2025-11-14T13:31:27-06:00 2024-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2024-01-01 431279063 CH ALLIED SERVICES INC CHAL 5738158732 1600 E BROADWAY COLUMBIA MO 65201 EDWARD CLAYTON CHIEF FINANCIAL OFFICER 5738158732 2025-11-13 1 1 STEPHANIE MCCARTHY P01805699 3149254300 2025-11-11 2024 2025-03-06 01:10:19Z BOONE HOSPITAL CENTER TROY GREER 1600 E BROADWAY COLUMBIA MO 65201 438804086 0 X WWW.BOONE.HEALTH X 1983 MO FULL SERVICE HOSPITAL STRIVING TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES SERVED. 12 12 2876 53 0 0 0 108952 395672151 434519288 611007 591929 2380395 3040987 398663553 438261156 49942 50811 0 0 187454111 195561836 0 0 0 249252450 271318826 436756503 466931473 -38092950 -28670317 246489087 238031619 181349358 200250533 65139729 37781086 TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 0 0 284298914 43311 369193577 THE ORGANIZATION OPERATES A 392-BED FULL SERVICE HOSPITAL AND EMPLOYED PHYSICIAN PRACTICES LOCATED IN COLUMBIA, MO. AS A REGIONAL REFERRAL CENTER LOCATED IN THE CENTER OF THE STATE, THE ORGANIZATION PROVIDES PROGRESSIVE HEALTHCARE PROGRAMS, SERVICES, AND TECHNOLOGY TO PEOPLE IN 25 MID-MISSOURI COUNTIES. FOR THE YEAR ENDED DECEMBER 31, 2024, THE ORGANIZATION PROVIDED CARE TO ITS COMMUNITY THROUGH 33,864 EMERGENCY DEPARTMENT VISITS, 10,151 SURGERY CASES AND 13,318 ADMISSIONS. 105597250 7500 76980794 THE ORGANIZATION OPERATES TWO PHYSICIAN SERVICE UNITS, CHAS PHYSICIAN SERVICES, LLC AND BOONE PHYSICIAN SERVICES, LLC. THE EMPLOYED PHYSICIANS PROVIDE CARE TO PATIENTS OF THE ORGANIZATION'S HOSPITAL AND VARIOUS CLINICS. 0 0 -8614096 THE HEALTH SYSTEM PROVIDES CARE WITHOUT CHARGE TO PATIENTS MEETING CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. BECAUSE THE HEALTH SYSTEM DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE AND IS INSTEAD AN OFFSET TO PATIENT SERVICE REVENUE. 389896164 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 1 211 0 1 2876 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X BRIAN WINN 5738153269 1600 E BROADWAY COLUMBIA MO 65201 JERRY KENNETT CHAIR 1.00 1.00 X X 0 0 0 BOB MCDAVID VICE CHAIR (TERM 03/24) 1.00 1.00 X X 0 0 0 JAN BECKETT SECRETARY 1.00 1.00 X X 0 0 0 WILLIAM ORSCHELN TREASURER 1.00 1.00 X X 0 0 0 RANDY MORROW BOARD MEMBER 1.00 1.00 X 0 0 0 CHARLES BONDURANT BOARD MEMBER 1.00 1.00 X 0 0 0 DIANNE LYNCH BOARD MEMBER 1.00 1.00 X 0 0 0 JUDY STARR BOARD MEMBER 1.00 1.00 X 0 0 0 GARY THOMPSON BOARD MEMBER 1.00 1.00 X 0 0 0 STAYCE SMITH BOARD MEMBER 1.00 1.00 X 0 0 0 MARY BECK BOARD MEMBER 1.00 1.00 X 0 0 0 JEFF LASHLEY BOARD MEMBER 1.00 1.00 X 0 0 0 BRADY DUBOIS PRESIDENT/CEO 20.00 20.00 X 682291 0 48318 EDWARD CLAYTON CFO 20.00 20.00 X 448424 0 48466 KATE PITZER HOSPITAL ADMINISTRATION/SECRETARY 37.00 3.00 X 237683 0 10757 CHRISTIAN JONES COO (BEG 2024) 40.00 0.00 X 246614 0 24334 CHAD PEW VP PROVIDER SERVICES 20.00 20.00 X 151349 0 10100 DREW WILKINSON VP PROVIDER SERVICES AND AMBULATORY OPS 40.00 0.00 X 187563 0 14576 KENYON WOODWARD CIO 40.00 0.00 X 274533 0 30790 ROBIN BLOUNT CMO 20.00 20.00 X 407577 0 31430 MONICA SMITH COO (LEFT 2024) 20.00 20.00 X 508704 0 12563 SHANNON KUCZYNSKI CNE 20.00 20.00 X 325111 0 16995 PETER GLOGGNER CPO 20.00 20.00 X 255498 0 23673 RICHARD MELLITT CARDIOTHORACIC SURGEON 40.00 0.00 X 1250339 0 37881 JOSS FERNANDEZ CARDIOTHORACIC SURGEON 40.00 0.00 X 1202538 0 12749 TERESA ELWING RADIOLOGIST 40.00 0.00 X 1234976 0 37915 MAXWELL LAZINGER RADIOLOGIST 40.00 0.00 X 1200336 0 48082 ANDREW GETZOFF RADIOLOGIST 40.00 0.00 X 1199942 0 43389 9813478 0 452018 297 0 1 0 MISSOURI CARDIOVASCULAR SPECIALISTS 1605 E BROADWAY STE 300 COLUMBIA MO 65201 CARDIOVASCULAR PHYSICIAN SERVICES 23549965 CENTRAL MISSOURI PHYSICAL THERAPY 303 N KEENE ST COLUMBIA MO 65201 PHYSICAL THERAPY SERVICES 15371429 MEDEFIS PO BOX 5068 NEW YORK NY 10087 STAFFING AGENCY 9045449 MID AMERICA ANESTHESIA CONSULTANTS 1316 OLD HIGHWAY 63 SUITE 102 COLUMBIA MO 65201 ANESTHESIA PHYSICIAN SERVICES 8405811 HUBER & ASSOCIATES INC 1400 CREEK TRAIL DRIVE JEFFERSON CITY MO 65109 INFORMATION TECHNOLOGY SERVICES 3313502 50 11023 97929 108952 PATIENT SERVICE REVENUE 621110 427302218 427302218 PHARMACY 456110 5701095 5701095 SHARED SERVICES 621110 1300842 1300842 COMMUNITY WELLNESS 624200 215133 215133 434519288 434821 434821 700038 542930 157108 157108 157108 FOOD SERVICES 722514 2199542 2199542 OTHER REVENUE 624100 837545 837545 MANAGEMENT SERVICES 541610 3900 3900 3040987 438261156 437560275 0 591929 X 50811 50811 3997350 3337787 659563 155363206 129728277 25634929 7564011 6315949 1248062 18629630 15555741 3073889 10007639 8356379 1651260 836983 698881 138102 228831 191074 37757 31374 26197 5177 96561023 80628455 15932568 668070 557838 110232 6202546 5179126 1023420 10890624 9093671 1796953 19195466 16028214 3167252 174987 146114 28873 2529678 2112281 417397 16518439 13792897 2725542 3428848 2863088 565760 MEDICAL SUPPLIES AND EQ 84950077 70933314 14016763 PHARMACEUTICALS AND VAC 23752223 19833106 3919117 DIETARY 2041235 1704431 336804 REPAIRS AND MAINTENANCE 1469134 1226727 242407 1839288 1535806 303482 466931473 389896164 77035309 0 6400511 1978324 27433596 26959884 52740082 57620870 140141 79330 10430272 12232375 4496190 4074020 120650458 72520241 62752513 48130217 2173620 2491469 79922162 84465130 246489087 238031619 60067700 62287318 412590 579124 28972866 44441918 91896202 92942173 181349358 200250533 X 37706133 10821203 27433596 26959883 65139729 37781086 246489087 238031619 X -28670317 1783792 1595 -473713 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 31374 31374 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE MISSOURI HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THESE DUES IS USED BY THE ASSOCIATIONS FOR LOBBYING ACTIVITIES. 17232813 8616191 8616622 800428 300226 500202 102259247 63603824 38655423 357970 357970 48130217 DUE FROM AFFILIATES 339545 RIGHT OF USE ASSETS 84125585 84465130 SECTION 457 PLAN PAYABLE 2578428 DUE TO THIRD PARTY PAYORS 5736987 RIGHT OF USE LIABILITIES 84626555 ADVANCED PAYMENTS 203 92942173 1 1 X 1 X 1 X 1 1 0 1 1 4469456 4469456 0.00960 26698495 24779066 1919429 0.00410 31167951 24779066 6388885 0.01370 240022 240022 0.00050 73792 73792 0.00020 120803427 74761344 46042083 0.09860 91362 91362 0.00020 121208603 74761344 46447259 0.09950 152376554 99540410 52836144 0.11320 347514 347514 0.00070 347514 347514 0.00070 1 17277604 14666328 105732545 97676603 8055942 X 1 1 1 1 BOONE HOSPITAL CENTER 1600 E BROADWAY COLUMBIA MO 65201 WWW.BOONE.HEALTH 361-14 X X X BOONE HOSPITAL CENTER 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X SEE PART V FOR URL X 1 22 1 SEE PART V FOR URL 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X SEE PART V FOR URL X SEE PART V FOR URL X SEE PART V FOR URL X X X X X X 1 X 0 X X X 1 X 0 0 BOONE HOSPITAL CENTER PART V, SECTION B, LINE 5: THE ORGANIZATION HELD A FORUM WITH 16 KEY STATEKHOLDERS OF THE COMMUNITY, INCLUDING RELIGIOUS LEADERS, MEMBERS OF THE HEALTH DEPARTMENT AND VARIOUS OTHER GROUPS THAT REPRESENT THE COMMUNITY. THE FOCUS GROUP REVIEWED THE COMMUNITY HEALTH NEED FINDINGS FROM THE 2019 CHNA AND PRIMARY DATA ON KEY HEALTH INDICATORS AND DISCUSSED CHANGES THAT HAD OCCURRED SINCE 2019. ADDITIONALLY, THE FOCUS GROUP REVIEWED GAPS IN MEETING NEEDS, AS WELL AS IDENTIFIED POTENTIAL COMMUNITY ORGANIZATIONS FOR BOONE HOSPITAL TO COLLABORATE WITH IN ADDRESSING NEEDS. BOONE HOSPITAL CENTER PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED THREE MAJOR NEEDS: DIABETES, HEART DISESASE AND SKIN CANCER.TO ADDRESS THE DIABETES NEED, THE ORGANIZATION DETERMINED THE FOLLOWING OBJECTIVES:SCREEN 350 ADULTS EACH YEAR FOR GLUCOSE USING BOONE HEALTH'S MOBILE HEALTH UNIT. WE WILL ALSO PARTNER WITH OTHER LOCAL ORGANIZATIONS: BOONE COUNTY HEALTH DEPT., COMPASS HEALTH NETWORK - FAMILY HEALTH CENTER, THE ARC, AND OTHER COMMUNITY ORGANIZATIONS; PROVIDE INDIVIDUALS WITH ON-SITE EDUCATION AND MATERIALS TO INCREASE THEIR KNOWLEDGE OF HEALTHY LIFESTYLE CHANGES TO HELP MANAGE THEIR CONDITION. DURING 2024 THERE WERE 347 SCREENINGS.TO ADDRESS THE HEART DISEASE NEED, THE ORGANIZATION DETERMINED THE FOLLOWING OBJECTIVES:SCREEN 350 ADULTS FOR HIGH BLOOD PRESSURE USING BOONE HEALTH'S MOBILE HEALTH UNIT. WE WILL ALSO PARTNER WITH OTHER LOCAL ORGANIZATIONS: BOONE COUNTY HEALTH DEPT., COMPASS HEALTH NETWORK - FAMILY HEALTH CENTER, THE ARC, AND OTHER COMMUNITY ORGANIZATIONS; PROVIDE INDIVIDUALS WITH ON-SITE EDUCATION AND MATERIALS TO INCREASE THEIR KNOWLEDGE OF HEALTHY LIFESTYLE CHANGES TO HELP MANAGE THEIR CONDITION. DURING 2024 THERE WERE 221 SCREENINGS.TO ADDRESS THE SKIN CANCER NEED, THE ORGANIZATION DETERMINED THE FOLLOWING OBJECTIVES:SCREEN 150 ADULTS EACH YEAR FOR SKIN CANCER USING BOONE HEALTH'S MOBILE HEALTH UNIT. WE WILL ALSO PARTNER WITH OTHER LOCAL ORGANIZATIONS: BOONE COUNTY HEALTH DEPT., COMPASS HEALTH NETWORK - FAMILY HEALTH CENTER, THE ARC, AND OTHER COMMUNITY ORGANIZATIONS; PROVIDE INDIVIDUALS WITH ON-SITE EDUCATION AND MATERIALS TO INCREASE THEIR KNOWLEDGE OF HEALTHY LIFESTYLE CHANGES TO HELP MANAGE THEIR CONDITION. DURING 2024 THERE WERE 165 SCREENINGS. PART V, LINE 16A FINANCIAL ASSISTANCE POLICY WEBSITE:HTTPS://BOONE.HEALTH/PATIENTS-VISITORS/BEFORE-AFTER-YOUR-VISIT/BILLING-AND-INSURANCE/DIRECT LINKHTTPS://BOONE.HEALTH/WP-CONTENT/UPLOADS/2021/03/BOONEHEALTH_FAP_2021_FINAL-APPROVED.PDF PART V, LINE 16B FINANCIAL ASSISTANCE APPLICATION WEBSITE:HTTPS://BOONE.HEALTH/PATIENTS-VISITORS/BEFORE-AFTER-YOUR-VISIT/BILLING-AND-INSURANCE/DIRECT LINKHTTPS://BOONE.HEALTH/WP-CONTENT/UPLOADS/2024/09/BOONE-FAA-ENS.PDF PART B, LINE 16C PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://BOONE.HEALTH/PATIENTS-VISITORS/BEFORE-AFTER-YOUR-VISIT/BILLING-AND-INSURANCE/ SCHEDULE H, PART V, SECTION B, LINE 7A THE ORGANIZATION'S 2022 COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT:HTTPS://BOONE.HEALTH/ABOUT-US/CHNA/DIRECT LINKHTTPS://BOONE.HEALTH/WP-CONTENT/UPLOADS/2023/01/CHNA-REPORT-2022-FINAL.PDF SCHEDULE H, PART V, SECTION B, LINE 10A THE ORGANIZATION'S 2022 IMPLEMENTATION STRATEGY CAN BE FOUND AT:HTTPS://BOONE.HEALTH/ABOUT-US/CHNA/DIRECT LINK:HTTPS://BOONE.HEALTH/WP-CONTENT/UPLOADS/2023/01/CHNA-REPORT-2022-FINAL.PDF 56 1 - BHMG - ASHLAND 605 C DOUGLAS DRIVE ASHLAND MO 65010 MEDICAL CLINIC 2 - BHMG - BOONVILLE 606 EAST SPRING STREET BOONVILLE MO 65233 MEDICAL CLINIC 3 - BHMG - CENTRAL 1605 EAST BORADWAY SUITE 110 COLUMBIA MO 65201 MEDICAL CLINIC 4 - BHMG - CENTRALIA 1021 EAST HIGHWAY 22 CENTRALIA MO 65240 MEDICAL CLINIC 5 - BHMG - GLASGOW 108 MARKET STREET GLASGOW MO 65254 MEDICAL CLINIC 6 - BHMG - HALLSVILLE 501 NORTH BOUTE B HALLSVILLE MO 65255 MEDICAL CLINIC 7 - BHMG - MEXICO 1051 OLD FARM ROAD EAST MEXICO MO 65265 MEDICAL CLINIC 8 - BHMG - MEXICO MEDICAL PARK 600 MEDICAL PARK DRIVE MEXICO MO 65265 MEDICAL CLINIC 9 - BHMG - MOBERLY 300 N MORLEY STREET SUITE A-C MOBERLY MO 65270 MEDICAL CLINIC 10 - BHMG - OSAGE BEACH 931 D HIGHWAY OSAGE BEACH MO 65065 MEDICAL CLINIC 11 - BHMG - SOUTH 900 W NIFONG BLVD SUITE 101 COLUMBIA MO 65203 MEDICAL CLINIC 12 - BHMG - RHEMATOLOGY 900 W NIFONG BLVD SUITE 101 COLUMBIA MO 65203 MEDICAL CLINIC 13 - BHMG - CONVENIENT CARE - PARKADE 601 BUSINESS LOOP 70 WEST SUITE 275 COLUMBIA MO 65203 MEDICAL CLINIC 14 - BHMG - NIFONG CONVENIENT CARE 900 W NIFONG BLVD SUITE 100 COLUMBIA MO 65203 MEDICAL CLINIC 15 - BHMG - PULMONARY AND SLEEP MEDICINE 1705 E BROADWAY SUITE 280 COLUMBIA MO 65201 MEDICAL CLINIC 16 - BHMG - HEART SURGERY 1605 E BROADWAY SUITE 210 COLUMBIA MO 65201 MEDICAL CLINIC 17 - BHMG - MID MO NEUROSURGERY 1605 E BROADWAY SUITE 100 COLUMBIA MO 65201 MEDICAL CLINIC 18 - BHMG - HOSPITALISTINTENSIVIST 1605 E BROADWAY COLUMBIA MO 65201 HOSPITAL BASED PRACTICE 19 - BHMG - DIABETES AND ENDOCRINOLOGY 1701 E BROADWAY SUITE 302 COLUMBIA MO 65201 MEDICAL CLINIC 20 - BHMG - SURGERY 1601 E BROADWAY SUITE 240 COLUMBIA MO 65201 MEDICAL CLINIC 21 - BHMG - PODIATRY 1705 E BROADWAY SUITE 280 COLUMBIA MO 65201 MEDICAL CLINIC 22 - BHMG - INFECTIOUS DISEASE 1705 E BROADWAY SUITE 280 COLUMBIA MO 65201 MEDICAL CLINIC 23 - BHMG - MEDICAL SPA 1601 E BROADWAY SUITE 260 COLUMBIA MO 65201 MEDICAL CLINIC 24 - BHMG - BARIATRICS 1605 E BROADWAY SUITE 204 COLUMBIA MO 65201 MEDICAL CLINIC 25 - BHMG - PAIN MANAGEMENT CLINIC 1600 E BROADWAY COLUMBIA MO 65201 MEDICAL CLINIC 26 - BHMG - VASCULAR SURGERY 1601 E BROADWAY SUITE 330 COUMBIA MO 65201 MEDICAL CLINIC 27 - BHMG - ONCGYN 1601 E BROADWAY SUITE 260 COLUMBIA MO 65201 MEDICAL CLINIC 28 - BHMG - BREAST CARE 1605 E BROADWAY SUITE 200 COLUMBIA MO 65201 MEDICAL CLINIC 29 - CHAS PHYSICIAN SERVICES LLC (MO HEART) 1605 E BROADWAY SUITE 300 COLUMBIA MO 65201 MEDICAL CLINIC 30 - CHAS PHYSICIAN SERVICES LLC (MO HEART) 606 E SPRING STREET BOONVILLE MO 65233 OUTREACH MEDICAL CLINIC 31 - CHAS PHYSICIAN SERVICES LLC (MO HEART) 130 E LOCKLING AVE BROOKFIELD MO 64628 OUTREACH MEDICAL CLINIC 32 - CHAS PHYSICIAN SERVICES LLC (MO HEART) 1241 W STADIUM BLVD 2ND FLOOR JEFFERSON CITY MO 65109 OUTREACH MEDICAL CLINIC 33 - CHAS PHYSICIAN SERVICES LLC (MO HEART) 404 PROVIDENCE ROAD MACON MO 63552 OUTREACH MEDICAL CLINIC 34 - CHAS PHYSICIAN SERVICES LLC (MO HEART) 2303 S HIGHWAY 65 MARSHALL MO 65340 OUTREACH MEDICAL CLINIC 35 - CHAS PHYSICIAN SERVICES LLC (MO HEART) 300 N MORLEY STREET MOBERLY MO 65270 OUTREACH MEDICAL CLINIC 36 - BHMG - PEAK - ASHLAND 603 SOUTH HENRY CLAY SUITE B ASHLAND MO 65010 PHYSICAL THERAPY CLINIC 37 - BHMG - PEAK - BOONVILLE 1921 BOONE VILLAGE PLAZA BOONVILLE MO 65233 PHYSICAL THERAPY CLINIC 38 - BHMG - PEAK - CAMDENTON 396 WEST HIGHWAY 54 STONE CASTLE CENTRE CAMDENTON MO 65020 PHYSICAL THERAPY CLINIC 39 - BHMG - PEAK - CENTRALIA 1238 RENINGTON DRIVE CENTRALIA MO 65240 PHYSICAL THERAPY CLINIC 40 - BHMG - PEAK - COLUMBIA BERRYWOOD 3301 BERRYWOOD DRIVE SUITE 204 COLUMBIA BERRYWOOD MO 65201 PHYSICAL THERAPY CLINIC 41 - BHMG - PEAK - COLUMBIA SOUTH 10 WEST NIFONG SUITE 121 COLUMBIA SOUTH MO 65203 PHYSICAL THERAPY CLINIC 42 - BHMG - PEAK - COLUMBIA WEST 2003 WEST BROADWAY SUITE 105 COLUMBIA WEST MO 65203 PHYSICAL THERAPY CLINIC 43 - BHMG - PEAK - FAYETTE 100 EAST DAVIS FAYETTE MO 65248 PHYSICAL THERAPY CLINIC 44 - BHMG - PEAK - FULTON 401 GAYLORD DRIVE FULTON MO 65251 PHYSICAL THERAPY CLINIC 45 - BHMG - PEAK - JEFF CITY SOUTH 1705 CHRISTY DRIVE SUITE 200 JEFF CITY SOUTH MO 65101 PHYSICAL THERAPY CLINIC 46 - BHMG - PEAK - JEFF CITY WEST 1002 DIAMOND RIDGE JEFF CITY WEST MO 65109 PHYSICAL THERAPY CLINIC 47 - BHMG - PEAK - KIRKSVILLE 1108 EAST PATTERSON SUITE 6 KIRKSVILLE MO 63501 PHYSICAL THERAPY CLINIC 48 - BHMG - PEAK - LINE 916 B EAST MAIN STREET LINE MO 65051 PHYSICAL THERAPY CLINIC 49 - BHMG - PEAK - MARCELINE 1410 NORTH KANSAS MARCELINE MO 64658 PHYSICAL THERAPY CLINIC 50 - BHMG - PEAK - MEXICO 2759A SOUTH CLARK MEXICO MO 65265 PHYSICAL THERAPY CLINIC 51 - BHMG - PEAK - MILAN 203 EAST 2ND STREET MILAN MO 63556 PHYSICAL THERAPY CLINIC 52 - BHMG - PEAK - MOBERLY 2100 SILVA LANE SUITE B MOBERLY MO 65270 PHYSICAL THERAPY CLINIC 53 - BHMG - PEAK - MONTGOMERY CITY 520 NORTH STURGEON MONTGOMERY CITY MO 63361 PHYSICAL THERAPY CLINIC 54 - BHMG - PEAK - OWENSVILLE 1212 HIGHWAY 28 OWENSVILLE MO 65066 PHYSICAL THERAPY CLINIC 55 - BHMG - PEAK - WAYNESVILLE 24530 SOUTHSIDE RD WAYNESVILLE MO 65583 PHYSICAL THERAPY CLINIC 56 - BHMG - PEAK - ROLLA 601A KINSHIGHWAY ROLLA MO 65401 PHYSICAL THERAPY CLINIC PART I, LINE 3C: FINANCIAL ASSISTANCE IS BASED ON THE PATIENT'S INCOME LEVEL, WHICH IS VERIFIED THROUGH PAY STUBS, SOCIAL SECURITY AWARDS LETTERS, SELF-EMPLOYMENT LEDGERS AND OTHER FINANCIAL RECORDS FOR THE PRECEDING THREE MONTHS. PART I, LINE 7: CHARITY CARE COST IS BASED ON THE TOTAL COST TO CHARGE RATIO DERIVED FROM THE MEDICARE COST REPORT FOR SERVICES PROVIDED TO PATIENTS. PART I, LINE 7G: COSTING METHODOLOGY:THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. COST COMPUTED ON IRS WORKSHEET 6 WAS COMPUTED FROM THE MEDICARE COST REPORT AND DEPARTMENT FINANCIAL STATEMENTS, USING SPECIFIC FINANCIAL DATA FOR EACH TYPE OF SUBSIDY. PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION PARTICIPATES IN CAREER DAYS TO EDUCATE STUDENTS ABOUT THE MEDICAL FIELD AND GENERATE MEDICAL PROFESSIONALS FOR THE FUTURE IN THE COMMUNITY. THE ORGANIZATION ALSO SUPPORTS MARATHONS AND OTHER ACTIVITIES TO ENCOURAGE A HEALTHIER OVERALL LIFESTYLE FOR COMMUNITY MEMBERS, AND IT ALSO PROVIDES DISASTER PREPARED PROGRAMS AND AMBULANCES TO LOCAL EVENTS IN ORDER TO ENSURE AND ENHANCE THE COMMUNITY'S WELLBEING IN THE EVENT OF AN EMERGENCY. PART III, LINE 2: METHODOLOGY IS CALCULATED ON A/R BALANCE BY PAYOR AND BASED HISTORICAL RESULTS. SELF PAY PATIENTS RECEIVE A 40% DISCOUNT WHICH IS ADJUSTED TO CONTRACTUAL. IF THE ACCOUNT IS BAD DEBT, THE ORGANIZATION ONLY EXPENSES 60% TO BAD DEBT EXPENSE. PART III, LINE 3: THE BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING THE MEDICARE COST REPORT. PART III, LINE 4: FOOTNOTE #2 IS LOCATED ON PAGES 10-14 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS AND BRIEFLY DESCRIBES THE PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS. BAD DEBT IS LISTED AS A DEDUCTION FROM REVENUE. THIS TREATEMENT IS CONSISTENT WITH THE HFMA PRINCIPLES AND PRACTICES BOARD STATEMENT NO. 15 AND WITH THE AICPA AUDIT AND ACCOUNTING GUIDE FOR HEALTHCARE ORGANIZATIONS. PART III, LINE 8: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE MEDICARE COST REPORT WAS USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6, WHICH ONLY REFLECTS HOSPITAL FACILITY ACTIVITY AND PAYMENTS FROM CMS AGENTS. WHEN SEQUESTRATION WITHHOLDINGS, COSTS AND PAYMENTS FOR MEDICARE ADVANTAGE PLAN PATIENTS, AND PHYSICIAN AND CLINIC SERVICES AND PAYMENTS ARE ALSO CONSIDERED, THE SHORTFALL BECOMES SIGNIFICANT. PART III, LINE 9B: IN THE EVENT OF NON-PAYMENT OF SERVICES (DISCOUNTED OR FULL RATE), THE ORGANIZATION MAY TAKE EXTRAORDINARY ACTIONS TO PURSUE COLLECTIONS, INCLUDING BUT NOT LIMITED TO; REFERRING THE ACCOUNT TO OUTSIDE COLLECTIONS AGENCIES, ADVERSE CREDIT REPORTING, AND/OR LEGAL ACTION, PURSUANT TO BOONE'S BILLING AND COLLECTIONS POLICY. A FREE COPY OF THE BILLING AND COLLECTIONS POLICY IS AVAILABLE BY REQUEST FROM PATIENT BUSINESS SERVICES 888-538-1535. PART VI, LINE 2: IN ADDITION TO ITS COMMUNITY INVOLVEMENT EFFORTS RELATED TO THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION'S BOARD OF DIRECTORS CONSISTS OF FIVE PUBLICLY ELECTED OFFICIALS AND SIX STRATEGICALLY SELECTED MEMBERS TO REPRESENT THE VARYING INTERESTS OF THE COMMUNITY, AND MULTIPLE HOSPITAL LEADERS SERVE ON VARIOUS BOARDS FOR OTHER ORGANIZATIONS ADDRESSING COMMUNITY NEEDS. PART VI, LINE 3: WHEN A PATIENT INQUIRES ABOUT FINANCIAL ASSISTANCE, THEY ARE GIVEN ALL INFORMATION REGARDING THE ORGANIZATION'S FAP. PART VI, LINE 4: THE ORGANIZATION IS LOCATED IN BOONE COUNTY IN THE CITY OF COLUMBIA, MISSOURI, THE COUNTY SEAT AND LARGEST CITY IN BOONE COUNTY. BOONE COUNTY HAS A POPULATION OF 179,704 (2020 CENSUS). THE POPULATION EXPERIENCED A 12.89 PERCENT INCREASE FROM 2010 TO 2020, A SIGNIFICANT GROWTH FOR THE COUNTY.AT THE TIME OF THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSEMENT, BOONE COUNTY HAD THE FOLLOWING DEMOGRAPHIC INFORMATION:51.5 PERCENT FEMALE48.5 PERCENT MALE80.4 PERCENT WHITE8.9 PERCENT AFRICAN AMERICAN4.4 PERCENT ASIAN3.5 PERCENT HISPANIC OR LATINO4.8 PERCENT TWO OR MORE RACES0.4 PERCENT AM. INDIAN & ALASKA NAT.0.1 PERCENT NATIVE HAW. & OTHER P.I. PERSONS 65 YEARS AND OVER IN THE COUNTY TOTALED 12.3 PERCENT COMPARED TO 16.9 PERCENT IN THE STATE. 94.6 PERCENT OF THE POPULATION 25 AND OLDER HAD A HIGH SCHOOL DIPLOMA COMPARED TO 90.6 PERCENT THE STATE. 47.7 PERCENT OF THE POPULATION 25 AND OLDER HAD A BACHELOR'S DEGREE WHEN COMPARED TO 29.9 PERCENT IN THE STATE. THE MEDIAN INCOME OF HOUSEHOLDS IN THE COUNTY AT $58,000 WAS SLIGHTLY HIGHER THAN THE STATE MEDIAN AVERAGE OF $57,400. WITH AN ESTIMATED POVERTY RATE OF 16.7 PERCENT, BOONE COUNTY HAD A HIGHER PERCENTAGE OF PERSONS LIVING IN POVERTY THAN MISSOURI (13.0 PERCENT). WHILE THIS HIGHER POVERTY RATE MIGHT BE ATTRIBUTABLE TO THE SUB-POPULATION OF COLLEGE STUDENTS WHO EARN LESS INCOME, IT IS IMPORTANT NOT TO OVERLOOK FAMILIES WHO LIVE BELOW THE POVERTY LEVEL. PART VI, LINE 5: THE ORGANIZATION PROVIDES VARIOUS HEALTH SCREENINGS TO MEMBERS OF THE COMMUNITY AT REDUCED COST OR NO COST. PRESENTATIONS AND EDUCATIONAL MATERIALS ARE ALSO MADE TO IMPROVE THE GENERAL HEALTH KNOWLEDGE OF THE COMMUNITY. PART VI, LINE 7, REPORTS FILED WITH STATES MO 1 COLUMBIA PUBLIC SCHOOLS 1818 WEST WORLEY COLUMBIA MO 65203 436000318 GOVERNMENT 0 20000 ATHLETICS AND ACTIVITIES INITIATIVE AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVENUE DALLAS TX 75231 135613797 501(C)(3) 0 12500 OPERATING SUPPORT PART I, LINE 2: SPONSORSHIPS ARE EVALUATED BY THE DIRECTOR OF MARKETING AND COMMUNITY WELLNESS AND THE CEO OF BOONE HEALTH. WE LOOK TO PARTNER WITH ESTABLISHED, REPUTABLE ORGANIZATIONS THAT SUPPORT OUR MISSION OF IMPROVING THE HEALTH OF PEOPLE AND COMMUNITIES WE SERVE. WE TYPICALLY PARTICIPATE IN THE EVENTS THAT WE SPONSOR TO CONFIRM THAT THE AUDIENCE AND BENEFIT PROVIDED MEETS THE ESTABLISHED GOALS. X X X 0 1 0 0 0 0 0 0 0 RICHARD MELLITT CARDIOTHORACIC SURGEON 933951 0 316388 0 0 0 23000 0 14881 0 1288220 0 0 0 TERESA ELWING RADIOLOGIST 533682 0 701294 0 0 0 23000 0 14915 0 1272891 0 0 0 MAXWELL LAZINGER RADIOLOGIST 495619 0 704717 0 0 0 23000 0 25082 0 1248418 0 0 0 ANDREW GETZOFF RADIOLOGIST 495225 0 704717 0 0 0 23000 0 20389 0 1243331 0 0 0 JOSS FERNANDEZ CARDIOTHORACIC SURGEON 900415 0 302123 0 0 0 12749 0 0 0 1215287 0 0 0 BRADY DUBOIS PRESIDENT/CEO 682291 0 0 0 0 0 23000 0 25318 0 730609 0 0 0 MONICA SMITH COO (LEFT 2024) 486670 0 0 0 22034 0 6686 0 5877 0 521267 0 0 0 EDWARD CLAYTON CFO 439285 0 0 0 9139 0 23000 0 25466 0 496890 0 0 0 ROBIN BLOUNT CMO 396692 0 0 0 10885 0 23000 0 8430 0 439007 0 0 0 SHANNON KUCZYNSKI CNE 320908 0 0 0 4203 0 15777 0 1218 0 342106 0 0 0 KENYON WOODWARD CIO 258950 0 0 0 15583 0 15491 0 15299 0 305323 0 0 0 PETER GLOGGNER CPO 255498 0 0 0 0 0 15243 0 8430 0 279171 0 0 0 CHRISTIAN JONES COO (BEG 2024) 246614 0 0 0 0 0 7875 0 16459 0 270948 0 0 0 KATE PITZER HOSPITAL ADMINISTRATION/SECRETARY 237683 0 0 0 0 0 10373 0 384 0 248440 0 0 0 DREW WILKINSON VP PROVIDER SERVICES AND AMBULATORY 187563 0 0 0 0 0 5241 0 9335 0 202139 0 0 0 CHAD PEW VP PROVIDER SERVICES 134665 0 0 0 16684 0 10100 0 0 0 161449 0 0 0 PART I, LINE 4B CONTRIBUTIONS TO A 457(F) PLAN WERE MADE BY THE ORGANIZATION FOR THE FOLLOWING PERSONS: BRADY DUBOIS - $23,000 MONICA SMITH - $6,685 ROBIN BLOUNT - $23,000 KENYON WOODWARD - $15,491 CHAD PEW - $10,100 EDWARD CLAYTON - $23,000 PETER GLOGGNER- $15,243 SHANNON KUCZYNSKI- $15,777 CHRIS JONES - $7,875 DREW WILKINSON - $5,241 KATE PITZER - $10,373 DISTRIBUTIONS FROM A 457(F) PLAN WERE TAKEN FOR THE FOLLOWING PERSONS: EDWARD CLAYTON - $9,139 MONICA SMITH - $22,034 ROBIN BLOUNT - $10,885 KENYON WOODWARD - $15,583 CHAD PEW- $16,684 SHANNON KUCZYNSKI - $4,203 MISSOURI CARDIOVASCULAR SPECIALISTS PRACTICE OF BOARD MEMBER JERRY KENNETT 24450030 PSA PAYMENTS 0 MID MO NEURO SURGERY PRACTICE OF BOARD MEMBER CHARLES BONDURANT 2112352 PSA PAYMENTS 0 FORM 990, PART VI, SECTION A, LINE 1A THE ORGANIZATION HAS ESTABLISHED AN EXECUTIVE COMMITTEE, WHICH CONSISTS OF THE CHAIR, VICE CHAIR, SECRETARY, TREASURER AND UP TO ONE OTHER BOARD MEMBER. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY TO TRANSACT ROUTINE BUSINESS OF THE ORGANIZATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT SUCH ACTIONS TAKEN SHALL BE CONSISTENT WITH AND NOT CONFLICT WITH ANY ACTIONS OR POLICIES OF THE BOARD OF DIRECTORS, THE ORGANIZATION'S BYLAWS OR APPLICABLE LAW. ALL ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE ARE PROMPTLY REPORTED TO THE BOARD OF DIRECTORS AT THE NEXT MEETING, AND THE EXECUTIVE COMMITTEE KEEPS REGULAR MINUTES OF ITS PROCEEDINGS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS BOONE HEALTH, INC., A MISSOURI NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THIS ORGANIZATION'S BOARD OF DIRECTORS SHALL AT ALL TIMES BE THOSE PERSONS WHO SERVE FROM TIME TO TIME ON THE BOARD OF DIRECTORS OF THE SOLE MEMBER, AND ANY APPOINTMENT, TERM, ELECTION, RESIGNATION, REMOVAL, OR VACANCY ON THE SOLE MEMBER'S BOARD OF DIRECTORS SHALL AUTOMATICALLY AND SIMULTANEOUSLY HAVE AN IDENTICAL EFFECT ON THIS ORGANIZATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF TRUSTEES OF BOONE COUNTY HOSPITAL RESERVES THE AUTHORITY TO APPROVE OF THE FOLLOWING ACTIONS BEFORE THEY ARE UNDERTAKEN: ANY CHANGE OR MODIFICATION TO THE PURPOSE OF THE ORGANIZATION; ANY TERMINATION, AMENDMENT, OR MODIFICATION TO THE LEASE; THE INCURRENCE OF DEBT FOR THE CORPORATION OR THE HEALTH SYSTEM THAT IS COLLATERALIZED BY THE HOSPITAL, THE HEALTHCARE FACILITIES LOCATED ON THE CAMPUS OF THE HOSPITAL, OR IS OTHERWISE OWNED BY THE TRUSTEES OR THE COUNTY (COLLECTIVELY, THE "FACILITIES") AND/OR ANY REVENUE OF THE HOSPITAL OR THE FACILITIES (OTHER THAN ANY EXISTING BONDS ISSUED FOR THE BENEFIT OF THE HOSPITAL OR THE FACILITIES; ANY ACTION EXPECTED TO AFFECT THE TAX-EXEMPT STATUS OF THE CORPORATION OR ANY OTHER TAX-EXEMPT SUBSIDIARY OF THE CORPORATION WHILE THERE IS ANY TAX-EXEMPT DEBT OUTSTANDING, THE PROCEEDS OF WHICH FINANCED OR REFINANCED ALL OR ANY PORTION OF THE HOSPITAL OR THE FACILITIES, ANY ACTION THAT COULD AFFECT THE TAX-EXEMPT STATUS OF ANY ENTITY OWNING OR OPERATING THE HOSPITAL OR THE FACILITIES THAT ARE OBLIGATED ON SUCH DEBT, OR ANY ACTION THAT COULD ADVERSELY AFFECT THE TAX-EXEMPT STATUS OF SUCH DEBT; ANY ACTION SUBJECT TO ANY RIGHTS VESTED TO THE TRUSTEES UNDER CHAPTER 205 REVISED MISSOURI STATUTES, SECTION 160 ET SEQ., AS SUCH ACT MAY BE AMENDED, MODIFIED, SUPPLEMENTED, CONSOLIDATED, OR REPLACED FROM TIME TO TIME; OR ANY ACTION REQUIRED TO ENSURE THE TRUSTEES' COMPLIANCE WITH ANY OF ITS OBLIGATIONS UNDER ANY INDENTURE, LOAN AGREEMENT, COVENANT AGREEMENT, DISCLOSURE AGREEMENT, TAX AGREEMENT, OR SIMILAR AGREEMENT RELATING TO OUTSTANDING INDEBTEDNESS SECURED BY ALL OR ANY PORTION OF THE HOSPITAL OR THE FACILITIES OR REVENUE OF THE HOSPITAL OR THE FACILITIES. FORM 990, PART VI, SECTION B, LINE 11B A INTIAL, DETAILED REVIEW OF THE FORM 990 IS CONDUCTED BY THE EXECUTIVE DIRECTOR OF FINANCE. A CURSORY REVIEW WILL THEN BE COMPLETED BY THE CHIEF FINANCIAL OFFICER, LEGAL COUNSEL AND DIRECTOR OF FINANCE BEFORE IT IS PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C ALL PERSONNEL OF THE ORGANIZATION AT THE DIRECTOR LEVEL OR ABOVE (INCLUDING KEY EMPLOYEES) 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 THE 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. THE BOARD OF DIRECTORS MUST THEN APPROVE THE BASE RATE AND INCENTIVE PLAN FOR THE ORGANIZATION'S CEO. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION PROVIDES THESE FORMS UPON REQUEST. 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 PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 11,974,448. MANAGEMENT AND GENERAL EXPENSES 2,366,208. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,340,656. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 4,165,386. MANAGEMENT AND GENERAL EXPENSES 823,100. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,988,486. JANITORIAL AND HOUSKEEPING CONTRACTS: PROGRAM SERVICE EXPENSES 250,138. MANAGEMENT AND GENERAL EXPENSES 49,428. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 299,566. CONSULTING FEES: PROGRAM SERVICE EXPENSES 75. MANAGEMENT AND GENERAL EXPENSES 15. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 90. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 38,719,417. MANAGEMENT AND GENERAL EXPENSES 7,651,142. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 46,370,559. ANSWERING SERVICE: PROGRAM SERVICE EXPENSES 35,627. MANAGEMENT AND GENERAL EXPENSES 7,040. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,667. COURIER SERVICE: PROGRAM SERVICE EXPENSES 244,765. MANAGEMENT AND GENERAL EXPENSES 48,367. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 293,132. LAB FEES: PROGRAM SERVICE EXPENSES 26,550. MANAGEMENT AND GENERAL EXPENSES 5,247. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,797. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 2,135,478. MANAGEMENT AND GENERAL EXPENSES 421,981. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,557,459. SECURITY: PROGRAM SERVICE EXPENSES 32. MANAGEMENT AND GENERAL EXPENSES 6. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 95,329. MANAGEMENT AND GENERAL EXPENSES 18,837. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 114,166. FOOD SERVICES: PROGRAM SERVICE EXPENSES 95,273. MANAGEMENT AND GENERAL EXPENSES 18,826. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 114,099. PROFESSIONAL SERVICES AGREEMENTS: PROGRAM SERVICE EXPENSES 22,885,937. MANAGEMENT AND GENERAL EXPENSES 4,522,371. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 27,408,308. FORM 990, PART XI, LINE 9: NET AMORTIZATION OF CONTRIBUTED RENT -473,713. FORM 990, PAGE 12, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. CHAS PHYSICIAN SERVICES LLC 1600 E BROADWAY COLUMBIA MO 65201 320275207 PHYSICIAN SERVICES MO 12903623 1753514 CH ALLIED SERVICES INC BOONE PHYSICIAN SERVICES LLC 1600 E BROADWAY COLUMBIA MO 65201 460552280 PHYSICIAN SERVICES MO 63592828 8942141 CH ALLIED SERVICES INC BOONE HOSPITAL CENTER'S VISITING NURSES INC 1600 E BROADWAY COLUMBIA MO 65201 430998347 HOME HEALTH AND HOSPICE MO 501(C)(3) LINE 12A, I CH ALLIED SERVICES INC 1 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 1 0 0 0 0 0 0 1 0 1 1 0 0 0 0