2024-02-06T14:50:04-06:00 2023-03-31 310800053 CLARK SCHAEFER HACKETT & CO 14 EAST MAIN STREET SUITE 500 SPRINGFIELD OH 45502 990 2022-04-01 341119524 FAMILY HEALTH SERVICES OF DARKE COUNTY INC FAMI 9375483806 5735 MEEKER RD GREENVILLE OH 45331 JARED POLLICK EXECUTIVE DIRECTOR 9375483806 2024-02-06 1 JARED POLLICK 999009999 0 JESSE YOUNG CPA P01236247 9373992000 2024-02-06 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JARED POLLICK 5735 MEEKER RD GREENVILLE OH 45331 40108307 0 X FAMILYHEALTHSERVICES.ORG X 1973 OH BUILDING HEALTHY LIVES TOGETHER 13 13 267 13 -842 0 6195699 6892846 25433842 32951991 120861 118355 0 -842 31750402 39962350 0 0 0 0 19332124 21155244 0 0 0 9175950 12027437 28508074 33182681 3242328 6779669 31538971 39260498 3662680 4817079 27876291 34443419 PROVIDE PRIMARY HEALTH CARE SERVICES FOR LOW-INCOME INDIVIDUALS BY MANAGING & OPERATING A HEALTH FACILITY & ITS PROGRAMS FOR ALL DARKE COUNTY RESIDENTS. 0 0 25551148 28944633 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 2023 FISCAL YEAR, THE CENTER HAD 26,857 PATIENTS AND 115,239 ENCOUNTERS. 2398927 3987123 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. 304972 WOMEN, INFANTS, AND CHILDREN PROGRAM - PROVIDES NUTRITION AND BREASTFEEDING EDUCATION FOR PREGNANT WOMEN AND WOMEN WITH SMALL CHILDREN. DURING THE 2023 FISCAL YEAR, THE CENTER HAD 1,998 PARTICIPANTS IN THE WIC PROGRAM AND HAD 7,992 ENCOUNTERS. 28255047 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 43 0 1 267 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 0 X AUSTIE AUKER FINANCE DIRECTOR 9375483806 5735 MEEKER ROAD GREENVILLE OH 45331 SONJA ETZELL PRESIDENT 2.00 X X 0 0 0 JOY GREER VICE PRESIDENT 2.00 X X 0 0 0 CRYSTA BLOOMINGDALE SECRETARY 2.00 X X 0 0 0 SCOTT CLUM TREASURER 2.00 X X 0 0 0 DAVID FARST TRUSTEE 2.00 X 0 0 0 CASSIDY HELMAN TRUSTEE 2.00 X 0 0 0 ROBB MAHER TRUSTEE 2.00 X 0 0 0 KATHY O'DELL TRUSTEE 2.00 X 0 0 0 MIKE RIEMAN TRUSTEE 2.00 X 0 0 0 STEVE STENTZEL TRUSTEE 2.00 X 0 0 0 TOM TREON TRUSTEE 2.00 X 0 0 0 JOHN WARNER TRUSTEE 2.00 X 0 0 0 ERIC EVERMAN TRUSTEE 2.00 X 0 0 0 JARED POLLICK EXECUTIVE DIRECTOR 40.00 X 207945 0 49595 AUSTIE AUKER FINANCE DIRECTOR 40.00 X 119160 0 19808 CARLOS MENENDEZ MEDICAL DIRECTOR 40.00 X 261121 0 27562 ANNA HATIC INTERNAL MEDICINE 40.00 X 244222 0 31961 KEN HARSHBARGER FAMILY PHYSICIAN 40.00 X 284304 0 53445 JAWAD REHMAN FAMILY PHYSICIAN 40.00 X 321613 0 50678 BRENT CRANE FAMILY PHYSICIAN 40.00 X 291953 0 50392 EEMAN DAJANI PEDIATRIC DENTIST 40.00 X 260418 0 31761 THOMAS BROWN FAMILY PHYSICIAN 40.00 X 267221 0 43569 2257957 0 358771 32 0 1 0 REHABILITATIVE SERVICES INC 4390 BUSCHOR RD COLDWATER OH 45828 PHYSICAL THERAPISTS 543123 ECLINICALWORKS LLC PO BOX 847950 BOSTON MA 02284 EMR SOFTWARE AND SERVICE 344680 SUD'S IN A BUCKET CLEANING SERVICES LLC 1788 RUSH RD NEW MADISON OH 45346 CLEANING SERVICES 100399 3 6351247 541599 465000 6892846 PATIENT SERVICE REVENUE 624100 19363522 19363522 PHARMACY REVENUE 456110 11615720 11615720 OTHER PROGRAM SERVICES 624100 1972749 1972749 32951991 138590 138590 21180 22022 -842 -842 -842 103700 123935 -20235 -20235 -20235 39962350 32931756 -842 138590 832448 379007 453441 16130595 14342854 1787741 42336 42336 3006063 2423552 582511 1143802 925236 218566 229631 173616 56015 164900 123048 41852 505834 399332 106502 169913 156358 13555 30834 30834 688805 546330 142475 203241 162568 40673 SUPPLIES 5257385 5047902 209483 CONTRACTUAL FEES 3432585 2762264 670321 COMMUNICATION 486550 88147 398403 PHARMACY COSTS 465000 465000 392759 217497 175262 33182681 28255047 4927634 0 11927212 17105899 679469 1182075 804416 150170 2782180 3333280 97587 164044 189880 139156 98188 17227538 6304822 9070393 10922716 4666891 4799723 1305210 1380980 31538971 39260498 2291905 2495981 15880 1036941 1370775 1268277 3662680 4817079 X 27876291 34443419 27876291 34443419 31538971 39260498 6779669 -212541 0 X X 0 1 X 1 1 1 X 3090659 3402578 6053752 6195699 6892846 25635534 3090659 3402578 6053752 6195699 6892846 25635534 25635534 75751 51963 94972 64018 138590 425294 28015 -128671 0 0 0 -100656 623586 1082104 2516550 1173831 1993929 7390000 33350172 111701151 0.76870 0.76670 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 390909 390909 13583400 4725419 8857981 2611816 1579403 1032413 641413 641413 10922716 DEFERRED COMPENSATION 1268277 1268277 X 39771831 -212541 -212541 39984372 -22022 -22022 39962350 33204703 22022 22022 33182681 0 33182681 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. 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. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED AGAINST RENTAL INCOME -22,022. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED AGAINST RENTAL INCOME 22,022. X X 0 1 0 0 0 0 0 0 0 JARED POLLICK EXECUTIVE DIRECTOR 204738 0 3207 0 0 0 29414 0 20181 0 257540 0 0 0 CARLOS MENENDEZ MEDICAL DIRECTOR 258181 0 2940 0 0 0 19279 0 8283 0 288683 0 0 0 ANNA HATIC INTERNAL MEDICINE 239945 0 4277 0 0 0 29730 0 2231 0 276183 0 0 0 KEN HARSHBARGER FAMILY PHYSICIAN 280829 0 3475 0 0 0 30786 0 22659 0 337749 0 0 0 JAWAD REHMAN FAMILY PHYSICIAN 318940 0 2673 0 0 0 29681 0 20997 0 372291 0 0 0 BRENT CRANE FAMILY PHYSICIAN 289280 0 2673 0 0 0 33102 0 17290 0 342345 0 0 0 EEMAN DAJANI PEDIATRIC DENTIST 257211 0 3207 0 0 0 29414 0 2347 0 292179 0 0 0 THOMAS BROWN FAMILY PHYSICIAN 262944 0 4277 0 0 0 29730 0 13839 0 310790 0 0 0 X 465000 0 0 0 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 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 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 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 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 XII, LINE 2C PROCESS HAS NOT CHANGED SINCE PRIOR YEAR. COMPREHENSIVE HEALTH NETWORK 5420 STATE ROUTE 571 GREENVILLE OH 45331 311242113 HOME HEALTH CARE OH 4108807 4174043 FAMILY HEALTH SERVICES OF DARKE COUNTY