COMMUNITY AND RURAL HEALTH SERVICES: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY AND RURAL HEALTH SERVICES (EIN 34-1120194)
- Tax period
- 2021-04-01 to 2022-03-31
- Filed
- 2023-02-15
- IRS object ID
- 202300469349300710
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-02-15T06:53:38-06:00 | ReturnTs |
| Tax Period End | 2022-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 310800053 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARK SCHAEFER HACKETT & CO | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14 EAST MAIN STREET SUITE 500 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45502 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341120194 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY AND RURAL HEALTH SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 4193338943 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2221 HAYES AVENUE | AddressLine1Txt |
| City | FREMONT | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43420 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOSEPH LISZAK | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 4193338943 | PhoneNum |
| Signature | 2023-02-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JOSEPH | PersonFirstNm |
| Person Last | LISZAK | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JESSE YOUNG CPA | PreparerPersonNm |
| PTIN | P01236247 | PTIN |
| Phone | 9373992000 | PhoneNum |
| Preparation | 2023-02-14 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-03-07 01:45:13Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOSEPH LISZAK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2221 HAYES AVENUE | AddressLine1Txt |
| City | FREMONT | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43420 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,899,941 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FREMONTCHS.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | COMMUNITY HEALTH SERVICES WILL STRIVE TO BE THE MODEL FOR COMPREHENSIVE AND QUALITY HEALTH CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 185 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $8,607,868 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,402,708 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,924,936 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,389,862 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,843 | PYInvestmentIncomeAmt |
| CY Investment Income | $36,766 | CYInvestmentIncomeAmt |
| PY Other Revenue | $37,480 | PYOtherRevenueAmt |
| CY Other Revenue | $70,605 | CYOtherRevenueAmt |
| PY Total Revenue | $13,579,127 | PYTotalRevenueAmt |
| CY Total Revenue | $13,899,941 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,331,438 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,873,162 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,703,874 | PYOtherExpensesAmt |
| CY Other Expenses | $3,097,995 | CYOtherExpensesAmt |
| PY Total Expenses | $11,035,312 | PYTotalExpensesAmt |
| CY Total Expenses | $11,971,157 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,543,815 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,928,784 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,095,349 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,093,831 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,769,963 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $839,661 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $14,325,386 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $16,254,170 | NetAssetsOrFundBalancesEOYAmt |
| Mission | COMMUNITY HEALTH SERVICES WILL STRIVE TO BE THE MODEL FOR COMPREHENSIVE AND QUALITY HEALTH CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,148,006 | ExpenseAmt |
| Revenue | $5,491,094 | RevenueAmt |
| Desc | COMMUNITY HEALTH SERVICES OFFERS A FULL SPECTRUM OF HEALTH CARE SERVICES PROVIDED BY PHYSICIANS, ADVANCED PRACTITIONERS, DENTISTS, COUNSELORS, AND OTHER HEALTH CARE PROFESSIONALS WHO ARE DEDICATED TO MEETING THE HIGHEST STANDARDS OF CARE. | Desc |
| Total Program Service Expenses | $9,148,006 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 11 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 185 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ASHLEY GAMBLE | PersonNm |
| Phone | 4193348943 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2221 HAYES AVENUE | AddressLine1Txt |
| City | FREMONT | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43420 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| MORGAN STANLEY | |||||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| COURTNEY COMBS | |||||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| TIM BUIT | |||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| IRMA CELESTINO | |||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JOSE SALINAS | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DAVID POLLICK | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| ZESTA JOHNSON | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| ANN WISE | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| DAVID O'NEAL | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MARK ADAMS | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JIM ELLIS | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| DELORES BUREL | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MARK EGBERT | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| JOSEPH LISZAK | |||||||||
| CEO | 40.00 | Yes (X) | $272,203 | $0 | $27,024 | ||||
| ASHLEY GAMBLE | |||||||||
| CFO (EFF JAN. 2022) | 40.00 | Yes (X) | $0 | $0 | $0 | ||||
| TYSON BOUYACK | |||||||||
| CFO (THRU DEC. 2021) | 40.00 | Yes (X) | $154,322 | $0 | $8,168 | ||||
| JENNIFER BECKER | |||||||||
| DENTAL DIRECTOR | 24.00 | $162,492 | $0 | $0 | Yes (X) | ||||
| YASMIN PIRZADA | |||||||||
| MEDICAL DIRECTOR | 34.00 | $253,128 | $0 | $10,725 | Yes (X) | ||||
| HELEN O'CONNEL | |||||||||
| PHYSICIAN | 40.00 | $289,866 | $0 | $10,209 | Yes (X) | ||||
| KRITI ARORA | |||||||||
| PHYSICIAN | 40.00 | $199,438 | $0 | $12,073 | Yes (X) | ||||
| ABEER AHMED | |||||||||
| PHYSICIAN | 40.00 | $213,832 | $0 | $0 | Yes (X) | ||||
| AARTI CHELLIAH | |||||||||
| PHYSICIAN | 40.00 | $192,374 | $0 | $11,869 | Yes (X) | ||||
| KOMAL MASOOD | |||||||||
| PHYSICIAN | 40.00 | $191,379 | $0 | $11,767 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,929,034 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $91,835 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 23 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| JANOTTA & HERNER INC | |||||
| 309 MONROE ST | MONROEVILLE | OH | 44847 | CONSTRUCTION COMPANY USED TO DESIGN/BUIL | $1,256,056 |
| ECLINICAL WORKS | |||||
| 2 TECHNOLOGY DRIVE | WESTBOROUGH | MA | 01581 | EHR SOFTWARE AND PRACTICE MANAGEMENT SOL | $304,874 |
| COMPUTOL | |||||
| 118 E 3RD ST | PERRYBURG | OH | 43551 | COMPUTER SUPPORT AND SERVICES | $186,093 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $8,265,448 | GovernmentGrantsAmt |
| All Other Contributions | $137,260 | AllOtherContributionsAmt |
| Noncash Contributions | $137,260 | NoncashContributionsAmt |
| Total Contributions | $8,402,708 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $4,865,836 | $4,865,836 |
| PHARMACY REVENUE | 446110 | $524,026 | $524,026 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,389,862 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,139 | TotalRevenueColumnAmt |
| Exclusion | $6,139 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $27,859 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $27,859 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,859 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,859 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $30,627 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $30,627 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,627 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $30,627 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $42,746 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $42,746 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $42,746 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,899,941 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,491,094 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $6,139 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $461,718 | TotalAmt |
| Management And General | $461,718 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,157,694 | TotalAmt |
| Program Services | $6,307,440 | ProgramServicesAmt |
| Management And General | $850,254 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $701,584 | TotalAmt |
| Program Services | $351,930 | ProgramServicesAmt |
| Management And General | $349,654 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $552,166 | TotalAmt |
| Program Services | $464,405 | ProgramServicesAmt |
| Management And General | $87,761 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $320,663 | TotalAmt |
| Program Services | $214,059 | ProgramServicesAmt |
| Management And General | $106,604 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,598 | TotalAmt |
| Program Services | $26,855 | ProgramServicesAmt |
| Management And General | $36,743 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $363,297 | TotalAmt |
| Program Services | $50,722 | ProgramServicesAmt |
| Management And General | $312,575 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $345,375 | TotalAmt |
| Program Services | $289,470 | ProgramServicesAmt |
| Management And General | $55,905 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,955 | TotalAmt |
| Program Services | $87,895 | ProgramServicesAmt |
| Management And General | $38,060 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $368,448 | TotalAmt |
| Program Services | $305,812 | ProgramServicesAmt |
| Management And General | $62,636 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,250 | TotalAmt |
| Management And General | $47,250 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| COMPUTER EQUIPMENT | $628,329 | $320,450 | $307,879 |
| MEDICAL & DENTAL SUPPLI | $525,101 | $485,991 | $39,110 |
| IN-KIND DONATIONS | $137,260 | $137,260 | |
| REPAIRS AND MAINTENANCE | $120,822 | $104,010 | $16,812 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,897 | TotalAmt |
| Program Services | $1,707 | ProgramServicesAmt |
| Management And General | $50,190 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,971,157 | TotalAmt |
| Program Services | $9,148,006 | ProgramServicesAmt |
| Management And General | $2,823,151 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,230,718 | BOYAmt |
| EOY | $3,112,542 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,868,145 | BOYAmt |
| EOY | $3,014,525 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $191,643 | BOYAmt |
| EOY | $543,353 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $566,122 | BOYAmt |
| EOY | $668,125 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,190 | BOYAmt |
| EOY | $292,976 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,691,875 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,229,565 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,135,531 | BOYAmt |
| EOY | $9,462,310 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,095,349 | BOYAmt |
| EOY | $17,093,831 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $613,396 | BOYAmt |
| EOY | $839,661 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,156,567 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,769,963 | BOYAmt |
| EOY | $839,661 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,325,386 | BOYAmt |
| EOY | $16,254,170 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,325,386 | BOYAmt |
| EOY | $16,254,170 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,095,349 | BOYAmt |
| EOY | $17,093,831 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,928,784 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,440,250 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,604,962 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,776,632 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,607,868 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,402,708 | CurrentTaxYearAmt |
| Total | $30,832,420 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,440,250 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,604,962 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,776,632 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,607,868 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,402,708 | CurrentTaxYearAmt |
| Total | $30,832,420 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $30,832,420 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,046 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,076 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,264 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,843 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,139 | CurrentTaxYearAmt |
| Total | $51,368 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $18,707 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,185 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,940 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $42,746 | CurrentTaxYearAmt |
| Total | $86,578 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $30,970,366 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $25,328,322 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99550 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99520 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $687,676 | OtherCostOrOtherBasisAmt |
| Book Value | $687,676 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,174,724 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,399,368 | DepreciationAmt |
| Book Value | $6,775,356 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,106 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,106 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,218,550 | OtherCostOrOtherBasisAmt |
| Depreciation | $814,091 | DepreciationAmt |
| Book Value | $404,459 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,594,819 | OtherCostOrOtherBasisAmt |
| Book Value | $1,594,819 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,462,310 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $13,899,941 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,899,941 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $13,899,941 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $11,971,157 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $11,971,157 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $11,971,157 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | COMMUNITY AND RURAL HEALTH SERVICES, INC. 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 COMMUNITY AND RURAL HEALTH SERVICES, INC.'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. COMMUNITY AND RURAL HEALTH SERVICES, INC.'S REPORTING RETURNS ARE SUBJECT TO AUDIT BY FEDERAL AND STATE TAXING AUTHORITIES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOSEPH LISZAK | ||||||||||||||
| CEO | $198,139 | $0 | $59,029 | $0 | $15,035 | $0 | $7,446 | $0 | $19,578 | $0 | $299,227 | $0 | $0 | $0 |
| TYSON BOUYACK | ||||||||||||||
| CFO (THRU DEC. 2021) | $120,322 | $0 | $28,460 | $0 | $5,540 | $0 | $4,479 | $0 | $3,689 | $0 | $162,490 | $0 | $0 | $0 |
| JENNIFER BECKER | ||||||||||||||
| DENTAL DIRECTOR | $123,597 | $0 | $31,775 | $0 | $7,120 | $0 | $0 | $0 | $0 | $0 | $162,492 | $0 | $0 | $0 |
| YASMIN PIRZADA | ||||||||||||||
| MEDICAL DIRECTOR | $239,617 | $0 | $200 | $0 | $13,311 | $0 | $5,651 | $0 | $5,074 | $0 | $263,853 | $0 | $0 | $0 |
| HELEN O'CONNEL | ||||||||||||||
| PHYSICIAN | $289,866 | $0 | $0 | $0 | $0 | $0 | $10,067 | $0 | $142 | $0 | $300,075 | $0 | $0 | $0 |
| KRITI ARORA | ||||||||||||||
| PHYSICIAN | $191,440 | $0 | $200 | $0 | $7,798 | $0 | $6,999 | $0 | $5,074 | $0 | $211,511 | $0 | $0 | $0 |
| ABEER AHMED | ||||||||||||||
| PHYSICIAN | $213,782 | $0 | $50 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $213,832 | $0 | $0 | $0 |
| AARTI CHELLIAH | ||||||||||||||
| PHYSICIAN | $191,563 | $0 | $200 | $0 | $611 | $0 | $6,795 | $0 | $5,074 | $0 | $204,243 | $0 | $0 | $0 |
| KOMAL MASOOD | ||||||||||||||
| PHYSICIAN | $183,544 | $0 | $200 | $0 | $7,635 | $0 | $6,693 | $0 | $5,074 | $0 | $203,146 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | COVID-19 SUPPLIES | Desc |
| Contribution | 0 | ContributionCnt |
| Noncash Contributions Rpt F990 | $137,260 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | 990 DRAFT RETURNS ARE PROVIDED TO BOARD MEMBERS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICIES ARE SIGNED ANNUALLY BY BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 15 | WAGES ARE REVIEWED AND APPROVED BY THE BOARD BASED UPON EDUCATION, YEARS OF EXPERIENCE, AND THE MARKETPLACE, WHICH CONSISTS OF OTHER HEALTH CENTERS IN THE REGION. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE RETURN IS KEPT IN THE CORPORATE FINANCIAL FILES, AND IN AVAILABLE UPON REQUEST. THE 990 IS ALSO AVAILABLE VIA THE INTERNET ON GUIDESTAR. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. ALL BOARD MEETINGS ARE OPEN TO THE PUBLIC. |
| PART XII, LINE 2C | THE PROCESS HAD NOT CHANGED FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY AND RURAL HEALTH SERVICES FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2221 HAYES AVE | AddressLine1Txt |
| City | FREMONT | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43420 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341626761 | EIN |
| Primary Activities | TO HOLD HEALTHCARE FACILITIES FOR COMMUNITY & RURAL HEALTH SERVICES. | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12C, III-FI | PublicCharityStatusTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY AND RURAL HEALTH SERVICES FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | K | TransactionTypeTxt |
| Involved | $12,000 | InvolvedAmt |
| Method Of Amount Determination | FV | MethodOfAmountDeterminationTxt |