Liabilities / Assets
56th percentile
Higher debt load relative to assets than 56% of similar nonprofits.
990 • Fiscal year 2019 • EIN 43-1704371
Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.
Liabilities / Assets
56th percentile
Higher debt load relative to assets than 56% of similar nonprofits.
Liabilities / Revenue
33rd percentile
Higher debt load relative to revenue than 33% of similar nonprofits.
Net Margin
60th percentile
Higher net margin than 60% of similar nonprofits.
Top Officer Pay
89th percentile
Higher top officer pay than 89% of similar nonprofits.
Top officer pay equals 0.5% of source-year revenue.
Asset Growth
66th percentile
Faster asset growth than 66% of similar nonprofits.
Revenue Growth
28th percentile
Faster revenue growth than 28% of similar nonprofits.
Assets
Up$533,165,787
Up $40,593,022 (+8.2%) from 2018
Net Assets
Up$343,936,021
Up $42,040,385 (+14%) from 2018
Liabilities
Down$189,229,766
Down $1,447,363 (-0.8%) from 2018
Revenue
Down$553,530,385
Down $9,985,141 (-1.8%) from 2018
Expenses
Down$513,690,534
Down $17,558,333 (-3.3%) from 2018
Net Income
Up$39,839,851
Up $7,573,192 (+23%) from 2018
The mission of freeman health services is to improve the health of the communities we serve through contemporary, innovative, quality healthcare solutions.
Freeman health system provides world-class, compassionate healthcare services where it matters most, close to home. See schedule o for additional information.
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Investments in Publicly Traded Securities | $229,662,490 | $261,103,110 | ▲ $31,440,620 |
| Land, Buildings, and Equipment, Net | $133,984,568 | $135,574,313 | ▲ $1,589,745 |
| Accounts Receivable | $58,676,229 | $61,531,684 | ▲ $2,855,455 |
| Cash and Non-Interest-Bearing Accounts | $22,790,613 | $25,333,635 | ▲ $2,543,022 |
| Savings and Temporary Cash Investments | $17,610,528 | $16,405,382 | ▼ $1,205,146 |
| Inventories for Sale or Use | $8,691,358 | $8,343,472 | ▼ $347,886 |
| Prepaid Expenses and Deferred Charges | $5,404,973 | $6,568,764 | ▲ $1,163,791 |
| Pledges and Grants Receivable | $4,711,035 | $4,434,832 | ▼ $276,203 |
| Investments Program Related | $2,201,512 | $4,037,495 | ▲ $1,835,983 |
| Investments Other Securities | $2,325,861 | $2,224,004 | ▼ $101,857 |
| Intangible Assets | $367,030 | $367,030 | → $0 |
| Other Notes and Loans Receivable, Net | $192,525 | $146,157 | ▼ $46,368 |
| Receivable From Disqualified Prsn | $0 | $0 | → $0 |
| Receivables From Officers Etc | $0 | $0 | → $0 |
| Loans From Officers Directors | $0 | $0 | → $0 |
| Total Assets | $492,572,765 | $533,165,787 | ▲ $40,593,022 |
| Other Assets Total | $5,954,043 | $7,095,909 | ▲ $1,141,866 |
| Liabilities | |||
| Tax Exempt Bond Liabilities | $104,416,177 | $95,352,538 | ▼ $9,063,639 |
| Accounts Payable and Accrued Expenses | $61,197,355 | $65,101,842 | ▲ $3,904,487 |
| Other Liabilities | $24,616,834 | $25,208,154 | ▲ $591,320 |
| Mortgage Notes Payable Secured by Investment Property | $446,763 | $3,567,232 | ▲ $3,120,469 |
| Grants Payable | $0 | $0 | → $0 |
| Unsecured Notes Loans Payable | $0 | $0 | → $0 |
| Deferred Revenue | $0 | $0 | → $0 |
| Escrow Account Liability | $0 | $0 | → $0 |
| Total Liabilities | $190,677,129 | $189,229,766 | ▼ $1,447,363 |
| Net Assets / Fund Balance | |||
| Unrestricted Net Assets | $295,897,840 | $337,951,639 | ▲ $42,053,799 |
| Temporarily Rstr Net Assets | $5,997,796 | $5,984,382 | ▼ $13,414 |
| Permanently Rstr Net Assets | $0 | $0 | → $0 |
| Total Net Assets Fund Balance | $301,895,636 | $343,936,021 | ▲ $42,040,385 |
| Total Liabilities and Net Assets / Fund Balance | $492,572,765 | $533,165,787 | ▲ $40,593,022 |
| Asset | Book Value | Depreciation | Basis |
|---|---|---|---|
| Buildings | $74,062,588 | $99,842,932 | $173,905,520 |
| Equipment | $39,206,762 | $109,610,358 | $148,817,120 |
| Other Land Buildings | $9,356,299 | $6,914,756 | $16,271,055 |
| Land | $12,691,693 | - | $7,654,521 |
| Leasehold Improvements | $256,971 | $2,461,095 | $2,718,066 |
| Period | Beginning | Contrib. | Gain/Loss | Other Uses | End |
|---|---|---|---|---|---|
| 2018 | $68,952 | - | ▲ $701 | - | $66,903 |
| 2017 | $63,894 | - | ▲ $7,498 | - | $68,952 |
| 2016 | - | $60,000 | ▲ $6,294 | - | $63,894 |
| Name | Title | Full / Part Time | Base | Other | Total |
|---|---|---|---|---|---|
| William J Nicholas | Physician | FT | $1,859,978 | $720,610 | $2,580,588 |
| Joshua Ball | Director | FT | $806,943 | $1,118,912 | $1,925,855 |
| Thomas B Coy | Physician | FT | $1,422,787 | $247,901 | $1,670,688 |
| Darwin Jeyaraj | Physician | FT | $639,276 | $1,001,127 | $1,640,403 |
| Paula F Baker | President/CEO | FT | $601,888 | $947,535 | $1,549,423 |
| Chance L Matthiesen | Physician | FT | $790,035 | $655,767 | $1,445,802 |
| Robert C Stauffer | Physician | FT | $1,080,927 | $298,652 | $1,379,579 |
| John M Cox Do | Director | FT | $837,361 | $176,702 | $1,014,063 |
| Steve W Graddy | CFO | FT | $340,576 | $298,154 | $638,730 |
| Michael J Leone | Controller | FT | $368,399 | $170,249 | $538,648 |
| Jeffrey Michael Carrier | Chief Clinical Officer | FT | $245,031 | $208,750 | $453,781 |
| Larry Mcintire Do | Director | FT | $353,524 | $71,585 | $425,109 |
| Kevin P Gaudette | VP Revenue Cycle | FT | $261,138 | $136,220 | $397,358 |
| Dennis a Estep | CMO | FT | $313,698 | $70,616 | $384,314 |
| Wesley B Braman | VP Business Development | FT | $220,635 | $104,609 | $325,244 |
| Leonard T Rollins | Chief Information Officer | FT | $202,789 | $77,841 | $280,630 |
| Mary a Frerer | Chief Human Resource Officer | FT | $183,560 | $88,716 | $272,276 |
| Name | Title |
|---|---|
| Lance Beshore Phd | Chair |
| J Scott Brothers | Vice Chair |
| Brandon C Davis | Director |
| Glenn Brown | Director |
| Glenn Mitch Mccumber | Director |
| James Fleischaker | Director |
| Mark Williams | Director |
| Rodney Mcfarland Md | Director |
| Jim Armstrong | Secretary/treasurer |
| Contractor | Services | Location | Compensation |
|---|---|---|---|
| Crothall Services Group | Housekeeping | 13028 COLLECTION CENTER DRIVE, Chicago, IL 60693 | $5,135,411 |
| Gateway Emergency Physicians LLP | Healthcare Svcs | PO BOX 677979, Dallas, TX 75267-7979 | $4,198,432 |
| Dewitt Associates INC | Construction Service | PO BOX 3378 GS, Springfield, MO 65808 | $3,053,146 |
| Choice Marketing LLC | Advertising | 501 E 7TH STREET, Joplin, MO 64801 | $1,677,190 |
| Morrison Mgt Specialist INC | Nutrition Services | 2400 YORKMONT ROAD, Charlotte, NC 28217 | $1,143,744 |
| Line Item | Amount |
|---|---|
| Salaries, Compensation, and Employee Benefits | $283,589,005 |
| Other Expenses | $226,681,678 |
| Grants and Similar Amounts Paid | $3,419,851 |
| Total Fundraising Expense | $782,286 |
| Professional Fundraising Fees | $0 |
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Other Salaries and Wages | $199,553,010 | $28,913,262 | $404,138 | $228,870,410 |
| Fees for Services Other | $20,582,340 | $14,846,988 | $68,670 | $35,497,998 |
| Other Employee Benefits | $24,084,743 | $3,628,511 | $116,756 | $27,830,010 |
| Office Expenses | $15,066,060 | $6,833,305 | $70,935 | $21,970,300 |
| Depreciation Depletion | $13,943,373 | $2,143,198 | $25,363 | $16,111,934 |
| Payroll Taxes | $11,699,522 | $1,828,031 | $47,518 | $13,575,071 |
| Insurance | $3,042,328 | $7,137,617 | - | $10,179,945 |
| Current Officers, Directors, Trustees, and Key Employees | $4,216,166 | $3,989,265 | - | $8,205,431 |
| Occupancy | $7,012,816 | - | $6,529 | $7,019,345 |
| Interest | $3,230,015 | $505,906 | $5,987 | $3,741,908 |
| Pension Plan Contributions | $2,978,620 | $480,648 | $14,850 | $3,474,118 |
| Grants to Domestic Orgs | $3,136,492 | - | - | $3,136,492 |
| Advertising | $1,784,703 | $286,436 | $2,889 | $2,074,028 |
| Comp Disqual Persons | $1,633,965 | - | - | $1,633,965 |
| Conferences and Meetings | $569,295 | $578,879 | $653 | $1,148,827 |
| Travel | $641,938 | $159,037 | $11,861 | $812,836 |
| Other Expenses | $139 | $454,565 | $6,137 | $454,704 |
| Fees for Services Accounting | - | $363,620 | - | $363,620 |
| Fees for Service Investment Mgmnt Fees | - | $335,862 | - | $335,862 |
| Grants to Domestic Individuals | $283,359 | - | - | $283,359 |
| Fees for Services Legal | - | $280,741 | - | $280,741 |
| Information Technology | - | $141,135 | - | $141,135 |
| Total Functional Expenses | $439,585,299 | $73,322,949 | $782,286 | $513,690,534 |
| Line Item | Amount |
|---|---|
| Total Expenses per Form 990 | $513,690,534 |
| Total Expenses per Audited Statements | $511,510,337 |
| Expenses per Audited Statements | $510,128,641 |
| Expenses Not Reported on Financial Statements | $3,561,893 |
| Other Expense Adjustments | $3,366,798 |
| Expenses Not Reported on Form 990 | $1,381,696 |
| Recipient | Location | Category | Purpose | Amount |
|---|---|---|---|---|
| Connect2culture | Joplin, MO | 501(c)(3) | Support & Capital | $1,525,000 |
| Pittsburg State University | Pittsburg, KS | 501(c)(3) | Support | $555,500 |
| Ozark Center | Joplin, MO | 501(c)(3) | Support | $424,580 |
| Crowder College | Neosho, MO | 501(c)(3) | Support | $69,724 |
| Missouri Southern Foundation | Joplin, MO | 501(c)(3) | Support | $61,417 |
| Joplin Regional Partnership | Joplin, MO | 501(c)(3) | Support | $40,000 |
| Ronald Mcdonald House | Joplin, MO | 501(c)(3) | Support | $33,100 |
| Community Health Clinic of Joplin | Joplin, MO | 501(c)(3) | Support | $29,000 |
| Joplin Memorial Run | Joplin, MO | 501(c)(3) | Support | $25,000 |
| School District of Joplin R-viii Foundation | Joplin, MO | 501(c)(3) | Support | $24,890 |
| Carl Junction Education Foundation | Carl Junction, MO | 501(c)(3) | Support | $22,973 |
| Joplin Area Chamber of Commerce | Joplin, MO | 501(c)(3) | Support | $15,000 |
| American Heart Association | Dallas, TX | 501(c)(3) | Support | $14,500 |
| Breast Foundation of the Ozarks | Springfield, MO | 501(c)(3) | Support | $10,000 |
| Joplin Family Ymca | Joplin, MO | 501(c)(3) | Support | $10,000 |
| Mcdonald County R1 School District | Anderson, MO | 501(c)(3) | Support | $9,000 |
| George a Spiva Center for the Arts | Joplin, MO | 501(c)(3) | Support | $8,000 |
| Joplin Humane Society | Joplin, MO | 501(c)(3) | Support | $6,500 |
| Line Item | Amount |
|---|---|
| Fundraising Gross Income | $462,284 |
| Fundraising Direct Expenses | $402,880 |
| Gaming Direct Expenses | $0 |
| Gaming Gross Income | $0 |
| Professional Fundraising Fees | $0 |
| Event | Gross Receipts | Gross Revenue | Direct Expenses | Net Income |
|---|---|---|---|---|
| Jewelry Sale | $107,397 | $107,397 | $82,554 | $24,843 |
| Shoe Sale | $78,676 | $78,676 | $63,017 | $15,659 |
| Total Events | $583,770 | $462,284 | $402,880 | $59,404 |
| Interested Party | Relationship | Description | Shared Revenue | Amount |
|---|---|---|---|---|
| Scott Mcclintick | See Part V | Employee Compensation | No | $731,001 |
| Kent Mcintire | See Part V | Employee Compensation | No | $645,494 |
| Adam Graddy | See Part V | Employee Compensation | No | $80,089 |
| Deborah Gaudette | See Part V | Employee Compensation | No | $72,992 |
| Ritchi Rollins | See Part V | Employee Compensation | No | $55,160 |
| Michaela Bennett | See Part V | Employee Compensation | No | $49,229 |
| Line Item | Beginning | End | Change |
|---|---|---|---|
| Loans from Officers, Directors, Trustees, and Key Employees | $0 | $0 | → $0 |
| Receivables from Disqualified Persons | $0 | $0 | → $0 |
| Receivables from Officers, Directors, Trustees, and Key Employees | $0 | $0 | → $0 |
| Liability | Amount |
|---|---|
| Est Self Insurance Cost | $17,480,027 |
| Due to 3rd Party | $6,100,000 |
| Other Liabilities | $1,523,933 |
| Due to Related Party | $104,194 |
| Bond | Issuer | Issued | Issue Price | Purpose |
|---|---|---|---|---|
| B | The Industrial Development Authority of Joplin Mo | 2015-02-26 | $40,712,377 | REFUND 2004 BONDS |
| C | Health and Educational Facilities Authority of Mo | 2012-12-20 | $40,129,591 | Refund 1994-a bonds and 1998a bond |
| B | The Industrial Development Authority of Joplin Mo | 2011-12-31 | $25,031,815 | Construct & equip west campus hosp |
| A | The Industrial Development Authority of Joplin Mo | 2014-06-18 | $15,995,508 | REFUND 2009 BONDS |
| D | The Industrial Development Authority of Joplin Mo | 2014-12-23 | $7,000,000 | Construct, improve, and equip east |
| A | The Industrial Development Authority of Jasper Co | 2014-12-23 | $5,000,000 | Acquire, construct, improve and eq |
| Bond | Total Proceeds | Spent | Retired | Issuance Costs |
|---|---|---|---|---|
| B | $40,712,377 | $37,248,410 | $4,920,000 | $532,154 |
| C | $40,129,591 | $36,042,809 | $17,960,000 | $530,282 |
| B | $25,031,815 | $0 | $6,965,000 | $403,785 |
| A | $15,995,508 | $15,995,808 | $4,253,753 | $0 |
| D | $7,000,000 | $0 | $3,032,688 | $0 |
| A | $5,000,000 | $0 | $2,166,206 | $0 |
“Review of the 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, the draft of the form 990 is reviewed by members of top management. Once a final draft is ready, a power point presentation is made to the board members at the board of directors meeting to explain the 990 and its uses. The board reviews the document for key information included. Paper copies are made available to the board members at their request.”
“Conflict of interest policy: the conflict of interest policy is reviewed by the board of directors each year in april. The board members are asked to sign a new conflict of interest policy and list any possible conflicts. This information is reviewed and maintained in the administrative offices. If a board member encounters a transaction that would cause a possible conflict of interest, a form detailing the transaction is completed and submitted to the board for review and approval. If a conflict is found, the interested person will not participate in the discussion or vote on a transaction involving his or her conflict. The conflict of interest policy was updated in fiscal year 2011 to require an attestation form from all employed physicians and level four supervisors/managers and up. Corporate officers and key employees are also required to annually disclose conflicts of interest.”
“Freeman health system compensation review: executive compensation philosophy & strategy i. Key principles freeman health system ("fhs") desires to ensure that its executive compensation program is competitive, fair, and equitable; compliant with regulatory guidelines; and representative of market best practices. Key principles that guide fhs's executive compensation decision-making process include: -executive compensation programs will support fhs's mission, values, strategic direction, and tax-exempt status. -fhs competes in a national market for its executives and thus will consider pay practices that are representative of the industry. -the relative pay levels of fhs executives will over time reflect both individual and organizational performance. -fhs intends to establish the rebuttable presumption of reasonableness under irs intermediate sanctions regulations. Thus, executive compensation programs and decisions will be approved, in advance of its implementation by the executive compensation committee (hereafter the "committee") of the board of directors: *the committee is comprised of members of the board of directors, who are independent of fhs's management, have no personal interest in the compensation arrangements, are not related to, or under the control of any individual whose compensation arrangement is being reviewed and have no material business relationship with fhs. *the committee will rely upon appropriate, independent comparability data to support its decision making process. *the committee will adequately document its deliberations, decisions, and actions on a timely basis. Ii. Primary program components fhs's executive total compensation program consists of the following components: -base salary -annual at risk compensation -standard all employee benefits -supplemental benefits and perquisites -severance annually, the committee will direct the review of the components of the executive compensation program and approve program modifications as appropriate. The committee may also authorize unique program components which support the achievements of fhs's mission. Iii. Market comparators fhs will consider a national peer group of healthcare organizations comparable to fhs in size (i.e., net revenues) and complexity to determine the market values for each of its executive positions. This peer group will primarily be comprised of not-for-profit healthcare organizations (but for-profit organizations may be considered selectively) for functionally comparable positions as reported in surveys conducted by independent firms. -cash compensation the following organizations/markets are the primary comparators for compensation purposes: *system level executives: health systems of comparable size to fhs, based on net revenue. These will be based on national healthcare labor markets. *hospital level executives: hospitals of comparable size to the fhs entity, based on net revenue. These will be based on national healthcare labor markets. *other executives: organizations of comparable size in relevant market segments such as medical group practices, home health, and the like. These will be based on national healthcare labor market. -executive benefits fhs will develop and administer executive benefit (i.e., standard benefits, supplemental executive benefits, and perquisites) plans that are based on national healthcare industry market norms. Iv. Market position targets fhs has established a target market position for each of the components of its executive total compensation program. -base salaries: fhs will manage its executives' base salaries around the 50th percentile of base salaries paid in the market. Salaries will vary from the 50th percentile based an executive's experience and performance. For example: *executives who are new to the organization and/or have limited or no prior executive-level experience should have salaries that are 80 to 90 percent of the 50th percentile. *experienced executives (with approximately 5”
“Freeman health system compensation review (continued): executive compensation committee charter this executive compensation committee charter was adopted by the board of directors (the "board") of freeman health system (hereafter "fhs") on april 25, 2008. This charter applies to fhs and all of its business entities, including freeman neosho hospital, ozark center and the freeman foundation (hereafter the "system"). This charter is a component of the flexible framework within which the board, assisted by its committees, directs the affairs of fhs. While the charter should be interpreted in the context of all applicable laws and regulations, as well as in the context of fhs's articles of incorporation and bylaws, it is not intended to establish by its own force any legally binding obligations. I. Purpose the executive compensation committee (hereafter the "committee") is authorized to act on the board's behalf in (i) determining appropriate compensation for system executives and other disqualified persons as defined in the irs intermediate sanctions regulations; (ii) evaluating system executivesother disqualified persons' cash compensation plans, policies, and programs; (iii) reviewing benefit plans for system executives and other disqualified persons; and (iv) verifying that compensation information is appropriately and fully disclosed. -a disqualified person: is any person who is or was in a position to exercise substantial influence over the affairs of the applicable tax-exempt organization. It is not necessary that the person actually exercise substantial influence, only that the person be in a position to do so. -for purposes of this charter, "executives" are defined as system executives and other disqualified persons validated by the committee. In discharging its role, the committee is empowered to investigate any matter brought to its attention with access to all books, records, facilities, and personnel of the system. It has the authority to retain outside advisors (e.g., legal counsel, compensation consultants, or other experts) and will receive adequate funding from the system to engage such advisors. It shall have the sole authority to retain, compensate, terminate, and oversee its advisors, who shall be accountable ultimately to the committee. To support the committee, a timetable and resource book will be developed containing the necessary data, information, and documents the committee will need to carry out its duties. The resource book will be distributed to the committee in advance of its meetings and fhs will maintain these books at its corporate office. The committee also will receive training in compensation plan design and administration, including legal and regulatory issues (as needed). Ii. Committee membership the committee is a standing committee of the board. In accordance with the corporate bylaws, it shall consist of at least three, but not more than five, members of the board. Each committee member has been determined by the board to be "independent" in accordance with irs intermediate sanctions regulations. At the start of the year, each member will review the organization's conflict of interest policy to ensure he or she has no conflict of interest and is "independent". If a real, potential, or perceived conflict of interest is identified, the committee member will review the issue with the committee chair and legal counsel to determine the appropriate action. In addition, no director may serve on the committee unless he or she is a "non-employee" member of a system board. The fhs board will appoint a committee chair to convene all sessions, set agendas for meetings, and determine the information needs of the committee. Before debating and voting on any compensation arrangement, each member shall determine whether he or she has a conflict of interest regarding the compensation arrangement. Any member with a conflict of interest regarding a particular compensation arrangement or transaction shall rec”
“Document availability: freeman health system does not make these documents available to the public.”
“Board member compensation: no directors receive compensation for their services as board members. Board members larry mcintire, joshua ball and john cox are employees of the organization and compensated as physicians. Additionally, paula baker receives compensation for her duties as president/ceo of both freeman health system and freeman neosho hospital.”
“Vision - to be the leading provider of patient centered, physician directed healthcare in an environment of compassion and trust, supported by dedicated employees with a desire to provide excellence in care and service. Freeman health system in joplin, missouri is a 404 bed, three hospital system providing comprehensive healthcare and behavioral health services to an area that includes more than 450,000 from missouri, arkansas, oklahoma, and kansas.”
“Program services: locally owned, not-for-profit and nationally recognized, freeman health system includes freeman hospital west, freeman hospital east, freeman neosho hospital, and ozark center-the areas largest provider of behavioral health services, as well as two urgent care clinics, dozens of physician clinics throughout the area, and a variety of specialty services. Freeman health systems mission is to improve the health of the communities it serves through contemporary, innovative, quality healthcare solutions. Freeman has a medical staff of more than 300 physicians representing more than 70 specialties. Freeman is a level ii stroke center, as designated by the missouri department of health and senior services. Freeman was the first hospital in the area to earn this distinction. This designation means the state has verified that freeman provides the highest level of rapid, expert care for patients with stroke/transient ischemic attack. Similarly, freeman is a level i stemi center, meaning it has demonstrated expertise in the coordinated care of patients experiencing the most serious kind of heart attack. Additionally, freeman is a level ii trauma center, and has a 24-bed nicu. As the only locally owned, not-for-profit health system in the area, freeman focuses on meeting the health and wellness needs of those it serves, as well as the needs of future generations. Freeman caregivers, leadership, and the board of directors play an active role in identifying the health needs of the region. Freeman is governed by a volunteer board of directors, who call the area home and rely on freeman for their own healthcare and the healthcare of their loved ones. Freeman is the only childrens miracle network hospital in a 70-mile radius. In fy19, freeman health system completed a project to expand magnetic resonance imaging services at freeman hospital west. To make room for the new equipment and upgrades, freeman renovated 425 square feet of existing space; added a third, more powerful "3t" machine; and upgraded an existing unit. 3t images can provide extremely clear and vivid images. The new mris are quieter, faster, and more comfortable, and they are ideal for imaging when minute details are especially critical to a patients diagnosis. Having three mris means patients can get in for scans more quickly because more patients can be seen at the hospital each day. The completion of this project enables freeman to improve the health of the community through the most advanced technologies, all with convenient access for patients and performed by a staff of compassionate, caring professionals. Freeman health system was honored with an "a" grade in both the spring and fall 2018 leapfrog group hospital safety score reports. The score rates how well hospitals protect patients from preventable errors, accidents, injuries, and infections. Additionally, freeman received dozens of awards in medical excellence and safety from carechex, an independent quality rating organization. The awards spanned a number of service lines, such as surgery, womens health, and trauma care, to name a few. Freeman was among the "top 100 in the nation in medical excellence" for bariatric surgery, chronic obstructive pulmonary disease (copd), gall bladder removal, general surgery, interventional carotid care, major bowel procedures, spinal fusion, and spinal surgery. In fy19, freeman health system was recognized as "high performing" in two areas in the "u.s. News & world report best hospitals assessment." the two areas of excellence are colon cancer surgery and treatment of obstructive pulmonary disease. This national distinction is a testament to the dedication and passion freeman caregivers have for their patients. Additionally, freeman health system was named a top teaching hospital by the leapfrog group. Freeman was one of two hospitals in missouri and 36 nationally to receive the honor. This award demonstrates freemans extraordinary dedication to patients and the lo”
“Outpatient services: emergency services the emergency department/trauma center at freeman hospital west treats approximately 45,000 patients each year. Emergency rooms routinely deal with homeless patients, mentally ill patients, and patients under the influence of drugs. Freeman places mental health counselors in the emergency room on an around-the-clock basis. These counselors are available to talk with patients who show signs of mental health or substance use conditions. After thorough evaluation, the counselors offer recommendations regarding follow-up care ranging from assessment of suicidality and need for inpatient psychiatric hospitalization to making outpatient therapy appointments for patients before they leave the emergency room. If evaluation mandates hospitalization, counselors help find appropriate accommodations and transportation. On average, counselors evaluate and recommend treatment for 54 psychiatric patients each week. As a result of this intervention, many previous frequent visitors to the emergency room have been redirected to appropriate psychiatric or substance use programs. Every two minutes, somewhere in america, someone is sexually assaulted. Freeman doctors and nurses offer compassionate and comprehensive care to victims of sexual assault in the emergency room through the sexual assault nurse examiner (sane) program. The program provides a coordinated hospital response and continuum of care for victims of sexual violence and ensures a medical evaluation, standardized forensic examination with evidence collection, and effective interface with law enforcement and advocacy services. It also provides education to local communities on sexual violence awareness, prevention, and available services. The nurse examiner reports the crime and/or collects evidence of the sexual assault only at the victims request. In partnership with lafayette house, the program also offers emergency shelter and services. On a related note, the freeman emergency room displays posters in conspicuous places to help human trafficking victims, in accordance with missouri house bill 1246. Additionally, emergency department nurses have been educated about human trafficking, including learning how to spot the warning signs and approach a suspected victim. This is important because nurses are some of the few professionals who might interact with human trafficking victims while they are still in captivity, and this training enables nurses help the victims. Many patients, who dont have a primary care physician, turn to the freeman emergency room for routine medical care. While freeman tries to educate the community on the benefits of using urgent care clinics and establishing a relationship with a primary care physician, many patients still visit the freeman emergency room for care of colds, stomach aches, bumps, and bruises that could be more efficiently treated in other venues. The cost of providing treatment in the emergency room setting is extremely expensive, and many of the patients seeking emergency care have no insurance. As a result, freeman health system often has to write off the cost of emergency treatment. Wes & jan houser womens pavilion for those needing a mammogram, bone density screening, or other diagnostic procedure, wes & jan houser womens pavilion provides care in a comfortable, soothing, compassionate, and respectful atmosphere. The freeman team of surgeons, radiologists, and registered mammography technologists use the latest technologies to ensure patients receive the best care, advice, and treatment. Wes & jan houser women's pavilion is designated as a breast imaging center of excellence by the american college of radiology (acr). By awarding facilities the status of breast imaging center of excellence, the acr recognizes breast imaging centers that have earned accreditation in mammography, stereotactic breast biopsy, and breast ultrasound. Many individuals without insurance cannot afford a mammogram for recomme”
“Outpatient services (continued): freeman bariatric center freeman bariatric center is accredited as a comprehensive center under the metabolic and bariatric surgery accreditation and quality improvement program (mbsaqip), a joint program of the american college of surgeons and the american society for metabolic and bariatric surgery. The first and only bariatric program in the area to be accredited, freeman bariatric center meets the highest standards for patient safety and quality of care. This accreditation signifies that the medical and surgical teams that work with patients affected by morbid obesity are highly-trained to offer personalized service and state-of-the-art care. Studies show patients have better weight-loss surgery outcomes in accredited bariatric surgical centers, which have undergone and passed rigorous evaluation in accordance with nationally recognized bariatric surgical standards. Accredited centers are also recognized for multidisciplinary teams with experts in areas such as nutrition and psychology to ensure a patients success after surgery. Freeman bariatric center offers free seminars on bariatric weight-loss surgery the second and fourth tuesday of each month. Spinal care services freeman neurospine began offering comprehensive spinal care services for patients with chronic back or neck pain, especially those who have not found relief through other treatments. The first and only service of its kind in the area, it utilizes a collaborative approach to address a patients total needs, from physical to emotional. This new service draws upon the expertise of an interdisciplinary team of specialists in neck and back problems, from physicians, neurosurgical nurse practitioners, physical therapists, counselors, and other highly trained spine care professionals. Together, the team develops a comprehensive, individualized treatment plan for each patient. Pediatric specialty care freeman health system partners with childrens mercy to enhance care for children in the four-state area. As part of this collaboration, childrens mercy opened a permanent location with several specialty clinics in joplin near the campus of freeman hospital west. These new joplin clinics, known as childrens kansas city, are an extension of childrens mercy, a nationally ranked pediatric medical center in kansas city, with full support of its 600 pediatric specialists. Pediatric specialties offered at the clinic include cardiology, endocrinology/diabetes, gastroenterology, hematology/oncology, nephrology, rheumatology and more. Convenient access to this caliber of pediatric specialty care not only improves outcomes for pediatric patients. It also saves families the expense and time involved with driving to kansas city for clinic appointments. School-based medicine freeman health system has entered into a school-based medicine partnerships with the carl junction schools, neosho schools, seneca schools, and mcdonald county schools to create greater access to healthcare for students and faculty alike. Increased access to medical services results in not only an environment of wellness for the school, but also for the entire community. Another benefit of school-based medicine is that it decreases time lost from the classroom for students and faculty needing medical attention. Additionally, this program can save parents from having to miss as much as a half-days work to take their children to a medical clinic or doctors office. Home care freeman home care has earned homecare elite status 10 times over the past several years. Homecare elite identifies the top 25 percent of medicare-certified agencies and highlights the top 100 and 500 overall. To make the list, home care providers are judged on quality of care, quality improvement, patient experience, best practices implementation, and financial management. Freeman home care has provided personalized home medical care for more than 30 years. Trained, cpr-certified professionals, including nurses”
“Inpatient services: freeman joplin inpatient services totaled 19,916 cases, of which, 3,868 or 19%, were medicaid cases. Additionally, 1,970 inpatient cases, or 10% of the total, fell into the self-pay (no insurance) category. Critical care patients rely on the intensive care unit (icu) for lifesaving treatment. In the icu, physicians lead critical care services and oversee the care of critically ill patients. Freemans specialized team of critical care physicians, nurses, and respiratory therapists provides exceptional care in the state-of-the-art, 33-bed icu, and 7-bed cardiovascular intensive care unit. Additionally, freeman hospital west offers a transitional care unit (tcu) for patients who are still too ill for the medical floor but have progressed to the point where they no longer need the level of care provided in the icu. Freeman joplin critical care services totaled 3,861 cases, of which, 360, or 9%, were medicaid cases. Additionally, 8% of the critical care cases fell into the self-pay (no insurance) category. Heart care freeman heart & vascular institute offers rapid, expert care when patients need it the most. Recognized by anthem blue cross and blue shield in missouri as a blue distinction center+ for cardiac care, freeman heart & vascular institute provides all cardiac services in one convenient location. Services include preventive care, emergency interventions, diagnostics, open-heart surgeries, structural heart clinic, rehabilitation, cardiology clinics, and education. Freeman began offering structural heart procedures in the first quarter of fy18. Cardiothoracic surgeons and cardiologists at freeman heart & vascular institute were the first in the area to perform the transcatheter aortic valve replacement (tavr) procedure. This minimally invasive technique gives hope to patients who suffer from severe aortic stenosis but are too frail for complex open heart surgery. Freeman heart & vascular institute freeman health system opened freeman heart & vascular institute in 1999 and has been a leader in heart care ever since. Serving an area that includes corners of four states, freeman heart & vascular institute brings lifesaving diagnostics and treatment to people where they live, enabling them to receive essential, high-quality heart care without the burden of traveling to larger metropolitan areas. Freeman heart & vascular institute has a proven track record of shaving minutes off the time it takes to restore blood flow and save precious heart muscle during myocardial infarction. In fact, the freeman team beats national door-to-balloon standards by more than 40 percent (national standard: 90 minutes, freeman: 44 minutes). After a heart attack, blood flow stops. The sooner doctors restore blood flow the better. Time is muscle and every wasted minute causes permanent heart damage. Freeman heart & vascular institute offers rapid, expert care when patients need it the most. Freeman heart & vascular institute provides all cardiac services in one convenient location, including preventive care, emergency interventions, diagnostics, open-heart surgeries, structural heart clinic, rehabilitation, cardiologist and cardiology clinics, education, and more. The facility, a three-story wing adjacent to freeman hospital west, includes cardiologist and cardiothoracic surgeon offices, three state-of-the-art operating suites and four cardiovascular catheterization labs. It also includes a cardiopulmonary rehabilitation unit that improves a patients ability to perform the normal activities of daily living. By teaching techniques for dealing with chest pain and shortness of breath, eating habits, cholesterol levels, and weight loss, freemans rehabilitation program provides a comfortable and familiar environment for recovery. Patients rely on freeman heart & vascular institute for a variety of noninvasive tests to diagnose heart disease and other conditions. Additionally, freeman serves patients with heart problems when they need help”
“Inpatient services (continued): hybrid cvor and structural heart program in late 2016, freeman health system completed upgrades to its state-of-the-art hybrid cardiovascular operating room (cvor) at freeman heart & vascular institute. This upgrade gave freeman maximum flexibility to use the treatments most appropriate for each patient, including structural heart procedures. This new set-up enabled physicians from different disciplines to merge their expertise in one room for the benefit of the patient. For instance, two teams-the cardiothoracic surgeons team and the cardiologists team, can work as one to achieve optimal results while improving patient care and efficiency. Access to minimally invasive procedures and complex procedures, along with accuracy, are key in successful cardiac outcomes. In its hybrid cvor, freeman uses a best-in-class cardiovascular x-ray imaging system with the flexibility and performance to meet any patients need. This system produces precise, high-resolution images that enable the heart-care team to perform procedures usually found at cardiac centers in university hospital settings. The systems design offers conformity to any patient, allowing for optimal angulations, streamlined positioning, and customizable configuration. In addition, ergonomic enhancements improve clinician speed and precision while reducing the potential for strain and injury. The system also includes a full suite of dose management optimization tools to facilitate safer exams for both the patient and the physician. Having the ability to perform simultaneous imaging studies and interventions in a cvor eliminates the need to move patients during a procedure and potentially reduces the risk of infection. Patients also benefit from shorter procedure times. By combining first-rate imaging capabilities within an advanced operating suite, freeman cardiothoracic surgeons have flexibility in real time to do whats best for the patient. This innovative environment also provides the potential to revolutionize the way freeman treats patients by integrating traditional cardiac surgery with endovascular surgery techniques and technology, further bridging the best of today with the latest advances of the future. Cardiothoracic surgeons and cardiologists at freeman heart & vascular institute are the first and only in the area to perform the transcatheter aortic valve replacement (tavr) procedure. This minimally invasive technique gives hope to patients who suffer from severe aortic stenosis, but who are too fragile for open heart surgery. Tavr is approved by the food and drug administration for individuals with aortic stenosis who are considered intermediate or high risk for standard valve replacement surgery. Untreated, aortic stenosis can be life-threatening. This condition occurs when calcium deposits narrow and stiffen the heart valve. In the summer of 2018, freeman heart & vascular institute celebrated one year of tavr procedures. In its first year, freemans tavr team completed more than 50 life-saving procedures. Because of tavr, patients were able to enjoy an improved quality of life. Clinical trials research is an integral part of the freeman heart and vascular program. Freeman hearth & vascular institute participates in many national studies of cardiovascular treatment. From time to time, patients may be offered the opportunity to participate in clinical trials. Heartwise patients often feel alarmed to learn they have a chronic cardiac condition. Although receiving this diagnosis can be frightening, it is treatable. While the heart no longer works as well as it should, many people live with this condition without ever suffering a heart attack. With the right team in place, the right medications and devices prescribed as needed, and the right lifestyle changes, patients can enjoy a healthy, happy life. Thats where heartwise, an initiative focused on empowering patients to better manage their chronic cardiac conditions, can help. Freeman”
“Inpatient services (continued): stroke care freeman health system was the first hospital in an 80-mile radius to be designated as a level ii stroke center by the missouri department of health & senior services. This certification means the state has verified that freeman is able to provide the highest level of expert care to patients who have experienced stroke or a tia. When stroke occurs, every minute matters and quality of care is vital. Timely treatment can mean the difference between returning to work or becoming permanently disabled, living at home or living in a nursing home. The state of missouri created the time critical diagnosis system to coordinate 911, emergency response, and hospitals to improve both the speed and quality of care to stroke patients. Freeman offers a free online stroke assessment to help people help learn about their risk of stroke. Because anyone can suffer a stroke, public education is vital. Freeman provides free stroke presentations to area businesses and organizations. Neurosciences freeman neurospine provides surgical and nonsurgical treatments for conditions ranging from back pain, work-related injuries, and carpal tunnel syndrome to stroke and complex spinal diseases. Freemans expert, multidisciplinary team includes neurosurgeons, neurologists, rehabilitation specialists, surgical assistants, physical therapists, massage therapists, and athletic trainers. Anthem blue cross blue shield of missouri named freeman health system as a blue distinction center for spine surgery. Hospitals designated as blue distinction centers for spine surgery demonstrate expertise in cervical and lumbar fusion, cervical laminectomy, and lumbar laminectomy/discectomy procedures, with fewer patient complications and hospital readmissions compared to their peers. Neurological surgeons at freeman have access to advanced tools in the or, including the o-arm imaging system. With the o-arm, neurosurgeons get cat scan images in the operating room that provide very accurate, detailed information about the spine. The o-arm provides a 360-degree picture of a complex structure. A lot of times, surgeons have to put complicated instrumentation into the spine and secure the spine in certain positions. The o-arm allows them to do that with great accuracy. Without this technology, some surgeries would be much more dangerous. Freeman pediatric unit the freeman pediatric unit provides care to children from birth to age 18 and works with families to make their children's hospitalization less traumatic by encouraging parental involvement. Chair beds in each room, as well as meal trays for parents, enable families to remain together during difficult times. Each room has a tv, and videos and video games are available upon request. The unit includes a brightly decorated examination room and a playroom filled with books and toys. Freeman joplin inpatient pediatric services totaled 224 cases, of which, 136, or 61%, were medicaid cases. Additionally, 4% of the pediatric inpatient cases fell into the self-pay (no insurance) category. Maternity services designed to give new mothers and their families the comforts of home within the security of a hospital, freeman maternity center delivered 2,043 babies in fy19. The unit includes board-certified obstetricians available 24 hours a day and perinatology care for women with high-risk pregnancies. In fy19, freeman maternity center served 846 medicaid patients, or 41% of its caseload. Self-pay patients (those with no insurance) represented 3% of the mothers delivering babies at freeman. As these statistics indicate, freeman provides a safety net for expectant mothers who live in poverty and receive government assistance and those who scrape by without assistance but have no health insurance. Medicaid reimbursement does not cover the cost of providing the level of treatment required. Anthem blue cross blue shield of missouri has recognized freeman health system as a blue distinction center+ for mat”
“Cancer care freeman cancer institute employs a social worker to help patients deal with the issues surrounding treatment and recovery. Freeman staff work with drug companies and other organizations to procure free cancer medications for patients who cannot afford them. To help catch breast cancer while it is treatable, the freeman helping friends mammogram fund, administered through freeman development office, provides mammograms for women who cant afford them. In fy 2019, helping friends mammogram fund helped 86 women by providing mammogram services that totaled $83,835. Patients facing cancer benefit from advanced treatment options provided by radiation oncology. Freeman has invested in the most recent, state-of-the-art technology available-the top-of-class truebeam linear accelerator, an innovative tool that enables doctors to use a radically different approach to treating cancer with image-guided radiotherapy. This precise technology provides improved outcomes, lower doses of radiation, and shorter treatment times. With this leading-edge radiotherapy system, freeman offers treatment that benefits patients by delivering enough radiation to eliminate a tumor while minimizing the amount of healthy tissue exposed to radiation. It is one of the most powerful and precise cancer treatment options in the area. Simple treatments that once took 15 minutes or more can be completed in less than two minutes after the patient is in position. Radiation therapy is used today in more than half of all cancer treatments due to its unique clinical advantages. In november of 2017, freeman health system became the first and only local hospital to offer high-dose rate (hdr) brachytherapy, a form of radiation therapy. Hdr brachytherapy enables doctors to deliver higher doses of radiation to specific areas of the body by placing radioactive sources inside the tumor cavity. During hdr brachytherapy, a high intensity radiation source is delivered through a catheter to the tumor site with millimeter precision through computer guidance. Since radiation is delivered directly to the cancer site, hdr brachytherapy treatment reduces the risk of damage to surrounding healthy tissue and organs. This translates to less time in the clinic, minimizing disruptions to patients and helping them return to everyday life more quickly. Treatment is delivered either once or twice per day for approximately one week. The radiation source is completely removed after each treatment. No radiation remains inside the body between treatments. Freeman cornell-beshore cancer institute was one of only four cancer centers in missouri to be recognized by the quality oncology practice initiative (qopi) certification program. The qopi certification program recognizes outpatient oncology practices that meet the highest standards for quality cancer care. Freeman cancer support group offers an opportunity for cancer patients, survivors, and family members to talk about their experiences and learn about support and resources in a caring and informative environment. Meetings, which are free and open to the public, are held monthly.”
“Common paymaster arrangement & salaries: freeman health system files all w-2's on behalf of freeman neosho hospital (fnh), a related organization. The amount of w-2's filed for the year on part v, line 2a, includes the amount of w-2's filed on behalf of fnh for those that work primarily for fnh and the w-2's filed for freeman health system employees. Salary and benefits expenses are allocated from freeman health system to fnh for those employees who work primarily for fnh.”
“Endowment funds: this endowment is used for nursing scholarships.”
“Uncertain tax positions: management has evaluated their income tax positions under the guidance included in asc 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.”
“Other revenue on line 1, but not on form 990, part viii, line 12: $ ( 2,000,000) grants paid ( 195,095) investment fees 307,855 investment in psc 947,911 net assets released from restriction ---------------- $ ( 939,329)”
“Other revenue on form 990, part viii, line 12, but not on line 1: $ ( 319,432) cost of goods sold ( 402,880) special events ( 659,384) rental expenses 960,330 temporarily restricted contributions 1,674,652 net psc revenue ---------------- $ 1,253,286”
“Other expenses on form 990, part ix, line 25, but not on line 1: other expenses on line 1, but not on form 990, part ix, line 25: $ 659,384 rental expenses 319,432 cost of goods sold 402,880 special events expense --------------- $ 1,381,696”
“Other expenses on form 990, part ix, line 25, but not on line 1: $ 1,366,798 psc expenses 2,000,000 grants paid -------------- $ 3,366,798”
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| IRS990/DeferredRevenueGrp/EOYAmt | 0 | 0 |
| IRS990/DelegationOfMgmtDutiesInd | 0 | false |
| IRS990/DepreciationDepletionGrp/FundraisingAmt | 0 | 25363 |
| IRS990/DepreciationDepletionGrp/ManagementAndGeneralAmt | 0 | 2143198 |
| IRS990/DepreciationDepletionGrp/ProgramServicesAmt | 0 | 13943373 |
| IRS990/DepreciationDepletionGrp/TotalAmt | 0 | 16111934 |
| IRS990/Desc | 0 | FREEMAN OFFERS OUTPATIENT SERVICES INCLUDING CANCER CARE, RADIATION ONCOLOGY, EMERGENCY MEDICINE, WOMENS SERVICES, GASTROENTEROLOGY, DIALYSIS, WOUND CARE, NEUROLOGY, ORTHOPAEDICS, OTOLARYNGOLOGY, GERIATRIC CARE, A PHARMACY, WALK-IN CLINICS, HOME CARE, OCCUPATIONAL MEDICINE, OUTPATIENT SURGERY, REHABILITATION THERAPIES, HEART AND VASCULAR SERVICES, RADIOLOGY, LABORATORY SERVICES, AND MORE. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. |
| IRS990/DescribedInSection501c3Ind | 0 | true |
| IRS990/DisregardedEntityInd | 0 | true |
| IRS990/DocumentRetentionPolicyInd | 0 | true |
| IRS990/DonorAdvisedFundInd | 0 | false |
| IRS990/ElectionOfBoardMembersInd | 0 | false |
| IRS990/EmployeeCnt | 0 | 4737 |
| IRS990/EmploymentTaxReturnsFiledInd | 0 | true |
| IRS990/EngagedInExcessBenefitTransInd | 0 | false |
| IRS990/EscrowAccountInd | 0 | false |
| IRS990/EscrowAccountLiabilityGrp/BOYAmt | 0 | 0 |
| IRS990/EscrowAccountLiabilityGrp/EOYAmt | 0 | 0 |
| IRS990/ExpenseAmt | 0 | 249202123 |
| IRS990/FamilyOrBusinessRlnInd | 0 | false |
| IRS990/FederalGrantAuditRequiredInd | 0 | false |
| IRS990/FeesForServicesAccountingGrp/ManagementAndGeneralAmt | 0 | 363620 |
| IRS990/FeesForServicesAccountingGrp/TotalAmt | 0 | 363620 |
| IRS990/FeesForServicesLegalGrp/ManagementAndGeneralAmt | 0 | 280741 |
| IRS990/FeesForServicesLegalGrp/TotalAmt | 0 | 280741 |
| IRS990/FeesForServicesLobbyingGrp/TotalAmt | 0 | 0 |
| IRS990/FeesForServicesManagementGrp/TotalAmt | 0 | 0 |
| IRS990/FeesForServicesOtherGrp/FundraisingAmt | 0 | 68670 |
| IRS990/FeesForServicesOtherGrp/ManagementAndGeneralAmt | 0 | 14846988 |
| IRS990/FeesForServicesOtherGrp/ProgramServicesAmt | 0 | 20582340 |
| IRS990/FeesForServicesOtherGrp/TotalAmt | 0 | 35497998 |
| IRS990/FeesForServicesProfFundraising/TotalAmt | 0 | 0 |
| IRS990/FeesForSrvcInvstMgmntFeesGrp/ManagementAndGeneralAmt | 0 | 335862 |
| IRS990/FeesForSrvcInvstMgmntFeesGrp/TotalAmt | 0 | 335862 |
| IRS990/ForeignActivitiesInd | 0 | false |
| IRS990/ForeignFinancialAccountInd | 0 | false |
| IRS990/ForeignGrantsGrp/TotalAmt | 0 | 0 |
| IRS990/ForeignOfficeInd | 0 | false |
| IRS990/Form8282PropertyDisposedOfInd | 0 | false |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 0 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 1 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 2 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 3 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 4 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 5 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 6 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 7 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 8 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 9 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 10 | 13.5 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 11 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 12 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 13 | 10.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 14 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 15 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 16 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 17 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 18 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 19 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 20 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 21 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 22 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 23 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 24 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt | 25 | 0.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 0 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 1 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 2 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 3 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 4 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 5 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 6 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 7 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 8 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 9 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 10 | 54.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 11 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 12 | 1.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 13 | 50.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 14 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 15 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 16 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 17 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 18 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 19 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 20 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 21 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 22 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 23 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 24 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 25 | 60.0 |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 5 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 6 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 7 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 8 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 9 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 10 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 11 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 12 | X |
| IRS990/Form990PartVIISectionAGrp/KeyEmployeeInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/KeyEmployeeInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/KeyEmployeeInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/KeyEmployeeInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/KeyEmployeeInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 5 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 6 | X |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 1 | 9032 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 2 | 28636 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 6 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 7 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 8 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 9 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 10 | 366903 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 11 | 24560 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 12 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 13 | 104775 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 14 | 63711 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 15 | 35442 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 16 | 56963 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 17 | 57106 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 18 | 44344 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 19 | 38173 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 20 | 25561 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 21 | 33079 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 22 | 24382 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 23 | 25509 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 24 | 35729 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 25 | 31879 |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 0 | LANCE BESHORE PHD |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 1 | LARRY MCINTIRE DO |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 2 | JOHN M COX DO |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 3 | RODNEY MCFARLAND MD |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 4 | JIM ARMSTRONG |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 5 | GLENN MITCH MCCUMBER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 6 | J SCOTT BROTHERS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 7 | GLENN BROWN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 8 | MARK WILLIAMS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 9 | JAMES FLEISCHAKER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 10 | PAULA F BAKER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 11 | JOSHUA BALL |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 12 | BRANDON C DAVIS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 13 | STEVE W GRADDY |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 14 | JEFFREY MICHAEL CARRIER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 15 | DENNIS A ESTEP |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 16 | MICHAEL J LEONE |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 17 | KEVIN P GAUDETTE |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 18 | WESLEY B BRAMAN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 19 | MARY A FRERER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 20 | LEONARD T ROLLINS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 21 | THOMAS B COY |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 22 | ROBERT C STAUFFER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 23 | WILLIAM J NICHOLAS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 24 | DARWIN JEYARAJ |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 25 | CHANCE L MATTHIESEN |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 1 | 416077 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 2 | 985427 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 6 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 7 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 8 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 9 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 10 | 1255901 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 11 | 1901295 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 12 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 13 | 551417 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 14 | 390070 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 15 | 348872 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 16 | 481685 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 17 | 340252 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 18 | 280900 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 19 | 234103 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 20 | 255069 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 21 | 1637609 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 22 | 1355197 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 23 | 2555079 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 24 | 1604674 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 25 | 1413923 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 6 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 7 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 8 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 9 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 10 | 313975 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 11 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 12 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 13 | 110283 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 14 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 15 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 16 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 17 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 18 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 19 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 20 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 21 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 22 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 23 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 24 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 25 | 0 |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 0 | CHAIR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 1 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 2 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 3 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 4 | SECRETARY/TREASURER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 5 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 6 | VICE CHAIR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 7 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 8 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 9 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 10 | PRESIDENT/CEO |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 11 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 12 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 13 | CFO |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 14 | CHIEF CLINICAL OFFICER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 15 | CMO |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 16 | CONTROLLER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 17 | VP REVENUE CYCLE |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 18 | VP BUSINESS DEVELOPMENT |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 19 | CHIEF HUMAN RESOURCE OFFICER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 20 | CHIEF INFORMATION OFFICER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 21 | PHYSICIAN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 22 | PHYSICIAN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 23 | PHYSICIAN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 24 | PHYSICIAN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 25 | PHYSICIAN |
| IRS990/Form990ProvidedToGvrnBodyInd | 0 | true |
| IRS990/Form990TFiledInd | 0 | true |
| IRS990/FormationYr | 0 | 1922 |
| IRS990/FormerOfcrEmployeesListedInd | 0 | false |
| IRS990/FSAuditedBasisGrp/ConsolidatedBasisFinclStmtInd | 0 | X |
| IRS990/FSAuditedInd | 0 | true |
| IRS990/FundraisingActivitiesInd | 0 | true |
| IRS990/FundraisingAmt | 0 | 121486 |
| IRS990/FundraisingDirectExpensesAmt | 0 | 402880 |
| IRS990/FundraisingGrossIncomeAmt | 0 | 462284 |
| IRS990/GainOrLossGrp/OtherAmt | 0 | 42055 |
| IRS990/GainOrLossGrp/SecuritiesAmt | 0 | 2857653 |
| IRS990/GamingActivitiesInd | 0 | false |
| IRS990/GamingDirectExpensesAmt | 0 | 0 |
| IRS990/GamingGrossIncomeAmt | 0 | 0 |
| IRS990/GoverningBodyVotingMembersCnt | 0 | 13 |
| IRS990/GrantAmt | 0 | 3419851 |
| IRS990/GrantsPayableGrp/BOYAmt | 0 | 0 |
| IRS990/GrantsPayableGrp/EOYAmt | 0 | 0 |
| IRS990/GrantsToDomesticIndividualsGrp/ProgramServicesAmt | 0 | 283359 |
| IRS990/GrantsToDomesticIndividualsGrp/TotalAmt | 0 | 283359 |
| IRS990/GrantsToDomesticOrgsGrp/ProgramServicesAmt | 0 | 3136492 |
| IRS990/GrantsToDomesticOrgsGrp/TotalAmt | 0 | 3136492 |
| IRS990/GrantsToIndividualsInd | 0 | true |
| IRS990/GrantsToOrganizationsInd | 0 | true |
| IRS990/GrantToRelatedPersonInd | 0 | false |
| IRS990/GrossAmountSalesAssetsGrp/OtherAmt | 0 | 53954 |
| IRS990/GrossAmountSalesAssetsGrp/SecuritiesAmt | 0 | 77857849 |
| IRS990/GrossReceiptsAmt | 0 | 629924176 |
| IRS990/GrossRentsGrp/RealAmt | 0 | 2619631 |
| IRS990/GrossSalesOfInventoryAmt | 0 | 565939 |
| IRS990/GroupReturnForAffiliatesInd | 0 | false |
| IRS990/IncludeFIN48FootnoteInd | 0 | false |
| IRS990/IncmFromInvestBondProceedsGrp/ExclusionAmt | 0 | 283774 |
| IRS990/IncmFromInvestBondProceedsGrp/TotalRevenueColumnAmt | 0 | 283774 |
| IRS990/IndependentAuditFinclStmtInd | 0 | false |
| IRS990/IndependentVotingMemberCnt | 0 | 8 |
| IRS990/IndivRcvdGreaterThan100KCnt | 0 | 307 |
| IRS990/IndoorTanningServicesInd | 0 | false |
| IRS990/InfoInScheduleOPartIIIInd | 0 | X |
| IRS990/InfoInScheduleOPartVIIInd | 0 | X |
| IRS990/InfoInScheduleOPartVIInd | 0 | X |
| IRS990/InfoInScheduleOPartVInd | 0 | X |
| IRS990/InformationTechnologyGrp/ManagementAndGeneralAmt | 0 | 141135 |
| IRS990/InformationTechnologyGrp/TotalAmt | 0 | 141135 |
| IRS990/InsuranceGrp/ManagementAndGeneralAmt | 0 | 7137617 |
| IRS990/InsuranceGrp/ProgramServicesAmt | 0 | 3042328 |
| IRS990/InsuranceGrp/TotalAmt | 0 | 10179945 |
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Displayed year
2019 • Form 990Detailed filing. Detailed filing data is available for this year.