYTotalExpensesAmt |
| CY Total Expenses | $25,207,790 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,616,468 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,006,846 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $20,316,160 | TotalAssetsBOYAmt |
| Total Assets EOY | $27,796,147 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,555,950 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,140,204 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $17,760,210 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $24,655,943 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PROVIDE 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 Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $18,862,014 | ExpenseAmt |
| Revenue | $20,206,259 | RevenueAmt |
| Desc | FAMILY 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 2021 FISCAL YEAR, THE CENTER HAD 26,649 PATIENTS AND 92,857 ENCOUNTERS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,288,450 | ExpenseAmt |
| Revenue | $3,859,653 | RevenueAmt |
| Desc | C.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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $329,553 | ExpenseAmt |
| Desc | WOMEN, INFANTS, AND CHILDREN PROGRAM - PROVIDES NUTRITION AND BREASTFEEDING EDUCATION FOR PREGNANT WOMEN AND WOMEN WITH SMALL CHILDREN. DURING THE 2021 FISCAL YEAR, THE CENTER HAD 1,376 PARTICIPANTS IN THE WIC PROGRAM AND HAD 5,504 ENCOUNTERS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $21,480,017 | 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | 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 | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 306 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | Yes (1) | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AUSTIE AUKER FINANCE DIRECTOR | PersonNm |
| Phone | 9375483806 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5735 MEEKER ROAD | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45331 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 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 |
|---|---|---|---|---|---|---|---|---|
| KARA ALLREAD | ||||||||
| PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAVID FARST | ||||||||
| VICE PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SONJA ETZELL | ||||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOY GREER | ||||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SCOTT CLUM | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| CRYSTA BLOOMINGDALE | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| TOM TREON | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHY O'DELL | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBB MAHER | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MIKE RIEMAN | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| STEVE STENTZEL | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JARED POLLICK | ||||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $110,026 | $0 | $20,851 | |||
| JEAN YOUNG | ||||||||
| EXECUTIVE DIRECTOR (THRU MAY 2020) | 40.00 | Yes (X) | $106,822 | $0 | $13,183 | |||
| AUSTIE AUKER | ||||||||
| FINANCE DIRECTOR | 40.00 | Yes (X) | $93,144 | $0 | $11,546 | |||
| CARLOS MENENDEZ | ||||||||
| MEDICAL DIRECTOR | 40.00 | $230,760 | $0 | $46,059 | Yes (X) | |||
| KENNETH HARSHBARGER | ||||||||
| FAMILY PHYSICIAN | 40.00 | $312,814 | $0 | $59,362 | Yes (X) | |||
| WILLIAM OSTERBUR | ||||||||
| FAMILY PHYSICIAN | 40.00 | $298,496 | $0 | $49,528 | Yes (X) | |||
| JENNIFER RAWLINS | ||||||||
| FAMILY PHYSICIAN | 40.00 | $280,124 | $0 | $36,885 | Yes (X) | |||
| EEMAN DAJANI | ||||||||
| PEDIATRIC DENTIST | 40.00 | $256,448 | $0 | $34,657 | Yes (X) | |||
| THOMAS BROWN | ||||||||
| FAMILY PHYSICIAN | 40.00 | $209,166 | $0 | $39,289 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,897,800 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $311,360 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 34 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| STAFFMARK INVESTMENT LLC | |||||
| PO BOX 952386 | ST LOUIS | MO | 63195 | STAFFING COMPANY | $289,835 |
| ECLINICALWORKS LLC | |||||
| PO BOX 847950 | BOSTON | MA | 02284 | EMR SOFTWARE AND SERVICE | $107,206 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,501,074 | GovernmentGrantsAmt |
| All Other Contributions | $552,678 | AllOtherContributionsAmt |
| Noncash Contributions | $468,149 | NoncashContributionsAmt |
| Total Contributions | $6,053,752 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 624100 | $17,367,215 | $17,367,215 |
| PHARMACY REVENUE | 446110 | $4,182,147 | $4,182,147 |
| OTHER PROGRAM SERVICES | 624100 | $2,516,550 | $2,516,550 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,065,912 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $94,972 | TotalRevenueColumnAmt |
| Exclusion | $94,972 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,214,636 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,065,912 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $94,972 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $632,390 | TotalAmt |
| Program Services | $69,205 | ProgramServicesAmt |
| Management And General | $563,185 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,356,938 | TotalAmt |
| Program Services | $12,139,630 | ProgramServicesAmt |
| Management And General | $1,217,308 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,698 | TotalAmt |
| Program Services | $82,698 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,984,531 | TotalAmt |
| Program Services | $1,676,061 | ProgramServicesAmt |
| Management And General | $308,470 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $921,534 | TotalAmt |
| Program Services | $779,296 | ProgramServicesAmt |
| Management And General | $142,238 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,935 | TotalAmt |
| Program Services | $7,399 | ProgramServicesAmt |
| Management And General | $96,536 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $422,988 | TotalAmt |
| Program Services | $376,268 | ProgramServicesAmt |
| Management And General | $46,720 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,533 | TotalAmt |
| Program Services | $117,133 | ProgramServicesAmt |
| Management And General | $3,400 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $989 | TotalAmt |
| Program Services | $989 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $594,629 | TotalAmt |
| Program Services | $543,744 | ProgramServicesAmt |
| Management And General | $50,885 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,617 | TotalAmt |
| Program Services | $19,275 | ProgramServicesAmt |
| Management And General | $66,342 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CONTRACTUAL FEES | $2,518,282 | $1,825,293 | $692,989 |
| SUPPLIES | $2,277,701 | $1,894,138 | $383,563 |
| PHARMACY COSTS | $1,301,712 | $1,301,712 | |
| COMMUNICATION | $276,787 | $220,830 | $55,957 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $526,526 | TotalAmt |
| Program Services | $426,346 | ProgramServicesAmt |
| Management And General | $100,180 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,207,790 | TotalAmt |
| Program Services | $21,480,017 | ProgramServicesAmt |
| Management And General | $3,727,773 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,083,895 | BOYAmt |
| EOY | $10,274,854 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $676,724 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $519,903 | BOYAmt |
| EOY | $507,649 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,861,199 | BOYAmt |
| EOY | $2,584,140 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $160,186 | BOYAmt |
| EOY | $126,213 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $141,954 | BOYAmt |
| EOY | $185,381 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $14,437,996 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,163,723 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,039,206 | BOYAmt |
| EOY | $9,274,273 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,230,759 | BOYAmt |
| EOY | $2,956,307 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,279,058 | BOYAmt |
| EOY | $1,210,606 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,316,160 | BOYAmt |
| EOY | $27,796,147 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,295,300 | BOYAmt |
| EOY | $1,798,487 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $12,891 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,260,650 | BOYAmt |
| EOY | $1,328,826 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,555,950 | BOYAmt |
| EOY | $3,140,204 | 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 | $17,760,210 | BOYAmt |
| EOY | $24,655,943 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,760,210 | BOYAmt |
| EOY | $24,655,943 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,316,160 | BOYAmt |
| EOY | $27,796,147 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,006,846 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $502,537 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $1,386,350 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 | $3,485,413 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,127,946 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,090,659 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,402,578 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,053,752 | CurrentTaxYearAmt |
| Total | $19,160,348 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,485,413 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,127,946 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,090,659 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,402,578 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,053,752 | CurrentTaxYearAmt |
| Total | $19,160,348 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $19,160,348 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $61,379 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $46,079 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $75,751 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $51,963 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $94,972 | CurrentTaxYearAmt |
| Total | $330,144 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | -$1,461 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | -$66,710 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $28,015 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | -$128,671 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | -$168,827 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,089,185 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,095,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $623,586 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,082,104 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,516,550 | CurrentTaxYearAmt |
| Total | $6,406,425 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $25,728,090 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $88,771,552 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.74470 | PublicSupportCY170Pct |
| Public Support PY170 | 0.78240 | 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $263,199 | OtherCostOrOtherBasisAmt |
| Book Value | $263,199 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,875,585 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,959,166 | DepreciationAmt |
| Book Value | $7,916,419 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,070,565 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,204,557 | DepreciationAmt |
| Book Value | $866,008 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $228,647 | OtherCostOrOtherBasisAmt |
| Book Value | $228,647 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,274,273 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION | $1,311,825 |
| REFUNDABLE ADVANCE | $17,001 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,328,826 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $30,717,173 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $502,537 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $502,537 | RevenueNotReportedAmt |
| Revenue Subtotal | $30,214,636 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $30,214,636 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $25,207,790 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $25,207,790 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $25,207,790 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | FHS 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
| 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 | Yes (1) | 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARLOS MENENDEZ | ||||||||||||||
| MEDICAL DIRECTOR | $205,715 | $0 | $25,045 | $0 | $0 | $0 | $29,976 | $0 | $16,083 | $0 | $276,819 | $0 | $0 | $0 |
| KENNETH HARSHBARGER | ||||||||||||||
| FAMILY PHYSICIAN | $310,125 | $0 | $2,689 | $0 | $0 | $0 | $38,824 | $0 | $20,538 | $0 | $372,176 | $0 | $0 | $0 |
| WILLIAM OSTERBUR | ||||||||||||||
| FAMILY PHYSICIAN | $295,521 | $0 | $2,975 | $0 | $0 | $0 | $37,261 | $0 | $12,267 | $0 | $348,024 | $0 | $0 | $0 |
| JENNIFER RAWLINS | ||||||||||||||
| FAMILY PHYSICIAN | $277,111 | $0 | $3,013 | $0 | $0 | $0 | $34,466 | $0 | $2,419 | $0 | $317,009 | $0 | $0 | $0 |
| EEMAN DAJANI | ||||||||||||||
| PEDIATRIC DENTIST | $200,172 | $0 | $56,276 | $0 | $0 | $0 | $32,311 | $0 | $2,346 | $0 | $291,105 | $0 | $0 | $0 |
| THOMAS BROWN | ||||||||||||||
| FAMILY PHYSICIAN | $204,113 | $0 | $5,053 | $0 | $0 | $0 | $24,793 | $0 | $14,496 | $0 | $248,455 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $468,149 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | FHS IS THE SOLE MEMBER OF C.H.N., LLC (CHN), A HOME HEALTH AGENCY CERTIFIED THROUGH THE OHIO DEPARTMENT OF HEALTH. EFFECTIVE JANUARY 31, 2020, CHN CONVERTED FROM AN S CORPORATION TO A SINGLE-MEMBER LLC OWNED BY FHS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 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 EXECUTIVE SECRETARY 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 12C | BOARD 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 15 | COMPENSATION PROCESS FOR TOP OFFICIALS: 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: 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 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST AT 5735 MEEKER RD. THE DOCUMENTS OR COPIES THEREOF ARE NOT PERMITTED TO LEAVE THE PREMISES. |
| FORM 990, PART XI, LINE 9: | CHN SINGLE MEMBER LLC CONVERSION 1,386,350. |
| FORM 990, PART XII, LINE 2C | PROCESS HAS NOT CHANGED SINCE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMPREHENSIVE HEALTH NETWORK | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5420 STATE ROUTE 571 | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45331 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311242113 | EIN |
| Primary Activities | HOME HEALTH CARE | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Total Income | $4,574,439 | TotalIncomeAmt |
| End Of Year Assets | $3,215,436 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAMILY HEALTH SERVICES OF DARKE COUNTY | BusinessNameLine1Txt |