2025-10-29T07:15:54-05:00 2024-12-31 331498605 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2024-01-01 341773323 COMMUNITY AMBULANCE SERVICE COMM 7404545000 2951 MAPLE AVENUE ZANESVILLE OH 43701 ADAM HOPPER CFO 7404545000 2025-10-27 1 1 AMY CIMINELLO P00796388 6148493000 2025-10-27 2024 2025-03-06 01:10:19Z MATTHEW PERRY 2951 MAPLE AVENUE ZANESVILLE OH 43701 10195872 0 X SEE SCHEDULE O X 1995 OH COMMUNITY AMBULANCE SERVICE IS ORGANIZED AND OPERATED TO PROVIDE EMERGENCY TRANSPORTATION AND MEDICAL SERVICES TO THOSE SERVED BY GENESIS HEALTHCARE SYSTEM (GHCS), A 501(C)(3) ORGANIZATION. GHCS IS LOCATED IN THE CITY OF ZANESVILLE, OHIO AND PROVIDES MEDICAL AND HOSPITAL CARE TO MUSKINGUM COUNTY AND FIVE CONTIGUOUS COUNTIES LOCATED IN THE APPALACHIAN FOOTHILLS. 6 1 163 1 0 0 52713 5000 9331616 10143086 12657 -4264 49933 47786 9446919 10191608 0 0 0 0 7112573 7010064 0 0 0 3678076 3029023 10790649 10039087 -1343730 152521 4633066 3916246 1595165 725824 3037901 3190422 X TO PROVIDE HIGH QUALITY, COURTEOUS, PROMPT, AND COST EFFECTIVE EMERGENCY AND NON-EMERGENCY TREATMENT AND TRANSPORTATION ALONG WITH EDUCATION SERVICES TO HEALTHCARE ORGANIZATIONS, MUNICIPALITIES, AND THE GENERAL PUBLIC. 0 0 9501938 0 10190872 COMMUNITY AMBULANCE SERVICE HAS HAD ANOTHER SUCCESSFUL YEAR IN 2024 LIVING OUT OUR MISSION OF SERVING OUT COMMUNITY BY PROVIDING COMPASSIONATE, EXCEPTIONAL CARE. WE TAKE PRIDE IN MEETING AND EXCEEDING EXPECTATIONS FOR EMERGENT PRE-HOSPITAL CARE IN OUR PRIMARY SERVICE AREAS. THIS YEAR WE WERE EXCITED TO EXPAND OUR NON-EMERGENCY SERVICE AREA, ADDING TRASNPORT SUPPORT FOR GENESIS COSHOCTON MEDICAL CENTER. WE MAINTAIN INDUSTRY STANDARD EQUIPMENT MAINTENANCE, WHILE MAINTENCE IS SCHEDULED AND PERFORMED ON A REGULAR BASIS. OUR TEAM ADHERE TO ALL CURRENT STATE AND LOCAL MEDICAL PROTOCOLS, AS WELL AS MONITORS AND MAINTAINS INDUSTRY STANDARD RESPONSE TIMES IN DEMONSTRATION OF THESE COMMITMENTS, COMMUNITY AMBULANCE SERVICE RESPONDED TO 20,251 REQUESTS FOR AMBULANCE SERVICE IN 2024 AND TRANSPORTED 15,534 PATIENTS. COMMUNITY AMBULANCE SERVICE (CAS) CURRENTLY PROVIDES EMERGENCY AMBULANCE SERVICE TO THE COMMUNITY OF ZANESVILLE, ALONG WITH MUTUAL AID SERVICES TO OTHER MEMBER DEPARTMENTS THROUGHOUT THE REMAINDER OF COSHOCTON, GUERNSEY, LICKING, MORGAN, MUSKINGUM, AND PERRY COUNTIES. SUPPORTING THE COMMUNITY IS A KEY PART OF OUR MISSION STATEMENT. IN PURSUIT OF THAT MISSION, CAS PROVIDED SUPPORT TO FUNDRAISING EFFORTS FOR SEVERAL LOCAL CHARITIES. OTHER IN KIND SERVICES TO THE COMMUNITY INCLUDED STANDBYS AT LOCAL EVENTS SUCH AS: COUNTY FAIR COVERAGE, PARTNERED WITH MUSKINGUM COUNTY HEALTH DEPT - PROJECT DAWN, FOURTH OF JULY EVENTS, LOCAL SPORTING EVENTS, FIRE AND REHAB STANDBYS FOR MULTIPLE FIRE DEPARTMENTS, EMERGENCY MEDICAL DISPATCH (EMD) FOR CITY OF ZANESVILLE AND MUSKINGUM COUNTY, AND SEVERAL OTHER ACTIVITIES THROUGHOUT THE SERVICE AREA. 9501938 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 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 9 0 1 163 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 1 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X ADAM HOPPER 7404545333 2951 MAPLE AVENUE ZANESVILLE OH 43701 MATTHEW PERRY PRESIDENT/CEO 0.00 50.00 X 0 1042506 35670 DIANNA LEVECK VICE PRESIDENT/GENESIS COA 0.09 49.91 X X 0 873193 34795 SHARON PARKER PRESIDENT/GENESIS COO 0.12 49.88 X 0 599352 30843 WENDY CEDOZ SECRETARY/GENESIS CLO 0.09 49.91 X X 0 586741 32553 ADAM HOPPER CHIEF FINANCIAL OFFICER:START 09/24 0.13 49.87 X 0 130955 7542 HEATH WILLIAMS DIRECTOR 0.09 0.00 X 0 0 0 MICHAEL NORMAN TREASURER/ GENESIS CSO 0.09 49.91 X 0 628779 42020 SHON BENDER PRESIDENT/GENESIS CNO 0.12 49.88 X 0 501021 17608 0 4362547 201031 0 0 1 0 0 5000 5000 EMERGENCY SERVICES 621990 8790971 8790971 COURIER SERVICE 621990 1027000 1027000 AMBULETTE SERVICE 621910 325115 325115 10143086 4264 -4264 -4264 -4264 VEHICLE MAINTENANCE 900099 36776 36776 INSURANCE CLAIM 900099 10920 10920 90 90 47786 10191608 10190872 0 -4264 5455110 5073252 381858 50857 47297 3560 984066 915181 68885 520031 483629 36402 15073 15000 73 66282 61642 4640 2992 2992 46022 42800 3222 316468 294315 22153 162130 162130 16715 1170 15545 5251 5251 368976 368976 416508 416508 BAD DEBT EXPENSE 1001211 1001211 AMBULANCE EXPENSES 525430 525430 MEDICAL SUPPLIES 74375 74375 DUES & SUBSCRIPTIONS 8603 8001 602 2987 2778 209 10039087 9501938 537149 0 771085 1356793 909457 635129 328641 399360 5753077 4460831 1458892 1292246 1164991 232718 4633066 3916246 1246925 512070 193745 125280 154495 88474 1595165 725824 X 3037901 3190422 3037901 3190422 4633066 3916246 152521 0 X X 0 1 X 1 1 1 X 33332 54942 145775 52713 5000 291762 5703786 6717980 8145132 9382829 10190872 40140599 5737118 6772922 8290907 9435542 10195872 40432361 0 0 0 40432361 2 2 2 2 5737118 6772922 8290909 9435542 10195872 40432363 1.00000 0.99990 0.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2454 2454 0 PART II-B, LINE 1: COMMUNITY AMBULANCE SERVICE PAYS MEMBERSHIP DUES TO THE FOLLOWING ORGANIZATIONS. A PORTION OF THE DUES ARE RELATED TO LOBBYING ACTIVITES. ZANESVILLE MUSKINGUM COUNTY CHAMBER OF COMMERCE: 10% OF $375 ($38) AMERICAN AMBULANCE ASSOCIATION: 50% OF $4,832 ($2,416) 632210 389514 242696 372042 122418 249624 2208180 1790598 417582 2540645 2158301 382344 1292246 RIGHT-OF-USE OPERATING LEASE ASSETS 87704 INVENTORY 54602 INTERCOMPANY RECEIVABLE 90412 232718 LEASE LIABILITIES - OPERATING 88474 88474 X PART X, LINE 2: THE SYSTEM AND ITS SUBSIDIARIES ARE TAX-EXEMPT ORGANIZATIONS, EXCEPT FOR CARELIFE. ANY POTENTIAL TAX LIABILITY FOR CARELIFE WOUND NOT BE SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. NO TAX PROVISION IS REFLECTED IN THE CONSOLIDATED FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND TO RECOGNIZE A TAX LIABILITY IF THE SYSTEM 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. 0 1 0 0 0 0 0 0 0 MATTHEW PERRY PRESIDENT/CEO 0 980642 0 61864 0 0 0 10350 0 25320 0 1078176 0 0 DIANNA LEVECK VICE PRESIDENT/GENESIS COA 0 555463 0 68335 0 249395 0 9352 0 25443 0 907988 0 0 MICHAEL NORMAN TREASURER/ GENESIS CSO 0 523156 0 73124 0 32499 0 10350 0 31670 0 670799 0 0 SHARON PARKER PRESIDENT/GENESIS COO 0 475653 0 65758 0 57941 0 10350 0 20493 0 630195 0 0 WENDY CEDOZ SECRETARY/GENESIS CLO 0 487322 0 59672 0 39747 0 10350 0 22203 0 619294 0 0 SHON BENDER PRESIDENT/GENESIS CNO 0 426726 0 52769 0 21526 0 10350 0 7258 0 518629 0 0 PART I, LINE 3: A RELATED ORGANIZATION, GENESIS HEALTHCARE SYSTEM, ESTABLISHES COMPENSATION OF THE ORGANIZATION'S CEO THROUGH A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACTS, COMPENSATION SURVEY/STUDY, AND APPROVAL BY THE BOARD AND COMPENSATION COMMITTEE. PART I, LINE 4B: A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS SET UP TO PROVIDE ADDITIONAL DEFERRED RETIREMENT INCOME TO THE GENESIS HEALTH CARE SYSTEM SENIOR LEADERSHIP TEAM MEMBERS. THIS PLAN IS FUNDED BY GENESIS AND VESTS WITH SERVICE. GENESIS HEALTHCARE SYSTEM MADE CONTRIBUTIONS TO NONQUALIFIED RETIREMENT PLANS FOR THE FOLLOWING INDIVIDUALS: DIANA LEVECK: $249,395 SHARON PARKER: $57,941 MICHAEL NORMAN: $32,499 WENDY CEDOZ: $39,747 SHON BENDER: $21,526 FORM 990, PART VI, SECTION A, LINE 6 GENESIS HEALTHCARE SYSTEM IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A GENESIS HEALTHCARE SYSTEM IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B GENESIS HEALTHCARE SYSTEM IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE CFO AND MADE AVAILABLE TO THE BOARD OF DIRECTORS IN ITS ENTIRETY FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ALL POTENTIAL CONFLICTS OF INTEREST OF BOARD MEMBERS AND OFFICERS MUST BE DISCLOSED TO THE BOARD OF DIRECTORS AND THE BOARD WILL DETERMINE IF A CONFLICT EXISTS AND APPROPRIATE PROCEDURES TO MITIGATE THE SITUATION, SUCH AS ALTERNATIVE TRANSACTIONS AND PARTICIPATION AND VOTING RESTRICTIONS. THE COMPLIANCE OFFICER MONITORS AND ENFORCES THESE POLICIES. ALL OFFICERS AND DIRECTORS REVIEW AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 2C: THE FINANCE COMMITTEE OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND IS INVOLVED IN THE SELECTION OF THE INDEPENDENT ACCOUNTANT WHICH COMPLETES THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.. FORM 990, PAGE 1, LINE J, WEBSITE: HTTPS://WWW.GENESISHCS.ORG/SERVICES-SEARCH/EMERGENCY-TRAUMA/COMMUNITY-AM BULANCE GENESIS HEALTHCARE FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 311629304 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 GOOD SAMARITAN MEDICAL CENTER FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 310969646 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE FOUNDATION 1 BETHESDA HEALTH FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 310885513 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE FOUNDATION 1 GOOD SAMARITAN MEDICAL CENTER 2951 MAPLE AVENUE ZANESVILLE OH 43701 314379479 MAINTAINS REAL ESTATE TITLE FOR HOSPITAL OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 CARESERVE 2951 MAPLE AVENUE ZANESVILLE OH 43701 311099924 FORMERLY OPERATED 2 NURSING HOMES THAT WERE SOLD PRIOR TO 2012 OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 GENESIS HEALTHCARE SYSTEM 2951 MAPLE AVENUE ZANESVILLE OH 43701 311480941 HEALTHCARE OH 501(C)(3) 3 N/A 0 GENESIS CAREGIVERS 2951 MAPLE AVENUE ZANESVILLE OH 43701 311282152 HOME CARE SERVICES OH 501(C)(3) 3 CARESERVE 1 BETHESDA HOSPITALITY SHOP 2951 MAPLE AVENUE ZANESVILLE OH 43701 316050713 GIFT SHOP OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 CARELIFE LLC 2951 MAPLE AVENUE ZANESVILLE OH 43701 311128717 PHYSICIAN SERVICES, HOME INFUSION, CHILDCARE SVCS, PHARMACY, DME OH N/A C 1 SOUTHEAST OHIO MEDICAL INSURANCE COMPANY FIRST CARIBBEAN HOUSE GEORGE TOWN CAYMAN ISLANDS CJ 980436356 CAPTIVE INSURANCE COMPANY CJ N/A C 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 1 1