2023-08-08T10:36:32-05:00 2022-09-30 481026809 Wendling Noe Nelson & Johnson LLC 623 SW 10th Ave Suite 300 Topeka KS 66612 990 2021-10-01 440668347 Cameron Regional Medical Center CAME 8166322101 1600 East Evergreen Street Cameron MO 64429 Joseph Abrutz Jr Administrator 8166322101 2023-08-07 1 Joseph Abrutz Jr 999009999 Heather R Eichem P01515553 7852334226 2023-08-07 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z Joseph Abrutz Jr 1600 East Evergreen Street Cameron MO 64429 78554975 0 X http://www.cameronregional.org/ X 1963 MO Provide inpatient and outpatient medical care to area residents regardless of ability to pay. 13 11 629 43 0 0 15869887 2350984 62509114 65012147 4116692 2497314 134886 163933 82630579 70024378 31650 30000 0 0 35367260 40465650 0 0 4852 30947586 32489719 66346496 72985369 16284083 -2960991 104254147 97363822 33259260 40071011 70994887 57292811 X Our mission at Cameron Regional Medical Center (CRMC) is caring for all patients. To this end, we organize people, equipment, and facilities in a manner that best responds to their needs and to the needs of our service area. Our priorities are patients and families, physicians, and employees. Our goal is to be a regionally-recognized leader in patient satisfaction by exceeding customer expectations and continuing to achieve excellence in quality and cost-effective health care services. Cameron Regional Medical Center (CRMC) will provide services in an atmosphere that involves compliance with governmental mandates. Throughout our organization, our employees strive to provide sensitive and quality health care at all times by living our values. Lastly, CRMC recognizes the importance of viable and profitable operations to guarantee the continued existence and growth of the facility. 0 0 64415623 30000 65012147 Acute care hospital organized to provide inpatient and outpatient care to area residents regardless of ability to pay. 64415623 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 60 0 1 629 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 0 0 X Joseph Abrutz Jr 8166322101 1600 East Evergreen St Cameron MO 64429 Warren McElwain President 1.00 X X 0 0 0 Delvin Jackson Vice-President 1.00 X X 0 0 0 Jennifer White Secretary 1.00 X X 0 0 0 Michael Poland Treasurer 1.00 X X 0 0 0 Barbara Ballew Director 1.00 X 0 0 0 Ken Raffety Director 1.00 X 0 0 0 Steve Tinnen Director 1.00 X 0 0 0 Mike Brown Director 1.00 X 0 0 0 David Just Director 1.00 X 0 0 0 JoEllen Pratt Director 1.00 X 0 0 0 Laeeq Azmat Tahirkheli Physician & Director 40.00 X 973926 0 0 Laura Harbison Physician & Director 40.00 X 392275 0 0 Mark Baker Director 1.00 X 0 0 0 Joseph F Abrutz Jr Administrator 40.00 X 499742 0 12804 Rosa Patti Chief Financial Officer 40.00 X 189875 0 15633 Muhammad Amin Physician 40.00 X 561262 0 0 Barry Littlejohn Physician 40.00 X 504571 0 0 Shahzad Shafique Physician 40.00 X 664266 0 0 Ly Phan Physician 40.00 X 487869 0 0 Arihant Jain Physician 40.00 X 569688 0 0 4843474 0 28437 46 0 1 0 Premier Specialty Network 1835 E Republic Rd Suite 200 Springfield MO 65804 Physician specialists 1779000 Psychiatric Solutions Inc PO Box 840839 Dallas TX 75284 Operation of BHU unit 1178267 Laboratory Corporation of America PO Box 12140 Burlington NC 27216 Reference lab services 1058725 Cameron Emergency Physicians PC 1600 E Evergreen Cameron MO 64429 Emergency physicians 1005412 Comp Health PO Box 972651 Dallas TX 75397 OB/GYN Coverage 759252 16 30180 2207188 113616 2350984 Patient service revenue 622110 65012147 65012147 65012147 998486 998486 14160 14160 47385 0 47385 47385 47385 10010590 4675 8530597 0 1479993 4675 1484668 1484668 Cafeteria 722210 114510 114510 Other income 900099 2038 2038 116548 70024378 65012147 0 2661247 X 2500 2500 27500 27500 2140894 1407327 733567 32030963 29736045 2294918 685001 624789 60212 3397567 3124508 273059 2211225 2016858 194367 706199 706199 164029 164029 10358643 9447191 911452 232965 67758 165207 1434618 1139720 294898 642759 553120 89639 243637 185878 57759 1089428 950652 138776 3031880 2609314 422566 773904 77462 696442 Medical supplies 5971993 5971993 Pharmaceuticals 4757891 4757891 Repairs and maintenance 1714771 1144578 570193 Collection fees 453972 785 453187 913030 569754 338424 4852 72985369 64415623 8564894 4852 388183 273176 19192502 15489984 8709815 10969906 1682452 1911047 339289 351941 80368282 56529191 22428286 23839091 48793481 40210306 2720139 4318371 104254147 97363822 5796800 7751065 24420470 28947595 625415 472115 63130 35371 2353445 2864865 33259260 40071011 X 70203446 56537898 791441 754913 70994887 57292811 104254147 97363822 X -2960991 -10717872 -23213 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3263004 3263004 30199758 18205094 11994664 42972615 37247145 5725470 3932905 1076952 2855953 23839091 Third party payor settlements 1406321 Advances 1458544 2864865 X Part X, Line 2: Management is not aware of any uncertainties in income tax positions. 1 1 1 X 1 X 1 1 0 1 1 698818 862478 0 0.00000 9850766 7389093 2461673 0.03370 10549584 8251571 2461673 0.03370 297077 1955 295122 0.00400 27500 27500 0.00040 22934229 12672539 10261690 0.14060 2500 2500 0.00000 23261306 12674494 10586812 0.14500 33810890 20926065 13048485 0.17870 1 2596954 259695 15796806 18255255 -2458449 X 1 1 1 1 Cameron Regional Medical Center 1600 East Evergreen Street Cameron MO 64429 X X X Cameron Regional Medical Center Inc 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X http://www.cameronregional.org X 1 18 0 1 0 1 X 100.000000000000 300.000000000000 X X X X 1 1 X X X 1 X https://cameronregional.org/ X https://cameronregional.org/ X https://cameronregional.org/ X X X X X 1 X 0 X X 1 X 0 0 Cameron Regional Medical Center, Inc. Part V, Section B, Line 5: The Medical Center conducted a town hall meeting and invited local hospital, public health community, mental health community, free clinics, community-based clinics, service providers, local residents, community leaders, opinion leaders, school leaders, business leaders, local government, faith-based organizations and persons (or organizations serving them), people with chronic conditions, uninsured community members, low income residents, and minority groups. Cameron Regional Medical Center, Inc. Part V, Section B, Line 11: With COVID-19 beginning in late February 2020 and extending to Spring 2023, Cameron Regional Medical Center (CRMC) had to once again reassign the majority of its energy and resources toward combatting the damaging effects of this world-wide pandemic throughout FYE September 30, 2022. COVID-19 required that screening protocols, social distancing, quarantining, and "no visitor" policies still be maintained in the interest of public health and welfare. Even though normal CHNA activities and collaborative efforts were somewhat impeded by COVID-19, CRMC continued its containment efforts throughout rural northwest Missouri. As in FYE 2021, COVID-19 was once again, by far, the most severe and demanding of community health needs in FYE 2022.The prolonged disquiet of COVID-19 continued to exacerbate challenges in health-care delivery and health outcomes. However, CRMC's resolve and commitment to its patients and area residents against the deadly effects of COVID-19 were only strengthened. As the Medical Center's positivity rate, ICU utilization, and BiPAP/ventilator usage were all dramatically climbing in the fall of 2021, multiple treatment methods and modalities were continually investigated. An off-site Monoclonal Antibody Infusion Center was established in August 2021 as a cooperative effort among area Health Departments, Emergency Preparedness personnel, First Responders, and CRMC (Region H Healthcare Coalition). This group came together with equipment, supplies, and manpower to initiate the Infusion Center in one of CRMC's properties. However, due to severe labor shortages, CRMC had to assume primary responsibility for operation and staffing of the Infusion Center in September 2021. With the assistance of area Nurse Practitioners, CRMC operated the Infusion Center on Monday, Wednesday, and Friday of each week, with as many as 39 infusions being performed per day. Due to high demand, over 820 infusions were performed in a four-month period, with patients coming from all over northwest Missouri, including adjacent urban areas. As the State of Missouri supplied the REGEN-COV monoclonal antibody therapy medication, infusions were provided to the patient at no cost. This treatment demonstrated great success in reducing COVID-related hospitalizations and deaths. The Infusion Center was invaluable in keeping hospital beds available at CRMC and other northwest Missouri hospitals. Due to regulations, the Infusion Center closed on December 31, 2021.COVID containment and mitigation efforts throughout the Medical Center, Infusion Center, Home Health, Hospice, and CRMC's 18 satellite clinics brought higher expenses via increasing charges for labor, purchased services, drugs, personal protective equipment (PPE), infection prevention/disinfecting/hygiene products, and other medical and safety supplies. This resource-intensive care created severe staffing shortages, exhaustion, and mental stress, taking a sharp toll on all CRMC staff. Wages/salaries had to be adjusted upward appreciably for purposes of recruitment and retention. Rural hospitals in particular suffered serious financial difficulties as a result of the above challenges.Despite these financial pressures, CRMC remained a leader for COVID treatment, testing, vaccination, and public education throughout rural northwest Missouri during FYE 2022. Since the onset of COVID-19, CRMC had tested approximately 29,040 individuals as of September 30, 2022, with 2,821 positive results (9.7% overall positivity rate). CRMC's 33 certified COVID vaccinators remained available during FYE 2022 to assist area County Health Departments with the staffing of vaccination clinics. These same vaccinators continued to administer vaccine to CRMC employees, providers, and volunteers on an as-needed basis. COVID booster shots were given to CRMC staff and volunteers beginning October 20, 2021.In January 2022, CRMC procured the appropriate freezer storage for COVID-19 vaccine in order to store same for Caldwell, Clinton, and DeKalb County Health Departments. This practice continues to present day.CRMC's COVID expense figure for the 12-month period ended September 30, 2022, was approximately $4.4m.General Notes Addressing Multiple CHNA Priorities/Objectives a) CRMC's 20th Annual Health Fair was held in Fall 2022. Due to COVID-19, and in order to decrease crowd size, the Health Fair was held in the same "distributed" format as the two previous years, with services being provided in six different locations throughout five counties in rural northwest Missouri. Health Fair services were provided at the Orthopedic & Rehab Center at CRMC (Cameron, MO - Clinton County), plus five satellite clinic locations (Bethany, MO - Harrison County; Hamilton, MO - Caldwell County; Jamesport, MO - Daviess County; Maysville, MO - DeKalb County; and Lathrop, MO - Clinton County). Extensive blood work (anemia, blood sugar, thyroid, cholesterol panel, iron, GFR, and BUN/Creatinine), blood pressures, and pulse oximetry were all provided free of charge. Medical providers were on site at each location and available to counsel/educate attendees regarding medications, vaccinations, mental health, exercise, nutrition, diabetes, etc. Over 300 participants from rural northwest Missouri attended this annual health and wellness event.In late Fall 2022, a public Health Fair was also provided in King City, Missouri (Gentry County), realizing 61 attendees. Again, the same extensive blood work was provided free of charge; andb) Compiled by CRMC staff at the time of the ACA/IRS's enactment of CHNA legislation, a Regional Resource Directory was developed and is updated on an annual basis. Covering CRMC's four-county primary service area (Clinton, Caldwell, Daviess and DeKalb), the directory includes mental health resources/services, alcohol/drug treatment (substance abuse) programs, physicians, wellness/fitness centers, medical clinics/services, nutrition resources, weight loss programs, dentists, and several other categories addressing the health and well-being of area residents. It is distributed to the public upon request and disseminated at certain public meetings and educational events sponsored by CRMC. Priority/Objective No. 1 - Mental Health (Diagnosis/Treatment)Even though a shortage of mental health providers has continued in northwest Missouri, CRMC remains diligent in maintaining and growing its offerings in this specialty, as the need only continues to escalate. During FYE 2022, five part-time Psychiatrists (including a Child Psychiatrist) provided outpatient services on a regularly-scheduled basis, in addition to a full-time Geriatric Psychiatrist who continues to provide inpatient services for CRMC's Behavioral Health Unit (BHU). For the past several years, CRMC's mental health services have been marketed widely throughout its service area, with free transportation being provided to those area residents in need of same. CRMC's 18 satellite clinics continue to serve as both education and referral centers for their patients' mental health needs. A CRMC Outpatient Clinic Calendar denoting mental health offerings is placed in 14-15 area newspapers on a monthly basis, as well as on the Medical Center's website. This Outpatient Clinic Calendar is also mailed to approximately 80 physicians and providers throughout northern Missouri.CRMC continues to significantly underwrite/subsidize its mental health program financially in order to assure these services remain readily available to all patients/payors (Medicare, Medicaid, self-pay, etc.).CRMC's 10-bed BHU utilized TelePsychiatry services at least one day per week during COVID-19 in order to maintain/enhance physician coverage. The BHU continues to play a vital role in CRMC's medical community, providing solutions and relief for area nursing homes, families, and physicians. A two-bed expansion of the Unit is scheduled for 2023. Cameron Regional Medical Center, Inc. Part V, Section B, Line 11: Through the CHNA process, Preferred Family Healthcare (PFH) in Kirksville, Missouri has become a valued partner for CRMC over the past several years, providing collective impact, resources, education, and brochures otherwise unavailable in the area for both mental/behavioral health and substance abuse (next section). Many CRMC staff members have participated in PFH's annual Mental Health First Aid classes that instruct on how to recognize signs of mental health or substance abuse challenges.The majority of CRMC's 18 satellite clinics continue to utilize the Patient Health Questionnaire-9 (PHQ-9) for depression screening purposes.CRMC and area Family Guidance offices work together closely on mental health cases, particularly on suicidal patients presenting to the Emergency Room. Upon notification to their hotline, Family Guidance will send a representative to perform the screening process and intake evaluation, day or night, 24-7. Working closely with the E.R. physician on a treatment plan, Family Guidance will facilitate transfer to an appropriate Psychiatric facility, if needed.Priority/Objective No. 2 - Substance Abuse (Opioids/Meth/Marijuana/Heroin, etc.)The CRMC Medical Staff and Board of Directors continue to prohibit the use and/or possession of marijuana (medical or otherwise) on the CRMC campus, premises, and in its outlying/satellite facilities.CRMC primary care providers provide substance abuse counseling at both the Medical Center and in its 18 satellite clinics. Educational materials are provided according to individual patient need.CRMC continues to assist the Cameron Police Department with marketing its annual "Prescription Drug Take-Back Day" that is held in concert with the DEA.For referral purposes, CRMC's Emergency Room maintains a list of area substance abuse/addiction treatment facilities, disseminating to patients and family members as appropriate.CRMC, through its network of primary care clinics, physicians, mid-levels, and the hospital Pharmacy, continues to facilitate and promote concerted efforts against prescription drug/medication abuse. The Medical Center's e-prescribing software and communication protocols with area pharmacies assist in monitoring/tracking "doctor shopping" efforts by patients suspected of abusing the system.As there is considerable cross-over in staff, CRMC pharmacists who also work locally in the retail setting continue to take the following precautions: a) Patients are not allowed to fill controlled prescriptions more than five days early; b) Any prescription presented by a patient not residing in the immediate area or written by a prescriber not in the immediate area will be investigated; c) Local retail pharmacy personnel and hospital pharmacy personnel communicate on a regular basis regarding suspicious controlled substance prescribing trends; and d) Any controlled prescription where the patient offers to pay by cash instead of using insurance will automatically be red-flagged by the pharmacist for further investigation.In terms of health-care professionals, the CRMC Medical Staff has been donating a substantial sum on an annual basis to the Missouri Association of Osteopathic Physicians and Surgeons' (MAOPS') Physicians Health Program (PHP) for many years. PHP provides addiction treatment resources and coordinates the care of the affected health-care professional throughout his/her treatment program, with the goal of facilitating and expediting his/her return to health and a normal personal and professional life.Priority/Objective No. 3 - Available Affordable Health Insurance Coverage (Not directly addressed - see below)Priority/Objective No. 4 - Child Care Services (Not directly addressed - see below) Priority/Objective No. 5 - Smoking/VapingDetailed information on smoking cessation continues to be included in all CRMC admission packets. For those Emergency Room patients who smoke, smoking cessation information is provided at the time of discharge. The Medical Center continues to assist its employees financially with smoking cessation products.CRMC primary care providers provide smoking cessation counseling at both the Medical Center and in its 18 satellite clinics. Educational materials are provided per individual patient need.Smoking/vaping is prohibited within all CRMC facilities.Priority/Objective No. 6 - Poverty/Employment Readiness (Not directly addressed - see below)Priority/Objective No. 7 - Alcohol/Drunk Driving (Not directly addressed - see below)Priority/Objective No. 8 - Obesity (Nutrition and Fitness)CRMC continues to sponsor free training/education classes focusing on diabetes, nutrition, food labels, and healthy eating. These are performed by CRMC's Registered Dieticians at least every 60 days, with excellent participation rates and feedback from the public.CRMC still provides a regimented physician-assisted weight loss program at lower-than-normal rates via one of its satellite clinics. The CRMC Foundation held its 33rd Annual 4-Mile Run, 2-Mile Walk, and Children's Fun Run on Saturday, July 2, 2022. Approximately 200 runners, walkers, and children participate each year in these fitness/wellness events. CRMC's Fitness Committee continues to sponsor fitness challenges for CRMC employees at least twice a year.CRMC continues to financially assist its employees and their immediate family members with membership fees at area fitness centers.The CRMC Foundation still operates and maintains a one-mile Wellness/Fitness Trail on the CRMC campus. This limestone footpath is available free-of-charge to the public 365 days per year during daylight hours. Annual maintenance expenses for the Trail average approximately $7,900.CRMC primary care providers continue to provide weight control counseling at both the Medical Center and in its 18 satellite clinics. Educational materials are provided according to individual patient need.Due to the 2018 closing of the Cameron Nutrition Site (Stella Grinstead Center) in Cameron, Missouri because of State funding withdrawal, CRMC is still operating the Meals on Wheels Program to benefit homebound Cameron residents living in Clinton County. This effort provides hot, nutritious meals, to participants, as well as a daily "eyes-on" well-check encounter by the program's volunteer drivers. This service DID NOT stop during COVID-19; however, delivery details were altered somewhat to protect both program participants and the volunteer drivers. During FYE 2022, CRMC delivered an average of 28 - 30 meals per day, five days per week.Priority/Objective No. 9 - Health Care Staffing ShortagesCRMC's 33rd Annual High School Scholarship program for FYE 2022 awarded a total of $10,500 to 20 graduating seniors from nine area school districts who were entering a health-care field of study. As a means for promoting the health-care industry as an excellent employment/career opportunity, awards are available to students residing throughout a five-county area and are renewable for an additional three years to cover undergraduate studies, provided the student remains in a health-care field of study and maintains at least a 3.0 GPA. In addition to the five counties, there is a special category for employees' children.CRMC continues to provide a total of $10,000 to second-year Allied Health Care students at North Central Missouri College in Trenton, Missouri on an annual basis. In FYE 2022, seven nursing students each received $1,500 for a total of $10,500.As a third prong to the Medical Center's scholarship efforts, the CRMC Medical Staff still awards one $5,000 scholarship each year to a promising first-year medical student. In FYE 2022, two such scholarships were awarded for a total of $10,000.CRMC serves as a clinical rotation site for many colleges, universities, and medical schools, including: a) North Central Missouri College in Trenton, Missouri (Nursing); b) Allen College (Occupational Therapy); c) Penn Valley Community College (Occupational Therapy); d) MHPC NW Consortium (Occupational Therapy); e) Concorde Career College (Respiratory Therapy); f) Barton Community College (Lab); g) University of Missouri - Kansas City (Family Nurse Practitioners); h) University of Missouri - Columbia (Family Nurse Practitioners); i) University of Missouri - Columbia (Physical Therapy); j) Missouri Western State College (Physical Therapy); k) Various online study programs (Family Nurse Practitioners); l) A.T. Still University - Kirksville College of Osteopathic Medicine (medical school students); m) Kansas City University (medical school students); n) University of Missouri - Columbia School of Medicine (medical school students); and o) University of Missouri - Kansas City School of Medicine (medical school students). This allows CRMC to have first-hand exposure to these students for prospective recruitment purposes. Cameron Regional Medical Center, Inc. Part V, Section B, Line 11: When dealing with difficult-to-fill health-care positions, CRMC will financially assist select employees, potential employees, and providers with education debt.CRMC continues to financially support the HOSA (Health Occupations Students of America) BioMedical Science Program at Cameron High School in order to cultivate and promote continued interest in healthcare professions.As previously indicated, TelePsychiatry services are utilized in CRMC's BHU to assure the Medical Director is always available for patient care needs. Due to COVID-19 and the associated burn-out among staff members, special bonuses were instituted at CRMC in late 2021 for retention purposes. CRMC employees who provided direct patient care received an additional $5.00 per hour in special COVID pay, while the balance of employees received an additional $3.00 per hour in special COVID pay. With the waning of COVID-19, these bonuses were later transitioned into permanent wage increases at a slightly reduced rate.The following identified needs were not a direct part of the Medical Center's mission or normal/direct operations in FYE 9-30-22. Rather, CRMC provided support measures and partnered with other entities throughout the area ("key stakeholders") as needed and appropriate.Priority/Objective No. 3 - Available Affordable Health Insurance CoverageCRMC does not provide health insurance products, but the Medical Center continually recognizes the financial stresses placed on area families and residents by today's medical costs. As a result, it provides support and financial assistance to its patients through various methods: a) The Medical Center assists individuals with both Medicare and Medicaid enrollment; b) CRMC subsidizes many of its Consulting Staff physicians (specialists) so they will see Medicaid patients, when otherwise they would not; c) Charity Care (financial assistance) is provided to qualifying individuals based on U.S. Federal Poverty Guidelines if the patient makes a good-faith effort and completes the applicable paperwork; d) A prompt-pay discount program is offered to anyone with self-pay balances, whether it be on hospital or satellite clinic services; e) Monthly audits are conducted internally to determine the public's satisfaction with CRMC's billing and collection practices; and f) Free public education meetings are held at least twice per year, centering on the Patient Protection and Affordable Care Act (PPACA), Medicare, Medicaid, Part D, Advantage plans, and other third-party payors. These question-and-answer sessions cover all facets of public health-care concerns, including billing, collecting, and insurance coverage.Priority/Objective No. 4 - Child Care ServicesAs child care is not a core component of CRMC's mission or operations, the Medical Center plays only a supporting role in addressing this need. The Medical Center cooperates with area economic development efforts toward promoting new businesses whenever feasible in the hope of realizing additional pre-schools and child care centers in rural northwest Missouri. CRMC financially supports the Cameron YMCA and the Cameron R-1 School District, both of which provide Pre-Kindergarten day-care/pre-school services.Priority/Objective No. 6 - Poverty/Employment ReadinessAlthough normal CRMC operations do not directly address poverty and employment preparedness, the Medical Center strives to provide public support and assistance whenever possible. As CRMC is situated on heavily-traveled Interstate 35, this is particularly evident with indigent patients presenting to the Emergency Room in need of money for food and/or travel. CRMC frequently provides funds and/or transportation when necessary, and also maintains a close working relationship with area Ministerial Alliances so that individuals and/or families in need are addressed in a timely manner.Other assistance efforts by CRMC come in the following forms: a) CRMC donates free-of-charge the use of a small building in Stewartsville, Missouri for Food Pantry purposes; b) Through the Caldwell County Health Department, the CRMC Foundation has made sizeable donations to the Hideaway Lakes project at Polo, Missouri, with the funds earmarked for children, the elderly, and the installation of a fresh water supply for this impoverished community; and c) As previously mentioned under Priority/Objective No. 1 - Mental Health, perhaps the single largest expenditure CRMC commits to area poverty is the provision of free transportation to allow individuals to obtain needed medical services. For those who have no other viable means of travel, the Medical Center operates five Patient Courtesy Vans six days per week throughout ten-plus counties in rural northwest Missouri. Patients are transported to and from the Medical Center, area physicians' offices, CRMC's satellite clinics, and/or CRMC's outpatient specialty clinics. Based on need and special circumstances, free transportation to area tertiary centers and ancillary services (dentist, drug store, etc.) is also made available. Priority/Objective No. 7 - Alcohol/Drunk Driving Although CRMC primary care providers provide alcohol counseling and educational materials to their patients at both the Medical Center and its 18 satellite clinics, alcohol abuse and resultant drunk driving are not a central component of CRMC's day-to-day operations. For many years, CRMC has financially supported many post-graduation and post-prom parties throughout five-counties to assist in providing alternative activities to drinking for the safety of area high school students. 19 1 - Walnut Medical Clinic 921 N Walnut Cameron MO 64429 Rural Health Clinic 2 - Cameron Medical Clinic 1600 E Evergreen Cameron MO 64429 Medical Clinic 3 - Westside Medical Offices 1608 E Evergreen Cameron MO 64429 Medical Clinic 4 - Bethany Health Services 903 North 25th Street Bethany MO 64424 Medical Clinic 5 - Hamilton Family Health Center 103 N Davis Hamilton MO 64644 Rural Health Clinic 6 - NW Missouri Obstetrics & Gynecology 221 E 7th Street Cameron MO 64429 Medical Clinic 7 - Cameron Specialists - Internal Medicine 1608 E Evergreen Cameron MO 64429 Medical Clinic 8 - Lathrop Medical Clinic 106 North Street Lathrop MO 64465 Medical Clinic 9 - Gallatin Family Medicine 502 S Main Gallatin MO 64640 Rural Health Clinic 10 - Maysville Family Health 1007 S Polk Maysville MO 64469 Rural Health Clinic 11 - Polo Family Health Center 198 Main Street Polo MO 64671 Rural Health Clinic 12 - Jamesport Outreach Clinic 409 W Auberry Grove Jamesport MO 64648 Rural Health Clinic 13 - Cameron Nephrology Clinic 1600 E Evergreen Suite B Cameron MO 64429 Medical Clinic 14 - Eagleville Medical Clinic 12050 12th Street Eagleville MO 64442 Rural Health Clinic 15 - Plattsburg Family Medicine 214 N Main Plattsburg MO 64477 Rural Health Clinic 16 - Stewartsville Medical Clinic 106 E 4th Stewartsville MO 64490 Rural Health Clinic 17 - Pattonsburg Medical Clinic 110 N Central Ave Pattonsburg MO 64670 Rural Health Clinic 18 - Gilman City Medical Clinic 427 Main Street Gilman City MO 64642 Rural Health Clinic 19 - Cameron Obstetrics & Gynecology 1600 E Evergreen Suite A Cameron MO 64429 Medical Clinic Part I, Line 7: A cost-to-charge ratio derived from Worksheet 2 was used to calculate the amounts reported on line 7. Part I, Line 7g: The costs of subsidized health services include costs attributable to multiple physician clinics in the amount of $17,934,895. Part III, Line 4: See Note B (beginning on page 16) of the audited financial statements regarding the allowance for uncollectible accounts.Part III Line 2:This amount was determined by multiplying a cost-to-charge ratio derived from Worksheet 2 by the Medical Center's bad debt expense for the tax year.Part III, Line 3:This amount was determined based on the overall income level of patients that submit all required documentation under the Medical Center's financial assistance policy. As a tax-exempt hospital, we must provide necessary services regardless of the patient's ability to pay for that care. Making quality patient care available to all in our community, regardless of their economic means, qualfies these bad debts as a community benefit. Part III, Line 8: Medicare costs were obtained from the Medical Center's as-filed Medicare cost report for the tax year.Any shortfalls are a benefit to the Medical Center's community since it represents health care provided at less than cost to elderly and needy residents of the Medical Center's service area.Revenue included in Medicare Cost Report $15,796,806Fee schedule revenue excluded from Medicare Cost Report 550,473Total Medicare revenue 16,347,279Expenses included in Medicare Cost Report $18,255,255Fee schedule expenses excluded from Medicare Cost Report 1,337,832Total Medicare expense 19,593,087Total net Medicare loss 3,245,808 Part III, Line 9b: At the time of admission and before discharge, each patient will receive a notice that the Medical Center has a Financial Assistance Policy (with a brief description of such policy) and directions for obtaining additional information about such policy. All itemized statements sent to the patient include a notice that the Medical Center has a Financial Assistance Policy and directions for obtaining additional information about such policy. If a patient submits a Financial Assistance Policy application, all payment notifications and collection actions are suspended until it is determined whether the patient is eligible for the Financial Assitance Policy (and if so, notifications and collection actions will cease). Part VI, Line 2: The Medical Center relies on the feedback and requests taken from patients of the Medical Center and its numerous clinics, as well as residents from its primary service area. Part VI, Line 3: The Medical Center employs a social worker that informs all patients of all available payment options. Part VI, Line 4: Cameron Regional Medical Center and its eleven rural health clinics are located in Northwest Missouri. The primary service area is comprised of four rural counties consisting of Daviess, Caldwell, DeKalb, and Clinton. There are approximately 50,032 individuals that reside in the primary service area. Of these residents approximately 11.9% of them have an annual income below the federal poverty level. The median annual income per household for the four counties is approximately 58,352. Approximately 34% of the total services provided are for Medicare patients and 14% are for Medicaid patients. The nearest surrounding hospitals are located in Smithville, Excelsior Springs, and Richmond. The distance between these facilities and Cameron Regional Medical Center is approximately 28, 28, and 31 miles respectively. Part VI, Line 5: Cameron Regional Medical Center's governing body is comprised of residents from its primary service area. The Medical Center extends medical privileges to all local physicians who meet the requirements of the medical staff bylaws. All surplus funds are used to maintain and improve the medical facility and medical equipment in order to provide the best medical treatment possible to every patient. 1 College scholarships 44 27500 Part I, Line 2: Scholarships are paid directly to the college of the recipient. X X X 0 1 0 0 0 1 0 1 0 Laeeq Azmat Tahirkheli Physician & Director 673284 0 300642 0 0 0 0 0 0 0 973926 0 0 0 Shahzad Shafique Physician 524836 0 139430 0 0 0 0 0 0 0 664266 0 0 0 Arihant Jain Physician 551841 0 17847 0 0 0 0 0 0 0 569688 0 0 0 Muhammad Amin Physician 432587 0 128675 0 0 0 0 0 0 0 561262 0 0 0 Joseph F Abrutz Jr Administrator 353174 0 146568 0 0 0 0 0 12804 0 512546 0 0 0 Barry Littlejohn Physician 467425 0 37146 0 0 0 0 0 0 0 504571 0 0 0 Ly Phan Physician 485376 0 2493 0 0 0 0 0 0 0 487869 0 0 0 Laura Harbison Physician & Director 384694 0 7581 0 0 0 0 0 0 0 392275 0 0 0 Rosa Patti Chief Financial Officer 101002 0 88873 0 0 0 0 0 15633 0 205508 0 0 0 Part I, Line 4b The Medical Center has established a deferred compensation plan (a 457 Plan subject to Code section 457(b)). The name of the Plan as adopted by the Medical Center is Cameron Regional Medical Center, Inc. 457(b) Plan. During the fiscal year end 09/30/2022, $20,308 was contributed to the Plan on behalf of Joseph F. Abrutz, Jr., Administrator of the Medical Center. Part I, Line 6 The Administrator is eligible for an annual bonus that is partially contingent on meeting a specific operating margin percentage. Part I, Line 7 The Administrator is eligible for an annual bonus that is partially contingent on meeting quality measure goals and strategic planning goals. The Chief Financial Officer also received a bonus during the fiscal year ending in 2022 for completing a variety of special projects for the Medical Center. A The Industrial Development Authority of Clinton County Missouri 431619770 18746NAM2 2017-09-06 10000000 Refund Series 2007B bonds issued on 05/17/2007 0 0 0 B The Industrial Development Authority of Clinton County Missouri 431619770 18746NAQ3 2017-09-06 3990000 Financing of capital project and equipment 0 0 0 C The Industrial Development Authority of the City of Cameron Missouri 431679396 133451BS2 2017-12-21 6105000 Refund Series 2011 bond and financing of capital project 0 0 0 D The Industrial Development Authority of the City of Cameron Missouri 431679396 NoneAvail 2019-08-22 2730000 Financing of capital projects 0 0 0 A 150000 10000000 482008 170257 9348788 2017 1 0 1 1 B 3990000 399872 68386 3504535 21250 2018 0 0 1 1 C 1630000 6105000 240525 121226 2827033 2939863 2019 1 0 1 1 D 2730000 175383 54600 2513835 2020 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 D 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer Name: The Industrial Development Authority of Clinton County, Missou Date the Rebate Computation was Performed: 09/01/2022 Issuer Name: The Industrial Development Authority of Clinton County, Missou Date the Rebate Computation was Performed: 09/01/2022 A Health and Educational Facilties Authority of the State of Missouri 431178966 NoneAvail 2022-04-20 5615000 Financing of capital projects 0 0 0 A 5615000 501408 112000 2977761 2032926 0 0 0 1 A 0 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 1 A 1 Form 990, Part VI, Section B, line 11b A copy of Form 990 is made available to the governing body prior to filing. Form 990, Part VI, Section B, line 12c Employees and Directors are required to complete an annual disclosure information form. Form 990, Part VI, Section B, line 15a The Board of Trustees is responsible for deteriming the job performance standards for the Administrator/CEO and determining compensation according to the organization's policies. Form 990, Part VI, Section C, line 19 Organization makes its governing documents available upon request. Form 990, Part IX, line 11g Professional fees: Program service expenses 5,993,005. Management and general expenses 88,803. Fundraising expenses 0. Total expenses 6,081,808. Purchased services: Program service expenses 2,428,035. Management and general expenses 609,649. Fundraising expenses 0. Total expenses 3,037,684. Reference lab fees: Program service expenses 1,003,478. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,003,478. Other fees for services: Program service expenses 22,673. Management and general expenses 213,000. Fundraising expenses 0. Total expenses 235,673. Form 990, Part XI, line 9: Change in beneficial interest in net assets of Foundation net of transfers -23,213. Form 990, Part XII, Line 2C: The audit committee assumes the responsibility for the oversight of the audited financial statements, review of the Form 990, and selection of the independent accounting firm. Form 990, Part XXII, Line 3b The Medical Center is currently in the process of completing its Single Audit. Cameron Regional Medical Center Provider Management Service Organization LL 1600 East Evergreen Street Cameron MO 64429 472649803 To provide support and administrative services to physician groups MO Cameron Regional Medical Center Cameron Regional Medical Center Foundation 1600 East Evergreen Street Cameron MO 64429 742933060 To support the operation of the Cameron Regional Medical Center, Inc. MO 501(c)(3) Line 7 0 0 0 1 0 1 0 0 0 0 0 0 1 1 1 1 0 0 0 0