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← MIDWEST COMMUNITY HEALTH ASSOCIATES INC

Form 990 for tax year 2022

Filed by MIDWEST COMMUNITY HEALTH ASSOCIATES INC.

Totals

Total revenue
$26,016,390
Total expenses
$41,569,896
Contributions and grants received
$0
Grants paid
$5,000
Program service revenue
$26,012,210
Investment income
-$144
Other revenue
$4,324
Total assets, end of year
$10,641,075
Total liabilities, end of year
$67,816,694
Net assets or fund balances, end of year
-$57,175,619
Program services expenses (Part IX)
$36,029,743
Management and general expenses
$5,540,153
Fundraising expenses
$0
Program service expenses (Part III)
$36,029,743

Program services were 86.7% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: NET PATIENT SERVICE REVENUE

    total $25,953,251 · related or exempt $25,953,251

  • 2b · Program service revenue: INTERUNIT RENT

    total $58,959 · related or exempt $58,959

  • 6a · Gross rents

    real property $15,692

  • 6b · Less rental expenses

    real property $11,368

  • 6c · Rental income or loss

    real property $4,324

  • 6d · Net rental income or loss

    total $4,324 · excluded $4,324

  • 7b · Less cost or other basis and sales expenses

    other assets $144

  • 7c · Gain or loss

    other assets -$144

  • 7d · Net gain or loss

    total -$144 · excluded -$144

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $5,000 · program services $5,000

  • 5 · Compensation of officers, directors and key employees

    total $339,215 · management and general $339,215

  • 7 · Other salaries and wages

    total $22,815,886 · program services $22,815,886

  • 9 · Other employee benefits

    total $5,431,373 · program services $5,431,373

  • 11g · Fees: other

    total $517,899 · program services $470,454 · management and general $47,445

  • 12 · Advertising and promotion

    total $35,993 · program services $35,879 · management and general $114

  • 13 · Office expenses

    total $673,575 · program services $400,682 · management and general $272,893

  • 14 · Information technology

    total $66,479 · program services $66,161 · management and general $318

  • 16 · Occupancy

    total $2,390,623 · program services $2,286,976 · management and general $103,647

  • 17 · Travel

    total $48,006 · program services $40,797 · management and general $7,209

  • 19 · Conferences, conventions and meetings

    total $803 · program services $803

  • 22 · Depreciation, depletion and amortization

    total $509,674 · program services $455,518 · management and general $54,156

  • 23 · Insurance

    total $692,705 · program services $366,619 · management and general $326,086

  • 24a · Other expenses: CORP SERVICE ALLOCATION

    total $4,386,802 · management and general $4,386,802

  • 24b · Other expenses: MEDICAL SUPPLIES

    total $3,414,488 · program services $3,414,488

  • 24c · Other expenses: PROVIDER CME, LICENSES

    total $174,460 · program services $174,460

  • 24d · Other expenses: DUES & SUBSCRIPTIONS

    total $36,675 · program services $35,871 · management and general $804

  • 24e · All other expenses

    total $30,240 · program services $28,776 · management and general $1,464

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $29,152 · end of year $55,116

  • 4 · Accounts receivable

    beginning of year $2,627,953 · end of year $2,859,240

  • 7 · Other notes and loans receivable

    beginning of year $408,266 · end of year $262,151

  • 9 · Prepaid expenses and deferred charges

    beginning of year $232,989 · end of year $142,000

  • 10a · Land, buildings and equipment: cost or other basis

    $6,679,802

  • 10b · Land, buildings and equipment: accumulated depreciation

    $4,282,381

  • 10c · Land, buildings and equipment, net

    beginning of year $2,709,918 · end of year $2,397,421

  • 14 · Intangible assets

    beginning of year $3,856,669 · end of year $3,855,364

  • 15 · Other assets

    beginning of year $1,412,787 · end of year $1,069,783

  • 17 · Accounts payable and accrued expenses

    beginning of year $1,329,380 · end of year $1,100,451

  • 25 · Other liabilities

    beginning of year $51,570,467 · end of year $66,716,243

  • 27 · Net assets without donor restrictions

    beginning of year -$41,622,113 · end of year -$57,175,619

Mission and programs · 2022

Mission

MIDWEST COMMUNITY HEALTH ASSOCIATES, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US.

Activities or mission (Part I)

IMPROVE HEALTH & PROVIDE QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US.

  • MIDWEST COMMUNITY HEALTH ASSOCIATES, INC. (MCHA) IS A MULTI-SPECIALTY MEDICAL GROUP SPECIALIZING IN FAMILY MEDICINE, PEDIATRICS, AUDIOLOGY, PHYSICAL MEDICINE & REHABILITATION, PODIATRY, ORTHOPEDICS, GENERAL SURGERY, OB/GYN, SLEEP MEDICINE, DERMATOLOGY, DIABETES MANAGEMENT, PHARMACEUTICAL MANAGEMENT, WALK-IN CLINICS, PHYSICAL & OCCUPATIONAL THERAPY, LABORATORY AND IMAGING SERVICES. THE PROVIDERS CONSIST OF PHYSICIANS, NURSE PRACTITIONERS, PHYSICIAN ASSISTANTS, PHARMACISTS, PHYSICAL THERAPISTS, ATHLETIC TRAINERS, OCCUPATIONAL THERAPISTS, LABORATORY TECHS AND RADIOLOGY TECHS. MCHA PROVIDES A VARIETY OF SERVICES AT ITS FIVE OFFICES LOCATED IN(SEE SCHEDULE O FOR CONTINUATION)BRYAN, MONTPELIER, ARCHBOLD, WAUSEON AND SHERWOOD OHIO. AT EACH OF THESE LOCATIONS, SERVICES ARE OFFERED MONDAY THROUGH FRIDAY AND SOME SATURDAY HOURS. ALL OFFICES PROVIDE LATE HOURS AT LEAST ONE DAY PER WEEK TO PROVIDE EXPANDED ACCESS TO THE COMMUNITY. THE BRYAN LOCATION CONSISTS OF THE ABOVE SPECIALTIES OF WHICH COLLABORATE WITH THE LOCAL HOSPITAL, HEALTH DEPARTMENTS AND OTHER HEALTH CARE PROVIDERS. MCHA PROVIDES ATHLETIC TRAINERS AT COMMUNITY SCHOOL SPORTS PROGRAMS. SEVERAL PROVIDERS HAVE A PRESENCE AT THE LOCAL HIGH SCHOOL GAMES FOR POTENTIAL INJURIES. SPONSORSHIPS, PRESENTATIONS, AND OTHER EDUCATIONAL OPPORTUNITIES AT COMMUNITY CAREER EVENTS WITH LOCAL SCHOOLS AND COLLEGES WERE PROVIDED LIMITEDLY DUE TO COVID-19 RESTRICTIONS. WE ALSO OFFER MENTORING AND INTERNSHIPS FOR COLLEGE AND HIGH SCHOOL STUDENTS, AND INTERNSHIPS FOR MID-LEVEL AND PHYSICIANS. VARIOUS PHYSICIANS AND LEADERS PARTICIPATED ON LOCAL COMMUNITY COMMITTEES (LOCAL HOSPITAL, HEALTH DEPARTMENT, BLACK SWAMP, UNITY WAY, YMCA, ROTARY, NAMI, SUFFICIENT GRACE MINISTRIES, ETC). IN ADDITION, COVID-19 RESOURCES AND SERVICES WERE PROVIDED TO THE COMMUNITY IN COLLABORATION WITH THE HEALTH DEPARTMENTS, HOSPITALS AND OTHER COMMUNITY MEMBERS. PROVIDERS CONTINUED TO VOLUNTEER SERVICES AT THE LOCAL UNDERSERVED/FREE CLINICS. ONGOING FINANCIAL SUPPORT WAS PROVIDED TO THE COMMUNITY CAPITAL CAMPAIGNS WITH YMCA, LOCAL COLLEGES AND SCHOOLS, AND MORE. MCHA CONTINUES TO PROVIDE FINANCIAL ASSISTANCE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. SUPPORT SERVICES FOR COMMUNITY CARE SUCH AS AN OB NAVIGATOR, CANCER NAVIGATOR, ETC. WAS PROVIDED TO HELP STREAMLINE CARE FOR PATIENTS. MCHA IS A CERTIFIED HEALTHCARE FACILITY AND OFFERS ANCILLARY SERVICES AT A LOWER COST (OUTPATIENT SETTING) SUCH AS X-RAY, CT, NUCLEAR MEDICINE, BONE DENSITY, MAMMOGRAMS, ULTRASOUNDS, BREAST CARE, LAB, ETC.). THE ORGANIZATION PARTICIPATES WITH LOCAL HEALTH CARE FACILITIES IN THE COMMUNITY HEALTH ASSESSMENT TO HELP CREATE/DEVELOP THE PLAN AS WELL AS BE PARTICIPANTS IN IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITY (I.E. TRANSPORTATION, TELEHEALTH SERVICES, CANCER SCREENINGS, MENTAL HEALTH AND HEALTHY BEHAVIORS, ETC.).

    Expenses $36,029,743 · Grants $5,000 · Revenue $26,012,210

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Michael Packnett

    DIRECTOR/CHAIR/PH PRESIDENT & CEO

    Total calculated
    $2,941,140
    From this org
    $0
    From related orgs
    $2,602,841
    Other
    $338,299
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,330,197 related
    Bonus
    $0 + $664,677 related
    Other
    $0 + $607,967 related
    Deferred
    $0 + $302,282 related
    Nontaxable benefits
    $0 + $36,017 related
    Filer's total
    $0 + $2,941,140 related

  • Raymond Dusman

    DIRECTOR/SEC & TREAS/PCE PRESIDENT

    Total calculated
    $1,837,910
    From this org
    $0
    From related orgs
    $1,453,383
    Other
    $384,527
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $877,523 related
    Bonus
    $0 + $396,014 related
    Other
    $0 + $179,846 related
    Deferred
    $0 + $349,539 related
    Nontaxable benefits
    $0 + $34,988 related
    Filer's total
    $0 + $1,837,910 related

  • Jeanne' Wickens

    PH CHIEF FINANCIAL OFFICER

    Total calculated
    $1,622,167
    From this org
    $0
    From related orgs
    $1,264,400
    Other
    $357,767
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $804,432 related
    Bonus
    $0 + $363,922 related
    Other
    $0 + $96,046 related
    Deferred
    $0 + $325,215 related
    Nontaxable benefits
    $0 + $32,552 related
    Filer's total
    $0 + $1,622,167 related

  • Sally Taylor

    MCHA VP

    Total calculated
    $339,215
    From this org
    $289,603
    From related orgs
    $0
    Other
    $49,612
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $220,018
    Bonus
    $66,747
    Other
    $2,838
    Deferred
    $20,498
    Nontaxable benefits
    $29,114
    Filer's total
    $339,215

  • Damoder Kesireddy

    MCHA PHYSICIAN

    Total calculated
    $1,462,995
    From this org
    $1,399,407
    From related orgs
    $0
    Other
    $63,588
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $1,113,727
    Bonus
    $248,084
    Other
    $37,596
    Deferred
    $33,550
    Nontaxable benefits
    $30,038
    Filer's total
    $1,462,995

  • Anthony Uribes

    MCHA PHYSICIAN

    Total calculated
    $630,215
    From this org
    $560,216
    From related orgs
    $0
    Other
    $69,999
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $447,899
    Bonus
    $107,299
    Other
    $5,018
    Deferred
    $33,550
    Nontaxable benefits
    $36,449
    Filer's total
    $630,215

  • Kenton Kamp

    MCHA PHYSICIAN

    Total calculated
    $565,500
    From this org
    $515,188
    From related orgs
    $0
    Other
    $50,312
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $392,771
    Bonus
    $95,579
    Other
    $26,838
    Deferred
    $33,550
    Nontaxable benefits
    $16,762
    Filer's total
    $565,500

  • Samuel Finck

    MCHA PHYSICIAN

    Total calculated
    $536,651
    From this org
    $507,292
    From related orgs
    $0
    Other
    $29,359
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $497,329
    Bonus
    $750
    Other
    $9,213
    Deferred
    $1,545
    Nontaxable benefits
    $27,814
    Filer's total
    $536,651

  • Kevin Park

    MCHA PHYSICIAN

    Total calculated
    $573,156
    From this org
    $503,430
    From related orgs
    $0
    Other
    $69,726
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $373,536
    Bonus
    $101,538
    Other
    $28,356
    Deferred
    $33,550
    Nontaxable benefits
    $36,176
    Filer's total
    $573,156

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · Discretionary spending account
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 1A
DISCRETIONARY SPENDING ACCOUNT - TAXABLE DISCRETIONARY SPENDING ACCOUNT PAID TO: SAMUEL FINCK $2,000; KENTON KAMP $3,500; DAMODER KESIREDDY $3,500; KEVIN PARK $3,500; ANTHONY URIBES $3,500
PART I, LINE 3
RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF MIDWEST COMMUNITY HEALTH ASSOCIATES, INC.'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC.
PART I, LINE 4B
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS THE FOLLOWING INDIVIDUALS PARTICIPATE IN SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLANS. BENEFITS EARNED UNDER THE PLANS WILL FUND THE EMPLOYEES' EVENTUAL RETIREMENT BENEFIT. THESE BENEFITS ARE PROVIDED IN EXCHANGE FOR THE EMPLOYEES' YEARS OF SERVICE TO THE ORGANIZATION AND THE AMOUNT OF THE BENEFITS MAY VARY FROM YEAR TO YEAR. THE FOLLOWING INDIVIDUALS VESTED IN A PORTION OF THEIR DEFERRED COMPENSATION PLANS, WHICH IS TREATED AS TAXABLE INCOME TO THE INDIVIDUALS AT THE TIME OF VESTING. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III): RAYMOND DUSMAN $149,322; MICHAEL PACKNETT $577,374; JEANNE' WICKENS $70,644 AMOUNTS LISTED ABOVE THAT HAVE BEEN REPORTED AS DEFERRED COMPENSATION ON PRIOR FORM 990 WILL ALSO BE REFLECTED IN SCHEDULE J, PART II, COLUMN (F). FOR EXAMPLE, THE AMOUNT OF $577,374 REPORTED AS REQUIRED FOR MR. PACKNETT WAS A RESULT OF THE VESTING OF SUCH AMOUNT UNDER THE TERMS OF THE RESPECTIVE PLANS. HOWEVER, THESE AMOUNTS WERE PREVIOUSLY REPORTED IN MR. PACKNETT'S DEFERRED COMPENSATION OVER MORE THAN 10 YEARS AS THE AMOUNTS WERE DEFERRED UNDER THE PLANS. AS SUCH, THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN (F) IS AN INDICATION OF AMOUNTS THAT HAVE BEEN REPORTED TWICE, ONCE AS A DEFERRAL AND ONCE AS VESTED. THE FOLLOWING INDIVIDUALS HAVE AN AMOUNT INCLUDED IN SCHEDULE J, PART II, COLUMN (C) FOR AN AMOUNT EARNED BUT NOT YET VESTED UNDER ONE OF PARKVIEW'S DEFERRED COMPENSATION PLANS. THE AMOUNTS ARE AT RISK AND WILL NOT BE PAID UNLESS AND UNTIL EACH EMPLOYEE HAS PROVIDED SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. BENEFITS UNDER THE PLANS VEST AT THE TIME SET FORTH IN THE PLAN DOCUMENTS AND ARE FORFEITED IF THE EMPLOYEES TERMINATE EMPLOYMENT BEFORE SATISFYING THOSE PLAN CONDITIONS. DEFERRALS REPORTED IN SCHEDULE J, PART II, COLUMN (C) INCLUDE: RAYMOND DUSMAN $315,989; MICHAEL PACKNETT $268,732; JEANNE' WICKENS $303,865
PART I, LINE 7
MANAGEMENT INCENTIVE COMPENSATION PLAN (MICP) AND PHYSICIAN AND PROVIDER INCENTIVE COMPENSATION PLAN (PICP) ARE ANNUAL INCENTIVE PROGRAMS. SYSTEM GOALS ARE APPROVED BY THE BOARD. AT CONCLUSION OF THE PLAN YEAR, RESULTS ARE SHARED WITH THE BOARD AND THE EXECUTIVE COMMITTEE OF THE BOARD APPROVES FINAL PAYMENT.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC

    N/A · ORTHOPAEDIC HOSPITAL · IN

  • MANAGED CARE SERVICES LLC

    N/A · HEALTH PLAN ADMINISTRATION · IN

  • FOUNDATION SURGERY AFFILIATE OF FORT WAYNE LLC

    N/A · SURGICAL SERVICES · IN

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • PARKVIEW PROFESSIONAL PROGRAMS INC

    C · REFERENCE LAB · IN

  • WOODLAND PLAZA MEDICAL PARK CONDO ASSOC INC

    C · PROPERTY OWNERS ASSOCIATION · IN

Provenance

Return type
form_990
Tax year
2022
Filed
10 November 2023
IRS schema version
2022v5.0
Source object
202313149349304136

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