CH ALLIED SERVICES INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- CH ALLIED SERVICES INC (EIN 43-1279063)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-12-08
- IRS object ID
- 202213429349301126
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-12-08T15:48:10-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 475 REGENCY PARK SUITE 175 | AddressLine1Txt |
| City | OFALLON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62269 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431279063 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CH ALLIED SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHAL | BusinessNameControlTxt |
| Phone | 5738158732 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 E BROADWAY | AddressLine1Txt |
| City | COLUMBIA | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65201 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EDWARD CLAYTON | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 5738158732 | PhoneNum |
| Signature | 2022-12-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | EDWARD | PersonFirstNm |
| Person Last | CLAYTON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFF PARKER | PreparerPersonNm |
| PTIN | P00970069 | PTIN |
| Phone | 6182331200 | PhoneNum |
| Preparation | 2022-12-07 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Initial Return | Yes (X) | InitialReturnInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOONE HOSPITAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TROY GREER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 E BROADWAY | AddressLine1Txt |
| City | COLUMBIA | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $456,381,294 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BOONE.HEALTH | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1983 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 2592 | TotalEmployeeCnt |
| Total Volunteers | 16 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $131,336,539 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $321,993,976 | CYProgramServiceRevenueAmt |
| CY Investment Income | -$32,460 | CYInvestmentIncomeAmt |
| CY Other Revenue | $2,807,368 | CYOtherRevenueAmt |
| CY Total Revenue | $456,105,423 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $531,675 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $168,418,442 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $213,059,889 | CYOtherExpensesAmt |
| CY Total Expenses | $382,010,006 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | $74,095,417 | CYRevenuesLessExpensesAmt |
| Total Assets EOY | $320,950,223 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $182,889,385 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances EOY | $138,060,838 | NetAssetsOrFundBalancesEOYAmt |
| Mission | OUR MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $263,129,678 | ExpenseAmt |
| Grant | $526,675 | GrantAmt |
| Revenue | $287,826,313 | RevenueAmt |
| Desc | THE ORGANIZATION OPERATES A 392-BED FULL SERVICE HOSPITAL AND EMPLOYED PHYSICIAN PRACTICES LOCATED IN COLUMBIA, MO. AS A REGIONAL REFERRAL CENTER LOCATED IN THE CENTER OF THE STATE, THE ORGANIZATION PROVIDES PROGRESSIVE HEALTHCARE PROGRAMS, SERVICES, AND TECHNOLOGY TO PEOPLE IN 25 MID-MISSOURI COUNTIES. FOR THE YEAR ENDED DECEMBER 31, 2021, THE ORGANIZATION PROVIDED CARE TO ITS COMMUNITY THROUGH 26,170 EMERGENCY DEPARTMENT VISITS, 8,906 SURGERY CASES AND 11,943 ADMISSIONS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $55,924,942 | ExpenseAmt |
| Grant | $5,000 | GrantAmt |
| Revenue | $34,167,663 | RevenueAmt |
| Desc | THE ORGANIZATION OPERATES TWO PHYSICIAN SERVICE UNITS, CHAS PHYSICIAN SERVICES, LLC AND BOONE PHYSICIAN SERVICES, LLC. THE EMPLOYED PHYSICIANS PROVIDE CARE TO PATIENTS OF THE ORGANIZATION'S HOSPITAL AND VARIOUS CLINICS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $319,054,620 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 158 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 2592 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TAMMI SEELE | PersonNm |
| Phone | 5738158732 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 E BROADWAY | AddressLine1Txt |
| City | COLUMBIA | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65201 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JERRY KENNETT | |||||||||
| CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RANDY MORROW | |||||||||
| VICE CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JAN BECKETT | |||||||||
| SECRETARY, PRIOR CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| GREG STEINHOFF | |||||||||
| TREASURER | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BOB MCDAVID | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CHARLES BONDURANT | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DIANNE LYNCH | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JUDY STARR | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GARY THOMPSON | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STAYCE SMITH | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WILLIAM ORSCHELN | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID APLINGTON | |||||||||
| BOARD MEMBER (TERM ENDED) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JOAN MAGRUDER | |||||||||
| BOARD MEMBER (TERM ENDED) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MONICA SMITH | |||||||||
| COO/VICE CHAIR (TERM ENDED) | 20.00 | 20.00 | Yes (X) | Yes (X) | $623,770 | $0 | $59,421 | ||
| ROBIN BLOUNT | |||||||||
| CMO/SECRETARY (TERM ENDED) | 40.00 | 0.00 | Yes (X) | Yes (X) | $796,058 | $0 | $35,890 | ||
| TROY GREER | |||||||||
| PRESIDENT/CEO | 20.00 | 20.00 | Yes (X) | $615,354 | $0 | $76,038 | |||
| JIM SINEK | |||||||||
| PRIOR CEO | 20.00 | 20.00 | Yes (X) | $939,250 | $0 | $0 | |||
| BRIAN WINN | |||||||||
| INTERIM CFO | 20.00 | 20.00 | Yes (X) | $139,784 | $0 | $36,302 | |||
| LAURA THOMAS | |||||||||
| CFO | 20.00 | 20.00 | Yes (X) | $121,135 | $0 | $16,923 | |||
| BARRY CHAMBERS | |||||||||
| PRIOR CFO | 20.00 | 20.00 | Yes (X) | $499,145 | $0 | $10,411 | |||
| KATE PITZER | |||||||||
| HOSPITAL ADMINISTRATION/SECRETARY | 40.00 | 0.00 | Yes (X) | $315,867 | $0 | $12,359 | |||
| CHAD PEW | |||||||||
| VP PROVIDER SERVICES | 20.00 | 20.00 | Yes (X) | $207,648 | $0 | $26,010 | |||
| MICHELLE ZVANUT | |||||||||
| VP - HUMAN RESOURCES | 40.00 | 0.00 | $440,728 | $0 | $30,899 | Yes (X) | |||
| KENYON WOODWARD | |||||||||
| CIO | 40.00 | 0.00 | $303,670 | $0 | $38,935 | Yes (X) | |||
| MARLENE LYON | |||||||||
| EXECUTIVE DIRECTOR - PATIENT CARE SERVICES | 40.00 | 0.00 | $289,229 | $0 | $29,741 | Yes (X) | |||
| RICHARD MELLITT | |||||||||
| CARDIOTHORACIC SURGEON | 40.00 | 0.00 | $1,126,403 | $0 | $39,675 | Yes (X) | |||
| JOSS FERNANDEZ | |||||||||
| CARDIOTHORACIC SURGEON | 40.00 | 0.00 | $1,047,923 | $0 | $16,138 | Yes (X) | |||
| TAREQ ABU SALAH | |||||||||
| PULMONOLOGIST | 40.00 | 0.00 | $600,349 | $0 | $35,922 | Yes (X) | |||
| ANNE PETERSEN | |||||||||
| GENERAL SURGEON | 40.00 | 0.00 | $445,991 | $0 | $22,370 | Yes (X) | |||
| REGGIE VADEN | |||||||||
| COLORECTAL SURGEON | 40.00 | 0.00 | $440,122 | $0 | $21,331 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $8,952,426 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $508,365 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 127 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MISSOURI CARDIOVASCULAR SPECIALISTS | |||||
| 1605 E BROADWAY STE 300 | COLUMBIA | MO | 65201 | CARDIOVASCULAR PHYSICIAN SERVICES | $18,908,970 |
| MEDEFIS | |||||
| PO BOX 5068 | NEW YORK | NY | 10087 | STAFFING AGENCY | $16,252,307 |
| ENSEMBLE RCM LLC | |||||
| 11511 REED HARTMAN HIGHWAY | CINCINATTI | OH | 45241 | REVENUE CYCLE MANAGEMENT | $6,165,606 |
| MID AMERICA ANESTHESIA CONSULTANTS | |||||
| 1316 OLD HIGHWAY 63 SUITE 102 | COLUMBIA | MO | 65201 | ANESTHESIA PHYSICIAN SERVICES | $4,563,477 |
| MEDICAL INFORMATION TECH INC | |||||
| PO BOX 74569 | CHICAGO | IL | 60696 | ELECTRONIC HEALTH RECORDS FEES | $4,252,300 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 19 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,359,467 | GovernmentGrantsAmt |
| All Other Contributions | $125,977,072 | AllOtherContributionsAmt |
| Noncash Contributions | $125,977,072 | NoncashContributionsAmt |
| Total Contributions | $131,336,539 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $319,083,596 | $319,083,596 |
| PHARMACY | 446110 | $2,401,665 | $2,401,665 |
| SHARED SERVICES | 621110 | $508,715 | $508,715 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $321,993,976 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $114,111 | TotalRevenueColumnAmt |
| Exclusion | $114,111 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $115,640 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $115,640 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $115,640 | TotalRevenueColumnAmt |
| Exclusion | $115,640 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $129,300 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $275,871 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$146,571 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$146,571 | TotalRevenueColumnAmt |
| Exclusion | -$146,571 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| FOOD SERVICES | 722514 | $1,537,100 | $1,537,100 |
| OTHER REVENUE | 624100 | $1,102,276 | $1,102,276 |
| MANAGEMENT SERVICES | 541610 | $52,352 | $52,352 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,691,728 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $456,105,423 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $321,993,976 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,774,908 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $531,675 | TotalAmt |
| Program Services | $531,675 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,327,934 | TotalAmt |
| Program Services | $4,448,665 | ProgramServicesAmt |
| Management And General | $879,269 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,315,415 | TotalAmt |
| Program Services | $108,809,462 | ProgramServicesAmt |
| Management And General | $21,505,953 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,816,032 | TotalAmt |
| Program Services | $5,691,182 | ProgramServicesAmt |
| Management And General | $1,124,850 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,695,242 | TotalAmt |
| Program Services | $14,774,996 | ProgramServicesAmt |
| Management And General | $2,920,246 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,263,819 | TotalAmt |
| Program Services | $6,900,041 | ProgramServicesAmt |
| Management And General | $1,363,778 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,516,388 | TotalAmt |
| Program Services | $7,110,928 | ProgramServicesAmt |
| Management And General | $1,405,460 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $711,811 | TotalAmt |
| Program Services | $594,341 | ProgramServicesAmt |
| Management And General | $117,470 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,165 | TotalAmt |
| Program Services | $113,694 | ProgramServicesAmt |
| Management And General | $22,471 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,107 | TotalAmt |
| Program Services | $21,799 | ProgramServicesAmt |
| Management And General | $4,308 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,837,537 | TotalAmt |
| Program Services | $49,962,547 | ProgramServicesAmt |
| Management And General | $9,874,990 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $599,599 | TotalAmt |
| Program Services | $500,647 | ProgramServicesAmt |
| Management And General | $98,952 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,927,437 | TotalAmt |
| Program Services | $6,619,172 | ProgramServicesAmt |
| Management And General | $1,308,265 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,156,972 | TotalAmt |
| Program Services | $6,810,827 | ProgramServicesAmt |
| Management And General | $1,346,145 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,843,500 | TotalAmt |
| Program Services | $10,723,937 | ProgramServicesAmt |
| Management And General | $2,119,563 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $202,018 | TotalAmt |
| Program Services | $168,679 | ProgramServicesAmt |
| Management And General | $33,339 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,269,436 | TotalAmt |
| Program Services | $2,729,866 | ProgramServicesAmt |
| Management And General | $539,570 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,193,560 | TotalAmt |
| Program Services | $17,695,987 | ProgramServicesAmt |
| Management And General | $3,497,573 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,852,333 | TotalAmt |
| Program Services | $2,381,612 | ProgramServicesAmt |
| Management And General | $470,721 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES AND EQ | $61,301,994 | $51,185,326 | $10,116,668 |
| PHARMACEUTICALS AND VAC | $19,897,376 | $16,613,712 | $3,283,664 |
| DIETARY | $2,021,896 | $1,688,223 | $333,673 |
| REPAIRS AND MAINTENANCE | $1,492,751 | $1,246,402 | $246,349 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,073,009 | TotalAmt |
| Program Services | $1,730,900 | ProgramServicesAmt |
| Management And General | $342,109 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $382,010,006 | TotalAmt |
| Program Services | $319,054,620 | ProgramServicesAmt |
| Management And General | $62,955,386 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $44,499,431 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $28,322,530 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $51,452,705 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $295,592 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $12,766,453 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $6,343,495 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $102,196,010 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $18,589,470 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $83,606,540 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,377,384 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $92,286,093 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $320,950,223 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $42,891,539 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $42,489 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $89,967,715 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $49,987,642 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $182,889,385 | 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) |
|---|---|---|
| EOY | $109,738,308 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $28,322,530 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $138,060,838 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $320,950,223 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $74,095,417 | ReconcilationRevenueExpnssAmt |
| Donated Services And Use Fclts | $1,783,792 | DonatedServicesAndUseFcltsAmt |
| Other Changes In Net Assets | $62,181,629 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $26,107 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $26,107 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE MISSOURI HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THESE DUES IS USED BY THE ASSOCIATIONS FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,467,297 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,255,175 | DepreciationAmt |
| Book Value | $13,212,122 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $800,428 | OtherCostOrOtherBasisAmt |
| Depreciation | $71,735 | DepreciationAmt |
| Book Value | $728,693 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $83,700,801 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,262,560 | DepreciationAmt |
| Book Value | $67,438,241 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,227,484 | OtherCostOrOtherBasisAmt |
| Book Value | $2,227,484 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $83,606,540 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATES | $4,210,470 |
| OPERATING RIGHT OF USE ASSETS | $21,436,087 |
| FINANCING RIGHT OF USE ASSETS | $66,639,361 |
| DEFERRED CHARGES | $175 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $92,286,093 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| SECTION 457 PLAN PAYABLE | $1,377,384 |
| DUE TO THIRD PARTY PAYORS | $48,610,258 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $49,987,642 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,129,237 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,129,237 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01340 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,768,828 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,478,882 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,289,946 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01650 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,898,065 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,478,882 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,419,183 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02990 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $61,610 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $61,610 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $79,484 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $79,484 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $66,974,991 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $34,902,468 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $32,072,523 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08400 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $529,070 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $529,070 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $67,645,155 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $34,902,468 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $32,742,687 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08580 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $93,543,220 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $49,381,350 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $44,161,870 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11570 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,100,272 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,100,272 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00550 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $264,785 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $264,785 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,365,057 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,365,057 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00620 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $23,564,392 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $14,554,990 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $86,199,904 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $85,742,914 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $456,990 | 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 (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | BOONE HOSPITAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 E BROADWAY | AddressLine1Txt |
| City | COLUMBIA | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.BOONE.HEALTH | WebsiteAddressTxt |
| State License | 361-14 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOONE HOSPITAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://BOONE.HEALTH/ABOUT-US/COMMITMENT-TO-COMMUNITY/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://BOONE.HEALTH/ABOUT-US/COMMITMENT-TO-COMMUNITY/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V FOR URL | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V FOR URL | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V FOR URL | 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 Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BOONE HOSPITAL CENTER | PART V, SECTION B, LINE 5: THE ORGANIZATION HOSTED A FOCUS GROUP WITH MEMBERS OF THE COMMUNITY, INCLUDING RELIGIOUS LEADERS, MEMBERS OF THE HEALTH DEPARTMENT AND VARIOUS OTHER GROUPS THAT REPRESENT THE COMMUNITY. THE FOCUS GROUP REVIEWED THE PRIMARY DATA AND COMMUNITY HEALTH NEED FINDINGS FROM 2016 AND DISCUSSED CHANGES THAT HAD OCCURRED SINCE 2016. ADDITIONALLY, THE FOCUS GROUP REVIEWED GAPS IN MEETING NEEDS, AS WELL AS IDENTIFIED POTENTIAL COMMUNITY ORGANIZATIONS FOR BOONE HOSPITAL TO COLLABORATE WITH IN ADDRESSING NEEDS. |
| BOONE HOSPITAL CENTER | PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED TWO MAJOR NEEDS: DIABETES AND HEART DISESASE.TO ADDRESS THE DIABETES NEED, THE ORGANIZATION DETERMINED THE FOLLOWING OBJECTIVES:SCREEN 500 ADULTS EACH YEAR FOR GLUCOSE AT BOONE HOSPITAL CENTER'S OUTPATIENT DIABETES AND NUTRITION CLINIC AS WELL AS UTILIZING THE BOONE HOSPITAL CENTER'S MOBILE HEALTH UNIT. WE WILL ALSO PARTNER WITH OTHER LOCAL ORGANIZATIONS: BOONE COUNTY HEALTH DEPT. LIVE WELL BY FAITH ETC.; FOLLOW-UP WITH 40% OF CLIENTS WHO OPT-IN AND ARE IDENTIFIED AS IN THE PRE-DIABETES OR DIABETES RANGE AT SCREENINGS; PROVIDE THE CLIENTS WITH REFERRAL SPECIALIST ACCESS AS WELL AS EDUCATIONAL MATERIALS TO INCREASE THEIR KNOWLEDGE OF HEALTHY LIFESTYLE CHANGES TO HELP MANAGE THEIR CONDITION.TO ADDRESS THE HEART DISEASE NEED, THE ORGANIZATION DETERMINED THE FOLLOWING OBJECTIVES:SET A BASELINE IN 2020 AND INCREASE THE NUMBER OF ADULTS WHO SCREEN FOR BLOOD PRESSURE, CHOLESTEROL AND BLOOD GLUCOSE IN BOONE COUNTY AND SURROUNDING COUNTIES BY 10% EACH YEAR; SUCCESSFUL CONTACT OF 40% OF AT-RISK PARTICIPANTS WHO OPT-IN FOR FOLLOW-UP EACH YEAR; WITHIN THE YEAR FOLLOWING THE INITIAL SCREENING, COMMUNITY EDUCATION STAFF WILL CONFIRM THAT FIVE (5) PERCENT OF THOSE CONTACTED WILL HAVE AN APPOINTMENT SCHEDULED FOR A FOLLOW-UP APPOINTMENT WITH THEIR PHYSICIAN.WHILE THE IMPLEMENTATION OF THE STRATEGY DEVELOPED IN THE 2019 CHNA WAS NOT ABLE TO BE FULLY ACCOMPLISHED DUE TO THE COVID PANDEMIC AND THE RESULTING RESTRICTIONS ON CERTAIN ACTIVITIES, THIS POTENTIAL OBSTACLE IS BEING FACTORED INTO THE STRATEGY BEING DEVELOPED FOR 2022. |
| PART V, LINE 16A | FINANCIAL ASSISTANCE POLICY WEBSITE:HTTPS://BOONE.HEALTH/WP-CONTENT/UPLOADS/2021/03/BOONEHEALTH_FAP_2021_FINAL-APPROVED.PDF |
| PART V, LINE 16B | FINANCIAL ASSISTANCE APPLICATION WEBSITE:HTTPS://BOONE.HEALTH/WP-CONTENT/UPLOADS/2021/03/BOONE_FA_APPLICATION_2021.PDF |
| PART B, LINE 16C | PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://BOONE.HEALTH/PATIENTS-VISITORS/BEFORE-AFTER-YOUR-VISIT/BILLING-AND-INSURANCE/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 30 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (30 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - BHMG - ASHLAND | ||||
| 605 C DOUGLAS DRIVE | ASHLAND | MO | 65010 | MEDICAL CLINIC |
| 2 - BHMG - BOONVILLE | ||||
| 606 EAST SPRING STREET | BOONVILLE | MO | 65233 | MEDICAL CLINIC |
| 3 - BHMG - CENTRAL | ||||
| 1605 EAST BORADWAY SUITE 110 | COLUMBIA | MO | 65201 | MEDICAL CLINIC |
| 4 - BHMG - CENTRALIA | ||||
| 1021 EAST HIGHWAY 22 | CENTRALIA | MO | 65240 | MEDICAL CLINIC |
| 5 - BHMG - GLASGOW | ||||
| 108 MARKET STREET | GLASGOW | MO | 65254 | MEDICAL CLINIC |
| 6 - BHMG - HALLSVILLE | ||||
| 501 NORTH BOUTE B | HALLSVILLE | MO | 65255 | MEDICAL CLINIC |
| 7 - BHMG - MEXICO | ||||
| 1051 OLD FARM ROAD EAST | MEXICO | MO | 65265 | MEDICAL CLINIC |
| 8 - BHMG - MEXICO MEDICAL PARK | ||||
| 600 MEDICAL PARK DRIVE | MEXICO | MO | 65265 | MEDICAL CLINIC |
| 9 - BHMG - MOBERLY | ||||
| 300 N MORLEY STREET SUITE A-C | MOBERLY | MO | 65270 | MEDICAL CLINIC |
| 10 - BHMG - OSAGE BEACH | ||||
| 931 D HIGHWAY | OSAGE BEACH | MO | 65065 | MEDICAL CLINIC |
| 11 - BHMG - SOUTH | ||||
| 900 W NIFONG BLVD SUITE 101 | COLUMBIA | MO | 65203 | MEDICAL CLINIC |
| 12 - BHMG - RHEMATOLOGY | ||||
| 900 W NIFONG BLVD SUITE 101 | COLUMBIA | MO | 65203 | MEDICAL CLINIC |
| 13 - BHMG - CONVENIENT CARE - PARKADE | ||||
| 601 BUSINESS LOOP 70 WEST SUITE 275 | COLUMBIA | MO | 65203 | MEDICAL CLINIC |
| 14 - BHMG - NIFONG CONVENIENT CARE | ||||
| 900 W NIFONG BLVD SUITE 100 | COLUMBIA | MO | 65203 | MEDICAL CLINIC |
| 15 - BHMG - PULMONARY AND SLEEP MEDICINE | ||||
| 1705 E BROADWAY SUITE 280 | COLUMBIA | MO | 65201 | MEDICAL CLINIC |
| 16 - BHMG - HEART SURGERY | ||||
| 1605 E BROADWAY SUITE 210 | COLUMBIA | MO | 65201 | MEDICAL CLINIC |
| 17 - BHMG - MID MO NEUROSURGERY | ||||
| 1605 E BROADWAY SUITE 100 | COLUMBIA | MO | 65201 | MEDICAL CLINIC |
| 18 - BHMG - HOSPITALISTINTENSIVIST | ||||
| 1605 E BROADWAY | COLUMBIA | MO | 65201 | HOSPITAL BASED PRACTICE |
| 19 - BHMG - DIABETES AND ENDOCRINOLOGY | ||||
| 1701 E BROADWAY SUITE 302 | COLUMBIA | MO | 65201 | MEDICAL CLINIC |
| 20 - BHMG - SURGERY | ||||
| 1601 E BROADWAY SUITE 240 | COLUMBIA | MO | 65201 | MEDICAL CLINIC |
| 21 - BHMG - PODIATRY | ||||
| 1705 E BROADWAY SUITE 280 | COLUMBIA | MO | 65201 | MEDICAL CLINIC |
| 22 - BHMG - INFECTIOUS DISEASE | ||||
| 1705 E BROADWAY SUITE 280 | COLUMBIA | MO | 65201 | MEDICAL CLINIC |
| 23 - BHMG - PLASTIC SURGERY | ||||
| 1601 E BROADWAY SUITE 260 | COLUMBIA | MO | 65201 | MEDICAL CLINIC |
| 24 - CHAS PHYSICIAN SERVICES LLC (MO HEART) | ||||
| 1605 E BROADWAY SUITE 300 | COLUMBIA | MO | 65201 | MEDICAL CLINIC |
| 25 - CHAS PHYSICIAN SERVICES LLC (MO HEART) | ||||
| 606 E SPRING STREET | BOONVILLE | MO | 65233 | OUTREACH MEDICAL CLINIC |
| 26 - CHAS PHYSICIAN SERVICES LLC (MO HEART) | ||||
| 130 E LOCKLING AVE | BROOKFIELD | MO | 64628 | OUTREACH MEDICAL CLINIC |
| 27 - CHAS PHYSICIAN SERVICES LLC (MO HEART) | ||||
| 1241 W STADIUM BLVD 2ND FLOOR | JEFFERSON CITY | MO | 65109 | OUTREACH MEDICAL CLINIC |
| 28 - CHAS PHYSICIAN SERVICES LLC (MO HEART) | ||||
| 404 PROVIDENCE ROAD | MACON | MO | 63552 | OUTREACH MEDICAL CLINIC |
| 29 - CHAS PHYSICIAN SERVICES LLC (MO HEART) | ||||
| 2303 S HIGHWAY 65 | MARSHALL | MO | 65340 | OUTREACH MEDICAL CLINIC |
| 30 - CHAS PHYSICIAN SERVICES LLC (MO HEART) | ||||
| 300 N MORLEY STREET | MOBERLY | MO | 65270 | OUTREACH MEDICAL CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | FINANCIAL ASSISTANCE IS BASED ON THE PATIENT'S INCOME LEVEL, WHICH IS VERIFIED THROUGH PAY STUBS, SOCIAL SECURITY AWARDS LETTERS, SELF-EMPLOYMENT LEDGERS AND OTHER FINANCIAL RECORDS FOR THE PRECEDING THREE MONTHS. |
| PART I, LINE 7: | CHARITY CARE COST IS BASED ON THE TOTAL COST TO CHARGE RATIO DERIVED FROM THE MEDICARE COST REPORT FOR SERVICES PROVIDED TO PATIENTS. |
| PART I, LINE 7G: | COSTING METHODOLOGY:THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THECALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. COST COMPUTED ON IRSWORKSHEET 6 WAS COMPUTED FROM THE MEDICARE COST REPORT AND DEPARTMENTFINANCIAL STATEMENTS, USING SPECIFIC FINANCIAL DATA FOR EACH TYPE OFSUBSIDY. |
| PART III, LINE 2: | METHODOLOGY IS CALCULATED ON A/R BALANCE BY PAYOR AND BASED HISTORICAL RESULTS. SELF PAY PATIENTS RECEIVE A 40% DISCOUNT WHICH IS ADJUSTED TO CONTRACTUAL. IF THE ACCOUNT IS BAD DEBT, THE ORGANIZATION ONLY EXPENSES 60% TO BAD DEBT EXPENSE. |
| PART III, LINE 3: | THE BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING THE MEDICARE COST REPORT. |
| PART III, LINE 4: | FOOTNOTE #3 IS LOCATED ON PAGE 14 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS AND BRIEFLY DESCRIBES THE PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS. BAD DEBT IS LISTED AS A DEDUCTION FROM REVENUE. THIS TREATEMENT IS CONSISTENT WITH THE HFMA PRINCIPLES AND PRACTICES BOARD STATEMENT NO. 15 AND WITH THE AICPA AUDIT AND ACCOUNTING GUIDE FOR HEALTHCARE ORGANIZATIONS. |
| PART III, LINE 8: | SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE MEDICARE COST REPORT WAS USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6, WHICH ONLY REFLECTS HOSPITAL FACILITY ACTIVITY AND PAYMENTS FROM CMS AGENTS. WHEN SEQUESTRATION WITHHOLDINGS, COSTS AND PAYMENTS FOR MEDICARE ADVANTAGE PLAN PATIENTS, AND PHYSICIAN AND CLINIC SERVICES AND PAYMENTS ARE ALSO CONSIDERED, THE SHORTFALL BECOMES SIGNIFICANT. |
| PART III, LINE 9B: | IN THE EVENT OF NON-PAYMENT OF SERVICES (DISCOUNTED OR FULL RATE), THE ORGANIZATION MAY TAKE EXTRAORDINARY ACTIONS TO PURSUE COLLECTIONS, INCLUDING BUT NOT LIMITED TO; REFERRING THE ACCOUNT TO OUTSIDE COLLECTIONS AGENCIES, ADVERSE CREDIT REPORTING, AND/OR LEGAL ACTION, PURSUANT TO BOONE'S BILLING AND COLLECTIONS POLICY. A FREE COPY OF THE BILLING AND COLLECTIONS POLICY IS AVAILABLE BY REQUEST FROM PATIENT BUSINESS SERVICES 888-538-1535. |
| PART VI, LINE 2: | IN ADDITION TO ITS COMMUNITY INVOLVEMENT EFFORTS RELATED TO THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION'S BOARD OF DIRECTORS CONSISTS OF FIVE PUBLICLY ELECTED OFFICIALS AND SIX STRATEGICALLY SELECTED MEMBERS TO REPRESENT THE VARYING INTERESTS OF THE COMMUNITY, AND MULTIPLE HOSPITAL LEADERS SERVE ON VARIOUS BOARDS FOR OTHER ORGANIZATIONS ADDRESSING COMMUNITY NEEDS. |
| PART VI, LINE 3: | WHEN A PATIENT INQUIRES ABOUT FINANCIAL ASSISTANCE, THEY ARE GIVEN ALL INFORMATION REGARDING THE ORGANIZATION'S FAP. |
| PART VI, LINE 4: | THE ORGANIZATION IS LOCATED IN BOONE COUNTY IN THE CITY OF COLUMBIA, MISSOURI, THE COUNTY SEAT AND LARGEST CITY IN BOONE COUNTY. BOONE COUNTY HAS A POPULATION OF 178,271 (2017 CENSUS ESTIMATE). THE POPULATION EXPERIENCED A 9.6 PERCENT INCREASE FROM 2010 TO 2017, A SIGNIFICANT GROWTH FOR THE COUNTY.AT THE TIME OF THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSEMENT, BOONE COUNTY HAD THE FOLLOWING DEMOGRAPHIC INFORMATION:51.5 PERCENT FEMALE (91,810)48.5 PERCENT MALE (86,461)79.0 PERCENT WHITE (140,834)9.6 PERCENT AFRICAN AMERICAN (17,114)5.0 PERCENT ASIAN (8,914)3.4 PERCENT HISPANIC OR LATINO (6,061)3.1 PERCENT TWO OR MORE RACES (5,526)0.4 PERCENT AM. INDIAN & ALASKA NAT. (713)0.1 PERCENT NATIVE HAW. & OTHER P.I. (178)PERSONS 65 YEARS AND OVER IN THE COUNTY TOTALED 11.8 PERCENT COMPARED TO 16.5 PERCENT IN THE STATE. 93.5 PERCENT OF THE POPULATION 25 AND OLDER HAD A HIGH SCHOOL DIPLOMA COMPARED TO 88.8 PERCENT THE STATE. 45.9 PERCENT OF THE POPULATION 25 AND OLDER HAD A BACHELOR'S DEGREE WHEN COMPARED TO 27.6 PERCENT IN THE STATE. THE MEDIAN INCOME OF HOUSEHOLDS IN THE COUNTY AT $52,005 WAS SLIGHTLY HIGHER THAN THE STATE MEDIAN AVERAGE OF $51,542. HOME OWNERSHIP WAS LOWER IN BOONE COUNTY (50.4 PERCENT) THAN THE STATE (57.8 PERCENT). WITH AN ESTIMATED POVERTY RATE OF 18.7 PERCENT, BOONE COUNTY HAD A HIGHER PERCENTAGE OF PERSONS LIVING IN POVERTY THAN MISSOURI (14.6 PERCENT). WHILE THIS HIGHER POVERTY RATE MIGHT BE ATTRIBUTABLE TO THE SUB-POPULATION OF COLLEGE STUDENTS WHO EARN LESS INCOME, IT IS IMPORTANT NOT TO OVERLOOK FAMILIES WHO LIVE BELOW THE POVERTY LEVEL. |
| PART VI, LINE 5: | THE ORGANIZATION PROVIDES VARIOUS HEALTH SCREENINGS TO MEMBERS OF THE COMMUNITY AT REDUCED COST OR NO COST. PRESENTATIONS AND EDUCATIONAL MATERIALS ARE ALSO MADE TO IMPROVE THE GENERAL HEALTH KNOWLEDGE OF THE COMMUNITY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MO |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| COLUMBIA TRACK CLUB | ||||||||
| 1800 PARKLAWN DRIVE | COLUMBIA | MO | 65202 | 431721553 | 501(C)(3) | $6,000 | $0 | HEART OF AMERICA MARATHON |
| COLUMBIA PUBLIC SCHOOLS | ||||||||
| 1818 WEST WORLEY | COLUMBIA | MO | 65203 | 436000318 | GOVERNMENT | $10,000 | $0 | ATHLETICS AND ACTIVITIES INITIATIVE |
| BOONE COUNTY | ||||||||
| 801 E WALNUT | COLUMBIA | MO | 65201 | GOVERNMENT | $500,000 | $0 | HEALTH PROGRAMMING FUND | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | SPONSORSHIPS ARE EVALUATED BY THE DIRECTOR OF MARKETING AND COMMUNITY WELLNESS AND THE CEO OF BOONE HEALTH. WE LOOK TO PARTNER WITH ESTABLISHED, REPUTABLE ORGANIZATIONS THAT SUPPORT OUR MISSION OF IMPROVING THE HEALTH OF PEOPLE AND COMMUNITIES WE SERVE. WE TYPICALLY PARTICIPATE IN THE EVENTS THAT WE SPONSOR TO CONFIRM THAT THE AUDIENCE AND BENEFIT PROVIDED MEETS THE ESTABLISHED GOALS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 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 | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RICHARD MELLITT | ||||||||||||||
| CARDIOTHORACIC SURGEON | $870,477 | $0 | $255,926 | $0 | $0 | $0 | $21,817 | $0 | $17,858 | $0 | $1,166,078 | $0 | $0 | $0 |
| JOSS FERNANDEZ | ||||||||||||||
| CARDIOTHORACIC SURGEON | $820,818 | $0 | $227,105 | $0 | $0 | $0 | $16,138 | $0 | $0 | $0 | $1,064,061 | $0 | $0 | $0 |
| JIM SINEK | ||||||||||||||
| PRIOR CEO | $758,020 | $0 | $181,230 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $939,250 | $0 | $0 | $0 |
| ROBIN BLOUNT | ||||||||||||||
| CMO/SECRETARY (TERM ENDED) | $689,650 | $0 | $106,408 | $0 | $0 | $0 | $27,186 | $0 | $8,704 | $0 | $831,948 | $0 | $0 | $0 |
| TROY GREER | ||||||||||||||
| PRESIDENT/CEO | $615,354 | $0 | $0 | $0 | $0 | $0 | $49,174 | $0 | $26,864 | $0 | $691,392 | $0 | $0 | $0 |
| MONICA SMITH | ||||||||||||||
| COO/VICE CHAIR (TERM ENDED) | $540,639 | $0 | $83,131 | $0 | $0 | $0 | $32,782 | $0 | $26,639 | $0 | $683,191 | $0 | $0 | $0 |
| TAREQ ABU SALAH | ||||||||||||||
| PULMONOLOGIST | $311,968 | $0 | $288,381 | $0 | $0 | $0 | $15,577 | $0 | $20,345 | $0 | $636,271 | $0 | $0 | $0 |
| BARRY CHAMBERS | ||||||||||||||
| PRIOR CFO | $405,562 | $0 | $93,583 | $0 | $0 | $0 | $4,260 | $0 | $6,151 | $0 | $509,556 | $0 | $0 | $0 |
| MICHELLE ZVANUT | ||||||||||||||
| VP - HUMAN RESOURCES | $357,597 | $0 | $83,131 | $0 | $0 | $0 | $14,204 | $0 | $16,695 | $0 | $471,627 | $0 | $0 | $0 |
| ANNE PETERSEN | ||||||||||||||
| GENERAL SURGEON | $445,991 | $0 | $0 | $0 | $0 | $0 | $8,598 | $0 | $13,772 | $0 | $468,361 | $0 | $0 | $0 |
| REGGIE VADEN | ||||||||||||||
| COLORECTAL SURGEON | $440,122 | $0 | $0 | $0 | $0 | $0 | $14,897 | $0 | $6,434 | $0 | $461,453 | $0 | $0 | $0 |
| KENYON WOODWARD | ||||||||||||||
| CIO | $232,299 | $0 | $71,371 | $0 | $0 | $0 | $21,302 | $0 | $17,633 | $0 | $342,605 | $0 | $0 | $0 |
| KATE PITZER | ||||||||||||||
| HOSPITAL ADMINISTRATION/SECRETARY | $315,867 | $0 | $0 | $0 | $0 | $0 | $12,359 | $0 | $0 | $0 | $328,226 | $0 | $0 | $0 |
| MARLENE LYON | ||||||||||||||
| EXECUTIVE DIRECTOR - PATIENT CARE SE | $262,425 | $0 | $26,804 | $0 | $0 | $0 | $11,883 | $0 | $17,858 | $0 | $318,970 | $0 | $0 | $0 |
| CHAD PEW | ||||||||||||||
| VP PROVIDER SERVICES | $177,648 | $0 | $30,000 | $0 | $0 | $0 | $9,000 | $0 | $17,010 | $0 | $233,658 | $0 | $0 | $0 |
| BRIAN WINN | ||||||||||||||
| INTERIM CFO | $116,240 | $0 | $23,544 | $0 | $0 | $0 | $9,663 | $0 | $26,639 | $0 | $176,086 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | CONTRIBUTIONS TO A 457(F) PLAN WERE MADE BY THE ORGANIZATION FOR THE FOLLOWING PERSONS: MICHELLE ZVANUT - $12,443 MONICA SMITH - $17,401 ROBIN BLOUNT - $21,439 TROY GREER - $31,000 LAURA THOMAS - $6,655 KENYON WOODWARD - $14,037 CHAD PEW - $9,000 DISTRIBUTIONS FROM A 457(F) PLAN WERE TAKEN FOR THE FOLLOWING PERSONS: BARRY CHAMBERS - $17,018 MICHELLE ZVANUT - $9,918 MONICA SMITH - $14,186 ROBIN BLOUNT - $18,540 | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| MISSOURI CARDIOVASCULAR SPECIALISTS | |||
| PRACTICE OF BOARD MEMBER JERRY KENNETT | $18,908,970 | PSA PAYMENTS | 0 |
| MID MO NEURO SURGERY | |||
| PRACTICE OF BOARD MEMBER CHARLES BONDURANT | $1,946,073 | PSA PAYMENTS | 0 |
| BRIANA WINN | |||
| DAUGHTER OF OFFICER BRIAN WINN | $49,946 | WAGES | 0 |
| PATSY WINN | |||
| WIFE OF OFFICER BRIAN WINN | $26,528 | WAGES | 0 |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | INHERENT CONTRIBUTION | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $125,977,072 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE M, PART I, LINE 25 | FormAndLineReferenceDesc |
| Explanation | A CHANGE IN CONTROL WAS DETERMINED TO HAVE OCCURRED ON JANUARY 1, 2021 AND AS A RESULT, THE ORGANIZATION RECOGNIZED AN INHERENT CONTRIBUTION FOR THE NET ASSETS CONTRIBUTED IN EXCESS OF LIABILITIES ASSUMED, AT FAIR VALUE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE ORGANIZATION HAS ESTABLISHED AN EXECUTIVE COMMITTEE, WHICH CONSISTS OF THE CHAIR, VICE CHAIR, SECRETARY, TREASURER AND UP TO ONE OTHER BOARD MEMBER. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY TO TRANSACT ROUTINE BUSINESS OF THE ORGANIZATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT SUCH ACTIONS TAKEN SHALL BE CONSISTENT WITH AND NOT CONFLICT WITH ANY ACTIONS OR POLICIES OF THE BOARD OF DIRECTORS, THE ORGANIZATION'S BYLAWS OR APPLICABLE LAW. ALL ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE ARE PROMPTLY REPORTED TO THE BOARD OF DIRECTORS AT THE NEXT MEETING, AND THE EXECUTIVE COMMITTEE KEEPS REGULAR MINUTES OF ITS PROCEEDINGS. |
| FORM 990, PART VI, SECTION A, LINE 3 | BJC WAS PREVIOUSLY THE SOLE CORPORATE MEMBER OF CHAS AND A TRANSITION OF CONTROL OCCURRED FROM BJC TO BOONE HEALTH, INC. DURING THE PERIOD OF JANUARY 1, 2021 TO MARCH 31, 2021. DURING THIS PERIOD HEALTH SYSTEM PAID BJC A MANAGEMENT FEE AND THE DIRECT COST OF OTHER SERVICES CONSISTENT WITH THE ORIGINAL LEASE AGREEMENT. INCLUDED IN THE AGREEMENT THE HEALTH SYSTEM RECEIVED SERVICES, INCLUDING LEGAL, INTERNAL AUDIT, MARKETING, RISK MANAGEMENT, INFORMATION SYSTEMS, AND CONTRACT AND REIMBURSEMENT SERVICES, FROM BJC. BJC WAS REIMBURSED FOR THE DIRECT COST OF INFORMATION SERVICES, REVENUE CYCLE, AND OTHER COSTS DIRECTLY ATTRIBUTABLE TO THE HEALTH SYSTEM. BJC ALSO RECEIVED A MANAGEMENT FEE OF 2.5% OF REVENUE TO COVER SOME OF THESE SERVICES. IN ADDITION TO THE MANAGEMENT FEE, EXPENSES FOR OTHER SERVICES, SUCH AS HEALTH INSURANCE, SELF-INSURANCE, AND PENSION FUNDING, WERE PAID TO BJC. FOR THE YEAR ENDED DECEMBER 31, 2021, THE HEALTH SYSTEM PAID BJC APPROXIMATELY $1,983,000 RELATED TO THE MANAGEMENT FEE. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS BOONE HEALTH, INC., A MISSOURI NONPROFIT CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THIS ORGANIZATION'S BOARD OF DIRECTORS SHALL AT ALL TIMES BE THOSE PERSONS WHO SERVE FROM TIME TO TIME ON THE BOARD OF DIRECTORS OF THE SOLE MEMBER, AND ANY APPOINTMENT, TERM, ELECTION, RESIGNATION, REMOVAL, OR VACANCY ON THE SOLE MEMBER'S BOARD OF DIRECTORS SHALL AUTOMATICALLY AND SIMULTANEOUSLY HAVE AN IDENTICAL EFFECT ON THIS ORGANIZATION'S BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE BOARD OF TRUSTEES OF BOONE COUNTY HOSPITAL RESERVES THE AUTHORITY TO APPROVE OF THE FOLLOWING ACTIONS BEFORE THEY ARE UNDERTAKEN: ANY CHANGE OR MODIFICATION TO THE PURPOSE OF THE ORGANIZATION; ANY TERMINATION, AMENDMENT, OR MODIFICATION TO THE LEASE; THE INCURRENCE OF DEBT FOR THE CORPORATION OR THE HEALTH SYSTEM THAT IS COLLATERALIZED BY THE HOSPITAL, THE HEALTHCARE FACILITIES LOCATED ON THE CAMPUS OF THE HOSPITAL, OR IS OTHERWISE OWNED BY THE TRUSTEES OR THE COUNTY (COLLECTIVELY, THE "FACILITIES") AND/OR ANY REVENUE OF THE HOSPITAL OR THE FACILITIES (OTHER THAN ANY EXISTING BONDS ISSUED FOR THE BENEFIT OF THE HOSPITAL OR THE FACILITIES; ANY ACTION EXPECTED TO AFFECT THE TAX-EXEMPT STATUS OF THE CORPORATION OR ANY OTHER TAX-EXEMPT SUBSIDIARY OF THE CORPORATION WHILE THERE IS ANY TAX-EXEMPT DEBT OUTSTANDING, THE PROCEEDS OF WHICH FINANCED OR REFINANCED ALL OR ANY PORTION OF THE HOSPITAL OR THE FACILITIES, ANY ACTION THAT COULD AFFECT THE TAX-EXEMPT STATUS OF ANY ENTITY OWNING OR OPERATING THE HOSPITAL OR THE FACILITIES THAT ARE OBLIGATED ON SUCH DEBT, OR ANY ACTION THAT COULD ADVERSELY AFFECT THE TAX-EXEMPT STATUS OF SUCH DEBT; ANY ACTION SUBJECT TO ANY RIGHTS VESTED TO THE TRUSTEES UNDER CHAPTER 205 REVISED MISSOURI STATUTES, SECTION 160 ET SEQ., AS SUCH ACT MAY BE AMENDED, MODIFIED, SUPPLEMENTED, CONSOLIDATED, OR REPLACED FROM TIME TO TIME; OR ANY ACTION REQUIRED TO ENSURE THE TRUSTEES' COMPLIANCE WITH ANY OF ITS OBLIGATIONS UNDER ANY INDENTURE, LOAN AGREEMENT, COVENANT AGREEMENT, DISCLOSURE AGREEMENT, TAX AGREEMENT, OR SIMILAR AGREEMENT RELATING TO OUTSTANDING INDEBTEDNESS SECURED BY ALL OR ANY PORTION OF THE HOSPITAL OR THE FACILITIES OR REVENUE OF THE HOSPITAL OR THE FACILITIES. |
| FORM 990, PART VI, SECTION B, LINE 11B | A INTIAL, DETAILED REVIEW OF THE FORM 990 IS CONDUCTED BY THE EXECUTIVE DIRECTOR OF FINANCE. A CURSORY REVIEW WILL THEN BE COMPLETED BY THE CHIEF FINANCIAL OFFICER, LEGAL COUNSEL AND DIRECTOR OF FINANCE BEFORE IT IS PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL PERSONNEL OF THE ORGANIZATION AT THE DIRECTOR LEVEL OR ABOVE (INCLUDING KEY EMPLOYEES) COMPLETE AN ANNUAL SURVERY TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST. THE ORGANIZATION'S RISK MANAGEMENT GROUP REVIEWS THE SURVEYS AND MONITORS ANY ITEMS THAT MAY LEAD TO A CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION UTILIZES AN INDEPENDENT COMPENSATION CONSULTANT TO DETERMINE STANDARD BASE RATES FOR THE CEO AND OTHER OFFICERS. AN INCENTIVE PLAN, WHICH IS BASED ON ORGANIZATIONAL PERFORMAION AS COMPARED TO KEY PERFORMANCE INDICATORS CHOSEN PRIOR TO THE FISCAL YEAR, IS ALSO DETERMINED BY THE INDEPENDENT COMPENSATION CONSULTANT. THE BOARD OF DIRECTORS MUST THEN APPROVE THE BASE RATE AND INCENTIVE PLAN FOR THE ORGANIZATION'S CEO. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE ORGANIZATION PROVIDES THESE FORMS UPON REQUEST. |
| 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 AT THIS TIME. |
| FORM 990, PART IX, LINE 11G | PURCHASED PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 6,860,265. MANAGEMENT AND GENERAL EXPENSES 1,355,917. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,216,182. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 3,981,910. MANAGEMENT AND GENERAL EXPENSES 787,016. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,768,926. JANITORIAL AND HOUSKEEPING CONTRACTS: PROGRAM SERVICE EXPENSES 119,102. MANAGEMENT AND GENERAL EXPENSES 23,540. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 142,642. CONSULTING FEES: PROGRAM SERVICE EXPENSES 204,012. MANAGEMENT AND GENERAL EXPENSES 40,323. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 244,335. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 34,959,655. MANAGEMENT AND GENERAL EXPENSES 6,909,699. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,869,354. ANSWERING SERVICE: PROGRAM SERVICE EXPENSES 63,342. MANAGEMENT AND GENERAL EXPENSES 12,519. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 75,861. COLLECTIONS SERVICE: PROGRAM SERVICE EXPENSES 76,772. MANAGEMENT AND GENERAL EXPENSES 15,174. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 91,946. COURIER SERVICE: PROGRAM SERVICE EXPENSES 8,057. MANAGEMENT AND GENERAL EXPENSES 1,593. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,650. LAB FEES: PROGRAM SERVICE EXPENSES 24,724. MANAGEMENT AND GENERAL EXPENSES 4,887. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,611. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 2,717,561. MANAGEMENT AND GENERAL EXPENSES 537,120. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,254,681. SECURITY: PROGRAM SERVICE EXPENSES 388. MANAGEMENT AND GENERAL EXPENSES 77. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 465. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 389,124. MANAGEMENT AND GENERAL EXPENSES 76,910. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 466,034. FOOD SERVICES: PROGRAM SERVICE EXPENSES 557,635. MANAGEMENT AND GENERAL EXPENSES 110,215. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 667,850. |
| FORM 990, PART XI, LINE 9: | EQUITY TRANSFER TO RELATED ORGANIZATION -1,526,052. ASSET TRANSFERS FROM BOARD OF TRUSTEES 35,385,151. DONATED SERVICES TO BE RECOGNIZED IN FUTURE YEARS 28,322,530. |
| FORM 990, PAGE 12, PART XII, LINE 2C | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| CHAS PHYSICIAN SERVICES LLC | |||||||||
| 1600 E BROADWAY | COLUMBIA | MO | 65201 | 320275207 | PHYSICIAN SERVICES | MO | $11,535,141 | $3,820,326 | CH ALLIED SERVICES INC |
| BOONE PHYSICIAN SERVICES LLC | |||||||||
| 1600 E BROADWAY | COLUMBIA | MO | 65201 | 460552280 | PHYSICIAN SERVICES | MO | $23,367,357 | $9,897,899 | CH ALLIED SERVICES INC |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| BOONE HOSPITAL CENTER'S VISITING NURSES INC | ||||||||||
| 1600 E BROADWAY | COLUMBIA | MO | 65201 | 430998347 | HOME HEALTH AND HOSPICE | MO | 501(C)(3) | LINE 12A, I | CH ALLIED SERVICES INC | Yes (1) |
| BOONE HEALTH INC | ||||||||||
| 1600 E BROADWAY | COLUMBIA | MO | 65201 | 850769204 | HOSPITAL GOVERNANCE | MO | 501(C)(3) | LINE 12C, III-FI | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOONE HOSPITAL CENTER'S VISITING NURSES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | R | TransactionTypeTxt |
| Involved | $1,526,052 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |
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