Missouri Highlands Health Care
Legal name: Big Springs Medical Association Inc
Nonprofit profile at a glance
- EIN
- 431068291
- IRS 990 coverage
- 2010–2024
- Official website data refreshed
- Sep 2026
- Forms available
- Form 990 2024, Form 990-T 2024
- Location
- Ellington, MO, US
- Phone
- 573.663.2313
- Rating
- 77
- Verdict
- SUPPORTED
- Rating confidence
- Moderate
Reported finances
- Revenue
- $43,452,434
- Expenses
- $41,658,678
- Assets
- $30,464,594
- Liabilities
- $5,607,308
Source: IRS Form 990. Selected filing: tax year 2024. Amounts in USD.
Leadership & pay
22 people listed
Executive titles in this filing
- CURT MAJORS (VICE-PRESIDENT)
- MICHAEL MORTON (PRESIDENT)
- KAREN WHITE (CHIEF EXECUTIVE OFFICER)
Highest reported compensation
- JOSH GAST (MEDICAL DIRECTOR): $646,554 total reported compensation
- VANESSA GIVENS (OB/GYN END 07/24): $379,486 total reported compensation
- FARRAH MCSPADDEN (OB/GYN END 07/24): $371,171 total reported compensation
Source: IRS Form 990. Selected filing: tax year 2024. Names and roles reflect this filing, not necessarily current officeholders.
Overview
Mission
To provide compassionate, high-quality healthcare to rural communities in Missouri, addressing unique health challenges through primary care, preventive care, behavioral health, and dental services.
What it reported doing in 2024
Big springs medical association provides medical services to residents of ellington, Missouri, and the surrounding areas. Some specific medical services that big springs medical association offers include: telehealth, community health and education, and patient pharmaceuticals assistance program. See schedule o for further details on these program services. During fiscal year 2025 the organization had 75,459 medical care and mental health visits combined. Telehealth through an arrangement made possible by the university of Missouri-columbia and the Missouri primary care association. See schedule o for additional detail.
Operating model
- Revenue model
- Other-operating. 76% of the money available for current operations came from other operating revenue.
- Distribution model
- Direct operator. The filing allocates 100% of reported program-service expenses outside its grant, affiliate-payment, and member-benefit lines. This expense classification does not rule out separately announced grant awards.
- Includes noncash contributions: Reported contributions include donated property or goods.
The verdict
SUPPORTED - The filed numbers largely add up and a large share of available resources goes toward mission work. Some filing-based governance responses are negative or unanswered and expenses are high relative to revenue.
Rating breakdown
- Financial Efficiency: 61
- Transparency & Controls: 90
- Accountability: 91
- Sustainability: 43
- Growth: 100
Detailed rating inputs
Financial Efficiency
- Mission deployment rate: 67.7%; rating input score 68
- Program expense ratio: 71.1%; rating input score 71
- Fundraising efficiency: Limited
Transparency & Controls
- Consistency checks: 100%; rating input score 100; 62nd percentile among comparable filings
- Pay-setting controls: 4 of 6 controls in place; rating input score 67
- Compensation committee: Pass
- Independent consultant: Missing
- Other Form 990s reviewed: Missing
- Written employment contract: Pass
- Compensation survey or study: Pass
- Board or committee approval: Pass
- Foreign activity oversight: Limited
- Grant itemization coverage: Limited
- Major donor itemization: Yes; rating input score 100
- Related-party transparency: Limited
Accountability
- Independent voting board: 100%; rating input score 100; 66th percentile among comparable filings
- Governance controls: 7 of 9 controls in place; rating input score 78
- Conflict-of-interest policy: Pass
- Whistleblower policy: Pass
- Document-retention policy: Pass
- CEO compensation review process: Pass
- Other executive compensation review process: Fail
- Form 990 shared with the board: Fail
- Board meeting minutes documented: Pass
- Audit committee oversight: Pass
- Independent financial-statement audit: Pass
Sustainability
- Operating margin: 4.1%; rating input score 51; 51st percentile among comparable filings
- Total-asset coverage ratio: 0.73; rating input score 26; 26th percentile among comparable filings
- Liabilities to assets ratio: 0.18; rating input score 61; 61st percentile among comparable filings
- Officer compensation ratio: 6.7%; rating input score 38; 38th percentile among comparable filings
Growth
- Program expense growth: 15.9% per year; rating input score 100; 85th percentile among comparable filings
- Revenue growth: 13.4% per year; rating input score 100; 83rd percentile among comparable filings
- Asset growth: 10.7% per year; rating input score 100; 68th percentile among comparable filings
Details
- What they do: 9 programs and campaigns described on the official site · 1 operating location identified
- Where the money goes: 67.7% of revenue deployed · 71.1% of spending went to programs
- Governance: 10 of 10 board members independent · 7 of 9 filing controls reported
- Programs: 3 filed program accomplishments · $29.6M in reported program spending
- Leadership: top reported pay $647K · 22 people listed · 4 of 6 pay-setting controls reported
- Highest-paid contractors: 5 contractors listed · $2.7M reported
- Consistency: 36 of 36 current checks pass
- Schedules: 7 filed schedules · includes major donors and executive pay
- Filing history: 15 filing years from 2010 to 2024
- Contacts: How to reach this organization
- Money network: 8 filed money-flow records
- Related organizations: Filed and resolved organization relationships.
- Grant readiness: Federal tax and exclusion status, award history, and grant-maker relationships.
- People: Everyone the filings name, and which of them the filings identify by more than a name.
- Staff and benefit plans: Retirement and health plans the organization files with the Department of Labor, and the people in them.
Key Signals
Signals prioritize questions for review. They are not findings of misconduct.
Grant-readiness screening is separate from the live rating, not a measure of program quality. Review the source records before making a grant decision.
- Review — Accountability: Governance controls: 2 of 9 not reported.
- Review — Sustainability: Operating margin scored 51/100.
- High — Sustainability: Total-asset coverage ratio scored 26/100.
- Moderate — Sustainability: Officer compensation ratio scored 38/100.
- High — Grant Readiness: Federal audit findings: this organization reported findings in its latest federal Single Audit.