2023-08-15T14:54:49-05:00 2022-09-30 430352985 KERBER ECK & BRAECKEL LLP 3401 OFFICE PARK DRIVE MARION IL 62959 990 2021-10-01 430633449 MISSOURI DELTA MEDICAL CENTER MISS 5734711600 1008 NORTH MAIN ST SIKESTON MO 638015044 JASON SCHRUMPF PRESIDENT 5734711600 2023-08-15 1 JASON SCHRUMPF 999009999 AMBER HALSTEAD P01343727 6189938724 2023-08-15 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z JASON SCHRUMPF 1008 NORTH MAIN ST SIKESTON MO 638015044 131854124 0 X WWW.MISSOURIDELTA.COM X 1948 MO MISSOURI DELTA MEDICAL CENTER IS A NOT FOR PROFIT CORPORATION WHICH STRIVES TO PROVIDE A COMPLETE HEALTH CARE SYSTEM TO RESIDENTS IN THE SERVICE AREA EITHER DIRECTLY OR IN COOPERATION WITH OTHERS. 19 17 1109 14 0 0 12719604 5599871 111815670 111576047 1525258 1650543 13229996 13059384 139290528 131885845 12000 10000 0 0 66305461 69286052 0 0 0 60688322 68660804 127005783 137956856 12284745 -6071011 113462739 88207805 49346706 32016688 64116033 56191117 X MISSOURI DELTA MEDICAL CENTER IS A NOT FOR PROFIT CORPORATION WHICH WILL STRIVE TO PROVIDE A COMPLETE HEALTH CARE SYSTEM TO RESIDENTS IN THE SERVICE AREA EITHER DIRECTLY OR IN COOPERATION WITH OTHERS. REFERRAL AGREEMENTS WILL BE SOUGHT FOR SERVICES NOT OFFERED LOCALLY. THE HOSPITAL WILL ALSO ACTIVELY OFFER OR SUPPORT APPROPRIATE PROGRAMS TO PROMOTE THE GENERAL HEALTH, AND TO MEET THE REHABILITATION, EDUCATIONAL AND SOCIAL NEEDS OF OUR SERVICE AREA. SERVICES WILL BE PROVIDED TO ALL RESIDENTS OF OUR SERVICE AREA REGARDLESS OF RACE, COLOR, RELIGION, SEX, AGE, NATIONAL ORIGIN, OR DISABILITY. 0 0 109041290 10000 111607768 MISSOURI DELTA MEDICAL CENTER PROVIDES QUALITY MEDICAL CARE TO THE RESIDENTS OF ITS COMMUNITY REGARDLESS OF ABILITY TO PAY. MDMC ALSO PROVIDES SHORT TERM REHABILITATION SERVICES THROUGH AN ACUTE IP REHABILITATION UNIT AND PSYCHIATRIC SERVICES THROUGH AN ACUTE IP GERIATRIC PSYCHIATRIC UNIT AND AN ADOLESCENT PSYCHIATRIC UNIT. THESE SERVICES ARE SUMMARIZED AS FOLLOWS:HOSPITAL:ACUTE INPATIENT DAYS 15,173ACUTE INPATIENT ADMISSIONS 3,441EMERGENCY ROOM VISITS 19,806RURAL HEALTH CLINIC VISITS 102,613 LABORATORY TESTS PERFORMED 389,665 RADIOLOGY EXAMS PERFORMED 47,073 PT, OT, ST TREATMENTS 106,802 PHYSICIAN OFFICE VISITS 68,878 REHAB INPATIENT DAYS 1,626REHAB INPATIENT ADMISSIONS 181GERIATRIC PSYCH INPATIENT DAYS 3,435GERIATRIC PSYCH INPATIENT ADMISSIONS 398ADOLESCENT PSYCH INPATIENT DAYS 2,594 ADOLESCENT PSYCH INPATIENT ADMISSIONS 578 THE HOSPITAL PROVIDED FREE CARE TO INDIGENT PATIENTS IN THE AMOUNTOF $444,096 VALUED AT BILLED CHARGES. THE HOSPITAL ALSO PROVIDED NUMEROUS FREE PROGRAMS AND REDUCED PRICE SERVICES THROUGH THE YEAR THAT THE HOSPITAL BELIEVES SERVES A COMMUNITY NEED. SERVICES PROVIDED FREE OF CHARGE OR BELOW COST TO THE GENERAL PUBLIC INCLUDE:1. PERIODIC BLOOD PRESSURE AND CHOLESTEROL SCREENINGS2. OUTPATIENT DIABETIC EDUCATION AND OTHER HEALTH EDUCATION CLASSES3. CHILDBIRTH CLASSES, FIRST AID CLASSES AND CPR COURSES4. RED CROSS BLOOD DRIVES5. COVID 19 VACCINATION CLINICS6. HEALTH EDUCATION ARTICLES IN THE LOCAL NEWSPAPER 109041290 1 1 0 1 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 0 0 0 0 0 1 1 0 0 0 0 0 0 1 1 0 0 0 1 167 0 1109 1 0 0 0 0 0 0 0 0 0 0 X 19 17 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 MO X GREG CARDA 5734711600 1008 NORTH MAIN STREET SIKESTON MO 638015044 DWIGHT BIZZELL DIRECTOR 1.00 X 0 0 0 JOHN BOLLINGER DIRECTOR 1.00 X 0 0 0 LEVEN COX DIRECTOR 1.00 X 0 0 0 EDWARD DEMENT DIRECTOR 1.00 X 0 0 0 BART GRANT DIRECTOR 1.00 X 0 0 0 CHARLES D JENNINGS JR DIRECTOR 1.00 X 0 0 0 DANIEL DEKE LAPE DIRECTOR 1.00 X 0 0 0 ROBERT MACGILLIVRAY DIRECTOR 1.00 X 0 0 0 BRITT MCCONNELL DIRECTOR 1.00 X 0 0 0 BRIAN MENZ DIRECTOR 1.00 X 0 0 0 JEFF PARTRIDGE DIRECTOR 1.00 X 0 0 0 TAMMY BURCH DIRECTOR 1.00 X 0 0 0 MATHEW DRAKE DIRECTOR 1.00 X 0 0 0 DAVID JONES DIRECTOR 1.00 X 0 0 0 MIKE MARSHALL DIRECTOR 1.00 X 0 0 0 BRETT MATTHEWS DIRECTOR 1.00 X 0 0 0 JULIE AYCOCK DIRECTOR 1.00 X 0 0 0 JOEL PATRICK EVANS SECRETARY 1.00 X 0 0 0 ELIZABETH JOHNSON CHAIRMAN 1.00 X 0 0 0 MICHAEL JONES VICE CHAIRMAN 1.00 X 0 0 0 MATT TANNER TREASURER 1.00 X 0 0 0 JASON SCHRUMPF PRESIDENT/CEO 40.00 X 411649 0 9712 GREG CARDA VP. FINANCE 40.00 X 229537 0 9051 JULIE FRASER VP, NURSING 40.00 X 201155 0 9004 JAMES HENSON SENIOR VICE PRESIDENT 40.00 X 244413 0 6521 DR RUDY RODRIGUEZ PHYSICIAN 40.00 X 1239744 0 10257 DR KENNETH MOY PHYSICIAN 40.00 X 841542 0 7547 DR BRANDON COVERT PHYSICIAN 40.00 X 1134287 0 1525 DR JEFFREY GRIESEMER PHYSICIAN 40.00 X 712612 0 6888 DR PAUL MONTANY PHYSICIAN 40.00 X 697499 0 4275 5712438 0 64780 86 0 1 0 PENZEL CONSTRUCTION CO 325 W JACKSON BLVD JACKSON MO 63755 CONSTRUCTION 3569335 RESOURCE ANESTHESIOLOGY ASSOCIATES 450 MAMARONECK AVENUE HARRISON NY 11528 ANESTHESIA SERVICES 1940356 MORRISON HEALTHCARE PO BOX 102289 ATLANTA GA 303682289 DIETARY SERVICES 1921592 HORIZON HEALTH PO BOX 840839 DALLAS TX 752840839 MANAGEMENT SERVICES 1879959 MEDICAL SOLUTIONS LLC 1010 NORTH 102ND ST SUITE 300 OMAHA NE 68114 CONTRACTED NURSES 1832743 40 884376 4715495 5599871 NET PATIENT SERVICE REVENUE 621110 111576047 111576047 111576047 1618822 1618822 -31721 31721 31721 31721 340 B PHARMACY PROGRAM 621110 7977823 7977823 EMPLOYEE PHARMACY SALES 722514 2988696 2988696 OTHER OPERATING REVENUE 621990 2001170 2001170 91695 91695 13059384 131885845 111607768 0 14678206 10000 10000 1086755 1086755 57229180 51318023 5911157 202904 178556 24348 7139280 6282566 856714 3627933 3192581 435352 24533 17173 7360 168975 118283 50692 5087501 3561251 1526250 54538 38177 16361 1828496 1276947 551549 3914240 2739968 1174272 108489 75942 32547 85319 59723 25596 508278 355795 152483 5129405 3590584 1538821 1291249 903874 387375 MEDICAL SUPPLIES 24399113 17079379 7319734 PURCHASE SERVICE 21569721 15098805 6470916 REPAIRS AND MAINTENANCE 2707903 1895532 812371 OTHER 1191488 834041 357447 591556 414090 177466 137956856 109041290 28915566 0 2940556 937590 25732772 3726960 23010066 19942248 377231 203319 3658084 4047717 3112581 3490033 138788265 83767477 53390692 55020788 1240757 839150 113462739 88207805 17762940 12586813 1454614 805976 9593312 9678711 1084778 1903767 19451062 7041421 49346706 32016688 X 64116033 56191117 64116033 56191117 113462739 88207805 -6071011 -1853905 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 8731 0 0 0 8731 0 784508 784508 55506957 28868871 26638086 64097282 53894514 10202768 8018099 10381419 1004092 17395426 55020788 PROFESSIONAL LIABILITY 568522 DUE TO THIRD PARTY 6472899 7041421 X PART X, LINE 2: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITION 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. 1 1 1 X 1 X 180.000000000000 1 1 1 0 1 1 1114740 1114740 0.00810 21589470 13917394 7672076 0.05560 22704210 13917394 8786816 0.06370 87310 87310 0.00060 87310 87310 0.00060 22791520 13917394 8874126 0.06430 1 11446326 26134685 29679470 -3544785 X 1 1 1 1 MISSOURI DELTA MEDICAL CENTER 1008 NORTH MAIN STREET SIKESTON MO 63801 X X MISSOURI DELTA MEDICAL CENTER 1 0 0 1 X X X X X X X X 22 1 1 1 1 X WWW.MISSOURIDELTA.COM X 1 19 1 WWW.MISSOURIDELTA.COM 0 1 X 100.000000000000 180.000000000000 X 1 1 X X X 1 X WWW.MISSOURIDELTA.COM X X 1 X X X 1 X X X X X 1 0 0 MISSOURI DELTA MEDICAL CENTER PART V, SECTION B, LINE 6A: FOR THE PURPOSES OF THE ASSESSMENT, COMMUNITY IS DEFINED AS THE GEOGRAPHIC AREA FROM WHICH A SIGNIFICANT NUMBER OF PATIENTS USING MDMC SERVICES RESIDE. THE PRIMARY SERVICE AREA FOR MDMC IS BASED ON THE NUMBER OF INPATIENT DISCHARGES AND OUTPATIENT VISITS BY PATIENTS THAT RESIDE IN SCOTT, MISSISSIPPI AND NEW MADRID COUNTIES. THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR SCOTT COUNTY WAS CONDUCTED IN PARTNERSHIP WITH SAINT FRANCIS MEDICAL CENTER. AS MISSISSIPPI COUNTY AND NEW MADRID COUNTY WERE THE PRIMARY SERVICE AREAS OF MDMC ALONE THE CHNA WAS NOT CONDUCTED IN PARTERNSHIP WITH SAINT FRANCIS MEDICAL CENTER. MISSOURI DELTA MEDICAL CENTER PART V, SECTION B, LINE 6B: FOR PURPOSES OF THE ASSESSMENT, THE HOSPITAL COLLECTED DATA FROM A VARIETY OF LOCAL, COUNTY, STATE AND NATIONAL RESOURCES IN ORDER TO PROFILE THE DEMOGRAPHICS, SOCIAL/ECONOMIC FACTORS, HEALTH STATUS AND ACCESS TO HEALTHCARE IN COMMUNITIES SERVICED. INDIVIDUALS REPRESENTING THE FOLLOWING ORGANIZATIONS PARTICIPATED IN THE PRIMARY RESEARCH IN SCOTT COUNTY: (1) BOOTHEEL COUNSELING SERVICES; (2) MISSOURI HOUSE OF REPRESENTATIVES; (3) AMERICAN RED CROSS; (4) FERGUSON MEDICAL GROUP; (5) SCOTT COUNTY HEALTH DEPARTMENT; (6) SEMO HEALTH NETWORK; (7) SIKESTON REGIONAL CHAMBER; (8) SCOTT COUNTY CENTRAL SCHOOLS. INDIVIDUALS REPRESENTING THE FOLLOWING ORGANIZATIONS PARTICIPATED IN THE PRIMARY RESEARCH IN NEW MADRID COUNTY: (1) NEW MADRID COUNTY HEALTH DEPARTMENT; (2) BOOTHEEL COUNSELING; (3) SEMO HEALTH NETWORK. INDIVIDUALS REPRESENTING THE FOLLOWING ORGANIZATIONS PARTICIPATED IN THE PRIMARY RESEARCH IN MISSISSIPPI COUNTY: (1) MISSISSIPPI COUNTY HEALTH DEPARTMENT; (2) L&S PHARMACY; (3) MISSOURI WOMEN, INFANTS AND CHILDREN (WIC). MISSOURI DELTA MEDICAL CENTER PART V, SECTION B, LINE 11: MEMBERS OF THE MISSOURI DELTA CHNA TEAM ANALYZED THE SURVEY DATA, FOCUS GROUP DATA, AND SECONDARY DATA TO PRIORITIZE THE COMMUNITY HEALTH NEEDS FOR MISSISSIPPI, NEW MADRID AND SCOTT COUNTIES. THE TOP FIVE PRIORITY NEEDS INCLUDE:1. CHILD AND ADULT OBESITY2. CHRONIC DISEASE A. DIABETES (DIET AND EXERCISE)B. CHRONIC RESPIRATORY DISEASE (SMOKING)C. HEART DISEASE (SMOKING/DIET AND EXERCISE)D. STROKE (HEALTHY LIFESTYLE)3. CANCER (SMOKING)4. MENTAL ILLNESS5. DRUG AND ALCOHOL ABUSECHILD AND ADULT OBESITY:SPECIFIC STRATEGIES INCLUDE EDUCATIONAL ACTIVITY BOOKS GEARED TOWARD FAMILIES WHICH INCLUDES HEALTHY EATING HABITS. BOOKS WILL BE AVAILABLE IN MDMC CLINIC WAITING ROOMS AND THE EMERGENCY ROOM. CREATION OF FITKIDZ THROUGH POSTERS, HANDOUTS, TV LOBBY, AND HEALTH FAIRS. CONTINUE TO HOLD CHRONIC DISEASE EDUCATIONAL WORKSHOPS AT MISSOURI DELTA MEDICAL CENTER. CONTINUE TO IDENTIFY PATIENTS IN NEED OF ATTENDING CHRONIC DESEASE EDUCATION WORKSHOPS OFFERED. PROVIDE SPEAKERS/PRESENTERS ABOUT HEALTHY EATING AT EVENTS SUCH AS THE ANNUAL WOMEN'S SHOW AND THE ANNUAL WOMEN'S HEALTH CONFERENCE. PARTICIPATE IN THE ANNUAL HEALTHY KIDS DAY PROGRAM AT THE YMCA WITH EDUCATIONAL DIETARY INFORMATION. PARTNER WITH STRATUS MEDICAL GROUP WITH PROMOTION OF THEIR HEALTHY WEIGHT MANAGEMENT PROGRAM. CHRONIC DISEASE: SPECIFIC STRATEGIES INCLUDE TO CONTINUE OFFERING CHRONIC DISEASE EDUCATIONAL WORKSHOPS AND PROMOTING THOSE THROUGH THE PHYSICIANS, CASE MANAGERS AND OTHER CIVIC ORGANIZATIONS. CONTINUE TO PROVIDE FREE PUBLIC HEALTH SCREENINGS AT HEALTH FAIRS THROUGHOUT THE COUNTIES WE SERVE; BLOOD PRESSURE, GLUCOSE, LUNG. POPULATION HEALTH WORKING THROUGH OUTREACH TO HELP EDUCATE PATIENTS AND PREVENT READMISSIONS. WORK WITH LOCAL HEALTH DEPARTMENTS IN EACH COUNTY TO PROMOTE THEIR DIABETES SUPPORT GROUPS AND SELF-HELP PROGRAMS. CANCER: SPECIFIC STRATEGIES INCLUDE TO CONTINUE TO PROMOTE SMOKING-CESSATION PROGRAMS THE LOCAL HEALTH DEPARTMENTS ARE PROVIDING AND EDUCATE MEDICAL PROVIDERS ON THE RESOURCES AVAILABLE FOR PATIENTS WHO WANT TO QUIT TOBACCO USAGE. MENTAL ILLNESS AND DRUG AND ALCOHOL ABUSE:SPECIFIC STRATEGIES INCLUDE TO PARTNER WITH BOOTHEEL COUNSELING IN PROVIDING MENTAL HEALTH FIRST AID PROGRAMS TO AREA EMPLOYERS. THIS PROGRAM INTRODUCES PARTICIPANTS TO RISK FACTORS AND WARNING SIGNS OF MENTAL ILLNESS. CONTINUE TO SUPPORT THE MENTAL HEALTH COUNSELORS IMPLEMENTED IN MDMC'S RURAL HEALTH CLINICS IN SIKESTON AND NEW MADRID. PARTNER WITH PHARMACIES THAT OFFER A MEDICATION RECONCILIATION PROGRAM IN WHICH THE PHARMACIST VISITS THE PATIENT'S HOME AND COMPARES HOME MEDS WITH DISCHARGE MEDS TO ENSURE NO DISCREPANCIES. 32 1 - RESTART OF SIKESTON 1008 NORTH MAIN STREET SIKESTON MO 63801 PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY 2 - RESTART OF CHARLESTON 512 EAST MARSHALL STREET CHARLESTON MO 63834 PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY 3 - RESTART OF NEW MADRID 406 HIGHWAY 61 NEW MADRID MO 63869 PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY 4 - RESTART OF EAST PRAIRIE 106 SOUTH WASHINGTON EAST PRAIRIE MO 63845 PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY 5 - EXPRESS CARE 1008 NORTH MAIN STREET SIKESTON MO 63801 RURAL HEALTH CLINIC 6 - BARTON-JOLLY PHYSICIAN SERVICES 1019 NORTH MAIN STREET SIKESTON MO 63801 PHYSICIAN OFFICE BUILDING 7 - MISSOURI DELTA PRIMARY CARE 102 HOSPITALITY DRIVE SIKESTON MO 63801 RURAL HEALTH CLINIC 8 - MEDX MEDICAL EQUIPMENT 708 N MAIN STREET SIKESTON MO 63801 DURABLE MEDICAL EQUIPMENT 9 - WELLPOINT PAIN CENTER 135 PLAZA DRIVE SUITE 201 SIKESTON MO 63801 PAIN CENTER 10 - SMITH STREET CLINIC 123 SMITH STREET SIKESTON MO 63801 RURAL HEALTH CLINIC 11 - MISSOURI DELTA ORTHOPEDICS 201 PLAZA DRIVE SUITE A SIKESTON MO 63801 PHYSICIAN OFFICE BUILDING 12 - WOMEN'S CARE CENTER 1013 NORTH MAIN STREET SIKESTON MO 63801 RURAL HEALTH CLINIC 13 - MISSOURI DELTA CANCER & INFUSION CENTER 1126 NORTH MAIN STREET SIKESTON MO 63801 CANCER AND INFUSION CENTER 14 - PORTAGEVILLE COMMUNITY CARE CENTER 204 EAST 3RD STREET PORTAGEVILLE MO 63873 RURAL HEALTH CLINIC 15 - MISSOURI DELTA UROLOGY 1106 NORTH MAIN STREET SIKESTON MO 63801 PHYSICIAN OFFICE BUILDING 16 - SURGEONS NORTH 1124 NORTH MAIN STREET SIKESTON MO 63801 PHYSICIAN OFFICE BUILDING 17 - FAMILY MEDICINE 1017 NORTH MAIN SIKESTON MO 63801 PHYSICIAN OFFICE BUILDING 18 - ENT & ALLERGY CLINIC 135 PLAZA DRIVE SUITE 202 SIKESTON MO 63801 RURAL HEALTH CLINIC 19 - NEW MADRID COMMUNITY CARE CENTER 615 MAIN STREET NEW MADRID MO 63834 RURAL HEALTH CLINIC 20 - CHARLESTON COMMUNITY CARE CENTER 1403 EAST MARSHALL STREET CHARLESTON MO 63834 RURAL HEALTH CLINIC 21 - MISSOURI DELTA ENDOCRINE & DIABETES CENT 1118 NORTH MAIN STREET SIKESTON MO 63801 PHYSICIAN OFFICE BUILDING 22 - MISSOURI DELTA WOUND & HYPERBARIC 201 PLAZA DRIVE SIKESTON MO 63801 WOUND CARE CENTER 23 - DERMATOLOGY 1015 NORTH MAIN SIKESTON MO 63801 PHYSICIAN OFFICE BUILDING 24 - RESTART SOUTH 806 SOUTH KINGSHIGHWAY SIKESTON MO 63801 PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY 25 - DEXTER COMMUNITY CARE CENTER 911B WEST BUS HWY 60 DEXTER MO 63841 RURAL HEALTH CLINIC 26 - SPECIALTY CLINIC 135 PLAZA DRIVE SUITE 102 SIKESTON MO 63801 PHYSICIAN OFFICE BUILDING 27 - BENTON COMMUNITY CARE CENTER 6468 STATE HWY 77 BENTON MO 63736 RURAL HEALTH CLINIC 28 - CHAFFEE MEDICAL CENTER 209 WEST YOAKUM CHAFFEE MO 63740 RURAL HEALTH CLINIC 29 - MISSOURI DELTA OCCUPATIONAL MEDICINE 135 PLAZA DRIVE SUITE 202 SIKESTON MO 63801 PHYSICIAN OFFICE BUILDING 30 - GYNECOLOGIC ONCOLOGY 201 PLAZA DRIVE SUITE C SIKESTON MO 63801 PHYSICIAN OFFICE BUILDING 31 - PODIATRY 201 PLAZA DRIVE SUITE A SIKESTON MO 63801 PHYSICIAN OFFICE BUILDING 32 - SURGEONS - 1ST FLOOR JOLLY BUILDING 1013 NORTH MAIN STREET SIKESTON MO 63801 PHYSICIAN OFFICE BUILDING PART III, LINE 2: THE CENTER REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS, AND OTHERS. THE CENTER PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE CENTER BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. PART III, LINE 8: IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUONT REPORTED ON LINE 6 IS ESTIMATED BY USING THE PERCENT OF OPERATING EXPENSE TO PATIENT REVENUE. PART III, LINE 9B: THE BAD DEBT POLICY STATES THAT IF IT IS DETERMINED THAT A PATIENT IS INDIGENT, PROCEED AS FOLLOWS: A. COMPLETE ACCOUNT ADJUSTMENT FORMS FOLLOWING ACCOUNT ADJUSTMENT PROCEDURES OR NOTE THE BALANCE WILL BE WRITTEN OFF AS CHARITY ACCORDING TO THE CHARITY CARE POLICY.B. ENTER THE FOLLOWING NOTATIONS ON THE COPY OF THE PATIENT ACCOUNTS ADMISSION REGISTRATION FORMS OR IN ACCOUNTS RECEIVABLE NOTES IN THE COMPUTER: "CHARGES DUE BY PATIENT WILL BE WRITTEN OFF AS MEDICARE BAD DEBT OR UNCOMPENSATED CARE." 1 RAY CLINTON HEALTHCARE SCHOLARSHIPS 2 2000 JUANITA WILLIAMS NURSING SCHOLARSHIPS 3 5000 COOPER SCHOLARSHIPS 1 1000 BRUCE MEMORIAL SCHOLARSHIPS 2 2000 CASH SCHOLARSHIP FUND PART I, LINE 2: THE SCHOLARSHIP PROGRAM IS DESIGNED TO PROVIDE A CONSISTENT FLOW OF REGISTERED NURSES TO MISSOURI DELTA MEDICAL CENTER. THE OBJECTIVE OF THE PLAN IS TO ENCOURAGE AND FINANCIALLY ASSIST QUALIFIED STUDENTS IN THEIR ENDEAVOR TO BECOME A REGISTERED NURSE. TO THE EXTENT OF AVAILABLE FUNDS, THE MEDICAL CENTER WILL PAY SCHOLARSHIPS TO QUALIFIED STUDENTS OF AN ACCREDITED REGISTERED NURSE PROGRAM. TO QUALIFY FOR THE PROGRAM A STUDENT MUST: A. BE A HIGH SCHOOL GRADUATE 1. RANK IN THE UPPER THIRD OF HIGH SCHOOL CLASS ACADEMICALLY 2. SHOW EVIDENCE OF MOTIVATION FOR NURSING EITHER BY APTITUDE TESTING OR BY REPORTED DEMONSTRATION OF INTEREST 3. PROVIDE LETTER OF RECOMMENDATION FROM AN APPROPRIATE SCHOOL OFFICIAL 4. BE APPROVED BY THE HOSPITAL SCHOLARSHIP SELECTION COMMITTEE B. STUDENT NURSES - ALL STUDENT NURSES MUST: 1. HAVE AT LEAST THE EQUIVALENT OF A 2.5 GRADE POINT AVERAGE IN A 4 POINT SYSTEM 2. MUST PROVIDE A LETTER OF RECOMMENDATION FROM RESPONSIBLE AND APPROPRIATE PERSON 3. BE APPROVED BY THE SCHOLARSHIP COMMITTEE C. CURRENT EMPLOYEES - ALL CURRENT EMPLOYEES MUST: 1. BE ENROLLED IN A NURSING PROGRAM AS A FULL-TIME STUDENT 2. NOT BE RECEIVING ANY HOSPITAL BENEFITS 3. BE APPROVED BY THE SCHOLARSHIP COMMITTEE X X X X 0 0 0 0 0 0 0 0 0 DR RUDY RODRIGUEZ PHYSICIAN 783015 0 436969 0 19760 0 1525 0 8732 0 1250001 0 0 0 DR BRANDON COVERT PHYSICIAN 550014 0 584148 0 125 0 1525 0 0 0 1135812 0 0 0 DR KENNETH MOY PHYSICIAN 367983 0 446785 0 26774 0 1525 0 6022 0 849089 0 0 0 DR JEFFREY GRIESEMER PHYSICIAN 351808 0 248933 0 111871 0 1525 0 5363 0 719500 0 0 0 DR PAUL MONTANY PHYSICIAN 367852 0 309505 0 20142 0 1525 0 2750 0 701774 0 0 0 JASON SCHRUMPF PRESIDENT/CEO 318674 0 73266 0 19709 0 1525 0 8187 0 421361 0 0 0 JAMES HENSON SENIOR VICE PRESIDENT 219679 0 24606 0 128 0 1338 0 5183 0 250934 0 0 0 GREG CARDA VP. FINANCE 207108 0 21879 0 550 0 1249 0 7802 0 238588 0 0 0 JULIE FRASER VP, NURSING 179713 0 20900 0 542 0 1071 0 7933 0 210159 0 0 0 RAYMOND EARL SISK SON-IN-LAW OF DIRECTOR 168652 EMPLOYEE COMPENSATION 0 CATHERINE SCHRUMPF SPOUSE OF PRESIDENT 18842 EMPLOYEE COMPENSATION 0 RHONDA MENZ WIFE OF DIRECTOR 34636 EMPLOYEE COMPENSATION 0 JUDITH MENZ MOTHER OF DIRECTOR 92559 EMPLOYEE COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 2 DAN JENNINGS JR AND JOHN BOLLINGER HAVE A BUSINESS RELATIONSHIP. BRITT MCCONNEL AND ROBERT MACGILLIVRAY HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B BEFORE THE FORM 990 IS FILED, THE VICE-PRESIDENT OF FINANCE OF THE ORGANIZATION REVIEWS THE FORM 990, WHICH IS PREPARED BY AN OUTSIDE TAX PREPARER. THE FINANCE COMMITTEE OF MISSOURI DELTA MEDICAL CENTER WILL ALSO PERFORM A REVIEW OF THE FORM 990 AFTER THE FORM HAS BEEN FILED. IN ADDITION, COPIES OF THE FORM 990 WILL BE AVAILABLE TO THE MISSOURI DELTA MEDICAL CENTER'S BOARD OF DIRECTORS AFTER THE ORGANIZATION'S FORM 990 HAS BEEN FILED. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY IS AS FOLLOWS: MEMBERS OF THE BOARD OF DIRECTORS, PRINCIPAL OFFICERS, AND MEMBERS OF ANY COMMITTEE WITH BOARD-DELEGATED POWERS HAVE AN OBLIGATION TO MAKE DECISIONS AND TO PERFORM THEIR DUTIES FOR THE SOLE BENEFIT OF THE HOSPITAL. ALL PERSONS SERVING IN SUCH CAPACITY SHOULD AVOID PLACING HIMSELF/HERSELF IN A POSITION WHERE PERSONAL INTERESTS ARE IN CONFLICT WITH THE INTERESTS OF THE HOSPITAL. THE FOLLOWING DEFINITIONS SHALL APPLY TO THIS POLICY: 1. AN "INTERESTED PERSON" IS A MEMBER OF THE BOARD OF DIRECTORS, PRINCIPAL OFFICER OR MEMBER OF ANY COMMITTEE WITH BOARD DELEGATED POWERS; 2. A PERSON HAS A "FINANCIAL INTEREST" IF THE PERSON HAS, DIRECTLY OR INDIRECTLY, THROUGH BUSINESS, INVESTMENT OR FAMILY: A. A PRESENT OR POTENTIAL OWNERSHIP, INVESTMENT, INTEREST, OR COMPENSATION ARRANGEMENT IN ANY ENTITY WITH WHICH THE HOSPITAL HAS OR MAY HAVE A TRANSACTION OR ARRANGEMENT; B. A COMPENSATION ARRANGEMENT WITH THE HOSPITAL OR ANY ENTITY OR INDIVIDUAL WITH WHICH THE ORGANIZATION HAS A TRANSACTION OR ARRANGEMENT. COMPENSATION INCLUDES ANY REMUNERATION, DIRECTLY OR INDIRECTLY, AND GIFTS OF FAVORS, WHICH ARE SUBSTANTIAL IN NATURE; 3. AN "AFFILIATED ORGANIZATION" INCLUDES ANY ORGANIZATION OR ENTITY OWNED OR OPERATED BY THE HOSPITAL OR IN WHICH THE HOSPITAL HAS A DIRECT FINANCIAL INTEREST; ANY "INTERESTED PERSON" MUST DISCLOSE TO THE HOSPITAL AND ANY AFFILIATED ORGANIZATION ALL FINANCIAL INTERESTS AND ALL MATERIAL FACTS RELATING THERETO. IF A CONFLICT DOES ARISE, THE HOSPITAL AND ANY AFFILIATED ORGANIZATION SHALL: A. REQUIRE THAT THE "INTERESTED PERSON" LEAVE THE MEETING DURING THE DISCUSSION OF AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST; B. APPOINT, IF APPROPRIATE, UNDER THE CIRCUMSTANCES THEN APPEARING, A NON-INTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT; C. DETERMINE, BY A MAJORITY VOTE OF NON-INTERESTED PERSONS PRESENT, THAT THE TRANSACTION OR ARRANGEMENT IS IN THE HOSPITAL OR AFFILIATED ORGANIZATION'S BEST INTERESTS AND FOR ITS OWN BENEFIT AND IS FAIR AND REASONABLE TO THE HOSPITAL OR AFFILIATED ORGANIZATION. D. TAKE APPROPRIATE DISCIPLINARY ACTION WITH RESPECT TO AN "INTERESTED PERSON" WHO VIOLATES THIS CONFLICT OF INTEREST POLICY TO PROTECT THE ORGANIZATION'S BEST INTERESTS. THE MINUTES OF ANY MEETING OF THE BOARD OF DIRECTORS OR ANY COMMITTEE WITH BOARD-DELEGATED POWERS SHALL INCLUDE THE FOLLOWING: 1. THE NAMES OF THE PERSONS WHO DISCLOSED FINANCIAL INTERESTS AND THE NATURE OF THEIR FINANCIAL INTEREST; 2. THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT AND A RECORD OF THE VOTE. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S SALARY AND ADMINISTRATIVE REVIEW COMMITTEE, WHICH IS MADE UP OF MEMBERS OF THE BOARD OF DIRECTORS, REVIEWS THE COMPENSATION FOR THE PRESIDENT AND VICE-PRESIDENTS OF THE MEDICAL CENTER. THE REVIEW OF COMPENSATION UTILIZES THE ANNUAL "EXECUTIVE COMPENSATION REPORT" THAT IS PUBLISHED BY THE MISSOURI HOSPITAL ASSOCIATION. A REVIEW OF THE MISSOURI DELTA MEDICAL CENTER'S PRESIDENT AND VICE-PRESIDENTS COMPENSATION WAS CONDUCTED FOR THE YEAR ENDING SEPTEMBER 30, 2022. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONS' GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST. MISSOURI DELTA MEDICAL CENTER FOUNDATION 1008 NORTH MAIN STREET SIKESTON MO 63801 431577510 FUNDRAISING MO 501(C)(3) LINE 3 MISSOURI DELTA MEDICAL CENTER 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1