Covered Entity Details

SCH260034-03 BATES COUNTY MEMORIAL HOSPITAL (Approved) - information as of 6/12/2025 5:56:40 AM

Main Details

Name

BATES COUNTY MEMORIAL HOSPITAL

Subdivision Name

BATES COUNTY MEMORIAL HOSPITAL - Family Care Clinic Nursery Street

Type

Sole Community Hospital

Rural

Yes

340B ID

SCH260034-03

Medicare Provider Number

260034

Outpatient Facility Provider Number

268606

Additional Details

Current Program Status

Approved

Registration Date

4/2/2025

Participating Start Date

7/1/2025

Participating Approval Date

5/5/2025

Last Recertification Date

Contacts

Authorizing Official

Bates County Memorial Hospital
Greg Weaver, CEO
(660) 200-7105

Primary Contact

Bates County Memorial Hospital
Jennifer Wainscott, Director of Finance
(660) 200-7002

Addresses

Street Address

617 W NURSERY ST
BUTLER, MO 64730-1840

Billing Address

Bates County Memoiral Hospital
615 W. Nursery St
P.O. box 370
Butler, MO 64730

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
The information entered for the Total Cost and Outpatient Charges for Line 88.00 are incorrect. Please update the information and submit the registration again. Hospitals registering outpatient facilities are asked to enter several figures from Worksheet A and Worksheet C from the latest filed Medicare cot report as well as a trial balance. Total costs from the cost center/line associated with the site being registered are found on Worksheet A, column 7. ($4,133,597) Outpatient charges associated with the cost center line being registered are found on Worksheet C, column 7. ($3,922,233) If the costs and charges from more than one clinic, service or facility are rolled up to a single cost center, you will need the specific costs and charges from the working trial balance. Please return this registration by 5/7/25. If you are unable to act on this record for any reason, please provide an explanation in the review box and return it to OPA. Records returned without action will be rejected. Thank you.	05/02/2025

Comment

Last Updated On

The information entered for the Total Cost and Outpatient Charges for Line 88.00 are incorrect. Please update the information and submit the registration again. Hospitals registering outpatient facilities are asked to enter several figures from Worksheet A and Worksheet C from the latest filed Medicare cot report as well as a trial balance. Total costs from the cost center/line associated with the site being registered are found on Worksheet A, column 7. ($4,133,597) Outpatient charges associated with the cost center line being registered are found on Worksheet C, column 7. ($3,922,233) If the costs and charges from more than one clinic, service or facility are rolled up to a single cost center, you will need the specific costs and charges from the working trial balance. Please return this registration by 5/7/25. If you are unable to act on this record for any reason, please provide an explanation in the review box and return it to OPA. Records returned without action will be rejected. Thank you.

05/02/2025

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
SCH260034-01	Child	SCH	BATES COUNTY MEMORIAL HOSPITAL	BATES COUNTY MEMORIAL HOSPITAL - Rich Hill Family Care Clinic	225 N 14TH ST	RICH HILL	MO	Approved
SCH260034-02	Child	SCH	BATES COUNTY MEMORIAL HOSPITAL	BATES COUNTY MEMORIAL HOSPITAL - Family Care Clinic Adrian	102 E MAIN ST	ADRIAN	MO	Approved
SCH260034-03	Child	SCH	BATES COUNTY MEMORIAL HOSPITAL	BATES COUNTY MEMORIAL HOSPITAL - Family Care Clinic Nursery Street	617 W NURSERY ST	BUTLER	MO	Approved
SCH260034-04	Child	SCH	BATES COUNTY MEMORIAL HOSPITAL	BATES COUNTY MEMORIAL HOSPITAL - Family Care Clinic High Street	706 S HIGH ST	BUTLER	MO	Approved

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		Weaver, Greg CEO Bates County Memorial Hospital 6602007105	5/5/2025 9:35 AM
Details	340B ID	Update	New Registration		SCH260034-03	5/5/2025 9:35 AM
Details	Entity Subname	Update	New Registration	BATES COUNTY MEMORIAL HOSPITAL	BATES COUNTY MEMORIAL HOSPITAL - Family Care Clinic Nursery Street	5/5/2025 9:35 AM
Dates	Participating Approval Date	Update	New Registration		5/5/2025 9:35:51 AM	5/5/2025 9:35 AM
Details	State	Update	New Registration	Pending	Approved	5/5/2025 9:35 AM
Dates	Signed By Date	Update	New Registration		5/3/2025 12:20:35 PM	5/5/2025 9:35 AM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	5/5/2025 9:35 AM
Details	Comments Public	Insert	New Registration		The information entered for the Total Cost and Outpatient Charges for Line 88.00 are incorrect. Please update the information and submit the registration again. Hospitals registering outpatient facilities are asked to enter several figures from Worksheet A and Worksheet C from the latest filed Medicare cot report as well as a trial balance. Total costs from the cost center/line associated with the site being registered are found on Worksheet A, column 7. ($4,133,597) Outpatient charges associ	5/2/2025 10:01 AM
Addresses	Main Address	Insert	New Registration		617 W NURSERY ST BUTLER, MO 64730-1840	4/2/2025 12:54 PM
Addresses	Billing Address	Insert	New Registration		Bates County Memoiral Hospital 615 W. Nursery St P.O. box 370 Butler, MO 64730	4/2/2025 12:54 PM
Contacts	Authorizing Official	Insert	New Registration		Weaver, Greg CEO Bates County Memorial Hospital 6602007105	4/2/2025 12:54 PM
Contacts	Primary Contact	Insert	New Registration		Wainscott, Jennifer Director of Finance Bates County Memorial Hospital 6602007002	4/2/2025 12:54 PM
Details	Assistance Received From Date	Insert	New Registration			4/2/2025 12:54 PM
Details	Assistance Received To Date	Insert	New Registration			4/2/2025 12:54 PM
Details	Last Recertification Date	Insert	New Registration			4/2/2025 12:54 PM
Details	Grant Number	Insert	New Registration			4/2/2025 12:54 PM
Details	340B ID	Insert	New Registration			4/2/2025 12:54 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/2/2025 12:54 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/2/2025 12:54 PM
Details	Medicare Provider Number	Insert	New Registration		260034	4/2/2025 12:54 PM
Details	Entity Name	Insert	New Registration		BATES COUNTY MEMORIAL HOSPITAL	4/2/2025 12:54 PM
Details	NOFO Number	Insert	New Registration			4/2/2025 12:54 PM
Details	Program Code	Insert	New Registration		SCH	4/2/2025 12:54 PM
Details	Entity Subname	Insert	New Registration		BATES COUNTY MEMORIAL HOSPITAL	4/2/2025 12:54 PM
Dates	Participating Approval Date	Insert	New Registration			4/2/2025 12:54 PM
Details	State	Insert	New Registration		Pending	4/2/2025 12:54 PM
Dates	Registration Date	Insert	New Registration		4/2/2025 12:54:09 PM	4/2/2025 12:54 PM
Dates	Signed By Date	Insert	New Registration			4/2/2025 12:54 PM
Dates	Start Date	Insert	New Registration			4/2/2025 12:54 PM
Terminations	Termination Comments	Insert	New Registration			4/2/2025 12:54 PM
Terminations	Termination Date	Insert	New Registration			4/2/2025 12:54 PM
Terminations	Termination Effective Date	Insert	New Registration			4/2/2025 12:54 PM
Terminations	Termination Reason	Insert	New Registration			4/2/2025 12:54 PM