2024-11-15T13:05:30-06:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2023-01-01 430998347 BOONE HOSPITAL CENTER'S VISITING NURSES BOON 5738158732 1605 E BROADWAY 250 COLUMBIA MO 65201 EDWARD CLAYTON CFO 5738158732 2024-11-14 1 0 AMBER ROGNAN-HAMILTON P01251012 3149254300 2024-11-12 2023 2024-10-15 13:58:12Z BRADY DUBOIS 1605 E BROADWAY 250 COLUMBIA MO 65201 2514830 0 X WWW.BOONE.HEALTH/SERVICES/HOME-CARE-AND-HOSPICE X 1972 MO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 7 0 34 0 0 0 0 0 2776381 2219398 1 57816 0 0 2776382 2277214 0 0 0 0 3095278 2377553 0 0 0 1055890 741014 4151168 3118567 -1374786 -841353 900412 95506 664082 460270 236330 -364764 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 1498515 0 1277188 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, 2023, THE HOME CARE PROGRAM COMPLETED 542 ADMISSIONS AND ADMINISTERED 7,362 PATIENT VISITS. 1105488 0 942210 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, 2023, THE HOSPICE PROGRAM PROVIDED 4,883 PATIENT CARE DAYS. 2604003 1 0 0 0 0 0 0 0 0 0 0 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 34 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 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 (TERM ENDED APRIL 2023) 20.00 20.00 X X 0 641971 17383 GENE MEYER INTERIM CHAIRMAN/CEO (TERM ENDED NOV 2023) 20.00 20.00 X X 0 372350 0 BRADY DUBOIS CHAIRMAN/CEO 20.00 20.00 X X 0 52459 3330 CHAD PEW VICE CHAIRMAN/VP PROVIDER (TERM ENDED SEP 2023) 20.00 20.00 X X 0 328808 50796 MICHAEL SZEWCZYK PRESIDENT/PHYSICIAN 1.00 40.00 X X 0 80048 0 LIZ EIKEL SECRETARY/COMPLIANCE SPECIALIST 1.00 40.00 X X 0 88502 20072 MONICA SMITH BOARD MEMBER/COO 20.00 20.00 X X 0 346751 49673 ANGELA YUEN BOARD MEMBER/HOSPITALIST 1.00 40.00 X 0 452126 38050 SHANNON KUCZYNSKI BOARD MEMBER/CNE 20.00 20.00 X 0 303695 21051 CHRISTOPHER SCHIAVO BOARD MEMBER/HOSPITALIST 1.00 40.00 X 0 399905 48284 ED CLAYTON CFO 20.00 20.00 X 0 428254 51817 KATE PITZER HOSPITAL ADMINISTRATION/GENERAL COUNSEL 3.00 37.00 X 0 220421 17449 KATHERINE LASSITER EXECUTIVE DIRECTOR 40.00 0.00 X 149402 0 26545 MELINDA FULLER PHYSICAL THERAPIST 40.00 0.00 X 116989 0 18841 TOM DOWNING PHYSICAL THERAPIST 40.00 0.00 X 120598 0 8166 ORLANDO ALCABASA PHYSICAL THERAPIST 40.00 0.00 X 114652 0 15249 501641 3715290 386706 4 0 1 0 MEDEFIS PO BOX 5068 NEW YORK NY 10087 AGENCY LABOR 345476 WELLDYNE PO BOX 90369 LAKELAND FL 33804 PHARMACY BENEFITS 159935 ENSEMBLE 11511 REED HARTMAN HWY BLUE ASH OH 45241 BILLING/COLLECTION 111317 3 HOME HEALTH 621610 1277188 1277188 HOSPICE 621610 942210 942210 2219398 295432 237616 57816 57816 57816 2277214 2219398 0 57816 1899879 1586399 313480 87061 72696 14365 264087 220513 43574 126526 105649 20877 1584 1323 261 240728 201008 39720 6067 5066 1001 37920 31663 6257 18135 15143 2992 102512 85598 16914 48756 40711 8045 90926 75923 15003 MEDICAL SUPPLIES AND EQ 122246 102075 20171 PHARMACEUTICALS AND VAC 47981 40064 7917 REPAIRS AND MAINTENANCE 9610 8024 1586 MISCELLANEOUS EXPENSES 8108 6770 1338 6441 5378 1063 3118567 2604003 514564 0 372808 5817 304961 89689 0 222643 900412 95506 246024 114183 418058 346087 664082 460270 X 236330 -364764 236330 -364764 900412 95506 -841353 240259 0 X X 0 1 X 1 0 X X X 1 CH ALLIED SERVICES INC 431279063 3 1 0 3118567 1 0 3118567 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 DUE TO AFFILIATES 346087 346087 0 1 0 0 0 0 0 0 0 TROY GREER CHAIRMAN/CEO (TERM ENDED APRIL 2023) 0 621070 0 0 0 20901 0 8585 0 8798 0 659354 0 0 ANGELA YUEN BOARD MEMBER/HOSPITALIST 0 440397 0 11729 0 0 0 22500 0 15550 0 490176 0 0 ED CLAYTON CFO 0 405754 0 0 0 22500 0 26400 0 25417 0 480071 0 0 CHRISTOPHER SCHIAVO BOARD MEMBER/HOSPITALIST 0 389631 0 10274 0 0 0 22500 0 25784 0 448189 0 0 MONICA SMITH BOARD MEMBER/COO 0 326960 0 0 0 19791 0 24257 0 25416 0 396424 0 0 CHAD PEW VICE CHAIRMAN/VP PROVIDER (TERM ENDE 0 315103 0 0 0 13705 0 23708 0 27088 0 379604 0 0 GENE MEYER INTERIM CHAIRMAN/CEO (TERM ENDED NOV 0 360252 0 0 0 12098 0 0 0 0 0 372350 0 0 SHANNON KUCZYNSKI BOARD MEMBER/CNE 0 288590 0 0 0 15105 0 20217 0 834 0 324746 0 0 KATE PITZER HOSPITAL ADMINISTRATION/GENERAL COUN 0 220421 0 0 0 0 0 17449 0 0 0 237870 0 0 KATHERINE LASSITER EXECUTIVE DIRECTOR 130577 0 18825 0 0 0 9751 0 16794 0 175947 0 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 - $15,500 CHAD PEW - $13,705 ED CLAYTON - $22,500 MONICA SMITH - $19,791 GENE MEYER- $12,098 SHANNON KUCZYNSKI - $15,105 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. DISTRIBUTIONS TO A 457(F) PLAN WERE MADE BY A RELATED ORGANIZATION, CH ALLIED SERVICES, INC., FOR THE FOLLOWING DIRECTORS OF THIS ORGANIZATION: TROY GREER- $20,901 MONICA SMITH- $12,052 CHAD PEW- $7,876 THE PARTICIPATION IN THE 457(F) PLAN IS 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, 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 0 1 0 0 0 0 0 1 0 1 1 1 0 0 0 0