2025-11-17T18:08:17-05:00 2024-12-31 200079326 DZA PLLC 12015 E MAIN AVE SPOKANE VALLEY WA 99206 990 2024-01-01 730570773 NEWMAN MEMORIAL HOSPITAL INC NEWM 5809382551 905 S MAIN ST SHATTUCK OK 73858 BRITTANY RASH CFO 5809382551 2025-11-17 true true RIKKI PATCH P01472231 5092420874 2025-11-17 2024 2025-03-06 01:10:19Z TOM VASKO 905 S MAIN ST SHATTUCK OK 73858 18136289 false X WWW.NEWMANMEMORIALHOSPITAL.ORG X 1920 OK TO PROVIDE THE HIGHEST QUALITY PATIENT CARE EXPERIENCE WITH COMMITTMENT TO VALUE AND EXCELLENCE. 8 6 169 23 0 860224 12232 12233004 17163453 21183 70215 69112 890389 13183523 18136289 18641 0 6276109 8133503 0 0 7151124 9127626 13427233 17279770 -243710 856519 4040545 5565689 2937173 3193838 1103372 2371851 X TO PROVIDE THE HIGHEST QUALITY PATIENT CARE EXPERIENCE WITH COMMITTMENT TO VALUE AND EXCELLENCE. false false 13936617 18641 17163453 NEWMAN MEMORIAL HOSPITAL IS A 25-BED CRITICAL ACCESS HOSPITAL LOCATED IN SHATTUCK, OKLAHOMA. THE HOSPITAL STRIVES TO PROVIDE ITS COMMUNITY AND PATIENTS A WIDE VARIETY OF SERVICES WITH EXCEPTIONAL CARE AND CONVENIENT SCHEDULING. WE PROVIDE GENERAL MEDICAL AND SURGICAL CARE FOR INPATIENT, OUTPATIENT AND EMERGENCY ROOM PATIENTS. IN ADDITION, OUR URGENT CARE CLINIC IS OPEN 7 DAYS A WEEK WITH NO APPOINTMENT NECESSARY TO SEE A PHYSICIAN. NEWMAN MEMORIAL HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, AGE, OR ABILITY TO PAY. THE HOSPITAL PROVIDED 3,249 DAYS OF ACUTE CARE SERVICES. IN ADDITION, THE HOSPITAL PROVIDED 2,448 OBSERVATION HOURS AND 6,464 RURAL HEALTH CLINIC VISITS. (SEE SCHEDULE O FOR CONTINUATION) 13936617 true false false true false false false false false false true false false false true true false true false false false false false false false false true true false true true false false false false false false false true false false false false false false false false false true 19 0 true 169 true false false false false false false false false false false false false X 8 6 false false false false false true false true true false false true true true true true true true true false OK X BRITTANY RASH 5809382551 905 S MAIN ST SHATTUCK OK 73858 DANA STUART CHIEF OF STA 40.00 X 346284 0 18454 TOM VASKO CEO 40.00 X 316290 0 10885 SHANDY BAGGS APRN 40.00 X 172522 0 11530 AMY VASKO RN 40.00 X 151287 0 8943 DORAN HAMMETT CFO 40.00 X 146180 0 3578 JERSON PENAFLOR LAB MANAGER 40.00 X 120751 0 9246 ROBYN GIRTON CHIEF ADMIN. 40.00 X 120601 0 9218 MATTHEW BUDIG COO 40.00 X 115448 0 7513 GREG HUENEGARDT PRESIDENT 5.00 X X 25000 0 0 ANGIE PRATHER VICE PRESIDE 2.00 X X 0 0 0 JENI HINKLE DIRECTOR 1.00 X 0 0 0 JOHN CULLY DIRECTOR 1.00 X 0 0 0 RICK MESSER DIRECTOR 1.00 X 0 0 0 BARCLAY HOLT DIRECTOR 1.00 X 0 0 0 DEELYN POOL DIRECTOR 1.00 X 0 0 0 1514363 79367 10 false true false CONCORD MEDICAL GROUP OF TEXAS 1602 AVENUE Q LUBBOCK TX 79401 PHYSICIAN SVS. 974695 OKLAHOMA CITY ORTHOPEDICS 13100 N WESTERN AVE SUITE 200 OKLAHOMA CITY OK 73114 PHYSICIAN SVS. 595750 HOSPITAL CARE CONSULTANTS 17304 PRESTON RD STE 1400 DALLAS TX 75252 PHYSICIAN SVS. 545843 PSYCHIATRIC MEDICAL CARE PO BOX 734606 DALLAS TX 75373 PHYSICIAN SVS. 513886 PICIS CLINICAL SOLUTIONS INC 9 CENTENNIAL DRIVE SUITE 202 PEABODY MA MA 01960 SOFTWARE SVS. 435507 12 11232 1000 12232 NET PATIENT SERVICE REVENUE 621110 16878061 16878061 PHARMACY REVENUE 456110 285392 285392 17163453 58376 58376 10385 10385 10385 10385 1938 9901 1938 9901 11839 11839 TAX FORGIVENESS 900099 812051 812051 CAFETERIA REVENUE 722514 59524 59524 OTHER REVENUE 900099 8429 8429 880004 18136289 17163453 960604 X 18641 18641 866669 364737 501932 6139356 5179678 959678 117047 97074 19973 377869 302763 75106 632562 450910 181652 6167 6167 20193 20193 5234478 4558710 675768 53740 10515 43225 635668 470189 165479 247479 175433 72046 64634 23294 41340 52969 2198 50771 403389 47550 355839 MEDICAL SUPPLIES & DRUGS 1921052 1921052 REPAIRS & MAINTENANCE 313463 269685 43778 174394 44188 130206 17279770 13936617 3343153 0 610334 215233 1195354 1791500 1866535 3112468 151701 222458 184071 194580 46500 17050 32550 29450 4040545 5565689 2336263 2489417 94449 90096 357199 456698 149262 157627 2937173 3193838 X 1103372 2371851 1103372 2371851 4040545 5565689 X 856519 411960 X false true X true true true X false false false false false false false false true 2054 2054 false SCHEDULE C, PART II-B, LINE 1 NEWMAN MEMORIAL HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS DUES TO OKLAHOMA HOSPITAL ASSOCIATION OF WHICH A PORTION OF SUCH DUES IS USED TO CARRY OUT LOBBYING ACTIVITIES. 46500 17050 29450 29450 ESTIMATED THIRD-PARTY SETTLEMENTS 157627 157627 X SCHEDULE D, PAGE 3, PART X THE HOSPITAL IS ORGANIZED AS AN OKLAHOMA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOSPITAL IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE HOSPITAL IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE HOSPITAL FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME FOR THE YEAR ENDING DECEMBER 31, 2017. THE HOSPITAL HAS RECORDED A LIABILITY TO THE OKLAHOMA TAX COMMISSION OF 0 AND 812,051 AS OF DECEMBER 31, 2024 AND 2023, RESPECTIVELY, RELATED TO POTENTIALLY UNRELATED BUSINESS TAXABLE INCOME GENERATED IN THE 2017 TAX YEAR. DURING 2021, THE INTERNAL REVENUE SERVICE ACCEPTED AN OFFER IN COMPROMISE FROM THE HOSPITAL, WHICH DISCHARGED THE FEDERAL TAX LIABILITY. true true true X 1.800000000000 true X true true false false 150159 150159 0.00870 1155878 1155878 1306037 1155878 150159 0.00870 6 451 39507 7334 32173 0.00190 1 5223 62300 19300 43000 0.00250 7 5674 101807 26634 75173 0.00440 7 5674 1407844 1182512 225332 0.01300 false 201379 40276 10012938 10122386 -109448 X true true 1 1 NEWMAN MEMORIAL HOSPITAL 905 S MAIN ST SHATTUCK OK 73858 WWW.NEWMANMEMORIALHOSPITAL.ORG 2243 X X X X 1 PROVIDER BASED RHC NEWMAN MEMORIAL HOSPITAL 1 false false true X X X X X X X X X X 22 true false true true X WWW.NEWMANMEMORIALHOSPITAL.ORG X true 22 true SEE PART VI false true X 180.000000000000 300.000000000000 X X X X X X true true X X X X true X SEE PART VI X SEE PART VI X SEE PART VI X X X X X true X false X X X X true X false false FACILITY 1, NEWMAN MEMORIAL HOSPITAL - PART V, LINE 3E IDENTIFICATION AND PRIORITIZATION OF HEALTH NEEDS ARE ADDRESSED ON PAGE 19 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE. FACILITY 1, NEWMAN MEMORIAL HOSPITAL - PART V, LINE 5 COMMUNITY INPUT WAS GATHERED THROUGH A SINGLE COMMUNITY MEETING HELD ON SEPTEMBER 6, 2022. ALL STAKEHOLDERS RECEIVED BOTH PRIMARY AND SECONDARY DATA PRIOR TO THEIR RESPECTIVE MEETINGS. THE OKLAHOMA OFFICE OF RURAL HEALTH FACILITATED THE GATHERING OF SECONDARY DATA, COMPLETION OF THE SURVEY, AND THE COMMUNITY MEETING. COMMUNITY MEMBERS WHO WERE INCLUDED TO PROVIDE INPUT CAME FROM A VARIETY OF ORGANIZATIONS, INCLUDING NEWMAN MEMORIAL HOSPITAL REPRESENTATIVES, NWDCS, INC., RETIRED INDIVIDUALS, EBENEZER BAPTIST CHURCH, SENIOR CENTER, ARNETT SCHOOLS, SHATTUCK SCHOOLS, SHATTUCK CHAMBER OF COMMERCE, AND WIOA. COMMUNITY MEMBERS WERE INVITED TO PARTICIPATE BROADLY THROUGH ARTICLES IN THE COUNTY NEWSPAPER, FACEBOOK POSTS ON NEWMAN MEMORIAL HOSPITAL AND NEWMAN HEALTHCARE ASSOCIATE'S PAGES. FLYERS WERE ALSO DISTRIBUTED AT THE GAGE ROTARY MEETING AND SHATTUCK SENIOR CENTER. EMAIL INVITATIONS WERE BROADLY SENT OUT THROUGH THE CHAMBER OF COMMERCE'S EMAIL DISTRIBUTION LIST, THE HOSPITAL'S MARKETING EMAIL LIST (WHICH CONTAINS MORE THAN 200 INDIVIDUALS), AND ALL HOSPITAL EMPLOYEES. INDIVIDUAL, PERSONAL INVITATIONS WERE EXTENDED TO SENIOR CENTER REPRESENTATIVES; SUPERINTENDENTS, PRINCIPALS, COUNSELORS, AND SCHOOL ADMINISTRATIVE ASSISTANTS FROM SHATTUCK, ARNETTE, AND GAGE/FARGO PUBLIC SCHOOLS; THE SAFETY COORDINATOR FOR ELLIS COUNTY; ELLIS COUNTY EMERGENCY MANAGEMENT; THE LOCAL MINISTERIAL ALLIANCE; THE LOCAL NEWSPAPER OWNER; ELLIS COUNTY COMMISSIONERS; ELLIS COUNTY EMS DIRECTOR/COORDINATOR; AND THE SHATTUCK CHAMBER OF COMMERCE BOARD OF DIRECTORS. A SIGNIFICANT EFFORT WAS MADE TO INCLUDE REPRESENTATIVES FROM THE PUBLIC HEALTH SECTOR AND THOSE WHO SERVE THE UNDERSERVED, LOW-INCOME, OR RACIALLY DIVERSE POPULATIONS IN ORDER TO GAIN THEIR PERSPECTIVES ON COMMUNITY NEEDS. FACILITY 1, NEWMAN MEMORIAL HOSPITAL - PART V, LINE 6B THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED WITH THE ASSISTANCE OF THE OKLAHOMA OFFICE OF RURAL HEALTH. THIS OFFICE WORKED CLOSELY WITH THE HOSPITAL TO ASSESS THE ECONOMIC IMPACT OF THE LOCAL HEALTH SECTOR, DEVELOP AND ANALYZE SURVEYS, AND GATHER LOCAL HEALTH DATA. FACILITY 1, NEWMAN MEMORIAL HOSPITAL - PART V, LINE 11 THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN 2022. THE FOLLOWING ITEMS WERE IDENTIFIED AS PRIORITIES AND THE ACTIONS TAKEN IN 2022. EXPAND EDUCATION OUTREACH TO THE COMMUNITY REGARDING HEALTH AND WELLNESS TOPICS SPECIFICALLY TARGETING ISSUES OF OBESITY AND PHYSICAL INACTIVITY. 1. THE HOSPITAL WILL PROVIDE EDUCATIONAL OUTREACH IN THE FORM OF PUBLIC SERVICE ANNOUNCEMENTS IN THE NEWSPAPER AND VIA SOCIAL MEDIA REGARDING HEALTHY EATING, SAFE WEIGHT LOSS, AND INCREASING ACTIVITY LEVELS. 2. THE HOSPITAL WILL LEAD THIS INITIATIVE BY EXAMPLE BY CREATING OPPORTUNITIES FOR ITS EMPLOYEES TO COMBAT OBESITY AND INACTIVITY THROUGH HEALTHY EMPLOYEE INITIATIVES. 3. THE HOSPITAL WILL SPONSOR AND/OR HOST OPPORTUNITIES FOR THE COMMUNITY TO ACTIVELY PARTICIPATE IN PROGRAMS TARGETING ACTIVITY AND HEALTHY WEIGHT MAINTENANCE THROUGH LUNCH AND LEARN PROGRAMS AND COMMUNITY ACTIVITIES. 4. THE EXPECTED OUTCOME OF THE ENHANCED EDUCATION OUTREACH IS INCREASED KNOWLEDGE OF EXISTING RESOURCES, IMPROVED HEALTH, AND IMPROVED QUALITY OF LIFE. INCREASING AVAILABILITY OF SPECIALISTS. 1. THE HOSPITAL IS PLANNING TO ADD TWO PHYSICIANS IN 2023 WHO ARE DUAL- CERTIFIED IN FAMILY PRACTICE AND OB/GYN. 2. A SURGEON WILL BE JOINING THE SPECIALTY CLINIC SOON TO DO OUTPATIENT GYNECOLOGICAL SURGERIES. 3. OTOLARYNGOLOGIST SERVICES WILL ALSO BE ADDED TO THE CURRENT TELEHEALTH OPTIONS. THE HOSPITAL IS ALSO ACTIVELY EXPLORING ADDITIONAL SERVICES TO OFFER VIA TELEHEALTH. NOT ALL NEEDS COULD BE ADDRESSED BY THE HOSPITAL DUE TO LACK OF EXPERTISE IN THE AREA AND FUNDS. THESE NEEDS WILL BE ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY. 1. MENTAL HEALTH AND SUBSTANCE ABUSE AMONG YOUNGER POPULATION. 2. TRANSPORTATION FOR ELDERLY (PRICE OF GAS ON FIXED INCOMES, MAYBE SHOULDNT BE DRIVING) WILL BE ADDRESSED BY ELLIS COUNTY TRANSPORTATION SERVICES. 3. LIFEFLIGHT CHARGES: HOW DO THOSE WHO DO NOT HAVE INSURANCE/COVERAGE PAY FOR THOSE SERVICES? GENERALLY, AMBULANCES CAN MAKE THE TRANSFERS AT THE HOSPITAL; HOWEVER, DURING COVID, AIR EVAC WAS UTILIZED MORE OFTEN THAN USUAL. 4. DHS, FAMILY SERVICES, AND HEALTH DEPARTMENT SERVICES ARE NOT AVAILABLE IN ELLIS COUNTY. PATIENTS ARE REFERRED TO SAYRE COUNTY. FOR SERIOUS NEEDS (WELL CHECKS) LAW ENFORCEMENT IS THE FIRST CALL. 5. ALCOHOL DRIVING DEATHS. 6. SELF-MEDICATION AND FENTANYL COMING INTO THE COMMUNITY. FACILITY 1, NEWMAN MEMORIAL HOSPITAL - PART V, LINE 13H PATIENTS WHO QUALIFY FOR THE FOLLOWING AID PROGRAMS WILL AUTOMATICALLY BE AWARDED FINANCIAL ASSISTANCE: SSI/DISABILITY, FOOD STAMPS. PATIENTS WHO QUALIFY FOR SPECIAL LOW INCOME MEDICARE BENEFICIARY (SLMB) WILL HAVE ANY CONSUMER RESPONSIBILITY ADJUSTED TO CHARITY. PATIENTS WHO HAVE MEDICARE AND MEDICAID (DUAL ELIGIBLE), AND MEDICARE DENIES THE CLAIM OR A PORTION OF THE CLAIM, I.E., AMBULANCE DETERMINED NOT MEDICALLY NECESSARY, NON-COVERED SELF-ADMINISTERED DRUGS, MEDICARE LOCAL COVERAGE DETERMINATIONS (WHEN AN ABN IS SIGNED), THOSE CHARGES WILL BE ADJUSTED TO CHARITY ONCE MEDICARE AND MEDICAID HAVE BEEN BILLED AND HAVE ASSIGNED AN AMOUNT TO PATIENT RESPONSIBILITY. SCHEDULE H, PART I, LINE 3C IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL ALSO USES THE FOLLOWING FACTORS TO DETERMINE FREE OR DISCOUNTED CARE: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, RESIDENCY. PATIENTS WHO QUALIFY FOR THE FOLLOWING AID PROGRAMS WILL AUTOMATICALLY BE AWARDED FINANCIAL ASSISTANCE: SSI/DISABILITY, FOOD STAMPS. PATIENTS WHO QUALIFY FOR SPECIAL LOW-INCOME MEDICARE BENEFICIARY (SLMB) WILL HAVE ANY CONSUMER RESPONSIBILITY ADJUSTED TO CHARITY. PATIENTS WHO HAVE MEDICARE AND MEDICAID (DUAL ELIGIBLE), AND MEDICARE DENIES THE CLAIM OR A PORTION OF THE CLAIM, I.E., AMBULANCE DETERMINED NOT MEDICALLY NECESSARY, NON-COVERED SELF-ADMINISTERED DRUGS, MEDICARE LOCAL COVERAGE DETERMINATIONS (WHEN AN ABN IS SIGNED), THOSE CHARGES WILL BE ADJUSTED TO CHARITY ONCE MEDICARE AND MEDICAID HAVE BEEN BILLED AND HAVE ASSIGNED AN AMOUNT TO PATIENT RESPONSIBILITY. SCHEDULE H, PART III, LINE 2 PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER EVERY EFFORT IS MADE TO COLLECT THE BALANCE AND PATIENTS ARE GIVEN OPPORTUNITIES TO COMPLETE CHARITY CARE APPLICATIONS OR SET UP PAYMENT PLANS. ALL DISCOUNTS AND CONTRACTUAL ADJUSTMENTS ARE APPLIED TO ACCOUNTS BEFORE THEY ARE WRITTEN OFF TO BAD DEBT. CURRENT PAYMENTS ON ACCOUNTS PREVIOUSLY WRITTEN OFF AS BAD DEBT REDUCE BAD DEBT EXPENSE. BAD DEBT EXPENSE ON LINE 2 IS REPORTED AT CHARGES AS PRESENTED ON THE FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 3 A REASONABLE ESTIMATE OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS 20%. THIS IS BASED ON THE PERCENTAGE OF INDIVIDUALS LIVING IN POVERTY. SCHEDULE H, PART III, LINE 4 THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 3 ON PAGE 13 OF THE AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE PROVISION FOR BAD DEBTS. SCHEDULE H, PART III, LINE 8 NEWMAN MEMORIAL HOSPITAL PROVIDES SERVICES TO MEDICARE PATIENTS EVEN THOUGH THERE IS A SHORTFALL BECAUSE ACCESS TO HEALTHCARE AND INDIVIDUAL'S HEALTH IS IMPORTANT. THE MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. BOTH THE TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES. SCHEDULE H, PART III, LINE 9B THE HOSPITAL HAS A 120-DAY APPLICATION PERIOD WHERE ANY PATIENT IS ABLE TO APPLY FOR FINANCIAL ASSISTANCE AND THERE ARE NO EXTRAORDINARY COLLECTION ACTIONS. PATIENTS ARE SENT A NOTICE 30 DAYS PRIOR TO ANY COLLECTION ACTIVITIES. AFTER 120 DAYS, ANY ACCOUNT MAY BE TURNED OVER TO COLLECTIONS; HOWEVER, A PATIENT HAS ANOTHER 120 DAYS TO COMPLETE AN APPLICATION FOR A TOTAL OF 240 DAYS. ONCE A PATIENT IS DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE, ANY PERSONAL PORTION DUE WOULD FOLLOW NORMAL COLLECTION ACTIONS. SCHEDULE H, PART VI, LINE 2 IN ADDITION TO THE CHNA, THE HOSPITAL ADDRESSED THE HEALTH NEEDS OF THE COMMUNITY BY HOSTING MONTHLY LUNCH AND LEARNS FOCUSING ON COMMUNITY HEALTH, EDUCATION, AND SAFETY. AT THE END OF EACH SESSION, A PROGRAM EVALUATION WAS COMPLETED BY ATTENDEES, GIVING THEM THE OPPORTUNITY TO REQUEST ADDITIONAL TOPICS OF INTEREST. NEWMAN EXPANDED TELEMEDICINE OPPORTUNITIES BY PURCHASING MONITORING CARTS FOR SPECIALISTS OUTSIDE OF OUR AREA AND CONTRACTING WITH SSM HEALTH TELEMEDICINE PROGRAM. THE LATEST CHNA IS AVAILABLE ON THE WEBSITE AS FOLLOWS: HTTPS://NEWMANMEMORIALHOSPITAL.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ SCHEDULE H, PART VI, LINE 3 PATIENTS ARE PROVIDED LITERATURE AT THE TIME OF REGISTRATION AND THEN ARE CONTACTED BY THE FINANCIAL COUNSELOR AFTER THEY RECEIVE A STATEMENT. THE FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE PROVIDED ON THE HOSPITAL'S WEBSITE. THE HEALTH CARE NEEDS OF ALL INDIVIDUALS RESIDING IN THE IMMEDIATE AND ADJACENT COMMUNITIES ARE CONSIDERED. NO INDIVIDUAL WILL BE DEPRIVED OF EMERGENCY OR CRITICAL CARE BECAUSE OF THEIR INABILITY TO PAY; HOWEVER, EVERY EFFORT WILL BE MADE TO COLLECT FUNDS OWED TO THE HOSPITAL FOR ELECTIVE CARE SINCE THE ABILITY TO CONTINUE TO PROVIDE AND IMPROVE SERVICES TO THE COMMUNITIES SERVED DEPENDS ON FINANCIAL STABILITY. THE LATEST FINANCIAL ASSISTANCE POLICY (FAP) IS AVAILABLE ON THE WEBSITE AS FOLLOWS: HTTPS://NEWMANMEMORIALHOSPITAL.ORG/PAY-ONLINE/ SCHEDULE H, PART VI, LINE 4 NEWMAN MEMORIAL HOSPITAL, INC. IS A 25-BED CRITICAL ACCESS HOSPITAL LOCATED IN SHATTUCK, OKLAHOMA. SHATTUCK IS A VERY RURAL TOWN ABOUT 3 HOURS FROM ANY METROPOLITAN AREA WITH A POPULATION OF APPROXIMATELY 1,243. THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY 43,661. ABOUT 20% OF THE POPULATION IS BELOW THE POVERTY LINE. THE MOST COMMON EMPLOYMENT INDUSTRIES ARE HEALTH CARE AND SOCIAL ASSISTANCE, EDUCATIONAL SERVICES, CONSTRUCTION, AND AGRICULTURE. THE ECONOMY OF SHATTUCK, OK EMPLOYS 633 PEOPLE. 85.4% OF THE POPULATION OF SHATTUCK, OK HAS HEALTH COVERAGE, WITH 47.3% ON EMPLOYEE PLANS, 14% ON MEDICAID, 12.7% ON MEDICARE, 10.4% ON NONGROUP PLANS, AND 1% ON MILITARY OR VA PLANS. PRIMARY CARE PHYSICIANS IN SHATTUCK, OK SEE APPROXIMATELY 1,600 PATIENTS PER YEAR ON AVERAGE. ALLIANCEHEALTH WOODWARD IS APPROXIMATELY THIRTY MILES AWAY. SCHEDULE H, PART VI, LINE 5 THE BOARD OF DIRECTORS CONSISTS OF MEMBERS THAT RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA REPRESENTING THE COMMUNITY IT SERVES. THE BOARD DEDICATES TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY. MEDICAL STAFF PRIVILEGES AT THE HOSPITAL ARE OPEN TO ALL MEDICAL PROVIDERS WITH ACTIVE LICENSURE. WHILE THE CREDENTIALING PROCESS ENSURES PRACTITIONERS OF THE HIGHEST CALIBER ARE PRIVILEGED, PRACTITIONERS FROM NUMEROUS SPECIALTIES ARE ENCOURAGED TO MEET THE EVER EXPANDING HEALTHCARE NEEDS OF THE COMMUNITY. ANY SURPLUS FUNDS ARE REINVESTED INTO EQUIPMENT AND BUILDING IMPROVEMENTS TO BETTER SERVE OUR PATIENTS. NEWMAN MEMORIAL HOSPITAL PROVIDES HEALTH COUNSELING AT AS MANY LOCAL HEALTH FAIRS AS POSSIBLE. THE HOSPITAL PARTICIPATES IN VARIOUS COMMUNITY ACTIVITIES TO INCREASE THEIR PRESENCE IN THE COMMUNITY. NEWMAN MEMORIAL HOSPITAL RUNS A MINIMUM OF THREE BLOOD DRIVES DURING THE YEAR. THE HOSPITAL ALSO HELD MULTIPLE FLU SHOT CLINICS, WITH THREE BEING AT LOCAL SENIOR CITIZEN CENTERS, AT THE HOSPITAL ITSELF, AND LOCAL BUSINESSES. THE HOSPITAL PROVIDES A MONTHLY LUNCH AND LEARN PROGRAM WITH THE GOAL OF PROVIDING A SPEAKER EACH MONTH TO TEACH ON A TOPIC THAT IMPROVES THE HEALTH AND SAFETY OF THE COMMUNITY. WHEN A LUNCH AND LEARN IS NOT AVAILABLE, EDUCATION IS SHARED VIA FACEBOOK AND LOCAL NEWSPAPERS. SOME OF THE TOPICS ADDRESSED INCLUDE: COVID SIGNS AND SYMPTOMS, AGE-RELATED EYE ISSUES, HEALTHY HEARTS, MEDICATION SAFETY, TRADITIONAL VS. ADVANTAGE MEDICARE, AND KNOW YOUR VETERAN'S BENEFITS. NEWMAN MEMORIAL HOSPITAL OPERATES A 24/7 EMERGENCY ROOM AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY. THE HOSPITAL PARTICIPATES IN EDUCATION AND TRAINING OF HEALTHCARE PROFESSIONALS BY WORKING WITH HIGH PLAINS TECHNOLOGY CENTER LPN PROGRAM. SCHEDULE H, PART VI, LINE 6 NEWMAN MEMORIAL HOSPITAL IS A ST. ANTHONY'S HOSPITAL (SSM) AFFILIATE. THE HOSPITAL ACCESSES THEIR ELECTRONIC HEALTH RECORDS THROUGH SSM ALONG WITH TRANSFER AGREEMENTS FOR A HIGHER LEVEL OF CARE. true SCHOLARSHIPS 9 18641 SCHEDULE I, PAGE 1, PART I, LINE 2 THE HOSPITAL MONITORS THE USE OF GRANT FUNDS THROUGH ENSURING ALL SCHOLARSHIPS GRANTED ARE UTILIZED FOR THE PURPOSE GIVEN. X X false false false false false false false false false DANA STUART CHIEF OF STAFF/DIR. 329992 16292 12075 6379 364738 TOM VASKO CEO 314998 1292 5033 5852 327175 SHANDY BAGGS APRN 129230 43292 5678 5852 184052 AMY VASKO RN 119995 31292 2845 6098 160230 CARDINAL HEALTH PHARMACY OWNED BY CHAIR 236700 340B PURCHASES false FORM 990, PART III THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 341,271 FOR CHARITY CARE, 11,339,530 FOR MEDICARE, 365,824 FOR MEDICAID, AND 8,047,600 FOR OTHER THIRD-PARTY PAYORS FOR THE YEAR. FORM 990, PAGE 6, PART VI, LINE 7A THE DIRECTORS INCLUDE AT LEAST TWO MEMBERS OF THE MEDICAL STAFF, ONE OF WHOM IS THE CHIEF OF STAFF, WHO IS ELECTED BY THE MEDICAL STAFF, IN AN EX OFFICIO CAPACITY WITH VOTE. THE OTHER IS A MEMBER OF THE MEDICAL STAFF ELECTED DIRECTLY BY THE BOARD. IN THE EVENT THAT THE CHIEF OF STAFF IS ALSO SERVING AS THE ELECTED MEMBER, THE VICE CHIEF OF STAFF SHALL BE SEATED AS THE OTHER MEDICAL STAFF MEMBER TO SERVE UNTIL THE ELECTED OFFICES OF THE MEDICAL STAFF CHANGE. NO MORE THAN TWENTY PERCENT OF THE DIRECTORS MAY BE PHYSICIANS WITH MEDICAL STAFF PRIVILEGES AT THE HOSPITAL. EX OFFICIO DIRECTORS SERVE ON THE BOARD BY VIRTUE OF THEIR OFFICIAL POSITION, AND REMAIN A DIRECTOR UNTIL THEY RESIGN OR ARE REMOVED FROM THE OFFICIAL POSITION. FORM 990, PAGE 6, PART VI, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE CEO & CFO WHO REVIEW THE FORM, SCHEDULES, AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A REVISED DRAFT IS THEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO SIGNS OFF ON THE FORM 8879-TE AND THE RETURN IS E-FILED BY THE PREPARER. FORM 990, PAGE 6, PART VI, LINE 12C OFFICERS AND DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY OR WHEN A POSSIBLE CONFLICT ARISES. ANY POTENTIAL CONFLICTS ARE REVIEWED BY THE BOARD OF DIRECTORS. NO CONTRACT OR TRANSACTION BETWEEN THIS CORPORATION AND ONE OR MORE OF ITS DIRECTORS, OR BETWEEN THIS CORPORATION AND ANY OTHER CORPORATION, PARTNERSHIP, ASSOCIATION, OR OTHER ORGANIZATION IN WHICH ONE OR MORE OF THE DIRECTORS ARE DIRECTORS OR OFFICERS, OR HAVE A FINANCIAL INTEREST, SHALL BE VOID OR VOIDABLE SOLELY FOR THAT REASON, OR SOLELY BECAUSE AN INTERESTED DIRECTOR IS PRESENT AT OR PARTICIPATES IN THE MEETING OF THE BOARD OR ANY COMMITTEE WHICH AUTHORIZES THE CONTRACT OR TRANSACTION, OR SOLELY BECAUSE THE VOTE OF ONE OR MORE INTERESTED DIRECTORS OR OFFICERS IS COUNTED FOR PURPOSES OF ESTABLISHING A QUORUM, IF: (1) THE MATERIAL FACTS AS TO THE RELATIONSHIP OR INTEREST OF SUCH DIRECTOR AND AS TO THE CONTRACT OR TRANSACTION ARE DISCLOSED OR ARE KNOWN TO THE BOARD OR THE COMMITTEE, AND THE BOARD OR COMMITTEE, IN GOOD FAITH AUTHORIZES THE CONTRACT OR TRANSACTION BY THE AFFIRMATIVE VOTES OF A MAJORITY OF THE DISINTERESTED DIRECTORS, EVEN THOUGH THE DISINTERESTED DIRECTORS MAY BE LESS THAN A QUORUM; AND (2) THE CONTRACT OR TRANSACTION IS FAIR AS TO THE CORPORATION AT THE TIME IT IS AUTHORIZED OR RATIFIED BY THE BOARD. COMMON OR INTERESTED DIRECTORS MAY BE COUNTED IN DETERMINING THE PRESENCE OF A QUORUM AT A MEETING OF THE BOARD, OR THE COMMITTEE WHICH AUTHORIZES THE CONTRACT OR TRANSACTION. FORM 990, PAGE 6, PART VI, LINE 15A COMPENSATION FOR THE CEO WAS DETERMINED THROUGH AN ANNUAL EVALUATION CONDUCTED BY THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS HIRED AN OUTSIDE CONSULTING FIRM FOR SALARY COMPARABILITY DATA. THE INFORMATION AND DECISION WERE DOCUMENTED IN THE BOARD MINUTES AND EMPLOYEE FILE. COMPENSATION FOR THE CFO WAS DETERMINED THROUGH AN ANNUAL EVALUATION CONDUCTED BY THE CEO. COMPARABILITY DATA AND SURVEY INFORMATION FROM THE OKLAHOMA HOSPITAL ASSOCIATION WAS USED. THE INFORMATION AND DECISION WERE DOCUMENTED IN THE EMPLOYEE FILE. FORM 990, PAGE 6, PART VI, LINE 15B SEE FORM 990, PART VI, LINE 15A. FORM 990, PAGE 6, PART VI, LINE 19 THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE HOSPITAL ALSO PROVIDES A COPY OF ITS ANNUAL AUDIT TO THE CITY OF SHATTUCK. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES 4,558,710 675,768 0 FORM 990, PART XI, LINE 9 TRANSFER FROM AUTHORITY 411,960