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← COMMUNITY HEALTH SERVICE AGENCY INC

Form 990 for tax year 2022

Filed by COMMUNITY HEALTH SERVICE AGENCY INC.

Totals

Total revenue
$21,247,563
Total expenses
$18,159,103
Contributions and grants received
$10,506,296
Grants paid
$0
Program service revenue
$10,520,860
Investment income
$43,662
Other revenue
$176,745
Total assets, end of year
$17,683,016
Total liabilities, end of year
$4,608,681
Net assets or fund balances, end of year
$13,074,335
Program services expenses (Part IX)
$13,535,955
Management and general expenses
$4,623,148
Fundraising expenses
$0
Program service expenses (Part III)
$13,535,955

Program services were 74.5% 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.

  • 1e · Government grants (contributions)

    $9,679,581

  • 1f · All other contributions, gifts and grants

    $826,715

  • 2a · Program service revenue: MEDICARE/MEDICAID

    total $6,542,640 · related or exempt $6,542,640

  • 2b · Program service revenue: PRIVATE PATIENT FEES

    total $3,978,220 · related or exempt $3,978,220

  • 3 · Investment income

    total $43,662 · excluded $43,662

  • 4 · Income from investment of tax-exempt bond proceeds

    total $0

  • 5 · Royalties

    total $0

  • 6d · Net rental income or loss

    total $0

  • 7d · Net gain or loss

    total $0

  • 8c · Net income from fundraising events

    total $0

  • 9c · Net income from gaming

    total $0

  • 10c · Net income from sales of inventory

    total $0

  • 11a · Other revenue: BOOK GAIN-INVOLUNTARY FIRE

    total $78,395 · excluded $78,395

  • 11b · Other revenue: GAIN ON SALE

    total $36,393 · excluded $36,393

  • 11c · Other revenue: MISCELLAENOUS INCOME

    total $61,957 · related or exempt $61,957

  • 11e · Other revenue, total

    $176,745

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $0

  • 2 · Grants to domestic individuals

    total $0

  • 3 · Grants to foreign organizations and individuals

    total $0

  • 4 · Benefits paid to or for members

    total $0

  • 5 · Compensation of officers, directors and key employees

    total $704,220 · program services $305,930 · management and general $398,290

  • 6 · Compensation of disqualified persons

    total $0

  • 7 · Other salaries and wages

    total $8,331,572 · program services $6,109,530 · management and general $2,222,042

  • 8 · Pension plan contributions

    total $66,437 · program services $48,818 · management and general $17,619

  • 9 · Other employee benefits

    total $663,150 · program services $487,353 · management and general $175,797

  • 10 · Payroll taxes

    total $704,655 · program services $514,760 · management and general $189,895

  • 11a · Fees: management

    total $161,814 · program services $18,700 · management and general $143,114

  • 11b · Fees: legal

    total $0

  • 11c · Fees: accounting

    total $0

  • 11d · Fees: lobbying

    total $0

  • 11e · Fees: professional fundraising services

    total $0

  • 11f · Fees: investment management

    total $0

  • 11g · Fees: other

    total $2,090,652 · program services $1,606,395 · management and general $484,257

  • 12 · Advertising and promotion

    total $157,769 · program services $45,100 · management and general $112,669

  • 13 · Office expenses

    total $193,440 · program services $104,501 · management and general $88,939

  • 14 · Information technology

    total $883,295 · program services $668,843 · management and general $214,452

  • 15 · Royalties

    total $0

  • 16 · Occupancy

    total $1,145,577 · program services $1,017,260 · management and general $128,317

  • 17 · Travel

    total $115,372 · program services $69,267 · management and general $46,105

  • 18 · Travel or entertainment for public officials

    total $0

  • 19 · Conferences, conventions and meetings

    total $0

  • 20 · Interest

    total $0

  • 21 · Payments to affiliates

    total $0

  • 22 · Depreciation, depletion and amortization

    total $397,427 · program services $325,721 · management and general $71,706

  • 23 · Insurance

    total $154,959 · program services $104,702 · management and general $50,257

  • 24a · Other expenses: Medical supplies

    total $1,571,593 · program services $1,496,872 · management and general $74,721

  • 24b · Other expenses: Bad debt provision

    total $241,209 · program services $241,209

  • 24c · Other expenses: Recruitment and Training

    total $129,765 · program services $92,865 · management and general $36,900

  • 24d · Other expenses: Telephone

    total $110,775 · program services $75,515 · management and general $35,260

  • 24e · All other expenses

    total $335,422 · program services $202,614 · management and general $132,808

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $5,677,575 · end of year $6,730,601

  • 2 · Savings and temporary cash investments

    beginning of year $673,782 · end of year $676,624

  • 3 · Pledges and grants receivable

    end of year $0

  • 4 · Accounts receivable

    beginning of year $2,084,285 · end of year $3,914,608

  • 5 · Loans and receivables from officers and key people

    end of year $0

  • 6 · Loans and receivables from disqualified persons

    end of year $0

  • 7 · Other notes and loans receivable

    end of year $0

  • 8 · Inventories for sale or use

    end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $373,505 · end of year $254,076

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

    $7,467,992

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

    $3,444,285

  • 10c · Land, buildings and equipment, net

    beginning of year $4,382,693 · end of year $4,023,707

  • 11 · Investments: publicly traded securities

    end of year $0

  • 12 · Investments: other securities

    end of year $0

  • 13 · Investments: program-related

    end of year $0

  • 14 · Intangible assets

    end of year $2,083,400

  • 15 · Other assets

    end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $1,034,419 · end of year $881,647

  • 19 · Deferred revenue

    beginning of year $534,281 · end of year $170,570

  • 23 · Secured mortgages and notes payable

    beginning of year $1,637,265 · end of year $1,456,143

  • 25 · Other liabilities

    end of year $2,100,321

  • 27 · Net assets without donor restrictions

    beginning of year $9,965,108 · end of year $13,065,475

  • 28 · Net assets with donor restrictions

    beginning of year $20,767 · end of year $8,860

Mission and programs · 2022

Mission

To improve the health and lives of those we serve with a commitment to patient centered excellence in all we do.

  • The organization provided general health and family planning services to its service area. During the year the Agency provided over 87,000 patient encounters under the Section 330 grant, Medicaid and Medicare.

    Expenses $13,032,553 · Revenue $10,520,860

  • The organization provided dental services to its consumers in its service area at reduced rates based on their abiiity to pay.

    Expenses $503,402

As filed on the 2022 return.

Listed in Part VII

  • KARA CIZDZIEL

    CMO

    Total calculated
    $257,089
    From this org
    $239,972
    From related orgs
    $0
    Other
    $17,117
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $239,972
    Bonus
    not reported
    Other
    not reported
    Deferred
    $7,196
    Nontaxable benefits
    $9,921
    Filer's total
    $257,089

  • KRISTI WHITENTON

    PEDIATRICIAN

    Total calculated
    $235,842
    From this org
    $220,446
    From related orgs
    $0
    Other
    $15,396
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $220,446
    Bonus
    not reported
    Other
    not reported
    Deferred
    not reported
    Nontaxable benefits
    $15,396
    Filer's total
    $235,842

  • MICHELLE CARTER

    CEO

    Total calculated
    $214,088
    From this org
    $202,088
    From related orgs
    $0
    Other
    $12,000
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $202,088
    Bonus
    not reported
    Other
    not reported
    Deferred
    $5,700
    Nontaxable benefits
    $13,685
    Filer's total
    $221,473

  • MICHAEL GLAS

    Deputy CEO/CFO

    Total calculated
    $180,373
    From this org
    $180,373
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $180,373
    Bonus
    not reported
    Other
    not reported
    Deferred
    not reported
    Nontaxable benefits
    not reported
    Filer's total
    $180,373

  • LISA BRITTMON

    Nurse Practitioner

    Total calculated
    $147,487
    From this org
    $126,296
    From related orgs
    $0
    Other
    $21,191
    Hours/week
    40

  • SHAREN OZAROWSKI

    NURSE PRACTITIONER

    Total calculated
    $136,479
    From this org
    $131,838
    From related orgs
    $0
    Other
    $4,641
    Hours/week
    36

  • TIFFANY WILLEFORD

    NURSE PRACTITIONER

    Total calculated
    $131,474
    From this org
    $119,943
    From related orgs
    $0
    Other
    $11,531
    Hours/week
    36

  • JENNIFER TORRES

    PEDIATRICIAN

    Total calculated
    $130,303
    From this org
    $120,034
    From related orgs
    $0
    Other
    $10,269
    Hours/week
    40

  • CATHY ELDREDGE

    DIRECTOR OF OPERATIONS

    Total calculated
    $112,844
    From this org
    $103,766
    From related orgs
    $0
    Other
    $9,078
    Hours/week
    40

  • MEREDITH LONGINO

    DIRECTOR OF OPERATIONS

    Total calculated
    $112,814
    From this org
    $92,436
    From related orgs
    $0
    Other
    $20,378
    Hours/week
    32

  • NONA JORDAN

    Vice-Chair

    Total calculated
    $0
    Hours/week
    2

  • AMY WADE

    Chair

    Total calculated
    $0
    Hours/week
    2

  • BRENDA SUE CREGG

    Director

    Total calculated
    $0
    Hours/week
    2

  • ALMA PAULIN

    Director

    Total calculated
    $0
    Hours/week
    2

  • PAUL PAINTER

    Director

    Total calculated
    $0
    Hours/week
    2

  • STAN MCKEE

    Secretary

    Total calculated
    $0
    Hours/week
    2

  • KEITH WINTERS

    Treasurer

    Total calculated
    $0
    Hours/week
    2

  • THOMAS GOSS

    Director

    Total calculated
    $0
    Hours/week
    2

  • PAUL KELLEY

    Director

    Total calculated
    $0
    Hours/week
    2

  • ANDREW BENCH

    Director

    Total calculated
    $0
    Hours/week
    2

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

  • 3 · Compensation committee
  • 3 · Compensation survey or study

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 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
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

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.

Provenance

Return type
form_990
Tax year
2022
Filed
6 December 2023
IRS schema version
2022v5.0
Source object
202333409349300933

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