2017-11-15T20:29:57-06:00 2017-03-31 621804252 WATKINS UIBERALL PLLC 1661 AARON BRENNER DR STE 300 MEMPHIS TN 38120 990 2016-04-01 431253101 SOUTHEAST MISSOURI HEALTH NETWORK SOUT 5733132500 6738 HIGHWAY 77 BENTON MO 63736 CHRIS JONES CEO 5737482407 2017-11-14 1 PEYTON DODSON P01421936 9017612720 216.136.84.170 2017-11-14 09:28:22 CS P EB49C48E2409B39FF89502C2F727A496674A9419 CF1AAFFF0D41E3789CC88B5129B2BCDB846D8665 2016 2017-02-10 21:41:12Z CHRIS JONES 6738 HIGHWAY 77 BENTON MO 63736 13080073 0 X WWW.SEMOHEALTHNETWORK.ORG X 1978 MO SEMO HEALTH NETWORK IS COMMITTED TO PROVIDING AFFORDABLE, QUALITY HEALTHCARE TO THE COMMUNITIES OF SOUTHEAST MISSOURI. 10 10 159 0 -4388 -3411 3625337 4020826 10124041 8881735 5056 23002 146512 134022 13900946 13059585 0 0 0 0 6571558 7718506 0 0 0 4201133 4249371 10772691 11967877 3128255 1091708 7274059 8045306 4324432 4003971 2949627 4041335 SEMO HEALTH NETWORK IS COMMITTED TO PROVIDING AFFORDABLE, QUALITY HEALTHCARE TO THE COMMUNITIES OF SOUTHEAST MISSOURI. 0 0 10289159 9018745 SEMO HEALTH NETWORK PROVIDED 31,454 MEDICAL VISITS, 16,717 DENTAL VISITS, AND 79 NUTRITION SERVICES IN SOUTHEAST MISSOURI THROUGH THE OPERATION OF MIGRANT AND COMMUNITY HEALTH CENTERS IN THE CALENDAR YEAR. 10289159 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 23 0 1 159 1 1 1 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X X SARA DEANE 5737482592 6738 HIGHWAY 77 BENTON MO 63736 CATHERINE BOCKHOLD PRESIDENT 2.00 X X 0 0 0 EVELYN PULLIAM VICE PRESIDENT 2.00 X X 0 0 0 MARY DAVIS TREASURER 2.00 X X 0 0 0 BYRON MCVAY SECRETARY 2.00 X X 0 0 0 VICKI GILLESPIE DIRECTOR 2.00 X 0 0 0 CINDY AMICK DIRECTOR 2.00 X 0 0 0 DAVID HOWARD DIRECTOR 2.00 X 0 0 0 EMILY DUGAN DEUSTER DIRECTOR 2.00 X 0 0 0 LANCE CRAWFORD DIRECTOR 2.00 X 0 0 0 SAM DUNCAN DIRECTOR 2.00 X 0 0 0 CHRIS JONES CEO 40.00 X 190630 0 16969 SARA BETH DEANE CFO 40.00 X 145866 0 12061 DARRYL ROBERTS COO 40.00 X 99434 0 16969 TERESA RICHEY CHIEF NURSING OFFICER 40.00 X 110623 0 1599 DR DANIEL DOMJAN CHIEF MEDICAL OFFICER 40.00 X 241088 0 16891 DR GAIL REDMAN CHIEF DENTAL OFFICER 40.00 X 204651 0 12061 DR GARY HARRIS DENTIST 40.00 X 168974 0 10892 TRAVIS WEISS PHYSICIAN ASSISTANT 40.00 X 136500 0 16969 DR DEAN O CANSLER DENTIST 32.00 X 135962 0 735 DR BRADLEY GRAF DENTIST 40.00 X 141882 0 16969 DR NATHAN SPRENGEL DOCTOR 40.00 X 228012 0 16969 1803622 0 139084 14 0 1 0 COVENTRY HEALTH CARE OF MO INC PO BOX 6473 CAROL STREAM IL 60197 INSURANCE 519373 SUSAN H SHEETS DDS 2436 MYRA DRIVE CAPE GIRARDEAU MO 63703 DENTAL SERVICE 388443 MCKESSON MEDICAL SURGICAL PO BOX 634404 CINCINNATI OH 45263 SUPPLIES 377052 DR PATRICIA MERKLEY 2116 MEGAN DRIVE SUITE 101 CAPE GIRARDEAU MO 63701 DENTAL SERVICE 270993 GREENWAY PO BOX 203658 DALLAS TX 72320 SOFTWARE 222181 8 4020826 4020826 PATIENT SERVICE FEES 621110 7196389 7196389 340B PHARMACY PROGRAM REVENUE 621110 1210512 1210512 PRIMARY CARE HOME REVENUE 621610 474834 474834 8881735 24402 24402 12700 17088 -4388 -4388 -4388 2000 3400 -1400 -1400 -1400 OTHER REVENUE 621110 138410 138410 138410 13059585 9018745 -4388 24402 1068841 542255 526586 5477775 5131895 345880 688563 688563 483327 475748 7579 1678 1678 48756 48756 90067 90067 33722 1869 31853 834614 820582 14032 44333 44333 282853 167855 114998 33914 13011 20903 45870 37974 7896 237986 193211 44775 301587 301587 141049 141049 CONTRACTED REFERRAL PAY 660170 660170 SOFTWARE FEES 373931 2417 371514 340B PHARMACY PROGRAM E 308094 308094 TELECOMMUNICATIONS 165413 159044 6369 645334 599502 45832 11967877 10289159 1678718 0 25737 580301 1160833 1980246 107133 136045 1617458 1044035 2711 34247 33900 6630818 2360039 4318828 4270779 7112 0 7274059 8045306 467160 602233 3197642 3031998 659630 369740 4324432 4003971 X 2784077 4041335 165550 0 2949627 4041335 7274059 8045306 1091708 0 X X 0 1 X 1 1 1 X 2941458 3357757 3781820 3625337 4020826 17727198 2941458 3357757 3781820 3625337 4020826 17727198 17727198 869 178 60 1107 7199 64930 158088 170097 175512 575826 18304131 0.96850 0.97570 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 228054 228054 147461 4503185 1043119 3607527 76713 25623 51090 1623063 1262993 360070 52342 28304 24038 4270779 DUE TO THIRD PARTIES 212187 PATIENT OVERPAYMENT PAYABLE 157553 369740 12768579 -291006 -291006 13059585 0 13059585 11643033 -324844 -324844 11967877 0 11967877 PART XI, LINE 2D - OTHER ADJUSTMENTS: 340B PROGRAM EXPENSE -308,094. RENTAL EXPENSES 17,088. PART XII, LINE 2D - OTHER ADJUSTMENTS: 340B PROGRAM EXPENSE -308,094. RENTAL EXPENSES 17,088. 340B BAD DEBT EXPENSE -33,838. X X X X 0 0 0 0 0 0 0 0 0 CHRIS JONES CEO 190630 0 0 0 0 0 0 0 0 16969 190630 16969 0 0 SARA BETH DEANE CFO 145866 0 0 0 0 0 0 0 0 12061 145866 12061 0 0 DR DANIEL DOMJAN CHIEF MEDICAL OFFICER 241088 0 0 0 0 0 0 0 0 16891 241088 16891 0 0 DR GAIL REDMAN CHIEF DENTAL OFFICER 204651 0 0 0 0 0 0 0 0 12061 204651 12061 0 0 DR GARY HARRIS DENTIST 168974 0 0 0 0 0 0 0 0 10892 168974 10892 0 0 TRAVIS WEISS PHYSICIAN ASSISTANT 136500 0 0 0 0 0 0 0 0 16969 136500 16969 0 0 DR BRADLEY GRAF DENTIST 141882 0 0 0 0 0 0 0 0 16969 141882 16969 0 0 DR NATHAN SPRENGEL DOCTOR 228012 0 0 0 0 0 0 0 0 16969 228012 16969 0 0 PART I, LINE 3 THE CONTRACTS ARE BROUGHT BEFORE THE BOARD AND THE SALARY IS DISCUSSED AND VOTED ON FOR EACH OFFICE DURING EXECUTIVE SESSIONS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE INDEPENDENT AUDITORS AND REVIEWED BY MANAGEMENT. A COPY IS PROVIDED TO BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANY CONFLICT BROUGHT TO LIGHT IS ADDRESSED AT THE BOARD MEETING AND A PLAN OF ACTION IS DECIDED BY THE BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION COMMITTEE MEETS AND REVIEWS PERFORMANCE APPRAISALS PREPARED BY ALL BOARD MEMBERS. THE COMMITTEE ALSO REVIEWS COMPENSATION OF OFFICIALS IN SIMILAR POSITIONS IN LIKE ORGANIZATIONS. AFTER THE REVIEW, THE EXECUTIVE DIRECTOR COMPENSATION IS THEN DETERMINED. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.