2023-12-21T10:02:50-06:00 2023-06-30 310800053 CLARK SCHAEFER HACKETT & CO 14 EAST MAIN STREET SUITE 500 SPRINGFIELD OH 45502 990 2022-07-01 311181991 COMMUNITY HOSPITAL HEALTH SERVICES FOUNDATION COMM 9375237000 200 MEDICAL CENTER DRIVE SPRINGFIELD OH 45504 JOY A ROGERS EXECUTIVE DIRECTOR 9375237000 2023-12-20 1 JOY ROGERS XXX-XX-XXXX 0 RENEA R IRICK P01586814 9373992000 2023-12-20 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z COMMUNITY HEALTH FOUNDATION JOY A ROGERS 200 MEDICAL CENTER DRIVE SPRINGFIELD OH 45505 282249 0 X WWW.COMMUNITY-HEALTH-FOUNDATION.ORG X 1986 OH TO PRESERVE REPRODUCTIVE SERVICES, TO PROMOTE HEALTH AND WELLNESS AND TO ADVOCATE FOR QUALITY HEALTHCARE THROUGH GRANT MAKING AND EDUCATION. 14 14 14 25 0 0 20902 31060 96767 196594 33627 47635 11377 6960 162673 282249 815900 491664 0 0 333902 328033 0 0 4134 247948 326264 1397750 1145961 -1235077 -863712 25614897 25363445 295210 275661 25319687 25087784 X TO PRESERVE REPRODUCTIVE SERVICES, TO PROMOTE HEALTH AND WELLNESS AND TO ADVOCATE FOR QUALITY HEALTHCARE THROUGH GRANT MAKING AND EDUCATION. 0 0 491664 491664 COMMUNITY GRANT PROGRAM:CHF PROVIDES SUPPORT TO NON-PROFIT ORGANIZATIONS THROUGH ITS COMMUNITY GRANTS PROGRAM. GRANT FUNDS ARE DIRECTED TO PROJECTS AND INITIATIVES THAT SUPPORT AND PROMOTE: HEALTHY LIVING, REPRODUCTIVE HEALTH, HEALTHY RELATIONSHIPS AND MENTAL, EMOTIONAL HEALTH, AND SAFETY NET SERVICES. GRANT FUNDS WERE PROVIDED TO 64 ORGANIZATIONS DURING FYE JUNE 30, 2023. GRANT FUNDING IS ALSO FOR HEALTH EQUITY PROJECTS INCLUDING PROJECTS IMPROVING THE SOCIAL DETERMINANTS OF HEALTH AS WELL AS ORAL HEALTH PROGRAMS. 69211 FAMILY HEALTH EDUCATION:CHF DISTRIBUTED OVER 2,992 COPIES OF ITS HEALTH RESOURCE GUIDE FOR CLARK AND CHAMPAIGN COUNTIES TO THE GENERAL PUBLIC AND SOCIAL SERVICE OR HEALTH AGENCIES THAT SERVE THE PUBLIC. THERE IS NO CHARGE FOR THIS PUBLICATION. THE GUIDE WAS ALSO MAINTAINED AND UPDATED ON OUR WEBSITE AND IS SEARCHABLE AND DOWNLOADABLE. HEALTH EXPO '22 WAS HELD ON SEPTEMBER 28, 2022 WITH FREE HEALTH SCREENINGS AND HEALTH AND WELLNESS EXHIBITORS; MORE THAN 400 ATTENDED HEALTH EXPO '22. CHF ALSO PARTICIPATES IN MANY HEALTH FAIRS AND EXPOS PROVIDING "MY PLATES", IN ENGLISH AND SPANISH, TO ELEMENTARY AGED CHILDREN TO PROMOTE HEALTHY EATING HABITS AND PORTION CONTROL, AS WELL AS INFORMATION ON HEALTHY LIVING. 41526 REPRODUCTIVE HEALTH EDUCATION AND INFORMATION:THROUGH ITS REPRODUCTIVE HEALTH EDUCATION, CHF PROVIDED COMPREHENSIVE SEXUALITY EDUCATION PROGRAMS TO MIDDLE AND HIGH SCHOOL YOUTH USING TRAINED AND CERTIFIED HEALTH EDUCATORS, SERVING 224 STUDENTS AT 3 DIFFERENT VENUES AS WELL AS VIRTUALLY. THE PURPOSE OF THIS EDUCATION IS TO IMPROVE ADOLESCENT SEXUAL HEALTH BY REDUCING THE INCIDENCE OF RISK TAKING SEXUAL BEHAVIORS IN TEENS, LOWERING UNPLANNED PREGNANCY RATES AND REDUCING THE NUMBER OF SEXUALLY TRANSMITTED INFECTIONS. 235316 196594 CHF PROVIDES CLINICAL REPRODUCTIVE SERVICES IN ITS PAVILION TO INCLUDE TUBAL LIGATIONS, VASECTOMIES AND CONTRACEPTIVE SHOTS. 235316 196594 837717 1 0 0 0 0 0 0 0 0 1 1 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 6 0 1 14 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X JOY A ROGERS 9375237000 200 MEDICAL CENTER DRIVE SPRINGFIELD OH 45504 LEANN CASTILLO CHAIR 2.00 X X 0 0 0 AMY STACY VICE CHAIR 1.00 X X 0 0 0 WENDY FORD SECRETARY 1.00 X X 0 0 0 MATTHEW SHROYER TREASURER 1.00 X X 0 0 0 KYLE CONROY TRUSTEE 1.00 X 0 0 0 JOHN BROWN TRUSTEE 1.00 X 0 0 0 STEPHANIE MCCUISTION TRUSTEE 1.00 X 0 0 0 MICHAEL COOPER TRUSTEE 1.00 X 0 0 0 ANNE HOLTZ TRUSTEE 1.00 X 0 0 0 MEGAN MILLER TRUSTEE 1.00 X 0 0 0 ANDREA O'CONNOR TRUSTEE 1.00 X 0 0 0 LORI ZAKEL PHD TRUSTEE 1.00 X 0 0 0 YAMINI TEEGALA MD TRUSTEE 1.00 X 0 0 0 CHRISTOPHER WELLS TRUSTEE 1.00 X 0 0 0 JOY A ROGERS EXECUTIVE DIRECTOR 40.00 X 154532 0 17013 154532 0 17013 1 0 1 0 ROCKING HORSE CENTER 651 S LIMESTONE STREET SPRINGFIELD OH 45505 LEASED EMPLOYEES 326722 1 31060 31060 HEALTH FACILITY LEASES 531190 196594 196594 196594 47635 47635 OTHER INCOME 621400 6960 6960 6960 282249 196594 0 54595 491664 491664 171545 106782 62864 1899 149605 93126 54822 1657 6883 6883 45927 45927 200 200 16658 16658 4171 2085 2086 3702 1851 1851 32344 23935 8086 323 319 160 159 1141 1141 147627 49028 98344 255 27675 17517 10158 PROGRAM EXPENSE 39758 39758 OTHER EXPENSE 2925 2052 873 DUES AND SUBSCRIPTIONS 1882 941 941 MEDICAL SUPPLIES 1351 1351 584 584 1145961 837717 304110 4134 285046 523657 62 72 28680 1300 4569728 1825322 2892032 2744406 1213866 1250249 21066352 20709412 128859 134349 25614897 25363445 295210 275661 295210 275661 X 24437056 24196559 882631 891225 25319687 25087784 25614897 25363445 X -863712 -11252 643061 X X 0 1 X 1 0 X 607722 4078 4516 616316 616463 4147 -12888 607722 567054 74058 24649 616463 559327 11883 4156 567054 545417 21618 7708 559327 0.31957 0.00000 0.68043 0 0 735507 109180 844687 1181099 1972923 1269479 1884543 571019 555843 15176 2744406 BENEFICIAL INTEREST IN FUND HELD BY SPRINGFIELD 20709412 F 20709412 X 914058 -11252 643061 631809 282249 0 282249 1145961 0 1145961 0 1145961 PART V, LINE 4: TO PROVIDE CLINICAL SERVICES, PRIMARY REPRODUCTIVE HEALTH SERVICES AND OTHER HEALTH SERVICES NOT PROVIDED BY COMMUNITY MERCY HEALTH PARTNERS AND PROVIDE REPRODUCTIVE HEALTH AND WOMEN'S HEALTH EDUCATION AND INFORMATION. PART X, LINE 2: ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - ACCOUNTING STANDARDS REQUIRE THE EVALUATION OF TAX POSITIONS TAKEN, OR EXPECTED TO BE TAKEN, IN THE COURSE OF PREPARING THE FOUNDATION'S TAX RETURNS, TO DETERMINE WHETHER THE TAX POSITIONS ARE "MORE LIKELY THAN NOT" OF BEING SUSTAINED BY THE APPLICABLE TAX AUTHORITY. THIS STATEMENT PROVIDES THAT A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED IN THE FINANCIAL STATEMENTS ONLY WHEN IT IS "MORE LIKELY THAN NOT" THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTION OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED UPON THE TECHNICAL MERITS AND CONSIDERATION OF ALL AVAILABLE INFORMATION. ONCE THE RECOGNITION THRESHOLD IS MET, THE PORTION OF THE TAX BENEFIT THAT IS RECORDED REPRESENTS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50 PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT WITH A TAXING AUTHORITY. BASED ON ITS REVIEW, MANAGEMENT DOES NOT BELIEVE THE FOUNDATION HAS TAKEN ANY MATERIAL UNCERTAIN TAX POSITIONS, INCLUDING ANY POSITION THAT WOULD PLACE THE FOUNDATION'S TAX-EXEMPT STATUS IN JEOPARDY, AS OF JUNE 30, 2023. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN FUNDS HELD BY SPRINGFIELD FOUNDATION 0 1159 SOUTH COMMUNITY DEVELOPMENT 562 E MAIN ST SPRINGFIELD OH 45503 842668950 501(C)(3) 25000 0 AFFORDABLE HOUSING FOR SOUTHWEST SPRINGFIELD ADVOCATES FOR BASIC LEGAL EQUALITY INC 525 JEFFERSON AVE TOLEDO OH 43604 237376131 501(C)(3) 7500 0 SUCCESS PROGRAM BRAXTON MILLER FOUNDATION PO BOX 10798 COLUMBUS OH 43201 853880600 501(C)(3) 6000 0 EXTENDED AFTERSCHOOL BASKETBALL PROGRAMS CHILDREN'S HUNGER ALLIANCE 1105 SCHROCK RD 505 COLUMBUS OH 43229 237303509 501(C)(3) 7500 0 FOOD ACCESS FOR CLARK COUNTY CHILDREN GRANT CLARK COUNTY COMBINED HEALTH DISTRICT 529 E HOME ROAD SPRINGFIELD OH 45503 311176975 501(C)(3) 65000 0 MATERNAL & INFANT VITALITY, HEALTH EQUITY COORDINATOR,AND SEXUAL HEALTH AND WELLNESS CLINIC CLARK COUNTY DEPARTMENT OF REENTRY 1345 LAGONDA AVE SPRINGFIELD OH 45503 316000132 501(C)(3) 6000 0 COMMUNITY IMPACT PROGRAM CLARK COUNTY LITERACY COALITION 137 E HIGH STREET SPRINGFIELD OH 45502 311266695 501(C)(3) 6000 0 BASIC LITERACY AND ENGLISH FOR SPEAKERS OF OTHER LANGUAGES GRANT HOPE 705 LINDEN AVE SPRINGFIELD OH 45505 311622572 501(C)(3) 19000 0 PROVIDE OPERATING SUPPORT FOR AFTERSCHOOL PROGRAM JEFFERSON STREET OASIS PO BOX 2812 SPRINGFIELD OH 45501 832865677 501(C)(3) 10000 0 EXPAND NEIGHBORHOOD OUTREACH AND RESIDENTS GROWING HEALTHY FOOD GRANT LIFECARE ALLIANCE 1699 W MOUND STREET COLUMBUS OH 43223 314379494 501(C)(3) 7500 0 MEALS ON WHEELS CHAMPAIGN COUNTY GRANT ON-THE-RISE 4177 DIALTON ROAD SPRINGFIELD OH 45502 043750441 501(C)(3) 7500 0 OPERATING SUPPORT PLANNED PARENTHOOD 2314 AUBURN AVE CINCINNATI OH 45219 310536688 501(C)(3) 15000 0 REPRODUCTIVE HEALTH CARE AND EDUCATION GRANT PREGNANCY RESOURCE CLINIC 1010 S LIMESTONE ST SPRINGFIELD OH 45505 311199270 501(C)(3) 15000 0 OPERATING SUPPORT PROJECT WOMAN 525 EAST HOME ROAD SPRINGFIELD OH 45503 237391095 501(C)(3) 7500 0 COMMUNITY ADVOCACY AND EDUCATION GRANT ROCKING HORSE CENTER 651 S LIMESTONE SPRINGFIELD OH 45505 311593544 501(C)(3) 109000 0 SCREENING INCENTIVE PROGRAMS AND DENTAL CLINIC, COMMUNITY HEALTH WORKER PROGRAM SECOND HARVEST FOOD BANK 20 N MURRAY ST SPRINGFIELD OH 45503 832134113 501(C)(3) 21000 0 CHILD SUMMER POWER PACK GRANT SIFI MINISTRY INC PO BOX 124 SPRINGFIELD OH 45501 274388478 501(C)(3) 7500 0 SAFE HARBOR RECOVERY HOUSE GRANT SPRINGFIELD PROMISE NEIGHBORHOOD PO BOX 145 SPRINGFIELD OH 45501 331147753 501(C)(3) 10000 0 EXPAND FAMILY GROWTH CENTER AT PROMISE VISIONING GARDEN X X 0 0 0 0 0 0 0 0 0 JOY A ROGERS EXECUTIVE DIRECTOR 154532 0 0 0 0 0 4314 0 12699 0 171545 0 0 0 PART I, LINE 3 A COMPENSATION COMMITTEE OF 3-4 DISINTERESTED MEMBERS OF THE BOARD OF TRUSTEES IS APPOINTED BY THE BOARD CHAIR. PROGRESS REPORT ON CEO GOALS IS REVIEWED, PERFORMANCE REVIEW SCORE SHEETS ARE COMPLETED INDIVIDUALLY BY MEMBERS, AND EXECUTIVE DIRECTOR PERFORMANCE IS REVIEWED AND COMPENSATION DETERMINED DURING A MEETING OF THE WHOLE COMMITTEE. COMPENSATION IS SET TAKING INTO ACCOUNT PERFORMANCE (MERIT) AND MARKET RANGES FOR SIMILAR POSITIONS. THERE ARE NO OTHER OFFICERS OR KEY EMPLOYEES RECEIVING COMPENSATION. JOHN BROWN JOHN BROWN IS PARK NATIONAL BANK'S DIVISION PRESIDENT. 47635 THE FOUNDATION HOLDS ASSETS MANAGED BY PARK NATIONAL BANK 0 SCHEDULE L, PART IV, PART B JOHN BROWN IS ON THE BOARD OF TRUSTEES OF COMMUNITY HOSPITAL HEALTH SERVICES FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11B IN THE EVENT THERE IS NOT A TIMELY BOARD MEETING FOR CONTEMPORANEOUS REVIEW, FORM 990 IS FORWARDED VIA ELECTRONIC MAIL OR U.S. MAIL TO EACH BOARD MEMBER FOR HIS/HER REVIEW PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990 IS ALSO REVIEWED AND DISCUSSED BY THE EXECUTIVE COMMITTEE AND/OR THE FINANCE COMMITTEE PRIOR TO FILING. BOTH COMMITTEES HAVE AUTHORITY TO ACT ON BEHALF OF THE BOARD TO DIRECT THE EXECUTIVE DIRECTOR TO SIGN AND TO FILE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C CHF REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY BY: 1) EACH PERSON NOMINATED TO THE BOARD OF TRUSTEES COMPLETES A CONFLICTS OF INTEREST DISCLOSURE CERTIFICATE; 2) ANNUALLY BY FEBRUARY 15, EACH TRUSTEE COMPLETES A CONFLICTS OF INTEREST DISCLOSURE CERTIFICATE; 3) A SUMMARY OF ALL CONFLICTS DISCLOSED BY TRUSTEES IS DISTRIBUTED TO ALL TRUSTEES AT THE APRIL QUARTERLY MEETING; 4) TRUSTEES WITH A CONFLICT RELATIVE TO SPECIFIC ITEMS OF DELIBERATION ARE ADVISED BY THE CHAIR TO REFRAIN FROM DISCUSSION AND VOTING OR ARE EXCUSED FROM THE MEETING IF THE CONFLICT IS MATERIAL; 5) THE CONTEMPORANEOUS MINUTES OF THE MEETING REFLECT THE NATURE OF THE CONFLICT AND THE FACT THAT THE MEMBER DID NOT PARTICIPATE IN DISCUSSION OR VOTING ON THE ITEM UNDER DELIBERATION. FORM 990, PART VI, SECTION B, LINE 15A A COMPENSATION COMMITTEE OF 3-4 DISINTERESTED MEMBERS OF THE BOARD OF TRUSTEES IS APPOINTED BY THE BOARD CHAIR. PROGRESS REPORT ON EXECUTIVE DIRECTOR GOALS IS REVIEWED, PERFORMANCE REVIEW SCORE SHEETS ARE COMPLETED INDIVIDUALLY BY MEMBERS, AND EXECUTIVE DIRECTOR PERFORMANCE IS REVIEWED AND COMPENSATION DETERMINED DURING A MEETING OF THE WHOLE COMMITTEE. COMPENSATION IS SET TAKING INTO ACCOUNT PERFORMANCE (MERIT) AND MARKET RANGES FOR SIMILAR POSITIONS. THERE ARE NO OTHER OFFICERS OR KEY EMPLOYEES RECEIVING COMPENSATION. FORM 990, PART VI, SECTION C, LINE 18 MOST RECENT FORM 990 PLUS PRIOR TWO FISCAL YEARS' FORMS 990 ARE POSTED ON COMMUNITY HOSPITAL HEALTH SERVICES FOUNDATION WEBSITE. REQUESTS FOR A COPY OF THE FORM 990 FOR ANY FISCAL YEAR MAY BE MADE BY TELEPHONE, ELECTRONIC MAIL, U.S. MAIL OR IN PERSON. REQUESTS WILL BE HONORED WITHIN 5 WORKING DAYS. A NOMINAL CHARGE TO COVER THE COST OF COPYING MAY BE MADE. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS MAY BE REQUESTED BY TELEPHONE, ELECTRONIC MAIL, U.S. MAIL OR IN PERSON; REQUESTS WILL BE HONORED WITHIN 5 WORKING DAYS. A NOMINAL CHARGE MAY BE MADE. AUDITED ANNUAL FINANCIAL STATEMENTS ARE ALSO AVAILABLE ON THE COMMUNITY HOSPITAL HEALTH SERVICES FOUNDATION WEBSITE. FORM 990, PART XI, LINE 9: SEE SCHEDULE D 643,061. PART XI LINE 2C COMMUNITY HOSPITAL HEALTH SERVICES FOUNDATION HAS NOT CHANGED ITS OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR. COMMUNITY MERCY HEALTH SYSTEM 100 MEDICAL CENTER DR SPRINGFIELD OH 45504 300272454 COMMUNITY HEALTH SYSTEM OH 501(C)(3) LINE 3 N/A 0 COMMUNITY MERCY HEALTH PARTNERS 100 MEDICAL CENTER DR SPRINGFIELD OH 45504 310785684 COMMUNITY HEALTH SYSTEM OH 501(C)(3) LINE 3 N/A 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 0 0 0 COMMUNITY MERCY HEALTH PARTNERS J 195389 COST COMMUNITY MERCY HEALTH PARTNERS E 165000 COST COMMUNITY MERCY HEALTH PARTNERS P 73346 COST