2024-11-13T10:59:04-06:00 2023-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2023-01-01 341773323 COMMUNITY AMBULANCE SERVICE COMM 7404545000 2951 MAPLE AVENUE ZANESVILLE OH 43701 ADAM HOPPER CFO 7404545000 2024-11-12 1 1 AMY CIMINELLO P00796388 6148493000 2024-11-08 2023 2024-10-15 13:58:12Z MATTHEW PERRY 2951 MAPLE AVENUE ZANESVILLE OH 43701 9446919 0 X SEE SCHEDULE O X 1995 OH COMMUNITY AMBULANCE SERVICE IS ORGANIZED AND OPERATED TO PROVIDE EMERGENCY TRANSPORTATION AND MEDICAL SERVICES TO THOSE SERVED BY GENESIS HEALTHCARE SYSTEM (GHCS), A 501(C)(3) ORGANIZATION. GHCS IS LOCATED IN THE CITY OF ZANESVILLE, OHIO AND PROVIDES MEDICAL AND HOSPITAL CARE TO MUSKINGUM COUNTY AND FIVE CONTIGUOUS COUNTIES LOCATED IN THE APPALACHIAN FOOTHILLS. 4 0 164 0 0 0 145775 52713 8117192 9331616 65334 12657 27940 49933 8356241 9446919 0 0 0 0 6244428 7112573 0 0 0 4137658 3678076 10382086 10790649 -2025845 -1343730 5483906 4633066 1124545 1595165 4359361 3037901 X TO PROVIDE HIGH QUALITY, COURTEOUS, PROMPT, AND COST EFFECTIVE EMERGENCY AND NON-EMERGENCY TREATMENT AND TRANSPORTATION ALONG WITH EDUCATION SERVICES TO HEALTHCARE ORGANIZATIONS, MUNICIPALITIES, AND THE GENERAL PUBLIC. 0 0 10244969 0 9381549 COMMUNITY AMBULANCE SERVICE CONTINUOUSLY SEEKS TO IMPROVE THE PRE-HOSPITAL HEALTHCARE PROVIDED IN ITS PRIMARY SERVICE AREAS WHILE ENSURING THAT EMERGENCY AND NON-EMERGENCY AMBULANCE SERVICE WILL BE AVAILABLE TO ALL THOSE IN NEED. THE EQUIPMENT IS MODERN, STATE OF THE ART, SATISFACTORILY MAINTAINED, AND ADEQUATELY OPERATED. RESPONSE TIMES ARE MONITORED AND KEPT WITHIN INDUSTRY ACCEPTED PARAMETERS AS WELL AS UTILIZATION AND ADHERENCE TO CURRENT AND LOCAL MEDICAL PROTOCOLS. IN DEMONSTRATION OF THESE COMMITMENTS, COMMUNITY AMBULANCE SERVICE RESPONDED TO 25,326 REQUESTS FOR AMBULANCE SERVICE IN 2023 AND TRANSPORTED 19,873 PATIENTS. COMMUNITY AMBULANCE SERVICE (CAS) CURRENTLY PROVIDES EMERGENCY AMBULANCE SERVICE TO THE COMMUNITY OF ZANESVILLE, ALONG WITH MUTUAL AID SERVICES TO OTHER MEMBER DEPARTMENTS THROUGHOUT THE REMAINDER OF COSHOCTON, GUERNSEY, LICKING, MORGAN, MUSKINGUM, AND PERRY COUNTIES. THE EMERGENCY REQUESTS WITHIN THE CITY OF ZANESVILLE WERE MET WITH A RESPONSE TIME AVERAGE OF 6 MINUTES 20 SECONDS.SUPPORTING THE COMMUNITY IS A KEY PART OF OUR MISSION STATEMENT. IN PURSUIT OF THAT MISSION, CAS PROVIDED SUPPORT TO FUNDRAISING EFFORTS FOR SEVERAL LOCAL CHARITIES. OTHER IN KIND SERVICES TO THE COMMUNITY INCLUDED STANDBYS AT LOCAL EVENTS SUCH AS: COUNTY FAIR COVERAGE, PARTNERED WITH MUSKINGUM COUNTY HEALTH DEPT - PROJECT DAWN, FOURTH OF JULY EVENTS, LOCAL SPORTING EVENTS, FIRE AND REHAB STANDBYS FOR MULTIPLE FIRE DEPARTMENTS, EMERGENCY MEDICAL DISPATCH (EMD) FOR CITY OF ZANESVILLE AND MUSKINGUM COUNTY, AND SEVERAL OTHER ACTIVITIES THROUGHOUT THE SERVICE AREA. 10244969 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 17 0 1 164 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X ADAM HOPPER 7404544773 2951 MAPLE AVENUE ZANESVILLE OH 43701 WENDY CEDOZ SECRETARY/GENESIS CLO 1.00 49.00 X 0 616780 26524 SHARON PARKER PRESIDENT/GENESIS COO 1.00 49.00 X 0 527646 40793 DIANNA LEVECK VICE PRESIDENT/GENESIS COA 1.00 49.00 X 0 700899 32380 MICHAEL NORMAN TREASURER/ GENESIS CFO 1.00 49.00 X 0 550475 42443 MATTHEW PERRY PRESIDENT/CEO 1.00 49.00 X 0 882675 41913 HEATH WILLIAMS DIRECTOR/EMERG SVCS DIRECT 1.00 49.00 X 0 156262 32066 0 3434737 216119 0 1 1 0 0 1000 51713 52713 EMERGENCY SERVICES 621990 8216417 8216417 COURIER SERVICE 621990 726355 726355 AMBULETTE SERVICE 621910 388844 388844 9331616 10149 2508 0 0 10149 2508 12657 12657 VEHICLE MAINTENANCE 900099 47344 47344 INSURANCE CLAIM 900099 2589 2589 49933 9446919 9381549 0 12657 5695262 5296594 398668 43159 40138 3021 884511 822595 61916 489641 455366 34275 14618 13750 868 110502 102767 7735 69279 64429 4850 286808 266731 20077 148804 148804 14606 1022 13584 6884 6884 424373 424373 334527 334527 BAD DEBT EXPENSE 1707555 1707555 AMBULANCE EXPENSES 530995 530995 MEDICAL SUPPLIES 26495 26495 DUES & SUBSCRIPTIONS 2090 1944 146 540 540 10790649 10244969 545680 0 248473 771085 1916786 909457 221097 328641 5554120 4095228 1568275 1458892 1265876 0 68585 194814 1164991 5483906 4633066 669688 1246925 260043 193745 194814 154495 1124545 1595165 X 4359361 3037901 4359361 3037901 5483906 4633066 -1343730 22270 0 X X 0 1 X 1 1 1 X 33332 54942 145775 52713 286762 6885153 5703786 6717980 8145132 9382829 36834880 6885153 5737118 6772922 8290907 9435542 37121642 0 0 0 37121642 2 2 2 2 2276 2276 6887429 5737118 6772922 8290909 9435542 37123920 0.99990 0.99990 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 58 58 0 PART II-B, LINE 1: COMMUNITY AMBULANCE SERVICE PAYS MEMBERSHIP DUES TO THE FOLLOWING ORGANIZATIONS. A PORTION OF THE DUES ARE RELATED TO LOBBYING ACTIVITES. ZANESVILLE MUSKINGUM COUNTY CHAMBER OF COMMERCE: 10% OF $375 ($38) PERRY CO CHAMBER OF COMMERCE: 10% OF $200 ($20). 621575 376576 244999 372042 102609 269433 2079356 1686224 393132 2481147 1929819 551328 1458892 RIGHT-OF-USE OPERATING LEASE ASSETS 154496 INVENTORY 50895 INTERCOMPANY RECEIVABLE 959600 1164991 LEASE LIABILITIES - OPERATING 154495 154495 X PART X, LINE 2: THE SYSTEM AND ITS SUBSIDIARIES ARE TAX-EXEMPT ORGANIZATIONS, EXCEPT FOR CARELIFE. ANY POTENTIAL TAX LIABILITY FOR CARELIFE WOUND NOT BE SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. NO TAX PROVISION IS REFLECTED IN THE CONSOLIDATED FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND TO RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER APPLICABLE TAXING AUTHORITIES. 0 1 0 0 0 0 0 0 0 MATTHEW PERRY PRESIDENT/CEO 0 850390 0 32285 0 0 0 9900 0 32013 0 924588 0 0 DIANNA LEVECK VICE PRESIDENT/GENESIS COA 0 462896 0 23365 0 214638 0 9352 0 23028 0 733279 0 214638 WENDY CEDOZ SECRETARY/GENESIS CLO 0 403322 0 20375 0 193083 0 5645 0 20879 0 643304 0 193083 MICHAEL NORMAN TREASURER/ GENESIS CFO 0 492976 0 25000 0 32499 0 9900 0 32543 0 592918 0 32499 SHARON PARKER PRESIDENT/GENESIS COO 0 447420 0 22285 0 57941 0 21974 0 18819 0 568439 0 57941 HEATH WILLIAMS DIRECTOR/EMERG SVCS DIRECT 0 148062 0 8200 0 0 0 4644 0 27422 0 188328 0 0 PART I, LINE 3: A RELATED ORGANIZATION, GENESIS HEALTHCARE SYSTEM, ESTABLISHES COMPENSATION OF THE ORGANIZATION'S CEO THROUGH A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACTS, COMPENSATION SURVEY/STUDY, AND APPROVAL BY THE BOARD AND COMPENSATION COMMITTEE. PART I, LINE 4B: A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS SET UP TO PROVIDE ADDITIONAL DEFERRED RETIREMENT INCOME TO THE GENESIS HEALTH CARE SYSTEM SENIOR LEADERSHIP TEAM MEMBERS. THIS PLAN IS FUNDED BY GENESIS AND VESTS WITH SERVICE. GENESIS HEALTHCARE SYSTEM MADE CONTRIBUTIONS TO NONQUALIFIED RETIREMENT PLANS FOR THE FOLLOWING INDIVIDUALS: DIANA LEVECK: $214,638 SHARON PARKER: $57,941 MICHAEL NORMAN: $22,831 WENDY CEDOZ: $193,083 FORM 990, PART VI, SECTION A, LINE 6 GENESIS HEALTHCARE SYSTEM IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A GENESIS HEALTHCARE SYSTEM IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B GENESIS HEALTHCARE SYSTEM IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE CFO AND MADE AVAILABLE TO THE BOARD OF DIRECTORS IN ITS ENTIRETY FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ALL POTENTIAL CONFLICTS OF INTEREST OF BOARD MEMBERS AND OFFICERS MUST BE DISCLOSED TO THE BOARD OF DIRECTORS AND THE BOARD WILL DETERMINE IF A CONFLICT EXISTS AND APPROPRIATE PROCEDURES TO MITIGATE THE SITUATION, SUCH AS ALTERNATIVE TRANSACTIONS AND PARTICIPATION AND VOTING RESTRICTIONS. THE COMPLIANCE OFFICER MONITORS AND ENFORCES THESE POLICIES. ALL OFFICERS AND DIRECTORS REVIEW AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 2C: THE FINANCE COMMITTEE OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND IS INVOLVED IN THE SELECTION OF THE INDEPENDENT ACCOUNTANT WHICH COMPLETES THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.. FORM 990, PAGE 1, LINE J, WEBSITE: HTTPS://WWW.GENESISHCS.ORG/SERVICES-SEARCH/EMERGENCY-TRAUMA/COMMUNITY-AM BULANCE GENESIS HEALTHCARE FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 311629304 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 GOOD SAMARITAN MEDICAL CENTER FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 310969646 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE FOUNDATION 1 BETHESDA HEALTH FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 310885513 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE FOUNDATION 1 GOOD SAMARITAN MEDICAL CENTER 2951 MAPLE AVENUE ZANESVILLE OH 43701 314379479 MAINTAINS REAL ESTATE TITLE FOR HOSPITAL OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 CARESERVE 2951 MAPLE AVENUE ZANESVILLE OH 43701 311099924 FORMERLY OPERATED 2 NURSING HOMES THAT WERE SOLD PRIOR TO 2012 OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 GENESIS HEALTHCARE SYSTEM 2951 MAPLE AVENUE ZANESVILLE OH 43701 311480941 HEALTHCARE OH 501(C)(3) 3 N/A 0 GENESIS CAREGIVERS 2951 MAPLE AVENUE ZANESVILLE OH 43701 311282152 HOME CARE SERVICES OH 501(C)(3) 3 CARESERVE 1 BETHESDA HOSPITALITY SHOP 2951 MAPLE AVENUE ZANESVILLE OH 43701 316050713 GIFT SHOP OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 CARELIFE LLC 2951 MAPLE AVENUE ZANESVILLE OH 43701 311128717 PHYSICIAN SERVICES, HOME INFUSION, CHILDCARE SVCS, PHARMACY, DME OH N/A C 1 SOUTHEAST OHIO MEDICAL INSURANCE COMPANY FIRST CARIBBEAN HOUSE GEORGE TOWN CAYMAN ISLANDS CJ 980436356 CAPTIVE INSURANCE COMPANY CJ N/A C 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 1 1