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COMMUNITY HOSPITAL HEALTH SERVICES FOUNDATION: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HOSPITAL HEALTH SERVICES FOUNDATION (EIN 31-1181991)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-01-13
IRS object ID
201620149349300032
Schema version
2014v6.0
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

FieldValueIRS element (for citing)
Return2016-01-13T15:06:28-06:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN310800053PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLARK SCHAEFER HACKETT & COBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line114 E MAIN STREET SUITE 500AddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45502ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN311181991EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HOSPITAL HEALTH SERVICES FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone9375237000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 MEDICAL CENTER DRIVEAddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45504ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOY A ROGERSPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone9375237000PhoneNum
Signature2016-01-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDARRIN SPITZERPreparerPersonNm
PTINP01399907PTIN
Phone9373992000PhoneNum
Preparation2016-01-11PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-04-25 22:37:26ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerJOY A ROGERSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 MEDICAL CENTER DRIVEAddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45505ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$166,304GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.COMMUNITY-HEALTH-FOUNDATION.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1986FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionTO PRESERVE REPRODUCTIVE SERVICES, TO PROMOTE HEALTH AND WELLNESS AND TO ADVOCATE FOR QUALITY HEALTHCARE THROUGH GRANT MAKING AND EDUCATION.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee39TotalEmployeeCnt
Total Volunteers40TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$96,842PYContributionsGrantsAmt
CY Contributions Grants$96,639CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$333,996PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$47,802PYOtherRevenueAmt
CY Other Revenue$69,665CYOtherRevenueAmt
PY Total Revenue$478,640PYTotalRevenueAmt
CY Total Revenue$166,304CYTotalRevenueAmt
PY Grants And Similar Paid$68,164PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$125,500CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$141,637PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$146,363CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$22,959CYTotalFundraisingExpenseAmt
PY Other Expenses$371,658PYOtherExpensesAmt
CY Other Expenses$432,867CYOtherExpensesAmt
PY Total Expenses$581,459PYTotalExpensesAmt
CY Total Expenses$704,730CYTotalExpensesAmt
PY Revenues Less Expenses-$102,819PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$538,426CYRevenuesLessExpensesAmt
Total Assets BOY$21,999,001TotalAssetsBOYAmt
Total Assets EOY$22,523,806TotalAssetsEOYAmt
Total Liabilities BOY$124,781TotalLiabilitiesBOYAmt
Total Liabilities EOY$45,718TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$21,874,220NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$22,478,088NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PRESERVE REPRODUCTIVE SERVICES, TO PROMOTE HEALTH AND WELLNESS AND TO ADVOCATE FOR QUALITY HEALTHCARE THROUGH GRANT MAKING AND EDUCATION.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$170,703ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescREPRODUCTIVE HEALTH EDUCATION AND INFORMATION:THROUGH ITS REPRODUCTIVE HEALTH EDUCATION, CHF PROVIDED COMPREHENSIVE SEXUALITY EDUCATION PROGRAMS TO MIDDLE AND HIGH SCHOOL YOUTH USING TRAINED AND CERTIFIED HEALTH EDUCATORS, SERVING 1,536 STUDENTS AT 9 DIFFERENT VENUES. THE PURPOSE OF THIS EDUCATION IS TO IMPROVE ADOLESCENT SEXUAL HEALTH BY REDUCING THE INCIDENCE OF RISK ]TAKING SEXUAL BEHAVIORS IN TEENS, LOWERING UNPLANNED PREGNANCY RATES AND REDUCING THE NUMBER OF SEXUALLY TRANSMITTED INFECTIONS. CHF ALSO COORDINATES THE PREP (PERSONAL RESPONSIBILITY EDUCATION PROGRAM) PROGRAM IN CLARK, CHAMPAIGN, GREENE AND LOGAN COUNTIES. THE PREP PROGRAM IS PRESENTED TO YOUTH IN FOSTER CARE AND ADJUDICATED YOUTH AND CONTAINS 19 MODULES FEATURING INFORMATION ON DAILY LIVING SKILLS, FINANCIAL LITERACY AND HEALTHY RELATIONSHIP SKILLS TO INCLUDE COMPREHENSIVE SEXUAL EDUCATION AMONG OTHER TOPICS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$125,500ExpenseAmt
Grant$125,500GrantAmt
Revenue$0RevenueAmt
DescCOMMUNITY GRANT PROGRAM:CHF PROVIDES SUPPORT TO NON-PROFIT ORGANIZATIONS THROUGH ITS COMMUNITY GRANTS PROGRAM, INITIATED IN FYE 6/30/15. GRANT FUNDS ARE DIRECTED TO PROJECTS AND INITIATIVES THAT SUPPORT AND PROMOTE: HEALTHY LIVING, REPRODUCTIVE HEALTH, HEALTHY RELATIONSHIPS AND MENTAL AND EMOTIONAL HEALTH. GRANT FUNDS WERE PROVIDED TO 25 ORGANIZATIONS DURING FYE JUNE 30, 2015.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$81,287ExpenseAmt
Grant$0GrantAmt
DescFAMILY HEALTH EDUCATION:CHF DISTRIBUTED OVER 5,500 COPIES OF ITS HEALTH RESOURCE GUIDE FOR CLARK AND CHAMPAIGN COUNTIES TO THE GENERAL PUBLIC AND SOCIAL SERVICE OR HEALTH AGENCIES THAT SERVE THE PUBLIC. THERE IS NO CHARGE FOR THIS PUBLICATION. THE GUIDE WAS ALSO MAINTAINED AND UPDATED ON OUR WEBSITE AND IS SEARCHABLE AND DOWNLOADABLE. CHF CONTINUED ITS FREE FAMILY HEALTH EDUCATION PROGRAM AND AN INTERACTIVE PUBLIC HEALTH EXPO WAS HELD DURING FYE JUNE 30, 2015, "HEALTHY FAMILIES '14". THIS EVENT FEATURES "TALK WITH A DOC" SESSIONS, EXHIBITS, DEMONSTRATIONS, AND HEALTH SCREENINGS; APPROXIMATELY 400 PERSONS ATTENDED THIS HEALTH AND WELLNESS EDUCATIONAL EVENT. CHF ALSO PARTICIPATES IN MANY HEALTH FAIRS AND EXPOS PROVIDING "MY PLATES" TO ELEMENTARY AGED CHILDREN TO PROMOTE HEALTHY EATING HABITS AND PORTION CONTROL. ADDITIONALLY, CHF PRODUCED AND DISTRIBUTED A "HEALTHY DINING GUIDE" WITH INFORMATION ON HEALTHIER MENU CHOICES AT AREA RESTAURANTS.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$154,446ExpenseAmt
DescCHF PROVIDES CLINICAL REPRODUCTIVE SERVICES IN ITS PAVILION TO INCLUDE TUBAL LIGATIONS, VASECTOMIES AND CONTRACEPTIVE SHOTS.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$154,446TotalOtherProgSrvcExpenseAmt
Total Program Service Expenses$531,936TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related InvstYes (1)ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document14IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee39EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOY A ROGERSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9375237000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 MEDICAL CENTER DRIVEAddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45505ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JAMES F PEIFER
CHAIR2.00Yes (X)Yes (X)$0$0$0
ROBYN KOCH-SCHUMAKER
VICE CHAIR1.00Yes (X)Yes (X)$0$0$0
STEPHEN NEELY
TREASURER1.00Yes (X)Yes (X)$0$0$0
CATHRYN S BALAS
SECRETARY1.00Yes (X)Yes (X)$0$0$0
DARRELL KITCHEN
TRUSTEE1.00Yes (X)$0$0$0
ELILLIAN DAUGHERTY MD
TRUSTEE1.00Yes (X)$0$0$0
SHAWN S OSTERHOLT MD
TRUSTEE1.00Yes (X)$0$0$0
SHEILA RICE
TRUSTEE1.00Yes (X)$0$0$0
TED VANDER ROEST
TRUSTEE1.00Yes (X)$0$0$0
MARK ELLIOTT
TRUSTEE1.00Yes (X)$0$0$0
RANDALL COMER
TRUSTEE1.00Yes (X)$0$0$0
MARIA GOESER
TRUSTEE1.00Yes (X)$0$0$0
ANNE HOLTZ
TRUSTEE1.00Yes (X)$0$0$0
STEPHANIE MCCUISTION
TRUSTEE1.00Yes (X)$0$0$0
ERIC ESPINOSA MD
TRUSTEE1.00Yes (X)$0$0$0
JOY A ROGERS
EXECUTIVE DIRECTOR40.00Yes (X)$93,354$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$93,354TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ROCKING HORSE CENTER
651 S LIMESTONE STREETSPRINGFIELDOH45505LEASED EMPLOYEES$198,922
COMMUNITY MERCY HEALTH PARTNERS
100 MEDICAL CENTER DRSPRINGFIELDOH45504EQUIPMENT MAINTENANCE$138,937
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
All Other Contributions$96,639AllOtherContributionsAmt
Total Contributions$96,639TotalContributionsAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$61,114RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$61,114RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$61,114TotalRevenueColumnAmt
Exclusion$61,114ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business621400BusinessCd
Total Revenue Column$8,551TotalRevenueColumnAmt
Related Or Exempt Func Income$8,551RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$8,551OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$166,304TotalRevenueColumnAmt
Related Or Exempt Func Income$8,551RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$61,114ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$125,500TotalAmt
Program Services$125,500ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$96,263TotalAmt
Program Services$38,505ProgramServicesAmt
Management And General$38,505ManagementAndGeneralAmt
Fundraising$19,253FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$49,678TotalAmt
Program Services$27,306ProgramServicesAmt
Management And General$22,372ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$422TotalAmt
Program Services$422ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$66,343TotalAmt
Program Services$53,074ProgramServicesAmt
Management And General$13,269ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$8,919TotalAmt
Management And General$8,919ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$32,440TotalAmt
Management And General$32,440ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$36,497TotalAmt
Program Services$32,792ProgramServicesAmt
Management And General$3,705ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$27,556TotalAmt
Program Services$20,438ProgramServicesAmt
Management And General$5,860ManagementAndGeneralAmt
Fundraising$1,258FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,846TotalAmt
Program Services$4,631ProgramServicesAmt
Management And General$919ManagementAndGeneralAmt
Fundraising$1,296FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$14,467TotalAmt
Program Services$10,428ProgramServicesAmt
Management And General$3,642ManagementAndGeneralAmt
Fundraising$397FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$122,074TotalAmt
Program Services$114,831ProgramServicesAmt
Management And General$6,488ManagementAndGeneralAmt
Fundraising$755FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$23,952TotalAmt
Program Services$15,898ProgramServicesAmt
Management And General$8,054ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PROGRAM EXPENSE$39,048$39,048
MARKETING/WEB MANAGEMEN$17,614$17,614
OTHER EXPENSE$15,793$10,131$5,662
MEDICAL SUPPLIES$15,246$15,246

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$6,072TotalAmt
Program Services$6,072ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$704,730TotalAmt
Program Services$531,936ProgramServicesAmt
Management And General$149,835ManagementAndGeneralAmt
Fundraising$22,959FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$491,308BOYAmt
EOY$590,726EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,186BOYAmt
EOY$24,830EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$25,038BOYAmt
EOY$22,914EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$4,027,220LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$524,606LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,560,477BOYAmt
EOY$3,502,614EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$17,797,144BOYAmt
EOY$18,268,382EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$114,848BOYAmt
EOY$114,340EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$21,999,001BOYAmt
EOY$22,523,806EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$124,781BOYAmt
EOY$45,718EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$124,781BOYAmt
EOY$45,718EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$21,106,459BOYAmt
EOY$21,704,060EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$767,761BOYAmt
EOY$774,028EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$21,874,220BOYAmt
EOY$22,478,088EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$21,999,001BOYAmt
EOY$22,523,806EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$538,426ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$1,142,294OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$496,138BeginningYearBalanceAmt
Investment Earnings Or Losses$24,142InvestmentEarningsOrLossesAmt
Other Expenditures$12,101OtherExpendituresAmt
End Year Balance$508,179EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$456,214BeginningYearBalanceAmt
Investment Earnings Or Losses$70,654InvestmentEarningsOrLossesAmt
Other Expenditures$30,730OtherExpendituresAmt
End Year Balance$496,138EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$433,953BeginningYearBalanceAmt
Contributions$10,700ContributionsAmt
Investment Earnings Or Losses$25,713InvestmentEarningsOrLossesAmt
Other Expenditures$14,152OtherExpendituresAmt
End Year Balance$456,214EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$428,052BeginningYearBalanceAmt
Contributions$12,841ContributionsAmt
Investment Earnings Or Losses$21,638InvestmentEarningsOrLossesAmt
Other Expenditures$28,578OtherExpendituresAmt
End Year Balance$433,953EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$407,486BeginningYearBalanceAmt
Contributions$8,682ContributionsAmt
Investment Earnings Or Losses$20,450InvestmentEarningsOrLossesAmt
Other Expenditures$8,566OtherExpendituresAmt
End Year Balance$428,052EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.38810BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.61190TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$350,000InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$109,180OtherCostOrOtherBasisAmt
Book Value$459,180BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$1,016,099InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$1,972,923OtherCostOrOtherBasisAmt
Depreciation$205,974DepreciationAmt
Book Value$2,783,048BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$579,018OtherCostOrOtherBasisAmt
Depreciation$318,632DepreciationAmt
Book Value$260,386BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,502,614TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescBENEFICIAL INTEREST IN FUND HELD BY SPRINGFIELDDesc
Book Value$18,268,382BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Program Rltd$18,268,382TotalBookValueProgramRltdAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,308,598TotalRevEtcAuditedFinclStmtAmt
Other Revenue$1,142,294OtherRevenueAmt
Revenue Not Reported$1,142,294RevenueNotReportedAmt
Revenue Subtotal$166,304RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$166,304TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$704,730TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$704,730ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$704,730TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:TO PROVIDE CLINICAL SERVICES, PRIMARY REPRODUCTIVE HEALTH SERVICES AND OTHER HEALTH SERVICES NOT PROVIDED BY COMMUNITY MERCY HEALTH PARTNERS AND PROVIDE REPRODUCTIVE HEALTH AND WOMEN'S HEALTH EDUCATION AND INFORMATION.
PART X, LINE 2:THE FOUNDATION HAS ADOPTED ACCOUNTING RULES THAT PRESCRIBE WHEN TO RECOGNIZE, AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN, OR EXPECTED TO BE TAKEN, ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE FOUNDATION ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON ITS REVIEW, MANAGEMENT DOES NOT BELIEVE THE FOUNDATION HAS TAKEN ANY MATERIAL UNCERTAIN TAX POSITIONS, INCLUDING ANY POSITION THAT WOULD PLACE THE FOUNDATION'S TAX EXEMPT STATUS IN JEOPARDY AS OF JUNE 30, 2015. THE FOUNDATION BELIEVES THEY ARE NO LONGER SUBJECT TO INCOME EXAMINATIONS FOR FISCAL YEARS PRIOR TO 2012.
PART XI, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN BENEFICIAL INTEREST IN FUNDS HELD BY SPRINGFIELD FOUNDATION
PART XII, LINE 2D - OTHER ADJUSTMENTS:OTHER

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
BIG BROTHERS BIG SISTERS
625 BURT STSPRINGFIELDOH45505310955969501(C)(3)$10,000CAMP OTY'OKWA GRANT
CATHOLIC CHARITIES
701 E COLUMBIA STSPRINGFIELDOH45503310536968501(C)(3)$10,000"PAVING" THE ROAD TO GOOD HEALTH
COMMUNITY MERCY FOUNDATION
100 W MCCREIGHTSPRINGFIELDOH45504311443778501(C)(3)$8,949MED ASSIST
ROCKING HORSE COMMUNITY HEALTH
1 E PLEASANT STSPRINGFIELDOH45506311593544501(C)(3)$8,750SCREENING INCENTIVE PROGRAMS
RECOVERY ZONE
PO BOX 765WEST LIBERTYOH43357311576428501(C)(3)$7,500WELLNESS MANAGEMENT & RECOVERY
COMMUNITY MERCY MED ASSIST
30 W MCCREIGHT AVESPRINGFIELDOH45504311443778501(C)(3)$7,126MED ASSIST PRESCRIPTION ASSISTANCE PROGRAM
ON-THE-RISE FARMS
4177 DIALTON ROADSPRINGFIELDOH45502043750441501(C)(3)$7,000OPERATING EXPENSES
PROJECT WOMAN
525 EAST HOME ROADSPRINGFIELDOH45503237391095501(C)(3)$7,000ALL READY AND PAVE PROGRAM
DEAF COMMUNITY RESOURCE CENTER
3323 STANLEY AVEDAYTONOH45404205202136501(C)(3)$6,000DEAF COMMUNITY HEALTHIER LIVING
SPRIGFIELD CHRISTIAN YOUTH MINISTRIES
1500 BROADWAY STSPRINGFIELDOH45504311623059501(C)(3)$7,000GIRL POWER, AFTER SCHOOL PROGRAM
FieldValueIRS element (for citing)
Total501c3 Org10Total501c3OrgCnt
Total Other Org10TotalOtherOrgCnt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11IN THE EVENT THERE IS NOT A TIMELY BOARD MEETING FOR CONTEMPORANEOUS REVIEW, FORM 990 IS FORWARDED VIA ELECTRONIC MAIL OR U.S. MAIL TO EACH BOARD MEMBER FOR HIS/HER REVIEW PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990 IS ALSO REVIEWED AND DISCUSSED BY THE EXECUTIVE COMMITTEE AND/OR THE FINANCE COMMITTEE PRIOR TO FILING. BOTH COMMITTEES HAVE AUTHORITY TO ACT ON BEHALF OF THE BOARD TO DIRECT THE EXECUTIVE DIRECTOR TO SIGN AND TO FILE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12CCHF REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY BY: 1) EACH PERSON NOMINATED TO THE BOARD OF TRUSTEES COMPLETES A CONFLICTS OF INTEREST DISCLOSURE CERTIFICATE; 2) ANNUALLY BY FEBRUARY 15, EACH TRUSTEE COMPLETES A CONFLICTS OF INTEREST DISCLOSURE CERTIFICATE; 3) A SUMMARY OF ALL CONFLICTS DISCLOSED BY TRUSTEES IS DISTRIBUTED TO ALL TRUSTEES AT THE APRIL QUARTERLY MEETING; 4) TRUSTEES WITH A CONFLICT RELATIVE TO SPECIFIC ITEMS OF DELIBERATION ARE ADVISED BY THE CHAIR TO REFRAIN FROM DISCUSSION AND VOTING OR ARE EXCUSED FROM THE MEETING IF THE CONFLICT IS MATERIAL; 5) THE CONTEMPORANEOUS MINUTES OF THE MEETING REFLECT THE NATURE OF THE CONFLICT AND THE FACT THAT THE MEMBER DID NOT PARTICIPATE IN DISCUSSION OR VOTING ON THE ITEM UNDER DELIBERATION.
FORM 990, PART VI, SECTION B, LINE 15AA COMPENSATION COMMITTEE OF 3-4 DISINTERESTED MEMBERS OF THE BOARD OF TRUSTEES IS APPOINTED BY THE CHAIRMAN OF THE BOARD. PROGRESS REPORT ON CEO GOALS IS REVIEWED, PERFORMANCE REVIEW SCORE SHEETS ARE COMPLETED INDIVIDUALLY BY MEMBERS, AND CEO PERFORMANCE IS REVIEWED AND COMPENSATION DETERMINED DURING A MEETING OF THE WHOLE COMMITTEE. COMPENSATION IS SET TAKING INTO ACCOUNT PERFORMANCE (MERIT) AND MARKET RANGES FOR SIMILAR POSITIONS. THERE ARE NO OTHER OFFICERS OR KEY EMPLOYEES RECEIVING COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 18MOST RECENT FORM 990 PLUS PRIOR TWO FISCAL YEARS' 990S ARE POSTED ON COMMUNITY HOSPITAL HEALTH SERVICES FOUNDATION WEBSITE. REQUESTS FOR A COPY OF THE FORM 990 FOR ANY FISCAL YEAR MAY BE MADE BY TELEPHONE, ELECTRONIC MAIL, U.S. MAIL OR IN PERSON. REQUESTS WILL BE HONORED WITHIN 5 WORKING DAYS. A NOMINAL CHARGE TO COVER THE COST OF COPYING MAY BE MADE.
FORM 990, PART VI, SECTION C, LINE 19COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS MAY BE REQUESTED BY TELEPHONE, ELECTRONIC MAIL, U.S. MAIL OR IN PERSON; REQUESTS WILL BE HONORED WITHIN 5 WORKING DAYS. A NOMINAL CHARGE MAY BE MADE. AUDITED ANNUAL FINANCIAL STATEMENTS ARE ALSO AVAILABLE ON THE COMMUNITY HOSPITAL HEALTH SERVICES FOUNDATION WEBSITE.
FORM 990, PART XI, LINE 9:SEE SCHEDULE D 1,142,294.
PART XI LINE 2CCOMMUNITY HOSPITAL HEALTH SERVICES FOUNDATION HAS NOT CHANGED ITS OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
COMMUNITY MERCY HEALTH SYSTEM
1 S LIMESTONE STSPRINGFIELDOH45502300272454COMMUNITY HEALTH SYSTEMOH501(C)(3)LINE 3N/A0
COMMUNITY MERCY HEALTH PARTNERS
1 S LIMESTONE STSPRINGFIELDOH45501310785684COMMUNITY HEALTH SYSTEMOH501(C)(3)LINE 3N/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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