Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 3 | SAMUEL U. RODGERS HEALTH CENTER CLOSED ITS NORTHLAND LOCATION EFFECTIVE JANUARY 2015. |
| FORM 990, PART III, LINE 4A | THE HEALTH CENTER IS LOCATED IN A COMMUNITY THAT IS A VITAL PART OF THE METROPOLITAN AREA'S MULTICULTURAL FABRIC. LOCATED NORTHEAST OF THE VINE DISTRICT, THE HEALTH CENTER IS ACCESSIBLE TO NEIGHBORHOOD RESIDENTS INCLUDING INDIVIDUALS AND FAMILIES RESIDING IN NEARBY PUBLIC HOUSING FAMILY DEVELOPMENTS. THE HEALTH CENTER'S GOAL IS THE SAME AS ITS MISSION, WHICH IS TO PROVIDE HIGH QUALITY, COMPASSIONATE HEALTH CARE TO ALL. COMPREHENSIVE CARE IS DELIVERED TO PEOPLE THROUGHOUT THE KANSAS CITY METROPOLITAN AREA AND RURAL LAFAYETTE COUNTY AND SURROUNDING AREAS IN MISSOURI. OUR OUTPATIENT PRIMARY CARE SERVICES INCLUDE: - ADULT & SENIOR SERVICES - BEHAVIORAL HEALTH - CHILDREN'S & ADOLESCENTS HEALTH - WOMEN'S HEALTH - DENTAL HEALTH - PODIATRY ON-SITE ANCILLARY AND SUPPORTIVE SERVICES INCLUDE: - LABORATORY - IMAGING - PHARMACY - INTERPRETERS - PATIENT TRANSPORTATION A FULL RANGE OF OUTREACH SERVICES COMPLETE THE ARRAY OF PRIMARY CARE SERVICES. THEY INCLUDE: - EDUCATION AND SCREENING FOR BREAST AND CERVICAL CANCER - COUNSELING AND TREATMENT FOR ALCOHOL, TOBACCO AND OTHER DRUG ABUSE - WIC AND NUTRITION EDUCATION SERVICES (SERVING 4,000 INDIVIDUALS MONTHLY) - MISSOURI HEALTHNET ENROLLMENT - COMMUNITY OUTREACH AND HEALTH EDUCATION TODAY'S CONSTANTLY CHANGING HEALTH CARE SYSTEM HAS ADDED A SPECIAL CHALLENGE TO THE HEALTH CENTER'S ABILITY TO CARE FOR THE MEDICALLY UNDERSERVED PEOPLE IN OUR SERVICE AREA: - THE KANSAS CITY AREA IS HOME TO AN INCREASING NUMBER OF FINANCIALLY INDIGENT AND UNINSURED PATIENTS WHO ARE INELIGIBLE FOR PUBLIC SUPPORT PROGRAMS; - MANY OF THE HEALTH CENTER'S PATIENTS ARE MEDICALLY UNINSURED WHILE THIRD PARTY REIMBURSEMENT REMAINS FLAT. THE HEALTH CENTER'S PATIENT BASE IS EXTRAORDINARILY DIVERSE. BECAUSE WE ARE LOCATED NEAR ONE OF THE LARGEST REFUGEE RESETTLEMENT FACILITIES IN THE MIDWEST, OUR HEALTH CENTER IS A POINT OF ENTRY TO PRIMARY CARE SERVICES FOR IMMIGRANTS FROM WAR-TORN NATIONS. MORE THAN 20 PERCENT OF THE 1.9 MILLION RESIDENTS OF THE KANSAS CITY METROPOLITAN AREA ARE UNINSURED OR ARE ON MEDICAID. ABOUT 31 PERCENT OF OUR PATIENTS ARE BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH. TO ENSURE THESE PATIENTS RECEIVE HIGH QUALITY CARE, THE HEALTH CENTER EMPLOYS A CADRE OF INTERPRETERS WHO SPEAK 12 LANGUAGES. AMONG PATIENTS SERVED, 43 PERCENT ARE HISPANIC/LATINO, 28 PERCENT CAUCASIAN, 19 PERCENT AFRICAN AMERICAN, 4 PERCENT REPRESENTING OTHER ETHNICITIES AND 6 PERCENT ARE ASIAN/PACIFIC ISLANDER. CHILDREN REPRESENT 41 PERCENT OF OUR PATIENT BASE. THUS, PROTECTING CHILDREN FROM CHILDHOOD DISEASES IS A VITAL PART OF OUR MISSION. UNCHECKED, THE RAVAGES OF CHILDHOOD ILLNESSES SUCH AS MEASLES, MUMPS, AND RUBELLA CAN CAUSE PERMANENT DISABILITY OR EVEN DEATH. 2011 - PROVIDED HEALTH CARE FOR 19,047 INDIVIDUALS THROUGH OVER 69,500 VISITS - LAUNCHED A DENTAL PRACTICE AT J.A. ROGERS ELEMENTARY SCHOOL TO PROVIDE ORAL HEALTH CARE SERVICES FOR LOW-INCOME CHILDREN - PROVIDED $2.9 MILLION IN INDIGENT CARE. 2012 - PROVIDED HEALTH CARE FOR 21,114 INDIVIDUALS THROUGH OVER 77,000 VISITS - LAUNCHED A DENTAL PRACTICE AT THE CLAY COUNTY LOCATION TO EXPAND THE HEALTH CENTER'S PRESENCE AT THAT LOCATION - PROVIDED $4.4 MILLION IN INDIGENT CARE. 2013 - PROVIDED HEALTH CARE FOR 21,400 INDIVIDUALS THROUGH OVER 73,800 VISITS - PROVIDED $4.2 MILLION IN INDIGENT CARE. - PATIENT-CENTERED MEDICAL HOME RECOGNITION LEVEL 3 - ESTABLISHED A PATIENT PORTAL. 2014 - PROVIDED HEALTH CARE FOR 25,512 INDIVIDUALS THROUGH OVER 81,143 VISITS - PROVIDED $6.3 MILLION IN INDIGENT CARE. - ONE OF 10 SITES IN THE US TO RECEIVE A SPECIAL GRANT FROM THE AMERICAN CANCER SOCIETY FOR AN HPV VACCINATION EFFORT FOR ADOLESCENTS. 2015 - PROVIDED HEALTH CARE FOR 24,611 INDIVIDUALS THROUGH OVER 77,804 VISITS - PROVIDED $7.3 MILLION IN INDIGENT CARE. - WIC SERVICES EARNED THE WIC LOVING SUPPORT AWARD OF EXCELLENCE FOR EXEMPLARY BREASTFEEDING SUPPORT AND PRACTICES FROM THE USDA. - HEALTH CENTER RECEIVED TWO QUALITY AWARDS, ONE FROM THE STATE OF MISSOURI AND ONE FROM THE FEDERAL GOVERNMENT FOR QUALITY CARE IMPROVEMENTS. |
| FORM 990, PART VI, SECTION B, LINE 11B | AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL. ANY QUESTIONS AND CONCERNS THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE 990 IS THEN PROVIDED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING THE 990. ANY QUESTIONS AND CONCERNS THE FINANCE COMMITTEE HAS ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE FINAL 990 WITH ALL REQUIRED SCHEDULES IS PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | DUTY TO DISCLOSE: IF AN INTERESTED PERSON HAS A POSITION OR FINANCIAL INTEREST IN ANY BUSINESS OR OTHER ENTITY WITH WHICH THE HEALTH CENTER IS CONSIDERING ENTERING INTO AN ARRANGEMENT OR TRANSACTION, THE INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE CONFLICT TO THE HEALTH CENTER'S BOARD OF DIRECTORS ("BOARD"). DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS: THE BOARD OF DIRECTORS WILL MAKE THE DETERMINATION. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST: - PRIOR TO ANY DISCUSSION AND VOTE ON WHETHER A CONFLICT OF INTEREST EXISTS, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OR THE EXECUTIVE COMMITTEE REGARDING THE INTERESTED PERSON'S POSITION OR FINANCIAL INTEREST. AFTER SUCH PRESENTATION, THE INTERESTED PERSON WILL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE PROPOSED TRANSACTION. - THE BOARD OR THE EXECUTIVE COMMITTEE WILL UNDERTAKE APPROPRIATE DUE DILIGENCE AND INFORM ITSELF OF ALL MATERIAL INFORMATION REASONABLY AVAILABLE TO IT AND EXPLORE ALL REASONABLE ALTERNATIVES TO THE PROPOSED TRANSACTION THAT WOULD NOT INVOLVE THE CONFLICT OF INTEREST. - IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR THE EXECUTIVE COMMITTEE WILL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE PROPOSED TRANSACTION IS (I) IN THE HEALTH CENTER'S BEST INTEREST, (II) FOR THE HEALTH CENTER'S OWN BENEFIT, AND (III) FAIR AND REASONABLE TO THE HEALTH CENTER. IN CONFORMITY WITH THIS DETERMINATION, THE BOARD OR THE EXECUTIVE COMMITTEE WILL MAKE ITS DECISION AS TO WHETHER THE HEALTH CENTER MAY ENTER INTO THE PROPOSED TRANSACTION. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY: IF THE BOARD OR THE EXECUTIVE COMMITTEE DETERMINES THAT THE COVERED PERSON HAS IN FACT FAILED TO DISCLOSE A POSITION OR A FINANCIAL INTEREST, THE BOARD OR THE EXECUTIVE COMMITTEE WILL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. DOCUMENTATION IN MINUTES: WITH RESPECT TO THE DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS, THE NAME OF THE INTERESTED PERSON WHO DISCLOSED OR WAS OTHERWISE FOUND TO HAVE A POSITION OR FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST; THE NATURE OF THE POSITION OR FINANCIAL INTEREST; ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT; AND THE BOARD OR THE EXECUTIVE COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. ANNUAL STATEMENTS: EACH COVERED PERSON WILL ANNUALLY SIGN A STATEMENT THAT AFFIRMS SUCH PERSON: - HAS RECEIVED A COPY OF THIS POLICY; - HAS READ AND UNDERSTANDS THE POLICY; - HAS AGREED TO COMPLY WITH THE POLICY; AND - UNDERSTANDS THE HEALTH CENTER IS EXEMPT FROM FEDERAL INCOME TAX AND TO MAINTAIN ITS FEDERAL TAX EXEMPTION THE HEALTH CENTER MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN ADDITION, EACH COVERED PERSON WILL ANNUALLY COMPLETE, SIGN AND PROMPTLY RETURN TO THE BOARD OR THE EXECUTIVE COMMITTEE A QUESTIONNAIRE AND DISCLOSURE STATEMENT SUBSTANTIALLY IN THE FORM ATTACHED HERETO. A COVERED PERSON NEED NOT DISCLOSE COMPENSATION PAID TO THE COVERED PERSON BY HEALTH CENTER PURSUANT TO A RESOLUTION OF THE BOARD. PERIODIC REVIEWS: THE PERIODIC REVIEWS AS REQUIRED BY THE POLICY WILL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: - WHETHER THE HEALTH CENTER COMPENSATION ARRANGEMENTS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND ARE THE RESULT OF ARM'S- LENGTH BARGAINING; AND - WHETHER TRANSACTIONS AND ARRANGEMENTS WITH OTHER ENTITIES AND INDIVIDUALS CONFORM TO THE HEALTH CENTER'S POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE HEALTH CENTER'S TAX-EXEMPT PURPOSES AND DO NOT RESULT IN PRIVATE INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT, OR IN AN EXCESS BENEFIT TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | THE EVALUATION FOR THE CEO FOR THE YEAR ENDING SEPTEMBER 30, 2015 WAS IN FEBRUARY, 2016. THIS EVALUATION WAS DONE BY THE HEALTH CENTER'S BOARD OF DIRECTORS. THE CHAIRPERSON OF THE BOARD WILL LEAD THE ASSESSMENT PROCESS. THE CHAIR SHALL SELECT A PERFORMANCE AND COMPENSATION COMMITTEE AND ITS CHAIR. THE CEO WILL COMPLETE A SELF-ASSESSMENT. THIS ALLOWS THE BOARD AND CEO TO COMPARE ONE ANOTHER'S PERCEPTION OF THE CEO'S PERFORMANCE. THE CHAIRPERSON OF THE PERFORMANCE AND COMPENSATION COMMITTEE WILL HAVE EACH BOARD MEMBER COMPLETE THE ASSESSMENT FORM INDIVIDUALLY AND COMPILE RESULTS. DISTRIBUTION OF THE ASSESSMENT FORM: THE COMMITTEE CHAIRPERSON WILL DISTRIBUTE THE CEO SELF-ASSESSMENT AND THE BOARD'S ASSESSMENT OF THE CEO WELL ENOUGH IN ADVANCE TO ALLOW AMPLE TIME FOR COMPLETION. THE COMMITTEE CHAIRPERSON WILL SET A DEADLINE FOR COMPLETING THE BOARD'S ASSESSMENT OF THE CEO. ANALYSIS OF THE RESULTS: THE RESPONSES FOR EACH QUESTION WILL BE ADDED TOGETHER AND THE AVERAGE RESPONSE COMPUTED. NEXT, THE AVERAGE RESPONSES FOR EACH QUESTION WILL BE ADDED TOGETHER AND THE AVERAGE RESPONSE FOR THE ASSESSMENT AS A WHOLE SHOULD BE CALCULATED. THE RESULTS WILL BE SHARED WITH THE BOARD FOR DISCUSSION AND ANALYSIS IN CLOSED SESSION. REVIEW OF THE RESULTS WITH THE CEO: THE CEO AND THE BOARD WILL MEET IN A CLOSED EXECUTIVE SESSION OR A SPECIAL MEETING TO REVIEW AND DISCUSS THE RESULTS. BASED ON THE RESULTS, THE BOARD AND CEO WILL DEVELOP A WRITTEN PERFORMANCE PLAN AND PERFORMANCE GOALS FOR THE CEO DESCRIBING AREAS OF FOCUS AND IMPROVEMENT FOR THE NEXT YEAR. THE PERFORMANCE ASSESSMENT WILL BE USED AS A BASIS FOR DETERMINING COMPENSATION. AN INDEPENDENT COMMITTEE, USING COMPARABILITY DATA WILL CONDUCT COMPENSATION ANALYSIS. SUCH DELIBERATIONS AND DECISIONS REGARDING COMPENSATION SHALL BE DOCUMENTED AND SUBSTANTIATED. THIS COMPENSATION REVIEW METHODOLOGY SHALL BE USED FOR ALL CHIEF OFFICER POSITIONS. SOLICIT THE CEO'S FEEDBACK: THE BOARD WILL OBTAIN THE CEO'S FEEDBACK REGARDING THE ASSESSMENT PROCESS. FEEDBACK WILL INCLUDE UNDERSTANDING THE CEO'S AGREEMENT OR DISAGREEMENT WITH THE BOARD'S ASSESSMENT; WHETHER THE FORMAT WAS APPROPRIATE, WHETHER THE BOARD AND THE CEO BELIEVED THAT THE FORM USED CAPTURED ALL OF THE NECESSARY ELEMENTS, AND WHICH AREAS COULD BE IMPROVED IN THE NEXT ASSESSMENT. OTHER OFFICERS AND KEY EMPLOYEES: ON A REGULAR BASIS, HUMAN RESOURCES WILL CONDUCT SALARY SURVEYS TO ENSURE CURRENT JOB PAY RANGES AND MEDIAN PAY FOR CERTAIN BENCHMARKED POSITIONS REMAIN COMPETITIVE IN THE MARKETPLACE AND CONSISTENT WITH THE COMPANY'S COMPENSATION PHILOSOPHY. AN INDEPENDENT COMMITTEE USING COMPARABILITY DATA WILL CONDUCT A COMPENSATION ANALYSIS. SUCH DELIBERATIONS AND DECISIONS REGARDING COMPENSATION SHOULD BE DOCUMENTED AND SUBSTANTIATED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT PROFESSIONAL SERVICES TOTAL FEES:1229437 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OUTSIDE LAB REFERRAL TOTAL FEES:389242 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:FACILITY MAINT & SECURITY TOTAL FEES:316124 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTANTS - PHYSICIANS TOTAL FEES:500595 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER FEES FOR SERVICES TOTAL FEES:539686 |
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