2021-07-12T15:09:24-05:00 2020-09-30 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2019-10-01 430662495 HANNIBAL REGIONAL HEALTHCARE SYSTEM INC HANN 5732481300 6500 HOSPITAL DRIVE PO BOX 551 HANNIBAL MO 63401 ROB GASAWAY VICE PRESIDENT - FINANCE 5732481300 2021-07-12 1 JEFF PARKER P00970069 6182331200 2021-07-12 2019 2022-09-23 18:48:47Z C TODD AHRENS 6500 HOSPITAL DRIVE PO BOX 551 HANNIBAL MO 63401 198407232 0 X HOSPITAL.HANNIBALREGIONAL.ORG X 1987 MO THE SYSTEM OPERATES A FULL SERVICE ACUTE CARE FACILITY. 12 11 1420 276 0 0 1766912 3816848 185967016 185974551 2487867 2015223 1720681 1912993 191942476 193719615 67632 43936 0 0 98199986 106722099 0 0 0 88702815 90117046 186970433 196883081 4972043 -3163466 194629855 216422031 73086240 98733986 121543615 117688045 YOUR HEALTH IS OUR MISSION 0 0 167693496 43936 185621546 THE SYSTEM OPERATES A FULL SERVICE 86 BED ACUTE CARE HOSPITAL FACILITY, A 13 BED INPATIENT REHAB FACILITY, SEVERAL PHYSICIAN PRACTICES AND PRIMARY CARE CLINICS, AND A HOME HEALTH AGENCY IN HANNIBAL MISSOURI AND SURROUNDING COUNTIES. 17,856 TOTAL INPATIENT DAYS WERE PROVIDED DURING THE COURSE OF THE YEAR. THE SYSTEM PROVIDES SERVICES TO PATIENTS THAT MEET THE HOSPITAL'S CHARITY CARE POLICY AS WELL AS SERVICES TO OTHER MEDICALLY INDIGENT PATIENTS UNDER CERTAIN GOVERNMENT-REIMBURSED PUBLIC AID PROGRAMS. THE TOTAL COST OF UNCOMPENSATED CARE WAS: CHARITY CARE - $3,908,756 AND STATE MEDICAID AND OTHER PUBLIC AID PROGRAMS - $15,680,782. 1772752 0 743148 THE HANNIBAL CHILDREN'S CENTER IS A LEARNING CENTER FOR CHILDREN AGES 6 WEEKS TO 12 YEARS. THE HCC IS A MISSION DRIVEN CENTER IN WHICH TEAM MEMBERS, FAMILIES, AND THE COMMUNITY COLLABORATE TO EMPOWER EACH CHILD TO BECOME HEALTHY, SELF-CONFIDENT, INDIVIDUALS BY PROVIDING THE RESOURCES TO DEVELOP A PASSION FOR LEARNING THROUGH INTERACTIVE PLAY.HANNIBAL CHILDREN'S CENTER IS LICENSED BY THE STATE OF MISSOURI - DEPARTMENT OF HEALTH AND SENIOR SERVICES AND ACCREDITED BY THE MISSOURI ACCREDITATION OF PROGRAMS FOR CHILDREN AND YOUTH. 169466248 1 1 0 1 0 1 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 206 0 1420 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X ROB GASAWAY 5732481300 6500 HOSPITAL DRIVE HANNIBAL MO 63401 PAT BENSON CHAIR 1.00 0.00 X X 0 0 0 DEBORAH THORNBURG VICE CHAIR, CHAIR 1.00 0.00 X X 0 0 0 JASON POAGE TREASURER 1.00 0.00 X X 0 0 0 CAROLYN SHAW SECRETARY 1.00 0.00 X X 0 0 0 STEVE MILLER ASST SECRETARY (TERM ENDED 12/19) 1.00 0.00 X X 0 0 0 PAUL EWERT DIRECTOR 1.00 0.00 X 0 0 0 BRAD KURZ VICE CHAIR 1.00 0.00 X X 0 0 0 DIRK SAUER DIRECTOR 1.00 0.00 X 0 0 0 GENE SCHOLES JR DIRECTOR 1.00 0.00 X 0 0 0 LINDA STRAUBE DIRECTOR 1.00 0.00 X 0 0 0 RICHARD VALUCK MD DIRECTOR & CARDIOLOGIST 41.00 0.00 X 606104 0 39302 JACK WHITAKER DIRECTOR (TERM ENDED 6/20) 1.00 0.00 X 0 0 0 LACEY YOUNG DIRECTOR (TERM ENDED 12/19) 1.00 0.00 X 0 0 0 MICHAEL HOLLIDAY DIRECTOR 1.00 0.00 X 0 0 0 JUSTIN TRANTHAM DIRECTOR 1.00 0.00 X 0 0 0 C TODD AHRENS PRESIDENT & CEO 40.00 1.00 X 715799 0 172324 ROB GASAWAY VICE PRESIDENT - FINANCE 40.00 0.00 X 311380 0 78603 TIMOTHY REUSCHEL VP - GENERAL COUNSEL (LEFT 01/19) 40.00 0.00 X 111457 0 45926 PRANAV PARIKH MD V.P. - QUALITY & MEDICAL AFFAIRS 40.00 0.00 X 556193 0 84837 AARON ZOOK VICE PRESIDENT - OPERATIONS 40.00 0.00 X 247699 0 63213 JULIE LEVERENZ VICE PRESIDENT - PATIENT EXPERIENCE (LEFT 3/20) 40.00 0.00 X 231996 0 55084 SUSAN WATHEN VICE PRESIDENT - HUMAN RESOURCES 40.00 0.00 X 226768 0 43326 G DOUG RUBLE VP - FACILITIES (LEFT 03/19) 40.00 0.00 X 103850 0 9086 PATRICIA BRAWNER VICE PRESIDENT - NURSING 40.00 0.00 X 234024 0 55701 WENDY HARRINGTON V.P. - HRHS DEVELOPMENT 1.00 40.00 X 233015 0 44485 SHENIECE SMITH VP - GENERAL COUNSEL 40.00 0.00 X 154930 0 24322 LUVELL GLANTON ANESTHESIOLOGIST - PAIN MANAGEMENT 40.00 0.00 X 801577 0 49263 JOEL HASSIEN RADIOLOGIST 40.00 0.00 X 728548 0 39292 LANCE DORSEY RADIOLOGIST 40.00 0.00 X 685048 0 49531 LAURA MAPLE OBSTETRICIAN AND GYNECOLOGIST 40.00 0.00 X 744914 0 12600 ASHRAF ALMASHHRAWI GASTROENTEROLOGIST 40.00 0.00 X 707401 0 34125 7400703 0 901020 118 0 1 0 MURRAY COMPANY INC 1215 FERN RIDGE PARKWAY SUITE 213 ST LOUIS MO 63141 CONSTRUCTION 15169902 ALLSCRIPTS LLC PO BOX 8538-0133 PHILADELPHIA PA 19171 IT SYSTEMS 2724932 INTERIM PHYSICIANS LLC PO BOX 679139 DALLAS TX 75267 LOCUM PROVIDERS 1812276 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 LOCUM PROVIDERS 1668899 COMPHEALTH PO BOX 972651 DALLAS TX 75397 LOCUM PROVIDERS 1452088 83 695512 3121336 3816848 NET PATIENT SERVICE REVENUE 621110 185231403 185231403 CHILDREN'S DEVELOPMENT CENTER 624410 743148 743148 185974551 1230899 1230899 474167 54617 419550 419550 419550 5417324 4633000 784324 784324 784324 CAFETERIA 722210 692285 692285 CONTRACTED SERVICES 621110 249868 249868 OTHER ADMINISTRATION 621110 209505 209505 341785 140275 201510 1493443 193719615 186364694 0 3538073 X 43936 43936 4115423 744542 3370881 78449570 67933690 10515880 3129036 2759084 369952 15958107 13398226 2559881 5069963 4231092 838871 274217 274217 120160 120160 36677 32022 4655 22863286 19370698 3492588 546475 546475 20649923 18512979 2136944 712658 365655 347003 2875853 2589467 286386 558300 471444 86856 93987 75481 18506 1650025 1497583 152442 10581559 9603956 977603 1032039 1032039 BAD DEBT EXPENSE 13753650 13753650 PHARMACY DRUGS 11702768 11702768 FOOD 825124 825124 RECRUITING EXPENSE 743658 743658 1096687 522812 573875 196883081 169466248 27416833 0 13342292 29749042 1063695 1071738 21167055 23924639 1181057 1118678 2796510 4833104 1057107 1846399 206109954 116246612 87133193 89863342 58910702 56633475 607644 743533 1032397 588797 6338203 6049284 194629855 216422031 22844676 23741328 26765452 43183016 42970547 4984479 3069550 2074069 2187109 73086240 98733986 X 115179844 111637716 6363771 6050329 121543615 117688045 194629855 216422031 -3163466 -692104 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 13365 0 0 1 23312 36677 0 PART II-B, LINE 1: A PORTION OF THE MEMBERSHIP DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION AND TO MISSOURI CHAMBER OF COMMERCE ARE RELATED TO LOBBYING. IN FY2020, A GRANT WAS ALSO PAID TO THE HEALTH CARE ISSUES COMMITTEE OF THE MISSOURI HOSPITAL ASSOCIATION FOR LOBBYING ON BEHALF OF A MEDICAID EXPANSION BALLOT INITIATIVE. 1 1048 25570 1045 0 0 3712256 3712256 86471351 42712912 43758439 10344759 7247642 3097117 104656430 66286058 38370372 925158 925158 89863342 SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN 2187109 2187109 1 1 X 1 X 0 1 1 1 0 1 1 3254267 1447948 1806319 0.00920 18684841 12374888 6309953 0.03200 21939108 13822836 8116272 0.04120 19352123 9975764 9376359 0.04760 239684 239684 0.00120 666404 666404 0.00340 20258211 9975764 10282447 0.05220 42197319 23798600 18398719 0.09340 2204846 747910 1456936 0.00740 4052 4052 0.00000 441445 441445 0.00220 2650343 747910 1902433 0.00960 1 13753650 10315238 41596980 48838412 -7241432 X 1 1 1 ADVANCE HANNIBAL REGIONAL HOSPITAL LLC OUTPATIENT PHYSICAL THERAPY 0.50000 0.50000 2 HANNIBAL REGIONAL PHYSICIAN HOSPITAL ORGANIZATION INC INSURANCE REPRICING 0.50000 0.50000 1 1 HANNIBAL REGIONAL HOSPITAL 6000 HOSPITAL DRIVE HANNIBAL MO 63401 HANNIBALREGIONAL.ORG 101-57 X X X HANNIBAL REGIONAL HEALTHCARE SYSTEM INC 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X SEE PART V, SECTION C FOR URL OF CHNA X 1 18 1 SEE PART V, SEC. C FOR IMPLEMENTATION STRATEGY URL 0 1 X 200.000000000000 200.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V, SECTION C FOR URL X SEE PART V, SECTION C FOR URL X SEE PART V, SECTION C FOR URL X X X X X 1 X 0 X X X X X 1 X 0 0 HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 5: A 90-MINUTE TOWN HALL MEETING WITH REQUIRED COMMUNITY PRIMARY SERVICE AREA RESIDENTS WAS CONDUCTED. CHNA DATA WAS REVIEWED AND A GROUP DISCUSSION WAS FACILITATED TO RANK ACTIVITY TO DETERMINE THE MOST IMPORTANT COMMUNITY HEALTH NEEDS. A BROAD-BASED STEERING COMMITTEE OF HEALTHCARE LEADERS FROM THROUGHOUT THE SIX COUNTY REGION WAS FORMED TO GUIDE THE ASSESSMENT PROCESS AND ESTABLISH THE THREE-YEAR STRATEGY TO ADDRESS THE PRIORITIES IDENTIFIED. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 6B: MARION COUNTY HEALTH DEPARTMENT, LEWIS COUNTY HEALTH DEPARTMENT, MONROE COUNTY HEALTH DEPARTMENT, PIKE COUNTY HEALTH DEPARTMENT, RALLS COUNTY HEALTH DEPARTMENT, AND SHELBY COUNTY HEALTH DEPARTMENT, FREE CLINIC, FQHC, MULTIPLE SOCIAL SERVICE AGENCIES, NON-EMPLOYED PHYSICIAN GROUPS AND OTHERS. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 11: BROAD-BASED OVERSIGHT GROUP IS MEETING ON A QUARTERLY BASIS TO ASSESS PROGRESS AND INFLUENCE THE WORK ESTABLISHED IN THE PLAN; A VARIETY OF BEHAVIORAL HEALTH AND PREVENTITIVE HEALTH SERVICES HAVE EMERGED IN THE REGION DUE TO THE VISIBILITY OF THIS PROBLEM; MENTAL HEALTH FIRST AID CLASSES ARE RAISING HEALTH LITERACY; SERVICES HAVE BEEN EXPANDED AT THE LOCAL FREE CLINIC TO ADDRESS ACCESS TO CARE, MENTAL HEALTH AND DENTAL HEALTH; A POPULATION HEALTH GRANT HELPED REDUCE THE INCIDENCE OF EMERGENCY DEPARTMENT VISITS FOR PATIENTS WITH CHRONIC DISEASE WHO WERE FORMERLY HIGH UTILIZERS; AN FQHC HAS ADDED MENTAL HEALTH AND DENTAL HEALTH CAPACITY IN THE REGION. ADDITIONALLY THE CHNA STEERING COMMITTEE HAS IDENTIFIED THE TOP EMERGING HEALTH NEEDS IN THE COMMUNITY AND ARE WORKING TOGETHER TO CREATE COLLABORATIVE EFFORTS TO RAISE AWARENESS AND EDUCATE THE COMMUNITY ON THESE NEEDS. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 13B: THE PATIENT'S ABILITY TO PAY OUTSIDE OF NORMAL LIVING EXPENSES AND DEBT. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 16J: PERSONAL CONTACT AND WEBSITE ACCCESS ARE THE MAIN POINTS OF CONTACT. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 20E: COMMUNICATIONS THROUGH MAIL AND PHONE INTERVIEWS ARE PURSUED TO RESOLVE ISSUES AND OBTAIN NEEDED INFORMATION TO QUALIFY PATIENTS. SCHEDULE H, PART V, SECTION B, LINE 7B THE ORGANIZATION'S MOST RECENT CHNA REPORT CAN BE FOUND AT:HTTPS://HANNIBALREGIONAL.ORG/PORTALS/0/HANNIBAL_REGIONAL_2019_COMMUNITY_HEALTH_NEEDS_ASSESSMENT.PDF?VER=2019-07-26-152557-163 SCHEDULE H, PART V, SECTION B, LINE 10 THE ORGANIZATION'S CURRENT IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTPS://HANNIBALREGIONAL.ORG/COMMUNITYHEALTH/CHNA/2016-2019REGIONALHEALTHSTRATEGY/TABID/208/DEFAULT.ASPX SCHEDULE H, PART V, SECTION B, LINE 16A THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP) CAN BE FOUND AT:HTTPS://HANNIBALREGIONAL.ORG/PATIENTSVISITORS/PATIENTSERVICES/FINANCIALASSISTANCE/TABID/241/DEFAULT.ASPX SCHEDULE H, PART V, SECTION B, LINE 16B THE ORGANIZATION'S FINANCIAL ASSISTANCE APPLICATION CAN BE FOUND AT:HTTPS://HANNIBALREGIONAL.ORG/PATIENTSVISITORS/PATIENTSERVICES/FINANCIALASSISTANCE/TABID/241/DEFAULT.ASPX SCHEDULE H, PART V, SECTION B, LINE 16C THE ORGANIZATION'S PLAIN LANGUAGE SUMMARY OF THE FAP CAN BE FOUND AT:HTTPS://HANNIBALREGIONAL.ORG/PATIENTSVISITORS/PATIENTSERVICES/FINANCIALASSISTANCE/TABID/241/DEFAULT.ASPX 22 1 - HANNIBAL REGIONAL MEDICAL GROUP 6500 HOSPITAL DRIVE HANNIBAL MO 63401 RURAL HEALTH CLINICS, SPECIALTY CLINIC, SAME DAY/URGENT CARE 2 - JAMES E CARY CANCER CENTER 5985 HOSPITAL DRIVE HANNIBAL MO 63401 CANCER CENTER 3 - COMPLETE FAMILY MEDICINE - KIRKSVILLE 1611 S BALTIMORE KIRKSVILLE MO 63501 RURAL HEALTH, SAME DAY/URGENT CARE, FAMILY PRACTICE CLINIC 4 - MONROE CITY FAMILY PRACTICE 821 BUSINESS HWY 24 WEST MONROE CITY MO 63456 RURAL HEALTH CLINIC 5 - PIKE MEDICAL CLINIC - BOWLING GREEN 8 TOWN CENTER DR BOWLING GREEN MO 63334 RURAL HEALTH CLINIC, SAME DAY/URGENT CARE 6 - PIKE MEDICAL CLINIC - LOUISIANA 211 S 3RD ST LOUISIANA MO 63353 RURAL HEALTH CLINIC 7 - CANTONLAGRANGE FAMILY PRACTICE 1802 ELM STREET CANTON MO 63435 RURAL HEALTH CLINIC 8 - SHELBINA FAMILY PRACTICE 400 S CENTER STREET SHELBINA MO 63486 RURAL HEALTH CLINIC 9 - PEDIATRIC THERAPY 150 MEDICAL DR HANNIBAL MO 63401 PEDIATRIC THERAPY 10 - EXPRESS CARE AT WAL-MART 3650 STARDUST DRIVE WAL-MART HANNIBAL MO 63401 RURAL HEALTH CLINIC, SAME DAY CLINIC 11 - COMPLETE FAMILY MEDICINE MOBERLY UC 1600 N MORLEY SUITE A-120-A MOBERLY MO 65270 SAME DAY/URGENT CARE CLINIC 12 - COMPLETE FAMILY MEDICINE MACON UC 1206 N MISSOURI ST MACON MO 63552 SAME DAY/URGENT CARE CLINIC 13 - SPEECH THERAPY 188A MEDICAL DRIVE HANNIBAL MO 63401 SPEECH THERAPY 14 - COMPLETE FAMILY MEDICINE LANCASTER RHC 1000 W WASHINGTON LANCASTER MO 63548 RURAL HEALTH CLINIC 15 - COMPLETE FAMILY MEDICINE LA PLATA RHC 29934 JULY RD LA PLATA MO 63549 RURAL HEALTH CLINIC 16 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 188A MEDICAL DRIVE HANNIBAL MO 63401 JOINT VENTURES - THERAPY 17 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 710 S BUSINESS 61 SUITE 100 BOWLING GREEN MO 63334 JOINT VENTURES - THERAPY 18 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 55 TROY SQUARE TROY MO 63379 JOINT VENTURES - THERAPY 19 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 821 US 24 WEST MONROE CITY MO 63456 JOINT VENTURES - THERAPY 20 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 1804 ELM ST CANTON MO 63435 JOINT VENTURES - THERAPY 21 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 1605 S BALTIMORE ST STE C KIRKSVILLE MO 63501 JOINT VENTURES - THERAPY 22 - HANNIBAL MEDICAL SUPPLIES 5 DIAMOND BLVD HANNIBAL MO 63401 JOINT VENTURES - MEDICAL SUPPLIES PART I, LINE 3C: THE ORGANIZATION USED AN ABILITY TO PAY STANDARD TO DETERMINE ELIGIBILITY. A PERSON IS ELIGIBLE FOR CHARITY CARE IF THEY MEET ANY OF THE FOLLOWING CRITERIA: THEIR INSURANCE IS INADEQUATE, THEY ARE UNINSURED, PATIENTS WITH A FAMILY INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINE, PATIENTS WITH A SPENDABLE INCOME THAT IS LESS THAN 5% OF THE BALANCE OWED TO THE HOSPITAL, THE PATIENT HAS LESS THAN $2,000 IN TOTAL ASSETS AVAILABLE TO PAY HOSPITAL EXPENSES (EXCEPTIONS INCLUDE HOME EQUITY, AUTO EQUITY, LIFE INSURANCE EQUITY). PART I, LINE 6A: THE MISSOURI HOSPITAL ASSOCIATION HAS INCLUDED HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. IN THEIR ANNUAL COMMUNITY BENEFIT REPORT. PART I, LINE 7: THE COST TO CHARGES RATIO WAS USED AS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. PART I, LN 7 COL(F): A GROSS ESTIMATE WAS MADE BASED ON CURRENT EXPERIENCE. PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES THAT PROMOTE THE HEALTH OF THE HOSPITAL'S COMMUNITY INCLUDES ITS CHILDREN'S CENTER FOR EDUCATION, DISASTER RECOVERY PLANNING, INTERPRETIVE SERVICES FOR NON-ENGLISH SPEAKING PATIENTS, AND RECRUITMENT COSTS FOR PHYSICIANS. PART III, LINE 2: HISTORICAL EXPERIENCE WAS USED TO ESTIMATE BAD DEBTS BY PAYOR CLASSIFICATION AND AGING CO-HORT. PART III, LINE 3: THE ESTIMATE WAS BASED ON AVAILABLE DATA. PART III, LINE 4: THE SYSTEM REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYORS, PATIENTS AND OTHERS. THE SYSTEM 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 SYSTEM BILLS THIRD-PARTY PAYORS 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. AT SEPTEMBER 30, 2020 AND 2019, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WAS APPROXIMATELY $8,245,000 AND $9,501,000, RESPECTIVELY. PART III, LINE 8: SOME MEDICARE SERVICES ARE PAID AT SUBSTANTIALLY LESS THAN COST THROUGH THE PROGRAM. THESE SERVICES COULD BE ELIMINATED TO INCREASE MARGIN BUT ARE PROVIDED IN THIS COMMUNITY DESPITE THE LOSS. PART III, LINE 9B: WHEN CHARITY CONSIDERATION IS REQUESTED ALL COLLECTION EFFORTS ARE HALTED UNTIL A DETERMINATION ON ELIGIBILITY IS MADE. COLLECTION EFFORTS ARE RESUMED ONLY IF THE INDIVIDUAL DOES NOT MEET ONE OF THE CHARITY CRITERIA. PART VI, LINE 2: THE ORGANIZATION RECEIVES ANNUAL UPDATES ON THE HEALTH STATUS OF ITS POPULATION FROM THE STATE THAT INCLUDE MORTALITY AND DISEASE STATUS. THE ORGANIZATION ALSO MONITORS NATIONAL DATA ON TRENDS AND DISEASE STATUS. PART VI, LINE 3: PERSONAL CONTACT AND WEBSITE ACCESS ARE THE MAIN POINTS OF CONTACT. PART VI, LINE 4: THE ORGANIZATION SERVES THE POPULACE OF A 12 COUNTY REGION IN NORTHEAST MISSOURI. THE AREA IS PRIMARILY A RURAL FARMING AREA WITH NUMEROUS POCKETS OF MEDICALLY UNDERSERVED AREAS. RESIDENTS ARE SERVED BY DISTANT ORGANIZATIONS IN COLUMBIA, MO AND ST. LOUIS, MO. CARE CAN ALSO BE ACCESSED AT LOCAL HOSPITALS IN QUINCY, IL, MACON, MO, MOBERLY, MO, AND KIRKSVILLE, MO. PART VI, LINE 5: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A. 1 MHA CENTER FOR EDUCATION PO BOX 60 JEFFERSON CITY MO 65102 430898947 501(C)(3) 37936 MCE HEALTH IMPR RESEARCH AND SCHOLARSHIP FUND, MHA SPECIAL PROJECTS, MISSOURI CENTER FOR PATIENT SAFETY CONTRIBUTION, MHA HEALTH INSTITUTE, AND MISSOURI POISON CENTER CONTRIBUTION . SALVATION ARMY 405 VERMONT STREET QUINCY IL 62301 362167910 501(C)(3) 6000 HOMELESS PREVENTION FOR HANNIBAL - CORPORATE SPONSOR 2 0 PART I, LINE 2: POLICY GA 1-112 CORPORATE CITIZENSHIP GUIDES THE ORGANIZATION IN CONTRIBUTING TO OTHER ORGANIZATIONS. ALL ACTIVITIES WHICH CONSTITUTE A CHARITABLE CONTRIBUTION ARE DOCUMENTED ON THE CHARITABLE CONTRIBUTION FORM. X X X X 0 1 0 0 0 0 0 0 0 RICHARD VALUCK MD DIRECTOR & CARDIOLOGIST 602007 0 0 0 4097 0 0 0 39302 0 645406 0 0 0 C TODD AHRENS PRESIDENT & CEO 595611 0 87861 0 32327 0 122358 0 49966 0 888123 0 0 0 ROB GASAWAY VICE PRESIDENT - FINANCE 264020 0 40020 0 7340 0 28814 0 49789 0 389983 0 0 0 TIMOTHY REUSCHEL VP - GENERAL COUNSEL (LEFT 01/19) 12661 0 39852 0 58944 0 0 0 45926 0 157383 0 0 0 PRANAV PARIKH MD V.P. - QUALITY & MEDICAL AFFAIRS 428725 0 120094 0 7374 0 34760 0 50077 0 641030 0 0 0 AARON ZOOK VICE PRESIDENT - OPERATIONS 219240 0 21496 0 6963 0 22932 0 40281 0 310912 0 0 0 JULIE LEVERENZ VICE PRESIDENT - PATIENT EXPERIENCE 191862 0 11327 0 28807 0 20548 0 34536 0 287080 0 0 0 SUSAN WATHEN VICE PRESIDENT - HUMAN RESOURCES 197433 0 21926 0 7409 0 20401 0 22925 0 270094 0 0 0 PATRICIA BRAWNER VICE PRESIDENT - NURSING 203126 0 23399 0 7499 0 21461 0 34240 0 289725 0 0 0 WENDY HARRINGTON V.P. - HRHS DEVELOPMENT 186151 0 39883 0 6981 0 18246 0 26239 0 277500 0 0 0 SHENIECE SMITH VP - GENERAL COUNSEL 139598 0 7700 0 7632 0 0 0 24322 0 179252 0 0 0 LUVELL GLANTON ANESTHESIOLOGIST - PAIN MANAGEMENT 715504 0 85000 0 1073 0 0 0 49263 0 850840 0 0 0 JOEL HASSIEN RADIOLOGIST 555693 0 170000 0 2855 0 0 0 39292 0 767840 0 0 0 LANCE DORSEY RADIOLOGIST 513975 0 170000 0 1073 0 0 0 49531 0 734579 0 0 0 LAURA MAPLE OBSTETRICIAN AND GYNECOLOGIST 548692 0 194879 0 1343 0 0 0 12600 0 757514 0 0 0 ASHRAF ALMASHHRAWI GASTROENTEROLOGIST 664808 0 16250 0 26343 0 0 0 34125 0 741526 0 0 0 PART I, LINE 4B JULIE LEVERENZ, SERP, $20,548, AMT VESTED FOR FY G. DOUG RUBLE, SERP, $23,864, AMT VESTED FOR FY TIM REUSCHEL, 457 PAYMENT, $57,881 A THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE CITY OF HANNIBAL MISSOURI 531320446 410632CP6 2017-11-06 44088479 CONSTRUCTION 0 0 0 A 44088479 3643238 445241 40000000 2019 0 0 1 1 A 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 1 THE BOARD OF DIRECTORS HAS DELEGATED TO THE COMPENSATION COMMITTEE, PURSUANT TO A CHARTER ADOPTED BY THE BOARD OF DIRECTORS, THE RESPONSIBILITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS IN ADMINISTERING COMPENSATION PLANS AND IN MAKING DECISIONS ON THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER AND THOSE EXECUTIVES WHO REPORT DIRECTLY TO THE CHIEF EXECUTIVE OFFICER WHO QUALIFY AS "DISQUALIFIED PERSONS" WITHIN THE MEANING OF SECTION 4958 OF THE INTERNAL REVENUE CODE. THE COMMITTEE THEN REPORTS ITS ACTIONS TO THE BOARD OF DIRECTORS. THE COMMITTEE IS COMPOSED SOLELY OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE SCOPE OF THE COMMITTEE INCLUDES, BUT IS NOT LIMITED TO, REVIEWING AND APPROVING THE ANNUAL BASE SALARY LEVELS, ANNUAL INCENTIVE OPPORTUNITY LEVELS, EXECUTIVE PERQUISITES, EMPLOYMENT AGREEMENTS, BENEFITS AND SUPPLEMENTAL BENEFITS. THE BOARD OF DIRECTORS HAS ALSO DELEGATED TO THE FINANCE COMMITTEE THE RESPONSIBILITY TO APPROVE THE ANNUAL FINANCIAL AUDIT. THE COMMITTEE THEN REPORTS ITS ACTIONS TO THE BOARD OF DIRECTORS, AND SHARES AND DISCUSSES THE AUDIT REPORT WITH THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED IN DETAIL BY MANAGEMENT. THE FORM IS THEN PROVIDED TO THE FINANCE COMMITTEE AND BOARD OF DIRECTORS FOR REVIEW AND COMMENT. ANY CHANGES ARE INCORPORATED PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A POLICY TITLED BUSINESS ETHICS, CONFLICT OF INTEREST AND TAX EXEMPT COMPLIANCE WHICH REQUIRES THAT ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THE HOSPITAL ALWAYS ACT IN THE BEST INTEREST OF THE HOSPITAL WITHOUT CONFLICTS OF INTEREST. ANNUALLY EACH MEMBER OF THE BOARD OF DIRECTORS, EACH OFFICER OF THE ORGANIZATION, AND CERTAIN OTHER MANAGERS RECEIVE A COPY OF THE POLICY AND ARE REQUIRED TO COMPLETE A CONFIDENTIALITY AGREEMENT AND A CONFLICT OF INTEREST QUESTIONNAIRE WHEREBY THE INDIVIDUAL ANSWERS QUESTIONS REGARDING FAMILY MEMBERS, SUBSTANTIAL BUSINESS OR INVESTMENT HOLDINGS, AND OTHER TRANSACTIONS OR AFFILIATIONS WITH BUSINESSES OR OTHER ORGANIZATIONS THAT MIGHT AFFECT THEIR RELATIONSHIP WITH THE HOSPITAL. AS PART OF THE CONFLICTS OF INTEREST QUESTIONNAIRE THE INDIVIDUAL IS ASKED TO ACKNOWLEDGE THAT THEY HAVE RECEIVED AND READ A COPY OF THE POLICY, AGREE TO COMPLY WITH THE POLICY, ACKNOWLEDGE THAT THE HOSPITAL IS A CHARITABLE ORGANIZATION, WHICH MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH OUR TAX EXEMPT PURPOSES IN ORDER TO MAINTAIN OUR TAX EXEMPT STATUS, AGREE TO REPORT PROMPTLY TO THE BOARD OF DIRECTORS ANY CHANGES IN THEIR ANSWERS TO THE QUESTIONS OR ANY CHANGE IN CIRCUMSTANCE THAT MIGHT DEVELOP PRIOR TO THE COMPLETION OF THEIR NEXT ANNUAL QUESTIONNAIRE. WITH RESPECT TO DIRECTORS OF THE ORGANIZATION, THEY ALSO ACKNOWLEDGE THAT NONE OF THE CONDITIONS OF THE POLICY WHICH WOULD MAKE THEM INELIGIBLE TO REMAIN ON THE BOARD EXIST AT THE TIME THEY SIGN THE ACKNOWLEDGMENT AND THAT THEY WOULD REPORT ANY CONDITIONS WHICH BECOME APPLICABLE IMMEDIATELY TO THE CHAIRPERSON OF THE BOARD OF DIRECTORS. ON AN ANNUAL BASIS THE GENERAL COUNSEL SENDS THESE DOCUMENTS TO EACH DIRECTOR, OFFICER AND CERTAIN KEY EMPLOYEES. ONCE THE DOCUMENTS ARE COMPLETED AND RETURNED, THE GENERAL COUNSEL REVIEWS THE QUESTIONNAIRES AND CONFERS WITH BOTH THE SECRETARY OF THE ORGANIZATION AND CHAIR OF THE GOVERNANCE COMMITTEE AS TO THE RESULTS AND ANY ISSUES THAT NEED TO BE ADDRESSED REGARDING ACUTAL OR POTENTIAL CONFLICTS DISCLOSED OR ANY OTHER FACT THAT MIGHT MAKE THE INDIVIDUAL NOT INDEPENDENT FOR IRS TAX EXEMPT PURPOSES. THE SECRETARY, WITH THE ASSISTANCE OF THE GENERAL COUNSEL, THEN SUBMITS TO THE BOARD OF DIRECTORS A CONFIDENTIAL REPORT CONCERNING ANY INTEREST OF EMPLOYEES OF THE HOSPITAL DISCLOSED BY SUCH QUESTIONNAIRE, ANY INTEREST OF DIRECTORS AND OFFICERS WHO ARE NOT EMPLOYEES OF THE HOSPITAL, AND WHAT ACTIONS THE PRESIDENT OF THE ORGANIZATION MAY TAKE AS A RESULT OF ANY CONFLICTS DISCLOSED BY SUCH INDIVIDUALS. AN INDIVIDUAL IS INELIGIBLE TO SERVE ON THE BOARD OF DIRECTORS FOR ANY OF THE FOLLOWING REASONS AS TAKEN FROM HANNIBAL REGIONAL HEALTHCARE SYSTEM BOARD OF DIRECTORS POLICY B-III: A. FAILURE TO ADHERE COMPLETELY TO DISCLOSURE REQUIREMENTS; B. THE INDIVIDUAL IS AN OWNER, PARTNER, EMPLOYEE, BOARD MEMBER OR INVESTOR IN A DIRECT COMPETITOR OF THE HOSPITAL, OR ANY ENTITY AFFILIATED WITH THE HOSPITAL. AN OWNERSHIP OR INVESTMENT INTEREST IN A DIRECT COMPETITOR OF THE HOSPITAL, OR ANY ENTITY AFFILIATED WITH THE HOSPITAL, OF FIVE (5) PERCENT OR LESS WILL NOT MAKE INDIVIDUAL INELIGIBLE TO SERVE ON THE BOARD OF DIRECTORS; C. THE INDIVIDUAL IS AN EMPLOYEE OF THE HOSPITAL, OR ANY ENTITY AFFILIATED WITH THE HOSPITAL, OR A FAMILY MEMBER IS A MEMBER OF THE MANAGEMENT TEAM OF THE HOSPITAL, OR ANY ENTITY AFFILIATED WITH THE HOSPITAL; D. THE INDIVIDUAL RECEIVES DIRECT COMPENSATORY BENEFIT FOR ONGOING SERVICES PROVIDED TO THE HOSPITAL, OR ANY ENTITY AFFILIATED WITH THE HOSPITAL (SERVING AS A "DE FACTO EMPLOYEE"); E. THE INDIVIDUAL IS AN OWNER, PARTNER, EMPLOYEE, BOARD MEMBER OR HAS A MATERIAL INVESTMENT INTEREST IN AN ENTITY WHICH HAS CONTRACTED FOR THE EXCLUSIVE PROVISION OF ANY MEDICAL SERVICES WITH THE HOSPITAL OR ANY OF ITS AFFILIATES. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS HAS DELEGATED TO THE COMPENSATION COMMITTEE, PURSUANT TO A CHARTER ADOPTED BY THE BOARD OF DIRECTORS, THE RESPONSIBILITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS IN ADMINISTERING COMPENSATION PLANS AND IN MAKING DECISIONS ON THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER AND THOSE EXECUTIVES WHO REPORT DIRECTLY TO THE CHIEF EXECUTIVE OFFICER WHO QUALIFY AS "DISQUALIFIED PERSONS" WITHIN THE MEANING OF SECTION 4958 OF THE INTERNAL REVENUE CODE. THE COMMITTEE ENGAGES AN INDEPENDENT CONSULTANT TO ASSIST THE COMMITTEE WITH ITS GOVERNANCE AND OVERSIGHT ROLE AND ITS COMPLIANCE WITH SECTION 4958 OF THE INTERNAL REVENUE CODE, BY PROVIDING AN OPINION ON THE REASONABLENESS OF THE ORGANIZATION'S COMPENSATION PLAN. THE CONSULTANT USES PUBLISHED SURVEY DATA TO PROVIDE COMPARATIVE MARKET DATA FOR EACH POSITION. THE COMMITTEE THEN REPORTS ITS ACTIONS TO THE BOARD OF DIRECTORS. THE COMMITTEE IS COMPOSED SOLELY OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE SCOPE OF THE COMMITTEE INCLUDES, BUT IS NOT LIMITED TO, REVIEWING AND APPROVING THE ANNUAL BASE SALARY LEVELS, ANNUAL INCENTIVE OPPORTUNITY LEVELS, EXECUTIVE PERQUISITES, EMPLOYMENT AGREEMENTS, BENEFITS AND SUPPLEMENTAL BENEFITS. ANNUALLY, HRHS, THROUGH ITS COMPENSATION COMMITTEE ENGAGES AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT TO PROVIDE OPINIONS RELATED TO THE REASONABLENESS OF EXECUTIVE COMPENSATION AND TO PROVIDE ADVICE AND GUIDANCE AS TO CURRENT TRENDS AND ISSUES. IN 2020, INTEGRATED HEALTHCARE STRATEGIES (IHS) PROVIDED THIS SERVICE TO HRHS. FORM 990, PART VI, SECTION C, LINE 19 THE ARTICLES OF INCORPORATION AND AMENDMENTS THERETO ARE AVAILABLE ON THE MISSOURI SECRETARY OF STATE'S WEBSITE. FORM 990, PART IX, LINE 11G PURCHASED SERVICES/PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 18,613,674. MANAGEMENT AND GENERAL EXPENSES 3,491,622. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,105,296. LAUNDRY SERVICE: PROGRAM SERVICE EXPENSES 318,518. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 318,518. CLEANING SERVICE: PROGRAM SERVICE EXPENSES 438,506. MANAGEMENT AND GENERAL EXPENSES 966. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 439,472. FORM 990, PART XII, LINE 2C THE ORGANIZATION'S POLICY REGARDING OVERSIGHT OF AUDIT IS CONSISTENT WITH THE PRIOR YEAR. LANAC 6000 HOSPITAL DRIVE HANNIBAL MO 63401 431822503 REAL ESTATE MO 0 0 HANNIBAL REGIONAL HOSPITAL HANNIBAL REGIONAL HOSPITAL FOUNDATION 175 SHINN LANE HANNIBAL MO 63401 431658744 FUNDRAISING MO 501(C)(3) LINE 12A, I HANNIBAL REGIONAL HEALTHCARE SYSTEM INC 1 HANNIBAL MEDICAL SUPPLIES LLC PO BOX 40 QUINCY IL 62306 262362717 MEDICAL SUPPLIES MO N/A RELATED 185899 361456 0 0 0.50000 ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 3652 STARDUST DRIVE HANNIBAL MO 63401 461561480 PT/OT SERVICES MO N/A RELATED 515362 175187 0 0 0.50000 HEALTH NETWORK OF MISSOURI LLC 227 UNIVERSITY HALL COLUMBIA MO 65211 471248962 COLLABORATIVE HEALTH NETWORK MO N/A RELATED -34602 28594 0 1 0.20000 HANNIBAL REGIONAL PHYSICIAN HOSPITAL ORGANIZATION INC 6500 HOSPITAL DRIVE HANNIBAL MO 64301 431706291 PHYSICIAN HOSPITAL ORGANIZATION MO N/A C 45154 78411 0.50000 0 0 1 1 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1 0 HANNIBAL REGIONAL HOSPITAL FOUNDATION C 695512 COST INCURRED HANNIBAL REGIONAL HOSPITAL FOUNDATION O 272161 COST INCURRED HANNIBAL REGIONAL HOSPITAL FOUNDATION P 122253 COST INCURRED HANNIBAL REGIONAL HOSPITAL FOUNDATION D 6049284 COST INCURRED SCHEDULE R, PAGE 2, PART III HRHS MAINTAINS CONTROL OF THE JOINT VENTURE ACTIVITIES LISTED ON SCHEDULE R, PART III BY HAVING ITS LEADERSHIP TEAM MEMBERS ON EACH JOINT VENTURE BOARD OF DIRECTORS. AS A RESULT, THE ENTITIES ARE LISTED ON SCHEDULE R, PART III AND RESULTING INCOME FROM THOSE ACTIVITIES ARE NOT BEING SUBJECTED TO UBIT.