2024-05-15T13:53:03-05:00 2023-06-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2022-07-01 341784017 COMMUNITY HEALTH ASSOCIATES INC COMM 4194681244 955 BUCYRUS ROAD GALION OH 448332399 D ERIC DRAIME CFO 4194681244 2024-05-15 1 D ERIC DRAIME 999009999 1 AMY CIMINELLO P00796388 6148493000 2024-05-06 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JERRY MORASKO 269 PORTLAND WAY SOUTH GALION OH 44833 56906501 0 X N/A X 1996 OH TO IMPROVE THE HEALTH AND WELL-BEING OF THOSE WE SERVE. 3 0 4 0 0 0 0 0 57092944 56892576 -31725 13925 0 0 57061219 56906501 0 0 0 0 55158914 53980223 0 0 0 22504859 26104238 77663773 80084461 -20602554 -23177960 7724241 8278639 3002102 2173433 4722139 6105206 TO IMPROVE THE HEALTH AND WELL-BEING OF THOSE WE SERVE. 0 0 69897383 0 56892576 PROVIDE MEDICAL SERVICE TO OFFICE, HOSPITAL, AND NURSING HOME PATIENTS. 69897383 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 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 1 0 0 0 1 0 0 4 1 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X D ERIC DRAIME 4194680501 269 PORTLAND WAY SOUTH GALION OH 44833 JERRY MORASKO PRESIDENT/CEO 0.20 40.60 X X 0 730265 16835 D ERIC DRAIME CFO/TREASURER 0.20 40.60 X X 0 387156 2750 SHELLIE BURGIN SECRETARY 0.20 40.20 X X 0 273402 2420 ROBERT DAWSON PHYSICIAN 40.00 0.00 X 1218083 0 7178 JAMES KERBS PHYSICIAN 40.00 0.00 X 692247 0 6042 DARYL SANDER PHYSICIAN 40.00 0.00 X 474923 0 4042 THOMAS J ZUESI PHYSICIAN 40.00 0.00 X 440901 0 11104 2826154 1390823 50371 4 0 1 0 0 NET PATIENT REVENUE 621110 56892576 56892576 56892576 13925 13925 56906501 56892576 0 13925 49850736 42995183 6855553 4129487 3561593 567894 292744 252485 40259 924 797 127 723887 624337 99550 684681 590523 94158 95229 82133 13096 PROFESSIONAL PHYSICIAN 18298516 15782075 2516441 MEDICAL SUPPLIES 3240873 3240873 BAD DEBT EXPENSE 2454245 2454245 PHYSICIAN RECRUITING 313139 313139 80084461 69897383 10187078 0 1756 1707 3720962 3533084 3567332 4151934 152623 166548 281568 425366 7724241 8278639 3002102 2173433 3002102 2173433 X 4722139 6105206 4722139 6105206 7724241 8278639 X -23177960 24561027 X X 0 1 X 1 1 0 X X 1 GALION COMMUNITY HOSPITAL 344451872 3 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART III, LINE 4A: PROVIDE MEDICAL SERVICES TO OFFICE, HOSPITAL, AND NURSING HOME PATIENTS. 0 OTHER ASSETS 425366 425366 0 1 0 0 0 0 0 1 0 ROBERT DAWSON PHYSICIAN 762428 0 192655 0 263000 0 0 0 7178 0 1225261 0 0 0 JERRY MORASKO PRESIDENT/CEO 0 665855 0 64410 0 0 0 0 0 16835 0 747100 0 0 JAMES KERBS PHYSICIAN 674610 0 17637 0 0 0 0 0 6042 0 698289 0 0 0 DARYL SANDER PHYSICIAN 443601 0 31322 0 0 0 0 0 4042 0 478965 0 0 0 THOMAS J ZUESI PHYSICIAN 338039 0 102862 0 0 0 0 0 11104 0 452005 0 0 0 D ERIC DRAIME CFO/TREASURER 0 336954 0 50202 0 0 0 0 0 2750 0 389906 0 0 SHELLIE BURGIN SECRETARY 0 237950 0 35452 0 0 0 0 0 2420 0 275822 0 0 PART I, LINE 4B 457(F) AND 457(B)- SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE ROBERT DAWSON - $22,309 JAMES KERBS - $22,309 DARYL SANDER - $22,309 THOMAS ZUESI - $22,315 PART I, LINE 7 PHYSICIANS QUALIFY FOR BONUSES BASED ON THEIR TARGET RVU'S. THIS TARGET IS FIGURED BY TAKING THEIR YEARLY SALARY AND DIVIDING IT BY THE RVU RATE WHICH COMES FROM MGMA GUIDELINES. PHYSICIAN BONUSES VARY BASED ON THEIR CONTRACT. THESE BONUSES ARE ACCRUED ON A MONTHLY BASIS AND PAID ON A QUARTERLY BASIS BASED ON THE PHYSICIAN'S CONTRACT TERM UNLESS THE PHYSICIAN IS NOT LIKELY TO MEET THE YEARLY TARGET. PART I, LINE 3: COMMUNITY HEALTH ASSOCIATES, INC. RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE -COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION SHALL, AT ALL TIMES, BE GALION COMMUNITY HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR DIRECTORS SHALL HAVE THE APPROVAL OF THE BOARD OF DIRECTORS OF GALION COMMUNITY HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER HAS THE RIGHT TO APPROVE OR RATIFY DECISIONS OF THE ORGANIZATION'S GOVERNING BODY, SUCH AS APPROVAL OF THE GOVERNING BODY'S ELECTION OR REMOVAL OF MEMBERS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE SUB-COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AND SENT TO THE EXECUTIVE COMMITTEE OF GALION COMMUNITY HOSPITAL'S BOARD FOR THEIR REVIEW PRIOR TO FILING. THE BOARD EXECUTIVE COMMITTEE APPROVES THE FORM 990 FOLLOWING REVIEW, AS AUTHORIZED BY THE FULL GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 12C GALION COMMUNITY HOSPITAL HAS A CONFLICT OF INTEREST POLICY THAT COVERS ALL BOARD OF DIRECTORS AND OFFICERS OF THE CORPORATION. CONFLICT OF INTEREST SURVEYS ARE REVIEWED BY BOARD CHAIRMAN AND THE CEO TO ENSURE COMPLIANCE. VARIOUS RESTRICTIONS ARE IMPOSED ON INDIVIDUALS WITH POTENTIAL CONFLICTS OF INTEREST (I.E. INABILITY TO VOTE) UNTIL DECISION HAS BEEN MADE ON POTENTIAL CONFLICT. COMMUNITY HEALTH ASSOCIATES, INC. HAS ADOPTED THIS POLICY. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS ARE AVAILABLE TO THE PUBLIC, OTHER THAN THE FINANCIAL STATEMENTS WHICH ARE ATTACHED TO GALION COMMUNITY HOSPITAL'S FORM 990. FORM 990, PART XI, LINE 9: TRANSFER FROM GALION COMMUNITY HOSPITAL 24,561,027. FORM 990, PART XI, LINE 2C THE ORGANIZATION HAS A FINANCE COMMITTEE WHICH OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART XII, LINE 3B: SINGLE AUDIT IS IN PROCESS AND WILL BE COMPLETED ON A CONSOLIDATED BASIS. FORM 990, PART IX COMMUNITY HEALTH ASSOCIATES, INC.'S EMPLOYEE BENEFIT AND RETIREMENT EXPENSES ARE REPORTED ON AVITA HEALTH SYSTEM'S RETURN IN PART IX. NORTH CENTRAL OHIO FAMILY CARE CENTER INC 269 PORTLAND WAY SOUTH GALION OH 44833 341807906 PHYSICIAN OFFICE OH 501(C)(3) LINE 12A, I GALION COMMUNITY HOSPITAL 1 GALION COMMUNITY HOSPITAL 269 PORTLAND WAY SOUTH GALION OH 44833 344451872 HOSPITAL SERVICES OH 501(C)(3) LINE 3 AVITA HEALTH SYSTEM 1 AVITA HEALTH FOUNDATION 269 PORTLAND WAY SOUTH GALION OH 44833 200934451 FUNDRAISING FOR GALION COMMUNITY HOSPITAL OH 501(C)(3) LINE 7 GALION COMMUNITY HOSPITAL 1 AVITA HEALTH SYSTEM 269 PORTLAND WAY SOUTH GALION OH 44833 274385692 HEALTHCARE OH 501(C)(3) LINE 12B, II N/A 0 CRAWFORD COUNTY SHARED HEALTH SERVICES INC 1220 NORTH MARKET STREET GALION OH 44833 341484014 HOME HEALTH & HOSPICE OH 501(C)(3) LINE 10 GALION COMMUNITY HOSPITAL 1 GALION COMMUNITY PAIN MANAGEMENT LLC 269 PORTLAND WAY SOUTH GALION OH 44833 300602607 HOSPITAL SUPPORT OH N/A 0 0 GALION COMMUNITY VASCULAR SERVICES LLC 269 PORTLAND WAY SOUTH GALION OH 44833 611613817 HOSPITAL SUPPORT OH N/A 0 0 AMERICAN SURGICAL SPINE SERVICES 629 N SANDUSKY AVE BUCYRUS OH 44820 371786727 HOSPITAL SUPPORT OH N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1