CARROLL COUNTY MEMORIAL HOSPITAL: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- CARROLL COUNTY MEMORIAL HOSPITAL (EIN 44-0629397)
- Tax period
- 2023-07-01 to 2024-06-30
- Filed
- 2025-05-06
- IRS object ID
- 202541269349302184
- Schema version
- 2023v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-05-06T12:31:45-05:00 | ReturnTs |
| Tax Period End | 2024-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT ST STE 200 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 680224722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 440629397 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARROLL COUNTY MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CARR | BusinessNameControlTxt |
| Phone | 6605421695 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 N JEFFERSON STREET | AddressLine1Txt |
| City | CARROLLTON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64633 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT THORESON | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6605421695 | PhoneNum |
| Signature | 2025-05-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MEGAN L KOZIOL CPA | PreparerPersonNm |
| PTIN | P01544037 | PTIN |
| Phone | 4023302660 | PhoneNum |
| Preparation | 2025-05-05 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SCOTT THORESON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 N JEFFERSON STREET | AddressLine1Txt |
| City | CARROLLTON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64633 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $45,148,606 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CARROLLCOUNTYHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1957 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | CARROLL COUNTY MEMORIAL HOSPITAL IS DEDICATED TO THE HEALTH AND WELL-BEING OF ALL WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 305 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $269,787 | PYContributionsGrantsAmt |
| CY Contributions Grants | $41,873 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $38,859,361 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $44,618,672 | CYProgramServiceRevenueAmt |
| PY Investment Income | $221,862 | PYInvestmentIncomeAmt |
| CY Investment Income | $174,823 | CYInvestmentIncomeAmt |
| PY Other Revenue | $214,771 | PYOtherRevenueAmt |
| CY Other Revenue | $264,976 | CYOtherRevenueAmt |
| PY Total Revenue | $39,565,781 | PYTotalRevenueAmt |
| CY Total Revenue | $45,100,344 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $20,696,966 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $22,503,544 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,054,804 | PYOtherExpensesAmt |
| CY Other Expenses | $22,031,436 | CYOtherExpensesAmt |
| PY Total Expenses | $40,751,770 | PYTotalExpensesAmt |
| CY Total Expenses | $44,534,980 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,185,989 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $565,364 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $39,557,467 | TotalAssetsBOYAmt |
| Total Assets EOY | $40,220,804 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,111,066 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,729,759 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $30,446,401 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $31,491,045 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CARROLL COUNTY MEMORIAL HOSPITAL IS DEDICATED TO THE HEALTH AND WELL-BEING OF ALL WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $38,707,109 | ExpenseAmt |
| Revenue | $44,705,007 | RevenueAmt |
| Desc | ACUTE CARE HOSPITAL ORGANIZED TO PROVIDE INPATIENT AND OUTPATIENT CARE TO AREA RESIDENTS REGARDLESS OF THEIR ABILITY TO PAY. | Desc |
| Total Program Service Expenses | $38,707,109 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 52 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 305 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LESLEY DELANEY | PersonNm |
| Phone | 6605421695 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 NORTH JEFFERSON ST | AddressLine1Txt |
| City | CARROLLTON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64633 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| TIMOTHY REID MD | ||||||||
| MEMBER/PHYSICIAN | 40.00 | 0.00 | Yes (X) | $304,416 | $0 | $57,981 | ||
| WADE MERTENSMEYER | ||||||||
| PRESIDENT | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ANNA BARLOW | ||||||||
| VICE PRESIDENT | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| TOM BURKHART | ||||||||
| SECRETARY/TREASURER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JENNIFER POSTON | ||||||||
| MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JANICE BURNSIDE | ||||||||
| MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JENNIFER LINK | ||||||||
| MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN BROWN | ||||||||
| MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MATT LOCK | ||||||||
| MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KEN BROWN | ||||||||
| MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KIM RITCHHART | ||||||||
| MEMBER THRU 9/2023 | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SCOTT THORESON | ||||||||
| CEO | 39.00 | 1.00 | $232,597 | $0 | $39,241 | Yes (X) | ||
| LESLEY DELANEY | ||||||||
| CFO | 39.00 | 1.00 | $131,731 | $0 | $34,567 | Yes (X) | ||
| GREGORY HUBBARD MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $570,823 | $0 | $54,822 | Yes (X) | ||
| RICHARD SMITH MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $543,744 | $0 | $37,323 | Yes (X) | ||
| ANDREW HORINE MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $471,274 | $0 | $46,943 | Yes (X) | ||
| JEREMY STAYTON MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $460,935 | $0 | $23,997 | Yes (X) | ||
| PAMELA RALLS MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $286,565 | $0 | $42,756 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,002,085 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $337,630 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 23 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HOSPITAL CARE CONSULTANTS INC | |||||
| 17304 PRESTON ROAD SUITE 1400 | DALLAS | TX | 75252 | HOSPITALIST SERVICES | $754,675 |
| ORACLE CERNER | |||||
| PO BOX 203448 | DALLAS | TX | 75320 | EMR | $685,074 |
| EMERGENCY STAFFING SOLUTIONS INC | |||||
| 17304 PRESTON ROAD SUITE 1400 | DALLAS | TX | 75252 | HOSPITALIST SERVICES | $674,122 |
| CREATIVE PLANNING | |||||
| PO BOX 950443 | ST LOUIS | MO | 63195 | IT MANAGED SERVICES | $660,934 |
| HAVE A NICE DAY ANESTHESIA | |||||
| 2106 WOODCREST DR | CHILLICOTHE | MO | 64601 | ANESTHESIA SERVICES | $460,206 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 16 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $41,873 | GovernmentGrantsAmt |
| Total Contributions | $41,873 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICARE/MEDICAID | 624100 | $29,022,998 | $29,022,998 |
| NET PATIENT SERVICE REVENUE | 624100 | $13,725,633 | $13,725,633 |
| 340B DRUG PRICING PROGRAM | 624100 | $1,256,204 | $1,256,204 |
| ELECTRONIC HEALTH RECORD INCENTIV | 624100 | $300,376 | $300,376 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $313,461 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $313,461 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $44,618,672 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $201,985 | TotalRevenueColumnAmt |
| Exclusion | $201,985 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $105,935 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $19,600 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $86,335 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $86,335 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $86,335 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $28,662 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$27,162 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$27,162 | TotalRevenueColumnAmt |
| Exclusion | -$27,162 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA | Desc |
| Business | 722514 | BusinessCd |
| Total Revenue Column | $178,641 | TotalRevenueColumnAmt |
| Exclusion | $178,641 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $178,641 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,100,344 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,705,007 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $353,464 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $808,098 | TotalAmt |
| Program Services | $351,337 | ProgramServicesAmt |
| Management And General | $456,761 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,568,617 | TotalAmt |
| Program Services | $14,451,516 | ProgramServicesAmt |
| Management And General | $2,117,101 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $852,443 | TotalAmt |
| Program Services | $719,810 | ProgramServicesAmt |
| Management And General | $132,633 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,274,386 | TotalAmt |
| Program Services | $3,546,094 | ProgramServicesAmt |
| Management And General | $728,292 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,999 | TotalAmt |
| Management And General | $36,999 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,438 | TotalAmt |
| Management And General | $124,438 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,533,874 | TotalAmt |
| Program Services | $10,880,033 | ProgramServicesAmt |
| Management And General | $653,841 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,331 | TotalAmt |
| Program Services | $34,383 | ProgramServicesAmt |
| Management And General | $24,948 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,110,333 | TotalAmt |
| Program Services | $804,659 | ProgramServicesAmt |
| Management And General | $305,674 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $655,615 | TotalAmt |
| Program Services | $595,437 | ProgramServicesAmt |
| Management And General | $60,178 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $916,395 | TotalAmt |
| Program Services | $734,921 | ProgramServicesAmt |
| Management And General | $181,474 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $202,137 | TotalAmt |
| Program Services | $142,357 | ProgramServicesAmt |
| Management And General | $59,780 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $181,487 | TotalAmt |
| Program Services | $126,857 | ProgramServicesAmt |
| Management And General | $54,630 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,401,249 | TotalAmt |
| Program Services | $1,912,409 | ProgramServicesAmt |
| Management And General | $488,840 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $201,542 | TotalAmt |
| Program Services | $142,869 | ProgramServicesAmt |
| Management And General | $58,673 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $2,985,711 | $2,985,092 | $619 |
| 340(B) PHARMACY EXPENSE | $859,289 | $859,289 | |
| MISC | $500,730 | $162,587 | $338,143 |
| FOOD | $262,306 | $257,459 | $4,847 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,534,980 | TotalAmt |
| Program Services | $38,707,109 | ProgramServicesAmt |
| Management And General | $5,827,871 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,368 | BOYAmt |
| EOY | $1,172 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,558,998 | BOYAmt |
| EOY | $12,332,443 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,212,410 | BOYAmt |
| EOY | $5,514,797 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $902,610 | BOYAmt |
| EOY | $940,982 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $479,880 | BOYAmt |
| EOY | $513,459 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $42,854,628 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $29,285,509 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,121,937 | BOYAmt |
| EOY | $13,569,119 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,901,536 | BOYAmt |
| EOY | $3,434,101 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,217,101 | BOYAmt |
| EOY | $1,110,874 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,027,627 | BOYAmt |
| EOY | $2,803,857 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,557,467 | BOYAmt |
| EOY | $40,220,804 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,421,142 | BOYAmt |
| EOY | $4,434,799 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,542,641 | BOYAmt |
| EOY | $4,217,299 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $147,283 | BOYAmt |
| EOY | $77,661 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,111,066 | BOYAmt |
| EOY | $8,729,759 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,817,653 | BOYAmt |
| EOY | $30,774,817 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $628,748 | BOYAmt |
| EOY | $716,228 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,446,401 | BOYAmt |
| EOY | $31,491,045 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,557,467 | BOYAmt |
| EOY | $40,220,804 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $565,364 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $391,800 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $87,480 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $11,455 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $11,455 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE AMOUNT OF SCHEDULE C, PART II-B, LINE 1I REPRESENTS THE LOBBYING PORTION OF DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $268,115 | OtherCostOrOtherBasisAmt |
| Book Value | $268,115 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,414,492 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,511,579 | DepreciationAmt |
| Book Value | $9,902,913 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,977,244 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,176,740 | DepreciationAmt |
| Book Value | $2,800,504 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,194,777 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,597,190 | DepreciationAmt |
| Book Value | $597,587 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,569,119 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ACCRUED INTEREST RECEIVABLE | $37,592 |
| BENEFICIAL INTEREST IN FOUNDATION | $716,234 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEM | $988,052 |
| OTHER ACCOUNTS RECEIVABLE | $814,007 |
| FINANCE LEASE ROU ASSET | $247,972 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,803,857 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| RENTAL DEPOSITS | $16,200 |
| FINANCE LEASE LIABILITY | $61,461 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $77,661 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $45,599,224 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $391,800 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $107,080 | OtherRevenueAmt |
| Revenue Not Reported | $498,880 | RevenueNotReportedAmt |
| Revenue Subtotal | $45,100,344 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $45,100,344 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $44,554,580 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $19,600 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $19,600 | ExpensesNotReportedAmt |
| Expenses Subtotal | $44,534,980 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $44,534,980 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ASC 740, INCOME TAXES. THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AS OF JUNE 30, 2024 AND 2023, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS ACCRUED. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN BENEFICIAL INTEREST OF FOUNDATION 87,480. RENTAL EXPENSES 19,600. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 19,600. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | 0 | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $122,467 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $122,467 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,922,673 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,092,141 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $830,532 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01860 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,045,140 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,092,141 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $952,999 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02130 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $56,709 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $56,709 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $95,842 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $95,842 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,322 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $13,322 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $165,873 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $165,873 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,211,013 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,092,141 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,118,872 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02510 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $285,802 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $285,802 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00640 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $285,802 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $285,802 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00640 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $546,432 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $75,408 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,873,831 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,920,464 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,046,633 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARROLL COUNTY MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 NORTH JEFFERSON ST | AddressLine1Txt |
| City | CARROLLTON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64633 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 210-58 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARROLL COUNTY MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://WWW.CARROLLCOUNTYHOSPITAL.ORG/COMMUNITY | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.CARROLLCOUNTYHOSPITAL.ORG/COMMUNITY | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.CARROLLCOUNTYHOSPITAL.ORG/PATIENTS/FINANCIAL-ASSISTANCE-POLICY | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.CARROLLCOUNTYHOSPITAL.ORG/PATIENTS/FINANCIAL-ASSISTANCE-POLICY | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.CARROLLCOUNTYHOSPITAL.ORG/PATIENTS/FINANCIAL-ASSISTANCE-POLICY | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CARROLL COUNTY MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: CARROLL COUNTY MEMORIAL HOSPITAL INTERVIEWED HOSPITAL STAKEHOLDERS, COMMUNITY LEADERS, AND BUSINESS OWNERS TO ASSESS PUBLIC PERCEPTIONS OF THE COUNTY'S HEALTH STATUS AND UNMET NEEDS. THE INFORMATION GATHERED FROM THE INTERVIEWS PLAYED AN INSTRUMENTAL PART IN THE DEVELOPMENT OF AN IMPLEMENTATION PLAN TO ADDRESS THE NEEDS OF THE COMMUNITY. |
| CARROLL COUNTY MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6B: CARROLL COUNTY HEALTH DEPARTMENT |
| CARROLL COUNTY MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: CARROLL COUNTY HAS AN IMPLEMENATION PLAN THAT WE FOLLOW TO MEET THE NEEDS IDENTIFIED IN THE CHNA. THREE PRIORITY AREAS OF SIGNIFICANT NEED WERE IDENTIFIED: SUBSTANCE ABUSE, MENTAL HEALTH AND OBESITY. EACH OF THESE WERE ADDRESSED IN THE IMPLEMENTATION STRATEGY. BELOW ARE THE ACTIONS TAKEN DURING THE FISCAL YEAR TO ADDRESS THESE NEEDS:THE MENTAL HEALTH TASK FORCE BEGAN 2023 BY EVALUATING THE PROGRESS ON PREVIOUS SUICIDE PREVENTION INITIATIVES. IN FEBRUARY, THE GROUP CONDUCTED A COMMUNITY SURVEY REGARDING INDIVIDUAL PREPAREDNESS WHEN ENCOUNTERING SOMEONE WITH SUICIDAL THOUGHTS. SIXTY INDIVIDUALS RESPONDED TO THE SURVEY.BASED ON THE RESULTS AND DISCUSSION AMONG THE TASK FORCE MEMBERS, THE GROUP FELT THERE WAS STILL MORE WORK TO BE DONE TOWARDS THE GOAL OF A "SUICIDE-SAFER" COMMUNITY.THE TASK FORCE HOSTED ROBIN BALKE FROM THE ORGANIZATION DEFEET LOCATED IN SALINE COUNTY. SHE SHARED INFORMATION REGARDING THEIR "YOU OKAY TODAY" T-SHIRT INITIATIVE. THE T-SHIRTS ARE PROVIDED TO INDIVIDUALS FOR FREE AFTER RECEIVING SUICIDE PREVENTION TRAINING. AFTER HEARING THE PRESENTATION, THE TASK FORCE DECIDED A SIMILAR CAMPAIGN WOULD BE A GOOD FIT FOR CARROLL COUNTY AND RECEIVED PERMISSION FROM DEFEET TO PRODUCE SIMILAR T-SHIRTS. THE GROUP APPLIED FOR AND RECEIVED A MINI GRANT THROUGH 4IMPRINT TOWARD THE PRODUCTION COST OF THE T-SHIRTS AND CARROLL COUNTY MEMORIAL HOSPITAL COVERED THE REMAINING COST.IN THE SPRING, THE GROUP UNVEILED A NEW COMMUNITY FACEBOOK GROUP LOCATED AT FACEBOOK.COM/CARROLLCOUNTYMENTALHEALTH. IT WAS CREATED AS A PLACE TO SHARE COMMUNITY MENTAL HEALTH RESOURCES. IN APRIL, THE GROUP RECOGNIZED ALCOHOL AWARENESS MONTH WITH A SOCIAL MEDIA CAMPAIGN AND A NEWSPAPER COLORING-PAGE CAMPAIGN. THE GROUP ALSO PROVIDED ADDITIONAL SUICIDE PREVENTION TRAINING OPPORTUNITIES AND REACHED OUT TO LOCAL BUSINESSES AND SCHOOLS TO OFFER TRAINING RESOURCES. IN TOTAL, SIXTY ADDITIONAL COMMUNITY MEMBERS WERE TRAINED IN SUICIDE PREVENTION STRATEGIES.QPR TRAINING WAS OFFERED IN MAY - QPR (QUESTION, PERSUADE, AND REFER) GATEKEEPER TRAINING FOR SUICIDE PREVENTION IS A 1 HOUR EDUCATIONAL PROGRAM DESIGNED TO TEACH LAY AND PROFESSIONAL "GATEKEEPERS" THE WARNING SIGNS OF A SUICIDE CRISIS AND HOW TO RESPOND.SAFETALK TRAINING WAS OFFERED IN MAY - SAFETALK IS A FOUR-HOUR FACE-TO-FACE WORKSHOP FEATURING POWERFUL PRESENTATIONS, AUDIOVISUALS AND SKILLS PRACTICE. YOU'LL LEARN HOW TO PREVENT SUICIDE BY RECOGNIZING SIGNS, ENGAGING SOMEONE AND CONNECTING THEM TO AN INTERVENTION RESOURCE FOR FURTHER SUPPORT. A SKILLED, SUPPORTIVE TRAINER WILL GUIDE YOU THROUGH THE COURSE AND A COMMUNITY RESOURCE WILL BE ON HAND TO SUPPORT YOUR SAFETY AND COMFORT.OVER THE SUMMER, THE MENTAL HEALTH TASK FORCE PARTNERED WITH THE NEWLY FORMED CARROLL COUNTY HEALTHY HABITS TASK FORCE TO PARTICIPATE IN THEIR FIRST EVENT, THE LET'S GET MOVING COMMUNITY CHALLENGE, BY HOSTING A RESOURCE TABLE. AS THE GROUP MOVED INTO THE FALL, THE FOCUS SHIFTED BACK TO SUICIDE PREVENTION. DURING FARM HEALTH AND SAFEY WEEK, THE GROUP PROVIDED SNACKS AND MENTAL HEALTH INFORMATION FOR THE AGRICULTURAL COMMUNITY AT THE LOCAL GRAIN ELEVATOR. AT THE END OF THE MONTH, THEY HOSTED THE SUICIDE PREVENTION AND RECOVERY AWARENESS WALK ON SEPTEMBER 30. THREE COMMUNITY MEMBERS SPOKE ABOUT THEIR EXPERIENCES WITH SUICIDE AND SUBSTANCE USE WITH TWENTY-SIX INDIVIDUALS IN ATTENDANCE. THE EVENT ALSO RECEIVED POSITIVE SUPPORT FROM LOCAL BUSINESSES WHO PROVIDED SELF-CARE DOOR PRIZES. IN OCTOBER, THE GROUP PROVIDED INCENTIVES, EDUCATIONAL MATERIALS AND AWARENESS VIDEOS TO LOCAL SCHOOL DISTRICTS IN RECOGNITION OF RED RIBBON WEEK. RED RIBBON WEEK IS THE LARGEST DRUG-ABUSE PREVENTION CAMPAIGN IN THE UNITED STATES. IN THE SAME MONTH, THE TASK FORCE HOSTED PATRICK BAINBRIDGE, LCSW WITH KC VA MEDICAL CENTER. HE SHARED SOME IMPORTANT STATISTICS ABOUT VETERANS' RESOURCES IN OUR AREA. HE ALSO SHARED SOME OF THE UNIQUE CHALLENGES VETERANS EXPERIENCE. THE GROUP LEARNED ABOUT THE HIGHER PERCENTAGE OF VETERANS IN CARROLL COUNTY AND THE IMPORTANCE OF MILITARY CULTURAL COMPETENCIES. AFTER HEARING THE PRESENTATION, THE GROUP DECIDED TO CREATE TWO VETERAN SPECIFIC INITIATIVES: - BUILD AN AWARENESS CAMPAIGN AROUND 988 PRESS 1 FOR VETERANS. - PROVIDE MILITARY CULTURAL COMPETENCY TRAINING TO LOCAL HEALTHCARE PROVIDERS.BOTH INITIATIVES ARE IN PROGRESS WITH THE CULTURAL COMPETENCY TRAINING SCHEDULED FOR MARCH. TO END THE SEASON, THE TASK FORCE OFFERED A VIRTUAL GRIEF & LOSS EDUCATION FORUM IN DECECEMBER. THE GROUP CONTINUES TO MEET REGULARLY AND ALSO PLANS TO HOST AN IN-PERSON NARCAN TRAINING SOON. OVERALL, PARTICIPATION HAS BEEN STEADY WITH HOPES FOR CONTINUED GROWTH.IN MARCH, CCMH ESTABLISHED A COMMUNITY-WIDE TASK FORCE TO ADDRESS OBESITY. THE GROUP IDENTIFIED CURRENT CHALLENGES, RESOURCES AND GAPS WITHIN OUR LOCAL COMMUNITY. AT THE SECOND MEETING, THE TASK FORCE COMPLETED SEVERAL EXERCISES TO NARROW THE FOCUS TO THE TOP THREE IDEAS, WHICH INCLUDED: - HOLD A COMMUNITY WALK - CREATE A COMMUNITY CHALLENGE - BUILD A RESOURCE GUIDETHE GROUP RENAMED ITSELF THE CARROLL COUNTY HEALTH HABITS TASK FORCE AND IT HELD AN EVENT IN JUNE. THE EVENT WAS THE LET'S GET MOVING: 21 DAY JUMPSTART COMMUNITY CHALLENGE. IT WAS CREATED AS A 21-DAY JUMP START TO HEALTHIER HABITS. ALL AGES WERE WELCOME, GIVEAWAYS WERE PROVIDED, AND RESOURCE TABLES WERE AVAILABLE. ALTHOUGH ATTENDANCE WAS LOW DUE TO HIGH TEMPERATURES AND CONFLICTING EVENTS, THE PARTICIPANTS FELT IT WAS A GOOD WAY TO CONNECT WITH ONE ANOTHER AS A NEW GROUP.IN ADDITION TO THE EVENT, THE TASK FORCE IS CONTINUING TO PURSUE ADDITIONAL IDEAS INCLUDING GROCERY STORE TOURS, PROMOTION OF THE LOCAL COMMUNITY GARDEN, AND THE PREVIOUSLY MENTIONED RESOURCE GUIDE.IN ADDITION TO THE CARROLL COUNTY HEALTH HABITS TASK FORCE, CCMH CONTINUES TO PURSUE THE CREATION OF AN OBESITY-SPECIFIC CLINIC. |
| CARROLL COUNTY MEMORIAL HOSPITAL | PART V, SECTION B, LINE 20E: IF EMPLOYMENT IS LISTED, WE TRY TO REACH AN EMPLOYER, IF THE PHONE NUMBER ON FILE DOESN'T REACH PATIENT. WE ALSO ATTEMPT TO REACH ANY LISTED CONTACTS IN ORDER TO SOLICIT INFORMATION REGARDING DIFFERENT PHONE NUMBERS OR ADDRESSES ON FILE FOR THE PATIENT. MULTIPLE ATTEMPTS ARE MADE TO REACH THE PATIENT UTILIZING AVAILABLE INFORMATION PRIOR TO COLLECTION ACTIVITIES BEING INSTITUTED. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - JEFFERSON MEDICAL GROUP | ||||
| 1502 N JEFFERSON | CARROLLTON | MO | 64633 | RURAL HEALTH CLINIC |
| 3 - JEFFERSON MEDICAL GROUP - HALE | ||||
| 221 ELM STREET | HALE | MO | 64643 | RURAL HEALTH CLINIC |
| 5 - JEFFERSON MEDICAL GROUP - BRUNSWICK | ||||
| 807 EAST BROADWAY STREET | BRUNSWICK | MO | 65236 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | ASIDE FROM THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE INCLUDE ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY. |
| PART I, LINE 7: | CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. UNREIMBURSED MEDICAID ON LINE 7B WAS CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. COMMUNITY HEALTH IMPROVEMENT SERVICES, LINE 7E, SUBSIDIZED HEALTH SERVICES, LINE 7G AND CASH AND IN-KIND CONTRIBUTIONS, LINE 7I, ARE REPORTED BASED ON ACTUAL EXPENSES REPORTED IN THE GENERAL LEDGER. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | CARROLL COUNTY MEMORIAL HOSPITAL PROVIDES SUPPORT TO THE SALARIES FOR THE INDIVIDUALS WORKING AT THE CHILDCARE CENTER. THE CHILDCARE CENTER PROVIDES MUCH NEEDED SERVICES TO FAMILIES IN THE COMMUNITY. |
| PART III, LINE 2: | THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSION BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS. |
| PART III, LINE 3: | THE ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON AN APPROXIMATE 13.8% OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN THE SERVICE AREA. |
| PART III, LINE 4: | THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES IMPLICIT PRICE CONCESSIONS IS LOCATED IN FOOTNOTE 1 ON PAGES 12 AND 13 OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE ENTIRE MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. SERVICES ARE PROVIDED TO PATIENTS UNDER THE MEDICARE PROGRAM EVEN THOUGH THE HOSPITAL KNOWS THEY WILL NOT RECOVER ALL OF THE COSTS FROM PROVIDING THE SERVICES. THIS PROGRAM IS CONSIDERED SUBSIDIZED BY THE HOSPITAL AND OTHER PAYORS. PATIENTS RELY ON THESE SERVICES FOR THEIR HEALTH AND WELL-BEING AND ARE ESSENTIAL FOR THEIR ACCESS TO HEALTHCARE. TOTAL REVENUE RECEIVED FROM MEDICARE IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT. BOTH TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES. |
| PART III, LINE 9B: | WE DO NOT PRESUME ELIGIBILITY FOR FINANCIAL ASSISTANCE. THOSE WHO BELIEVE THEY ARE ELIGIBLE, MUST FILL OUT AN APPLICATION. OUR PATIENT FINANCE SPECIALISTS OFTEN CALL BEFORE SENDING A PATIENT TO COLLECTIONS AND WILL ASK IF THE PATIENT WOULD LIKE AN APPLICATION AT THAT TIME AS WELL. IF A PATIENT IS ELIGIBLE, THEY RECEIVE THE APPLICABLE DISCOUNT AND THEN THE REMAINING BALANCE IS STILL SUBJECT TO OUR ORDINARY COLLECTIONS PRACTICES (MUST PAY BALANCES OFF WITHIN TWO YEARS AND HAVE A MINIMUM PAYMENT OF $25). IF A PATIENT IS DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE, ALL COLLECTION EFFORTS STOP UNTIL THE PROPER DISCOUNT CAN BE APPLIED. |
| PART VI, LINE 2: | CARROLL COUNTY MEMORIAL HOSPITAL RELIES ON INTERACTION WITH LOCAL CARE AGENCIES AS WELL AS FEEDBACK FROM PATIENTS AND PRIMARY SERVICE AREA RESIDENTS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY. |
| PART VI, LINE 3: | EACH PATIENT IS PROVIDED WITH PAYMENT INFORMATION IN CLEAR, EASY-TO-UNDERSTAND LANGUAGE. CCMH CHECKS ON PUBLIC-ASSISTANCE PROGRAMS TO SEE IF THE PATIENT QUALIFIES. A PATIENT CAN OBTAIN A FINANCIAL ASSITANCE APPLICATION AT ANY CARROLL COUNTY MEMORIAL HOSPITAL FACILITY REGISTRATION DESK OR AT THE PATIENT ADVOCATE OFFICE(S) LOCATED AT CCMH. REQUEST TO HAVE AN APPLICATION MAILED TO YOU OR IF YOU HAVE ANY QUESTIONS CALL (660) 542-1695 EXT 7200. A PATIENT CAN ALSO REQUEST AN APPLICATION BY MAIL AT CARROLL COUNTY MEMORIAL HOSPITAL, OR DOWNLOAD AN APPLICATION FROM THE HOSPITAL'S WEBSITE. |
| PART VI, LINE 4: | CARROLL COUNTY MEMORIAL HOSPITAL IS LOCATED IN CARROLLTON, MISSOURI. THE HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF CARROLLTON AND THE SURROUNDING AREAS OF CARROLL COUNTY. CARROLL COUNTY MEMORIAL HOSPITAL OPERATES TWO SATELLITE CLINICS LOCATED IN BRUNSWICK AND HALE. CARROLL COUNTY HAS A POPULATION OF APPROXIMATELY 8,679 RESIDENTS, WITH 35.5% OF THE RESIDENTS LIVING IN URBAN AREAS AND 64.5% LIVING IN RURAL AREAS. THE MEDIAN ANNUAL HOUSEHOLD INCOME FOR CARROLL COUNTY IS APPROXIMATELY $43,583. |
| PART VI, LINE 5: | CARROLL COUNTY MEMORIAL HOSPITAL WAS ORIGINALLY FOUNDED BY LOCAL CITIZENS FOCUSED ON HEALTHCARE FOR CARROLL COUNTY AND THE SURROUNDING AREA. CCMH IS "DEDICATED TO THE HEALTH AND WELL-BEING OF ALL WE SERVE AND UNDERSTANDS COMMUNITY HEALTH GOES BEYOND THE WALLS OF THE HOSPITAL.CCMH CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS. THE ASSESSMENT HELPS THE HOSPITAL SET GOALS TO IMPROVE THE HEALTH STATUS OF ITS PATIENTS AND THE COMMUNITY. CCMH'S CURRENT GOALS ARE FOCUSED ON LIFESTYLE BEHAVIORS, ACCESS TO CARE, AND MENTAL HEALTH FOR YOUTH AND ADULTS.CCMH PARTICIPATES IN THE CARROLL COUNTY COALITION FOCUSING ON MENTAL HEALTH AND SUBSTANCE USE DISORDER. CCMH HAS IMPLEMENTED THE FOLLOWING STRATEGIES TO ADDRESS MENTAL HEALTH INITIATIVES:1. INCREASE AWARENESS OF COMMUNITY RESOURCES THROUGH A COMMUNITY RESOURCE GUIDE.2. COLLABORATE WITH LOCAL SCHOOL DISTRICTS TO REVIEW CURRENT METHODS OF IDENTIFYING YOUTH AT-RISK AND OFFER COLLABORATIVE ASSISTANCE.3. PROVIDE RESOURCES TO SUPPORT AND ASSIST WITH PREVENTION AND TREATMENT OF SUBSTANCE USE DISORDER.4. PROVIDE PSYCHIATRIC AND THERAPY SERVICES.CCMH ALSO WORKS TO IMPROVE ACCESS TO BASIC AND PREVENTATIVE CARE ESPECIALLY FOR THE UNINSURED AND UNDER-INSURED THROUGH THE FOLLOWING STRATEGIES:1. PROVIDE COMMUNITY EDUCATION AND AWARENESS.2. IMPROVE ACCESSIBILITY THROUGH SATELLITE CLINICS IN SURROUNDING COMMUNITIES.3. SUPPORT THE NURSE NAVIGATOR PROGRAM TO ASSIST PATIENTS WITH GUIDANCE THROUGHOUT THEIR HEALTHCARE JOURNEY.4. EXPAND VIRTUAL VISITS.THE HOSPITAL ALSO HOUSES THE CCMH WELLNESS CENTER, A UNIQUE REHAB AND FITNESS CENTER, WHICH INCORPORATES AN INDOOR POOL, SAUNA, HOT TUB, INDOOR 1/16-MILE WALKING TRACK, AND STATE OF THE ART FITNESS EQUIPMENT WITH CERTIFIED THERAPISTS AND TRAINERS PROVIDING THERAPY AND PROGRAMS TO RESIDENTS OF CARROLL COUNTY AND THE SURROUNDING AREAS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MO |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GREGORY HUBBARD MD | ||||||||||||||
| PHYSICIAN | $568,014 | $0 | $100 | $0 | $2,709 | $0 | $26,400 | $0 | $28,560 | $0 | $625,783 | $0 | $0 | $0 |
| RICHARD SMITH MD | ||||||||||||||
| PHYSICIAN | $368,736 | $0 | $174,485 | $0 | $523 | $0 | $26,400 | $0 | $10,980 | $0 | $581,124 | $0 | $0 | $0 |
| ANDREW HORINE MD | ||||||||||||||
| PHYSICIAN | $393,259 | $0 | $77,818 | $0 | $197 | $0 | $26,400 | $0 | $20,598 | $0 | $518,272 | $0 | $0 | $0 |
| JEREMY STAYTON MD | ||||||||||||||
| PHYSICIAN | $434,220 | $0 | $26,247 | $0 | $468 | $0 | $8,651 | $0 | $20,451 | $0 | $490,037 | $0 | $0 | $0 |
| TIMOTHY REID MD | ||||||||||||||
| MEMBER/PHYSICIAN | $241,320 | $0 | $62,881 | $0 | $215 | $0 | $25,086 | $0 | $32,951 | $0 | $362,453 | $0 | $0 | $0 |
| PAMELA RALLS MD | ||||||||||||||
| PHYSICIAN | $205,346 | $0 | $81,030 | $0 | $189 | $0 | $22,214 | $0 | $20,592 | $0 | $329,371 | $0 | $0 | $0 |
| SCOTT THORESON | ||||||||||||||
| CEO | $231,016 | $0 | $100 | $0 | $1,481 | $0 | $18,698 | $0 | $20,600 | $0 | $271,895 | $0 | $0 | $0 |
| LESLEY DELANEY | ||||||||||||||
| CFO | $131,522 | $0 | $100 | $0 | $109 | $0 | $11,232 | $0 | $23,369 | $0 | $166,332 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 5 | FormAndLineReferenceDesc |
| Explanation | A PORTION OF PHYSICIAN COMPENSATION WAS CALCULATED MONTHLY USING A PERCENTAGE OF REIMBURSEMENT. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE, COMPRISED OF THE ELECTED OFFICERS AND TWO OTHER MEMBERS OF THE BOARD APPOINTED BY THE PRESIDENT, HAS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | A SEPARATE ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL. ANY QUESTIONS AND CONCERNS THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE FORM 990 WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD SETS THE CONFLICT OF INTEREST POLICY AND ADMINISTRATION IS CHARGED WITH ASSURING THAT COMPLIANCE IS MAINTAINED. THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY AND EACH BOARD MEMBER SIGNS A CONFLICT OF INTEREST DISCLOSURE FORM. IF A CONFLICT ARISES THE CONFLICTED PERSON DOES NOT TAKE PART IN THE VOTE ON THE ISSUE. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD CONDUCTS AN ANNUAL SALARY REVIEW FOR THE CEO. THE BOARD APPROVES THE AMOUNT OF COMPENSATION. THE LAST REVIEW WAS CONDUCTED IN 2022. ALL OTHER MANAGEMENT POSITIONS ARE HIRED, REVIEWED, AND MONITORED BY THE CEO AND LEADERSHIP TEAM. COMPENSATION REVIEWS OCCUR ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PHARMACY EXPENSE: PROGRAM SERVICE EXPENSES 3,547,441. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,547,441. OTHER CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 7,332,592. MANAGEMENT AND GENERAL EXPENSES 653,841. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,986,433. |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST - FND 87,480. |
| PART XII, LINE 2C | THE BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARROLL COUNTY MEMORIAL HOSPITAL FDN | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 N JEFFERSON ST | AddressLine1Txt |
| City | CARROLLTON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64633 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 463696048 | EIN |
| Primary Activities | SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 7 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARROLL COUNTY MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |