2019-09-12T07:59:43-05:00 2019-03-31 310800053 CLARK SCHAEFER HACKETT & CO 14 EAST MAIN STREET SUITE 500 SPRINGFIELD OH 45502 990 2018-04-01 341119524 FAMILY HEALTH SERVICES OF DARKE COUNTY INC FAMI 9375483806 5735 MEEKER RD GREENVILLE OH 45331 JEAN YOUNG EXECUTIVE DIRECTOR 9375483806 2019-09-04 1 JESSE YOUNG CPA P01236247 9373992000 2019-09-04 74.121.64.228 2019-09-04 05:44:54 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 C2F47ED791055C5DDCDF6A32451FD928BA2C2B7F 2018 2019-02-21 02:37:17Z JEAN YOUNG 5735 MEEKER RD GREENVILLE OH 45331 20398360 0 X FAMILYHEALTHSERVICES.ORG X 1973 OH BUILDING HEALTHY LIVES TOGETHER 13 13 221 13 28015 -85909 3127946 3090659 15283107 13966784 37175 64420 1776219 2008606 20224447 19130469 0 0 0 0 13432061 13786604 0 0 0 4446814 4942708 17878875 18729312 2345572 401157 19191881 19195896 3996605 3601541 15195276 15594355 PROVIDE PRIMARY HEALTH CARE SERVICES FOR LOW-INCOME INDIVIDUALS BY MANAGING & OPERATING A HEALTH FACILITY & ITS PROGRAMS FOR ALL DARKE COUNTY RESIDENTS. 0 0 16265357 15936044 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 2019 FISCAL YEAR, THE CENTER HAD 27,762 PATIENTS AND 115,442 ENCOUNTERS. 319443 WOMEN, INFANTS, AND CHILDREN PROGRAM - PROVIDES NUTRITION AND BREASTFEEDING EDUCATION FOR PREGNANT WOMEN AND WOMEN WITH SMALL CHILDREN. DURING THE 2019 FISCAL YEAR, THE CENTER HAD 1,523 PARTICIPANTS IN THE WIC PROGRAM AND HAD 6,092 ENCOUNTERS. 16584800 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 48 0 1 221 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X JEAN YOUNG EXECUTIVE DIRECTOR 9375483806 5735 MEEKER ROAD GREENVILLE OH 45331 MIKE RIEMAN PRESIDENT 2.00 X X 0 0 0 KARA ALLREAD VICE PRESIDENT 2.00 X X 0 0 0 SONJA ETZELL SECRETARY 2.00 X X 0 0 0 KENT JAMES TREASURER 2.00 X X 0 0 0 DAVID FARST TRUSTEE 2.00 X 0 0 0 SCOTT CLUM TRUSTEE 2.00 X 0 0 0 CRYSTA HUTCHINSON TRUSTEE 2.00 X 0 0 0 TOM TREON TRUSTEE 2.00 X 0 0 0 KATHY O'DELL TRUSTEE 2.00 X 0 0 0 ROBB MAHER TRUSTEE 2.00 X 0 0 0 SHERRY SMITH TRUSTEE 2.00 X 0 0 0 STEVE STENTZEL TRUSTEE 2.00 X 0 0 0 ERIC EVERMAN TRUSTEE 2.00 X 0 0 0 JEAN YOUNG EXECUTIVE DIRECTOR 40.00 X 151970 0 25668 AUSTIE AUKER FINANCE DIRECTOR 40.00 X 86070 0 8999 CARLOS MENENDEZ MEDICAL DIRECTOR 40.00 X 199005 0 37009 JENNIFER RAWLINS FAMILY PHYSICIAN 40.00 X 209079 0 27407 THOMAS BROWN FAMILY PHYSICIAN 40.00 X 221947 0 37636 M LYNNE HAWLEY FAMILY PHYSICIAN 40.00 X 195798 0 34192 KENNETH HARSHBARGER FAMILY PHYSICIAN 40.00 X 260823 0 47396 WILLIAM OSTERBUR FAMILY PHYSICIAN 40.00 X 285105 0 44931 1609797 0 263238 29 0 1 0 ECLINICALWORKS LLC PO BOX 847950 BOSTON MA 02284 EMR SOFTWARE AND SERVICE 314472 STAFFMARK INVESTMENT LLC PO BOX 952386 ST LOUIS MO 63195 STAFFING COMPANY 140758 2 2505221 585438 510000 3090659 PATIENT SERVICE REVENUE 624100 13343198 13343198 OTHER PROGRAM SERVICES 900099 623586 623586 13966784 75751 75751 20000 31331 -11331 -11331 -11331 3217151 1236560 1980591 1980591 INCOME FROM S CORPORATION 900003 28015 28015 28015 19130469 15936044 28015 75751 437045 149254 287791 10708221 10130556 577665 52859 52859 1777654 1632831 144823 810825 748806 62019 48245 48245 53970 5978 47992 420366 218223 202143 66624 39992 26632 112666 97021 15645 572047 528440 43607 92916 49287 43629 CONTRACTUAL FEES 1644594 1229080 415514 SUPPLIES 1427928 1273950 153978 COMMUNICATION 174604 156053 18551 EMPLOYEE DEVELOPMENT 162319 143334 18985 166429 129136 37293 18729312 16584800 2144512 0 5207836 5428516 56581 2482361 2469510 124799 156327 111554 125249 13911280 4497842 9793007 9413438 1196948 1274265 59980 56964 215396 215046 19191881 19195896 1051673 1146004 24562 2903667 2430975 41265 0 3996605 3601541 X 15195276 15594355 15195276 15594355 19191881 19195896 X 401157 25937 -28015 X X 0 1 X 1 1 1 X 1929920 2240744 3485413 3127946 3090659 13874682 1929920 2240744 3485413 3127946 3090659 13874682 13874682 26163 43424 61379 46079 75751 252796 -29751 50456 -1461 -66710 28015 -19451 338362 218507 1089185 1095000 623586 3364640 17472667 77240067 0.79410 0.76830 X 232199 232199 11508171 3348510 8159661 2170910 1149332 1021578 9413438 X 20364951 25937 25937 20339014 -1208545 -1208545 19130469 19965872 1236560 1236560 18729312 0 18729312 PART X, LINE 2: 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. AS THE SOLE SHAREHOLDER OF CHN, A FOR-PROFIT S-CORPORATION, FHS REPORTS THE INCOME REFLECTED ON CHN'S TAX RETURN AND PAYS APPLICABLE INCOME TAXES. FHS' REPORTING RETURNS ARE SUBJECT TO AUDIT BY FEDERAL AND STATE TAXING AUTHORITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: INCOME FROM S CORPORATION NOT RECORDED ON BOOKS 28,015. PHARMACY PURCHASES INCLUDED IN COGS -726,560. IN-KIND PHARMACY AND VACCINES FOR CHILDREN DONATIONS -510,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: PHARMACY PURCHASES INCLUDED IN COGS 726,560. IN-KIND PHARMACY AND VACCINES FOR CHILDREN DONATIONS 510,000. X X 0 0 0 0 0 0 0 0 0 JEAN YOUNG EXECUTIVE DIRECTOR 133485 0 18485 0 0 0 17760 0 7908 0 177638 0 0 0 CARLOS MENENDEZ MEDICAL DIRECTOR 186645 0 12360 0 0 0 24520 0 12489 0 236014 0 0 0 JENNIFER RAWLINS FAMILY PHYSICIAN 208282 0 797 0 0 0 25186 0 2221 0 236486 0 0 0 THOMAS BROWN FAMILY PHYSICIAN 220260 0 1687 0 0 0 28560 0 9076 0 259583 0 0 0 M LYNNE HAWLEY FAMILY PHYSICIAN 195523 0 275 0 0 0 25845 0 8347 0 229990 0 0 0 KENNETH HARSHBARGER FAMILY PHYSICIAN 259987 0 836 0 0 0 31691 0 15705 0 308219 0 0 0 WILLIAM OSTERBUR FAMILY PHYSICIAN 284760 0 345 0 0 0 35993 0 8938 0 330036 0 0 0 A HEALTH CARE FACILITIES REVENUE BOND 341119524 2006-12-18 5700000 FINANCE RENOVATION OF APPROXIMATELY 30,000 SQUARE FOOT FAMILY HEALTH CENTER 0 0 0 A 5700000 2008 0 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 0 0 0 0 0 0 A 0 X 510000 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B BOTH FORMS 990 AND 990T ARE 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: INCOME FROM S CORPORATION NOT RECORDED ON BOOKS -28,015. FORM 990, PART XII, LINE 2C: PROCESS HAS NOT CHANGED SINCE PRIOR YEAR. CHN INC ADULT DAY CARE 5420 STATE ROUTE 571 GREENVILLE OH 45331 311242113 HOME HEALTH CARE OH S 10576 1195563 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0