2024-05-15T10:50:27-05:00 2023-06-30 FORVIS LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2022-07-01 430715842 GENERAL JOHN J PERSHING MEMORIAL HOSPITAL ASSOCIATION % KARLA CLUBINE GENE 6602582222 130 E LOCKLING St BROOKFIELD MO 64628 KARLA CLUBINE CEO 6602582222 2024-05-15 true Karla Clubine 999009999 Michael J Engle P00482834 8162216300 2024-05-15 3 2022 2023-04-26 12:10:37Z KARLA CLUBINE 130 LOCKLING STREET BROOKFIELD MO 64628 20176322 false X WWW.PHSMO.ORG X 1955 MO SERVING OTHERS THROUGH quality, COMPASSIONATE CARE. 9 8 175 18 0 0 124987 168578 19137700 19822843 110609 148792 39143 35211 19412439 20175424 6720 13360 0 0 9135980 10581938 0 0 0 11902691 11947357 21045391 22542655 -1632952 -2367231 18730718 14639933 9445152 7721598 9285566 6918335 SERVING OTHERS THROUGH QUALITY, COMPASSIONATE CARE. false false 1537861 1244 1845506 INPATIENT ACUTE CARE SERVICES WITH 288 INPATIENT ADMISSIONS. 13768064 11136 16522340 OUTPATIENT SERVICES WITH APPROXIMATELY 24,167 REGISTRATIONS. THIS INCLUDES 7,897 EMERGENCY ROOM VISITS. 1212449 980 1454997 TWO PROVIDER BASED RURAL HEALTH CLINICS WITH 12,133 VISITS. 16518374 true false false true false false false false false false true false false false true false true false false false false false false false false false true true false false true false false false false false false true false false false false false false false false false false true 55 0 true 175 true false false false false false false false false false false false false X 9 8 false true false false true true true true true false false true true true true true true true false false MO X KARLA CLUBINE 6602581141 130 E LOCKLING AVE BROOKFIELD MO 64628 X DR Brian Kevin KNOWLES DIRECTOR/PHYSICIAN 40.0 0.0 X 277360 0 11330 DR OGE CHUKWU PHYSICIAN 40.0 0.0 X 241612 0 11330 KARLA CLUBINE CEO 40.0 0.0 X 155652 0 39935 BRIAN CASEBOLT DIRECTOR OF PHARMACY 40.0 0.0 X 137142 0 42126 KEN BARANSKI CFO 40.0 0.0 X 134822 0 42080 GARY FITE REHAB SERVICES DIRECTOR 40.0 0.0 X 136956 0 30538 AMY CREASON NURSE PRACTITIONER 40.0 0.0 X 112897 0 40783 IRENE PARSONSON NURSE PRACTITIONER 40.0 0.0 X 119828 0 15202 JIM ELLIOTT DIRECTOR/VICE PRESIDENT 1.0 0.0 X X 0 0 0 MARK CLEVELAND DIRECTOR 1.0 0.0 X 0 0 0 GARY ROUTLEDGE DIRECTOR 1.0 0.0 X 0 0 0 JOE SMITH DIRECTOR 1.0 0.0 X 0 0 0 BRIAN WINN DIRECTOR 1.0 0.0 X 0 0 0 DAVID SHAW DIRECTOR/SECRETARY 1.0 0.0 X X 0 0 0 WILLIAM THUDIUM DIRECTOR/PRESIDENT 1.0 0.0 X X 0 0 0 GAIL TURNER DIRECTOR/TREASURER 1.0 0.0 X X 0 0 0 1316269 0 233324 9 false true true DOCS WHO CARE PA 800 WEST FRONTIER LANE OLATHE KS 66061 PHYSICIAN STAFFING 1657435 HAVE A NICE DAY ANESTHESIA ASSOCIAT 2016 WOODCREST DRIVE CHILLICOTHE MO 64601 ANESTHESIA SERVICES 267259 CORROHEALTH BOX 654380 DALLAS TX 75265 BILLING CONSULTANT 217776 BOONE HEALTH 1600 EAST BROADWAY COLUMBIA MO 65201 MANAGEMENT 195000 FORVIS LLP PO BOX 200870 DALLAS TX 75320 ACCOUNTING/AUDITING 178601 9 154705 13873 168578 NET PATIENT SERVICE REVENUE 622100 19681275 19681275 340B REVENUE 900099 141568 141568 19822843 149486 149486 0 0 9980 9980 0 9980 9980 204 898 -898 204 -694 -694 0 0 0 0 0 0 0 0 0 CAFETERIA 722514 13521 13521 PURCHASING REBATES 900099 18 18 MISCELLANOUS INCOME 900099 11692 11692 25231 20175424 19822843 184003 X 13360 13360 0 0 0 687596 288690 398906 71954 51184 20770 7423553 5607096 1816457 74943 68910 6033 1746442 1378307 368135 577450 422339 155111 196500 196500 0 132332 132332 0 0 0 3913798 3120575 793223 0 60512 35290 25222 470891 167737 303154 626628 313314 313314 0 382067 16363 365704 4919 3332 1587 0 7408 4310 3098 161983 66413 95570 0 1173536 481150 692386 345092 212622 132470 BAD DEBT 1170295 1170295 MEDICAL SUPPLIES 1914571 1914571 MEDICAID PAYMENTS 750125 750125 DUES AND SUBSCRIPTIONS 60367 18130 42237 576333 414261 162072 22542655 16518374 6024281 0 0 0 6375365 4214387 0 0 4482947 3300478 0 0 0 0 26101 53279 166531 189964 355490 360685 24750834 18422247 7168473 6328587 0 0 0 0 0 0 0 0 155811 192553 18730718 14639933 3916645 2659638 0 0 1515906 1412125 0 0 0 0 0 0 4012601 3622171 0 0 0 27664 9445152 7721598 X 9277720 6908659 7846 9676 9285566 6918335 18730718 14639933 -2367231 X false true X false true true X false false false false false true 6808 false false false 6808 false SCHEDULE C, PART II-B, LINE 1F FOR FISCAL YEAR ENDING JUNE 30, 2023, $6,328 OF DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION WERE USED FOR LOBBYING/ADVOCACY EXPENDITURES. 107129 107129 14498359 10759366 3738993 10063097 7662881 2400216 82249 82249 6328587 0 Right of Use Liability - Meadville Clinic 27664 27664 18977870 18977870 1197554 1197554 20175424 21345101 21345101 1197554 1197554 22542655 SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 4B PROVISION FOR UNCOLLECTIBLE ACCOUNTS $ 1,170,295 COLLECTION FEES 27,259 ------------- TOTAL $ 1,197,554 SCHEDULE D, PART XII, LINE 4B PROVISION FOR UNCOLLECTIBLE ACCOUNTS $ 1,170,295 COLLECTION FEES 27,259 ------------- TOTAL $ 1,197,554 true true X true X true X true true false false 24973 5796 19177 0.00090 4059981 5799651 4084954 5805447 19177 0.00090 38095 29857 8238 0.00040 5000 5000 0.00020 43095 29857 13238 0.00060 4128049 5835304 32415 0.00150 true 1170295 215151 7808380 7911102 -102722 X true true 1 1 GENERAL JOHN J PERSHING MEM HOSPITAL 130 E LOCKLING AVE PO BOX 408 BROOKFIELD MO 64628 WWW.PHSMO.ORG 198-56 X X X X COMMMUNITY MED ASSOC APPLEGATE MED GROUP MEADVILLE MED CLINIC GENERAL JOHN J PERSHING MEM HOSPITAL 1 false false true X X X X X X X X X 21 true false false true X SEE PART V, SECTION C X true 21 true SEE PART V, SECTION C false true X 100 300. X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 MANY LOCAL STAFF MEMBERS, BOARD MEMBERS, AND HOSPITAL AUXILIARY WERE INVOLVED IN THE CHNA PROJECT, ALONG WITH COLLABORATION WITH THE LINN COUNTY HEALTH DEPARTMENT. THE CHNA TOWN HALL MEETING HAD 38 STAKEHOLDERS AND COMMUNITY LEADERS PRESENT. SCHEDULE H, PART V, SECTION B, LINE 7A THE COMPLETE CHNA CAN BE FOUND AT: https://phsmo.org/wp-content/uploads/2022/05/2022CHNA.pdf SCHEDULE H, PART V, SECTION B, LINE 10A THE IMPLEMENTATION STRATEGY CAN BE FOUND AT: https://www.phsmo.org/wp-content/uploads/2022/05/2022CHNAIMPPLAN.pdf SCHEDULE H, PART V, SECTION B, LINE 11 MANY FACTORS remained unchanged between the 2019 and 2022 community health needs assessments. FINDINGS INDICATED SEVERAL VULNERABILITIES IN HEALTHCARE SERVICES PROVIDED TO THE COMMUNITY AND UNFAVORABLE TRENDS IN HEALTHCARE FACTORS. UNEMPLOYMENT IS A LARGE FACTOR CONTRIBUTING TO INDIVIDUALS LACKING THE FINANCIAL CAPABILITY TO ACCESS HEALTHCARE. INCREASING RATES OF UNEMPLOYMENT WILL RAISE THE NEED FOR COMMUNITY HEALTH CENTERS AND ADDITIONAL SAFETY-NET CLINICS IN THE COUNTY. IN TERMS OF ECONOMIC STATUS, LINN COUNTY IS WORSE OFF IN RELATION TO THE REST OF MISSOURI AND THE UNITED STATES AND HAS A HIGH PERCENTAGE OF FAMILIES BELOW THE POVERTY LEVEL. ANALYZING THE VARIOUS CLASSES OF WORKERS GIVES AN IDEA AS TO THE AVAILABILITY OF HEALTH INSURANCE TO THE LABOR FORCE. THE 2022 CHNA INDICATED THAT A LARGE PERCENTAGE OF LINN COUNTY WORKERS ARE EMPLOYED IN THE EDUCATION, MANUFACTURING, AND RETAIL INDUSTRIES. THE 2022 CHNA INDICATED LINN COUNTY BOASTS A LARGER PERCENTAGE OF SELF-EMPLOYED WORKERS THAN BOTH MISSOURI AND THE UNITED STATES. HAVING A HIGH NUMBER OF SELF-EMPLOYED WORKERS COULD MEAN THAT PORTION OF THE POPULATION HAS TO PROVIDE THEIR OWN HEALTH INSURANCE AND THE INCREASINGLY HIGH PREMIUMS AND DEDUCTIBLES COULD BE A DETERRENT. IT WOULD BE EASY FOR ONE TO FOCUS ON THE OBVIOUS HEALTHCARE FACTORS AFFECTING THE CITIZENS OF LINN COUNTY SUCH AS OBESITY, HEART DISEASE, DIABETES, LACK OF EXERCISE, AND LACK OF ACCESS TO RECREATIONAL LOCATIONS, AS THE NEEDS TO ADDRESS IN THE COUNTY; HOWEVER, IT WOULD BE A DISSERVICE TO THE CITIZENS AND THE COMMUNITY IF PERSHING HEALTH SYSTEM DID NOT CONSIDER THE SIGNIFICANT IMPACT THAT THE LEVEL OF POVERTY PLAYS IN ALL OF THESE ISSUES. THIS WOULD LEAD ONE TO QUESTION IF THE TRUE ISSUE IS RELATED TO THE SIGNIFICANT NUMBER OF CITIZENS WHO LIVE IN POVERTY IN LINN COUNTY AS THE PRIMARY CAUSE FOR MANY, IF NOT ALL, OF THE HEALTH NEEDS IDENTIFIED. RESIDENTS LIVING IN POVERTY REGARD HEALTH NEEDS AS SIGNIFICANTLY LESS IMPORTANT, ESPECIALLY WHEN TRYING TO MEET BASIC NEEDS TO SURVIVE. HOW CAN A PERSON LIVING IN POVERTY BE EXPECTED TO ADDRESS OBESITY, HEART DISEASE, AND DIABETES IF THEY ARE UNABLE TO ADDRESS THE BASIC NEEDS OF THEIR HOUSEHOLD SUCH AS RUNNING WATER, FOOD, RENT, AND UTILITIES WITHOUT STRUGGLES? UNLESS OR UNTIL POVERTY IS ADDRESSED, CHRONIC ILLNESS WILL ALWAYS BE SIGNIFICANT FOR COUNTY RESIDENTS. POVERTY ISSUES RELATED TO HEALTHCARE WILL IMPACT THE QUALITY OF CARE THAT CITIZEN'S ACCESS, WHICH IN RETURN IMPACT THE OVERALL HEALTH OF THE CITIZENS. LINN COUNTY RANKS 33RD IN HEALTH OUTCOMES ACCORDING TO COUNTY HEALTH RANKINGS AND 77TH IN HEALTH FACTORS FOR THE STATE OF MISSOURI. NEGATIVE TRENDS IN ADULT OBESITY, HEART DISEASE, AND PHYSICAL INACTIVITY ARE ALL HIGHER THAN MISSOURI AND NATIONAL AVERAGES AND CONTRIBUTE TO AN INCREASING PREMATURE DEATH RATE FOR THE COUNTY. HOWEVER, UNTIL POVERTY IS ADDRESSED, ANY INTERVENTION APPLIED TO THESE CHRONIC ISSUES WILL HAVE VERY LITTLE IMPACT. ANOTHER AREA OF CONCERN IDENTIFIED WAS LACK OF RECREATIONAL AREAS FOR EXERCISE. MANY CITIZENS WHO LIVE IN POVERTY WOULD BE QUICK TO SAY THAT WHETHER OR NOT THEY HAVE ACCESS TO RECREATIONAL AREAS IS NOT A PRIORITY FOR THEM. AFTER SPEAKING WITH COMMUNITY HEALTHCARE SERVICE PROVIDERS, SEVERAL WEAKNESSES IN THE PROVISION OF SERVICES TO THE COMMUNITY WERE REVEALED. TO HELP ADDRESS THE CHILDHOOD POVERTY PERSHING HOPSITAL OFFERED FREE MEALS TO CHILDREN THROUGH THE SUMMER FOOD SERVICE PROGRAM FROM JUNE TO AUGUST. PERSHING SPONSORED A CANNED FOOD DRIVE AT CHRISTMAS FOR THE LOCAL FOOD BANK, AS WELL AS A CLOTHING DRIVE FOR LOCAL FOSTER CHILDREN. PERSHING ALSO CONTINUES TO OFFER REDUCED COST MEDICAL SCREENINGS DURING OUR ANNUAL HEALTH FAIR, WHERE COMMUNITY MEMBERS CAN ACCESS BASIC LABS AT REDUCED COST. PERSHING CONTINUES TO OFFER FREE HEALTH AND WELLNESS CHECKS FOR ALL SCHOOL-AGED CHILDREN DURING THE MONTHS OF MAY TO AUGUST. SCHEDULE H, PART V, SECTION B, LINE 16A THE FAP CAN BE FOUND AT: https://phsmo.org/wp-content/uploads/2021/10/3-23fap-policy.pdf SCHEDULE H, PART V, SECTION B, LINE 16B THE FAP APPLICATION CAN BE FOUND AT: https://phsmo.org/wp-content/uploads/2024/04/Financial-Application.pdf SCHEDULE H, PART V, SECTION B, LINE 16C THE PLAIN LANGUAGE SUMMARY CAN BE FOUND AT: https://phsmo.org/wp-content/uploads/2024/04/FAP-Plain-Language-Summary.pd f 3 COMMUNITY MEDICAL ASSOCIATES 130 E LOCKLING AVE BROOKFIELD MO 64628 PROVIDER BASED RURAL HEALTH CLINIC APPLEGATE MEDICAL GROUP 125 E LOCKLING AVE BROOKFIELD MO 64628 PROVIDER BASED RURAL HEALTH CLINIC MEADVILLE MEDICAL CLINIC 101 E HAYWARD MEADVILLE MO 64659 PROVIDER BASED RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 3C MEDICAL INDIGENCY, UNDERINSURANCE STATUS AND RESIDENCY ARE FACTORS USED IN ELIGIBILITY CRITERIA FOR PROVIDING FREE AND DISCOUNTED CARE AS EXPLAINED IN THE FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTs CONTAINED IN THE TABLE OF SCHEDULE H, PART I, LINE 7 IS A COST-TO-CHARGE RATIO. SCHEDULE H, PART I, LINE 7, COLUMN F THE BAD DEBT EXPENSE INCLUDED IN FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,170,295. SCHEDULE H, PART III, SECTION A, LINE 2 THE GROSS BAD DEBT EXPENSE BEING REPORTED IS ACTUAL BAD DEBTS WRITTEN OFF PER OUR POLICY PLUS ACCRUAL OF ESTIMATES ON ACCOUNTS RECEIVABLE. OUR FINANCIAL ASSISTANCE POLICY ALLOWs FOR INDIGENT CARE DISCOUNTS. ANY PAYMENT ON A PREVIOUS BAD DEBT IS RECORDED AS A RECOVERY ON OUR BOOKS, IN A SEPARATE RECOVERY ACCOUNT. SCHEDULE H, PART III, SECTION A, LINE 3 NET BAD DEBT $1,170,295 TIMES COST-TO-CHARGE RATIO FROM AUDITED FINANCIAL STATEMENTS (PAGEs 28 AND 30) OR 55.71% multiplied by COMPUTED 33% COLLECTION SUPERVIOR'S ESTIMATE OF BAD DEBTS THAT COULD BE CHARITY IF THE PERSONS FILLed OUT OUR FORMS COMPLETELY. THIS EQUALS $1,170,295 X 55.71% X 33%. ESTIMATE EQUALS $215,151. SCHEDULE H, PART III, SECTION A, LINE 4 PLEASE SEE NOTE 1 OF THE ATTACHED FINANCIAL STATEMENTS FOR THE FOOTNOTE DESCRIBING THE ORGANIZATION'S BAD DEBT EXPENSE. SCHEDULE H, PART III, SECTION B, LINE 8 SERVING PATIENTS WITH GOVERNMENT HEATH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SCHEDULE H, PART III, SECTION C, LINE 9B OUR FINANCIAL ASSISTANCE POLICY AND COLLECTION POLICY are APPLIED TO ALL TYPES OF PATIENTS. SCHEDULE H, PART VI, LINE 2 PERSHING IS A SMALL RURAL CRITICAL ACCESS HOSPITAL AND as such RECEIVES CONTINUOUS FEEDBACK FROM THE PATIENTS WE SERVE, OUR PHYSICIANS, OTHER MEDICAL PROVIDERS, BOARD MEMBERS AND FROM VARIOUS ONGOING PATIENT SATISFACTION SURVEYS. SUCH SURVEYS ARE REPORTED AT BOARD MEETINGS AND DISTRIBUTED TO ALL HOSPITAL DEPARTMENTS. SCHEDULE H, PART VI, LINE 3 INFORMATION ON OUR FINANCIAL ASSISTANCE POLICY (FAP) IS ON OUR WEBSITE. THE FAP, CHARITY CARE AND COLLECTION (PAYMENT ARRANGEMENTS) INFORMATION IS AVAILABLE THROUGH OUR COLLECTION PERSONNEL AND OTHERS AT PERSHING HOSPITAL AND THROUGH OUR WALK-IN CLINIC, COMMUNITY MEDICAL ASSOCIATE AT APPLEGATE MEDICAL GROUP, AND MEADVILLE MEDICAL CLINIC. FURTHER, WE PRINT A REFERENCE TO OUR FAP POLICY ON THE FRONT OF EACH PATIENT BILLING STATEMENT SENT OUT. SOCIAL SERVICES, THROUGH THE ASSESSMENT/CONSULTATION PROCESS, IDENTIFIES AND ASSISTS IN THE APPLICATION PROCESS. SCHEDULE H, PART VI, LINE 4 PERSHING HEALTH SYSTEM SERVES LINN COUNTY (POPULATION OF AROUND 13,000) AND SURROUNDING AREA. IT IS MADE UP OF RURAL COMMUNITIES WITH A MIXTURE OF BUSINESSES AND AGRICULTURE. SCHEDULE H, PART VI, LINE 5 PERSHING HEALTH SYSTEM CONSISTS OF PERSHING MEMORIAL HOSPITAL AND Two PROVIDER BASED Rural health clinics: 1) COMMUNITY MEDICAL ASSOCIATES, LOCATED WITHIN THE HOSPITAL AND OPEN six DAYS A WEEK AND 2) MEADVILLE MEDICAL CLINIC, 12 MILES FROM THE HOSPITAL, SERVES ONE OF THE SMALL COMMUNITIES WITHIN OUR SERVICE AREA WITH A NURSE PRACTITIONER. ALL OF THE PROVIDER-BASED Rural health clinics PROVIDED CLINICAL ROTATION SITEs FOR MEDICAL STUDENTS AND NURSE PRACTITIONERS AND PROVIDED JOB SHADOWING AND CLINICAL ROTATIONS TO THE AREA CAREER CENTERS. THEY ALSO PROVIDED FREE SPORTS PHYSICALS/HEALTHY CHILD EXAMS FOR ALL LINN COUNTY CHILDREN BETWEEN THE AGES OF 3 AND 18 AND/OR HIGH SCHOOL SENIOR From May to August. NURSE PRACTITIONERS PROVIDE WELL CHILD EXAMS YEARLY AT THE LINN COUNTY HEALTH DEPARTMENT. COMMUNITY MEDICAL ASSOCIATES ALSO ASSISTS WITH LOCAL EMPLOYERS IN CONDUCTING BMI, BODY MEASUREMENTS, AND HEIGHT/WEIGHT ASSESMENTS TO HELP PROMOTE A HEALTHY LIFESTYLE, and IN TURN, EMPLOYEES RECEIVE A REDUCTION IN INSURANCE PREMIUMS. HOSPITAL WEEK, HELD ANNUALLY AT THE LOCAL (BROOKFIELD) PARK BAPTIST CHURCH AND AT MARCELINE BETHANY BAPTIST CHURCH, PROCESSED BLOOD DRAWS. OTHER HEALTH FAIRS AND EVENTs were conducted AT OTHER BUSINESSES IN OUR SERVICE AREA. THE HOSPITAL HELD commUNITY SERVICE PROJECTs DURING THE YEAR. PERSHING HEALTH SYSTEM COLLABERATED WITH THE FOOD BANK OF CENTRAL AND NORTHEAST MISSOURI TO SPONSOR THE BUDDY PACK PROGRAM. THE BUDDY PACK PROGRAM PROVIDES MEALS ON WEEKENDS TO LINN COUNTY CHILDREN WHO RESIDE IN A FOOD INSECURE HOME. PERSHING STAFF ARE ACTIVELY INVOLVED (AND DONATE THEIR TIME) IN a MONTHLY MEETING OF THE FOLLOWING GROUPS: LINN COunty C-2000, MINISTRIES IN LINN COUNTY, AND COMMUNITY CONNECTIONS. THE FOCUS OF ALL GROUPS IS TO IMPROVE THE LIVES OF CITIZENS IN LINN COunty BY ADDRESSING SUICIDE, COMMUNITY POVERTY, AND HEALTHCARE ISSUES. PERSHING HEALTH SYSTEM PARTICIPATED IN A MOM'S BREAKING THE SILENCE COMMUNITY EVENT. THE PURPOSE OF THE EVENT WAS TO PROVIDE SUICIDE AWARENESS AND HEALTHY MENTAL HEALTH COPING SKILLS TO THE COMMUNITY. PERSHING health system PARTICIPATED IN PARADE ACTIVITIES AND SPONOSORED THE LOCAL PINK OUT GAME, WHERE CANCER PREVENTION MATERIAL WAS PROVIDED TO THOSE COMMUNITY MEMBERS ATTENDING. FORM 990 DISCLOSURE REQUIRED UNDER REV. PROC. 2015-21 PERSHING MEMORIAL HOSPITAL DISCOVERED DURING THE PREPARATION OF THE FISCAL YEAR 2023 990 THAT THEY DID NOT FULLY COMPLY WITH 501(R) DURING THE YEAR. THE HOSPITAL BELIEVED THEY WERE IN COMPLIANCE UNTIL A REVIEW OF THEIR WEBSITE, FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND PROVIDER LIST REVEALED INADVERTANT AND MINOR ERRORS. PERSHING MEMORIAL HOSPITAL WILL HAVE THESE UPDATES CORRECTED IN JUNE 2024. EDUCATION AND UPDATED PROCESSES AND PROCEDURES WILL KEEP THESE ERRORS FROM HAPPENING AGAIN. X X false false false false false false false false false BRIAN CASEBOLT DIRECTOR OF PHARMACY 137142 0 0 0 0 0 2858 0 39268 0 179268 0 0 0 AMY CREASON NURSE PRACTITIONER 112897 0 0 0 0 0 1515 0 39268 0 153680 0 0 0 KEN BARANSKI CFO 134822 0 0 0 0 0 2812 0 39268 0 176902 0 0 0 GARY FITE REHAB SERVICES DIRECTOR 136956 0 0 0 0 0 2819 0 27719 0 167494 0 0 0 DR OGE CHUKWU PHYSICIAN 241612 0 0 0 0 0 0 0 11330 0 252942 0 0 0 DR Brian Kevin KNOWLES DIRECTOR/PHYSICIAN 277360 0 0 0 0 0 0 0 11330 0 288690 0 0 0 KARLA CLUBINE CEO 155652 0 0 0 0 0 10558 0 29377 0 195587 0 0 0 FORM 990, PART VII SECTION A & SCHEDULE J, PART II THE COMPENSATION BEING REPORTED FOR KARLA CLUBINE IS PAID BY BOONE HOSPITAL CENTER, AN UNRELATED ORGANIZATION, FOR SERVICES AS CEO. See Part V SCHEDULE L, PART IV, LINE 1 TRANSACTION 1: A. JENNIFER THUDIUM B. JENNIFER THUDIUM IS AN EMPLOYEE OF PERSHING MEMORIAL HOSPITAL, AND IS THE DAUGHTER-IN-LAW OF WILLIAM THUDIUM, WHO IS A DIRECTOR OF PERSHING MEMORIAL HOSPITAL. C. $ 71,954 D. COMPENSATION E. NO FORM 990, PART VI, SECTION A, LINE 3 PERSHING MEMORIAL HOSPITAL HAS A MANAGEMENT AGREEMENT WITH BOONE HOSPITAL FOR THE OPERATION AND MANAGEMENT OF THE HOSPITAL. THE MANAGEMENT AGREEMENT PROVIDES DAILY OPERATING AUTHORITY TO THE MANAGEMENT COMPANY AND CEO SERVICES. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE CLASS OF ASSOCIATION MEMBERSHIP. ALL MEMBERS OF THE CORPORATION ARE ENTITLED TO VOTE IN PERSON AT ALL MEETINGS OF MEMBERSHIP. THE MEETING OF MEMBERSHIP IS AN ANNUAL MEETING HELD ON THE FOURTH MONDAY IN JUNE. MEMBERS OF THIS CORPORATION HAVE THE RIGHT TO ELECT THE MEMBERS OF THE BOARD OF DIRECTORS AT THIS MEETING. MEMBERS ARE NOT ENTITLED TO RECEIVE A SHARE OF THE CORPORATION'S PROFITS, EXCESS DUES OR A SHARE OF THE CORPORATION'S NET ASSETS UPON DISSOLUTION. FORM 990, PART VI, SECTION A, LINE 7A & 7B MEMBERS OF THE CORPORATION HAVE THE RIGHT TO ELECT ALL MEMBERS OF THE BOARD OF DIRECTORS AT THE ANNUAL MEETING OF MEMBERSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE FORM 990 IS THEN REVIEWED BY OFFICERS AND ACCOUNTING PERSONNEL. ANY QUESTIONS THEY HAVE ARE ADDRESSED. ONCE ALL REVIEWS ARE COMPLETED, THE FINAL RETURN IS PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN WITH THE IRS. THE FORM 990 IS THEN FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY AND THE CONFLICT OF INTEREST DISCLOSURE FORM AND QUESTIONNAIRE are DISTRIBUTED ANNUALLY TO THE BOARD OF DIRECTORS AND OFFICERS. THE QUESTIONNAIRE IS COMPLETED TO IDENTIFY ANY RELATIONSHIPS, POSITIONS, OR CIRCUMSTANCES WITH RESPECT TO WHICH IT IS BELIEVED A CONFLICT MAY ARISE. IN SUCH A CASE THAT A CONFLICT OF INTEREST DOES OCCUR, THE DISCLOSING INDIVIDUAL WITH THE CONFLICT OF INTEREST DOES NOT ATTEND ANY MEETINGS OR DISCUSSIONS REGARDING THE MATTER. THE DISCLOSING INDIVIDUAL DOES NOT VOTE OR ENDEAVOR TO INFLUENCE CORPORATE ACTION IN ANY SUCH MATTER. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S COMPENSATION IS INCLUDED IN THE INDEPENDENT CONTRACT FEE TO BOONE HOSPITAL. BOONE HOSPITAL DETERMINES AND PAYS HER COMPENSATION. THE INDEPENDENT CONTRACTOR FEE IS APPROVED BY THE FILING ORGANIZATION'S BOARD OF DIRECTORS. THE CEO DETERMINES THE CFO'S COMPENSATION ANNUALLY. COMPENSATION SURVEYS ARE USED ANNUALLY TO EVALUATE COMPENSATION LEVELS. THE CEO CONDUCTS AN ANNUAL EVALUATION OF KEY MANAGEMENT STAFF. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND 990 FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:1989548 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:1924250