2015-08-10T15:58:15-05:00 2014-12-31 BKD LLP 211 N BROADWAY SUITE 600 ST LOUIS MO 631022733 990 2014-01-01 430926316 Independence Health Systems Inc % BONNIE SCHNURBUSCH INDE 5735476546 800 SOUTH KINGSHIGHWAY Suite PERRYVILLE MO 63775 BRIAN DREYER PRESIDENT, BOARD OF DIRECTORS 5735476546 2015-08-06 true Donna J Larson P00043751 3142315544 2014 2016-02-25 16:41:14Z BONNIE SCHNURBUSCH 800 S KINGSHIGHWAY PERRYVILLE MO 63775 9092478 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 9 285 50 0 30160 20135 8191250 8972791 32423 21368 80603 78184 8334436 9092478 0 0 0 0 3755573 3843484 0 0 0 3638921 3696009 7394494 7539493 939942 1552985 9921571 11319318 6720252 6511072 3201319 4808246 TO PROVIDE THE ELDERLY WITH RETIREMENT AND HEALTH CARE SERVICES WHICH ARE DEDICATED TO EXCELLENCE, IN AN ENVIRONMENT WHICH PROMOTES LIVING WITH DIGNITY, SECURITY AND INDEPENDENCE. false false 6049487 8972791 PROVIDED LONG TERM CARE FOR THE ELDERLY AT VARIOUS STAGES: SKILLED NURSING FACILTY, 123 LICENSED BEDS; RESIDENTIAL CARE, 95 LICENSED BEDS; INDEPENDENT LIVING, TWO COTTAGES AND THREE DUPLEXES. ACCEPT MEDICARE, MEDICAID, AND PRIVATE PAY WHERE APPLICABLE. APPLICABLE. 6049487 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 27 0 true 285 true 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 X TERRI GREEN BOARD MEMBER 1.0 0.0 X 0 0 0 EDWARD WELKER BOARD MEMBER 1.5 0.0 X 0 0 0 PATTY WICHERN BOARD MEMBER 1.0 0.0 X 0 0 0 VIDA YAMNITZ BOARD MEMBER 1.0 0.0 X 0 0 0 DENIS ERNST VICE-PRESIDENT 1.5 0.0 X X 0 0 0 DON PALISCH BOARD MEMBER 1.0 0.0 X 0 0 0 PAT LUEHRS BOARD MEMBER 1.0 0.0 X 0 0 0 JUDITH ERNST SECRETARY/TREASURER 1.5 0.0 X X 0 0 0 BRIAN DREYER PRESIDENT 1.0 0.0 X X 0 0 0 BONNIE SCHNURBUSCH ADMINISTRATOR/CEO 40.0 0.0 X 0 0 0 THREASA WHITE ACCOUNTANT/CFO 40.0 0.0 X 68601 0 3699 RHONDA PFISTER ACCOUNTANT/CFO 40.0 0.0 X 9515 0 0 78116 0 3699 0 false false true PERRY COUNTY HEALTH SYSTEMS 434 NORTH WEST STREET PERRYVILLE MO 63775 MANAGEMENT SERVICES 225291 REHAB CARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 THERAPY SERVICES 504275 2 20135 20135 Room and Board 623000 8972791 8972791 8972791 21368 21368 0 0 0 0 0 0 0 0 0 Beauty & Barber Shop 812900 32055 32055 Maintenance Fees 900099 15480 15480 Employee & Guest Meals 722513 17113 17113 13536 13536 78184 9092478 8972791 99552 0 0 0 0 81815 81815 0 3168889 2750213 418676 0 0 317851 272353 45498 274929 232865 42064 225290 128641 96649 2290 2290 38438 38438 0 0 0 310000 308671 1329 14261 8143 6118 1148902 656023 492879 0 0 324141 185085 139056 0 0 0 290422 290422 0 275972 248375 27597 105957 60501 45456 Food 276388 276388 NFRA Fees 489259 489259 Licenses and Fees 12467 7119 5348 Bad Debt Expense 70796 70796 111426 64633 46793 7539493 6049487 1490006 0 15472 15472 5103286 6163241 0 0 574136 734866 0 0 0 0 0 0 45566 48082 0 0 12071118 9741823 2199814 2329295 1081100 1135046 0 0 0 0 0 0 902197 893316 9921571 11319318 525727 611547 0 0 99525 99525 6095000 5800000 0 0 0 0 0 0 0 0 0 0 6720252 6511072 X 3201319 4808246 0 0 0 0 3201319 4808246 9921571 11319318 1552985 53942 X false true X true false X 0 35150 27009 30160 20135 112454 7934326 8217467 8351858 8271853 9050975 41826479 0 0 0 7934326 8252617 8378867 8302013 9071110 41938933 0 0 0 0 0 0 0 0 0 0 0 0 0 41938933 60463 44968 43462 32323 21368 202584 0 60463 44968 43462 32323 21368 202584 0 0 7994789 8297585 8422329 8334336 9092478 42141517 0.99519 0.99416 0.00481 0.00585 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 811362 585015 10269 597753 808893 814911 580672 9969 594190 811362 816790 583703 12205 597787 814911 823841 576554 12045 595650 816790 815115 583443 18183 592900 823841 1.00000 false false 254200 254200 10710403 8955219 1755184 1106515 786604 319911 2329295 Investments Held for Bond Rese 808893 Bond Issuance Costs 84423 893316 9067695 53942 53942 9013753 78725 78725 9092478 7460768 7460768 78725 78725 7539493 PART V, LINE 4 THE ENDOWMENT FUNDS ARE TO BE USED FOR BOND PAYMENTS. 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. PART XI & XII, LINE 4B OTHER RECONCILING ITEMS: BAD DEBT EXPENSE $70,796 MISCLASSIFIED REVENUE $7,929 -------- TOTAL $78,725 X true true X false false false false false false false false false BONNIE SCHNURBUSCH ADMINISTRATOR/CEO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE J, 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. FORM 990, PART VII, LINE 5 INDEPENDENCE HEALTH SYSTEM, INC. PAYS PERRY COUNTY HEALTH SYSTEMS $225,290, WHICH INCLUDES 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 1725000 5800000 7525000 604070 2134822 0 84423 0 0 0 0 0 2008 true false true true A 0 A false true true true false false 0 false 0 false false A false SCHEDULE K, PART IV, LINE 2C REBATE COMPUTATION WAS PERFORMED ON 3/1/2014 FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBERS JUDY ERNST AND BRIAN DREYER HAVE A BUSINESS RELATIONSHIP. ADMINISTRATOR BONNIE SCHNURBUSCH AND BOARD MEMBER BRIAN DREYER HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, 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, PART VI, SECTION B, 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, PART VI, SECTION B, 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, & 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 POSSIBLE CONFLICT OF INTEREST MIGHT ARISE. FORM 990, PART VI, SECTION B, LINE 15A A COMPENSATION REVIEW WAS CONDUCTED IN 2014 BY PATRICK CARRON, CEO OF PERRY COUNTY HEALTH SYSTEMS, AND THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15B THE CEO CONDUCTED THE ANNUAL PERFORMANCE AND SALARY REVIEW OF THE CFO IN JULY 2014. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.