2021-03-08T14:37:22-06:00 2020-06-30 430352985 KERBER ECK & BRAECKEL LLP 3401 OFFICE PARK DRIVE MARION IL 62959 990 2019-07-01 800618988 LAWRENCE COUNTY MEMORIAL HOSPITAL LAWR 6189431000 2200 STATE STREET LAWRENCEVILLE IL 62439 CARL ATEN CHAIRMAN 6189431000 2021-02-25 1 MARK DALLAS P00187265 6189938724 2021-02-25 2019 2022-09-23 18:48:47Z CARL ATEN 2200 STATE STREET LAWRENCEVILLE IL 62439 20005479 0 X WWW.LCMHOSP.ORG X 1950 IL AT LAWRENCE COUNTY MEMORIAL HOSPITAL, WE OFFER COMPASSIONATE, PROFESSIONAL HEALTHCARE THAT MEETS THE HIGHEST STANDARDS OF EXCELLENCE. 11 8 197 18 0 0 580576 2023425 16659517 16647395 80005 7021 806008 1327638 18126106 20005479 0 0 0 0 10038417 10155006 0 0 0 8061551 8853574 18099968 19008580 26138 996899 12881657 15350688 3811768 5283900 9069889 10066788 AT LAWRENCE COUNTY MEMORIAL HOSPITAL, WE OFFER COMPASSIONATE, PROFESSIONAL HEALTHCARE THAT MEETS THE HIGHEST STANDARDS OF EXCELLENCE. 0 0 12857810 17975033 THE HOSPITPAL'S MISSION IS TO PROVIDE HIGH QUALITY CARE AND COST EFFECTIVE HEALTHCARE, WHICH INCLUDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO THE RESIDENTS OF LAWRENCE COUNTY, IL. ALL EXPENSES RELATE TO COSTS ASSOCIATED WITH PROVIDING THESE SERVICES, AND MAINLY INCLUDE SALARY AND WAGES TO STAFF AND COST OF SUPPLIES. 12857810 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 1 48 0 197 1 0 0 0 0 0 0 0 0 0 0 X 11 8 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 IL X X AARON TEACHOUT 6189437202 2200 STATE STREET LAWRENCEVILLE IL 62439 CARL ATEN CHAIRMAN 5.50 1.50 X X 0 0 0 RON WALDROP VICE CHAIRMAN 1.50 X X 0 0 0 KEVIN STRANGE TREASURER 1.00 0.50 X 0 0 0 REBECCA NESTLEROAD SECRETARY 2.00 2.00 X X 0 0 0 ANNETTE AKERS TRUSTEE 2.00 X 0 0 0 STANLEY WILLIAMS TRUSTEE 4.00 X 0 0 0 BJ SHAFFER TRUSTEE 1.50 X 0 0 0 DR GARY CARR TRUSTEE /PHYSICAN 40.00 X 235466 0 4812 L DENNIS ZEHNER TRUSTEE 4.00 X 0 0 0 JARED FLORENCE TRUSTEE 2.00 X 0 0 0 JAMES PORTER MD TRUSTEE 0.50 X 0 0 0 DON ROBBINS CEO 45.00 X 220491 0 30869 LARRY SPOUR CFO 45.00 X 158852 0 22239 RITA GARVEY CNO 45.00 X 114456 0 3434 VALERIE BURNS PHYSICAN 50.00 X 188561 0 10432 STEVEN RAMSARAN PHYSICAN 40.00 X 375030 0 25961 RODNEY FINCH CRNA 40.00 X 209969 0 22578 TANNA MCCULLOUGH NURSE PRACTITIONER 45.00 X 135098 0 30193 FARIS AL GEBORY SURGEON 20.00 X 166711 0 9408 1804634 0 159926 11 0 1 0 BLUECROSS BLUESHIELD OF IL PO BOX 121134 DALLAS TX 753121134 SELF INSURED INSURANCE 1438614 CORE PHYSICIAN RESOURCES 503A NORTH FIRST STREET FAIRFIELD IL 62837 CONTRACTED ED PHYSICIAN GROUP 593583 COMPHEALTH PO BOX 972651 DALLAS TX 753972651 CONTRACTED SURGEONS 381305 DEACONESS REGIONAL HEALTHCARE 600 MARY ST EVANSVILLE IN 47710 HEALTH PARTNER 346630 MARTIN GOLDSTONE MD 3926 W TOUHY LINCOLNWOOD IL 60712 CONTRACTED ED PHYSICIAN 337105 22 2003883 19542 2023425 PATIENT SERVICE REVENUE 621110 16647395 16647395 16647395 7021 7021 15799 0 15799 15799 15799 340B REVENUE 446110 1141977 1141977 CAFETERIA INCOME 722514 110454 110454 OTHER REVENUE 900099 42408 42408 17000 17000 1311839 20005479 17975033 0 7021 X 1804634 1804634 6019625 4514719 1504906 126963 95223 31740 1635859 1226895 408964 567925 425944 141981 907763 907763 40524 40524 44050 44050 3209593 2619100 590493 74185 73510 675 354099 115592 238507 20560 15421 5139 835060 626295 208765 44722 44722 6813 6813 729657 547243 182414 160861 120646 40215 UNCOLLECTABLE AMOUNTS 842624 842624 MEDICAL SUPPLY 678492 678492 DONATIONS 505295 505295 DRUG EXPENSE 229076 229076 170200 170200 19008580 12857810 6150770 0 3609268 5634142 426640 408578 2430479 1747043 306235 335492 518038 173644 15050656 9711599 5590997 5339057 0 1712732 12881657 15350688 1618651 1915293 1150000 3112964 206677 255643 836440 0 3811768 5283900 X 9069889 10066788 9069889 10066788 12881657 15350688 996899 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20150 20150 9860698 5525853 4334845 5169808 4185746 984062 5339057 THIRD - PARTY REIMBURSEMENT 1712732 1712732 X 19155840 -849639 -849639 20005479 0 20005479 18158941 -849639 -849639 19008580 0 19008580 PART X, LINE 2: THERE WERE NO UNCERTAIN TAX LIABILITIES IDENTIFIED AND RECORDED AS A LIABILITY AT JUNE 30, 2020 OR 2019 . PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE -842,624. INVESTMENT EXPENSE -7,015. PART XII, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE -842,624. INVESTMENT EXPENSE -7,015. 1 1 1 X 110.000000000000 1 X 1 1 0 0 790636 790636 0.04160 4073532 3851965 221567 0.01170 4864168 3851965 1012203 0.05330 4864168 3851965 1012203 0.05330 1 842624 8577551 8113980 463571 X 1 1 1 1 LAWRENCE COUNTY MEMORIAL HOSPITAL 2200 STATE STREET LAWRENCEVILLE IL 62439 HTTPS://WWW.LCMHOSP.ORG 0005769 X X X X LAWRENCE COUNTY MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X 19 1 0 0 1 X HTTPS://LCMHOSP.ORG/WP-CONTENT/UPLOADS/2018/02/ASSESSMENT_2016 X 1 18 1 HTTPS://LCMHOSP.ORG/WP-CONTENT/UPLOADS/2018/02/ASSESSMENT_2016 0 1 X 110.000000000000 300.000000000000 X X 1 1 X X X X X 1 X HTTPS://WWW.LCMHOSP.ORG X HTTPS://WWW.LCMHOSP.ORG X X X 1 X 1 X X X X X 1 X 0 1 LAWRENCE COUNTY MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: LCMH CONTRACTED WITH QHR CONSULTING SERVICES AS IT PERTAINED TO THE PREPARATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE FIRM PERFORMS SEVERAL INDEPENDENT DATA COLLECTIONS, AND RESOLVES ANY DATA INCONSISTENCIES OR DISCREPANCIES FROM THE COMBINED OPINIONS FORMED FROM LOCAL EXPERTS. ADDITIONALLY, QHR RELIES ON SECONDARY SOURCE DATA, AND MOST SECONDARY SOURCES USE THE COUNTY AS THE SMALLEST UNIT OF ANALYSIS. FINALLY, QHR ASKED OUR LOCAL EXPERT AREA RESIDENTS TO NOTE IF THEY PERCEIVED THE PROBLEMS OR NEEDS IDENTIFIED BY SECONDARY SOURCES TO EXIST IN THEIR PORTION OF THE COUNTY. MOST DATA USED IN THE ANALYSIS IS AVAILABLE FROM PUBLIC INTERNET SOURCES.IN ADDITION, WE DEVELOPED A CHNA "ROUND 1" SURVEY TO OUR LOCAL EXPERT ADVISORS TO GAIN LOCAL INPUT AS TO LOCAL HEALTH NEEDS AND THE NEEDS OF PRIORITY POPULATIONS. LOCAL EXPERT ADVISORS WERE LOCAL INDIVIDUALS SELECTED TO CONFORM TO THE INPUT REQUIRED BY THE FEDERAL GUIDELINES AND REGULATIONS. WE RECEIVED COMMUNITY INPUT FROM 15 LOCAL EXPERT ADVISORS.INFORMATION ANALYSIS AUGMENTED BY LOCAL OPINIONS SHOWED HOW LAWRENCE COUNTY RELATES TO ITS PEERS IN TERMS OF PRIMARY AND CHRONIC NEEDS AND OTHER ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS. RESPONDENTS COMMENTED ON IF THEY BELIEVE CERTAIN POPULATION GROUPS (OR PEOPLE WITH CERTAIN SITUATIONS) NEED HELP TO IMPROVE THEIR CONDITION, AND IF SO, WHO NEEDS TO DO WHAT.WITH THE PRIOR STEPS IN IDENTIFYING POTENTIAL COMMUNITY NEEDS, THE LOCAL EXPERTS PARTICIPATED IN A STRUCTURED COMMUNICATION TECHNIQUE CALLED A "WISDOM OF CROWDS" METHOD. THE PREMISE OF THIS APPROACH RELIES ON A PANEL OF EXPERTS WITH THE ASSUMPTION THAT THE COLLECTIVE WISDOM OF PARTICIPANTS IS SUPERIOR TO THE OPINION OF ANY ONE INDIVIDUAL, REGARDLESS OF THEIR PROFESSIONAL CREDENTIALS.IN THE LCMH PROCESS, EACH LOCAL EXPERT HAD THE OPPORTUNITY TO INTRODUCE NEEDS PREVIOUSLY UNIDENTIFIED AND TO CHALLENGE CONCLUSIONS DEVELOPED FROM THE DATA ANALYSIS. WHILE THERE WERE A FEW OPINIONS OF THE DATA CONCLUSIONS NOT BEING COMPLETELY ACCURATE, THE VAST MAJORITY OF COMMENTS AGREED WITH OUR FINDINGS. WE DEVELOPED A SUMMARY OF ALL NEEDS IDENTIFIED BY ANY OF THE ANALYZED DATA SETS. THE LOCAL EXPERTS THEN ALLOCATED 100 POINTS AMONG THE POTENTIAL SIGNIFICANT NEED CANDIDATES, INCLUDING THE OPPORTUNITY TO AGAIN PRESENT ADDITIONAL NEEDS THAT WERE NOT IDENTIFIED FROM THE DATA. A RANK ORDER OF PRIORITIES EMERGED, WITH SOME NEEDS RECEIVING NONE OR VIRTUALLY NO SUPPORT, AND OTHER NEEDS RECEIVING IDENTICAL POINT ALLOCATIONS.WE DICHOTOMIZED THE RANK ORDER OF PRIORITIZED NEEDS INTO TWO GROUPS: "SIGNIFICANT AND "OTHER IDENTIFIED NEEDS." OUR CRITERIA FOR IDENTIFYING AND PRIORITIZING SIGNFICANT NEEDS WAS BASED ON A DESCENDING FREQUENCY RANK ORDER OF THE NEEDS BASED ON TOTAL POINTS CAST BY THE LOCAL EXPERTS, FURTHER RANKED BY A DESCENDING FREQUENCY COUNT OF THE NUMBER OF LOCAL EXPERTS CASTING ANY POINTS FOR THE NEED. BY OUR DEFINITION, A SIGNIFICANT NEED HAD TO INCLUDE ALL RANK ORDERED NEEDS UNTIL AT LEAST FIFTY PERCENT (50%) OF ALL POINTS WERE INCLUDED AND THE EXTENT POSSIBLE, REPRESENTED POINTS ALLOCATED BY A MAJORITY OF VOTING LOCAL EXPERTS. THE DETERMINATION OF THE BREAK POINT - "SIGNIFICANT" AS OPPOSED TO "OTHER" - WAS A QUALITATIVE INTERPRETATION BY QUORUM AND THE LCMH EXECUTIVE TEAM WHERE A REASONABLE BREAK POINT IN RANK ORDER OCCURRED. LAWRENCE COUNTY MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: CHNA SIGNIFICANT NEEDS ARE:1. MENTAL HEALTH/SUICIDE/SUBSTANCE ABUSE -2016 SIGNIFICANT NEEDLCMH SERVICES, PROGRAMS, AND RESOURCES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:A. PROVIDE FRONT-LINE STAFFING NEEDS (PRIMARY CARE SERVICES/EMERGENCY DEPARTMENT SERVICES) FOR INITIAL TREATMENT, IDENTIFICATION, AND REFERRAL TO THE APPROPRIATE MENTAL HEALTH/SUBSTANCE ABUSE SERVICEB. FACILITY SPACE PROVIDED BI-WEEKLY TO LOCAL SUBSTANCE ABUSE SUPPORT GROUPSC. FINANCIAL SUPPORT PROVIDED TO LOCAL LAW ENFORCEMENT AGENCIES (DRUG AWARENESS PROGRAMS) FOR THE LOCAL SCHOOL DISTRICTD. DINE WITH A DOC EDUCATION SEMINAR ON DEPRESSION PREVENTION/DIAGNOSIS/TREATMENT FOR SENIOR CITIZENSE. MEMBER OF THE LAWRENCE COUNTY DRUG COALITIONF. COLLABORATED WITH THE LAWRENCE COUNTY SHERIFF'S DEPARTMENT IN PRESCRIPTION DRUG TAKE-BACK ACTIVITIES, WHICH ALLOWS COMMUNITY MEMBERS THE OPPORTUNITY TO TURN IN UNUSED OR EXPIRED MEDICATION FOR SAFE DISPOSALG. BROUGHT IN NATIONAL SUBSTANCE ABUSE EXPERT (AWARENESS/TREATMENT/EDUCATION)ADDITIONALLY, LCMH PLANS TO TAKE THE FOLLOWING STEPS TO ADDRESS THIS NEED:A. CONTINUE ABOVE ACTIONSB. WORKING ON DEVELOPING A COMMUNITY HEALTH GROUP CONSORTIUMC. EXPLORE HIRING A LICENSED CLINICAL SOCIAL WORKER TO SUPPLEMENT PSYCH COVERAGED. EXPLORE ADDING GERIATRIC OUTPATIENT PSYCH SERVICES AT LCMH2. STROKE - 2016 SIGNIFICANT NEED; #3 LEADING CAUSE OF DEATHLCMH SERVICES, PROGRAMS, AND RESOURCES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:A. EXPANDED REHABILITATION SERVICES TO TREAT STROKE PATIENTSB. DINE WITH A DOC EDUCATION SEMINAR ON STROKE PREVENTION/DIAGNOSIS/TREATMENT FOR SENIOR CITIZENSC. PROVIDE EDUCATIONAL MATERIALS (PREVENTION/IDENTIFICATION)D. BOARD-CERTIFIED NEURO-RADIOLOGIST READING CT SCANS AND IMPLEMENTING STAT READS FOR STROKE PATIENTSE. EXPAND TELEMEDICINE OPPORTUNITIES TO MONITOR BLOOD PRESSURE/VITAL SIGNSF. DESIGNATED AS A STROKE READY HOSPITAL IN 2014G. ADDED OCCUPATIONAL THERAPY SERVICES IN 2015H. IMPLEMENTED 'GET WITH THE GUIDELINES' STROKE READINESS PROTOCOL IN EMERGENCY DEPARTMENTI. HIRED A CARE COORDINATOR WHO MONITORS HIGH-RISK PATIENTS AND PROVIDES FOLLOW-UP CALLS ON DISCHARGES/EDUCATIONADDITIONALLY, LCMH PLANS TO TAKE THE FOLLOWING STEPS TO ADDRESS THIS NEED:A. CONTINUE ABOVE ACTIONSB. INCREASE STROKE EDUCATION/PREVENTIONC. EXPLORE ADDING STROKE AS AN EDUCATIONAL SPEAKING ENGAGEMENT TOPIC PUT ON BY LCMH SURGEON AND OTHER PROVIDERS.3. CORONARY HEART DISEASE - 2016 SIGNIFICANT NEED; #1 LEADING CAUSE OF DEATHLCMH SERVICES, PROGRAMS, AND RESOURCES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:A. VISITING CARDIOLOGY CLINIC IN LAWRENCE MEDICAL CENTERB. LCMH PRIMARY CARE CLINIC SERVICESC. LCMH DIAGNOSTIC IMAGINGD. LCMH LABORATORY SERVICESE. STRESS TEST SERVICESF. HOLTER/EVENT MONITORSG. LCMH CARDIAC REHAB PROGRAMH. PROMOTE GO RED FOR WOMEN (NATIONAL MOVEMENT TO END HEART DISEASE/STROKE AMONG WOMEN)I. PROMOTE HEART HEALTH MONTHJ. PROVIDE FREE CHOLESTEROL SCREENINGS AT COMMUNITY EVENTS AND HEALTH FAIRSK. REFER PATIENTS TO HEALTH DEPARTMENT SMOKING CESSATION PROGRAML. DINE WITH A DOC EDUCATION SEMINAR ON HEART DISEASE PREVENTION/DIAGNOSIS/TREATMENT FOR SENIOR CITIZENSM. HIRED A CARE COORDINATOR WHO MONITORS HIGH-RISK PATIENTS AND PROVIDES FOLLOW-UP CALLS ON DISCHARGE/EDUCATIONADDITIONALLY, LCMH PLANS TO TAKE THE FOLLOWING STEPS TO ADDRESS THIS NEED:A. CONTINUE ABOVE ACTIONSB. INCREASE CARDIOLOGY COVERAGE TO SEE PATIENTS ON REGULAR BASIS IN SPECIALTY CLINIC THROUGH RECENT PARTNERSHIP WITH DEACONESS4. CANCER - 2016 SIGNIFICANT NEED; #2 LEADING CAUSE OF DEATHLCMH SERVICES, PROGRAMS, AND RESOURCES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:A. LCMH DIAGNOSTIC IMAGINGB. LCMH LABORATORY SERVICESC. LCMH SCREENING COLONOSCOPYD. WEEKLY VISITING OB/GYN AT CLINIC PROVIDED CERVICAL CANCER SCREENINGSE. LCMH PRIMARY CARE SERVICES AND SURGICAL CLINIC PROVIDERS ADDRESS THIS NEED BY EDUCATION AND MEDICAL SERVICESF. LCMH SCREENING PROGRAMS AT VARIOUS COMMUNITY EVENTSG. PARTICIPATE BREAST CANCER AWARENESS MONTHH. UTILIZE MOBILE MAMMOGRAPHY UNIT TO PROVIDE ON-SITE SCREENING TO LOCAL INDUSTRIESI. PROVIDE EDUCATIONAL MATERIALS REGARDING PREVENTION/DIAGNOSIS/TREATMENTJ. DINE WITH A DOC EDUCATION SEMINAR ON CANCER PREVENTION/DIAGNOSIS/TREATMENT FOR SENIOR CITIZENSK. DONATE MEETING SPACE FOR LOCAL CANCER BOARD MEETINGSL. THROUGH COMMUNITY DONATIONS/BENEFIT EVENTS TO THE CANCER BOARD OF DIRECTORS, LCMH OFFERS CANCER PATIENTS FREE TRANSPORTATION, WIGS, HATS, ETC. M. PROVIDE PERIODIC COMMUNITY EDUCATION SEMINARS ON CANCERADDITIONALLY, LCMH PLANS TO TAKE THE FOLLOWING STEPS TO ADDRESS THIS NEED:A. CONTINUE ABOVE ACTIONSB. RESEARCH IMPLEMENTING STEREOTACTIC MOBILE SERVICES FOR BREAST CORE BIOPSIESC. CONTINUE TO EXPLORE OPPORTUNITIES TO DELIVER ON-SITE ONCOLOGY CLINICAL SERVICES THROUGH RECENT PARTNERSHIP WITH DEACONESSD. EXPLORE HOSTING A 'SPRING INTO HEALTH' WELLNESS FAIR DURING SPRING TIMEFRAME5. AFFORDABILITYLCMH SERVICES, PROGRAMS, AND RESOURCES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:A. RADIOLOGY DIRECTOR WORKS WITH PRAIRIE STATE WOMEN'S HEALTH THROUGH THE ILLINOIS BREAST AND CERVICAL CANCER PROGRAM, A STATE FUNDED PROGRAM FOR UNDERINSURED WOMENB. LCMH EMPLOYEE ASSISTS PATIENTS WITH STATE FUNDING REGISTRATIONC. LCMH FINANCIAL ASSISTANCE POLICYD. LAWRENCE COUNTY COMMUNITY RESOURCE GUIDE THAT PROVIDES INFORMATION ON THE RESOURCES AVAILABLE TO THE COMMUNITYE. RURAL HEALTH CLINIC PROVIDES FREE SPORTS PHYSICALS TO LOCAL STUDENTSF. LCMH PROVIDERS CONDUCTED FREE HEALTH SCREENINGS AT THE LOCAL HEALTH DEPARTMENT ON HEALTH DAYG. PRICE LIST AVAILABLE ON WEBSITEH. LCMH CHARITY CARE PROGRAM PROVIDES OVER $1M ANNUALLY TO COVER COSTS OF CAREI. PARTICIPANTION IN MEDICAID AND MEDICAIRD MANAGED CARE ORGANIZATIONSJ. OPENED ACUTE CARE CLINIC IN 2017 WITH "AFTER-HOURS" ACCESSK. OFFERED CLIA-WAIVED INFLUENZA A/B, RSV & STREP A TESTINGL. REGULAR COMMUNICATION WITH HEALTH DEPARTMENT ADDITIONALLY, LCMH PLANS TO TAKE THE FOLLOWING STEPS TO ADDRESS THIS NEED:A. CONTINUE ABOVE ACTIONSB. RESEARCH IMPLEMENTING AN ADDITIONAL RURAL HEALTH CLINICC. ENHANCE HOSPITAL BEHAVIORAL HEALTH SERVICES WITH GERIATRIC PSYCH SERVICESD. EXPLORE EXPANDING AFFORDABLE SERVICES THROUGH RECENT PARTNERSHIP WITH DEACONESSE. EXPLORE OPPORTUNITY TO MAKE PRICE TRANSPARENCY INFORMATION MORE RELATABLEF. CONDUCT REGULAR CHARGE MASTER REVIEWS TO ENSURE PRICING TRANSPARENCYG. RADIOLOGY DIRECTOR IS WORKING WITH THE ILLINOIS CRITICAL ACCESS HOSPITAL ASSOCIATION TO RESEARCH POSSIBLE GRANT FUNDING FOR SOME SERVICES RELATED TO MAMMOGRAPHY6. ALCOHOL ABUSEDUE TO THE SIMILAR NATURE OF PRIORITY 1 AND 6, ONE IMPLEMENTATION PLAN HAS BEEN CREATED TO ADDRESS BOTH NEEDS. SEE PRIORITY 1 FOR IMPLEMENTATION PLAN7. EDUCATION/PREVENTIONLCMH SERVICES, PROGRAMS, AND RESOURCES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:A. PROVIDE FRONT-LINE STAFFING NEEDS (PRIMARY CARE SERVICES/EMERGENCY DEPARTMENT SERVICES) FOR INITIAL TREATMENT, IDENTIFICATION, AND REFERRAL TO THE APPROPRIATE MENTAL HEALTH/SUBSTANCE ABUSE SERVICEB. FACILITY SPACE PROVIDED BI-WEEKLY TO LOCAL SUBSTANCE ABUSE SUPPORT GROUPSC. MEMBER OF THE LAWRENCE COUNTY DRUG COALITIOND. COLLABORATED WITH THE LAWRENCE COUNTY SHERRIFF'S DEPARTMENT IN PRESCRIPTION DRUG TAKE-BACK ACTIVITIES, WHICH ALLOWS COMMUNITY MEMBERS THE OPPORTUNITY TO TURN IN UNUSED OR EXPIRED MEDICATION FOR SAFE DISPOSALE. EXPANDED REHABILITATION SERVICES TO TREAT STROKE PATIENTSF. EXPAND TELEMEDICINE OPPORTUNITIES TO MONITOR BLOOD PRESSURE/VITAL SIGNSG. HIRED A CARE COORDINATOR WHO MONITORS HIGH-RISK PATIENTS AND PROVIDES FOLLOW-UP CALLS ON DISCHARGES/EDUCATIONH. IMPLEMENTED 'GET WITH THE GUIDELINES' STROKE READINESS PROTOCOL IN EMERGENCY DEPARTMENTI. LAWRENCE COUNTY COMMUNITY RESOURCE GUIDE THAT PROVIDES INFORMATION ON THE RESOURCES AVAILABLE TO THE COMMUNITYJ. RURAL HEALTH CLINIC PROVIDES FREE SPORTS PHYSICALS TO LOCAL STUDENTSK. LCMH PROVIDERS CONDUCTED FREE HEALTH SCREENINGS AT THE LOCAL HEALTH DEPARTMENT ON HEALTH DAYL. OFFERED CLIA-WAIVED INFLUENZA A/B, RSV & STREP A TESTINGM. LCMH DIAGNOSTIC IMAGINGN. LCMH LABORATORY SERVICESO. LCMH SCREENING COLONOSCOPYADDITIONALLY, LCMH PLANS TO TAKE THE FOLLOWING STEPS TO ADDRESS THIS NEED:A. CONTINUE ABOVE ACTIONSB. DEVELOP AD CAMPAIGN TO ADDRESS MENTAL HEALTH/BEHAVIORAL HEALTH/SUICIDE/SUBSTANCE ABUSE INCLUDING ALCOHOL ABUSEC. QUARTERLY NEWS STORIES DEVELOPED IN-HOUSE TO EDUCATE THE PUBLIC ON MENTAL HEALTH AND THE OPTIONS FOR PATIENTS AS PRESENTED BY LOCAL HEALTHCARE PROVIDERS IN LAWRENCE COUNTYD. DEVELOP A COMMUNITY HEALTH & WELLNESS CONSORTIUM MADE UP OF HEALTHCARE PROFESSIONALS, HEALTH RELATED BUSINESSES, LOCAL SCHOOLS AND COMMUNITY STAKEHOLDERS TO ADDRESS OVERALL COMMUNITY HEALTH AND WELLNESSE. CANCER EDUCATION CAMPAIGN: LCMH WILL DEVELOP AN EDUCATIONAL SEMINAR SERIES PRESENTED BY LOCAL PHYSICIANS TO THE COMMUNITY DESIGNED TO EDUCATE THE COMMUNITY LAWRENCE COUNTY MEMORIAL HOSPITAL PART V, SECTION B, LINE 13B: LCMH CHARGES ARE THE SAME AMOUNT FOR ALL PATIENTS AND DISCOUNTS ARE GIVEN BASED ON FEDERAL POVERTY GUIDELINES. LAWRENCE COUNTY MEMORIAL HOSPITAL PART V, SECTION B, LINE 13H: LCMH CHARGES THE SAME AMOUNT FOR ALL PATIENTS AND DISCOUNTS ARE GIVEN BASED ON FEDERAL POVERTY GUIDELINES. LAWRENCE COUNTY MEMORIAL HOSPITAL PART V, SECTION B, LINE 15E: LCMH CHARGES THE SAME AMOUNT FOR ALL PATIENTS AND DISCOUNTS ARE GIVEN BASED ON FEDERAL POVERTY GUIDELINES. LAWRENCE COUNTY MEMORIAL HOSPITAL PART V, SECTION B, LINE 19E: LCMH USES SEARCH AMERICA WHICH MEANS THAT ADDITIONAL THIRD-PARTIES ARE NOT NEEDED BEFORE MAKING REASONABLE EFFORTS REGARDING ELIGIBILITY. LAWRENCE COUNTY MEMORIAL HOSPITAL PART V, SECTION B, LINE 20E: OUTPATIENTS ARE NOTIFIED ON THE FIRST STATEMENT THEY RECEIVE THAT SHOWS ANY PATIENT BALANCE. LCMH ATTEMPTS TO NOTIFY ALL INPATIENTS AS PART OF THEIR STAY BUT WITH ALOS OF 3 DAYS, THIS IS NOT ALWAYS ACCOMPLISHED. THEY ALSO RECEIVE NOTICE ON THER FIRST STATEMENT OF THE FINANCIAL ASSISTANCE POLICY. ALL UNINSURED PATIENTS RECEIVE AN FA APPLICATION UPON REGISTRATION. LAWRENCE COUNTY MEMORIAL HOSPITAL PART V, SECTION B, LINE 24: CHARGES ARE ALL AT NORMAL RATES. ANY FAP DISCOUNT IS APPLIED BASED ON NORMAL CHARGES. NO FAP-ELIGIBLE PATIENT PAID ANYTHING CLOSE TO USUAL CHARGES. PART I, LINE 7G: COMMUNITY BUILDING ACTIVITIES PART III, LINE 2: ACCOUNTS ARE REPORTED AS BAD DEBT ONLY IF PATIENTS ARE NOT ELIGIBLE UNDER PRESUMPTIVE CHARITY OR DO NOT COMPLETE AN APPLICATION FOR FINANCIAL ASSISTANCE IF THEY CANNOT BE QUALIFIED AS PRESUMPTIVE.BAD DEBT EXPENSES ARE ACCOUNTS FOR PATIENTS THAT HAVE NOT PAID LCMH FOR THE SERVICES PROVIDED. EVERY EFFORT IS MADE TO QUALIFY THEM AS PRESUMPTIVE IF THEY DO NOT DIRECTLY REQUEST FINANCIAL ASSISTANCE. AN ELECTRONIC RESOURCE IS USED TO QUALIFY PATIENTS AS CHARITY BEFORE THE COLLECTION PROCESS IS STARTED.THE HOSPITALS ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 93% AT JUNE 30, 2020 AND 95% AT JUNE 30, 2019. IN ADDITION, THERE WERE NO SIGNIFICANT FLUCTUATIONS IN WRITE-OFFS FROM SELF-PAY PATIENTS DURING FISCAL YEAR 2020 COMPARED TO FISCAL YEAR 2019.THE HOSPITAL PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS MEETING CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. PART III, LINE 8: MEDICARE AMOUNTS ARE TAKEN FROM THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 9B: ANY PATIENT BALANCE THAT HAS GONE THROUGH THE IN-HOUSE COLLECTION PROCESS WILL BE SUBMITTED TO SEARCH AMERICA PRIOR TO BECOMING BAD DEBT. SEARCH AMERICA WILL YIELD BACK FEDERAL POVERTY PERCENTAGES THAT CAN BE USED TO QUALIFY AS PRESUMPTIVE CHARITY WITHOUT APPLICATION BY THE PATIENT OR FAMILY. PART VI, LINE 2: LCMH UTILIZED SERVICES FROM QHR TO PERFORM A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE REPORT WAS PROVIDED IN JUNE, 2019. PART VI, LINE 3: LCMH HAS POSTERS IN ALL REGISTRATION AREAS RELATED TO ANY HOSPITAL DEPARTMENT INCLUDING OUR RURAL HEALTH CLINIC INFORMING PATIENTS THAT WE SEE ANYONE REGARDLESS OF THEIR ABILITY TO PAY AND THAT FINANCIAL ASSISTANCE IS AVAILABLE TO UNINSURED AND UNDERINSURED PERSONS. ALL ED PATIENTS ARE SEEN BY A PRACTITIONER PRIOR TO REQUEST FOR ANY FINANCIAL INFORMATION/INSURANCE AS REQUIRED BY EMTALA. ALL PATIENTS THAT DO NOT HAVE INSURANCE OR THAT HAVE A PATIENT BALANCE AFTER INSURANCE ARE CONTACTED BY OUR PATIENT FINANCIAL SERVICES REPRESENTATIVE WHO THEN PROVIDES A FINANCIAL ASSISTANCE FORM. PART VI, LINE 4: LCMH SERVES AS A PREDOMINANTLY RURAL COUNTY IN SOUTHEASTERN ILLINOIS. THE POPULATION IS MORE ELDERLY AND LESS AFFLUENT THAN MOST COUNTIES IN THE STATE. 18.5% OF THE POPULATION HAS LESS THAN A HIGH SCHOOL DIPLOMA WITH ANOTHER 36.8% HAVING ONLY A HIGH SCHOOL EDUCATION. 10.4% OF THE HOUSEHOLDS REPORT INCOME OF LESS THAN $15,000.A LARGE TERTIARY HOSPITAL IS WITHIN 12 MILES OF LCMH LOCATED IN VINCENNES, IN. MANY PATIENTS WITH INSURANCE MAKE THE DRIVE LEAVING LCMH WITH A MUCH HIGHER PERCENT OF MEDICAID BUSINESS. WITH LCMH MOVEMENT TO NOT-FOR-PROFIT STATUS IN FY2012, A MORE CONCERTED EFFORT WAS UNDERTAKEN AT THE DIRECTION OF OUR BOARD TO IDENTIFY ANY PATIENT THAT IS ELIGIBLE FOR FINANCIAL ASSISTANCE.TO BETTER SERVE THE NEED OF THESE PATIENTS, LCMH OPENED A RURAL HEALTH CLINIC STAFFED WITH PHYSICIANS AND MID-LEVEL PRACTITIONERS TO PROVIDE A PRIMARY SOURCE OF CARE THAT IS EASILY ACCESSIBLE FOR THEM. IN FY2016, LCMH RHC EXTENDED THEIR HOURS ON EVENINGS AND WEEKENDS TO PROVIDE PRIMARY CARE TO THE COMMUNITY. PART VI, LINE 5: LCMH PARTICIPATES IN MANY COMMUNITY GROUPS THAT ARE DESIGNED TO IMPROVE THE HEALTH OF THE COMMUNITY. LCMH PROVIDES A MEETING LOCATION FOR ALCOHOLICS ANONYMOUS TWICE PER WEEK AS WELL AS A LOCATION FOR A LOCAL BEREAVEMENT AND SUPPORT GROUP.LCMH LEADERSHIP ALSO IS ONE OF SEVERAL BOARDS IN THE AREA TO SUPPORT ECONOMIC DEVELOPMENT AS WELL AS PROVIDE RESOURCES DURING FLOODING AND PROVIDE ACTIVE LEADERSHIP IN COMMITTES FOR ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK PROVIDING SUPPORT TO ALL CAHS IN ILLINOIS TO HELP THEM BETTER SERVE THEIR COMMUNITIES. PART VI, LINE 6: LCMH IS AFFILIATED WITH DEACONESS AS OF MAY 2019. THROUGH THIS AFFILIATION LCMH IS ABLE TO IMPROVE THE PHYSICIAN RECRUITMENT EFFORTS TO BRING HIGHLY QUALIFIED PHYSICIANS TO THE AREA AS WELL AS PARTNER TO IMPROVE BEHAVIORAL HEALTH IN THE AREA. IN ADDITION, THE HOSPITAL IS ABLE TO PARTNER IN GENERATING EDUCATION MATERIAL TO THE COMMUNITIES WITH VALUABLE INFORMATION RELATED TO VARIOUS HEALTH ISSUES AND SHARE RESOURCE INFORMATION TO ASSIST THOSE IN THE COMMUNITY. X X 0 0 0 0 0 0 0 1 0 DR GARY CARR TRUSTEE /PHYSICAN 0 0 0 0 235466 0 4812 0 0 0 240278 0 0 0 DON ROBBINS CEO 220491 0 0 0 0 0 0 0 30869 0 251360 0 0 0 LARRY SPOUR CFO 158852 0 0 0 0 0 0 0 22239 0 181091 0 0 0 VALERIE BURNS PHYSICAN 188561 0 0 0 0 0 3800 0 6632 0 198993 0 0 0 STEVEN RAMSARAN PHYSICAN 211755 0 0 0 163275 0 0 0 25961 0 400991 0 0 0 RODNEY FINCH CRNA 209969 0 0 0 0 0 0 0 22578 0 232547 0 0 0 TANNA MCCULLOUGH NURSE PRACTITIONER 135098 0 0 0 0 0 4232 0 25961 0 165291 0 0 0 FARIS AL GEBORY SURGEON 166711 0 0 0 0 0 0 0 9408 0 176119 0 0 0 PART I, LINE 7 PHYSICIAN COMPENSATION PAID BASED ON ANTICIPATED VOLUME (VISITS) AND RECONCILED QUARTERLY. RON WALDROP FAMILY MEMBER 44116 W-2 WAGES 0 STAN WILLIAMS FAMILY MEMBER 81695 W-2 WAGES 0 DR GARY CARR CONTRACTED PHYSICIAN AND BOARDMEMBER 240278 1099 0 SCH L, PART IV RON WALDROP IS A VOTING OFFICER OF THE HOSPITAL BOARD. HIS DAUGHTER-IN-LAW IS EMPLOYED IN THE IT DEPARTMENT. THE 2019 WAGES PAID BY LAWRENCE COUNTY MEMORIAL HOSPITAL LISTED ON HER W-2 TOTALED $44,116. SCH L, PART IV STAN WILLIAMS IS A VOTING MEMBER OF THE HOSPITAL BOARD. HIS SON-IN-LAW IS THE DIRECTOR OF THE IT DEPARTMENT. THE 2019 W-2 WAGES PAID BY LAWRENCE COUNTY MEMORIAL HOSPITAL LISTED ON HIS W-2 TOTALED $81,695. SCH L, PART IV DR. GARY CARR IS A VOTING MEMBER OF THE HOSPITAL BOARD. HE IS ALSO CONTRACTED AS A PHYSICIAN FOR THE HOSPITAL. THE 2019 WAGES PAID BY LAWRENCE COUNTY MEMORIAL HOSPITAL ON HIS 1099-MISC TOTALED $240,278. FORM 990, PART VI, SECTION A, LINE 3 LCMH HAS A MANAGEMENT AGREEMENT WITH DEACONESS. DEACONESS PROVIDES ASSISTANCE IN THE EVALUATION OF OFFICERS, PROVIDES ADMINISTRATIVE RESOURCES, CONSULTING SERVICES, CHARGE MASTER AND COMPLIANCE SERVICES. COMPENSATION OF BOARD MEMBERS FORM 990 PART VII, SECTION A DR GARY CARR IS COMPENSATED FOR BEING A PRACTICING PHYSICIAN AT LCMH. HE IS NOT COMPENSATED AS A MEMBER OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE CFO AND AN INDEPENDENT ACCOUNTING FIRM REVIEWED THE FORM 990 BEFORE FILING. AN ELECTRONIC OR HARD COPY OF THE FORM 990 IS PROVIDED TO ALL BOARD MEMBERS AFTER IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES AND DEPARTMENT LEADERS SIGN ANNUAL CONFLICT OF INTEREST POLICY STATEMENTS. ANYONE WITH A CONFLICT DOES NOT PARTICIPATE IN ANY RELATED DECISION MAKING PROCESSES. STAFF AND DEPARTMENT LEADERS HAVE THIS INCLUDED AS A PART OF THEIR ANNUAL TRAINING CONDUCTED ELECTRONICALLY THROUGH HEALTH STREAM. THE SIGNED STATEMENTS ARE REVIEWED BY THE COO AND THE CEO. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS FOR TOP OFFICIAL - A REVIEW IS CONDUCTED ANNUALLY BY THE ENTIRE BOARD OF TRUSTEES ALONG WITH THE REGIONAL MANAGEMENT TEAM FROM DEACONESS. NATIONAL COMPARATIVE DATA IS PROVIDED BY DEACONESS AS PART OF THE ANNUAL CEO AND CFO EVALUATION AND WAGE ADJUSTMENT. OFFICER COMPENSATION DECISIONS ARE ALSO DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 18 FORM 1023 HAS BEEN FILED, APPROVED AND IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE AVAILABLE UPON REQUEST AT THE ADMINISTRATIVE OFFICES. FORM 990, PART IX, LINE 11G CONTRACTED PHYSICIAN: PROGRAM SERVICE EXPENSES 714,381. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 714,381. CONTRACTED SURGEON: PROGRAM SERVICE EXPENSES 244,634. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 244,634. LAUNDRY SERVICE: PROGRAM SERVICE EXPENSES 97,954. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 97,954. CPSI - HOSPITAL SOFTWARE: PROGRAM SERVICE EXPENSES 194,560. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 194,560. DIAGNOSTIC SHARED MRI: PROGRAM SERVICE EXPENSES 132,351. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 132,351. NUCLEAR MEDICINE, ULTRASOUND, MAMMOGRAM: PROGRAM SERVICE EXPENSES 222,696. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 222,696. CONTRACTED OB/GYN: PROGRAM SERVICE EXPENSES 87,390. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 87,390. VARIOUS OTHER SERVICES: PROGRAM SERVICE EXPENSES 907,508. MANAGEMENT AND GENERAL EXPENSES 302,499. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,210,007. COLLECTIONS SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 134,794. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 134,794. BILLING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 110,140. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 110,140. CODING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 24,998. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,998. RED CROSS: PROGRAM SERVICE EXPENSES 17,626. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,626. INVESTMENT EXP: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 18,062. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,062. END AND DEV FOUNDATION FOR LAWRENCE COUNTY 2200 STATE STREET LAWRENCEVILLE IL 62439 376052607 FUND RAISING IL 501(C)(3) LINE 10 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 LCMH E&D FOUNDATION C 18721 FMV