SAINT LUKES HOSPITAL OF CHILLICOTHE: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- SAINT LUKES HOSPITAL OF CHILLICOTHE (EIN 43-1735565)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-14
- IRS object ID
- 201303189349307045
- Schema version
- 2012v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-14T16:53:24-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431735565 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAINT LUKE'S HOSPITAL OF CHILLICOTHE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SAIN | NameControl |
| Phone | 6606461480 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 CENTRAL STREET | AddressLine1 |
| City | CHILLICOTHE | City |
| State | MO | State |
| ZIP Code | 64601 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MATT WENZEL | Name |
| Title | CEO | Title |
| Phone | 6606461480 | Phone |
| Date Signed | 2013-11-14 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEDRICK MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MATT WENZEL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 CENTRAL STREET | AddressLine1 |
| City | CHILLICOTHE | City |
| State | MO | State |
| ZIP Code | 64601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 43162816 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SAINTLUKESHEALTHSYSTEM.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1888 | YearFormation |
| State Legal Domicile | MO | StateLegalDomicile |
| Activity Or Mission Description | CRITICAL ACCESS HOSPITAL | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 347 | TotalNbrEmployees |
| Total Nbr Volunteers | 62 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 126745 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 100734 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 37656413 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 43030296 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 461099 | InvestmentIncomePriorYear |
| Investment Income Current Year | 31786 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 38244257 | TotalRevenuePriorYear |
| Total Revenue Current Year | 43162816 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 41689 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 33812 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 17798451 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 17277804 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 18801560 | OtherExpensePriorYear |
| Other Expenses Current Year | 21696970 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 36641700 | TotalExpensesPriorYear |
| Total Expenses Current Year | 39008586 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1602557 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 4154230 | RevenuesLessExpensesCY |
| Total Assets BOY | 24413957 | TotalAssetsBOY |
| Total Assets EOY | 28738496 | TotalAssetsEOY |
| Total Liabilities BOY | 2595226 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2635855 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 21818731 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 26102641 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SAINT LUKE'S HOSPITAL OF CHILLICOTHE IS COMMITTED TO PROVIDING THE HIGHEST LEVEL OF EXCELLENCE IN HEALTH CARE AND HEALTH RELATED SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 34077074 | Expense |
| Grants | 33812 | Grants |
| Revenue | 43030296 | Revenue |
| Description | SAINT LUKE'S HOSPITAL OF CHILLICOTHE D/B/A HEDRICK MEDICAL CENTER ("HMC") IS A LICENSED CRITICAL ACCESS HOSPITAL PROVIDING BOTH INPATIENT AND OUTPATIENT SERVICES. HMC IS LOCATED IN CHILLICOTHE (LIVINGSTON COUNTY), MISSOURI, APPROXIMATELY 90 MILES NORTHEAST OF KANSAS CITY. HEDRICK MEDICAL CENTER IS A FAITH-BASED, NOT-FOR-PROFIT COMMUNITY HOSPITAL COMMITTED TO THE HIGHEST LEVELS OF EXCELLENCE IN PROVIDING HEALTH CARE AND HEALTH RELATED SERVICES IN A CARING ENVIRONMENT. AS A MEMBER OF SAINT LUKE'S HEALTH SYSTEM, HMC IS DEDICATED TO ENHANCING THE PHYSICAL, MENTAL AND SPIRITUAL HEALTH OF THE COMMUNITIES SERVED. THE HOSPITAL PARTICIPATES IN THE MEDICAID AND MEDICARE PROGRAMS AND HAS CHARITY CARE POLICIES FOR ASSISTING PEOPLE WITHOUT ADEQUATE MEANS TO PAY FOR THEIR CARE. IN ADDITION TO THE ACTIVE MEDICAL STAFF, HMC'S SPECIALTY CLINICS HOST MORE THAN 30 VISITING SPECIALISTS.THE HOSPITAL ALSO PROVIDES HEALTH RELATED ACTIVITIES AND SERVICES IN SUPPORT OF THE COMMUNITY, INCLUDING BUT NOT LIMITED TO SOCIAL WORK SERVICES, SPIRITUAL SERVICES, AND COMMUNITY EDUCATION / HEALTH FAIRS. | Description |
| Total Program Service Expense | 34077074 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 43 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 347 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6606461480 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 CENTRAL STREET | AddressLine1 |
| City | CHILLICOTHE | City |
| State | MO | State |
| ZIP Code | 64601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| MICHAEL PALMER | ||||||||
| DIRECTOR-CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | ||
| DON SIPES | ||||||||
| DIRECTOR-PRESIDENT | 1.00 | X | X | 0 | 339041 | 55262 | 50.00 | |
| DARREL RINEHART | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| ROLLIE STADLMAN | ||||||||
| DIRECTOR-VICE CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | ||
| DELOS CLOW | ||||||||
| DIRECTOR & EMPLOYED PHYSICIAN | 40.00 | X | 281859 | 0 | 31364 | |||
| JANE NEAL | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| CHRISTOPHER HULETT TERMED 912 | ||||||||
| DIRECTOR | 1.00 | X | 131375 | 0 | 1336 | |||
| CYNTHIA CHRISTENSEN | ||||||||
| DIRECTOR-TREASURER | 1.00 | X | X | 0 | 267955 | 45110 | 50.00 | |
| BETTY PRESTON-STEELE | ||||||||
| DIRECTOR-SECRETARY | 1.00 | X | X | 0 | 0 | 0 | ||
| CAROL SLOAN | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| DONALD METRY | ||||||||
| DIRECTOR | 1.00 | X | 37485 | 0 | 0 | |||
| JAMES SUCHSLAND | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| TERRY PLASTER | ||||||||
| ASSIST SECR & EMPLOYEE | 40.00 | X | 47127 | 0 | 11422 | |||
| MATT WENZEL | ||||||||
| CEO | 40.00 | X | 212324 | 0 | 43669 | |||
| JANET BUCKMAN | ||||||||
| CFO | 40.00 | X | 176061 | 0 | 15699 | |||
| CATHERINE HAMILTON | ||||||||
| CNO | 40.00 | X | 110370 | 0 | 21975 | |||
| GREGORY MILLER | ||||||||
| PHYSICIAN | 40.00 | 316373 | 0 | 29078 | X | |||
| SALWAT SHAMI | ||||||||
| PHYSICIAN | 40.00 | 124323 | 0 | 17273 | X | |||
| JENNA GIBSON | ||||||||
| PHARMACY OPERATIONS MGR | 40.00 | 127703 | 0 | 25555 | X | |||
| JASON GAULT | ||||||||
| PHYSICIAN | 40.00 | 360277 | 0 | 30247 | X | |||
| YULIA VAKSMAN | ||||||||
| PHYSICIAN | 40.00 | 280168 | 0 | 19023 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2205445 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 606996 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 347013 | TotalOtherCompensation |
| Number Individuals GT100 K | 10 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| EMS LLC | |||||
| 920 MAIN STREET SUITE 300 | KANSAS CITY | MO | 64105 | ER PHYSICIANS | 1803888 |
| HAVE A NICE DAY ANESTHESIA ASSOCIATES | |||||
| 2106 WOODCREST | CHILLICOTHE | MO | 64601 | ANESTHESIA SERVICES | 793448 |
| SHARED MEDICAL SERVICES | |||||
| PO BOX 330 | COTTAGE GROVE | WI | 53527 | READS MRI SCANS | 286125 |
| CPSI | |||||
| PO BOX 850309 6600 WALL ST | MOBILE | AL | 36685 | SOFTWARE SYSTEM SETUP AND SERVICE | 282067 |
| WEATHERBY LOCUMS | |||||
| 6451 NORTH FEDERAL HIGHWAY SUITE 8 | FT LAUDERDALE | FL | 33308 | TEMP HELP | 228586 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Government Grants | 47795 | GovernmentGrants |
| All Other Contributions | 52939 | AllOtherContributions |
| Total Contributions | 100734 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REVENUE | 622110 | 41056739 | 41056739 |
| EHR MEANINGFUL USE FDS | 622110 | 1275540 | 1275540 |
| PATIENT REHAB SERVICES | 622210 | 413731 | 413731 |
| RENT FROM AFFILIATES | 531120 | 100756 | 100756 |
| CAFETERIA SALES | 622110 | 86904 | 86904 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 96626 | TotalRevenueColumn |
| Related Or Exempt Function Income | 96626 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 43030296 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 31786 | TotalRevenueColumn |
| Exclusion | $31,786 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 43162816 | TotalRevenueColumn |
| Related Or Exempt Function Income | 43030296 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $31,786 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33812 | Total |
| Program Services | 33812 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1084579 | Total |
| Program Services | 445932 | ProgramServices |
| Management And General | 638647 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12326133 | Total |
| Program Services | 11770755 | ProgramServices |
| Management And General | 555378 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 204459 | Total |
| Program Services | 186255 | ProgramServices |
| Management And General | 18204 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2759177 | Total |
| Program Services | 2513513 | ProgramServices |
| Management And General | 245664 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 903456 | Total |
| Program Services | 823017 | ProgramServices |
| Management And General | 80439 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 324233 | Total |
| Management And General | 324233 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 85782 | Total |
| Management And General | 85782 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6158091 | Total |
| Program Services | 5574793 | ProgramServices |
| Management And General | 583298 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18295 | Total |
| Program Services | 4328 | ProgramServices |
| Management And General | 13967 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1263281 | Total |
| Program Services | 1126613 | ProgramServices |
| Management And General | 136668 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 106062 | Total |
| Program Services | 74818 | ProgramServices |
| Management And General | 31244 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1855036 | Total |
| Program Services | 1745094 | ProgramServices |
| Management And General | 109942 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 162782 | Total |
| Program Services | 132649 | ProgramServices |
| Management And General | 30133 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78838 | Total |
| Program Services | 1893 | ProgramServices |
| Management And General | 76945 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1539552 | Total |
| Program Services | 1267898 | ProgramServices |
| Management And General | 271654 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 250651 | Total |
| Program Services | 109901 | ProgramServices |
| Management And General | 140750 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBTS | 3932198 | 3932198 | |
| MEDICAL SUPPLIES | 3758222 | 3755064 | 3158 |
| SHARED SERVICES-SLHS | 1990461 | 495320 | 1495141 |
| DUES & SUBSCRIPTIONS | 94697 | 36995 | 57702 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78789 | Total |
| Program Services | 46226 | ProgramServices |
| Management And General | 32563 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39008586 | Total |
| Program Services | 34077074 | ProgramServices |
| Management And General | 4931512 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6717888 | BOY |
| EOY | 10136484 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2271663 | BOY |
| EOY | 965281 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6384313 | BOY |
| EOY | 5239537 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38279 | BOY |
| EOY | 33870 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 527482 | BOY |
| EOY | 495658 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 259164 | BOY |
| EOY | 179591 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 8138200 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 5241314 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3685835 | BOY |
| EOY | 2896886 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4341023 | BOY |
| EOY | 8514202 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 178416 | BOY |
| EOY | 59506 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9894 | BOY |
| EOY | 217481 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24413957 | BOY |
| EOY | 28738496 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2221780 | BOY |
| EOY | 2039974 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 373446 | BOY |
| EOY | 595881 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2595226 | BOY |
| EOY | 2635855 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21818731 | BOY |
| EOY | 26102641 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21818731 | BOY |
| EOY | 26102641 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24413957 | BOY |
| EOY | 28738496 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 4154230 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 129680 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $8,110 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 8110 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | LINE F - PORTION OF DUES PAID TO VARIOUS HOSPITAL AND MEDICAL ASSOCIATIONS USED TOWARD LOBBYING ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1398030 | OtherCostOrOtherBasis |
| Depreciation | 1176143 | Depreciation |
| Book Value | 221887 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5470460 | OtherCostOrOtherBasis |
| Depreciation | 3354956 | Depreciation |
| Book Value | 2115504 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1269710 | OtherCostOrOtherBasis |
| Depreciation | 710215 | Depreciation |
| Book Value | 559495 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2896886 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | STATE STREET INVESTMENTS | Description |
| Book Value | 8514202 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 8514202 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| PAYABLES TO AFFILIATES | $243,375 |
| ESTIMATED THIRD PARTY PAYOR SETTLEMENTS | $352,506 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 595881 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 39392643 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 39392643 | RevenueSubtotal |
| Other Revenues Not Included | 3770173 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 3770173 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 43162816 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 35076273 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 35076273 | ExpensesSubtotal |
| Other Expenses Not Included | 3932313 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 3932313 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 39008586 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAX ON ITS RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. MANAGEMENT IS NOT AWARE OF ANY UNCERTAINTIES IN INCOME TAX POSITIONS. TAX YEARS ENDING ON AND BEFORE DECEMBER 31, 2008, ARE NOT SUBJECT TO EXAMINATION BY TAXING AUTHORITIES. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RISK RETENTION GROUP SUBSCRIBER SAVINGS ACCOUNT DIVIDEND 11,042. EXPENSES RECORDED IN OTHER INCOME 115. UNREALIZED GAINS ON INVESTMENTS -173,180. BAD DEBT NETTED WITH PATIENT SERVICE REVENUE PER BOOKS 3,932,198. ROUNDING -2. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | ROUNDING | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | EXPENSES RECORDED IN OTHER INCOME 115. BAD DEBT NETTED WITH PATIENT SERVICE REVENUE PER BOOKS 3,932,198. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 133.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 756919 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 756919 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02160 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7021014 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6885659 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 135355 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00390 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7777933 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6885659 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 892274 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02550 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8214 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 8214 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4288311 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3807218 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 481093 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01370 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 45900 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 45900 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4342425 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3807218 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 535207 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01520 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12120358 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10692877 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1427481 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04070 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $3,932,198 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 15432198 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 15350602 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 81596 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEDRICK MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 CENTRAL ST | AddressLine1 |
| City | CHILLICOTHE | City |
| State | MO | State |
| ZIP Code | 64601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEDRICK MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 133.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| HEDRICK FAMILY CARE | ||||
| 861 FAIRWAY DRIVE | CHILLICOTHE | MO | 64601 | RURAL HEALTH CLINIC |
| HMC REHAB | ||||
| 1422 NORTH WASHINGTON SUITE A | CHILLICOTHE | MO | 64601 | RURAL REHABILITATION CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation | Return ReferenceReturnReference | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 7: COST OF CHARITY CARE AND UNREIMBURSED HEALTH SERVICES WERE CALCULATED USING THE APPROPRIATE COST TO CHARGE RATIO FROM THE HOSPITAL'S COST REPORT. | ||
| PART I, L7 COL(F): TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) OF $39,008,585 LESS BAD DEBT EXPENSE OF $3,938,719 EQUALS TOTAL EXPENSE OF $35,069,866 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). | ||
| PART II: THE ORGANIZATION IS INVOLVED IN SEVERAL COMMUNITY ORGANIZATIONS THAT ARE DEDICATED TO THE IMPROVEMENT OF LIFE IN THE COMMUNITY THROUGH PHYSICAL IMPROVEMENTS AND HOUSING. THE ORGANIZATION HELPS SUPPORT HABITAT FOR HUMANITY THROUGH DONATIONS OF TIME BY EMPLOYEES AND MONETARY NEEDS. MANY OF OUR EMPLOYEES PARTICIPATE IN LOCAL ORGANIZATIONS AND CHURCH GROUPS THAT ARE WORKING TO HELP THE COMMUNITY GROW AND BE BETTER. | ||
| BAD DEBT EXPENSE IS REPORTED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT IT ALIGNS WITH GAAP. | PART III, LINE 2, BAD DEBT | |
| PART III, LINE 4: FINANCIAL STATEMENT FOOTNOTE REGARDING BAD DEBT EXPENSE: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACOCUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE MEDICAL CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS 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 MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY 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) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.BAD DEBT IS RECORDED CONSISTENT WITH FINANCIAL STATEMENTS. | ||
| PART III, LINE 9B: IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE THE ACCOUNT IS ADJUSTED ACCORDINGLY. ANY REMAINING BALANCE WOULD BE COLLECTED UNDER THE DEBT COLLECTION POLICY. OUR COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. ALTHOUGH WE ARE NOT LEGALLY BOUND BY THE FAIR DEBT COLLECTION PRACTICES ACT, THE PRINCIPLES ADDRESSED ARE GENERALLY FOLLOWED. | ||
| PART V, SECTION B, LINE 14G: THE HOSPITAL FOLLOWS THE SAINT LUKE'S HEALTH SYSTEM POLICIES FOR UNINSURED. IN ADDITION TO THESE POLICIES, THE HOSPITAL PROVIDES EDUCATION ON FINANCIAL ASSISTANCE ELIGIBILITY TO PATIENTS AND PERSONS WHO MAY BE BILLED FOR SERVICES THROUGH MANY SOURCES INCLUDING THE SLHS WEB SITE, INFORMATION ON BILLING STATEMENTS, INFORMATION UPON CHECK-IN LOCATED IN THE ADMITTING PATIENT PACKETS, ON OUR B-131 RELEASE TO TREAT FORMS SIGNED BY ALL PATIENTS REQUESTING SERVICES, AND VISITS BY SOCIAL WORKER TEAMS WHEN AN INPATIENT AS WELL AS FOLLOW UP CALLS AFTER DISCHARGE. FINANCIAL ASSISTANCE OR MEDICAID APPLICATIONS ARE REQUESTED ON ALL UNINSURED PATIENTS PRIOR TO DISCHARGE.THE HOSPITAL ALSO CONTRACTS WITH ELIGIBILITY ENROLLMENT SERVICE COMPANIES TO SCREEN ALL UNINSURED PATIENTS, ANY PATIENT IDENTIFIED BY A SOCIAL WORKER OR CASE MANAGER AS WELL AS ALL PATIENTS THAT REQUEST ASSISTANCE IN APPLYING FOR MEDICAID OR OTHER GOVERNMENT COVERAGE. | HEDRICK MEDICAL CENTER | |
| PART VI, LINE 2: THE HOSPITAL ASSESSES COMMUNITY NEEDS ON AN ANNUAL BASIS IN NUMEROUS WAYS, INCLUDING THROUGH ITS COMPREHENSIVE, DATA DRIVEN, ANNUAL STRATEGIC PLANNING PROCESS. WE INVITE COMMUNITY FEEDBACK. WE ALSO SEND PATIENT SATISFACTION SURVEYS TO OUR PATIENTS TO MEASURE HOW WE ARE MEETING THEIR NEEDS. | ||
| PART VI, LINE 3: SEE RESPONSE TO PART V, LINE 14G. | ||
| PART VI, LINE 4: HEDRICK MEDICAL CENTER IS LOCATED IN CHILLICOTHE, MISSOURI. THE HOSPITAL IS WITHIN AN 90 MILE DRIVE OF THE KANSAS CITY METROPOLITAN AREA. THE CITY OF CHILLICOTHE POPULATION IS 8,968, WHILE LIVINGSTON COUNTY (THE COUNTY THE HOSPITAL IS LOCATED) POPULATION IS 14,558. THE MEDIAN AGE IS 39.7 AND MEDIAN HOSEHOLD INCOME IS $32,793. PERSONS 65 YEARS OLD AND OVER MAKE UP 19% OF THE POPULATION WITH 23% OF THE POPULATION UNDER 18 YEARS OF AGE. | ||
| PART VI, LINE 6: THE HOSPITAL IS AFFILIATED WITH SAINT LUKE'S HEALTH SYSTEM, WHICH CONSISTS OF 11 AREA HOSPITALS AND SEVERAL PRIMARY AND SPECIALTY CARE PRACTICES, AND PROVIDES A RANGE OF INPATIENT, OUTPATIENT, AND HOME CARE SERVICES. FOUNDED AS A FAITH-BASED, NOT-FOR-PROFIT ORGANIZATION, OUR MISSION INCLUDES A COMMITMENT TO THE HIGHEST LEVELS OF EXCELLENCE IN HEALTH CARE AND THE ADVANCEMENT OF MEDICAL RESEARCH AND EDUCATION. THE HEALTH SYSTEM IS AN ALIGNED ORGANIZATION IN WHICH THE PHYSICIANS AND HOSPITALS ASSUME RESPONSIBILITY FOR ENHANCING THE PHYSICAL, MENTAL, AND SPIRITUAL HEALTH OF PEOPLE IN THE METROPOLITAN KANSAS CITY AREA AND THE SURROUNDING REGION. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| YMCA | |||||||
| 1725 LOCUST STREET | CHILLICOTHE | MO | 64601 | 431493664 | 501(C)(3) | 12000 | DONATION FOR THE YMCA BUILDING FUND AND OTHER CONTRIBUTIONS. |
| CHILLICOTHE EDUCATION FOUNDATION | |||||||
| PO BOX 530 | CHILLICOTHE | MO | 64601 | 431624183 | 501(C)(3) | 8333 | DONATION FOR JERRY LITTON MEMORIAL STADIUM. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: GRANTS ARE PROVIDED TO QUALIFIED 501(C)(3) CHARITIES. ALL DONEE INFORMATION IS KEPT AS PART OF THE ORGANIZATION'S BOOKS AND RECORDS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DON SIPES | ||||||||||||||
| DIRECTOR-PRESIDENT | 0 | 235195 | 0 | 66841 | 0 | 37005 | 0 | 37870 | 0 | 17392 | 0 | 394303 | 0 | 17999 |
| DELOS CLOW | ||||||||||||||
| DIRECTOR & EMPLOYED PHYSICIAN | 234934 | 0 | 45000 | 0 | 1925 | 0 | 11250 | 0 | 20114 | 0 | 313223 | 0 | 0 | 0 |
| CYNTHIA CHRISTENSEN | ||||||||||||||
| DIRECTOR-TREASURER | 0 | 189000 | 0 | 53358 | 0 | 25597 | 0 | 39300 | 0 | 5810 | 0 | 313065 | 0 | 15500 |
| MATT WENZEL | ||||||||||||||
| CEO | 169384 | 0 | 41604 | 0 | 1336 | 0 | 23704 | 0 | 19965 | 0 | 255993 | 0 | 0 | 0 |
| JANET BUCKMAN | ||||||||||||||
| CFO | 154780 | 0 | 20447 | 0 | 834 | 0 | 7131 | 0 | 8568 | 0 | 191760 | 0 | 0 | 0 |
| GREGORY MILLER | ||||||||||||||
| PHYSICIAN | 170131 | 0 | 145572 | 0 | 670 | 0 | 10000 | 0 | 19078 | 0 | 345451 | 0 | 0 | 0 |
| JENNA GIBSON | ||||||||||||||
| PHARMACY OPERATIONS MGR | 123926 | 0 | 3060 | 0 | 717 | 0 | 5951 | 0 | 19604 | 0 | 153258 | 0 | 0 | 0 |
| JASON GAULT | ||||||||||||||
| PHYSICIAN | 295881 | 0 | 63561 | 0 | 835 | 0 | 10000 | 0 | 20247 | 0 | 390524 | 0 | 0 | 0 |
| YULIA VAKSMAN | ||||||||||||||
| PHYSICIAN | 254743 | 0 | 24789 | 0 | 636 | 0 | 4766 | 0 | 14257 | 0 | 299191 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 7 | THE ORGANIZATION HAS ADOPTED A MANAGEMENT INCENTIVE COMPENSATION PLAN FOR CERTAIN MEMBERS OF SENIOR AND MIDDLE MANAGEMENT TO PROMOTE EFFECTIVE MANAGEMENT OF OPERATIONS, QUALITY OF CARE AND SERVICE, AND OPTIMAL USE OF RESOURCES. THE INCENTIVES ARE CALCULATED AS A PERCENTAGE OF BASE SALARY CONTINGENT ON ACHIEVING QUALITY, PATIENT SATISFACTION, EMPLOYEE RETENTION, FINANCIAL AND OTHER OPERATIONAL PERFORMANCE TARGETS ESTABLISHED BY THE BOARD'S COMPENSATION COMMITTEE ON AN ANNUAL BASIS. INCENTIVE AWARDS ARE PAID AT THE DISCRETION OF THE BOARD OF DIRECTORS. THIS INCENTIVE COMPENSATION IS EVALUATED AS PART OF THE REVIEW OF MARKET COMPETITIVE DATA AND REASONABLENESS OF OVERALL COMPENSATION AND BENEFITS. | |
| PART III | PART II: DON SIPES AND CYNTHIA CHRISTENSEN DID NOT RECEIVE COMPENSATION FOR DUTIES AS A DIRECTOR OR OFFICER OF THE FILING ORGANIZATION BUT RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS FOR SERVICES RENDERED TO THE RELATED ORGANIZATIONS. COMPENSATION REPORTED FOR BOARD MEMBERS IS FOR PHYSICIAN SERVICES RENDERED TO THE ORGANIZATION. BOARD MEMBERS ARE NOT COMPENSATED. | SUPPLEMENTAL INFORMATION |
Schedule L IRS990ScheduleL
Loan Table LoanTable (2 entries)
| Purpose Of LoanPurposeOfLoan | Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|---|
| GREGORY MILLER MD DIRECTOR | ||||||
| RECRUITMENT LOAN DURING FAMILY PRACTICE RESIDENCY | X | $65,803 | 24359 | 0 | 1 | 1 |
| JASON GAULT MD HIGHEST COMPENSATE | ||||||
| RECRUITMENT LOAN DURING GENERAL SURGERY RESIDENCY | X | $37,067 | 9511 | 0 | 1 | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 33870 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | DON SIPES AND CYNTHIA CHRISTENSEN HAVE A BUSINESS RELATIONSHIP BECAUSE DON SIPES IS AN OFFICER AND CYNTHIA CHRISTENSEN IS A HIGHEST COMPENSATED EMPLOYEE OF THE SOLE CORPORATE MEMBER, SAINT LUKE'S HEALTH SYSTEM, A 501(C)(3) ORGANIZATION. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE CORPORATE MEMBER IS SAINT LUKE'S HEALTH SYSTEM, A 501(C)(3) ORGANIZATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE GOVERNING BODY IS ELECTED BY THE SOLE CORPORATE MEMBER. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE MEMBER HAS SPECIFIED RESERVE POWERS OVER MAJOR DECISIONS SUCH AS AMENDMENTS TO ARTICLES AND BYLAWS, DEBT, BUDGETS, CAPITAL EXPENDITURES AND STRATEGIC OPERATING DECISIONS. AS PART OF AN INTEGRATED HEALTH SYSTEM, THE SOLE MEMBER ALSO PROVIDES VARIOUS MANAGEMENT AND SUPPORT FUNCTIONS TO THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS PREPARED JOINTLY BY ACCOUNTING STAFF OF THE ENTITY AND SAINT LUKE'S HEALTH SYSTEM (SYSTEM) TAX STAFF. THE RETURN IS REVIEWED BY THE ENTITY'S CFO OR CEO BEFORE FILING. THE 990 DRAFT WAS ALSO PRESENTED TO THE AUDIT COMMITTEE OF THE SYSTEM BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING. THE 990 WAS PROVIDED TO THE ORGANIZATION'S BOARD MEMBERS BEFORE FILING WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | SAINT LUKE'S HEALTH SYSTEM AND ITS AFFILIATES, INCLUDING THE FILING ORGANIZATION, HAVE COMPREHENSIVE WRITTEN CONFLICT OF INTEREST POLICIES APPLICABLE TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES. ANY ACTUAL, POSSIBLE OR PERCEIVED CONFLICT OF INTEREST IS EXPECTED TO BE HANDLED THROUGH FULL AND TIMELY DISCLOSURE OF ANY SUCH INTEREST, TOGETHER WITH ABSENCE OF PERSUASION IN ANY DISCUSSION AND IN ANY VOTE WHEREIN THE INTEREST IS INVOLVED. DISCLOSURE IS TO BE MADE WHEN THE INTEREST ARISES, AT ANY TIME THE INTEREST BECOMES A MATTER OF GOVERNING BOARD ACTION, AND THEN ANNUALLY THROUGH COMPLETION OF A CONFLICT OF INTEREST QUESTIONNAIRE. THE SYSTEM VICE PRESIDENT OF INTERNAL AUDIT OR THE SYSTEM VICE PRESIDENT OF HUMAN RESOURCES REVIEWS COMPLETED QUESTIONNAIRES AND FURTHER INVESTIGATES POSSIBLE CONFLICTS OF INTEREST. A REPORT IS PROVIDED TO THE AUDIT COMMITTEE OF THE SYSTEM BOARD OF DIRECTORS AND ANY IDENTIFIED CONFLICT OF INTEREST IS REPORTED TO THE APPLICABLE ENTITY. | |
| FORM 990, PART VI, SECTION B, LINE 15 | ANNUALLY, THE SAINT LUKE'S HEALTH SYSTEM BOARD OF DIRECTORS' COMPENSATION COMMITTEE REVIEWS, DISCUSSES, SETS AND APPROVES COMPENSATION FOR THE ORGANIZATION'S TOP MANAGEMENT EXECUTIVE AND CFO. INDEPENDENT, EXTERNAL DIRECTORS SERVE ON THE COMPENSATION COMMITTEE. AN INDEPENDENT COMPENSATION CONSULTING FIRM ANNUALLY PROVIDES A WRITTEN REPORT AND REASONABLENESS OPINION. THE CONSULTANT REVIEWS THE SYSTEM'S EXECUTIVE COMPENSATION PHILOSOPHY AND ANALYZES MARKET COMPETITIVENESS (IN TOTAL AND BY EACH COMPENSATION AND BENEFIT ELEMENT) FOR THE EXECUTIVES USING APPROPRIATE COMPARABILITY DATA. COMPENSATION COMMITTEE ACTIONS ARE CONTEMPORANEOUSLY DOCUMENTED. THE PROCESS SATISFIES THE REBUTTABLE PRESUMPTION PROCEDURE. COMPENSATION FOR OFFICERS NOT REVIEWED BY THE COMPENSATION COMMITTEE IS SET/APPROVED ANNUALLY BY SAINT LUKE'S HEALTH SYSTEM EXECUTIVE MANAGEMENT BASED ON MARKET COMPENSATION. | |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT PUBLICLY AVAILABLE. | |
| FORM 990, PART VII | DON SIPES AND CYNTHIA CHRISTENSEN DID NOT RECEIVE COMPENSATION FOR DUTIES AS A DIRECTOR OR OFFICER OF THE FILING ORGANIZATION BUT RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS FOR SERVICES RENDERED TO THE RELATED ORGANIZATIONS. COMPENSATION REPORTED FOR BOARD MEMBERS IS FOR SERVICES AS EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION. BOARD MEMBERS ARE NOT COMPENSATED. | |
| FORM 990, PART IX, LINE 11G | PHYSICIAN REMUNERATION: PROGRAM SERVICE EXPENSES 3,120,051. MANAGEMENT AND GENERAL EXPENSES 150. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,120,201. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 421,671. MANAGEMENT AND GENERAL EXPENSES 152,423. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 574,094. OTHER SERVICES: PROGRAM SERVICE EXPENSES 2,033,071. MANAGEMENT AND GENERAL EXPENSES 430,725. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,463,796. | OTHER FEES |
| FORM 990, PART XI, LINE 9: | RISK RETENTION GROUP SUBSCRIBER SAVINGS ACCOUNT DIVIDEND -11,042. PENSION LIABILITY TRANSFER TO SLHS -32,459. UNREALIZED GAIN INVESTMENTS 173,180. ROUNDING 1. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| PART V, LINE 1A | HEDRICK MEDICAL CENTER (HMC) IS PART OF SAINT LUKE'S HEALTH SYSTEM, AN INTEGRATED HEALTH SYSTEM. THE MAJORITY OF HMC VENDORS ARE PAID THROUGH A CENTRALIZED PAYMENT SYSTEM WITH 1099S ISSUED BY THE CENTRALIZED SERVICE ENTITY. | NUMBER REPORTED IN BOX 3 OF FORM 1096 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (19 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|
| ST LUKES HOSPITAL OF KANSAS CITY | ||||||||||
| 4401 WORNALL ROAD | KANSAS CITY | MO | 64111 | 440545297 | HEALTH CARE | MO | 501(C)(3) | 170B1AIII | 0 | |
| SAINT LUKE'S HEALTH SYSTEM | ||||||||||
| 10920 ELM AVENUE | KANSAS CITY | MO | 64134 | 431747502 | HEALTH SYSTEM | KS | 501(C)(3) | 509(A)(3) - TYPE 1 | 0 | ST LUKES HOSPITAL OF KANSAS CITY |
| SAINT LUKE'S NORTHLAND HOSPITAL CORPORATION | ||||||||||
| 601 S 169 HWY | SMITHVILLE | MO | 64089 | 440545393 | HEALTH CARE | MO | 501(C)(3) | 170B1AIII | 0 | SAINT LUKE'S HEALTH SYSTEM |
| SAINT LUKE'S SOUTH HOSPITAL INC | ||||||||||
| 12300 METCALF AVE | OVERLAND PARK | KS | 66213 | 481203262 | HEALTH CARE | KS | 501(C)(3) | 170B1AIII | 0 | SAINT LUKE'S HEALTH SYSTEM |
| SAINT LUKE'S EAST HOSPITAL | ||||||||||
| 100 NE SAINT LUKES BLVD | LEES SUMMIT | MO | 64086 | 562488077 | HEALTH CARE | MO | 501(C)(3) | 170B1AIII | 0 | SAINT LUKE'S HEALTH SYSTEM |
| SAINT LUKE'S MEDICAL GROUP | ||||||||||
| 6750 ANTIOCH STE 210 | SHAWNEE MISSION | KS | 66204 | 431598353 | HEALTH CARE | MO | 501(C)(3) | 170B1AIII | 0 | SAINT LUKE'S HEALTH SYSTEM |
| CRITTENTON | ||||||||||
| 10918 ELM AVENUE | KANSAS CITY | MO | 64134 | 440545808 | HEALTH CARE | MO | 501(C)(3) | 170B1AIII | 0 | ST LUKES HOSPITAL OF KANSAS CITY |
| SAINT LUKE'S HEALTH SYSTEM HOME CARE AND HOSPICE | ||||||||||
| 3100 BROADWAY STE 1000 | KANSAS CITY | MO | 64111 | 431127200 | HEALTH CARE | MO | 501(C)(3) | 170B1AIII | 0 | SAINT LUKE'S HEALTH SYSTEM |
| ST LUKE'S OF TRENTON | ||||||||||
| 191 IOWA BLVD | TRENTON | MO | 64683 | 431707306 | HEALTH CARE | MO | 501(C)(3) | 170B1AIII | 0 | SAINT LUKE'S HEALTH SYSTEM |
| SAINT LUKE'S HOSPITAL OF GARNETT | ||||||||||
| 421 SOUTH MAPLE | GARNETT | KS | 66032 | 742849611 | HEALTH CARE | KS | 501(C)(3) | 170B1AIII | 0 | SAINT LUKE'S HEALTH SYSTEM |
| CABOT WESTSIDE HEALTH CENTER | ||||||||||
| 2121 SUMMIT | KANSAS CITY | MO | 64108 | 440546280 | HEALTH CARE | MO | 501(C)(3) | 170B1AVI | 0 | SAINT LUKE'S HEALTH SYSTEM |
| MIDWEST EAR INSTITUTE INC | ||||||||||
| 4200 PENNSYLVANIA STE 100 | KANSAS CITY | MO | 64111 | 480905027 | HEALTH CARE | KS | 501(C)(3) | 170B1AIII | 0 | ST LUKES HOSPITAL OF KANSAS CITY |
| CUSHING MEMORIAL HOSPITAL CORPORATION | ||||||||||
| 711 MARSHALL | LEAVENWORTH | KS | 66048 | 480543792 | HEALTH CARE | KS | 501(C)(3) | 170B1AIII | 0 | SAINT LUKE'S HEALTH SYSTEM |
| SAINT LUKE'S CANCER INSTITUTE LLC | ||||||||||
| 4323 WORNALL ROAD PEET | KANSAS CITY | MO | 64111 | 431933950 | HEALTH CARE | MO | 501(C)(3) | 170B1AIII | 0 | SAINT LUKE'S HEALTH SYSTEM |
| SAINT LUKE'S CARE | ||||||||||
| 10920 ELM AVENUE | KANSAS CITY | MO | 64134 | 260185090 | HEALTH CARE | MO | 501(C)(3) | 509(A)(3) - TYPE 1 | 0 | SAINT LUKE'S HEALTH SYSTEM |
| MEDICAL PLAZA IMAGING ASSOCIATES LLC | ||||||||||
| 4401 WORNALL ROAD | KANSAS CITY | MO | 64111 | 431609584 | HEALTH CARE | MO | 501(C)(3) | 170B1AIII | 0 | SAINT LUKE'S HEALTH SYSTEM |
| SAINT LUKE'S COLLEGE OF HEALTH SCIENCES | ||||||||||
| 624 WESTPORT ROAD | KANSAS CITY | MO | 64111 | 272716128 | POST-SECONDARY NURSING EDUCATION | MO | 501(C)(3) | 170B1AII | 0 | ST LUKES HOSPITAL OF KANSAS CITY |
| SLCC INC | ||||||||||
| 4330 WORNALL RD SUITE 2000 | KANSAS CITY | MO | 64111 | 271994652 | HEALTH CARE | KS | 501(C)(3) | 170B1AIII | 0 | SAINT LUKE'S HEALTH SYSTEM |
| SLNC INC | ||||||||||
| 4401 WORNALL ROAD | KANSAS CITY | MO | 64111 | 451470888 | HEALTH CARE | KS | APPLIED FOR 501(C)(3 | 170B1AIII | 0 | SAINT LUKE'S HEALTH SYSTEM |
Form990 Schedule R Part III Form990ScheduleRPartIII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|
| MEDICAL PLAZA PARTNERS LP | |||||||
| 4320 WORNALL RD STE 410 | KANSAS CITY | MO | 64111 | 431357824 | OWN & OPERATE MEDICAL OFFICE BUILDING | MO | N/A |
| MEDICAL PARK ASSOCIATES A LP | |||||||
| 601 S 169 HWY | SMITHVILLE | MO | 64089 | 431311049 | OWN & OPERATE MEDICAL OFFICE BUILDING | MO | N/A |
| ST LUKES SURGICENTER-LEE'S SUMMIT LLC | |||||||
| 11221 ROE AVE STE 230 | OVERLAND PARK | KS | 66211 | 470853481 | HEALTH CARE | MO | N/A |
| SAINT LUKES SOUTH SURGERY CENTER LLC | |||||||
| 11221 ROE AVE STE 230 | OVERLAND PARK | KS | 66211 | 201721929 | HEALTH CARE | KS | N/A |
| FAMILY ADVOCATES LLC | |||||||
| 10918 ELM AVENUE | KANSAS CITY | MO | 64134 | 202739036 | FOSTER CARE | MO | N/A |
| SAINT LUKE'S CARDIOLOGY SERVICES LLC | |||||||
| 10920 ELM AVENUE | KANSAS CITY | MO | 64134 | 263726426 | HEALTH CARE | MO | N/A |
| SAINT LUKE'S -GI DIAGNOSTICS LLC | |||||||
| 4321 WASHINGTON SUITE 5700 | KANSAS CITY | MO | 64111 | 274142549 | HEALTH CARE | MO | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| SAINT LUKE'S HEALTH SYSTEM RISK RETENTION GROUP | |||||||||
| 10920 ELM AVENUE | KANSAS CITY | MO | 64134 | 371471890 | INSURANCE | SC | N/A | C | 0 |
| ST LUKE'S HEALTH VENTURES INC | |||||||||
| 4320 WORNALL ROAD STE 410 | KANSAS CITY | MO | 64111 | 431278476 | ACCOUNTING | MO | N/A | C | 0 |
| MEDICAL PLAZA MANAGEMENT INC | |||||||||
| 4320 WORNALL ROAD STE 410 | KANSAS CITY | MO | 64111 | 431352317 | MEDICAL OFFICE BUILDING MANAGEMENT | MO | N/A | C | 0 |
| VENTURE FINANCIAL SERVICES INC | |||||||||
| 9500 E 63RD STREET STE 202 | RAYTOWN | MO | 64133 | 431605740 | COLLECTIONS | MO | N/A | C | 0 |
| SPELMAN DEVELOPMENT CORPORATION | |||||||||
| 601 S 169 HWY | SMITHVILLE | MO | 64089 | 431296007 | MEDICAL OFFICE BUILDING RENTALS | MO | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | TRANSACTIONS WITH RELATED ORGANIZATIONS | Identifier |
| Return Reference | SCHEDULE R, PART V, ITEM 1 | ReturnReference |
| Explanation | SAINT LUKE'S HEALTH SYSTEM (SYSTEM) AND ITS AFFILIATED ENTITIES OPERATE AS A HIGHLY INTEGRATED HEALTH CARE DELIVERY SYSTEM. THE SYSTEM MANAGES AND OPERATES RELATED HOSPITALS AND THEIR AFFILIATES AS A COMMON MISSION ORIENTED HEALTH CARE SYSTEM IN ORDER TO BETTER SERVE THE HEALTH-RELATED NEEDS OF GREATER KANSAS CITY AND SURROUNDING AREAS. AS A RESULT, THERE ARE NUMEROUS INTERCOMPANY INTERACTIONS INCLUDING CENTRALIZED SUPPORT SERVICES AND SHARING OF RESOURCES AND COSTS. | Explanation |