Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (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 | |||||
| (A)
BURRELL INC |
431081715 | 7 | Yes | 0 | 0 | |
| (B)
PREFERRED FAMILY HEALTHCARE INC |
431236557 | 7 | Yes | 0 | 0 | |
|
Total 2
|
0 | 0 | ||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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 on 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 0.015 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 0.035 | 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 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2022. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, SECTION D, LINE 3 | BOARD OF DIRECTORS: THE ORGANIZATION'S BOARD OF DIRECTORS CURRENTLY IS COMPRISED ENTIRELY OF INDIVIDUALS WHO ALSO SERVE ON THE BOARDS OF DIRECTORS OF BURRELL AND PFH (I.E., THE SOLE SUPPORTED ORGANIZATIONS). EVEN IF, IN THE FUTURE, LESS THAN ALL OF THE ORGANIZATION'S DIRECTORS ALSO ARE DIRECTORS OF THE SUPPORTED ORGANIZATIONS, THE BYLAWS MANDATE THAT AT LEAST ONE (1) OF THE DIRECTORS WILL BE SOMEONE ON THE BURRELL BOARD AND AT LEAST ONE (1) WILL BE SOMEONE ON THE PFH BOARD. THIS BOARD OVERLAP WILL ENSURE THAT THE SUPPORTED ORGANIZATIONS ALWAYS HAVE A SIGNIFICANT VOICE IN BRIGHTLI'S OPERATIONS. |
| SCHEDULE A, SECTION E, LINE 3A | BOARD OF DIRECTORS: PURSUANT TO BRIGHTLI'S BYLAWS, THE GOVERNING BOARD IS SELECTED BY BURRELL AND PFH. MORE SPECIFICALLY, OF THE NINE (9) DIRECTORS, BURRELL SELECTS FIVE (5), AND PFH SELECTS FOUR (4). THE BYLAWS FURTHER SPECIFY THAT, AT ALL TIMES, AT LEAST ONE (1) OF THE DIRECTORS SHALL SERVE ON THE BOARD OF DIRECTORS OF BURRELL, AND AT LEAST ONE (1) OF THE DIRECTORS SHALL SERVE ON THE BOARD OF DIRECTORS OF PFH. AT THIS TIME, ALL FIVE (5) BURRELL APPOINTEES TO THE BOARD ARE INDIVIDUALS WHO ALSO SERVE ON BURRELL'S BOARD, AND ALL FOUR PFH APPOINTEES TO THE BOARD ARE INDIVIDUALS WHO ALSO SERVE ON PFH'S BOARD. THE OFFICERS ARE ELECTED BY THE BOARD OF DIRECTORS. MAINTAINING A CLOSE AND CONTINUOUS RELATIONSHIP WITH ITS SUPPORTED ORGANIZATIONS IS DEFINITIONAL TO BRIGHTLI WHICH WILL BE THE MEMBER TO BOTH BURRELL AND PFH AND WILL BE INVOLVED IN THE OPERATIONS OF BOTH OF THESE ORGANIZATIONS ON A DAILY BASIS. THE EXTENSIVE OVERLAP BETWEEN THE GOVERNING BOARDS OF BRIGHTLI, BURRELL, AND PFH LIKEWISE WILL ENSURE A CLOSE AND CONTINUOUS RELATIONSHIP BETWEEN THE ORGANIZATIONS. |
| SCHEDULE A, SECTION E, LINE 3B | SUBSTANTIAL DEGREE OF DIRECTIONS: BRIGHTLI WILL EXERCISE A SUBSTANTIAL DEGREE OF DIRECTION OVER ITS SUPPORTED ORGANIZATIONS' POLICIES, PROGRAMS, AND ACTIVITIES. AT LEAST FOR THE IMMEDIATE FUTURE, HOWEVER, BRIGHTLI WILL NOT HAVE THE AUTHORITY TO ELECT A MAJORITY OF THE DIRECTORS OR OFFICERS OF BURRELL AND PFH TO COMPLY WITH FEDERALLY QUALIFIED HEALTH CENTER REGULATIONS. BRIGHTLI WILL POSSESS AN OVERSIGHT ROLE WITH RESPECT TO SUCH DIRECTORS AND OFFICERS, HOWEVER, AND WILL HAVE THE AUTHORITY TO RECOMMEND REMOVAL AND REPLACEMENT OF SUCH DIRECTORS AND OFFICERS, WHERE APPROPRIATE. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 1 | ORGANIZATION'S MISSION: THE ORGANIZATIONS PRIMARY FUNCTION WILL BE TO PROVIDE GOVERNANCE, LEADERSHIP, AND OTHER SIMILAR SUPPORT FOR TAX EXEMPT RELATED ENTITIES. THE ORGANIZATION WILL ENGAGE IN ADMINISTRATIVE, MANAGEMENT, AND OVERSIGHT ACTIVITIES THAT ARE TYPICAL FOR NONPROFIT PARENT ORGANIZATIONS. THE ORGANIZATION WILL COORDINATE THE OPERATIONS OF THE RELATED ENTITIES AND FACILITATE THEIR PROVISION OF CHARITABLE HEALTH CARE SERVICES. THIS WILL BE ACCOMPLISHED THROUGH STRATEGIC PLANNING AND A FOCUS ON FUTURE CHARITABLE ACTIVITIES BY PROVIDING OVERALL COORDINATION FOR THE ORGANIZATIONS WITHIN THE SYSTEM IN SUCH MATTERS AS APPROVING BUDGETS, STRATEGIC PLANNING, MARKETING, ALLOCATING RESOURCES, SECURING TAX-EXEMPT BOND FINANCING, AND PROVIDING COMMUNITY EDUCATION |
| FORM 990, PART V, LINES 1A & 2A | PAYROLL AGENT: BURRELL INC AND PREFERRED HEALTH CARE FILE CONSOLIDATED PAYROLL FORMS AND REPORTS WITH THE IRS UNDER THEIR EINS WHICH INCLUDE ITS TAX-EXEMPT SUBSIDIARIES. THIS INCLUDES FORM 941'S, W-2'S, 1099'S AND OTHER RELATED FILINGS. |
| FORM 990, PART VI, SECTION A, LINE 2 | BUSINESS AND FAMILY RELATIONSHIPS: C.J. DAVIS AND ADAM ANDREASSEN HAVE A BUSINESS RELATIONSHIP. ANDREW SCHWEND IS THE SON OF MICHAEL SCHWEND. |
| FORM 990, PART VI, SECTION A, LINE 7A | SELECTION OF BOARD MEMBERS: PURSUANT TO THE APPLICANT'S BYLAWS, THE APPLICANT'S GOVERNING BOARD IS SELECTED BY BURRELL AND PFH. MORE SPECIFICALLY, OF THE APPLICANT'S NINE (9) DIRECTORS, BURRELL SELECTS FIVE (5), AND PFH SELECTS FOUR (4). THE BYLAWS FURTHER SPECIFY THAT, AT ALL TIMES, AT LEAST ONE (1) OF THE APPLICANT'S DIRECTORS SHALL SERVE ON THE BOARD OF DIRECTORS OF BURRELL, AND AT LEAST ONE (1) OF THE APPLICANT'S DIRECTORS SHALL SERVE ON THE BOARD OF DIRECTORS OF PFH. AT THIS TIME, ALL FIVE (5) BURRELL APPOINTEES TO THE APPLICANT'S BOARD ARE INDIVIDUALS WHO ALSO SERVE ON BURRELL'S BOARD, AND ALL FOUR PFH APPOINTEES TO THE APPLICANT'S BOARD ARE INDIVIDUALS WHO ALSO SERVE ON PFH'S BOARD. THE APPLICANT'S OFFICERS ARE ELECTED BY THE BOARD OF DIRECTORS. MAINTAINING A CLOSE AND CONTINUOUS RELATIONSHIP WITH ITS SUPPORTED ORGANIZATIONS IS DEFINITIONAL TO THE APPLICANT WHICH, AS THE PARENT ORGANIZATION FOR THE SYSTEM, WILL BE THE MEMBER TO BOTH BURRELL AND PFH AND WILL BE INVOLVED IN THE OPERATIONS OF BOTH THESE ORGANIZATIONS ON A DAILY BASIS. THE EXTENSIVE OVERLAP BETWEEN THE GOVERNING BOARDS OF THE APPLICANT, BURRELL, AND PFH LIKEWISE WILL ENSURE A CLOSE AND CONTINUOUS RELATIONSHIP BETWEEN THE ORGANIZATIONS. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW OF FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, A TENTATIVE DRAFT OF THE 990 IS REVIEWED BY THE SYSTEM DIRECTOR OF FINANCE, THE VICE PRESIDENT OF FINANCE, THE EXECUTIVE VICE PRESIDENT OF FINANCE, THE CHIEF FINANCIAL OFFICER, AND THE PRESIDENT/CEO BEFORE BEING PROVIDED TO THE BOARD OF DIRECTORS. THE 990 IS EMAILED TO THE BOARD OF DIRECTORS FOR REVIEW BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: THE ORGANIZATION INQUIRES ANNUALLY IF ANY OF THE BOARD MEMBERS HAVE A CONFLICT OF INTEREST. POTENTIAL CONFLICTS ARE REVIEWED BY THE BOARD OF DIRECTORS. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER ABSTAINS FROM VOTING ON THE MATTER AND THE RESOLUTION IS DOCUMENTED IN THE BOARD MINUTES. CORPORATE COMPLIANCE IS RESPONSIBLE FOR MONITORING AND COMPLIANCE OF THE CONFLICT-OF-INTEREST POLICY FOR ALL EMPLOYEES. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | COMPENSATION REVIEW: BURRELL INC (A TAX EXEMPT RELATED PARTY) HIRED GALLAGHER TO DO A COMPENSATION REVIEW FOR EXECUTIVES IN JULY 2021. THE MISSOURI COALITION SPONSORED A CUSTOM COMPENSATION AND BENEFITS SURVEY PERFORMED BY CBIZ IN 2022. THE CEO COMPENSATION WAS APPROVED BY BOTH THE FINANCE COMMITTEE AND THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. ADDITIONALLY, FINANCIALS ARE MADE AVAILABLE AT EACH BOARD MEETING. |
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