2020-05-11T16:28:39-05:00 2019-06-30 390758449 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2018-07-01 391919806 COMMUNITY HEALTH SYSTEMS INC COMM 6083610311 74 ECLIPSE BOULEVARD BELOIT WI 535116214 MARY E JOHNSON CHIEF EXECUTIVE OFFICER 6083610311 2020-04-23 1 CHLOE CHIUMINATTO P01924323 4144319300 2020-04-23 184.59.22.73 2020-04-23 10:02:40 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 CC322FB1B7FC8ED290785ACCB7D2994D8745AEAD 2018 2020-11-19 02:30:22Z MARY E JOHNSON 74 ECLIPSE BOULEVARD BELOIT WI 535116214 6944242 0 X WWW.CHSOFWI.ORG X 1997 WI OUR MISSION IS TO PROVIDE HEALTH AND SOCIAL SERVICES THAT WILL PROMOTE COMFORT, HEALING, AND PREVENTION OF ILLNESSES AND INJURIES. OUR SERVICES ARE CULTURALLY COMPETENT AND SENSITIVE, COMMUNITY ORIENTED, AND PROVIDED REGARDLESS OF INCOME. 7 7 106 12 0 0 2393196 2558254 6077455 4340469 1448 23540 0 4194 8472099 6926457 0 0 0 0 4221016 4629751 0 0 0 2680998 2661424 6902014 7291175 1570085 -364718 5104459 4264421 1645101 1169781 3459358 3094640 X OUR MISSION IS TO PROVIDE HEALTH AND SOCIAL SERVICES THAT WILL PROMOTE COMFORT, HEALING, AND PREVENTION OF ILLNESSES AND INJURIES. OUR SERVICES ARE CULTURALLY COMPETENT AND SENSITIVE, COMMUNITY ORIENTED, AND PROVIDED REGARDLESS OF INCOME. 1 1 4534179 0 4340469 COMMUNITY HEALTH SYSTEMS, INC. OPERATES TWO SITES, WHICH OFFER A COMPLIMENT OF MEDICAL, BEHAVIORAL HEALTH, AND DENTAL SERVICES IN BELOIT AND JANESVILLE, WISCONSIN. THE JANESVILLE LOCATION WAS CLOSED IN MAY OF 2018. DURING FISCAL YEAR 2019, THESE SITES HAD OVER 31,000 VISITS. 4534179 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 17 0 106 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X MARY E JOHNSON 6083610311 74 ECLIPSE BOULEVARD BELOIT WI 535116214 LANA TASHA BELL DIRECTOR 0.50 X 0 0 0 JEREMY BROWN DIRECTOR (THRU 04/19) 0.50 X 0 0 0 IAN HEDGES DIRECTOR (THRU 11/18) 0.50 X 0 0 0 WHITNEY HELM DIRECTOR (THRU 11/18) 0.50 X 0 0 0 DORIS MULDER DIRECTOR 0.50 X 0 0 0 DALIA OCHOA DIRECTOR (THRU 12/18) 0.50 X 0 0 0 BRIAN WILSON DIRECTOR 0.50 X 0 0 0 MEGGE CASIQUE CHAIR 0.50 X X 0 0 0 PATRICK KUELZ VICE CHAIR 0.50 X X 0 0 0 RUTH GRAY SECRETARY (THRU 07/18) 0.50 X X 0 0 0 LINDA GARZA SECRETARY (BEG. 08/18) 0.50 X X 0 0 0 KRISTIN LOEHR TREASURER 0.50 X X 0 0 0 JULIE SPRECHER CHIEF EXECUTIVE OFFICER 40.00 X 171748 0 11369 MARY E JOHNSON CHIEF OPERATING OFFICER (BEG. 03/19) 40.00 X 0 0 0 MARK LUNDVALL CHIEF FINANCIAL OFFICER 40.00 X 109636 0 2366 NAHEED AHMAD DENTIST 40.00 X 113832 0 9319 MANUJ GOEL MD MEDICAL DIRECTOR (THRU 12/18) 40.00 X 192640 0 25919 CHRISTOPHER GREENWALDT DENTIST 40.00 X 123635 0 7288 KATIE WILSON DENTIST 40.00 X 114342 0 8193 825833 0 64454 6 0 1 0 OCHIN INC 1881 SW NAITO PARKWAY PORTLAND OR 97201 COMPUTER SOFTWARE SERVICE AND SUPPORT 192436 APPLIED TECH 203 S PATERSON STREET SUITE 500 MADISON WI 53703 COMPUTER AND IT SUPPORT 165573 LABORATORY CORPORATION OF AMERICA HOLDIN PO BOX 2270 BURLINGTON NC 27216 CONTRACTED LABORATORY SERVICES 102267 3 2557904 350 2558254 PATIENT SERVICE REVENUE 621300 4339222 4339222 1247 1247 4340469 25325 25325 4194 0 4194 4194 4194 16000 17785 -1785 -1785 -1785 6926457 4340469 0 27734 347155 187879 159276 2304741 1221615 1083126 39302 39302 1663604 1012576 651028 274949 173204 101745 609 609 626070 443979 182091 107497 44847 62650 63773 33858 29915 168115 104329 63786 369269 247609 121660 9342 6044 3298 38806 23630 15176 49071 49049 22 238610 80418 158192 29495 29495 MEDICAL & PHARMACY SUPP 406908 406803 105 BAD DEBT EXPENSE 360590 360590 EQUIPMENT & MAINTENANCE 140799 118704 22095 DUES 33179 12327 20852 19291 6718 12573 7291175 4534179 2756996 0 160788 173168 2501988 1471491 114196 99258 301847 500755 25672 28167 23118 107133 3177640 1428799 1782103 1748841 194747 135608 5104459 4264421 626037 267822 1134 1134 1017930 900825 1645101 1169781 X 3459358 3094640 3459358 3094640 5104459 4264421 -364718 0 X 0 1 X 1 1 1 X 1916026 2003915 2582302 2393196 2558254 11453693 1916026 2003915 2582302 2393196 2558254 11453693 11453693 722 1448 29519 31689 11485382 29722707 0.99720 0.99980 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1350292 436440 913852 782335 411939 370396 985564 580420 405144 59449 59449 1748841 CAPITAL LEASE OBLIGATION 900825 900825 6567652 -360590 -360590 6928242 -1785 -1785 6926457 6932370 1785 1785 6930585 360590 360590 7291175 PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -360,590. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF PROPERTY AND EQUIPMENT -1,785. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF PROPERTY AND EQUIPMENT 1,785. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 360,590. X X 0 0 0 0 0 0 0 0 0 JULIE SPRECHER CHIEF EXECUTIVE OFFICER 161133 0 10615 0 0 0 2326 0 9043 0 183117 0 0 0 MANUJ GOEL MD MEDICAL DIRECTOR (THRU 12/18) 192040 0 600 0 0 0 0 0 25919 0 218559 0 0 0 FORM 990, PART III, LINE 2 THE CORPORATION OPENED THE BEHAVIORAL HEALTH DEPARTMENT IN OCTOBER OF 2018. FORM 990, PART III, LINE 3 THE CORPORATION CLOSED THE JANESVILLE SITE IN MAY OF 2018. FORM 990, PART VI, SECTION A, LINE 8B THE CORPORATION'S GOVERNING BODY DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE PREPARED FORM 990 IS REVIEWED AND APPROVED BY THE MEMBERS OF THE GOVERNING BODY AND MANAGEMENT BEFORE THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C CONFLICTS OF INTEREST MAY INCLUDE, BUT ARE NOT LIMITED TO RELATIONSHIPS, ASSOCIATIONS, OR BUSINESS DEALINGS WITH VENDORS, SUPPLIERS, OTHER HEALTHCARE ORGANIZATIONS, OR INDIVIDUALS. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMUNITY HEALTH SYSTEM'S, INC. (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'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. IF THE GOVERNING BOARD OR CHS EXECUTIVE TEAM HAS REASONABLE CAUSE TO BELIEVE A MEMBER/EMPLOYEE HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE BOARD MEMBER/EMPLOYEE OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE BOARD MEMBER'S/EMPLOYEE'S RESPONSE AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE GOVERNING BOARD OR CHS EXECUTIVE TEAM WILL DETERMINE IF THE BOARD MEMBER/EMPLOYEE HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AND SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15 ON AN ANNUAL BASIS, THE CORPORATION'S HUMAN RESOURCE MANAGER PROVIDES THE MEMBERS OF THE GOVERNING BODY WITH COMPENSATION DATA FOR COMPARABLE POSITIONS AT SIMILAR ORGANIZATIONS FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) LATEST COMPENSATION SURVEYS. THE GOVERNING BODY ALSO PERFORMS AN ANNUAL PERFORMANCE REVIEW OF THE CORPORATION'S CHIEF EXECUTIVE OFFICER. THE MEMBERS OF THE GOVERNING BODY DETERMINE AND VOTE TO APPROVE THE COMPENSATION ANMOUNTS FOR THE YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.