2020-04-22T09:19:33-07:00 2019-06-30 990 2018-07-01 440546366 CAPITAL REGION MEDICAL CENTER CAPI 5736325000 1125 Madison Street Jefferson City MO 65101 Tom Luebbering Vice President of Finance 5736325101 2020-04-22 150.199.9.242 2018 2020-11-19 02:30:22Z Tom Luebbering 1125 Madison Street Jefferson City MO 65101 223004076 0 X crmc.org X 1945 MO Capital Region Medical Center embraces its mission: To improve health and promote wellness in the communities we serve. 12 10 1750 212 10477 0 382682 595980 201952742 220009155 1913744 2380919 -26176 0 204222992 222986054 0 0 0 0 106253995 104458252 0 0 0 91722247 106079572 197976242 210537824 6246750 12448230 203894492 216034215 70083184 71157209 133811308 144877006 X Capital Region Medical Center embraces its mission; To imporove the health and promote wellness in the communities we serve. 0 1 3091569 0 0 Inpatient and Outpatient Charity Care: Capital Region Medical Center serves the community by providing medical care to all patients regardless of their ability to pay. Patients who qualify for charity care will be identified as soon as possible, either before the services are provided or after an individual has received services to stabilize their medical condition. If it is difficult to determine a patient's eligibility for charity care prior to providing the service, the determination should be made as soon as possible after the provision of the service. Upon registration, patients without Medicare/Medicaid, adequate health insurance or other local health care financial assistance will receive either a packet of information that addresses the financial assistance policy and procedures or immediate financial counseling assistance from staff within established business hours. The packet of information will clearly indicate that CRMC provides care without regard to ability to pay, to individuals with limited financial resources and explain how patients apply for financial assistance. CRMC provides a variety of services ranging from emergency services to inpatient and outpatient elective surgery, diagnostic testing and education programs. Charity care policies and procedures are in place to address any instances in which patients may access services. 2490833 0 791631 Support of Medical Education - In 1952 CRMC entered into the teaching and training of physicians with programs to teach medical students and interns. Today CRMC serves as the primary clinical training site for one of the two Family Medicine Residency Programs sponsored by the University of Missouri-Columbia School of Medicine. CRMC also serves as a clinical training site for other specialty Residency Programs sponsored by the University of Missouri-Columbia School of Medicine. In addition medical students from the Kirksville College of Osteopathic Medicine and University of Health Sciences located in Kansas City schools of Medicine complete clinical rotations at CRMC. Capital Region Medical Center supports Lincoln University School of Nursing program, Columbia College Nursing Program, Missouri State University and Drury University; RN, BSN and MSN from Central Missouri State, Central Methodist; Social Work and Case Management students from MU and Lincoln; MSN students from St. Louis University, UMKC, Maryville, Chamberlain College, Frontier Nursing; Graceland, Herzing, Vanderbuilt and Walden University in Family Nurse Practitioner clinicals for which we provide the preceptors/clinical supervisors as well as the facilities. CRMC also assists Metro Business College and Stephens College with Registered Medical Assistants; Stephens College and the University of North Dakota Physician's Assistant programs and local schools for Paramedic and EMT training. In addition to the direct financial support that Capital Region provides, we also provide support to Columbia College MSN students and Lincoln University School of Nursing BSN program in leadership training. We assist students from Rolla Technical College and Columbia Technical College in the surgical tech program. CRMC provides training to phlebotomist/tech students from Moberly Community College and Metro Business College to assist them with fulfilling their clinical requirements. CRMC provides oversight and mentoring to the St. Louis College of Pharmacy, University of Missouri-Columbia and Kansas City Pharmacy Programs. We provide support to St. Louis University and University of Missouri-Columbia PT and Kansas City and State Tech PTA programs. As well as assistance to the University of Missouri dietetics program. Our support for these programs in not only through the provision of training facilities but also adjunct faculty and resources. 223586 0 75000 Community Health Resident Clinic: CRMC provides Residents and Physician Supervisors to staff the Community Health Center clinic. In addition to providing a valuable training tool for the medical students, the resident clinic serves a unique community benefit by providing over 1400 patient visits from the eight county service area. The charge for service is based on the individual's ability to pay, which in many cases is free. 183901725 0 219101147 All other inpatient and outpatient services provided to patients. 183901725 0 219101147 189707713 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 195 0 1 1750 1 1 1 0 0 0 0 0 0 0 X 12 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Tom Luebbering 5736325101 1432 Southwest Blvd Jefferson City MO 65109 Diane Light Board Member/Physician 40 X 497990 0 68829 Carlos Graham Board Member 2.50 X 0 0 0 Lorilei Schwartz Chair 2.50 X 0 0 0 Amy Freeman Board Member 2.50 X 0 0 0 Stevan Whitt Board member 2.50 X 0 0 0 Marc Ellinger Vice Chair 2.50 X 0 0 0 Mary Beck Board Member 2.50 X 0 0 0 David Minton board member 2.50 X 0 0 0 Jonathan Curtright board member 2.50 X 0 0 0 Samuel Bushman Board Member 2.5 X 0 0 0 Lisa Kolb Waggoner Board Member/Physician 40 X 226153 0 63619 Gaspare Calvaruso President 40 X 454671 0 76159 Tom Luebbering Vice President 40 X 219026 0 61236 Janet Weckenborg Vice President 40 X 221154 0 71545 Randall Haight Vice President/Physician 40 X 360490 0 74280 Sarah Morrow Vice President 40 X 175794 0 41932 Glenda Dahlstrom Vice President 40 X 196542 0 49460 Michelle Barg Vice President/Physician 40 X 258764 0 36514 Beylnda Imhoff - partial year Vice President 40 X 57576 0 10176 Belynda Imhoff - Paid by Cerner Vice President 40 X 152648 0 23937 Ted Brandt - partial year Vice President 40 X 8664 0 0 Ted Brandt - Paid by Univ of MO Vice President 40 X 91391 0 29685 Tom Niekamp -partial year - PRN Vice President 5 X 34296 0 0 Tom Niekamp - Paid by Univ of MO Vice President 40 X 102289 0 36218 Mitchell Godbee Chief of Staff/Physician 40 X 1233541 0 105678 Dennis Luetkemeyer Physician 40 X 642717 0 82533 Eston Schwartz Physician 40 X 647419 0 83406 Adam Patterson Physician 40 X 611947 0 80133 Scott Anderson Physician 40 X 611947 0 80133 6805019 0 1075473 130 0 1 1 Cerner Corporation 2800 Rockcreek Parkway Kansas City MO 641172551 Computer Management and Support 4985511 University of Missouri One Hospital Drive Columbia MO 65201 Physician and Professional Services 3536999 Morrison Healthcare PO Box 102289 Atlanta GA 303682289 Management Food Services 1582404 Boyce and Bynum Laboratory PO Box 7406 Columbia MO 65205 Lab Services 1350430 WAVCO Construction PO Box 104388 Jefferson City MO 651104388 Construction Management 677648 90 0 0 0 528823 0 67157 0 595980 Net Patient Service Revenue 622110 213441454 213430977 10477 0 Other Revenue 900099 6567701 6567701 0 0 0 0 0 0 220009155 2344339 0 0 2344339 51852 0 0 51852 0 0 0 0 0 0 0 2750 0 18022 0 -15272 -15272 0 0 -15272 0 0 0 0 0 0 222986054 219998678 10477 2380919 0 0 0 0 0 0 0 0 3208704 2855747 352957 0 0 0 0 0 83204191 74051730 9152461 0 2169363 1930733 238630 0 11658987 10282061 1376926 0 4217007 3753136 463871 0 0 0 0 0 165300 122455 42845 0 164731 122033 42698 0 0 0 0 0 0 0 16955 12560 4395 0 19066393 14124384 4942009 0 285543 211531 74012 0 250345 225344 25001 0 6784657 5427726 1356931 0 0 0 0 0 609509 548641 60868 0 0 0 0 0 0 0 0 0 347369 312679 34690 0 1525864 1340982 184882 0 0 0 0 0 11627235 10495411 1131824 0 1330495 1197626 132869 0 Supplies 49563437 49257145 306292 0 Repairs and Maintenance 2993775 2694803 298972 0 Utilities and Phone 2615126 2353968 261158 0 FRA Taxes 5269939 5269939 0 0 3462899 3117079 345820 210537824 189707713 20830111 0 0 0 32574266 27776272 0 0 21036352 22978786 0 0 0 0 0 0 4078934 4480236 3662555 3647510 263052755 180729344 80544105 82323411 53236724 65302025 0 0 0 0 0 0 8761556 9525975 203894492 216034215 22492496 26105802 0 0 40111164 37097692 0 0 0 0 7479524 7953715 70083184 71157209 X 129788947 140912801 3952015 3893859 70346 70346 133811308 144877006 203894492 216034215 X 12448230 221017 0 0 0 -1603549 X 1 X 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 0 1 13096 13096 0 Schedule C, Part II-B, Line 1 CRMC is a member of Missouri Hospital Association. Just one of the benefits of membership is that MHA communicates with government on issues that are important to Missouri hospitals. A portion of the annual dues is attributable to lobbying. 10707466 0 10707466 153362846 0 110959851 42402995 2595594 0 1626427 969167 96386849 0 68143066 28243783 0 0 0 0 82323411 0 457B Liability 3394271 Insurance Payable 1955605 Malpractice Liability 2450341 Other Liabilities 153498 7953715 X 222457231 0 0 0 0 0 222457231 0 528823 528823 222986054 210711198 0 0 0 173374 173374 210537824 0 0 0 210537824 Schedule D, Part X, Line 2 Because CRMC did not have any tax liabilities, the wording is silent. Footnote 1 would have disclosed this if it was applicable. Income Taxes: The Medical Center has been recognized as exempt from income taxes under Section 501 of the Internal Revenue Code and a similar provision of state law. However, the Medical Center is subject to federal income tax on any unrelated business taxable income. Schedule D, Part XI, Line 4b 528823 Change in Unrealized Gains Schedule D, Part XII, Line 2d Foundation Expense -158102 Loss on Sale -15272 Total -173374 1 1 X 1 X 1 X 1 1 1 0 0 3091569 0 3091569 0.0147 18038865 14301606 3737259 0.0177 0 0 0 0 0 0 21130434 14301606 6828828 0.0324 30 16375 973045 522408 452637 0.002 16 2714469 866631 1847838 0.009 104568 0 104568 0.0005 46 16375 3792082 1389039 2405043 0.0115 46 16375 24922516 15690645 9233871 0.0439 55440 0 55440 57178 0 57178 8192141 5794046 2398095 0 0 8304759 5794046 2510713 0 0 7499638 0 57347392 50499134 6848258 X 1 1 1 1 Capital Region Medical Center 1125 Madison Street Jefferson City MO 65101 crmc.org 419-19 X X X X Capital Region Medical Center 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X www.crmc.org X X 1 18 1 https://www.crmc.org/about-us/community-involvement/community-health-needs-assessment/ 0 0 1 X 200 200 X X X 1 1 X X X X 1 X https://www.crmc.org/patients-and-visitors/billing-insurance/financial-assistance/ X https://www.crmc.org//media/1268/2404-007.pdf X https://www.crmc.org/patients-and-visitors/billing-insurance/financial-assistance/ X X X X X 1 X 0 X X X X 1 X 0 0 Schedule H, Part V, Section B, Line 5-Capital Region Medical Center The Central Missouri Community Health Assessment Partnership (CMCHAP) was created and embarked on a mission to improve the health of residents of the four counties of Cole, Miller, Moniteau and Osage. The partnership worked collaboratively to collect and analyze health data and gather input from community members to aid in assessing and prioritizing needs. This unique partnership of health care and social service providers was financially funded by the two local hospitals - Capital Region Medical Center and SSM St. Mary's Health Center, and nine other community partners joined together to form the CMCHAP. Schedule H, Part V, Section B, Line 6a-Capital Region Medical Center Capital Region Medical Center and SSM St. Mary's Hospital. Schedule H, Part V, Section B, Line 6b-Capital Region Medical Center The Health Departments of Cole, Callaway, Miller, Moniteau and Osage Counties, Community Health Center of Central Missouri, Central Missouri United Way, Compass Health Network, and the Missouri Coalition for Community Behavioral Healthcare. . Schedule H, Part V, Section B, Line 7b-Capital Region Medical Center Capital Region Medical Center - Capital Region Medical Center made the CHNA available online at www.crmc.org. Additionally, paper copies were made available through the public relations department. A review of the CHNA was provided to Medical Center managers, Board of Directors, the CRMC Foundation, and also at the Community Outreach meeting held in several of the outlying counties we serve. Schedule H, Part V, Section B, Line 7d-Capital Region Medical Center Capital Region Medical Center made the CHNA available online at www.crmc.org. Additionally paper copies were made available through the public relations department. A review of the CHNA was provided to medical center managers, Board of Directors, the CRMC foundation, and also at the community outreach meeting held in several of the outlying communities CRMC serves. Schedule H, Part V, Section B, Line 11-Capital Region Medical Center CRMC has a dedicated department referenced as Community Benefit that works collectively with community partners to address determined needs. There is also an internal team that reviews the CHNA and determines the strategic plan for implementing strategies to address such needs. This team meets regularly and provides an update to the Board of Directors in August each year. The top five needs determined in the August 2018 CHNA are as follows: 1. Improve Access to Health Care and Support Services. 2. Mental Health Disorders and Substance Abuse. 3. Chronic Disease and & Health Risks Prevention - Overweight/Obesity & Physical Inactivity, Smoking & Tobacco Use. 4. Improve Health Literacy 5. Address Social Determinants of Health. Strategies have included support groups, smoking cessation, lifestyle, chronic disease management & diabetes self management and weight loss programs. Implemented tracking and education of depression and body mass index screenings at all primary care visits. We have increased the number of participating providers including primary and psychiatrics. We work with the Council for Drug Free Youth on many projects and also created the Behavioral Health Resource Partnership. CRMC has been actively engaging the medical team in policies to decrease usage of controlled substances with emphasis on reducing risk of opiod abuse. To help combat environmental and abuse issues, CRMC also placed a bin in the pharmacy for people to safely dispose of unused prescription medications. Our implementation strategies also encourage improved nutrition and increased physical activity. We sponsor farmers' markets and implemented fresh fruits and vegetables at local food pantries, buddy packs at local schools, and partnered with several schools and recreation centers to develop healthy concession policies. CRMC has worked with multiple city governments on bike/pedestrian plans, complete streets policies, as well as trails, including the Rock Island Trail. Lastly, we are continuing our partnership with Missouri Foundation for Health, 3 school districts and communities on the Healthy Schools/Healthy Communities initiative. Schedule H, Part V, Section B, Line 15e-Capital Region Medical Center Use of Human Arc to assist in Medicaid application. 20 Capital Region Physicians 1125 Madison Street Jefferson City MO 65101 Medical Center Expansion - Physician clinics and outpatient services Capital Region Southwest 1432 Southwest Blvd Jefferson City MO 65109 Outpatient and Wellness Services CRMC Healthplex West 3308 West Edgewood Jefferson City MO 65109 Urgent Care and Outpatient Therapy CRMC-SW Clinic 1500 Southwest Blvd Jefferson City MO 65109 Family Practice Clinic Primary Care 1014 Madison Street Jefferson City MO 65101 Primary Care - Family Practice Clinic CRMC- Versailles 901 Kidwell Drive Versailles MO 65084 Family Practice Clinic CRMC - Eldon 103 Business Hwy 54 North Eldon MO 65026 Family Practice Clinic West Truman Clinic 3527 W Truman Blvd Jefferson City MO 65109 Physician Clinic CRMC-Owensville 3536 Kuhne Road Owensville MO 65066 Family Practice Clinic CRMC Surgicare 1705 Christy Drive Jefferson City MO 65101 Surgeon Eastland Urgent Care 915 A Eastland Drive Jefferson City MO 65101 Urgent Care Clinic CRMC-California 704 Buchanan California MO 65018 Family Practice Clinic CRMC-Linn 916 East Main Street Linn MO 65051 Family Practice Capital Region Family Medical Center 420 East High Street Jefferson City MO 65101 Family Practice Clinic CRMC Quick Care 3721 W Truman Blvd Jefferson City MO 65109 Quick Care Clinic CRMC-Holts Summit 180 North Star Holts Summit MO 65043 Family Practice Clinic Vienna Family Practice 111 Parkway Vienna MO 65582 Family Practice Clinic St Elizabeth Clinic 631 S Walnut Street St Elizabeth MO 65075 Physician Clinic CRMC - Downtown Urgent Care - closed April 30th 2019 220 Madison Street Jefferson City MO 65101 Urgent Care CRMC Integrative Medicine - closed Dec 31 2018 999 Diamond Ridge Suite 201 Jefferson City MO 65109 Family medicine and Integrative Medicine clinic Schedule H, Part I, Line 3c Average Medicare and Commercial/Managed Care Adjustments were used to calculate 65% auto self pay. Schedule H, Part I, Line 7 Cost to charge ratio Schedule H, Part I, Line 7, Column f N/A Schedule H, Part I, Line 7g N/A Schedule H, Part II CRMC participates with many community partners throughout the year to carry out our mission to improve health and promote wellness in the communities we serve. Strategically our implementation strategy focuses our community health activities and resources based on the findings of the community health needs assessment. In order to be impactful on the health and wellness of our community, partnerships, collaborations and working with coalitions is a must. The expenses noted in this section are reflective of our participation in such community building activities. Specific details are include on each particular line. Schedule H, Part II, Line 3 CRMC provides a building for use to the St. Nicholas Academy. It is a not for profit organization which is creating a group home for at risk youth. This is the normal annual rental amount for this square footage. St. Nicholas Academy pays $1 per year in rent. Schedule H, Part II, Line 6 CRMC partners with Community Health Center to provide leadership and resources. One of our VPs serves on the board of directors and attends regular meetings. CRMC Administration team provides leadership for Missouri Society for Healthcare Engineering. As well as the Rape and Abuse Crisis Center, Missouri Physical Therapy Association, and Physical Therapy Assistant Advisory. CRMC also provides onsite education to State Technical College PTA program and the University of Missouri PT programs. In our Community Outreach meetings, CRMC president and other Administrative members hold meetings in the communities we serve. At these meetings, CRMC gives an update from CRMC. They also ask for input from community members about ways CRMC can improve healthcare in their community. Schedule H, Part II, Line 7 CRMC provides leadership for many local organizations by serving on their Board of Directors including YMCA, United Way, Jefferson City Cosmopolitan Club, Chamber of Commerce, Civic Progress, the Old Munichburg Association, Kiwanis, Zonta Club, Helias and Jefferson City Public School Foundation, Rotary, Big Brothers/Big Sisters and several other local business associations. Schedule H, Part II, Line 8 Capital Region recruited and retained physicians to provide medical care in rural and underserved areas. Schedule H, Part III, Section A, Line 4 Bad debt expense was not significant for the year ended June 30, 2019. Prior to Adoption of ASU 2014-09, Revenues from Contracts with Customers (Topic 606) Accounts receivable were reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Medical Center analyzed its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for uncollectible accounts. Management regularly reviewed data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have thirdparty coverage, the Medical Center analyzed contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Medical Center records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates or the discounted rates if negotiated or provided by policy and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. Schedule H, Part III, Section B, Line 8 Line 2 is determined using the cost to charge ratio from Worksheet 2. Schedule H, Part III, Section C, Line 9b All Self Pay patients automatically receive a 65% Self Pay discount. For collection practices, we run presumptive charity using Paro Presumptive Charity software to identify all patients under the presumptive score of 279%, which equals 200% of FPL. We write off to charity all patients under the threshold and do not send to collections. All patients over 279% of presumptive score must complete the financial application to prove need of charity assistance. In addition patients are screened for Medicaid eligibility using a company called Human Arc. Schedule H, Part VI, Line 2 The CMCHAP conducted a comprehensive community health assessment using both secondary and primary analysis, which allowed us to measure perception, health risks, health factors, health outcomes and characteristics specific to the communities in these five central counties. This is the third comprehensive regional health assessment completed in this collaborative fashion by the CMCHAP. The objectives were to identify factors influencing health status, determine and prioritize issues of greatest concern, identify unmet health needs and project a source of reliable information that will support the development of solutions, The needs assessment was conducted using three methods: secondary data analysis, discussions with community groups and provide clients and surveys completed by community members, community leaders and local physicians. Existing data previously collected for other purposes, called secondary data, was compiled from a variety of credible local state and federal sources to provide a context for analysis and interpretation. Community discussion groups, much like town hall meetings, were organized by the Steering Team and facilitated by Michael Feliz, a community health development specialist. Throughout this process, more than 150 individuals participated in nine discussion groups and consumer interview sessions. An addition to the data collection for 2018 was the inclusion of a survey to assess the perception of health care and health status across the five county region in the analysis. These surveys were made available in physician offices, online and in community health departments. Upon reviewing the findings from all the sources information, the Steering Team, identified the most serious health issue and then ranking them using a priory matrix. The results were: 1. Access to Health Care 2. Mental Health and Substance Abuse 3. Chronic Disease and Health Risks Preventions 4. Health Literacy and 5. Social Determinants of Health Schedule H, Part VI, Line 3 At every location, registration staff have financial assistance packets available to hand out. All self pay patients are referred to one of the three financial counselors in the area. Patient financial counselors visit all self pay in house patients. Also Human Arc helps patients apply for Medicaid and an Accountable Care representative is on site one day per week. Signs are posted in rooms and at registration sites. For every statement sent, there is a number printed to call for assistance. All first letters indicate who to call for assistance. All clinics are aware of the policy - so is the medical staff. It is posted on our website and on our online bill pay. Schedule H, Part VI, Line 4 The five county region included both urban and rural areas. The local area economy is heavily dependent on state government. The total population for the region based on the 2010 census was 175,851. The region is expecting an increase of 5.5% from 2010-2020. Cole County which has the largest population of our region, shows a projected growth in population of 6.11%, which is a slight increase of the actual growth experienced of 6.04% growth between the 2000-2010 censuses. The age distribution continues to shift toward a larger population of older adults. Understanding the older population generally have more chronic disease and face more barriers in accessing care. It was notified that the concentration of the aging population in the rural counties where there are fewer services is of growing concern. Community discussion groups noted increase in minority and diverse groups. Schedule H, Part VI, Line 5 As a community based hospital, Capital Region Medical Center lives its mission to improve health and promote wellness to the communities it serves every day. A full service hospital offering a complete continuum of care. CRMC provides access to exceptional health care services throughout its service area. CRMC operates a large clinic network and comprehensive cancer facility, employees over 120 providers, houses an inpatient rehabilitation facility and includes a medically based fitness facility. Schedule H, Part VI, Line 6 CRMC is an affiliate of MU Health. Through this partnership, our community benefits from the access of a community based hospital and a higher level of care when needed. Schedule H, Part VI, Line 7 N/A X 1 1 X X X 0 0 0 1 0 1 0 1 0 Gaspare Calvaruso President 363970 0 78224 0 12477 0 11000 0 65159 0 530830 0 0 0 Tom Luebbering Vice President 185425 0 33108 0 494 0 7698 0 53538 0 280263 0 0 0 Janet Weckenborg Vice President 182277 0 37619 0 1258 0 7571 0 63974 0 292699 0 0 0 Glenda Dahlstrom Vice President 168382 0 27089 0 1071 0 3516 0 45944 0 246002 0 0 0 Sarah Morrow Vice President 156516 0 18994 0 284 0 6308 0 35623 0 217725 0 0 0 Randall Haight Vice President/Physician 265080 0 94589 0 821 0 10626 0 63654 0 434770 0 0 0 Michelle Barg Vice President/Physician 223794 0 34630 0 340 0 8624 0 27889 0 295277 0 0 0 Lisa Kolb Waggoner Board Member/Physician 178450 0 46838 0 865 0 7496 0 56123 0 289772 0 0 0 Diane Light Board Member/Physician 385542 0 111331 0 1117 0 11000 0 57829 0 566819 0 0 0 Mitchell Godbee Chief of Staff/Physician 779353 0 453548 0 640 0 11000 0 94678 0 1339219 0 0 0 Eston Schwartz Physician 596409 0 50100 0 910 0 11000 0 72406 0 730825 0 0 0 Dennis Luetkemeyer Physician 573679 0 67696 0 1342 0 10454 0 72079 0 725250 0 0 0 Scott Anderson Physician 599794 0 23392 0 2422 0 11000 0 71655 0 708263 0 0 0 Adam Patterson Physician 544281 0 67081 0 586 0 11000 0 69133 0 692081 0 0 0 Beylnda Imhoff - partial year Vice President 42992 0 14533 0 52 0 0 0 10176 0 67753 0 0 0 Belynda Imhoff - Paid by Cerner Vice President 137041 0 15607 0 0 0 305 0 23631 0 176584 0 0 0 Ted Brandt - partial year Vice President 0 0 8664 0 0 0 0 0 0 0 8664 0 0 0 Ted Brandt - Paid by Univ of MO Vice President 66614 0 10000 0 14777 0 7998 0 21687 0 121076 0 0 0 Tom Niekamp -partial year - PRN Vice President 34296 0 0 0 0 0 0 0 0 0 34296 0 0 0 Tom Niekamp - Paid by Univ of MO Vice President 101778 0 0 0 511 0 9352 0 26866 0 138507 0 0 0 Schedule J, Part I, Line 1a CRMC pays dues for the President to be a member of the Jefferson City Country Club. This is used for many business reasons. Any personal expenses incurred are reimbursed by the President of the Medical Center Schedule J, Part I, Line 3 Annually, all board members complete an evaluation of the CEO and individually present the results to the board chair who presents them to the compensation committee, consisting of 3 board members, including the Chair and Vice Chair, The compensation committee reviews the evaluation results with the CEO and determines the CEO's salary based on salary surveys from three different organizations. The comparable data are based on Missouri or the region. The compensation committee members do not have a conflict of interest with respect to the compensation arrangements. The committee documents their review and decisions. Schedule J, Part I, Line 5 For all employees an annual bonus is partially based on the achievement of certain organizational goals. These goals pertain to quality, service, and financial indicators. Schedule J, Part I, Line 6 For all employees, an annual bonus is partially based on the achievement of certain organizational goals. These goals pertain to quality, service, and financial indicators. Schedule J, Part I, Line 7 The President, Vice President, Directors, and Managers participate in the Management Incentive Compensation Program. They receive additional bonus compensation if certain stated goals are met. Most Physicians receive a base salary, but also have the ability to earn an additional amount based on production. A Health Facilities Revenue Bonds Series 2011 431178966 60637ACF7 2011-11-22 32690247 Refund Series 1998 and 2004 Bonds (issued 12/29/98 and 6/29/2004) 0 0 0 B Health Pacilities Revenue Bonds Series 2017 431178966 000000000 2017-03-09 20000000 Reimburse CRMC for constructions cost of medical office building 0 0 0 A 12900000 0 32690247 2908325 0 0 434131 0 0 0 28320002 0 2004 1 0 1 1 B 2450173 0 20000000 0 0 0 0 0 0 0 20000000 2016 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 A 0 B 0 Lori Luebbering Wife of Tom Luebbering, Vice President 23142 Salary as a nurse for CRMC 0 Kathleen Weckenborg daughter in law of Janet Weckenborg 56429 Salary as a occupational therapist for CRMC 0 Form 990, Part III, Line 3 On 8/1/2018, Capital Region joined Louisiana Health Group, LLC to form the partnership LHCG CXXXXIII, LLC. This partnership purchased the previous Capital Region Home Health agency. Capital Region Medical Center is a 20% partner. Form 990, Part VI, Section A, Line 6 The organization has 2 members - The University of Missouri-Columbia Medical Alliance and CRMC Healthcare. Form 990, Part VI, Section A, Line 7a All elections for appointments to the Governing Body are subject to approval of the member, the University of Missouri Medical Alliance. Form 990, Part VI, Section A, Line 7b The bylaws provide a number of instances requiring approval by the University of Missouri Medical Alliance, e,g, amendment of the bylaws, dissolution of the organization, sale of substantial assets, and discontinuance of a major service. Form 990, Part VI, Section B, Line 11b The 990 is reviewed by the Director of Accounting, legal counsel, the Vice President of Finance, and the President. The President presents it to the board chair and the Executive Committee of the board. The Executive Committee makes a presentation to the board and copies are available to all members. Form 990, Part VI, Section B, Line 12c The hospital's legal counsel attends board meetings. He is continually monitoring if any transaction would be a conflict of interest. The Vice President of Finance reviews all payments to physicians and identifies any potential conflicts. The Director of Accounting reviews payments and identifies any potential conflicts. Form 990, Part VI, Section B, Line 15 All board members complete an evaluation of the CEO and individually present the results to the board chair, who presents to the compensation committee, consisting of three board members, including Chair and Vice Chair. The compensation committee reviews the evaluation results with the CEO and determines the CEO's salary based on salary surveys from three different organizations. The comparable data are based on Missouri and the regions. The compensation committee members do not have a conflict of interest with respect to the compensation agreements. The committee documents their review and decision and meets at least annually. The CEO sets the recommended salaries for key employees using comparable data from three salary surveys. The Vice President of Human Resources participates in determining the appropriate salary. Form 990, Part VI, Section C, Line 19 Capital Region includes financial statements in the annual report provided to the Board of Governors (approximately 500 members). Financial information is reviewed at the Medical Executive and Medical Staff meetings monthly. The information is then shared at the monthly managers' meeting and then communicated to all staff at department meetings. The Capital Region website (crmc.org) provides important information about the medical center to the community. The "Fraud and Wrongdoing" policy, "Privacy" policy, "Affiliation and Accreditations" policy, leader profiles, site locations, and contact information are all disclosed on the website. Form 990, Part XI, Line 9 Transfers to UMC-MA -1387291 Decr in Foundation NA SFAS#136 -58156 Paid Foundation Expenses -158102 Capital Region Medical Foundation PO Box 1128 Jefferson City MO 651021128 431506900 Raise Money and manage funds to be used by Capital Region Medical Center MO 501(c)(3) Supporting Org Typ I N/A Still Osteopathic Medical Foundation PO Box 1128 Jefferson City MO 651021128 431720296 Support Osteopathic Education MO 501(c)(3) Support Org Typ III N/A Capital Region Medical Center Partners 1125 Madison Street Jefferson City MO 65101 446014361 Support Capital Region Medical Center MO 501(c)(3) Support Org Typ I N/A CRMC Healthcare Inc 1125 Madison Street Jefferson City MO 65101 461699021 Support Capital Region Medical Center MO 501 (c)(3) Type II Support Org N/A University of Missouri - Columbia Medical Alliance 1000 West Nifong Building 7 Suite 300 Columbia MO 65211 311574931 Support and encourage health care delivery and medical education MO 501 (c)(3) Type I Support Org N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 Capital Region Medical Foundation o 158102 Salary, benefits, and other expenses of the Foundation Director Capital Region Medical Foundation c 528823 Cash value of donations Capital Region Medical Center Partners q 24285 Partners reimburse CRMC for the Salary and FICA expense of the gift shop manager. Capital Region Medical Center Partners c 67157 Cash value of donations given to Capital Region. Capital Region Medical Center Partners m 375405 In fiscal year ending June 30, 2019, the Partners donated 43,651 hours of service valued at $375,405 University of Missouri - Columbia Medical Alliance r 1387291 The Medical Center is required to make annual contributions to the Medical Alliance for the purposes of the integrated healthcare delivery system created by the affiliation agreement. Each annual contribution represents 1% of the Medical Center's excess of revenue over expenses. Still Osteopathic Medical Foundation q 964 The Still Foundation reimburses CRMC for expenses related to the Physician Health Program. Extension was approved