2018-01-23T09:15:38-06:00 2017-05-31 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2016-06-01 431068291 BIG SPRINGS MEDICAL ASSOCIATION INC % KAREN R WHITE BIGS 5736632313 PO BOX 157 ELLINGTON MO 63638 KAREN R WHITE CEO/CFO 2018-01-31 true Krystal K Creach P01248198 4178658701 167.68.126.162 43032920180235000000 2018-01-23 P 35B2FEF9FD89B74F90B63698513A1BB518488CA1 9ED1AFD43ECA266599EA2022F4AABFE45DA09571 2016 2021-01-29 14:40:06Z MISSOURI HIGHLANDS HEALTH CARE KAREN R WHITE PO BOX 157 ELLINGTON MO 63638 14175333 false X WWW.MOHIGH.ORG X 1975 MO THE ORGANIZATION PROVIDES HIGH QUALITY, COST EFFECTIVE MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES TO MEDICALLY-UNDERSERVED RESIDENTS OF ELLINGTON, MO AND SURROUNDING AREAS 9 9 138 14 0 0 3502000 5325150 6912827 8791141 -6470 3666 51792 39538 10460149 14159495 112738 130010 0 0 5846476 6921055 0 0 0 4499263 5410283 10458477 12461348 1672 1698147 8652897 10311847 1764706 1725509 6888191 8586338 X THE ORGANIZATION ENDEAVORS TO MEET THE PRIMARY AND PREVENTATIVE HEALTH CARE NEEDS OF THE MEDICALLY-UNDERSERVED BY PROVIDING HIGH QUALITY, COST EFFECTIVE CARE AND SERVICES TO ITS PATIENTS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. false false 5302735 130010 4470246 BIG SPRINGS MEDICAL ASSOCIATION PROVIDES MEDICAL SERVICES TO RESIDENTS OF ELLINGTON, MISSOURI, AND THE SURROUNDING AREAS. SOME SPECIFIC MEDICAL SERVICES THAT BIG SPRINGS MEDICAL ASSOCIATION OFFERS INCLUDE: TELEHEALTH, COMMUNITY HEALTH AND EDUCATION, AND PATIENT PHARMACEUTICALS ASSISTANCE PROGRAM. SEE SCHEDULE O FOR FURTHER DETAILS ON THESE PROGRAM SERVICES. DURING 2017, THE ORGANIZATION HAD 46,618 MEDICAL CARE VISITS. SEE SCHEDULE O FOR ADDITIONAL DETAIL. 2628849 4294449 BIG SPRINGS MEDICAL ASSOCIATION PROVIDES DENTAL SERVICES TO RESIDENTS OF ELLINGTON, MISSOURI, AND POPLAR BLUFF, MISSOURI AS WELL AS THE SURROUNDING AREAS. DENTAL SERVICES PROVIDED INCLUDE: REGULAR CLEANINGS AND CHECK UPS, EMERGENCY VISITS FOR ACUTE PAIN OR SWELLING, TRAUMA ASSOCIATED WITH BROKEN TEETH, CLEANING AND MEDICATION FOR ANUG, AND EQUILIBRATION OF TEETH IN TRAUMATIC OCCLUSION. DURING 2017, THE ORGANIZATION HAD 12,316 DENTAL CARE VISITS. 95401 26446 BIG SPRINGS MEDICAL ASSOCIATION PROVIDES BEHAVIORAL HEALTH SERVICES TO RESIDENTS OF ELLINGTON, MISSOURI, AND THE SURROUNDING AREAS. BEHAVIORAL SERVICES INCLUDE INDIVIDUAL THERAPY AND COUNSELING FOR PATIENTS AS WELL AS BRIEF INTERVENTION SESSIONS FOR ALL PATIENTS. DURING 2017, THE ORGANIZATION HAD 2,976 BEHAVIOR CARE VISITS. SEE SCHEDULE O FOR ADDITIONAL DETAIL. 8026985 true true false true false false false false false false true false false true true false true false false false false false false false false false false true false true false false false false false false false false true false false false false false false false false true 47 0 true 138 true false false false false false false false false false false X 9 9 false false false false false false false true true false false true true true true true true true false false X X KAREN R WHITE 5736632313 PO BOX 157 ELLINGTON MO 63638 JOETTA MARTIN VICE PRESEDENT 1.0 0.0 X X 0 0 0 MICHAEL MORTON PRESIDENT 1.0 0.0 X X 0 0 0 LANCE MAYFIELD SECRETARY 1.0 0.0 X X 0 0 0 KATHY HART TREASURER BEGINNING 06/2016 1.0 0.0 X X 0 0 0 LINDA LUNSFORD DIRECTOR 1.0 0.0 X 0 0 0 SCOTT OATMAN DIRECTOR 1.0 0.0 X 0 0 0 DEBBIE SANDARCIERO DIRECTOR BEGINNING 03/2017 1.0 0.0 X 0 0 0 DONALD BLACK DIRECTOR ENDING 03/2017 1.0 0.0 X 0 0 0 JOHN MARK BREWER DIRECTOR BEGINNING 12/2016 1.0 0.0 X 0 0 0 RYAN CHILTON DIRECTOR 1.0 0.0 X 0 0 0 KANDRA COUNTS DIRECTOR ENDING 12/2016 1.0 0.0 X 0 0 0 ERIC FUCHS DIRECTOR ENDING 06/2016 1.0 0.0 X 0 0 0 SISTER RITA SCHONHOFF DIRECTOR ENDING 07/2016 1.0 0.0 X 0 0 0 PAULETTE WILLIAMS DIRECTOR ENDING 06/2016 1.0 0.0 X 0 0 0 KAREN WHITE CEO/CFO 40.0 0.0 X 147697 0 21078 TAMMY LINDSAY MEDICAL DIRECTOR 40.0 0.0 X 199112 0 3000 JOSEPH CAMIRE PHYSICIAN 40.0 0.0 X 201422 0 3000 RICHARD HESTER PHYSICIAN 40.0 0.0 X 198603 0 16691 KRISTEN GREEN DENTIST 40.0 0.0 X 172041 0 3000 BRADLEY DANIEL DENTIST 40.0 0.0 X 168949 0 17441 KAMI WALLNER DENTIST 40.0 0.0 X 138197 0 1615 1226021 0 65825 14 false true false POPLAR BLUFF CHILDREN'S DENTISTRY L 4348 STATE HWY PP POPLAR BLUFF MO 63901 ORAL HEALTH 700800 MEDUSIND INC 815 HERNDON AVE STE 100 ORLANDO FL 32803 BILLING 347546 GREENWAY 4301 W BOY SCOUT BLVD STE 800 TAMPA FL 33607 EMR 263206 TRIGGERFISH TECHNOLOGIES 3815 FARON ST STE E ST ST JOSEPH MO 65406 IT SERVICES 206108 NITEL 1101 W LAKE ST 6TH FLOOR CHICAGO IL 60607 COMMUNICATIONS 157018 5 4883312 441838 118922 5325150 NET PATIENT SERVICE REVENUE 624100 8370004 8370004 CAPITATION REVENUE 624100 366772 366772 OTHER REVENUE 624100 54365 54365 8791141 3110 3110 0 0 7400 7400 0 0 0 8994 8438 556 556 556 0 0 0 0 0 0 0 0 0 GAIN FROM EQUITY INVESTEE 900099 39538 39538 39538 14159495 8791141 43204 X 130010 130010 0 0 0 370887 202112 168775 0 5561536 3733255 1828281 76125 51659 24466 477727 329989 147738 434780 289373 145407 0 47686 47686 42825 42825 0 0 0 1738971 898211 840760 200496 200496 696034 403001 293033 211461 135418 76043 0 276164 176852 99312 115110 2482 112628 0 37394 37394 19820 12693 7127 0 493503 349866 143637 67010 30634 36376 MEDICAL SUPPLIES 1280989 1280989 GRANT RELATED EXPENSES 149656 149656 LICENSES, DUES, SUBSCRIPTIONS 27392 27392 BAD DEBT 441 441 5331 5331 12461348 8026985 4434363 0 58749 47372 178595 124239 111381 241546 759108 731385 0 0 0 0 0 0 16632 20905 77567 83835 12062752 3642918 7294489 8419834 0 0 84122 108094 0 0 0 0 72254 534637 8652897 10311847 793937 1139571 0 0 0 0 0 0 0 0 0 0 420769 302191 0 0 550000 283747 1764706 1725509 X 6783566 8586338 104625 0 0 0 6888191 8586338 8652897 10311847 1698147 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true false SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE MISSOURI PRIMARY CARE ASSOCIATION (MPCA). A PORTION OF THESE DUES MAY BE USED FOR LOBBYING PURPOSES. 676248 676248 7878048 2125717 5752331 166633 166633 0 2099778 1320776 779002 1242045 29792 1212253 8419834 EST AMOUNT DUE FROM 3RD PARTY 533533 OTHER RECEIVABLES 1104 534637 0 EST AMOUNT DUE TO 3RD PARTY 283747 283747 14270523 104184 104184 14166339 -6844 -6844 14159495 12467751 6844 6844 12460907 441 441 12461348 SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ (441) BAD DEBT EXPENSE 104,625 NET ASSETS RELEASED FROM RESTRICTION ---------- $ 104,184 SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ (7,400) RENTAL EXPENSES 556 GAIN ON DISPOSAL OF PP&E ---------- $ (6,844) SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 7,400 RENTAL EXPENSES (556) GAIN ON DISPOSAL OF PP&E ---------- $ 6,844 SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 441 BAD DEBT EXPENSE true DOUGLAS COUNTY HEALTH DEPARTMENT PO BOX 940 AVA MO 65608 431747760 GOVERNMENT 33600 DELTA PASS-THRU WHOLE HEALTH OUTREACH INC 180 COUNTY ROAD 700 ELLINGTON MO 63638 431577997 501(C)(3) 17900 DELTA PASS-THRU WHOLE KIDS OUTREACH INC 62143 HIGHWAY 21 ELLINGTON MO 63638 431839370 501(C)(3) 26000 DELTA PASS-THRU 3 SCHEDULE I, PART 1, LINE 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS: THE CEO/CFO REVIEWS ALL GRANT CONTRACTS AND ANY INVOICES; A COMPUTERIZED ACCOUNTING SYSTEM WITH GRANT FUNDING ALLOCATION ALLOWS TRACKING OF FUNDS AND EXPENDITURES. SCHEDULE I, PART II, LINE 1, COLUMN H PURPOSE OF GRANT: BIG SPRINGS MEDICAL ASSOCIATION IS CONTRACTED WITH COLLABORATIVES IN THE AREA TO ACT AS A FIDUCIARY AGENT FOR GRANT PROCEEDS. THE MISSOURI PRIMARY CARE ASSOCIATION (MPCA) AND HRSA PROVIDE GRANT MONEY TO BIG SPRINGS MEDICAL ASSOCIATION FOR RURAL HEALTHCARE SERVICES; THEN, BIG SPRINGS MEDICAL ASSOCIATION PASSES THIS GRANT MONEY THROUGH TO SUB-RECIPIENTS. X X X X X false false false false false false false true false KAREN WHITE CEO/CFO 127697 0 20000 0 0 0 3000 0 18078 0 168775 0 0 0 TAMMY LINDSAY MEDICAL DIRECTOR 187820 0 11292 0 0 0 3000 0 0 0 202112 0 0 0 JOSEPH CAMIRE PHYSICIAN 194522 0 6900 0 0 0 3000 0 0 0 204422 0 0 0 RICHARD HESTER PHYSICIAN 191703 0 6900 0 0 0 3000 0 13691 0 215294 0 0 0 KRISTEN GREEN DENTIST 172041 0 0 0 0 0 3000 0 0 0 175041 0 0 0 BRADLEY DANIEL DENTIST 168949 0 0 0 0 0 3000 0 14441 0 186390 0 0 0 SCHEDULE J, PART I, LINE 7 OTHER NON-FIXED PAYMENTS: PHYSICIANS RICHARD HESTER AND JOSEPH CAMIRE, ALONG WITH MEDICAL DIRECTOR, TAMMY LINDSAY, RECEIVED COLLABORATIVE BONUSES BASED ON THEIR NUMBER OF PATIENT VISITS DURING THE YEAR. CEO/CFO, KAREN WHITE, RECEIVED A BONUS BASED ON THE BOARD'S EVALUATION OF HER PERFORMANCE. X 2 118922 FMV false true false SCHEDULE M, PART I, LINE 20, COLUMN B NUMBER OF CONTRIBUTORS: THE NUMBER IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTORS WHO CONTRIBUTED VACCINES DURING THE YEAR. FORM 990, PART I, LINE 6 VOLUNTEERS: THE ORGANIZATION'S BOARD OF DIRECTORS IS A VOLUNTEER BOARD. FORM 990, PART III, LINE 1 ORGANIZATION'S MISSION: THE ORGANIZATION, A FEDERALLY QUALIFIED HEALTH CENTER, ENDEAVORS TO MEET THE PRIMARY AND PREVENTATIVE HEALTH CARE NEEDS OF THE MEDICALLY-UNDERSERVED RESIDENTS OF BUTLER, CARTER, IRON, REYNOLDS, RIPLEY, and SHANNON COUNTIES IN MISSOURI BY PROVIDING HIGH QUALITY, COST EFFECTIVE CARE AND SERVICES TO PATIENTS, REGARDLESS OF THEIR PAYER SOURCE. THE ORGANIZATION PLACES PARTICULAR EMPHASIS ON CARE PROVIDED TO UNINSURED AND UNDERINSURED PATIENTS, STRIVES TO ENSURE ITS LONG-TERM FISCAL SOLVENCY, SUPPORTS PROGRAMS THAT IMPROVE COMMUNITY HEALTH STATUS AND THAT PROMOTE HEALTHY BEHAVIORS WITHIN OUR POPULATION, AND DESIRES TO REMAIN AN "EMPLOYER OF CHOICE" IN THE AREA. FORM 990, PART III, LINE 4A ADDITIONAL PROGRAM SERVICES DETAIL: TELEHEALTH THROUGH AN ARRANGEMENT MADE POSSIBLE BY THE UNIVERSITY OF MISSOURI-COLUMBIA AND THE MISSOURI PRIMARY CARE ASSOCIATION, TELEHEALTH AND TELECOMMUNICATIONS EQUIPMENT IS INSTALLED AT OUR OFFICES IN ANNAPOLIS, ELLINGTON, EMINENCE, NAYLOR, PILOT KNOB, POPLAR BLUFF, VIBURNUM, AND VAN BUREN. THROUGH THIS SERVICE, WE ARE ABLE TO OFFER PATIENTS ACCESS TO SPECIALISTS IN PSYCHIATRY, DERMATOLOGY AND OTHER DISCIPLINES AT MEDICAL INSTITUTIONS IN LARGER CITIES. ACCESS TO TELEHEALTH LINKAGES CAN BE AN ENORMOUS CONVENIENCE, GIVING OUR PATIENTS ACCESS TO CERTAIN SPECIALTY CONSULTS WITH LEAVING OUR IMMEDIATE SERVICE AREA. COMMUNITY HEALTH AND EDUCATION PART OF OUR MISSION STATEMENT READS, "MISSOURI HIGHLANDS HEALTH CARE SUPPORTS PROGRAMS THAT IMPROVE COMMUNITY HEALTH STATUS AND THAT PROMOTE HEALTHY BEHAVIORS WITHIN OUR POPULATION." IT IS BY DESIGN THAT THE WORD COMMUNITY IS SO PROMINENTLY DISPLAYED. MISSOURI HIGHLANDS HEALTH CARE FACILITATES AND PARTICIPATES IN COMMUNITY GROUPS INVOLVING EMERGENCY MEDICAL PROFESSIONALS, SCHOOL NURSES, HEAD START PROGRAMS, HEALTH DEPARTMENTS, AND OTHERS. MISSOURI HIGHLANDS HEALTH CARE (MHHC) IS THE FISCAL AGENT FOR VARIOUS GRANTS RECEIVED TO ADDRESS AND IMPROVE COMMUNITY HEALTH STATUS. PATIENT PHARMACEUTICALS ASSISTANCE PROGRAM MISSOURI HIGHLANDS HEALTH CARE HELPS ELIGIBLE PATIENTS OBTAIN THEIR PRESCRIBED MEDICATIONS FREE OR AT A REDUCED COST FROM DRUG MANUFACTURERS. THIS IS A SERVICE WE CALL OUR PHARMACEUTICALS ASSISTANCE PROGRAM. OUR PROGRAM COORDINATOR HELPS OUR PATIENTS WORK THROUGH THE NECESSARY APPLICATION PROCEDURES WITH DRUG MANUFACTURERS. SOME PATIENT INFORMATION, USUALLY RELATED TO INCOME, IS REQUIRED TO COMPLETE THE APPLICATION. IN THE END, THE RELATIONSHIP CREATED EXISTS DIRECTLY BETWEEN THE PATIENT AND MANUFACTURER. MHHC FACILITATES THE CONNECTION FOR OUR ELIGIBLE PATIENTS. FORM 990, PART III, LINE 4C ADDITIONAL PROGRAM SERVICES DETAIL: TELEHEALTH THROUGH AN ARRANGEMENT MADE POSSIBLE BY THE UNIVERSITY OF MISSOURI-COLUMBIA AND THE MISSOURI PRIMARY CARE ASSOCIATION, TELEHEALTH AND TELECOMMUNICATIONS EQUIPMENT IS INSTALLED AT OUR OFFICES IN ELLINGTON, POPLAR BLUFF, VIBURNUM AND VAN BUREN. THROUGH THIS SERVICE, WE ARE ABLE TO OFFER PATIENTS ACCESS TO SPECIALISTS IN PSYCHIATRY AT BEHAVIORAL HEALTH INSTITUTIONS IN LARGER CITIES. ACCESS TO TELEHEALTH LINKAGES CAN BE AN ENORMOUS CONVENIENCE, GIVING OUR PATIENTS ACCESS TO CERTAIN SPECIALTY CONSULTS WITH LEAVING OUR IMMEDIATE SERVICE AREA. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW POLICY: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE CEO AND CFO REVIEW THE FORM 990 IN DETAIL. AFTER THIS REVIEW, THE 990 IS MADE AVAILABLE TO THE BOARD OF DIRECTORS BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE CORPORATE COMPLIANCE OFFICER REVIEWS THE CONFLICT OF INTEREST POLICY WITH THE BOARD ANNUALLY AS PART OF THE OVERALL CORPORATE COMPLIANCE PROGRAM COMPLETED IN JANUARY OF EACH YEAR. INQUIRIES ARE MADE REGARDING ANY EXISTING CONFLICTS OF INTEREST. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY BOARD MEMBER IS DISCLOSED TO OTHER BOARD MEMBERS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTION. ANY BOARD MEMBER HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHOULD NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER. FURTHERMORE, HE/SHE SHOULD NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING, EVEN WHERE PERMITTED BY LAW. THE MINUTES OF THE MEETING SHOULD REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THE QUORUM SITUATION. THE FOREGOING REQUIREMENT SHOULD NOT BE CONSTRUED AS PREVENTING THE BOARD MEMBER FROM BRIEFLY STATING HIS/HER POSITION IN THE MATTER, NOR FROM ANSWERING PERTINENT QUESTIONS OF OTHER BOARD MEMBERS SINCE HIS/HER KNOWLEDGE MAY BE OF GREAT ASSISTANCE. THIS POLICY IS REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF BOARD MEMBERS, AND ANY NEW BOARD MEMBER IS ADVISED OF THE POLICY UPON ENTERING THE DUTIES OF HIS/HER OFFICE. THE BOARD CHAIRPERSON AND SECRETARY ARE AUTHORIZED AND DIRECTED TO SEE THAT THIS POLICY IS FOLLOWED. FORM 990, PART VI, SECTION B, LINE 15A & 15B COMPENSATION REVIEW: THE BOARD CONDUCTS A REVIEW OF THE CEO'S CONTRACT USING A COMPENSATION COMMITTEE, IN WHICH THE BOARD OBTAINS COMPARABLE COMPENSATION INFORMATION FROM THE MPCA FOR PERSONS IN SIMILAR POSITIONS. THE ORGANIZATION ALSO USES FORMS 990 OF OTHER ORGANIZATIONS IN THIS REVIEW. THIS PROCESS IS DOCUMENTED IN THE BOARD MINUTES AND COMPLETED BIANNUALLY. THE CEO DIRECTS AND COMPLETES A SIMILAR REVIEW FOR OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION'S BYLAWS, CONFLICT OF INTEREST POLICY, AND/OR FINANCIAL STATEMENTS ARE AVAILABLE FOR VIEWING AT THE CENTRAL ADMINISTRATION OFFICE OF THE ORGANIZATION OR CAN BE MAILED UPON REQUEST. THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE ONLY PROVIDED UPON THE APPROVAL OF A WRITTEN REQUEST. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES: $ 752,081 CONTRACTED DENTAL SERVICES 679,414 CONTRACTED ADMIN SERVICES 148,167 DATA PROCESSING 138,303 CONTRACTED MENTAL HEALTH SERVICES 13,179 PAYROLL PROCESSING 7,827 CONTRACTED HEALTH SERVICES ----------- $ 1,738,971