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SEE SCHEDULE O FOR ADDITIONAL INFORMATION. false false 113816239 148878789 LAKE REGIONAL HEALTH SYSTEM PROVIDES OUTPATIENT SERVICES SUCH AS DIAGNOSTIC IMAGING, LABORATORY AND PHYSICAL THERAPY SERVICES TO THE COMMUNITY AND SURROUNDING RURAL AREAS. THE HOSPITAL PROVIDED A TOTAL OF 372,932 OUTPATIENT SERVICE VISITS. THE HOSPITAL PROVIDED COVID-19 TESTING AND IP TREATMENT SERVICES DURING ITS 2023 FISCAL YEAR. 55883463 60482008 LAKE REGIONAL HEALTH SYSTEM PROVIDES INPATIENT SERVICES TO THE COMMUNITY AND SURROUNDING RURAL AREAS. THE HOSPITAL PROVIDED 18,677 INPATIENT DAYS, 2,329 SKILLED NURSING FACILITY INPATIENT DAYS AND 1,147 NURSERY PATIENT DAYS FOR A TOTAL OF 22,153 INPATIENT DAYS. 9559215 23262311 LAKE REGIONAL HEALTH SYSTEM'S EMERGENCY DEPARTMENT IS A LEVEL III TRAUMA CENTER (GRANTED THROUGH A SPECIAL STATE CREDENTIALING PROCESS REQUIRING EXTENSIVE EDUCATION AND SERVICE REVIEW) PROVIDING 24-HOUR EMERGENCY MEDICAL SERVICE TO A FIVE COUNTY AREA. THE UNIVERSITY OF MISSOURI STAFF FOR LIFE HELICOPTER IS BASED HERE. 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THIS CONTRIBUTION INCLUDED THE DONOR RESTRICTION THAT THE ENDOWMENT WOULD BE ESTABLISHED WITH THE INTENTION OF GENERATING INVESTMENT INCOME TO BE USED IN THE DAILY OPERATIONS OF THE ORGANIZATION AND THE PRINCIPLE OF THE ENDOWMENT FUND WOULD REMAIN IN PERPETUITY. SCHEDULE D, PART X, LINE 2 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. true true X true X false true true true false false 4948568 4948568 0.02100 39655612 34547553 5108059 0.02170 44604180 34547553 10056627 0.04270 87316 25794 61522 0.00030 986381 986381 0.00420 189511 189511 0.00080 1263208 25794 1237414 0.00530 45867388 34573347 11294041 0.04800 false 22109839 4052733 53031097 55773870 -2742773 X true true LAKE REG IMAGING PTR DIAGNOSTIC IMAGING SERVICES 0.51 0.49 1 1 LAKE REGIONAL HEALTH SYSTEM 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 WWW.LAKEREGIONAL.COM 291-35 X X X LAKE REGIONAL HEALTH SYSTEM 1 false false true X X X X X X X X X 21 true false false true X SEE PART V SUPPLEMENTAL INFO true 21 true SEE PART V SUPPLEMENTAL INFO false true X 200. 0. X X X true true X X X true X SEE PART V SUPPLEMENTAL INFO X SEE PART V SUPPLEMENTAL INFO X SEE PART V SUPPLEMENTAL INFO X X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY REPRESENTATION: FROM MAY TO JULY 2021, A TOTAL OF 724 COMMUNITY SURVEYS WERE COLLECTED ONLINE AND VIA PAPER COPY. THE SURVEY WAS INTENDED TO YIELD INFORMATION ABOUT THE OVERALL HEALTH OF THE COMMUNITY. SURVEY TOPICS INCLUDE DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS, BEHAVIORAL RISK FACTORS, HEALTH CONDITIONS, RESPONSE TO COVID-19, AND ACCESS TO HEALTH CARE. NOTICE OF THE SURVEY WAS SHARED WITH THE COMMUNITY THROUGH LOCAL MEDIA AND SOCIAL MEDIA. TO REACH LOW-INCOME, MEDICALLY UNDERSERVED AND CHRONICALLY ILL POPULATIONS, A PAPER VERSION OF THE SURVEY WAS DISTRIBUTED AT SUPPORT GROUPS, COMMUNITY EVENTS, COUNTY HEALTH DEPARTMENT SITES, A FREE CLINIC SITE, A FEDERALLY-QUALIFIED HEALTH CENTER AND LAKE REGIONAL PRIMARY CARE CLINICS. THE ONLINE SURVEY WAS SHARED WITH LAKE-AREA COMMUNITY PARTNERS, INCLUDING SCHOOL DISTRICTS; POPULATION HEALTH PARTNERS, INCLUDING COUNTY HEALTH DEPARTMENTS; AND BUSINESS PARTNERS, INCLUDING CHAMBERS OF COMMERCE. LAKE REGIONAL EMPLOYEES ALSO PARTICIPATED IN THE SURVEY. ADDITIONALLY, DIRECT INTERVIEWS WITH LOCAL FIRST RESPONDERS, BUSINESS OWNERS, SCHOOL HEALTH COORDINATORS, AND OTHER HEALTH ORGANIZATION REPRESENTATIVES ALSO WERE RECORDED SCHEDULE H, PART V, SECTION B, LINE 7A CHNA WEBSITE: HTTPS://WWW.LAKEREGIONAL.COM/ABOUT-US/REPORTS/ SCHEDULE H, PART V, LINE 10A IMPLEMENTATION STRATEGY WEBSITE: HTTPS://WWW.LAKEREGIONAL.COM/ABOUT-US/REPORTS/ SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING IDENTIFIED NEEDS: LAKE AREA COMMUNITY HEALTH PARTNERS MET IN AUGUST 2021 TO REVIEW THE DATA COLLECTED FROM SECONDARY RESEARCH AND THE COMMUNITY NEEDS ASSESSMENT SURVEY. THE COMMITTEE INCLUDED LAKE REGIONAL EMPLOYEES; LOCAL HEALTH DEPARTMENT ADMINISTRATORS; AND A REPRESENTATIVE FROM A FEDERALLY-QUALIFIED HEALTH CENTER. COMMON THEMES WERE IDENTIFIED, SCORED AND WEIGHTED TO PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. THE TOP COMMUNITY HEALTH PRIORITIES IDENTIFIED WERE: - MENTAL HEALTH - ACCESS TO HEALTH CARE - ABILITY TO PAY AND/OR LACK OF INSURANCE MENTAL HEALTH WAS CITED AS THE HIGHEST PRIORITY NEED TO BE ADDRESSED. THE AREA FACES LIMITED RESOURCES FOR TREATMENT OF MENTAL HEALTH, INCLUDING LACK OF ACCESS TO BEHAVIOR HEALTH SPECIALISTS. GOALS RELATED TO MENTAL HEALTH INCLUDED: INCREASE STAFF AND COMMUNITY KNOWLEDGE ABOUT RISK FACTORS AND WARNING SIGNS OF MENTAL ILLNESS, AS WELL AS HOW TO INTERACT WITH A PERSON IN CRISIS. OFFER MONTHLY SUPPORT GROUP MEETINGS TO ASSIST INDIVIDUALS IN ENHANCING COPING SKILLS FOLLOWING PHYSICAL, MENTAL AND/OR EMOTIONAL TRAUMA, THROUGH EDUCATION, MUTUAL SUPPORT AND INFORMATION SHARING IN A CONFIDENTIAL SETTING. CONNECT BEHAVIORAL HEALTH PATIENTS TO COUNSELING AND COMMUNITY RESOURCES. ACCESS TO HEALTH CARE WAS CITED AS ONE OF THE MOST PRESSING HEALTH CONCERNS AS IT RELATES TO LACK OF HEALTH PROVIDERS OR RECEIVING MEDICAL ATTENTION IN A TIMELY MANNER. GOALS RELATED TO ACCESS TO HEALTH CARE INCLUDED: EXPANSION IN LACLEDE COUNTY, INCLUDING BUILDING A NEW CLINIC INCLUDING SPECIALTY, REHAB, AND OTHER SERVICES. OUTREACH SERVICES IN LACLEDE COUNTY, INCLUDING CARDIAC AND ORTHOPEDIC SERVICES CURRENTLY AND PLANS TO ADD GASTROENTEROLOGY, NEPHROLOGY, AND SLEEP MEDICINE. TELEHEALTH EXPANSION AND PROMOTION AT ALL SPECIALTY AND PRIMARY CARE CLINICS. ABILITY TO PAY FOR HEALTH CARE AND LACK OF INSURANCE WAS CITED AS ANOTHER ONE OF THE MOST PRESSING HEALTH CONCERNS AND RELATES TO ECONOMIC FACTORS INCLUDING LOW-PAYING JOBS, SEASONAL EMPLOYMENT, HIGH HEALTH-CARE COSTS, LIMITED LOW-COST HOUSING AND AFFORDABILITY OF BASIC NECESSITIES. GOALS RELATED TO ABILITY TO PAY INCLUDED: EDUCATE LAKE REGIONAL STAFF AND COMMUNITIES REGARDING ASSISTANCE PROGRAMS, AS WELL AS FREE, LOW-COST, AND SLIDING SCALE CLINICS AND SERVICES. OFFERING FINANCIAL ASSISTANCE THROUGH COMMERCE BANK HEALTH SERVICES FINANCING PROGRAM. MISSOURI HEALTHNET EXPANSION AND ENROLLMENT SCHEDULE H, PART V, SECTION B, LINE 13H FACTORS USED IN DETERMINING BASIS FOR AMOUNTS CHARGED TO PATIENTS: FINANCIAL ASSISTANCE WILL BE CONSIDERED ON CATASTROPHICALLY NEEDY PATIENTS ON A CASE-BY-CASE BASIS. THE HOSPITAL WILL USE PRESUMPTIVE ELIGIBILITY WHEN A PATIENT IS PROVEN TO HAVE THE FOLLOWING CIRCUMSTANCES: -HOMELESS OR RECEIVING CARE FORM A HOMELESS CLINIC -PARTICIPATION IN WOMEN'S INFANTS AND CHILDREN'S PROGRAMS (WIC) -FOOD STAMP ELIGIBILITY -ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G. MEDICAID SPEND-DOWN) -LOW INCOME/SUBSIDIZED HOUSING (SECTION 8) IS PROVIDED AS A VALID ADDRESS -PATIENT IS DECEASED WITH NO KNOWN ESTATE -INCARCERATED PRISONERS NOT EXPECTED TO BE RELEASED SOON -MENTALLY INCAPACITATED SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C URL: HTTP://LAKEREGIONAL.COM/PATIENTS/PATIENT-RESOURCES/FINANCIAL-SERVICES/ UNINSURED-PATIENTS/DEFAULT.ASPX SCHEDULE H, PART V, SECTION B, LINE 16I LEP TRANSLATIONS: THERE ARE NO GROUPS WITH LIMITED ENGLISH PROFICIENCY THAT RISE TO THE THRESHOLD REQUIRED UNDER IRC SECTION 501(R). HOWEVER, A SPANISH TRANSLATION IS AVAILABLE. SCHEDULE H, PART V, SECTION B, LINE 16J OTHER METHODS OF PUBLICIZING CHARITY CARE POLICY: ALL PATIENTS THAT ARE IN A ROOM HAVE ACCESS TO A BINDER THAT EXPLAINS THE FINANCIAL ASSISTANCE POLICY. 5 LAKE REGIONAL IMAGING PARTNERS 54 HOSPITAL DR OSAGE BEACH MO 65065 IMAGING CENTER ELDON REHAB THERAPY 304 EAST 4TH STREET ELDON MO 65026 REHAB THERAPY LAKE OZARK REHAB THERAPY 1870 BAGNELL DAM BLVD LAKE OZARK MO 65049 REHAB THERAPY LAURIE REHAB THERAPY 156 MISSOURI BLVD LAURIE MO 65038 REHAB THERAPY CAMDENTON REHAB THERAPY 1930 N BUSINESS ROUTE 5 CAMDENTON MO 65020 REHAB THERAPY SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: THE PERCENT OF TOTAL EXPENSE ON SCHEDULE H, PART I, LINE 7, COLUMN (F), WAS CALCULATED USING TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A). SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEET 1, 3, AND 6. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HEALTH SYSTEMS DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HEALTH SYSTEM'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED APRIL 30, 2023. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: LINE 3 WAS DETERMINED BY TAKING THE BAD DEBT EXPENSE (LINE 2) TIMES THE PERCENT OF PERSONS BELOW THE POVERTY LEVEL BASED ON US CENSUS BUREAU DATA. SCHEDULE H, PART III, SECTION A, 4 BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENTS ACCOUNTS RECEIVABLE, THAT NOTE CAN BE FOUND ON PAGE 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION B, LINE 8 COMMUNITY BENEFIT: MEDICARE DATA COMPUTED USING THE MEDICARE COST REPORT FILED WITH CMS WAS UTILIZED FOR THE COMPUTATIONS IN PART III, SECTION B. MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT, AS LRHS IS CLASSIFIED AS A RURAL REFERRAL CENTER AND SOLE COMMUNITY HOSPITAL, AND ALTERNATIVELY COULD QUALIFY AS A MEDICARE-DEPENDENT HOSPITAL. THIS DEMONSTRATES THAT LRHS IS THE ONLY REASONABLE SOURCE OF HOSPITAL CARE AVAILABLE TO MEDICARE BENEFICIARIES IN OUR SERVICE AREA, AND LIKEWISE TREATS ALL BENEFICIARIES IN OUR SERVICE AREA THAT PRESENT THEMSELVES FOR CARE, DESPITE KNOWING WE WILL GENERALLY LOSE MONEY FOR CARING FOR MEDICARE PATIENTS. ADDITIONALLY, SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SCHEDULE H, PART VI, SECTION C, LINE 9B COLLECTION POLICY: COLLECTION ACTIVITY WILL BE SUSPENDED DURING THE CONSIDERATION OF COMPLETED FINANCIAL ASSISTANCE APPLICATION OR AN APPLICATION FOR ANY OTHER HEALTHCARE BRACKET (I.E. MEDICARE, MEDICAID, ETC.) A NOTE WILL BE ENTERED INTO THE PATIENT'S ACCOUNT TO SUSPEND COLLECTION ACTIVITY UNTIL THE FINANCIAL ASSISTANCE PROCESS IS COMPLETE. IF THE ACCOUNT HAS BEEN PLACED WITH A COLLECTION AGENCY, THE AGENCY WILL BE NOTIFIED TO SUSPEND COLLECTION EFFORTS UNTIL A DETERMINATION IS MADE. THIS NOTIFICATION WILL BE DOCUMENTED IN THE ACCOUNT NOTES. THE PATIENT WILL BE NOTIFIED VERBALLY THAT THE COLLECTION ACTIVITY WILL BE SUSPENDED DURING CONSIDERATION. IF A FINANCIAL ASSISTANCE DETERMINATION ALLOWS FOR A PERCENT REDUCTION BUT LEAVES THE PATIENT WITH A SELF-PAY BALANCE, PAYMENT TERMS WILL BE ESTABLISHED ON THE BASIS OF DISPOSABLE INCOME. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT DESCRIBED IN SCHEDULE H, PART V, SECTION B, A SECONDARY DATA REPORT WAS COMPILED FROM WWW.EXPLOREMOHEALTH.ORG, WHICH SUPPLIES COUNTY HEALTH DATA WITH ZIP CODE LEVEL DATA AND ANALYSIS FROM THE WASHINGTON SCHOOL OF MEDICINE AND HOSPITAL INDUSTRY DATA INSTITUTE. THIS REPORT REFERENCES SEVERAL SOURCES INCLUDING BUT NOT LIMITED TO THE U.S. CENSUS BUREAU, MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES, AND CENTERS FOR DISEASE CONTROL AND PREVENTION. PRIMARY DATA COLLECTION INVOLVED CONDUCTING A NEEDS ASSESSMENT SURVEY. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SIGNAGE WILL BE POSTED IN ALL PATIENT INTAKE AREAS, INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY ROOM AND THEY ADMISSION/PATIENT REGISTRATION AREAS. ALL PUBLIC INFORMATION AND/OR FORMS REGARDING THE PROVISIONS OF FINANCIAL ASSISTANCE WILL USE LANGUAGES THAT ARE APPROPRIATE FOR LRHS SERVICE AREA IN ACCORDANCE WITH THE STATE'S LANGUAGE ASSISTANCE SERVICES ACT. THIS POLICY WILL BE MADE AVAILABLE IN SPANISH. THE FINANCIAL ASSISTANCE APPLICATION IS POSTED ON THE LRHS WEBSITE. LRHS HAS FINANCIAL COUNSELORS IN THE PATIENT FINANCIAL SERVICE DEPARTMENT. THESE COUNSELORS MEET WITH SELF PAY PATIENTS WHEN THEY ARE IN THE FACILITY TO DISCUSS THE POLICY, AS WELL AS EDUCATE PATIENTS ON ASSISTANCE THEY MAY BE ELIGIBLE FOR UNDER FEDERAL, STATE AND LOCAL GOVERNMENT PROGRAMS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: LRHS IS LOCATED IN OSAGE BEACH, MISSOURI, AND SERVES THE AREA SURROUNDING THE LAKE OF THE OZARKS, A 54,000 ACRE MAN-MADE LAKE LOCATED IN CENTRAL MISSOURI. LRHS' SERVICE AREA ENCOMPASSES A FOUR COUNTY AREA: CAMDEN, LACLEDE, MILLER, AND MORGAN COUNTIES. THE OVERALL SERVICE AREA 2019 POPULATION IS ESTIMATED AT 96,469. IN ADDITION TO THE RESIDENT POPULATION OF NEARLY 100,000, IN THE OVERALL SERVICE AREA, THE EVER-INCREASING VISITOR POPULATION IS A SIGNIFICANT FACTOR FOR THIS POPULAR TOURIST DESTINATION. THE LAKE OF THE OZARKS CONVENTION AND VISITORS BUREAU ESTIMATES THAT 5.0 MILLION VISITORS WILL TRAVEL TO THE REGION ANNUALLY. THE PROJECTED POPULATION GROWTH OF LRHS' SERVICE AREA AND ESPECIALLY THE CONTINUING MIGRATION INTO THE LAKE AREA OF RETIREES AND THE EVER-INCREASING VISITOR POPULATION, IS A SIGNIFICANT FACTOR IN THE RISING NEED FOR ACCESSIBLE AND EXPANDED MEDICAL SERVICES FOR THE LAKE AREA. THE MEDIAN HOUSEHOLD INCOME FOR EACH COUNTY IS AS FOLLOWS: CAMDEN = $53,478, LACLEDE = $47,257, MILLER = $47,171 AND MORGAN = $39,003. THE CAMDEN COUNTY 2022 ANNUAL UNEMPLOYMENT RATE AT 2.8%, BELOW THE STATE (3.4%) AND NATIONAL (3.6%) AVERAGES. CAMDEN COUNTY HAS APPROXIMATELY 14.8% OF PERSONS BELOW POVERTY LEVEL. THE IMMEDIATE 4-COUNTY AREA OF CAMDEN, LACLEDE, MILLER, AND MORGAN ESTIMATES UNINSURED INDIVIDUALS AT 34.25%. THERE ARE NO OTHER HOSPITALS WITHIN A 25-MILE RADIUS. USING HOSPITAL INDUSTRY DATA INSTITUTE DATA, THE LRHS MARKET IS PRIMARILY SHARED WITH 4 HOSPITALS IN THE AREA. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: LRHS SHOWS ITS SUPPORT OF THE COMMUNITY BY PROVIDING A TWO-DAY CAREER CAMP FOR STUDENTS 10-14. THE STUDENTS LEARN ABOUT CAREERS IN NURSING, REHAB THERAPIES, LABORATORY, SURGERY AND RESPIRATION THERAPIES, AND LABORATORY. CAMP INSTRUCTORS ALSO COVER TOPICES SUCH AS PATIENT CONFIDENTIALITY, INFECTION CONTROL, DISASTER MANAGEMENT, DATA MANAGEMENT, PROFESSIONAL SCHOOLS IN MISSOURI AND SCHOLARSHIP OPPORTUNITIES. ANOTHER APPROACH TO SUPPORTING THE COMMUNITY IS THORUGH LRHS'S COLLARBORATION WITH LAKE AREA COMMUNITY PARTNERS (INCLUDING SCHOOL DISTRICTS, POPULATION HEALTH PARTNERS SUCH AS THE COUNTY HEALTH DEPARTMENTS AND BUSINESS PARTNERS SUCH AS THE CHAMBER OF COMMERCE) TO CREATE AN ACTIONABLE PLAN ADDRESSING THE COMMUNITY'S KEY HEALTH NEEDS. THIS OCCURS DURING OUR COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. ACTION PLANS ARE CREATED AND MAINTAINED TO ENSURE WORK IS BEING DONE TO IMPROVE THE ISSUES IDENTIFIED. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: THE AFFILIATED HEALTH CARE SYSTEM OF THE ORGANIZATION INCLUDES LAKE REGIONAL MEDICAL MANAGEMENT AND LAKE REGIONAL IMAGING PARTNERS. A WHOLLY OWNED SUBSIDIARY, LAKE REGIONAL MEDICAL MANAGEMENT, INC., D/B/A LAKE REGIONAL MEDICAL GROUP (MEDICAL MANAGEMENT), OPERATES MEDICAL CLINICS AND RETAIL PHARMACIES IN CAMDEN, MILLER AND MORGAN COUNTIES. THE ORGANIZATION HAS A 51% OWNERSHIP OF LAKE REGIONAL IMAGING PARTNERS, LLC (IMAGING PARTNERS). IMAGING PARTNERS IS A LIMITED LIABILITY COMPANY THAT OPERATES AN IMAGING CENTER IN OSAGE BEACH, MISSOURI, WHICH OFFERS CLOSED HYBRID MRI SERVICES, PET AND CT SCANS, ULTRASOUND SERVICES AND RADIOGRAPHY IMAGING SERVICES. THE 49% MINORITY INTEREST IN IMAGING PARTNERS IS OWNED BY A GROUP OF LOCAL RADIOLOGISTS. true SCHOLARSHIPS 8 26241 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.: THE ORGANIZATION HAS AN AGREEMENT WITH MHA, AND DUE TO INCREASED PAYMENTS UNDER THE FEDERAL REIMBURSEMENT ALLOWANCE PROGRAM, THE ORGANIZATION MADE CHARITABLE CONTRIBUTIONS TO THE MHA CENTER FOR EDUCATION. THE CONTRIBUTIONS ARE USED FOR FUNDING SCHOLARSHIPS TO MEDICAL, NURSING AND ALLIED HEALTH PROFESSIONALS, AND WORKFORCE INITIATIVES TO ADDRESS THE SHORTAGES OF NURSING AND ALLIED HEALTH PROFESSIONALS AND HOSPITAL EMPLOYEES. X X true true X X X X X false true false false false true false false false JEFFREY JONES CHIEF OF STAFF 0 458856 0 10000 0 1875 0 12200 0 1847 0 484778 0 0 KEVIN BYRNE DO BOARD MEMBER 0 954727 0 10000 0 4591 0 12200 0 5580 0 987098 0 0 JOSH BRICKNER DO BOARD MEMBER END 10/22 0 600976 0 0 0 21064 0 12200 0 1262 0 635502 0 0 JOHN PATTON BOARD MEMBER BEG 07/22 0 800499 0 10000 0 1195 0 12200 0 2601 0 826495 0 0 HENRY ZEISEL CFO 373870 0 18375 0 2585 0 49685 0 5090 0 449605 0 0 0 JENNIFER BETHUREM VP OF PUBLIC AFFAIRS 176777 0 8450 0 379 0 24756 0 2816 0 213178 0 0 0 KEVIN MCROBERTS CEO 479134 0 16580 0 23924 0 12200 0 4880 0 536718 0 0 0 MELISSA HUNTER COO 357160 0 11451 0 16869 0 42360 0 3253 0 431093 0 0 0 MICHAEL BURCHAM LRMG ADMINISTRATION 196226 0 0 0 16594 0 8438 0 3147 0 224405 0 0 0 PATRICK NEECE CIO 267122 0 12587 0 566 0 38746 0 2152 0 321173 0 0 0 THOMAS WILLIAMS VP OF HUMAN RESOURCES 199411 0 9191 0 578 0 27301 0 4761 0 241242 0 0 0 ANGELA BRECKENRIDGE PHYSICIAN 503836 0 0 0 3120 0 0 0 1199 0 508155 0 0 0 HARBAKSH SANGHA PHYSICIAN 906465 0 0 0 22595 0 12200 0 6074 0 947334 0 0 0 JOHN BRAND PHYSICIAN 415561 0 227374 0 424 0 12200 0 8008 0 663567 0 0 0 MICHELLE HELTON PHYSICIAN 419260 0 52005 0 355 0 12200 0 5324 0 489144 0 0 0 PATRICK O'NEIL PHYSICIAN 454181 0 83964 0 21721 0 12200 0 4189 0 576255 0 0 0 SCHEDULE J, PART I, LINE 1A REIMBURSEMENT POLICY: THE ORGANIZATION HAS A WRITTEN POLICY FOR REIMBURSEMENT RELATED TO TRAVEL FOR COMPANIONS. DIRECTORS AND KEY EMPLOYEES ARE ELIGIBLE TO RECEIVE THIS BENEFIT. THE ORGANIZATION PROVIDES ONE TYPE OF GROSS UP PAYMENT FOR THE CEO'S AUTO ALLOWANCE. THE CEO IS THE ONLY PERSON THAT RECEIVES THIS BENEFIT. THIS PAYMENT IS REPORTED AS TAXABLE COMPENSATION ON THE CEO'S W-2 FORM EACH YEAR. THE AUTO ALLOWANCE FOR 2022 WAS $3,884. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING PEOPLE PARTICIPATED IN A 457(F) NONQUALIFIED RETIREMENT PLAN AND HAD A DEFERRED CONTRIBUTION TO A 457(F) NONQUALIFIED RETIREMENT PLAN: CONTRIBUTIONS: $ 17,238 JENNIFER BETHUREM 30,160 MELISSA HUNTER 27,474 PATRICK NEECE 18,750 THOMAS WILLIAMS 37,485 HENRY ZEISEL SCHEDULE J, PART I, LINE 5A COMPENSATION CONTINGENT ON REVENUES OF THE ORGANIZATION: INDIVIDUALS RECEIVING INCENTIVE COMPENSATION ON PART II OF SCHEDULE J ARE ELIGIBLE TO RECEIVE THESE PAYMENTS IN AN AMOUNT THAT IS A PERCENTAGE OF BASE COMPENSATION FOR MEETING CERTAIN PERFORMANCE CRITERIA, INCLUDING SPECIFIED REVENUE TARGETS. A HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF MO 431178966 2021-08-18 60252593 DEFEASE 2012, FUND 2016 & CAPITAL false false false B HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF MO 431178966 60636AFK4 2020-02-01 8000000 REFUND & REDEEM 2010 BOND true false false A 0 0 60252593 0 3091348 12414490 874760 0 0 43871995 0 0 true false true true B 6500000 0 8000000 0 7955000 45000 0 0 0 0 0 0 true false true true A false false false false 0 false false false true B false false false false 0 false false false true A false true false false false false 0 false 0 false true B false true false false false false 0 false 0 false true A true B true MITCH SHIELDS FAMILY MEMBER OF L SHIELDS 62183 WAGES true SHERRIE WILLIAMS VP TOM WILLIAMS SPOUSE 128840 WAGES true LAKE OZARK ANESTHESIA ASSOC OWNED BY ALAN MEAD 2441692 PHYSICIAN SERVICES true FORM 990, PART III, LINE 1 ORGANIZATION'S MISSION: OUR MISSION: PROVIDE EXCEPTIONAL HEALTHCARE. OUR VISION: TO BE THE FIRST CHOICE FOR HEALTH CARE. OUR CORE COMPETENCIES: AGILITY, COMMUNITY FOCUS, SERVICE EXCELLENCE. OUR VALUES: INTEGRITY, PATIENT CENTERED, CLINICAL EXCELLENCE, COMMITMENT TO COMMUNITY. THE SYSTEM WAS ORGANIZED IN 1973 FOR THE PURPOSE OF ESTABLISHING A NEW HOSPITAL FOR MEDICAL AND SURGICAL CARE AND FOR THE TREATMENT OF PERSONS RESIDING OR VISITING IN THE LAKE OF THE OZARKS AREA OF CENTRAL MISSOURI. IN THE MORE THAN 40 YEARS SINCE THEN, THE SYSTEM HAS EVOLVED TO PROVIDE MORE COMPREHENSIVE HEALTH CARE, INCLUDING ADDING CARDIAC-CARE, OUTPATIENT SERVICES, CANCER AND ORTHOPEDIC PROGRAMS AND CONTINUALLY EXPANDING SERVICES AND FACILITIES OVER THE YEARS. IT IS NOW DESIGNATED AS A REGIONAL REFERRAL CENTER BY MEDICARE AND HAS NEARLY 1,400 EMPLOYEES. ITS BOARD HAD ADOPTED GOVERNANCE BEST PRACTICES AND A WIDE-RANGING CORPORATE COMPLIANCE PROGRAM. BASED ON PERIODIC COMMUNITY ASSESSMENTS, THE BOARD HAS ALSO COMMITTED TO ENHANCED UNCOMPENSATED CARE POLICIES AND NUMEROUS COMMUNITY PROGRAMS (E.G. HEALTH SCREENINGS, WELLNESS ENHANCED AND RELATED CARE PROGRAMS). THE SYSTEM IS ORGANIZED AS A COMMUNITY-BASED NONPROFIT PUBLIC BENEFIT CORPORATION UNDER THE LAWS OF THE STATE OF MISSOURI. THE SYSTEM OWNS AND OPERATES A 116-LICEENSED BED ACUTE CARE HOSPITAL (THE "HOSPITAL") LOCATED ON HIGHWAY 54 IN OSAGE BEACH, MISSOURI. THE HOSPITAL IS LICENSED BY THE MISSOURI DEPARTMENT OF HEALTH AND ACCREDITED BY THE JOINT COMMISSION. THE HOSPITAL IS DESIGNATED AS A SOLE COMMUNITY HOSPITAL, MEANING THAT THE HOSPITAL IS THE PRIMARY HEALTH CARE PROVIDER FOR A MAJORITY OF MEDICARE PATIENTS WITHIN A 35-MILE RADIUS OF THE HOSPITAL. THE CORPORATION HAS ONE ACTIVE, WHOLLY-OWNED FOR-PROFIT SUBSIDIARY, LAKE REGIONAL MEDICAL MANAGEMENT, INC. ("LRMM"), WHICH OPERATES FOUR RETAIL PHARMACIES AND FIFTEEN SPECIALTY CLINICS. OPERATIONS OF LRMM ARE GOVERNED BY A SEPARATE BOARD OF DIRECTORS. THE SYSTEM IS CURRENTLY GOVERNED BY A SIXTEEN-MEMBER BOARD OF DIRECTORS (THE "BOARD"). THE BOARD HAS GENERAL RESPONSIBILITY FOR THE BUSINESS AND AFFAIRS OF THE SYSTEM, AND MAY DO AND PERFORM ALL ACTS NECESSARY TO CARRY OUT ITS PURPOSES. UNDER THE TERMS OF THE BYLAWS, THE MEMBERS OF THE BOARD SERVE THREE-YEAR STAGGERED TERMS, AND NEW MEMBERS ARE ELECTED BY THE CURRENT BOARD MEMBERS. THE OFFICERS OF THE BOARD ARE ELECTED BY THE BOARD FOR TWO-YEAR TERMS. BOARD MEMBERS SERVE IN A VOLUNTARY CAPACITY AND RECEIVE NO REMUNERATION FOR SERVICE RENDERED IN SUCH CAPACITY. FORM 990, PART III, LINE 4A-C PROGRAM SERVICE ACCOMPLISHMENTS: THE HOSPITAL PROVIDES CHARITY CARE IN SUPPORT OF ITS MISSION. THE HOSPITAL VOLUNTARILY PROVIDES FREE CARE TO PATIENTS WHO LACK FINANCIAL RESOURCES AND ARE DEEMED TO BE MEDICALLY INDIGENT. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED IN NET PATIENT SERVICE REVENUE. IN ADDITION, THE HOSPITAL PROVIDES SERVICES TO OTHER MEDICALLY INDIGENT PATIENTS UNDER CERTAIN GOVERNMENT REIMBURSED PUBLIC AID PROGRAMS. SUCH PROGRAMS PAY PROVIDERS AMOUNTS WHICH ARE LESS THAN ESTABLISHED CHARGES FOR THE SERVICES PROVIDED TO THE RECIPIENTS AND MANY TIMES THE PAYMENTS ARE LESS THAN THE COST OF RENDERING THE SERVICES PROVIDED. UNCOMPENSATED CHARGES RELATED TO THESE SERVICES INCLUDE CHARITY CARE, BAD DEBT, UNPAID MEDICARE, FREE MEDICAL SERVICES, HEALTH PROFESSIONALS EDUCATION, FINANCIAL CONTRIBUTIONS, AND TAXES. IN ADDITION TO UNCOMPENSATED CHARGES, THE HOSPITAL ALSO COMMITS SIGNIFICANT TIME AND RESOURCES TO ENDEAVORS AND CRITICAL SERVICE WHICH MEET OTHERWISE UNFILLED COMMUNITY NEEDS. MANY OF THESE ACTIVITIES ARE SPONSORED WITH THE KNOWLEDGE THAT THEY WILL NOT BE SELF-SUPPORTING OR FINANCIALLY VIABLE. SUCH PROGRAMS INCLUDE HEALTH SCREENING AND ASSESSMENTS, PRENATAL EDUCATION AND CARE, COMMUNITY EDUCATIONAL SERVICES, AND VARIOUS SUPPORT GROUPS. FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES: OTHER SERVICES INCLUDE MANAGEMENT FEES, CAFETERIA INCOME, INCOME FOR THE AUXILIARY, AND OTHER PROGRAM SERVICE ACTIVITIES. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIP: OFFICERS KEVIN MCROBERTS AND HENRY ZEISEL AS WELL AS BOARD MEMBERS CHARLES MCELYEA AND DENNIS MICHAELREE ARE ALL BOARD MEMBERS OF LAKE REGIONAL MEDICAL MANAGEMENT (LRMM), A RELATED TAXABLE ORGANIZATION. OFFICER HENRY ZEISEL AND BOARD MEMBER JAMES JUDAS JR ARE BOARD MEMBERS OF LAKE REGIONAL HEALTH FOUNDATION, A RELATED TAX EXEMPT ORGANIZATION. KEVIN BYRNE, DO, JOHN PATTON, DO, JOSH BRICKNER, AND JEFFREY JONES ARE ALSO EMPLOYED BY LRMM. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: 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. THE 990 WAS THOROUGHLY REVIEWED BY THE MANAGER OF ACCOUNTING AND CFO. AFTER ANY CHANGES WERE MADE, THE MEMBERS OF THE BOARD OF DIRECTORS WERE PROVIDED A COPY. THE 990 WAS PRESENTED TO THE BOARD BY THE INDEPENDENT ACCOUNTANTS WHO PREPARED THE 990, AND THE BOARD HAD THE OPPORTUNITY TO ASK ANY QUESTIONS BEFORE THE 990 WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: EACH YEAR, ALL MEMBERS OF THE BOARD OF DIRECTORS, SENIOR MANAGEMENT, AND THE DEPARTMENT HEADS ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AND PROPERLY DISCLOSE ANY ACTUAL, POTENTIAL, OR PERCEIVED CONFLICT OF INTEREST. A COPY OF THE CONFLICT OF INTEREST POLICY IS PROVIDED TO EACH DIRECTOR AT THE TIME OF APPOINTMENT, TO EACH NEW PRINCIPAL OFFICER AND EMPLOYEE AT THE TIME OF EMPLOYMENT, AND ANNUALLY TO EVERY INTERESTED PERSON. EACH INTERESTED PERSON IS REQUIRED TO SUBMIT A STATEMENT TO THE CEO ANNUALLY VERIFYING THE UNDERSTANDING WITH THE POLICY AND STATING THAT ALL CONFLICTS HAVE BEEN DISCLOSED, OR THAT NO CONFLICTS EXIST. THE CEO SUBMITS HIS ANNUAL STATEMENT TO THE CHAIRMAN OF THE BOARD. IN THE EVENT AN INTERESTED PERSON DEVELOPS A POTENTIAL CONFLICT OF INTEREST, THE PERSON MUST IMMEDIATELY UPON LEARNING ABOUT THE POTENTIAL CONFLICT DISCLOSE THE NATURE OF THE CONFLICT TO THE BOARD OF DIRECTORS. THE PERSON THEN LEAVES THE BOARD OR COMMITTEE MEETING WHILE THE ISSUE IS DISCUSSED AMONG REMAINING BOARD MEMBERS TO DETERMINE WHETHER A CONFLICT EXISTS BY MAJORITY VOTE. IF A CONFLICT DOES EXIST, A SEPARATE PERSON IS ASSIGNED TO INVESTIGATE ALTERNATIVES TO THE CONFLICT AND DETERMINE IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS POSSIBLE. IF THIS IS NOT POSSIBLE, THE BOARD THEN DECIDES BY MAJORITY VOTE IF THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE, AND WHETHER IT SHOULD OR SHOULD NOT BE ENTERED. IF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, THE PERSON WILL BE INFORMED OF THIS BASIS FOR SUCH BELIEF AND WILL BE GIVEN AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE PERSON'S RESPONSE AND CONDUCTING FURTHER INVESTIGATION, THE ORGANIZATION DETERMINES THAT THE PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, APPROPRIATE CORRECTIVE ACTION WILL BE TAKEN. ADDITIONALLY, THE ORGANIZATION HAS IMPLEMENTED A TAX COMPLIANCE QUESTIONNAIRE THAT ASKS DETAILED QUESTIONS, AND PROVIDES RESPONDENTS WITH APPROPRIATE DEFINITIONS AND INSTRUCTIONS, TO ENABLE THE ORGANIZATION TO GATHER INFORMATION REQUIRED TO ANSWER QUESTIONS ON THE 990 RELATING TO THE FOLLOWING AREAS: 1) THE NUMBER OF INDEPENDENT VOTING BOARD MEMBERS, 2) RELATIONSHIPS BETWEEN INTERESTED PERSONS, 3) LOANS TO OR FROM INTERESTED PERSONS, 4) GRANTS OR ASSISTANCE BENEFITING INTERESTED PERSON, AND 5) BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS. FORM 990, PART VI, SECTION B, LINE 15B COMPENSATION DETERMINATION: THE ORGANIZATION USED ARTHUR J GALLAGHER & CO, AN INDEPENDENT ORGANIZATION, TO HELP EVALUATE AND SET THE COMPENSATION FOR THE ORGANIZATION'S CEO. THE COMPENSATION DELIBERATIONS WERE DOCUMENTED IN THE MINUTES OF BOTH THE COMPENSATION COMMITTEE AND THE BOARD. THE REPORT IS DATED NOVEMBER 2022. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENT AVAILABILITY: CERTAIN ASPECTS OF THE FINANCIAL STATEMENTS ARE AVAILABLE IN THE ORGANIZATION'S ANNUAL REPORT WHICH CAN BE FOUND ON THE ORGANIZATION'S WEBSITE. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE GENERAL PUBLIC. FORM 990, PART VII BOARD MEMBER COMPENSATION: GRANT BARNUM, DO, IS PAID AS A PHYSICIAN OF LAKE REGIONAL MEDICAL MANAGEMENT. BOARD MEMBERS DO NOT RECEIVE ANY COMPENSATION FOR THEIR SERVICES PROVIDED AS A MEMBER OF THE BOARD DIRECTORS. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ (8,655,285) TRANSFERS TO AFFILIATES FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:19040144 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:7341683 FORM 990 PART IX LINE 11G DESCRIPTION:AGENCY FEES TOTAL FEES:4034031 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION TOTAL FEES:3644965 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES TOTAL FEES:2537634 FORM 990 PART IX LINE 11G DESCRIPTION:LABORATORY FEES TOTAL FEES:118091 LAKE REGIONAL HEALTH FOUNDATION 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 881797380 SUPPORT MO 501(C)(3) 12 A I LRHS true LAKE REGIONAL IMAGING CENTER 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 202107048 DIAGNOSTIC IMAGIN MO LRHS RELATED 942742 1925533 false 0 true 0.51000 LAKE REGIONAL MEDICAL MANAGEMENT 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 431473438 PHYSICIANS MO LRHS C CORP 19675545 6959356 1.00000 true true true false false false false false false false true true true false false true true false true false LAKE REGIONAL MEDICAL MANAGEMENT B 14075941 FMV LAKE REGIONAL IMAGING PARTNERS K 78694 FMV LAKE REGIONAL MEDICAL MANAGEMENT L 1256502 FMV LAKE REGIONAM IMAGING PARTNERS L 1503410 FMV LAKE REGIONAL MEDICAL MANAGEMENT P 2147806 FMV LAKE REGIONAL HEALTH FOUNDATION R 588673 FMV