2022-10-31T12:11:43-05:00 2021-12-31 FORVIS LLP 1201 Walnut Suite 1700 KANSAS CITY MO 641062246 990 2021-01-01 480630224 COMMUNITY MEMORIAL HEALTHCARE INC % CURTIS R HAWKINSON COMM 7855622311 708 N 18TH STREET MARYSVILLE KS 66508 CURTIS HAWKINSON CEO 7855622311 2022-11-15 true Curtis Hawkinson XXX-XX-XXXX Michael J Engle P00482834 8162216300 2022-11-15 2 2021 2022-09-23 18:48:47Z CURTIS HAWKINSON 708 N 18TH STREET MARYSVILLE KS 66508 32025513 false X WWW.CMHCARE.ORG X 1955 KS CMH IS A NOT-FOR-PROFIT MEMBERSHIP CORPORATION THAT OWNS AND OPERATES A GENERAL ACUTE CARE HOSPITAL FOR PATIENTS IN MARYSVILLE, KANSAS AND SURROUNDING AREAS. 13 12 237 12 0 0 558514 4668315 23134640 25727025 308058 470107 635218 1159561 24636430 32025008 0 0 0 0 12941927 14021133 0 0 0 10728538 11998154 23670465 26019287 965965 6005721 24403327 22404597 12231429 4202503 12171898 18202094 X THE MISSION STATEMENT OF COMMUNITY MEMORIAL HEALTHCARE, INC. IS TO EXCEL AT CARING FOR YOU. THE VISION STATEMENT OF COMMUNITY MEMORIAL HEALTHCARE, INC. IS TO EXCEED EXPECTATIONS AS A TRUSTED AND VALUED HEALTH PROVIDER. false false 4355758 0 5868647 THREE RURAL HEALTH CLINICS WITH A TOTAL OF 18,956 OFFICE VISITS. 5121677 0 10795124 ACUTE ADULT, PEDIATRIC AND INFANT INPATIENT CARE, SWING BED, LABOR AND DELIVERY AND OBSERVATION CARE. 3,780 DAYS OF CARE PROVIDED. 2989250 0 3514990 24 HR EMERGENCY ROOM SERVICES - 3,134 VISITS, DURABLE MEDICAL EQUIPMENT SALES, AND HOME HEALTH SERVICES - 5,750 VISITS 10210748 5548265 22677433 true true false true false false false false false true false false false true false false false true 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 true true true false false true 42 0 true 237 true false false false false false false false false false false false false X 13 12 false false false false true true true true true false false true true true true true true true false false KS X CURTIS R HAWKINSON 7855622311 708 N 18TH ST MARYSVILLE KS 66508 X JACOB NAGLEY PHYSICIAN 40.0 0.0 X 438145 0 36316 BEN BRUNA PHYSICIAN 40.0 0.0 X 395466 0 36481 SHANE THORESON PHYSICIAN 40.0 0.0 X 369517 0 36481 DANIELLE WURTZ PHYSICIAN 40.0 0.0 X 358090 0 36481 JOHN HAEFELE PHYSICIAN 40.0 0.0 X 344614 0 36369 CHERYL RICE PHYSICIAN 40.0 0.0 X 310714 0 36481 CURTIS R HAWKINSON CEO 40.0 0.5 X 174613 0 28654 DAN FEHR CFO 40.0 0.5 X 130321 0 25061 MARGE SCHLABACH DIRECTOR 1.0 0.0 X 0 0 0 ROBERT VOET DIRECTOR/CHAIRPERSON 2.0 0.5 X X 0 0 0 GAIL GILKERSON DIRECTOR 1.0 0.0 X 0 0 0 KEN LAMOREAUX DIRECTOR 1.0 0.0 X 0 0 0 CANDACE WRIGHT DIRECTOR/VICE CHAIRPERSON 1.0 0.0 X X 0 0 0 NICK WOLFE DIRECTOR 1.0 0.0 X 0 0 0 EDWARD POPEJOY DIRECTOR 1.0 0.0 X 0 0 0 ERIN WRIGHT DIRECTOR 1.0 0.5 X 0 0 0 MARY CAFFREY DIRECTOR 1.0 0.5 X 0 0 0 JEFF CRIST DIRECTOR 1.0 0.0 X 0 0 0 GARY HOLLE DIRECTOR 1.0 0.0 X 0 0 0 GAGE ZIERLEIN DIRECTOR 1.0 0.0 X 0 0 0 LORI BEIKMANN DIRECTOR 1.0 0.0 X 0 0 0 2521480 0 272324 14 false true false CRIST PIESCHL REHABILITATION 535 RIDGE ROAD WATERVILLE KS 66548 PHYSICAL THERAPIES 1164460 MARYSVILLE ANESTHESIA 1017 BROADWAY SUITE 7 MARYSVILLE KS 66508 CRNA 353604 CPSI 6600 WALL STREET MOBILE AL 36695 COMPUTER SERVICES 330017 QUALIVIS 5930 CORNERSTONE COURT WEST SUITE SAN DIEGO CA 92121 CONTRACT NURSING 225293 DAVID SAMANI MD 2222 S 16TH STREET SUITE 240 LINCOLN NE 68502 SURGEON 212000 9 61387 4546171 60757 4668315 Net Patient Service Revenue 621400 24796323 24796323 Dietary Income 624200 36972 36972 Other Operating Revenue 900099 893730 893730 25727025 258021 258021 0 0 0 0 0 211040 1551 505 211040 1046 212086 212086 0 0 0 0 0 0 0 0 0 Sales Tax Revenue 900099 1159561 1159561 1159561 32025008 25727025 0 1629668 X 0 0 0 0 790596 637236 153360 156226 124025 32201 10498408 8334503 2163905 318743 231423 87320 1504697 1429810 74887 752463 681415 71048 0 12911 12911 82502 82502 0 0 0 3029174 2967387 61787 35291 32627 2664 424923 302124 122799 77809 115 77694 0 920258 860147 60111 124134 124134 0 3483 3483 8260 2789 5471 0 1511665 1413825 97840 261379 141247 120132 BAD DEBT EXPENSE 1367270 1367270 MEDICAL SUPPLIES 3480084 3480084 EQUIP RENTAL & MAINTENANCE 430193 425433 4760 DUES & SUBSCRIPTIONS 175626 91777 83849 53192 30062 23130 26019287 22677433 3341854 0 995953 34590 10796320 6676406 20640 0 3783214 4906755 0 0 0 0 0 0 620040 846239 824444 880099 0 0 6322200 6771115 0 0 0 0 0 0 1040516 2289393 24403327 22404597 1938845 2117472 0 0 3976058 2012471 0 0 0 0 0 0 2261366 72560 0 0 4055160 0 12231429 4202503 X 12075464 18126300 96434 75794 12171898 18202094 24403327 22404597 X 6005721 45115 0 0 0 -20640 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 2368 false false false 2368 false SCHEDULE C, PART II-B, LINE 1F THE LOBBYING EXPENSES ARE THE PORTION OF HOSPITAL ASSOCIATION DUES THAT ARE RELATED TO LOBBYING. 1060979 68419 4000 59493 4926 1060979 1060979 47924 2000 44939 985 1060979 1060979 50831 1000 48115 1716 1060979 1060979 50661 2000 48661 1060979 1060979 27670 2000 25670 1060979 0.92860 0.07140 false false DUE FROM FOUNDATION 1878311 DUE FROM THIRD PARTY 411082 2289393 SCHEDULE D, PART V, LINE 4 BOARD-DESIGNATED ASSETS LIMITED TO USE OF $985,185 INCLUDE ASSETS SET ASIDE BY THE BOARD OF DIRECTORS FOR FUTURE CAPITAL IMPROVEMENTS AND OPERATIONS OVER WHICH THE BOARD RETAINS CONTROL AND MAY, AT ITS DISCRETION, SUBSEQUENTLY USE THE ASSETS FOR OTHER PURPOSES. PERMANENTLY RESTRICTED ASSETS OF $75,794 HAVE BEEN RESTRICTED BY DONORS TO BE MAINTAINED BY CMH IN PERPETUITY WITH THE INCOME TO BE USED FOR SCHOLARSHIPS. 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. true true X true X true X 0 true true true false false 174465 174465 0.00710 1529214 951074 578139 0.02350 1703679 951074 752604 0.03060 37027 20491 16536 0.00070 37027 20491 16536 0.00070 1740706 971565 769140 0.03130 false 1367270 341750 8183215 8255949 -72734 X true true 1 1 COMMUNITY MEMORIAL HOSPITAL 708 N 18TH ST MARYSVILLE KS 66508 WWW.CMHCARE.ORG H058001 X X X X COMMUNITY MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 19 true false false true X SEE PART V, SECTION C true 20 true SEE PART V, SECTION C false true X 150. 0. X X X X X true true X 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 A TARGETED SURVEY WAS SENT TO MEMBERS OF THE LOCAL SCHOOL SYSTEM, RELIGIOUS ORGANIZATIONS, GOVERNMENTAL AGENCIES, NON-PROFITS, AND OTHER PUBLIC HEALTH AGENCIES, REGIONAL MENTAL HEALTH PROVIDERS, AND BUSINESS LEADERS. SCHEDULE H, PART V, SECTION B, LINE 7A THE COMPLETE CHNA CAN BE FOUND AT: HTTP://WWW.CMHCARE.ORG/DOCS/FINAL_CHNA_REPORT%2C_2019.PDF SCHEDULE H, PART V, SECTION B, LINE 10A THE IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTP://WWW.CMHCARE.ORG/DOCS/IMPLEMENTATION_STRATEGY_2020-2022_FINAL.PDF SCHEDULE H, PART V, SECTION B, LINE 11 OUR 2019 HEALTH NEEDS ASSESSMENT WAS SUMMARIZED AND PRIORITIZED INTO 6 ISSUES WHICH DID NOT VARY SIGNIFICANTLY FROM OUR PREVIOUS CHNA. ISSUES INCLUDE MENTAL HEALTH, OBESITY, AGING POPULATION, POVERTY, AND ACCESS TO CARE. TO ASSIST OUR AGING COMMUNITY MEMBERS, WE CONDUCT MONTHLY HEALTH TOPIC LUNCHEONS GEARED TOWARDS OUR OLDER POPULATION WHEN COVID RESRICTIONS ALLOW. WE PROVIDE SWING-BED, HOME HEALTH, AND DME SERVICES TO ASSIST OUR POPULATION AS THEY AGE BUT HAVE INTRODUCED NO NEW PROGRAMS BASED ON THIS CHNA. FINANCIAL CONSTRAINTS AND INSURANCE OPTIONS ARE OUTSIDE OF OUR CONTROL, BUT WE DO INFORM ALL PATIENTS OF OUR FINANCIAL ASSISTANCE OPTION THAT IS GRANTED TO THOSE DEMONSTRATING FINANCIAL NEEDS BASED UPON OUR ESTABLISHED CRITERIA. ADDITIONALLY, WE HAVE A RESOURCE WITHIN OUR PHARMACY THAT WORKS WITH INSURANCE AND PHARMACEUTICAL COMPANIES TO ASSIST LOW-INCOME PATIENTS OBTAIN FREE AND REDUCED MEDICATIONS WHICH IS CURRENTLY ASSISTING 7 OF OUR MOST VULNERABLE PATIENTS OBTAIN MEDICATION WORTH NEARLY $12,000 PER YEAR. WHEN COVID RESTRICTION AND NECESSARY SUPPLIES ALLOW, WE CONDUCT A HEALTH FAIR EACH YEAR WHICH PROVIDES (NEARLY 500 PEOPLE) A COMPREHENSIVE LAB PANEL FOR A FLAT $30 FEE CASH PRICE AND ANNUAL SPORTS PHYSICALS FOR $27.50 FEE CASH PRICE TO PROVIDE LOW-COST OPTIONS FOR ANNUAL DIAGNOSTIC SERVICES. TO ASSIST WITH COMMUNITY OBESITY WE PROVIDE DAILY, LOW-COST, PREPARED FOODS FOR THE RESIDENTS OF LOCAL DISABILITY HOUSING. WE DO NOT PROVIDE STRUCTURED MENTAL HEALTH SERVICES LOCALLY, BUT PARTNER WITH A REGIONAL PROVIDER TO ALLOW CONSULTATION VIA WEB-CAM AND REFERRALS TO THEIR OFFICES. WE CONTINUE TO HAVE A WIDE VARIETY OF SPECIALIST SERVICES PROVIDED ON-SITE WITH PHYSICIANS WHO DRIVE FROM MORE THAN 70 MILES AWAY TO CONDUCT WEEKLY OR MONTHLY CLINIC SCHEDULES. WE PROVIDE SPACE TO A DIALYSIS PROVIDER TO CONDUCT TREATMENTS ON-SITE RATHER THAN REQUIRING PATIENT AND CAREGIVERS TO TRAVEL 70 MILES EACH WAY SEVERAL TIMES EACH WEEK FOR TREATMENTS. SCHEDULE H, PART V, SECTION B, LINE 13a ELIGIBILITY FOR DISCOUNTED CARE FAP applications are compared against 150% of the FPL for a complete charity discount. Any applicant whose income exceeds 150% of the FPL, may be eligible for a partial charity discount. 50% of income over the FPL is compared against outstanding medical bills, those bills in excess of that calculation are eligible for a partial charity discount. Applicants with higher income may still be eligible for partial charity if the amount of their medical debt is proportionally higher than their income regardless of level. SCHEDULE H, PART V, SECTION B, LINE 16A THE FAP CAN BE FOUND AT: https://www.cmhcare.org/docs/2022_Financial_Assistance_Policy.pdf SCHEDULE H, PART V, SECTION B, LINE 16B THE FAP APPLICATION CAN BE FOUND AT: https://www.cmhcare.org/docs/FINANCIALASSISTANCEAPP2016.PDF SCHEDULE H, PART V, SECTION B, LINE 16C THE PLAIN LANGUAGE SUMMARY CAN BE FOUND AT: https://www.cmhcare.org/docs/2018_fap_PLAIN_LANGUAGE.PDF 5 COMMUNITY PHYSICIANS CLINIC 1902 MAY ST MARYSVILLE KS 66508 RURAL HEALTH CLINIC BLUE RAPIDS MEDICAL CLINIC 607 LINCOLN BLUE RAPIDS KS 66411 RURAL HEALTH CLINIC COMMUNITY MEDICAL EQUIPMENT 805 BROADWAY MARYSVILLE KS 66508 DURABLE MEDICAL EQUIPMENT CMH HOME HEALTH 805 BROADWAY MARYSVILLE KS 66508 HOME HEALTH AGENCY COMMUNITY PHYSICIANS CLINIC - WYMORE 100 NORTH 7TH WYMORE NE 68466 RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 3B FAP applications are compared against 150% of the FPL for a complete charity discount. Any applicant whose income exceeds 150% of the FPL, may be eligible for a partial charity discount. 50% of income over the FPL is compared against outstanding medical bills, those bills in excess of that calculation are eligible for a partial charity discount. Applicants with higher income may still be eligible for partial charity if the amount of their medical debt is proportionally higher than their income regardless of level. SCHEDULE H, PART 1, LINE 3C FAP PROVIDES DISCOUNTS FOR INCOME LEVELS ABOVE 150% OF FPG. 50% OF INCOME ABOVE FPG APPLIED TO OUTSTANDING BALANCE AND DIFFERENCE IS ELIGIBLE FOR DISCOUNT IF NO OTHER ASSETS ARE IDENTIFIED. THIS ALLOWS DISCOUNTS TO APPLY IN CATASTROPHIC SITUATIONS EVEN WHEN THE PATIENT WOULD NOT OTHERWISE HAVE QUALIFIED FOR CHARITY CONSIDERATION. SCHEDULE H, PART I, LINE 7 THE COST-TO-CHARGE RATIO WAS USED AS THE COSTING METHODOLOGY TO REPORT CHARITY CARE AND OTHER COMMUNITY BENEFITS AT COST. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. SCHEDULE H, PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), SUBTRACTED FOR PURPOSES OF CALCULATING SHCEDULE H, PART I, LINE 7 IS $1,367,270. SCHEDULE H, PART III, SECTION A, LINE 2 A PAYER SPECIFIC RESERVE IS CALCULATED EACH MONTH BASED ON TOTAL RECEIPTS AS A PERCENTAGE OF HISTORICAL GROSS AR. THIS IS SEPARATED INTO CONTRACT ADJUSTMENTS AND UNCOLLECTED BALANCES. AS ACCOUNTS ARE DEEMED NONCOLLECTABLE, AND IF ANY AMOUNTS ARE LATER RECEIVED, THESE ARE APPLIED TO THE RESERVE AND THE DIFFERENCE IS REPORTED AS MONTHLY BAD DEBT EXPENSE. UNDER GAAP STANDARDS IN 2021 GROSS AR, CONTRACT ADJ, AND UNCOLLECTED AMOUNTS ARE COMBINED INTO A SINGLE NET REVENUE LINE ON THE AUDIT FINANCIALS. SCHEDULE H, PART III, SECTION A, LINE 3 MARSHALL COUNTY KS HAS APPROXIMATELY 10% OF THE POPULATION BELOW THE POVERTY LINE, WHILE WE USE 150% OF THE FPG AS OUR CHARITY ELIGIBILITY. PATIENTS WITH NO INSURANCE OR HIGH DEDUCTIBLE PLANS COMPOSE A DISPROPORTIONATE AMOUNT OF OUR BAD DEBT. THE CULTURE IN OUR COMMUNITY DISCOURAGES ASKING FOR CHARITY AND MANY WHO WE ARE CONFIDENT WOULD QUALIFY WILL NOT APPLY, EVEN WHEN SUGGESTED TO THEM. BASED ON THESE FACTORS WE ESTIMATE AT LEAST 25% OF OUR BAD DEBT WOULD BE CHARITY ELIGIBLE IF THEY WOULD APPLY. SCHEDULE H, PART III, SECTION A, LINE 4 SEE NUMBERED PAGES 12 THROUGH 16 OF AUDIT REPORT FOR DESCRIPTION OF THIS TOPIC. SPECIFIC NOTE 2 STARTS AT THE BOTTOM OF PAGE 14. GAAP REPORTING CHANGES HAVE ELIMINATED THE SEPARATE BAD DEBT LINE REPLACED BY A NET PATIENT SERVICES REVENUE LINE INCLUDING WHAT WAS PREVIOUSLY CLASSIFIED AS BAD DEBT AS A COMPONENT. SCHEDULE H, PART III, SECTION B, LINE 8 THE NUMBERS WERE DERIVED FROM THE MEDICARE COST REPORT. ALLOWABLE EXPENSES LESS THE BAD DEBT REDUCTION AND SEQUESTRATION REDUCTIONS. THESE COSTS ARE ALLOWABLE PER MEDICARE BUT WERE STATUTORILY REDUCED BY AN ARBITRARY PERCENTAGE REDUCTION TO ARRIVE AT FINAL REIMBURSEMENT. BY DEFINITION THE DIFFERENCE IS LEGITIMATE COSTS OF DOING BUSINESS THAT ARE NONETHELESS NOT PAID BY MEDICARE. SCHEDULE H, PART III, SECTION C, LINE 9B PATIENTS ARE INFORMED OF OUR FINANCIAL ASSISTANCE POLICY AT THE TIME OF SERVICES. IF REQUESTED, THEY ARE GIVEN THE APPLICATION AT TIME OF SERVICE OR PRIOR TO DISMISSAL. FINANCIAL ASSISTANCE IS OFFERED AT TIME LETTERS ARE SENT OUT REQUESTING PAYMENT AGREEMENTS AND AGAIN BEFORE ACCOUNTS ARE SENT TO COLLECTION. SCHEDULE H, PART VI, LINE 2 COMMUNITY MEMORIAL HEALTHCARE REVIEWED OUR PRIOR CHNA AND THOSE OF SURROUNDING COMMUNITIES, REVIEWED DEMOGRAPHIC INFORMATION OF HISTORICAL PATIENT ENCOUNTERS, AND UTILIZED PUBLICLY AVAILABLE CDC AND HEALTH RANKING DATA ON HEALTH FACTORS, OUTCOMES, AND MARKETSHARE; COMPARING LOCAL AND NATIONAL RESULTS. WE THEN SURVEYED KEY STAKEHOLDERS IN OUR COMMUNITY TO DETERMINE ANY NEW OR CONTINUING AREAS OF CONCERN IN OUR SPECIFIC COMMUNITY. THIS INFORMATION WAS AGGREGATED AND COMPARED TO CAPABILITIES OF CMH AND OF OTHER COMMUNITY RESOURCES AVAILABLE IN OUR AREA. SCHEDULE H, PART VI, LINE 3 THE INSURANCE OFFICE PERSONNEL EXPLAIN ELIGIBILITY TO PATIENTS AND WILL ASSIST WITH PAPERWORK. THE AVAILABILITY OF FINANCIAL ASSISTANCE IS POSTED THROUGHOUT THE BUILDING (I.E. THE BUSINESS OFFICE, THE CLINICS, EMERGENCY DEPARTMENT) AND ON OUR WEBSITE. PATIENTS WHO ARE IDENTIFIED EITHER BEFORE SERVICES ARE RENDERED OR PRIOR TO DISCHARGE ARE CONTACTED BY THE BUSINESS OFFICE PERSONNEL TO ASSESS QUALIFICATION FOR MEDICAID OR FINANCIAL ASSISTANCE. BUSINESS OFFICE PERSONNEL ATTEMPT TO CONTACT PATIENTS VIA PHONE AND MAIL REGARDING THEIR BILL. PART OF THE CHARITY CARE PROGRAM IS TO ATTEMPT ENROLLMENT INTO THE MEDICAID PROGRAM. SCHEDULE H, PART VI, LINE 4 COMMUNITY MEMORIAL HEALTHCARE, INC. IS A NOT-FOR-PROFIT MEMBERSHIP CORPORATION WHICH OWNS AND OPERATES A GENERAL ACUTE CARE HOSPITAL, THREE RURAL HEALTH CLINICS, AND A HOME HEALTH AGENCY. 80% OF THE POPULATION WE SERVE ARE RESIDENTS OF MARSHALL COUNTY KS, 13% LIVE IN NEIGHBORING WASHINGTON COUNTY, 4% LIVE IN GAGE COUNTY NE, AND 3% LIVE ELSEWHERE DUE TO OUR PROXIMITY TO A MULTI-STATE EAST/WEST HIGHWAY. MARSHALL COUNTY HAS AN ESTIMATED POPULATION OF JUST UNDER 10,000. 50% OF OUR RESIDENTS ARE 45 YEARS OR OLDER AND 71% LIVE OUTSIDE OF CITY BOUNDARIES. HOUSEHOLD INCOME IS 20% LOWER THAN THE NATIONAL AVERAGE AND OUR POVERTY LEVEL IS 9%. THE CLOSEST TERTIARY HOSPITALS ARE MORE THAN 80 MILES IN ANY DIRECTION. WITHIN THAT GEOGRAPHIC CIRCLE ARE A HANDFUL OF ACUTE PRIMARY HOSPITALS OF SIMILAR SIZE AND CAPABILITIES TO CMH. SCHEDULE H, PART VI, LINE 5 AS THE COVID PANDEMIC CONTINUED INTO ITS SECOND YEAR, MUCH OF OUR USUAL COMMUNITY BENEFIT PROGRAMMING CONTINUED TO BE SUSPENDED. EACH YEAR FOR OVER A DECADE, CMH HAS CONDUCTED A HEALTH FAIR IN APRIL WHICH OFFERED A SCREENING BLOOD TEST FOR A SMALL FLAT FEE AND HAD GROWN TO A RATE OF OVER 500 TESTS IN A COUPLE OF HOURS. WITH 2020 SOCIAL DISTANCE REQUIREMENTS, WE CANCELED THE PROGRAM. IN 2021 WE CHANGED OUR SCHEDULE TO FALL INSTEAD OF SPRING TO ALLOW VACCINATION RATES TO LOWER SOCIAL DISTANCING RISKS. WORLDWIDE SUPPLY CHAIN ISSUES MEANT THAT WE COULD NOT PROCURE THE NECESSARY SUPPLIES AND THE PROGRAM WAS SUSPENDED FOR A SECOND YEAR. OVER THE PAST SEVERAL YEARS WE HAVE CONDUCTED A MONTHLY HEALTH EDUCATION PROGRAM FOR OUR ELDERLY POPULATION. THE COVID VUNERABILITY OF THIS HIGH-RISK GROUP MEANT THAT THE PROGRAMMING REMAINED SUSPENDED FOR 2021. PROGRAMS THAT WE WERE ABLE TO CONTINUE IN 2021 INCLUDE BREAST CANCER AWARENESS ACTIVITIES HELD EACH OCTOBER FOR THE STAFF AND PUBLIC, INCLUDING AN AFTER-HOURS CONVENIENCE MAMMOGRAM CLINIC, AN IN-MEMORIAM PINK BALLOON LAUNCH, AND EDUCATIONAL SPEAKERS. CMH IS THE LEAD SPONSOR OF THE PONY EXPRESS HALF MARATHON & 5K AND ALSO SUPPORTS THE PONY EXPRESS GRAVEL DASH BICYCLE RACE BY DONATING BOTTLED WATER AND REFRESHMENTS TO PARTICIPANTS AND STAFFING A FIRST AID TENT. CMH ALSO PROVIDES A FIRST AID TENT AND MEDICAL STAFF AT OTHER COMMUNITY EVENTS, INCLUDING BIG BLUE RIVER DAYS AND THE MARSHALL COUNTY ART COOPERATIVE'S OUTDOOR MUSIC FESTIVALS. THE CMH CONFERENCE ROOM IS SHARED WITH THE OUTSIDE COMMUNITY AND NON-PROFITS FOR EDUCATIONAL PURPOSES AND SEVERAL SUPPORT GROUPS USE THE CONFERENCE SPACE FOR MONTHLY MEETINGS, INCLUDING TWO GRIEF SUPPORT GROUPS, BREASTFEEDING SUPPORT, SUPPORT FOR PARKINSON'S DISEASE PATIENTS AND THEIR CARETAKERS, AND ALZHEIMER'S PATIENTS AND THEIR CARETAKERS. CMH PROVIDES DAILY MEALS AT COST TO THE LOCAL RESIDENTIAL CARE FACILITY POPULATION. THE CMH MEDICAL STAFF PARTICIPATE ON SEVERAL COMMUNITY BOARDS, SERVE AS MEDICAL DIRECTORS FOR LOCAL NURSING HOME AND HOSPICE ORGANIZATIONS, FUNCTION AS THE COUNTY PUBLIC HEALTH OFFICER, AND ALL PHYSICIAN STAFF FUNCTION AS DEPUTY COUNTY CORONERS AND SEVERAL PROVIDE MEDICAL SUPPORT AT SCHOOL ATHLETIC EVENTS. CMH STAFF MEMBERS PARTICIPATE IN VARIOUS FUNDRAISERS FOR THE COMMUNITY INCLUDING ADOPT-A-FAMILY, TOYS FOR TOTS BAKE SALES, CASUAL FOR A CAUSE JEANS DAYS, AND MORE. CMH STAFF MEMBERS DONATE CASES OF FACIAL TISSUES TO AREA SCHOOLS TO PREVENT THE SPREAD OF GERMS THROUGHOUT THE SCHOOL YEAR. CMH CLINICAL AND MEDICAL STAFF OFFER A JOB SHADOWING PROGRAM PROVIDING INTERNSHIP OPPORTUNITIES FOR TEENS, UNDERGRADUATE COLLEGE STUDENTS, AND MEDICAL STUDENTS. THE HOSPITAL WORKS WITH COLLEGES AND UNIVERSITIES TO SERVE AS A TRAINING SITE FOR NURSING AND OTHER HEALTHCARE-RELATED JOBS. OTHER ANNUAL PROGRAMS THAT REMAINED SUSPENDED DUE TO COVID RESTRICTIONS INCLUDE: 1) CMH STAFF HOSTS A SAFE BABYSITTING CLASS FOR 5TH & 6TH GRADE STUDENTS TO LEARN CPR/INFANT CPR, GENERIC FIRST AID, DIAPER CHANGING, BOTTLE MAKING, AND OTHER BASICS 2) CMH HOSTS KINDERGARTNERS FROM AREA SCHOOLS TO BECOME FAMILIAR WITH THE HOSPITAL, MEET EMERGENCY ROOM AND OTHER MEDICAL STAFF, LEARN ABOUT COMMON CHILDHOOD HEALTH CONCERNS SUCH AS A BROKEN BONE, AND LEARN ABOUT CAREERS IN HEALTHCARE. SCHEDULE H, PART VI, LINE 6 NOT APPLICABLE SCHEDULE H, PART VI, LINE 7 NOT APPLICABLE X X X false false false false false false false false false CURTIS R HAWKINSON CEO 164321 0 0 0 10292 0 8074 0 20580 0 203267 0 0 0 DAN FEHR CFO 127070 0 0 0 3251 0 4941 0 20120 0 155382 0 0 0 JACOB NAGLEY PHYSICIAN 416152 0 0 0 21993 0 15302 0 21014 0 474461 0 0 0 SHANE THORESON PHYSICIAN 369031 0 0 0 486 0 15302 0 21179 0 405998 0 0 0 DANIELLE WURTZ PHYSICIAN 327879 0 0 0 30211 0 15302 0 21179 0 394571 0 0 0 JOHN HAEFELE PHYSICIAN 325757 0 0 0 18857 0 15302 0 21067 0 380983 0 0 0 BEN BRUNA PHYSICIAN 394980 0 0 0 486 0 15302 0 21179 0 431947 0 0 0 CHERYL RICE PHYSICIAN 310174 0 0 0 540 0 15302 0 21179 0 347195 0 0 0 0 SEE SCHEDULE L PART V SCHEDULE L, PART IV TRANSACTION 1 (A) CYNTHIA VOET (B) CYNTHIA VOET IS AN EMPLOYEE OF COMMUNITY MEMORIAL HEALTHCARE, INC. AND THE SPOUSE OF ROBERT VOET. ROBERT VOET IS A DIRECTOR AND BOARD CHAIRMAN OF COMMUNITY MEMORIAL HEALTHCARE, INC. (C) $92,662 (D) COMPENSATION (E) NO TRANSACTION 2 (A) ALLISON MINGE (B) ALLISON MINGE IS AN EMPLOYEE OF COMMUNITY MEMORIAL HEALTHCARE, INC. AND THE DAUGHTER OF ROBERT VOET. ROBERT VOET IS A DIRECTOR AND BOARD CHAIRMAN OF COMMUNITY MEMORIAL HEALTHCARE, INC. (C) $63,564 (D) COMPENSATION (E) NO FORM 990, PART III, LINE 4D OUTPATIENT ANCILLARY - 767 SERVICES FORM 990, PART VI, SECTION A, LINE 6 ANY PERSON, FIRM, ASSOCIATION, CORPORATION, OR BODY POLITIC OR SUBDIVISION THEREOF, MAY BECOME A MEMBER OF THE COMMUNITY MEMORIAL HEALTHCARE, INC. BY: (A) PAYING A MEMBERSHIP FEE OF $100.00; AND (B) AGREEING TO COMPLY WITH AND BE BOUND BY THE ARTICLES OF INCORPORATION AND BYLAWS AND ANY RULES AND REGULATIONS ADOPTED BY THE BOARD OF DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A A CERTIFICATE OF MEMBERSHIP SHALL ENTITLE THE LEGAL HOLDER TO ONE VOTE UPON MATTERS SUBMITTED TO A VOTE AT A MEETING OF THE MEMBERS WHERE THE LEGAL HOLDER OF THE CERTIFICATE IS A FIRM, ASSOCIATION, CORPORATION, OR A BODY POLITIC, OR A SUBDIVISION THEREOF, THE PRESIDENT, CHIEF EXECUTIVE OFFICER OR HIS DESIGNEE SHALL CAST THE VOTE. ALL QUESTIONS REQUIRING A VOTE OF THE MEMBERS SHALL BE DECIDED BY A VOTE OF A MAJORITY OF THE MEMBERS PRESENT EXCEPT AS OTHERWISE PROVIDED BY LAW, THE ARTICLES OF INCORPORATION OR THE BYLAWS. FORM 990, PART VI, SECTION A, LINE 7B 1. ANY SALE, LEASE, OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF CORPORATE PROPERTY AND ASSETS OR ANY DISSOLUTION OF THE CORPORATION SHALL BE GOVERNED BY K.S.A. 17-6801 ET SEQ., REQUIRING A MAJORITY VOTE OF THE MEMBERS ENTITLED TO VOTE THEREON AT A DULY CALLED MEETING OF THE MEMBERS. 2. THE BYLAWS MAY NOT BE AMENDED, REVISED, OR REPEALED WITHOUT VOTE BY THE MEMBERSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE CFO GATHERS INFORMATION TO PREPARE THE FORM 990 TAX RETURN. THIS INFORMATION IS THEN GIVEN TO AN INDEPENDENT ACCOUNTING FIRM WHO PREPARES AND REVIEWS THE FORM 990. THE INDEPENDENT ACCOUNTING FIRM THEN PROVIDES THE CFO AND FINANCE COMMITTEE A DRAFT OF THE FORM 990 FOR COMMENTS AND APPROVAL. ONCE THE CFO, FINANCE COMMITTEE, AND THE ACCOUNTING FIRM APPROVE THE FORM 990, A COPY OF THE FORM 990 IS GIVEN TO THE GOVERNING BOARD MEMBERS ALONG WITH A RESPONSE TIME FOR QUESTIONS AND COMMENTS. ALL ISSUES ARE RESOLVED, A FINAL COPY OF THE FORM 990 IS SENT TO THE ENTIRE BOARD, AND THE 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS, OFFICERS, AND COMMITTEE MEMBERS COMPLETE A DISCLOSURE STATEMENT AT THE BEGINNING OF EACH CMH FISCAL YEAR AND PROVIDE SUCH STATEMENT TO THE CMH COMPLIANCE OFFICER. THE DISCLOSURE STATEMENT SHALL INCLUDE ANY INVESTMENT IN, OR ANY MANAGERIAL, CONSULTING, OR EMPLOYMENT RELATIONSHIP WITH, ANY OUTSIDE ENTITY THAT PROVIDES OR SEEKS TO PROVIDE GOODS OR SERVICES TO CMH, COMPETES WITH, OR INCLUDES CMH AS A JOINT VENTURE OR EQUITY INVESTOR. THE INTERESTED DIRECTOR ABSTAINS FROM DISCUSSION AND VOTING ON THE MATTER BY TEMPORARILY LEAVING THE BOARD MEETING WHILE THE DISINTERESTED DIRECTORS DISCUSS AND VOTE. THE DISCLOSURE AND ABSTENTION SHALL BE RECORDED IN THE MINUTES OF THE BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION COMMITTEE CONSISTS OF FOUR MEMBERS OF THE BOARD AND MEETS AT LEAST SEMI-ANNUALLY OR MORE OR LESS FREQUENTLY AS NECESSARY. THE COMPENSATION COMMITTEE EXISTS TO DESIGN, IMPLEMENT, AND EVALUATE COMPENSATION FOR THE CEO, PHYSICIANS AND OTHER PERSONNEL. THE COMPENSATION COMMITTEE COMPLETES MEDICAL STAFF CONTRACT NEGOTIATIONS, EVALUATES AND COMPARES PERSONNEL WAGES TO INDUSTRY BENCHMARKS, AND PERFORMS THE CEO AND BOARD EVALUATIONS. THE COMPENSATION COMMITTEE APPROVED THE INITIAL CONTRACT FOR THE CEO AND THE CEO IS SUBJECT TO THE SAME PERCENTAGE ANNUAL INCREASE AS OTHER PERSONNEL. THE DELIBERATIONS AND DECISIONS REGARDING COMPENSATION ARRANGEMENTS ARE DOCUMENTED IN BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9 CHANGES IN NET ASSETS WITH DONOR RESTRICTIONS $-20,640 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED SVC-PHYS THPY TOTAL FEES:778606 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED SVC-ANESTHESIA TOTAL FEES:433345 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED SVC-OPER ROOM TOTAL FEES:417004 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED SVC-OCCP THPY TOTAL FEES:215770 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES FOR SERVICES TOTAL FEES:1184449 CMH FOUNDATION 708 N 18TH ST MARYSVILLE KS 66508 320297285 SUPPORT KS 501(C)(3) 12a CMH true false false true true false false false false false false true false true true true false false false false CMH FOUNDATION C 61387 FMV CMH FOUNDATION K 837161 FMV