2026-07-20T12:44:21-05:00 2025-09-30 470698853 BLAND & ASSOCIATES 450 REGENCY PARKWAY SUITE 340 OMAHA NE 68114 990 2024-10-01 480608913 SALEM HOSPITAL INC SALE 6209471450 704 S ASH STREET HILLSBORO KS 67063 PETER MUNGAI CEO/ADMINISTRATOR 6209472272 2026-07-20 1 1 MIKE MULLER P01798781 4023978822 2026-07-20 2024 2025-03-06 01:10:19Z SALEM HOME PETER MUNGAI 704 S ASH STREET HILLBORO KS 67063 5112152 0 X WWW.SALEMHOMEKS.ORG X 1953 KS SALEM HOME WILL MASTER PERSON-CENTERED CARE TO BENEFIT RESIDENTS, FAMILIES, STAFF, AND THE COMMUNITY. 7 7 107 15 10301 0 2097 15974 5089640 4967034 13569 15722 103592 100720 5208898 5099450 0 0 0 0 2628574 2848174 0 0 0 2036662 1991676 4665236 4839850 543662 259600 2890498 5723438 369135 2942385 2521363 2781053 SALEM HOME WILL MASTER PERSON-CENTERED CARE TO BENEFIT RESIDENTS, FAMILIES, STAFF, AND THE COMMUNITY. 0 0 4158785 5055675 PROVIDED LONG-TERM CARE VIA A SKILLED NURSING FACILITY AND INDEPENDENT LIVING APARTMENTS. CARE WAS PROVIDED FOR A TOTAL OF 77 NURSING FACILITY RESIDENTS AND 11 APARTMENT RESIDENTS. THERE WERE A TOTAL OF 15,418 CENSUS DAYS FOR THE NURSING FACILITY RESIDENTS PER MEDICAID CENSUS REPORT FOR CALENDAR YEAR 2025. 4158785 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 10 0 1 107 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 KS X HEATHER CROCKER 6209471459 704 S ASH ST HILLSBORO KS 67063 JARED JOST BOARD CHAIRMAN 1.00 X X 0 0 0 LAURA ENSEY SECRETARY/DIRECTOR 1.00 X X 0 0 0 TOM KOSLOWSKY VICE-CHAIR 1.00 X 0 0 0 EILEEN UNRUH DIRECTOR 1.00 X 0 0 0 HANK WIEBE DIRECTOR 1.00 X 0 0 0 DELAYNE HERBEL DIRECTOR 1.00 X 0 0 0 MARY LANCASTER DIRECTOR 1.00 X 0 0 0 PETER MUNGAI CEO/ADMINISTRATOR 40.00 X 112466 0 2288 HEATHER CROCKER DIRECTOR OF FINANCE 40.00 X 75236 0 6637 187702 0 8925 1 0 0 0 0 15974 15974 NET RESIDENT SERVICE R 623000 4967034 4967034 4967034 17500 17500 83208 0 83208 83208 83208 10924 12702 -1778 -1778 -1778 MEALS 900099 9226 9226 OTHER REVENUE 722513 4250 4250 SHARED SERVICES REVENU 900099 2961 2961 1075 1075 17512 5099450 5055675 10301 17500 X 196627 187954 8673 2283480 2074385 209095 186198 177985 8213 181869 173847 8022 24269 24269 663426 663426 161726 125046 36680 184836 184836 6839 4549 2290 12488 12488 163528 163528 73375 73375 FOOD 252438 252438 CONTRACT SERVICES 144242 50497 93745 MEDICAL SUPPLIES 134489 134489 BAD DEBT 62122 62122 107898 67211 40687 4839850 4158785 681065 0 314540 384147 597598 847389 421800 388867 1422 946 49304 51766 2405982 984866 1501755 1421116 4079 4169 0 2625038 2890498 5723438 360575 368433 8560 9360 2564592 369135 2942385 X 2521363 2781053 2521363 2781053 2890498 5723438 259600 90 0 X 0 1 X 1 0 X 0 0 0 0 0 1 370 0 0 0 370 0 PART II-B, LINE 1: A PORTION OF THE LEADING AGE KANSAS ANNUAL DUES ARE FOR LOBBYING ACTIVITIES. 10000 10000 399859 5876 393983 1786643 919529 867114 209480 59461 150019 1421116 BONDS 2625038 2625038 X 5101318 90 1778 1868 5099450 0 5099450 4841628 1778 1778 4839850 0 4839850 PART X, LINE 2: THE ORGANIZATION HAS RECEIVED EXEMPTION FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS NOT CLASSIFIED AS A PRIVATE FOUNDATION. AS SUCH, NO PROVISION FOR INCOME TAXES IS REFLECTED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, IN THE U.S. FEDERAL AND STATE JURISDICTIONS. AS OF SEPTEMBER 30, 2025 AND 2024, THE ORGANIZATION HAS NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. TAX YEARS SUBSEQUENT TO 2021 REMAIN SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF PROPERTY AND EQUIPMENT 1,778. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF PROPERTY AND EQUIPMENT 1,778. FORM 990, PART VI, SECTION B, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990. THE RETURN IS THEN REVIEWED BY THE CHIEF EXECUTIVE OFFICER. ANY QUESTIONS OR CONCERNS THE CHIEF EXECUTIVE OFFICER HAS ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS ARE MADE. THE FINAL FORM 990, WITH ALL REQUIRED SCHEDULES, IS PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS DIRECTORS, OFFICERS, AND ALL EMPLOYEES WHO CAN INFLUENCE THE ACTIONS OF SALEM HOME. THESE INDIVIDUALS ARE REQUIRED TO ANNUALLY SIGN A STATEMENT CONFIRMING THAT THEY RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAVE READ AND UNDERSTAND THE POLICY, AND HAVE AGREED TO COMPLY WITH THE POLICY. ANY POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED TO THE CHIEF EXECUTIVE OFFICER (OR TO THE BOARD CHAIR IF IT IS THE CEO WHO HAS THE POTENTIAL CONFLICT). THE POTENTIAL CONFLICT WILL THEN BE BROUGHT TO THE BOARD OF DIRECTORS WHO SHALL DETERMINE IF AN ACTUAL CONFLICT EXISTS. IF AN ACTUAL CONFLICT EXISTS, THE INDIVIDUAL WITH THE CONFLICT MUST RECUSE THEMSELF FROM THE BOARD MEETING UNTIL THE DISCUSSION AND APPROVAL OF THE TRANSACTION IS COMPLETED. FORM 990, PART VI, SECTION B, LINE 15A IN 2016, THE INTERIM CEO REVIEWED COMPARABLE POSITIONS AND PROVIDED THE BOARD OF DIRECTORS WITH SUGGESTED COMPENSATION FOR THE NEW CEO POSITION. THE BOARD OF DIRECTORS AGREED UPON COMPENSATION, WHICH WAS DOCUMENTED IN AN OFFER LETTER TO THE NEW CEO. THIS OFFER LETTER WAS SIGNED BY THE NEW CEO, INTERIM CEO, AND BOARD OF DIRECTORS CHAIRMAN. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 663,426. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 663,426.