2019-11-14T16:29:06-06:00 2018-12-31 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2018-01-01 273868479 SOUTHEAST HEALTH CENTER OF RIPLEY COUNTY % KRISTA BERRY SOUT 5733344822 1701 LACEY ST CAPE GIRARDEAU MO 63701 STEVEN J HAAS CFO 5733344822 2019-10-15 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920193185000020 2019-11-14 P 8705656393E68C4A592E0CEA227AF158EB1E06AC DC217978BA4E90A39731850ED9CC10A93A8E606F 2018 2020-04-17 16:48:07Z KENNETH W BATEMAN 1701 LACEY ST CAPE GIRARDEAU MO 63701 9355854 false X WWW.SEHEALTH.ORG X 2010 MO TOGETHER WE WILL EVOLVE HEALTHCARE THROUGH INNOVATION, COMPASSION AND PARTNERSHIPS. X 7 6 110 9 0 9291 376389 12454714 8977765 309587 -1458024 0 0 12773592 7896130 0 0 0 0 5651201 5328519 0 0 0 7673841 6994946 13325042 12323465 -551450 -4427335 4941264 768686 2470883 1459700 2470381 -691014 X WITH OUR COLLECTIVE EXPERTISE, WE STRIVE TO BE THE BEST IN PATIENT EXPERIENCE AND OUTCOMES, INSTILLING CONFIDENCE WITHIN OUR COMMUNITY AND EMPOWERMENT AMONG OUR EMPLOYEES. EMPOWERMENT AMONG OUR EMPLOYEES. false true 10370391 8977765 SOUTHEAST HEALTH CENTER OF RIPLEY COUNTY (SEH) OPERATES A GENERAL MEDICAL HOSPITAL IN RURAL DONIPHAN, MO. THE FACILITY INCLUDES AN EMERGENCY ROOM, MEDICAL FLOOR LICENSED FOR 21 BEDS, A CLINICAL AND HOSPITAL LABORATORY, RADIOLOGY, REHABILITATION SERVICES, RESPIRATORY THERAPY, AND A PHARMACY. SEH ALSO PROVIDES INTERMITTENT HOME SERVICES TO HOMEBOUND PATIENTS. APPROXIMATELY 5,000 PATIENTS VISIT THE EMERGENCY ROOM EACH YEAR. THE NEXT CLOSEST HOSPITAL IS MORE THAN 25 MILES AWAY. SEE SCHEDULE O FOR MORE INFORMATION. 10370391 true true false true false false false false false false false false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false true false true false false false true 19 0 true 110 true false false false false false false false false false false false false X 7 6 false false false false true true true true true false false true true true true true true false false false X KRISTA BERRY 5733344822 1701 LACEY ST CAPE GIRARDEAU MO 63701 BRIAN ROBISON CHAIRMAN 2.0 3.0 X X 0 0 0 MICHELLE AYCOCK VICE CHAIRMAN 2.0 3.0 X X 0 0 0 MARK AVERY SECRETARY/TREASURER 2.0 3.0 X X 0 0 0 KENNETH BATEMAN PRESIDENT/CEO, DIRECTOR 2.0 41.0 X X 0 692467 145133 CLAY CROSSON DIRECTOR 2.0 3.0 X 0 0 0 FREDDIE LEROUX DIRECTOR END 04/18 2.0 3.0 X 0 0 0 STEVE MCPHEETERS DIRECTOR END 09/18 2.0 3.0 X 0 0 0 GREG MATHIS DIRECTOR 2.0 3.0 X 0 0 0 JOHN M THOMPSON DIRECTOR 2.0 3.0 X 0 0 0 STEVEN HAAS VP & CFO 2.0 41.0 X 0 317617 34302 MEYYAPPAN PALANIAPPAN MEDICAL DIRECTOR 40.0 0.0 X 207912 0 35418 GREGORY ZOLKOWSKI MEDICAL DIRECTOR 40.0 0.0 X 603104 0 37649 GEORGE CHARLES TECHNOLOGIST RADIOLOGY 40.0 0.0 X 115878 0 6111 CHERYL BARTON CEO 40.0 0.0 X 151350 0 19965 KATHREEN FRIEND APRN 40.0 0.0 X 170443 0 10118 GARY WARD PHYSICIAN 40.0 0.0 X 201363 0 27918 BETH SJOBLOM PHYSICIAN 40.0 0.0 X 520258 0 16519 1970308 1010084 333133 7 false true false BARTON ASSOCIATES PO BOX 417844 BOSTON MA 02241 PHYSICIAN COVERAGE 382836 MEDICAL SOLUTIONS PO BOX 310737 DES MOINES IA 50331 NURSE COVERAGE 308051 JACKSON AND COKER PO BOX 277638 ATLANTA GA 30384 PHYSICIAN COVERAGE 246878 JOHN A EPPOLITO JR 378 GOLDEN LANE POPLAR BLUFF MO 63901 PHYSICIAN COVERAGE 125615 4 8717 367672 376389 NET PATIENT SERVICE REVENUE 900099 8275903 8275903 OTHER REVENUE 900099 701862 701862 8977765 1700 1700 0 0 0 0 0 1459724 -1459724 -1459724 -1459724 0 0 0 0 0 0 0 0 0 0 7896130 8977765 -1458024 X 0 0 0 0 884083 884083 0 3415665 2629645 786020 159980 125714 34266 497416 420746 76670 371375 309385 61990 0 0 20282 20282 0 0 0 2149580 1899567 250013 912 912 368908 159998 208910 152407 123219 29188 0 883506 672759 210747 26121 20318 5803 0 8790 8355 435 5200 4159 1041 0 164501 127189 37312 187027 10256 176771 BAD DEBT 2279159 2279159 MEDICAL SUPPLIES & DRUGS 352275 352275 PROVIDER TAX 334451 334451 MISCELLANEOUS 61827 9113 52714 12323465 10370391 1953074 0 71363 203854 0 0 0 0 1324751 30853 0 0 0 0 0 0 92055 0 99333 0 1743937 0 0 0 0 0 0 0 0 0 1609825 533979 4941264 768686 1015273 1287097 0 0 0 0 0 0 0 0 0 0 157273 0 0 0 1298337 172603 2470883 1459700 X 2470381 -691014 0 0 0 0 2470381 -691014 4941264 768686 X -4427335 1265940 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 5233 5233 false SCHEDULE C, PART II-B, LINE 1I OTHER LOBBYING ACTIVITIES: THE ORGANIZATION IS A MEMBER OF THE MISSOURI HOSPITAL ASSOCIATION, OF WHICH THE FOLLOWING PORTION OF DUES PAID IS ATTRIBUTABLE TO LOBBYING: 24.2% OF $12,491 OR $3,023. THE ORGANIZATION IS A MEMBER OF THE AMERICAN HEART ASSOCIATION, OF WHICH THE FOLLOWING PORTION OF DUES PAID IS ATTRIBUTABLE TO LOBBYING: 22.73% OF $7,424 OR $1,657. DUE FROM 3RD PARTY 533979 533979 0 DUE TO 3RD PARTY 172603 172603 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true true X true X true X true false true true 43877 43877 0.00440 2036823 2644602 -607779 0.00000 2080700 2644602 -563902 0.00440 423562 356511 67051 0.00670 423562 356511 67051 0.00670 2504262 3001113 -496851 0.01110 false 2279159 544719 2512510 3235923 -723413 X true true 1 1 SOUTHEASTHEALTH CENTER OF RIPLEY CTY 109 PLUM STREET DONIPHAN MO 63935 WWW.SEHEALTH.ORG 528 X X X SOUTHEASTHEALTH CENTER OF RIPLEY CTY 1 false false true X X X X X X X X X 16 true true false true X WWW.SEHEALTH.ORG/ABOUT/COMMUNITY-HEALTH X X true 16 true WWW.SEHEALTH.ORG/ABOUT/COMMUNITY-HEALTH false true X 200. 300. X X X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: SOUTHEASTHEALTH OBTAINED INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY BY DISTRIBUTING ONLINE QUESTIONNAIRES TO MEMBERS OF THE HEALTH COMMUNITIES COALITIONS IN THE AREA, CONDUCTING IN-PERSON FOCUS GROUPS WITH THE HEALTH COMMUNITIES COALITIONS IN CAPE GIRARDEAU AND RIPLEY COUNTY, AND OBTAINING PERSPECTIVES OF MEMBER OF THE SOUTHEASTHEALTH BOARD OF DIRECTORS. BOARD MEMBERS INCLUDE LEADERS IN BUSINESS AND GOVERNMENT, EDUCATORS, AND HEALTHCARE PROFESSIONALS WITH DEEP INVOLVEMENT IN THE COMMUNITY. SCHEDULE H, PART V, SECTION B, LINE 6A CHNA CONDUCTED WITH OTHER HOSPITALS: THE CHNA PROCESS WAS CONDUCTED WITH SOUTHEAST HEALTH, A RELATED ORGANIZATION, AND SOUTHEASTHEALTH'S REGIONAL HOSPITAL FACILITIES. SCHEDULE H, PART V, SECTION B, LINE 7D OTHER METHODS OF AVAILABILITY OF THE CHNA: IN COORDINATION WITH SOUTHEASTHEALTH, A RELATED ORGANIZATION, AND IN ADDITION TO THE HOSPITAL'S WEBSITE (SEHEALTH.ORG), THE RESULTS WERE SHARED WITH THE RIPLEY COUNTY COMMUNITY ADVISORY GROUP. SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING SIGNIFICANT NEEDS: MEMBERS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT TEAM ANALYZED SURVEY DATA, FOCUS GROUP DATA, AND SECONDARY DATA IN THE CHNA REPORT TO PRIORITIZE THE COMMUNITY HEALTH NEEDS FOR EACH COUNTY. THE PRIORITY NEEDS WERE FIRST IDENTIFIED BY THE PRIMARY RESEARCH OR WHAT THE COMMUNITY FINDS MOST IMPORTANT. THESE HIGH PRIORITY NEEDS WERE THEN VALIDATED BY THE SECONDARY RESEARCH LOOKING AT THE COMMUNITY STATISTICS AND TRENDS AGAINST THE STATE STATISTICS AND TRENDS. THE TEAM IDENTIFIED 6 HEALTH NEEDS AND DEVELOPED IMPROVEMENT STRATEGIES FOR EACH AREA: -CANCER (SMOKING, COLON CANCER) -OBESITY (DIET AND EXERCISE) -CHRONIC DISEASE *STROKE *HEART DISEASE *DIABETES (DIET AND EXERCISE) *CHRONIC RESPIRATORY DISEASE (SMOKING) -SUBSTANCE ABUSE/MENTAL HEALTH (DRUG AND ALCOHOL, ANXIETY AND DEPRESSION) -HEALTH CARE AFFORDABILITY (UNINSURED/UNDERINSURED) -PRE-CONCEPTUAL AND PERINATAL HEALTH SCHEDULE H, PART V, SECTION B, LINE 13H ADDITIONAL CRITERIA USED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE OTHER THAN INCOME AND ASSETS ALREADY SPECIFIED INCLUDE: - ELIGIBILITY FOR MEDICAID SCHEDULE H, PART V, SECTION B, LINES 16A-16C FAP AVAILABILITY: THE FULL WEBSITE ADDRESS FOR LINES 16A-16C IS AS FOLLOWS: HTTPS://WWW.SEHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, LINE 16I LEP TRANSLATIONS: THERE ARE NO GROUPS WITH LIMITED ENGLISH PROFICIENCY THAT RISE TO THE THRESHOLD REQUIRED UNDER IRC SECTION 501(R). 5 RIPLEY COUNTY HOME HEALTH AGENCY 109 PLUM STREET DONIPHAN MO 63935 HOSPITAL BASED HHA FAMILY MEDICINE OF DONIPHAN 1 HOSPITAL DRIVE DONIPHAN MO 63935 RURAL HEALTH CLINIC RIPLEY COUNTY RURAL HEALTH CLINIC 109 LEROUX DRIVE DONIPHAN MO 63935 RURAL HEALTH CLINIC THERAPY SERVICES OF DONIPHAN 208 N GRAND AVENUE DONIPHAN MO 63935 THERAPY SERVICES SOUTHEAST HOME HEALTH 208 N GRAND AVENUE DONIPHAN MO 63935 HOSPITAL BASED HHA SCHEDULE H, PART I, LINE 7, COLUMN F TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE OF $2,279,159. SCHEDULE H, PART I, LINE 7G SUBSIDIZED SERVICES: THE ORGANIZATION HAS INCLUDED COSTS ASSOCIATED WITH RURAL HEALTH CENTERS (RHC) IN THE CALCULATION OF SUBSIDIZED SERVICES ON LINE 7G, WITH A NET SUBSIDY FROM RHCS OF $67,501. SOUTHEASTHEALTH PROVIDES PRIMARY CARE SERVICES TO THE SURROUNDING COMMUNITIES AT THE CENTERS. THESE SERVICES ARE PROVIDED IN RURAL AREAS WHERE THERE WOULD BE A SHORTAGE OF QUALITY MEDICAL CARE WITHOUT THE SERVICES AND CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEET 1. IRS WORKSHEETS 3 AND 6 USED SPECIFIC COST TO CHARGE RATIO FOR EACH SERVICE. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HEALTH SYSTEM DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HEALTH SYSTEMS ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANXIAL STATEMENTS FOR THE YEAR ENDED DECEMBER 31,2018. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: SOUTHEAST HEALTH CENTER OF RIPLEY COUNTY ESTIMATES THAT APPROXIMATELY 23.9% OF THE PATIENT ACCOUNTS WRITTEN OFF TO BAD DEBTS MAY QUALIFY FOR CHARITY CARE OR OTHER ASSISTANCE BUT CHOSE NOT TO APPLY USING POVERTY LEVELS FOR RIPLEY COUNTY FROM US CENSUS BUREAU DATA. THEREFORE, THE BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING 23.9% OF THE AMOUNT REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE: THAT FOOTNOTE CAN BE FOUND ON PAGE 9 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION B, LINE 8 COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SCHEDULE H, PART III, SECTION C, LINE 9B BILLING, CREDIT AND COLLECTION POLICY: SEH RIPLEY WILL ASSIST ALL PATIENTS IN THE BILLING OF INSURANCE CLAIMS TO GOVERNMENTAL AGENCIES, COMMERCIAL INSURANCE CARRIERS AND OTHER THIRD PARTY PAYERS. THIS POLICY OUTLINES THE PROCESS FOR MANAGING ALL PATIENT/GUARANTOR RESPONSIBLE BALANCES DUE TO SEH RIPLEY FOR SERVICES PROVIDED. SELF-PAY PATIENTS/GUARANTORS (PATIENTS WITHOUT HEALTH CARE INSURANCE) WILL BE COOPERATED WITH FULLY WHILE BEING ENCOURAGED TO SATISFY THEIR FINANCIAL OBLIGATIONS TO SEH RIPLEY ON A TIMELY BASIS. AN ATMOSPHERE OF MUTUAL UNDERSTANDING BETWEEN THE PATIENTS WE SERVE AND SEH RIPLEY WILL BE MAINTAINED AT ALL TIMES. SEH RIPLEY WILL ONLY BILL FOR SERVICES ACTUALLY PROVIDED TO PATIENTS AND WILL PROVIDE ASSISTANCE TO PATIENTS SEEKING TO UNDERSTAND THE COST OF THEIR CARE. STAFF WILL ALSO ATTEMPT TO RESOLVE QUESTIONS AND OBJECTIONS TO THE SATISFACTION OF THE PATIENT. SOUTHEAST HEALTH OF RIPLEY'S PROCEDURES ARE AS FOLLOWS: 1. ALL PATIENTS/GUARANTORS WILL BE PROVIDED A BILLING STATEMENT WITH A SUMMARY OF CHARGES, INSURANCE PAYMENTS / ADJUSTMENTS AND BALANCE DUE FROM THE PATIENT / GUARANTOR. 2. SEH RIPLEY WILL CONDUCT ACCOUNT FOLLOW-UP WITH PATIENTS/GUARANTORS AS FOLLOWS: A. BILLING STATEMENTS WILL BE SENT TO THE PATIENT/GUARANTOR ROUTINELY EVERY 30 DAYS WITH PAYMENT OPTIONS, INCLUDING INFORMATION REGARDING FINANCIAL ASSISTANCE / CHARITY CARE / UNINSURED DISCOUNT B. AT 90 DAYS FROM THE INITIAL BILLING STATEMENT, UNRESOLVED ACCOUNTS WILL RECEIVE A "FINAL DEMAND" FOR PAYMENT STATEMENT. AT THIS TIME THE ACCOUNT WILL QUALIFY FOR COLLECTION ACTION C. AT 120 DAYS FROM THE INITIAL BILLING STATEMENT, UNRESOLVED ACCOUNTS MAY BE PLACED WITH AN EXTERNAL COLLECTION AGENCY 3. SEH RIPLEY OFFERS SEVERAL DIFFERENT PAYMENT OPTIONS TO SETTLE ACCOUNTS: A. PAYMENT IN FULL: CASH, CHECK, MASTERCARD, VISA, DISCOVER B. THREE EQUAL INSTALLMENTS OVER 90 DAYS C. SHORT TERM MONTHLY PAYMENT ARRANGEMENTS MAY BE ESTABLISHED TO RESOLVE THE ACCOUNT BALANCE WITHIN 12 EQUAL MONTHLY INSTALLMENTS D. TERMS LONGER THAN TWELVE (12) MONTHS MAY BE CONSIDERED BASED UPON SPECIAL CIRCUMSTANCES AND APPROVED BY DIRECTOR REVENUE CYCLE E. FINANCIAL ASSISTANCE / CHARITY CARE / UNINSURED DISCOUNT IS AVAILABLE, REFER TO THE POLICY GUIDELINES 4. COLLECTION AGENCY: UNRESOLVED ACCOUNTS WILL BE ASSIGNED AT 120 DAYS FROM INITIAL BILLING AND WILL REMAIN WITH THE PRIMARY COLLECTION AGENCY FOR 120 DAYS FROM PLACEMENT. A. COLLECTIONS EFFORTS WILL BE CONDUCTED UTILIZING PATIENT/GUARANTOR BILLING STATEMENTS, COLLECTION LETTERS AND TELEPHONE CONTACT B. PAYMENT ARRANGEMENTS ARE AVAILABLE AS STATED ABOVE C. FINANCIAL ASSISTANCE / CHARITY CARE / UNINSURED DISCOUNTS ARE AVAILABLE AS STATED ABOVE D. UNRESOLVED ACCOUNTS ARE SUBJECT TO CREDIT BUREAU REPORTING AT 60 DAYS FROM PLACEMENT WITH THE COLLECTION AGENCY E. UNRESOLVED ACCOUNTS ARE SUBJECT TO LEGAL ACTION AT 120 DAYS FROM PLACEMENT WITH THE COLLECTION AGENCY. ANY COLLECTION COSTS INCURRED, SUCH AS ATTORNEY FEES AND/OR COURT COSTS WILL BECOME THE RESPONSIBILITY OF THE PATIENT /GUARANTOR AND WILL BE ADDED TO THE ACCOUNT BALANCE 5. BAD DEBT: UNRESOLVED ACCOUNTS THAT HAVE COMPLETED THE COLLECTION PROCESS WILL BE CONSIDERED "UNCOLLECTABLESUBJECT TO BAD DEBT WRITE-OFF. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: FOLLOWING ARE WAYS IN WHICH SOUTHEASTHEALTH CENTER OF RIPLEY COUNTY ASSESSED THE NEEDS OF ITS COMMUNITY BEFORE, DURING AND AFTER THE FORMAL CHNA WAS COMPLETED: - DEFINED "COMMUNITY" AS OUR PRIMARY SERVICE AREA BASED ON PATIENT ORIGIN DATA - MADE CONTACT AND DISCUSSED CHNA (COMMUNITY HEALTH NEEDS ASSESSMENT) WITH COUNTY HEALTH COALITION - COLLECTED SECONDARY DATA - HELD A FOCUS GROUP TO COLLECT PRIMARY DATA THAT INCLUDED PEOPLE WITH SPECIAL KNOWLEDGE OF HEALTH ISSUES - ASSESSED ALL PRIMARY AND SECONDARY DATA FOR THE SERVICE AREA - CREATED A COMPREHENSIVE LIST OF COMMUNITY HEALTH ISSUES, BEHAVIOR AND LIFESTYLE ISSUES CONTRIBUTING TO HEALTH, AND ENVIRONMENTAL AND SOCIAL ISSUES RELATED TO HEALTH FOR THE SERVICE AREA - PRIORITIZED THE LIST BASED ON INPUT FROM THE COALITIONS, CONSISTENCY BETWEEN SECONDARY AND PRIMARY DATA, OUR ABILITY TO ADDRESS, AND THE POTENTIAL TO EFFECT CHANGE - CREATED LIST OF PRIORITIZED HEALTH NEEDS AND BEHAVIORS IN COLLABORATION WITH RIPLEY COUNTY COMMUNITY HEALTH COALITION WE'VE ESTABLISHED IMPROVEMENT ACTION FRAMEWORK WITHIN WHICH RIPLEY COUNTY COALITION CONSTITUENTS' CAN TAKE A COMPREHENSIVE APPROACH TO MAINTAINING AND IMPROVING HEALTH BY: ASSESSING ITS HEALTH NEEDS, DETERMINING ITS RESOURCES AND ASSETS FOR PROMOTING HEALTH, DEVELOPING AND IMPLEMENTING A STRATEGY FOR ACTION, AND ESTABLISHING WHERE RESPONSIBILITY SHOULD LIE FOR SPECIFIC RESULTS. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: IN ADDITION TO THE CENTRALIZED BUSINESS OFFICE, THE HOSPITAL HAS DESIGNATED BUSINESS OFFICE STAFF ONSITE AT EACH FACILITY TO PROVIDE PATIENT EDUCATION AND ASSISTANCE. POLICIES AND PROCEDURES IN PLACE FOR CASH COLLECTION, INCLUDING PAYMENT AGREEMENTS PLUS CHARITY/INDIGENT CARE. A REVIEW IS COMPLETED WITH PATIENTS AND BUSINESS OFFICE STAFF IF A PATIENT IS DEEMED A POSSIBLE CANDIDATE FOR FINANCIAL ASSISTANCE. FINANCIAL EVALUATION FORMS ARE ALSO MADE AVAILABLE FOR PATIENTS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: RIPLEY COUNTY IS LOCATED IN SOUTHEAST MISSOURI WITH A MOSTLY RURAL POPULATION OF 13,936. WHITES COMPRISE 96.6% OF THE TOTAL POPULATION AND THE COUNTY HAS A HIGHER PERCENTAGE OF THE OLDER POPULATION, AGES 60 - 84 THAN DOES THE STATE OF MISSOURI. 78% OF RIPLEY COUNTY RESIDENTS 25 YEARS AND OVER HAVE GRADUATED FROM HIGH SCHOOL, WITH 16.8% GOING ON TO RECEIVE A POST-SECONDARY DEGREE. THE UNEMPLOYMENT RATE WAS 5.7% IN 2017, WHICH IS HIGHER THAN MISSOURI'S 3.8%. RIPLEY COUNTY HAS 18.4% OF RESIDENTS IN POVERTY, WITH 11.7% ELIGIBLE FOR FOOD STAMPS, AND 15.8% UNINSURED. RIPLEY COUNTY DOES HAVE SOME HEALTH CARE PROVIDERS, INCLUDING A SMALL HOSPITAL, A COUNTY HEALTH DEPARTMENT, EMERGENCY SERVICES, RURAL HEALTH CLINICS, ASSISTED LIVING FACILITIES, AND A SKILLED NURSING FACILITY. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: PROMOTION OF COMMUNITY HEALTH IS BENEFICIAL IN THE FOLLOWING WAYS: - TO SHARE THE ASSESSMENT PROCESS AND FINDINGS WITH THE COUNTY RESIDENTS AND TO EDUCATE LOCAL RESIDENTS, HEALTH CARE PROVIDERS, AND STUDENTS REGARDING PRESSING HEALTH PROBLEMS - TO EMPOWER COMMUNITY MEMBERS - TO ACT ON ISSUES OF CONCERN - TO IDENTIFY EMERGING ISSUES - TO PROVIDE DATA FOR DECIDING PROGRAMMATIC/ORGANIZATIONAL DECISIONS, AND TO PLAN EFFECTIVE, COLLABORATIVE INTERVENTIONS - TO PROMOTE BETTER HEALTH TO ADVOCATE FOR COMMUNITY CHANGE WITH POLITICIANS AND OTHER LOCAL DECISION-MAKERS - TO PROMOTE COLLABORATION AND PARTNERSHIP AMONG COMMUNITY MEMBERS AND GROUPS - TO FURNISH A BASELINE BY WHICH TO MONITOR CHANGES - TO SERVE AS A REFERENCE POINT AND A HISTORICAL PERSPECTIVE FOR FUTURE ASSESSMENTS - TO PROVIDE A RESOURCE FOR ACTIVITIES SUCH AS WRITING GRANT APPLICATIONS - TO SERVE AS A MODEL FOR OTHER COUNTIES WHO ARE PLANNING AN ASSESSMENT SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: SOUTHEAST HOSPITAL, D/B/A SOUTHEASTHEALTH (THE "HEALTH SYSTEM"), PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT, EMERGENCY CARE AND PHYSICIAN SERVICES TO PATIENTS IN THE CAPE GIRARDEAU AND THE SURROUNDING SOUTHEAST MISSOURI AREA. SOUTHEASTHEALTH HOSPITAL IS LOCATED IN CAPE GIRARDEAU, MISSOURI, AND HAS MULTIPLE CAMPUSES AND FACILITIES, SUCH AS HEALTHPOINT FITNESS, SOUTHEAST HOME HEALTH, SOUTHEAST HOSPICE, SOUTHEAST MEDICAL PLAZA, SOUTHEAST CANCER CENTER AND VARIOUS OUTPATIENT CLINICS. SOUTHEASTHEALTH OF RIPLEY COUNTY, D/B/A SOUTHEASTHEALTH CENTER OF RIPLEY COUNTY, AND SOUTHEASTHEALTH CENTERS OF REYNOLDS COUNTY AND STODDARD COUNTY ARE COLLECTIVELY REFERRED TO AS SOUTHEASTHEALTH REGIONAL SYSTEM. THE SOUTHEASTHEALTH REGIONAL SYSTEM EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT, EMERGENCY CARE, PHYSICIAN SERVICES AND RETAIL PHARMACY OPERATIONS IN DEXTER, MISSOURI; DONIPHAN, MISSOURI; ELLINGTON, MISSOURI, AND THEIR SURROUNDING AREAS.SOUTHEASTHEALTH SERVIR, OPERATED BY SOUTHEASTHEALTH HOSPITAL, PROVIDES SOFTWARE SUPPORT FOR THE HOSPITAL'S REVENUE CYCLE. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: MISSOURI true true false false false false false false false KENNETH BATEMAN PRESIDENT/CEO, DIRECTOR 0 665368 0 0 0 27099 0 115125 0 30008 0 837600 0 0 CHERYL BARTON CEO 115847 0 0 0 35503 0 8483 0 11482 0 171315 0 0 0 KATHREEN FRIEND APRN 83434 0 80922 0 6087 0 9372 0 746 0 180561 0 0 0 GARY WARD PHYSICIAN 200046 0 0 0 1317 0 11169 0 16749 0 229281 0 0 0 BETH SJOBLOM PHYSICIAN 518968 0 0 0 1290 0 15125 0 1394 0 536777 0 0 0 MEYYAPPAN PALANIAPPAN MEDICAL DIRECTOR 195187 0 12725 0 0 0 10560 0 24858 0 243330 0 0 0 GREGORY ZOLKOWSKI MEDICAL DIRECTOR 480075 0 0 0 123029 0 15125 0 22524 0 640753 0 0 0 STEVEN HAAS VP & CFO 0 313998 0 0 0 3619 0 15125 0 19177 0 351919 0 0 SCHEDULE J, PART I, LINE 3 CEO COMPENSATION DETERMINATION: SOUTHEAST HOSPITAL, A RELATED ORGANIZATION, COMPLETES THE COMPENSATION REVIEW OF THE SYSTEM CEO USING THE FOLLOWING METHODS: - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS: THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE YEAR: - GREGORY ZOLKOWSKI RECEIVED $120,000 - CHERYL BARTON RECEIVED $18,754 - KATHREEN FRIEND RECEIVED $3,504 SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN: SOUTHEAST HEALTH A RELATED ORGANIZATION CONTRIBUTED $100,000 TO A 457(F) PLAN ON BEHALF OF KENNETH BATEMAN. BUILDING AND EQUIPMENT 2018-12-21 1135627 BOOK VALUE 430991713 RIPLEY COUNTY MEMORIAL HOSPITAL 109 PLUM STREET DONIPHAN MO 63935 GOVT true false false false SCHEDULE N, PART II, LINE 2A BOARD MEMBER: BOARD MEMBER FREDDIE LEROUX WAS A BOARD MEMBER OF RIPLEY COUNTY MEMORIAL HOSPTIAL BEFORE THE SALE OF ASSETS AND REMAINED A MEMBER. FORM 990, PART III, LINE 3 SIGNIFICANT CHANGES: THE ORGANIZATION CEASED HOSPITAL OPERATIONS ON 10/15/18 AND CLINIC OPERATIONS ON 11/30/18. FORM 990, PART III, LINE 4A PROGRAM ACHIEVEMENTS: SEH ALSO CONDUCTS NUMEROUS EDUCATIONAL ACTIVITIES FOR THE BENEFIT OF THE PUBLIC AND OFFERS A WIDE RANGE OF HEALTH RELATED CLASSES. SEH UTILIZES SOUTHEAST HOSPITAL WHICH PROVIDES A REGIONAL SYSTEM OF HEALTHCARE SERVICES INCLUDING A FULL SERVICE HOSPITAL IN CAPE GIRARDEAU, MO. SEH IS A CRITICAL HEALTHCARE RESOURCE FOR THE RESIDENTS OF RURAL RIPLEY COUNTY. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS: THE SOLE MEMBER IS SOUTHEASTHEALTH HOSPITAL HOLDINGS, LLC, A DISREGARDED ENTITY OF SOUTHEAST HOSPITAL, A RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A POWERS OF MEMBERS OVER GOVERNING BODY: THE BOARD OF DIRECTORS OF SOUTHEAST HEALTH CENTER OF RIPLEY COUNTY ARE ELECTED BY SOUTHEASTHEALTH SYSTEM (SYSTEM) AT THE ANNUAL MEETING OF THE SYSTEM IN ACCORDANCE WITH THE SYSTEM'S BYLAWS, WITH THE DIRECTORS TO BE ELECTED FROM THE SLATE OF CANDIDATES PREPARED BY THE SYSTEM'S GOVERNANCE AND NOMINATING COMMITTEE. THE SYSTEM BOARD OF DIRECTORS HAS THE POWER TO ELECT, EVALUATE, AND REMOVE THE DIRECTORS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO A TWO-THIRDS OR GREATER VOTE OF THE SYSTEM BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B MEMBER GOVERNANCE DECISIONS: THE MEMBER RESERVES ALL POWER, SUBJECT TO THE AUTHORITY OF SOUTHEASTHEALTH SYSTEM (SYSTEM) TO TAKE THE ACTIONS BELOW WITH RESPECT TO SOUTHEAST HEALTH CENTER OF RIPLEY COUNTY: (1) ESTABLISH AND INTERPRET PHILOSOPHY, EXPECTATIONS, AND CORE VALUES OF THE CORPORATION AND THE CORPORATION'S SUBSIDIARIES; (2) ESTABLISH ANNUAL PERFORMANCE OBJECTIVES AND COMPENSATION FOR THE PRESIDENT OF THE CORPORATION AND THE PRESIDENT/CEOS OF THE CORPORATION'S SUBSIDIARIES; (3) ESTABLISH THE DEBT LIMITS OF, AND DEBT GUIDELINES FOR, THE CORPORATION AND THE CORPORATION'S SUBSIDIARIES; (4) SELECT THE AUDITOR FOR THE CORPORATION AND THE CORPORATION'S SUBSIDIARIES; (5) ESTABLISH GUIDELINES FOR TRANSFERRING OR ENCUMBERING ASSETS OF THE CORPORATION AND THE CORPORATION'S SUBSIDIARIES FINANCED USING TAX-EXEMPT BONDS; AND (6) ESTABLISH GUIDELINES FOR PROJECTS AND TRANSACTIONS WHICH MAY BE APPROVED BY THE CORPORATION OR THE CORPORATION'S SUBSIDIARIES; THE MEMBER FURTHER RESERVES THE POWER TO TAKE THE ACTIONS AS DESCRIBED BELOW WITH RESPECT TO SOUTHEAST HEALTH CENTER OF RIPLEY COUNTY, PROVIDED, HOWEVER, THAT THE BOARD SHALL HAVE THE RIGHT TO MAKE RECOMMENDATIONS REGARDING SUCH ACTIONS WHICH THE MEMBER MAY TAKE INTO CONSIDERATION, BUT THE BOARD SHALL NOT HAVE THE POWER TO TAKE ANY OF THE FOLLOWING ACTIONS UNLESS DIRECTED TO DO SO BY THE MEMBER, AND FURTHER SUBJECT TO THE MEMBER'S AUTHORITY GRANTED BY THE SYSTEM: (1) ESTABLISH, MODIFY, AND INTERPRET MISSION AND VISION STATEMENTS FOR THE CORPORATION AND THE CORPORATION'S SUBSIDIARIES; (2) APPROVE THE FORMATION OR ACQUISITION OF LEGAL ENTITIES BY THE CORPORATION OR THE CORPORATION'S SUBSIDIARIES; (3) APPROVE THE SALE, TRANSFER, DISPOSITION OF, OR SUBSTANTIAL CHANGE TO THE USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR THE CORPORATION'S SUBSIDIARIES; (4) APPROVE A DIVESTITURE, MERGER, DISSOLUTION, REORGANIZATION, CLOSING, OR CONSOLIDATION INVOLVING THE CORPORATION OR THE CORPORATION'S SUBSIDIARIES; (5) APPROVE A CHANGE TO THE CORPORATE MEMBERSHIP OR OWNERSHIP OF THE CORPORATION OR THE CORPORATION'S SUBSIDIARIES; (6) ADOPT AND AMEND THE ARTICLES OF INCORPORATION, BYLAWS, ARTICLES OF ORGANIZATION, AND/OR OPERATING AGREEMENT AS APPLICABLE, OF THE CORPORATION AND THE CORPORATION'S SUBSIDIARIES; (7) ESTABLISH CORE COMPETENCIES FOR THE DIRECTORS OR MANAGERS (AS APPLICABLE); (8) ELECT, EVALUATE, AND REMOVE THE DIRECTORS OR MANAGERS (AS APPLICABLE) OF THE CORPORATION'S SUBSIDIARIES; (9) TRANSFER ASSETS AND REALLOCATE DEBT OF THE CORPORATION AND THE CORPORATION'S SUBSIDIARIES; AND (10) ESTABLISH POLICIES AND PROCEDURES, INCLUDING POLICIES FOR PROVIDER CREDENTIALING, QUALITY, AND PATIENT SAFETY (AS APPLICABLE), FOR THE CORPORATION AND THE CORPORATION'S SUBSIDIARIES. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT AND MANAGEMENT. THE FORM 990 IS REVIEWED BY THE ACCOUNTING DEPARTMENT, LEGAL COUNSEL, AND MANAGEMENT AND IS THEN PROVIDED TO THE BOARD OF DIRECTORS ELECTRONICALLY BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: ALL TRUSTEES AND KEY EMPLOYEES (ADMINISTRATIVE STAFF) ARE REQUIRED TO READ THE ORGANIZATIONAL ETHICS STATEMENT ANNUALLY AND COMPLETE A CERTIFICATION STATEMENT TO THAT EFFECT. DIRECTORS, OFFICERS, MANAGERS AND KEY EMPLOYEES MUST DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST TO THE BOARD OF DIRECTORS. THE REMAINING DIRECTORS WILL DISCUSS AND VOTE UPON WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE CHAIRMAN SHALL APPOINT A DISINTERESTED DIRECTOR TO INVESTIGATE ALTERNATIVE OPTIONS FOR THE TRANSACTION/ARRANGEMENT IN QUESTION. IF A MORE ADVANTAGEOUS OPTION IS NOT AVAILABLE, A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WILL DETERMINE IF IT IS IN THE BEST INTEREST OF THE ORGANIZATION TO CONTINUE WITH THE TRANSACTION/ARRANGEMENT. IF A CONFLICT OF INTEREST HAS FAILED TO BEEN DISCLOSED, THE INTERESTED PARTY WILL BE NOTIFIED AND APPROPRIATE DISCIPLINARY ACTION WILL BE TAKEN AS NEEDED. FORM 990, PART VI, SECTION B, LINE 15A EXECUTIVE COMPENSATION REVIEW: DATA FROM TWO ORGANIZATIONS (MO HOSPITAL ASSOCIATION AND ANOTHER INDEPENDENT AGENCY) ARE USED FOR COMPARISON. RECOMMENDATIONS ARE MADE FROM THAT INFORMATION TO THE BOARD OF TRUSTEES, WHO THEN DETERMINE THE COMPENSATION FOR THE SYSTEM CEO. THE BOARD OF SOUTHEASTHEALTH COMPLETES THIS REVIEW ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15B OTHER OFFICER AND KEY EMPLOYEE COMPENSATION REVIEW: THE SYSTEM CEO DETERMINES COMPENSATION FOR THE SYSTEM CFO. HUMAN RESOURCES COMPILES EXTERNAL DATA FOR COMPARABLE AMOUNTS TO CONFIRM RATES ARE ADEQUATE. FORM 990, PART VI, SECTION C, LINE 19 PUBLIC DISCLOSURE: COPIES OF THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FEDERAL FORM 990 ARE AVAILABLE AT THE ADMINISTRATIVE OFFICE UPON REQUEST. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ 1,265,940 TRANSFER TO/FROM AFFILIATES FORM 990 PART IX LINE 11G DESCRIPTION:SPECIALIST FEES TOTAL FEES:778933 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT LABOR TOTAL FEES:540814 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:499615 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE CONTRACTS TOTAL FEES:256347 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:52575 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:21296 SOUTHEAST HOSPITAL 1701 LACEY STREET CAPE GIRARDEAU MO 63701 430654874 HOSPITAL MO 501(C)(3) 3 SEH SYSTEM false SOUTHEASTHEALTH SYSTEM 1701 LACEY STREET CAPE GIRARDEAU MO 63701 474890906 PARENT MO 501(C)(3) 12C III-FI NA false false false false false false false false false false false false false false true true true true true true