2016-05-12T14:48:49-05:00 2015-06-30 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2014-07-01 430715842 GENERAL JOHN J PERSHING MEMORIAL HOSPITAL ASSOCIATION % GARY TANDY CFO GENE 6602581288 130 E LOCKLING BROOKFIELD MO 64628 PHIL HAMILTON CEO 6602582222 2016-05-16 true Kevin Ensminger CPA P01310558 8162216300 2014 2016-08-17 19:52:53Z PHIL HAMILTON 130 E LOCKLING PO BOX 408 BROOKFIELD MO 64628 18613067 false X HTTP://WWW.PERSHINGHEALTHSYSTEM.COM/ X 1955 MO SERVING OTHERS THROUGH QUALITY, COMPASSIONATE CARE. 10 8 183 37 0 0 1226 3879 17742920 18454295 75017 41692 93825 113201 17912988 18613067 9109 9864 0 0 8470983 8117434 0 0 0 10153657 10453585 18633749 18580883 -720761 32184 20400463 20190394 7744413 7502160 12656050 12688234 SERVING OTHERS THROUGH QUALITY, COMPASSIONATE CARE. false false 2437851 1677 3137230 INPATIENT ACUTE CARE SERVICES WITH 535 INPATIENT ADMISSIONS 10468420 7201 13471635 OUTPATIENT SERVICES WITH APPROXIMATELY 23,000 REGISTRATIONS. THIS INCLUDES 5,339 EMERGENCY ROOM VISITS. 1434030 986 1845430 COMMUNITY MEDICAL ASSOCIATES, OUR PROVIDER BASED RURAL HEALTH CLINIC, WITH BOTH SCHEDULED AND WALK-IN SERVICES, IS OPEN 8 HOURS A DAY MONDAY THRU SATURDAY AND 5 HOURS ON SUNDAY. IT HAD 12,959 VISITS THIS PAST FISCAL YEAR. IT IS A LOWER COST ALTERNATIVE THAN USING THE EMERGENCY ROOM. APPLEGATE MEDICAL GROUP SAW 9,288 PATIENTS, OPEN 5 DAYS A WEEK AND MEADVILLE MEDICAL CENTER IS OPEN 3 DAYS A WEEK AND SAW 1,325 PATIENTS. 14340301 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 43 0 true 183 true false false false false false false false false false false X 10 8 true 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 102830 0 0 CARY SAYRE DIRECTOR 1.0 0.0 X 0 0 0 PHIL HAMILTON CEO 40.0 0.0 X 140494 0 14473 GARY TANDY CFO 40.0 0.0 X 104354 0 12963 WACLAW DYMEK EMPLOYED PHYSICIAN 40.0 0.0 X 393642 0 23435 SISENARDO GALVEZ EMPLOYED PHYSICIAN 30.0 0.0 X 197243 0 1005 GRACE DYMEK EMPLOYED PHYSICIAN 40.0 0.0 X 161710 0 3372 GARY FITE DIRECTOR OF PHYSICAL THERAPY 40.0 0.0 X 125518 0 22153 BRIAN CASEBOLT DIRECTOR OF PHARMACY 40.0 0.0 X 110642 0 32270 1336433 0 109671 7 false true true DR GARRETT ELAM PHYSICIAN SERVICES 173880 HAVE A NICE DAY ANESTHESIA ASSOC ANESTHESIA GROUP 199405 DR PEPITO C RIVERA PHYSICIAN SERVICES 566192 DR KAREN SYLVARA PHYSICIAN SERVICES 140455 DR JERRY WAIT PHYSICIAN SERVICES 162260 8 3879 3879 Net Patient Service Rev 621400 17687251 17687251 340B Revenue 900099 767044 767044 18454295 41692 41692 0 0 22075 22075 0 22075 22075 0 0 0 0 Cafeteria 900099 34321 34321 Miscellaneous income 900099 13593 13593 Vending Machines 900099 43212 43212 91126 18613067 18454295 154893 9864 9864 0 0 0 371662 94780 276882 239150 172188 66962 6005755 4477110 1528645 77556 59363 18193 966516 712219 254297 456795 328892 127903 0 26508 26508 80532 80532 11295 11295 0 0 3463337 2788098 675239 0 23097 16630 6467 563714 405874 157840 0 0 395607 284837 110770 4726 4726 0 8273 8273 265066 190848 74218 0 1323060 952603 370457 220919 159062 61857 Bad Debt Expense 2110286 2110286 Medical Supplies 1160272 835396 324876 Taxes & Licenses 49882 49882 Medicaid FRA Payments 696408 696408 50603 45843 4760 18580883 14340301 4240582 0 0 0 6723106 7223699 0 0 3631472 3976252 0 0 0 0 241240 243465 229166 212306 247853 272916 19872493 12102383 8929314 7770110 0 0 0 0 0 0 0 0 398312 491646 20400463 20190394 1392611 1405612 0 0 0 0 0 0 0 0 0 0 6351802 6096548 0 0 0 0 7744413 7502160 X 12648703 12681893 7347 6341 0 0 12656050 12688234 20400463 20190394 32184 X false true X false false X false false false false false true 11295 false false false 11295 false SCHEDULE C, PART II-B, LINE 1F FOR 2015, $11,295 OF DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION WERE USED FOR LOBBYING/ADVOCACY EXPENDITURES. 107129 107129 13621933 7182882 6439051 6143431 4919501 1223930 7770110 16854998 2681 2681 16852317 1760750 1760750 18613067 16821808 16821808 1759075 1759075 18580883 SCHEDULE D, PART X, LINE 2 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, LINES 2D & 4B LINE 2D: NET ASSETS RELEASED FROM RESTRICTIONS $ 2,681 LINE 4B: RESTRICTED CONTRIBUTIONS RECEIVED $ 1,675 PROVISION FOR UNCOLLECTIBLE ACCOUNTS $ 1,759,075 ----------- TOTAL $ 1,760,750 SCHEDULE D, PART XII, LINE 4B PROVISION FOR UNCOLLECTIBLE ACCOUNTS $ 1,759,075 true true true X 133. true X 213. true true true false true true 201526 201526 0.01220 2836511 2404619 431891 0.02620 3038037 2404619 633417 0.03840 17162 33423 -16261 4999 4999 0.00030 22161 33423 -11262 0.00030 3060198 2438042 622155 0.03870 true 2110286 263861 8094853 8134188 -39335 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 12 true false false true X WWW.PERSHINGHEALTHSYSTEM.COM X true 12 true WWW.PERSHINGHEALTHSYSTEM.COM false false true X 133. 213. X X X X true true X X X true X WWW.PERSHINGHEALTHSYSTEM.COM X WWW.PERSHINGHEALTHSYSTEM.COM X WWW.PERSHINGHEALTHSYSTEM.COM X X X X X true X false X X X X true X false false PART V, SECTION B, LINE 5 THE HOSPITAL RECEIVED INPUT FROM SEVERAL REPRESENTATIVES FROM THE COMMUNITY INCLUDING INDEPENDENT HEALTHCARE PROFESSIONALS, COUNTY HEALTH DEPARTMENT OFFICIALS, PERSHING MEMORIAL HOSPITAL EMPLOYEES, AND OTHER MEMBERS OF THE COMMUNITY. PART V, SECTION B, LINE 11 THE HOSPITAL HAS BEEN WORKING ON THE IDENTIFIED NEEDS ACCORDING TO OUR IMPLEMENTATION PLAN AS ADOPTED BACK IN 2013. EACH NEED/PRIORITY IS LISTED BELOW WITH A DESCRIPTION OF HOW THE HOSPITAL IS ADDRESSING EACH SIGNIFICANT NEED IDENTIFIED: PRIORITY #1: HELPING CHILDREN IN POVERTY Pershing Health System is addressing childhood poverty in the following manner: -Free wellness exams for all school aged children in Linn County held one Saturday a month during May, June, July, August. Approx. 188 children received exams -Foster Child Clothing Drive- Adoptions of all local foster children (57 children total) in Linn County and purchase clothing items needed during the Christmas Holiday. -Food Pantry Drive -Diaper Drive participant -Healthy Eating booth at Healthy Kids Fair at YMCA. Educated children on healthy food choices and gave out fruit as snack. Approx. 250 children from Linn County area attended -Participation in the Linn County Health Department Drive Through Flu Clinic. PRIORITY #2: ADULT SMOKING IN LINN COUNTY Pershing Health System is addressing adult smoking in the following manner: -This priority went unaddressed due to lack of resources in the area to have sufficient training of employee's to be a smoking cessation instructor. -Referrals have been made to local stakeholder agency that offers smoking cessation classes. PRIORITY #3: ADDRESSING ADULT OBESITY Pershing Health System is addressing Adult obesity in the following manner: - Hospitals week Health Fair held at YMCA 2 days a week in Brookfield, and at Bethany Baptist Church in Marceline 2 days a week. - Job health fair at local factories where Pershing employees go to the local factories to bring health care to factory workers in the work environment. This allows the worker to remain at work and still have basic medical assessment completed. PRIORITY #4: INCREASING ACCESS TO MENTAL HEALTH PROVIDERS AND SERVICES Pershing Health system has addressed mental health in the following manner: - Unfortunately as is common in most rural areas, Linn County has a lack of mental health providers and services. Pershing Health System does not have the resources that would be required to effect the changes that are needed to completely address the lack of mental health care and access to mental health providers and services. However, Pershing Health System has utilized available resources to participate and engage with community agencies and initiatives to enhance relationships among community stakeholders and consumers of mental health care to increase awareness in responding to mental health crises and improve continuity of care for mental health consumers. PRIORITY #5: A LACK OF PRIMARY CARE ACCESS AND PHYSICIANS Pershing Health System has addressed lack of primary care/access to physicians in the following manner: - Hospitals week Health Fair held at YMCA 2 days a week in Brookfield, and at Bethany Baptist Church in Marceline 2 days a week. - Free wellness exams for all school aged children in Linn County held one Saturday a month during May, June, July, August. Approx. 188 children received exams - Participation in the Linn County Health Department Drive Through Flu Clinic. PRIORITY #6: MEDICATION EDUCATION Pershing Health System has addressed medication education in the following manner: - Hospitals week Health Fair held at YMCA 2days a week in Brookfield, and at Bethany Baptist Church in Marceline 2 days a week. - Free wellness exams for all school aged children in Linn County held one Saturday a month during May, June, July, August. Approx. 188 children received exams - Participation in the Linn County Health Department Drive Through Flu Clinic. 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 MANAGED CARE CONTRACTUAL WRITE OFFS DIVIDED BY MANAGE CARE REVENUES. 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 PART I, LINE 3C THE ORGANIZATION USED FACTORS SUCH AS ASSET LEVEL, MEDICAL INDIGENCY, UNDERINSURANCE STATUS AND RESIDENCY TO DETERMINE ELIGIBILITY FOR FREE AND DISCOUNTED CARE. PART I, LINE 7 THE COST METHOD USED TO CALCULATE THE AMOUNTS IN THIS TABLE IS A COST TO CHARGE RATIO. 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 2,110,286. PART III, SECTION A, LINE 2 BAD DEBT EXPENSE IS THAT PORTION OF ANY SELF PAY BALANCE REFERRED ON FOR OUTSIDE COLLECTION SERVICES, AND THAT EITHER DID NOT APPLY OR DID NOT QUALIFY UNDER OUR FINANCIAL ASSISTANCE POLICY - CHARITY CARE POLICY. THE HOSPITAL PROVIDES SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATE (TO PATIENTS WHO MEET THE CRITERIA OF IT'S FINANCIAL ASSISTANCE POLICY - CHARITY CARE POLICY). THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY - CHARITY CARE POLICY IS FOUNDED ON THE FEDERAL POVERTY INCOME GUIDELINES. ACCOUNTS AND AMOUNTS DETERMINED TO MEET THIS CRITERIA ARE NOT REPORTED AS NET REVENUE AND ARE NOT PURSUED FOR COLLECTION. 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. PART III, SECTION A, LINE 4 PLEASE SEE NOTE 1 BEGINNING ON PAGE 7 OF THE ATTACHED FINANCIAL STATEMENTS FOR THE FOOTNOTE DESCRIBING THE ORGANIZATION'S BAD DEBT EXPENSE. PART III, SECTION B, LINE 8 PERSHING MEMORIAL HOSPITAL BELIEVES THAT THE COMMUNITY DESERVES TO BE PROVIDED QUALITY HEALTHCARE LOCALLY. MEDICARE CURRENTLY REIMBURSES THE HOSPITAL LESS THAN THE COST OF THE SERVICES PROVIDED TO ITS PATIENTS. THEREFORE, PERSHING MEMORIAL HOSPITAL BELIEVES THAT THIS MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT. PART III, SECTION C, LINE 9B WE HAVE A FINANCIAL ASSISTANCE POLICY AND COLLECTION POLICY THAT COVERS CRITERIA FOR PAYMENT ARRANGEMENTS AND FOR PARTIAL OR FULL CHARITY CARE WRITE-OFF. PART VI, LINE 2 - NEEDS ASSESSMENT 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. PART VI, LINE 3 - PATIENT EDUCUCATION OF ELIGIBILITY FOR ASSISTANCE INFORMATION ON OUR FINANCIAL ASSISTANCE POLICY (FAP) IS ON OUR WEBSITE. THE FAP, CHARITY CARE AND COLLECTION (PAYMENT ARRANGEMENTS) INFORMATION IS AVAILABLE THRU OUR COLLECTION PERSONNEL AND OTHERS AT PERSHING HOSPITAL AND THRU OUR WALK-IN CLINIC, COMMUNITY MEDICAL ASSOCIATES, 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, THRU THE ASSESSMENT/CONSULTATION PROCESS, IDENTIFIES AND ASSISTS IN THE APPLICATION PROCESS FOR INDIVIDUALS. PART VI, LINE 4 - COMMUNITY INFORMATION 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 BUSINESSS AND AGRICULTURE. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH 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, NURSE PRACTITIONERS, NURSING. PROVIDED JOB SHADOWING AND CLINICAL ROTATIONS TO THE AREA CAREER CENTERS. PROVIDE FREE SPORTS PHYSICALS AT THE BEGINNING OF EACH SCHOOL YEAR. NURSE PRACTITIONERS PROVIDE WELL CHILD EXAMS YEARLY AT THE LINN CO. 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, ANNUAL PUBLIC EVENT DONE AT THE LOCAL (BROOKFIELD) YMCA AND AT MARCELINE BETHANY BAPTIST CHURCH: -PROCESSED BLOOD DRAWS; PHYSICIAL AND OCCUPATIONAL THERAPY HEALTH BOOTH; BLOOD PRESSURES 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 false false false false false false false false false PHIL HAMILTON CEO 120961 0 17872 0 1661 0 2630 0 11843 0 154967 0 0 0 WACLAW DYMEK EMPLOYED PHYSICIAN 323085 0 70557 0 0 0 3842 0 19593 0 417077 0 0 0 SISENARDO GALVEZ EMPLOYED PHYSICIAN 197243 0 0 0 0 0 0 0 1005 0 198248 0 0 0 GRACE DYMEK EMPLOYED PHYSICIAN 161710 0 0 0 0 0 2346 0 1026 0 165082 0 0 0 FORM 990, PART VII, LINE 5 PHIL HAMILTON RECEIVED $162,480 FROM BOONE HOSPITAL CENTER, AN UNRELATED ORGANIZATION, FOR HIS SERVICES AS CEO. DR KAREN SYLVARA SPOUSE OF DIRECTOR 198450 CONTRACT PHYSICIAN false JENNIFER THUDIUM DAUGHTER-IN-LAW OF DIR 40700 EMPLOYEE false FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION ENTERED INTO A MANAGEMENT AGREEMENT 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 DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST AND FINANCIAL STATEMENT AVAILABLE TO THE PUBLIC. FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:1630508 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:26605 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:1806224