2020-07-14T12:45:29-05:00 2019-06-30 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2018-07-01 430715842 GENERAL JOHN J PERSHING MEMORIAL HOSPITAL ASSOCIATION % GARY TANDY CFO GENE 6602581288 130 E LOCKLING PO BOX 408 BROOKFIELD MO 64628 PHIL HAMILTON CEO 6602582222 2020-07-15 true Michael J Engle P00482834 8162216300 167.68.126.162 43372220201965000115 2020-07-14 P B144830DC55092E8AD143C17330E778E1DD7CB33 C3C6DD2B6E9CEB5587735CB2BC18A5C965BB9C50 2018 2021-01-29 14:40:06Z PHIL HAMILTON 130 E LOCKLING PO BOX 408 BROOKFIELD MO 64628 17975582 false X WWW.PHSMO.ORG/ X 1955 MO SERVING OTHERS THROUGH QUALITY, COMPASSIONATE CARE. 10 8 182 24 0 30960 10724 17836441 17761653 122382 124089 76248 79116 18066031 17975582 8642 8628 0 0 8661436 9072281 0 0 0 9631714 10098198 18301792 19179107 -235761 -1203525 18100023 17680233 6562200 7345935 11537823 10334298 SERVING OTHERS THROUGH QUALITY, COMPASSIONATE CARE. false false 1999835 1122 2309015 INPATIENT ACUTE CARE SERVICES WITH 199 INPATIENT ADMISSIONS. 11845178 6643 13676473 OUTPATIENT SERVICES WITH APPROXIMATELY 18,722 REGISTRATIONS. THIS INCLUDES 4,500 EMERGENCY ROOM VISITS. 1538334 863 1776165 COMMUNITY MEDICAL ASSOCIATES, ONE OF OUR 3 PROVIDER BASED RURAL HEALTH CLINICS, WITH BOTH SCHEDULED AND WALK-IN SERVICES IS OPEN 8 HOURS A DAY MONDAY THRU SATURDAY AND 5 HOURS ON SUNDAY. IT HAD 9,073 VISITS THIS PAST FISCAL YEAR. IT IS A LOWER COST ALTERNATIVE THAN USING THE EMERGENCY ROOM. APPLEGATE MEDICAL GROUP SAW 5,850 PATIENTS, OPEN 5 DAYS A WEEK AND MEADVILLE MEDICAL CENTER IS OPEN 3 DAYS A WEEK AND SAW 1,529 PATIENTS. 15383347 true true false true false false false false false false true false false false false false true false false false false false false false false false true true false false true false false false false false false true false false false false false false false false false false true 54 0 true 182 true false false false false false false false false false false X 10 8 false true false false true true true true true false false false true true true true true true false false MO X GARY TANDY CFO 6602582222 130 E LOCKLING PO BOX 408 BROOKFIELD MO 64628 X JIM ELLIOTT DIRECTOR/VICE PRESIDENT 1.0 0.0 X X 0 0 0 MARK CLEVELAND DIRECTOR 1.0 0.0 X 0 0 0 GARY ROUTLEDGE DIRECTOR 1.0 0.0 X 0 0 0 JOE SMITH DIRECTOR 1.0 0.0 X 0 0 0 BRIAN WINN DIRECTOR 1.0 0.0 X 0 0 0 DAVID SHAW DIRECTOR/SECRETARY 1.0 0.0 X X 0 0 0 WILLIAM THUDIUM DIRECTOR/PRESIDENT 1.0 0.0 X X 0 0 0 GAIL TURNER DIRECTOR/TREASURER 1.0 0.0 X X 0 0 0 PAUL WILLIAMS DO DIRECTOR 1.0 0.0 X 0 0 0 TOD T SYLVARA DO DIRECTOR/CONTRACTED PHYSICIAN 3.0 0.0 X 24120 0 0 PHIL HAMILTON CEO 40.0 0.0 X 176112 0 18165 GARY TANDY CFO 40.0 0.0 X 118002 0 13901 BRIAN CASEBOLT DIRECTOR OF PHARMACY 40.0 0.0 X 130838 0 33870 KENDAL GENO EMPLOYED PHYSICIAN 40.0 0.0 X 281729 0 36064 KARLA CLUBINE NURSE PRACTITIONER 40.0 0.0 X 110068 0 33243 SISENARDO GALVEZ EMPLOYED PHYSICIAN 36.0 0.0 X 188676 0 1353 GARY FITE DIRECTOR OF PHYSICAL THERAPY 40.0 0.0 X 130592 0 23178 1160137 0 159774 6 false true true AMN WORKFORCE SOLUTIONS LLC PO BOX 8559 ATLANTA GA 303740490 STAFFING COMPANY 142923 BKD LLP 1201 WALNUT STE 1700 KANSAS CITY MO 641062246 AUDIT AND CONSULTING 121959 BOONE HOSPITAL 1600 E BROADWAY COLUMBIA MO 65201 MANAGEMENT 272185 DOCS WHO CARE PA 800 W FRONTIER LANE OLATHE KS 66061 PHYSICIAN STAFFING 1553818 HAVE A NICE DAY ANESTHESIA ASSOCIAT 2106 WOODCREST DRIVE CHILLICOTHE MO 64601 ANESTHESIA SERVICES 182494 5 10724 7080 10724 NET PATIENT SERVICE REV 621400 16596209 16596209 340B REVENUE 900099 1165444 1165444 17761653 121734 121734 0 0 10378 10378 0 10378 10378 2355 2355 2355 2355 0 0 0 0 0 0 0 0 0 VENDING MACHINES 900099 25896 25896 CAFETERIA 900099 24941 24941 MISCELLANEOUS INCOME 900099 17901 17901 68738 17975582 17761653 203205 8628 8628 0 0 0 328183 15080 313103 79086 56151 22935 6600538 5463249 1137289 91805 76689 15116 1475547 1190025 285522 497122 394666 102456 0 11463 11463 81929 81929 0 0 0 3913887 3152266 761621 0 17614 12506 5108 1037863 704693 333170 0 0 360226 255760 104466 6643 6643 0 336 336 218568 89613 128955 0 552685 226601 326084 191840 136206 55634 BAD DEBT EXPENSE 1864355 1864355 MEDICAL SUPPLIES 1100787 1100787 MEDICAID FRA PAYMENTS 545823 545823 DUES & SUBSCRIPTIONS 116359 72854 43505 77820 17395 60425 19179107 15383347 3795760 0 0 0 8144286 6543193 0 0 3912769 4324675 0 0 0 0 73222 13354 216566 174260 277063 255359 21225456 14995325 5342646 6230131 0 0 0 0 0 0 0 0 133471 139261 18100023 17680233 1298960 1670740 0 0 0 0 0 0 0 0 0 0 5263240 5675195 0 0 0 0 6562200 7345935 X 11515823 10333034 22000 1264 0 0 11537823 10334298 18100023 17680233 -1203525 X false true X false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 5367 false false false 5367 false SCHEDULE C, PART II-B, LINE 1F FOR 2019, $5,367 OF DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION WERE USED FOR LOBBYING/ADVOCACY EXPENDITURES. 107129 107129 13765223 9115648 4649575 7353104 5879677 1473427 6230131 16111227 16111227 1864355 1864355 17975582 17314752 17314752 1864355 1864355 19179107 SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 4B PROVISION FOR UNCOLLECTIBLE ACCOUNTS $ 1,864,355 SCHEDULE D, PART XII, LINE 4B PROVISION FOR UNCOLLECTIBLE ACCOUNTS $ 1,864,355 true true X true X true X true true false true true 112766 112766 0.00650 2098098 2397916 2210864 2397916 112766 0.00650 27740 43110 4999 4999 0.00030 32739 43110 4999 0.00030 2243603 2441026 117765 0.00680 true 1864355 337597 7448961 7666260 -217299 X true true 1 1 GENERAL JOHN J PERSHING MEM HOSPITAL 130 E LOCKLING AVE PO BOX 408 BROOKFIELD MO 64628 WWW.PHSMO.ORG 198-56 X X X X COMMMUNITY MED ASSOC APPLEGATE MED GROUP MEADVILLE MED CLINIC GENERAL JOHN J PERSHING MEM HOSPITAL 1 false false true X X X X X X X X X 18 true false false true X SEE PART V, SECTION C X true 18 true SEE PART V, SECTION C false true X 100 300. X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 MANY LOCAL STAFF MEMBERS, BOARD MEMBERS, HOSPITAL AUXILIARY WERE INVOLVED IN THE CHNA PROJECT, ALONG WITH COLLABORATION WITH THE LINN COUNTY HEALTH DEPARTMENT. THE CHNA TOWN HALL MEETING HAD 38 STAKEHOLDERS AND COMMUNITY LEADERS PRESENT. SCHEDULE H, PART V, SECTION B, LINE 7A THE COMPLETE CHNA CAN BE FOUND AT: http://www.phsmo.org/Documents/chna%202019/Pershing%202019%20CHNA%20Report %20Final.pdf SCHEDULE H, PART V, SECTION B, LINE 10A THE IMPLEMENTATION STRATEGY CAN BE FOUND AT: http://www.phsmo.org/Documents/chna%202019/2019CHNA%20ImpPlan%20LinnCoMO.x lsx SCHEDULE H, PART V, SECTION B, LINE 11 MANY FACTORS DURING THE LAST THREE YEARS SINCE THE PREVIOUS 2016 COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED HAVE GONE UNCHANGED AS INDICATED BY THE MOST CURRENT 2019 COMMUNITY HEALTH NEEDS ASSESSMENT. FINDINGS INDICATED SEVERAL VULNERABILITIES IN HEALTHCARE SERVICES PROVIDED TO THE COMMUNITY AND UNFAVORABLE TRENDS IN HEALTHCARE FACTORS. UNEMPLOYMENT IS A LARGE FACTOR CONTRIBUTING TO INDIVIDUALS LACKING THE FINANCIAL CAPABILITY TO ACCESS HEALTHCARE. INCREASING RATES OF UNEMPLOYMENT WILL RAISE THE NEED FOR COMMUNITY HEALTH CENTERS AND ADDITIONAL SAFETY-NET CLINICS IN THE COUNTY. IN TERMS OF ECONOMIC STATUS, LINN COUNTY IS WORSE OFF IN RELATION TO THE REST OF MISSOURI AND THE UNITED STATES AND HAS A HIGH PERCENTAGE OF FAMILIES BELOW THE POVERTY LEVEL. ANALYZING THE VARIOUS CLASSES OF WORKERS GIVES AN IDEA AS TO THE AVAILABILITY OF HEALTH INSURANCE TO THE LABOR FORCE. THE 2016 CHNA INDICATED THAT A LARGE PERCENTAGE OF LINN COUNTY WORKERS ARE EMPLOYED IN THE EDUCATION, MANUFACTURING, AND RETAIL INDUSTRIES. THE 2016 CHNA INDICATED LINN COUNTY BOASTS A LARGER PERCENTAGE OF SELF-EMPLOYED WORKERS THAN BOTH MISSOURI AND THE UNITED STATES. HAVING A HIGH NUMBER OF SELF-EMPLOYED WORKERS COULD MEAN THAT PORTION OF THE POPULATION HAS TO PROVIDE THEIR OWN HEALTH INSURANCE AND THE INCREASINGLY HIGH PREMIUMS AND DEDUCTIBLES COULD BE A DETERRENT. SCHEDULE H, PART V, SECTION B, LINE 16A THE FAP CAN BE FOUND AT: http://www.phsmo.org/FAP_Files/2019%20Fap/Pershing%20Health%20System%20FAP %20fy%202020.docx SCHEDULE H, PART V, SECTION B, LINE 16B THE FAP APPLICATION CAN BE FOUND AT: http://www.phsmo.org/FAP_Files/FAP07012016/070616%20rev/PHS%20FAP%20applic ation%20final%20version.xlsx SCHEDULE H, PART V, SECTION B, LINE 16C THE PLAIN LANGUAGE SUMMARY CAN BE FOUND AT: http://www.phsmo.org/FAP_Files/FAP07012016/070616%20rev/PHS%20fap%20plain% 20lang%20sum,%20hosp%20&%20clinics%20final%20version.docx 3 COMMUNITY MEDICAL ASSOCIATES 130 E LOCKLING AVE BROOKFIELD MO 64628 PROVIDER BASED RURAL HEALTH CLINIC APPLEGATE MEDICAL GROUP 125 E LOCKLING AVE BROOKFIELD MO 64628 PROVIDER BASED RURAL HEALTH CLINIC MEADVILLE MEDICAL CLINIC 101 E HAYWARD MEADVILLE MO 64659 PROVIDER BASED RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 3C MEDICAL INDIGENCY, UNDERINSURANCE STATUS AND RESIDENCY ARE FACTORS USED IN ELIGIBILITY CRITERIA EXPLAINED IN THE FAP FOR PROVIDING FREE AND DISCOUNTED CARE. SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT CONTAINED IN THE TABLE OF SCHEDULE H, PART I, LINE 7 IS A COST-TO-CHARGE RATIO. SCHEDULE H, PART I, LINE 7, COLUMN F THE BAD DEBT EXPENSE INCLUDED IN FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,864,355. SCHEDULE H, PART III, SECTION A, LINE 2 THE GROSS BAD DEBT EXPENSE BEING REPORTED IS ACTUAL BAD DEBTS WRITTEN OFF PER OUR POLICY PLUS ACCRUAL OF ESTIMATES ON ACCOUNTS RECEIVABLE. OUR FINANCIAL ASSISTANCE POLICY ALLOWED FOR INDIGENT CARE DISCOUNTS. ANY PAYMENT ON A PREVIOUS BAD DEBT IS RECORDED AS A RECOVERY ON OUR BOOKS, IN A SEPARATE RECOVERY ACCOUNT. SCHEDULE H, PART III, SECTION A, LINE 3 USED THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 TIMES NET BAD DEBTS TIMES COMPUTED 30% COLLECTION SUPERVISOR'S ESTIMATE OF BAD DEBTS THAT COULD BE CHARITY IF THE PERSONS WOULD ONLY FILL OUT OUR FORMS. THIS = $1,864,355 (BAD DEBT NET OF RECOVERIES) X 30% (OR APPROXIMATELY $559,307/YEAR) ESTIMATE X 60.36% COST TO CHARGE RATIO = $337,597 SCHEDULE H, PART III, SECTION A, LINE 4 PLEASE SEE NOTE 1 OF THE ATTACHED FINANCIAL STATEMENTS FOR THE FOOTNOTE DESCRIBING THE ORGANIZATION'S BAD DEBT EXPENSE. SCHEDULE H, PART III, SECTION B, LINE 8 PERSHING MEMORIAL HOSPITAL BELIEVES THAT THE COMMUNITY DESERVES TO BE PROVIDED QUALITY HEALTHCARE LOCALLY. MEDICARE CURRENTLY REIMBURSES THE HOSPITAL LESS THAN THE COST OF THE SERVICES PROVIDED TO ITS PATIENTS. THEREFORE, PERSHING MEMORIAL HOSPITAL BELIEVES THAT THIS MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT. SCHEDULE H, PART III, SECTION C, LINE 9B OUR FINANCIAL ASSISTANCE POLICY AND COLLECTION POLICY IS APPLIED TO ALL TYPES OF PATIENTS. SCHEDULE H, PART VI, LINE 2 PERSHING IS A SMALL RURAL CRITICAL ACCESS HOSPITAL AND AS SUCH RECEIVES CONTINUOUS FEEDBACK FROM THE PATIENTS WE SERVE, OUR PHYSICIANS, OTHER MEDICAL PROVIDERS, BOARD MEMBERS (WHO REPRESENT A WIDE REPRESENTATION OF OUR COMMUNITY), AND FROM VARIOUS ONGOING PATIENT SATISFACTION SURVEYS. SUCH SURVEYS ARE REPORTED AT BOARD MEETINGS AND DISTRIBUTED TO ALL HOSPITAL DEPARTMENTS. SCHEDULE H, PART VI, LINE 3 INFORMATION ON OUR FINANCIAL ASSISTANCE POLICY (FAP) IS ON OUR WEBSITE. THE FAP, CHARITY CARE AND COLLECTION (PAYMENT ARRANGEMENTS) INFORMATION IS AVAILABLE THROUGH OUR COLLECTION PERSONNEL AND OTHERS AT PERSHING HOSPITAL AND THROUGH OUR WALK-IN CLINIC, COMMUNITY MEDICAL ASSOCIATE AT APPLEGATE MEDICAL GROUP, AND MEADVILLE MEDICAL CLINIC. FURTHER, WE PRINT A REFERENCE TO OUR FAP POLICY ON THE FRONT OF EACH PATIENT BILLING STATEMENT SENT OUT. SOCIAL SERVICES, THROUGH THE ASSESSMENT/CONSULTATION PROCESS, IDENTIFIES AND ASSISTS IN THE APPLICATION PROCESS. SCHEDULE H, PART VI, LINE 4 PERSHING HEALTH SYSTEM SERVES LINN COUNTY (POPULATION OF AROUND 13,000) AND SURROUNDING AREA. IT IS MADE UP OF RURAL COMMUNITIES WITH A MIXTURE OF BUSINESSES AND AGRICULTURE. SCHEDULE H, PART VI, LINE 5 PERSHING HEALTH SYSTEM CONSISTS OF PERSHING MEMORIAL HOSPITAL AND 3 (THREE) PROVIDER BASED RHCS: 1) APPLEGATE MEDICAL GROUP-LOCATED ACROSS THE STREET FROM THE HOSPITAL, 2) COMMUNITY MEDICAL ASSOCIATES, LOCATED WITHIN THE HOSPITAL AND OPEN 6 DAYS A WEEK AND 3) MEADVILLE MEDICAL CLINIC, 12 MILES FROM THE HOSPITAL, SERVES ONE OF THE SMALL COMMUNITIES WITHIN OUR SERVICE AREA WITH A 3 DAY A WEEK NURSE PRACTITIONER. ALL OF THE PROVIDER BASED RHC PROVIDED CLINICAL ROTATION SITE FOR MEDICAL STUDENTS AND NURSE PRACTITIONERS AND PROVIDED JOB SHADOWING AND CLINICAL ROTATIONS TO THE AREA CAREER CENTERS. THEY ALSO PROVIDED FREE SPORTS PHYSICALS/HEALTHY CHILD EXAMS FOR ALL LINN COUNTY CHILDREN BETWEEN THE AGES OF 3 AND 18 AND/OR HIGH SCHOOL SENIOR. NURSE PRACTITIONERS PROVIDE WELL CHILD EXAMS YEARLY AT THE LINN COUNTY HEALTH DEPT. COMMUNITY MEDICAL ASSOCIATES ALSO ASSISTS WITH LOCAL EMPLOYERS IN CONDUCTING BMI, BODY MEASUREMENTS, AND HEIGHT/WEIGHT ASSESMENTS TO HELP PROMOTE A HEALTHY LIFESTYLE, IN TURN, EMPLOYEES RECEIVE A REDUCTION IN INSURANCE PREMIUMS. HOSPITAL WEEK, HELD ANNUALLY, ARE DONE AT THE LOCAL (BROOKFIELD) YMCA AND AT MARCELINE BETHANY BAPTIST CHURCH: -PROCESSED BLOOD DRAWS; PHYSICAL AND OCCUPATIONAL THERAPY HEALTH BOOTH; BLOOD PRESSURE AND PULSE OXIMETRY TESTS ARE PERFORMED, PROMOTED WEB VIEW ACCESS FOR PATIENTS FROM OUR 3 RURAL HEALTH CLINICS. PROVIDED ADVANCED DIRECTIVES INFORMATIONAL PACKETS. OTHER HEALTH FAIRS AND EVENTS: -CONDUCTED FAIRS AT OTHER BUSINESSES IN OUR SERVICE AREA. TOURS: TOURS OF THE HOSPITAL WERE CONDUCTED THIS YEAR WITH AREA SCHOOLS - A ONCE A YEAR PUBLIC EVENT WHICH LETS US PROMOTE THE POSITIVE ASPECTS OF PERSHING HEALTH SYSTEM. THE HOSPITAL HELD THREE COMMUNITY SERVICES PROJECTS DURING THE YEAR. THE FIRST PROJECT WAS TO COLLECT USED EYE GLASSES FOR THE NEEDY AND DONATE TO THE LIONS CLUB. AN ESTIMATED TOTAL OF $5,000 WAS DONATED THROUGH A CLOTHING DRIVE WHICH WAS HELD FOR FOSTER CHILDREN. ALL NEEDED CLOTHING ITEMS, BEDDING ITEMS, TOILETRY ITEMS, SHOES, COATS, GLOVES AND WINTER HATS, ALONG WITH A NEEDED TOY ITEMS WERE DONATED TO EVERY FOSTER CHILD LOCATED IN THE SERVICE AREA. PERSHING DONATED 470 POUNDS OF FOOD TO THE LOCAL FOOD PANTRY. PERSHING DONATED A GIFT BASKET TO MOM BREAKING THE SILENCE BENEFIT AUCTION IN ORDER TO RAISE MONEY FOR SUICIDE AWARENESS-$500. STAFF ACTIVELY INVOLVED (AND DONATE THEIR TIME) IN MONTHLY MEETING OF THE FOLLOWING GROUPS: LINN COUNTY AREA HEALTH AND WELLBEING TASKFORCE, LINN CO C-2000, AND COMMUNITY CONNECTIONS. THE FOCUS OF ALL 3 GROUPS IS TO IMPROVE THE LIVES OF CITIZENS IN LINN CO BY ADDRESSING SUICIDE, COMMUNITY POVERTY, AND HEALTHCARE ISSUES. PERSHING SPONSORED A SUMMER FOOD SERVICE PROGRAM WHERE 200 CHILDREN WERE FED LUNCH DURING JULY AND AUGUST ~ $5,000 IN MAN HOURS. DONATIONS OF SHOWER CAPS TO LOCAL CANCER PATIENT IN NEED -$100; FOOD ITEMS TO LINN COUNTY HEALTH KIDS SUMMIT AND SERVED A HEALTHY SNACK -$150, AND VARIOUS OTHER DONATIONS. X X false false false false false false false false false PHIL HAMILTON CEO 155468 0 20644 0 0 0 3071 0 15094 0 194277 0 0 0 BRIAN CASEBOLT DIRECTOR OF PHARMACY 130838 0 0 0 0 0 2722 0 31148 0 164708 0 0 0 KENDAL GENO EMPLOYED PHYSICIAN 267390 0 0 0 14339 0 4768 0 31296 0 317793 0 0 0 SISENARDO GALVEZ EMPLOYED PHYSICIAN 188676 0 0 0 0 0 0 0 1353 0 190029 0 0 0 GARY FITE DIRECTOR OF PHYSICAL THERAPY 130592 0 0 0 0 0 2685 0 20493 0 153770 0 0 0 FORM 990, SCHEDULE J, PART II THE COMPENSATION BEING REPORTED FOR PHIL HAMILTON IS PAID BY BOONE HOSPITAL CENTER, AN UNRELATED ORGANIZATION, FOR HIS SERVICES AS CEO. SEE PART V SCHEDULE L, PART IV, LINE 1 TRANSACTION 1: A. DR. KAREN SYLVARA B. DR. KAREN SYLVARA IS A CONTRACTED PHYSICIAN OF PERSHING MEMORIAL HOSPITAL, AND IS THE SPOUSE OF TOD T. SYLVARA, WHO IS A DIRECTOR OF PERSHING MEMORIAL HOSPITAL. C. $ 37,590 D. COMPENSATION E. NO TRANSACTION 2: A. JENNIFER THUDIUM B. JENNIFER THUDIUM IS AN EMPLOYEE OF PERSHING MEMORIAL HOSPITAL, AND IS THE DAUGHTER-IN-LAW OF WILLIAM THUDIUM, WHO IS A DIRECTOR OF PERSHING MEMORIAL HOSPITAL. C. $ 41,496 D. COMPENSATION E. NO FORM 990, PART VI, SECTION A, LINE 3 PERSHING MEMORIAL HOSPITAL HAS A MANAGEMENT AGREEMENT WITH BOONE HOSPITAL FOR THE OPERATION AND MANAGEMENT OF THE HOSPITAL. THE MANAGEMENT AGREEMENT PROVIDES DAILY OPERATING AUTHORITY TO THE MANAGEMENT COMPANY AND CEO SERVICES. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE CLASS OF ASSOCIATION MEMBERSHIP. ALL MEMBERS OF THE CORPORATION ARE ENTITLED TO VOTE IN PERSON AT ALL MEETINGS OF MEMBERSHIP. THE MEETING OF MEMBERSHIP IS AN ANNUAL MEETING HELD ON THE FOURTH MONDAY IN JUNE. MEMBERS OF THIS CORPORATION HAVE THE RIGHT TO ELECT THE MEMBERS OF THE BOARD OF DIRECTORS AT THIS MEETING. MEMBERS ARE NOT ENTITLED TO RECEIVE A SHARE OF THE CORPORATIONS PROFITS, EXCESS DUES OR A SHARE OF THE CORPORATIONS NET ASSETS UPON DISSOLUTION. FORM 990, PART VI, SECTION A, LINE 7A & 7B MEMBERS OF THE CORPORATION HAVE THE RIGHT TO ELECT ALL MEMBERS OF THE BOARD OF DIRECTORS AT THE ANNUAL MEETING OF MEMBERSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE FORM 990 IS THEN REVIEWED BY OFFICERS AND ACCOUNTING PERSONNEL. ANY QUESTIONS THEY HAVE ARE ADDRESSED. THE FORM 990 IS THEN FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY AND THE CONFLICT OF INTEREST DISCLOSURE FORM AND QUESTIONNAIRE IS DISTRIBUTED ANNUALLY TO THE BOARD OF DIRECTORS AND OFFICERS. THE QUESTIONNAIRE IS COMPLETED TO IDENTIFY ANY RELATIONSHIPS, POSITIONS, OR CIRCUMSTANCES WITH RESPECT TO WHICH IT IS BELIEVED A CONFLICT MAY ARISE. IN SUCH A CASE THAT A CONFLICT OF INTEREST DOES OCCUR THE DISCLOSING INDIVIDUAL WITH THE CONFLICT OF INTEREST DOES NOT ATTEND ANY MEETINGS OR DISCUSSIONS REGARDING THE MATTER. THE DISCLOSING INDIVIDUAL DOES NOT VOTE OR ENDEAVOR TO INFLUENCE CORPORATE ACTION IN ANY SUCH MATTER. FORM 990, PART VI, SECTION B, LINE 15A & 15B THE CEO'S COMPENSATION IS INCLUDED IN THE INDEPENDENT CONTRACT FEE TO BOONE HOSPITAL. BOONE HOSPITAL DETERMINES AND PAYS HIS COMPENSATION. THE INDEPENDENT CONTRACTOR FEE IS APPROVED BY THE FILING ORGANIZATION'S BOARD OF DIRECTORS. THE CEO DETERMINES THE CFO'S COMPENSATION ANNUALLY. COMPENSATION SURVEYS ARE USED ANNUALLY TO EVALUATE COMPENSATION LEVELS. THE CEO CONDUCTS AN ANNUAL EVALUATION OF KEY MANAGEMENT STAFF. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9 NET ASSETS RELEASED FROM RESTRICTIONS 16,072 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:1908763 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:2005124