2021-11-15T16:17:31-06:00 2020-12-31 BKD LLP 312 WALNUT STREET SUITE 3000 CINCINNATI OH 45202 990 2020-01-01 310884250 HEALTHSOURCE OF OHIO INC % THOMAS DUCRO JR HEAL 5135767700 424 WARDS CORNER RD Suite 200 LOVELAND OH 45140 THOMAS DUCRO JR CFO 5135767700 2021-11-15 true THOMAS DUCRO JR 999009999 AARON HERSHBERGER P00961884 5136218300 2 2020 2022-09-23 18:48:47Z KIMBERLY PATTON 424 WARDS CORNER RD SUITE 200 LOVELAND OH 45140 58527239 false X WWW.HEALTHSOURCEOFOHIO.ORG X 1976 OH HEALTHSOURCE OF OHIO IS A NONPROFIT COMMUNITY HEALTH CENTER THAT PROVIDES QUALITY, PATIENT-CENTERED HEALTH CARE TO UNDERSERVED PATIENTS IN SOUTHWEST OHIO. 10 10 530 1516837 0 9021032 16454851 38449559 38829469 971620 1089759 2324853 2153160 50767064 58527239 0 0 0 0 27162713 27507335 0 0 0 17815501 21932576 44978214 49439911 5788850 9087328 73477170 84578401 7918070 8631584 65559100 75946817 X HEALTHSOURCE OF OHIO IS A NONPROFIT PRIMARY CARE ORGANIZATION CONSISTING OF MEDICAL, DENTAL AND MENTAL HEALTH SERVICES. WE SEEK TO BRING TO THE PEOPLE OF SOUTHWEST OHIO A COMPREHENSIVE, EXCEPTIONAL QUALITY OF HEALTHCARE THAT RESPONDS TO THE NEEDS OF THE COMMUNITY. false false 41364320 39117997 FEDERAL COMMUNITY HEALTH CENTERS PROVIDING MEDICAL, DENTAL, PHARMACY, AND MENTAL HEALTH VISITS. 41364320 true true false false false false false false false false true true false false false true false true false false false false false false false false false false false true false false false false false false false false false false false false true true true true false false true 57 0 true 530 true true true false false false false false false false false false false false X 10 10 false false false false false false false true true false false true true true true true true true true false X THOMAS DUCRO JR 5135767700 424 WARDS CORNER RD STE 200 LOVELAND OH 45140 KIMBERLY PATTON PRESIDENT/CEO 40.0 1.0 X 303716 0 21715 SHERRY JOHNSON DO PHYSICIAN 40.0 0.0 X 305025 0 19901 MICHAEL DIETZ PHYSICIAN 40.0 0.0 X 282576 0 26634 HOLLY BINNIG MD MEDICAL DIRECTOR 40.0 0.0 X 280965 0 13196 JEFFREY LUBOW MD PHYSICIAN 40.0 0.0 X 253767 0 29840 TIFFANY NOLAN MD PHYSICIAN 40.0 0.0 X 279893 0 0 CASEY OGBURN PHYSICIAN 40.0 0.0 X 249695 0 26004 THOMAS DUCRO CFO 40.0 0.0 X 252320 0 20705 LISA JACKSON VP-MARKETING 40.0 0.0 X 238240 0 13583 HEATHER MCNICHOLS VP-HUMAN RESOURCES 40.0 0.0 X 213492 0 13361 MARY BRIDGET FOSSETT VP-OPERATIONS 40.0 0.0 X 205869 0 12178 SHAWN FRICK CENTERPRISE - PRESIDENT/CEO 40.0 0.0 X 104994 0 2650 KEVIN LEFLER TRUSTEE 3.0 0.0 X 0 0 0 JAMES TOMASZEWSKI CHAIRPERSON - TERM ENDED 6/30 3.0 0.0 X X 0 0 0 RAY TAKIGIKU PHD TRUSTEE 3.0 0.0 X 0 0 0 ROBERT MANNING TRUSTEE 3.0 0.0 X 0 0 0 MARK MCANDREW VICE-CHAIRMAN 3.0 0.0 X X 0 0 0 MICHAEL OBERDOERSTER MD TRUSTEE 3.0 0.0 X 0 0 0 CYNDY WRIGHT CHAIRPERSON 3.0 0.0 X X 0 0 0 DIANA WILLIAMS TRUSTEE 3.0 0.0 X 0 0 0 JINA BOHL TRUSTEE 3.0 0.0 X 0 0 0 MEGAN MITCHELL SECRETARY-TREASURER 3.0 0.0 X X 0 0 0 SANDRA MONGOLD TRUSTEE 3.0 1.0 X 0 0 0 2970552 0 199767 63 false true false ROUNDTOWER TECHNOLOGIES LLC 5905 E GALBRAITH RD SUITE 30 CINCINNATI OH 45206 INFO TECHNOLOGY 424405 ENVISION COMMERCIAL CLEANING 52 EAST CRESCENTVILLE RD WEST CHESTER OH 45246 CLEANING 256368 HEALTHCARE GA BATAVIA OH MOB LLC PO BOX 209362 AUSTIN TX 78720 RENT 288471 WCBC LIMITED PARTNERSHIP 6281 TRI-RIDGE BLVD STE 180 LOVELAND OH 45140 RENT 306750 FAIRWAY CAPITAL RECOVER LLC 4000 EXECUTIVE PARK DR STE 3 CINCINNATI OH 45241 COLLECTION 125584 5 16054851 400000 16454851 NET PATIENT FEES 621110 23261170 23261170 PHARMACY REVENUE 446110 14911376 13836093 1075283 OTHER REVENUE 621110 656923 656923 38829469 1089759 1089759 0 0 347795 0 347795 0 347795 347795 0 0 0 0 0 0 0 0 0 0 Centerprise Billing/Consulting 561499 1805365 1363811 441554 1805365 58527239 39117997 1516837 1437554 0 0 0 0 1470131 1232117 238014 0 21169186 17741895 3427291 804083 673902 130181 2576335 2159226 417109 1487600 1246758 240842 1705235 1429157 276078 1497 1255 242 60555 50751 9804 0 0 0 2518487 2110744 407743 196013 164278 31735 308535 258583 49952 2376506 1991750 384756 0 2067807 1733029 334778 126142 105720 20422 0 135521 113580 21941 85036 85036 0 2027376 1699144 328232 131402 110128 21274 SUPPLIES 8852733 7419476 1433257 DUES AND SEMINARS 148523 124477 24046 MISCELLANEOUS 1191208 998350 192858 49439911 41364320 8075591 0 0 0 5063155 11232850 0 0 4610079 5087508 0 0 0 0 0 0 583579 574035 318804 260683 46716750 18603330 29137409 28113420 0 0 33764144 39309905 0 0 0 0 0 0 73477170 84578401 5693952 5327802 0 0 69488 1318097 0 0 0 0 0 0 2154630 1985685 0 0 0 0 7918070 8631584 X 65559100 75946817 0 0 65559100 75946817 73477170 84578401 X 9087328 1293278 7111 X false true X true true true X 9130572 8264648 8912845 9021032 16454851 51783948 0 0 9130572 8264648 8912845 9021032 16454851 51783948 0 51783948 801566 790584 1186874 1292196 1437554 5508774 3143600 756111 1123530 988957 1516836 7529034 0 64821756 187252046 0.79887 0.80481 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2732369 2732369 28483750 7459034 21033716 2059717 2059717 0 13084029 8788132 4295897 356885 305447 51438 28113420 VARIOUS INVESTMENTS 15662622 F RESTRICTED COLLATERAL 23633082 F INVESTMENT CENTERPRISE 14201 F 39309905 0 0 X SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE HEALTHSOURCE AND FOUNDATION HAVE BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, BOTH ENTITIES ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. CENTERPRISE IS A SINGLE MEMBER LIMITED LIABILITY CORPORATION AND IS DISREGARDED FOR INCOME TAX PURPOSES. ALL THREE ENTITIES FILE RETURNS IN THE U.S. FEDERAL JURISDICTION. X X X false false false false false false false false false KIMBERLY PATTON PRESIDENT/CEO 255617 0 41758 0 6341 0 7081 0 14634 0 325431 0 THOMAS DUCRO CFO 218279 0 33116 0 925 0 6071 0 14634 0 273025 0 LISA JACKSON VP-MARKETING 193442 0 28445 0 16353 0 6008 0 7575 0 251823 0 MARY BRIDGET FOSSETT VP-OPERATIONS 178688 0 25444 0 1737 0 5060 0 7118 0 218047 0 HEATHER MCNICHOLS VP-HUMAN RESOURCES 173846 0 26066 0 13580 0 5449 0 7912 0 226853 0 HOLLY BINNIG MD MEDICAL DIRECTOR 225503 0 33233 0 22229 0 6098 0 7098 0 294161 0 SHERRY JOHNSON DO PHYSICIAN 219400 0 10475 0 75150 0 7712 0 12189 0 324926 0 TIFFANY NOLAN MD PHYSICIAN 202846 0 17096 0 59951 0 0 0 0 0 279893 0 MICHAEL DIETZ PHYSICIAN 66703 0 67701 0 148172 0 5819 0 20815 0 309210 0 JEFFREY LUBOW MD PHYSICIAN 207731 0 14350 0 31686 0 6531 0 23309 0 283607 0 CASEY OGBURN PHYSICIAN 186567 0 14350 0 48778 0 5847 0 20157 0 275699 0 FORM 990, PART VI, SECTION B, LINE 11B GOVERNING BODY AND MANAGEMENT THE 2020 HEALTHSOURCE OF OHIO FORM 990 WAS PREPARED BY BKD, LLP, HEALTHSOURCE OF OHIO'S AUDIT FIRM, AND THEN REVIEWED IN DETAIL BY MANAGEMENT AND THE FINANCE COMMITTEE. ONCE REVIEWED AND APPROVED, THE FINANCE COMMITTEE RECOMMENDS ACCEPTANCE TO THE FULL BOARD PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY THE BOARD SIGNS A CONFLICT OF INTEREST STATEMENT ANNUALLY. ALL NEW MEMBERS ARE REQUIRED TO SIGN THE STATEMENT WHEN THEY ARE APPOINTED TO THE BOARD. HEALTHSOURCE OF OHIO PERSONNEL AUTHORIZED TO PURCHASE GOODS OR SERVICES ARE REQUIRED TO COMPLETE A NO CONFLICT OF INTEREST STATEMENT AS PART OF THE PURCHASING PROCESS. FORM 990, PART VI, SECTION B, LINE 15A & 15B REVIEW OF COMPENSATION THE BOARD OF HEALTHSOURCE OF OHIO UTILIZES COMPARABLE DATA ALONG WITH SALARY COMPENSATION SURVEY GUIDELINES TO DETERMINE THE COMPENSATION PAID TO THE PRESIDENT/CEO. COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION ARE DETERMINED BY THE PRESIDENT/CEO. FORM 990, PART VI, SECTION C, LINE 19 DISCLOSURE HEALTHSOURCE OF OHIO MAKES ITS MOST RECENTLY AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 OTHER CHANGES GAIN ON SWAP $7,111 TOTAL $7,111 CENTERPRISE INC 424 WARDS CORNER RD STE 200 LOVELAND OH 45140 461104165 CONSULTING OH 2293656 2576184 HSO THE HEALTHSOURCE FOUNDATION 424 WARDS CORNER RD STE 200 LOVELAND OH 45140 454682089 SUPPORT OH 501(C)(3) 11A HSO true false true false false false false false false false false false false false false false false true false false HEALTHSOURCE FOUNDATION B 320000 CASH VALUE HEALTHSOURCE FOUNDATION Q 103620 BOOK VALUE