2020-07-08T12:16:43-05:00 2019-06-30 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2018-07-01 440629397 CARROLL COUNTY MEMORIAL HOSPITAL CARR 6605421695 1502 N JEFFERSON STREET CARROLLTON MO 64633 JEFF TINDLE CEO 6605421695 2020-07-02 1 MARC D BEHRENS P01543366 4023302660 163.116.133.118 2020-07-02 08:07:05 CD P 06718D1991FB6EEBEB7ECD4F00D4AA79CF05A929 606148D43A08485A4B3CE148BC63DC11C84FD005 2018 2020-11-06 18:47:13Z JEFF TINDLE 1502 N JEFFERSON STREET CARROLLTON MO 64633 31264589 0 X WWW.CARROLLCOUNTYHOSPITAL.ORG X 1957 MO CARROLL COUNTY MEMORIAL HOSPITAL IS DEDICATED TO THE HEALTH AND WELL-BEING OF ALL WE SERVE. 11 11 248 28 0 0 13939 0 32499341 30542859 157170 270500 627734 409325 33298184 31222684 11411 3028 0 0 13376856 13700285 0 0 0 19717791 18577691 33106058 32281004 192126 -1058320 41454466 38922388 18187910 16610872 23266556 22311516 CARROLL COUNTY MEMORIAL HOSPITAL IS DEDICATED TO THE HEALTH AND WELL-BEING OF ALL WE SERVE. 0 0 28956500 3028 30597509 ACUTE CARE HOSPITAL ORGANIZED TO PROVIDE INPATIENT AND OUTPATIENT CARE TO AREA RESIDENTS REGARDLESS OF THEIR ABILITY TO PAY. 28956500 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 16 0 1 248 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 0 0 X JEFF TINDLE 6605421695 1502 NORTH JEFFERSON ST CARROLLTON MO 64633 RANDALL BARRY PRESIDENT 1.00 0.00 X X 0 0 0 JUDITH DELANY VICE PRESIDENT 1.00 1.00 X X 0 0 0 KEN BROWN SECRETARY 1.00 0.00 X X 0 0 0 BEN POLEN MEMBER 1.00 0.00 X 0 0 0 REX BUHRMESTER MEMBER 1.00 0.00 X 0 0 0 DEBBIE MINNICK MEMBER 1.00 0.00 X 0 0 0 CHARLIE LOCK MEMBER 1.00 0.00 X 0 0 0 JENNIFER POSTON MEMBER 1.00 0.00 X 0 0 0 JIM GIBSON MEMBER 1.00 0.00 X 0 0 0 MATT LOCK MEMBER 1.00 0.00 X 0 0 0 TIM REID MD MEMBER 1.00 0.00 X 0 0 0 JEFF TINDLE CEO 40.00 0.00 X 275247 0 25296 AMY IRELAND CHIEF REVENUE OFFICER 40.00 0.00 X 0 0 0 RICHARD SMITH PHYSICIAN 40.00 0.00 X 479755 0 32451 ANDREW HORINE PHYSICIAN 40.00 0.00 X 386330 0 42140 PAMELA RALLS PHYSICIAN 40.00 0.00 X 379116 0 41117 TIMOTHY REID PHYSICIAN 40.00 0.00 X 285345 0 53366 GREGORY STAFFORD PHYSICIAN'S ASSISTANT 40.00 0.00 X 247546 0 30333 2053339 0 224703 11 0 1 0 CERNER CORPORATION PO BOX 959159 ST LOUIS MO 63195 SOFTWARE & CONTRACT EMPLOYEES 1730946 HCA MID AMERICA 5440 W 110TH ST STE 400 OVERLAND PARK KS 66211 MANAGEMENT SERVICES 605192 PREMIER SPECIALTY NETWORK 1835 E REPUBLIC RD SUITE 200 SPRINGFIELD MO 65804 MEDICAL SERVICES 420357 PSYCHIATRIC MEDICAL CARE PO BOX 734606 DALLAS TX 75373 MEDICAL SERVICES 323115 HAVE A NICE DAY ANESTHESIA 2106 WOODCREST DRIVE CHILLICOTHE MO 64601 MEDICAL SERVICES 246530 12 MEDICARE/MEDICAID 624100 20334864 20334864 NET PATIENT SERVICE REVENUE 624100 9403478 9403478 340B DRUG PRICING PROGRAM 624100 772820 772820 ELECTRONIC HEALTH RECORD INCENTIV 624100 31697 31697 30542859 200919 200919 85608 30958 54650 54650 54650 80528 10947 69581 69581 69581 CAFETERIA 722514 195015 195015 MISCELLANEOUS 624100 159660 159660 354675 31222684 30597509 0 625175 X 3028 3028 300543 300543 10424158 9938633 485525 502986 482838 20148 2472598 2069376 403222 292182 292182 3190 3190 6380537 5581800 798737 16489 9647 6842 771538 628842 142696 529121 459434 69687 779441 651723 127718 378391 359006 19385 701601 516384 185217 2992145 2749287 242858 67633 55816 11817 MEDICAL SUPPLIES 3727409 3727409 BAD DEBT EXPENSE 925268 925268 340(B) PHARMACY EXPENSE 348469 348469 FOOD 250535 246157 4378 413742 203383 210359 32281004 28956500 3324504 0 773 772 7826859 10188656 3670301 2775216 603842 459227 344767 431282 40386176 18560627 24366488 21825549 1633025 859184 3008411 2382502 41454466 38922388 3108168 2880393 68461 29215 14995081 13683264 16200 18000 18187910 16610872 X 22971854 21960883 294702 350633 23266556 22311516 41454466 38922388 X -1058320 47349 55931 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 8196 8196 0 PART II-B, LINE 1: THE AMOUNT OF SCHEDULE C, PART II-B, LINE 1I REPRESENTS THE LOBBYING PORTION OF DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. 268115 268115 28972373 12332090 16640283 9199394 5436003 3763391 1946294 792534 1153760 21825549 BENEFICIAL INTEREST IN FOUNDATION 300633 OTHER ACCOUNTS RECEIVABLE 151492 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 1722285 DUE FROM FOUNDATION 181081 ACCRUED INTEREST RECEIVABLE 27011 2382502 RENTAL DEPOSITS 18000 18000 X 30431654 47349 86889 134238 30297416 925268 925268 31222684 31386694 30958 30958 31355736 925268 925268 32281004 PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN TAX EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE THE HOSPITAL TO MEET A COMMUNITY BENEFIT STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. THE HOSPITAL ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ASC 740, INCOME TAXES. THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT JUNE 30, 2019 AND 2018, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS ACCRUED. 1 1 X 1 X 1 X 1 1 1 0 0 299112 0 299112 0.00950 2604331 1996697 607634 0.01940 2903443 1996697 906746 0.02890 30612 0 30612 0.00100 650063 0 650063 0.02070 4998 0 4998 0.00020 685673 685673 0.02190 3589116 1996697 1592419 0.05080 1 925268 0 13306166 13542235 -236069 X 1 1 1 1 CARROLL COUNTY MEMORIAL HOSPITAL 1502 NORTH JEFFERSON ST CARROLLTON MO 64633 210-58 X X X X PHYSICIAN CLINICS CARROLL COUNTY MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X HTTP://WWW.CARROLLCOUNTYHOSPITAL.ORG/COMMUNITY X 1 18 1 HTTP://WWW.CARROLLCOUNTYHOSPITAL.ORG/COMMUNITY 0 1 X 200.000000000000 300.000000000000 X X X X X 1 1 X X X X 1 X HTTPS://WWW.CARROLLCOUNTYHOSPITAL.ORG/PATIENTS/FINANCIAL-ASSISTANCE-POLICY X HTTPS://WWW.CARROLLCOUNTYHOSPITAL.ORG/PATIENTS/FINANCIAL-ASSISTANCE-POLICY X HTTPS://WWW.CARROLLCOUNTYHOSPITAL.ORG/PATIENTS/FINANCIAL-ASSISTANCE-POLICY X X X X X X 1 X 0 X X X X 1 X 0 0 CARROLL COUNTY MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: CARROLL COUNTY MEMORIAL HOSPITAL INTERVIEWED HOSPITAL STAKEHOLDERS, COMMUNITY LEADERS, AND BUSINESS OWNERS TO ASSESS PUBLIC PERCEPTIONS OF THE COUNTY'S HEALTH STATUS AND UNMET NEEDS. THE INFORMATION GATHERED FROM THE INTERVIEWS PLAYED AN INSTRUMENTAL PART IN THE DEVELOPMENT OF AN IMPLEMENTATION PLAN TO ADDRESS THE NEEDS OF THE COMMUNITY. CARROLL COUNTY MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: CARROLL COUNTY HAS AN IMPLEMENTATION PLAN THAT WE FOLLOW TO MEET THE NEEDS IDENTIFIED IN THE CHNA. THREE PRIORITY AREAS OF SIGNIFICANT NEED WERE IDENTIFIED: MENTAL HEALTH (YOUTH AND ADULT), LIFESTYLE BEHAVIORS, AND ACCESS TO CARE. EACH OF THESE WERE ADDRESSED IN THE IMPLEMENTATION STRATEGY.IT SHOULD BE NOTED THAT IN ANY CASE OF PRIORITIZATION, THERE WOULD ALSO BE SOME AREAS OF NEEDS THAT ARE IDENTIFIED BUT NOT CHOSEN AS A PRIORITY. IF THE OPPORTUNITY ARISES, WE WILL TRY TO INTEGRATE OTHER AREAS OF NEED INTO THE PLAN. INSTEAD OF DIRECTLY ADDRESSING INDIVIDUAL CHRONIC HEALTH CONDITIONS SUCH AS CANCER, HEART DISEASE, AND OBESITY; THE DECISION WAS MADE TO ADDRESS HEALTHY LIFESTYLE BEHAVIORS. RESEARCH HAS SUGGESTED THAT MODIFICATION OF LIFESTYLE BEHAVIORS CAN IMPACT CHRONIC HEALTH CONDITIONS. INCREASED AWARENESS OF THE BENEFIT OF HEALTHY LIFESTYLES TO PREVENT CHRONIC DISEASES IS AN AREA FOR CONTINUED EMPHASIS. ANOTHER CRITICAL AREA RELATED TO CHRONIC HEALTH CONDITIONS IS ASSISTING INDIVIDUALS WITH CHRONIC HEALTH ISSUES LEARN TO MANAGE THEIR CONDITION AND MAINTAIN OPTIMUM HEALTH. IDEALLY, BETTER MANAGEMENT DECREASES HOSPITALIZATIONS AND EMERGENCY ROOM VISITS DUE TO CHRONIC HEALTH CONDITIONS. 4 1 - JEFFERSON MEDICAL GROUP 1502 N JEFFERSON CARROLLTON MO 64633 HOME HEALTH AGENCY 2 - JEFFERSON MEDICAL GROUP - NORBORNE 105 EAST 2ND STREET NORBONNE MO 64668 RURAL HEALTH CLINIC 3 - JEFFERSON MEDICAL GROUP - HALE 321 ELM STREET HALE MO 64643 RURAL HEALTH CLINIC 4 - CCMH HOME HEALTH 1502 N JEFFERSON CARROLLTON MO 64633 HOME HEALTH AGENCY PART I, LINE 3C: DISCOUNTED OR FREE CARE IS BASED OFF OF 200% OF FEDERAL POVERTY GUIDELINES. ALSO, IN CATASTROPHIC MEDICAL CASES WHERE THE PATIENTS MEDICAL BILLS EXCEED 20% OF THEIR GROSS INCOME, PLUS ASSETS FOR THE YEAR. PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2. PART I, LINE 7G: NO PHYSICAN CLINIC COSTS ARE INCLUDED. PART I, LN 7 COL(F): THE AMOUNT OF 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 $925,268. PART III, LINE 2: PATIENT ACCOUNTS MEETING THE REQUIREMENTS TO QUALITY FOR BAD DEBT ARE WRITTEN OFF TO BAD DEBT AND SENT TO A THIRD PARTY COLLECTION AGENCY. THE AMOUNT OF BAD DEBT IS ROUTED TO A SPECIFIC GL ACCOUNT. DISCOUNTS AND PATIENT PAYMENTS APPLIED TO ACCOUNTS IN BAD DEBT ARE RECORDED THROUGH BAD DEBT ADJUSTMENTS IN ORDER TO RECONCILE THE BAD DEBT AMOUNT ACCORDINGLY. PART III, LINE 3: THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE IS BASED ON SELF-PAY ONLY PATIENTS COVERED BY MEDICAID HMOS AND THE PERCENT OF THE ELIGIBLE MEDICAID AND MEDICAID HMO PATIENTS DIVIDED BY TOTAL BAD DEBT, THIS PERCENTAGE IS THEN MULTIPLIED BY SELF-PAY PATIENTS (PRIM HEALTH PLAN). THE TWO ESTIMATES ARE THEM COMBINED. PART III, LINE 4: THE HOSPITAL'S FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT. HOWEVER, PAGES 8 AND 10 OF THE ATTACHED FINANCIAL STATEMENTS INCLUDE FOOTNOTES TITLED "PATIENT RECEIVABLES, NET," "NET PATIENT SERVICE REVENUE AND "CHARITY CARE". PART III, LINE 8: CCMH BELIEVES THAT MEDICARE SHORTFALLS SHOULD QUALIFY AS A COMMUNITY BENEFIT COST IF THE MEDICARE BENEFICIARY IS INDIGENT. PART III, LINE 9B: EACH PATIENT IS PROVIDED WITH PAYMENT INFORMATION IN CLEAR, EASY-TO-UNDERSTAND LANGUAGE. CCMH CHECKS ON PUBLIC-ASSISTANCE PROGRAMS TO SEE IF THE PATIENT QUALIFIES. THE HOSPITAL OFFERS DISCOUNTS ON CHARGES TO UNDERINSURED PATIENTS WHEN POSSIBLE. PART VI, LINE 2: CARROLL COUNTY MEMORIAL HOSPITAL RELIES ON INTERACTION WITH LOCAL CARE AGENCIES AS WELL AS FEEDBACK FROM PATIENTS AND PRIMARY SERVICE AREA RESIDENTS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY. PART VI, LINE 3: CARROLL COUNTY MEMORIAL HOSPITAL PROVIDES EACH PATIENT WITH A LETTER THAN CLEARLY STATES PAYMENT INFORMATION IN AN EASY-TO-UNDERSTAND LANGUAGE. THE HOSPITAL INFORMS PATIENTS PROMPTLY ABOUT THE CHARGE FOR ANY ITEM OF SERVICE PROVIDED. THE LETTER INFORMS THE PATIENTS THAT IF THEY ARE NOT ABLE TO PAY THEIR HOSPITAL BILL THERE ARE PROGRAMS THAT MAY HELP ALLEVIATE THE BURDEN. IF THE HOSPITAL IS PROMPTED IT WILL CHECK FOR PUBLIC-ASSISTANCE OR CHARITY CARE PROGRAMS TO SEE IF THE PATIENT QUALIFIES. PART VI, LINE 4: CARROLL COUNTY MEMORIAL HOSPITAL IS LOCATED IN CARROLLTON, MISSOURI. THE HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF CARROLLTON AND THE SURROUNDING AREAS OF CARROLL COUNTY. CARROLL COUNTY MEMORIAL HOSPITAL OPERATES TWO SATELLITE CLINICS LOCATED IN HALE AND NORBORNE. CARROLL COUNTY HAS A POPULATION OF APPROXIMATELY 8,909 RESIDENTS, WITH 35.5% OF THE RESIDENTS LIVING IN URBAN AREAS AND 64.5% LIVING IN RURAL AREAS. THE MEDIAN ANNUAL HOUSEHOLD INCOME FOR CARROLL COUNTY IS APPROXIMATELY $43,583. PART VI, LINE 6: IN 2014, CCMH REACHED A MANAGEMENT AGREEMENT WITH HCA MIDWEST HEALTH SYSTEM. THIS STRATEGIC PARTNERSHIP MEANS CCMH - THE COMMUNITY'S PREMIER HEALTHCARE PROVIDER - WILL HAVE GREATER ACCESS TO RESOURCES, ADVANCED TECHNOLOGY AND SERVICES THAT MIGHT NOT OTHERWISE BE AVAILABLE. PATIENTS AND THEIR FAMILIES WHO ENTRUST CARE TO US WILL BENEFIT FROM BEST PRACTICES, POLICIES AND PROCEDURES, TOOLKITS, PROTOCOLS, TRAINING AND MORE. MOST IMPORTANTLY, THIS AGREEMENT WITH HCA MIDWEST HEALTH SYSTEM ALIGNS WITH CCMH'S COMMITMENT TO PROVIDE HIGH-QUALITY, COMPASSIONATE AND INNOVATIVE CARE TO THE COMMUNITY.AS THE REGION'S LEADING HEALTHCARE PROVIDER, HCAM MIDWEST HEALTH SYSTEM IS COMMITTEE TO THE COMMUNITIES IT SERVES. IT HAS SIX ACUTE CARE HOSPITALS, ONE PSYCHIATRIC HOSPITAL, FOUR CRITICAL ACCESS HOSPITALS (INCLUDING CCMH), SIX SURGERY CENTERS, 10 URGENT CARE LOCATIONS, MORE THN 30 PRIMARY CAR LOCATIONS, 2,100 PHYSICIANS AND HEALTHCARE PROVIDERS AND 9,000 SUPPORTING TEAM MEMBERS.IN ADDITION TO SOLIDIFYING CCMH'S LONGSTANDING MISSION, VISION AND CORE VALUES OF BEING A TRUSTED COMMUNITY HEALTHCARE PARTNER, THE HCA AGREEMENT MEANS:- STAFF REMAINS CCMH EMPLOYEES- PATIENTS WILL HAVE ACCESS TO THEIR SAME CCMH PHYSICIANS- OPPORTUNITY TO BRING SPECIALTY PHYSICIANS TO THE COMMUNITY THROUGH ONSIDE CLINICS AND TELEMEDICINE SO EMPLOYEES AND PATIENTS HAVE INCREASED ACCESS TO MORE CARE OPTIONS WITHOUT LEAVING THE COMMUNITY.- IF A PATIENT DOES REQUIRE HIGHER-LEVEL CARE, TRANSFER TO AN HCA FACILITY WILL BE SEAMLESS WITH THE GOAL TO RETURN THE PATIENT BACK TO THE COMMUNITY HOSPITAL AS SOON AS POSSIBLE FOR POST-ACUTE AND FOLLOW-UP CARE. - THE CCMH HOSPITAL BOARD WILL REMAIN IN COMPLETE CONTROL OF LEADERSHIP AND MANAGEMENT DECISIONS. PART VI, LINE 7, REPORTS FILED WITH STATES MO X 1 1 X X 0 0 0 1 0 0 0 0 0 JEFF TINDLE CEO 275247 0 0 0 0 0 7501 0 17795 0 300543 0 0 0 RICHARD SMITH PHYSICIAN 413130 0 66625 0 0 0 22000 0 10451 0 512206 0 0 0 ANDREW HORINE PHYSICIAN 341596 0 44734 0 0 0 22000 0 20140 0 428470 0 0 0 PAMELA RALLS PHYSICIAN 347023 0 32093 0 0 0 22000 0 19117 0 420233 0 0 0 TIMOTHY REID PHYSICIAN 241708 0 43637 0 0 0 22000 0 31366 0 338711 0 0 0 GREGORY STAFFORD PHYSICIAN'S ASSISTANT 224769 0 22777 0 0 0 19882 0 10451 0 277879 0 0 0 PART I, LINE 1A COUNTRY CLUB MEMBERSHIP DUES ARE PAID FOR JEFFREY TINDLE. THE MEMBERSHIPS WERE USED ONLY FOR BUSINESS PURPOSES. THEREFORE, THE AMOUNT OF DUES WAS NOT INCLUDED IN HIS W-2. PART I, LINE 5 A PORTION OF PHYSICIAN COMPENSATION WAS CALCULATED QUARTERLY USING A PERCENTAGE OF REIMBURSEMENT. FORM 990, PART VI, SECTION A, LINE 3 HOSPITAL CORPORATION OF AMERICA (HCA), AN UNRELATED ORGANIZATION, SUPPLIES THE CEO AS PART OF A MANAGEMENT AGREEMENT. ALL COMPONENTS OF THAT COMPENSATION ARE REIMBURSED BY CARROLL COUNTY MEMORIAL HOSPITAL TO HCA. FORM 990, PART VI, SECTION B, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL. ANY QUESTIONS AND CONCERNS THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE FORM 990 WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD SETS POLICY AND ADMINISTRATION IS CHARGED WITH ASSURING THAT COMPLIANCE IN MAINTAINED. CONFLICT OF INTEREST IS REVIEWED ANNUALLY AND EACH BOARD MEMBER SIGNS A CONFLICT OF INTEREST DISCLOSURE FORM. IF A CONFLICT ARISES THE CONFLICTED PERSON DOES NOT TAKE PART IN THE VOTE ON THE ISSUE. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD CONDUCTS AN ANNUAL SALARY REVIEW FOR THE CEO, WITH PARTICIPATION FROM HCA. HCA PROVIDES SALARY RECOMMENDATIONS. THE BOARD APPROVES THE AMOUNT OF COMPENSATION. THE LAST REVIEW WAS CONDUCTED IN 2019. ALL OTHER MANAGEMENT POSITIONS ARE HIRED, REVIEWED, AND MONITORED BY THE CEO AND LEADERSHIP TEAM. COMPENSATION REVIEWS OCCUR ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PHARMACY EXPENSE: PROGRAM SERVICE EXPENSES 954,971. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 954,971. MEDICAID ADMINISTRATION: PROGRAM SERVICE EXPENSES 760,462. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 760,462. OTHER CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 3,866,367. MANAGEMENT AND GENERAL EXPENSES 798,737. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,665,104. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST OF FOUNDATION 55,931. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. CARROLL COUNTY MEMORIAL HOSPITAL FDN 1502 N JEFFERSON ST CARROLLTON MO 64633 463696048 SUPPORT MO 501(C)(3) LINE 7 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0