2024-08-13T09:34:26-05:00 2023-09-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2022-10-01 341596175 SHARE FOUNDATION OF COMMUNITY HOSPITALS OF WILLIAMS COUNTY INC SHAR 4196361131 433 WEST HIGH STREET BRYAN OH 43506 CHRISTA POMEROY CFO 4196361131 2024-08-08 1 0 AMY CIMINELLO P00796388 6148493000 2024-08-08 2022 2024-08-08 14:25:15Z CHAD D TINKEL 433 WEST HIGH STREET BRYAN OH 43506 1256672 0 X WWW.CHWCHOSPITALS.ORG X 1988 OH TO CONDUCT FUNDRAISING ACTIVITIES TO PROVIDE ASSISTANCE TO COMMUNITY HOSPITALS AND WELLNESS CENTERS, FOR THE UNCOMPENSATED CARE DELIVERED BY COMMUNITY HOSPITALS AND WELLNESS CENTERS. 10 8 0 9 0 0 5264 1305 0 0 197680 1255367 0 0 202944 1256672 0 0 0 0 0 0 0 0 0 0 0 0 0 202944 1256672 6911741 4141434 0 0 6911741 4141434 TO CONDUCT FUNDRAISING ACTIVITIES TO PROVIDE ASSISTANCE TO COMMUNITY HOSPITALS AND WELLNESS CENTERS, FOR THE UNCOMPENSATED CARE DELIVERED BY COMMUNITY HOSPITALS AND WELLNESS CENTERS. 0 0 0 0 0 TO PROVIDE ASSISTANCE FOR UNCOMPENSATED CARE DELIVERED BY COMMUNITY HOSPITALS & WELLNESS CENTERS. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 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 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X CHRISTA POMEROY 4196333594 433 WEST HIGH STREET BRYAN OH 43506 CHAD D TINKEL PRES/SECRETARY, CEO-CHWC 0.50 49.50 X X 0 367685 43175 STEVE BUMB MD CHIEF OF STAFF 0.50 49.50 X 0 306264 23674 CHRISTOPHER KANNEL CHAIR OF BOARD 0.10 0.10 X X 0 0 0 KATRINA HESTER DIRECTOR 0.10 0.10 X 0 0 0 CINDY REED DIRECTOR 0.10 0.10 X 0 0 0 RUSS DAVIES DIRECTOR 0.10 0.10 X 0 0 0 ALLYN LUCE DIRECTOR 0.10 0.10 X 0 0 0 LARS ELLAR DIRECTOR (EFFECTIVE 01/23) 0.10 0.10 X 0 0 0 JIM WATKINS DIRECTOR 0.10 0.10 X 0 0 0 ELENA WEST DIRECTOR 0.10 0.10 X 0 0 0 CHRISTA POMEROY VP/CFO 0.50 49.50 X 0 187092 15373 DR CAROLYN DORSTEN VICE CHIEF 0.10 0.10 X 0 0 0 0 861041 82222 0 0 1 0 0 1305 1305 1255367 1255367 1256672 0 0 1255367 0 0 0 0 12921 14252 6898820 4127182 6911741 4141434 0 0 X 6911741 4141434 6911741 4141434 6911741 4141434 1256672 -4026979 0 X X 0 1 X 1 0 X X 1 COMMUNITY HOSPITALS AND WELLNESS CENTERS 341048666 3 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 X PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND TO RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL AND HAS CONCLUDED THAT, AS OF SEPTEMBER 30, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. 0 1 0 0 0 0 0 0 0 CHAD D TINKEL PRES/SECRETARY, CEO-CHWC 0 367685 0 0 0 0 0 20500 0 22675 0 410860 0 0 STEVE BUMB MD CHIEF OF STAFF 0 306264 0 0 0 0 0 0 0 23674 0 329938 0 0 CHRISTA POMEROY VP/CFO 0 187092 0 0 0 0 0 0 0 15373 0 202465 0 0 PART I, LINE 3 COMMUNITY HOSPITALS AND WELLNESS CENTERS USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR ON THE SHARE FOUNDATION'S BEHALF: -COMPENSATION COMMITTEE -FORM 990 OF OTHER ORGANIZATIONS -WRITTEN EMPLOYMENT CONTRACT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B CHAD TINKEL PARTICIPATED IN A 457(B) RETIREMENT PLAN WITH COMMUNITY HOSPITALS AND WELLNESS CENTERS. $20,500 CONTRIBUTIONS WERE MADE TO THE 457(B) PLANS DURING THE CALENDAR YEAR. THE HOSPITAL HAS A SUPPLEMENTAL EXECUTIVE RETENTION PLAN FOR THESE EXECUTIVES UNDER IRC SECTION 457(B). THE AMOUNTS DEFERRED UNDER THIS PLAN WILL BE TAXABLE TO THE EXECUTIVE WHEN VESTED AND THERE IS NO LONGER A SUBSTANTIAL RISK OF FORFEITURE. IN ORDER TO HAVE THE RIGHT TO FUTURE PAYMENT OF ANY EMPLOYER DEFERRAL, THE EXECUTIVE WILL HAVE TO REMAIN IN SERVICE UNTIL THE ACCOUNT BECOMES VESTED AS PROVIDED IN THE PLAN DOCUMENT. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, FORM 990 IS PROVIDED TO THE BOARD, AND A SUMMARY OF THE DISCLOSURES AND CHANGES TO THE FORM IS PRESENTED BY THE CFO AT A MONTHLY BOARD MEETING. IF A BOARD MEMBER IS NOT IN ATTENDANCE FOR THIS PRESENTATION, THAT INDIVIDUAL WILL RECEIVE A COPY OF FORM 990 AT A LATER DATE, PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS AND VOTING MEMBERS OF THE BOARD ARE COVERED BY THE CONFLICT OF INTEREST POLICY, WHICH THEY SIGN ON AN ANNUAL BASIS. CONFLICTS OF INTEREST ARE REVIEWED ON A CASE BY CASE BASIS. IF A TRANSACTION ARISES THAT WOULD RESULT IN A CONFLICT, THE INTERESTED INDIVIDUAL SIGNS A CONFLICT OF INTEREST STATEMENT NOTING THAT THEY ARE NOT INDEPENDENT WITH RESPECT TO THE TRANSACTION, AND THEY ABSTAIN FROM VOTING ON THAT MATTER. THE POLICY IS MONITORED BY ALL BOARD MEMBERS AND OFFICERS. THE POLICY IS REVIEWED WITH ANY NEW BOARD MEMBERS OR OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: SHARE FOUNDATION HAS AN AUDIT COMMITTEE FROM A RELATED PARTY THAT OVERSEES THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART VI, LINES 12 - 15: THE FOUNDATION FOLLOWS THE POLICIES OF COMMUNITY HOSPITALS AND WELLNESS CENTERS FOR CONFLICTS OF INTEREST, WHISTLEBLOWER, DOCUMENT RETENTION & DESTRUCTION, AND COMPENSATION. COMMUNITY HOSPITALS & WELLNESS CENTERS 433 WEST HIGH STREET BRYAN OH 43506 341048666 HOSPITAL CARE OH 501(C)(3) 3 N/A 0 COMMUNITY HOSPITALS & WELLNESS CENTERS PAIN MANAGEMENT LLC 433 WEST HIGH ST BRYAN OH 43506 461084537 MEDICAL SERVICES OH N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0