2021-04-02T13:49:26-05:00 2020-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2019-07-01 730790960 Purcell Municipal Hospital PURC 4055276524 1500 North Green Avenue Purcell OK 73080 Mary Morris CFO 4055276524 2021-03-31 1 Kim Hunwardsen CPA P00484560 6122536500 2021-03-30 2019 2022-09-23 18:48:47Z Kem Scully 1500 North Green Avenue Purcell OK 73080 13762523 0 X www.purcellhospital.com X 1970 OK To provide short-term acute health care to the citizens of Purcell, Oklahoma and surrounding area. 5 5 154 6 0 0 18057 10206 14111919 13666508 17895 5431 91262 80378 14239133 13762523 0 0 0 0 5243692 5180667 0 0 0 8365213 9259150 13608905 14439817 630228 -677294 5648708 8386206 992707 4407499 4656001 3978707 X To enrich the health and lives of those we serve through individualized, compassionate and exceptional care. 0 1 12201115 13666508 The Hospital is a 39-bed acute care hospital located in the City of Purcell, Oklahoma. The Hospital is leased from the City of Purcell, Oklahoma to the Purcell Public Works Authority. The Hospital is a public trust created under the laws of the State of Oklahoma and is exempt from income taxes under Section 115 of the Internal Revenue Code as a political subdivision of the State of Oklahoma.The Hospital provides short-term acute health and emergency care to the citizens of Purcell, Oklahoma and surrounding communities regardless of ability to pay. We offer a medical clinic and specialty clinic to make access to specialists more convenient for the community. (Continued on Schedule O)Eye surgery, pain management, scopes and general surgery are performed in our facility. Our facility can also fulfill the needs of swing beds and observation stays.The Hospital provides health care services to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since the Hospital does not pursue collection of these amounts, they are not reported as patient service revenue. The estimated cost of providing these services was $20,000 for the year ended June 30, 2020, calculated by multiplying the ratio of cost to gross charges for the Hospital by the gross uncompensated charges associated with providing charity care to its patients. 12201115 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 28 0 1 154 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 1 1 1 0 0 OK X X Kem Scully CEO 4055276524 1500 North Green Ave Purcell OK 73080 Kem Scully CEO 40.00 1.00 X 136584 0 22289 Tonya Shandy Physician Assistant 40.00 X 127410 0 17580 Amy E Pedlow Physician Assistant 32.00 X 108630 0 0 Mary Morris CFO 40.00 X 69011 0 11138 David Shirley Chair 1.00 X X 0 0 0 Justin Blankenship Vice Chair 1.00 X X 0 0 0 Todd Clouse Secretary 1.00 X X 0 0 0 Kyle Nondorf Board Member until Nov 2019 1.00 X 0 0 0 Trey Smith Board Member 1.00 X 0 0 0 Tammy Powell Board Member starting Jan 2020 1.00 X 0 0 0 441635 0 51007 3 0 1 0 McClain Emergency Group PO Box 677979 Dallas TX 752677979 ED Coverage (Physicians) 1267536 SSMOK PO Box 205 Oklahoma City OK 73101 Software and Support 171993 Laboratory Corp of America PO Box 12140 Burlington NC 272162140 Reference Lab 133970 GE Precision Healthcare LLC PO Box 96483 Chicago IL 60693 Maint Contract/Repairs 118923 St Anthony Hospital PO Box 205 Oklahoma City OK 73101 Nuc Med/Telehealth 106608 5 10206 10206 Patient Service Revenue 621110 12417299 12417299 Sales tax 900099 1217071 1217071 32138 32138 13666508 5431 5431 80378 0 80378 80378 80378 13762523 13666508 0 85809 X 239297 239297 190101 190101 3913147 3445293 467854 528909 459571 69338 309213 260069 49144 71982 71982 38500 38500 2517723 1990839 526884 21125 6373 14752 1405505 1211077 194428 46480 46480 15515 3880 11635 29896 15986 13910 19167 19167 428673 55734 372939 159798 159798 Bad Debt Expense 3832582 3832582 Medical Supplies 460966 460966 Repairs and Maintenance 164281 164274 7 Food 38723 38723 8234 8234 14439817 12201115 2238702 0 1414350 4124798 1275850 1478886 43021 44363 134154 44328 11797995 9389468 2546704 2408527 234629 285304 5648708 8386206 751486 995633 2059547 241221 360819 991500 992707 4407499 X 4656001 3978707 4656001 3978707 5648708 8386206 -677294 0 X 0 1 X 1 0 X 22186 22186 5265335 4000753 1264582 1072514 937488 135026 5393239 4409815 983424 44721 41412 3309 2408527 9910774 -3851749 -3851749 13762523 0 13762523 10588068 0 10588068 3851749 3851749 14439817 Part XI, Line 2d - Other Adjustments: Provision for Bad Debts included in revenue for financial statements -3,832,582. Interest Expense included in revenue for financial statements -19,167. Part XII, Line 4b - Other Adjustments: Provision for Bad Debts included in revenue for financial statements 3,832,582. Interest Expense included in revenue for financial statements 19,167. 1 1 X 1 X 1 X 1 1 0 0 20000 20000 0.00190 20000 20000 0.00190 3616694 2086361 1530333 0.14430 3616694 2086361 1530333 0.14430 3636694 2086361 1550333 0.14620 0 3832582 682200 2860607 2839093 21514 X 1 1 1 1 Purcell Municipal Hospital 1500 North Green Avenue Purcell OK 73080 www.purcellhospital.com 2280 X X X 1 Provider based clinic Purcell Municipal Hospital 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X www.purcellhospital.com/about/ X 1 18 1 www.purcellhospital.com/about/ 0 1 X 150.000000000000 250.000000000000 X X X 1 1 X X X X 1 X https://purcellhospital.com/patient-info/ X https://purcellhospital.com/patient-info/ X https://purcellhospital.com/patient-info/ X X X X X X 1 X 0 X X X X 1 X 0 0 Purcell Municipal Hospital Part V, Section B, Line 5: A survey ran from April 2, 2019 to April 16, 2019. Community meetings were held on April 2, 16 and April 30, 2019. Attendees were from Purcell Schools, McClain Bank, Purcell Municipal Hospital, Glenn A. Mead DDS, OSU Extension office, City of Purcell, Edward Jones Investments, HealthBack, Wadley's Funeral, Wadley's EMS, Lexington Nursing Home, Farmers Insurance, Mid America Tech Center, Therapy in Motion, Rob's Ranch for Men/Addiction Treatment, and Purcell Register (newspaper). Purcell Municipal Hospital Part V, Section B, Line 6b: Oklahoma Office of Rural Health and OSU Center for Rural Health Purcell Municipal Hospital Part V, Section B, Line 11: A Community Health Needs Assessment was completed in FY2019. Access to primary care including increasing the number of providers was the need identified.The hospital is moving forward with a new facility and there will also be a physician's building on the grounds. Groundbreaking ceremony was held March 2, 2020. The new hospital and physician's building will aid in the recruitment of physicians and specialists. Extended clinic hours will allow greater access for all individuals in the community. Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. Part I, Ln 7 Col(f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $3,832,582. Part III, Line 2: Accounts are not written off to bad debt until all payments, discounts and contractual allowances are applied and internal collection efforts have been exhausted. When a payment is received on an account previously written off to bad debt, the payment reduces the current year's bad debt expense. Part III, Line 3: The amount of bad debt estimated to be attributable to patients under the Organization's charity care policy is 17.8%. This was determined by using the percentage of the population in the service area that is under the federal poverty guideline established for charity care. Part III, Line 4: Footnote from organization's financial statements: The footnote that describes bad debt expense is found on page 13 and 14 of the attached audit report. Part III, Line 8: Total revenue received from Medicare (including DSH and IME) is the gross reimbursement plus settlement (including LSA). Both the total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.Hospital services reimbursed on a fee schedule are not included in the Medicare calculation per the 990 instructions. Had this been reported the total loss from Medicare services would have been ($121,562).Medicare fee schedule revenue $ 210,373Medicare estimated costs of care relating to payments (331,935)Net (Shortage) $ (121,562) Part III, Line 9b: Purcell Municipal Hospital will not impose extraordinary collection actions such as wage garnishments or other legal actions for any patient without first making reasonable efforts to determine whether that patient is eligible for financial assistance under the policy. Collection efforts will cease for patients that are in the process of applying for financial assistance. Once there is a determination of financial assistance, any personal portion due would follow normal collection procedures. Part VI, Line 2: In addition to our Community Health Needs Assessment statistical analysis of public data, specifically community out-migration data is analyzed to determine unmet community needs. Constituents vocalize directly to hospital employees, administration, and governing board their desires for services to be rendered locally. Physicians with admitting privileges at PMH communicate to the governing board and administration any unmet patient needs. Part VI, Line 3: Patients are informed and educated about the Financial Assistance policy at PMH during the admission process and during any post-discharge financial counseling. Patients are advised about their potential eligibility for state, federal and local assistance during the same process. Communication about the Hospital's financial assistance program is publicized on the Hospital's website and through various postings throughout the hospital. Program information includes a contact phone number and is written in the primary language spoken by the community's population. A request for financial assistance may be made by the patient or a family member. Part VI, Line 4: Purcell Municipal Hospital (PMH) is a 39-bed acute care hospital located in the City of Purcell, Oklahoma. The Hospital is leased from the City of Purcell, Oklahoma to the Purcell Public Works Authority. PMH serves patients from central and southern McClain County, northern and western Garvin County, and western Pontotoc County. The Hospital serves a significant undocumented patient base serving the agriculture and equine industries.Purcell and McClain County of Oklahoma have been deemed a medically underserved area (MUA) by the U.S. Department of Health and Human Services through the health resources and services administration.Purcell, Oklahoma has a population of 6,420 with a median household income of $53,155 and the poverty rate is at 17.8%. The economy is specialized in mining, quarrying, oil, gas extraction; construction; and public administration. Part VI, Line 5: Purcell Municipal Hospital is governed by a 6-person board appointed by the trustees of the Purcell Public Works Authority for a 4-year term of office. The attendance of the Chief of Medical Staff (ex-officio and non-voting) and the Chief Executive Officer (ex-officio and non-voting) at the monthly board meetings are required by the Hospital's by-laws. Each meeting is open to the public and adheres to the guidelines set forth in the Oklahoma Open Meetings Act. A one-cent sales tax increase was earmarked for Purcell Municipal Hospital on January 1, 2017. The sales tax increase will help generate needed revenue to meet operational expenses at the Hospital. The sales tax will remain in effect for three years. An election was held in August 2018 and a continuation of the one cent sales tax for 20 additional years was passed.The PMH medical staff is open to all community physicians that meet the medical staff by-law criterion for the desired privileging level.The Hospital is the sole provider in the community. Health screenings are conducted throughout the year.We are a sole community provider. We have an Auxiliary Gift Shop that is staffed by volunteers. CPR certification is provided to our healthcare employees located in patient care areas. We participate in the Community Needs Assessment. We offer outpatient cataract surgery so that our aging community doesn't have to travel a greater distance for this service. We also have an endoscopy department that provides the patients with the choice of having their needed screenings locally rather than having to travel to another facility at a greater distance. We also have a clinic that is able to offer a less expensive alternative for minor emergencies rather than the more expensive Emergency Department. This has been received well by the community. We also rent out a space to specialist such as cardiologist, eyes, ortho, urologist and other specialties so that our community and surrounding areas may have easier access to this much needed health care. Part VI, Line 7, Reports Filed With States OK X X 0 0 0 0 0 0 0 0 0 Kem Scully CEO 136584 0 0 0 0 0 0 0 22817 0 159401 0 0 0 Brittany Scully Daughter-in-law to CEO 89940 Employee compensation and benefits 0 Susie Thrash Daughter to CFO 34838 Employee compensation and benefits 0 Brad Scully Son of CEO 65323 Employee compensation and benefits 0 Form 990, Part III, line 3 The Clinic's extended hours ceased operations on April 30, 2020. Care continued for walk-ins during normal weekday business hours. Form 990, Part VI, Section A, line 7a All Board members are approved and appointed by Purcell Public Works Authority. Form 990, Part VI, Section A, line 7b No member of the Board shall, without the prior written consent of Purcell Public Works Authority: (a) Enter into any contract with the Board or the Authority relating in any manner to the Hospital; or (b) Profit in any manner, directly or indirectly, by reason of membership on the Board; or (c) Be eligible for employment by the Board or the Authority within two years after expiration of the term for which such member was appointed. Form 990, Part VI, Section A, line 8b No committees are able to act on behalf of the board. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the Board of Directors prior to filing. The CEO & CFO review the 990 with the Hospital's auditor to ensure its accuracy. Form 990, Part VI, Section B, line 12c At the beginning of each calendar year, board members and officers are required to complete a conflict of interest statement and disclose all possible conflicts of interest. These are reviewed and if a conflict arises the board member with the conflict would not vote on the matter and may be asked to leave the meeting. If the agenda to be voted on concerns SSM and the affiliation, the SSM Member will not vote. Form 990, Part VI, Section B, line 15a Compensation for the CEO is reviewed annually and determined by the Board of Directors. Multiple resources are used as comparable data. Wage comparisons reported by the Oklahoma Hospital Association are used most often. These comparisons use various criteria including bed size, number of employees and revenue category. The process is documented in the personnel file and compensation is reported in the Board minutes. Compensation for the CFO is reviewed annually and determined by the CEO. The review is shared with the Board of Directors but the Board does not determine the compensation. Wage comparisons are used similar to the determination for the CEO. The process is documented in the personnel file. Form 990, Part VI, Section C, line 19 Any governing document, conflict of interest statement, and financial statements are available to the public upon request. Form 990, Part IX, line 11g Contracted Services: Program service expenses 1,671,983. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,671,983. Other Purchased: Program service expenses 318,856. Management and general expenses 248,044. Fundraising expenses 0. Total expenses 566,900. Collection Service: Program service expenses 0. Management and general expenses 278,840. Fundraising expenses 0. Total expenses 278,840. Purcell Municipal Hospital Foundation Inc 1500 North Green Ave Purcell OK 73080 731528938 Support Purcell Municipal Hospital OK 501(c)(3) Line 12a, I Purcell Municipal Hospital 1 Purcell Public Works Authority 230 West Main Street Purcell OK 73080 736005387 Lessor of Purcell Municipal Hospital OK N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0