2023-11-15T09:38:14-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2022-01-01 430998347 BOONE HOSPITAL CENTER'S VISITING NURSES BOON 5738158732 1605 E BROADWAY 250 COLUMBIA MO 65201 EDWARD CLAYTON CFO 5738158732 2023-11-15 1 EDWARD CLAYTON 999009999 0 AMBER ROGNAN-HAMILTON P01251012 3149254300 2023-11-06 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z TROY GREER 1605 E BROADWAY 250 COLUMBIA MO 65201 2776382 0 X WWW.BOONE.HEALTH/SERVICES/HOME-CARE-AND-HOSPICE X 1972 MO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 6 0 36 0 0 0 655113 0 2596299 2776381 3 1 58 0 3251473 2776382 0 0 0 0 1914755 3095278 0 0 0 1293545 1055890 3208300 4151168 43173 -1374786 2071418 900412 442781 664082 1628637 236330 TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. WE WILL ACCOMPLISH THAT MISSION BY MAKING BOONE AN EXCELLENT PLACE TO WORK AND TO RECEIVE HEALTH CARE. 0 0 1863987 0 1493019 BOONE HEALTH HOME CARE AND HOSPICE BRINGS THE EXCELLENCE OF BOONE HEALTH DIRECTLY TO OUR PATIENT'S HOMES.BOONE HEALTH HOME CARE IS THERE FOR PATIENTS WHO HAVE BEEN DISCHARGED FROM THE HOSPITAL, OR OTHER FACILITY, WHILE STILL NEEDING CLOSE MEDICAL SUPERVISION. OTHER TIMES, OUR HOME CARE SERVICES HELP WHEN A DOCTOR DECIDES THAT A PATIENT NEEDS ASSISTANCE BUT MAY NOT NEED TO COME TO THE HOSPITAL. FOR THE YEAR ENDED DECEMBER 31, 2022, THE HOME CARE PROGRAM COMPLETED 827 ADMISSIONS AND ADMINISTERED 9,761 PATIENT VISITS. 1602236 0 1283362 HOME-BASED HOSPICE SERVICES ARE AVAILABLE TO PATIENTS WHEN THEY AND THEIR PHYSICIANS DETERMINE THAT A CURE IS NO LONGER AN OPTION. WE HELP PATIENTS WITH TERMINAL ILLNESSES THAT HAVE LIFE EXPECTANCIES OF SIX MONTHS OR LESS. WITH HOSPICE CARE, OUR FOCUS IS ON MAINTAINING QUALITY OF LIFE BY KEEPING PATIENTS PAIN FREE AND COMFORTABLE AS POSSIBLE. FOR THE YEAR ENDED DECEMBER 31, 2022, THE HOSPICE PROGRAM PROVIDED 7,892 PATIENT CARE DAYS. 3466223 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 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 1 0 0 0 1 X 0 0 36 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 0 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 X KAT BRISSLEY 5738158000 1600 E BROADWAY COLUMBIA MO 65201 TROY GREER CHAIRMAN/CEO 20.00 20.00 X X 0 614636 52697 CHAD PEW VICE CHAIRMAN/VP PROVIDER 20.00 20.00 X X 0 329753 46166 MICHAEL SZEWCZYK PRESIDENT/PHYSICIAN 1.00 40.00 X X 0 27737 0 LIZ EIKEL SECRETARY/COMPLIANCE SPECIALIST 1.00 40.00 X X 0 39097 9083 MONICA SMITH BOARD MEMBER/COO 20.00 20.00 X X 0 394907 64009 ANGELA YUEN BOARD MEMBER/HOSPITALIST 1.00 40.00 X 0 477889 38890 LAURA THOMAS CFO (TERM ENDED AUGUST 2022) 20.00 20.00 X 0 318841 8483 ED CLAYTON CFO 20.00 20.00 X 0 172678 37502 0 2375538 256830 0 0 1 0 MEDEFIS PO BOX 5068 NEW YORK NY 10087 AGENCY LABOR 1194592 SIMITREE 4130 WHITNEY AVENUE HAMDEN CT 60651 CONSULTING 162393 ENSEMBLE 11511 REED HARTMAN HWY BLUE ASH OH 45241 BILLING/COLLECTION 130287 3 HOME HEALTH 621610 1493019 1493019 HOSPICE 621610 1283362 1283362 2776381 1 1 2776382 2776381 0 1 X 2768103 2311366 456737 75919 63392 12527 130234 108745 21489 121022 101053 19969 502163 419306 82857 258 215 43 56718 47360 9358 1116 932 184 97952 81790 16162 54915 45854 9061 107303 89598 17705 MEDICAL SUPPLIES AND EQ 115406 96364 19042 PHARMACEUTICALS AND VAC 43307 36161 7146 BAD DEBTS 29228 24405 4823 REPAIRS AND MAINTENANCE 14446 12062 2384 33078 27620 5458 4151168 3466223 684945 0 1196332 372808 421646 304961 2095 413066 190423 329946 222643 121399 0 2071418 900412 333151 246024 109630 0 418058 442781 664082 X 1628637 236330 1628637 236330 2071418 900412 X -1374786 -17521 X X 0 1 X 1 1 1 X X X 1 CH ALLIED SERVICES INC 431279063 3 1 0 3466223 1 0 3466223 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 413066 190423 222643 222643 DUE TO AFFILIATES 418058 418058 0 1 0 0 0 0 0 0 0 TROY GREER CHAIRMAN/CEO 0 613636 0 1000 0 0 0 24840 0 27857 0 667333 0 0 ANGELA YUEN BOARD MEMBER/HOSPITALIST 0 451227 0 26662 0 0 0 20500 0 18390 0 516779 0 0 MONICA SMITH BOARD MEMBER/COO 0 303907 0 91000 0 0 0 36277 0 27732 0 458916 0 0 CHAD PEW VICE CHAIRMAN/VP PROVIDER 0 272337 0 57416 0 0 0 20151 0 26015 0 375919 0 0 LAURA THOMAS CFO (TERM ENDED AUGUST 2022) 0 280941 0 37900 0 0 0 4496 0 3987 0 327324 0 0 ED CLAYTON CFO 0 162678 0 10000 0 0 0 26794 0 10708 0 210180 0 0 PART I, LINE 4B CONTRIBUTIONS TO A 457(F) PLAN WERE MADE BY A RELATED ORGANIZATION, CH ALLIED SERVICES, INC., FOR THE FOLLOWING DIRECTORS OF THIS ORGANIZATION: TROY GREER - $20,500 CHAD PEW - $10,500 ED CLAYTON - $3,308 MONICA SMITH - $14,193 THE CONTRIBUTIONS WERE A RESULT OF PERFORMANCE OF SERVICES TO THE RELATED ORGANIZATION AND WERE NOT A RESULT OF SERVING AS DIRECTORS OF THIS ORGANIZATION. FORM 990, PAGE 4, PART V, LINE 1A ALL VENDOR INVOICES FOR THIS ORGANIZATION ARE PAID BY A RELATED ENTITY, CH ALLIED SERVICES, INC. (FEIN 43-1279063). AS A RESULT, ALL FORMS 1099 ARE FILED BY THE RELATED ENTITY. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS CH ALLIED SERVICES, INC., A MISSOURI NON-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS OF THIS ORGANIZATION ARE ELECTED BY THE SOLE MEMBER AT ITS ANNUAL MEETING. THE SOLE MEMBER MAY ALSO REMOVE ANY DIRECTOR WITH OR WITHOUT CAUSE. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER RESERVES THE AUTHORITY TO APPROVE OF THE FOLLOWING ACTIONS BEFORE THEY ARE UNDERTAKEN: CREATION OR TRANSFER OF A MEMBERSHIP INTEREST IN THE ORGANIZATION; SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION; MERGER OF THE ORGANIZATION; AMENDING THE ARTICLES OR THE BYLAWS; INCURRENCE OF DEBT, INCLUDING, WITHOUT LIMITATION, BORROWINGS, GUARANTEES, LOANS, ENCUMBRANCES, OPERATING LEASES, OR CAPITAL LEASES; CREATION OF SUBSIDIARIES OF THE ORGANIZATION; ANY ACTION THAT WOULD IMPAIR OR AFFECT THE TAX-EXEMPT STATUS OF THE ORGANIZATION; OR DISSOLUTION, LIQUIDATION, OR TERMINATION OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CFO AND CONTROLLER OF BOONE HEALTH, INC., A RELATED ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 12C ALL PERSONNEL OF THE ORGANIZATION AT THE DIRECTOR LEVEL OR ABOVE COMPLETE AN ANNUAL SURVERY TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST. THE ORGANIZATION'S RISK MANAGEMENT GROUP REVIEWS THE SURVEYS AND MONITORS ANY ITEMS THAT MAY LEAD TO A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 A RELATED ENTITY, CH ALLIED SERVICES, INC., PAYS THE COMPENSATION FOR ALL OFFICERS OF THIS ORGANIZATION. THE RELATED ORGANIZATION UTILIZES AN INDEPENDENT COMPENSATION CONSULTANT TO DETERMINE STANDARD BASE RATES FOR THE CEO AND OTHER OFFICERS. AN INCENTIVE PLAN, WHICH IS BASED ON ORGANIZATIONAL PERFORMAION AS COMPARED TO KEY PERFORMANCE INDICATORS CHOSEN PRIOR TO THE FISCAL YEAR, IS ALSO DETERMINED BY THE INDEPENDENT COMPENSATION CONSULTANT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. FORM 990, PART IX, LINE 11G PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 113,807. MANAGEMENT AND GENERAL EXPENSES 22,489. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 136,296. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 34,919. MANAGEMENT AND GENERAL EXPENSES 6,900. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,819. JANITORIAL AND HOUSEKEEPING: PROGRAM SERVICE EXPENSES 5,457. MANAGEMENT AND GENERAL EXPENSES 1,078. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,535. CONSULTING: PROGRAM SERVICE EXPENSES 138,914. MANAGEMENT AND GENERAL EXPENSES 27,450. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 166,364. REVENUE CYCLE OPERATIONS: PROGRAM SERVICE EXPENSES 126,209. MANAGEMENT AND GENERAL EXPENSES 24,940. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 151,149. FORM 990, PART XI, LINE 9: TRANSFER OF NET ASSETS TO AFFILIATE -17,521. FORM 990, PAGE 12, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. CH ALLIED SERVICES INC 1600 E BROADWAY COLUMBIA MO 65201 431279063 HOSPITAL MO 501(C)(3) LINE 3 BOONE HEALTH INC 0 BOONE HEALTH INC 1600 E BROADWAY COLUMBIA MO 65201 850769204 HOSPITAL GOVERNANCE MO 501(C)(3) LINE 12C, III-FI 0 0 0 0 1 0 0 0 0 0 0 1 0 1 1 1 0 0 0 0