2017-05-04T10:39:34-05:00 2016-06-30 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2015-07-01 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 2017-05-15 true Kevin Ensminger CPA P01310558 8162216300 2015 2021-01-29 14:40:06Z PHIL HAMILTON 130 E LOCKLING PO Box 408 BROOKFIELD MO 64628 16816127 false X WWW.PERSHINGHEALTHSYSTEM.COM/ X 1955 MO SERVING OTHERS THROUGH QUALITY, COMPASSIONATE CARE. 10 8 190 47 0 0 3879 3373 18454295 16671527 41692 53190 113201 87767 18613067 16815857 9864 9112 0 0 8117434 7762397 0 0 0 10453585 9536368 18580883 17307877 32184 -492020 20190394 19463347 7502160 7267133 12688234 12196214 SERVING OTHERS THROUGH QUALITY, COMPASSIONATE CARE. false false 2073512 1458 2667444 INPATIENT ACUTE CARE SERVICES WITH 323 INPATIENT ADMISSIONS. 9589998 6743 12336930 OUTPATIENT SERVICES WITH APPROXIMATELY 29,072 REGISTRATIONS. THIS INCLUDES 4,939 EMERGENCY ROOM VISITS. 1295946 911 1667153 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 11,382 VISITS THIS PAST FISCAL YEAR. IT IS A LOWER COST ALTERNATIVE THAN USING THE EMERGENCY ROOM. APPLEGATE MEDICAL GROUP SAW 6,499 PATIENTS, OPEN 5 DAYS A WEEK AND MEADVILLE MEDICAL CENTER IS OPEN 3 DAYS A WEEK AND SAW 1,396 PATIENTS. 12959456 true false 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 48 0 true 190 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 true false MO X GARY TANDY CFO 6602582222 130 E LOCKLING PO BOX 408 BROOKFIELD MO 64628 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 1.0 0.0 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/CONTRACTED PHYSICIAN 1.0 0.0 X 0 0 0 TOD T SYLVARA DO DIRECTOR/CONTRACTED PHYSICIAN 1.0 0.0 X 86765 0 0 PHIL HAMILTON CEO 40.0 0.0 X 172932 0 14788 GARY TANDY CFO 40.0 0.0 X 102536 0 14955 WACLAW DYMEK EMPLOYED PHYSICIAN 48.0 0.0 X 344990 0 27417 SISENARDO GALVEZ EMPLOYED PHYSICIAN 36.0 0.0 X 234435 0 1089 KARLA CLUBINE NURSE PRACTITIONER 40.0 0.0 X 111268 0 38424 GARY FITE DIRECTOR OF PHYSICAL THERAPY 40.0 0.0 X 124472 0 24530 BRIAN CASEBOLT DIRECTOR OF PHARMACY 40.0 0.0 X 119813 0 37229 1297211 0 158432 6 false true false DR PEPITO RIVERA PHYSICIAN SERVICES 496635 DR JERRY WAIT PHYSICIAN SERVICES 153090 HAVE A NICE DAY ANESTHESIA GROUP 187530 DR KAREN SYLVARA PHYSICIAN SERVICES 218260 DR GARRETT ELAM PHYSICIAN SERVICES 138250 8 3373 3373 NET PATIENT SERVICE REVENUE 621400 15918552 15918552 340B Revenue 900099 752975 752975 16671527 53160 53160 0 0 17193 17193 0 17193 17193 300 270 30 30 30 0 0 0 Cafeteria 900099 33221 33221 Miscellaneous income 900099 17044 17044 Vending Machines 900099 20309 20309 70574 16815857 16671527 140957 9112 9112 0 0 0 388829 67165 321664 253666 180103 73563 5740581 4264588 1475993 76082 57986 18096 856339 624161 232178 446900 317299 129601 0 4355 4355 97630 97630 0 0 0 3397767 2648706 749061 0 15046 10683 4363 880009 624806 255203 0 0 413799 293797 120002 4875 4875 0 15464 15464 254706 180841 73865 0 1170386 830974 339412 220110 156278 63832 Bad Debt Expense 1395263 1395263 Medical Supplies 1022973 726311 296662 Taxes & Licenses 68318 68318 Medicaid FRA Payments 510377 510377 65290 61006 4284 17307877 12959456 4348421 0 0 0 7223699 7374314 0 0 3976252 4419321 0 0 0 0 243465 248802 212306 218160 272916 248774 19879339 13231760 7770110 6647579 0 0 0 0 0 0 0 0 491646 306397 20190394 19463347 1405612 1436199 0 0 0 0 0 0 0 0 0 0 6096548 5830934 0 0 0 0 7502160 7267133 X 12681893 12184943 6341 11271 0 0 12688234 12196214 20190394 19463347 -492020 X false true X false false X false false false false false true 10497 false false false 10497 false SCHEDULE C, PART II-B, LINE 1F FOR 2016, $10,497 OF DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION WERE USED FOR LOBBYING/ADVOCACY EXPENDITURES. 107129 107129 13622655 7749815 5872840 6149555 5481945 667610 6647579 15415664 9569 9569 15406095 1409762 1409762 16815857 15912614 15912614 1395263 1395263 17307877 SCHEDULE D, PART XI, LINE 2D NET ASSETS RELEASED FROM RESTRICTIONS $ 9,569 SCHEDULE D, PART XI, LINE 4B RESTRICTED CONTRIBUTIONS RECEIVED $ 14,499 PROVISION FOR UNCOLLECTIBLE ACCOUNTS $ 1,395,263 ----------- TOTAL $ 1,409,762 SCHEDULE D, PART XII, LINE 4B PROVISION FOR UNCOLLECTIBLE ACCOUNTS $ 1,395,263 true true true X 133. true X 213. true true false true true 182692 182692 0.01150 2585766 2613060 -27294 2768458 2613060 155398 0.01150 19646 35438 -15792 4999 4999 0.00030 24645 35438 -10793 0.00030 2793103 2648498 144605 0.01180 true 1798863 209289 7604983 7449062 155921 X true true 1 1 GENERAL JOHN J PERSHING MEM HOSPITAL 130 E LOCKLING AVE PO BOX 408 BROOKFIELD MO 64628 WWW.PERSHINGHEALTHSYSTEM.COM 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 15 true false false true X SEE PART V, SECTION C X true 15 true SEE PART V, SECTION C false true X 133. 213. X 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 true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 THREE LOCAL STAFF MEMBERS WERE INVOLVED IN THE CHNA PROJECT, ALONG WITH COLLABORATION WITH THE LINN COUNTY HEALTH DEPARTMENT. FURTHER, A MASTERS OF PUBLIC HEALTH STUDENT FROM THE UNIVERSITY OF MISSOURI-COLUMBIA WAS USED TO CONDUCT THE 2016 ASSESSMENT. SCHEDULE H, PART V, SECTION B, LINE 7A THE COMPLETE CHNA CAN BE FOUND AT: http://www.phsmo.org/Documents/2016%20Pershing%20CHNA%20final%20copy.docx SCHEDULE H, PART V, SECTION B, LINE 10A THE IMPLEMENTATION STRATEGY CAN BE FOUND AT: http://www.phsmo.org/Documents/CHNA%20Implementation%20Plan%202016.doc SCHEDULE H, PART V, SECTION B, LINE 11 MANY FACTORS DURING THE LAST THREE YEARS SINCE THE PREVIOUS 2013 COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED HAVE GONE UNCHANGED AS INDICATED BY THE MOST CURRENT 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. OVERALL, THIS ASSESSMENT SUGGESTS THAT THE HEALTH SERVICES WITHIN LINN COUNTY ARE SUFFICIENT TO SERVE THE RESIDENTS IN THE COUNTY. HOWEVER, OUR FINDINGS INDICATED SEVERAL VULNERABILITIES IN HEALTHCARE SERVICES PROVIDED TO THE COMMUNITY AND UNFAVORABLE TRENDS IN HEALTHCARE FACTORS. ONE POSITIVE FACTOR NOTED IS THE CONTINUED TREND OF A DECLINE IN UNEMPLOYMENT IN LINN COUNTY. WHILE UNEMPLOYMENT RATES FOR LINN COUNTY REMAIN SLIGHTLY HIGHER THAN STATE AVERAGES, THE TREND CONTINUES DOWNWARD. 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 2013 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. IT WOULD BE EASY FOR ONE TO FOCUS ON THE OBVIOUS HEALTHCARE FACTORS AFFECTING THE CITIZENS OF LINN COUNTY SUCH AS OBESITY, HEART DISEASE, DIABETES, LACK OF EXERCISE, AND LACK OF ACCESS TO RECREATIONAL LOCATIONS AS THE NEEDS TO ADDRESS IN THE COUNTY; HOWEVER, IT WOULD BE A DISSERVICE TO THE CITIZENS AND THE COMMUNITY IF PERSHING HEALTH SYSTEM DID NOT CONSIDER THE SIGNIFICANT IMPACT THAT THE LEVEL OF POVERTY PLAYS IN ALL OF THESE ISSUES. THIS WOULD LEAD ONE TO QUESTION IF THE TRUE ISSUE IS RELATED TO THE SIGNIFICANT AMOUNT OF CITIZENS WHO LIVE IN POVERTY IN LINN COUNTY AS THE PRIMARY CAUSE FOR MANY, IF NOT ALL, OF THE HEALTH NEEDS IDENTIFIED. RESIDENTS LIVING IN POVERTY REGARD HEALTH NEEDS AS SIGNIFICANTLY LESS IMPORTANT, ESPECIALLY WHEN TRYING TO MEET BASIC NEEDS TO SURVIVE. HOW CAN A PERSON LIVING IN POVERTY BE EXPECTED TO ADDRESS OBESITY, HEART DISEASE, AND DIABETES IF THEY ARE UNABLE ADDRESS THE BASIC NEEDS OF THEIR HOUSEHOLD SUCH AS RUNNING WATER, FOOD, RENT, AND UTILITIES WITHOUT STRUGGLES? UNLESS OR UNTIL POVERTY IS ADDRESSED CHRONIC ILLNESS WILL ALWAYS BE SIGNIFICANT FOR COUNTY RESIDENTS. POVERTY ISSUES RELATED TO HEALTHCARE WILL IMPACT THE QUALITY OF CARE THAT CITIZEN'S ACCESS, WHICH IN RETURN IMPACT THE OVERALL HEALTH OF THE CITIZENS. LINN COUNTY RANKS 33RD IN HEALTH OUTCOMES ACCORDING TO COUNTY HEALTH RANKINGS AND 77TH IN HEALTH FACTORS FOR THE STATE OF MISSOURI. NEGATIVE TRENDS IN ADULT OBESITY, HEART DISEASE, AND PHYSICAL INACTIVITY ARE ALL HIGHER THAN MISSOURI AND NATIONAL AVERAGES AND CONTRIBUTE TO AN INCREASING PREMATURE DEATH RATE FOR THE COUNTY. HOWEVER, UNTIL POVERTY IS ADDRESSED, ANY INTERVENTION APPLIED TO THESE CHRONIC ISSUES WITH HAVE VERY LITTLE IMPACT. ANOTHER AREA OF CONCERN IDENTIFIED WAS LACK OF RECREATIONAL AREAS FOR EXERCISE. MANY CITIZENS WHO LIVE IN POVERTY WOULD BE QUICK TO SAY THAT WHETHER OR NOT THEY HAVE ACCESS TO RECREATIONAL AREAS IS NOT A PRIORITY FOR THEM. AFTER SPEAKING WITH COMMUNITY HEALTHCARE SERVICE PROVIDERS, SEVERAL WEAKNESSES IN THE PROVISION OF SERVICES TO THE COMMUNITY WERE REVEALED. ONE OF THE WEAKNESSES THAT FALLS BELOW ACCEPTABLE LEVELS IS THE NUMBER OF PRIMARY CARE PROVIDERS PER NUMBER OF THE POPULATION, AS INDICATED IN SURVEY POPULATION. PERSHING MEMORIAL HOSPITAL IS ATTEMPTING TO RECRUIT AND RETAIN PRIMARY CARE PROVIDERS IN ORDER TO ADDRESS THE SHORTAGE IN THE COMMUNITY. IT IS INDICATED THAT A LARGE NUMBER OF PREVENTABLE HOSPITALIZATIONS ARE STILL OCCURRING IN THE COUNTY, SO IF PRIMARY CARE SERVICES CAN BE STRENGTHENED IT WOULD LIKELY OFFSET THOSE EVENTS AND REDUCE THE BURDEN ON THE COUNTY'S EMERGENCY DEPARTMENT. PERSHING HAS A STRONG PLAN IN PLACE TO ADDRESS THIS ISSUE INCLUDING PERSHING'S PARTICIPATION IN PRIMARY CARE RESOURCE INITIATIVE FOR MISSOURI (PRIMO). PERSHING MEMORIAL HOSPITAL CURRENTLY SUPPORTS TWO STUDENTS IN MEDICAL SCHOOL THROUGH THIS PROGRAM AND WILL EMPLOY THEM UPON COMPLETION OF THEIR RESIDENCY. PERSHING HIRED A FOURTH NURSE PRACTITIONER TO WORK FULL TIME IN THE COMMUNITY MEDICAL ASSOCIATES CLINIC. PERSHING HEALTH SYSTEM IS CONTINUALLY RECRUITING FAMILY PRACTICE PHYSICIANS AND NURSE PRACTITIONERS TO THE AREA TO PROVIDE INPATIENT CONSULTS AND PRIMARY CARE AND WILL CONTINUE TO DO SO IN THE FORESEEABLE FUTURE. PERSHING ALSO HAS MULTIPLE RESIDENT PHYSICIANS PRACTICING IN THE CLINICS AND EMERGENCY DEPARTMENT THIS COULD LEAD TO EMPLOYMENT OF THESE PHYSICIANS IN THE FUTURE UPON THEIR GRADUATION. LINN COUNTY'S PROXIMITY TO KANSAS CITY AND COLUMBIA CREATES A NUMBER OF UNIQUE WEAKNESSES AND STRENGTHS. FIRST, THE ATTRACTION OF KANSAS CITY AND COLUMBIA OFTEN LURES PROVIDERS, MAKING IT DIFFICULT FOR LINN COUNTY TO RECRUIT PROVIDERS. KANSAS CITY ALSO BOASTS A STRONG HEALTHCARE INFLUENCE CREATING A MISPERCEPTION OF LOWER QUALITY HEALTHCARE IN LINN COUNTY. THIS MISPERCEPTION LEADS TO A PORTION OF THE POPULATION BELIEVING THAT IN ORDER TO RECEIVE QUALITY HEALTHCARE THEY MUST TRAVEL OUTSIDE OF THE COMMUNITY. THIS TAKES A NUMBER OF POSSIBLE PATIENTS OUTSIDE THE COMMUNITY. ANOTHER STRESSOR ON THE HEALTH OF LINN COUNTY IS THE LACK OF SPECIALTY PROVIDERS. WHILE THE LACK OF LOCAL SPECIALISTS COULD MAKE FOR A DEFICIENCY IN SPECIALTY CARE FOR THE COMMUNITY, IT IS ONE ASPECT THAT THE PROXIMITY TO KANSAS CITY AND COLUMBIA ALLEVIATES. WITH KANSAS CITY OFFERING A NUMBER OF SPECIALTY SERVICES, LINN COUNTY IS RELIEVED FROM THE PRESSURES OF THESE HARD TO RECRUIT POSITIONS. NONETHELESS, PERSHING MEMORIAL HOSPITAL SHOULD CONTINUE TO ATTEMPT TO RECRUIT SPECIALISTS IN ORDER TO ADDRESS THE SHORTAGE THEY HAVE IN THE COMMUNITY. ONE OTHER WAY THAT PERSHING HEALTH SYSTEM HAS ADDRESSED THE LACK OF ACCESS TO HEALTH CARE IS OFFERING MULTIPLE HEALTH FAIRS IN THE COMMUNITY INCLUDING THE ANNUAL HEALTH FAIR THAT OCCURS IN THE MARCELINE, MO AND BROOKFIELD, MO AREAS AND IS ALWAYS COORDINATED DURING NATIONAL HOSPITAL WEEK. PERSHING OFFERS MANY HEALTH SCREENINGS DURING THIS TIME AT A REDUCED COST TO THE PUBLIC. PERSHING ALSO HAS MULTIPLE HEALTH FAIRS FOR LOCAL EMPLOYERS WHERE PERSHING STAFF WILL GO TO THE WORKPLACE AND CONDUCT A HEALTH FAIR. THIS ADDRESSES THE NEED FOR CITIZENS TO TRAVEL FOR NEEDED HEALTH SCREENINGS. PERSHING ALSO OFFERS FREE PHYSICALS TO ALL LINN COUNTY SCHOOL AGED CHILDREN, ONE TIME MONTHLY DURING THE SUMMER MONTHS. PERSHING ALSO HAS AN EVER-GROWING NUMBER OF SPECIALISTS WHO TRAVEL TO PERSHING MEMORIAL HOSPITAL FOR SPECIALTY CLINICS INCLUDING: CARDIOVASCULAR, OB/GYN, DERMATOLOGY, OPHTHALMOLOGY, ORTHOPEDICS AND GENERAL/SAME DAY SURGERY, TO NAME ONLY A FEW. PERSHING NEEDS TO CONTINUE TO FOCUS ON WAYS OF MAKING THE PUBLIC AWARE OF THE MULTIPLE CLINICS THAT ARE AVAILABLE IN THE AREA AND ENCOURAGE THE PUBLIC TO TAKE ADVANTAGE OF THE SERVICES. THE INFORMATION PROVIDED IN THIS ASSESSMENT SHOULD BE USED AS A TOOL TO COMMUNITY STAKEHOLDERS WHEN DECIDING THE NEXT STEP IN COMMUNITY HEALTH. THE HEALTH OF LINN COUNTY IS STABLE, BUT ALSO SHOULD EXPECT TO CONFRONT CHALLENGES CAUSED BY NEGATIVE TRENDS IN HEALTH FACTORS AND A CHANGING POPULATION MIX. IT WILL BE IMPORTANT THAT THE COMMUNITY ADDRESSES THESE CHALLENGES AND MAKE DECISIONS BASED ON COMMUNITY NEEDS MOVING FORWARD. SCHEDULE H, PART V, SECTION B, LINE 16A THE FAP CAN BE FOUND AT: http://www.phsmo.org/FAP_Files/FAP07012016/070616%20rev/Pershing%20Health% 20System%20FAP.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 SCHEDULE H, PART V, SECTION B, LINE 22D THE HOSPITAL FACILITY DETERMINED THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIABLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE BY TAKING THE AVERAGE OF ALL MANAGED CARE DISCOUNTS. 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 SEE PART VI, SECTION B, LINE 13 FOR THE LIST OF OTHER FACTORS USED IN ELIGIBILITY CRITERIA EXPLAINED IN THE FAP FOR PROVIDING FREE AND DISCOUNT 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 1,395,263. SCHEDULE H, PART III, SECTION A, LINE 2 THE 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 SEPARATELY. SCHEDULE H, PART III, SECTION A, LINE 3 USED THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 AND APPLIED THAT PERCENTAGE TO NET BAD DEBTS TO ARRIVE AT AN ESTIMATED COST OF BAD DEBT. THEN, PER COLLECTION SUPERVISOR'S ESTIMATE, APPLIED 15% TO THE NET BAD DEBTS TO ARRIVE AT ESTIMATED COST THAT COULD BE CHARITY. 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 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 WE OPERATE THREE (3) PROVIDER BASED RHCS: 1) APPLEGATE MEDICAL GROUP, WHICH INCLUDES THE ONLY LOCALLY AVAILABLE PEDIATRICIAN. IT ALSO INCLUDES AN INTERNAL MEDICAL PHYSICIAN. 2) COMMUNITY MEDICAL ASSOCIATES, LOCATED WITHIN THE HOSPITAL BUILDING AND OPEN 7 DAYS A WEEK, 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 AT THE BEGINNING OF EACH SCHOOL YEAR. NURSE PRACTITIONERS PROVIDE WELL CHILD EXAMS YEARLY AT THE LINN COUNTY HEALTH DEPT. 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. HOSPITAL WEEK, AN ANNUAL PUBLIC EVENT 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 WERE 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. NEWSPAPER ARTICLES: RADIOLOGY-MRI; RHC-GERD, HIGH BLOOD PRESSURE EDUCATION, UNDERSTANDING COST SHARING, SETTING LIMITS, DISCIPLINE TECHNIQUES; SOCIAL SERVICES -TIPS FOR HEALTHY AGING; OCCUPATIONAL THERAPY-O.T. AND THE PAINFUL SHOULDER; SPEECH AND LANGUAGE THERAPY SERVICES; CARDIAC AND PULMONARY REHAB PATIENTS; LAB-COMMUNITY BASED HEALTH SCREENINGS, POISONOUS HOUSE PLANTS; RESPIRATORY THERAPY-SLEEP. -NUMEROUS OTHER MINOR CONTRIBUTIONS TO THE GENERAL WELFARE AND SAFETY OF OUR COMMUNITY. X X false false false false false false false false false PHIL HAMILTON CEO 149693 0 21300 0 1939 0 3061 0 11727 0 187720 0 0 0 WACLAW DYMEK EMPLOYED PHYSICIAN 304553 0 40437 0 0 0 4901 0 22516 0 372407 0 0 0 SISENARDO GALVEZ EMPLOYED PHYSICIAN 193607 0 0 0 40828 0 0 0 1089 0 235524 0 0 0 BRIAN CASEBOLT DIRECTOR OF PHARMACY 112925 0 0 0 6888 0 1039 0 36190 0 157042 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. $216,405 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. $37,261 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 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 AND FINANCIAL STATEMENT AVAILABLE UPON REQUEST. FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:1726870 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:32262 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:1638635