2020-02-24T17:50:35-06:00 2019-06-30 431001367 BROWN SMITH WALLACE LLP 6 CITYPLACE DRIVE SUITE 900 ST LOUIS MO 63141 990 2018-07-01 430666765 THE RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED CHILDREN RANK 3148726400 11365 DORSETT ROAD MARYLAND HEIGHTS MO 63043 R BRETT MOOREHOUSE PRESIDENT & CEO 3148726400 2020-02-21 1 JENNIFER M VACHA P01251998 3149831200 199.119.121.196 2020-02-21 13:24:26 CS P 7A438EF9BDDAA6C6A5B70F65D90C9F31F3581C70 6D0FEAEE1E557C934F385645978F4402E0388339 2018 2020-09-23 17:36:50Z WALTER BAZAN JR 11365 DORSETT ROAD MARYLAND HEIGHTS MO 63043 51988894 0 X WWW.RANKENJORDAN.ORG X 1940 MO PEDIATRIC BRIDGE HOSPITAL PROVIDING A CONTINUUM OF CARE FOR MEDICALLY COMPLICATED CHILDREN 27 23 504 126 0 0 3610545 3189474 29229246 40717492 1204486 922709 -81200 317996 33963077 45147671 38730 34795 0 0 20712896 24607563 0 0 618111 11664786 13477943 32416412 38120301 1546665 7027370 88033644 95334862 40091698 40176754 47941946 55158108 RANKEN JORDAN IS A PEDIATRIC BRIDGE HOSPITAL PROVIDING A CONTINUUM OF CARE FOR MEDICALLY COMPLICATED CHILDREN AND THEIR FAMILIES. WE ARE A LEADER IN PROVIDING INTENSIVE TRANSITIONAL CARE AND LIVING SUPPORT FOR THESE CHILDREN. 0 0 28359369 34795 39788329 DURING THE CURRENT FISCAL YEAR, RANKEN JORDAN PROVIDED 13,493 DAYS OF MEDICAL CARE FOR INPATIENTS. OF THOSE DAYS, 81% WERE CHILDREN THAT WERE ABLE TO RECEIVE SOME FORM OF MEDICAID ASSISTANCE. NO INPATIENT EVER LEAVES RANKEN JORDAN WITH A PATIENT RESPONSIBILITY DUE. IT IS THE GOAL OF THE ENTIRE STAFF AT RANKEN JORDAN TO ASSURE THAT WHEN A CHILD LEAVES OUR CARE, THEIR FAMILY HAS BEEN WELL TRAINED TO PROVIDE QUALITY CARE AND THEY HAVE A SAFE ENVIRONMENT TO GO HOME TO. 958819 929163 DURING THE CURRENT FISCAL YEAR, RANKEN JORDAN PROVIDED 21,084 UNITS OF OUTPATIENT SERVICES TO CHILDREN REQUIRING INTENSIVE THERAPY. RANKEN JORDAN PROVIDES PHYSICAL, OCCUPATIONAL, SPEECH, AND AQUATIC THERAPIES ON AN OUTPATIENT BASIS. RANKEN JORDAN ALSO OFFERS A DAY TREATMENT PROGRAM THAT PROVIDES INTENSIVE THERAPY THROUGHOUT THE DAY. RANKEN JORDAN OUTPATIENT PROGRAMS ALSO INCLUDE CONSTRAINT INDUCED MOVEMENT THERAPY, PAIN MANAGEMENT SERVICES AND PHYSIATRY SERVICES. 825969 A VARIETY OF COMMUNITY PROGRAMS ARE ALSO PROVIDED TO SUPPORT CHILDREN WITH COMPLEX MEDICAL NEEDS AND THEIR FAMILIES. THESE PROGRAMS ARE ALWAYS OFFERED FREE OF CHARGE AND OPEN TO THE GENERAL PUBLIC. THIS PROGRAMMING INCLUDES (BUT IS NOT LIMITED TO) SUPPORT GROUPS, SPORTS-RELATED ACTIVITIES FOR CHILDREN WITH SPECIAL NEEDS, AND SOCIAL ENRICHMENT ACTIVITIES FOR CHILDREN WITH COMPLEX MEDICAL NEEDS. A TOTAL OF 3,587 INDIVIDUALS WERE SERVED BY THE COMMUNITY PROGRAMS DURING THE YEAR. 30144157 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 8 0 1 504 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 27 23 1 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X THE ORGANIZATION 3148726400 11365 DORSETT ROAD MARYLAND HEIGHTS MO 63043 R BRETT MOOREHOUSE PRESIDENT/CEO 50.00 X X 256674 0 12249 WALTER BAZAN JR CHAIR 10.00 X X 0 0 0 ELIZABETH PROSPERI VICE CHAIR 5.00 X X 0 0 0 THOMAS J MINOGUE SECRETARY 5.00 X X 0 0 0 SONDRA M DENK TREASURER 5.00 X X 0 0 0 NICHOLAS A HOLEKAMP MD CHIEF MEDICAL OFFICER 50.00 X X 372333 0 57581 ROMA NEMANI BORDEWICK BOARD MEMBER 5.00 X 0 0 0 CHRIS CIOFFI BOARD MEMBER 3.00 X 0 0 0 STEVE CORTOPASSI BOARD MEMBER 3.00 X 0 0 0 MIKE DETWILER BOARD MEMBER 3.00 X 0 0 0 PAM DUFFY BOARD MEMBER 3.00 X 0 0 0 GEORGE R EDINGER SR BOARD MEMBER (RESIGN 2/2019) 3.00 X 0 0 0 DEREK GLANVILL BOARD MEMBER 3.00 X 0 0 0 CHARLES HESSLER BOARD MEMBER (RESIGN 10/2018) 3.00 X 0 0 0 KRISTEN HOGAN BOARD MEMBER 3.00 X 0 0 0 NOREEN LAFFEY BOARD MEMBER 3.00 X 0 0 0 KEN MARX BOARD MEMBER (EFF. 3/2019) 3.00 X 146541 0 2862 MIKE MATHENY BOARD MEMBER 3.00 X 0 0 0 TERI MURRAY BOARD MEMBER 3.00 X 0 0 0 JOHN PROSPERI BOARD MEMBER 3.00 X 0 0 0 JOHN RAHAL BOARD MEMBER 3.00 X 0 0 0 JEANA REISINGER BOARD MEMBER (RESIGN 2/2019) 3.00 X 0 0 0 STEVE RENNE BOARD MEMBER 3.00 X 0 0 0 MICHAEL SCULLY BOARD MEMBER 3.00 X 0 0 0 RABBI MARK L SHOOK BOARD MEMBER 3.00 X 0 0 0 THAD SIMONS BOARD MEMBER 3.00 X 0 0 0 KURTIS T SOBUSH MD BOARD MEMBER 3.00 X 0 0 0 KIT SUNDARARAMAN BOARD MEMBER (RESIGN 2/2019) 3.00 X 0 0 0 RICHARD A VANDEGRIFT BOARD MEMBER 3.00 X 0 0 0 BILL WILLHITE BOARD MEMBER 5.00 X 0 0 0 NICK WILLIAMSON BOARD MEMBER 3.00 X 0 0 0 JOHN CLAGG CFO (EFF. 5/2019) 50.00 X 0 0 0 ELIZABETH AKRE SUGARBAKER MD PHYSICIAN 40.00 X 188426 0 13170 SUSAN CONGER MD PHYSICIAN 40.00 X 254125 0 15732 EUGENE EVRA MD PHYSICIAN 40.00 X 233639 0 15191 ROD PELLENBERG MD PHYSICIAN 40.00 X 212881 0 2371 AMY ZIMMERMANN MD PHYSICIAN 40.00 X 239991 0 15449 1904610 0 134605 30 0 1 0 CERNER CORPORATION PO BOX 959156 ST LOUIS MO 63195 CONSULT/ELEC HEALTH REC 1241120 MB TECHNOLOGY SOLUTIONS 1001 CRAIG ROAD SUITE 400 ST LOUIS MO 63146 COMPUTER CONSULTING 341210 THOMPSON COBURN PO BOX 18379M ST LOUIS MO 63195 LEGAL SERVICES 206091 3 686335 72579 2430560 3189474 INPATIENT CARE 621110 39788329 39788329 OUTPATIENT CARE 621110 929163 929163 40717492 613266 613266 6842750 6533307 309443 309443 309443 212064 686335 307916 -95852 -95852 MO HOSPITAL PLAN 900099 198406 198406 REFUNDS/REBATES 900099 188975 188975 MISCELLANEOUS REVENUE 900099 26467 26467 413848 45147671 40717492 0 1240705 34795 34795 871945 581316 290629 19646529 17041099 2402061 203369 383657 383657 2283270 2211923 71347 1422162 1186575 203109 32478 199114 199114 81400 81400 17109 17109 525257 260926 264331 201310 8317 192993 3748289 2593117 1124791 30381 1447224 6239 1440985 478525 449814 23926 4785 23035 3130 19905 54507 30569 23343 595 1631422 1533537 81571 16314 3056173 2872803 152808 30562 552253 79154 473099 FRA ASSESSMENT 1448256 1448256 COMMUNITY OUTREACH 14069 246 4825 8998 38120301 30144157 7358033 618111 1400 400 689714 1962064 1288199 1043637 4393391 5531722 1444962 1535504 74554020 19675628 55518927 54878392 24697051 30383143 88033644 95334862 2851659 3018314 152345 86850 36577345 36513899 510349 557691 40091698 40176754 X 46277557 53263640 1664389 0 1894468 47941946 55158108 88033644 95334862 X 7027370 295992 -107200 X X 0 1 X 1 0 X 3865887 4214060 3010704 3610545 3189474 17890670 3865887 4214060 3010704 3610545 3189474 17890670 6365156 11525514 467076 441183 477752 523973 613266 2523250 14116 26737 413848 454701 20868621 150088839 0.55230 0.54390 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2014 AMOUNT: $ 14,116. 2015 AMOUNT: $ 26,737. 2018 AMOUNT: $ 413,848. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 17109 17109 0 PART II-B, LINE 1: RANKEN JORDAN PAYS DUES TO A VARIETY OF OTHER PROFESSIONAL ORGANIZATIONS. A PORTION OF THOSE DUES ARE IDENTIFIED BY EACH ORGANIZATION AS ALLOCABLE TO LOBBYING. THE TOTAL DEEMED AS LOBBYING BY EACH ORGANIZATION FOR THE YEAR IS REFELCTED ABOVE AS "OTHER ACTIVITIES". 0 272500 272500 0.00000 1.00000 0.00000 0 0 759000 1600177 2359177 53986046 8923785 45062261 15972488 10187182 5785306 2236309 564661 1671648 54878392 OTHER LIABILITIES 557691 557691 X 45443663 295992 295992 45147671 0 45147671 38227501 107200 107200 38120301 0 38120301 PART V, LINE 4: THE HOSPITAL WAS GIFTED A DONOR-RESTRICTED AMOUNT OF $272,500 IN JUNE 2019 TO ESTABLISH AN ENDOWMENT FUND. THE EARNINGS ON THE INVESTED ENDOWMENT GIFT ARE TO BE USED FOR ANNUAL MAINTENANCE OF THE PLAYGROUND IN PERPETUITY AND ANNUAL FUNDING TO FOSTER PLAY FOR KIDS IN PERPETUITY. THE BOARD OF DIRECTORS IS IN THE PROCESS OF FORMALIZING THE INVESTMENT AND SPENDING POLICIES SURROUNDING THE ENDOWMENT RECEIVED IN JUNE 2019. PART X, LINE 2: THE HOSPITAL HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE HOSPITAL HAS ADDRESSED THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, ACCOUNTING FOR INCOME TAXES. IN THAT REGARD, THE HOSPITAL HAS EVALUATED ITS TAX POSITIONS, EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS AND BELIEVES THAT NO PROVISION FOR INCOME TAXES IS NECESSARY, AT THIS TIME, TO COVER ANY UNCERTAIN TAX POSITIONS. PART XII, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT ON PROMISE RECEIVABLES 107,200. DINNER AUCTION 666315 534139 132176 3568 82895 55786 47231 GOLF TOURNAMENT 166930 114388 52542 41467 24302 2750 22572 6 65154 37808 27346 1225 116 26004 898399 686335 212064 46260 107313 58536 95807 307916 -95852 1 1 1 X 400.000000000000 1 X 1 1 0 1 1 4 31750 31750 0.00080 21416149 8684884 12731265 0.33450 27327216 14520758 12806458 0.33650 4 48775115 23205642 25569473 0.67180 3587 63083 63083 0.00170 3 1004 156080 156080 0.00410 3 4591 219163 219163 0.00580 3 4595 48994278 23205642 25788636 0.67760 1 62045 62045 0 0 1 1 1 1 THE RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED CHILDREN 11365 DORSETT ROAD MARYLAND HEIGHTS MO 63043 X X PEDIATRIC SPECIALTY HOSPITAL THE RANKEN-JORDAN HOME FOR CONVALESCENT 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X WWW.RANKENJORDAN.ORG X 0 0 1 X 400.000000000000 400.000000000000 1 1 X X X 1 X RANKENJORDAN.ORG/WP-CONTENT/UPLOADS/2018/05/FINANCIAL-ASSISTANCE_102618.PDF X RANKENJORDAN.ORG/WP-CONTENT/UPLOADS/2018/05/FINANCIAL-ASSISTANCE_102618.PDF X RANKENJORDAN.ORG/WP-CONTENT/UPLOADS/2018/05/FINANCIAL-ASSISTANCE_102618.PDF X X X X X X 1 X 0 X 0 X X 0 0 THE RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED C PART V, SECTION B, LINE 5: IN CONDUCTING THE 2018 TAX YEAR CHNA, RANKEN JORDAN TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY THROUGH FACILITATION OF A PATIENT AND FAMILY ADVISORY COUNCIL, INTERNAL FOCUS GROUP, ANONYMOUS COMMUNITY SURVEYS, COMMUNITY PROGRAM PARTICIPANT SURVEYS, AND ONE ON ONE INTERVIEWS. PERSONS CONSULTED DURING THIS PROCESS INCLUDE CURRENT AND FORMER PATIENTS AND THEIR FAMILY MEMBERS, MEMBERS OF OUR MULTIDISCIPLINARY STAFF, PERSONS LIVING IN THE LOCAL COMMUNITY, REPRESENTATIVES FROM LOCAL CHILDREN'S HOSPITALS, AND POLITICAL REPRESENTATIVES OF THE AREAS FROM WHICH WE ADMIT PATIENTS. THE RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED C PART V, SECTION B, LINE 6B: ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK THE RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED C PART V, SECTION B, LINE 11: RANKEN JORDAN IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA THROUGH COMMUNITY PROGRAMMING AND WORKING WITH LOCAL PARTNERS. THE RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED C PART V, SECTION B, LINE 20E: NO COLLECTION ACTIONS ARE TAKEN AGAINST OUR PATIENTS. RANKEN JORDAN HAS NO AFFILIATION WITH ANY COLLECTION AGENCY OR ORGANIZATION. COLLECTION ACTIVITIES WOULD GO AGAINST THE MISSION OF RANKEN JORDAN, TO CARE FOR CHILDREN. PART I, LN 7 COL(F): BAD DEBT IS RECORDED FOR PATIENTS THAT ARE ELIGIBLE FOR HEALTH INSURANCE BUT THE SERVICE IS NOT COVERED. BAD DEBT IS RECORDED AT THE NET REALIZABLE AMOUNT. PART III, LINE 2: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY.) FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT CERTAIN PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 3: BAD DEBT IS RECORDED FOR PATIENTS THAT ARE ELIGIBLE FOR HEALTH INSURANCE BUT THE SERVICE IS NOT COVERED AND DEEMED TO BE A MEDICAL BENEFIT AND PROVIDED WITHOUT COST TO THE PATIENT. BAD DEBT IS DETERMINED BY TAKING THE GROSS CHARGES, LESS ANY CONTRACTUAL ALLOWANCE AGREEMENT WITH THE PAYER. BAD DEBT IS THEN RECORDED AT THE NET REALIZABLE AMOUNT. THE AMOUNTS SHOULD BE INCLUDED IN COMMUNITY BENEFIT BECAUSE EFFORTS WERE NOT MADE TO COLLECT THE AMOUNT FROM THE PATIENT'S FAMILY. PART III, LINE 4: THE HOSPITAL'S ACCOUNTS RECEIVABLE ARE PRIMARILY COMPRISED OF AMOUNTS DUE FROM MEDICAID, PRIVATE INSURANCE, SELF-PAY PATIENTS, AND OTHER THIRD-PARTY PAYORS. THE HOSPITAL EVALUATES THE VALUATION OF ACCOUNTS RECEIVABLE BASED ON ANALYSIS OF HISTORICAL TRENDS, AS WELL AS ITS UNDERSTANDING OF THE NATURE AND COLLECTABILITY OF ACCOUNTS BASED ON THEIR AGE AND OTHER FACTORS. PART III, LINE 9B: RANKEN JORDAN DOES NOT HAVE A FORMAL WRITTEN COLLECTION POLICY BECAUSE NO COLLECTION ACTION IS TAKEN AGAINST OUR PATIENTS. RANKEN JORDAN HAS NO AFFILIATION WITH ANY COLLECTION AGENCY OR ORGANIZATION. RANKEN JORDAN INTERNALLY IDENTIFIES THE TIME PERIOD FOR WHICH UNPAID PATIENT ACCOUNTS WILL REMAIN OPEN AND AVAILABLE TO COLLECT. FORMAL COLLECTION ACTIVITIES WOULD GO AGAINST THE MISSION OF RANKEN JORDAN, TO CARE FOR CHILDREN. PART VI, LINE 2: RANKEN JORDAN IS A MEMBER OF THE MISSOURI HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION AND THE CHILDREN'S HOSPITAL ASSOCIATION. THROUGH THESE AFFILIATIONS, RANKEN JORDAN IS ABLE TO MONITOR AND PARTICIPATE IN PROGRAMS THAT HAVE BEEN DETERMINED TO MEET THE NEEDS OF THE COMMUNITY ON THE LOCAL LEVEL. RANKEN JORDAN PARTNERS WITH DISABLED ATHLETES SPORTS ASSOCIATION (DASA), ST. LOUIS ARC, AND THE CITY OF MARYLAND HEIGHTS TO PROVIDE PROGRAMMING THAT MEETS THE NEEDS OF CHILDREN WITH COMPLEX MEDICAL ISSUES. PART VI, LINE 3: ALL RANKEN JORDAN PATIENTS AND FAMILIES ARE ASSIGNED A SOCIAL WORKER UPON ADMISSION. THAT PERSON WORKS DIRECTLY WITH THE PATIENT AND THE FAMILY TO MAKE SURE THAT THEIR FINANCIAL RESPONSIBILITIES ARE FULLY EXPLAINED. RANKEN JORDAN HAS THE ABILITY TO ASSIST FAMILIES IN APPLYING FOR MEDICAID/MEDICARE COVERAGE IF THEY HAVE NOT ALREADY DONE SO. DUE TO THE SPECIAL NATURE OF THE PATIENTS, RANKEN JORDAN SERVICES, AND THE MISSION OF THE ORGANIZAITON, NO INPATIENT RECEIVES A BILL FOR CARE RECEIVED. RANKEN JORDAN DOES NOT WORK WITH OR TURN ANY PATIENT'S ACCOUNTS OVER FOR COLLECTION. PART VI, LINE 4: RANKEN JORDAN SERVES THE METROPOLITAN ST. LOUIS AREA. PATIENTS ARE ACCEPTED BASED ON ADMISSION CRITERIA FOR SPECIALTY HOSPITALS. THE SERVICES PROVIDED ARE UNIQUE IN THAT THEY ARE ONLY AVAILABLE IN A LIMITED AMOUNT OF LOCATIONS THROUGHOUT THE COUNTRY. CARE IS PROVIDED FOR CHILDREN WITH COMPLEX MEDICAL NEEDS, WITH THE GOAL OF SEEING THEM RETURN TO A SAFE HOME ENVIRONMENT. PART VI, LINE 5: RANKEN JORDAN PROVIDES THE COMMUNITY WITH MANY OPPORTUNITES FOR CHILDREN WITH COMPLEX MEDICAL NEEDS AND THEIR FAMILIES TO BE ABLE TO BECOME ACTIVE IN THE COMMUNITY. PROGRAMS ARE OFFERED SUCH AS "CHALLENGER BASEBALL AND GOLF THAT ALLOW CHILDREN TO PARTICIPATE IN SPORTS DESPITE THEIR PHYSICAL LIMITATIONS. EDUCATION OPPORTUNITIES ARE PROVIDED FOR THESE CHILDREN THAT INCLUDE COOKING, MARTIAL ARTS, CAMP, AND SOCIAL GATHERING PROGRAMS. ALL PROGRAMS ARE PROVIDED FREE OF CHARGE TO FAMILIES AND ARE OPEN TO THE GENERAL PUBLIC. PART VI, LINE 6: RANKEN JORDAN IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. 1 TRANSPORTATION FOR PATIENT FAMILIES 1109 25466 LODGING FOR OUT-OF-TOWN PARENTS 11 1480 INTERPRETER SERVICES FOR PATIENTS THAT DO NOT SPEAK ENGLISH OR ARE HEARING IMPAIRED 13 7229 PERSONAL ITEMS FOR PATIENTS AND PATIENT FAMILIES 2 620 PART I, LINE 2: THE ORGANIZATION HAS POLICIES IN PLACE TO RECEIVE REQUESTS FOR ASSISTANCE. ALL REQUESTS FOR ASSISTANCE ARE EVALUATED BY THE SOCIAL SERVICES DEPARTMENT AND EVALUATED AGAINST SET POLICIES. ALL REQUESTS ARE THOROUGHLY DOCUMENTED IN THE PATIENT'S FILE. THE ORGANIZATION TAKES CARE TO ENSURE THAT PATIENTS RECEIVING GRANT ASSISTANCE MEET ESTABLISHED CRITERIA. ANY GRANT ASSISTANCE PROVIDED TO INDIVIDUALS IS HANDLED INTERNALLY AND THE INDIVIDUALS DO NOT RECEIVE DIRECT PAYMENT OF THE FUNDS AWARDED. X X X X X X 0 1 0 0 0 0 0 0 0 R BRETT MOOREHOUSE PRESIDENT/CEO 256674 0 0 0 0 0 10327 0 1922 0 268923 0 0 0 NICHOLAS A HOLEKAMP MD CHIEF MEDICAL OFFICER 372333 0 0 0 0 0 52054 0 5527 0 429914 0 0 0 ELIZABETH AKRE SUGARBAKER MD PHYSICIAN 188426 0 0 0 0 0 7711 0 5459 0 201596 0 0 0 SUSAN CONGER MD PHYSICIAN 254125 0 0 0 0 0 10363 0 5369 0 269857 0 0 0 EUGENE EVRA MD PHYSICIAN 233639 0 0 0 0 0 9560 0 5631 0 248830 0 0 0 ROD PELLENBERG MD PHYSICIAN 212881 0 0 0 0 0 2371 0 0 0 215252 0 0 0 AMY ZIMMERMANN MD PHYSICIAN 239991 0 0 0 0 0 9818 0 5631 0 255440 0 0 0 PART I, LINE 4B NICHOLAS HOLEKAMP IS A PARTICIPANT IN A 457(F) PLAN. CONTRIBUTIONS WERE MADE ON HIS BEHALF. PART I, LINE 7 INCENTIVES PAID BY THE ORGANIZATION ARE DISCRETIONARY. THE BOARD DETERMINES IF/WHEN INCENTIVES WILL BE PAID AT THE END OF THE FISCAL YEAR. THEY RESEARCH CURRENT EXECUTIVE SALARIES OF LIKE ORGANIZATIONS, RESULTS OF THE YEAR, AND BENEFITS PACKAGES, TO COME TO A DETERMINATION. THERE IS NO WRITTEN AGREEMENT OR GUARANTEE INCENTIVES WILL BE PAID ANNUALLY. NO INDIVIDUALS RECEIVED THE NON-FIXED PAYMENT FOR CALENDAR YEAR 2018. A IDA OF THE COUNTY OF ST LOUIS MISSOURI 431170145 79130GJC6 2016-09-26 37207987 REFUNDING SERIES 2007 BONDS; EXPANSION 1 0 0 A 20900000 37207987 15642185 519597 21565802 2017 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 ELLEN SIMONS NAHLIK (SEE PART V) FAMILY MEMBER OF BOARD MEMBER 65000 EMPLOYMENT WAGES 0 FORM 990, PART VI, SECTION A, LINE 2 JOHN PROSPERI (BOARD MEMBER) AND ELIZABETH PROSPERI (VICE CHAIRMAN) HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 4 THE RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED CHILDREN AMENDED ITS BYLAWS EFFECTIVE MAY OF 2019. SIGNIFICANT CHANGES TO THE AMENDED BYLAWS INCLUDE: 1.INCREASING THE MAXIMUM NUMBER OF INDIVIDUALS ALLOWED TO SERVE ON THE BOARD OF DIRECTORS TO 36 INDIVIDUALS 2.OUTLINING THE DUTIES OF THE FOLLOWING OFFICERS OF THE BOARD: PRESIDENT AND CHIEF EXECUTIVE OFFICER: THE PRESIDENT SHALL BE RESPONSIBLE FOR THE MANAGEMENT OF THE BUSINESS AND AFFAIRS OF THE CORPORATION IN ALL OF ITS ACTIVITIES IN ACCORDANCE WITH THE POLICIES ADOPTED BY THE BOARD OR BY ANY COMMITTEE OF THE BOARD. SECRETARY: THE SECRETARY SHALL BE RESPONSIBLE FOR KEEPING RECORDS OF ACTIONS OF THE BOARD, INCLUDING TAKING MINUTES AT ALL MEETINGS OF THE BOARD AND ARRANGING FOR THE DISTRIBUTION OF MEETING NOTICES, MINUTES AND MEETING AGENDAS TO EACH DIRECTOR. TREASURER: THE TREASURER SHALL BE RESPONSIBLE FOR PRIMARY FIDUCIARY OVERSIGHT OF THE CORPORATION AND ITS FINANCIAL STATEMENTS. THE TREASURER SHALL ASSIST IN THE PREPARATION OF THE BUDGET AND THE DEVELOPMENT OF FUNDRAISING PLANS. CHIEF MEDICAL OFFICER: THE CHIEF MEDICAL OFFICER SHALL IMPLEMENT THE POLICIES OF THE BOARD RELATING TO MEDICAL STAFF AND REPORT TO THE BOARD ON THE PERFORMANCE AND MAINTENANCE OF QUALITY OF CARE WITH RESPECT TO THE MEDICAL STAFF'S DELEGATED RESPONSIBILITY TO PROVIDE MEDICAL CARE. FORM 990, PART VI, SECTION B, LINE 11B THE INITIAL FORM 990 IS ORIGINALLY PRESENTED TO THE FINANCE COMMITTEE BY OUR INDEPENDENT AUDITORS. ONCE APPROVED BY THE FINANCE COMMITTEE, IT WILL BE MADE AVAILABLE ELECTRONICALLY TO THE FULL BOARD FOR FINAL APPROVAL. ONCE FINAL APPROVAL IS RECEIVED, THE FORM 990 WIL BE FILED ELECTRONICALLY BY OUR INDEPENDENT AUDITORS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS ALL EMPLOYEES, OFFICERS, DIRECTORS AND KEY EMPLOYEES OF THE ORGANIZATION. THE EXECUTIVE COMMITTEE HAS OVERSIGHT RESPONSIBILITIES FOR THE PROGRAM. THE COMPLIANCE OFFICER CONDUCTS THE DAY-TO-DAY OPERATIONS OF THE COMPLIANCE PROGRAM, INCLUDING COORDINATION OF THE RECEIPT OF REPORTS OF NONCOMPLIANCE. THE ORGANIZATION ADDED THE POSITION OF COMPLIANCE OFFICER/RISK MANAGER AS A FULL-TIME POSITION DURING FISCAL YEAR 6/30/14. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE, UNDER THE ADVISEMENT OF AN OUTSIDE CONSULTING GROUP, MEETS ANNUALLY TO REVIEW THE COMPENSATION OF TOP MANAGEMENT OFFICIALS. THE MEETINGS ARE HELD ANNUALLY IN MAY. THE EXECUTIVE COMPENSATION COMMITTEE FINDINGS ARE APPROVED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: BAD DEBT ON PROMISE RECEIVABLES -107,200. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR.