2018-05-29T14:10:07-05:00 2017-12-31 430352985 KERBER ECK & BRAECKEL LLP 3266 LEXINGTON AVE CAPE GIRARDEAU MO 637012609 990 2017-01-01 430926316 INDEPENDENCE HEALTH SYSTEM INC INDE 5735476546 800 SOUTH KINGSHIGHWAY PERRYVILLE MO 63775 BONNIE SCHNURBUSCH ADMINISTRATOR/CEO 5735476546 2018-05-12 true NANCY S LEGRAND CPA P00066956 5733340568 2018-05-21 2017 2022-09-23 18:48:47Z BONNIE SCHNURBUSCH 800 S KINGSHIGHWAY PERRYVILLE MO 63775 9383809 false X WWW.INDEPENDENCEHEALTHSYSTEM.ORG X 1969 MO TO PROVIDE THE ELDERLY WITH RETIREMENT & HEALTH CARE SERVICES DEDICATED TO EXCELLENCE, IN AN ENVIRONMENT WHICH PROMOTES LIVING WITH DIGNITY, SECURITY & INDEPENDENCE. 9 9 250 30 0 16400 18385 9117143 9101302 37807 192253 71098 71869 9242448 9383809 0 0 3957810 4064457 0 0 3810340 3790160 7768150 7854617 1474298 1529192 13416726 14800505 5794706 5415107 7622020 9385398 TO PROVIDE THE ELDERLY WITH RETIREMENT AND HEALTH CARE SERVICES WHICH ARE DEDICATED TO EXCELLLENCE, IN AN ENVIRONMENT WHICH PROMOTES LIVING WITH DIGINITY, SECURITY AND INDEPENDENCE. false false 9101302 PROVIDED LONG TERM CARE FOR THE ELDERLY AT VARIOUS STAGES: SKILLED NURSING FACILITY, 123 LICENSED BEDS; RESIDENTIAL CARE, 95 LICENSED BEDS; INDEPENDENT LIVING, TWO COTTAGES AND THREE DUPLEXES. ACCEPT MEDICARE, MEDICAID, AND PRIVATE PAY WHERE APPLICABLE. 6536475 6536475 6536475 true true false false false false false false false true true false false true false false true false false false false false false false false false false false false true true false false false false false false false false false false false false false false false false false false false true 31 0 true 250 true false false false false false false false false false false false false X 9 9 true true false false false false false true true false false true true true true true true true false false X BONNIE SCHNURBUSCH 5735476546 800 S KINGSHIGHWAY PERRYVILLE MO 63775 EDWARD WELKER BOARD MEMBER 1.00 X 0 0 0 PATTY WICHERN VICE PRESIDE 1.50 X X 0 0 0 DON PALISCH BOARD MEMBER 1.00 X 0 0 0 VIDA YAMNITZ BOARD MEMBER 1.00 X 0 0 0 PAT LUEHRS BOARD MEMBER 1.00 X 0 0 0 JENNIFER STREILER BOARD MEMBER 1.00 X 0 0 0 JUDITH ERNST SECRETARY / 1.50 X X 0 0 0 BRIAN DREYER PRESIDENT 1.50 X X 0 0 0 TERRI GREEN BOARD MEMBER 1.00 X 0 0 0 TAMMY HANNERS ACCOUNTANT/C 40.00 X 65000 0 0 BONNIE SCHNURBUSCH ADMINISTRATO 40.00 X 0 0 0 65000 false false true REHAB CARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 THERAPY SERVICE 456559 PERRY COUNTY HEALTH SYSTEMS 434 NORTH WEST STREET PERRYVILLE MO 63775 MANAGEMENT FEE 246961 TYCO SIMPLEX GRINNELL 11360 LACKLAND RD ST LOUIS MO 63146 CONSTRUCTION 194942 PRESCRIPTION PLUS LTC 212 HOSPITAL LANE SUITE 103 PERRYVILLE MO 63775 PRESCRIPTION 135965 4 18385 18385 ROOM AND BOARD 623000 9101302 9101302 9101302 192253 192253 BEAUTY & BARBER SHOP 812900 33256 33256 EMPLOYEE & GUEST MEALS 900099 21714 21714 MAINTENANCE FEES 722513 16752 16752 147 147 71869 9383809 9101302 264122 3449402 2937128 512274 371527 316351 55176 243528 207361 36167 248852 138859 109993 6483 6483 44359 44359 580378 580378 17687 9869 7818 87261 48692 38569 349114 194806 154308 11434 6380 5054 245099 245099 318493 286644 31849 193607 108033 85574 NFRA FEES 558143 558143 FOOD 440718 440718 SUPPLIES 313031 174671 138360 REPAIR & MAINTENANCE 156593 87379 69214 218908 195964 22944 7854617 6536475 1318142 0 18000 18159 6762636 4950698 475789 568376 44732 44187 33401 34863 13313477 10169277 3055267 3144200 2212268 5234928 814633 805094 13416726 14800505 611780 575769 99525 99525 5083401 4739813 5794706 5415107 X 7622020 9385398 7622020 9385398 13416726 14800505 1529192 234186 X false true X true false X 30160 20135 17863 16400 18385 102943 8271853 9050975 8653327 9188241 9173171 44337567 8302013 9071110 8671190 9204641 9191556 44440510 44440510 32323 21368 28103 37807 192253 311854 32323 21368 28103 37807 192253 311854 8334336 9092478 8699293 9242448 9383809 44752364 0.99300 0.99630 0.01000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 814633 644814 -5575 648779 805094 805900 583124 15209 589600 814633 808893 593783 596776 805900 811362 585015 10269 597753 808893 814911 580672 9969 594190 811362 1.00000 false false 254200 254200 11883367 9395269 2488098 1175910 774008 401902 3144200 BOND PURCHASE 805094 805094 9595527 234186 234186 9361341 22468 22468 9383809 7832149 7832149 22468 22468 7854617 SCHEDULE D, PAGE 2, PART V, LINE 4 THE ENDOWMENT FUNDS ARE TO BE USED FOR BOND PAYMENTS. SCHEDULE D, PAGE 4, PART XI, LINE 4B BAD DEBT EXPENSE 22,468 MISCLASSIFIED REVENUE 0 SCHEDULE D, PAGE 4, PART XII, LINE 4B BAD DEBT EXPENSE 22,468 MISCLASSIFIED REVENUE 0 SCHEDULE D, PAGE 4, PART XIII MANAGEMENT HAS EVALUATED THEIR TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. X true true X false false false false false false false false false BONNIE SCHNURBUSCH ADMINISTRATOR/CEO SCHEDULE J, PAGE 1, PART I, LINE 1A BONNIE SCHUNURBUSCH RECEIVED PAYMENT OF COUNTRY CLUB DUES WHICH WERE CONSIDERED NON-TAXABLE. THE MEMBERSHIP IS USED AS A MARKETING TOOL FOR THE ADMINISTRATOR AND CONSIDERED 100% BUSINESS USE. SCHEDULE J, PART III FORM 990, PART VII, LINE 5 INDEPENDENCE HEALTH SYSTEM, INC. PAYS PERRY COUNTY HEALTH SYSTEMS 246,961, WHICH INCLUDE THE USE OF BONNIE SCHNURBUSCH AS THEIR EXECUTIVE DIRECTOR. A PERRY COUNTY MISSOURI 434002739 71459EAT3 2008-03-01 7525000 REFUNDING 1996B, 1997B, 1998B true false false A 2720000 4805000 7525000 604352 65187 6792729 2008 true false true true A false false false false false false false A false true true true false false false false false A false SCHEDULE K - DATE REBATE COMPUTATION PERFORMED PERRY COUNTY, MISSOURI 03/12/18 FORM 990, PAGE 6, PART VI, LINE 2 JUDY ERNST BRIAN DREYER BOARD MEMBER BOARD MEMBER BUSINESS RELATIONSHIP BONNIE SCHNURBUSCH BRIAN DREYER CEO BOARD MEMBER BUSINESS RELATIONSHIP FORM 990, PAGE 6, PART VI, LINE 3 THE ORGANIZATION OPERATES UNDER AN ANNUAL MANAGEMENT AGREEMENT WITH PERRY COUNTY MEMORIAL HOSPITAL, AN UNRELATED ENTITY. THE HOSPITAL IS RESPONSIBLE FOR THE GENERAL SUPERVISION AND MANAGEMENT OF THE DAILY OPERATION OF THE ORGANIZATION, AS WELL AS PROVIDING THE SERVICES OF THE ORGANIZATION'S ADMINISTRATOR. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS REVIEWED BY THE CEO AND CFO WITH THE PREPARER AND PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING. FORM 990, PAGE 6, PART VI, LINE 12C A LETTER AND QUESTIONNAIRE CONCERNING THE POSSIBILITY OF CONFLICTS OF INTEREST IS SENT TO EACH MEMBER OF THE BOARD OF DIRECTORS, THE CEO, AND THE CFO. A LETTER PERTAINING TO CONFLICTS OF INTEREST IS SIGNED BY EACH DEPARTMENT HEAD, RESPONSES ARE REVIEWED BY THE HR DIRECTOR, CFO, AND CEO, DEPENDING ON WHETHER IT IS A BOARD OF DIRECTOR MEMBER OR DEPARTMENT HEAD. BOARD OF DIRECTOR MEMBERS WOULD ABSTAIN FROM ANY VOTE WHERE A POSSIBILE CONFLICT OF INTEREST MIGHT ARISE. FORM 990, PAGE 6, PART VI, LINE 15A A COMPENSATION REVIEW WAS CONDUCTED IN 2017 BY PATRICK CARRON, CEO OF PERRY COUNTY HEALTH SYSTEMS, AND THE BOARD OF DIRECTORS FOR INDEPENDENCE HEALTH SYSTEM. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 BAD DEBT EXPENSE -22,468 MISCLASSIFIED REVENUE 0 BAD DEBT EXPENSE 22,468 MISCLASSIFIED REVENUE 0