2024-11-07T07:22:26-06:00 2023-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2023-01-01 300329769 HEALTH PROFESSIONALS OF HOLMES COUNTY INC HEAL 3306741015 981 WOOSTER RD MILLERSBURG OH 44654 TIA CERNAVA CHIEF FINANCIAL OFFICER 3306741015 2024-11-07 1 1 EMILIE M KNIERIEM CPA P01330194 3176334705 2024-11-04 2023 2024-10-15 13:58:12Z TIA CERNAVA 981 WOOSTER RD MILLERSBURG OH 44654 6119236 0 X N/A X 2005 OH TO OPERATE EXCLUSIVELY FOR CHARITABLE PURPOSES INCLUDING FURTHERING THE CHARITABLE PURPOSES OF POMERENE HEALTH FOUNDATION AND POMERENE HOSPITAL. 4 0 0 56 0 0 0 20 5352706 6119216 0 0 0 0 5352706 6119236 0 0 0 0 0 0 0 0 0 10046731 11690619 10046731 11690619 -4694025 -5571383 4106434 3635298 8773496 2151397 -4667062 1483901 TO OPERATE EXCLUSIVELY FOR CHARITABLE PURPOSES INCLUDING FURTHERING THE CHARITABLE PURPOSES OF POMERENE HEALTH FOUNDATION AND POMERENE HOSPITAL. 0 0 10842971 6119216 TO PROVIDE LEASING OF EMPLOYEES IN THE PROFESSIONAL FIELD TO POMERENE HOSPITAL. 10842971 1 0 0 0 0 0 0 0 0 0 0 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 41 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 0 0 0 OH X TIA CERNAVA 3306741015 981 WOOSTER ROAD MILLERSBURG OH 44654 JASON JUSTUS CHAIR/PRESIDENT 1.00 40.00 X X 0 315627 17540 TIA CERNAVA VICE PRESIDENT 1.00 40.00 X X 0 179335 32343 JASON ROHR TREASURER 1.00 40.00 X X 0 108165 18661 TERESA BALDER SECRETARY 1.00 40.00 X X 0 112347 35268 0 715474 103812 0 0 1 0 POMERENE EMERGENCY PHYSICIANS 2624 MACNAUGHTEN ROAD NORTHWEST NORTH CANTON OH 44720 PHYSICIAN SERVICES 2217796 BARRETT PAIN ASSSOCIATES 844 BOULEVARD STREET DOVER OH 44622 PAIN MANAGEMENT 939992 KOMBIAN GBARUK 5480 GORDON WAY DUBLIN OH 43017 PHYSICIAN SERVICES 351510 ANESTHESIA CARE OF UNION HOSPITAL 17351 TALL TREE TRAIL MILLERSBURG OH 44023 ANESTHESIA SERVICES 229167 WOOSTER ORTHOPAEDICS & SPORTS MEDICINE 3373 COMMERCE PKWY STE 2 WOOSTER OH 44691 ORTHOPAEDICS COVERAGE SERVICES 219000 7 20 20 NET PATIENT REVENUE 900099 6119216 6119216 6119216 6119236 6119216 0 0 X 9773203 8948479 824724 874 867 7 68735 60093 8642 691563 686220 5343 38205 37910 295 65881 65372 509 BILLING & EMR 449761 446286 3475 MEDICAL SUPPLIES 306207 303841 2366 MAINTENANCE 268800 266723 2077 DUES & SUB. 27240 27030 210 150 150 11690619 10842971 847648 0 833776 976090 750513 515509 2522145 2143699 4106434 3635298 6427 0 8767069 2151397 8773496 2151397 X -4667062 1483901 -4667062 1483901 4106434 3635298 X -5571383 11722346 X X 0 1 X 1 0 X 20 20 785637 769844 782856 5352706 6119216 13810259 785637 769844 782856 5352706 6119236 13810279 0 0 0 13810279 785637 769844 782856 5352706 6119236 13810279 1.00000 1.00000 0.00000 X 0 ROU ASSET 2143699 2143699 ROU LIABILITY 2151397 2151397 X PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF AN UNCERTAIN POSITION HAS BEEN TAKEN THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THESE ENTITIES AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION IS REQUIRED TO FILE FEDERAL FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, WHICH IS AN INFORMATION RETURN ONLY. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. HOWEVER, AS OF THE DATE THE CONSOLIDATED FINANCIAL STATEMENTS WERE AVAILABLE TO BE ISSUED, THERE WERE NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THESE INCOME TAX RETURNS ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS). THE ORGANIZATION HAS FILED ITS APPLICABLE FEDERAL INCOME TAX RETURNS FOR PERIODS THROUGH DECEMBER 31, 2022. THESE INCOME TAX RETURNS ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS). 0 0 0 0 0 0 0 0 0 JASON JUSTUS CHAIR/PRESIDENT 0 281624 0 26315 0 7688 0 9579 0 7961 0 333167 0 0 TIA CERNAVA VICE PRESIDENT 0 160679 0 13284 0 5372 0 5608 0 26735 0 211678 0 0 PART I, LINE 3 A RELATED ORGANIZATION (POMERENE HOSPITAL) DETERMINES THE CEO'S COMPENSATION BY USING THE FOLLOWING METHODS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION COMMITTEE -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES TO DOCUMENT. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE GOVERNING BODY RECEIVES AN ELECTRONIC COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW AND APPROVAL PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C UPON APPOINTMENT, AND THEREAFTER, ANNUALLY, THROUGH SIGNED ACKNOWLEDGMENT OF THE CONFLICT OF INTEREST AGREEMENT, OR AT THE TIME WHEN AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST MAY ARISE, EACH COVERED PERSON MUST IDENTIFY AND DISCLOSE AT ANY MEETING ALL MATERIAL FACTS AND DETAILS RELATING TO THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST SO THAT THE DISINTERESTED POMERENE DECISION MAKERS ARE ABLE TO MAKE AN OBJECTIVE, BUSINESS DETERMINATION, CONSISTENT WITH POMERENE'S MISSION AND PURPOSE. ANY COVERED PERSON WITH AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST MUST NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE WITH RESPECT TO ANY VOTE OR ACTION TAKEN BY POMERENE DECISION MAKERS VOTING ON THE PROPOSED MATTER, CONTRACT, TRANSACTION, OR BUSINESS ARRANGEMENT. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER MEDICAL PROFESSIONALS: PROGRAM SERVICE EXPENSES 7,391,305. MANAGEMENT AND GENERAL EXPENSES 681,210. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,072,515. PROFESSIONAL FEES - PAIN MGMT: PROGRAM SERVICE EXPENSES 815,614. MANAGEMENT AND GENERAL EXPENSES 75,170. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 890,784. PROFESSIONAL FEES - OB/GYN: PROGRAM SERVICE EXPENSES 741,560. MANAGEMENT AND GENERAL EXPENSES 68,344. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 809,904. FORM 990, PART XI, LINE 9: TRANSFER FROM AFFILIATE 11,722,346. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. THE CONTROLLER, STAFF ACCOUNTANT, AND FINANCIAL ANALYST PROVIDE REQUESTED DATA TO THE AUDITORS. THE AUDITOR'S FINDINGS ARE REVIEWED AND PRESENTED TO THE CFO FOR APPROVAL. POMERENE HOSPITAL 981 WOOSTER RD MILLERSBURG OH 44654 311518658 HOSPITAL OH 501(C)(3) LINE 3 N/A 0 POMERENE HEALTH FOUNDATION 981 WOOSTER RD MILLERSBURG OH 44654 475317369 FUNDRAISING OH 501(C)(3) LINE 12B, II POMERENE HOSPITAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1