2022-02-11T08:52:49-06:00 2021-03-31 310800053 CLARK SCHAEFER HACKETT & CO 14 EAST MAIN STREET SUITE 500 SPRINGFIELD OH 45502 990 2020-04-01 341120194 COMMUNITY AND RURAL HEALTH SERVICES INC COMM 4193338943 2221 HAYES AVENUE FREMONT OH 43420 JOSEPH LISZAK CEO 4193338943 2022-02-10 1 JOSEPH LISZAK 999009999 JESSE YOUNG CPA P01236247 9373992000 2022-02-10 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z COMMUNITY HEALTH SERVICES JOSEPH LISZAK 2221 HAYES AVENUE FREMONT OH 43420 13579127 0 X WWW.FREEMONTCHS.COM X 1972 OH COMMUNITY HEALTH SERVICES WILL STRIVE TO BE THE MODEL FOR COMPREHENSIVE AND QUALITY HEALTH CARE. 12 12 159 12 0 0 4776632 8607868 5938946 4924936 19463 8843 51460 37480 10786501 13579127 0 0 0 0 7761435 8331438 0 0 0 2323886 2703874 10085321 11035312 701180 2543815 12707184 16095349 925613 1769963 11781571 14325386 COMMUNITY HEALTH SERVICES WILL STRIVE TO BE THE MODEL FOR COMPREHENSIVE AND QUALITY HEALTH CARE. 0 0 8617252 4962416 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. 8617252 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 14 0 1 159 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 X ASHLEY GAMBLE 4193348943 2221 HAYES AVENUE FREMONT OH 43420 MORGAN STANLEY CHAIR 1.00 X X 0 0 0 COURTNEY COMBS VICE CHAIR 1.00 X X 0 0 0 TIM BUIT TREASURER 1.00 X X 0 0 0 IRMA CELESTINO SECRETARY 1.00 X X 0 0 0 JOSE SALINAS BOARD MEMBER 1.00 X 0 0 0 DAVID POLLICK BOARD MEMBER 1.00 X 0 0 0 ZESTA JOHNSON BOARD MEMBER 1.00 X 0 0 0 ANN WISE BOARD MEMBER 1.00 1.00 X 0 0 0 DAVID O'NEAL BOARD MEMBER 1.00 X 0 0 0 MARK ADAMS BOARD MEMBER 1.00 X 0 0 0 JIM ELLIS BOARD MEMBER 1.00 1.00 X 0 0 0 DELORES BUREL BOARD MEMBER 1.00 X 0 0 0 JOSEPH LISZAK CEO 40.00 X 233536 0 19278 TYSON BOUYACK CFO 40.00 X 131252 0 7220 JENNIFER BECKER DENTAL DIRECTOR 33.00 X 166522 0 0 YASMIN PIRZADA MEDICAL DIRECTOR 38.50 X 238417 0 5761 BONNIE MCNAMARA PHYSICIAN 38.50 X 162685 0 22363 JAMES RICHARD PHYSICIAN 35.50 X 112191 0 3466 AARTI CHELLIAH PHYSICIAN 40.00 X 185193 0 7045 HELEN O'CONNEL PHYSICIAN 40.00 X 274128 0 14622 KRITI ARORA PHYSICIAN 40.00 X 192446 0 7096 1696370 0 86851 16 0 1 0 JANOTTA & HERNER INC 309 MONROE ST MONROEVILLE OH 44847 CONSTRUCTION COMPANY USED TO DESIGN/BUIL 584021 BENCO DENTAL CO 10014 INTERNATIONAL BLVD WEST CHESTER OH 45246 PURCHASE OF DENTAL SUPPLIES & EQUIPMENT 378563 COMPUTOL 118 E 3RD ST PERRYBURG OH 43551 COMPUTER SUPPORT AND SERVICES 161008 ALLSCRIPTS 222 W MERCHANDISE MART PLAZA 2024 CHICAGO IL 60654 PRACTICE MANAGEMENT AND ELECTRONIC HEALT 144422 8 7715279 892589 265634 8607868 PATIENT SERVICE REVENUE 621110 4281911 4281911 PHARMACY REVENUE 446110 643025 643025 4924936 8843 8843 27540 0 27540 27540 27540 MISCELLANEOUS INCOME 621110 9940 9940 9940 13579127 4962416 0 8843 391286 391286 6849751 5977967 871784 88421 88421 520145 317899 202246 481835 376955 104880 217858 147510 70348 85953 38893 47060 352360 87535 264825 399094 270593 128501 356749 293146 63603 72928 44593 28335 335102 278135 56967 41297 7746 33551 MEDICAL & DENTAL SUPPLI 434992 423737 11255 IN-KIND DONATIONS 265634 265634 REPAIRS AND MAINTENANCE 97036 76206 20830 DUES AND SUBSCRIPTIONS 38871 4703 34168 6000 6000 11035312 8617252 2418060 0 3409504 5230718 964945 1868145 446269 566122 158311 191643 97998 103190 10045000 1909469 7630157 8135531 12707184 16095349 925613 613396 0 1156567 925613 1769963 X 11781571 14325386 11781571 14325386 12707184 16095349 2543815 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 687676 687676 8174724 1135483 7039241 16106 16106 0 1166494 757880 408614 8135531 REFUNDABLE ADVANCE 1156567 1156567 X 13579127 0 13579127 0 13579127 11035312 0 11035312 0 11035312 PART X, LINE 2: 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. X 0 0 0 0 0 0 0 0 0 JOSEPH LISZAK CEO 179034 0 47053 0 7449 0 5720 0 13558 0 252814 0 0 0 JENNIFER BECKER DENTAL DIRECTOR 144805 0 20012 0 1705 0 0 0 0 0 166522 0 0 0 YASMIN PIRZADA MEDICAL DIRECTOR 223413 0 400 0 14604 0 0 0 5761 0 244178 0 0 0 BONNIE MCNAMARA PHYSICIAN 162285 0 400 0 0 0 5223 0 17140 0 185048 0 0 0 AARTI CHELLIAH PHYSICIAN 175183 0 400 0 9610 0 1284 0 5761 0 192238 0 0 0 HELEN O'CONNEL PHYSICIAN 268872 0 400 0 4856 0 8262 0 6360 0 288750 0 0 0 KRITI ARORA PHYSICIAN 186170 0 400 0 5876 0 1335 0 5761 0 199542 0 0 0 X COVID-19 SUPPLIES 0 265634 FV 0 0 0 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. COMMUNITY AND RURAL HEALTH SERVICES FOUNDATION INC 2221 HAYES AVE FREMONT OH 43420 341626761 TO HOLD HEALTHCARE FACILITIES FOR COMMUNITY & RURAL HEALTH SERVICES. OH 501(C)(3) LINE 12C, III-FI 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0