2019-04-24T12:21:32-07:00 2018-06-30 990 2017-07-01 440546366 CAPITAL REGION MEDICAL CENTER CAPI 5736325000 1125 Madison Street Jefferson City MO 65101 Tom Luebbering Vice President of Finance 5736325101 2019-04-24 150.199.9.242 2017 2019-02-21 02:37:17Z Tom Luebbering 1125 Madison Street Jefferson City MO 65101 204224157 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 1739 300 3584 0 462655 382682 185704863 201952742 579734 1913744 -31086 -26176 186716166 204222992 0 0 0 0 99620422 106253995 0 0 0 82313109 91722247 181933531 197976242 4782635 6246750 199928767 203894492 71045088 70083184 128883679 133811308 Capital Region Medical Center embraces its mission; To imporove the health and promote wellness in the communities we serve. 0 0 3370266 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. 1974330 0 773937 Support of Medical Education - In 1988, Capital Region accepted its first Family Practice resident. Since then, the program has offered one-on-one guidance. We reinforce values of ethical practice, community orientation, personal/professional balance, and lifelong learning. 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. 197484 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 2000 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. 163793072 0 201074045 All other inpatient and outpatient services provided to patients. 163793072 0 201074045 169335152 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 1 170 0 1 1739 1 1 1 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 0 X Tom Luebbering 5736325101 1432 Southwest Blvd Jefferson City MO 65109 Samuel Bushman Board Member 2.50 0 X 0 0 0 Lisa Kolb Waggoner Board Member/Physician 40 0 X 219979 0 60003 Diane Light Board Member/Physician 40 0 X 296107 0 58530 Carlos Graham Board Member 2.50 0 X 0 0 0 Jack Pletz Board member 2.50 0 X 0 0 0 Lorilei Schwartz Chair 2.50 0 X 0 0 0 Amy Freeman Board Member 2.50 0 X 0 0 0 Stevan Whitt Board member 2.50 0 X 0 0 0 Marc Ellinger Vice Chair 2.50 0 X 0 0 0 Mary Beck Board Member 1.5 0 X 0 0 0 David Minton board member 1.5 0 X 0 0 0 Jonathan Curtright board member 1.5 0 X 0 0 0 Thomas Niekamp Vice President 40 0 X 8664 0 0 Gaspare Calvaruso President 40 0 X 414620 0 73266 Tom Luebbering Vice President 40 0 X 201191 0 57018 Janet Weckenborg Vice President 40 0 X 201229 0 51724 Jason Cecil - partial Vice President 40 0 X 27884 0 11028 Randall Haight Vice President/Physician 40 0 X 336685 0 70000 Sarah Morrow Vice President 40 0 X 162509 0 36479 Deborah Voskamp - partial Vice President 40 0 X 21931 0 4532 Belynda Imhoff Vice President 40 0 X 128405 0 25617 Glenda Dahlstrom Vice President 40 0 X 96711 0 27182 Mitchell Godbee Chief of Staff/Physician 40 0 X 1163812 0 139523 Dennis Luetkemeyer Physician 40 0 X 664593 0 75448 Eston Schwartz Physician 40 0 X 592428 0 77683 Adam Patterson Physician 40 0 X 647474 0 79775 Scott Anderson Physician 40 0 X 577386 0 77337 Patricia Macfarlane Physician 0 0 X 1027286 0 43250 6788894 0 968395 127 1 1 1 University of Missouri One Hospital Drive Columbia MO 65201 Physician and Professional Services 2586953 Boyce and Bynum Laboratory PO Box 7406 Columbia MO 65205 Lab Services 1818898 Aramark Healthcare Support Services 25271 Network Place Chicago IL 606731252 Management Services 1607096 Morrison Healthcare PO Box 102289 Atlanta GA 303682289 Management Food Services 495588 Strategic Sourcing Results 150 N Michigan Ave Ste 2800 Chicago IL 60601 Consulting 478932 66 0 0 0 350843 0 31839 0 382682 Net Patient Service Revenue 622000 196571998 196571998 0 0 Other Revenue 900099 5377160 5377160 0 0 3584 0 3584 0 201952742 1867365 0 0 1867365 45744 0 0 45744 0 0 0 0 0 0 0 1800 0 1165 0 635 635 0 0 635 0 K1 Gain (OPTI) 611710 2703 2703 0 0 K1 Loss (Healthnet MU) 561000 -28879 -28879 0 0 0 0 0 0 -26176 204222992 201922982 3584 1913744 0 0 0 0 0 0 0 0 2582630 0 2582630 0 0 0 0 0 82580986 69341873 13239113 0 2299738 1879576 420162 0 13622478 11133651 2488827 0 5168163 4223940 944223 0 0 0 0 0 180510 147526 32984 0 182668 149290 33378 0 0 0 0 0 0 0 3600 2942 658 0 15232497 12449520 2782977 0 302577 247288 55289 0 266991 218212 48779 0 1255752 1026326 229426 0 0 0 0 0 568678 464765 103913 0 0 0 0 0 0 0 0 0 439426 359131 80295 0 1632103 1632103 0 0 0 0 0 0 11884142 8946298 2937844 0 1569417 1282642 286775 0 Supplies 45293298 44538097 755201 0 Repairs and Maintenance 4490098 3669634 820464 0 Utilities and Phone 2589183 2116068 473115 0 FRA Taxes 4052233 4052233 0 0 1779074 1454037 325037 197976242 169335152 28641090 0 6005304 0 3221323 32574266 0 0 18967363 21036352 0 0 0 0 0 0 3986176 4078934 2698505 3662555 252782713 172238608 81110495 80544105 53236724 75082112 0 0 0 8857489 8761556 199928767 203894492 20505116 22492496 43027836 40111164 7512136 7479524 71045088 70083184 X 124887589 129788947 3925744 3952015 70346 70346 128883679 133811308 199928767 203894492 X 6246750 0 0 0 0 -1319121 X 1 X 1 X 1 0 X 0 0 0 0 0 0 0 0 1 10806 10806 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 ($10,806). 10405632 0 10405632 151584222 0 106644174 44940048 2462044 0 1563805 898239 88330815 0 64030629 24300186 0 0 0 0 80544105 0 457(B) Payable 3008993 Malpractice Liability 2627022 Insurance Payable 1692710 Other Long Term Liabilities 150799 7479524 203898325 0 0 0 26176 26176 203872149 0 350843 350843 204222992 198104776 0 0 0 128534 128534 197976242 0 0 0 197976242 Schedule D, Part XI, Line 2d Net share of K-1 losses/gains. -28,879+2703 Schedule D, Part XI, Line 4b Change in Unrealized Gains Schedule D, Part XII, Line 2d Foundation Expenses (-129169) + Gain on Sale of assets (635) = -128534 Reported on Income Schedule on 990 1 1 X 1 X 1 X 1 1 1 0 0 3370266 0 3370266 0.017 19278237 15293803 3984434 0.0201 0 0 0 0 0 0 22648503 15293803 7354700 0.0371 10 12321 834039 597524 236515 0.0012 2171814 848937 1322877 0.0067 2573494 1781475 792019 0.004 0 0 0 0 78393 0 78393 0.0004 10 12321 5657740 3227936 2429804 0.0123 10 12321 28306243 18521739 9784504 0.0494 26910 0 26910 0.0001 37455 0 37455 0.0002 29440 0 29440 0.0001 8044623 5705463 2339160 0.012 0 0 8138428 5705463 2432965 0.0124 0 6821703 0 55761955 52683174 3078781 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 15 1 1 1 1 X www.crmc.org X 1 15 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 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 included six additional partners: the Community Health Center of Central Missouri, Cole County Health Department, Jefferson City Medical Group, Missouri Primary Care Association, Samaritan Center of Jefferson City, and Central Missouri United Way. Schedule H, Part V, Section B, Line 6a-Capital Region Medical Center Capital Region Medical Center and SSM St. Mary's Schedule H, Part V, Section B, Line 6b-Capital Region Medical Center The Community Health Center of Central Missouri, Cole County Health Department, Jefferson City Medical Group, Missouri Primary Care Association, Samaritan Center of Jefferson City and Central Missouri United Way 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 counties we serve. Schedule H, Part V, Section B, Line 11-Capital Region Medical Center Capital Region Medical Center approved the CHNA implementation strategy in June of 2015 to address the top 5 identified needs: Obesity/Cardiovascular Health, Mental Wellness, Health Literacy, Substance Abuse, and Dental. The strategies involve many different internal and external partnerships. Strategies include community education and screenings, smoking cessation programs, support groups, employer sponsored wellness programs, and faith based parish nurse programs. Additionally, we have built in core measures with our physician group so that body mass index and depression screens are done with appropriate education and referral for abnormal screens at every visit. We have increased the number of primary care providers as well as mental health providers. In regards to substance abuse, we are working with our physician group, ED, and county officials to strengthen our policies on opiate prescriptions and implementing pain medication contracts with our patients and providers. Our implementation strategies also encourage improved nutrition, which we are sponsoring community supported agriculture, farmers' markets and implemented fresh fruits and vegetables at local food pantries, buddy packs and even school and local government policies on healthy concessions. Lastly, we are continuing our partnership with Missouri Foundation for Health in a 5 year grant with 3 school districts. The grant's goal is to reduce childhood obesity by 5% in 5 years. Schedule H, Part V, Section B, Line 13-Capital Region Medical Center We use FPL up to 279% of FPL for presumptive charity. We have catastrophic assistance if more than 15% of income is owed in medical bills regardless of income. Underinsured get assistance if application complete. We give 65% discount equal to average Medicare Plus all Commercial and managed care plans during 12 months of claims. Schedule H, Part V, Section B, Line 15e-Capital Region Medical Center Use of Human Arc to assist in Medicaid application Schedule H, Part V, Section B, Line 18-Capital Region Medical Center No actions taken on individuals before determining eligibility. We run presumptive charity and follow the 248 day rule before ECA's. Schedule H, Part V, Section B, Line 22d-Capital Region Medical Center CRMC used average of Medicare and Commercial Managed Care discounts to calculate the 65% self pay automatic discount for all uninsured patients. 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 CRMC- Versailles 901 Kidwell Drive Versailles MO 65084 Family Practice Clinic Primary Care 1014 Madison Street Jefferson City MO 65101 Primary Care - Family Practice Clinic CRMC - Eldon 103 Business Hwy 54 North Eldon MO 65026 Family Practice Clinic CRMC-Owensville 3536 Kuhne Road Owensville MO 65066 Family Practice Clinic CRMC-California 704 Buchanan California MO 65018 Family Practice Clinic CRMC Quick Care 3721 W Truman Blvd Jefferson City MO 65109 Quick Care Clinic Integrative Medicine 1002 Diamond Ridge Suite 203 Jefferson City MO 65109 Family Practice/Alternative Medicine CRMC-Holts Summit 180 North Star Holts Summit MO 65043 Family Practice Clinic CRMC-Linn 916 East Main Street Linn MO 65051 Family Practice Downtown Urgent Care 220 Madison Street Jefferson City MO 65101 Urgent Care Capital Region Family Medical Center 420 East High Street Jefferson City MO 65101 Family Practice Clinic Vienna Family Practice 111 Parkway Vienna MO 65582 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 St Elizabeth Clinic 631 S Walnut Street St Elizabeth MO 65075 Physician Clinic West Truman Clinic 3527 W Truman Blvd Jefferson City MO 65109 Physician 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 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. The lease began on January 1, 2018. So this is for 6 months rent at the normal rental rate for the square footage. 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 Audit Report. Page 8 and 9. Schedule H, Part III, Section B, Line 8 Line 2 is determined using the cost of 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 collections practices we run presumptive charity using Paro Presumptive Charity software to identify all patients under 279% of FPL. We write off to charity all patients under the threshold and do not send to collections. All over 279% of FPL 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 four central counties. This is the second 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 2015 was the inclusion of a survey to assess the perception of health care and health status across the four 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 sercius health issue and then ranking them using a priory matrix. The results were: 1. Health Disease/Obesity prevention 2. Mental Health 3. Health Literacy 4. Substance Abuse and 5. Dental Care. 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 our 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 four 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 130,223. 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. 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. CMRC 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 1 0 0 1 0 1 0 1 0 Lisa Kolb Waggoner Board Member/Physician 176591 0 42586 0 802 0 7400 0 52603 0 279982 0 0 0 Diane Light Board Member/Physician 271382 0 23717 0 1008 0 10800 0 47730 0 354637 0 0 0 Gaspare Calvaruso President 357747 0 44572 0 12301 0 10800 0 62466 0 487886 0 0 0 Tom Luebbering Vice President 180718 0 20358 0 476 0 7443 0 49575 0 258570 0 0 0 Janet Weckenborg Vice President 174956 0 25132 0 1141 0 7242 0 44482 0 252953 0 0 0 Randall Haight Vice President/Physician 258340 0 77589 0 757 0 10310 0 59690 0 406686 0 0 0 Sarah Morrow Vice President 151819 0 10464 0 226 0 4750 0 31729 0 198988 0 0 0 Mitchell Godbee Chief of Staff/Physician 790336 0 372836 0 640 0 10800 0 128723 0 1303335 0 0 0 Dennis Luetkemeyer Physician 574044 0 89207 0 1342 0 5823 0 69625 0 740041 0 0 0 Patricia Macfarlane Physician 0 0 0 0 1027286 0 0 0 43250 0 1070536 0 0 0 Eston Schwartz Physician 591519 0 0 0 910 0 10800 0 66883 0 670112 0 0 0 Adam Patterson Physician 525531 0 121357 0 586 0 10800 0 68975 0 727249 0 0 0 Belynda Imhoff Vice President 122530 0 5653 0 222 0 2474 0 23174 0 154053 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 to 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 4 a. Patricia Macfarlane received a legal settlement (770,464.46 on W2, 256,821.49 on 1099) b. Contributions were to a 457(b) plan only. 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 and most Department Directors and Vice Presidents participate in the Management Incentive Compensation Program (MICP). They receive additional bonus compensation if certain stated goals are met. Most physicians received a base salary, but also have the ability to earn an additional amount based on productions. 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 2017-03-09 20000000 Reimburse CRMC for constructions cost of medical office building 0 0 0 A 10905000 0 32690247 2908325 0 0 434131 0 0 0 28320002 0 2004 1 0 1 1 B 1079131 0 20000000 0 0 0 0 0 0 0 20000000 0 2016 0 0 1 1 A 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 Schedule K, Part IV, Line 2c-11/22/2011 32,690,247 Health Facilities Revenue Bonds Series 2011 Rebate computation was performed as of November 1, 2016. Lori Luebbering Wife of Tom Luebbering, officer 11550 Employed by CRMC 0 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 appointment 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 or 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 all 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 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 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 participated 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 location, and contact information are all disclosed on the website. Form 990, Part XI, Line 9 K1 Loss $26176, Transfers to UMC-MA -$1440270, Increase in Foundation NA SFAS#136 $26271, Paid Foundation Expenses -$129169, Change in Unrealized Gains $197871. 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 - 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 Still Opti LLC 800 West Jefferson Street Kirksville MO 63501 431831943 To promote the highest quality of osteopathic education. MO N/A Related 1 0.0797 Health Network of Missouri LLC 227 University Hall Columbia MO 65211 471248962 To improve quality of care and establish clinical integration among participants MO N/A Unrelated 0 0 0.16667 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 Capital Region Medical Foundation o 129169 Salary and other expenses of the Foundation Director University of Missouri - Medical Alliance r 1940270 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 annual net patient service revenues, and may not exceed 25% of the Medical Center's excess of revenues over expenses. Capital Region Medical Foundation c 350843 Cash value of donations Capital Region Medical Center Partners q 22421 Partners reimburse CRMC for the salary and FICA tax of the gift shop manager. Capital Region Medical Center Partners m 356264 In fiscal year ending June 30, 2018, the Partners donated 45,384 hours of service valued at $356,264. The was based on the minimum wage in effect in 2018 Capital Region Medical Center Partners c 31839 Cash value of donations given to Capital Region. Capital Region was approved for a 6 month extension until May 15, 2019