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COMMUNITY HEALTH SERVICES INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HEALTH SERVICES INC (EIN 06-0863942)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-10-12
IRS object ID
201242869349300609
Schema version
2011v1.2
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)
Timestamp2012-10-12T08:57:34-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN221478099EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1COHNREZNICK LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1180 GLASTONBURY BOULEVARDAddressLine1
CityGLASTONBURYCity
StateCTState
ZIP Code06033ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN060863942EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH SERVICES INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOMMNameControl
Phone8602499625Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 ALBANY AVENUEAddressLine1
CityHARTFORDCity
StateCTState
ZIP Code06120ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKENNETH M GREENName
TitleCHIEF EXECUTIVE OFFICERTitle
Phone8602499625Phone
Date Signed2012-10-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NamePAUL BALLASYName
PTINP00852868PTIN
Phone8606333000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKENNETH M GREENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1500 ALBANY AVENUEAddressLine1
CityHARTFORDCity
StateCTState
ZIP Code06120ZIPCode
FieldValueIRS element (for citing)
Gross Receipts20697449GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CHSHARTFORD.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1967YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE MEDICAL SERVICES FOR THE RESIDENTS OF THE GREATER HARTFORD CONNECTICUT AREA. TO PROVIDE QUALITY HEALTH CARE SERVICES TO LOW AND MODERATE INCOME INDIVIDUALS IN THE GREATER HARTFORD CONNECTICUT AREA REGARDLESS OF ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees172TotalNbrEmployees
Total Nbr Volunteers12TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year6143203ContributionsGrantsPriorYear
Contributions Grants Current Year8776058ContributionsGrantsCurrentYear
Program Service Revenue Prior Year11806712ProgramServiceRevenuePriorYear
Program Service Revenue CY11854001ProgramServiceRevenueCY
Investment Income Prior Year518InvestmentIncomePriorYear
Investment Income Current Year774InvestmentIncomeCurrentYear
Other Revenue Prior Year48802OtherRevenuePriorYear
Other Revenue Current Year14551OtherRevenueCurrentYear
Total Revenue Prior Year17999235TotalRevenuePriorYear
Total Revenue Current Year20645384TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year11207622SalariesEtcPriorYear
Salaries Etc Current Year10471692SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year5184729OtherExpensePriorYear
Other Expenses Current Year5553104OtherExpensesCurrentYear
Total Expenses Prior Year16392351TotalExpensesPriorYear
Total Expenses Current Year16024796TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1606884RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4620588RevenuesLessExpensesCY
Total Assets BOY14021894TotalAssetsBOY
Total Assets EOY18588181TotalAssetsEOY
Total Liabilities BOY1833704TotalLiabilitiesBOY
Total Liabilities EOY1785254TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY12188190NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY16802927NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE MEDICAL SERVICES FOR THE RESIDENTS OF THE GREATER HARTFORD CONNECTICUT AREA. TO PROVIDE QUALITY HEALTH CARE SERVICES TO LOW AND MODERATE INCOME INDIVIDUALS IN THE GREATER HARTFORD CONNECTICUT AREA REGARDLESS OF ABILITY TO PAY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense12723044Expense
Grants0Grants
Revenue11902167Revenue
DescriptionPROVIDE QUALITY HEALTH CARE SERVICES TO OVER 18,000 PATIENTS WHO ARE LOW AND MODERATE INCOME INDIVIDUALS IN THE GREATER HARTFORD CONNECTICUT AREA.Description
Total Program Service Expense12723044TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109619NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees172NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCTStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSCOTT BRABANTNamePerson
Telephone Number8602499625TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1500 ALBANY AVENUEAddressLine1
CityHARTFORDCity
StateCTState
ZIP Code06120ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
JACQUELINE MCDERMOTT-SELMAN
CHAIRWOMAN0.50XX000
AIGNER MITCHELL
VICE CHAIRWOMAN0.50XX000
MISHONE DONELSON
TREASURER0.50XX000
RICHARD ORDER
SECRETARY0.50XX000
KHADIJA ABDUL-SALAAM
DIRECTOR0.50X000
BIREE ANDEMARIAM
DIRECTOR0.50X000
JABER ASLANZADEH
DIRECTOR0.50X000
KRISTEN CLARK
DIRECTOR0.50X000
MARC A DIBELLA
DIRECTOR0.50X000
TAWANA DILLARD
DIRECTOR0.50X000
PATRICIA GIBBS
DIRECTOR0.50X000
SHERWOOD LEWIS
DIRECTOR0.50X000
EVELYN RICHARDSON
DIRECTOR0.50X000
FLOYD PAULLING
DIRECTOR0.50X000
CLORINDA SOLDEVILA
DIRECTOR0.50X000
KENNETH GREEN
CHIEF EXECUTIVE OFFICER40.00X153653015010
ANDREA MONTGOMERY
CHIEF OPERATING OFFICER40.00X12186706274
JOHVONNE CLAYBOURNE DO
CHIEF MEDICAL OFFICER40.00X154004020371
RITU DUTTA
DIRECTOR OF WOMEN'S HEALTH40.00183977013738X
KATHLEEN CUSICK
PHYSICIAN40.00180983015952X
TULIKA KAUSHIK
DENTIST40.00146074020382X
TERESITA FLYNN
FORMER CFO40.0011289107784X
GRETCHEN ALLEN
FORMER MEDICAL DIRECTOR40.00159210015497X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1212659TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation115008TotalOtherCompensation
Number Individuals GT100 K16NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SUFFOLK CONSTRUCTION
99 CONIFER HILL DRIVEDANVERSMA01923CONSTRUCTION MANAGEMENT3661689
STAFF CARE
PO BOX 281923ATLANTAGA30384HEALTHCARE STAFFING214174
DENTURE CENTER LLC
38 FLEETWOOD RDNEWINGTONCT06111DENTAL SUPPLIES173592
UCONN HEALTH CENTER SCHOOL OF DENTAL MED
263 FARMINGTON AVENUEFARMINGTONCT06030DENTAL SERVICES120779
DIVERSITIES BUILDING SERVICES LLC
340 QUINNIPIAC STREETWALLINGFORDCT06492JANITORIAL SERVICES107303
FieldValueIRS element (for citing)
Number Of Contractors GT100 K12NumberOfContractorsGT100K
Fundraising Events26219FundraisingEvents
Government Grants8165258GovernmentGrants
All Other Contributions584581AllOtherContributions
Noncash Contributions308623NoncashContributions
Total Contributions8776058TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICEDescription
Business Code620000BusinessCode
Total Revenue Column11854001TotalRevenueColumn
Related Or Exempt Function Income11854001RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue11854001TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column774TotalRevenueColumn
Exclusion$774ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events18450GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events26219CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses52065FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-33615TotalRevenueColumn
Exclusion-$33,615ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column48166TotalRevenueColumn
Related Or Exempt Function Income48166RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue48166TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column20645384TotalRevenueColumn
Related Or Exempt Function Income11902167RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$32,841ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1482572Total
Program Services1146547ProgramServices
Management And General336025ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7145503Total
Program Services5554114ProgramServices
Management And General1591389ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total159279Total
Program Services116752ProgramServices
Management And General42527ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1031523Total
Program Services755943ProgramServices
Management And General275580ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total652815Total
Program Services478513ProgramServices
Management And General174302ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total134318Total
Management And General134318ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total65765Total
Management And General65765ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total851787Total
Program Services826227ProgramServices
Management And General25560ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total8766Total
Program Services7258ProgramServices
Management And General1508ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total820424Total
Program Services748484ProgramServices
Management And General71940ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total156180Total
Program Services114168ProgramServices
Management And General42012ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total481913Total
Program Services352278ProgramServices
Management And General129635ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total29208Total
Program Services12589ProgramServices
Management And General16619ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total35789Total
Program Services15425ProgramServices
Management And General20364ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total37066Total
Program Services27080ProgramServices
Management And General9986ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total738262Total
Program Services539374ProgramServices
Management And General198888ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total160491Total
Program Services117255ProgramServices
Management And General43236ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT12214941221494
OUTSIDE SERVICES472569361093111476
VACCINES308623308623
OTHER EXPENSES25407164648943

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total5042Total
Program Services3363ProgramServices
Management And General1679ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total16024796Total
Program Services12723044ProgramServices
Management And General3301752ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY689890BOY
EOY1006086EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY185928BOY
EOY772256EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1397438BOY
EOY1081537EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY141822BOY
EOY250609EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY58238BOY
EOY154883EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis21310270LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5996961LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY11536793BOY
EOY15313309EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY11785BOY
EOY9501EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY14021894BOY
EOY18588181EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1023920BOY
EOY1103212EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY735523BOY
EOY669311EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY74261BOY
EOY12731EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1833704BOY
EOY1785254EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY12158190BOY
EOY16753259EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY30000BOY
EOY49668EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12188190BOY
EOY16802927EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14021894BOY
EOY18588181EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses4620588ReconcilationRevenueExpenses
Reconcilation Other Changes-5851ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5802065CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4749427CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5819655CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6143203CurrentTaxYearMinus1Year
Current Tax Year8776058CurrentTaxYear
Total31290408Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5802065CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4749427CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5819655CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6143203CurrentTaxYearMinus1Year
Current Tax Year8776058CurrentTaxYear
Total31290408Total
FieldValueIRS element (for citing)
Public Support Total17031290408PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11184CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1402CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years735CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year518CurrentTaxYearMinus1Year
Current Tax Year774CurrentTaxYear
Total14613Total
FieldValueIRS element (for citing)
Total Support31305021TotalSupport
Public Support Pertcentage1700.99950PublicSupportPertcentage170
Public Support Pertcent Prior Year0.99340PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis133022OtherCostOrOtherBasis
Book Value133022BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis13001617OtherCostOrOtherBasis
Depreciation4161972Depreciation
Book Value8839645BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2641302OtherCostOrOtherBasis
Depreciation1834989Depreciation
Book Value806313BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5534329OtherCostOrOtherBasis
Book Value5534329BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings15313309TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionSHORT-TERM LEASE PAYABLEDescription
Amount$12,731Amount
FieldValueIRS element (for citing)
Total Of Amounts12731TotalOfAmounts
Total Revenue20645384TotalRevenue
Total Expenses16024796TotalExpenses
Excess Or Deficit For Year4620588ExcessOrDeficitForYear
Net Unrealized GL On Investments-5851NetUnrealizedGLOnInvestments
Total Adjustments-5851TotalAdjustments
Excess Or Deficit Per FS4614737ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt20691598TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-5851NetUnrealizedGainsInvestments
Other Revenues52065OtherRevenues
Revenue Not Rptd F99046214RevenueNotRptdF990
Revenue Subtotal20645384RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99020645384TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt16076861TotExpensesEtcAuditedFinclStmt
Other Expenses Included52065OtherExpensesIncluded
Expenses Not Rptd F99052065ExpensesNotRptdF990
Expenses Subtotal16024796ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99016024796TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE CENTER HAS NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2011. THE CENTER'S U.S. FEDERAL AND STATE INFORMATION RETURNS PRIOR TO CALENDAR YEAR 2008 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. IF THE CENTER HAS UNRELATED BUSINESS INCOME TAXES, IT WILL RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS AS PART OF THE INCOME TAX PROVISION AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH THE RELATED TAX LIABILITY IN THE STATEMENT OF FINANCIAL POSITION.
PART XII, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EXPENSE 52,065.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EXPENSES 52,065.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event12011 GALANameOfEvent1
Gross Receipts Event144669GrossReceiptsEvent1
Charitable Contributions Event126219CharitableContributionsEvent1
Gross Revenue Event118450GrossRevenueEvent1
Food And Beverage Event19940FoodAndBeverageEvent1
Other Direct Expenses Event142125OtherDirectExpensesEvent1
Gross Receipts Total44669GrossReceiptsTotal
Charitable Contributions Total26219CharitableContributionsTotal
Gross Revenue Total Events18450GrossRevenueTotalEvents
Food And Beverage Total Events9940FoodAndBeverageTotalEvents
Other Direct Expenses Total Events42125OtherDirectExpensesTotalEvents
Direct Expense Summary Events52065DirectExpenseSummaryEvents
Net Income Summary-33615NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KENNETH GREEN
1536530000031380118720168663000
JOHVONNE CLAYBOURNE DO
1540040000065740137970174375000
RITU DUTTA
183977000007200065380197715000
KATHLEEN CUSICK
180983000007665082870196935000
TULIKA KAUSHIK
1460740000000203820166456000
TERESITA FLYNN
112891000000077840120675000
GRETCHEN ALLEN
1592100000000154970174707000

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990308623NoncashContribsRptdF990
Method Of Determining RevenuesCOSTMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE FINANCE DEPARTMENT ALONG WITH THE CEO REVIEWS THE FORM 990 IS THEN FORWARDED TO THE FINANCE COMMITTEE WHO REVIEWS THE 990. THE 990 IS THEN DISTRIBUTED TO THE FULL BOARD FOR APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CCOMMUNITY HEALTH SERVICES, INC. REQUIRES THAT ALL EMPLOYEES AND BOARD MEMBERS TO SIGN A WRITTEN CONFLICT OF INTEREST POLICY. THIS CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY THE CORPORATE COMPLIANCE OFFICER AND THE CORPORATE COMPLIANCE TEAM WHICH MEETS ON A QUARTERLY BASIS.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF DIRECTORS, IN AN EXECUTIVE MEETING, DETERMINES THE COMPENSATION OF THE CEO. THEY USE A LOCAL NONPROFIT CEO COMPENSATION SURVEY AS A GUIDELINE. THE CEO DETERMINES THE COMPENSATION OF THE ORGANIZATION'S EMPLOYEES. HE IS GUIDED BY STATE AND NATIONAL GUIDELINES AND SURVEYS AS WELL AS SURVEY DONE YEARLY FOR THE COMMUNITY HEALTH CENTERS IN CONNECTICUT BY THE COMMUNITY HEALTH CENTER ASSOCIATION OF CONNECTICUT.
FORM 990, PART VI, SECTION C, LINE 19COMMUNITY HEALTH SERVICES' GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -5,851.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CNO CHANGES FROM THE PRIOR YEAR.