CHMC COMMUNITY HEALTH SERVICES NETWORK: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- CHMC COMMUNITY HEALTH SERVICES NETWORK (EIN 31-1459815)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-11
- IRS object ID
- 201641329349302859
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-11T13:32:07-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 East Fifth Street Suite 1900 | AddressLine1Txt |
| City | Cincinnati | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311459815 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHMC Community Health Services Network | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHMC | BusinessNameControlTxt |
| Phone | 5138031106 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3333 Burnet Avenue | AddressLine1Txt |
| City | Cincinnati | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 452293039 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Tom Dewitt | PersonNm |
| Person Title | Director | PersonTitleTxt |
| Phone | 5138031106 | PhoneNum |
| Signature | 2016-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Alicia Janisch | PreparerPersonNm |
| PTIN | P00741382 | PTIN |
| Phone | 5137847100 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Dee Ellingwood | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3333 Burnet Avenue | AddressLine1Txt |
| City | Cincinnati | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 452293039 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,099,911 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | Provide medical services to children in the community | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,356,919 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,025,071 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $85,519 | PYOtherRevenueAmt |
| CY Other Revenue | $74,840 | CYOtherRevenueAmt |
| PY Total Revenue | $3,442,438 | PYTotalRevenueAmt |
| CY Total Revenue | $4,099,911 | 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 | $2,191,560 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,276,403 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,214,677 | PYOtherExpensesAmt |
| CY Other Expenses | $1,498,080 | CYOtherExpensesAmt |
| PY Total Expenses | $3,406,237 | PYTotalExpensesAmt |
| CY Total Expenses | $3,774,483 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $36,201 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $325,428 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,828,488 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,305,629 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $201,689 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $353,402 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,626,799 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,952,227 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CHMC Community Health Services Network ("CHSN") is organized and operated exclusively to support Cincinnati Children's Hospital Medical Center ("CCHMC") in CCHMC's efforts to provide medical services to all of the children in the community. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,774,483 | ExpenseAmt |
| Revenue | $4,099,911 | RevenueAmt |
| Desc | Cincinnati Children's Hospital Medical Center ("CCHMC") is devoted to providing medical services to all of the children in the community. CHMC community health services network ("CHSN") is organized and operated exclusively to support CCHMC in this effort by reaching out to the medically underserved and economically disadvantaged neighborhoods of our community.CHSN serves as the structure for bringing medical professionals who share the vision of providing quality medical care to the underprivileged and underserved. CHSN carries out its charitable purposes by seeking and hiring such "mission oriented physicians. In addition, CHSN will make medical professionals an integral part of these underprivileged neighborhoods by establishing sites within these communities where resident physicians will work. The resident physicians will be able to learn more about the patients they seek to serve and thereby provide better service to them. Furthermore, in order to ensure its goals are met, CHSN will act as a liaison between the neighborhoods and CCHMC and will focus on how to best meet the difficult and unique needs of the underprivileged neighborhoods of our community. | Desc |
| Total Program Service Expenses | $3,774,483 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | 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 | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Michael Bauer | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5138031106 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3333 Burnet Avenue | AddressLine1Txt |
| City | Cincinnati | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 452293039 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| Michael Fisher | |||||||
| Director | 1.00 | 49.00 | Yes (X) | $0 | $1,041,567 | $214,263 | |
| Scott J Hamlin | |||||||
| Director/Treasurer/Secretary | 1.00 | 49.00 | Yes (X) | $0 | $1,201,344 | $166,069 | Yes (X) |
| Steve Muething | |||||||
| Director (Thru 2014) | 1.00 | 49.00 | Yes (X) | $0 | $370,244 | $74,368 | |
| Tom Dewitt MD | |||||||
| Director | 1.00 | 49.00 | Yes (X) | $0 | $312,655 | $50,399 | |
| Dee Ellingwood | |||||||
| Director/President (Thru 2014) | 1.00 | 49.00 | Yes (X) | $0 | $563,328 | $31,223 | Yes (X) |
| Mark Mumford | |||||||
| Director | 1.00 | 49.00 | Yes (X) | $0 | $737,068 | $135,096 | |
| Charlene Mason | |||||||
| Director | 1.00 | 49.00 | Yes (X) | $0 | $345,465 | $38,719 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,571,671 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $710,137 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Turner Construction | |||||
| 250 W Court Street | Cincinnati | OH | 45202 | Construction | $871,508 |
| Margaret Mary Community Hospital | |||||
| 321 Mitchell Avenue | Batesville | IN | 47006 | Rent | $204,771 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Net Patient Revenue | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $4,025,071 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,025,071 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,025,071 | TotalProgramServiceRevenueAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $74,840 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $74,840 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $74,840 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,099,911 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,099,911 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,966,579 | TotalAmt |
| Program Services | $1,966,579 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $309,824 | TotalAmt |
| Program Services | $309,824 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,900 | TotalAmt |
| Program Services | $30,900 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $601,420 | TotalAmt |
| Program Services | $601,420 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,728 | TotalAmt |
| Program Services | $244,728 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,206 | TotalAmt |
| Program Services | $28,206 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,141 | TotalAmt |
| Program Services | $82,141 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Collection fees | $406,712 | $406,712 |
| Other | $103,973 | $103,973 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,774,483 | TotalAmt |
| Program Services | $3,774,483 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $301,567 | BOYAmt |
| EOY | $991,192 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $314,337 | BOYAmt |
| EOY | $373,623 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $9,508 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,127,020 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $195,714 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $148,615 | BOYAmt |
| EOY | $931,306 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,063,969 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,828,488 | BOYAmt |
| EOY | $2,305,629 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $201,689 | BOYAmt |
| EOY | $353,402 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $201,689 | BOYAmt |
| EOY | $353,402 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,626,799 | BOYAmt |
| EOY | $1,952,227 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,626,799 | BOYAmt |
| EOY | $1,952,227 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,828,488 | BOYAmt |
| EOY | $2,305,629 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $325,428 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,871,766 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,862,546 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,284,561 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,356,919 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,025,071 | CurrentTaxYearAmt |
| Total | $16,400,863 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,871,766 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,862,546 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,284,561 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,356,919 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,025,071 | CurrentTaxYearAmt |
| Total | $16,400,863 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $16,400,863 | PublicSupportTotal509Amt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $63,565 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $227,926 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $34,351 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $85,520 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $74,840 | CurrentTaxYearAmt |
| Total | $486,202 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,935,331 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,090,472 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,318,912 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,442,439 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,099,911 | CurrentTaxYearAmt |
| Total | $16,887,065 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.97120 | PublicSupportCY509Pct |
| Public Support PY509 | 0.96940 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,500 | OtherCostOrOtherBasisAmt |
| Book Value | $7,500 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $723,729 | OtherCostOrOtherBasisAmt |
| Depreciation | $44,669 | DepreciationAmt |
| Book Value | $679,060 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $395,791 | OtherCostOrOtherBasisAmt |
| Depreciation | $151,045 | DepreciationAmt |
| Book Value | $244,746 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $931,306 | TotalBookValueLandBuildingsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Michael Fisher | ||||||||||||||
| Director | $0 | $872,843 | $0 | $100,000 | $0 | $68,724 | $0 | $185,013 | $0 | $29,250 | $0 | $1,255,830 | $0 | $0 |
| Scott J Hamlin | ||||||||||||||
| Director/Treasurer/Secretary | $0 | $646,438 | $0 | $230,907 | $0 | $323,999 | $0 | $139,506 | $0 | $26,563 | $0 | $1,367,413 | $0 | $261,920 |
| Steve Muething | ||||||||||||||
| Director (Thru 2014) | $0 | $285,952 | $0 | $68,702 | $0 | $15,590 | $0 | $49,476 | $0 | $24,892 | $0 | $444,612 | $0 | $0 |
| Tom Dewitt MD | ||||||||||||||
| Director | $0 | $278,544 | $0 | $975 | $0 | $33,136 | $0 | $26,000 | $0 | $24,399 | $0 | $363,054 | $0 | $0 |
| Dee Ellingwood | ||||||||||||||
| Director/President (Thru 2014) | $0 | $371,659 | $0 | $77,273 | $0 | $114,396 | $0 | $1,616 | $0 | $29,607 | $0 | $594,551 | $0 | $56,540 |
| Mark Mumford | ||||||||||||||
| Director | $0 | $487,395 | $0 | $192,367 | $0 | $57,306 | $0 | $107,686 | $0 | $27,410 | $0 | $872,164 | $0 | $0 |
| Charlene Mason | ||||||||||||||
| Director | $0 | $270,068 | $0 | $55,486 | $0 | $19,911 | $0 | $26,000 | $0 | $12,719 | $0 | $384,184 | $0 | $16,053 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 4b | Certain officers and key employees of Cincinnati Children's Hospital Medical Center ("CCHMC"), a related organization to CHSN, have arrangements which provide for supplemental retirement benefits as described in IRC Sec. 457(F). Due to the substantial risk of forfeiture provision, these arrangements are non-vested and there is no guarantee that these officers and faculty members will ever receive these benefits. The following is a listing of officers and key employees that received a deferral, subject to the substantial risk of forfeiture provision, under CCHMC's IRC. Sec. 457(f) plan during the year (these amounts are included in the totals for Schedule J, Part II, Column C, deferred compensation): 1. Mark Mumford - $81,686 2. Michael Fisher - $159,013 3. Scott Hamlin - $113,506 4. Charlene Mason - $16,102 The following is a listing of officers and key employees that received a payment under CCHMC's IRC Sec. 457(f) plan during the year: 1. Scott Hamlin - $261,920 2. Dee Ellingwood - $56,540 3. Charlene Mason - $16,053 |
| Form 990, Schedule J | CHMC Community Health Services Network relied on Cincinnati Children's Hospital Medical Center ("CCHMC"), a related organization, to establish the compensation of individuals listed on Form 990, Part VII. CCHMC used one or more of the methods described below to establish an appropriate level of compensation: Compensation Committee Independent Compensation Consultant Form 990 of other organizations Compensation survey or study Approval by the Board or Compensation Committee Explanation of the benefits: All compensation and benefits reported on Form 990, Part VII and Schedule J, Part II are provided by CCHMC, a related entity to CHSN. The employee benefit plan contribution amounts listed on Schedule J, Part II may include one or more of the following benefits: 1. Elective employee deferrals under IRC Sec. 403(b) 2. Discretionary employer contributions under IRC Sec. 403(b) 3. Elective employee deferrals under IRC Sec. 457(b) 4. Elective employee deferrals under IRC Sec. 457(f) In addition to the retirement plan contributions disclosed on Form 990, Part VII and Schedule J, Part II, the following non-taxable employee welfare benefits were made available to the employed, compensated officers and key employees listed on Form 990, Part VII and Schedule J, Part II: 1. Health and dental insurance benefits 2. Group life insurance (portions of which are taxed) 3. Unemployment benefits 4. Disability benefits The officers and key employers listed on Form 990, Part VII and Schedule J, Part II are also eligible for any other available employer benefits. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | Article III of CHSN's code of regulations provides that Children's Hospital Medical Center, a related organization, possesses the authority to appoint, elect, and remove members of CHSN's board of trustees. |
| Form 990, Part VI, Section A, line 7a | Article III of CHSN's code of regulations provide that Children's Hospital Medical Center, a related organization, possesses the authority to appoint, elect, and remove members of CHSN's board of trustees. |
| Form 990, Part VI, Section B, line 11 | The CHMC Community Health Services Network ("CHSN") form 990 is prepared by senior management from Cincinnati Children's Hospital Medical Center ("CCHMC"), a related organization. External tax consultants then review the Form 990 for completeness and accuracy. The Form 990 is then made available to all CHSN board members in advance of filing. |
| Form 990, Part VI, Section B, line 12c | All of CHSN's board members receive an annual questionnaire requesting information regarding family and business relationships that could potentially result in a conflict of interest under CHSN's conflict of interest policy. Once the questionnaires have been completed by all of CHSN's board members, the questionnaires are reviewed and if CHSN determines that a relationship exists that presents a conflict of interest, CHSN follows the provisions set forth in CHSN's conflict of interest policy to resolve the conflict and determines the appropriate reporting to the board and, if required, Form 990 disclosure. |
| Form 990, Part VI, Section B, line 15 | CHSN's board members are employed by Cincinnati Children's Hospital Medical Center ("CCHMC"), a related organization. CCHMC has a compensation committee that annually reviews the recommendations of CCHMC management regarding employee performance evaluation and compensation adjustments for disqualified persons to ensure that CCHMC has complied with the provisions of the rebuttable presumption of reasonableness under IRC Sec. 4958. |
| Form 990, Part VI, Section C, line 19 | CHSN's governing documents, conflict of interest policy, and financial statements are maintained on file by CCHMC senior management and are available to the public upon request either in-person, by telephone, or by written request. |
| Form 990, Part VI, Section B, Question 13 | CHSN's Board of Trustees has not formally adopted a written whistleblower policy. However, CHSN is a related organization of Cincinnati Children's Hospital Medical Center ("CCHMC"). CCHMC has a written whistleblower policy and CHSN abides by the provisions of this policy. |
| Form 990, Part VI, Section B, Question 14 | CHSN's Board of Trustees has not formally adopted a written document retention and destruction policy. However, CHSN is a related organization of Cincinnati Children's Hospital Medical Center ("CCHMC"). CCHMC has a written document retention and destruction policy and CHSN abides by the provisions of this policy. |
| Form 990, Part VIII | All individuals listed on Form 990, Part VII are employed by Cincinnati Children's Hospital Medical Center ("CCHMC"), a related organization. Each individual devotes an average of 50 hours/week for their duties to CCHMC and affiliated entities. |
| Form 990, Part XII, Line 2B | CHSN's financial statements are included as part of the Cincinnati Children's Hospital Medical Center & affiliates financial statement audit. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Children's Hospital Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3333 Burnet Avenue | AddressLine1Txt |
| City | Cincinnati | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45229 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310833936 | EIN |
| Primary Activities | Pediatric Medicine | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Children's Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Children's Hospital Medical Center | ||
| R | $3,916,195 | Cash |
| Children's Hospital Medical Center | ||
| S | $5,052,130 | Cash |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Form 990, Schedule R | FormAndLineReferenceDesc |
| Explanation | During the time period covered by this return, CHMC Community Health Services Network received certain accounting and administrative services from Cincinnati Children's Hospital Medical Center at no cost. The value of these services is an unspecified amount. | ExplanationTxt |
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