PICKAWAY HEALTH SERVICES: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- PICKAWAY HEALTH SERVICES (EIN 31-1438107)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-07
- IRS object ID
- 201903119349302535
- Schema version
- 2018v3.1
- 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 | 2019-11-07T14:31:48-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9200 WORTHINGTON RD STE 200 | AddressLine1Txt |
| City | WESTERVILLE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43082 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311438107 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PICKAWAY HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PICK | BusinessNameControlTxt |
| Phone | 7404742126 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 N PICKAWAY STREET | AddressLine1Txt |
| City | CIRCLEVILLE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43113 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ASHTON COX | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 7404742126 | PhoneNum |
| Signature | 2019-11-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARGOT BURKE | PreparerPersonNm |
| PTIN | P01588992 | PTIN |
| Phone | 6148852583 | PhoneNum |
| Preparation | 2019-11-07 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 47.227.233.166 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-07 | IPDt |
| IP Tm | 13:43:45 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B19D0506B86ED19F1A0FD2AFEEB91090E576B51F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BERGER HEALTH PARTNERS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ASHTON COX | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 N PICKAWAY STREET | AddressLine1Txt |
| City | CIRCLEVILLE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43113 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,073,358 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PICKAWAYHEALTHSERVICES.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TO ATTRACT AND RETAIN QUALIFIED HEALTHCARE PROFESSIONALS TO MEET THE EXPANDING HEALTHCARE NEED OF PICKAWAY COUNTY IN A MANNER THAT IS COMPASSIONATE, EXCEEDS PATIENT SERVICE EXPECTATIONS, AND RESULTS IN A FINANCIALLY SELF-SUSTAINING ORGANIZATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 126 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,815,080 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,586,751 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,919,381 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,049,473 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,283,667 | PYOtherRevenueAmt |
| CY Other Revenue | $1,437,134 | CYOtherRevenueAmt |
| PY Total Revenue | $15,018,128 | PYTotalRevenueAmt |
| CY Total Revenue | $15,073,358 | 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 | $9,930,476 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,363,155 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,847,107 | PYOtherExpensesAmt |
| CY Other Expenses | $4,452,858 | CYOtherExpensesAmt |
| PY Total Expenses | $14,777,583 | PYTotalExpensesAmt |
| CY Total Expenses | $14,816,013 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $240,545 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $257,345 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,347,777 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,540,896 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $957,420 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $893,194 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $390,357 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $647,702 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO ATTRACT AND RETAIN QUALIFIED HEALTHCARE PROFESSIONALS TO MEET THE EXPANDING HEALTHCARE NEED OF PICKAWAY COUNTY IN A MANNER THAT IS COMPASSIONATE, EXCEEDS PATIENT SERVICE EXPECTATIONS, AND RESULTS IN A FINANCIALLY SELF-SUSTAINING ORGANIZATION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $13,056,404 | ExpenseAmt |
| Revenue | $8,486,607 | RevenueAmt |
| Desc | THE FAMILY PRACTICE GROUP OFFERS A FULL RANGE OF MEDICAL SERVICE IN ADDITION TO COMMUNITY EDUCATION AND WELLNESS PROJECTS CONSISTENT WITH THE CHARITABLE PURPOSE OF A 501(C)(3) ENITY INTERNAL MEDICINE OFFERS A FULL RANGE OF SERVICES CONSISTENT WITH THE CHARITABLE PURPOSE OF A 501(C)(3) ENTITY. THE OB/GYN PRACTICE OFFERS A FULL RANGE OF SERVICES CONSISTENT WITH THE CHARITABLE PURPOSE OF A 501(C)(3) ENTITY. | Desc |
| Total Program Service Expenses | $13,056,404 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 14 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 126 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | 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 | Yes (1) | 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 |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KARA MARQUARDT | PersonNm |
| Phone | 7404208089 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 N PICKAWAY STREET | AddressLine1Txt |
| City | CIRCLEVILLE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43113 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MADELINE SANDERS | ||||||||
| CHAIR | 3.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TIM COLBURN | ||||||||
| SECRETARY | 4.00 | 36.00 | Yes (X) | Yes (X) | $0 | $304,268 | $38,490 | |
| ANDREW BINEGAR | ||||||||
| MEMBER | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KRISTY BLUM | ||||||||
| MEMBER | 40.00 | 0.00 | Yes (X) | $195,673 | $0 | $19,497 | ||
| FRANKLIN CHRISTMAN | ||||||||
| MEMBER - TERM ENDED 7/2018 | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JOY EWING | ||||||||
| MEMBER | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT MABE | ||||||||
| MEMBER | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JEREMY NEFF | ||||||||
| MEMBER | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MATT TOOTLE | ||||||||
| MEMBER | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CAROLYN YOST | ||||||||
| MEMBER | 40.00 | 0.00 | Yes (X) | $316,632 | $0 | $25,020 | ||
| CHRISTY ALONZO | ||||||||
| VICE CHAIR - TERM ENDED 3/2018 | 3.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RICH FILLER | ||||||||
| CFO | 5.00 | 35.00 | Yes (X) | $185,501 | $0 | $33,590 | ||
| ASHTON COX | ||||||||
| EXECUTIVE DIRECTOR | 40.00 | 0.00 | Yes (X) | $119,994 | $0 | $19,154 | ||
| DAVID B GOLDFARB | ||||||||
| EMPLOYEE | 40.00 | 0.00 | $453,703 | $0 | $20,400 | Yes (X) | ||
| YADWINDER SINGH | ||||||||
| EMPLOYEE | 40.00 | 0.00 | $437,645 | $0 | $9,918 | Yes (X) | ||
| RAUL A ZAMORA | ||||||||
| EMPLOYEE | 40.00 | 0.00 | $364,354 | $0 | $14,468 | Yes (X) | ||
| ROBERT G KLOOS | ||||||||
| EMPLOYEE | 40.00 | 0.00 | $378,484 | $0 | $7,879 | Yes (X) | ||
| ARNOLD N PALMER JR | ||||||||
| EMPLOYEE | 40.00 | 0.00 | $341,649 | $0 | $25,351 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,793,635 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $304,268 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $213,767 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 27 | 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 |
|---|---|---|---|---|---|
| NTT DATA SERVICES | |||||
| PO BOX 677959 | DALLAS | TX | 75267 | BILLING SERVICES | $887,549 |
| OHIOHEALTHWORKHEALTH | |||||
| DEPT L-3234 | COLUMBUS | OH | 43260 | CLINIC SERVICES CONTRACTING | $348,370 |
| HEMATOLOGY ONCOLOGY CONSULTANTS INC | |||||
| 300 POLARIS PARKWAY | WESTERVILLE | OH | 43082 | ONCOLOGY CONTRACTING | $178,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $6,586,751 | RelatedOrganizationsAmt |
| Total Contributions | $6,586,751 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $7,049,473 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,049,473 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,049,473 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PURCHASE DISCOUNTS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $4,563 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,563 | RelatedOrExemptFuncIncomeAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,432,571 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,432,571 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,437,134 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,073,358 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,486,607 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $915,061 | TotalAmt |
| Program Services | $805,254 | ProgramServicesAmt |
| Management And General | $109,807 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,065,547 | TotalAmt |
| Program Services | $7,081,550 | ProgramServicesAmt |
| Management And General | $983,997 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,581 | TotalAmt |
| Program Services | $142,191 | ProgramServicesAmt |
| Management And General | $19,390 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $704,716 | TotalAmt |
| Program Services | $620,150 | ProgramServicesAmt |
| Management And General | $84,566 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $516,250 | TotalAmt |
| Program Services | $454,300 | ProgramServicesAmt |
| Management And General | $61,950 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,110 | TotalAmt |
| Management And General | $37,110 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,712 | TotalAmt |
| Management And General | $41,712 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,112,403 | TotalAmt |
| Program Services | $1,858,915 | ProgramServicesAmt |
| Management And General | $253,488 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144,153 | TotalAmt |
| Program Services | $134,451 | ProgramServicesAmt |
| Management And General | $9,702 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $777,285 | TotalAmt |
| Program Services | $722,875 | ProgramServicesAmt |
| Management And General | $54,410 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,625 | TotalAmt |
| Program Services | $1,511 | ProgramServicesAmt |
| Management And General | $114 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,226 | TotalAmt |
| Program Services | $40,200 | ProgramServicesAmt |
| Management And General | $3,026 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,461 | TotalAmt |
| Management And General | $75,461 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,741 | TotalAmt |
| Program Services | $116,939 | ProgramServicesAmt |
| Management And General | $8,802 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DRUGS AND MEDICAL SUPPL | $931,697 | $931,697 | |
| TUITION REIMBURSEMENT | $94,051 | $82,765 | $11,286 |
| DUES AND SUBSCRIPTIONS | $53,134 | $49,414 | $3,720 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,260 | TotalAmt |
| Program Services | $14,192 | ProgramServicesAmt |
| Management And General | $1,068 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,816,013 | TotalAmt |
| Program Services | $13,056,404 | ProgramServicesAmt |
| Management And General | $1,759,609 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,199 | BOYAmt |
| EOY | $86,006 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $640,959 | BOYAmt |
| EOY | $416,467 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $343,839 | BOYAmt |
| EOY | $728,423 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,733,781 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,423,781 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $348,780 | BOYAmt |
| EOY | $310,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,347,777 | BOYAmt |
| EOY | $1,540,896 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $957,420 | BOYAmt |
| EOY | $893,194 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $957,420 | BOYAmt |
| EOY | $893,194 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $390,357 | BOYAmt |
| EOY | $647,702 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $390,357 | BOYAmt |
| EOY | $647,702 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,347,777 | BOYAmt |
| EOY | $1,540,896 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $257,345 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BERGER HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 316400103 | EIN |
| Organization Type | 6 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
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
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,597 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,597 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,047 | OtherCostOrOtherBasisAmt |
| Depreciation | $32,634 | DepreciationAmt |
| Book Value | $20,413 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,679,130 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,389,550 | DepreciationAmt |
| Book Value | $289,580 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7 | OtherCostOrOtherBasisAmt |
| Book Value | $7 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $310,000 | TotalBookValueLandBuildingsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIM COLBURN | ||||||||||||||
| SECRETARY | $0 | $304,268 | $0 | $0 | $0 | $0 | $37,800 | $0 | $690 | $0 | $38,490 | $304,268 | $0 | $0 |
| KRISTY BLUM | ||||||||||||||
| MEMBER | $195,673 | $0 | $0 | $0 | $0 | $0 | $5,000 | $0 | $14,497 | $0 | $215,170 | $0 | $0 | $0 |
| CAROLYN YOST | ||||||||||||||
| MEMBER | $294,668 | $0 | $21,964 | $0 | $0 | $0 | $5,000 | $0 | $20,020 | $0 | $341,652 | $0 | $0 | $0 |
| RICH FILLER | ||||||||||||||
| CFO | $178,001 | $0 | $7,500 | $0 | $0 | $0 | $24,500 | $0 | $9,090 | $0 | $219,091 | $0 | $0 | $0 |
| DAVID B GOLDFARB | ||||||||||||||
| EMPLOYEE | $440,003 | $0 | $13,700 | $0 | $0 | $0 | $5,000 | $0 | $15,400 | $0 | $474,103 | $0 | $0 | $0 |
| YADWINDER SINGH | ||||||||||||||
| EMPLOYEE | $437,645 | $0 | $0 | $0 | $0 | $0 | $5,000 | $0 | $4,918 | $0 | $447,563 | $0 | $0 | $0 |
| RAUL A ZAMORA | ||||||||||||||
| EMPLOYEE | $335,989 | $0 | $28,365 | $0 | $0 | $0 | $5,000 | $0 | $9,468 | $0 | $378,822 | $0 | $0 | $0 |
| ROBERT G KLOOS | ||||||||||||||
| EMPLOYEE | $340,999 | $0 | $37,485 | $0 | $0 | $0 | $5,000 | $0 | $2,879 | $0 | $386,363 | $0 | $0 | $0 |
| ARNOLD N PALMER JR | ||||||||||||||
| EMPLOYEE | $341,649 | $0 | $0 | $0 | $0 | $0 | $5,000 | $0 | $20,351 | $0 | $367,000 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | PICKAWAY HEALTH SERVICES IS ORGANIZED AS A COMPONENT UNIT OF BERGER HEALTH SYSTEM, THE PARENT ORGANIZATION AND MEMBER OF THE CONSOLIDATED GROUP. PICKAWAY HEALTH SERVICES OPERATES INDEPENDENTLY OF THE HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | PICKAWAY HEALTH SERVICES IS ORGANIZED AS A COMPONENT UNIT OF BERGER HEALTH SYSTEM, THE PARENT ORGANIZATION AND MEMBER OF THE CONSOLIDATED GROUP. PICKAWAY HEALTH SERVICES OPERATES INDEPENDENTLY OF THE HOSPITAL. PICKAWAY HEALTH SERVICES BOARD OF DIRECTORS ARE APPROVED BY THE BOARD OF DIRECTORS OF BERGER HOSPITAL. THE ONLY RELATED ENTITY MEMBER OF THE BOARD IS THE BERGER HEALTH SYSTEM PRESIDENT/CEO WHO SERVES AS THE SECRETARY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED FOR COMPLETENESS AND ACCURACY BY BOTH THE EXECUTIVE DIRECTOR AND CFO. THE FORM 990 IS PROVIDED TO AND REVIEWED BY THE BOARD PRIOR TO FILING THE RETURN WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THEIR CONFLICT OF INTEREST POLICY BY DISTRIBUTING ANNUAL QUESTIONNAIRES TO THE BOARD MEMBERS, DIRECTORS, AND OFFICERS. NEW BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. ANNUALLY THE QUESTIONNAIRES MUST BE SIGNED AND RETURNED TO PICKAWAY HEALTH SERVICES TO BE FILED FOR FURTHER REVIEW BY THE PRESIDENT/CEO OF BERGER HEALTH SYSTEM AND CORPORATE COMPLIANCE OFFICER. AT ANY TIME THAT AN ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED TO THE RESPECTIVE BOARD, WHETHER THROUGH THE VOLUNTARY SUBMISSION OF A CONFLICTS OF INTEREST STATEMENT BY A BOARD MEMBER, OR BY A DISCLOSURE BY A PERSON OTHER THAN THE BOARD MEMBER, THE BOARD SHALL REVIEW THE MATTER TO DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. THE CONFLICTED BOARD MEMBER SHALL NOT BE PRESENT DURING ANY MEETING IN WHICH THE BOARD CONDUCTS ITS EVALUATION, EXCEPT TO ANSWER QUESTONS AS MAY BE NECESSARY ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED. BOARD MEMBERS SHALL MAKE A FINDING AS TO WHETHER A CONFLICT OF INTEREST INDEED EXISTS, AND SHALL FORWARD THAT FINDING TO THE RESPECTIVE BOARDS FOR DISCUSSION AND VOTE. THE CONFLICTED BOARD MEMBER MAY NOT BE PRESENT AND MUST ABSTAIN FROM VOTING WHEN THIS VOTE IS TAKEN. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S COMPENSATION FOR THE EXECUTIVE DIRECTOR AND OTHER OFFICERS IS DETERMINED BASED ON THE RESULTS OF AN INDEPENDENT COMPENSATION CONSULTATION AND USE OF SALARY SURVEYS. THE EXECUTIVE DIRECTOR'S COMPENSATION IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE. DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATION AND DISCUSSIONS IS DONE CONTEMPORANEOUSLY IN THE CONTRACTS FOR THE OFFICERS AND IN THE MINUTES OF THE BOARD MEETINGS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 539,213. MANAGEMENT AND GENERAL EXPENSES 73,529. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 612,742. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,319,702. MANAGEMENT AND GENERAL EXPENSES 179,959. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,499,661. |
| FORM 990 PART XII, LINE 2C | THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS FROM THE PREVIOUS YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BERGER HOSPITAL | |||||||||||
| 600 N PICKAWAY ST | CIRCLEVILLE | OH | 43113 | 316400103 | ACUTE CARE HOSPITAL | OH | GOVERNMENTAL HOSPITA | N/A | N/A | 0 | |
| BERGER HEALTH FOUNDATION | |||||||||||
| 1280 N COURT ST | CIRCLEVILLE | OH | 43113 | 331031454 | SUPPORT THE HOSPITAL AND COMMUNITY PROGRAMS | OH | 501(C)(3) | LINE 7 | Yes (1) | BERGER HOSPITAL | |
| BERGER HEALTH SYSTEM | |||||||||||
| 600 N PICKAWAY ST | CIRCLEVILLE | OH | 43113 | 262545110 | INACTIVE ACUTE CARE HOSPITAL | OH | GOVERNMENTAL HOSPITA | N/A | N/A | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| PICKAWAY PROFESSIONAL SERVICES INC | |||||||||
| 600 N PICKAWAY ST | CIRCLEVILLE | OH | 43113 | 611408162 | ANESTHESIOLOGISTS | OH | N/A | C | 0 |
| BERGER HEALTH FOUNDATION VENTURES | |||||||||
| 1204 N COURT STREET | CIRCLEVILLE | OH | 43113 | 412218009 | MEDICAL SERVICES | OH | N/A | C | 0 |
| 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 | Yes (1) | 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 | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | 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 |
Comments