2016-04-13T09:24:01-05:00 2015-05-31 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2014-06-01 680545808 COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI % TOBY BARNETT COMM 5736322777 3400 WEST TRUMAN BLVD JEFFERSON CITY MO 65109 TOBY BARNETT CFO 5736322777 2016-03-07 true Brian D Todd P00422601 4178658701 2014 2016-08-17 19:52:53Z JEFF DAVIS 3400 WEST TRUMAN BLVD JEFFERSON CITY MO 65109 9406654 false X WWW.CHCCMO.ORG X 2003 MO TO PROVIDE MEDICAL, DENTAL AND MENTAL HEALTH SERVICES TO RESIDENTS OF COLE, OSAGE, MONITEAU AND CALLAWAY COUNTIES REGARDLESS OF ABILITY TO PAY. 13 13 126 14 0 0 2576296 2285735 6718335 7126278 569 491 0 -5850 9295200 9406654 0 0 0 0 6088156 6324407 0 0 0 3694237 3840380 9782393 10164787 -487193 -758133 6045029 5996831 4817122 5527057 1227907 469774 X TO PROVIDE IMPROVED ACCESS TO PRIMARY CARE, BEHAVIORAL HEALTHCARE AND ORAL HEALTH CARE SERVICES FOR MEDICALLY UNDERSERVED INDIVIDUALS IN CENTRAL MISSOURI REGARDLESS OF THEIR ABILITY TO PAY. OUR VISION IS EMBRACING PEOPLE AND INSPIRING HEALTH. false false 4460546 3138667 MEDICAL PRACTICE - A WIDE-RANGE OF PRIMARY CARE SERVICES ARE PROVIDED BY A DEDICATED TEAM OF PHYSICIANS, FAMILY NURSE PRACTITIONERS, SOCIAL WORKERS, NURSES, AND SUPPORT STAFF INCLUDING: OBSTETRICAL CARE, PEDIATRIC CARE, ADULT HEALTHCARE, PHYSICAL EXAMS, FAMILY PLANNING, AND PAIN MANAGEMENT. DURING FISCAL YEAR 2015, THE MEDICAL PRACTICE HAD 28,526 VISITS OF WHICH 40% WERE MEDICAID AND 31% WERE UNINSURED, RECEIVING $605,277 IN DISCOUNTS. 3362494 3620589 DENTAL PRACTICE - THE ORGANIZATION OFFERS A FULL RANGE OF PREVENTIVE, FUNCTIONAL, AND RESTORATIVE DENTAL CARE, INCLUDING: CLEANINGS, HYGIENE AND TISSUE MANAGEMENT, SEALANTS, CHECK-UPS AND X-RAYS, FILLINGS, EXTRACTIONS, ORAL CANCER SCREENING, HEALTHY GUM CARE, ROOT CANALS, CROWNS AND BRIDGES, AND FULL AND PARTIAL DENTURES. EMERGENCY DENTAL CARE IS ALSO AVAILABLE. DURING FISCAL YEAR 2015, THE DENTAL PRACTICE HAD 13,636 VISITS OF WHICH 64% WERE MEDICAID AND 23% WERE UNINSURED, RECEIVING $309,520 IN DISCOUNTS. 233570 355326 THE MENTAL HEALTH PRACTICE HAD 3,413 VISITS OF WHICH 36% WERE MEDICAID AND 34% WERE UNINSURED, RECEIVING $105,025 IN DISCOUNTS. SEE SCHEDULE O FOR MORE INFORMATION. 18324 11696 8074934 true true false true false false false false false false true false false false true false true false false false false false false false false false false false false true false false false false false false false false true false false false false false false false false true 1 0 true 126 true false false false false false false false false false false X 13 13 false false true false false false false true true false false true true true true true true true false false X TOBY BARNETT 5736320243 2730 W MAIN ST JEFFERSON CITY MO 65109 AMANDA GRELLNER PRESIDENT 1.0 0.0 X X 0 0 0 LINDA MCANANY VICE PRESIDENT 1.0 0.0 X X 0 0 0 THOMAS NIEKAMP TREASURER/TEMP CEO 9/14-12/14 1.0 0.0 X X 0 0 0 CHRISTINE ELLINGER SECRETARY 1.0 0.0 X X 0 0 0 JIM CLARDY DIRECTOR 1.0 0.0 X 0 0 0 LAWRENCE WANSING DIRECTOR 1.0 0.0 X 0 0 0 KATHY DOTHAGE DIRECTOR 1.0 0.0 X 0 0 0 DEBBIE HAMLER DIRECTOR 1.0 0.0 X 0 0 0 LINDA BICKEL DIRECTOR 1.0 0.0 X 0 0 0 PAMELA MURRAY DIRECTOR 1.0 0.0 X 0 0 0 BEVERLY STAFFORD DIRECTOR 1.0 0.0 X 0 0 0 DARREL KING DIRECTOR 1.0 0.0 X 0 0 0 RHONDA DRIVER DIRECTOR 1.0 0.0 X 0 0 0 CHARLES GLASPER DIRECTOR ENDING 10/2014 1.0 0.0 X 0 0 0 TOBY BARNETT CHIEF FINANCIAL OFFICER 40.0 0.0 X 106181 0 9963 DON HOLLOMAN CEO ENDING 9/2014 40.0 0.0 X 124674 0 11857 CRYSTAL SULLIVAN CHIEF CLINICAL OFFICER 40.0 0.0 X 229413 0 18475 JEFF DAVIS CEO BEGINNING 1/2015 40.0 0.0 X 0 0 0 BETHANY BAILLARGEON DENTAL DIRECTOR 40.0 0.0 X 144808 0 10165 RICHARD DAUGHERTY PHYSICIAN 40.0 0.0 X 169729 0 14773 BETH MORREY DENTIST 40.0 0.0 X 146519 0 10194 NANCY HOWE PHYSICIAN 40.0 0.0 X 207192 0 12373 MEGAN KING PHYSICIAN 40.0 0.0 X 168672 0 11156 1297188 0 98956 10 false true false TRANSAMERICA FUNDS INVESTMENT FIRM 286607 LABCORP CLINICAL LABORATORY 211836 COMPASS HEALTH MENTAL HLTH PROVIDER 160510 SOCKET TELECOM TELECOMMUNICATIONS 160157 TRIGGERFISH CORPORATION IT SERVICES 159978 8 42000 1972641 271094 204344 2285735 Net Patient Service Revenue 624100 6817914 6817914 MISCELLANEOUS INCOME 624100 217364 217364 EHR INCENTIVE REVENUE 624100 91000 91000 7126278 491 491 0 0 0 0 0 0 0 0 0 LOSS ON INVESTMENT IN EQUITY INVESTEE 900099 -5850 -5850 -5850 9406654 7126278 -5359 0 0 0 0 546363 247888 298475 0 4801744 4190336 611408 132329 117511 14818 445395 390009 55386 398576 336461 62115 0 15709 15709 79067 79067 0 0 0 974927 663103 311824 55386 55386 571603 342584 229019 159313 124932 34381 0 202084 158472 43612 43649 43649 0 65152 21805 43347 1911 1911 0 392243 303345 88898 14882 10800 4082 MEDICAL SUPPLIES & DRUGS 686618 686618 BAD DEBT 481070 481070 LICENSES, DUES, SUBSCRIPTIONS 48543 48543 RECRUITING & RETENTION 8392 8392 39831 39831 10164787 8074934 2089853 0 110698 282362 1429150 1255922 345242 575611 1181851 1104068 0 0 0 0 0 0 210933 249527 82215 70732 4465395 2119320 2591332 2346075 0 0 43340 39474 0 0 0 0 50268 73060 6045029 5996831 836288 772395 0 0 80834 4662 0 0 0 0 0 0 100000 0 0 0 3800000 4750000 4817122 5527057 X 838049 221138 389858 248636 0 0 1227907 469774 6045029 5996831 -758133 X false true X true true true X 1141830 1445672 2248341 2576296 2308664 9720803 0 0 1141830 1445672 2248341 2576296 2308664 9720803 107661 9613142 82 180 466 569 491 1788 0 -5850 -5850 9716741 29349079 0.98934 0.98700 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 OTHER LOBBYING ACTIVITIES: DURING THE FISCAL YEAR, THE ORGANIZATION PAID DUES TO THE MISSOURI PRIMARY CARE ASSOCIATION IN THE AMOUNT OF $11,603. A PORTION OF DUES MAY BE ATTRIBUTABLE TO LOBBYING PURPOSES. 667588 667588 1334851 679447 655404 450274 303360 146914 1827832 1059261 768571 184850 77252 107598 2346075 0 Due to Third Party Payers 4750000 4750000 9066806 -291767 -291767 9358573 48081 48081 9406654 9683717 9683717 481070 481070 10164787 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: 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 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $ (481,070) BAD DEBT EXPENSE 189,303 NET ASSETS RELEASED FROM RESTRICTION ---------- $ (291,767) SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 48,081 TEMPORARILY RESTRICTED CONTRIBUTIONS SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 481,070 BAD DEBT EXPENSE X X false false false false false false false false false CRYSTAL SULLIVAN CHIEF CLINICAL OFFICER 229413 0 0 0 0 0 6882 0 11593 0 247888 0 0 0 BETHANY BAILLARGEON DENTAL DIRECTOR 144808 0 0 0 0 0 4344 0 5821 0 154973 0 0 0 RICHARD DAUGHERTY PHYSICIAN 169729 0 0 0 0 0 5092 0 9681 0 184502 0 0 0 BETH MORREY DENTIST 146519 0 0 0 0 0 4396 0 5798 0 156713 0 0 0 NANCY HOWE PHYSICIAN 207192 0 0 0 0 0 6216 0 6157 0 219565 0 0 0 MEGAN KING PHYSICIAN 168672 0 0 0 0 0 5060 0 6096 0 179828 0 0 0 X 1 204344 FMV false false false SCHEDULE M, PART I, COLUMN B NUMBER OF CONTRIBUTORS: THE ORGANIZATION RECEIVED VACCINES FROM A SINGLE DONOR. FORM 990, PART I, LINE 6 NUMBER OF VOLUNTEERS THE TOTAL NUMBER OF VOLUNTEERS INCLUDES NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART III, LINE 4C PROGRAM SERVICES: FOR PATIENTS NEEDING BEHAVIORAL AND MENTAL HEALTH SERVICES, THE ORGANIZATION employs a Clinical Psychologist and a Licensed Clinical Social Worker as well as PARTNERs WITH PATHWAYS COMMUNITY BEHAVIORAL HEALTH CARE, A NON-FOR-PROFIT COMMUNITY MENTAL HEALTH COMPANY. COMMITTED TO PROVIDING EXCEPTIONAL CARE FOR THE MIND, BODY, AND SPIRIT, COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI OFFERS HIGHLY TRAINED PROFESSIONALS TO PROVIDE BEHAVIORAL HEALTH AND ADDICTION SERVICES FOR INDIVIDUALS AND THEIR FAMILIES IN A CARING AND CONFIDENTIAL MANNER. THE ORGANIZATION KNOWS THAT MENTAL, EMOTIONAL AND BEHAVIORAL WELLNESS CONTRIBUTE TO PHYSICAL WELL BEING. THEREFORE, IT INTEGRATES BEHAVIORAL HEALTH SERVICES INTO ITS DISEASE MANAGEMENT AND PRIMARY/PREVENTATIVE CARE. THE ORGANIZATION'S PROFESSIONALS WORK TOGETHER TO PROVIDE TOOLS AND TREATMENTS INCLUDING: ASSESSMENT AND PRIVATE CONSULTATIONS, GROUP THERAPY SESSIONS, PHARMACOLOGICAL SUPPORT, FAMILY COUNSELING, AND OUTSIDE REFERRALS FOR MORE SPECIALIZED CARE. FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES: ADDITIONAL PROGRAM SERVICES PROVIDED BY THE HEALTH CENTER INCLUDE THE VISION AND OUTREACH PROGRAMS. THE VISION PRACTICE HAD 284 VISITS OF WHICH 49% WERE MEDICAID AND 38% WERE UNINSURED, RECEIVING $5,268 IN DISCOUNTS. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: THE ORGANIZATION UPDATED ITS BYLAWS EFFECTIVE DECEMBER 2014. SIGNIFICANT CHANGES TO THE BYLAWS INCLUDE ADDITIONAL RESPONSIBILITIES OF THE BOARD OF DIRECTORS: 1. SELECTING SERVICES BEYOND THOSE REQUIRED IN LAW TO BE PROVIDED BY THE HEALTH CENTER, AS WELL AS THE LOCATION AND MODE OF DELIVERY OF THOSE SERVICES. 2. DETERMINING THE HOURS DURING WHICH SERVICES ARE PROVIDED AT CORPORATION SITES THAT ARE APPROPRIATE AND RESPONSIVE TO THE COMMUNITY'S NEEDS. 3. SELECTION OF THE FINANCIAL AUDITOR AND ACCEPTANCE OF THE CORPORATION ANNUAL AUDIT. 4. REVIEW AND APPROVAL OF HRSA GRANT APPLICATIONS PRIOR TO SUBMISSION. 5. GRANTING PRIVILEGES TO NEW AND ESTABLISHED LICENSED INDEPENDENT PRACTITIONERS AND LICENSED CLINICAL STAFF TO PRACTICE WITHIN THE CORPORATION, AS WELL AS DEFINING A PROCESS OF APPEALS AND DECISIONS TO DISCONTINUE APPOINTMENT OR DENY CLINICAL PRIVILEGES OF LICENSED INDEPENDENT PRACTITIONERS AND LICENSED CLINICAL STAFF. FORM 990, PART VI, SECTION B, LINE 11B 990 REVIEW PROCESS: 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. PRIOR TO FILING, THE FORM 990 IS FIRST REVIEWED BY TOP MANAGEMENT. ONCE MANAGEMENT IS CONFIDENT WITH THE RETURN, A FINAL DRAFT IS E-MAILED TO EACH BOARD MEMBER FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: THE CONFLICT OF INTEREST POLICY IS REVIEWED AND SIGNED ANNUALLY BY BOARD MEMBERS AND ADMINISTRATIVE TEAM MEMBERS. POLICY: CONFLICT OF INTEREST AVOIDANCE PROCEDURES HELP BOARD MEMBERS, CONSULTANTS, EMPLOYEES AND THOSE WHO PROVIDE SERVICES OR FURNISH GOODS TO THE COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI IDENTIFY SITUATIONS THAT ARE OR MAY BE A CONFLICT OF INTEREST OR THE APPEARANCE OF CONFLICT OF INTEREST. A. CONFLICT OF INTEREST DEFINED. THE FOLLOWING CIRCUMSTANCES SHALL BE DEEMED TO CREATE CONFLICTS OF INTEREST: 1. OUTSIDE INTERESTS. (I) A CONTRACT OR TRANSACTION BETWEEN COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI AND A RESPONSIBLE PERSON OR FAMILY MEMBER. (II) A CONTRACT OR TRANSACTION BETWEEN COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI AND AN ENTITY IN WHICH A RESPONSIBLE PERSON OR FAMILY MEMBER HAS A MATERIAL FINANCIAL INTEREST OR OF WHICH SUCH PERSON IS A DIRECTOR, OFFICER, AGENT, PARTNER, EMPLOYEE, ASSOCIATE, TRUSTEE, PERSONAL REPRESENTATIVE, RECEIVER, GUARDIAN, CUSTODIAN, CONSERVATOR, OR OTHER LEGAL REPRESENTATIVE. 2. OUTSIDE ACTIVITIES. (I) A RESPONSIBLE PERSON COMPETING WITH COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI IN THE RENDERING OF SERVICES OR ANY OTHER CONTRACT OR TRANSACTION WITH A THIRD PARTY. (II) A RESPONSIBLE PERSON'S HAVING A MATERIAL FINANCIAL INTEREST IN; OR SERVING AS A DIRECTOR, OFFICER, EMPLOYEE, AGENT, PARTNER, ASSOCIATE, TRUSTEE, PERSONAL REPRESENTATIVE, RECEIVER, GUARDIAN, CUSTODIAN, CONSERVATOR, OR OTHER LEGAL REPRESENTATIVE OF, OR CONSULTANT TO; AN ENTITY OR INDIVIDUAL THAT COMPETES WITH COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI IN THE PROVISION OF SERVICES OR IN ANY OTHER CONTRACT OR TRANSACTION WITH A THIRD PARTY. 3. GIFTS, GRATUITIES AND ENTERTAINMENT. A RESPONSIBLE PERSON ACCEPTING GIFTS, ENTERTAINMENT, OR OTHER FAVORS FROM ANY INDIVIDUAL OR ENTITY THAT: (I) DOES OR IS SEEKING TO DO BUSINESS WITH, OR IS A COMPETITOR OF COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI; OR (II) HAS RECEIVED, IS RECEIVING, OR IS SEEKING TO RECEIVE A LOAN OR GRANT, OR TO SECURE OTHER FINANCIAL COMMITMENTS FROM COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI; (III) IS A CHARITABLE ORGANIZATION; UNDER CIRCUMSTANCES WHERE IT MIGHT BE INFERRED THAT SUCH ACTION WAS INTENDED TO INFLUENCE OR POSSIBLY WOULD INFLUENCE THE RESPONSIBLE PERSON IN THE PERFORMANCE OF HIS OR HER DUTIES. THIS DOES NOT PRECLUDE THE ACCEPTANCE OF ITEMS OF NOMINAL OR INSIGNIFICANT VALUE OR ENTERTAINMENT OF NOMINAL OR INSIGNIFICANT VALUE THAT ARE NOT RELATED TO ANY PARTICULAR TRANSACTION OR ACTIVITY OF COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI. B. PROCEDURES 1. BOARD MEMBERSHIP. NO BOARD MEMBER MAY BE AN EMPLOYEE OF THE COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI OR IMMEDIATE FAMILY MEMBER OF AN EMPLOYEE. 2. BOARD PARTICIPATION. BEFORE BOARD OR COMMITTEE ACTION ON A CONTRACT OR TRANSACTION INVOLVING A CONFLICT OF INTEREST OR APPEARANCE OF A CONFLICT OF INTEREST, A DIRECTOR OR COMMITTEE MEMBER HAVING A CONFLICT OF INTEREST AND WHO IS IN ATTENDANCE AT THE MEETING SHALL DISCLOSE ALL FACTS MATERIAL TO THE CONFLICT OF INTEREST. SUCH DISCLOSURE SHALL BE REFLECTED IN THE MINUTES OF THE MEETING. 3. RESPONSIBLE PERSONS WHO ARE NOT MEMBERS OF THE BOARD OF DIRECTORS OF COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI, OR WHO HAVE A CONFLICT OF INTEREST WITH RESPECT TO A CONTRACT OR TRANSACTION THAT IS NOT THE SUBJECT OF BOARD OR COMMITTEE ACTION, SHALL DISCLOSE TO THE CHAIR OR THE CHAIR'S DESIGNEE ANY CONFLICT OF INTEREST THAT SUCH RESPONSIBLE PERSON HAS WITH RESPECT TO A CONTRACT OR TRANSACTION. SUCH DISCLOSURE SHALL BE MADE AS SOON AS THE CONFLICT OF INTEREST IS KNOWN TO THE RESPONSIBLE PERSON. THE RESPONSIBLE PERSON SHALL REFRAIN FROM ANY ACTION THAT MAY AFFECT COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI'S PARTICIPATION IN SUCH CONTRACT OR TRANSACTION. IN THE EVENT IT IS NOT ENTIRELY CLEAR THAT A CONFLICT OF INTEREST EXISTS, THE INDIVIDUAL WITH THE CONFLICT SHALL DISCLOSE THE CIRCUMSTANCES TO THE BOARD PRESIDENT WHO SHALL DETERMINE WHETHER THERE EXISTS A CONFLICT OF INTEREST THAT IS SUBJECT TO THIS POLICY. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION REVIEW POLICY: IN FY 2015, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS CONDUCTED AN ANNUAL PERFORMANCE AND COMPENSATION REVIEW FOR THE CEO. MPCA SALARY DATA WAS USED AS COMPARABILITY DATA. THE BOARD'S DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON WRITTEN REQUEST FOR A LEGITIMATE BUSINESS PURPOSE (AS DETERMINED BY TOP MANAGEMENT). APPROVED DOCUMENTS WILL BE DISTRIBUTED VIA MAIL.