GENERAL JOHN J PERSHING MEMORIAL HOSPITAL ASSOCIATION: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- GENERAL JOHN J PERSHING MEMORIAL HOSPITAL ASSOCIATION (EIN 43-0715842)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-03-29
- IRS object ID
- 202310889349300431
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-03-29T12:43:46-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 Walnut Suite 1700 | AddressLine1Txt |
| City | Kansas City | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 641062246 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 430715842 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GENERAL JOHN J PERSHING MEMORIAL | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL ASSOCIATION | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % KEN BARANSKI CFO | InCareOfNm |
| Business Name Control | GENE | BusinessNameControlTxt |
| Phone | 6602581288 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 130 LOCKLING STREET | AddressLine1Txt |
| City | BROOKFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64628 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KARLA CLUBINE | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6602582222 | PhoneNum |
| Signature | 2023-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Karla | PersonFirstNm |
| Person Last | Clubine | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Michael J Engle | PreparerPersonNm |
| PTIN | P00482834 | PTIN |
| Phone | 8162216300 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KARLA CLUBINE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 130 LOCKLING STREET | AddressLine1Txt |
| City | BROOKFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64628 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,416,776 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PHSMO.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1955 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | SERVING OTHERS THROUGH QUALITY, COMPASSIONATE CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 175 | TotalEmployeeCnt |
| Total Volunteers | 17 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,908,936 | PYContributionsGrantsAmt |
| CY Contributions Grants | $124,987 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $18,544,270 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $19,137,700 | CYProgramServiceRevenueAmt |
| PY Investment Income | $65,076 | PYInvestmentIncomeAmt |
| CY Investment Income | $110,609 | CYInvestmentIncomeAmt |
| PY Other Revenue | $57,710 | PYOtherRevenueAmt |
| CY Other Revenue | $39,143 | CYOtherRevenueAmt |
| PY Total Revenue | $22,575,992 | PYTotalRevenueAmt |
| CY Total Revenue | $19,412,439 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $6,655 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $6,720 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,551,761 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,135,980 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,580,588 | PYOtherExpensesAmt |
| CY Other Expenses | $11,902,691 | CYOtherExpensesAmt |
| PY Total Expenses | $20,139,004 | PYTotalExpensesAmt |
| CY Total Expenses | $21,045,391 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,436,988 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,632,952 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $21,656,541 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,730,718 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,738,023 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,445,152 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,918,518 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,285,566 | NetAssetsOrFundBalancesEOYAmt |
| Mission | SERVING OTHERS THROUGH QUALITY, COMPASSIONATE CARE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,574,388 | ExpenseAmt |
| Grant | $688 | GrantAmt |
| Revenue | $1,959,701 | RevenueAmt |
| Desc | INPATIENT ACUTE CARE SERVICES WITH 215 INPATIENT ADMISSIONS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $12,738,093 | ExpenseAmt |
| Grant | $5,568 | GrantAmt |
| Revenue | $15,855,584 | RevenueAmt |
| Desc | OUTPATIENT SERVICES WITH APPROXIMATELY 20,595 REGISTRATIONS. THIS INCLUDES 4,656 EMERGENCY ROOM VISITS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,062,405 | ExpenseAmt |
| Grant | $464 | GrantAmt |
| Revenue | $1,322,415 | RevenueAmt |
| Desc | COMMUNITY MEDICAL ASSOCIATES, ONE OF OUR 2 PROVIDER BASED RURAL HEALTH CLINICS, WITH BOTH SCHEDULED AND WALK-IN SERVICES IS OPEN 10 HOURS A DAY MONDAY THRU FRIDAY, AND 4 HOURS ON SATURDAY (8:00-noon). IT HAD 10,416 VISITS THIS PAST FISCAL YEAR. IT IS A LOWER COST ALTERNATIVE THAN USING THE EMERGENCY ROOM. MEADVILLE MEDICAL CENTER IS OPEN 3 DAYS A WEEK AND SAW 1,530 PATIENTS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $15,374,886 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 60 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 175 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MO | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEN BARANSKI CFO | PersonNm |
| Phone | 6602582222 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 130 EAST LOCKLING STREET PO BOX 40 | AddressLine1Txt |
| City | BROOKFILED | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64628 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| PHIL HAMILTON | ||||||||
| CEO - ENDED 11/2021 | 40.0 | 0.0 | Yes (X) | $185,211 | $0 | $22,350 | ||
| BRIAN CASEBOLT | ||||||||
| DIRECTOR OF PHARMACY | 40.0 | 0.0 | $134,530 | $0 | $39,613 | Yes (X) | ||
| IRENE PARSONSON | ||||||||
| NURSE PRACTITIONER | 40.0 | 0.0 | $132,488 | $0 | $35,426 | Yes (X) | ||
| KARLA CLUBINE | ||||||||
| CEO - BEGAN 11/2021 | 40.0 | 0.0 | Yes (X) | $126,526 | $0 | $39,452 | ||
| GARY FITE | ||||||||
| DIRECTOR OF PHYSICAL THERAPY | 40.0 | 0.0 | $134,230 | $0 | $26,228 | Yes (X) | ||
| AMY CREASON | ||||||||
| NURSE PRACTITIONER | 40.0 | 0.0 | $110,917 | $0 | $36,824 | Yes (X) | ||
| GARY TANDY | ||||||||
| CFO - ENDED 07/2021 | 40.0 | 0.0 | Yes (X) | $84,431 | $0 | $8,691 | ||
| KENNETH E BARANSKI | ||||||||
| CFO - BEGAN 07/2021 | 40.0 | 0.0 | Yes (X) | $50,612 | $0 | $12,140 | ||
| BK KNOWLES | ||||||||
| DIRECTOR/PHYSICIAN | 40.0 | 0.0 | $25,654 | $0 | $0 | Yes (X) | ||
| JIM ELLIOTT | ||||||||
| DIRECTOR/VICE PRESIDENT | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MARK CLEVELAND | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| GARY ROUTLEDGE | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| JOE SMITH | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| BRIAN WINN | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| DAVID SHAW | ||||||||
| DIRECTOR/SECRETARY | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| WILLIAM THUDIUM | ||||||||
| DIRECTOR/PRESIDENT | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| GAIL TURNER | ||||||||
| DIRECTOR/TREASURER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| PAUL WILLIAMS DO | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $984,599 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $220,724 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (true) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BOONE HOSPITAL | |||||
| 1600 EAST BROADWAY | COLUMBIA | MO | 65201 | MANAGEMENT | $241,683 |
| DOCS WHO CARE PA | |||||
| 800 WEST FRONTIER LANE | OLATHE | KS | 66061 | PHYSICIAN STAFFING | $1,605,827 |
| HAVE A NICE DAY ANESTHESIA ASSOCIAT | |||||
| 2106 WOODCREST DRIVE | CHILLICOTHE | MO | 64601 | ANESTHESIA SERVICES | $211,205 |
| BROOKFIELD FAMILY HEALTH CLINIC PC | |||||
| 624 WEST LOCKLING AVENUE | BROOKFIELD | MO | 64628 | PHYSICIAN STAFFING | $193,484 |
| TITAN NURSE STAFFING LLC | |||||
| 2110 SOUTH 169 PLAZA SUITE 100 | OMAHA | NE | 68130 | STAFF NURSES | $542,577 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $105,373 | GovernmentGrantsAmt |
| All Other Contributions | $19,614 | AllOtherContributionsAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $124,987 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621400 | $18,963,572 | $18,963,572 |
| 340B REVENUE | 900099 | $174,128 | $174,128 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $19,137,700 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $110,946 | TotalRevenueColumnAmt |
| Exclusion | $110,946 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,087 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,087 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,087 | TotalRevenueColumnAmt |
| Exclusion | $9,087 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $469 | SecuritiesAmt |
| Other | $3,868 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$469 | SecuritiesAmt |
| Other | $132 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$337 | TotalRevenueColumnAmt |
| Exclusion | -$337 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA | 900099 | $19,846 | $19,846 |
| VENDING MACHINES | 900099 | $7,061 | $7,061 |
| MISCELLANOUS INCOME | 900099 | $3,149 | $3,149 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $30,056 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,412,439 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,137,700 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $149,752 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,720 | TotalAmt |
| Program Services | $6,720 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $415,948 | TotalAmt |
| Program Services | $153,688 | ProgramServicesAmt |
| Management And General | $262,260 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,059 | TotalAmt |
| Program Services | $32,052 | ProgramServicesAmt |
| Management And General | $13,007 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,761,269 | TotalAmt |
| Program Services | $4,657,870 | ProgramServicesAmt |
| Management And General | $2,103,399 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,755 | TotalAmt |
| Program Services | $58,044 | ProgramServicesAmt |
| Management And General | $13,711 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,312,236 | TotalAmt |
| Program Services | $1,028,362 | ProgramServicesAmt |
| Management And General | $283,874 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $529,713 | TotalAmt |
| Program Services | $393,876 | ProgramServicesAmt |
| Management And General | $135,837 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $222,004 | TotalAmt |
| Management And General | $222,004 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,703 | TotalAmt |
| Management And General | $1,703 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,386 | TotalAmt |
| Management And General | $133,386 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,075,046 | TotalAmt |
| Program Services | $3,593,470 | ProgramServicesAmt |
| Management And General | $481,576 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,632 | TotalAmt |
| Program Services | $5,328 | ProgramServicesAmt |
| Management And General | $12,304 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $473,125 | TotalAmt |
| Program Services | $173,952 | ProgramServicesAmt |
| Management And General | $299,173 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $528,591 | TotalAmt |
| Program Services | $264,295 | ProgramServicesAmt |
| Management And General | $264,296 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $327,055 | TotalAmt |
| Program Services | $14,514 | ProgramServicesAmt |
| Management And General | $312,541 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,815 | TotalAmt |
| Program Services | $2,693 | ProgramServicesAmt |
| Management And General | $22,122 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,483 | TotalAmt |
| Program Services | $3,452 | ProgramServicesAmt |
| Management And General | $10,031 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,090 | TotalAmt |
| Program Services | $72,607 | ProgramServicesAmt |
| Management And General | $104,483 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,126,758 | TotalAmt |
| Program Services | $461,971 | ProgramServicesAmt |
| Management And General | $664,787 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,473 | TotalAmt |
| Program Services | $169,497 | ProgramServicesAmt |
| Management And General | $91,976 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $1,533,567 | $1,533,567 | |
| MEDICAL SUPPLIES | $1,744,115 | $1,744,115 | |
| MEDICAL PAYMENTS | $709,664 | $709,664 | |
| DUES AND SUBSCRIPTIONS | $45,618 | $14,440 | $31,178 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $487,566 | TotalAmt |
| Program Services | $280,709 | ProgramServicesAmt |
| Management And General | $206,857 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,045,391 | TotalAmt |
| Program Services | $15,374,886 | ProgramServicesAmt |
| Management And General | $5,670,505 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,361,652 | BOYAmt |
| EOY | $6,375,365 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,639,142 | BOYAmt |
| EOY | $4,482,947 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,767 | BOYAmt |
| EOY | $26,101 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $181,374 | BOYAmt |
| EOY | $166,531 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $249,372 | BOYAmt |
| EOY | $355,490 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $24,417,184 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $17,248,711 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,064,234 | BOYAmt |
| EOY | $7,168,473 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,000 | BOYAmt |
| EOY | $155,811 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,656,541 | BOYAmt |
| EOY | $18,730,718 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,322,464 | BOYAmt |
| EOY | $3,916,645 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,743,687 | BOYAmt |
| EOY | $1,515,906 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,671,872 | BOYAmt |
| EOY | $4,012,601 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,738,023 | BOYAmt |
| EOY | $9,445,152 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,913,305 | BOYAmt |
| EOY | $9,277,720 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,213 | BOYAmt |
| EOY | $7,846 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,918,518 | BOYAmt |
| EOY | $9,285,566 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,656,541 | BOYAmt |
| EOY | $18,730,718 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,632,952 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | false | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (true) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $6,328 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $6,328 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1F | FormAndLineReferenceDesc |
| Explanation | FOR 2021, $6,328 OF DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION WERE USED FOR LOBBYING/ADVOCACY EXPENDITURES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $107,129 | OtherCostOrOtherBasisAmt |
| Book Value | $107,129 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,278,214 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,277,167 | DepreciationAmt |
| Book Value | $4,001,047 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,911,575 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,971,544 | DepreciationAmt |
| Book Value | $2,940,031 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $120,266 | OtherCostOrOtherBasisAmt |
| Book Value | $120,266 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,168,473 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $17,878,872 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $17,878,872 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,533,567 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,533,567 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $19,412,439 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $19,511,824 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $19,511,824 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,533,567 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,533,567 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $21,045,391 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 $ 1,533,567 |
| SCHEDULE D, PART XII, LINE 4B | PROVISION FOR UNCOLLECTIBLE ACCOUNTS $ 1,533,567 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $73,947 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $73,947 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,065,958 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,110,509 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,139,905 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,110,509 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $73,947 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,200 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,638 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,562 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,999 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,999 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,199 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,638 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,561 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,161,104 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,123,147 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $82,508 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00430 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,533,567 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $281,944 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,660,814 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,631,167 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $29,647 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GENERAL JOHN J PERSHING MEM HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 130 E LOCKLING AVE PO BOX 408 | AddressLine1Txt |
| City | BROOKFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64628 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PHSMO.ORG | WebsiteAddressTxt |
| State License | 198-56 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | COMMMUNITY MED ASSOC APPLEGATE MED GROUP MEADVILLE MED CLINIC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GENERAL JOHN J PERSHING MEM HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | MANY LOCAL STAFF MEMBERS, BOARD MEMBERS, 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://www.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 DURING THE LAST THREE YEARS SINCE THE PREVIOUS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED HAVE GONE UNCHANGED AS INDICATED BY THE MOST CURRENT 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. 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://www.phsmo.org/wp-content/uploads/2021/10/Pershing-Health-System-FA P-FY-2022.pdf |
| SCHEDULE H, PART V, SECTION B, LINE 16B | THE FAP APPLICATION CAN BE FOUND AT: https://www.phsmo.org/wp-content/uploads/2023/01/App-for-financial-assista nce2023.pdf |
| SCHEDULE H, PART V, SECTION B, LINE 16C | THE PLAIN LANGUAGE SUMMARY CAN BE FOUND AT: https://phsmo.org/financial-assistance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 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 |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 3C | MEDICAL INDIGENCY, UNDERINSURANCE STATUS AND RESIDENCY ARE FACTORS USED IN ELIGIBILITY CRITERIA EXPLAINED IN THE FAP FOR PROVIDING FREE AND DISCOUNTED CARE. |
| SCHEDULE H, PART I, LINE 7 | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT 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 $ 1,533,567. |
| 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 ALLOWED 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 $1,533,567 TIMES COST TO CHARGE RATIO FROM AUDITED FINANCIAL STATEMENTS (PAGE 28 AND 30) OR 55.71% TIME COMPUTED 33% COLLECTION SUPERVIOR'S ESTIMATE OF BAD DEBTS THAT COULD BE CHARITY IF THE PERSONS WOULD FILL OUT OUR FORMS COMPLETELY. THIS EQUALS $1,533,567 X 55.71% X 33%. ESTIMATE EQUALS $281,944. |
| 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 C, LINE 9B | OUR FINANCIAL ASSISTANCE POLICY AND COLLECTION POLICY IS 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 (WHO REPRESENT A WIDE REPRESENTATION OF OUR COMMUNITY), 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 2 (Two) PROVIDER BASED RHCS: 1) COMMUNITY MEDICAL ASSOCIATES, LOCATED WITHIN THE HOSPITAL AND OPEN 6 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 RHC PROVIDED CLINICAL ROTATION SITE 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 DEPT. COMMUNITY MEDICAL ASSOCIATES ALSO ASSISTS WITH LOCAL EMPLOYERS IN CONDUCTING BMI, BODY MEASUREMENTS, AND HEIGHT/WEIGHT ASSESMENTS TO HELP PROMOTE A HEALTHY LIFESTYLE, 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 CO C-2000, MINISTRIES IN LINN COUNTY, AND COMMUNITY CONNECTIONS. THE FOCUS OF ALL GROUPS IS TO IMPROVE THE LIVES OF CITIZENS IN LINN CO 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 PARTICIPATED IN PARADE ACTIVITIES AND SPONOSORED THE LOCAL PINK OUT GAME WHERE CANCER PREVENTION MATERIAL WAS PROVIDED TO THOSE COMMUNITY MEMBERS ATTENDING. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PHIL HAMILTON | ||||||||||||
| CEO - ENDED 11/2021 | $161,112 | $0 | $24,099 | $0 | $0 | $0 | $6,558 | $0 | $15,792 | $0 | $207,561 | $0 |
| KARLA CLUBINE | ||||||||||||
| CEO - BEGAN 11/2021 | $126,526 | $0 | $0 | $0 | $0 | $0 | $2,629 | $0 | $36,823 | $0 | $165,978 | $0 |
| IRENE PARSONSON | ||||||||||||
| NURSE PRACTITIONER | $132,488 | $0 | $0 | $0 | $0 | $0 | $2,669 | $0 | $32,757 | $0 | $167,914 | $0 |
| BRIAN CASEBOLT | ||||||||||||
| DIRECTOR OF PHARMACY | $134,530 | $0 | $0 | $0 | $0 | $0 | $2,789 | $0 | $36,824 | $0 | $174,143 | $0 |
| GARY FITE | ||||||||||||
| DIRECTOR OF PHYSICAL THERAPY | $134,230 | $0 | $0 | $0 | $0 | $0 | $2,751 | $0 | $23,477 | $0 | $160,458 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, PART VII SECTION A & SCHEDULE J, PART II | FormAndLineReferenceDesc |
| Explanation | THE COMPENSATION BEING REPORTED FOR PHIL HAMILTON AND KARLA CLUBINE IS PAID BY BOONE HOSPITAL CENTER, AN UNRELATED ORGANIZATION, FOR THEIR SERVICES AS CEO. | ExplanationTxt |
Schedule L IRS990ScheduleL
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART IV, LINE 1 | FormAndLineReferenceDesc |
| Explanation | 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. $ 45,059 D. COMPENSATION E. NO | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 CORPORATIONS PROFITS, EXCESS DUES OR A SHARE OF THE CORPORATIONS 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 IS 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 & 15B | 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 ONLY ARE AVAILABLE UPON REQUEST. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT SERVICES TOTAL FEES:2210517 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:1864529 |
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